Artificial intelligence assisted surgical processes and methods

Abstract

A method of performing an endoscopic vessel harvesting procedure can include loading pre-operative patient data into an artificial intelligence system, developing a surgical plan for the endoscopic vessel harvesting using the artificial intelligence system, and while performing the endoscopic vessel harvesting procedure according to the surgical plan, using the artificial intelligence system to observe the endoscopic vessel harvesting procedure and altering the surgical plan based on real-time in vivo images of a site of interest.

Description

ARTIFICIAL INTELLIGENCE ASSISTED SURGICAL PROCESSES AND METHODSCLAIM OF PRIORITY

[0001] This application claims the benefit of U.S. Provisional Patent Application Serial No. 63 / 717,138, filed on November 6, 2024, the benefit of priority of which is claimed hereby, and which is incorporated by reference herein in its entirety.FIELD OF THE DISCLOSURE

[0002] The present disclosure relates to artificial intelligence assisted medical procedures. In particular, the present disclosure relates to a surgical device having visualization and lighting features with integrated artificial intelligence.BACKGROUND

[0003] Generally, current surgical planning is completed based on pre-operative testing, pre-operative imaging, and the doctor’s medical training. The doctor reviews the pre-operative testing and imaging and will develop a pre-operative surgical plan. Once the procedure begins, generally, the doctor is left to rely on their education and training alone. In some cases, there are additional medical professionals present during the procedure, but again, should any issues arise during the procedure any available solutions are limited to those that the doctors can arrive at in a high pressure environment. Even the best doctors have a limited pool of knowledge to draw from and may not choose the optimal treatment.

[0004] Additionally, in the case of endoscopic vessel harvesting (EVH) procedures, current surgical tools, such as EVH devices, can be supplemented with additional components and their respective associated systems for performing different procedures. In some implementations, for example, EVH devices can be configured to receive a reusable rigid endoscope within a cannula of the EVH device. Similarly, conventional EVH devices can be configured to couple with a reusable camera and independent light source. Traditionally, the reusable camera can be coupled to a proximal end of the rigid endoscope. The EVH device and each reusable component can each include their own independent power and communication cords communicating with separate processing components located outside of a sterile field. For example, the reusable camera can have a power / video cable plugged into a camera processor. The camera processor processes the image data from the camera and displays it on a monitor attached to the camera processor. It is also common to have fiberopticlight cord attached to the endoscope, which can be attached to a separate light source to deliver light down the cord, down the scope to the distal tip of the EVH device.

[0005] Configurations for conventional EVH devices have a number of drawbacks. For example, each reusable component for use with an EVH device has to be individually sterilized prior to use with the EVH device within a sterile field. This requires significant time and risks if any of the reusable components is not properly sterilized. Additionally, having multiple separate systems with separate power / communication cords adds bulk, movement restrictions, etc. to the EVH device which can make the device more difficult to use.SUMMARY

[0006] There is a need for improvements for surgical procedures. The present disclosure is directed toward further solutions to address this need, in addition to having other desirable characteristics. Specifically, the present disclosure is directed to systems and methods that utilize Artificial Intelligence to improve surgical outcomes.

[0007] In Example 1, a method of performing an endoscopic vessel harvesting procedure can include loading pre-operative patient data into an artificial intelligence system, developing a surgical plan for the endoscopic vessel harvesting using the artificial intelligence system, and while performing the endoscopic vessel harvesting procedure according to the surgical plan, using the artificial intelligence system to observe the endoscopic vessel harvesting procedure and altering the surgical plan based on real-time in vivo images of a site of interest.

[0008] In Example 2, the method of Example 1 can optionally be configured such that altering the surgical plan utilizes manual input from a practitioner.

[0009] In Example 3, the method of Example 1 or Example 2 can optionally be configured such that altering the surgical plan is performed by the artificial intelligence system alone or in combination with manual input.

[0010] In Example 4, the method of any one of Examples 1 -3 can optionally be configured such that the pre-operative patient data includes a pre-operative image.

[0011] In Example 5, the method of Example 4 can optionally further include annotating the pre-operative image prior to developing the surgical plan.

[0012] In Example 6, the method of Example 5 can optionally further include overlaying the annotated pre-operative image onto the real-time in vivo images of the site of interest.

[0013] In Example 7, the method of any one of Examples 1-6 can optionally further include displaying at least one of a training video or an educational video on a display for reference by a practitioner.

[0014] In Example 8, a method of performing an endoscopic vessel harvesting procedure can include advancing a unitary vessel harvesting device into a patient along a vessel, the unitary vessel harvesting device including an optical coherence tomography (OCT) sensor; observing a target vessel section, using the OCT sensor, from within the patient; and determining the quality of the vessel section based on data from the observing step.

[0015] In Example 9, a robotic endoscopic vessel harvesting system can include a unitary endoscopic vessel harvesting (EVH) device including an end effector and an imaging device for observing a surgical site within a patient, a handle extending from the unitary EVH device including buttons or inputs which can be manipulated by a human surgeon or a robot, and a surgical robot including an end effector for interfacing with the unitary EVH device and controlling the unitary EVH device to complete an EVH procedure.

[0016] In Example 10, the robotic endoscopic vessel harvesting system of Example 9 can optionally be configured such that the imaging device comprises a Complementary Metal- Oxi de- Semi conductor (CMOS) sensor.

[0017] In Example 11, the robotic endoscopic vessel harvesting system of Example 9 can optionally be configured such that the imaging device comprises a Charge Coupled Device (CCD).

[0018] In Example 12, the robotic endoscopic vessel harvesting system of Example 9 can optionally be configured such that the imaging device comprises an Optical Coherence Tomography (OCT) sensor.

[0019] In Example 13, the robotic endoscopic vessel harvesting system of Example 9 can optionally be configured such that the imaging device comprises a camera.

[0020] In Example 14, the robotic endoscopic vessel harvesting system of any one of Examples 9-13 can optionally be configured such that the imaging device is located adjacent to a dissection tip at a distal end of the unitary EVH device.

[0021] In Example 15, the robotic endoscopic vessel harvesting system of Example 14 can optionally be configured such that the imaging device is located within a cavity formed in the dissection tip.

[0022] In Example 16, the robotic endoscopic vessel harvesting system of Example 15 can optionally be configured such that the imaging device is provided on a specialized circuit board within the cavity.

[0023] In Example 17, the robotic endoscopic vessel harvesting system of Example 16 can optionally be configured such that the specialized circuit board further includes an illumination source.

[0024] In Example 18, the robotic endoscopic vessel harvesting system of Example 16 or Example 17 can optionally be configured such that the specialized circuit board further includes communication circuitry.

[0025] In Example 19, the robotic endoscopic vessel harvesting system of any one of Examples 14-18 can optionally be configured such that the dissection tip has a generally conical shape.

[0026] In Example 20, the robotic endoscopic vessel harvesting system of any one of Examples 14-19 can optionally be configured such that the dissection tip is at least one of radially pliable, flexible, or deformable so that the dissection tip may deflect under exertion of force applied thereto.

[0027] In Example 21, the method or robotic endoscopic vessel harvesting system of any one or any combination of Examples 1-20 can optionally be configured such that all elements or options recited are available to use or select from.BRIEF DESCRIPTION OF THE FIGURES

[0028] These and other characteristics of the present disclosure will be more fully understood by reference to the following detailed description in conjunction with the attached drawings, in which:

[0029] FIG. 1 is an example illustration of a conventional EVH setup including independent components coupled to the EVH device;

[0030]

[0031] FIGS. 2A and 2B are example vessel harvesting devices in accordance with the present disclosure;

[0032] FIGS. 3A and 3B are example dissection tips for a vessel harvesting device in accordance with the present disclosure;

[0033] FIG. 4 is an example specialized integrated circuit for a dissection tip of a vessel harvesting device in accordance with the present disclosure;

[0034] FIGS. 5A and 5B are example systems for use with a vessel harvesting device in accordance with the present disclosure;

[0035] FIGS. 6A, 6B, and 6C are example procedures provided using a vessel harvesting device in accordance with the present disclosure;

[0036] FIG. 7 is a diagrammatic illustration of a high-level architecture for implementing processes in accordance with aspects of the present disclosure;

[0037] FIG. 8 is a block diagram of a high-level functionality of a vessel harvesting device in accordance with the present disclosure;

[0038] FIG. 9 is an example system for use with a vessel harvesting device in accordance with the present disclosure; and

[0039] FIG. 10 is a flow chart illustrating a method of use.DETAILED DESCRIPTION

[0040] The following description provides example embodiments only, and is not intended to limit the scope, applicability, or configuration of the disclosure. Rather, the following description of the example embodiments will provide those skilled in the art with an enabling description for implementing one or more example embodiments. It being understood that various changes may be made in the function and arrangement of elements without departing from the spirit and scope of the disclosure as set forth in the appended claims.

[0041] Specific details are given in the following description to provide a thorough understanding of the embodiments. However, it will be understood by one of ordinary skill in the art that the embodiments may be practiced without these specific details. For example, systems, processes, and other elements in the instant disclosure may be shown as components in block diagram form in order not to obscure the embodiments in unnecessary detail. In other instances, well-known processes, structures, and techniques may be shown without unnecessary detail in order to avoid obscuring the embodiments. Further, like reference numbers and designations in the various drawings indicated like elements.

[0042] The present disclosure provides for systems, methods, and devices used for artificial intelligence guided, assisted, and planed medical procedures. For example, the disclosure sets forth an integrated system that can provide for the ability to provide medical practitioners with real-time, in the moment, surgical plan details pertaining to the specific step of the procedure without the need for the practitioner to wind through a series of menus via a graphical user interface (GUI). Alternatively, or additionally, the system can provide real-timefeedback on an ongoing procedure based on pre-operative data, historical clinical data, accepted medical knowledge, and real-time in vivo images of the site of interest. The system can, in general, include a surgical device having a surgical tool and at least one imaging device, and an artificial intelligence (Al) system. The Al system can, in some embodiments, additionally, or alternatively, provide input on the preoperative surgical plan or even create the plan on its own based on the patient’s pre-operative data.

