The present disclosure relates to surgical instruments and, in various arrangements, to surgical stapling and cutting instruments and staple cartridges for use therewith that are to staple and cut tissue.
In accordance with the present disclosure, a method for sequential firings of staple cartridges is disclosed. The sequential firings including a first firing that deploys first staples into a first tissue portion from a first staple cartridge and a second firing that deploys second staples into a second tissue portion from a second staple cartridge. The method comprises monitoring a parameter indicative of a tissue response associated with the first firing, assessing the tissue response based on the parameter, and adjusting an operational parameter associated with the second firing based on the tissue response during the first firing.
In accordance with the present disclosure, a method executable by a control circuit of a surgical system including an end effector and a motor powered by a power source is disclosed. The method comprises setting a power source lower threshold, transitioning the motor to an on state for a first period, the on state in which the motor drives a motion at the end effector to perform a tissue treatment event, detecting a dropped voltage potential of the power source at the end of the first period, conducting a first comparison between the dropped voltage potential and the power source lower threshold, and transitioning the motor to an off state for a second period based on the first comparison, the off state in which the motor ceases to the motion at the end effector.
Various features of the embodiments described herein, together with advantages thereof, may be understood in accordance with the following description taken in conjunction with the accompanying drawings as follows:
Corresponding reference characters indicate corresponding parts throughout the several views.
Applicant of the present application owns the following U.S. Patent Applications that were filed on even date herewith and which are each herein incorporated by reference in their respective entireties:
Applicant of the present application owns the following U.S. Patent Applications that were filed on even date herewith and which are each herein incorporated by reference in their respective entireties:
Numerous specific details are set forth to provide a thorough understanding of the overall structure, function, manufacture, and use of the embodiments as described in the specification and illustrated in the accompanying drawings. Well-known operations, components, and elements have not been described in detail so as not to obscure the embodiments described in the specification. The reader will understand that the described and illustrated embodiments are non-limiting examples, and thus it can be appreciated that the specific structural and functional details disclosed herein may be representative and illustrative. Variations and changes may be made without departing from the scope of the claims.
Various exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, the reader will readily appreciate that the various methods and devices disclosed herein can be used in numerous surgical procedures and applications including, for example, in connection with open surgical procedures. As the present Detailed Description proceeds, the reader will further appreciate that the various instruments disclosed herein can be inserted into a body in any way, such as through a natural orifice, through an incision or puncture hole formed in tissue, etc. The working portions or end effector portions of the instruments can be inserted directly into a patient's body or can be inserted through an access device that has a working frame through which the end effector and elongate shaft of a surgical instrument can be advanced.
Referring to
The surgical stapling system 5 further includes an articulation joint 30 configured to permit the end effector 20 to be rotated, or articulated, relative to the shaft 10. The end effector 20 is rotatable about an articulation axis extending through the articulation joint 30. Other embodiments are envisioned which do not include an articulation joint. In the illustrated example, cooperating articulation rods 31, 32 are configured to articulate the end effector 20 relative to the shaft 10 about an articulation joint 30. The surgical stapling system 5 further includes an articulation lock bar 33 configured to selectively prevent the articulation of the end effector 20.
The staple cartridge 22 includes a cartridge body 27 with a proximal end, a distal end, and a deck 26 extending between the proximal end and the distal end. In use, the staple cartridge 22 is positioned on a first side of the tissue to be stapled and the anvil 24 is positioned on a second side of the tissue. In accordance with the present disclosure, the anvil 24 may be moved toward the staple cartridge 22 to compress and clamp the tissue against the deck 26. Further, in accordance with the present disclosure, the staple cartridge 22 may be moved relative to the anvil 24 or, alternatively, both the staple cartridge 22 and the anvil 24 may be moved to compress and clamp the tissue.
A drive shaft 40 is movable distally to motivate a firing beam 60 to transition the end effector 20 toward the closed configuration, thereby compressing the tissue. In the illustrated example, the firing beam 60 is in the form of an I-beam that includes a first cam and a second cam configured to engage the first jaw 19 and second jaw 23, respectively. As the firing beam 60 is advanced distally, the first cam and the second cam can control the distance, or tissue gap, between the deck of the staple cartridge 22 and the anvil 24. In the illustrated example, the firing beam 60 motivates a sled 50 to deploy the staples 25 from the staple cartridge 22. In accordance with the present disclosure, a separate closure mechanism, e.g., a closure tube, can be employed to transition the end effector 20 toward the closed configuration. Also in accordance with the present disclosure, the firing beam 60 may or may not include the first and second cams. Further, in accordance with the present disclosure, the firing beam 60 may be in the form of an E-beam with first, second, and third cams. In accordance with the present disclosure, the firing beam 60 and the closure tube may cooperatively effect closure of the end effector 20. Also, in accordance with the present disclosure, the firing beam 60 may only effect deployment of the staples 25.
In accordance with the present disclosure, as illustrated in
The staples 25 removably stored in the cartridge body 27 can be deployed into the tissue. The cartridge body 27 includes staple cavities 28 defined therein wherein staples 25 are removably stored in the staple cavities 28. The staple cavities 28 are arranged in longitudinal rows. In the illustrated example, three rows of staple cavities 28 are positioned on a first side of a longitudinal slot 29 and three rows of staple cavities 28 are positioned on a second side of the longitudinal slot. Other arrangements of staple cavities 28 and staples 25 are possible.
The staples 25 are supported by staple drivers 35 in the cartridge body 27. The staple drivers 35 are movable between a first, or unfired position, and a second, or fired, position to eject the staples 25 from the staple cavities 28. The staple drivers 35 are movable between their unfired positions and their fired positions by a sled 50 that includes ramped surfaces 51 configured to slide under the staple drivers 35 and lift the staple drivers 35, and the staples 25 supported thereon, toward the anvil 24. In the illustrated example, the distal movement of the drive shaft 40 causes the sled 50 to move distally within the staple cartridge 22 to deploy the staples 25.
Referring primarily to
The sled 50 and the staple drivers 35a-d are configured to stagger staple formation of staples 25 in staple cavities 28a-d. The ramped surfaces 51 are shaped and arranged to facilitate an offset firing of the staples 25 in the staple cavities 28a-d to reduce the forces experienced by the sled 50 as the sled 50 is moved along the staple-forming distance (D). In other words, the ramped surfaces 51 can be tailored to stagger staple-formation progress in a manner that maintains the firing forces experienced by the sled 50 at, or below, a predetermined threshold (FT) (
In the example illustrated in
With continued reference to
Other factors can influence staple-formation progress and peak forces such as, for example, geometries of cam surfaces of the staple drivers, and contact locations between the ramped surfaces 51 and the staple drivers 35. In the illustrated example, contact locations 52, 53 define locations on the cam surfaces of the staple drivers 35a-d where the ramped surfaces 51 of the sled 50 first engage and lift the staple drivers 35a-d to deploy the staples 25. The staggered staple-formation progress is aided by geometries of cam surfaces of the staple drivers 35a-d and/or contact locations 52, 53 between the cam surfaces of the staple drivers 35a-d and corresponding ramped surfaces 51a-d.
In the illustrated example, the contact location 52 of the staple driver 35a is a distance (d) from a proximal staple leg 26a of a staple 25a supported by the staple driver 35a. The contact location 52 is closer to the proximal staple leg 26a than a distal staple leg 27a of the staple 25a. Furthermore, the contact location 53 of the staple driver 35b is a distance (e) from a proximal leg 26b of a distal staple 25b supported by the staple driver 35b, and a distance (f) from a distal staple leg 27c of a proximal staple 25c supported by the staple driver 35b. The distances d, e, f are different from one another, and are tailored to support the staggered staple-formation progress along the staple-forming distance (D). In the illustrated example, the distance (f) is greater than the distance (d), and the distance (d) is greater than the distance (e). Similar contact locations and/or contact surfaces geometries are implemented in the staple drivers 35c, 35d, and other staple drivers 35 along the firing stroke.
Since the forces exerted by the staple drivers 35a-d against the sled 50 vary depending on the staple formation stages of the staples 25 in the staple cavities 28a-d along the staple forming distance (D), staggering the transition of such staples through the different stages maintains the overall firing force required to move the sled 50 along the staple-forming distances (e.g. D, D1) at, or below, a predetermined threshold (FT), as illustrated in
Various methods, devices, and systems provided by the present disclosure yield useful clinical outcomes extrapolated from the positional data and the force data of the graph 150. As discussed in greater detail below, the shape of the force profiles 152, location of the highest peaks 153, and/or other characteristics of the curved line 151 can be considered along with various characteristics of the staple cartridge 22 to yield useful clinical outcomes such as, for example, detecting staple malformation and/or controlling various operational parameters associated with the surgical stapling system 5.
In accordance with the present disclosure, the control circuit 100 may be configured to communicate with a motor assembly 110 that includes a motor 113 and a motor controller, for example. The motor assembly 110 may generate rotational motion to effect a translating motion of the drive shaft 40. The control circuit 160 may generate a motor set point signal. The motor set point signal may be provided to a motor controller. The motor controller may comprise one or more circuits configured to provide a motor drive signal to a motor to drive the motor 113 as described herein. In some examples, the motor 113 may be a brushed DC electric motor. For example, the velocity of the motor 113 may be proportional to the motor drive signal. Further, in accordance with the present disclosure, the motor 113 may be a brushless DC electric motor and the motor drive signal may comprise a PWM signal provided to one or more stator windings of the motor. Also, in accordance with the present disclosure, the motor controller may be omitted, and the control circuit 100 may generate the motor drive signal directly. The position, movement, displacement, and/or translation of the drive shaft 40, the firing beam 60 and/or the sled 50 (collectively referred to herein as the “firing assembly”) can be measured/monitored by the control circuit 100 based on input from one or more sensors 120.
The motor assembly 110 may be powered by a power source 111 that in one form may comprise a removable power pack. The power pack may include a housing configured to support a plurality of batteries that may each include, for example, a Lithium Ion (“LI”) or other suitable battery, and may be connected in series, for example. The power source 111 may be replaceable and/or rechargeable. Other power sources are contemplated by the present disclosure.
The sensors 120 may include a position sensor 121 configured to sense a position, movement, displacement, and/or translation of one or more components of the firing assembly such as, for example, the drive shaft 40, the firing beam 60 and/or the sled 50. The sensor 121 may include any type of sensor that is capable of generating position data that indicate a position of the firing assembly. In some examples, the sensor 121 may include an encoder configured to provide a series of pulses to the control circuit 100 as the firing assembly translates distally and proximally. The control circuit 100 may track the pulses to determine the position, movement, displacement, and/or translation of the components of the firing assembly. Other suitable position sensors may be used, including, for example, a proximity sensor. Other types of position sensors may provide other signals indicating motion of the firing assembly. Where the motor 113 is a stepper motor, the control circuit 100 may track the position of components of the firing assembly by aggregating the number and direction of steps that the motor 113 has been instructed to execute. The sensors 120 may be located in the end effector 20 or at any other portion of the surgical stapling system 5.
Various sensors 120 may be adapted to measure various other parameters such as gap distance versus time, tissue compression versus time, and anvil strain versus time. The sensors 120 may comprise a magnetic sensor, a magnetic field sensor, a strain gauge, a pressure sensor, a force sensor, an inductive sensor such as an eddy current sensor, a resistive sensor, a capacitive sensor, an optical sensor, and/or any other suitable sensor for measuring one or more parameters of the end effector 20. The one or more sensors 120 may be sampled in real time during a clamping operation by the processor 104 of the control circuit 100. The control circuit 100 receives real-time sample measurements to provide and analyze time-based information and assess, in real time, a measured parameter such as, for example, force and/or position parameters.
The one or more sensors 120 may comprise a strain gauge, such as a micro-strain gauge, configured to measure the magnitude of the strain in the anvil 24 during a clamped condition. The strain gauge provides an electrical signal whose amplitude varies with the magnitude of the strain. The sensors 120 may comprise a pressure sensor configured to detect a pressure generated by the presence of compressed tissue between the anvil 24 and the staple cartridge 22. The sensors 120 may be configured to detect impedance of a tissue section located between the anvil 24 and the staple cartridge 22 that is indicative of the thickness and/or fullness of tissue located therebetween.
The sensors 120 may include a force sensor 122 configured to measure forces associated with firing and/or closure conditions. For example, sensor 122 can be at an interaction point between a closure tube and the anvil 24 to detect the closure forces applied by a closure tube to the anvil 24. The forces exerted on the anvil 24 can be representative of the tissue compression experienced by the tissue section captured between the anvil 24 and the staple cartridge 22. The sensor 122 can be positioned at various interaction points along the closure drive system to detect the closure forces applied to the anvil 24.
Similarly, a force sensor 122 can be at an interaction point between components of the firing assembly to detect the firing forces applied by the firing assembly to advance the firing beam 60 and the sled 50 to deploy the staples into tissue and cut the tissue. The measured forces represent a firing load experienced by the firing assembly. Alternatively, or additionally, a current sensor can be employed to measure the current drawn by the motor of the motor assembly 110. The force required to advance the firing assembly corresponds to the current drawn by the motor 113. The measured force can be converted to a digital signal and provided to the control circuit 100.
Further to the above, the surgical stapling system 5 includes a user interface 140 having an input device (e.g., a capacitive touchscreen or a keyboard) for receiving inputs from a user and an output device (e.g., a display screen) for providing outputs to a user. Outputs can include data from a query input by the user, suggestions for products or mixes of products to use in a given procedure, and/or instructions for actions to be carried out before, during, or after surgical procedures. The user interface 140 can be in communication with the control circuit 100, as illustrated in
Various algorithms, instruments, and systems are provided for non-visually detecting staple malformation. Staple malformation occurs when staples 25 deployed into the tissue grasped by the end effector 20 are not properly formed between the anvil 24 and the staple drivers 35 of the staple cartridge 22. Examples of malformed staples include staples where at least one of the staple legs is over-formed or under-formed thereby yielding a formed-staple shape that deviates from a standard B-shape. Staple malformation can lead to clinical complication including, for example, excessive bleeding and/or improper tissue healing. A clinician may not be able to visually detect an occurrence of staple malformation. Without detection, choices that caused a staple malformation can be repeated, thereby leading to additional complications.
According to the method 200, the control circuit 100 receives 201 a first signal from the position sensor 121. The first signal is indicative of a firing position along a staple-forming distance (e.g., D, D1). The control circuit 100 receives 202 a second signal from the force sensor 122. The second signal is indicative of a force to form staples 25 residing in staple cavities 28 positioned along the staple-forming distance. Further to the method 200, the control circuit 100 detects 203 malformation of the staples 25 based on the first signal and based on the second signal, as described in greater detail below. Optionally, according to the method 200, the control circuit 100 can perform a clinical action in response to detecting 203 the staple malformation. In the illustrated example, according to the clinical action, the control circuit 100 adjusts 204 a parameter of the surgical stapling system 5 based on the detection 203 of the staple malformation. The parameter can be, for example, a cartridge selection for the next staple cartridge reload to address detected 203 staple malformation.
In one exemplification, adjusting 204 a parameter of the surgical stapling system 5 can include recommending a different type of cartridge for the next staple cartridge reload to address staple formation. The control circuit 100 can be configured to receive an input indicative of a type of staple cartridge 22 that yielded the detected 203 staple malformation. The input can be in the form of a user input through the user interface 140, for example. Additionally, or alternatively, the input can be received from an identification chip on the staple cartridge 22 that is configured to communicate a staple cartridge identifier to the control circuit 100. In response to detecting 203 a staple malformation, the processor 104 may query a database 124 that stores various staple cartridge types for a staple cartridge reload different from the identified staple cartridge that yielded the staple malformation. The control circuit 100 may recommend a staple cartridge reload based on the results of the query through the user interface 140, for example. As described in greater detail below, the selection can be based on the received 201 first signal and based on the received 202 second signal. In accordance with the present disclosure, the control circuit 100 may issue an alert through the user interface 140 in response to detecting 203 staple malformation. The control circuit 100 also may prompt for a user input through the user interface 140 in response to detecting 203 the staple malformation, for example.
In the example illustrated in
As illustrated in
In accordance with the present disclosure, the staple cartridge reload may be too thick (i.e. includes staples with relatively large cross-sectional dimensions for a selected application), and a staple formation may not be properly completed. Consequently, the buckling forces may be lower than a predefined threshold, and the final forming, or crunching, forces may also deviate from a predefined range, which indicates that the final forming, or crunching, may not have occurred.
The force discrepancies at the individual staple driver level translate into force discrepancies at the combined forces level associated with all the staple drivers 35, as illustrated in
According to the method 350, the control circuit 100 then detects staple malformation based on the initial buckling force and the final staple forming force. For example, according to the method 350, the control circuit compares 361 the initial buckling force and the final forming force to each other, or to predetermined thresholds, and may detect staple malformation based on the comparison. In accordance with the present disclosure, the staple malformation may be detected 353 based on a result of a mathematical relation between the determined values of the initial buckling force and the final forming force. Further, in accordance with the present disclosure, staple malformation may be detected 353 if the initial buckling force is less than the final forming force. Also, in accordance with the present disclosure, staple malformation may be detected 353 based on a ratio between the final forming force and the initial buckling. Further, in accordance with the present disclosure, staple malformation may be detected 353 if the initial buckling force is outside a predefined threshold range, and/or if a ratio between the final forming force and the initial buckling force is outside a predefined threshold.
It will be appreciated that the first and second predetermined positions along the staple forming distance (D) depend on various characteristics of the staple cartridge 22 such as, for example, the shape of the cam surfaces of the staple drivers, the shape of the ramped surfaces of the sled, and/or the spacing of the staple cavities. Accordingly, the control circuit 100 can be configured to identify the first and second predetermined positions based on a cartridge identifier that can be received by the control circuit 100 through the user interface 140, or via a communication from an identification chip of the staple cartridge 22, for example. In accordance with the present disclosure, the first and second predetermined positions can be identified by the processor 104 in a look-up table or a database 124 based on the received cartridge identifier.
After identifying the first and second predetermined positions, the control circuit 100 can receive position data from the position sensor 121 to determine the position of the sled 50 and detect the sled 350 reaching the first determined position and the second predetermined position. The control circuit 100 can receive force measurement data from the force sensor 122 to determine the initial buckling force at the first predetermined position, and the final forming, or crunching, force at the second predetermined position. Accordingly, the initial buckling force and the final forming, or crunching, force can be determined by the control circuit 100 based on input from both the position sensor 121 and the force sensor 122.
As previously described with reference to
With reference to
Various characteristics of the tissue grasped between the staple cartridge 22 and the anvil 24 can influence the FTF. For example, tissue thickness and/or tissue type can influence FTF. An inexperienced clinician may operate the end effector 25 to grasp an excessively thick tissue bite. The increased thickness and/or stiffness of the tissue can yield an increased resistance to the advancement of the drive shaft 40 by the motor assembly 110 during a tissue treatment event, which increases the FTF. The control circuit 100 may utilize a predetermined parameter threshold to maintain the FTF within a safe range. The control circuit 100 may pause the tissue treatment event if the parameter reaches, or exceeds, the predetermined parameter threshold. As discussed in greater detail below, the parameter is indicative of the tissue response to the tissue treatment event, and can be measured by one or more of the sensors 120.
In accordance with the present disclosure, pausing the tissue treatment event can give the tissue time to relax, and time for fluid within the tissue to egress to parts of the tissue not grasped by the end effector 20, which reduces the tissue resistance, and ultimately reduces the FTF when the tissue treatment event is resumed. In accordance with the present disclosure, however, where the tissue resistance may be more due to the tissue stiffness than the tissue fluid build-up, the tissue response during a pause of the tissue treatment even can be less prominent. Stiffness of tissue change based on the tissue type and patient specific issues. Understanding how the tissue responds to a pause in the tissue treatment event informs future pauses and/or generally informs changes to aspects of the tissue treatment event such as, for example, the motion of the drive shaft 40 and/or current supplied to the motor assembly 110, for example.
The present disclosure further provides methods, devices, and systems for predictively and autonomously implementing a future pause to the tissue treatment event based on the tissue response during the threshold-based pause. In accordance with the present disclosure, the future pauses may be based on the tissue response during a previous threshold-based pause interval, but are independent of the FTF threshold. In other words, the future pauses are not triggered by reaching, or exceeding, an FTF threshold. Rather, they are predictively and autonomously implemented based on the tissue response to one or more previous pauses. Further, in accordance with the present disclosure, a future pause may be implemented based on one or more previous non-threshold-based pauses, one or more previous threshold-based pauses or a combination of one or more threshold-based pauses, and one or more non-threshold-based pauses.
In accordance with the present disclosure of the method 400, the previous pause may be a threshold-based pause and the future pause is a non-threshold based pause. Also, in accordance with the present disclosure of the method 400, the previous pause may be a threshold-based pause and the future pause is also a threshold-based pause. Further, in accordance with the present disclosure of the method 400, the previous pause is a non-threshold-based pause and the future pause is a threshold-based pause. Further, in accordance with the present disclosure of the method 400, the previous pause is a non-threshold-based pause and the future pause is a non-threshold-based pause.
In accordance with the present disclosure, the characteristic of the future pause determined 403 by the method 400 can be a starting point of the future pause. Further, in accordance with the present disclosure, the starting point can be a selected position along the firing stroke. Also, in accordance with the present disclosure, the starting point can be a selected time during the tissue treatment event. Further, in accordance with the present disclosure, the characteristic of the future pause determined 403 by the method 400 can be a duration (D) of the future pause. Also, in accordance with the present disclosure, the duration can be a time-based duration. Further, in accordance with the present disclosure, the duration (D) may be based on a tissue response. For example, a pause can be maintained until a parameter (e.g. force exerted against the drive shaft 40) associated with the tissue response reaches a predetermined value.
In accordance with the present disclosure, the characteristic of the future pause determined 403 by the method 400 can be a frequency of repetition of the future pause. Further, in accordance with the present disclosure, the characteristic of the future pause determined 403 by the control circuit 100 according to the method 400 can be any combination selected from a group that includes the starting point, the duration, and/or the frequency parameters. Other characteristics of the future pause can also be determined 403 by the control circuit 100.
In accordance with the present disclosure, the parameter can be indicative of the tissue resistance exerted against the drive shaft 40 during the threshold-based pause. Also, in accordance with the present disclosure, the parameter can be measured by one or more of the sensors 120. Further, in accordance with the present disclosure, the parameter can be a force exerted by the tissue against the drive shaft 40 during the threshold-based pause, which can be measured by a force sensor 122, for example.
In accordance with the present disclosure, the control circuit may pause 407 the tissue treatment event by disconnecting power from the power source 111 to the motor assembly 110. Alternatively, the control circuit may pause 407 the tissue treatment event by reducing power supplied to the motor assembly 110. The reduced power can be a power level sufficient to maintain the drive shaft 40 at a current position, but not cause an additional advancement of the drive shaft 40 beyond the current position. The control circuit 100 can be configured to receive positional data from a position sensor 121, for example, indicative of the position of the drive shaft 40, and gradually reduce the current supplied to the motor 113 of the motor assembly 110 until the positional data indicate that no additional change is detected in the position of the drive shaft 40, for example.
Referring to
With reference now to
During an initial part of the firing stroke, prior to pausing, the force curves 501, 601 are similar to the force curves 502, 602, respectively. In the illustrated examples, corresponding standard deviations determined during the initial part 505 of the firing stroke are identical, or virtually identical. In accordance with the present disclosure, the standard deviations may be calculated based on a force data set along a portion of the firing stroke. Further, in accordance with the present disclosure, the standard deviations may be calculated based on a force data set that includes force peak and valley portions. Tight standard deviations are indicative of a smooth FTF during a tissue treatment event.
In the illustrated example, a first pause (pause A) of the tissue treatment event is implemented by the control circuit 100 based on reaching, or exceeding, a predetermined force threshold (FT). Tissue grasped by the end effector 20 is allowed to relax during the Pause A, which reduces the force exerted against the drive shaft 40, as evident from comparing the force curves 601, 602. In the illustrated example, pause A is implemented for a time period (t1). The force (F) exerted against the drive shaft 40 by the tissue gradually decreases by an amount (ΔFa) during the time period (t1). Upon completion of the pause A, the control circuit 100 resumes the tissue treatment event.
As previously discussed in the present disclosure, a change in one or more parameters during a pause can be informative of the tissue response during a tissue treatment event. In the illustrated example, the change in the force (F) exerted against the drive shaft 40 by the amount (ΔFa) can indicate characteristics of the tissue response that can be useful in implementing future pauses of the tissue treatment event.
In the illustrated example, the control circuit 100 can determine the amount of change in force (ΔFa), and utilize this value to determine one or more characteristics of one or more future pauses such as, for example, pause B and/or pause C. Additionally, or alternatively, the control circuit 100 can determine a rate of change of the force (F) during that time period (t1), and utilize this value to determine one or more characteristics of one or more of future pauses such as, for example, pause B and/or pause C.
In accordance with the present disclosure, the control circuit 100 may determine one or more characteristics of one or more of future pauses such as, for example, pause B and/or pause C based on the shape of the force curve 601 during a previous pause such as, for example, pause A. For example, a slope of the curve force during pause A can inform decisions regarding future pauses B, C. Also, in accordance with the present disclosure, a steep slope can indicate a greater thickness and/or flexibility of the tissue grasped by the end effector 20. In contrast, a shallow slope can indicate a lesser thickness and/or flexibility of the tissue. Further, in accordance with the present disclosure, the slope value may be directly proportional to the thickness and/or flexibility of the grasped tissue.
With reference to
Referring back to
In any event, certain characteristics of the pause B are determined based on the pause A. In the illustrated example, a duration (D) of the pause B is determined based on the amount of change in force (ΔFa) detected during the pause A. As described above, the control circuit 100 may determine the amount of change in force (ΔFa) based on input from one or more force sensors 122, for example, and then query the database 550 for values of a duration (D) of the pause B corresponding to the amount of change in force (ΔFa).
Further to the above, the control circuit 100 implements a third pause (pause C). In the illustrated example, a starting point(S) of the pause B, and a duration (D), of the pause C is selected from the database 550 based on an amount of change in force (ΔFa) detected during the pause A and/or the amount of change in force (ΔFb) detected during the pause B, for example.
In accordance with the present disclosure, the control circuit 100 may assign weights to changes to a parameter associated with multiple previous pauses based on where and/or when the previous pauses were implemented along the firing stroke. The assigned weights may then contribute in determining a characteristic of the future pause. The weights can, for example, be assigned based on where and/or when the previous pauses were implemented along the firing stroke. In the illustrated example, a first weight is assigned for the amount of change in force (ΔFa) and a second weight is assigned to the amount of change in force (ΔFb). In accordance with the present disclosure, the weight value may depend on the temporal relation between a previous pause and a future pause.
Graph 700 depicts firing force on the x-axis and time on the y-axis. In the illustrated example, a pause to the tissue treatment event is implemented at t1 based on the behavior of firing force curve 701 during a time period a at an initial portion of the tissue treatment event. The pause at t1 prevents the firing force from reaching force threshold (FTHT1). Dashed curve 703 outlines a behavior of the firing force without the pause at t1.
In the example illustrated in
Another pause to the tissue treatment event is implemented at t2 based on the behavior of firing force curve 701 during and/or after the pause at t1, and/or the behavior of the firing force curve 701 at a time period β at an intermediate portion of the tissue treatment event. In the illustrated example, the firing force curve 702, while not reaching the force threshold (FTHT1), due to the pause started at t1, still exceeded a force threshold (FTHT2), which informs an effectiveness of the pause at t1. The behavior of the firing force during the pause is a factor that is considered in implementing the pause at t2.
In the illustrated example, the pause at t2 is implemented based on the behavior of the firing force during the time period β, which is determined by calculating the area under the firing force curve 701 during the time period β, and is further based on the behavior of the firing force after the pause at t1. Dashed curve 704 outlines a behavior of the firing force without the pause at t2, where the firing force would have exceeded a force threshold (FTHT3).
In accordance with the present disclosure, the time periods α, β can be predetermined time periods, selected by an algorithm implementing the pauses of the tissue treatment event. The selection can be made based on one or more factors including a staple cartridge characteristic (e.g., size, color, type, length, staple height, staple diameter) and/or tissue characteristics (e.g., thickness, density, impedance), for example. Further, in accordance with the present disclosure, the time periods α, β can be adaptively determined based on the behavior of the firing force during the tissue treatment event, or previous tissue treatment events.
During a surgical stapling procedure, a clinician may operate a surgical stapling system 5 to sequentially fire multiple staple cartridges along a selected tissue resection line to achieve a clinical outcome. For example, in a stomach resection procedure, the clinician may sequentially fire staple cartridges of different characteristics (e.g., size, color, type, length, staple height, staple diameter, staple size) along a selected tissue resection line to remove a portion of the stomach. The staple cartridges can be fired along the tissue resection line in an end-to-end arrangement.
The clinician may examine the tissue to be resected using any suitable imaging technique such as, for example, x-ray, registered magnetic resonance imaging (MRI), and/or computerized tomography (CT) scan. The clinician may then select a suitable tissue resection line, and staple cartridges for sequential firing along the selected tissue resection line. Visual examination, however, has its limitations, and a tissue response to stapling can vary depending on many factors including, for example, patient age, tissue health, and/or tissue type. Moreover, tissue thickness and/or stiffness may vary along the selected tissue resection line, resulting in unexpected tissue responses.
Various methods, devices, and systems are provided for adaptively adjusting operational parameters of the surgical stapling system 5 during a staple cartridge firing based on a tissue response in an earlier phase/zone of the staple cartridge firing. Moreover, various methods, devices, and systems are provided for adaptively adjusting operational parameters of the surgical stapling system 5 during a staple cartridge firing based on a tissue response in one or more previous staple cartridge firings in a surgical procedure involving multiple sequential firings.
In accordance with the present disclosure, the processor 104 may execute various program instructions, which can be stored in a memory circuit such as the memory circuit 106, to implement various algorithms associated with firing a staple cartridge by the surgical stapling system 5. Various aspects of such algorithms, e.g., thresholds, limits, triggers, conditions, pauses, wait time, are adjusted based on information learned from a tissue response in an earlier phase/zone of the staple cartridge firing, and/or based on a tissue response in one or more previous staple cartridge firings in a surgical procedure involving multiple sequential firings, as described in more detail below.
One or more firings of staple cartridges can precede the first firing of the first staple cartridge along the tissue resection line. Additionally, the first staple cartridge can be the same as, or different than, the second staple cartridge in color, size, shape, staple height, staple diameter, and/or any other suitable feature.
With reference now to
In accordance with the present disclosure, the monitored 706 parameter can be a tissue resistance to the advancement of the firing assembly during the first firing. The control circuit 100 can monitor 706 the tissue resistance using one or more of the sensors 120. Additionally, one or more force sensors 122 can measure the force exerted against the drive shaft 40, the sled 50, and/or the firing beam 60, which represents the tissue response during the first firing.
Alternatively, or additionally, a current sensor can be employed together with the control circuit 100 to assess the tissue response during the first firing. In accordance with the present disclosure, the control circuit 100 can be coupled to a current sensor to receive a signal indicative of the current supplied by the power source 111 to the motor of motor assembly 110 during the first firing. A change in the current draw of the motor is representative of a change in the tissue resistance to the advancement of the firing assembly, which is representative of the tissue response during the first firing.
Alternatively, or additionally, the tissue response can be assessed based on a secondary input such as a temperature sensor that measures a temperature of the motor, for example. If the temperature of the motor is higher than a predetermined threshold, the increase in the temperature of the motor is indicative of an overload, or stall, condition.
Further to the above, according to the method 709, the control circuit 100 assesses 707 the tissue response based on the monitored 706 parameter. In accordance with the present disclosure, the control circuit 100 may assess 707 the tissue response by comparing measured values of the monitored 706 parameter to a predetermined threshold. The processor 104 may determine the values based on input from the sensors 120, retrieve the predetermined threshold, and compare the values to the retrieved predetermined threshold. The values can be determined by the control circuit 100 by sampling sensor readings of the parameter.
In accordance with the present disclosure, the predetermined threshold of the parameter can be selected by the processor 104 based on the cartridge type of the first staple cartridge. Different predetermined thresholds can be preset for different staple cartridge types. The control circuit 100 can retrieve an identifier of the first staple cartridge, and query a database stored in the memory 106, for example, for the predetermined threshold based on the retrieved identifier. The database may include a list of identifiers and corresponding predetermined thresholds. Also, in accordance with the present disclosure, the control circuit 100 may communicate wirelessly, or through a wired connection, with a cartridge chip, or memory unit, within the first staple cartridge to retrieve the identifier associated with the first staple cartridge. The identifier may be provided by a clinician through the user interface 140.
Further to the above, the control circuit 100 may store an outcome of the comparison, indicative of the tissue response, for use in the second firing. A tissue response that violates one or more predetermined thresholds of the first staple cartridge can inform the selection of the second staple cartridge. Accordingly, adjusting 703 the operational parameter associated with the second firing may include the control circuit 100 selecting, or at least recommending, a second staple cartridge with different predetermined thresholds than the first staple cartridge, where the tissue response during the first firing indicates a violation of the one or more predetermined of the first staple cartridge.
After completion of the first firing, the control circuit 100 may select, or at least recommend, a staple cartridge type for the second firing based on the stored outcome of the comparison. In accordance with the present disclosure, the control circuit 100 can detect an identifier of the second staple cartridge in a similar manner to that described in connection with the first staple cartridge, and prompt the clinician, for example through the user interface 140, to change to a different staple cartridge type based on the outcome of the comparison during the first firing.
In accordance with the present disclosure, the surgical system 5 can be used in a sleeve gastrectomy, for example, involving multiple sequential firings along a planned tissue resection line. After the first firing on the sleeve using a clinician chosen staple cartridge, the control circuit 100 may determine, based on the tissue response during the first firing, that the tissue thickness is greater than that recommended for the staple cartridge utilized in the first firing. The control circuit 100 may then prompt the clinician through the user interface 140 as to the higher than expected tissue thickness and asks if the clinician wishes to adjust the current thresholds, for example, to accommodate increase during a second firing, change to a cartridge that is more appropriate to the tissue thickness, or to adapt the speed and pauses within the surgical system 5 to compensate for the differences. The control circuit 100 can provide the clinician an interrelationship between firing speeds, pauses, and loads associated with a selected, or recommended, staple cartridge, allowing the clinician to adjust the balance of the such interactive thresholds.
