BR112020012951A2 - variable output cartridge sensor assembly - Google Patents

Abstract

the present invention relates to a surgical instrument cartridge that can be used with different versions of surgical instruments. the surgical instrument includes a sensor that has different output modes and a control circuit attached to the sensor. the control circuit is configured to determine whether a version of the modular component matches a version of the surgical instrument and cause the sensor to output data detected by the sensor in different output formats that are compatible with the version of the specific surgical instrument in which the cartridge has been inserted.

Description

Invention Patent Descriptive Report for "VARIABLE OUTPUT CARTRIDGE SENSOR SET".

REMISSIVE REFERENCE TO DEPOSIT REQUESTS CORRELATES

[0001] This application claims the priority benefit set forth in Title 35 of USC § 119 (e) of US Provisional Patent Application Serial No. 62 / 691.227, entitled CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS, filed on 28 June 2018, the description being incorporated herein as a reference in its entirety.

[0002] This application also claims the priority benefit set forth in Title 35 of USC § 119 (e) of US Provisional Patent Application Serial No. 62 / 650,887, entitled SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES, filed on March 30, 2018, US Provisional Patent Application Serial No. 62 / 650,877, entitled SURGICAL SMOKE EVACUATION SENSING AND CONTROLS, filed on March 30, 2018, US Provisional Patent Application Serial No. 62 / 650,882, entitled SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM, filed on March 30, 2018, and US Provisional Patent Application Serial No. 62 / 650,898, entitled CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS, filed on March 30, 2018, with the description each of which is incorporated herein by reference in its entirety.

[0003] This application also claims the priority benefit provided for in Title 35 of U.S.C. § 119 (e) of U.S. Provisional Patent Application serial number 62 / 640,417, entitled TEMPERATURE

CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEM THEREFOR, filed March 8, 2018, and U.S. Provisional Patent Application Serial No. 62 / 640,415, entitled ESTIMATING

STATE OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR, filed on March 8, 2018, the description of each of which is incorporated herein by reference in its entirety.

[0004] This application also claims the priority benefit set forth in Title 35 of USC§ 119 (e) of US Provisional Patent Application Serial No. 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28, 2017, of US Provisional Patent Application no. on December 28, 2017, the description of each of which is incorporated herein by reference in its entirety.

BACKGROUND OF THE INVENTION

[0005] The present description refers to several surgical systems.

SUMMARY

[0006] In a general aspect, a modular component is provided for use with a surgical instrument. The modular component comprises a sensor and a control circuit coupled to the sensor. The control circuit is configured to determine if a version of the modular component matches a version of the surgical instrument in the event that the modular component is coupled to the surgical instrument and cause the sensor to emit data detected by the sensor in one of the first modes output or a second output mode, depending on whether the version of the modular component corresponds to the version of the surgical instrument. The data from the first output mode is compatible with a first version of the surgical instrument and the data from the second output mode is compatible with a second version of the surgical instrument.

[0007] In another general aspect, a modular component is provided for use with a surgical instrument. The modular component comprises a sensor and a control circuit coupled to the sensor. The control circuit is configured to receive output from the sensor, determine whether a modular component version matches a surgical instrument version in the event that the modular component is coupled to the surgical instrument and convert the data output to a first format in a second format according to the possibility that the modular component version corresponds to the surgical instrument version. The first format is compatible with a first version of the surgical instrument and the second format is compatible with a second version of the surgical instrument.

[0008] In another general aspect, a surgical system is provided. The surgical system comprises a surgical instrument and a modular component that can be connected to the surgical instrument. The modular component comprises a sensor and a control circuit coupled to the sensor. The control circuit is configured to determine if a version of the modular component matches a version of the surgical instrument in the event that the modular component is coupled to the surgical instrument and cause the sensor to emit data detected by the sensor in one of the first modes output or a second output mode, depending on whether the version of the modular component corresponds to the version of the surgical instrument. The data from the first output mode is compatible with a first version of the surgical instrument and the data from the second output mode is compatible with a second version of the surgical instrument.

FIGURES

[0009] The appeals of several aspects are presented with particularity in the attached claims. The various aspects, however, with regard to both the organization and the methods of operation, together with objects and additional advantages of them, can be better understood in reference to the description presented below, considered together with the attached drawings. , as follows.

[00010] Figure 1 is a block diagram of an interactive surgical system implemented by computer, according to at least one aspect of the present description.

[00011] Figure 2 is a surgical system being used to perform a surgical procedure in an operating room, in accordance with at least one aspect of the present description.

[00012] Figure 3 is a central surgical controller paired with a visualization system, a robotic system, and an intelligent instrument, in accordance with at least one aspect of the present description.

[00013] Figure 4 is a partial perspective view of a central surgical controller compartment, and a generator module in combination received slidably in a central surgical controller compartment drawer, in accordance with at least one aspect of this description.

[00014] Figure 5 is a perspective view of a generator module in combination with bipolar, ultrasonic and monopolar contacts and a smoke evacuation component, in accordance with at least one aspect of the present description.

[00015] Figure 6 illustrates individual power bus connectors for a plurality of side coupling ports of a side modular cabinet configured to receive a plurality of modules, in accordance with at least one aspect of the present description.

[00016] Figure 7 illustrates a vertical modular cabinet configured to receive a plurality of modules, in accordance with at least one aspect of the present description.

[00017] Figure 8 illustrates a surgical data network comprising a central modular communication controller configured to connect modular devices located in one or more operating rooms of a healthcare facility, or any environment in a utility facility. specially equipped for surgical operations, to the cloud, in accordance with at least one aspect of the present description.

[00018] Figure 9 illustrates an interactive surgical system implemented by computer, in accordance with at least one aspect of the present description.

[00019] Figure 10 illustrates a central surgical controller that comprises a plurality of modules coupled to the modular control tower, in accordance with at least one aspect of the present description.

[00020] Figure 11 illustrates an aspect of a central controller device of a universal serial bus (USB) network, in accordance with at least one aspect of the present description.

[00021] Figure 12 illustrates a logical diagram of a control system for a surgical instrument or tool, according to at least one aspect of the present description.

[00022] Figure 13 illustrates a control circuit configured to control aspects of the instrument or surgical tool, according to at least one aspect of the present description.

[00023] Figure 14 illustrates a combinational logic circuit configured to control aspects of the instrument or surgical tool, according to at least one aspect of the present description.

[00024] Figure 15 illustrates a sequential logic circuit configured to control aspects of the instrument or surgical tool, according to at least one aspect of the present description.

[00025] Figure 16 illustrates an instrument or surgical tool that comprises a plurality of motors that can be activated to perform various functions, according to at least one aspect of the present description.

[00026] Figure 17 is a schematic diagram of a robotic surgical instrument configured to operate a surgical tool described in the present invention, in accordance with at least one aspect of the present description.

[00027] Figure 18 illustrates a block diagram of a surgical instrument programmed to control the distal translation of a displacement member, in accordance with at least one aspect of the present description.

[00028] Figure 19 is a schematic diagram of a surgical instrument configured to control various functions, in accordance with at least one aspect of the present description.