[0043] In an embodiment, the system can include the Al system and the surgical tool. The surgical tool can include any imaging device suitable for a given procedure and any necessary tooling to complete the procedure.

[0044] Any suitable computing device can be used to implement the Al system and methods / functionality described herein and be converted to a specific system for performing the operations and features described herein through modification of hardware, software, and firmware, in a manner significantly more than mere execution of software on a generic computing device, as would be appreciated by those of skill in the art. One illustrative example of such a computing device 700 is depicted in FIG. 7. The computing device 700 is merely an illustrative example of a suitable computing environment and in no way limits the scope of the present disclosure. A “computing device,” as represented by FIG. 7, can include a “workstation,” a “server,” a “laptop,” a “desktop,” a “hand-held device,” a “mobile device,” a “tablet computer,” or other computing devices capable of performing the same or similar functions, as would be understood by those of skill in the art. Given that the computing device 700 is depicted for illustrative purposes, embodiments of the present disclosure may utilize any number of computing devices 700 in any number of different ways to implement a single embodiment of the present disclosure. Accordingly, embodiments of the present disclosure are not limited to a single computing device 700, as would be appreciated by one with skill in the art, nor are they limited to a single type of implementation or configuration of the example computing device 700.

[0045] The computing device 700 can include a bus 710 that can be coupled to one or more of the following illustrative components, directly or indirectly: a memory 712, one or more processors 714, one or more presentation components 716, input / output ports 718, input / output components 720, and a power supply 724. One of skill in the art will appreciate that the bus 710 can include one or more busses, such as an address bus, a data bus, or any combination thereof. One of skill in the art additionally will appreciate that, depending on the intended applications and uses of a particular embodiment, multiple of these components canbe implemented by a single device. Similarly, in some instances, a single component can be implemented by multiple devices. As such, FIG. 7 is merely illustrative of an exemplary computing device that can be used to implement one or more embodiments of the present disclosure, and in no way limits the disclosure.

[0046] The computing device 700 can include or interact with a variety of computer- readable media. For example, computer-readable media can include Random Access Memory (RAM); Read Only Memory (ROM); Electronically Erasable Programmable Read Only Memory (EEPROM); flash memory or other memory technologies; CD-ROM, digital versatile disks (DVD) or other optical or holographic media; magnetic cassettes, magnetic tape, magnetic disk storage or other magnetic storage devices that can be used to encode information and can be accessed by the computing device 700. Alternatively, any computer-readable media can be used capable of performing such functions.

[0047] The memory 712 can include computer- storage media in the form of volatile and / or nonvolatile memory. The memory 712 may be removable, non-removable, or any combination thereof. Exemplary hardware devices are devices such as hard drives, solid-state memory, optical-disc drives, and other such hardware capable of performing these functionalities. The computing device 700 can include one or more processors that read data from components such as the memory 712, the various I / O components 716, etc. Presentation component s) 716 present data indications to a user or other device. Exemplary presentation components include a display device, speaker, printing component, vibrating component, and other such presentation components that are capable of performing presentation functions.

[0048] The I / O ports 718 can enable the computing device 700 to be logically coupled to other devices, such as I / O components 720. Some of the VO components 720 can be built into the computing device 700. Examples of such VO components 720 include a microphone, joystick, recording device, game pad, satellite dish, scanner, printer, wireless device, networking device, and other such I / O components capable of performing I / O functions.

[0049] In some embodiments, a system can include any combination of the aforementioned functional modules disposed on, or remote from, a device. For example, systems 300, 350 can have alternative arrangements and / or alternative functional modules from those shown in FIGS. 5A and 5B. For example, the functional modules can include 1) an image sensor; 2) a lighting source; 3) a video processor; 4) a signal / data transmission module; 5) a video / image display; 6) a power source for the display; 7) a power source for the lighting source, video processor, transmission module; and / or 8) Software control of features. Othermodules are considered to be within the scope of this disclosure. Moreover, it is contemplated that these functional modules may be disposed entirely on, within, or external to the device.

[0050] In an embodiment, the image sensor can be a digital or analogue image sensor capable of capturing still or video images. For example, the imaging device can be one or more of a Complementary Metal-Oxide-Semiconductor (CMOS) sensors, Optical Coherence Tomography (OCT) sensor, Charge Coupled Device (CCD), fluorescent imaging technology, camera, ultrasound, CT sensor, MRI, or other imaging devices capable of collecting an image of any type. The imaging device can provide image or video feedback as the surgical tool is advanced to the site of interest as well as the procedure itself. In some embodiments, the system can include a single imaging device or a plurality of imaging device. The image sensor can be placed at the tip of device as shown in FIG. 3B. Alternatively, the image sensor can be secured to any part of the housing, e.g., at the tip or in the back at the handle. In some embodiments, the image sensor can be organized onto a small circuit board along with other components of the system as shown and described with reference to FIG. 4. Additionally, or alternatively, the image sensor can be detachable from the device 100 and can be re-sterilizable or a disposable / single use module.

[0051] In some embodiments, the image sensor can be an OCT sensor and the surgical device can, in an embodiment additionally include a digital or analogue image sensor to view the advancement of the device to the target location and view any surgical procedures that may be required. The OCT sensor can be disposed within the device, proximate the distal end, or at any point along the length of the device. Alternatively, the OCT sensor can be disposed external to the surgical device. Regardless of the location of the OCT sensor, relative to the surgical device, the OCT sensor can provide real-time assessment as to the quality of any tissue to be harvested. In combination with a computing device, e.g., the Al system, the OCT sensor can provide for clinical means to judge the quality of any tissue that may be harvested - before it has been harvested. The OCT sensor can provide the ability to determine the quality of the tissue from outside to inside of the tissue. It is contemplated that other sensors, able to non- invasively determine tissue quality, may be used in place of the OCT sensor.

[0052] In one example of use, during an EVH procedure, the OCT sensor can be used to determine the quality of a vein segment to be harvested. In the event that the vein segment is not of usable quality for the remainder of the procedure (e.g., a coronary artery bypass graft), the doctor is able to advance along the vein until a vein segment of suitable quality is found. The use of the OCT sensor allows for the doctor, or surgeon, to avoid needless harvesting ofunsuitable quality tissue. In addition, the real-time tissue “grading” can provide for better health outcomes after the coronary artery bypass graft is complete.

[0053] In an embodiment, the illumination source 208 (see FIG. 4) can be alternative light sources including LEDs or other light-emitting technology (e.g., incandescent bulbs, fiberoptics, etc.). In some embodiments, such as in device 100 of FIGS. 2A and 2B, the light source can be disposed within the distal dissection tip 120. Alternatively, or additionally, a light source can be disposed at the tip proximate to the image sensor. In some embodiments, the light source can be housed in in the handle housing 102 and light can be delivered to the tip via optical cables. In a further alternative, the light source can be arranged external to the device (e.g., in a tower 150) and the light can be delivered to the device 100 via optical cables. Depending on the procedure to be performed, it can be advantageous for variable parameters of the light to be controllable such that the light has a variable, or fixed, intensity and a variable, or fixed, color profile. A user can adjust the intensity or color profile for a given procedure, e.g., in cases where certain contrasts are used a light having a particular profile may be needed to view the contrast. Other variables of the light source can be adjusted using controls on the device 100, on the tower 150, or on an external controller, as needed.

[0054] In some embodiments, the systems 300, 350 (see FIGS. 5A and 5B) can include a video processor 154 for processing the raw image data that is collected by the image sensor 204. The video processor 154 can be disposed anywhere within the system 300, 350. For example, the video processor 154 can be disposed inside the body of the device 100 or placed external to the device, e.g., in the tower 150. The video processor 154 can be detachable from the device 100 and can be re-sterilizable, or, alternatively, the video processor 154 can be a disposable single use module. The video processor 154 can support all types of image and video signals for display (e.g., HDMI, DVI, etc) the video. In some embodiments, for example, the video processor and / or the wireless transceiver can be disposed in the proximal end of the device 100. In some cases, the video processor and wireless transceiver, alone or in combination, can in be disposed within the proximal, or tail, end of the device. The video processor and / or wireless transceiver can be detachable and re-sterilizable for reuse or they can be disposable.

[0055] In some embodiments, the various modules of the system 300, 350, e.g., the video processor, the transceiver, and light source can be powered by a standard outlet power (110V, 220V in US, Europe or anywhere with the appropriate adapters). Alternatively, or additionally, the system can be powered by a battery - either disposable batteries or rechargeable using anyavailable battery technology (e.g., lithium ion, alkaline, etc). For example, the video processor can be powered with batteries that are either rechargeable or disposable, or the video processor can be powered via a standard outlet power running through a bifurcated cord that carries the generator power.

[0056] In some embodiments, the computing device can be controlled by non-transitory computer readable medium, i.e., computer software. For example, the non-transitory computer-readable media can comprise all computer-readable media except for a transitory, propagating signal. Such software can be written onto, and stored, on a chip, e.g., circuit board 202, that can be contained within the body of the device or external to the device. The software can be used to control any number of functions of the device including the light intensity of the light source, focus of the imaging device, white balance of the imaging device, and other camera / light source functions.

[0057] In some embodiments, the system 300, 350 can include a transceiver module, e.g., communication circuitry 206 (see FIG. 4). The transceiver module 206 can be a wired or wireless module that is able to send image or video signals from the imaging device 204 via wires or through a wireless protocol to another module or device, e.g., a memory storage or display device. In some embodiments, the transceiver module 206 can send one of, or both, analog or digital signals from an image sensor to be delivered to a video processor via any conductive material or wirelessly. In some embodiments, the device 100 can be used in combination with any number of display devices. For example, a medical professional can be using a headset 866 (see FIG. 8) while a team of medical students can be observing a procedure in a remote location on a computer monitor 862, or other display type.