Graph 710 illustrates upper (Th1) and lower (Th2) predetermined thresholds associated with the first staple cartridge, and upper (Th3) and lower (Th4) predetermined thresholds associated with the second staple cartridge. Curve line 711 illustrates a tissue response in accordance with the upper (Th1) and lower (Th2) predetermined thresholds associated with a first staple cartridge. Since a suitable tissue response is detected, the control circuit 100 selects, or at least recommends, the first staple cartridge type for the subsequent firing.
In contrast, curve line 712 illustrates a tissue response that violates the upper (Th1) predetermined threshold associated with the first staple cartridge during the first firing. In response, the control circuit 100 selects, or at least recommends, a different staple cartridge type for the second firing, with higher upper (Th3) and lower (Th4) predetermined thresholds. Alternatively, if a clinician elects to use the first staple cartridge type in the second firing, the control circuit 100 overrides the upper (Th1) predetermined threshold, and adjusts 703 other operational parameters of the surgical system 5 such as, for example, motor output, clamp time, and/or firing pauses during the second firing to maintain and/or return the second firing to a level below the upper (Th1) predetermined threshold.
In accordance with the present disclosure, the surgical stapling system 5 may execute the method 709 in a gastric bypass surgery that involves multiple firings along a planned transection line across the stomach. Some clinicians tend to use different staple cartridge types, e.g. different sizes such as a thick reload followed by a thin reload, along the tissue resection line. Others tend to use the same staple cartridge type, e.g. a specific size such as a thick reload or a thin reload, along the tissue resection line. For the latter, the control circuit 100 may execute the method 709 by adjusting 703 a tissue compression parameter and/or a firing parameter based on the tissue response to the thick reload or the thin reload. For example, if the tissue response in a previous firing indicates that the utilized staple cartridge size is too thick for the tissue, the control circuit 100 increases tissue compression time and/or decreases firing speed. In contrast, if the tissue response in a previous firing indicates that the utilized staple cartridge size is too thin for the tissue, the control circuit 100 may decrease tissue compression time and/or increases firing speed.
In accordance with the present disclosure, the control circuit 100 may monitor the same parameter, or parameters, during the method 709 and the method 750. The control circuit 100 may monitor a first parameter during the method 709, and a second parameter, different than the first parameter, in the method 750. The methods 709, 750 can be executed separately or in combination.
As described above, the tissue response depends, at least in part, on characteristics of the tissue such as, for example, tissue thickness and/or stiffness, which can gradually change along a tissue resection line. Accordingly, a change in the tissue response between a proximal segment and a distal segment of a firing along a tissue resection line can be predictive of the tissue response, and characteristics, in a subsequent firing along the tissue resection line.
In the illustrated example, according to the method 750, the control circuit 100 assesses 751 the tissue response at a proximal segment of the first firing, assesses 752 the tissue response at a distal segment of the first firing, and adjusts 753 the operational parameter associated with the second firing based on a change in the tissue response between the proximal and distal segments of the first firing.
In accordance with the present disclosure, the change in the tissue response can be assessed based on values of the parameter detected at the different segments of the first firing. A first value of the parameter, which can be determined at the proximal segment, may be compared to a first predetermined threshold to determine a first delta between the first value and the first predetermined threshold. Similarly, a second value of the parameter, which can be determined at the distal segment, may be compared to a second predetermined threshold to determine a second delta between the second value and the second predetermined threshold. In accordance with the present disclosure, the change in the tissue response can be determined based on the first delta and the second delta. The change in the tissue response can be determined based on a mathematical relation between the first delta and the second delta such as, for example, a ratio of the first delta to the second delta.
Further to the above, the first and second predetermined thresholds can be selected based on the firing positions of one or more components of the firing assembly, during the advancement of the firing assembly along the firing stroke, where the first value and the second value, respectively, are measured. A database (e.g., database 124
In either event, the processor 104 employs the database, table, and/or equation to determine the first and second predetermined thresholds of the parameter based on the firing positions. One or more position sensors 121 can provide signals to the processor 104, which may be utilized by the processor 104 to determine the firing positions. In accordance with the present disclosure, the firing positions can be represented as distances from a starting position of the firing assembly. Alternatively, or additionally, the firing positions can be represented as ranges indicative of discrete portions of the firing such as, for example, a proximal portion, an intermediate portion, and/or a distal portion.
In accordance with the present disclosure, the first tissue response at the proximal segment and the second tissue response at the distal segment may indicate a change in tissue stiffness between the proximal segment and the distal segment of the first firing. Said another way, the change in the tissue response between the proximal segment and the distal segment may indicate a change in the tissue stiffness in a proximal-to-distal direction. The control circuit 100 can then adjust 753 one or more operational parameters of the surgical system 5 to address a predicted tissue stiffness in the second firing learned from the change in the tissue response between the proximal segment and the distal segment of the first firing.
If the predicted tissue stiffness is higher than expected, the control circuit 100 can adjust a firing algorithm of the second firing to reduce the firing speed, for example by introducing and/or adjusting one or more pauses during the second firing. Additionally, or alternatively, the control circuit 100 may select, or at least recommend, a different staple cartridge, one more suited for the predicted tissue stiffness. Additionally, or alternatively, the control circuit 100 may adjust or remove one or more predetermined thresholds, and/or changes a clamp, or tissue compression, time associated with to the second firing.
Conversely, if the predicted tissue stiffness is lower than expected, i.e., tissue becomes softer, the control circuit 100 can adjust a firing algorithm of the second firing to increase the firing speed, and/or remove and/or adjust one or more planned pauses during the second firing. Additionally, or alternatively, the control circuit 100 may select, or at least recommend, a different staple cartridge, one more suited for the predicted tissue stiffness. Additionally, or alternatively, the control circuit 100 may adjust or remove one or more predetermined thresholds, and/or changes a clamp, or tissue compression, time associated with the second firing.
Like the method 750, the method 760 includes assessing the tissue response at multiple segments of the first firing. In the illustrated example, in accordance with the method 760, the control circuit 100 assesses 761 a first tissue response at a first segment of the first firing and assesses 762 a second tissue response at a segment of the first firing. The details of assessing a tissue response during a firing are similar to those described in connection with the methods 709, 750, and are not repeated herein for brevity.
According to the method 760, the control circuit 100 adjusts 763 a firing algorithm a first adjustment based on the first tissue response, which constitutes a first intervention. According to the method 760, the control circuit 100 determines 762 whether the first tissue response at a first segment of the firing is not acceptable, e.g., the value of the monitored parameter indicative of the tissue response is lower or higher than a predetermined threshold, the control circuit 100 adjusts 763 a firing algorithm a first adjustment based on the first value or based on the delta between the first value and the predetermined threshold. In accordance with the present disclosure, adjusting 763 the firing algorithm may include changing a motor output by, for example, changing a motor voltage parameter such as, for example, pulse-width-modulation (PWM) and/or amplitude.
Following the first adjustment 763, the control circuit 100 continues to assess 764 the tissue response at a second segment of the first firing, distal to the first segment, to determine the efficacy of the first intervention. According to the method 760, the control circuit 100 determines 765 whether a tissue response at the second segment of the firing is also not acceptable, e.g., the value of the monitored parameter indicative of the tissue response is lower or higher than a predetermined threshold, the control circuit 100 further adjusts 766 the firing algorithm a second adjustment, in a learned response, based on the assessed 764 tissue response, and the first adjustment. The second adjustment can, for example, a second adjustment to the motor output by, for example, changing a motor voltage parameter such as, for example, pulse-width-modulation (PWM) and/or amplitude.
Accordingly, the method 750 takes an adaptive approach in selecting the second adjustment, by taking into consideration the first adjustment. Said another way, the second adjustment is based on the tissue response to the first adjustment. For example, if the first adjustment was not effective in addressing the trigger of the first threshold, as can be determined based on the second value, the second delta, or measurements of other parameters relevant to the first firing, the control circuit 100 responds by selecting a more suitable second adjustment. In accordance with the present disclosure, a table, database, and/or equation can be employed to select the second adjustment based on the second value, or the second delta, and the first adjustments.
Further to the above, the learned or adaptive behavior of the control circuit 100 can be implemented automatically or can be conditioned upon a clinician approval receivable through the user interface 140. In accordance with the present disclosure, the control circuit 100 may calculate the second adjustment based on the tissue response and the first adjustment, and prompt the clinician for an approval to implement the second adjustment. If the approval is entered through the user interface 140, the control circuit 100 may then execute the second adjustment. The clinician may be further permitted to modify the second adjustment.
In accordance with the present disclosure, firing algorithm adjustments, in accordance with one more methods (e.g., methods 709, 750, 760) of the present disclosure, can include adjustments to predetermined thresholds. The learned behavior in a first firing can lead to one or more adjustments to one or more predetermined thresholds in a later segment of the first firing, and/or in a second firing that follows the first firing. Such thresholds include global thresholds including, for example, a global force-to-fire threshold that, if reached, the control circuit 100 deactivates the surgical system to avoid potential damage to the surgical system 5.
Such thresholds also include a device-specific force-to-fire threshold that is based on a particular surgical system 5. During final testing of the surgical system 5, where internal loads and frictions are documented, force-to-fire threshold is calculated as a combination of the actual force-to-fire threshold with shaft loads added. Such thresholds also include a cartridge-specific force-to-fire threshold, which are based on various staple cartridge characteristics such as, for example, cartridge size.
Referring still to
In the illustrated example, the control circuit 100 introduces additional variations, in the form of interrogation pulses (a-k), to improve the adaptive behavior of the surgical system 5. During firing, the motor voltage is typically held constant while being pulse-width modulated for the purpose of delivering power to the motor of the motor assembly 110. The control circuit 100 introduces additional small variations into the motor voltage (dithering) to better understand the response of the measured aspects (motor current/speed/knife location), and the impact on the surgical system 5.
In accordance with the present disclosure, the control circuit 100 may introduce small spikes, e.g., interrogation pulses (a-k, at the end of each PWM cycle (e.g., at t1-t2), which are too small to have a clinical impact on RMS current, but rather create small peak responses in current (e.g., at t3). As illustrated in
In contrast, if the current peak response is equal to, or higher than, the predetermined threshold, the control circuit 100 may adjust an operational parameter of the surgical system 5 such as, for example, the next PWM cycle pulse to be shorter in time (e.g., A′, I′). Such adjustment decreases current draw by the motor assembly 110, thereby reducing velocity and/or force applied to the firing assembly, which effectively returns the tissue response to an acceptable value.
In accordance with the present disclosure, the control circuit 100 may begin the firing at 50% duty cycle on the motor assembly 110 to ensure the mechanical integrity of the components of the firing assembly, and/or to test a mechanical cartridge lockout, for example. During this initial segment, the force-to-fire can be monitored, and an initial peak level of the force-to-fire can be determined based on inputs from the force sensor 122, for example, to the control circuit 100. This initial peak can be used to set initial thresholds for the other segments of the firing stroke, in accordance with the method 760, for example.
In accordance with the present disclosure, if the control circuit 100 detects a thick, or dense, tissue based on the initial peak is designated “high,” based on a comparison to an initial predetermined threshold, for example, this can be an indication that the tissue is thick or dense. In response, the control circuit 100 may increase predetermined thresholds for a second segment of the firing stroke. If, however, the initial force reading is low, the control circuit 100 may reduce predetermined thresholds for the second segment of the firing stroke. The increase or decrease can be based on the initial peak, or the delta between the initial peak and the initial predetermined threshold.
As the firing stroke transitions to a third segment, e.g. midpoint to end of cutline, the predetermined thresholds of the third segments can be adjusted based on the initial peak, based on the predetermined thresholds of the second segment, and/or based on the tissue response in the second segment. In accordance with the present disclosure, the thresholds of the third segment can be set higher than the previous segment to ensure the completion of the firing,
Further to the above, upon completion of the firing stroke, the firing assembly is returned by the motor assembly 110 to a home position. The control circuit 100 may remove, or adjust the predetermined thresholds to a maximum, during the return of the firing assembly.
A motor assembly 2009 includes one or more motors, driven by motor drivers. The motor assembly 2009 operably couples to a drive assembly 2011 to drive, or effect, one or more motions at an end effector 2010. The drive assembly 2011 may include any number of components suitable for transmitting motion to the end effector 2010 such as, for example, one or more gears, gear sets, gear transmissions with one or multiple selectable gears, linkages, bars, tubes, and/or cables, for example.
One or more of sensors 2008, for example, provide real-time feedback to the processor 2006 about one or more operational parameters monitored during a surgical procedure being performed by the surgical system 2002. The operational parameters can be associated with a user performing the surgical procedure, a tissue being treated, and/or one or more components of the surgical system 2002, for example. The sensors 2008 may comprise any suitable sensor, such as, for example, a magnetic sensor, such as a Hall effect sensor, a strain gauge, an encoder, a position sensor, a force sensor, a pressure sensor, an inductive sensor, such as an eddy current sensor, a resistive sensor, a capacitive sensor, an optical sensor, and/or any other suitable sensor.
Further to the above, in various arrangements, the sensors 2008 may comprise any suitable sensor for detecting one or more conditions at the end effector 2010 including, without limitation, a tissue thickness sensor such as a Hall Effect Sensor or a reed switch sensor, an optical sensor, a magneto-inductive sensor, a force sensor, a pressure sensor, a piezo-resistive film sensor, an ultrasonic sensor, an eddy current sensor, an accelerometer, a pulse oximetry sensor, a temperature sensor, a sensor configured to detect an electrical characteristic of a tissue path (such as capacitance or resistance), or any combination thereof. As another example, and without limitation, the sensors 2008 may include one or more sensors located at, or about, an articulation joint extending proximally from the end effector 2010. Such sensors may include, for example, a potentiometer, a capacitive sensor (slide potentiometer), piezo-resistive film sensor, a pressure sensor, a pressure sensor, or any other suitable sensor type. In some arrangements, the sensor 2008 may comprise a plurality of sensors located in multiple locations in the end effector 2010.
In accordance with the present disclosure, the surgical system 2002 may include a feedback system 2013 which may include one or more devices for providing a sensory feedback to a user. Such devices may comprise, for example, visual feedback devices (e.g., an LCD display screen, a touch screen, LED indicators), audio feedback devices (e.g., a speaker, a buzzer) or tactile feedback devices (e.g., haptic actuators).
The microcontroller 2005 may be programmed to perform various functions such as precise control over the speed and position of the drive assembly 2011. In accordance with the present disclosure, the microcontroller 2005 may be any single-core or multicore processor such as those known under the trade name ARM Cortex by Texas Instruments. Additionally, the main microcontroller 2005 may be an LM4F230H5QR ARM Cortex-M4F Processor Core, available from Texas Instruments, for example, comprising an on-chip memory of 256 KB single-cycle flash memory, or other non-volatile memory, up to 40 MHz, a prefetch buffer to improve performance above 40 MHZ, a 32 KB single-cycle SRAM, and internal ROM loaded with StellarisWare® software, a 2 KB EEPROM, one or more PWM modules, one or more QEI analogs, and/or one or more 12-bit ADCs with 12 analog input channels, details of which are available for the product datasheet.
The microcontroller 2005 may be configured to compute a response in the software of the microcontroller 2005. The computed response is compared to a measured response of the actual system to obtain an “observed” response, which is used for actual feedback decisions. The observed response is a favorable, tuned value that balances the smooth, continuous nature of the simulated response with the measured response, which can detect outside influences on the system.
The motor assembly 2009 includes one or more electric motors and one or more motor drivers. The electric motors can be in the form of a brushed direct current (DC) motor with a gearbox and mechanical links to the drive assembly 2011. In accordance with the present disclosure, a motor driver may be an A3941 available from Allegro Microsystems, Inc.
In accordance with the present disclosure, the motor assembly 2009 may include a brushed DC driving motor having a maximum rotational speed of approximately 25,000 RPM. The motor assembly 2009 may include a brushless motor, a synchronous motor, a stepper motor, or any other suitable electric motor. The motor driver may comprise an H-bridge driver comprising field-effect transistors (FETs), for example.
The motor assembly 2009 can be powered by a power source 2012. In accordance with the present disclosure, the power source 2012 may include one or more batteries which may include a number of battery cells connected in series that can be used as the power source to power the motor assembly 2009. Further, in accordance with the present disclosure, the battery cells of the power assembly may be replaceable and/or rechargeable. Additionally, the battery cells may comprise lithium-ion batteries which can be couplable to and separable from the power assembly.
Further to the above, the end effector 2010 includes a first jaw 2001 and a second jaw 2003. At least one of the first jaw 2001 and the second jaw 2003 is rotatable relative to the other during a closure motion that transitions the end effector 2010 from an open configuration toward a closed configuration. In accordance with the present disclosure, a cartridge jaw can be movable relative to a fixed anvil jaw to a clamped position. Additionally, an anvil jaw can be movable relative to a fixed cartridge jaw to a clamped position. Furthermore, an anvil jaw and a cartridge jaw may both be movable relative to each other to a clamped position. The closure motion may cause the jaws 2001, 2003 to grasp tissue therebetween. In accordance with the present disclosure, sensors, such as, for example, a strain gauge or a micro-strain gauge, can be configured to measure one or more parameters of the end effector 2010, such as, for example, the amplitude of the strain exerted on the one or both of the jaws 2001, 2003 during a closure motion, which can be indicative of the closure forces applied to the jaws 2001, 2003. The measured strain can be converted to a digital signal and provided to the processor 2006, for example. Alternatively, additionally, sensors such as, for example, a load sensor, can measure a closure force and/or a firing force applied to the jaws 2001, 2003.
In accordance with the present disclosure, a current sensor can be employed to measure the current drawn by a motor of the motor assembly 2009. The force required to advance the drive assembly 2011 can correspond to the current drawn by the motor, for example. The measured force can be converted to a digital signal and provided to the processor 2006.
In accordance with the present disclosure, strain gauge sensors can be used to measure the force applied to the tissue by the end effector 2010, for example. A strain gauge can be coupled to the end effector 2010 to measure the force on the tissue being treated by the end effector 2010. Additionally, the strain gauge sensors can measure the amplitude or magnitude of the strain exerted on a jaw of an end effector 2010 during a closure motion which can be indicative of the tissue compression. The measured strain can be converted to a digital signal and provided to a processor 2006.
The measurements of the tissue compression, the tissue thickness, and/or the force required to close the end effector on the tissue, as respectively measured by the sensors 2008 can be used by the microcontroller 2005 to characterize the selected position of one or more components of the drive assembly 2011 and/or the corresponding value of the speed of one or more components of the drive assembly 2011. In accordance with the present disclosure, a memory (e.g. memory 2007) may store a technique, an equation, and/or a look-up table which can be employed by the microcontroller 2005 in the assessment.
The system 2002 may comprise wired or wireless communication circuits to communicate with surgical hubs (e.g. surgical hub 2014), communication hubs, and/or robotic surgical hubs, for example. Additional details about suitable interactions between a system 2002 and the surgical hub 2014 are disclosed in U.S. patent application Ser. No. 16/209,423 entitled METHOD OF COMPRESSING TISSUE WITHIN A STAPLING DEVICE AND SIMULTANEOUSLY DISPLAYING THE LOCATION OF THE TISSUE WITHIN THE JAWS, now U.S. Patent Application Publication No. 2019/0200981, the entire disclosure of which is incorporated by reference in its entirety herein.
In accordance with the present disclosure the control circuit 2004 can be configured to implement various processes described herein. The control circuit 2004 may comprise a microcontroller comprising one or more processors (e.g., microprocessor, microcontroller) coupled to at least one memory circuit. The memory circuit stores machine-executable instructions that, when executed by the processor, cause the processor to execute machine instructions to implement various processes described herein. The processor may be any one of a number of single-core or multicore processors known in the art. The memory circuit may comprise volatile and non-volatile storage media. The processor may include an instruction processing unit and an arithmetic unit. The instruction processing unit may be configured to receive instructions from the memory circuit of this disclosure.
Alternatively, in accordance with the present disclosure, the control circuit 2004 can be in the form of a combinational logic circuit configured to implement various processes described herein. The combinational logic circuit may comprise a finite state machine comprising a combinational logic configured to receive data, process the data by the combinational logic, and provide an output.
Alternatively, in accordance with the present disclosure, the control circuit 2004 can be in the form of a sequential logic circuit. The sequential logic circuit can be configured to implement various processes described herein. The sequential logic circuit may comprise a finite state machine. The sequential logic circuit may comprise a combinational logic, at least one memory circuit, and a clock, for example. The at least one memory circuit can store a current state of the finite state machine. In accordance with the present disclosure, the sequential logic circuit may be synchronous or asynchronous. Further, in accordance with the present disclosure, the control circuit 2004 may comprise a combination of a processor (e.g., processor 2006) and a finite state machine to implement various processes herein. Additionally, the finite state machine may comprise a combination of a combinational logic circuit (and the sequential logic circuit, for example.
The surgical stapling assembly 2100 further comprises a firing driver 2150 actuatable through the end effector 2120 by a drive assembly such as the drive assembly 2011, for example. The firing driver 2150 can comprise any suitable firing driver such as, for example, a distal I-beam head, discussed in greater detail below. The firing driver 2150 is configured to push a sled of the replaceable staple cartridge 2130 from an unfired position to a fired position. During distal translation of the sled within the replaceable staple cartridge 2130, the sled is configured to sequentially lift a plurality of staple drivers with staples 2101 supported thereon. As the drivers are lifted toward the anvil jaw 2140, the drivers are configured to eject the staples 2101 from a plurality of staple cavities and against the anvil jaw 2140.
In accordance with the present disclosure, the sled can be part of the firing driver. Any suitable combination of firing components can be considered the firing driver.
In accordance with the present disclosure, moving the anvil jaw 2140 into a clamped position to clamp tissue between the anvil jaw 2140 and the replaceable staple cartridge 2130 may be performed by a closure driver. The closure driver may be separate from the firing driver 2150 and may be actuatable independently of the firing driver. Alternatively, the closure driver may not be separate from the firing driver 2150, and the clamping, or closing, motion may be performed by the firing driver 2150. Opposing jaw-camming pins of a distal I-beam head of the firing driver 2150 are configured to cam the anvil jaw 2140 into a clamped position as the firing driver 2150 is actuated distally through an initial clamping stroke, or motion. In addition to moving the anvil jaw 2140 from an unclamped position to a clamped position during a clamping stroke, the opposing jaw-camming pins are configured to control a tissue gap distance between the anvil jaw 2140 and the replaceable staple cartridge 2130 during the staple firing stroke by limiting the separation of the cartridge channel jaw 2121 and the anvil jaw 2140 during the staple firing stroke with the opposing jaw-camming pins. One of the jaw-camming pins is configured to engage the cartridge channel jaw 2121 and one of the jaw-camming pins is configured to engage the anvil jaw 2140. Discussed in greater detail herein, this clamping action provided by the opposing jaw-camming pins induces clamping forces on the firing driver 2150 and other drive components.
In accordance with the present disclosure, many different forces can be transmitted through the surgical stapling assembly 2100 and these forces can induce loads on the firing driver 2150. These loads can include, but are not limited to, jaw-camming loads experienced during the staple firing stroke as a result of the interaction between the jaws 2121, 2140 and the jaw-camming pins of the firing driver 2150, tissue loads experienced during the staple firing stroke as a result of the interaction between a cutting edge, or knife, of the firing driver 2150 or firing assembly generally, for example, and the patient tissue T, and/or staple firing loads experienced during the staple firing stroke as a result of the firing of the staples 2101 by the firing driver 2150. In accordance with the present disclosure, these loads experienced by the firing driver 2150 can be transmitted through the drive assembly, or drive train, which drives the firing driver 2150, to the prime mover of the drive train such as the motor, for example.
The loads experienced by the firing driver 2150 can affect the overall performance of the staple firing stroke performed by the surgical stapling assembly 2100. Various components of a drive assembly are provided which, in accordance with the present disclosure, may be utilized in a surgical stapling drive assembly to help increase the efficiency, control, and/or reliability, for example, of a surgical stapling drive stroke.
In accordance with the present disclosure, one or more components of the drive assembly, or drive train, may be designed so as to optimize one or more characteristics of the drive train for a drive stroke such as, for example, a surgical stapling drive stroke. Such characteristics may include inertial mass and/or storable kinetic energy, for example. These characteristics can be utilized by a control circuit (e.g., control circuit 2004) to further optimize the drive stroke, as discussed in greater detail below.
The motor 2210 comprises an output pinion gear 2211 driven by the motor 2210 and configured to impart drive motions to the gear train 2220. The gear train 2220 comprises a plurality of gear sets 2230, 2240, 2250, and 2260. The first gear set 2230 comprises a plurality of input planet gears 2231 meshed with the output pinion gear 2211, a carrier 2232 by which the input planet gears 2231 are supported, and an output gear 2233 supported by the carrier 2232. The output pinion gear 2211 is meshed with and configured to drive the planet gears 2231 which are directly coupled to the carrier 2232. Thus, the planet gears 2231, the carrier 2232, and the output gear 2233 all rotate together when driven by the output pinion gear 2211. The second gear set 2240 comprises a plurality of input planet gears 2241 meshed with the output gear 2233, a carrier 2242 by which the input planet gears 2241 are supported, and an output gear 2243 supported by the carrier 2242. The output gear 2233 is meshed with and configured to drive the planet gears 2241 which are directly coupled to the carrier 2242. Thus, the planet gears 2241, the carrier 2242, and the output gear 2243 all rotate together when driven by the output gear 2233. The third gear set 2250 comprises a plurality of input planet gears 2251 meshed with the output gear 2243, a carrier 2252 by which the input planet gears 2251 are supported, and an output gear 2253 supported by the carrier 2252. The output gear 2243 is meshed with and configured to drive the planet gears 2251 which are directly coupled to the carrier 2252. Thus, the planet gears 2251, the carrier 2252, and the output gear 2253 all rotate together when driven by the output gear 2243. The output gear set 2260 comprises a plurality of planet gears 2261 meshed with the output gear 2253. The output gear set 2260 is configured to drive the output 2270 to drive a drive driver such as, for example, the firing driver 2150.
Any suitable gear ratio or ratios can be employed within the gear train 2220. In accordance with the present disclosure, each gear stage may employ between about a 5:1 and a 10:1 gear ratio, for example. Each gear stage may reduce the output speed by about 5:1, 6:1, and/or 7:1, for example. In accordance with the present disclosure, if the input speed of the motor 2210 is 20,000 RPM, for example, the output speed of the output 2270 may be reduced by 5:1 at each gear stage. Multiple gear stages can provide a compound gear ratio. Additionally, a lesser gear ratio may be utilized closer to the motor 2210 so as to conserve rotational speed at the first gear stage from the motor 2210. Further, in accordance with the present disclosure, greater gear ratios which are different than the lesser gear ratio can be used downstream of the motor 2210 so as to reduce the speed of the output 2270 as desired. Discussed in greater detail below, the conservation of rotational speed of the gear set(s) closer to the motor 2210 increases the ability of the drive train 2220 to produce and conserve angular momentum to overcome possible stall conditions, as discussed in greater detail below. In accordance with the present disclosure, output speed and/or torque of the output 2270 may be controlled by a motor control circuit (e.g., control circuit 2004) by varying input voltage and/or current to the motor 2210. Load on the motor 2210 can be monitored and utilized to further control the motor 2210.
In accordance with the present disclosure, gear trains for various surgical instruments can include any number of suitable number of gear stages. A surgical stapling assembly, such as the surgical stapling assembly 2100, for example, can include three gear stages and can complete a full firing stroke (about 2.5 inches, for example) in about three seconds with a load up to about 200 lbs. Alternatively, a circular surgical stapler can include five gear stages, and can complete a full firing stroke (about 0.5 inches, for example) in about 2-5 seconds with a load up to about 600 lbs. The number of gear stages may depend on the required firing load, duration of stroke, and/or length of stroke, for example. As the firing load increases during a firing stroke, the potential for motor stall increases. Increasing the inertial properties of one or more of the gear stages can increase the amount of momentum generated during the firing stroke in the gear train and, under potential stall-inducing loads, can help the gear train push through the potential stall-inducing loads without stalling. In accordance with the present disclosure, the gear stage which rotates with the highest speed (closest to the motor, for example) can be modified so as to increase the inertial properties thereof and, because inertia is proportional to the mass and rotational velocity of the gear stage, the gear stage closest to the motor can provide the most momentum within the gear train.
In accordance with the present disclosure, a housing ring gear may be employed with the drive assembly 2200. Such a housing ring gear can be fixed relative to the gear sets 2230, 2240, 2350, and 2260 and meshed with the planet gears 2231, 2241, 2251, and 2261. In accordance with the present disclosure, a shiftable gear may be provided to switch between different gears during a staple firing stroke.
In accordance with the present disclosure, the first gear set 2230 may spin at a rotational speed faster than all of the subsequent gear sets. Furthermore, the first gear set 2230 may comprise increased inertial properties such as for example, inertial mass and moment arms, relative to subsequent gear sets so as to increase the amount of rotational kinetic energy, or angular momentum, produced by the first gear set 2230. Discussed in greater detail below, the material selection and geometry of each individual gear set can be selected based on the location of the gear set relative to the output 2270 and/or the motor 2210 and/or based on the nominal rotational speed of the gear set determined by the gear ratio relative to the motor 2210. In accordance with the present disclosure, materials and/or geometries of one or more gear sets rotating with a greater velocity closer to the motor 2210 may be selected so as to prioritize the generation and/or storability of kinetic energy within the gear sets positioned closer to the motor 2210. Further, in accordance with the present disclosure, materials and/or geometries of one or more gear sets rotating with a lesser velocity further downstream of the motor 2210 may be selected so as to prioritize manufacturing costs and/or loading properties, for example. Additionally, one or more gear sets further downstream in the gear train 2220 may be comprised of plastic while one or more gear sets closer to the motor 2210 may be comprised of metal.
Turning now to
In accordance with the present disclosure, the inertial properties may be selected based on a nominal operating speed of the gear set. As discussed above, a gear set having the greatest inertia may be selected for the first gear set coupled to the motor 2210 so as to generate a greater amount of kinetic energy with the fastest spinning gear set. For example, the gear set(s) closer to the motor 2210 can be driven at higher speeds than the gear sets further downstream of the motor 2210. Because of the higher nominal operating speed of the gear sets closer to the motor, these gear sets can include materials and design features so as to increase their inertial mass. Increasing the inertial mass of the faster-spinning gear sets can be employed to increase the overall inertia of the drive assembly 2200. The gear sets further downstream from the motor 2210 may be spun at lower nominal operating speeds and thus, increasing their inertial mass may minimally increase the overall inertia of the drive assembly 2200. In accordance with the present disclosure, all of the gear sets may be designed so as to increase the overall inertia of the drive assembly 2200. Additionally, the gear sets operating at lower nominal operating speeds may be selected so as to reduce manufacturing costs and/or reduce load properties.
The gear set 2300 comprises a carrier 2301 and planet gears 2302 rotatably mounted to the carrier 2301. In accordance with the present disclosure, a first material may be utilized for the carrier 2301 and a second material different than the first material may be utilized for the planet gears 2302. The first material may be lighter, as represented by mass in a given volume, than the second material. In accordance with the present disclosure, the first material may comprise a metal material and the second material may comprise a plastic material.
The gear set 2310 comprises a carrier 2311 and planet gears 2312 rotatably mounted to the carrier 2311. In accordance with the present disclosure, the carrier 2311 and the planet gears 2312 may comprise the same material. The material of the carrier 2311 and the planet gears 2312 may comprise a plastic material. Additionally, the inertial mass of the gear set 2300 may be more than the inertial mass of the gear set 2310.
The gear set 2320 comprises a carrier 2321 and planet gears 2322 rotatably mounted to the carrier 2321. In accordance with the present disclosure, the material of the carrier 2321 may comprise a plastic material. The material of the planet gears 2322 may comprise a hybrid material including at least two different materials. One of the materials may comprise tungsten. Additionally, the inertial mass of the gear set 2320 may be more than the inertial mass of the gear sets 2300, 2310. While plastic materials and metal materials are provided as examples of suitable materials for varying inertial mass of various components of the drive assembly 2200. It is readily understood that any suitable materials with different densities can be utilized.
The gear set 2330 comprises a carrier 2331 and planet gears 2335 rotatably mounted to the carrier 2331. As can be seen in
Referring still to
The carrier 2410 comprises a primary body portion 2411 and a pinion 2415 fixedly attached to the primary body portion 2411 such that the primary body portion 2411 and the pinion 2415 rotate together. The primary body portion 2411 comprises a plurality of mounting posts 2412 extending therefrom each of which is configured to rotatably support a planet gear thereon. The carrier 2410 comprises a first inertia value. In accordance with the present disclosure, the carrier 2410 may comprise a Nylon material, for example.
The carrier 2420 comprises a primary body portion 2421 and a pinion 2425 fixedly attached to the primary body portion 2421 such that the primary body portion 2421 and the pinion 2425 rotate together. The primary body portion 2421 comprises a plurality of mounting posts 2422 extending therefrom each of which are configured to rotatably support a planet gear thereon. The carrier 2420 comprises a second inertia value. In accordance with the present disclosure, the carrier 2420 can be cast with a steel material, for example. The first inertia value of the carrier 2410 may be less than the second inertia value of the carrier 2420.
The carrier 2430 comprises a primary body portion 2431, a secondary body portion 2434, and a pinion 930 fixedly attached to the primary body portion 2431 and the secondary body portion 2434 such that the primary body portion 2431, the secondary body portion 2434, and the pinion 2436 rotate together. The primary body portion 2431 comprises a plurality of secondary posts 2432 extending therefrom. In accordance with the present disclosure, the secondary posts 2432 can increase the inertial properties such as for example, the inertial mass, of the carrier 2430 relative to a carrier without secondary posts. The secondary body portion 2434 comprises a plurality of mounting posts 2435 each of which is configured to rotatably support a planet gear thereon. The carrier 2430 comprises a third inertia value.
In accordance with the present disclosure, the carrier 2430 may comprise a steel material and a Nylon material. The primary body portion 2431 may be cast with a steel material and the secondary body portion 2434 may comprise a Nylon material. The pinion 2436 may be part of the primary body portion 2431 and may also be made of a Nylon material. Alternatively, the pinion 2436 may be part of the secondary body portion 2434 and may also be cast with a steel material. Additionally, the third inertia value may be greater than the first inertia value of the carrier 2410 and the second inertia value of the carrier 2420.