[00029] Figure 20 is a stroke length graph that shows an example of a control system that modifies the stroke length of a gripping set based on the articulation angle.

[00030] Figure 21 is a positioning chart for the closing pipe assembly showing an example of a control system that modifies a longitudinal position of the closing pipe assembly based on the pivot angle.

[00031] Figure 22 is a comparison of a stapling method that uses controlled tissue compression versus a stapling method without controlled tissue compression.

[00032] Figure 23 is a force graph shown in section A and a related displacement graph shown in section B, where the strength graph and displacement graph have a geometric x axis that defines time, a geometric y axis of the graph displacement defines a travel displacement of a firing rod, and a geometric axis y of the force graph defines a torsional force detected in a motor that is configured to advance the firing rod.

[00033] Figure 24 is a schematic illustration of a fabric contact circuit that shows the completion of the circuit through contact with the fabric of a pair of spaced contact plates.

[00034] Figure 25 is a perspective view of a surgical instrument that has a set of interchangeable drive axles operationally coupled to it, according to at least one aspect of this description.

[00035] Figure 26 is an exploded view of a portion of the surgical instrument of Figure 25, in accordance with at least one aspect of this description.

[00036] Figure 27 is an exploded view of portions of the interchangeable drive shaft assembly, in accordance with at least one aspect of this description.

[00037] Figure 28 is an exploded view of an end actuator of the surgical instrument of Figure 25, in accordance with at least one aspect of this description.

[00038] Figure 29A is a block diagram of a control circuit for the surgical instrument of Figure 25 that comprises two drawing sheets, according to at least one aspect of this description.

[00039] Figure 29B is a block diagram of a control circuit for the surgical instrument of Figure 25 comprising two drawing sheets, according to at least one aspect of this description.

[00040] Figure 30 is a block diagram of the control circuit of the surgical instrument of Figure 25 that illustrates interfaces between the handle assembly, the feeding assembly and the handle assembly and the interchangeable drive shaft assembly, according with at least one aspect of this description.

[00041] Figure 31 represents an example of a medical device that can include one or more aspects of the present invention.

[00042] Figure 32 represents an example of an end actuator of a medical device surrounding the tissue, according to one or more aspects of the present description.

[00043] Figure 33 represents an example of an end actuator of a medical device that compresses the tissue, according to one or more aspects of the present description.

[00044] Figure 34 represents exemplary forces exerted by an end actuator of a medical device that compresses the tissue, according to one or more aspects of the present description.

[00045] Figure 35 also represents exemplary forces exerted by an end actuator of a medical device that compresses the tissue, according to one or more aspects of the present description.

[00046] Figure 36 represents an example of a tissue compression sensor system, according to one or more aspects of the present description.

[00047] Figure 37 also represents an example of a tissue compression sensor system, according to one or more aspects of the present description.

[00048] Figure 38 also represents an example of a tissue compression sensor system, according to one or more aspects of the present description.

[00049] Figure 39 is also an example of a circuit diagram, according to one or more aspects of the present description.

[00050] Figure 40 is also an example of a circuit diagram, according to one or more aspects of the present description.

[00051] Figure 41 is a graph that represents an example of frequency modulation, according to one or more aspects of the present description.

[00052] Figure 42 is a graph representing a composite RF signal, according to one or more aspects of the present description.

[00053] Figure 43 is a graph representing filtered RF signals, according to one or more aspects of the present description.

[00054] Figure 44 is a perspective view of a surgical instrument with an articulable interchangeable drive shaft.

[00055] Figure 45 is a side view of the tip of the surgical instrument.

[00056] Figures 46 to 50 are graphs plotting span size over time (Figure 46), trigger current over time (Figure 47), tissue compression over time (Figure 48), anvil deformation over time (Figure 49) and trigger strength over time (Figure 50).

[00057] Figure 51 is a graph plotting tissue displacement as a function of tissue compression for normal tissues.

[00058] Figure 52 is a graph plotting tissue displacement as a function of tissue compression to distinguish between normal and diseased tissues.

[00059] Figure 53 illustrates an embodiment of an end actuator comprising a first sensor and a second sensor.

[00060] Figure 54 is a logic diagram illustrating a modality of a process for adjusting the measurement of the first sensor based on the input from the second sensor of the end actuator illustrated in Figure 53.

[00061] Figure 55 is a logic diagram illustrating a modality of a process for determining a lookup table for a first sensor based on input from a second sensor.

[00062] Figure 56 is a logic diagram illustrating a modality of a process for calibrating a first sensor in response to an input from a second sensor.

[00063] Figure 57 is a logic diagram illustrating a modality of a process for determining and showing the thickness of a section of tissue trapped between an anvil and an end actuator staple cartridge.

[00064] Figure 58 is a logic diagram illustrating a modality of a process for determining and showing the thickness of a section of tissue stuck between the anvil and the end actuator staple cartridge.

[00065] Figure 59 is a graph illustrating an adjusted Hall effect thickness measurement compared to an unmodified Hall effect thickness measurement.

[00066] Figure 60 illustrates an embodiment of an end actuator comprising a first sensor and a second sensor.

[00067] Figure 61 illustrates an embodiment of an end actuator comprising a first sensor and a plurality of second sensors.

[00068] Figure 62 is a logic diagram illustrating a modality of a process for adjusting a measurement of a first sensor in response to a plurality of secondary sensors.

[00069] Figure 63 illustrates a modality of a circuit configured to convert signals from a first sensor and a plurality of secondary sensors into digital signals receivable by a processor.

[00070] Figure 64 illustrates an embodiment of an end actuator comprising a plurality of sensors.

[00071] Figure 65 is a logic diagram illustrating one embodiment of a process for determining one or more tissue properties based on a plurality of sensors.

[00072] Figure 66 illustrates an embodiment of an end actuator comprising a plurality of sensors coupled to a second claw member.

[00073] Figure 67 illustrates an embodiment of a staple cartridge comprising a plurality of sensors formed integrally thereon.

[00074] Figure 68 is a logic diagram illustrating a modality of a process for determining one or more parameters of a section of tissue attached to an end actuator.

[00075] Figure 69 illustrates an embodiment of an end actuator comprising a plurality of redundant sensors.

[00076] Figure 70 is a logic diagram illustrating a modality of a process for selecting the most reliable output from a plurality of redundant sensors.

[00077] Figure 71 illustrates an embodiment of an end actuator comprising a sensor comprising a specific sampling rate to limit or eliminate false signals.

[00078] Figure 72 is a logical diagram illustrating a modality of a process for generating a thickness measurement for a section of tissue located between an anvil and a clip cartridge of an end actuator.

[00079] Figures 73 and 74 illustrate an embodiment of an end actuator comprising a sensor to identify clip cartridges of different types.

[00080] Figure 75 illustrates an aspect of a segmented flexible circuit configured to attach securely to a claw member of an end actuator, in accordance with at least one aspect of this description.

[00081] Figure 76 illustrates an aspect of a segmented flexible circuit configured to be mounted on a claw member of an end actuator, in accordance with at least one aspect of this description.