[0058] Turning now to FIG. 8, the system 800 can include a display 856, or display device to output the image or video from the image sensor. The system can be designed to work with video displays 856 used to receive video signals (e.g., LED displays, OLED displays, CRT displays, plasma displays, a light projector, a laser projector, etc.). Examples of such display devices can include the tower monitor 856, a handheld tablet 860, a computer monitor 862, a laptop display 864, a headset 866 (e.g., META QUEST™, VALVE INDEX®, HTC VIVE®, HP REVERB®, APPLE VISION PRO™, or other such headsets / goggles capable of providing a user with a display mounted to their face), goggles, digital contact lenses, or other wearable device (e.g., APPLE WATCH®, FITBIT®, GOOGLE PIXEL®), or projected onto an available surface via a projector 868, or other display capable of performing these functions. In some cases, the display device 856, 860, 862, 864, 866, 868 can be integrated directlyinto / onto the device. Alternatively, the display can be disposed on the device as a separable module or can be remote from the device. The system 800 is shown as a block diagram in FIG. 8 for the sake of simplicity. The dashed lines are not intended to illustrate proximity or relative locations of the various components but are shown as functional connections between the various components. For example, a tower monitor 856 can be located directly on the device 100, or the tower monitor 865 can be separate from the device 100 and functionally connected via a wired or wireless connection to transmit and receive data. Similarly, a headset 866 can be connected to the device 100 via a wired or wireless connection.

[0059] In some embodiments, the display device can be removably attached to the device 100. Alternatively, the display device can be fixedly attached to, or within, the device 100 itself. In some embodiments, the display device can be a tablet 860, or other display, which can be fixed to the device 100 using known mechanical or chemical fasteners. In some embodiments, the display can be part of a compact device such as a smart phone, tablet, smart watch, or other handheld devices which can have a total weight that does not impact the performance of the device 100. In certain situations, where the display is attached to the device, the display can be disposable as it is difficult to sanitize a display for a medical procedure. Alternatively, the display can be reusable and covered with a plastic covering for sanitary purposes.

[0060] The display devices can be powered by any standard outlet power (110V, 220V in US, Europe or anywhere with the appropriate adapters) and / or can be battery powered - either disposable batteries or rechargeable using any available battery technology (e.g., lithium ion, alkaline, etc.). The video signal can be delivered to the display device, e.g., the tower, an IPAD®, or headset, via a wired, or wireless, connection to the device.

[0061] In some embodiments, the video display can be in the form of a headset 866, e.g., a VR headset, or AR headset. For example, the headset 866 can be an OCULUS® or APPLE VISION PRO™ headset (or other such headsets capable of providing the wearer with a personal display) with a mobile device sized display arranged in front of the eyes of a user or can be a display that is pushed up against the face and forehead like a VR display. In some embodiments, the headset 866 can include pico-projectors, or variants of LED / AMOLED to display the image to the user. For example, the headset 866 can use 2 displays (one for each eye). The individual displays can, in one example, be about U” wide, though other sizes are contemplated to be within the scope of this disclosure. In front the individual displays can be heavy powered lenses that can magnify an image to look akin to a large display to the user.The display of the headset 866 can be adjustable to extend in and out from the facial plane and / or rotate up and down around the head (axis across the ears). A head band can be arranged, or connected, to either end of the headset 866 and can be arranged to be disposed around the circumference of the head. In some embodiments, the headset 866 can be fixed or can be adjustable. When the device 100 is being used in a medically sterile environment, or in cases where all instruments are required to be sterile, the headset 866 can be sterilized, sterile wrapped, or, in some cases, can be used unsterile. If headset 866 is unsterile, control (e.g., adjustments) of the system 800 can be accomplished either with assistance from someone outside the sterile field or the headset can be provided with a piece of sterile tape, or a wrap, placed over the controls for interface by the operator in the sterile field. The tape or wrap can be discarded after use in that case. Alternatively, the system 800 can receive other types of control inputs such as voice commands.

[0062] In some embodiments, as shown in FIG. 9, the device 100 can be connected, via cable 112 or a wireless signal, to a central hub 900. The central hub 900 can function as a central device that can functionally connect the device 100 to the peripheral devices, power, and / or generator 152. For example, the central hub 900 can allow a video signal from the device 100 to be processed and distributed to a monitor 862, a headset 866, and / or a tablet 860 - separately or simultaneously. In addition, the electrosurgical generator 152 can be connected to the device 100 via the central hub 900. For example, a video signal from the device 100 can be sent to headset 866 for display, via a wireless or wired connection. In some embodiments where the headset 866 is connected via a wireless connection, the headset can be paired to the tower 150 or the central hub, or puck 900, as seen in FIG. 9. The headset 866 can be programed to automatically turn on or off, depending on the state of the device 100, can auto pair to the puck 900, or can be manually powered on / off or paired.

[0063] In some embodiments, the headset 866 can contain various functions to aid in the completion of a given medical procedure. Such functions can be performed by computer software. For example, in certain cases it may be beneficial to provide video signal recording and still frame capturing of the video data feed. The data capture can be controlled by the operator or can be integrated into the function of the headset 866. For example, the headset 866 may always be recording on a loop and overwriting old data after a predefined period of time (e.g., 4 hours). Data can be stored onto a media storage device 812, such as an integrated media storage device on the headset 866 (e.g., SD card, SSD drive, or other such media storage device) or can be streamed to an external storage media device. Connections can be made tothe external storage media device to download data stored on the headset. In some embodiments, the headset 866 can include a wireless transmitter / receiver and unique ID to which other wireless devices can connect (securely or un-securely). The headset 866 can also deliver the raw video signal to other display for concurrent display (wired or wirelessly). For example, a clinician can connect to a wireless hub via a handheld mobile device or IPAD / tablet device or a computer to receive a real-time feed of what the operator is seeing. In some embodiments, the signal processing of a video feed from the imaging device 204 can be performed on the device 100, or done on a separate device, e.g., the central hub 900 outside of the device 100, or in or out of the sterile field. Further, it is contemplated that the video signal can be transmitted via a wired, or wireless, connection before and after processing. In some embodiments, the video signal can be auto recorded and stored on the hub 900. Alternatively, the video signal can be stored in the device 100 or in any of the peripherals (e.g., headset 866). The video signal can also be manually controlled by the operator or can be auto recorded. In some embodiments, the headset 866 can make use of virtual reality (VR) or augmented reality (AR) by displaying superimposed patient data, or the artificial intelligence (Al) system described above.

[0064] In a method of use, as shown in FIG. 10, in addition, or alternatively, to those described herein, the system 800 can be used to provide the operator on the fly educational, or instructional, information overlaid on the video stream from device 100 via the Al systems or traditional computing systems. For example, in the pre-operative preparation stage, an ultrasound, CT scan, X-ray, etc., can be taken of the site of interest where the procedure will be taking place in a first step 1000. In an optional second step 1002, the operator can annotate the image of the site of interest with anatomical markers or the medical procedure plan. In a third step 1004, during the procedure, should the operator require the pre-operative image for reference, the system 800 can overlay the pre-operative image on top of the live video feed being displayed, for example, on the headset 866. In some examples, the pre-operative image can precisely match the anatomical structures in both the pre-operative image and the live video feed to ensure that the overlay is accurate. For example, this process may involve some image editing to ensure that the pre-operative image is correctly oriented and sized to match the live video feed. Additionally, or alternatively, the system 800 can store relevant training / educational videos showing procedure steps for the operator to review during the procedure. Alternatively, the training / educational video can be an audio file or other instructional data or flow charts. For example, the operator may have a need to review theproper steps for a procedure during the actual procedure. In that case, the operator, or an assistant, can bring up the training / educational video, in step 1006, and bring up the video in a picture-in-picture arrangement on the headset 866. The operator can then review the video while having the site of interest in their field of view. Steps 1004, 1006 can occur separately, or concurrently, and can be performed any number of times during a procedure and can be automatically brought up by the Al system. It is also contemplated that step 1006 may include a video conference with a colleague who may be able to coach or guide the operator through the procedure from a remote location. In step 1008, the procedure can be completed based on the real-time information provided in steps 1004 and 1006. In some embodiments, the various steps disclosed herein can be executed by the computing device 700 which can be controlled by non-transitory computer readable medium, i.e., computer software. For example, the non- transitory computer-readable media can comprise all computer-readable media except for a transitory, propagating signal.

[0065] In an embodiment, the Al system can be arranged within, or on, the surgical tool. Alternatively, the Al and processing can be performed on the central hub 900, or a remote device. In some embodiments, Al can be loaded onto the central hub 900, a remote processor, the device 100, or a headset 866 or other display. The Al can, additionally or alternatively, be run on a remote server that is in communication with at least one of the displays via a local or wide area networks via a wired or wireless connection. It is understood that the Al capabilities both generative and non-generative, e.g. machine learning and image recognition, include other features not explicitly discussed herein but are within the scope of the instant disclosure.

[0066] In some embodiments, the instant Al system can be utilized before, during, and after a procedure. In an example, the Al system can be configured to be loaded with preoperative data about a patient. This pre-operative data can include, but is not limited to, the patient’s full (or partial) medical records, diagnosis information including any and all medical notes, pre-operative imaging data from CT / ultrasound / MRI data, blood work, and any other medical testing data. In addition, in some cases, the practitioner or doctor, can load in a planned procedure into the Al system to allow the Al to analyze the planned procedure against the diagnosis, the medical records, the imaging data, and any other diagnostic data the hospital may have for the patient. The Al can act as a check on the doctor’s planned procedure or can note potential areas of concern via the analysis. Where the Al finds areas of concern with the planned procedure, a generative Al can provide proposed solutions to obviate any concern with the planned procedure. For example, the generative Al can develop a revised plannedprocedure for the doctor’s review. In some embodiments, the Al system can be trained using historic medical records and data to “teach” the Al system standard of care for each procedure, success rates with certain variables (e.g., age, weight, comorbidities, etc.), and up-to-date medical techniques. With a trained Al system, a surgical procedure can be designed efficiently, safely, and with the best expected prognosis.