The carrier 2440 comprises a body portion 2441 and a pinion 2445 fixedly attached to the body portion 2441 such that the body portion 2441 and the pinion 2445 rotate together. The body portion 2441 comprises a plurality of mounting posts 2443 extending therefrom and a plurality of secondary posts 2442 extending therefrom. In accordance with the present disclosure, the secondary posts 2442 can increase the inertial properties such as for example, the inertial mass, of the carrier 2440 relative to a carrier without secondary posts. Each mounting post 2443 is configured to rotatably support a planet gear thereon. The carrier 2440 comprises a fourth inertia value. The carrier 2440 can be entirely cast, or otherwise formed, with a steel material. Additionally, the fourth inertia value may be greater than the first inertia value of the carrier 2410, the second inertia value of the carrier 2420, and the third inertia value of the carrier 2430.
Various other components of a drive assembly 2200 can be selected for altering the inertial properties of the drive assembly of a surgical stapling device, for example.
In accordance with the present disclosure, the flywheel 2500 may be passively actuated between a plurality of different configurations so as to provide different levels of inertia in each of the configurations. Alternatively, the flywheel 2500 may be actively actuated manually and/or automatically by a control circuit (e.g., control circuit 2004) between a plurality of different configurations so as to provide different levels of inertia. Additionally, the flywheel 2500 may be configured to utilize conservation of momentum to store rotational kinetic energy during a drive stroke.
The flywheel 2500 comprises an inner hub portion 2501, an outer rim portion 2502, and a plurality of struts, or arms, 2503 connecting the inner hub portion 2501 and the outer rim portion 2502. In accordance with the present disclosure, the inner hub portion 2501 can be mounted to a drive shaft of a drive assembly (e.g., drive assembly 2200). The flywheel 2500 can be mounted to the drive assembly near the motor before the gear box. Alternatively, the flywheel 2500 can be mounted to the drive assembly within the gear box. Additionally, the flywheel 2500 can be mounted to the drive assembly downstream, or distal, of the gear box.
The struts 2503 each comprise a radially-extending arm mounted to the inner hub portion 2501 and outer rim portion 2502 and can be oriented in a plurality of arm pairs. The flywheel 2500 further comprises masses 2504 slidably mounted to the struts 2503 such that the masses 2504 can be positioned near the inner hub portion 2501 as the flywheel 2500 rotates and the masses 2504 can be positioned near the outer rim portion 2502 as the flywheel 2500 rotates. The masses 2504 are configured to increase the rotational inertia of a drive assembly during a firing stroke by providing masses which are movable away from the center of rotation to increase the moment of inertia of the flywheel 2500 and, thus, the drive assembly.
In accordance with the present disclosure, the masses 2504 can be passively actuated between an inner position near the inner hub portion 2501 (
In the instance of passive actuation of the masses 2504, the springs 2505 may comprise any suitable preselected spring constant selected so as to allow the masses 2504 to move radially outwardly as the flywheel 2500 increases rotational velocity to a nominal rotational velocity. During a decrease in velocity, the rotational kinetic energy stored in the flywheel 2500 is directed through, or released into, the drive assembly (e.g., drive assembly 2200) in an effort to reduce the possibility of a stall condition. As the speed of the flywheel 2500 decreases, the masses 2504 may be pulled back in closer to the inner hub portion 2504 to prepare for the next drive stroke by way of the springs 2505. In accordance with the present disclosure, the spring constant of the springs 2505 may be selected so as to control the position of the masses 2504 at different rotational speeds of the flywheel 2500. Further, in accordance with the present disclosure, the masses 2504 may not be pulled in closer to the inner hub portion 2504 until the flywheel 2500 fully stops rotating or nearly fully stops rotating, for example.
In accordance with the present disclosure, each spring 2505 may comprise a different spring constant so as to control the release of the masses 2504 toward the outer rim portion 2502. Such a configuration can allow for varied levels of inertia during a drive stroke. The different spring constants would require different rotational velocities of the flywheel 2500 to deploy each mass 2504 toward the outer rim portion 2502. In accordance with the present disclosure, the different rotational velocities required to deploy each mass to achieve a specific inertia level can be known and can be pursued by a control circuit (e.g., control circuit 2004) accordingly. For example, if a detected load on a motor is increasing at a predetermined rate that indicates a potential stall condition is imminent, the control circuit can be configured to automatically increase the rotational speed of the flywheel 2500 so as to generate more kinetic energy within the drive assembly. This additional kinetic energy can help push through the potential stall condition. If the load falls below a predetermined threshold after the potential stall condition is detected, the rotational speed of the flywheel 2500 can be reduced to move one or more masses 2504 back toward the inner hub portion 2501 and reduce the inertia level of the drive assembly when high stored kinetic energy is not necessary and, in accordance with the present disclosure, less desirable. If the kinetic energy stored in a drive assembly is too high, the magnitude of undershoot error and/or overshoot error of the drive stroke can increase. For example, a target velocity of a drive driver may be overshot and undershot by a larger margin with the unnecessary, increased stored kinetic energy than if the increased stored kinetic energy was not present in the drive assembly.
In accordance with the present disclosure, the masses 2504 can be actuated automatically by a control circuit (e.g., control circuit 2004) between the inner positions (
As can be seen in
Different inertial properties of components of a drive assembly can vary the ability of the drive assembly to store mechanical energy during a drive stroke within the drive assembly. In accordance with the present disclosure, more inertial mass of a gear stage of a gear box, for example, can increase the rotational kinetic energy of the drive assembly during a drive stroke. An inertial mass of one or more gear box components may be selected to provide sufficient kinetic energy during the drive stroke to overcome a stall condition of the motor caused by the external application of a predicted stall-induced load on the drive element. Additionally, increasing the moment arm of the planet gears of a gear stage can increase the inertia of the gear stage and, thus, the drive assembly. Increasing the mass of one or more of the planet gears can increase the inertia of the gear stage. This increase in rotational energy of a gear stage can result in an increased ability of the drive assembly to generate and/or conserve angular momentum. The increased ability to conserve angular momentum, or store rotational energy, can help reduce the possibility of motor stall, for example, discussed in greater detail below.
The drive assemblies and systems provided herein are configured to increase the amount of load absorbable within the system without stalling the motor. In accordance with the present disclosure, the increased inertial properties of the gear train may allow the systems to overcome force variations beyond a peak motor input torque (maximum torque available by the motor) owing to the stored kinetic energy in the system.
In accordance with the present disclosure, a control circuit (e.g., control circuit 2004) of a surgical instrument coupled to a motorized drive train which controls a drive stroke of the surgical instrument can utilize inertial characteristics of a drive train to help automatically reduce the likelihood of motor stall during the drive stroke.
In accordance with the present disclosure, the control circuit 2004 can be configured to monitor one or more parameters of the drive assembly during a drive stroke and the stored kinetic energy of the drive assembly in an effort to detect an imminent motor stall condition. The control circuit 2004 is configured to compare, or evaluate, the monitored one or more parameters and the stored kinetic energy of the drive assembly to determine if motor stall is imminent.
The parameters can include any suitable parameter or combination of parameters of the drive assembly. In accordance with the present disclosure, the parameters can include various motor parameters such as, for example, motor velocity, motor current, motor acceleration, motor load, motor efficiency, motor heat, and/or voltage sag, etc. The parameters can include various gear box parameters such as, for example, rotational velocity, rotational acceleration, and/or stored kinetic energy of one or more gear stages. Additionally, the parameters can include various aspects of a drive member, or driver, such as, for example, load on the drive member (which can be induced by stapling forces caused by ejecting staples from a staple cartridge and forming the staples against the anvil, clamping forces caused by clamping tissue between the jaws and/or controlling a tissue gap distance between the jaws during a staple firing stroke, and/or tissue-cutting forces caused by the interaction between a tissue-cutting knife of the drive member and the tissue during the staple firing stroke), velocity of the drive member, and/or acceleration of the drive member.
Any of the parameters or combination of parameters discussed herein can be utilized in determining that a motor stall event is imminent. A reduction in speed of the drive member, rapid deceleration of the drive member, and/or increased motor current and/or torque, for example, can all be signs of an imminent motor stall condition. A reduction in gear stage speed can also indicate motor stall is imminent. In accordance with the present disclosure, an increase in motor heat, motor torque, and/or motor current can indicate that a motor stall event is imminent. A combination of parameters may be monitored by the control circuit 2004 to detect an imminent motor stall condition. Additionally, more than one parameter of a drive assembly may be monitored and only when every monitored parameter indicates that a motor stall condition is imminent does the control circuit 2004 determine that a motor stall condition is imminent.
In accordance with the present disclosure, one or more of the parameters can be configured to be monitored over a period of time and analyzed to determine the rate at which the parameter is changing, for example. The rate of change of the parameters can be evaluated by the control circuit 2004 during a staple firing stroke and, when one or more particular parameters changes a predetermined amount, or at a predetermined threshold rate of change, over a predetermined period of time, the control circuit 2004 can utilize this information in determining an imminent motor stall condition. For example, if current increases rapidly at a predetermined threshold rate of increase, this can be utilized to determine that a motor stall condition is imminent.
In accordance with the present disclosure, the control circuit 2004 can detect an imminent motor stall condition based on multiple parameters, as discussed above. The control circuit 2004 may separately compare values, which can be determined based on sensor signals received from sensors that monitor such parameters, to a predetermined threshold associated with each parameter. Alternatively, the imminent motor stall condition can be a function of a number of parameters weighed diffidently in a predetermined equation for detecting the imminent motor stall condition.
As discussed herein, the control circuit 2004 is further configured to monitor and/or determine a kinetic energy stored in the drive assembly during a staple firing stroke, for example, to evaluate alongside, or compare with, the monitored parameter. If the determined stored kinetic energy of the drive assembly is below a predetermined kinetic energy threshold for a given stall condition, which would indicate that the motor is likely to stall unless an adjustment is made to the drive stroke, an adjustment can be made to the drive stroke in an effort to overcome the stall condition and completely prevent the motor from stalling. In accordance with the present disclosure, the adjustment can include making a motor adjustment which increases the kinetic energy of the drive assembly to push through, or overcome, the imminent stall condition.
The kinetic energy stored in the drive assembly can be determined in any suitable manner such as, for example, by monitoring the rotational speed of the motor and/or a particular gear stage, for example. In accordance with the present disclosure, the control circuit 2004 can calculate the kinetic energy stored in the drive assembly using the known values of drive assembly such as for example, the mass of the gear box components (planet gears and carriers), and a variable parameter (parameter which changes during the firing stroke) of the gear box component (speed of a particular gear stage). The control circuit 2004 can be configured to sum the kinetic energy storage of every component in the drive assembly to determine the total stored kinetic energy in the drive assembly at any given time during the firing stroke.
As the stored kinetic energy increases and decreases during the drive stroke, the ability of the drive assembly to overcome a stall condition increases and decreases. For example, if the drive member is moving relatively slowly during the drive stroke, a relatively low amount of stored kinetic energy can be present within the drive assembly. Therefore, the ability of the drive assembly to overcome a potential motor stall event decreases. Given this decrease in stored kinetic energy, the control circuit 2004 is configured to adjust the sensitivity of the trigger, or parameter, thresholds of the monitored parameters which would require, or trigger, a motor adjustment to overcome a stall condition. For example, as the stored kinetic energy of the drive assembly decreases, the tolerance for stall-related variations of the drive assembly is decreased because less kinetic energy is stored within the drive assembly lowering the ability of the drive assembly to overcome a stall condition. As another example, as the stored kinetic energy of the drive assembly increases, the tolerance for stall-related variations of the drive assembly is increased because more kinetic energy is stored within the drive assembly increasing the ability of the drive assembly to overcome a stall condition.
In accordance with the present disclosure, the control circuit 2004 can be further configured to utilize a kinetic energy threshold during a drive stroke. The kinetic energy threshold may be predetermined, or preset. Additionally, the kinetic energy threshold may be adjusted in real time by the control circuit 2004 during the drive stroke based on one or more parameters of the drive stroke. Different kinetic energy thresholds may be set for different stages of the drive stroke. The stages may include, for example, a lockout stage where an I-beam is either locked out or defeats the lockout as the I-beam moves through the lockout stage, an initial clamping stage where the I-beam engages opposing jaw-camming channels defined in the jaws as the jaws initially clamp on tissue, a tissue cutting and stapling stage where the I-beam ejects staples, cuts tissue, and holds the jaws clamped during the stapling and cutting of tissue, and/or an ending stage after the firing of staples.
The kinetic energy threshold can be preset for each stage corresponding to the anticipated stored kinetic energy which may be required to overcome a potential stall condition during each stage of the drive stroke. For example, the lockout stage may require a relatively low kinetic energy. This may be due to the fact that there is little-to-no jaw-camming forces acting on the I-beam pins, no cutting of tissue, and no stapling of tissue, for example. Thus, the likelihood of motor stall may be much less likely during the lockout stage of the drive stroke. Because motor stall is unlikely and/or because the load, for example, experienced during the lockout stage is low, a relatively low kinetic energy threshold can be set by the control circuit 2004 for the lockout stage.
In accordance with the present disclosure, the tissue cutting and stapling stage may involve the greatest loads on the drive assembly. In accordance with the present disclosure, a relative high kinetic energy threshold may be set to ensure that a maximum amount of available stored kinetic energy of the drive assembly is being provided during the tissue cutting and stapling stage so that, in the event of detecting a possible motor stall condition, a maximum amount of kinetic energy is stored in the drive assembly to overcome the motor stall condition.
In accordance with the present disclosure, the kinetic energy threshold may be utilized by the control circuit 2004 to ensure that the drive assembly is actuated to provide a stored kinetic energy which meets and/or exceeds the kinetic energy threshold during a particular stage of the drive stroke. The control circuit 2004 can be configured to compare the determined stored kinetic energy of the drive assembly with the kinetic energy threshold and initiate a motor control adjustment should the stored kinetic energy of the drive assembly fall below the kinetic energy threshold, for example, in an effort to maintain a stored kinetic energy that meets and/or exceeds the kinetic energy threshold.
In accordance with the present disclosure, a comparison of the kinetic energy threshold and the stored kinetic energy of the drive assembly may be utilized to adjust a sensitivity of one or more parameter thresholds indicative of motor stall. Such parameter thresholds are monitored parameter values of the drive stroke which may trigger a motor adjustment. The parameter thresholds may comprise a range of monitored parameter values where, for example, when the monitored parameter falls outside of the range, a motor adjustment is triggered. Alternatively, a parameter threshold may not comprise a range but, rather, a single value where, for example, when the monitored parameter exceeds, or falls below, the parameter threshold, a motor adjustment may be made. A motor adjustment may be made to, ultimately, prevent motor stall. This can be achieved by adjusting torque output of the motor, speed output of the motor, acceleration output of the motor, etc. For example, a motor adjustment may include increasing the speed of the motor to a maximum speed for a short duration in an effort to serve as a kinetic buffer during the potential stall event. In accordance with the present disclosure, the motor adjustment may be held until a stall condition is no longer detected. A multitude of quick speed bursts may be provided by the control circuit 2004 in an attempt to overcome the potential stall condition.
As discussed herein, the sensitivity, or tolerance, of the parameter threshold can be adjusted in real time based on the stored kinetic energy of a drive assembly during a drive stroke. In other words, with less stored, or storable, kinetic energy, a parameter threshold can be adjusted to be more sensitive such that a more marginal variation of the monitored parameter would trigger a motor adjustment. This can be a result of the greater stall risk associated with less stored, or storable, kinetic energy. Similarly, with more stored, or storable, kinetic energy, the parameter threshold can be adjusted to be less sensitive so that a greater variation of the monitored parameter is permitted prior to triggering a motor adjustment. This can be a result of the lower stall risk associated with more stored, or storable, kinetic energy. In accordance with the present disclosure, the sensitivity may be adjusted based on the amount of stored kinetic energy. Additionally, the sensitivity may be based on the comparison of the amount of stored kinetic energy at a given moment and the kinetic energy threshold.
For example, if the stored kinetic energy of the drive assembly is much greater than the kinetic energy threshold, the parameter threshold can be set a first, less conservative, sensitivity. If the stored kinetic energy of the drive assembly is much lower than the kinetic energy threshold, the parameter threshold can be set at a second, more conservative, sensitivity.
In accordance with the present disclosure, there may be increased risk of motor stall in a device without an adaptable sensitivity adjustment of the parameter thresholds. Assume the parameter threshold is not adjusted as the speed of the drive element, for example, varies through the drive stroke, and the parameter threshold is set at a 10% increase in load thereby initiating a motor adjustment at a 10% increase in load at any given drive element speed. Should the load increase 10%, a motor adjustment is made. This may be adequate at higher, more nominal drive element speeds, where a 10% increase in load may not necessarily stall the motor. However, at a lower speed, a 10% increase in load may cause a motor stall because of the lower storable kinetic energy. Thus, the control circuit (e.g., control circuit 2004) described herein would adjust the parameter threshold to a more sensitive load variation such as, for example, 5% at lower speeds. The parameter threshold may be adjusted fluidly with the monitored parameter of the drive assembly (drive element speed, in this instance). This can allow for a more adaptable motor control algorithm that can provide a surgeon with varying drive element speed while minimizing the risk of motor stall no matter what speed the surgeon, or a surgical robot, is actuating the drive element.
In accordance with the present disclosure, the control circuit 2004 can be configured to switch between a first drive configuration of the gear box to provide a first inertia value and a second drive configuration of the gear box to provide a second inertia value. The first drive configuration may include a slower speed but more torque while the second drive configuration may include an increased speed but less torque. The drive configurations may be switched between automatically by the control circuit 2004 or manually by a clinician. In accordance with the present disclosure, a solenoid may be provided to switch between different drive configurations. The first drive configuration provides a first amount of storable kinetic energy while the second drive configuration provides a second amount of storable kinetic energy which is greater than the first amount of storable kinetic energy. The drive configuration can be chosen by the control circuit 2004 depending on the minimum kinetic energy threshold of the current stage of the drive stroke. Additionally, the drive configuration can be chosen by the control circuit 2004 depending on stored kinetic energy of the drive assembly at a given time. For example, as the stored kinetic energy falls, the drive configuration may switch to the higher torque, lower speed configuration.
In accordance with the present disclosure, a target speed for the drive element may be selected based on the desired stored kinetic energy for the stage of the drive stroke. If motor stall risk is relatively low, a lower target speed may be selected. If motor stall risk is relatively high, a higher target speed may be selected to ensure a maximum amount of storable kinetic energy. Tissue thickness and/or clamping load can affect the velocity of the drive element and thus storage of kinetic energy in the drive assembly. Thicker tissue may increase the load on the drive element and decrease the speed of the drive element. This can reduce the stored kinetic energy in the drive assembly. Thinner tissue may decrease the load on the drive element and maintain a consistently higher speed of the drive element. This can increase the amount of stored kinetic energy in the drive assembly.
As discussed herein, motor adjustments can be made by the control circuit 2004 in an effort to overcome a potential stall condition. The motor adjustments can include any suitable adjustment such as those described herein. In accordance with the present disclosure, motor input voltage and/or current can be adjusted. A drive configuration of a gear box can be adjusted to change the amount of available kinetic energy to overcome the potential stall condition. Once a motor stalls, it may be significantly more difficult for a motor to restart a drive stroke. Motor stall may require reversing the drive element before re-advancing the drive element through the rest of the drive stroke. Such a motion may introduce a degree of unpredictability in forming the rest of the staples and/or cutting tissue through the rest of the drive stroke. The increased load on the drive element for restarting a drive element after a motor stall can present unnecessary stress and strain on drive assembly components. Additionally, motor stall may introduce voltage sag in a battery source for the motor and affect the integrity of the battery for future use. Motor stall may damage the motor, mechanical drive train components, gear box gears, etc. Providing a motor-adjustment when detecting a potential stall condition can provide a kinetic buffer to reduce the likelihood of motor stall.
Reducing motor stall of a surgical stapling instrument can increase longevity of the instrument and its components (battery, motor, etc.), increase the reliability of a surgical stapling and cutting drive stroke (ensure proper staple formation and clean tissue-cutting), increase confidence in surgeon to perform each drive stroke, reduce time of the drive stroke and, thus, the surgical stapling operation.
The control circuit 2004 is configured to monitor 2711 a first parameter of the drive assembly during the drive stroke. As discussed herein, the first parameter may include any suitable parameter or combination of parameters indicative of the stored kinetic energy of the drive assembly. Such a parameter can include, for example, an output speed of the motor. The control circuit 2004 is further configured to determine 2712 a stored kinetic energy of the drive assembly based on the monitored 2711 first parameter. As discussed herein, determining the stored kinetic energy of the drive assembly can be achieved by utilizing known values of the drive assembly such as, for example, inertial mass, gear set moment arms, etc., and utilizing the monitored first parameter such as, for example, output speed of the drive train. This information can be used to calculate the total stored kinetic energy at any given moment during the drive stroke. In accordance with the present disclosure, the stored kinetic energy of the drive assembly may vary over time owning to external factors such as tissue load, for example, and/or owing to controllable inputs such as, for example, motor voltage/speed.
The control circuit 2004 is further configured to monitor 2713 a second parameter of the drive assembly during the drive stroke. In accordance with the present disclosure, the first parameter and the second parameter may be different. The second parameter may comprise tissue-induced load on the drive element, for example. Additionally, the monitored second parameter may be utilized to help detect a potential, or imminent, stall condition during the drive stroke. In the example of tissue-induced load on the drive element, a certain tissue load magnitude can indicate a potential stall condition. A threshold rate of increase of tissue load on the drive element can indicate a potential stall condition. As discussed herein, a combination of parameters can be utilized to help detect and/or alert of a potential stall condition. For example, in addition to tissue load on the drive element, drive element output speed can also be monitored and when the drive element speed and the tissue-induced load on the drive element meet a predetermined criteria, a potential stall condition can be indicated.
The control circuit is further configured to compare 2714 the monitored second parameter to a parameter threshold indicative of a motor stall condition. Such a parameter threshold may indicate a need for motor adjustment to prevent the motor from stalling. As discussed herein, the parameter threshold can include an acceptable percentage change in the monitored second parameter or the surpassing of a straight threshold value of the monitored second parameter, for example, before a motor adjustment is suggested or even necessary to prevent motor stall.
The control circuit 2004 is further configured to determine 2715 a motor setting of the motor based on the determined stored kinetic energy and the comparison of the monitored second parameter to the parameter threshold. The motor setting can include any suitable motor setting. In accordance with the present disclosure, the control circuit 2004 may determine to keep the motor setting the same. Additionally, the control circuit 2004 may determine that the stored kinetic energy of the drive assembly is adequate to overcome the potential stall condition with the current motor setting. The control circuit 2004 may adjust the motor setting such as, for example, increasing the speed of the motor, to increase kinetic energy in an effort to overcome the potential stall condition.
The control circuit 2004 is further configured to adjust 2716 a sensitivity of the parameter threshold indicative of a motor stall condition. In accordance with the present disclosure, the sensitivity of the parameter threshold may be a tolerance of acceptable variation of the monitored second parameter relative to the parameter threshold that indicates a motor stall condition. For example, as the stored kinetic energy increases, the control circuit 2004 can set a more tolerant parameter threshold to allow for more load on the firing beam before making a motor adjustment, for example, with the understanding that the drive assembly contains enough stored kinetic energy to overcome the increased load, or increased parameter threshold. On the other hand, the control circuit 2004 can set a more stringent parameter threshold, or tighten the tolerance of the parameter threshold, so that as the stored kinetic energy decreases, for example, even a slight load on the firing beam may indicate a motor stall condition.
In accordance with the present disclosure, the sensitivity of the parameter threshold may be based on the determined 2712 stored kinetic energy of the drive assembly. As discussed herein, the sensitivity of the parameter threshold can be represented by the magnitude of change of the monitored second parameter which would require a motor adjustment to prevent motor stall. In other words, the tolerance of change of the monitored second parameter before a motor adjustment is initiated can be decreased as the stored kinetic energy decreases. The tolerance of change of the monitored second parameter before a motor adjustment is initiated can be increased as the stored kinetic energy increases. As discussed herein, more stored kinetic energy can allow for a greater variance of the monitored second parameter before initiating a motor adjustment to prevent motor stall because the drive assembly has more kinetic energy to serve as a kinetic buffer through an imminent stall condition.
In accordance with the present disclosure, the tolerance level of variance of the monitored second parameter before initiating a motor adjustment may be tightened as the stored kinetic energy decreases. Similarly, the tolerance level of variance of the monitored second parameter before initiating a motor adjustment can be widened as the stored kinetic energy increases. The tolerance level, or sensitivity, may be adjusted from a 10% acceptable increase threshold of tissue-induced load on the drive element for a first kinetic energy to a 5% acceptable increase threshold of tissue-induced load on the drive element for a second kinetic energy where the second kinetic energy is lower than the first kinetic energy.
In accordance with the present disclosure, the motor control adjustment can be initiated 2717 based on the monitored second parameter exceeding the adjusted parameter threshold. Any suitable motor control adjustment can be initiated such as those disclosed herein. For example, the speed of the motor may be increased to a maximum level in an effort to increase the kinetic energy and, thus, stored kinetic energy to provide a kinetic buffer through the imminent stall condition.
While stall conditions are generally indicated as the events to be prevented, other drive assembly-related events can be monitored and used as the triggering event for sensitivity adjustments, motor control adjustments, and/or stored kinetic energy adjustments. For example, battery integrity of a battery powering a motor can be monitored and kinetic buffers can be utilized to help reduce the load on the battery over time. In accordance with the present disclosure, motor heat may effect motor efficiency over time and can be used to trigger kinetic buffers so as to help reduce motor heat during the life of the motor and/or during a single drive stroke, for example, of the motor.
While surgical stapling drive strokes are generally described in connection with the drive assemblies, control circuits, and processes disclosed herein, it can be appreciated that the drive assemblies, control circuits, and processes can be employed with a separate closure motor and/or closure drive assembly.
Still referring to
The minimum kinetic energy threshold is also configured to be adjusted based on a zone within which the drive element is positioned during the drive stroke. As discussed herein, maintaining a particular kinetic energy through particular sections of the drive stroke can increase reliability and predictability of the drive stroke reducing the possibility of motor stall, for example. A system which simply increases the motor speed to a maximum for example ahead of a potential stall condition may be undesirable. In accordance with the present disclosure, maximizing motor speed during the staple firing and tissue-cutting part of the drive stroke may be okay while maximizing motor speed during the tissue clamping part of the drive stroke may clamp tissue too quickly or apply too much pressure to tissue compared to the desired levels of the user. Thus fine tuning the kinetic buffer can ensure proper amounts of speed and force are applied during specific parts of the drive stroke without overcompensating, for example, ahead of a potential stall condition.
In accordance with the present disclosure, a potential stall condition near, at, or after the staple firing and tissue-cutting part of the stroke may not be as important to buffer as a potential stall condition during other parts of the stroke. The control circuit 2004 can be configured to adjust the motor control program so as to not ram the drive element into the end of the end effector in the event of detecting a potential stall condition.
In at least one instance, energy in a drive train of a motorized surgical instrument can be harvested to recharge a battery in a system where a motor of the surgical instrument is powered by an onboard battery. In at least one instance, regenerative braking can employed by the motorized surgical instrument by converting the motor into a generator which can be used to recover kinetic energy and use the recovered energy immediately and/or store the recovered energy in a capacitor and/or a battery of the motorized surgical instrument, for example. Such regenerative breaking can be employed at any suitable point during a stroke of the motorized surgical instrument. For example, regenerative breaking can be employed at or near the end of the cut line, before, during, and/or after a fault condition (hitting an existing staple line in the tissue, for example, triggering a current spike), in between motor pulses and/or during pauses in motor control signals (use “off” portion of PWM signal to recharge battery using regenerative braking), and/or during retraction portion of the stroke. Dynamic braking regeneration can be used to charge a boosting circuit which can be used to overcome, or push through, a tough portion of tissue, for example. One example of a power recovery circuit 2730 can be seen in
The end effector 3002 comprises a first jaw 3004 and a second jaw 3006. The first jaw 3004 comprises a staple cartridge 3008 insertable into and removable from the first jaw 3004; however, other embodiments are envisioned in which a staple cartridge is not removable from, or at least readily replaceable from, the first jaw 3004. The second jaw 3006 comprises an anvil configured to deform staples ejected from the staple cartridge 3008. The second jaw 3006 is pivotably coupled to the first jaw 3004 such that the second jaw 3006 is pivotable relative to the first jaw 3004 between an open position, where the tip of the second jaw 3006 is space apart from the first jaw 3004 (see
The surgical stapling system comprises an articulation joint 3009 configured to permit the end effector 3002 to be rotated, or articulated, relative to the shaft 3003. The end effector 3002 is rotatable about an articulation axis extending through the articulation joint. Some embodiments may omit the articulation joint 3009. The shaft assembly 3000 comprises cooperating articulation rods 3010, 3011 configured to articulate the end effector 3002 relative to the shaft 3003 about the articulation joint 3009. The shaft assembly 3000 comprises an articulation lock bar 3012 configured to prevent rotation of the end effector 3002, an outer shaft tube 3013 configured to house internal components of the shaft assembly 3000, and a spine portion 3014 configured to provide structure support to the shaft assembly 3000.
The staple cartridge 3008 comprises a cartridge body 3015 including a deck 3018 extending between a proximal end 3016 and a distal end 3017. In use, the staple cartridge 3008 is positioned on a first side of tissue to be stapled and the anvil 3006 is positioned on a second side of the tissue. The anvil 3006 is moved toward the staple cartridge 3008 to compress and clamp the tissue against the deck 3018. Thereafter, staples 3023 removably stored in the cartridge body 3015 are deployed into the tissue. The cartridge body 3015 comprises a plurality of staples removably stored in a plurality of staple cavities 3019 defined within the cartridge body 3015. The staple cavities 3019 are arranged in six longitudinal rows. Three rows of staple cavities are positioned on a first side of a longitudinal slot 3020 and three rows of staple cavities are positioned on a second side of the longitudinal slot 3020. Other arrangements of staple cavities 3019 and staples may be possible.
The staples 3023 are supported by staple drivers in the cartridge body 3015. Staples supported on staple drivers are disclosed in U.S. Patent Application Publication No. 2021/0059672, which is herein incorporated by reference in its entirety. The drivers are movable between a first, unfired position, and a second, fired, position to eject the staples from the staple cavities 3019. The drivers are retained in the cartridge body 3015 by a retainer 3021 which extends around the bottom of the cartridge body 3015 and includes resilient members 3022 configured to grip the cartridge body 3015 and hold the retainer 3021 to the cartridge body 3015. The drivers are movable between their unfired positions and their fired positions by a sled. The sled is movable between a proximal position adjacent the proximal end 3016 and a distal position adjacent the distal end 3017. The sled comprises a plurality of ramped surfaces configured to slide under the drivers and lift the drivers, and the staples supported thereon, toward the anvil. In accordance with the present disclosure, the staples may not be supported by staple drivers, but rather, the staples may include integral drive surfaces that are directly engaged by the sled to lift the staples, examples of which are described in U.S. Patent Application Publication No. 2015/0173756, which is herein incorporated by reference in its entirety.
The sled is moved distally by a firing driver exemplified as a firing bar 3024 configured to contact the sled and push the sled toward the distal end 3017. The longitudinal slot 3020 defined in the cartridge body 3015 is configured to receive the firing driver 3024. The anvil 3006 also includes a slot configured to receive the firing driver 3024. The firing driver 3024 comprises a first cam 3025 which engages the first jaw 3004 and a second cam 3026 which engages the second jaw 3006. As the firing driver 3024 is advanced distally, the first cam 3025 and the second cam 3026 can control the distance, or tissue gap, between the deck 3018 of the staple cartridge 3008 and the anvil 3006. The firing driver 3024 also comprises a knife 3027 configured to incise the tissue captured intermediate the staple cartridge 3008 and the anvil 3006. The knife 3027 is desirably positioned at least partially proximal to the ramped surfaces to eject the staples ahead of the knife 3027. The shaft assembly 3000 comprises a firing bar 3028 attached to the firing driver 3024 and is configured to drive the firing driver through the staple cartridge 3008. In accordance with the present disclosure, the firing bar 3028 may comprise a plurality of laminated strips. More details of the shaft assembly 3000 are disclosed in U.S. patent application Ser. No. 15/385,887 entitled METHOD FOR ATTACHING A SHAFT ASSEMBLY TO A SURGICAL INSTRUMENT AND, ALTERNATIVELY, TO A SURGICAL ROBOT, which is herein incorporated by reference in its entirety.
In accordance with the present disclosure, the anvil 3006 may be moved from the open position to the closed position using a closure system that is controlled separately from the firing driver 3024, where the firing driver 3024 is considered to be a part of a firing system that is separate and distinctly operable from the closure system. Further, in accordance with the present disclosure, the anvil 3006 may comprise a ramp 3029 on a proximal end thereof and the closure system may comprise a closure member, such as an outer shaft tube 3013, that can be movable distally to engage the ramp 3029 and cam the anvil 3006 to the closed position. In the closed position, the first cam 3025 and the second cam 3026 of the firing driver 3024 translate distally and maintain the anvil 3006 in the closed position. To transition the anvil 3006 to the open position, the closure member may be retracted proximal and the anvil 3006 may be biased to the open position by springs positioned within the end effector 3002. The anvil 3006 may include a tab and the closure member may define an aperture at the distal end thereof which engages the tab as the closure member moves proximally, thereby positively transitioning the anvil 3006 to the open position. Exemplary closure systems and closure members are disclosed in U.S. Patent Application Publication No. 2021/0059672, the entire disclosure of which is hereby incorporated by reference herein.
In accordance with the present disclosure, the firing driver 3024 may move the anvil 3006 from the open position to the closed position. The anvil 3006 includes a ramp that extends from a wall defining the slot in the anvil 3006 and that is engaged by the firing driver 3024 during a first portion of the stroke of the firing driver 3024 to move the anvil 3006 to the closed position. At the end of the first portion of the stroke, the firing driver 3024 can continue advancing distally through a second portion of the stroke to deploy staples from the staple cartridge 3008 and incise tissue captured by the end effector 3002. Exemplary firing drivers that close the anvil and fire staples are disclosed in U.S. Pat. No. 11,160,551.
A motor assembly 3036 includes a motor, driven by a motor driver. The motor assembly 3036 operably couples to a drive assembly 3037 to drive, or effect, motion at an end effector 3038, similar to the end effector 3002 shown in
A sensor(s) 3039, for example, provides real-time feedback to the processor 3034 about an operational parameter monitored during a surgical procedure being performed by the surgical system 3030. The operational parameter can be associated with a user performing the surgical procedure, a tissue being treated, and/or one or more components of the surgical system 3030, for example. The sensor 3039 may comprise one or more than one suitable sensor, such as, for example, a magnetic sensor, such as a Hall effect sensor, a strain gauge, a pressure sensor, a force sensor, an inductive sensor, such as an eddy current sensor, a resistive sensor, a capacitive sensor, an optical sensor, a current sensor, a voltage sensor, and/or any other suitable sensor.