[00082] Figure 77 illustrates an aspect of an end actuator configured to measure a GT fabric span, in accordance with at least one aspect of this description.

[00083] Figure 78 illustrates an aspect of an end actuator comprising a segmented flexible circuit, in accordance with at least one aspect of this description.

[00084] Figure 79 illustrates the end actuator shown in Figure 78 with the claw member holding the fabric between the claw member and the staple cartridge, in accordance with at least one aspect of this description.

[00085] Figure 80 is a diagram of an absolute positioning system for a surgical instrument, in which the absolute positioning system comprises an arrangement of the controlled motor drive circuit comprising a sensor arrangement, according to at least one aspect of this description.

[00086] Figure 81 is a diagram of a position sensor comprising a magnetic rotating absolute positioning system, in accordance with at least one aspect of this description.

[00087] Figure 82 is a sectional view of an end actuator of a surgical instrument showing a course of the firing member in relation to the tissue trapped inside the end actuator, in accordance with at least one aspect of this description.

[00088] Figure 83 is a first plot of two plots of closing force (FTC) that represents the force applied to a closing member to close on thick and thin tissue during a closing phase and a second plot of two plots of firing force (FTF) that represents the force applied to a firing member to fire through thick, thin tissue during a firing phase.

[00089] Figure 84 is a graph of a control system configured to provide progressive closure of a closing member during a firing stroke when the displacement member advances distally and attaches to a gripping arm to lower the force load. of closing on the closing member at a desired rate and decreasing the load of the firing force on the shooting member, according to at least one aspect of this description.

[00090] Figure 85 illustrates a feedback control system of the derivative integral proportional controller (PID), according to at least one aspect of this description.

[00091] Figure 86 is a logic flow diagram representing a process of a control program or a logical configuration to determine the speed of a closing member, according to at least one aspect of this description.

[00092] Figure 87 is a timeline representing the situational recognition of a central surgical controller, in accordance with at least one aspect of the present description.

[00093] Figure 88 illustrates a perspective view of a staple cartridge that includes an active element and a sensor, in accordance with at least one aspect of the present description.

[00094] Figure 89 illustrates a block diagram of an active sensor assembly, in accordance with at least one aspect of the present description.

[00095] Figure 90 illustrates a logical flow diagram of a process for determining a type of tissue, in accordance with at least one aspect of the present description.

[00096] Figure 91 is a perspective view of a cartridge that includes hydrophobic areas, in accordance with at least one aspect of the present description.

[00097] Figure 92 is a perspective view of a cartridge that includes a pair of data elements, in accordance with at least one aspect of the present description.

[00098] Figure 93 illustrates a block diagram of a sensor assembly for detecting and / or receiving data from data elements associated with a cartridge, in accordance with at least one aspect of the present description.

[00099] Figure 94 illustrates a logic flow diagram of a process for resolving data identification conflicts, in accordance with at least one aspect of the present description.

[000100] Figure 95 illustrates a block diagram of a circuit that includes a variable output sensor, according to at least one aspect of the present description.

[000101] Figure 96 illustrates a logic diagram of a process for controlling a sensor output mode, in accordance with at least one aspect of the present description.

[000102] Figure 97 illustrates an end actuator comprising a first sensor and a second sensor, in accordance with at least one aspect of the present description.

[000103] Figure 98 illustrates a perspective view of an end actuator, with the anvil in an open position, including a plurality of light sources arranged between the proximal end and the distal end of the staple cartridge on each side of the platform cartridge, according to at least one aspect of the present description.

DESCRIPTION

[000104] The applicant for this application holds the following

U.S. Patent Applications filed on June 29, 2018, the description of each of which is incorporated herein by reference in its entirety: ● U.S. Patent Application Serial No. __________, entitled

CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS, Attorney Document No. END8542USNP / 170755; ● U.S. Patent Application Serial No. __________, entitled

CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS, Attorney Document No. END8543USNP / 170760; ● U.S. Patent Application Serial No. __________, entitled

SYSTEMS FOR ADJUSTING END EFFECTOR PARAMETERS BASED ON PERIOPERATIVE INFORMATION, Attorney Document No. END8543USNP1 / 170760-1; ● U.S. Patent Application Serial No. _______________, entitled SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING, Attorney Document No. END8543USNP2 / 170760-2; ● U.S. Patent Application Serial No. _______________, entitled SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING, Attorney Document No. END8543USNP3 / 170760-3; ● U.S. Patent Application Serial No. __________, entitled

SURGICAL SYSTEMS FOR DETECTING END EFFECTOR TISSUE DISTRIBUTION IRREGULARITIES, Attorney Document No. END8543USNP4 / 170760-4; ● U.S. Patent Application Serial No. __________, entitled

SYSTEMS FOR DETECTING PROXIMITY OF SURGICAL END EFFECTOR TO CANCEROUS TISSUE, Attorney Document No. END8543USNP5 / 170760-5; ● U.S. Patent Application Serial No. _______________, entitled SURGICAL INSTRUMENT CARTRIDGE SENSOR ASSEMBLIES, Attorney Document No. END8543USNP6 / 170760-6; ● U.S. Patent Application Serial No. _______________, entitled SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE, Attorney Document No. END8544USNP / 170761; ● U.S. Patent Application Serial No. _______________, entitled SURGICAL INSTRUMENT HAVING A FLEXIBLE CIRCUIT, Attorney Document No. END8544USNP1 / 170761-1; ● U.S. Patent Application Serial No. __________, entitled SURGICAL INSTRUMENT WITH A TISSUE MARKING ASSEMBLY, Attorney Document No. END8544USNP2 / 170761-2; ● U.S. Patent Application Serial No. __________, entitled

SURGICAL SYSTEMS WITH PRIORITIZED DATA TRANSMISSION CAPABILITIES, Attorney Document No. END8544USNP3 / 170761-3; ● U.S. Patent Application Serial No. __________, entitled SURGICAL EVACUATION SENSING AND MOTOR CONTROL, Attorney Document No. END8545USNP / 170762; ● U.S. Patent Application Serial No. __________, entitled SURGICAL EVACUATION SENSOR ARRANGEMENTS, Attorney Document No. END8545USNP1 / 170762-1; ● U.S. Patent Application Serial No. __________, entitled SURGICAL EVACUATION FLOW PATHS, Attorney Document No. END8545USNP2 / 170762-2; ● U.S. Patent Application Serial No. __________, entitled SURGICAL EVACUATION SENSING AND GENERATOR CONTROL, Attorney Document No. END8545USNP3 / 170762-3;

● U.S. Patent Application Serial No. __________, entitled SURGICAL EVACUATION SENSING AND DISPLAY, Attorney Document No. END8545USNP4 / 170762-4; ● U.S. Patent Application Serial No. __________, entitled

COMMUNICATION OF SMOKE EVACUATION SYSTEM

PARAMETERS TO HUB OR CLOUD IN SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM, Attorney Document No. END8546USNP / 170763; ● U.S. Patent Application Serial No. __________, entitled

SMOKE EVACUATION SYSTEM INCLUDING A SEGMENTED CONTROL CIRCUIT FOR INTERACTIVE SURGICAL PLATFORM, Attorney Document No. END8546USNP1 / 170763-1; ● U.S. Patent Application Serial No. __________, entitled

SURGICAL EVACUATION SYSTEM WITH A COMMUNICATION

CIRCUIT FOR COMMUNICATION BETWEEN A FILTER AND A SMOKE EVACUATION DEVICE, Attorney Document No. END8547USNP / 170764; and ● U.S. Patent Application Serial No. __________, entitled DUAL IN-SERIES LARGE AND SMALL DROPLET FILTERS, Attorney Document No. END8548USNP / 170765.