[0067] In some embodiments, the use of the instant Al system can avoid many common mistakes, which may otherwise be repeated over and over again. For example, in some cases the time spent assessing conduit quality, by the surgeon, during the pre-op planning stage may be better utilized on other aspects, because once the surgery begins the conduit can end up being of poor quality. The instant Al system can, in contrast, make the decisions about the quality of the conduit at the moment, in vivo, based on, for instance, ultrasound or OCT, patient comorbidities, and other common factors. The Al system in combination with the unitary device, in one embodiment, can carry out a few steps of the vessel harvesting procedure before deciding to pivot to another useful conduit, based on the ultrasound or OCT sensor information. This implementation can save time, money, and most importantly, allow the patient to keep their conduits that would otherwise be harvested only to be thrown away. In some embodiments, the Al system can, additionally or alternatively, analyze medical studies to predict the right conduit match to the patient habitus, blocked arteries, and perfect conduit match.

[0068] In an embodiment, a doctor can take preoperative images to begin to plan an EVH procedure using the device 100. Any type of pre-operative images can be used in the foregoing devices, systems, and methods and may be dependent on the patient. For example, amputees may have a certain type of conduit that is better based on the data that is there but has never been aggregated. Ultrasound is a common modality to individually assess the quality of the conduit by looking from the outside of the patient. Commonly, after a patient has ultrasound the communication between the surgeon and the harvester is little more than a brief description of what the person using the ultrasound thinks they saw. The Al system could take those ultrasound images and give the surgeon a detailed assessment as to where along that conduit the surgeon should begin and end the harvest, or what the precent likelihood is of harvesting the conduit and having that conduit be unusable. Based on the doctor’s training and medical knowledge, the patient’s medical history and diagnosis, and the preoperative imaging, the doctor can plan a preferred route to a vessel and a desired length needed for a coronary artery bypass grafting (CABG) procedure. Traditionally, this pre-op plan may be peer reviewed.However, in an embodiment, the instant Al system can review the doctor’s proposed pathway to harvest a desired length of a vein for an EVH procedure. The Al may determine that the proposed pathway may be too risky, or a more efficient or safe plan may be needed, and can propose an alternative pathway. Moreover, or alternatively, the Al can determine the optimal length of the vein to be harvested. The Al revised plan can, in an embodiment, be further peer reviewed. The Al system can additionally provide real time sharing of data, including any internal imaging, along with past outcomes, into a database which the Al can be trained form to yield increased efficiencies in the surgical process by reducing the need for a surgeon to potentially attempt harvesting a vessel which is unusable thereby increasing the surgery time and costing the patient a length of otherwise usable conduit.

[0069] In some cases, the Al can generate the initial planned approach for a surgical procedure. Similar to the Al revised plan, discussed above, the doctor can make use of generative Al to develop the surgical plan based on, for example, a medical database, the patient’s medical history and diagnosis, and the preoperative imaging for the doctor to review. Utilizing outside functions such as the patient’s ultrasound images combined with inputs for the case dynamics, can aid with limb selection and the needed conduit length for EVH procedures. In some embodiments, Al can continue to collect data and ultimately drive the correct operative process based on patient habitus. If the doctor decides an alternative approach may be clinically beneficial or more feasible, the Al can be used to review the human revised plan ahead of the procedure.

[0070] Once the Al generated, reviewed, or revised plan is finalized by the doctor, the Al plan can be loaded onto the device 100, the hub 900, the computing device 700, or any network connected device for display to the surgeon during the procedure. In some embodiments, the finalized plan can be displayed concurrently over a live feed of the surgical procedure. For example, in the case of the device 100, a live feed can be provided by the imaging device 204 to any display, e.g., the headset 866, with the Al instructions overlayed on top of the live feed. The Al can analyze the live feed to provide step accurate instructions based on the location, or anatomy, shown in the live feed. For example, the Al can instruct the surgeon to slow the advance of the device 100 as the device 100 approaches the site of interest identified during the pre-operative planning phase. In an embodiment, the Al can analyze the live feed and provide directions for where to advance the device 100 in the form of arrows or other visual indicators, akin to a GPS program. These instructions can be overlayed on top of the live feed that the surgeon is viewing during the procedure to allow the surgeon to concentrate on the taskat hand. In this, and the other examples, the instructions can be in the form of text, images, audio, and / or instructive videos to provide the clinician with the necessary instruction at the needed time.

[0071] In some cases, the Al can continuously review the image feed from the imaging device 204 and should there be any deviation by surgeon, the Al can alert the surgeon that the device or end effectors are advancing outside of the pre-operative plan. The Al can, therefor, prevent avoidable errors by the surgeon. Similarly, there may be some anatomical obstacles that were not visible via noninvasive imaging techniques. When the obstacle, or anomaly, is detected by the Al, based on the stream of data from the imaging device 204, the Al can revise the procedure on the fly to provide the surgeon with one, or more, alternative approaches to the site of interest. This can allow the surgeon to focus on the procedure and not waste time or resources determining next steps.

[0072] In some embodiments, an ultrasound probe, or an optical coherence tomography infrared (OCT) catheter can be integrated into the device in place of, or in addition, to a camera or imaging sensor. In such an embodiment, the unitary surgical device can provide a real-time surgical assessment in-vivo. The Al can then use the surgical assessment to provide decision making based on what data can be provided by an ultrasound. This assessment can be inside the intima or just in the field of view via the camera lens of the device. The Al can aid the clinician in deciding next steps, e.g., how to navigate an abnormality or determine whether or not, and how, to proceed based on Al diagnosis of the visual medical evidence. In some embodiments, the Al can suggest best practices to the surgeon via a display, e.g., a VR / AR headset, and display how to videos or papers on procedural options given the assessment of the data. Thus, the Al can pull the appropriate information for the surgeon without the surgeon needing to work through the data and conduct a search for the needed instructional information. For example, in the case of a superficial bifurcating vein in a diabetic patient, the Al can have access to aggregated historical data such that the Al can then determine how much of this vein, and which leg, may be usable. Al assessment could save time and improve outcomes utilizing a library of video and written study data to automatically retrieve the appropriate files from that library given ultrasound, visual, OCT, or other sensor information.

[0073] In another example, the imaging device 204 can view the surgical operation itself as well. The Al can, in real time, review the data from the imaging device 204 and alert the surgeon of deviations from the pre-operative surgical plan. For example, the surgeon may be alerted that a length of a vessel is too short to complete a by-pass procedure and to harvest alonger length of the vessel - before the surgeon performs the final steps of the vessel harvesting. In another example, the Al algorithm may be able to quickly, in real-time, determine which branch of a bifurcation terminates and is not the main trunk, thereby allowing the user to make the instant operative decision to cut the correct branch and follow the correct vein. This would eliminate time and potential complications with unnecessary exploratory surgery. The Al intervention in this case can be in the form of a visual overlay on top of the live feed from the imaging device 204, can be an audio alert, a flashing light, haptics, or other alert, and combinations thereof.

[0074] In some embodiments, it is contemplated that a surgical device can be robotic and therefore able to drive and direct itself with or without human operator intervention. In such a case, the generative Al can drive the robotic device, with human surgeons assistance or supervision. For example, the robotic device can include the imaging device 204 at a distal end of the device to allow the surgeon to view the advancement of the device to a site of interest, then using the same imaging device 204 the surgeon can see the harvesting procedure taking place. As the surgeon views the procedure, they can maintain the option of taking full manual control of the procedure, or allow the procedure to be completed by the Al driven robotic device. In some embodiments, the Al can develop a robotic assisted approach to harvesting conduit for coronary artery bypass grafting (CABG), also called heart bypass surgery, in a minimally invasive fashion using a unitary vessel harvesting device. Alternatively, traditional computing technologies can be programed to autonomously complete the procedure, with doctor review, without any Al technology.

[0075] In an embodiment, the device 100 can be designed with input controls which can be sized to be ergonomically held and controlled by a human surgeon or a robot 170 (see FIG. 2 A) with an end effector. Alternatively, the device 100 can be integrated into a surgical robotic system such that the device 100 becomes an end effector of the surgical robot. In some embodiments, the device 100 can be driven, or advanced, at an incision site by a robotic arm. The robotic arm can include visualization, ultrasound, or OCT capabilities to assess the inside of the conduit. Such visualization, ultrasound, or OCT capabilities can be arranged at the distal end of the unitary device. In an embodiment, the surgical procedure could be completed by a plurality of robotic arms that, in combination can cut, cauterize, dissect, retract, and maneuver the device 100 within the body to perform the endoscopic vessel harvesting, or removal of the conduit. Alternatively, the robotic arm can receive input data from the device 100 which can include the visualization, ultrasound, or OCT capabilities, such that the device 100 can be aunitary EVH device which can be connected to a universal surgical robotic arm, without concern for the sensors available on a given robotic arm. The operator could direct the robot to follow the conduit, which can be mapped prior to the procedure, using any type of common mapping modalities such as ultrasound. The robotic arms can then respond to user commands to perform the necessary steps to free the conduit from its surrounding tissues and safely remove it in a no touch fashion.

[0076] In some embodiments, the surgical robot can be used in combination with the Al system such that it can perform an EVH procedure alone without human intervention. Such a system can use the patients pre-operative anatomical mapping to plan out a surgery and expertly maneuver through one or a plurality of devices to complete the procedure. In an embodiment, where a plurality of robotic arms are used, those robotic arms can be powered with common energy sources and cutting / coagulation functions to dissect around the surrounding structures and harvest the conduit robotically in a no touch minimally invasive fashion.

[0077] While examples discussed above relate to the device 100 with respect to vessel harvesting, it is contemplated that the implementation of Al discussed herein can be applicable for use in any medical procedure. For example, the instant system including the use of Al can be used for any surgical procedure including, but not limited to, all endoscopic procedures, spinal surgeries, ocular surgeries, cosmetic surgeries, etc.