The sensor(s) 3039 may comprise one or more than one suitable sensor for detecting one or more than one condition at the end effector 3038 including, without limitation, a tissue thickness sensor such as a Hall Effect Sensor or a reed switch sensor, an optical sensor, a magneto-inductive sensor, a force sensor, a pressure sensor, a piezo-resistive film sensor, an ultrasonic sensor, an eddy current sensor, an accelerometer, a pulse oximetry sensor, a temperature sensor, a sensor configured to detect an electrical characteristic of a tissue path (such as capacitance or resistance), or any combination thereof. As another example, and without limitation, the sensor(s) 3039 may include a sensor located at, or about, an articulation joint, similar to articulation joint 3009, extending proximally from the end effector 3038. Such sensors may include, for example, a potentiometer, a capacitive sensor (slide potentiometer), piezo-resistive film sensor, a pressure sensor, a pressure sensor, or any other suitable sensor type. In accordance with the present disclosure, the sensor(s) 3039 may comprise a plurality of sensors located in multiple locations in the end effector 3038.
In accordance with the present disclosure, the system 3030 may include a feedback system 3040 which may include a device for providing sensory feedback to a user. Such devices may comprise, for example, visual feedback devices (e.g., an LCD display screen, a touch screen, LED indicators), audio feedback devices (e.g., a speaker, a buzzer) or tactile feedback devices (e.g., haptic actuators).
The microcontroller 3033 may be programmed to perform various functions such as precise control over the speed and position of the drive assembly 3037. In accordance with the present disclosure, the microcontroller 3033 may be any single-core or multicore processor such as those known under the trade name ARM Cortex by Texas Instruments. Further, in accordance with the present disclosure, the main microcontroller 1933 may be an LM4F230H5QR ARM Cortex-M4F Processor Core, available from Texas Instruments, for example, comprising an on-chip memory of 256 KB single-cycle flash memory, or other non-volatile memory, up to 40 MHZ, a prefetch buffer to improve performance above 40 MHz, a 32 KB single-cycle SRAM, and internal ROM loaded with StellarisWare® software, a 2 KB EEPROM, one or more PWM modules, one or more QEI analogs, and/or one or more 12-bit ADCs with 12 analog input channels, details of which are available for the product datasheet.
The microcontroller 3033 may be configured to compute a response in the software of the microcontroller 3033. The computed response is compared to a measured response of the actual system to obtain an “observed” response, which is used for actual feedback decisions. The observed response is a favorable, tuned value that balances the smooth, continuous nature of the simulated response with the measured response, which can detect outside influences on the system.
The motor assembly 3036 includes one or more than one electric motor and one or more than one motor driver. The electric motor may be a brushed direct current (DC) motor with a gearbox and mechanical links to the drive assembly 3037. In accordance with the present disclosure, a motor driver may be an A3941 available from Allegro Microsystems, Inc.
In various forms, the motor assembly 3036 includes a brushed DC driving motor having a maximum rotational speed of approximately 25,000 RPM. The motor assembly 3036 may include a brushless motor, a cordless motor, a synchronous motor, a stepper motor, or any other suitable electric motor. The motor driver may comprise an H-bridge driver comprising field-effect transistors (FETs), for example. Those skilled in the art will appreciate that an amount of power any motor produces is determined solely by the voltage applied to the motor and the current drawn by the windings of the motor.
The motor assembly 3036 can be powered by a power source 3041. In accordance with the present disclosure, the power source 3041 may include one or more than one battery to power the motor assembly 3036. A battery may include a number of battery cells connected in series. The battery cells may be replaceable and/or rechargeable. Additionally, or alternatively, the battery cells can be lithium-ion batteries coupleable to and separable from the power assembly.
The end effector 3038 includes a first jaw 3042 and a second jaw 3043. At least one of the first jaw 3042 or the second jaw 3043 is rotatable relative to the other during a closure motion that transitions the end effector 3038 from an open configuration to a closed configuration. The closure motion may cause the jaws 3042, 3043 to grasp tissue therebetween. In accordance with the present disclosure, sensors, such as, for example, a strain gauge or a micro-strain gauge, can be configured to measure a parameter of the end effector 3038, such as, for example, the amplitude of the strain exerted on one or both of the jaws 3042, 3043 during a closure motion, which can be indicative of the closure forces applied to the jaws 3042, 3043. The measured strain is converted to a digital signal and provided to the processor 3034, for example. Alternatively or additionally, sensors such as, for example, a load sensor, can measure a closure force and/or a firing force applied to the jaws 3042, 3043. In accordance with the present disclosure, the sensors may comprise a first sensor to measure a first force on a firing driver 3024 during a firing stroke, and a second sensor to measure a second force on a closure member, such as the outer shaft tube 3013, during a closure stroke. The processor 3034 can receive these force measurements and determine a relationship therebetween, such as a distribution ratio of the force exerted on the firing driver 3024 and the outer shaft tube 3013.
In accordance with the present disclosure, a current sensor can be employed to measure the current drawn by a motor of the motor assembly 3036. The force required to advance the drive assembly 3037 can correspond to the current drawn by the motor, for example. The measured force is converted to a digital signal and provided to the processor 3034.
In accordance with the present disclosure, a strain gauge sensor can measure the force applied to the tissue by the end effector 3038. The strain gauge sensor can be coupled to the end effector 3038 to measure the force on the tissue being treated by the end effector 3038. The strain gauge sensor can measure the amplitude or magnitude of the strain exerted on a jaw of an end effector 3038 during a closure motion, which can be indicative of the tissue compression. The measured strain is converted to a digital signal and provided to a processor 3034.
The measurements of the tissue compression, tissue thickness, and/or force required to close the end effector on the tissue, as respectively measured by the sensors 3039 can be used by the microcontroller 3033 to characterize the selected position and/or corresponding value of the speed of one or more than one component of the drive assembly 3037. In accordance with the present disclosure, a memory 3035 can store instructions, an equation, and/or a lookup table which can be employed by the microcontroller 3033 in the assessment of position and speed on the one or more than one component of the drive assembly 3037.
The surgical system 3030 may comprise wired or wireless communication circuits to communicate with surgical hubs (e.g., surgical hub 3044), communication hubs, and/or robotic surgical hubs, for example. Additional details about suitable interactions between a surgical system 3030 and the surgical hub 3044 are disclosed in U.S. patent application Ser. No. 16/209,423 entitled METHOD OF COMPRESSING TISSUE WITHIN A STAPLING DEVICE AND SIMULTANEOUSLY DISPLAYING THE LOCATION OF THE TISSUE WITHIN THE JAWS, now U.S. Patent Application Publication No. 2019/0200981, the entire disclosure of which is herein incorporated by reference in its entirety.
The control circuit 3032 can be configured to implement various processes described herein. In accordance with the present disclosure, the control circuit 3032 may comprise a microcontroller 3033 comprising processor 3034 (e.g., microprocessor) coupled to a memory circuit 3035. The memory circuit 3035 stores machine-executable instructions that, when executed by the processor 3034, cause the processor 3034 to execute machine instructions to implement various processes described herein. The processor 3034 may be a single-core or multicore processor. The memory circuit 3035 may comprise volatile or non-volatile storage media. The processor 3034 may include a central processing unit (CPU) and an arithmetic unit. The CPU may be configured to receive instructions from the memory circuit 3035.
Alternatively, the control circuit 3032 can be a combinational logic circuit configured to implement various processes described herein. The combinational logic circuit may comprise a finite state machine comprising a combinational logic configured to receive data, process the data by the combinational logic, and provide an output.
Alternatively, the control circuit 3032 is a sequential logic circuit configured to implement various processes described herein. The sequential logic circuit may comprise a finite state machine. The sequential logic circuit may comprise a combinational logic, at least one memory circuit, and a clock, for example. The at least one memory circuit can store a current state of the finite state machine. In accordance with the present disclosure, the sequential logic circuit may be synchronous or asynchronous. The control circuit 3032 may comprise a combination of a processor (e.g., processor 3034) and a finite state machine to implement various processes herein. The finite state machine may comprise a combination of a combinational logic circuit (and the sequential logic circuit, for example.
In accordance with the present disclosure, a first motor can be activated to perform a first function, a second motor can be activated to perform a second function, a third motor can be activated to perform a third function, a fourth motor can be activated to perform a fourth function, and so on. Additionally, in accordance with the present disclosure, the plurality of motors can be individually activated to cause firing, closure, and/or articulation motions in an end effector, such as end effector 3002 or end effector 3038, as examples. The firing, closure, and/or articulation motions can be transmitted to the end effector through a shaft assembly, such as shaft assembly 3000, for example.
The surgical system 3050 may include a firing motor 3056 operably coupled to a firing motor drive assembly 3057, which can be configured to transmit firing motions, generated by the motor 3056, to the end effector The firing motions including, for example, displacement of the firing bar 3028 and firing driver 3024. The firing motions generated by the motor 3056 may deploy the staples from the staple cartridge 3008 into tissue captured by the end effector, and/or advance the firing driver the knife 3027 to cut the captured tissue. The firing driver may be retracted by reversing the direction of the motor 3056.
The surgical system 3050 may include a closure motor 3058 operably coupled to a closure motor drive assembly 3059 configured to transmit closure motions, generated by the motor 3058, to the end effector. In particular, the closure motions displace a closure member, such as outer shaft tube, to close an anvil and compress tissue between the anvil and the staple cartridge. The closure motions may cause the end effector to transition from an open configuration to an approximated, or closed, configuration to grasp tissue, for example. The end effector may be transitioned to an open position by reversing the direction of the motor 3058.
The surgical system 3050 may include one or more than one articulation motors 3060a, 3060b, operably coupled to respective one or more than one articulation motor drive assemblies 3061a, 3061b configured to transmit articulation motions, generated by the motors 3060a, 3060b, to the end effector. The articulation motions may cause the end effector to articulate relative to a shaft, for example. In accordance with the present disclosure, the first articulation motor 3060a may drive a first articulation bar, such as articulation rod 3010, to rotate the end effector in a first direction and the second articulation motor 3060b may drive a second articulation bar, such as articulation bar 3011, to rotate the end effector in a second direction opposite the first direction.
The surgical system 3050 may include a plurality of motors configured to perform various independent functions. In accordance with the present disclosure, the plurality of motors of the surgical instrument or tool can be individually or separately activated to perform one or more than one function while the other motors remain inactive. The articulation motors 3060a, 3060b can be activated to cause the end effector to be articulated while the firing motor 3056 remains inactive. Alternatively, the firing motor 3056 can be activated to fire the plurality of staples, and/or to advance the cutting edge, while the articulation motors 3060a, 3060b remains inactive. The closure motor 3058 may be activated simultaneously with the firing motor 3056 to cause the closure member and the firing driver to advance distally at the same time, or in an overlapping fashion, as described in more detail herein below.
The surgical system 3050 may include a common control module 3062 which can be employed with a plurality of motors of the surgical instrument or tool. The common control module 3062 may accommodate one of the plurality of motors at a time. For example, the common control module 3062 can be coupleable to and separable from the plurality of motors of the robotic surgical instrument individually. A plurality of the motors of the surgical instrument or tool may share the common control module 3062. A plurality of motors of the surgical instrument or tool can be individually and selectively engaged with the common control module 3062. The common control module 3062 can be selectively switched from interfacing with one of a plurality of motors of the surgical instrument or tool to interfacing with another one of the plurality of motors of the surgical instrument or tool.
The common control module 3062 can be selectively switched between operable engagement with the articulation motors 3060a, 3060b and operable engagement with either the firing motor 3056 or the closure motor 3058. In the example illustrated in
Each of the motors 3056, 3058, 3060a, 3060b may comprise a torque sensor to measure the output torque on the shaft of the motor. The force on an end effector may be sensed in any conventional manner, such as by force sensors on the outer sides of the jaws or by a torque sensor for the motor actuating the jaws.
As illustrated in
The processor 3052 may control the motor driver 3067 to control the position, direction of rotation, and/or velocity of a motor that is coupled to the common control module 3062. In accordance with the present disclosure, the processor 3052 can signal the motor driver 3067 to stop and/or disable a motor that is coupled to the common control module 3062.
The memory 3053 may include program instructions for controlling each of the motors of the surgical system 3050 coupleable to the common control module 3062. For example, the memory 3053 may include program instructions for controlling the firing motor 3056, the closure motor 3058, and the articulation motors 3060a, 3060b to cause the processor 3052 to control the firing, closure, and articulation functions in accordance with inputs from algorithms or control programs of the surgical instrument or tool.
A mechanism and/or sensor(s) 3054 can be employed to alert the processor 3052 to the program instructions that should be used in a particular setting. For example, the sensor(s) 3054 may alert the processor 3052 to use the program instructions associated with firing, closing, and articulating the end effector. In accordance with the present disclosure, the sensor(s) 3054 may comprise position sensors to sense the position of the switch 3063, for example. Accordingly, the processor 3052 may use the program instructions associated with firing the I-beam of the end effector upon detecting, through the sensors 3054 for example, that the switch 3063 is in the first position 3064; the processor 3052 may use the program instructions associated with closing the anvil upon detecting, through the sensors 3054 for example, that the switch 3063 is in the second position 3065; and the processor 3052 may use the program instructions associated with articulating the end effector upon detecting, through the sensors 3054 for example, that the switch 3063 is in the third or fourth position 3066a, 3066b. In accordance with the present disclosure, the controller 3051 can communicate with a display 3068, which can be similar to feedback system 3040, to provide feedback to a user. In addition, the display 3068 can include an input interface such that a user can provide input for controlling the surgical system 3050. The controller 3051 can include a timer 3069 to measure elapsed time.
Referring also to
The firing system includes a firing driver 3024, that is movable from a proximal, unfired position, toward a distal, fired position, during a firing stroke to deploy staples stored in a staple cartridge 3008, and to incise tissue captured by the end effector with a knife 3027. The firing driver is driven between the proximal, unfired position and the distal, fired position by a firing motor 3056. The firing driver includes a first cam 3025 and a second cam 3026 to engage the first jaw and the second jaw, respectively, during the firing stroke to apply a closure force to the end effector to maintain the second jaw in the closed position. In accordance with the present disclosure, a power source 3041, 3055 may power the firing motor.
The surgical system includes a control system 3033 or controller 3051, as examples, to actuate the closure motor and firing motor to drive the closure member and the firing driver, respectively, through their respective strokes. The surgical system includes a voltage sensor 3039, to sense a voltage potential of the power source.
During use, the closure motor and firing motor draw current and consume power from the power source to drive the closure member and firing driver, respectively, through their respective strokes. As the motor draws current and consume power from the power source, the voltage potential of the power source is loaded and the voltage drops, or sags, causing the power output of the motors to drop. It is desirable to minimize power source voltage drop over the closure stroke/firing stroke of the closure member/firing driver, respectively, to increase the power output of the power source to the respective motors over their respective strokes. It is desirable to maximize the short inconsistent current draw from the power source by the motor during use thereof.
Voltage drop can be minimized by way of pulse width modulation and micro-recoveries during each “off” period of the pulses. Referring now to
In accordance with the present disclosure, the control system may implement a firing algorithm, which may cause a firing motor 3056, to draw current from a power source having a maximum (or peak) voltage potential VMAX1 and drive a firing driver 3024 through a firing stroke. The algorithm implements a duty cycle 3110 of 100% (e.g., where the motor is held in an “on” state), as shown in graph 3104. Based on the algorithm, the current 3112 drawn by the motor from the power source is held constant, or substantially constant, at IMAX and the voltage potential 3114 of the power source drops from the maximum voltage potential VMAX1 to a minimum voltage potential at the end of the firing stroke.
In accordance with the present disclosure, the control system may implement an adaptive firing algorithm that causes the firing motor to drive the firing driver with adaptive pulse width modulation to diminish power source voltage drop over the firing stroke. Further, in accordance with the present disclosure, graphs 3100, 3102, 3104 may illustrate three exemplary firing strokes of a firing driver using the adaptive firing algorithm using three different power sources—a first power source having a maximum voltage potential of VMAX1, a second power source having a voltage potential of VMAX2, and a third power source having a voltage potential of VMAX3. The first power source includes cells that each have a voltage potential of Vcell1 that collectively form the first power source. The second power source includes cells that each have a voltage potential of Vcell2 that collectively form the second power source. The third power source includes cells that each have a voltage potential of Vcell3 that collectively form the third power source.
As shown in graphs 3100, 3102, 3104, at to, the control system implements the adaptive firing algorithms, which causes the firing motor to transition from an “off” state, in which the motor does not drive, or ceases to drive, the firing driver to prevent it from moving toward the fired position, to an “on” state, in which the motor drives the firing driver toward the fired position, for a first period T1. During the first period T1, the current 3120 drawn by the motor from the first power source increases from 0 to a first maximum current IMAX1 and the voltage potential 3126 applied to the motor from the first power source drops from the maximum voltage potential VMAX1 to a first lower voltage potential. Similarly, the current 3122 drawn by the motor from the second power source increases from 0 to a first max current IMAX2 and the voltage potential 3128 applied to the motor from the second power source drops from the maximum voltage potential VMAX2 to a first lower voltage potential. Similarly, the current 3124 applied to the motor from the third power source increases from 0 to a first max current IMAX3 and the voltage potential 3130 applied to the motor from the third power source drops from the maximum voltage potential VMAX3 to a first lower voltage potential. In accordance with the present disclosure, the control system can detect, or measure, the currents drawn by the motors and voltages applied to the motors using a current sensor and a voltage sensor, respectively. It will be appreciated that the motor can drive the firing driver in either a forward direction (proximal to distal) or a backward direction (distal to proximal).
In accordance with the present disclosure, T1 may be a predetermined period that may be stored in a memory 10035, and may be retrievable by the control system. Further, in accordance with the present disclosure, T1 may be based on the implemented duty cycle. Alternatively, or additionally, T1 may be a variable period. Alternatively, or additionally, T1 may be based on a rate at which the voltage potential drops from the maximum voltage potential Alternatively, or additionally, T1 may be based on the maximum voltage potential dropping a predetermined amount. Alternatively, or additionally, T1 may be based on the maximum voltage potential dropping to a predetermined lower voltage potential.
At time t1, the algorithm automatically causes the motor to transition to the “off” state for a second period T2, during which time the current 3122, 3122, 3124 drawn by the motor from the power sources drops from the first max current IMAX1 to a first lower current and the voltage potential 3126, 3128, 3130 of the power sources recovers from the first lower voltage potential to a first recovered voltage potential that is less than the maximum voltage potentials of the respective power sources.
In accordance with the present disclosure, T2 may be a predetermined period that may be stored in a memory 10035, and may be retrievable by the control system. Alternatively, or additionally, T2 may be based on the implemented duty cycle. Alternatively, or additionally, T2 may be a variable period. Alternatively, or additionally, T2 may be based on T1. Alternatively, or additionally, T2 may be based on a magnitude of the voltage potential drop over T1. Alternatively, or additionally, T2 may be based on a rate at which the voltage potential dropped over T1. Alternatively, or additionally, T2 may be based on the time required for the power source to recover a threshold amount of voltage potential from the first dropped voltage potential. Alternatively, or additionally, T2 may be based on a rate at which the voltage potential recovers from the first dropped voltage potential. In accordance with the present disclosure, T2 may be different than T1. Alternatively, or additionally, T2 may be the same as T1
At time t2, the algorithm automatically causes the motor to transition to the “on” state for a third period T3, during which time the current 3122, 3122, 3124 drawn by the motor from the power sources increases from the first lower current to a second maximum current that is greater than the first maximum current IMAX1 and the voltage potential 3126, 3128, 3130 applied to the motor from the power sources drops from the first recovered voltage potential to a second lower voltage potential that is less than the first lower voltage potential.
In accordance with the present disclosure, T3 may be a period stored in a memory 10035, and may be retrievable by the control system. Alternatively, or additionally, T3 may be based on the implemented duty cycle. In accordance with the present disclosure, T3 may be a variable period. Alternatively, or additionally, T3 may be based on T1 or T2, or a combination thereof. Alternatively, or additionally, T3 may be based on a rate at which the voltage potential recovered during T2. Alternatively, or additionally, T3 may be based on a magnitude of the voltage potential recovered during T2. Alternatively, or additionally, T3 may be based on a rate at which the voltage drops from the first recovered voltage potential. Alternatively, or additionally, T3 may be based on the voltage potential dropping a predetermined amount from the first recovered voltage potential. Alternatively, or additionally, T3 may be based on the voltage potential dropping to a predetermined voltage potential from the first recovered voltage potential. Alternatively, or additionally, T3 may be different than T1 and/or T2. Alternatively, or additionally, T3 may be the same as T1 and/or T3.
At time t3, the algorithm automatically causes the motor to transition to the “off” state for a fourth period T4, during which time the current 3122, 3122, 3124 drawn by the motor from the power sources drops from the second maximum current IMAX2 to a second lower current that is less than the first lower current and the voltage potential 3126, 3128, 3130 of the power sources recovers from the second lower voltage potential to a second recovered voltage potential that is less than the first recovered voltage potential.
In accordance with the present disclosure, T4 may be a predetermined period that may be stored in a memory 10035, and may be retrievable by the control system. Alternatively, or additionally, T4 may be a variable period. Alternatively, or additionally, T4 may be based on T1, T2, or T3, or any combination thereof. Alternatively, or additionally, T4 may be based on a magnitude of the voltage potential drop over T1 or T3, or a combination thereof. Alternatively, or additionally, T4 may be based on a rate at which the voltage potential dropped over T1 or T3, or a combination thereof. Alternatively, or additionally, T4 may be based on the time required for the power source to recover a threshold amount of voltage potential from the second dropped voltage potential. Alternatively, or additionally, T4 may be based on a rate at which the voltage potential recovers from the second dropped voltage potential or a rate at which the voltage potential recovered from the first dropped voltage potential, or a combination thereof. Alternatively, or additionally, T4 may be different than T1, T2, and/or T3. Alternatively, or additionally, T4 may be the same as T1, T2 and/or T3. Alternatively, or additionally, T4 may be about 10 to 50 times larger than T2. As shown in graph 3100, during the fourth period T4, the motor is maintained in an “off” state for a period that allows the power sources to recover a δ amount. Specifically, the motor remains in the “off” state for the fourth period T4 such that the first power source recovers a first amount δ1, the second power source recovers a second amount δ2, and the third power source recovers a third amount δ3.
At time t4, the algorithm automatically causes the motor to transition to the “on” state for a fifth period T5, during which time the current 3122, 3122, 3124 drawn by the motor from the power sources increases from the second lower current to a third maximum current IMAX3 and the voltage potential 3126, 3128, 3130 applied to the motor from the power sources drops from the second recovered voltage potential to a third lower voltage potential.
In accordance with the present disclosure, T5 may be a predetermined period that is stored in a memory 10035, and is retrievable by the control system. Further, in accordance with the present disclosure, T5 may be based on the implemented duty cycle. Alternatively, or additionally, T5 may be a variable period. Additionally, in accordance with the present disclosure, T5 may be based on T1 T2, T3, or T4, or any combination thereof. Alternatively, or additionally, T5 may be based on a rate at which the voltage potential recovered during T2 or T4, or a combination thereof. Alternatively, or additionally, T5 may be based on a magnitude of the voltage potential recovered during T2 or T4, or a combination thereof. Alternatively, or additionally, T5 may be based on a rate at which the voltage drops from the second recovered voltage potential or a rate at which the first recovered voltage potential dropped, or a combination thereof. Alternatively, or additionally, T5 may be based on the voltage potential dropping a predetermined amount from the second recovered voltage potential. Alternatively, or additionally, T5 may be based on the voltage potential dropping to a predetermined voltage potential from the second recovered voltage potential. Alternatively, or additionally, T5 may be different than T1, T2, T3 and/or T4. Alternatively, or additionally, T5 may be the same as T1, T2, T3 and/or T4.
At time t5, the algorithm automatically causes the motor to transition to the off state for a sixth period T6, during which time the current 3122, 3122, 3124 applied to the motor from the power sources drops from the third maximum current IMAX3 to a third lower current and the voltage potential 3126, 3128, 3130 of the power sources recovers from the third lower voltage potential to a third recovered voltage potential.
In accordance with the present disclosure, T6 may be a predetermined period that may be stored in a memory 10035, and may be retrievable by the control system. Alternatively, or additionally, T6 may be based on the implemented duty cycle. Alternatively, or additionally, T6 may be a variable period. Alternatively, or additionally, T6 may be based on T1, T2, or T3, T4, or T5, or any combination thereof. Alternatively, or additionally, T6 may be based on a magnitude of the voltage potential drop over T1, T3, or T5, or any combination thereof. Alternatively, or additionally, T6 may be based on a rate at which the voltage potential dropped over T1, T3, or T5, or any combination thereof. Alternatively, or additionally, T6 may be based on the time required for the power source to recover a threshold amount of voltage potential from the third dropped voltage potential. Alternatively, or additionally, T6 may be based on a rate at which the voltage potential recovers from the third lower voltage potential, a rate at which the voltage potential recovered from the first lower voltage potential, or a rate at which the voltage potential recovered from the second lower voltage potential, or any combination thereof. In accordance with the present disclosure, T6 may be different than T1, T2, T3, T4 and/or T5. Alternatively, or additionally, T6 is the same as T1, T2, T3, T4, and/or T5.
At time t6, the algorithm automatically causes the motor to transition to the on state for a seventh period T7, during which time the current 3122, 3122, 3124 applied to the motor from the power sources increases from the third lower current and the voltage potential 3126, 3128, 3130 applied to the motor from the power source drops from the third recovered voltage potential. During the seventh period t7, the firing driver reaches the distal fired position of the firing stroke and the firing algorithm ceases.
As shown, the algorithm is adaptive and reacts to changes in the voltage potential over the firing stroke of the firing driver. Based on the adaptive nature of the algorithm and the “micro-recoveries” of the voltage potential during the firing stroke, the overall macro-recovery curves 3132, 3134, 3136 of the voltage potentials over time are substantially higher compared to when the motor is left “on” (duty cycle of 100%) for the entire firing stroke, or the firing algorithm uses a constant pulse width modulation algorithm. In addition, the algorithm implemented by the control system implements a variable length pulse width modulation that has variable on/off times based the voltage drops and recovers over the firing stroke.
The first power source, which has a first maximum voltage potential VMAX1, experiences less modulation during the algorithm than the second power source, which has a second maximum voltage potential VMAX2 less than the first maximum voltage potential VMAX1. Similarly, the second power source, which has a second maximum voltage potential VMAX2, experiences less modulation during the algorithm than the third power source, which has a third maximum voltage potential VMAX3 less than the second maximum voltage potential VMAX2. In accordance with the present disclosure, referring to graph 3100, during the second recovery period T4, the first power source recovers δ1, the second power source recovers δ2 which is more than δ1, and the third power source recovers δ3 which is more than δ1 and δ3.
In accordance with the present disclosure, utilizing pulse width modulation can lead to a retardation of heat creation that would result in a locked rotor condition. Further, in accordance with the present disclosure, a larger powered accumulator of a lower ultimate pulse width modulation limit may be utilized to momentarily unstick a locked motor. The motor may reverse direction to result in backward motion of the firing driver and then may reverse direction again to restart forward motion of the firing driver to get through a portion of tissue where mechanical work needed. Alternatively, or additionally, the motor can reverse direction to result in backward motion of the firing driver and then reverse direction again to re-build up dynamic inertia of the firing driver.
In accordance with the present disclosure, voltage drop can be minimized by accumulating power within the system. Additionally, in accordance with the present disclosure, accumulation of power within the system can be accomplished using a circuit 3140, illustrated in
In accordance with the present disclosure, accumulation of power within the system may be accomplished by using a switching capacitor circuit 3146, illustrated in
In accordance with the present disclosure, accumulation of power within the system may be accomplished using capacitors plus pulse width modulation signals that are additive. A duty cycle of the motor may be selected such that the capacitors are re-charged after each drain, which reduces, or diminishes, power source voltage drop. Additionally, or alternatively, the duty cycle may be selected between 30-50%. A selected balance between pulse withdrawn activations and the capacitor sizing leads to a reduction, or elimination, or voltage sag from the power source.
In accordance with the present disclosure, accumulation of power within the system may be based on the chemistry of the system. Additionally, or alternatively, accumulation of power within the system may be based on the duty cycle of the power source, the chemistry of the power source, or the power source chemistry recovery, or a combination thereof. For example, a material for a power source may be selected based on the observed power source voltage drop under load over time.
In accordance with the present disclosure, accumulation of power within the system may be based on motor power consumption, chemistry of the power source, or recovery of the power source, or a combination thereof. The control system can monitor the voltage potential of the power source over the course of a firing stroke in order to determine if the firing stroke should be paused to allow the power source to recover. Graphs 3150, 3160, 3170 shown in
Based on the firing stroke power source, a control system comprising a controller 3033, 3051, sets a power source upper threshold VU, a power source lower threshold VL, and a power source recovery threshold VR. In accordance with the present disclosure, the control system may interrogate the power source to determine a type of the power source. Based on the determination, the control system retrieves the power source upper threshold VU, the power source lower threshold VL, and the power source recovery threshold VR from a memory. Alternatively, the power source upper threshold VU, the power source lower threshold VL, and the power source recovery threshold VR are user defined. Alternatively, the power source upper threshold VU, the power source lower threshold VL, and the power source recovery threshold VR are based on the maximum voltage potential of the power source. Alternatively, the power source upper threshold VU, the power source lower threshold VL, and the power source recovery threshold VR are a predefined percentage of the maximum voltage potential of the power source. Alternatively, the power source upper threshold VU, the power source lower threshold VL, and the power source recovery threshold VR are the same regardless of the power source used by the motor.
At time t1, the control system initiates an adaptive firing algorithm based on a user providing an input to the control system. In accordance with the present disclosure, the adaptive firing algorithm may be similar to other adaptive firing algorithms discussed elsewhere herein. The adaptive firing algorithm may be stored in a memory 3053, and executable by a processor 3052. In accordance with the present disclosure, the user may provide the input to the control system via an input interface at display 3068. Based on the initiation of the adaptive firing algorithm, the adaptive firing algorithm applies a first duty cycle to the motor.
Based on the initiation of the adaptive firing algorithm, at t1, the motor is transitioned to an on state for a first period according to the first duty cycle, causing the motor to draw power from the power source to drive a firing driver, such as firing driver 3024, toward its fired position. During the first period (from t1 to t2), the power source applies a maximum current IMAX to the motor and the voltage potential of the power source drops from VMax to a first lower voltage potential V1. In accordance with the present disclosure, the control system may detect, or measure, the applied currents and voltages using a current sensor and a voltage sensor, respectively.
At time t2, the control system detects, via the voltage sensor, that the voltage potential of the power source has dropped to a first dropped voltage potential V1. In accordance with the present disclosure, the control system may store the first dropped voltage potential V1 in the memory for subsequent evaluations. The control system compares the first lower voltage potential V1 to the power source lower threshold VL to determine if the first lower voltage potential V1 is above or below the power source lower threshold VL. Based on the control system determining that the first lower voltage potential V1 is above the power source lower threshold VL, the firing algorithm maintains the first duty cycle. Based on the control system determining that the first lower voltage potential V1 has reached or dropped below the power source lower threshold VL, the control system adjusts the firing algorithm. As shown in graph 3160, since the first dropped voltage potential V1 is determined to be above the power source lower threshold VL, the motor is transitioned to an “off” state for a second period according to the first duty cycle. During the second period (from t2 to t3), the voltage potential of the power source recovers to a first recovered voltage potential V2.
At time t3, the control system detects, via the voltage sensor, that the voltage potential of the power source has recovered to a first recovered voltage potential V2. In accordance with the present disclosure, the control system may store the first recovered voltage potential V2 in the memory for subsequent evaluations. The control system compares the first recovered voltage potential V2 to the power source upper threshold VU to determine if the first recovered voltage potential V2 is above or below the power source upper threshold VU. Based on the control system determining that the first recovered voltage potential V2 is above the power source upper threshold VU, the firing algorithm maintains the first duty cycle. Based on the control system determining that the first recovered voltage potential V2 has reached or dropped below the power source upper threshold VU, the control system adjusts the firing algorithm, as will be discussed in more detail below. As shown in graph 3160, since the first recovered voltage potential V2 is determined to be above the power source upper threshold VU, the motor is transitioned to the on state for a third period according to the first duty cycle. During the third period (from t3 to t4), the power source supplies the maximum current IMAX to the motor and the voltage potential of the power source drops to a second dropped voltage potential V3.
In accordance with the present disclosure, the control system may evaluate the two data points (e.g., the maximum voltage potential VMax and the first recovered voltage potential V2) and may project 3162 an anticipated recovered voltage potential over time utilizing the first duty cycle. Based on the projected voltage drop over time, the control system predicts a time that the recovered voltage potential of the power source is expected to fail to reach the power source upper threshold VU prior to a later transition of the motor to an “on” state. In accordance with the present disclosure, the surgical system may comprise a display 3068, and the control system may display the predicted time on the display.
In accordance with the present disclosure, the control system may adjust the duty cycle of the firing algorithm based on the prediction. Additionally, based on the prediction, the control system may adjust the algorithm to change the duty cycle of the motor so as to maintain the recovered voltage potential above the power source recovery threshold VU prior to subsequent transitions of the motor to the on state for the remainder of the firing stroke. In accordance with the present disclosure, based on the prediction, the control system may adjust the duty cycle to increase a length of the “off” pulses of the duty cycle. Additionally, or alternatively, based on the prediction, the control system may adjust the duty cycle to increase a length of the “on” pulses of the duty cycle. Further, in accordance with the present disclosure, based on the prediction, the control system may adjust the duty cycle to increase a length of the “on” pulses and the “off” pulses of the duty cycle.
At time t4, the control system detects, via the voltage sensor, the drop in voltage potential of the power source to a second lower voltage potential V3. The control system can store the second lower voltage potential V3 in the memory for subsequent evaluations. The control system compares the second lower voltage potential V3 to the power source lower threshold VL to determine if the second lower voltage potential V3 is above the power source lower threshold VL. Based on the control system determining that second lower voltage potential V3 is above the power source lower threshold VL, the firing algorithm maintains the first duty cycle. Based on the control system determining that second lower voltage potential V3 has reached or dropped below the power source lower threshold VL, the control system adjusts the firing algorithm. Since the second lower voltage potential V3 is determined to be above the power source lower threshold VL, the motor is transitioned to an “off” state for a fourth period according to the first duty cycle as shown in graph 3160. During the fourth period (from t4 to t5), the voltage potential of the power source recovers to a second recovered voltage potential V4.