[000105] The applicant for this application holds the following US Provisional Patent Applications, filed on June 28, 2018, the description of which is incorporated herein by reference in its entirety: ● US Provisional Patent Application n Serial number 62 / 691,228, entitled A METHOD OF USING REINFORCED FLEX CIRCUITS WITH MULTIPLE SENSORS WITH ELECTROSURGICAL DEVICES; ● U.S. Provisional Patent Application Serial No. 62 / 691,227, entitled CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS;

● U.S. Provisional Patent Application Serial No. 62 / 691,230, entitled SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE; ● U.S. Provisional Patent Application Serial No. 62 / 691,219, entitled SURGICAL EVACUATION SENSING AND MOTOR CONTROL; ● U.S. Provisional Patent Application Serial No. 62 / 691,257, entitled COMMUNICATION OF SMOKE EVACUATION SYSTEM

PARAMETERS TO HUB OR CLOUD IN SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM; ● U.S. Provisional Patent Application Serial No. 62 / 691,262, entitled SURGICAL EVACUATION SYSTEM WITH A

COMMUNICATION CIRCUIT FOR COMMUNICATION BETWEEN A FILTER AND A SMOKE EVACUATION DEVICE; and ● U.S. Provisional Patent Application Serial No. 62 / 691,251, entitled DUAL IN-SERIES LARGE AND SMALL DROPLET FILTERS.

[000106] The applicant for this application holds the following US Patent Applications, filed on March 29, 2018, the description of which is incorporated herein by reference in its entirety for reference: ● US Patent Application No. series 15 / 940,641, entitled

INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES; ● U.S. Patent Application Serial No. 15 / 940,648, entitled

INTERACTIVE SURGICAL SYSTEMS WITH CONDITION HANDLING OF DEVICES AND DATA CAPABILITIES; ● U.S. Patent Application Serial No. 15 / 940,656, entitled

SURGICAL HUB COORDINATION OF CONTROL AND COMMUNICATION OF OPERATING ROOM DEVICES; ● U.S. Patent Application Serial No. 15 / 940,666, entitled

SPATIAL AWARENESS OF SURGICAL HUBS IN OPERATING ROOMS; ● U.S. Patent Application Serial No. 15 / 940,670, entitled

COOPERATIVE UTILIZATION OF DATA DERIVED FROM SECONDARY SOURCES BY INTELLIGENT SURGICAL HUBS; ● U.S. Patent Application Serial No. 15 / 940,677, entitled SURGICAL HUB CONTROL ARRANGEMENTS; ● U.S. Patent Application Serial No. 15 / 940,632, entitled

DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD; ● U.S. Patent Application Serial No. 15 / 940,640, entitled

COMMUNICATION HUB AND STORAGE DEVICE FOR STORING

PARAMETERS AND STATUS OF A SURGICAL DEVICE TO BE SHARED WITH CLOUD BASED ANALYTICS SYSTEMS; ● U.S. Patent Application Serial No. 15 / 940,645, entitled

SELF DESCRIBING DATA PACKETS GENERATED AT AN ISSUING INSTRUMENT; ● U.S. Patent Application Serial No. 15 / 940,649, entitled

DATA PAIRING TO INTERCONNECT A DEVICE MEASURED PARAMETER WITH AN OUTCOME; ● U.S. Patent Application Serial No. 15 / 940,654, entitled SURGICAL HUB SITUATIONAL AWARENESS; ● U.S. Patent Application Serial No. 15 / 940,663, entitled SURGICAL SYSTEM DISTRIBUTED PROCESSING; ● U.S. Patent Application Serial No. 15 / 940,668, entitled AGGREGATION AND REPORTING OF SURGICAL HUB DATA; ● U.S. Patent Application Serial No. 15 / 940,671, entitled

SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER; ● U.S. Patent Application Serial No. 15 / 940,686, entitled

DISPLAY OF ALIGNMENT OF STAPLE CARTRIDGE TO PRIOR LINEAR STAPLE LINE; ● U.S. Patent Application Serial No. 15 / 940,700, entitled STERILE FIELD INTERACTIVE CONTROL DISPLAYS; ● U.S. Patent Application Serial No. 15 / 940,629, entitled COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS; ● U.S. Patent Application Serial No. 15 / 940,704, entitled USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT; ● U.S. Patent Application Serial No. 15 / 940,722, entitled

CHARACTERIZATION OF TISSUE IRREGULARITIES THROUGH THE USE OF MONO-CHROMATIC LIGHT REFRACTIVITY; and ● U.S. Patent Application Serial No. 15 / 940,742, entitled DUAL CMOS ARRAY IMAGING.

[000107] The applicant for the present application holds the following US Patent Applications, filed on March 29, 2018, the description of each of which is incorporated herein by reference in its entirety: ● US Patent Application No. series 15 / 940,636, entitled

ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES; ● U.S. Patent Application Serial No. 15 / 940,653, entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL HUBS; ● U.S. Patent Application Serial No. 15 / 940,660, entitled CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER; ● U.S. Patent Application Serial No. 15 / 940,679, entitled CLOUD-BASED MEDICAL ANALYTICS FOR LINKING OF LOCAL

USAGE TRENDS WITH THE RESOURCE ACQUISITION BEHAVIORS OF LARGER DATA SET;

● U.S. Patent Application Serial No. 15 / 940,694, entitled CLOUD-BASED MEDICAL ANALYTICS FOR MEDICAL FACILITY SEGMENTED INDIVIDUALIZATION OF INSTRUMENT FUNCTION; ● U.S. Patent Application Serial No. 15 / 940,634, entitled CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES; ● U.S. Patent Application Serial No. 15 / 940,706, entitled

DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK; and ● U.S. Patent Application Serial No. 15 / 940,675, entitled CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES.

[000108] The applicant for this application holds the following US Patent Applications, filed on March 29, 2018, the description of which is incorporated herein by reference in its entirety for reference: ● US Patent Application No. series 15 / 940,627, entitled DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; ● U.S. Patent Application Serial No. 15 / 940,637, entitled COMMUNICATION ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; ● U.S. Patent Application Serial No. 15 / 940,642, entitled CONTROLS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; ● U.S. Patent Application Serial No. 15 / 940,676, entitled AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; ● U.S. Patent Application Serial No. 15 / 940,680, entitled CONTROLLERS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; ● U.S. Patent Application Serial No. 15 / 940,683, entitled COOPERATIVE SURGICAL ACTIONS FOR ROBOT-ASSISTED

SURGICAL PLATFORMS; ● U.S. Patent Application Serial No. 15 / 940,690, entitled DISPLAY ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; and ● U.S. Patent Application Serial No. 15 / 940,711, entitled SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS.