[0078] In an embodiment, as discussed throughout, the surgical tool can be a unitary device for vessel harvesting that reduces an amount of clutter in the sterile field by simplifying the equipment needed to perform the procedure. For example, the present disclosure can incorporate a unique combination of circuitry and wiring to replace the need for modular elements to be combined with a vessel harvesting device for medical procedures. The disposable vessel harvesting device can include an integrated camera and a light source (i.e., light emitting diodes (LEDs)) within a tip of the vessel harvesting device.

[0079] The disposable vessel harvesting device can include or otherwise be compatible with multiple other components for vessel harvesting. For example, the disposable vessel harvesting device can include cutting components as discussed in U.S. Patent Nos. 9,119,900, 9,498,246, 9,814,481, and 9,943,328, all incorporated herein by reference. In such an implementation, the disposable vessel harvesting device can be used to visualize and isolate the main vessel from the surrounding connective tissue by dissecting the main vessel from surrounding connective tissue. The vessel visualization can then introduce a tributary sealing instrument, to seal and sever side branches. Once the side branches are sealed, another devicecan be used to harvest a section of the main vessel to be used as a bypass graft. The disposable vessel harvesting device of the present disclosure can combine the dissection function, the tributary sealing and severing function, and, optionally, main vessel sealing and severing function, which can result in decreased vessel manipulation and improvement in ease of the procedure. The devices of the present disclosure may also be used to extract the sealed and severed main vessel from the patient.

[0080] FIGS. 1 through 6C, wherein like parts are designated by like reference numerals throughout, illustrate an example embodiment or embodiments of improved vessel harvesting device for harvesting vessels, according to the present disclosure. Although the present disclosure will be described with reference to the example embodiment or embodiments illustrated in the figures, it should be understood that many alternative forms can embody the present disclosure. One of skill in the art will additionally appreciate different ways to alter the parameters of the embodiment(s) disclosed, such as the size, shape, or type of elements or materials, in a manner still in keeping with the spirit and scope of the present disclosure.

[0081] Referring to FIG. 1, a representative conventional system 1 for performing an endoscopic harvesting procedure is depicted. The system 1 typically includes a reusable endoscopic harvesting device 2 configured to receive a separate reusable endoscope 3 and a reusable camera 4, each separately connected to a central control tower 5. Traditionally, to be reusable, each of the endoscopic harvesting device 2, endoscope 3, and camera 4 must be sterilized and require their own power, data communication lines, and / or processing component extending from the tower 5. The tower 5 can generally be defined as a location outside of the sterile field where peripherals (e.g., a monitor, generator(s), CO2 source, light source, and / or a camera processor) are located during the procedure. As depicted in FIG. 1, for example, the endoscopic harvesting device 2 can have a power cable 12 connected to an electrosurgical generator 22, the endoscope 3 can have a separate power cable 13 connected to a light source component 23, and the camera 4 can have a cable 14 connected to a video processor 24 relaying information to a video monitor 25. Additionally, each cable 12, 13, 14 can include their own power sources and power cabling. In operation, each of the components 2, 3, 4 of device 1 would need to be sterilized when being utilized within a sterile field 30 of a procedure.

[0082] Referring to FIGS. 2A and 2B, example vessel harvesting devices 100 in accordance with the present disclosure is depicted. The embodiments of FIGS. 2A and 2B are generally similar, with the main distinction being the embodiment of FIG. 2A is configured to be controlled by a robot 170 rather than a human hand in FIG. 2B. The device 100, in someembodiments, can include housing 102 which can be configured to house the various components of the device 100, including internal wiring to receive and deliver power to said components, and communicate data to systems outside of the housing 102. The housing 102 can also include buttons, switches, etc. for controlling operation of the device 100. For example, the housing 102 can include a button for powering a cutting component of the device 100. The housing 102 can be constructed from any combination of materials utilizing any combination of systems and methods known in the art. For example, the housing 102 can be constructed from a biocompatible material, such as, plastic material, elastomeric material, metallic material, shape memory material, composite material or any other materials that has the desired characteristics. In some embodiments, the device 100 and components thereof can be disposable.

[0083] In some embodiments, the housing 102 can be coupled to wires or cabling 112 that is configured for providing power and transferring data between the device 100 and the subsystems thereof. For example, the cable 112 can provide power to a combination of an integrated circuit, imaging device, illumination device, transceiver, etc. as discussed in greater detail herein. As would be appreciated by one skilled in the art, the cable 112 can also be configured to provide power to other systems known in the art, for example, a cutting subsystem of the device 100, such as the cutting systems discussed with respect to U.S. Patent Nos. 9,119,900, 9,498,246, 9,814,481, and 9,943,328, all incorporated herein by reference. The cable 112 can provide a combination of wiring for different power and data cabling within a singular shield or can be a combination of wires braided together into a single line. The cable 112 can provide a singular structure that can include any combination of elements that require a physical connection to one or more other devices within the tower 150.

[0084] In some embodiments, the cable 112 can include one or more conductive lines for providing power to the housing 102, from an outside source (e.g., control tower 150), for its various functions. The power provided over the one or more conductive lines can be used to power any combination of components that are part of the device 100, for example, an electrocautery lead, a light source, imaging devices, an insufflation device, computing devices, circuit boards, or any combination of devices and electronics that require powering. The cable 112 can include a single conductive line to provide all the power to the housing 102 and the components therein, can include a plurality of separate conductive lines for dedicated power for each of the components within the device, or a combination, therefore. The cable 112 can include any combination of conductive lines and light transmission lines for any combinationof devices. For example, the cable 112 can include three dedicated lines (e.g., positive, negative, and signal lines) for an electrocautery component, two dedicated lines for an illumination source 208 (e.g., signal line and light transmission line), a dedicated line for an imaging device 204 (e.g., signal line) all positioned within the device 100. In some embodiments, the one or more conductive lines can be wires including any combination of wire gauge. The cable 112 can also include different gauge wires to provide different levels of power to different components of the device 100.

[0085] In some embodiments, the cable 112 can include one or more optical fibers that are designed to carry light. The one or more optical fibers can be used to transmit light from a light source outside of the device 100 (e.g., from the tower 150) to an illumination source within the device 100 (e.g., illumination source 208). In some embodiments, a combination of the one or more conductive lines and the one or more optical fibers (e.g., fiber optics) can be used to transmit data and / or signals to and from a computing device (e.g., video processor 154) located remotely from the device 100 (e.g., from the tower 150) to a device within the device 100 (e.g., integrated circuit 200). For example, the one or more conductive lines and / or the one or more optical fibers can be used to transmit signal wires from an imaging device 204 within the device 100 to a video processor 154 separate from the device 100.

[0086] In some embodiments, the cable 112 can include additional functional elements. For example, the cable 112 can include channels for providing CO2 for insufflation, fluids, saline for washing / irrigation, etc. The cable 112 can be coupled to any portion of the device 100 using any combination of coupling mechanisms. For example, it can be a removeable cable 112 inserted into a port on the device 100 or it can be a fixedly attached cable 112 coupled to contacts within the device 100.

[0087] In some embodiments, an elongated body 104 can extend from the distal end of the housing 102. The elongated body 104 can be substantially solid or hollow and have a proximal end 106 and a distal end 108. The proximal end 106 can be coupled to and / or within the housing 102 using any combination of coupling mechanisms. In some embodiments, the elongated body 103 can include an inner cavity extending from the proximal end 106 to the distal end 108 to enable power and / or data transmission lines to extend between the proximal end 106 and the distal end 108 to the housing 102 and the cable 112 coupled to the housing 102. As would be appreciated by one skilled in the art, the elongated body 104 can house and / or be coupled to a variety of other tools or components, for example, a cutting tool. Insome embodiments, components can be inserted on / around the device 100. For example, a trocar 110 can be removably slide onto the elongated body 104 of the device 100.

[0088] In some embodiments, the elongated body 104 can be configured for passing extravascularly through an entry incision to a vessel harvesting site. To aid in navigating the elongated body 104 to a site of harvesting, the elongated body 104 may be sufficiently rigid axially along its length. To provide the elongated body 104 with such characteristic, in an embodiment, the elongated body 104 may be made from a biocompatible material, such as, plastic material, elastomeric material, metallic material, shape memory material, composite material or any other materials that has the desired characteristics. To the extent desired, the elongated body 104 can be provided with some flexibility to move radially or laterally from side to side depending on the application.

[0089] In some embodiments, the elongated body 104 of the device 100 may be solid. In other embodiments, the device 100 may include one or more lumen with lumen that accommodate advancing instruments, wires, power / data lines, or materials therethrough. In some embodiments, the device 100 may include a conduit through which wires or cabling may be advanced for powering and / or communicating with electrical components within the device 100.

[0090] In some embodiments, the elongated body 104 can terminate at a dissection tip 120 or can have a dissection tip 120 coupled to the distal end 108 of the elongated body 104. Referring to FIGS. 3A and 3B, example depictions of a dissection tip 120 are provided. FIG. 3A depicts an isometric view of an example dissection tip 120. In some embodiments, the dissection tip 120 may include a generally tapered section 124 which terminates in a generally blunt end 126 for atraumatic separation of a vessel segment, being harvested from surrounding tissue, while minimizing or preventing tearing or puncturing of nearby vessels or tissue as the device 100 is navigated along a vessel segment. Although illustrated as being blunt, it should of course be understood that, to the extent desired, the end 126 of the dissection tip 120 may be made relatively pointed to enhance advancement of the distal end of the device 100. Similarly, the tapered section 124 may be configured differently structurally to enhance the operability of the device 100.