In accordance with the present disclosure, the control system may evaluate the two data points, the first lower voltage potential V1 and the second lower voltage potential V3, and may project 3164 an anticipated voltage potential drop over time utilizing the first duty cycle. Based on the projected voltage drop over time, the control system predicts a time that the voltage potential of the power source is expected to drop below the power source lower threshold VL during a subsequent “on” state of the motor. In accordance with the present disclosure, the control system may display the predicted time on the display. Additionally, or alternatively, the control system may display both predicted times (predicted time that power source will fail to recover to the power source upper threshold VU and predicted time that power source will drop below the power source lower threshold VL) to inform a user as to which event is expected to occur first.
In accordance with the present disclosure, the control system may adjust the duty cycle of the firing algorithm based on the prediction. Additionally, in accordance with the present disclosure, based on the prediction, the control system may adjust the algorithm to control the duty cycle of the motor to maintain the lower voltage potential above the power source lower threshold VL for the remainder of the firing stroke. Further, in accordance with the present disclosure, based on the prediction, the control system may adjust the duty cycle to increase a length of the “off” pulses of the duty cycle. Additionally, in accordance with the present disclosure, based on the prediction, the control system may adjust the duty cycle to increase a length of the “on” pulses of the duty cycle. Further, in accordance with the present disclosure, based on the prediction, the control system may adjust the duty cycle to increase a length of the “on” pulses and the “off” pulses of the duty cycle.
As shown in graph 3160, from time t4 to t6, the control system maintains the first duty cycle to transition the motor to the “off” state (t4 to t5), the “on” state (t5 to t6), and the “off” state (t6 and t7). At each time point, the control system compares the detected voltage potential to a respective threshold (power source upper threshold VU and power source lower threshold VL) to determine if the first duty cycle should be maintained. At each time point, the control system stores the detected voltage potential in the memory and uses the data points to update the respective projections 3162, 3164 and predictions.
As shown in graph 3160, at time t7, the motor is transitioned to the “on” state for a period according to the first duty cycle, which causes the voltage potential to drop to a third lower voltage potential. During the “on” state, as also seen in graph 3160, the voltage potential of the power source drops below the power source lower threshold VL. In accordance with the present disclosure, despite dropping below the power source lower threshold VL, the firing algorithm can maintain the motor in the on state according to the first duty cycle to allow the motor to finish the “on” pulse. Further, in accordance with the present disclosure, upon detecting the voltage potential dropping below the power source lower threshold VL, the control system can transition the motor to the “off” state, cutting short the “on” pulse, to allow the power source to recover for a recovery period.
In the firing algorithm, the control system compares the third lower voltage potential to the power source lower threshold VL to determine if the third lower voltage potential is above or below the power source lower threshold VL. Since the third lower voltage potential is determined by the control circuit to have dropped below the power source lower threshold VL, the control system transitions the motor to the “off” state and maintains the motor in the “off” state for a recovery period. In accordance with the present disclosure, the recovery period can correspond to the time required for the voltage potential of the power source to recover from the third lower voltage potential to the power source recovery threshold VR. Further, in accordance with the present disclosure, the recovery period may be longer than the “off” pulse for the first duty cycle. As shown in graph 3160, at time t9, based on the control system detecting that the voltage potential of the power source has reached the power source recovery threshold VR, the control system transitions the motor to the on state and resumes applying the firing algorithm with the first duty cycle. In accordance with the present disclosure, based on the control system detecting that the voltage potential of the power source has reached the power source recovery threshold VR, the control system may transition the motor to the on state and may apply a second duty cycle that is different than the first duty cycle.
While
After re-implementing the first duty cycle, the control system continues to compare the detected voltage potentials to the respective thresholds at each on and off pulse to determine if the first duty cycle should be maintained for the remainder of the firing stroke. As shown in graph 3160, at time t10, the firing stroke of the firing driver ends before either thresholds are reached or dropped below, and therefore, no additional recovery periods are needed. However, it should be understood that, had a respective threshold been reached or dropped below, the control system would operate in a similar manner as described above, in which the motor is maintained in an off state for a recovery period to allow the voltage potential of the power source to recover to the power source recovery threshold VR.
The method 3180 comprises transitioning 3184 a motor to an “on” state for a first period. In accordance with the present disclosure, the control system may implement a first duty cycle which turns the motor on for a first period according to the duty cycle. The motor may comprise a firing motor 3056 that drives a firing driver 3024 toward a fired position to deploy staples 3023 from a staple cartridge 3008 when the motor is in an “on” state.
The method 3180 comprises detecting 3186 a dropped voltage potential of a power source at the end of the first period. The control system can interrogate a voltage sensor 3039 to determine the voltage potential of a power source 3041, 3055 that powers the motor. During the “on” state of the motor, the voltage potential of the power source drops from a maximum, or recovered, voltage potential to a lower voltage potential.
The method 3180 comprises conducting 3188 a first comparison between the lower “dropped” voltage potential and the power source lower threshold. In accordance with the present disclosure, the control system may compare the lower “dropped” voltage potential to the power source lower threshold to determine if the lower “dropped” voltage potential is above or below the power source lower threshold.
The method 3180 comprises transitioning 3190 the motor to an “off” state for a second period based on the first comparison. In accordance with the present disclosure, based on the lower “dropped” voltage potential being above the power source lower threshold, the control system may maintain the current duty cycle of the motor and allows the motor to remain “off” for a period according to the duty cycle. Additionally, in accordance with the present disclosure, based on the dropped voltage potential reaching or falling below the power source lower threshold, the control system may transition the motor to the “off” state for a recovery period, which may be longer than the current duty cycle time. The recovery period may correspond to the time required for the voltage potential of the power source to recover to the power source recovery threshold.
The method 3180 comprises detecting 3192 a recovered voltage potential of the power source at the end of the second period. In accordance with the present disclosure, once the second period has elapsed, the control system may interrogate the voltage sensor to determine the voltage potential of the power source. As discussed elsewhere herein, during the “off” state of the motor, the voltage potential of the motor rises, or recovers, from a lower “dropped” voltage potential.
The method 3180 comprises conducting 3194 a second comparison between the recovered voltage potential and the power source upper threshold. The control system can compare the recovered voltage potential to the power source upper threshold to determine if the lower “dropped” voltage potential has reached, or is below, the power source upper threshold.
The method 3180 comprises controlling 3196 the motor based on the second comparison. In accordance with the present disclosure, based on the recovered voltage potential reaching the power source upper threshold, the control system may allow the motor to maintain the current duty cycle of the motor, and thus, may turn the motor back to the “on” state after the second period has elapsed. Alternatively, based on the recovered voltage potential failing to reach the power source upper threshold, the control system may maintain the motor in the “off” state to allow for additional recovery of the motor. Additionally, in accordance with the present disclosure, the control system may maintain the motor in the “off”′ state after the second period for a recovery period, which may correspond to the time required for the voltage potential of the power source to recover to the power source recovery threshold.
At time t1, a control system comprising a controller 3033, 3051 applies a firing algorithm, which causes the firing motor to transition to an “on” state and draw current from the battery 3200 to drive the firing driver toward the distal position. From time t1 to t2, as shown in graphs 3210, 3220, 3230, the voltage output 3208 of the battery 3200 drops from Vmax to V1, the current drawn by the motor increases and is maintained at IMax, and the power consumed by the motor increases to PMax and drops to P1. At time t2, the firing algorithm transitions the motor to the “off” state, causing the motor to stop drawing current from the battery 3200. From time t2 to t3, based on the chemistry and the circuitry of the battery 3200, the voltage potential of the battery 3200 first sharply rises and then steadily rises to a first recovered voltage VR.
In accordance with the present disclosure, the period from t2 to t3 may be a variable period. Additionally, or alternatively, the period from t2 to t3 may be a predetermined period. Additionally, or alternatively, the period may be based on an applied duty cycle to the motor. Additionally, or alternatively, the period from t2 to t3 may be based on a magnitude of the voltage potential drop from t1 to t2. Additionally, or alternatively, the period from t2 to t3 may be based on a rate at which the voltage potential dropped from t1 to t2. Additionally, or alternatively, the period from t2 to t3 may be based on the time required by the battery 3200 to recover a threshold amount of voltage potential from V1. The time from t2 to t3 may be based on a rate at which the voltage potential recovers from V1.
At time t3, the firing algorithm transitions the firing motor to the “on” state again such that the motor draws current from the battery 3200 to resume driving the firing driver toward the fired position.
Voltage drop is minimized by accumulating power within the system. In accordance with the present disclosures, accumulation of power within the system may be accomplished by storing energy during off states of the power source. An “off” state may comprise an “off” pulse of a pulse width modulation signal. Further, additionally, or alternatively, an “off” state may comprise a state in between firing strokes of a firing driver between the conclusion of a first firing stroke and the start of a second firing stroke. In accordance with the present disclosure, energy may be stored in the system using capacitors. Energy stored within a capacitor is given by the classic equation U=0.5 (C) (V2), where U is the capacitor energy, C is the capacitance of the capacitor, and V is the voltage. Based on this equation, the same capacitor charged to a higher voltage will store exponentially more energy within a system.
The control system can comprise a voltage convertor to control voltage that is applied to the motor from the power source, which reduces power source voltage drop. A constraint of many voltage converter methodologies is a limitation of load curves. Total output power is fixed for variable voltages, which impacts the current available for sourcing.
In accordance with the present disclosure, power can be accumulated in the system using a storage capacitor. The storage capacitor may be selectively connected to the motor using active or passive components (e.g., via Diode OR'ing) to allow for very low impact on inrush capabilities. Further, in accordance with the present disclosure, referring to
In operation, during an “off” state of the motor 3252, current flows from the power source 3254 to the storage capacitor 3256 via the buck converter 3258 to charge the storage capacitor 3256. When the motor 3252 transitions to an “on” state to drive a firing driver, current flows from the storage capacitor 3256 and the power source 3254 to the motor 3252 to mitigate motor 3252 inrush current. After the initial transition to the “on” state, the current flows from the power source 3254 to the motor 3252 to drive the firing driver. When the motor 3252 is again transitioned to the “off” state, the current once again flows from the power source 3254 to the storage capacitor 3256 via the buck converter 3258 to charge the storage capacitor 3256.
In accordance with the present disclosure, the storage capacitor 3256 may have a much lower internal resistance when compared to the power source 3254. Accordingly, the voltage drop associated with the storage capacitor 3256 will be much smaller than the power source 3254 voltage drop. The storage capacitor 3256 will aid in keeping the voltage potential to the motor 3252 high, which provides the motor 3252 with more power to complete the firing stroke.
In accordance with the present disclosure, a variable output DC/DC converter can be placed in series with a switching circuit, such as conventional mechanical switch, or electronic switch such as a MOSFET, as examples. Based on the motor being in an “off” state, the DC/DC converter will change its output to a higher voltage to charge capacitors and store energy. A diode OR will drop the voltage to the appropriate level.
Referring now to
In accordance with the present disclosure, accumulation of power within the system can be accomplished by managing power accumulation available within the power source. For instance, due to motor inrush current, the current drawn by the motor from the power source at the beginning of any firing stroke will be substantial. This places a significant limitation on the energy storage capabilities for subsequent firings of the motor. Utilizing a starting consistent operational parameter allows the power source to “recover” and accumulate energy in between firing strokes to provide a more consistent firing outcome over multiple firing strokes of the firing driver. Accordingly, it is desirable that a user of the system be aware of the power accumulation of the power source prior to initiating a subsequent firing stroke in order to understand that the device may perform less than normal unless a sufficient amount of power has been recovered/re-accumulated.
In accordance with the present disclosure, a control system comprising controller 3033, 3051, can monitor an amount of energy accumulated in a power source 3055 after the conclusion of the firing strokes of a firing driver 3024. For instance, a user may provide a first firing input to the control system at an input interface of display 3068. Based on receiving the first firing input, the control system controls a firing motor 3056 to drive the firing driver through a first firing stroke from the proximal, unfired position to the distal, fired position.
Based on the conclusion of the first firing stroke, the control system interrogates a sensor to monitor an amount of power that is re-accumulating within the power source over time. In accordance with the present disclosure, the sensor may comprise a voltage sensor 3054 and the control system may monitor the voltage potential of the power source over time using the voltage sensor. The control system displays the monitored amount of power on a display 3068 to notify the user of the amount of power within the power source. In accordance with the present disclosure, the control system may display the maximum power of the power source on the display. Based on visual cues, a user can determine whether to proceed with a second firing stroke of the firing driver, or wait an additional period prior to the initiation of the second firing stroke to allow for additional power accumulation in the power source.
In accordance with the present disclosure, the control system may set a recovery threshold of the power source. The recovery threshold may correspond to a threshold amount of energy required of the power source to accomplish a subsequent firing stroke. Alternatively, the recovery threshold may correspond to a threshold amount of energy required to allow the firing driver to operate in the same manner as in the first firing stroke. Alternatively, the recovery threshold may be stored in a memory and retrievable by the control system. Alternatively, the recovery threshold may be user defined. Alternatively, the recovery threshold may be a predefined percentage of the maximum voltage potential of the power source. Alternatively, the recovery threshold may comprise a recovery voltage potential of the power source.
In accordance with the present disclosure, the control system may display the recovery threshold on the display to enable the user to visually compare the monitored amount of power of the power source to the recovery threshold. Based on the visual comparison, a user can choose to wait until the power has reached the recovery threshold until actuating a second firing stroke of the firing driver. The user also can choose to actuate the second firing stroke of the firing driver prior to the monitored power reaching the recovery threshold; however, the displayed power will indicate to the user that the system will perform less than normal as the power source was not allowed to re-accumulate to the recovery threshold.
In accordance with the present disclosure, the control system may include a firing lockout to prevent the user from performing another firing stroke until a sufficient amount of energy has been re-accumulated in the power source. Further, in accordance with the present disclosure, the control system may compare the monitored power to the recovery threshold based on a user providing a second firing input to the input interface. Based on the monitored power being less than the recovery threshold, the control system ignores the second firing input and prevents the motor from driving the firing driver through the firing stroke because a sufficient amount of energy has not been re-accumulated in the power source. The control system issues a notification on a display 3068 indicating that a sufficient amount of energy has not been re-accumulated and that additional time is required until the subsequent firing stroke can be initiated. Based on the monitored power reaching or exceeding the recovery threshold, the control system allows the firing stroke to commence and controls the motor to drive the firing driver through the subsequent firing stroke. In accordance with the present disclosure, the control system may display a notification on the display to inform the user that the firing system is available for actuation based on the monitored energy reaching the recovery threshold.
In accordance with the present disclosure, the control system may include a firing lockout to prevent the user from performing another firing stroke until a threshold period has elapsed from the conclusion of a previous firing stroke. The threshold period may be fixed. Further, in accordance with the present disclosure, the power source may comprise an RC circuit and the RC time constant dictates the threshold period. Based on the RC time constant, the control system prevents a user from initiating a subsequent firing stroke for a fixed period to guarantee that the capacitor has had sufficient time to recharge over the period equal to the RC time constant. The threshold period may be variable. Additionally, in accordance with the present disclosure, based on system characterization, and known RC time constant recharge rates, the firing lockout may lock out the user from actuating the firing system for a variable period based on a calculation of predicted energy storage in the power source. Based on the threshold period elapsing, the control system displays a notification on the display to inform the user that the firing system is available for actuation and allows the user to initiate the subsequent firing stroke.
The control system can monitor time, intensity, and/or duration of power draw from the power source during use thereof. Based on the monitored parameters, the control system controls when, and how much, subsequent power draws are allowed or enabled. Such control allows for electrolyte recovery in the power source, as well as allows for heat dissipation of the cells of the power source, which improves the output capacity for the next power usage of the power source, such as during a subsequent firing stroke of the firing driver.
The method 3270 comprises receiving 3274 a first firing input. A user provides a first firing input to a control system comprising a controller 3033, 3051 at an input interface of display 3068 in order to perform a first firing stroke of the firing driver.
The method 3270 comprises controlling 3276 a motor to drive a firing driver through a first firing stroke based on receiving the first firing input. Based on receiving the first firing input, the control system can control a firing motor 3056 to drive a firing driver 3024 through a first firing stroke, from the proximal, unfired position to the distal, fired position.
The method 3270 comprises monitoring 3278 a power source voltage potential at the end of conclusion the first firing stroke. The motor draws current from a power source 3055 to drive the firing driver through the firing stroke and a voltage sensor 3039 senses the voltage potential of the power source over time. The control system interrogates the voltage sensor after the firing stroke has concluded to determine the dropped voltage potential of the power source and to monitor the voltage recovery of the power source over time. In accordance with the present disclosure, the method may comprise displaying the monitored voltage potential on a display 3068 to enable a user to visually track the voltage recovery of the power source over time.
The method 3270 comprises receiving 3280 a second firing input. In accordance with the present disclosure, a user may provide the second firing input to a control system comprising a controller 3033, 3051 at the input interface in order to perform a second firing stroke of the firing driver.
The method 3270 comprises comparing 3282 the monitored voltage potential to the recovery threshold based on receiving the second firing input. In accordance with the present disclosure, based on the user attempting to initiate a second firing stroke of the firing driver by providing a second firing input to the input interface, the control system may compare the monitored voltage potential to the recovery threshold in order to determine if the firing driver should be allowed to advance through a second firing stroke.
The method 3270 comprises abstaining 3284 from controlling the motor to drive the firing driver through a second firing stroke based on the monitored voltage potential being less than the recovery threshold. In accordance with the present disclosure, based on the control system determining that the monitored voltage has not yet reached the recovery threshold, the control system may ignore the second firing input and may abstain from advancing the firing driver through the second firing stroke with the motor. The method 3270 comprises issuing 3286 a notification on a display. In accordance with the present disclosure, the control system may transmit a signal to the display to display a notification that informs the user that the power source has not yet reached the recovery threshold, and therefore, the second firing stroke cannot be completed at this time.
The method 3270 comprises controlling 3288 the motor to drive the firing driver through a second firing stroke based on the monitored voltage potential reaching or exceeding the recovery threshold. In accordance with the present disclosure, based on the monitored voltage potential reaching or exceeding the recovery threshold, the control system may control the motor to drive the firing driver through the second firing stroke. The method may comprise issuing a notification on the display based on the monitored voltage potential reaching the recovery threshold. Accordingly, a user is notified that the power source has recovered a sufficient amount of energy and that a second firing stroke can now be completed.
In accordance with the present disclosure, the method 3270 optionally may further comprise monitoring an elapsed period based on the first firing stroke concluding, comparing the elapsed period to a recovery time period based on receiving the second firing input, and performing an action, such as abstaining from driving the motor or controlling the motor to drive the firing driver through a second firing stroke, based on the comparison.
The method 3300 comprises controlling 3304 a motor to drive a firing driver through a first firing stroke based receiving the first firing input. Based on receiving the first firing input, the control system can control a the firing motor 3056 to drive a firing driver 3024 through a first firing stroke from the proximal, unfired position to the distal, fired position.
The method 3300 comprises monitoring 3306 an elapsed period based on the first firing stroke concluding. In accordance with the present disclosure, based on the firing driver reaching the distal, fired position, the control system may initiate a timer, such as timer 3069, in order to measure an elapsed period from the conclusion of the firing stroke. As described elsewhere herein, after the conclusion of the firing stroke, a power source, such as power source 3055, that powers the motor begins to re-accumulate energy in preparation for a subsequent firing stroke.
The method 3300 comprises receiving 3308 a second firing input. In accordance with the present disclosure, a user can provide the second firing input to a control system, such as controller 3033 or controller 3051, at the input interface in order to perform a second firing stroke of the firing driver.
The method 3300 comprises comparing 3310 the elapsed period to a recovery time period based on receiving the second firing input. In accordance with the present disclosure, based on the user attempting to initiate a second firing stroke of the firing driver by providing the second firing input to the input interface, the control system may compare the elapsed period to the recovery time period in order to determine if the firing driver should be allowed to advance through a second firing stroke. By comparing the elapsed period to the recovery threshold, the control system determines if a sufficient amount of energy has been re-accumulated by the power source in order to complete the second firing stroke. In accordance with the present disclosure, the recovery period may be a predetermined period stored in a memory.
Alternatively, or additionally, the recovery period may be a predetermined period input by a user at the input interface. Alternatively, or additionally, the recovery period may be based on the RC time constant of the power source. Alternatively, or additionally, the recovery period may be a variable period. In accordance with the present disclosure, based on the known RC time constant recharge rate of the power source, the control system can predict the time required before a subsequent firing stroke can be completed and the recovery period comprises this predicted period. Further, in accordance with the present disclosure, the recovery period may be a variable period based on the recharge rate of the power source.
The method 3300 comprises abstaining 3312 from controlling the motor to drive the firing driver through a second firing stroke based on the elapsed period being less than the recovery time period. Based on the control system determining that the elapsed period has not yet reached the recovery time period, the control system can ignore the second firing input and abstains from advancing the firing driver through the second firing stroke with the motor. The method 3300 comprises issuing 3314 a notification on a display. In accordance with the present disclosure, the control system may transmit a signal to the display to display a notification informing the user that the recovery time period has not yet elapsed and therefore, the second firing stroke cannot be completed at this time. The control system may display a countdown to inform a user as to how long until the subsequent firing stroke can be performed.
The method 3300 comprises controlling 3316 the motor to drive the firing driver through a second firing stroke based on the elapsed time reaching or exceeding the recovery time period. In accordance with the present disclosure, based on the elapsed period reaching or exceeding the recovery time period, the control system can control the motor to drive the firing driver through the second firing stroke. Further, in accordance with the present disclosure, the method may comprise issuing a notification on the display based on the elapsed period reaching the recovery time period. Accordingly, a user is notified that the power source has recovered a sufficient amount and that a second firing stroke can now be completed.
In accordance with the present disclosure, the method 3300 optionally may further comprise monitoring a power source voltage potential at the end of conclusion the first firing stroke, comparing the monitored voltage potential to the recovery threshold based on receiving the second firing input, and performing an action, such as abstaining from driving the motor or controlling the motor to drive the firing driver through a second firing stroke, based on the comparison.
In accordance with the present disclosure, voltage drop may be minimized by adjusting the configuration of the battery cells in the power source. Adjusting the configuration of the battery cells may comprise adjusting the number and/or configurations of the cells within the battery to minimize voltage drop.
Balancing the cells of the battery affects the impact of the battery output performance. The number of streams affects the impact of the battery output performance. In accordance with the present disclosure, voltage drop can be minimized by selectively placing some, or all, cells in parallel with one another. Alternatively, voltage drop can be minimized by selectively placing some, or all, cells in series with one another. Alternatively, voltage drop can be minimized by selectively placing some cells in series and some cells in parallel with one another. Paralleling cells increases the capacity of the output of the power source. Placing the cells in series increases the voltage of the output since series cells have internal resistance that are additive. Accordingly, a user can selectively place the battery cells in series and/or parallel based on the desired outcome. Alternatively, the combination of the battery cell chemistries may enhance the overall performance of the battery. For instance a secondary cell may be utilized in combination with a primary cell, where the secondary cell is used to handle the circuit inrush current. In accordance with the present disclosure, the control circuit can selectively switch between the primary cell and the secondary cell based on which of the cells is better suited for a desired need.
In accordance with the present disclosure, the control system may actively control the number of cells used during a firing stroke and makes adjustments “on the fly”. The control system may set a voltage drop threshold and may monitor the battery voltage drop during the firing stroke. Based on the voltage potential reaching or dropping below the voltage drop threshold, the control system changes a state of the battery to actively switch additional cells into the circuit to add additional power. In accordance with the present disclosure, the control system may utilize a first number of cells during an initial portion of a firing stroke. Based on the voltage potential reaching or dropping below the voltage drop threshold, the control circuit changes the state of the power source such that a second number of cells which is more than the first number of cells are utilized. The control system may complete this transition using switching circuitry to place additional cells in series and/or parallel with the first number of cells depending on a desired need. Additionally, in accordance with the present disclosure, based on the rate of change of the voltage drop, the control system may determine whether or not to switch from a primary power source configured to provide a first voltage potential to a second power source configured to provide a second voltage potential different than the first voltage potential.
In accordance with the present disclosure, the surgical system can include an auxiliary battery pack and the control system switches to the auxiliary battery pack if the primary power source voltage potential drops below a threshold level. Additionally, in accordance with the present disclosure, the control system can couple the auxiliary battery pack to the primary battery pack to enhance the power output of the system to a higher level than was previously available. For instance, the control system may interrogate a force sensor to determine if more power is necessary to complete a firing stroke. Based on the determination, the control circuit couples the auxiliary battery pack to the primary battery pack to provide the necessary power to complete the firing stroke.
In accordance with the present disclosure, the power source may comprise a battery that includes cells comprised of lithium ion. Alternatively, the cells may comprise lithium cobalt cells (NCA). Alternatively, the cells may comprise lithium nickel manganese cobalt cells (NMC). Alternatively, the cells may comprise lithium nickel cobalt aluminum cells (NCA). Alternatively, the cells may comprise lithium iron phosphate cells (LFP). Alternatively, the cells may comprise lithium manganese spinel cells (LMO). Alternatively, the cells may comprise lithium titanate cells (LTO). Alternatively, the cells may comprise lithium cobalt oxide cells (LCO).
During operation of a surgical stapling system, heat is generated by the motor, the motor controller, the power source, or other components, for example. As these components heat up, the system operates less efficiently than if the components were maintained at cooler temperatures. These increasing temperatures ultimately affect the amount of force output by the surgical system. Accordingly, it would be desirable to dissipate heat from heat sensitive components to other portions of the surgical system to reduce the heat impacts during heavy usage of the surgical stapling system.
In one embodiment, the surgical stapling system includes a heat sink to extract heat from the heat generating components of the surgical stapling instrument. In one aspect, the heat sink enables the motor to operate at an improved consistent internal temperature and operate more efficiently. In some embodiments, the heat sink removes heat via convection or radiation heat transfer to equalize the internal ambient temperature of the surgical stapling system.
In one aspect, in a surgical stapling system, heat is generated at the gearbox of the motor, the power source (such as a battery), the printed circuit board (PCB) power supplies, and other electrical components of the PCB. In some embodiments, the motor controller is configured to accommodate the heat generated by various components. For instance, in some embodiments, the MOSFETs in the H-bridge of the motor controller are selected such that they can handle, at least, two times more heat dissipation than a standard surgical stapling instrument. In some embodiments, the motor controller comprises an SOT-23 MOSFET, which has a small outline and low power dissipation. In some embodiments, the motor controller comprises a D-pack MOSFET, which has a larger outline than an SOT-23 MOSFET, an additional thermal capacity, and an addition heat sinking capacity with a metal plate on the backside. In one aspect, active or passive cooling components, such as a heat sink, allows for a compact surgical stapling system form factor making it more cost effective due, in part, to the ability of using “smaller” MOSFETS and components that is achievable by keeping the temperatures cool under active control.
In one aspect, during calibration of the surgical stapling system, a baseline internal resistance of the H-bridge is calculated to optimize field performance of the system as the instrument heats up. A heating transfer function of the system, determined by passing current through the H-bridge while the motor is powered in an unloaded state and the instrument is cooled, via active or passive heat components, can be adjusted based on a determined position along the heating/resistance curve. In various embodiments, the surgical system comprises MOSFET with a built-in temperature sensor to sense internal temperature of the system. In some embodiments, the MOSFET comprises an integrated temperature sensor and is known as a TEMPFET. In some embodiments, the surgical system comprises a sensor external to the MOSFET that is utilized to make adjustments to the surgical system based on the sensed temperatures of the internal components.
In various embodiments, the surgical system comprises an active cooling system to control the internal temperature of the surgical system. In some embodiments, the active cooling system is configured to drive the RDS (ON) resistance of the H-bridge MOSFETS below the current ambient temperature, which would drive the RDS (ON) resistance of the MOSFET lower than the level associated with the ambient surrounding device temperature. In one aspect, these small adjustments to the component temperature help drive additional power to the motor and not being burned up in heat.
In various embodiments, shrouds are mechanically and electrically integrated with the PCB to utilize the additional surface area and materials to control the temperature of the PCT.
As the temperature of the power source or the motor increases, the surgical instrument becomes less efficient. Accordingly, it would be desirable to cool the power source and/or motor during operation of the surgical instrument.
In various embodiments, the power source is cooled using forced air from one of the motors. In some embodiments, the motor vents push air to the internals of the power source for additional cooling. In some embodiments, pass through vents are molded into the power source housing to allow for additional flow across the cells of the power source.
In various embodiments, the power source is sealed and filled with a paraffin wax type of material. As the cells temperature increases, the paraffin melts, which will draw heat away from the cells. Once the cell returns to normal operating temperature, the wax re-solidifies.
In various embodiments, the cells of the power source are wrapped with a heat sinking material. The heat sinking material is integrated with the power source shrouds to increase the surface area and give the material access to the “outside” ambient temperature.
In various embodiments, the surgical instrument comprises a thermopile that coverts thermal energy into electrical energy. In one aspect, the thermopile absorbs heat generated by the surgical device and converts this heat to electrical energy. In some embodiments, this electrical energy is used to power an active cooling element, such as cooling fan. In some embodiments, this electrical energy is used to recharge the power source. In some embodiments, energy harvesting technology is employed to harvest heat generated by the power source to produce power. This power is utilized to power an auxiliary cooling system or recharge the power source itself.
In various embodiments, the temperature of the motor is controlled by using the air escaping from the spinning rotor of the motor. In some embodiments, the shrouds are designed such that the escaped air is redirected to flow directly across the motor. In various embodiments, the temperature of the motor is controlled by physically attaching metal portions of the motor directly to the coated shrouds comprised of a thermally conductive material to increase the surface area to dissipate heat. In various embodiments, the temperature of the motor is controlled by wrapping the metal motor can with a circular heat sink to increase the surface area of the motor. In addition, in some embodiment, forced air is added to increase the heat transfer of the system.
In various embodiments, the temperature of the motor can be controlled by replacing the internal gear material from plastic to metal. The metal material being a better heat conductor than plastic would aid in pulling a substantial amount of heat out of the gearbox and the motor. In one aspect, changing a component (gear) that is in direct contact with the heat source (motor) to one having a heat transfer characteristics, can yield a higher heat transfer and greater cooling. In one embodiment, the gear can be comprised of a high carbon filled material.
During a surgical stapling procedure, a clinician may operate a powered surgical stapling instrument 5 to sequentially fire multiple staple cartridges along a selected tissue resection line to achieve a clinical outcome. For example, in a stomach resection procedure, the clinician may sequentially fire staple cartridges of different characteristics (e.g., size, color, type, length, staple height, staple diameter, staple size) along a selected tissue resection line to remove a portion of the stomach. The staple cartridges can be fired along the tissue resection line in an end-to-end arrangement.
The clinician may examine the tissue to be resected using any suitable imaging technique such as, for example, x-ray, registered magnetic resonance imaging (MRI), and/or computerized tomography (CT) scan. The clinician may then select a suitable tissue resection line, and staple cartridges for sequential firing along the selected tissue resection line. Visual examination, however, has its limitations, and a tissue response to stapling can vary depending on many factors including, for example, patient age, tissue health, and/or tissue type. Moreover, tissue thickness and/or stiffness may vary along the selected tissue resection line, resulting in unexpected tissue responses.
Various methods, devices, and systems are provided for adaptively adjusting operational parameters of the powered surgical stapling instrument 5 during a staple cartridge firing based on a tissue response in an earlier phase/zone of the staple cartridge firing. Moreover, various methods, devices, and systems are provided for adaptively adjusting operational parameters of the powered surgical stapling instrument 5 during a staple cartridge firing based on a tissue response in one or more previous staple cartridge firings in a surgical procedure involving multiple sequential firings.
In accordance with the present disclosure, the processor 104 can execute various program instructions, which can be stored in a memory circuit such as the memory circuit 106, to implement various algorithms associated with firing a staple cartridge by the powered surgical stapling instrument 5. Various aspects of such algorithms, e.g., thresholds, limits, triggers, conditions, pauses, wait time, are adjusted based on information learned from a tissue response in an earlier phase/zone of the staple cartridge firing, and/or based on a tissue response in one or more previous staple cartridge firings in a surgical procedure involving multiple sequential firings, as described in more detail below.
In accordance with the present disclosure, the control circuit 100 and the motor assembly 110 may have different voltage levels. The control circuit 100 may have a first voltage level that is different than the voltage of the motor assembly 110. This mitigates in transit loss of voltage or current through motor control systems of the surgical instrument. In transit loss occurs during the transit of power from the power source to the motor assembly. In accordance with the present disclosure, the motor assembly 110 may have an “H-bridge” portion that operates at a voltage level that is different than at least one other portion of the circuit. The voltage of the control circuit 100 may be higher than the voltage within the motor assembly 110 to minimize resistive losses of the transit of the power from the power source to the motor assembly. Alternatively, the voltage of the control circuit 100 may be lower than the motor assembly 110, causing higher motor efficiency.
Transmissibility improvements lead to an increase in power transfer and higher motor efficiency. In accordance with the present disclosure, power transfer can be optimized by architectural improvements. For example, a reduction of intermediate control elements within the control circuit 100 reduces overall power consumption. Distance, resistance, conductor shape, and shape all effect electrical current capacity and as a result overall power consumption. For example, resistances are between 80 mOhms to 170-200 mOhms to reduce power consumption.
In addition, parasitic losses and losses to other forms of energy, such as magnetic, capacitive, and heat, occur in the surgical instrument. Heat dissipation is a form of loss that occurs in a circuit due to proximity or enclosure constraints to other electronics. Minimization of these losses is necessary for extending battery life and efficient power transfer to the motor. With a set battery voltage the present disclosure is directed to maximizing the power delivered to the motor system. For example, the present disclosure is directed to capturing as much of the magnetic field as possible, using flux rings and running the motor at its peak spots on the motor curve. Since each cell within the battery has some internal resistance, by minimizing the current being pulled by the device, this lowers the losses caused by the internal battery resistance (heat from the battery). The cell heating can also negatively impact the battery performance.