[000109] The applicant for this application holds the following US Provisional Patent Applications, filed on March 28, 2018, the description of which is incorporated herein by reference in its entirety: ● US Provisional Patent Application n Serial number 62 / 649,302, entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES; ● U.S. Provisional Patent Application Serial No. 62 / 649,294, entitled DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD; ● U.S. Provisional Patent Application Serial No. 62 / 649,300, entitled SURGICAL HUB SITUATIONAL AWARENESS; ● U.S. Provisional Patent Application Serial No. 62 / 649,309, entitled SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER; ● U.S. Provisional Patent Application Serial No. 62 / 649,310, entitled COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS; ● U.S. Provisional Patent Application Serial No. 62 / 649,291, USE OF LASER LIGHT AND RED-GREEN-BLUE

COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT; ● U.S. Provisional Patent Application Serial No. 62 / 649,296,

titled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES; ● U.S. Provisional Patent Application Serial No. 62 / 649,333, entitled CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER; ● U.S. Provisional Patent Application Serial No. 62 / 649,327, entitled CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES; ● U.S. Provisional Patent Application Serial No. 62 / 649,315, entitled DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK; ● U.S. Provisional Patent Application Serial No. 62 / 649,313, entitled CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES; ● U.S. Provisional Patent Application Serial No. 62 / 649,320, entitled DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; ● U.S. Provisional Patent Application Serial No. 62 / 649,307, entitled AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT- ASSISTED SURGICAL PLATFORMS; and ● U.S. Provisional Patent Application Serial No. 62 / 649,323, entitled SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS.

[000110] The applicant for this application holds the following US Provisional Patent Applications, filed on April 19, 2018, the description of which is incorporated herein by reference in its entirety: ● US Provisional Patent Application n Serial number 62 / 659,900, entitled METHOD OF HUB COMMUNICATION.

[000111] The applicant for this application holds the following U.S. Provisional Patent Applications, filed on March 30,

2018, the description of each of which is incorporated herein by reference in its entirety: ● U.S. Provisional Patent Application Serial No. 62 / 650,887, entitled SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES; ● U.S. Provisional Patent Application Serial No. 62 / 650,877, entitled SURGICAL SMOKE EVACUATION SENSING AND CONTROLS; ● U.S. Provisional Patent Application Serial No. 62 / 650,882, entitled SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM; and ● U.S. Provisional Patent Application Serial No. 62 / 650,898, entitled CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS.

[000112] The applicant for this application holds the following provisional US Patent Applications, filed on March 8, 2018, with the description of each of which is incorporated herein by reference in its entirety: ● US Provisional Patent Application n Serial number 62 / 640,417, entitled TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEM THEREFOR; and ● U.S. Provisional Patent Application Serial No. 62 / 640,415, entitled ESTIMATING STATE OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR.

[000113] The applicant for the present application holds the following provisional US Patent Applications, filed on December 28, 2017, with the description of each of which is incorporated herein by reference in its entirety: ● US Provisional Patent Application n Serial number 62 / 611.341, entitled INTERACTIVE SURGICAL PLATFORM;

● U.S. Provisional Patent Application Serial No. 62 / 611,340, entitled CLOUD-BASED MEDICAL ANALYTICS; and ● U.S. Provisional Patent Application Serial No. 62 / 611,339, entitled ROBOT ASSISTED SURGICAL PLATFORM.

[000114] Before explaining in detail the various aspects of surgical instruments and generators, it should be noted that the illustrative examples are not limited, in terms of application or use, to the details of construction and arrangement of parts illustrated in the drawings and description attached. Illustrative examples can be implemented or incorporated into other aspects, variations and modifications, and can be practiced or performed in a variety of ways. Furthermore, except where otherwise indicated, the terms and expressions used in the present invention were chosen for the purpose of describing illustrative examples for the convenience of the reader and not for the purpose of limiting it. In addition, it should be understood that one or more of the aspects, expressions of aspects, and / or examples described below can be combined with any one or more of the other aspects, expressions of aspects and / or examples described below.

[000115] Referring to Figure 1, a computer-implemented interactive surgical system 100 includes one or more surgical systems 102 and a cloud-based system (for example, cloud 104 which may include a remote server 113 coupled to a storage device 105). Each surgical system 102 includes at least one central surgical controller 106 in communication with the cloud 104 which can include a remote server 113. In one example, as illustrated in Figure 1, surgical system 102 includes a visualization system 108, a robotic system 110, a smart handheld surgical instrument 112, which are configured to communicate with one another and / or the central controller 106. In some respects, a surgical system 102 may include a number of central controllers M 106, an N number of visualization systems 108, an O number of robotic systems 110, and a P number of smart, hand-held surgical instruments 112, where M, N, O, and P are whole numbers greater than or equal to one.

[000116] Figure 3 represents an example of a surgical system 102 being used to perform a surgical procedure on a patient who is lying on an operating table 114 in a surgical operating room 116. A robotic system 110 is used in the surgical procedure as a part of the surgical system 102. The robotic system 110 includes a surgeon console 118, a patient car 120 (surgical robot) and a robotic central surgical controller

122. Patient carriage 120 can manipulate at least one removably attached surgical tool 117 through a minimally invasive incision in the patient's body while the surgeon views the surgical site through the surgeon's console 118. An image of the surgical site can be obtained by a medical imaging device 124, which can be manipulated by patient's car 120 to guide imaging device 124. The robotic central controller 122 can be used to process images of the surgical site for subsequent display to the surgeon via the console of the surgeon 118.

[000117] Other types of robotic systems can readily be adapted for use with the surgical system 102. Various examples of robotic systems and surgical instruments that are suitable for use with the present description are described in provisional patent application no. 62 / 611,339, entitled ROBOT ASSISTED SURGICAL PLATFORM, filed on December 28, 2017, whose description is hereby incorporated by reference in its entirety.

[000118] Various examples of cloud-based analysis that are performed by cloud 104, and are suitable for use with the present description, are described in US Provisional Patent Application Serial No. 62 / 611.340, entitled CLOUD-BASED MEDICAL ANALYTICS , filed on December 28, 2017, the description of which is incorporated herein by reference, in its entirety.

[000119] In several aspects, the imaging device 124 includes at least one Image sensor and one or more optical components. Suitable image sensors include, but are not limited to, load-coupled device (CCD) sensors and complementary metal oxide semiconductor (CMOS) sensors.

[000120] The optical components of the imaging device 124 may include one or more light sources and / or one or more lenses. One or more light sources can be directed to illuminate portions of the surgical field. The one or more image sensors can receive reflected or refracted light from the surgical field, including reflected or refracted light from tissue and / or surgical instruments.