[0091] In some embodiments, to reduce likelihood of trauma during a dissection process, the dissection tip 120 can be radially pliable, flexible, or deformable so that the dissection tip may deflect slightly under exertion of force applied to the dissection tip 120. In some embodiments, the dissection tip 120 can be radially compressible so that the walls of thedissection tip 120 can deform under exertion of force normal to the tip surface. To that end, the dissection tip 120 can be formed from thin wall plastic material to enable the dissection tip to flex under load. Suitable materials include, but are not limited to, polycarbonate, polyethylene terephthalate glycol-modified (PETG), polyethylene terephthalate (PET) and other materials that provide enough optical clarity while allowing the dissection tip to flex under load. At the same time, the dissection tip 120 may be provided with sufficient column strength in axial or longitudinal direction to allow dissection of the vessel from the surrounding connective tissue. In other words, while being axially rigid to permit advancement of the tip 120 through tissue, tip 120 may be radially pliable, flexible, or deformable. Other characteristics of the dissection tip 120 are contemplated, such as having variable strengths: (1) in an axial direction versus a longitudinal direction, wherein the axial strength is greater than the longitudinal strength; (2) in a longitudinal direction versus an axial direction, wherein the longitudinal strength is greater than the axial strength; or (3) the axial direction versus a longitudinal direction, wherein the axial strength is approximate the longitudinal strength. It is also possible that the dissection tip 120 can include two or more materials, wherein at least one material can have different material properties, such as elasticity, hardness, tensile strength, or the like.

[0092] Continuing with FIG. 3A and FIG. 3B, in some embodiments, the dissection tip 120 can be cone shaped, and can be shaped at its distal end 129 in a manner so as to minimize the negative effects of visual distortion or blinding at the center of the field of visualization when viewing through an imaging device (e.g., a camera) within the dissection tip 120. Internal surface 121 of the dissection tip 120 may be tapered, with a relatively constant slope toward the distal end 126 of the dissection tip 120, terminating at an internal apex 123, which may be a sharp point, as shown in FIG. 3B. External surface 125 of the dissection tip 120 may also be tapered with a constant slope toward the distal end 126 of the dissection tip 120; however, at the distal end 126, a relatively rounded, blunt end can be formed to minimize tissue damage during dissection. As illustrated, at the distal end 126, the external surface 125 of the dissection tip 120 can be folded back on itself in a proximal direction to then terminate at an external apex 127, maintaining the blunt exterior surface and forming an indent in the distal end of the dissection tip 120.

[0093] In some embodiments, both the internal apex 123 and the external apex 127 can be collinear with the central longitudinal axis of the cannula 100. In other words, the centers of the internal apex 123 and the external apex 127 can be located on the central longitudinalaxis of the elongated body 104. By providing an apex on each of the internal surface 121 and the external surface 125 of the dissection tip 120 that are also collinear with the axis of any imaging device within the dissection tip 120, those surfaces perpendicular to the light path (which is parallel to the axis of the elongated body 104) can be eliminated, which then can eliminate light refraction from the perpendicular surface back into the camera and, thus, can minimize or eliminate the visual distortion or blinding when viewing through an internal imaging device with a light source and camera system.

[0094] Referring to FIG. 3B, in some embodiments, the dissection tip 120 can include an inner cavity in fluid communication with an inner cavity of the elongated body 104 to enable power and data communication to be delivered between the dissection tip 120 and the housing 102. This can also include sending and receiving power and data to / from the dissection tip 120 to the cable 112 and to the tower 150. FIG. 3B depicts a cross-sectional view of an example dissection tip 120 with an inner cavity. In some embodiments, a specialized integrated circuit 200 configured for illumination and / or electronic imaging can be integrated within the inner cavity of the dissection tip 120 for capturing image data outside of the dissection tip 120. The specialized circuit 200 can be sized and dimensioned to fit within the dissection tip 120 of the device 100 and positioned at a location in which imaging can be captured from within the dissection tip 120. For example, the dissection tip 120 can have a circular cross section of approximately 2-10 mm in diameter and positioned at the distal end of the dissection tip 120. Alternatively, the dissection tip 120 can have any appropriate cross section that is configured to be received within a lumen, or cavity, of a patient.

[0095] Referring to FIG. 4, an illustrative diagram of an example specialized circuit 200 for use within the dissection tip 120 is depicted. In some embodiments, the specialized circuit 200 can include a customized printed circuit board 202 with any combination of an imaging device 204, communication circuitry 206, illumination source 208, a battery 210, and / or a wireless transceiver 212 mounted thereon. The imaging device 204, communication circuitry 206, illumination source 208, the battery 210, and the wireless transceiver 212 can be embedded within or on the printed circuit board 202 in any combination of methods known in the art.

[0096] In some embodiments, the imaging device 204 can include any combination of digital imaging devices that are sized and dimensioned to fit on a circuit board 202 and positioned within the dissection tip 120. For example, the imaging device 204 can be a camera designed to take any combination of images and videos. The size and resolution of the imagingdevice 204 can be influence the size of the specialized circuit 200. For example, the higher the resolution, the larger the imaging device 204 may be increasing the required size of the specialized circuit 200. In some embodiments, the imaging device 204 can be designed to capture light, convert the captured light into a signal, and transmit the signal along the cable 112 to a destination device (e.g., tower 150). In some embodiments, the imaging device 204 can include a lens and camera chip mounted on circuit board 202 at the tip of the device 100. The ambient light can pass through the glass lens and the early camera processing can be processed (e.g., on the circuit board 202) within the tip 120 of the device 100. This process can be performed without having to send ambient light all the way down fiberoptic rods or other methods within the handle for processing. The pre-processed electrical signal can be sent from the circuit board 202 along transmission lines over the cable 112 to the video processor 154 (see FIGS. 5A and 5B) that is either embedded in the handle 102 or in an external tower 150.

[0097] In some embodiments, the communication circuitry 206 can include any combination of electrical contacts, transceivers, plugs, wiring, etc. configured to transmit data to and from the imaging device 204 over wiring to cable 112 for transmission of power and / or data to and from the device 100 to a remote source (e.g., tower 150). For example, the communication circuitry 206 can be any combination of a hard-wired bus, channel, pins, etc. for communicating data over transmission lines, such as small gauge wires (or any wiring / conductive elements known in the art), extending through the elongated body 104 to the housing 102. In some embodiments, the communication circuitry 206 can be different types of transmission lines than the transmission lines found within the cable 112.

[0098] In some embodiments, the printed circuit board 202 can include or otherwise be attached to an illumination source 208, for example, light emitting diode(s) (LED) configured to illuminate the surrounding area near the tip 120 for image capture by the imaging device 204. The illumination source 208 can include any combination of light sources, such as LEDs, known in the art and can be configured to provide illumination within a vessel. For example, the illumination source 208 can 1) be arranged as part of, or on the printed circuit board 202, 2) the illumination source 208 can be arranged on a handle of the device 100 and the light can be directed through fiber optics to the tip, and / or 3) the light source can be arranged as part of the tower 150 and passed to the tip via fiber optics embedded within, or separate from the cable 112. With all the components on the specialized circuit 200 located internally within the dissection tip 120, the device 100 may not require a separate endoscope, light source, cameraand each of their associated external cablings, as discussed in greater detail with respect to FIGS. 5 A and 5B.

[0099] In some embodiments, the device 100 can be sterile out of its packaging without the need to attach separate components that need sterilization (e.g., endoscope, camera, light, etc.) and the entire device 100 can be disposed of after use. Conventional medical devices 1 that are used as part of medical procedure can include a separate reusable camera 4 that use traditional rigid rod lenses which pass captured images from a separate reusable endoscope 3 to a camera 4. A rigid rod lens can be part of a separate device, such as an endoscope 3, with a glass lens at the tip. The ambient light that enters the lens is focused and travels up fiber optic rods in the rod shaft back to an eyepiece. The camera 4 is attached to the eyepiece and takes that light and processes it and then sends that signal over its own wiring to a video processor 24 and then out to a monitor 25.

[0100] Such devices 1 can also pass light from an endoscope 3, which can be very expensive, necessitating that they are used as reusable devices 1. Reusable devices need to then be sterilized before reuse, with each of the separate components being individually sterilized (e.g., endoscope, camera, light, etc.). In particular, such traditional devices 1, use separate external cameras 4 that require the use of an expensive light source box 23 within a tower 5. The light source box 23 can generate light to be passed along a separate cable 13 and through the rod lens out the tip and into the body of the vessel harvest device 2. During the procedure, light inside the body passes back through the rod lens to an expensive camera 4 attached to the rod lens proximally which processes the light and makes the image, sending that back to a similarly expensive video processor 24.

[0101] In contrast, in accordance with the present disclosure, there is no need for a separate light source box in the control tower 150 because the specialized circuit 200 has an imaging device 204 and one or more illumination sources 208 (e.g., LEDs) thereon. This combination of elements is significantly less expensive because they only need one to two simple wire(s) to deliver power to the illumination sources 208 to create light distally within a body. Additionally, the combination of the illumination sources 208 and the imaging device 204 do not require expensive components like a rod lens that necessitates transferring light generated in light boxes and transmit it to the location since light is generated by the illumination sources 208 within the dissection tip 120. Similarly, the device 100 of the present disclosure does not require an expensive rod lens to deliver the image back to a camera because the imaging device 204 is placed distally on the specialized circuit 200 within the dissectiontip 120. Having cost effective components, such as the imaging device 204 and the illumination sources 208 within a specialized circuit 200 that are coupled to cost effecting power and data lines within the cable 112 provides a compact device 100 for disposable one-time use.

[0102] In some embodiments, the dissection tip 120 can be transparent to allow for illumination through (e.g., via illumination source 204) and viewing through the tip 120 (e.g., via the imaging device 204), for example, while procedures are performed using the device 100. The dissection tip 120 in some embodiments, may be provided with any shape as long as it facilitates image capturing (e.g., by imaging device 204) therethrough, and allows for necessary control during tissue dissecting, i.e., separation. Similarly, the positioning of the specialized circuit 200 within the dissection tip 120 can be located and oriented in a manner that facilitates sufficient illumination and image capturing therethrough, and allows for necessary control during tissue dissecting.

[0103] In some embodiments, the combination of the shape and material of the dissection tip 120 in combination with the positioning of the imaging device 204 and the illumination source 208 can facilitate sufficient light to enable a capturing image data of sufficient quality for use during a procedure. The illumination source 208 can have one light source at a single location or multiple light sources at multiple locations to provide the preferred lighting for image capture by the imaging device 204. For example, the illumination source 208 can include multiple light sources (e.g., 4-12 LEDs) laid out in a distributed and symmetrical pattern to ensure even light distribution (e.g., circular ring pattern). In some embodiments, when there are multiple light sources within illumination source 208, they can be wired to be controlled as a single unit or controlled individually. Similarly, specialized circuit 200 can include the imaging device 204 and / or different types of imaging devices 204.