In accordance with the present disclosure, the overall current path may be minimized as the circuit components are closely spaced to minimize losses. The current path is through the positive (+) terminal of the battery 4004 to the H-Bridge, to the motor, and to the negative (−) return terminal of the battery 4004. Adjacent circuit components also lose power through induced capacitive coupling and inductive coupling.
The control circuit 4000 is disposed on a printed circuit board (PCB). On the PCB, power electronics 4001 are separated from the logic circuits 4003, such as the digital electronics or electrical conductors carrying data signals to physically and electrically isolate noisy power signal traces from digital/data traces. Accordingly, the digital traces are free from unwanted noise or interference caused by electric, magnetic, or thermal sources.
In accordance with the present disclosure, to minimize parasitic losses in the control circuit 4000, the voltage source to power the control circuit may be unpaired or decoupled from the voltage source to power the motor. This technique enables different power sources to be used. For example, a 24V battery to power a 12V motor uses a step-down circuit at the motor. The 24V battery then has less electrical losses while in storage than a 12V battery. This minimizes parasitic losses. Additional losses occur due to the skin effect in electrical conductors during pulse width modulation (PWM). For example, in electromagnetism, the skin effect refers to the tendency of an alternating electric current (AC) to become distributed within an electrical conductor such that the current density is largest near the surface of the electrical conductor and decreases exponentially with greater depths in the conductor. Thus, in AC circuits, power transfer is mostly through skin transfer while in DC circuits power transfer occurs mid-electrical conductor.
Motor efficiency is a measurement of how much of the electrical energy applied to a motor is converted to mechanical energy. Much of the remaining energy is converted into heat, which can cause a motor to burn out if the motor is operated at a torque and/or revolutions per minute (RPM) where the motor efficiency is very low. Motor heating is directly related to output torque of the motor system. Thus, it is important to control motor generated heat. One way to control motor generated heat is to use a flux ring to envelop the motor.
As heat is introduced to the evaporator 4026, from a motor coupling side 4034 of the vapor chamber 4020, the working fluid within the vapor chamber 4020 turns to vapor which moves to areas of lower pressure. In accordance with the present disclosure, the evaporator 4026 can be in contact with one side of the motor 4012 through the motor coupling side 4014. In another example, the evaporator 4026 is in contact with an open side of the flux ring 4010. The condenser 4022, usually a finned structure, cools the vapor such that the vapor condenses back to a liquid which is absorbed by the wick 4024 and returned via capillary action to the heat source area.
In accordance with the present disclosure, the vapor chamber 4020 can be part of the flux ring 4010 shown in
Additional techniques to minimize system parasitic losses and cool system components by removing the heat (energy) from the system components include removing heat from the H-bridge and the transistors (e.g., MOSFET devices) by way of cooling mechanisms including heat sinks, heat pipes, or vapor chambers.
Other contributing sources of heat include heat energy generated by motor vibrations when the motor is out of specification, e.g., when the motor is being operated above its operating conditions. When the motor vibrates, the motor gearbox may encounter tooth loading, which will add heat energy to the system. One solution is to optimize the impact angle for high loading conditions. During low loading conditions the efficiency is lower but it allows higher outputs during critical high loading conditions of the instrument firing process.
Another solution is to replace plastic gears with metal gears. The loading characteristics of plastic gears change the optimized or efficiency of the contact to the mating gear. The loading profile would “steal” output power due to the gear requiring more energy to rotate. If the gears are metal the contact point would not deflect which would keep the power input required lower than if plastic gears are used.
Other sources of heat energy that can be mitigated include electromagnetic interference (EMI) and electromagnetic compatibly (EMC). This includes adding effective EMI/EMC shielding and filtering to the surgical instrument to simultaneously improve EMI/EMC immunity and reduce electromagnetic emissions, while minimizing risk.
Moreover, motor efficiency can be optimized by tuning the motor drive configurations to compensate for resistance changes or losses to the power supply voltage level. One method for compensating the power supply voltage applied to the motor is through continuous control variation of one or more H-Bridge transistors by operating at least one of the transistors in the linear operating region. Operating the H-Bridge transistors in the linear region provides additional control of the current flowing to the motor. The linear region could be used to lower the current flowing to the motor, which in turn lowers the speed and reduces energy consumption that contributing to the system heat energy losses.
Before describing techniques for operating a motorized surgical instrument, such as the powered surgical stapling instrument 5 shown in
In the saturation region 4102, the MOSFET device will be biased so that the maximum gate voltage is applied to the MOSFET device resulting in channel resistance RDS being as small as possible with maximum drain current flowing through the MOSFET device. Therefore for enhancement type MOSFET devices the conductive channel is open and the device is switched “ON.”
The cut-off region 4108 occurs when VGS<VTH. The MOSFET device operates as an open switch. The breakdown voltage 4110 is shown on graph 4120. By applying a suitable drive voltage to the gate of a MOSFET device, the resistance of the drain-source channel, RDS(on) can be varied from an “OFF-resistance” of many hundreds of kilo-Ohms, effectively acting as an open circuit, to an “ON-resistance” of less than 1Ω, effectively acting as a short circuit.
For example, where there is no load, the speed of the motor is at a maximum. For example, when the motor is stalled 4142, there is a maximum current being applied to the motor, but no torque is being created and the rotor does not rotate while the motor is stalled. The speed and efficiency are also zero. The rated operating point is between the no load and stall conditions. The speed 4132, efficiency 4134, current 4138, and power 4136 lines all intersect the rated operating point 4140 of the motor. Rated operating point 4140 intersects all the lines for a specific load applied to the motor.
In accordance with the present disclosure, the motor control system 4200 can be located within the powered surgical instrument, such as, for example, the powered surgical stapling instrument 5 shown in
With reference back to
In accordance with the present disclosure, when the voltage source 4202 is higher than the input voltage rating of the motor 4210, the control circuit 4204 may step the voltage source 4202 voltage down to a voltage usable by the motor 4210 by controlling the conductivity of the transistor 4206 between the first and second current carrying terminals 4207, 4209.
For example, in accordance with the present disclosure, the control circuit 4204 may set the transistor 4206 in the linear mode (as discussed above in connection with
In accordance with the present disclosure, the control circuit 4204 may set the transistor 4206 in the linear mode (as discussed above in connection with
In accordance with the present disclosure, the control circuit 4204 can control the output voltage of the transistor 4206 at the second current carrying terminal 4209 of the transistor 4206 to a second voltage level by applying a stored profile to the control terminal 4205 of the transistor 4206. The stored profile stores a compensation factor to compensate for voltage drops of the voltage source 4202 during a firing operation of the powered surgical instrument driven by the motor 4210. The control circuit 4204 adjusts for the voltage drop and increases the voltage applied to the motor 4210 such that the voltage applied to the motor is similar to the voltage level of the voltage source 4202. In accordance with the present disclosure, the control circuit 4204 can set a current for the motor 4210 by controlling the control terminal 4205 of the transistor 4206 to adjust the conductivity of the transistor 4206 and apply a desired transistor voltage at the second current carrying terminal 4209 of the transistor 4206 that is compensated for the transmission/parasitic losses 4208 such that the second voltage level 4212 is suitable for efficiently operating the motor 4210 during the firing process.
In accordance with the present disclosure, any voltage drop can be ‘pre-compensated’ when the fire-trigger of the powered surgical instrument is activated. Pre-compensation may be based on known profiles of inrush current for a given motor 4210. For example, each powered surgical instrument includes a memory to store motor profiles. The powered surgical instruments are individually calibrated to meet a predetermined performance based on predetermined parameters. In accordance with the present disclosure, the compensation parameter values may be physically stored in a potentiometer circuit or in a memory circuit of the control circuit 4204, such as for example, an EEPROM (electrically erasable programmable read only memory). Further, in accordance with the present disclosure, the potentiometer can be controlled by the control circuit 4204 to adjust the second voltage level 4212 applied to the motor 4210. One example of a stored voltage profile during a firing operation is described below in connection with
To determine the profile in calibration, the second voltage level 4212 applied to the motor 4210 is measured and compared to a desired voltage to be applied to the motor 4210. A compensation factor is determined based on the difference between the applied voltage and the desired voltage. The control circuit 4204 stores the compensation factor 4222.
For example, the first circuit portion 4201 comprises the control circuit 4204 and the second circuit portion 4203 comprises the motor 4210. The transistor 4206 may separate the first circuit portion 4201 and second circuit portion 4203. The motor 4210 receives the second voltage level 4212. The control circuit 4204 receives the first voltage level. In accordance with the present disclosure, the first voltage level may be a compensated voltage, compensated by the compensation factor 4222, such that the first voltage level is higher than the second voltage level.
In accordance with the present disclosure, the first voltage level—the voltage at the voltage source 4202—may be higher than the second voltage level 4212 applied to the motor 4210. Alternatively, the first voltage level—the voltage at the voltage source 4202—may be lower than the second voltage level 4212 applied to the motor 4210.
The control circuit 4204 also minimizes or maximizes the power applied to the motor 4210 and stores algorithms to modulate the power applied to the motor 4210. For example, the first several firings of the powered surgical instrument will encounter a higher force to fire and will require more power applied to motor 4210 to advance the drive shaft 40. Based on the device cycle number, the control circuit 4204 increases the output power and monitors the power throughout the cycles. The control circuit 4204 counts the number of cycles and stores the device cycle number. The control circuit 4204 also determines the second voltage level 4212 to apply to the motor based on the stored number of cycles for the device. The control circuit 4204 also stores the output power of the prior cycles and determines a desired output power to the motor 4210, at least based in part, on prior output power.
In accordance with the present disclosure, the increase in output power from the voltage source 4202 may be controlled by changing the second voltage level 4212, e.g., the voltage applied to the motor 4210. By way of example, if the motor control system 4200 uses an 18V voltage source 4202, e.g., battery, to power the control circuit 4204 and the motor 4210, during the initial firing cycle the control circuit 4204 applies the full 18 volts to the motor 4210. As the load increases, the second voltage level 4212 applied to the motor 4210 is adjusted to the voltage necessary to complete the firing cycle. If the first several firing were at an increased load—higher than a predetermined threshold, the control circuit 4204 continues to apply the full 18 volts to the motor 4210. If the initial firings are lower than the threshold, the motor 4210 is throttled down to a lower voltage that better matches the loads on the end effector 20 (
In another example, during a motor 4210 stall condition, the control circuit 4204 raises the second voltage level 4212 applied to the motor 4210 incrementally to attempt to return the firing beam 60/knife (
In accordance with the present disclosure, the motor 4210 may be a bipolar or unipolar stepper motor to operate outside of the pull-out and pull-in torque of the motor 4210, which causes the motor 4210 and the attached drive system to vibrate.
In accordance with the present disclosure, the transistor 4206 can be replaced with a DC/DC power converter. The DC/DC power converter drops a higher voltage provided by the voltage source 4202 down to a lower second voltage level 4212 for operating the motor 4210. In accordance with the present disclosure, the transistor 4206 may be a MOSFET device. Further, in accordance with the present disclosure, the transistor 4206 may be a BJT device.
In accordance with the present disclosure, a higher second voltage level 4212 can be utilized to drive the motor 4210, such as a 14V second voltage level 4212 for a 12V battery voltage source 4202. An unknown amount of voltage drop, such as 1V for example, will occur due to transmission/parasitic losses 4208. The transistor 4206 can then be used in the linear region to compensate the remaining overhead voltage down to second voltage level 4212 that is acceptable for the motor 4210. The control circuit 4204 controls the voltage drop of the transistor 4206 by controlling the conductivity of the transistor 4206 through the control terminal 4205.
In accordance with the present disclosure, the control circuit 4204 can monitor the voltage drop and dynamically compensates the voltage drop. The voltage drop is due to voltage and battery sag.
With reference now to
The motor control system 4300 comprises a voltage monitor circuit 4314 coupled to the second conduction terminal 4309 of the transistor 4306, the voltage monitor circuit 4314 measures the voltage applied to the motor 4310 and provides the voltage as feedback to the control circuit 4304. In accordance with the present disclosure, the control circuit 4304 can receive the second voltage level 4312 applied to the motor 4310 as measured by the voltage monitor circuit 4314 and may adjust the second voltage level 4312 based on the measured voltage. In accordance with the present disclosure, the control circuit 4304 may compare a predetermined value of the second voltage level 4312 to the voltage applied to the motor 4310 as measured by the voltage monitor circuit 4314 and may adjust the second voltage level 4312 based on the comparison. For example, the predetermined value of the second voltage level 4312 is the voltage level of the voltage source 4302.
Compensation can also be used to allow for monitoring. Compensation can be used to allow for both unintentional losses as well as losses due to passive elements (e.g., diodes) and active elements (e.g., other active/powered circuitry).
The differential voltage measured by the first and second voltage monitor circuits 4414, 4416 implement a current monitor to monitor the current supplied to the motor 4410. The control circuit 4404 receives a first voltage measured by the first voltage monitor circuit 4414 and a second voltage monitored by the second voltage monitor 4416 to derive a measured current to the motor 4410 and adjusts the current based on the measured current. In accordance with the present disclosure, the control circuit 4404 can monitor both current and voltage applied to the motor 4410. The control circuit 4404 stores an algorithm in memory and actively monitors both the voltage level supplied by voltage source 4402 as well as the second voltage level 4412 applied to the motor 4410 to provide the status of the current being drawn by the motor 4410. The differential voltage is measured across the transmission/parasitic losses 4408 which acts as a shunt for the purposes of monitoring current supplied to the motor 4410. This value could be characterized and calibrated during the manufacturing process against a known quantity to save the need to use a shunt resistor and therefore save costs. For example, the transmission/parasitic losses 4408 could be characterized during manufacturing and together with the differential voltage measured by the first and second voltage monitor circuits 4414, 4416 implement a current monitor to measure the current supplied to the motor 4410. The control circuit 4404 adjusts the current and voltage applied to the motor 4410 based on the monitored voltage and current.
During a surgical stapling procedure, a clinician may operate a surgical stapling instrument 5 to fire sequentially multiple staple cartridges along a selected tissue resection line to achieve a clinical outcome. For example, in a stomach resection procedure, the clinician may sequentially fire staple cartridges of different characteristics (e.g., size, color, type, length, staple height, staple diameter, staple size) along a selected tissue resection line to remove a portion of the stomach. In operation, the staple cartridges fire along the tissue resection line in an end-to-end arrangement.
The clinician may examine the tissue selected for resection using any suitable imaging technique such as, for example, x-ray, registered magnetic resonance imaging (MRI), and/or computerized tomography (CT) scan. The clinician may then select a suitable tissue resection line, and staple cartridges for sequential firing along the selected tissue resection line. Visual examination, however, has its limitations, and a tissue response to stapling can vary depending on many factors including, for example, patient age, tissue health, and/or tissue type. Moreover, tissue thickness and/or stiffness may vary along the selected tissue resection line, resulting in unexpected tissue responses.
Various methods, devices, and systems are provided for adaptively adjusting operational parameters of the surgical stapling instrument 5 during a staple cartridge firing based on a tissue response in an earlier phase/zone of the staple cartridge firing. Moreover, various methods, devices, and systems are provided for adaptively adjusting operational parameters of the surgical stapling instrument 5 during a staple cartridge firing based on a tissue response in one or more previous staple cartridge firings in a surgical procedure involving multiple sequential firings.
In accordance with the present disclosure, the processor 104 can execute various program instructions, which can be stored in a memory circuit such as the memory circuit 106, to implement various algorithms associated with firing a staple cartridge by the surgical stapling instrument 5. Such algorithms, e.g., thresholds, limits, triggers, conditions, pauses, and/or wait time, can be adjusted based on information learned from a tissue response in an earlier phase/zone of the staple cartridge firing, and/or based on a tissue response in one or more previous staple cartridge firings in a surgical procedure involving multiple sequential firings, as described in more detail below.
Parasitic losses occur within the circuitry of a surgical instrument. Parasitic losses can occur when power is consumed even when the device is powered off. Additionally, parasitic losses can occur when energy is lost during the powering of components in an electrical circuit. Momentary overcoming of the parasitic losses within the surgical instrument allows the instrument to minimize the diversion of power away from the motor and increase the power of the motor. The three main contributors to parasitic losses in power semiconductors are conduction, switching, and blocking (also known as reverse leakage). Conduction losses are the product of current flowing through an electrical component. The ripple current affects the power loss.
In accordance with the present disclosure, the surgical instrument may comprise a control circuit that can actively reduce its draw of power to enable the motor to use the full battery output. Battery powered surgical instruments have control electronics that are capable of operating a motor control circuit while reducing the power draw of the control electronics from the primary power source to such a level that the motor is capable of utilizing nearly all of the outputted power of the battery. The control electronics can have an integrated power accumulator and/or a boost circuit capable of providing the control circuit with a voltage level that is different from the voltage of the primary battery pack. Additionally, the control electronics can be selectively severable from the output power of the primary battery pack temporarily and re-coupleable. The electrical components can be temporarily removed from the primary power source.
In addition, optimization of power supply efficiency for a rated output current optimizes overall circuit efficiency and reduces circuit losses. A power supply with multiple converter circuits may be capable of specifying different loading conditions (voltage and current requirements). The converter circuits can be any of a buck, boost, or buck-boost converter circuit. LDO regulators are more efficient than power supplies at low loading situations. An LDO voltage regulator, for example, optimizes voltage output based on pre-determined loading conditions. The surgical device may switch from a power supply to an LDO regulator during low loads to increase battery life. In switching from one power source to another, additional capacitance holds the voltage rail until the switch is complete.
The power management circuit 5010 receives input power from a power supply 5002 and an Input/Output (IO) power supply 5020. In the example illustrated in
The control circuit 5012 comprises a system control circuit 5114, a flash I/O circuit 5016, and a host domain circuit 5018. The control circuit 5012 communicates with the power management circuit 5010 through the SPI 5024 to control the control logic and register circuit 5008 to select the output voltages V2, V3 supplied by the converter circuit 5006a, 5006b, respectively. In accordance with the present disclosure, the output voltage V2 may be in a range from 1.1V to 3.6V at 1 A and the output voltage V3 is in a range from 0.7V to 1.335V at 1 A. Further, in accordance with the present disclosure, the LDO regulator 5004 may output voltage V1 of approximately 3.0V at 250 mA. The control circuit 5012 may comprise additional control electronics (not shown) that draw power from the power supply 5002. The control circuit 5012 can be one embodiment of the control circuit 100 shown in
With continued reference to
The control circuit 5012 stores the operating range of the power supply 5002, the LDO regulator 5004, and the plurality of converter circuits 5006a, 5006b. In accordance with the present disclosure, the expected operating range of the power supply 5002, the LDO regulator 5004, and the plurality of converter circuits 5006a, 5006b may dictate the selection of the power source. The operating range includes at least one of the voltage (V) and current (I) output of each power source.
The control circuit 5012 stores the efficiencies of each selectable power source, for example, the power supply 5002, the LDO regulator 5004, and the plurality of converter circuits 5006a, 5006b. In addition, the control circuit 5012 stores the voltage (V) and current (I) output of each power source. The control circuit 5012 may determine the power source based in part on the voltage (V) and current (I) output of each of the selectable power sources.
In accordance with the present disclosure, the control circuit 5012 can couple the power sources of the power management circuit 5010, such as for example, the LDO regulator 5004 and the plurality of converter circuits 5006a, 5006b selected by the control circuit 5012, to the motor 5026. Where at least one of the converter circuits 5006a, 5006b is a boost converter circuit, the control circuit 5012 can be configured to couple the boost converter circuit to the motor 5026 based on the voltage load at the motor 5026 exceeding the pre-determined voltage load. Additionally, where at least one of the converter circuits 5006a, 5006b is a boost converter circuit, the control circuit 5012 can be configured to determine a voltage sag at the motor 5026 and can couple the voltage boost converter circuit to the motor 5026. Alternatively, where at least one of the converter circuits 5006a, 5006b is a buck converter circuit, the buck converter circuit 5012 can be selected based on the current exceeding the pre-determined current load. The regulator 5004 can be a low dropout (LDO) regulator, and the control circuit 5012 can couple the motor 5026 to the LDO regulator based on the voltage load of the motor 5026 being below the pre-determined voltage load.
Similar to the power management circuit 5010 described in connection with
The control circuit 5112 comprises a system control circuit 5114, a host controller 5128, a host-1 flash I/O circuit 5116, a host-2 domain circuit 5118, and a host-3 domain circuit 5130. The control circuit 5112 communicates with the power management circuit 5110 through the SPI 5124 to control the control logic and register circuit 5108 to select the output voltages V2, V3, V4 supplied by the converter circuit 5106a, 5106b, 5106c, respectively. In accordance with the present disclosure, the output voltage V2 may be in a range from 1.1V to 3.6V at 1.6 A, the output voltage V3 is in a range from 1.1V to 3.6V at 1 A, and the output voltage V3 is in a range from 0.7V to 1.335V at 1 A. Further, in accordance with the present disclosure, the LDO regulator 5104 may output voltage V1 at approximately 1.2V to 3.1V at up to 250 mA. The control circuit 5112 may comprise additional control electronics (not shown) that draw power from the power supply 5102. The control circuit 5112 can be one embodiment of the control circuit 100 shown in
With continued reference to
The control circuit 5112 stores the operating range of the power supply 5102, the LDO regulator 5104, and the plurality of converter circuits 5106a, 5106b, 5106c. In accordance with the present disclosure, the selection of the power source may be based on the expected operating range of the power supply 5102, the LDO regulator 5104, and the plurality of converter circuits 5106a, 5106b, 5106c. The operating range includes at least one of the voltage and current output of each power source.
The control circuit 5112 stores the efficiencies of each selectable power source, for example, the power supply 5102, the LDO regulator 5104, and the plurality of converter circuits 5106a, 5106b, 5106c. In addition, the control circuit 5112 stores the voltage and current output of each power source. The control circuit 5112 can determine the power source based in part on the voltage (V) and current (I) output of each of the selectable power sources.
In accordance with the present disclosure, the control circuit 5112 can couple the power sources of the power management circuit 5110, such as for example the LDO 5104 and the plurality of converter circuits 5106a, 5106b, 5106c selected power source by the control circuit 5112, to the motor 5126. Where at least one of the converter circuits 5106a, 5106b, 5106c is a boost converter circuit, the control circuit 5112 can be configured to couple the boost converter circuit to the motor 5126 based on the voltage load at the motor 5126 exceeding the pre-determined voltage load. Further, where at least one of the converter circuits 5106a, 5106b, 5106c is a boost converter circuit, the control circuit 5112 can be configured to determine a voltage sag at the motor 5126 and couple the voltage boost converter circuit to the motor 5126. Where at least one of the converter circuits 5106a, 5106b, 5106c is a buck converter circuit, the buck converter circuit 5112 may be selected based on the current exceeding the pre-determined current load. The regulator 5104 can be a low dropout (LDO) regulator, and the control circuit 5112 may couple the motor 5126 to the LDO regulator based on the voltage load of the motor 5126 being below the pre-determined voltage load.
The converter circuits 5006a, 5006b described in connection with
In accordance with the present disclosure, the output 5204 can be coupled to a motor (e.g., the motor 5026, 5126 shown in
In accordance with the present disclosure, the buck-boost converter circuit 5300 shown in
By way of example and with reference back to
By way of example and with reference back to
The input 5406 is coupled to a power source, such as the battery for the surgical instrument. The output 5408 can be coupled to the motor. The control circuit 5012, 5112 (shown in
The control circuit 5012, 5112 (shown in
The control circuit 5012, 5112 (shown in
The voltage boost converter circuit 5510 can maintain the output voltage 5516 (VOUT) under high current loads from the motor 5026, 5126 (
The voltage boost converter circuit 5510 provides several advantages. For example, under heavy loading conditions of the battery pack, such as for example the battery pack 5502 shown in
For example, the electrical system of the surgical stapling instrument 5 (
In accordance with the present disclosure, the variable resistor 5540 can be adjustable in “real” time based on the system performance by the control circuit 5012, 5112 (
In accordance with the present disclosure, motor load feedback can be a measured parameter and the resistance values of at least one of the first resistor 5520 (RSH) and the second resistor 5522 (RSL) (
In accordance with the present disclosure, the control circuit 5012, 5112 (
Driving the transistor hard out of the linear region and into the saturation region quickly saves energy. In addition, switching between the linear and saturation states can be done as fast as possible to minimize losses. The graph 5550 illustrates the hard turn on curve 5558 and the hard turn off curve 5559. The control circuit 5012, 5112 (
In accordance with the present disclosure, the use of fast recovery diodes may improve switching losses, but increases conduction losses. To reduce losses, the components of the overall electrical circuitry that are not in use should thus be put in a sleep state or turned off. These small currents can add up to a substantial “parasitic” current draw of the power source. The graph 5600 of reverse recovery illustrates that the reverse recovery charge 5602 is based on the current and the required recovery time.
For example, the surgical stapling instrument 5 (
With reference to
Further, in accordance with the present disclosure, the power management circuit 5010, 5110 can monitor a sensor or circuit element to determine when to turn on and off the surgical stapling instrument 5 (
In accordance with the present disclosure, the power management circuit 5010, 5110, under control of the control circuit 5012, 5112, may engage or disengage unused electrical components. For example, the power management circuit is to engage circuit components when the device determines an activity has occurred. The power management circuit is to couple the electrical components of the circuit to a power source to engage the surgical stapling instrument 5. The power management circuit 5010, 5110 disengages when the surgical stapling instrument 5 determines that there has been a lack of activity for a pre-determined amount of time or that the activity has ended. Disengaging may be severing a connection between the unused electrical components and the power source.
In accordance with the present disclosure, the end of activity can be determined by the orientation of the surgical stapling instrument 5 (
In accordance with the present disclosure, the power management circuit 5010, 5110 can electrically disengage, severs, or disconnect circuit components that are not is use while operating the surgical stapling instrument 5 (
Further, in accordance with the present disclosure, the power management circuit 5010, 5110 can interact with external mechanisms or features to determine activity of the surgical stapling instrument 5 (
In accordance with the present disclosure, the external feature of the surgical stapling instrument 5 (
Further, in accordance with the present disclosure, the external feature can be a device located in the operating room. The power management circuit 5010, 5110 determines that the surgical stapling instrument 5 (
In accordance with the present disclosure, the power management circuit 5010, 5110 can interact with devices externally connected through a wireless connection. The externally connected devices inform the power management circuit 5010, 5110 as to its status during the surgical procedure. Additionally, the power management circuit 5010, 5110 can receive signals from an externally connected device coupled to a surgical hub or surgical energy generator hub (e.g., ultrasonic, monopolar or bipolar RF, or any combination of ultrasonic, monopolar or bipolar RF energy). Some of the received signals indicate that there will be a delay before the externally connected device will be required again or that the externally connected device service in the procedure is complete. The externally connected device can be partially or completely turned off based on the signals. Alternatively, the externally connected devices can be partially or completely turned on by the signals. Engaging circuit components may include turning on the externally connected device or the surgical stapling instrument 5 (
Further, in accordance with the present disclosure, the power management circuit 5010, 5110 can control the user interface. The power management circuit 5010, 5110 adjusts the brightness or contrast of a display portion of the surgical stapling instrument 5. For example, during a firing stage of the surgical stapling instrument 5, the power management circuit 5010, 5110, controls the display. In accordance with the present disclosure, a user may not look at the display until the firing stage is complete. Accordingly, during the firing stage the display is turned off and the display is turned on after the firing stage.
Further, in accordance with the present disclosure, the power management circuit 5010, 5110 may disengage circuit components while the surgical stapling instrument 5 (
Additionally, in accordance with the present disclosure, the power management circuit 5010, 5110 can also control the power management of the communication systems. The power management circuit 5010, 5110 may control the data rate of the communication system. The control circuit 100 (
Additionally, in accordance with the present disclosure, the power management circuit 5010, 5110 may disable the communication systems based on a lack of detecting associated hardware in the operating room. The power management circuit 5010, 5110 determines a lack of hardware in the operation room based on: (1) no detection of devices within a received signal strength indication link range, (2) no devices acting as a preparing advertising beacon, and (3) a lack of audio-based communication, infrared IR based communication, and RFID signals.
Further, in accordance with the present disclosure, the power management circuit 5050, 5110 may not be part of the control circuit 100 (
In accordance with the present disclosure, the power management circuit 5010, 5110 can charge a super capacitor. When additional power is required to service the electrical system, the super capacitor can deliver an additional pulse of energy into the system. The energy can be a burst mode of short duration.
For example, the control circuit 100 (
In accordance with the present disclosure, the supercapacitor circuit (
The switch 5722 is controlled by the control circuit 100, 5012, 5112 (
In accordance with the present disclosure, the power boost can also prevent a brownout condition of the electronics for lack of sufficient power to the electronics.
In accordance with the present disclosure, the vibration circuit 5800 may comprise a piezoelectric material 5802 coupled between a first electrode 5804a and a second electrode 5804b. Under mechanical vibration the piezoelectric material 5802 generates an alternating voltage across the first 5804a and second electrodes 5804b. The vibration circuit 5800 also comprises a rectifier 5806 to convert the alternating voltage into a DC output voltage. The vibration circuit 5800 also comprises a filtering capacitor 5808. The vibration circuit 5800 also comprises a regulator 5810 to maintain a fixed output voltage irrespective of input voltage or load conditions. The voltage at the output of the regulator 5810 can be used to charge a storage capacitor 5812 (Cstorage) or charge a rechargeable battery 5814.
The collected power is stored and can be released if needed by the surgical stapling instrument 5 (
In accordance with the present disclosure, the circuit 5900 can store the energy in the inductor 5904 for future extraction. The collected energy is stored in the inductor 5904 and released if and when it is needed by the surgical stapling instrument 5 (
In accordance with the present disclosure, the control circuit 100, 5012, 5112 (
In accordance with the present disclosure, a higher performance battery pack can be used during over stressed firing conditions. For example, a battery cell is at 3.0 volts, whereas other battery cells in the same size at 3.3 to 3.8 volts. The use of four battery cells with a 0.3 to 0.8 volt increase, increases the total voltage by 1.2 to 3.2 volts (10% to 26% increase). This battery system would have a longer life due to the increased initial voltage.
The shaft 6001 further includes a distal shaft portion 6001b coupled to an end effector 6002. An articulation joint assembly 6003 extends between the proximal shaft portion 6001a and the distal shaft portion 6001b. The articulation joint assembly 6003 includes an articulation driver 6006 movable distally to rotate the end effector 6002 from an unarticulated position, as illustrated in
Further to the above, the end effector 6002 includes a first jaw 6011 and a second jaw 6012 movable relative to the first jaw 6011 to transition the end effector 6002 from an open configuration, as illustrated in
In the illustrated example, a drive shaft 6030 extends distally along the longitudinal central axis 6005 in the unarticulated position, and is coupled to a firing beam 6031 movable by the drive shaft 6030 to drive a sequential deployment of staples from the staple cartridge 6014 and to cut the stapled tissue. Additional details are described in U.S. patent application Ser. No. 14/200,111, entitled CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS, filed Mar. 7, 2014, which issued on Apr. 25, 2017 as U.S. Pat. No. 9,629,629, which is hereby incorporated by reference herein in its entirety.
The surgical instrument 6000 further includes a flex circuit 6020 that transmits at least one of data or power through the articulation joint assembly 6003 to the end effector 6002 from a power source or a data source proximal to the articulation joint assembly 6003. In accordance with the present disclosure, the flex circuit 6020 may transmit power to the end effector 6002 for powering an electronics package 6009 that communicates with a chip in the staple cartridge 6014, for example. Additionally, or alternatively, the flex circuit 6020 may define a communication pathway between the chip and a processor of the surgical instrument 6000 positioned proximal to the articulation joint assembly 6003. In accordance with the present disclosure, as illustrated in
In accordance with the present disclosure, the flex circuit 6020 may comprise floating ends. Additionally, in accordance with the present disclosure, the flex circuit 6020 may comprise fixed ends. Alternatively, in accordance with the present disclosure, the flex circuit 6020 may comprise one floating end and one fixed end. Further, in accordance with the present disclosure, the flex circuit 6020 may include a flexible substrate, and a conductive layer disposed on the flexible substrate.
Translating a flex circuit around an articulation joint requires some manner of accommodation for the different distances spanned by the flex circuit in the unarticulated position and the articulated position. One approach is to provide some manner of strain-relief or allow the flex circuit to change its effective length. A key challenge with strain relief is the number of times the strain relief can be activated and the number of times it can fully recover either due to loss of elasticity, interference due to debris, or fatigue of the copper wiring within the flex circuit. Also, changing the effective length of the flex circuit has its own challenges. The unaccommodated additional length, in the unarticulated position, may cause portions of the flex circuit to extend outside the surgical instrument, or may wrap around, or interfere, with other components.
In accordance with the present disclosure, the present disclosure may present solutions that avoid the forgoing challenges. In accordance with the present disclosure, as illustrated in
In the illustrated example, the flex circuit 6020 is offset from the central longitudinal axis 6005, and includes a proximal flex-circuit portion 6020a positioned in the proximal shaft portion 6001a, a distal flex-circuit portion 6020b positioned in the distal shaft portion 6001b, and an intermediate flex-circuit portion 6020c extending between the proximal and distal flex-circuit portions 6020a, 6020b through the articulation joint assembly 6003 in a predefined passageway, as illustrated in
The folded proximal segment 6021 is tucked in the cavity 6025, and transitions between a first folded configuration, as illustrated in
Further to the above, the proximal segment 6021 transitions between the second folded configuration, as illustrated in
Accordingly, the proximal segment 6021 maintains a curved, or folded, state throughout a full range of articulation of the end effector 6002, while experiencing a reduction in curvature as the end effector 6002 moves from the first articulated position (
As best illustrated in
In accordance with the present disclosure, proximal segment 6021 may have a flex radius greater than, or equal to, about 2× the thickness of the flex circuit 6020 throughout a full range of articulation of the end effector 6002. Further, in accordance with the present disclosure, the proximal segment 6021 may have a flex radius selected from a range of about 2× to about 4× the thickness of the flex circuit 6020, for example, throughout a full range of articulation of the end effector 6002. This arrangement ensures an articulation of the end effector 6002 that only causes a change in the tortuous path of the flex circuit 6020 without strain relief or a change in the effective length of the intermediate flex-circuit portion 6002c.
In the illustrated example, the proximal segment 6021 defines a first radius of curvature (r1) in the unarticulated position (
Further to the above, referring primarily to
In the illustrated example, the proximal segment 6021 enters the cavity 6025 by extending toward the drive shaft 6030, then curves away from the drive shaft 6030. The distal segment 6022, which extends distally from the proximal segment 6021, and partially wraps around the articulation joint 6077, then extends distally toward the end effector 6002. Other pathways and curvatures of the intermediate flex-circuit portion 6002c are contemplated by the present disclosure.