[000121] The one or more light sources can be configured to radiate electromagnetic energy in the visible spectrum, as well as in the invisible spectrum. The visible spectrum, sometimes called the optical spectrum or light spectrum, is that portion of the electromagnetic spectrum that is visible to (that is, can be detected by) the human eye and can be called visible light or simply light. A typical human eye will respond to wavelengths in the air that are from about 380 nm to about 750 nm.

[000122] The invisible spectrum (that is, the non-luminous spectrum) is that portion of the electromagnetic spectrum located below and above the visible spectrum (that is, wavelengths below about 380 nm and above about 750 nm). The invisible spectrum is not detectable by the human eye. Wavelengths greater than about 750 nm are longer than the visible red spectrum, and they become invisible infrared (IR), microwaves, radio and electromagnetic radiation. Wavelengths shorter than about 380 nm are shorter than the ultraviolet spectrum, and they become invisible ultraviolet, x-ray, and electromagnetic gamma-ray radiation.

[000123] In several respects, the imaging device 124 is configured for use in a minimally invasive procedure. Examples of imaging devices suitable for use with the present description include, but are not limited to, an arthroscope, angioscope, bronchoscope, choledocoscope, colonoscope, cytoscope, duodenoscope, enteroscope, esophagus-duodenoscope (gastroscope), endoscope, laryngoscope, nasopharyngoscope neproscope, sigmoidoscope, thoracoscope, and ureteroscope.

[000124] In one aspect, the imaging device employs multiple spectrum monitoring to discriminate topography and underlying structures. A multi-spectral image is one that captures image data within wavelength bands across the electromagnetic spectrum. Wavelengths can be separated by filters or using instruments that are sensitive to specific wavelengths, including light from frequencies beyond the visible light range, for example, IR and ultraviolet light. Spectral images can allow the extraction of additional information that the human eye cannot capture with its receivers for the colors red, green, and blue. The use of multispectral imaging is described in more detail under the heading "Advanced Imaging Acquisition Module" in US Provisional Patent Application Serial No. 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28, 2017, the description of which is here incorporated as a reference in its entirety. Multispectral monitoring can be a useful tool for relocating a surgical field after a surgical task is completed to perform one or more of the tests previously described on the treated tissue.

[000125] It is axiomatic that strict sterilization of the operating room and surgical equipment is necessary during any surgery. The strict hygiene and sterilization conditions required in an "operating room", that is, an operating or treatment room, justify the highest possible sterilization of all medical devices and equipment. Part of this sterilization process is the need to sterilize anything that comes into contact with the patient or enters the sterile field, including imaging device 124 and its connectors and components. It will be understood that the sterile field can be considered a specified area, such as inside a tray or on a sterile towel, which is considered free of microorganisms, or the sterile field can be considered an area, immediately around a patient, who was prepared to perform a surgical procedure. The sterile field may include members of the brushing team, who are properly dressed, and all furniture and accessories in the area.

[000126] In various aspects, the visualization system 108 includes one or more imaging sensors, one or more image processing units, one or more storage arrays and one or more screens that are strategically arranged in relation to the sterile field, as shown in Figure 2. In one aspect, the display system 108 includes an interface for HL7, PACS and EMR. Various components of the 108 display system are described under the heading "Advanced Imaging Acquisition Module" in US Provisional Patent Application Serial No. 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed December 28, 2017, the description of which is incorporated herein as a reference in its entirety.

[000127] As shown in Figure 2, a primary screen 119 is positioned in the sterile field to be visible to the operator on the operating table 114. In addition, a viewing tower 111 is positioned outside the sterile field. The display tower 111 includes a first non-sterile screen 107 and a second non-sterile screen 109, which are opposite each other. The visualization system 108, guided by the central controller 106, is configured to use screens 107, 109, and 119 to coordinate the flow of information to operators inside and outside the sterile field. For example, the central controller 106 can have the visualization system 108 display a snapshot of a surgical site, as recorded by an imaging device 124, on a non-sterile screen 107 or 109, while maintaining a live transmission of the surgical site on main screen 119. Snapshot on non-sterile screen 107 or 109 can allow a non-sterile operator to perform a diagnostic step relevant to the surgical procedure, for example.

[000128] In one aspect, the central controller 106 is also configured to route a diagnostic input or feedback by a non-sterile operator in the display tower 111 to the primary screen 119 within the sterile field, where it can be seen by a sterile operator on the operating table. In one example, the entry may be in the form of a modification of the snapshot displayed on the non-sterile screen 107 or 109, which can be routed to main screen 119 by central controller 106.

[000129] With reference to Figure 2, a 112 surgical instrument is being used in the surgical procedure as part of the surgical system

102. Central controller 106 is also configured to coordinate the flow of information to a screen of surgical instrument 112. For example, in U.S. Provisional Patent Application Serial No. 62 / 611,341,

entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28, 2017, whose description is hereby incorporated by reference in its entirety for reference. An entry or diagnostic feedback inserted by a non-sterile operator in the viewing tower 111 can be routed by the central controller 106 to the surgical instrument screen 115 in the sterile field, where it can be seen by the surgical instrument operator 112. Exemplary surgical instruments that are suitable for use with surgical system 102 are described under the heading "Surgical Instrument Hardware" and in provisional patent application serial number 62 / 611.341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28, 2017, the description of which is incorporated herein as a reference in its entirety, for example.

[000130] Now with reference to Figure 3, a central controller 106 is shown in communication with a visualization system 108, a robotic system 110 and an intelligent hand held surgical instrument 112. The central controller 106 includes a central controller screen 135, an imaging module 138, a generator module 140, a communication module 130, a processor module 132 and a storage matrix 134. In certain respects, as shown in Figure 3, central controller 106 additionally includes a smoke evacuation module 126 and / or a suction / irrigation module 128.

[000131] During a surgical procedure, the application of energy to the tissue, for sealing and / or cutting, is generally associated with the evacuation of smoke, suction of excess fluid and / or irrigation of the tissue. Fluid, power, and / or data lines from different sources are often intertwined during the surgical procedure. Valuable time can be wasted in addressing this issue during a surgical procedure. To untangle the lines, it may be necessary to disconnect the lines from their respective modules, which may require a restart of the modules. The central compartment of the central controller 136 offers a unified environment for managing power, data and fluid lines, which reduces the frequency of entanglement between such lines.

[000132] Aspects of the present description feature a central surgical controller for use in a surgical procedure that involves applying energy to tissue at a surgical site. The central surgical controller includes a central controller compartment and a combination generator module received slidingly at a central controller compartment docking station. The docking station includes data and power contacts. The combined generator module includes two or more of an ultrasonic energy generating component, a bipolar RF energy generating component, and a monopolar RF energy generating component which are housed in a single unit. In one aspect, the combined generator module also includes a smoke evacuation component, at least one power application cable to connect the combined generator module to a surgical instrument, at least one smoke evacuation component configured to evacuate smoke, fluid , and / or particulates generated by applying therapeutic energy to the tissue, and a fluid line that extends from the remote surgical site to the smoke evacuation component.

[000133] In one aspect, the fluid line is a first fluid line and a second fluid line extends from the remote surgical site to a suction and irrigation module received slidingly in the central controller compartment. In one aspect, the central controller compartment comprises a fluid interface.