[0104] Continuing with FIG. 4, in some embodiments, the specialized circuit 200, and components thereon, can receive power over and transmit data over the single cable 112 coupled to the housing 102 to a processing unit(s) (e.g., video processor 154) within a control or processing tower 150. In some embodiments, the cable 112 can be directly or indirectly connected to the communication circuitry 206 to provide data communication and power to the circuit 200. For example, the cable 112 can include one or more conductive and / or optic lines for transmitting signals, such as image data, from the imaging device 204 to the tower 150 for video processing and display. Power and data can be conveyed from the cable 112 attached to the housing 102, through the elongated body 104, and to the specialized circuit 200. For example, small gauge wires coupled to the cable 112 within the housing 102 and extendingthrough the elongated body 104 between the dissection tip 120 and the housing 102 can be used to deliver power to the illumination source(s) 208 and transmit control and video signals between the imaging device 204 and an external video processor 154.

[0105] In some embodiments, the specialized circuit 200 and / or the housing 102 can optionally include a battery 210 for powering the imaging device 204, illumination source 208, and / or other components within the device 100. The battery 210 can be designed to provide the power for the specialized circuit 200 and the electrical components / devices thereon (e.g., imaging device 204, illumination devices 208, etc.). The battery 210 can be used to supplement or replace the power being supplied from the tower 150. In some embodiments, the battery 210 can be rechargeable such that power supplied through the cable 112 or another cable can provide energy to charge the battery 210 within the housing 102 of the device 100. The battery 210 can be configured to hold a charge to sufficiently power the device 100 and all of the components thereon for the duration of a medical procedure. Additionally, or alternatively, the battery 210 can be in the tower 150. In some embodiments, the system 300 (see FIG. 5A) can be powered solely, or in combination with a battery, by a traditional power cord connected to an outlet at one end and to the device 100 via the cable 112.

[0106] Referring to FIG. 5 A, an example system 300 with the specialized circuit 200 wired for power and data transmission to a location external to the device 100 is depicted. In some embodiments, the system 300 can include the device 100, as discussed with respect to FIGS. 2A and 2B, coupled to a processing tower 150 via the cable 112. The cable 112 can be configured to receive power from a power supply within the tower 150 and share data with one or more processing units within the tower 150. The tower 150 can include a combination of processing units responsible for managing the various sub-systems of the device 100. In some embodiments, the processing units can include an electrosurgical generator 152, a video processor 154, and a video monitor 156. The electrosurgical generator 152 can be configured to provide and control the power to the device 100 for performing electrosurgical tasks, for example, imaging, illumination, cauterizing, cutting, etc. The video processor 154 can be configured to receive (e.g., via cable 112), interpret, transform, and relay video signal data provided by the imaging device 204 within the device 100. The video processor 154 can also convey video signals in a displayable format to the video monitor 156 for displaying to a user. In some embodiments, the electrosurgical generator 152, the video processor 154, and the video monitor 156 can all be integrated within a single compact device.

[0107] In some embodiments, the cable 112 can include separate wires for transmitting the video signal from the wires providing electrosurgical power to the device 100. For example, at or within the tower 150, the cable 112 can be split into two separate wirings for separate connections into the electrosurgical generator 152 and the video processor 154. In other words, the combination of wires integrated into the single cable 112 can bifurcate at the tower 150 to connect to each respective processing unit, such that the experience of the user is unchanged because only one cable 112 leaves the device 100 in the sterile field 130, unlike the multiple cables required to operate the system 1 of FIG. 1. In some embodiments, the video processor 154 can also provide power to the specialized circuit 200 and illumination source 208 through the separate video signal wires integrated into the single cable 112. This configuration can be used in addition to or in place of the electrosurgical generator. Additionally, with the integrated imaging device 204 on the specialized circuit 200, there is no need for a separate rigid endoscope with its own cabling and separate light source with its own cabling.

[0108] Referring to FIG. 5B, an example system 350 in which the specialized circuit 200 is configured for wireless power and data transmission is depicted. In some embodiments, the system 350 can include the device 100, as discussed with respect to FIGS. 2A and 2B, coupled to a processing tower 150 via the cable 112. The cable 112 can be configured to receive power from an electrosurgical generator within the tower 150. The tower 150 can include a combination of processing units responsible for managing the various sub-systems of the device 100. In some embodiments, the processing units can include an electrosurgical generator 152, a video processor 154, and a video monitor 156. The electrosurgical generator 152 can be configured to provide and control the power to the device 100 for performing electrosurgical tasks, for example, cauterizing, cutting, etc. The video processor 154 can be configured to receive (e.g., via transceiver 116), interpret, transform, and relay video signal data provided by the imaging device 204 within the device 100. The video processor 154 can also convey video signals in a displayable format to the video monitor 156 for displaying to a user.

[0109] Continuing with FIG. 5B, in some embodiments, the specialized circuit 200 and / or the housing 102 can also include a wireless transceiver 212 (see FIG. 4), included within or otherwise coupled to the communication circuitry 116, for communicating data to and from external processor(s) (e.g., video processor 154). The data from the imaging device 204 can be transmitted back to the tower 150 using any combination of methods for processing and / orviewing. The signal can be transmitted either wirelessly from the wireless transceiver 212 and / or data lines within cable 112 back to a video processor 154 in the tower 150 and then out to the video monitor 156. In some embodiments, the wireless transceiver 212 can be powered by the battery 210 and / or through the cable 112 and can be configured to transmit data in any wireless format known in the art, for example, Bluetooth, Wi-Fi, RF, etc. In some embodiments, the combination of an onboard battery 210 and transceiver 212 can allow the dissection tip 120 to operate independently from the rest of the device 100, without the addition of wiring in the elongated body 104 and / or the cable 112. As would be appreciated by one skilled in the art, any combination of the illumination source(s) 208, battery 210, and transceiver 212 can be located on the specialized chip 200 or communicatively attached to the specialized chip 200 from a separate location. For example, the battery 210 and / or transceiver 212 can be located on a circuit board within the housing 102 and coupled to the specialized chip 200 through wires extending through the elongated body 104 of the device 100. In this example, any video signals from the imaging device 204 would be transmitted from the specialized chip 200 to the circuit board within the housing 102 via the internal wiring.

[0110] In some embodiments, the onboard illumination devices 208 for illumination, imaging device 204, and power for the specialized circuit 200 can be provided via the battery 210 and the image data (and other data signals) can be transmitted via a wireless transceiver 212. The video processor 154 can be configured with a corresponding transceiver for communicating with the transceiver 212 on the device 100. In some embodiments, the communication medium, frequency, etc. of the wireless data transmission can be adjusted to avoid interference with other devices in the area.

[0111] Providing independent power and lighting for the specialized circuit 200 with the optional combination of the wireless transmission of video signals enables an unchanged user experience because only one cable 112 leaves the device 100 in the sterile field 130, unlike the multiple cables required to operate the system 1 of FIG. 1. In some embodiments, a power supply can be coupled to the device 100, without the need of the cable 112 (e.g., a battery 210), to power the other components. For example, the device 100 can be adapted for use without the cable 112 by having a battery 210 with sufficient power to power the illumination devices 208, imaging device 204, and communication means (transceiver 212 or communication path 206) for exploratory procedures. In another example, the device 100 can utilize additional power from the cable 112 to power more power intensive components, such as an electrosurgical cutting tool. Additionally, with the integrated imaging device 204 on thespecialized circuit 200, there is no need for a separate rigid endoscope with its own cabling and separate light source. The battery 210 can be configured to power the illumination devices 208 at the end of the device 100 and the transmitter to deliver the video signal to the video processor 154 within the tower 150. The combination of features of the present disclosure provides a simple system which can be adapted for different procedures.

[0112] FIGS. 6A, 6B, and 6C depict example procedures provided using a vessel harvesting device in accordance with the present disclosure.

[0113] In use, the instant Al system can be used to complete a surgical procedure. For example, a doctor can perform medical testing, including imaging, of a patient to diagnose them. Once the doctor, or other medical professional, has arrived at a diagnosis the doctor can determine that surgical intervention is necessary. The doctor can create a surgical plan based on their expertise and a review of the pre-operative data including, but not limited to, the patient’s full (or partial) medical records, diagnosis information including any and all medical notes, pre-operative imaging data from CT / ultrasound / MRI data, blood work, and any other medical testing data. In addition, in some embodiments, the practitioner or doctor, can load in a planned procedure into the Al system to allow the Al to analyze the planned procedure against the diagnosis, the medical records, the imaging data, and any other diagnostic data the hospital may have for the patient. In the case that the Al finds areas of concern with the planned procedure, a generative Al can provide proposed solutions to obviate any concern with the planned procedure. For example, the generative Al can develop a revised planned procedure for the doctor’s review.

[0114] In an embodiment, a doctor can take preoperative images to begin to plan an EVH procedure using the device 100. Based on the doctor’s training and medical knowledge, the patient’s medical history and diagnosis, and the preoperative imaging, the doctor can plan a preferred route to a vessel and a desired length needed for a coronary artery bypass grafting (CABG) procedure. Traditionally, this pre-op plan may be peer reviewed. The instant Al system can additionally review the doctor’s proposed pathway to harvest a desired length of a vein for an EVH procedure. The Al may determine that the proposed pathway may be too risky, or a more efficient or safe plan may be needed, and can propose an alternative pathway. Moreover, or alternatively, the Al can determine the optimal length of the vein to be harvested. The Al revised plan can, in an embodiment, be further peer reviewed.