Further to the above, the multi-axis articulation joint assembly 7200 extends between a proximal shaft portion 7101 and the distal shaft portion 7102. As illustrated in
In accordance with the present disclosure, when the multi-axis articulation assembly 7200 is in a non-articulated state, the first articulation joint 7220 and the second articulation joint 7230 can be longitudinally separated by a longitudinal distance D and the multi-axis articulation joint assembly 7200 is aligned with the longitudinal axis LT of the surgical instrument 7000. Additional details are described in U.S. patent application Ser. No. 17/032,279, entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, Sep. 25, 2020, which is hereby incorporated by reference herein in its entirety.
Further to the above, the multi-axis articulation joint assembly 7200 is able to transition from a non-articulated state, as illustrated in
Still referring to
Now referring back to
The surgical instrument 7000 further includes a wiring assembly 7300 disposed within the shaft 7100 and the multi-axis articulation joint assembly 7200. The wiring assembly 7300 includes a wiring harness extending through the cavity 7210 of the multi-axis articulation joint assembly 7200 that transmits at least one of data or power through the multi-axis articulation joint assembly 7200 to a further distal component, such as an end effector 7500, from a power source or a data source proximal to the multi-axis articulation joint assembly 7200. In accordance with the present disclosure, the wiring assembly 7300 can transmit power to the end effector 7500 for powering a chip in the staple cartridge 7514, for example. Additionally, or alternatively, the wiring assembly 7300 may define a communication pathway between the chip and a processor of the surgical instrument 7000 positioned proximal to the multi-axis articulation joint assembly 7200. Portions of the wiring assembly 7300, such as a wiring harness 7310, are able to transition between a non-articulated state, such as illustrated in
Routing a wiring harness through a multi-axis articulation joint requires some manner of accommodation for transitioning between various rotationally offset articulation planes along the length of the multi-axis articulation joint. One accommodation is to incorporate reinforcements, such as strain reliefs or wiring harness junctions, into sections of the wiring harness where any significant amount of flexing and/or bending during an articulation is anticipated. However, the reinforcements themselves may have a limited number of activation cycles before exhibiting a decline in elasticity, interference due to debris, and/or fatigue of copper strands within the wiring harness.
Additionally, there is generally limited space allowed for a wiring harness, and any required movement thereof, within a cavity of a multi-axis articulation joint. Therefore, the use of any reinforcements therein must be balanced with the number of desired conductors and/or geometry thereof to avoid limiting a range of articulation and/or increasing the footprint of the articulation joint. While round cabling can bend in multiple directions, round cables are typically not space efficient and can be limited in allowable bend radius, especially in situations where a multiconductor harness is desirable.
Furthermore, flat wiring harnesses can contain many conductors placed side-by-side spanning the width of the flat wiring harness. This arrangement can be resilient to repeated flexing and/or bending while providing better space efficiency than round cabling. However, flat wiring harnesses are generally limited to flexing about a single linear axis. For example, a flat wiring harness may be resilient to repetitive bends when a thickness thereof is subjected to deformations or bends about a single bend axis parallel to, or extending along, a width of the flat wiring harness with a bend radius extending along the thickness. Said another way, the plane along which a width of the flat wiring harness extends is generally transversely oriented with respect to a plane of rotation. Implementing a flat wiring harness within a multi-axis articulation joint can require multiple flat sections adjoined and reinforced by connector sections should multiple bending planes be required, thereby increasing the overall footprint of the wiring harness. Thus, standard implementations of wiring harnesses through a multi-axis articulation may result in a limited articulation range and/or electrical communication through the wiring harness, and/or a larger articulation joint footprint, each of which is undesirable.
The present disclosure presents solutions that avoid the forgoing challenges. In accordance with the present disclosure, as illustrated in
Now referring to
Further to the above, the proximal flat portion 7312 is associated with a first bending plane BP1 and the distal flat portion 7316 is associated with a second bending plane BP2, where the width of the wiring harness at each portion extends along the corresponding bending plane. In the non-articulated state, the bending planes BP1, BP2 intersect respective articulation planes AP1/AP2 and thus, are transversely oriented to their respective articulation planes and to one another. In accordance with the present disclosure, the bending planes BP1/BP2 may intersect the articulation planes AP1/AP2 such that their normal vectors intersect each other perpendicularly. Furthermore, each of the bending planes may curve or deform with the wiring harness, such as during an articulation, as illustrated in
Further to the above, the preset twist 7314 is configured to accommodate the multiplanar articulations without incorporating additional reinforcements into the wiring harness 7310. In accordance with the present disclosure, the preset twist 7314 can define an angle that corresponds to the rotational offset between the first and second articulation joints 7220 and 7230. In the context of the present disclosure, the angle of the preset twist 7314 can be defined by the rotational offset between the flat portions 7312, 7316 adjoining the preset twist 7314 when viewed from the proximal end 7201 or distal end 7202 in the non-articulated state.
Additionally, the preset twist 7314 is maintained, or partially maintained, throughout a full range of motion of the articulation joint assembly, thereby preserving the relative planar orientations between the flat sections 7312, 7316 and respective articulation planes AP1, AP2 in the non-articulated state. The preset twist 7314 can be integrated into the wiring harness 7310 prior to assembling the surgical instrument. Additionally, the substrate of the wiring harness 7310 may comprise a tough yet flexible polymeric base material, such as, for example, a polyimide-based material, and may be molded to position the preset twist 7314 between the first and second articulation joints 7220/7230 upon routing the wiring harness 7310 through the surgical instrument 7000. Any layers of the wiring harness 7310 may also comprise the polymeric base material and/or another suitable flexible base material having desirable electrical properties. Thus, the wiring harness 7310 does not have to be rearranged and/or stretched from a resting state to provide the preset twist 7314, thereby avoiding any differences in space requirements for the wiring harness 7310 between non-articulated and articulated states. Additionally, the preset twist 7314 obviates the need for a separate biasing member to maintain the orientations of the adjoining flat portions 7312, 7316, thereby minimizing the number of additional components within the multi-axis articulation assembly and issues associated therewith.
In accordance with the present disclosure, the preset twist 7314 can be a permanent twist preformed prior to assembly with the surgical instrument 7000. Further, in accordance with the present disclosure, the preset twist 7314 can be formed by heating the polymeric base material of the wiring harness 7310, twisting the wiring harness to form the preset twist 7314, then allowing the polymeric base material to cool down. Additionally, more than one preset twist 7314 can be defined in the wiring harness 7310. In accordance with the present disclosure, one or more preset bends may be defined in the wiring harness 7310 in addition to, or instead of, the preset twist 7314. The preset twist 7314 can be formed by twisting the wiring harness 7310 to a twist angle that corresponds to a desired angle between articulation planes AP1, AP2, for example.
In accordance with the present disclosure, a proximal portion 7340 of the wiring assembly 7300 is housed in a retainer 7103 nested within the shaft 7100. The proximal portion 7340 is similar in many aspects to other wiring harnesses described elsewhere in the present disclosure. Thus, the proximal portion 7340 can have a cross-sectional profile defined by a thickness and a width greater than the thickness, and multiple conductive paths embedded in a tough and resilient polymeric base layer. Additionally, the proximal portion 7340 is in electrical communication with the wiring harness 7310 and/or physically joined therewith. Further, in accordance with the present disclosure, the proximal portion 7340 and the wiring harness 7310 can be routed through the surgical instrument 7000 as a single assembly.
Now referring to
The channel 7104 may be supplemented by guiding posts 7108 to maintain an orientation of the portion of the wiring assembly 7300 therein. The guiding posts 7108 may be molded out of the same material as the retainer 7103 and spaced such that they do not impart any friction on the proximal portion 7340 of the wiring assembly or impede any movements thereof which may occur during operation of the surgical instrument 7000. The guiding posts 7108 may be longitudinally offset from each other to facilitate routing the proximal portion 7340 of the wiring assembly therethrough without introducing an amount of curvature into the proximal portion 7340 which would induce binding in the longitudinal direction. Additionally, or alternatively, slots can be molded into the retainer 7103 for routing the wiring assembly therethrough.
Further to the above, the wiring assembly 7300 may include scissoring portions to facilitate longitudinal expansion in areas of the surgical instrument where any components thereof may be longitudinally displaced during operation. As best illustrated in
Now referring to
Still referring to
With an industry shift toward smart cartridges arises a need for an effective transmission of power and/or data between the surgical instrument and disposable smart cartridges. Chips, sensors, and/or other electrical components on the staple cartridges provide tremendous functionality, but require higher power and better communication capabilities. Physical electrical interfaces between the surgical instrument and the staple cartridge are capable of meeting the power/data requirements, but suffer from exposure to saline and/or other bodily fluids during a surgical procedure, which can negatively impact power and/or data transmission.
Power and/or data transmission between the surgical instrument and the staple cartridge can also be accomplished wirelessly using wireless antennas, as described in greater detail below. Nonetheless, size constraints (e.g., diameter of antenna coil is roughly equivalent to the maximum transmission distance) can be quite taxing on the antenna coils' ability to meet the higher power and/or data transmission requirements. Moreover, slight misalignments between the antenna coils can seriously impact the ability of the antenna coils to effectively transmit power and/or data wirelessly therebetween. The present disclosure can provide technical solutions for ensuring effective power and/or data transmission between a surgical instrument (e.g., surgical instrument 8000) and a disposable cartridge (e.g., staple cartridge 8040).
The shaft 8001 further includes a distal shaft portion 8001b coupled to an end effector 8002. An articulation joint assembly 8003 extends between the proximal shaft portion 8001a and the distal shaft portion 8001b. The articulation joint assembly 8003 includes an articulation driver movable distally to rotate the end effector 8002 from an unarticulated position toward an articulated position. The articulation joint assembly 8003 can be removed, and the proximal shaft portion 8001a and the distal shaft portion 8001b define a continuous shaft.
Further to the above, the end effector 8002 includes a first jaw 8011 and a second jaw 8012 movable relative to the first jaw 8011 to transition the end effector 8002 from an open configuration, as illustrated in
While the present disclosure can be explained in the context of a linear stapler, this should not be construed as limiting. The present disclosure can readily be implemented in other types of surgical instruments that employ smart cartridges.
In the illustrated example, a drive shaft 8030 extends distally along the longitudinal central axis 8005. The drive shaft 8030 is coupled to a firing beam 8031, and is movable by the drive shaft 8030 to motivate a sequential deployment of staples from the staple cartridge 8040, and motivate a cutting of the stapled tissue by a knife on the firing beam 8031, for example. Additional details are described in U.S. patent application Ser. No. 14/200,111, entitled CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS, filed Mar. 7, 2014, which issued on Apr. 25, 2017 as U.S. Pat. No. 9,629,629, which is hereby incorporated by reference herein in its entirety.
The closure of the end effector 8002 can be driven separately, e.g., by a closure tube, from staple firing. A closure tube could motivate one, or both, the jaws 8011, 8012 to move toward the closed configuration prior to, or concurrently with, advancement of the firing beam 8031 to deploy the stapes and cut the tissue grasped by the end effector 8002.
The surgical instrument 8000 further includes a wiring harness 8020 comprising a flex circuit that transmits at least one of data or power through the articulation joint assembly 8003 to the end effector 8002 from a power source or a data source proximal to the articulation joint assembly 8003. The flex circuit can transmit power to the end effector 8002 for powering an electronics package that communicates with a chip in the staple cartridge 8040, for example. A wireless signal-transfer circuit 8050 (
The flex circuit can comprise floating ends. The flex circuit can comprise fixed ends. The flex circuit can comprise one floating end and one fixed end. The flex circuit can include a flexible substrate and a conductive layer disposed on the flexible substrate.
The interconnecting wiring harness 8020 can be comprise of twisted wire pairs or a flex circuit with similar shielding or overlapping conductors, for example, in order to minimize the electrical coupling to adjacent metallic components that may cause parasitic losses. The flex circuit may include a shielding layer that can be integrated into some of the layers of the flex circuit, for example, for magnetic coupling mitigation. The flex circuit traces can be overlaid in a twisted pair pattern to minimize the magnetic coupling to external metal and, thereby, minimize the creation of reinforced magnetic fields, for example. The flex circuit can be coiled/twisted down the entirety of the pathway of the wiring harness 8020, which can be the entire, or at least part of the entire, length of the shaft 8001, for example.
The coiled flex circuit allows for longitudinal movement of the flexible circuit. The flex circuit can be put into the twist-curl shape, which allows the flex circuit to have some shape memory. Accordingly, the coiled flex circuit may extend, then retract to an original shape, with articulation of the end effector 8001, for example, without risking damage to flex circuit components.
As best illustrated in
Referring to
Referring primarily to
The aligner 8060 includes a channel alignment component 8061 (
As illustrated in
The predetermined spatial relation between the antennas 8051, 8052, as defined by the interlocking interface of the components of the aligner 8060, comprises a translational misalignment tolerance of less than or equal to a predefined distance. The translational misalignment tolerance includes a tolerance in one or more dimensions such as, for example, a longitudinal translational misalignment tolerance, a transverse translational misalignment tolerance, and/or a vertical translational misalignment tolerance. The aligner 8060 is to resist longitudinal, vertical, and/or transverse movement, or sliding, of the staple cartridge 8040 relative to the longitudinal channel 8015 in the assembled configuration, to ensure a proper alignment of the antennas 8051, 8052.
Additionally, or alternatively, the predetermined spatial relation comprises an angular misalignment tolerance of less than or equal to a predefined angle. The interlocking interface of the components of the aligner 8060 resists pitch, yaw, and/or roll movement of the staple cartridge 9040 relative to the longitudinal channel 8015.
The translational misalignment tolerance and/or the angular misalignment tolerance can be selected from a range of about 0.01% to about 10%, for example. Other values and/or ranges are contemplated by the present disclosure. The aligner 8060 can ensure a translational misalignment less than or equal to ±5 mm, ±3 mm, or ±1 mm, for example. The aligner 8060 can ensure an angular misalignment of less than or equal to ±5°, ±3°, or ±1°, for example.
The aligner 8060 can maintain an air-gap distance between the antennas 8051, 8052, in the assembled configuration, of about 4.5 mm. In some aspects, the air-gap distance is any value selected from a range of about 3 mm to about 10 mm, for example.
The alignment components 8061, 8062 can be designed in an offset configuration to resolve a manufacturing-induced misalignment between the channel antenna 8051 and the cartridge antenna 8052 in the assembled configuration. The manufacturing-induced misalignment may be due cartridge shrinkage. The designed offset between the alignment components 8061, 8062 can be tuned to address the manufacturing-induced misalignment.
An important characteristic of the aligner 8060 is its distance from the antennas 8051, 8052 in the assembled configuration. To effectively maintain the predetermined spatial relation between the antennas 8051, 8052, in a manner that ensures efficient/optimal power and/or data transfer therebetween, the aligner 8060 is to be positioned a predetermined distance (D),
The aligner 8060 and the antennas 8051, 8052 are located at a proximal portion 8059 of the end effector 8002, as best illustrated in
The aligner 8060 is positioned distal to the antennas 8051, 8052 in the assembled configuration, as illustrated in
Referring primarily to
Instead of the insulative, or non-conductive, layer 8070, or in addition thereto, a ferrite shield 8080 can be utilized to focus/manage the magnetic field in the inductive coupling between the antennas 8051, 8052.
The longitudinal channel 8115 and staple cartridge 8140 comprise cavities 8171, 8172, respectively, defined in corresponding outer surfaces thereof, as illustrated in
The longitudinal channel 8215 and staple cartridge 8240 cooperatively form an aligner 8260 that incorporates, or integrates, antennas 8251, 8252 into a channel alignment component 8261 and cartridge alignment component 8262, respectively. As illustrated in FIG. 122, the antennas 8251, 8252 can be positioned on, or embedded in, the channel alignment component 8261 and cartridge alignment component 8262, respectively.
The staple cartridge 8240 is similar in many respects to the staple cartridge 8040, which are not repeated herein for brevity. The cartridge alignment component 8262 is positioned on a cartridge body 8245 of the staple cartridge 8240, and is shaped and sized for a matting engagement with the channel alignment component 8261 defined on a side wall 8217 of the longitudinal channel 8215.
The channel alignment component 8261 includes a depression, or cavity 8267, defined in the side wall 8217. The cartridge alignment component 8262 includes a corresponding projection 8268 for matting engagement with the cavity 8267. The antennas 8251, 8252 reside in the cavity 8267 and projection 8268, respectively. The antennas 8251, 8252 are within sufficiently close proximity for signal transmission therebetween when the projection 8268 is assembled with the cavity 8267.
The staple cartridge 8340 is removably insertable in the longitudinal channel 8315. The staple cartridge 8340 and the longitudinal channel 8315 can be transitioned between an assembled configuration, wherein the staple cartridge 8340 is positioned in the longitudinal channel 8315, and an unassembled configuration where the staple cartridge 8340 is separate from the longitudinal channel 8315. The staple cartridge 8340 includes staples deformable against staple forming pockets of an anvil of the end effector 8302, in the assembled configuration.
The staple cartridge 8340 is configured for wireless transmission of power and/or data with the surgical instrument 8300, in the assembled configuration, as illustrated in
The sled 8370 is movable distally from a home position (
The surgical instrument 8300 further includes a channel antenna 8351 positioned at a side wall of 8317 of the longitudinal channel 8315, in alignment with the cartridge antenna 8352, while the sled 8370 is in the home position, as illustrated in
The aligner 8360 is at a proximal portion of the end effector 8302, and is adjacent the channel antenna 8351 and the cartridge antenna 8352 in the assembled configuration. The aligner 8360 is configured to maintain a predefined spatial relation between the channel antenna 8351 and the cartridge antenna 8352, while the sled 8370 is in the home position.
The aligner 8360 includes a channel alignment component 8361 and a cartridge alignment component 8362 configured for matting engagement with the channel alignment component 8361. The alignment components 8361, 8362 are similar to the alignment components 8261, 8262, respectively. The channel alignment component 8361 protrudes, or outwardly extends, from the side wall 8317, and is configured to house the channel antenna 8351 therein. The cartridge alignment component 8362 defines an opening configured to receive the channel alignment component 8361 in the assembled configuration. Alternatively, the opening can be defined by the side wall 8317, and the protrusion by the cartridge body of the staple cartridge 8315. In any event, the channel alignment component 8361 and corresponding cartridge alignment component 8362, cooperatively maintain the channel antenna 8351 and the cartridge antenna 8352 in a predefined spatial relation.
In various aspects, one or more electrical circuits, e.g., various flex circuits described herein, can be integrated into mechanical and/or structural components of a surgical instrument such as, for example, a handle, a shaft, and/or an end effector. The electrical circuits can be incorporated into the body of the components or their coatings. Various conductors can be incorporated in shrouds of a handle, for example.
In some aspects, anvils and/or longitudinal channels of the present disclosure can be modified to include print traces directly onto metal surfaces of the anvils and/or the longitudinal channels, for example, to minimize space needed for the electrical circuits. The same approach can be applied to coils for wireless communications. The coil can be printed directly on the walls of the longitudinal channels. In fact, the metal channel backing may increase the wireless strength.
In some aspects, the metal components of the shafts and/or the handles described herein can be utilized as ground return for electrical circuits therein. In one example, one or more of the drive/firing bars described herein can be made from a plurality of metal laminates, one or more of which can be used as conductors through the shaft, by applying conductive traces thereto. A dielectric layer must be placed be utilized to separate the laminates from the conductive traces. In some aspects, the laminates can be made out of a non-conductive material to allow the material to be receptive to an electrical conductor. The traces can be made from conductive inks or epoxies.
Conductive traces can also be applied to a handle shroud of a surgical instrument, in accordance with the present disclosure. The surgical instrument can be battery powered, and the battery can be stored within the handle shroud, for example. The conductive traces can be utilized to form power and ground connections from the battery, which can be routed to various portion of the surgical instrument, while occupying minimal space there within. For example, power to the motor could be routed down the handle plastic to the area near the handle end. The plastic cross rib could have the electrical contacts set up such that when the MGB is placed into the shroud, the motor terminals contact the plastic rib in the proper location to be energized.
Various sensors, in accordance with the present disclosure, can be connected for data and/or power transmission through conductive traces disposed in nearby portion of a surgical instrument such as, for example, the shrouds that are designed to wrap and protect the internal frame that carries and locates the mechanical components of the surgical instrument. One or more sensors could be positioned to take advantage of the shrouds proximity to key mechanical components. For example, sensors could be attached to the shroud near trigger such as, for example, a closure trigger. By placing the sensor on the shroud near the closure trigger, a direct measure of the closure trigger location during the closure cycle can be achieved. This direct measure can be correlated to the closure state of the surgical instrument. The shrouds location near the closure trigger would allow the sensor to be positioned perpendicular to the trigger, and ensure a high fidelity signal.
Further to the above, the placement of conductive traces directly on, or near, functional components such as, for example, a motor and/or a motor gear box permits a direct measurement of speed at the motor, or at the motor gearbox. The shroud portions of the handle closely surround the motor gearbox to keep the size of the handle at an optimal size for a proper grip. Accordingly, placement of the sensors and/or the conductive traces on, or near, the shroud portions extending around the motor, or the motor gear box, permits optimal sensor measurements. For example, a motor encoder can be placed directly at the back end of the motor, which permits more accurate speed measures, and reduces feedback error. The conductive traces, which are placed on the surrounding shroud portions, can then connect the motor encoder to a control circuit of the surgical instrument.
In addition to the conductive traces, in place of the conductive traces, a semi rigid wiring harness can be utilized in the shroud portions of the handle, for power and/or data transmission along a fixed semi-rigid track within the shrouds.
A motor assembly 9009 includes one or more motors, driven by motor drivers. The motor assembly 9009 operably couples to a drive assembly 9011 to drive, or effect, one or more motions at an end effector 9010. The drive assembly 9011 may include any number of components suitable for transmitting motion to the end effector 9010 such as, for example, one or more gears, gear sets, gear transmissions with one or multiple selectable gears, linkages, bars, tubes, and/or cables, for example.
One or more of sensors 9008, for example, provide real-time feedback to the processor 9006 about one or more operational parameters monitored during a surgical procedure being performed by the surgical system 9002. The operational parameters can be associated with a user performing the surgical procedure, a tissue being treated, and/or one or more components of the surgical system 9002, for example. The sensors 9008 may comprise any suitable sensor, such as, for example, a magnetic sensor, such as a Hall effect sensor, a strain gauge, an encoder, a position sensor, a force sensor, a pressure sensor, an inductive sensor, such as an eddy current sensor, a resistive sensor, a capacitive sensor, an optical sensor, and/or any other suitable sensor.
Further to the above, in accordance with the present disclosure, the sensors 9008 may comprise any suitable sensor for detecting one or more conditions at the end effector 9010 including, without limitation, a tissue thickness sensor such as a Hall Effect Sensor or a reed switch sensor, an optical sensor, a magneto-inductive sensor, a force sensor, a pressure sensor, a piezo-resistive film sensor, an ultrasonic sensor, an eddy current sensor, an accelerometer, a pulse oximetry sensor, a temperature sensor, a sensor configured to detect an electrical characteristic of a tissue path (such as capacitance or resistance), or any combination thereof. As another example, and without limitation, the sensors 9008 may include one or more sensors located at, or about, an articulation joint extending proximally from the end effector 9010. Such sensors may include, for example, a potentiometer, a capacitive sensor (slide potentiometer), piezo-resistive film sensor, a pressure sensor, a pressure sensor, or any other suitable sensor type. In some arrangements, the sensor 9008 may comprise a plurality of sensors located in multiple locations in the end effector 9010, including the staple cartridge, for example.
In accordance with the present disclosure, the surgical system 9002 can include a feedback system 9013 which includes one or more devices for providing a sensory feedback to a user. Such devices may comprise, for example, visual feedback devices (e.g., an LCD display screen, a touch screen, LED indicators), audio feedback devices (e.g., a speaker, a buzzer) or tactile feedback devices (e.g., haptic actuators).
The microcontroller 9005 may be programmed to perform various functions such as precise control over the speed and position of the drive assembly 9011. The microcontroller 9005 may be any single-core or multicore processor such as those known under the trade name ARM Cortex by Texas Instruments. Additionally, the main microcontroller 9005 may be an LM4F230H5QR ARM Cortex-M4F Processor Core, available from Texas Instruments, for example, comprising an on-chip memory of 256 KB single-cycle flash memory, or other non-volatile memory, up to 40 MHZ, a prefetch buffer to improve performance above 40 MHz, a 32 KB single-cycle SRAM, and internal ROM loaded with StellarisWare® software, a 2 KB EEPROM, one or more PWM modules, one or more QEI analogs, and/or one or more 12-bit ADCs with 12 analog input channels, details of which are available for the product datasheet.
The microcontroller 9005 may be configured to compute a response in the software of the microcontroller 9005. The computed response is compared to a measured response of the actual system to obtain an “observed” response, which is used for actual feedback decisions. The observed response is a favorable, tuned value that balances the smooth, continuous nature of the simulated response with the measured response, which can detect outside influences on the system.
The motor assembly 9009 includes one or more electric motors and one or more motor drivers. The electric motors can be in the form of a brushed direct current (DC) motor with a gearbox and mechanical links to the drive assembly 9011. In accordance with the present disclosure, a motor driver may be an A3941 available from Allegro Microsystems, Inc.
In accordance with the present disclosure, the motor assembly 9009 may include a brushed DC driving motor having a maximum rotational speed of approximately 25,000 RPM. Alternatively, the motor assembly 9009 may include a brushless motor, a synchronous motor, a stepper motor, or any other suitable electric motor. The motor driver may comprise an H-bridge driver comprising field-effect transistors (FETs), for example.
The motor assembly 9009 can be powered by a power source 9012. The power source 9012 can include one or more batteries which may include a number of battery cells connected in series that can be used as the power source to power the motor assembly 9009. In accordance with the present disclosure, the battery cells of the power assembly may be replaceable and/or rechargeable. Further, accordance with the present disclosure, the battery cells comprise lithium-ion batteries which can be couplable to and separable from the power assembly.
Further to the above, the end effector 9010 includes a first jaw 9001 and a second jaw 9003. At least one of the first jaw 9001 and the second jaw 9003 is rotatable relative to the other during a closure motion that transitions the end effector 9010 from an open configuration toward a closed configuration. In accordance with the present disclosure, a cartridge jaw may be movable relative to a fixed anvil jaw to a clamped position. Additionally, an anvil jaw may be movable relative to a fixed cartridge jaw to a clamped position. Furthermore, an anvil jaw and a cartridge jaw may both be movable relative to each other to a clamped position. The closure motion may cause the jaws 9001, 9003 to grasp tissue therebetween. In accordance with the present disclosure, sensors, such as, for example, a strain gauge or a micro-strain gauge, can be configured to measure one or more parameters of the end effector 9010, such as, for example, the amplitude of the strain exerted on the one or both of the jaws 9001, 9003 during a closure motion, which can be indicative of the closure forces applied to the jaws 9001, 9003. The measured strain is converted to a digital signal and provided to the processor 9006, for example. Alternatively, additionally, sensors such as, for example, a load sensor, can measure a closure force and/or a firing force applied to the jaws 9001, 9003.
In accordance with the present disclosure, a current sensor can be employed to measure the current drawn by a motor of the motor assembly 9009. The force required to advance the drive assembly 9011 can correspond to the current drawn by the motor, for example. The measured force is converted to a digital signal and provided to the processor 9006.
In accordance with the present disclosure, strain gauge sensors can be used to measure the force applied to the tissue by the end effector 9010, for example. A strain gauge can be coupled to the end effector 9010 to measure the force on the tissue being treated by the end effector 9010. In accordance with the present disclosure, the strain gauge sensors can measure the amplitude or magnitude of the strain exerted on a jaw of an end effector 9010 during a closure motion which can be indicative of the tissue compression. The measured strain is converted to a digital signal and provided to a processor 9006.
The measurements of the tissue compression, the tissue thickness, and/or the force required to close the end effector on the tissue, as respectively measured by the sensors 9008 can be used by the microcontroller 9005 to characterize the selected position of one or more components of the drive assembly 9011 and/or the corresponding value of the speed of one or more components of the drive assembly 9011. In accordance with the present disclosure, a memory (e.g. memory 9007) may store a technique, an equation, and/or a look-up table which can be employed by the microcontroller 9005 in the assessment.
The system 9002 may comprise wired or wireless communication circuits to communicate with surgical hubs (e.g. surgical hub 9014), communication hubs, and/or robotic surgical hubs, for example. Additional details about suitable interactions between a system 9002 and the surgical hub 9014 are disclosed in U.S. patent application Ser. No. 16/209,423 entitled METHOD OF COMPRESSING TISSUE WITHIN A STAPLING DEVICE AND SIMULTANEOUSLY DISPLAYING THE LOCATION OF THE TISSUE WITHIN THE JAWS, now U.S. Patent Application Publication No. 2019/0200981, the entire disclosure of which is incorporated by reference in its entirety herein.
In accordance with the present disclosure, the control circuit 9004 can be configured to implement various processes described herein. The control circuit 9004 may comprise a microcontroller comprising one or more processors (e.g., microprocessor, microcontroller) coupled to at least one memory circuit. The memory circuit stores machine-executable instructions that, when executed by the processor, cause the processor to execute machine instructions to implement various processes described herein. The processor may be any one of a number of single-core or multicore processors known in the art. The memory circuit may comprise volatile and non-volatile storage media. The processor may include an instruction processing unit and an arithmetic unit. The instruction processing unit may be configured to receive instructions from the memory circuit of this disclosure.
Alternatively, the control circuit 9004 can be in the form of a combinational logic circuit configured to implement various processes described herein. The combinational logic circuit may comprise a finite state machine comprising a combinational logic configured to receive data, process the data by the combinational logic, and provide an output.
Alternatively, the control circuit 9004 can be in the form of a sequential logic circuit. The sequential logic circuit can be configured to implement various processes described herein. The sequential logic circuit may comprise a finite state machine. The sequential logic circuit may comprise a combinational logic, at least one memory circuit, and a clock, for example. The at least one memory circuit can store a current state of the finite state machine. In accordance with the present disclosure, the sequential logic circuit may be synchronous or asynchronous. Additionally, the control circuit 9004 may comprise a combination of a processor (e.g., processor 9006) and a finite state machine to implement various processes herein. Furthermore, the finite state machine may comprise a combination of a combinational logic circuit (and the sequential logic circuit, for example.
In accordance with the present disclosure, the staple cartridges described herein are replaceable. The staple cartridge can include one or more electronic systems onboard the staple cartridge. Discussed in greater detail below, one or more of the electronic systems onboard the staple cartridge may be modular and/or replaceable. In accordance with the present disclosure, the electronic systems may be in electrical communication with one or more components of the surgical system 9002. The one or more electronic systems can include, sensor circuits including sensors to measure end effector parameters during a surgical stapling procedure, cartridge-identifying circuits including a circuit with a detectable property to be able to identify one or more properties of the replaceable staple cartridge, and an onboard memory and processor. Additionally, the electronic systems can include a modular electronics package including a PCB, for example, which is attachable to, and detachable from, the replaceable staple cartridge. Furthermore, one or more of the electronic systems may be replaceable with the same or different electronic systems. Such an arrangement can enable a manufacturer or user, for example, to specifically select the desired onboard electronics of the replaceable staple cartridge. For example, different electronics packages may be desired for different types of target tissue. In accordance with the present disclosure, the hardwired electrical pathways between the sensor circuits of the replaceable staple cartridge and the modular electronics package can be modified from electronics package to electronics package.
One or more of the electronic systems of the staple cartridge may also include the method for communicating power and/or data to and/or from the staple cartridge to a control circuit of the overall surgical stapling system (surgical robot, instrument handle, motor control circuits, etc.). In accordance with the present disclosure, power and/or data may be transmitted to and/or from the staple cartridge by way of hardwired connections where physical contact between contacts or connectors of the staple cartridge and contacts or connectors of the cartridge jaw within which the staple cartridge is to be installed is required. In addition to, or in lieu of, the hardwired connections, the staple cartridge and cartridge jaw may each comprise one or more wireless transmission coils to transmit data and/or power to and/or from the staple cartridge.
The surgical stapling assembly 9100 further comprises a firing driver 9150 actuatable through the end effector 9120 by a drive assembly such as the drive assembly 9011, for example. The firing driver 9150 can comprise any suitable firing driver such as, for example, a distal I-beam head, discussed in greater detail below. The firing driver 9150 is configured to push a sled of the replaceable staple cartridge 9130 from an unfired position to a fired position. During distal translation of the sled within the replaceable staple cartridge 9130, the sled is configured to sequentially lift a plurality of staple drivers with staples 9101 supported thereon. As the drivers are lifted toward the anvil jaw 9140, the drivers are configured to eject the staples 9101 from a plurality of staple cavities and against the anvil jaw 9140.
In accordance with the present disclosure, the sled may be part of the firing driver. Any suitable combination of firing components can be considered the firing driver.
In accordance with the present disclosure, moving the anvil jaw 9140 into a clamped position to clamp tissue between the anvil jaw 9140 and the replaceable staple cartridge 9130 can be performed by a closure driver. The closure driver may be separate from the firing driver 9150 and may be actuatable independently of the firing driver. Alternatively, the closure driver may not be separate from the firing driver 9150. In accordance with the present disclosure, the clamping, or closing, motion may be performed by the firing driver 9150. Opposing jaw-camming pins of a distal I-beam head of the firing driver 9150 are configured to cam the anvil jaw 9140 into a clamped position as the firing driver 9150 is actuated distally through an initial clamping stroke, or motion. In addition to moving the anvil jaw 9140 from an unclamped position to a clamped position during a clamping stroke, the opposing jaw-camming pins are configured to control a tissue gap distance between the anvil jaw 9140 and the replaceable staple cartridge 9130 during the staple firing stroke by limiting the separation of the cartridge channel jaw 9121 and the anvil jaw 9140 during the staple firing stroke with the opposing jaw-camming pins. One of the jaw-camming pins is configured to engage the cartridge channel jaw 9121 and one of the jaw-camming pins is configured to engage the anvil jaw 9140.
In accordance with the present disclosure, the replaceable staple cartridge 9130 may comprise onboard electronics. The onboard electronics require power and/or data transmission to and/or from the replaceable staple cartridge. Thus, an electrical interface exists between the replaceable staple cartridge and the cartridge channel jaw 9121. In accordance with the present disclosure, a control circuit (e.g., control circuit 9004) can be electrically coupleable to the onboard electronics of the replaceable staple cartridge 9130. Any suitable transmission technique can be employed. Various examples are described in greater detail below.