[000134] Certain surgical procedures may require the application of more than one type of energy to the tissue. One type of energy may be more beneficial for cutting the fabric, while another type of energy may be more beneficial for sealing the fabric. For example, a bipolar generator can be used to seal the tissue while an ultrasonic generator can be used to cut the sealed tissue. Aspects of the present description present a solution in which a modular compartment of the central controller 136 is configured to accommodate different generators and facilitate interactive communication between them. One of the advantages of the modular compartment of the central controller 136 is that it allows the quick removal and / or replacement of several modules.

[000135] Aspects of the present description feature a modular surgical compartment for use in a surgical procedure that involves applying energy to the tissue. The modular surgical compartment includes a first energy generator module, configured to generate a first energy for application to the tissue, and a first docking station that comprises a first docking port that includes first data and power contacts, the first being The power generator module is slidingly mobile in an electrical coupling with the power and data contacts and the first power generator module is slidingly mobile out of the electrical coupling with the first power and data contacts.

[000136] In addition to the above, the modular surgical compartment also includes a second energy generator module configured to generate a second energy, different from the first energy, for application to the tissue, and a second docking station comprising a second docking port which includes second data and power contacts, the second power generating module being slidably movable in an electrical coupling with the power and data contacts, and the second power generating module being slidingly movable outwards electrical coupling with the second power and data contacts.

[000137] In addition, the modular surgical compartment also includes a communication bus between the first coupling port and the second coupling port, configured to facilitate communication between the first energy generating module and the second energy generating module.

[000138] With reference to Figures 3 to 7, aspects of the present description are presented for a modular compartment of the central controller 136 that allows the modular integration of a generator module 140, a smoke evacuation module 126, and a suction module / irrigation 128. The central controller 136 modular compartment further facilitates interactive communication between modules 140, 126, 128. As illustrated in Figure 5, generator module 140 can be a generator module with integrated, supported monopoly, bipolar and ultrasonic components in a single enclosure unit 139 slidably insertable into the modular compartment of central controller 136. As shown in Figure 5, generator module 140 can be configured to connect to a monopolar device 146, a bipolar device 147 and an ultrasonic device

148. Alternatively, generator module 140 may comprise a series of monopolar, bipolar and / or ultrasonic generator modules that interact through the central controller modular compartment

136. The central controller modular compartment 136 can be configured to facilitate the insertion of multiple generators and interactive communication between generators anchored in the central controller modular compartment 136 so that the generators would act as a single generator.

[000139] In one aspect, the modular compartment of the central controller 136 comprises a modular power and a back communication board 149 with external and wireless communication heads to allow the removable fixing of modules 140, 126, 128 and interactive communication between the themselves.

[000140] In one aspect, the modular compartment of the central controller 136 includes docking stations, or drawers, 151, here also called drawers, which are configured to receive slidingly the modules 140, 126, 128. Figure 4 illustrates a partial perspective view of a central surgical controller compartment 136, and a combined generator module 145 slidably received at a docking station 151 of the central surgical controller compartment 136. A docking port 152 with power and data contacts in a rear side of the combined generator module 145 is configured to engage a corresponding docking port 150 with the power and data contacts of a corresponding docking station 151 from the central controller modular compartment 136 as the combined generator module 145 is slid into position at the corresponding docking station 151 of the central controller 136 modular bay. In one aspect, the combined generator module 145 includes a bipolar, ultrasonic and monopolar module and a smoke evacuation module integrated into a single cabinet unit 139, as shown in Figure 5.

[000141] In several respects, the smoke evacuation module 126 includes a fluid line 154 that carries captured / collected fluid smoke away from a surgical site and to, for example, the smoke evacuation module 126. Suction a vacuum that originates from the smoke evacuation module 126 can pull the smoke into an opening of a utility conduit at the surgical site. The utility conduit, coupled to the fluid line, can be in the form of a flexible tube that ends in the smoke evacuation module 126. The utility conduit and the fluid line define a fluid path that extends towards the smoke evacuation module 126 which is received in the central controller compartment

136.

[000142] In several aspects, the suction / irrigation module 128 is coupled to a surgical tool comprising a fluid suction line and a fluid suction line. In one example, the suction and suction fluid lines are in the form of flexible tubes that extend from the surgical site towards the suction / irrigation module 128. One or more drive systems can be configured to cause irrigation and aspiration of fluids to and from the surgical site.

[000143] In one aspect, the surgical tool includes a drive shaft that has an end actuator at a distal end of the same and at least an energy treatment associated with the end actuator, a suction tube, and a suction tube. irrigation. The suction tube can have an inlet port at a distal end of it and the suction tube extends through the drive shaft. Similarly, an irrigation pipe can extend through the drive shaft and may have an entrance port close to the power application implement. The power application implement is configured to deliver ultrasonic and / or RF energy to the surgical site and is coupled to the generator module 140 by a cable that initially extends through the drive shaft.

[000144] The irrigation tube can be in fluid communication with a fluid source, and the suction tube can be in fluid communication with a vacuum source. The fluid source and / or the vacuum source can be housed in the suction / irrigation module 128. In one example, the fluid source and / or the vacuum source can be housed in the central controller compartment 136 separately from the control module. suction / irrigation 128. In such an example, a fluid interface can be configured to connect the suction / irrigation module 128 to the fluid source and / or the vacuum source.

[000145] In one aspect, modules 140, 126, 128 and / or their corresponding docking stations in the central compartment modular module 136 may include alignment features that are configured to align the docking ports of the modules in engagement with their counterparts at the docking stations of the central compartment of the central controller 136. For example, as shown in Figure 4, the combined generator module 145 includes side brackets 155 which are configured to slide the corresponding brackets 156 of the corresponding docking station 151 of the compartment. modular central controller 136. The brackets cooperate to guide the coupling port contacts of the combined generator module 145 in an electrical engagement with the coupling port contacts of the central controller 136 modular compartment.

[000146] In some respects, the drawers 151 of the modular compartment of the central controller 136 are the same, or substantially the same size, and the modules are adjusted in size to be received in the drawers 151. For example, the side brackets 155 and / or 156 can be larger or smaller depending on the size of the module. In other respects, drawers 151 are different in size and are each designed to accommodate a specific module.

[000147] In addition, the contacts of a specific module can be switched to engage with the contacts of a specific drawer to avoid inserting a module in a drawer with unpaired contacts.

[000148] As shown in Figure 4, the docking port 150 of one drawer 151 can be coupled to the docking port 150 of another drawer 151 via a communication link 157 to facilitate interactive communication between the modules housed in the modular compartment of the central controller 136. The coupling ports 150 of the modular compartment of the central controller 136 can, alternatively or additionally, facilitate interactive wireless communication between the modules housed in the modular compartment of the central controller 136. Any suitable wireless communication can be used, such as Air Titan Bluetooth.