[0115] In some cases, in place of the doctor determining the best pre-operative plan, the Al system can generate the initial planned approach for a surgical procedure. Similar to the Alrevised plan, discussed above, the doctor can make use of generative Al to develop the surgical plan based on, for example, a medical database, the patient’s medical history and diagnosis, and the preoperative imaging for the doctor to review. Utilizing outside functions such as the patient’s ultrasound images combined with inputs for the case dynamics, the Al system can generate a pre-operative surgical plan. In some embodiments, Al can continue to collect data and ultimately drive the correct operative process based on patient habitus. If the doctor decides an alternative approach may be clinically beneficial or more feasible, the Al can be used to review the human revised plan ahead of the procedure.

[0116] Once the pre-operative plan is finalized by the doctor, the Al plan can be loaded onto the device 100, the hub 900, the computing device 700, or any network connected device for display to the surgeon during the procedure. In some embodiments, the finalized plan can be displayed concurrently over a live feed of the surgical procedure. For example, in the case of the device 100, a live feed can be provided by the imaging device 204 to any display, e.g., the headset 866, with the Al instructions overlayed on top of the live feed. In some embodiments, the doctor can use a graphical user interface to pull up various menus to display the instructions. Alternatively, the Al can analyze the live feed to provide step accurate instructions based on the location, or anatomy, shown in the live feed. For example, the Al can instruct the surgeon to slow the advance of the device 100 as the device 100 approaches the site of interest identified during the pre-operative planning phase. In an embodiment, the Al can analyze the live feed and provide directions for where to advance the device 100 in the form of arrows or other visual indicators, akin to a GPS program. These instructions can be overlayed on top of the live feed that the surgeon is viewing during the procedure to allow the surgeon to concentrate on the task at hand. In this, and the other examples, the instructions can be in the form of at least one of text, images, video or voice calls, or instructive videos to provide the clinician with the necessary instruction at the needed time.

[0117] In a use, the Al can continuously review the image feed from the imaging device 204 and should there be any deviation by the surgeon, the Al can alert the surgeon that the device or end effectors are advancing outside of the pre-operative plan. The Al can, therefor, prevent avoidable errors by the surgeon. Similarly, there may be some anatomical obstacles that were not visible via noninvasive imaging techniques. When the obstacle, or anomaly, is detected by the Al, based on the stream of data from the imaging device 204, the Al can revise the procedure on the fly to provide the surgeon with one, or more, alternative approaches to thesite of interest. This can allow the surgeon to focus on the procedure and not waste time or resources determining next steps.

[0118] In another example, the imaging device 204 can view the surgical operation itself as well. The Al can, in real time, review the data from the imaging device 204 and alert the surgeon of deviations from the pre-operative surgical plan. For example, the surgeon may be alerted that a length of a vessel is too short to complete a by-pass procedure and to harvest a longer length of the vessel - before the surgeon performs the final steps of the vessel harvesting. In another example, the Al algorithm may be able to quickly, in real-time, determine which branch of a bifurcation terminates and is not the main trunk, thereby allowing the user to make the instant operative decision to cut the correct branch and follow the correct vein. This would eliminate time and potential complications with unnecessary exploratory surgery. The Al intervention in this case can be in the form of a visual overlay on top of the live feed from the imaging device 204, can be an audio alert, a flashing light, or other alert, and combinations thereof. It is contemplated that in any case the doctor can override the Al system and take back total control of the procedure.

[0119] In an alternative use, the input data and data collected during the medical, or surgical, procedures can be used not only to enhance the Al model for developing surgical procedures, but also by providing design input for next generation medical devices. For example, the Al may detect a higher probability of injury to the patient if the length of the device exceeds a certain value. The Al can additionally note that a shorter device length, or an increased flexibility may provide for added maneuverability of the device through small conduits. In addition, or alternatively, Al may provide next generation suggestive design input requirements including, in any combination, the length of a device, timed power on and off based on tissue thickness for ligating, the effectors design, developing optimal specifications (e.g., sharpness of blades, design of distal cone end impacting tissue etc), and determining which combination of features can provide for success to produce the fastest learning curve.

[0120] All patents, patent applications, and published references cited herein are hereby incorporated by reference in their entirety. It should be emphasized that the above-described embodiments of the present disclosure are merely possible examples of implementations, merely set forth for a clear understanding of the principles of the disclosure. Many variations and modifications may be made to the above-described embodiment(s) without departing substantially from the spirit and principles of the disclosure. It will be appreciated that several of the above-disclosed and other features and functions, or alternatives thereof, may bedesirably combined into many other different systems or applications. All such modifications and variations are intended to be included herein within the scope of this disclosure, as fall within the scope of the appended claims.

[0121] As utilized herein, the terms “comprises” and “comprising” are intended to be construed as being inclusive, not exclusive. As utilized herein, the terms “example,” “example,” and “illustrative,” are intended to mean “serving as an example, instance, or illustration” and should not be construed as indicating, or not indicating, a preferred or advantageous configuration relative to other configurations. As utilized herein, the terms “about,” “generally,” and “approximately” are intended to cover variations that may existing in the upper and lower limits of the ranges of subjective or objective values, such as variations in properties, parameters, sizes, and dimensions. In one non-limiting example, the terms “about,” “generally,” and “approximately” mean at, or plus 10 percent or less, or minus 10 percent or less. In one non-limiting example, the terms “about,” “generally,” and “approximately” mean sufficiently close to be deemed by one of skill in the art in the relevant field to be included. As utilized herein, the term “substantially” refers to the complete or nearly complete extend or degree of an action, characteristic, property, state, structure, item, or result, as would be appreciated by one of skill in the art. For example, an object that is “substantially” circular would mean that the obj ect is either completely a circle to mathematically determinable limits, or nearly a circle as would be recognized or understood by one of skill in the art. The exact allowable degree of deviation from absolute completeness may in some instances depend on the specific context. However, in general, the nearness of completion will be so as to have the same overall result as if absolute and total completion were achieved or obtained. The use of “substantially” is equally applicable when utilized in a negative connotation to refer to the complete or near complete lack of an action, characteristic, property, state, structure, item, or result, as would be appreciated by one of skill in the art.

[0122] Numerous modifications and alternative embodiments of the present disclosure will be apparent to those skilled in the art in view of the foregoing description. Accordingly, this description is to be construed as illustrative only and is for the purpose of teaching those skilled in the art the best mode for carrying out the present disclosure. Details of the structure may vary substantially without departing from the spirit of the present disclosure, and exclusive use of all modifications that come within the scope of the appended claims is reserved. Within this specification embodiments have been described in a way which enables a clear and concise specification to be written, but it is intended and will be appreciated that embodiments may bevariously combined or separated without parting from the instant disclosure. It is intended that the present disclosure be limited only to the extent required by the appended claims and the applicable rules of law.

[0123] It is also to be understood that the following claims are to cover all generic and specific features of the instant disclosure described herein, and all statements of the scope of the instant disclosure which, as a matter of language, might be said to fall therebetween.

Claims

CLAIMSWhat is claimed is:

1. A method of performing an endoscopic vessel harvesting procedure, the method comprising, loading pre-operative patient data into an artificial intelligence system; developing a surgical plan for the endoscopic vessel harvesting using the artificial intelligence system; and while performing the endoscopic vessel harvesting procedure according to the surgical plan, using the artificial intelligence system to observe the endoscopic vessel harvesting procedure and altering the surgical plan based on real-time in vivo images of a site of interest.

2. The method of claim 1, wherein altering the surgical plan utilizes manual input from a practitioner.

3. The method of claim 1, wherein altering the surgical plan is performed by the artificial intelligence system.

4. The method of any of claims 1-3, wherein the pre-operative patient data includes a pre-operative image.

5. The method of claim 4, further comprising annotating the pre-operative image prior to developing the surgical plan.

6. The method of claim 5, further comprising overlaying the annotated pre-operative image onto the real-time in vivo images of the site of interest.

7. The method of any of claims 1-3, further comprising displaying at least one of a training video or an educational video on a display for reference by a practitioner.

8. A method of performing an endoscopic vessel harvesting procedure, the method comprising, advancing a unitary vessel harvesting device into a patient along a vessel, the unitary vessel harvesting device including an optical coherence tomography (OCT) sensor;observing a target vessel section, using the OCT sensor, from within the patient; and determining the quality of the vessel section based on data from the observing step.

9. A robotic endoscopic vessel harvesting system, the system comprising, a unitary endoscopic vessel harvesting (EVH) device including an end effector and an imaging device for observing a surgical site within a patient; a handle extending from the unitary EVH device including buttons or inputs which can be manipulated by a human surgeon or a robot; and a surgical robot including an end effector for interfacing with the unitary EVH device and controlling the unitary EVH device to complete an EVH procedure.

10. The robotic endoscopic vessel harvesting system of claim 9, wherein the imaging device comprises a Complementary Metal-Oxide-Semiconductor (CMOS) sensor.

11. The robotic endoscopic vessel harvesting system of claim 9, wherein the imaging device comprises a Charge Coupled Device (CCD).

12. The robotic endoscopic vessel harvesting system of claim 9, wherein the imaging device comprises an Optical Coherence Tomography (OCT) sensor.

13. The robotic endoscopic vessel harvesting system of claim 9, wherein the imaging device comprises a camera.

14. The robotic endoscopic vessel harvesting system of any of claims 9-13, wherein the imaging device is located adjacent to a dissection tip at a distal end of the unitary EVH device.

15. The robotic endoscopic vessel harvesting system of claim 14, wherein the imaging device is located within a cavity formed in the dissection tip.

16. The robotic endoscopic vessel harvesting system of claim 15, wherein the imaging device is provided on a specialized circuit board within the cavity.

17. The robotic endoscopic vessel harvesting system of claim 16, wherein the specialized circuit board further includes an illumination source.

18. The robotic endoscopic vessel harvesting system of claim 17, wherein the specialized circuit board further includes communication circuitry.

19. The robotic endoscopic vessel harvesting system of claim 14, wherein the dissection tip has a generally conical shape.

20. The robotic endoscopic vessel harvesting system of claim 14, wherein the dissection tip is at least one of radially pliable, flexible, or deformable so that the dissection tip may deflect under exertion of force applied thereto.

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