The onboard electronics, or electronics sub-assembly, 9250 are positioned within the receptacle 9245. The receptacle 9245 can be configured to receive one or more modular electronics packages 9260. In accordance with the present disclosure, when installed in the receptacle 9245, the modular electronics packages 9260 can be electrically coupled with the wireless transmission interface 9270 via electrical traces 9280 positioned within the receptacle 9245. Additionally, in accordance with the present disclosure, additional electrical traces can be employed to connect the receptacle 9245 (and, thus, the electronics package 9260 and/or wireless transmission interface 9270) to various sensors onboard the staple cartridge 9240. The modular electronics package 9260 comprises a PCB including a processer and a memory. However, any suitable modular electronics package 9260 can be employed with any suitable electrical components such as sensors, multiple processors, multiple memories, etc. The modular electronics package 9260 is pinned to the sidewall 9244 via attachment pins 9261. A user may replace the modular electronics package 9260 with a different modular electronics package 9260 by disengaging the pins 9261, removing the modular electronics package 9260, placing a different modular electronics package in place of the modular electronics package 9260, and re-engaging the pins 9261. Each modular electronics package 9260 may comprise attachment pins which can be press fit, or snap fit, into corresponding apertures defined in the receptacle 9245 such that the pins remain a part of the modular electronics package 9260.
In accordance with the present disclosure, the one or more modular electronics packages 9260 can be electrically coupled with onboard electrical circuits of the replaceable staple cartridge 9240 such as, for example, sensor circuits including sensors for measuring one or more end effector parameters, lockout circuits for identifying of the staple cartridge is spent or unspent, cartridge-identifying circuits for identifying the specific type, size, length, and/or color, of the staple cartridge 9240, and/or RFID circuits, etc. The signals received from the various onboard circuits can be communicated to the modular electronics package 9260. In accordance with the present disclosure, the signals received from the various onboard circuits can be communicated to the control circuit 9004 of the surgical system 9002 with which the staple cartridge 9260 is used in addition to, or in lieu of, to the modular electronics package 9260. The onboard circuits can be powered through the onboard electronics package 9260. Additionally, the onboard circuits can receive power directly from the wireless transmission interface 9270. Multiple power sources may be employed. Further, accordance with the present disclosure, one or more of the power sources used can act as backup power sources.
As discussed above, the wireless transmission interface 9270 is configured to transmit data and/or power to the control circuit 9004 of the surgical system 9002. The wireless transmission interface 9270 comprises a proximal transmission coil 9271 and a distal transmission coil 9272. In accordance with the present disclosure, one of the coils may transmit data therethrough and the other coil may transmit power therethrough. The wireless transmission interface 9270 is configured to transmit the power and/or data to and/or from the modular electronics package 9260 through electrical traces 9280. In accordance with the present disclosure, the modular electronics package 9260 may comprise contacts configured to engage the electrical traces 9280 upon installation of the modular electronics pack 9260 into the receptacle 9245.
Referring to
As can be seen in
Described herein are a plurality of onboard electronics of a replaceable surgical staple cartridge. In accordance with the present disclosure, one or more of the onboard electronics can be identifiable, or detectable, by the control circuit 9004 of the surgical system 9002. Certain control algorithms can be selected and/or adjusted based on the specific onboard electronics. For example, a clinician may plan a procedure targeting a specific type of tissue. The specific type of tissue may require a specific length, type, or color staple cartridge. The specific type of tissue may also require a specific firing algorithm. For example, the specific type of tissue may be thinner than other types of tissue and a slower, more delicate, firing and/or clamping control algorithm may be selected by the control circuit 9004.
When the control circuit 9004 selects a specific control algorithm, the onboard electronics can be utilized in a specific predetermined manner. For example, a sensor circuit onboard a replaceable staple cartridge can be utilized to detect a tissue density, for example, regardless of which modular electronics package is installed in the staple cartridge. The measured tissue density can be used during firing to modify the firing control algorithm. However, depending on which modular electronics package (selected for a specific type of tissue) is installed, the firing control algorithm can be modified differently for the same tissue density measurement with a different modular electronics package (associated with a different type of tissue) installed in the stapling end effector. Such an arrangement can allow a user to change the onboard control circuit by swapping the modular electronics package with a different modular electronics package to accommodate the specific procedure within which the staple cartridge is to be used. The selected control circuit may process sensor circuit values differently depending on the type of tissue associated with that modular electronics package.
Changing the modular electronics package may also be performed to update the software, firmware, and/or other control programs/algorithms of the replaceable staple cartridge. In accordance with the present disclosure, the replaceable staple cartridge can be manufactured and the modular electronics package can be updated over time so the physical design of the replaceable staple cartridge need not change overtime as the control algorithms/programs are updated. Upon distributing the replaceable staple cartridge, the most up to date modular electronics package can be easily and quickly installed on the replaceable staple cartridge. New modular electronics packages can be designed to fit in the existing cartridge receptacle.
The replaceable staple cartridge 9340 comprises a proximal end 9341, a slot 9342 configured to receive at least a portion of the firing drive 9320 during the firing stroke, and a proximally-facing side 9343. The replaceable staple cartridge 9340 further comprises an electronic system 9350. The electronic system 9350 may comprise any suitable electronic components such as those disclosed herein. For example, the replaceable staple cartridge 9340 comprises a wireless transmission interface, one or more onboard sensor circuits, one or more onboard cartridge identifier circuits, and/or one or more modular electronics packages. One or more of the electronic components are configured to receive power and/or data from the surgical instrument (surgical robot and/or surgical instrument handle, for example) to which the replaceable staple cartridge 9340 is attached. The electronic system 9350 of the replaceable staple cartridge 9340 further comprises electrical connectors 9360, 9370 through which power and/or data is transferred.
The electrical connector 9360 is positioned within the cartridge channel jaw 9330 and at least a portion of the channel retainer 9311. The electrical connector 9360 comprises a female slot 9362 configured to receive a male end 9372 of the electrical connector 9370. The electrical connector 9360 comprises a body 9361 at least partially positioned within a slot 9312 of the channel retainer 9311. As can be seen in
The replaceable staple cartridge 9340 is configured to be slid proximally into the cartridge channel jaw 9330. This distal-to-proximal installation motion allows the male end 9372 of the electrical connector 9370 to be inserted into the female slot 9362 of the electrical connector 9360 when installing the replaceable staple cartridge 9340 into the cartridge channel jaw 9330. Once connected, power and/or data may be transferred through the contacts 9363, 9373. The electronic system 9350 further comprises an electrical cable 9351 connected to the contacts 9373 to carry electrical signals to the various onboard electronics of the replaceable staple cartridge 9340. The various onboard electronics of the replaceable staple cartridge 9340 may receive electrical signals from the electrical connector 9370 individually. As can be seen in
The onboard electronics 9423 can comprise any suitable onboard electronics such as those disclosed herein. In accordance with the present disclosure, the onboard electronics 9423 may comprise a modular electronics package, a PCB including a processor and a memory among other electrical components, a wireless transmission interface, one or more sensor circuits electrically coupled to the electrical connector 9421 and/or the modular electronics package, PCB, and/or the wireless transmission interface, and/or one or more cartridge-identifier circuits electrically coupled to the electrical connector 9421 and/or the modular electronics package, PCB, and/or the wireless transmission interface.
In accordance with the present disclosure, one or more modular electronics packages may be capable of being installed into a receptacle of a replaceable staple cartridge. Where multiple modular electronics packages (PCBs, for example) are installed into the receptacle, each modular electronics package is electrically coupled to each other. Additionally, each modular electronics package can be electrically coupled to the control circuit 9004 independently through the electrical connector of the replaceable staple cartridge. In accordance with the present disclosure, the entire receptacle may contain multiple sets of electrical contacts for each component installed in the receptacle. Each set of electrical contacts can be electrically coupled to the wireless transmission interface and/or the electrical connector.
In accordance with the present disclosure, all of the electrical components installed in the receptacle of a replaceable staple cartridge can be powered through a wireless coil of the wireless transmission interface (and thus the corresponding wireless transmission interface of the cartridge channel jaw) and receive and/or transmit data through another wireless coil of the wireless transmission interface (and thus the corresponding wireless transmission interface of the cartridge channel jaw). In accordance with the present disclosure, one or more of the electrical components installed in the receptacle may be battery powered.
In addition to, or in lieu of, receiving power and data through a wireless transmission interface, the electrical components installed in the receptacle of a replaceable staple cartridge are electrically coupled to the surgical instrument through the electrical connector of the replaceable staple cartridge to receive power and/or data therethrough. Such an electrical connection can serve as a redundancy, or back up, path of electrical power and/or data to and/or from the replaceable staple cartridge. In accordance with the present disclosure, some of the electrical components of a replaceable staple cartridge can be electrically coupled to the surgical instrument through the electrical connector, while others can be electrically coupled to the surgical instrument through the wireless transmission interface. Additionally, in accordance with the present disclosure, all of the data transfer may be achieved through the hardwired interface and all of the power transfer may be achieved through the wireless transmission interface. Alternatively, all of the power transfer may be achieved through the hardwired interface and all of the data transfer may be achieved through the wireless transmission interface. In accordance with the present disclosure, certain components of the staple cartridge may receive power through the hardwired interface and certain components of the staple cartridge may receive power through the wireless transmission interface. Alternatively, in accordance with the present disclosure, certain components of the staple cartridge may receive data through the hardwired interface and certain components of the staple cartridge may receive data through the wireless transmission interface.
The distal connector 9550 is mounted to the proximal face 9521 and comprises a tab 9554 extending underneath a bottom of a cartridge body of the replaceable staple cartridge 9520. The tab 9554 may serve to support the replaceable staple cartridge 9520 against the cartridge channel jaw 9510 upon installation. In accordance with the present disclosure, the tab 9554 may serve as an alignment aid for aligning the proximal connector 9540 and the distal connector 9550 during and/or after installation of the replaceable staple cartridge 9520 in the cartridge channel jaw 9530. The distal connecter 9550 comprises electrical contacts 9552 extending from a proximal side 9551 of the connector 9550, through the connector 9550, and electrically coupled to electrical traces, or leads, 9553 distal to the connector 9550. In accordance with the present disclosure, the electrical traces 9553 can be positioned within slots, or channels, defined in the cartridge body of the replaceable staple cartridge 9540. The electrical traces 9553 are configured to carry electrical signals to and/or from onboard electronics 9560.
In accordance with the present disclosure, the electrical connectors 9543 may be spring loaded such that, as the replaceable staple cartridge 9520 is installed in the cartridge channel jaw 9510 in a distal-to-proximal direction, the electrical connectors 9542 are able to be engaged by and pushed into the slots, as necessary, by corresponding contacts 9552 upon installation of the replaceable staple cartridge 9520 into the cartridge channel jaw 9510 to affirmatively bias the connectors 9542 into engagement with the contacts 9552.
In accordance with the present disclosure, the one or more onboard electronics discussed herein may be installed into a cartridge channel jaw in addition to, or in place of, onboard electronics installed on a replaceable staple cartridge.
The surgical stapling assembly 9600 further comprises a firing drive 9620 and an electronics assembly 9660 positioned between the replaceable staple cartridge 9630 and the shaft assembly 9610. The electronics assembly 9660 can be configured to receive power and/or data from the wireless transmission interface 9641. In accordance with the present disclosure, the electronics assembly 9660 may comprise onboard sensor circuits configured to measure one or more parameters of the firing driver 9620 during a firing stroke. This information can be transmitted to the PCB 9650 and/or back to a control circuit of the surgical instrument through the cable 9642. As can be seen in
The male connector 9670 comprises a connector body 9671 having a male end 9672. Electrical contacts 9673 are exposed on the male end 9672. The male connector 9670 further comprises alignment fins 9674 extending from the connector body 9671 to the male end 9672. In accordance with the present disclosure, the fins 9674 may provide additional support, or rigidity, to the male end 9672. The female connector 9680 comprises a connector body 9681 having a female end 9682. Electrical contacts 9683 are exposed inside of the female end 9682. The female end 9682 further comprises slots 9684 defined in the female end to receive the fins 9674 of the male end 9672 upon complete insertion of the male end 9672 into the female end 9682. As can be seen in
The circuit 9730 is configured to be detectable by a control circuit of a surgical instrument to which the replaceable staple cartridge 9700 is configured to be attached. The circuit 9730 comprises circuit contacts 9731, a resistance element 9732, and electrical traces 9733 electrically coupling the contacts 9731 and the resistance element 9732. The circuit 9730 is configured to be electrically coupled with a circuit of the instrument to which the cartridge 9700 is attached upon installation of the cartridge 9700 into the instrument. The resistance element 9732 is detectable by a control circuit of the instrument. The resistance element 9732 comprises a resistance value indicative of one or more properties of the replaceable staple cartridge 9700 such as, for example, cartridge color, type, size, length, staple height, staple diameter, etc.
Upon installation of the replaceable staple cartridge 9700 into an instrument, the control circuit, such as the control circuit 9004, for example, utilizes a lookup table of resistance values to identified the one or more properties, or characteristics, of the replaceable staple cartridge 9700. Such information may also be stored in the modular electronics package. The control circuit 9004 can compare the information gathered from the circuit 9730 and the information on the modular electronics package to identify the staple cartridge 9700 and verify the authenticity of the cartridge 9700, for example. In accordance with the present disclosure, where a modular electronics package is not installed and/or not required, the control circuit 9004 can identify the cartridge 9700 using only the circuit 9730. Additionally, the circuit 9730 can be screen printed onto the cartridge body 9710.
In accordance with the present disclosure, the modular electronics package 9740, when installed in the cartridge 9700, can be electrically coupled to the circuit 9730. Such an arrangement allows the modular electronics package 9740 to identify cartridge characteristics upon installation of the modular electronics package 9740 into the replaceable staple cartridge 9700. The modular electronics package 9740 may then be configured to make adjustments to firing stroke control feedback circuits, communicate this information to a surgical instrument and/or surgical robot, for example, etc.
In accordance with the present disclosure, sensor arrays may be provided on stapling end effectors to measure one or more parameters of tissue before, during, and/or after clamping, stapling, and cutting tissue. A control circuit can be provided to intelligently decode information gathered by these sensor arrays to more accurately define a state of the tissue during a surgical stapling procedure.
The control circuit is further configured to compare 9753 the monitored end effector parameter reading of the first sensor to the monitored end effector parameter readings of the second sensors. Comparing this information allows the control circuit to analyze the readings of each of the sensors relative to each other and not in a vacuum where the end effector parameter readings of each sensor is viewed independently.
In accordance with the present disclosure, the first sensor may be distal to the plurality of second sensors, which may be distributed along a length of the stapling end effector. Positioning the first sensor distal to the plurality of the second sensors allows the control circuit to determine if the jaws of the stapling end effector have been overstuffed with tissue, for example. The control circuit can be further configured to determine 9754 a state of the tissue clamped between the first jaw and the second jaw of the stapling end effector based on the comparison of the monitored end effector parameter reading of the first sensor to the monitored end effector parameter readings of the second sensors.
In accordance with the present disclosure, the control circuit can be configured to determine if the jaws have been overstuffed or if the tissue clamped between the jaws of the stapling end effector is indeed thicker than expected, for example. If the jaws are overstuffed with tissue, the rotatable jaw to clamp the tissue may not be able to fully close, for example. Such a configuration may arise where a thick portion of tissue is stuck in the smaller gap between the jaws nearer a pivot location of the jaws. In such a configuration, a larger gap between tissue and the jaws may exist between the jaws distal to the second sensors (or nearer the distal end of the jaws, for example). In such a scenario, the plurality of second sensors may indicate that thick tissue is clamped between the jaws at the location of the second sensors. This can be determined by measuring little, to no, gap distance between the jaw on which the sensors are placed and the tissue itself, for example. Another method for determining this can include a significant pressure reading indicating the tissue is being squeezed substantially by the jaws at the location of the second sensors.
The control circuit is also configured to monitor the end effector parameter reading of the first sensor that is distal to the second sensors and compare the reading to the readings of the second sensors. In the scenario where the jaws are overstuffed (thick tissue present toward a proximal end of the jaws and thin, or no, tissue present toward the distal end), the reading of the first sensor may indicate that little, or no, tissue is present toward the distal end. This can be determined by a much greater than expected gap distance between the jaw on which the sensor is placed and the tissue itself, for example. Another method for determining this can include little, to no, pressure detected at the first sensor indicating the tissue nearer the first sensor is not substantially consuming the gap between the jaws of the stapling end effector.
In the scenario of overstuffing the jaws, a highly disproportionate difference may exist between the end effector parameter reading of the first sensor and the end effector parameter readings of the second sensors. This difference can be defined by a threshold percentage difference, for example. Once the control circuit identifies that a threshold percentage difference exists, action can be taken by the control circuit. In accordance with the present disclosure, the control circuit can be configured to alert a user that the jaws are overstuffed and/or prompt the user to unclamp, and re-clamp, tissue.
In accordance with the present disclosure, a highly disproportionate difference between the end effector parameter reading of the first sensor and the end effector parameter readings of the second sensors can indicate that the jaws are clamped onto a foreign object. In such a scenario, the control circuit may alert a user that the jaws are clamped onto a foreign object. Additionally, the control circuit can be configured to prompt a user to unclamp, and re-clamp, tissue. Highly disproportionate differences in strain values between the second sensors (an average strain across all of the second sensors) and the first sensor can indicate the presence of a foreign object.
In accordance with the present disclosure, a third sensor may be employed to measure the same, and/or a different end effector parameter. In such an instance, the control circuit can be configured to compare the highly disproportionate difference discussed above to the end effector parameter reading of the third sensor. In accordance with the present disclosure, the third sensor may comprise a Hall effect sensor. The third sensor can be used to validate, or verify, the state of tissue, or state of what is positioned between the jaws, determined when comparing the reading of the first sensor to the readings of the second sensors. A high Hall effect sensor reading can indicate an overstressed-tissue condition.
In an instance where the distal-most sensor indicates thick, or dense, tissue and the first sensor and/or second sensors indicate tissue of a nominal thickness, for example, the control circuit determines that calcified tissue and/or irregular tissue is positioned nearer the distal end of the jaws. The control circuit can then recommend not to fire with this determination of the state of the tissue.
In accordance with the present disclosure, the second sensors may comprise strain gauges positioned on the channel jaw, cartridge deck, and/or anvil jaw and the first sensor may comprise a Hall effect sensor. Additionally, one or more of the strain gauges may comprise half bridge, and/or full bridge, strain gauges. In such an instance, an electronics package module capable of receiving and decoding information gathered from the half bridge, and/or full bridge, strain gauges may be required. Any suitable strain gauge can be used. Strain gauges which measure stress and/or strain in multiple directions can allow a control circuit to determine the amount of twist experienced by the jaw to which they are attached such as, for example, anvil twist. Anvil twist is indicated by rotational twisting of the anvil relative to a longitudinal axis of the anvil.
In accordance with the present disclosure, the angle of the jaw can be measured with a first sensor, and a Hall effector sensor at the distal end can measure a gap distance between the jaws at the distal end. Additionally, a third sensor may be employed to measure tissue-conductivity in between the first sensor and the Hall effect sensor.
In accordance with the present disclosure, sensors may be selected so as to measure tissue location as well as tissue thickness. Alternatively, sensors may be selected so as to measure tissue composition. In such an instance, multiple complex sensors, which require an electronics control package with a processor to operate and use with a surgical system, such as the surgical system 9002, for example, can be utilized to measure various tissue parameters. Density, thickness, and/or electrical conductivity of the tissue are all examples of tissue parameters measurable by a complex sensor. In accordance with the present disclosure, the modular electronics package installed on the staple cartridge may comprise a multiplexer onboard the modular electronics package electrically couplable with the sensor circuits. The sensor circuits may utilize impedance spectroscopy to measure electrical properties of the tissue and/or whatever is positioned between the jaws. In accordance with the present disclosure, tissue perfusion may be measured using a sensor circuit. Additionally, multiple laser Doppler imaging sensors may be used to scan tissue.
The sensor circuit 9050 comprises a plurality of sensors 9851, 9852 mounted to the anvil jaw 9840. In accordance with the present disclosure, some or all of the sensors 9851, 9852 can be mounted to the channel jaw 9820 and/or the staple cartridge 9830. The plurality of sensors 9851, 9852 comprise a plurality of first sensors 9851 and a second sensor 9852 distal to the plurality of first sensors 9851. The sensors 9851, 9852 may comprise any suitable sensor to measure an end effector parameter. In accordance with the present disclosure, the sensors 9851 may comprise strain gauges to measure strain induced by clamping tissue between the jaws. Additionally, the sensor 9852 may comprise a Hall effect sensor configured to measure a gap distance between the jaws 9820, 9840 at a distal end 9802 of the surgical stapling end effector 9800. The surgical stapling end effector 9800 further comprises a proximal end 9801.
As can be seen in
In accordance with the present disclosure, electrical traces can be positioned within one or more pathways, or channels, defined in and/or on the anvil jaw and/or the staple cartridge jaw and can be coupled with sensors along the length of the anvil jaw and/or staple cartridge jaw. Additionally, the pathways can be cut into the jaws with a laser. Alternatively, the electrical traces can be plated onto the jaws.
In accordance with the present disclosure, a wireless coil may be first used to check cartridge viability (authenticity, unfired, etc.) and, upon passing a first check through the wireless coil, the control circuit can be configured permit power and/or data transfer to the staple cartridge assembly through another coil and/or other electrical system (hardwired, electrical connector, etc.).
For example, nearer the distal end of a stapling end effector, the cantilever beam effect of the jaw which is clamped from an open position to a closed position can be higher than the cantilever beam effector of the jaw nearer the proximal end of the stapling end effector. This cantilever beam effect can result in greater strain value measurements within these zones given the jaw's inability to resist deflection in this zone compared to more proximal zones where the movable jaw is much stiffer. A higher strain reading within this distal zone, for example, could be expected given the decreased stiffness of the jaw within this zone compared to others. This sensor reading can be compared to different sensor reading thresholds as compared to other zones given the difference in predictable behavior of the zone. Similarly, nearer the proximal end of the stapling end effector, the movable jaw may comprise a much greater stiffness and not be expected to experience the same amount of strain as more distal zones under a given tissue load. Thus, a predetermined tissue-overstuffing strain value indicative of tissue over-stuffing may be much lower in this zone as compared to a more distal zone. Given the greater stiffness of this portion of the movable jaw, the same amount increase, for example, of the measured strain value relative to the predetermined tissue-overstuffing strain value in both zones with different jaw stiffness, for example, may indicate a much more significant overstuffing scenario in the zone where the movable jaw is much stiffer. Placing sensors in discrete zones can allow a control circuit to determine which zone is experiencing overstuffing, for example.
Many of the surgical instrument systems described herein are motivated by an electric motor; however, the surgical instrument systems described herein can be motivated in any suitable manner. In accordance with the present disclosure, the surgical instrument systems described herein can be motivated by a manually-operated trigger, for example. In accordance with the present disclosure, the motors disclosed herein may comprise a portion or portions of a robotically controlled system. Moreover, any of the end effectors and/or tool assemblies disclosed herein can be utilized with a robotic surgical instrument system. U.S. patent application Ser. No. 13/118,241, entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, now U.S. Pat. No. 9,072,535, for example, discloses several examples of a robotic surgical instrument system in greater detail.
Although various devices have been described herein in connection with certain embodiments, modifications and variations to those embodiments may be implemented. Particular features, structures, or characteristics may be combined in any suitable manner in one or more embodiments. Thus, the particular features, structures, or characteristics illustrated or described in connection with one embodiment may be combined in whole or in part, with the features, structures or characteristics of one or more other embodiments without limitation. Also, where materials are disclosed for certain components, other materials may be used. According to various embodiments, a single component may be replaced by multiple components, and multiple components may be replaced by a single component, to perform a given function or functions. The foregoing description and following claims are intended to cover all such modification and variations.
While several configurations have been described, additional modifications are within the scope of the present disclosure, which is intended to cover any variations, uses, or adaptations of the disclosed configurations using its general principles.
The foregoing detailed description has set forth various forms of the devices and/or processes via the use of block diagrams, flowcharts, and/or examples. Insofar as such block diagrams, flowcharts, and/or examples contain one or more functions and/or operations, it will be understood by those within the art that each function and/or operation within such block diagrams, flowcharts, and/or examples can be implemented, individually and/or collectively, by a wide range of hardware, software, firmware, or virtually any combination thereof. Those skilled in the art will recognize that some aspects of the forms disclosed herein, in whole or in part, can be equivalently implemented in integrated circuits, as one or more computer programs running on one or more computers (e.g., as one or more programs running on one or more computer systems), as one or more programs running on one or more processors (e.g., as one or more programs running on one or more microprocessors), as firmware, or as virtually any combination thereof, and that designing the circuitry and/or writing the code for the software and or firmware would be well within the skill of one of skill in the art in light of this disclosure. In addition, those skilled in the art will appreciate that the mechanisms of the subject matter described herein are capable of being distributed as one or more program products in a variety of forms, and that an illustrative form of the subject matter described herein applies regardless of the particular type of signal bearing medium used to actually carry out the distribution.
Instructions used to program logic to perform various disclosed aspects can be stored within a memory in the system, such as dynamic random access memory (DRAM), cache, flash memory, or other storage. The instructions can be distributed via a network or by way of other computer readable media. Thus a machine-readable medium may include any mechanism for storing or transmitting information in a form readable by a machine (e.g., a computer), but is not limited to, floppy diskettes, optical disks, compact disc, read-only memory (CD-ROMs), and magneto-optical disks, read-only memory (ROMs), random access memory (RAM), erasable programmable read-only memory (EPROM), electrically erasable programmable read-only memory (EEPROM), magnetic or optical cards, flash memory, or a tangible, machine-readable storage used in the transmission of information over the Internet via electrical, optical, acoustical or other forms of propagated signals (e.g., carrier waves, infrared signals, digital signals, etc.). Accordingly, the non-transitory computer-readable medium includes any type of tangible machine-readable medium suitable for storing or transmitting electronic instructions or information in a form readable by a machine (e.g., a computer).
Any of the software components or functions described in this application, may be implemented as software code to be executed by a processor using any suitable computer language such as, for example, Python, Java, C++ or Perl using, for example, conventional or object-oriented techniques. The software code may be stored as a series of instructions, or commands on a computer readable medium, such as RAM, ROM, a magnetic medium such as a hard-drive or a floppy disk, or an optical medium such as a CD-ROM. Any such computer readable medium may reside on or within a single computational apparatus and may be present on or within different computational apparatuses within a system or network.
As used in any aspect herein, the term “control circuit” or “control system” may refer to, for example, hardwired circuitry, programmable circuitry (e.g., a computer processor including one or more individual instruction processing cores, processing unit, processor, microcontroller, microcontroller unit, controller, digital signal processor (DSP), programmable logic device (PLD), programmable logic array (PLA), or field programmable gate array (FPGA)), state machine circuitry, firmware that stores instructions executed by programmable circuitry, and any combination thereof. The control circuit may, collectively or individually, be embodied as circuitry that forms part of a larger system, for example, an integrated circuit (IC), an application-specific integrated circuit (ASIC), a system on-chip (SoC), desktop computers, laptop computers, tablet computers, servers, smart phones, etc. Accordingly, as used herein “control circuit” includes, but is not limited to, electrical circuitry having at least one discrete electrical circuit, electrical circuitry having at least one integrated circuit, electrical circuitry having at least one application specific integrated circuit, electrical circuitry forming a general purpose computing device configured by a computer program (e.g., a general purpose computer configured by a computer program which at least partially carries out processes and/or devices described herein, or a microprocessor configured by a computer program which at least partially carries out processes and/or devices described herein), electrical circuitry forming a memory device (e.g., forms of random access memory), and/or electrical circuitry forming a communications device (e.g., a modem, communications switch, or optical-electrical equipment). Those having skill in the art will recognize that the subject matter described herein may be implemented in an analog or digital fashion or some combination thereof.
As used in any aspect herein, the term “logic” may refer to an app, software, firmware and/or circuitry configured to perform any of the aforementioned operations. Software may be embodied as a software package, code, instructions, instruction sets and/or data recorded on non-transitory computer readable storage medium. Firmware may be embodied as code, instructions or instruction sets and/or data that are hard-coded (e.g., nonvolatile) in memory devices.
As used in any aspect herein, the terms “component,” “system,” “module” and the like can refer to a computer-related entity, either hardware, a combination of hardware and software, software, or software in execution.
As used in any aspect herein, an “algorithm” refers to a self-consistent sequence of steps leading to a desired result, where a “step” refers to a manipulation of physical quantities and/or logic states which may, though need not necessarily, take the form of electrical or magnetic signals capable of being stored, transferred, combined, compared, and otherwise manipulated. It is common usage to refer to these signals as bits, values, elements, symbols, characters, terms, numbers, or the like. These and similar terms may be associated with the appropriate physical quantities and are merely convenient labels applied to these quantities and/or states.
Unless specifically stated otherwise as apparent from the foregoing disclosure, it is appreciated that, throughout the foregoing disclosure, discussions using terms such as “processing,” “computing,” “calculating,” “determining,” “displaying,” or the like, refer to the action and processes of a computer system, or similar electronic computing device, that manipulates and transforms data represented as physical (electronic) quantities within the computer system's registers and memories into other data similarly represented as physical quantities within the computer system memories or registers or other such information storage, transmission or display devices.
One or more components may be referred to herein as “configured to,” “configurable to,” “operable/operative to,” “adapted/adaptable,” “able to,” “conformable/conformed to,” etc. Those skilled in the art will recognize that “configured to” can generally encompass active-state components and/or inactive-state components and/or standby-state components, unless context requires otherwise.
Those skilled in the art will recognize that, in general, terms used herein, and especially in the appended claims (e.g., bodies of the appended claims) are generally intended as “open” terms (e.g., the term “including” should be interpreted as “including but not limited to,” the term “having” should be interpreted as “having at least,” the term “includes” should be interpreted as “includes but is not limited to,” etc.). It will be further understood by those within the art that if a specific number of an introduced claim recitation is intended, such an intent will be explicitly recited in the claim, and in the absence of such recitation no such intent is present. For example, as an aid to understanding, the following appended claims may contain usage of the introductory phrases “at least one” and “one or more” to introduce claim recitations. However, the use of such phrases should not be construed to imply that the introduction of a claim recitation by the indefinite articles “a” or “an” limits any particular claim containing such introduced claim recitation to claims containing only one such recitation, even when the same claim includes the introductory phrases “one or more” or “at least one” and indefinite articles such as “a” or “an” (e.g., “a” and/or “an” should typically be interpreted to mean “at least one” or “one or more”); the same holds true for the use of definite articles used to introduce claim recitations.
In addition, even if a specific number of an introduced claim recitation is explicitly recited, those skilled in the art will recognize that such recitation should typically be interpreted to mean at least the recited number (e.g., the bare recitation of “two recitations,” without other modifiers, typically means at least two recitations, or two or more recitations). In those instances where a convention analogous to “at least one of A, B, and C, etc.” is used, in general such a construction is intended in the sense one having skill in the art would understand the convention (e.g., “a system having at least one of A, B, and C” would include but not be limited to systems that have A alone, B alone, C alone, A and B together, A and C together, B and C together, and/or A, B, and C together, etc.). In those instances where a convention analogous to “at least one of A, B, or C, etc.” is used, in general such a construction is intended in the sense one having skill in the art would understand the convention (e.g., “a system having at least one of A, B, or C” would include but not be limited to systems that have A alone, B alone, C alone, A and B together, A and C together, B and C together, and/or A, B, and C together, etc.). It will be further understood by those within the art that typically a disjunctive word and/or phrase presenting two or more alternative terms, whether in the description, claims, or drawings, should be understood to contemplate the possibilities of including one of the terms, either of the terms, or both terms unless context dictates otherwise. For example, the phrase “A or B” will be typically understood to include the possibilities of “A” or “B” or “A and B.”
With respect to the appended claims, those skilled in the art will appreciate that recited operations therein may generally be performed in any order. Also, although various operational flow diagrams are presented in a sequence(s), it should be understood that the various operations may be performed in other orders than those which are illustrated, or may be performed concurrently. Examples of such alternate orderings may include overlapping, interleaved, interrupted, reordered, incremental, preparatory, supplemental, simultaneous, reverse, or other variant orderings, unless context dictates otherwise. Terms like “responsive to,” “related to,” or other past-tense adjectives are generally not intended to exclude such variants, unless context dictates otherwise.
It is worthy to note that any reference to “one aspect,” “an aspect,” “an exemplification,” “one exemplification,” and the like means that a particular feature, structure, or characteristic described in connection with the aspect is included in one aspect. Thus, appearances of the phrases “in one aspect,” “in an aspect,” “in an exemplification,” and “in one exemplification” in various places throughout the specification are not necessarily all referring to the same aspect. The particular features, structures or characteristics may be combined in any suitable manner in various aspects.
It is worthy to note that any reference numbers included in the appended claims are used to reference exemplary embodiments/elements described in the present disclosure. Accordingly, any such reference numbers are not meant to limit the scope of the subject matter recited in the appended claims.
Any patent application, patent, non-patent publication, or other disclosure material referred to in this specification and/or listed in any Application Data Sheet is incorporated by reference herein, to the extent that the incorporated materials is not inconsistent herewith. As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated by reference herein, but which conflicts with existing definitions, statements, or other disclosure material set forth herein will only be incorporated to the extent that no conflict arises between that incorporated material and the existing disclosure material.
The terms “proximal” and “distal” are used herein with reference to a clinician manipulating the handle portion of the surgical instrument. The term “proximal” refers to the portion closest to the clinician and the term “distal” refers to the portion located away from the clinician. It will be further appreciated that, for convenience and clarity, spatial terms such as “vertical”, “horizontal”, “up”, and “down” may be used herein with respect to the drawings. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and/or absolute.
In summary, numerous benefits have been described which result from employing the concepts described herein. The foregoing description of the one or more forms has been presented for purposes of illustration and description. It is not intended to be exhaustive or limiting to the precise form disclosed. Modifications or variations are possible in light of the above teachings. The one or more forms were chosen and described in order to illustrate principles and practical application to thereby enable one of ordinary skill in the art to utilize the various forms and with various modifications as are suited to the particular use contemplated. It is intended that the claims submitted herewith define the overall scope.