[000149] Figure 6 illustrates individual power bus connectors for a plurality of side coupling ports of a side modular cabinet 160 configured to receive a plurality of modules from a central surgical controller 206. Side modular cabinet 160 is configured to receive and laterally interconnect modules 161. Modules 161 are slidably inserted into docking stations 162 of side modular cabinet 160, which includes a back plate for interconnecting modules 161. As shown in Figure 6, modules 161 are arranged laterally in the side modular cabinet 160. Alternatively, modules 161 can be arranged vertically in a side modular cabinet.

[000150] Figure 7 illustrates a vertical modular cabinet 164 configured to receive a plurality of modules 165 from the central surgical controller 106. The modules 165 are slidably inserted into docking stations, or drawers, 167 of the vertical modular cabinet 164, which includes a rear panel for interconnecting the modules 165. Although the drawers 167 of the vertical modular cabinet 164 are arranged vertically, in certain cases, a vertical modular cabinet 164 may include drawers that are arranged laterally. In addition, modules 165 can interact with each other through the coupling ports of the vertical modular cabinet

164. In the example in Figure 7, a screen 177 is provided to show data relevant to the operation of modules 165. In addition, the vertical modular cabinet 164 includes a master module 178 that houses a plurality of submodules that are received in a sliding way on master module 178.

[000151] In several aspects, the imaging module 138 comprises an integrated video processor and a modular light source and is adapted for use with various imaging devices. In one aspect, the imaging device is comprised of a modular cabinet that can be mounted with a light source module and a camera module. The case can be a disposable case. In at least one example, the disposable case is removably coupled to a reusable controller, a light source module, and a camera module. The light source module and / or the camera module can be selected selectively depending on the type of surgical procedure. In one aspect, the camera module comprises a CCD sensor. In another aspect, the camera module comprises a CMOS sensor. In another aspect, the camera module is configured for imaging the scanned beam. Similarly, the light source module can be configured to provide a white light or a different light, depending on the surgical procedure.

[000152] During a surgical procedure, removing a surgical device from the surgical field and replacing it with another surgical device that includes a different camera or other light source may be inefficient. Temporarily losing sight of the surgical field can lead to undesirable consequences. The imaging device module of the present description is configured to allow the replacement of a light source module or a "midstream" camera module during a surgical procedure, without the need to remove the imaging device from the surgical field.

[000153] In one aspect, the imaging device comprises a tubular cabinet that includes a plurality of channels. A first channel is configured to receive the Camera module in a sliding way, which can be configured for a snap-fit fit (pressure fit) with the first channel. A second channel is configured to slide the camera module, which can be configured for a snap-fit fit (pressure fit) with the first channel. In another example, the camera module and / or the light source module can be rotated to an end position within their respective channels. A threaded coupling can be used instead of a pressure fitting.

[000154] In several examples, multiple imaging devices are placed in different positions in the surgical field to provide multiple views. Imaging module 138 can be configured to switch between imaging devices to provide an ideal view. In several respects, imaging module 138 can be configured to integrate images from different imaging devices.

[000155] Various image processors and imaging devices suitable for use with the present description are described in US Patent No. 7,995,045 entitled COMBINED SBI AND CONVENTIONAL IMAGE PROCESSOR, granted on August 9, 2011 which is incorporated herein by way of reference in its entirety. In addition, US Patent No. 7,982,776, entitled SBI MOTION ARTIFACT REMOVAL APPARATUS AND METHOD, issued July 19, 2011, which is incorporated herein by reference in its entirety, describes various systems for removing motion artifacts from image data. Such systems can be integrated with imaging module 138. In addition, publication of U.S. Patent Application No. 2011/0306840, entitled CONTROLLABLE

MAGNETIC SOURCE TO FIXTURE INTRACORPOREAL APPARATUS, published on December 15, 2011, and the publication of US Patent Application No. 2014/0243597, entitled SYSTEM FOR PERFORMING A MINIMALLY INVASIVE SURGICAL PROCEDURE, published on August 28, 2014, with the description each of which is incorporated herein by reference in its entirety.

[000156] Figure 8 illustrates a surgical data network 201 comprising a central modular communication controller 203 configured to connect modular devices located in one or more operating rooms of a healthcare facility, or any environment in a healthcare facility. audiences specially equipped for surgical operations, to a cloud-based system (for example, cloud 204 which may include a remote server 213 coupled to a storage device 205). In one aspect, the modular communication central controller 203 comprises a central network controller 207 and / or a network key 209 in communication with a network router. The central modular communication controller 203 can also be coupled to a local computer system 210 to provide local computer processing and data manipulation. The surgical data network 201 can be configured as a passive, intelligent, or switching network. A passive surgical data network serves as a conduit for the data, allowing the data to be transmitted from one device (or segment) to another and to cloud computing resources. An intelligent surgical data network includes features to allow traffic to pass through the surgical data network to be monitored and to configure each port on the central network controller 207 or network key 209. An intelligent surgical data network can be called a a central controller or a controllable key. A central switching controller reads the destination address of each packet and then forwards the packet to the correct port.

[000157] The modular devices 1a to 1n located in the operating room can be coupled to the central controller of modular communication 203. The central network controller 207 and / or the network switch 209 can be coupled to a network router 211 to connect devices 1a through 1n to the 204 cloud or the local computer system

210. The data associated with devices 1a to 1n can be transferred to cloud-based computers via the router for remote data processing and manipulation. The data associated with devices 1a to 1n can also be transferred to the local computer system 210 for processing and manipulation of the local data. Modular devices 2a to 2m located in the same operating room can also be coupled to a network switch 209. Network switch 209 can be attached to the central network controller 207 and / or to network router 211 to connect devices 2a 2m to cloud 204. The data associated with devices 2a to 2n can be transferred to cloud 204 via network router 211 for data processing and manipulation. The data associated with devices 2a to 2m can also be transferred to the local computer system 210 for processing and manipulation of the local data.

[000158] It will be understood that the surgical data network 201 can be expanded by interconnecting multiple central network controllers 207 and / or multiple network switches 209 with multiple network routers 211. The central communication controller 203 may be contained in a modular control roaster configured to receive multiple devices 1a to 1n / 2a to 2m. The local computer system 210 can also be contained in a modular control tower. The modular communication central controller 203 is connected to a screen 212 to show the images obtained by some of the devices 1a to 1n / 2a to 2m, for example, during surgical procedures. In several respects, devices 1a to 1n / 2a to 2m can include, for example, several modules such as an imaging module 138 coupled to an endoscope, a generator module 140 coupled to an energy-based surgical device, an evacuation module smoke 126, a suction / irrigation module 128, a communication module 130, a processor module 132, a storage matrix 134, a surgical device attached to a screen, and / or a non-contact sensor module, among others modular devices that can be connected to the modular communication central controller 203 of the surgical data network 201.

[000159] In one aspect, the surgical data network 201 may comprise a combination of central network controller (s), network key (s) and network router (s) connecting devices 1a to 1n / 2a to 2m to the cloud. Any or all of the devices 1a to 1n / 2a to 2m coupled to the central network controller or network key can collect data in real time and transfer the data to cloud computers for data processing and manipulation. It will be understood that cloud computing depends on sharing computing resources instead of having local servers or personal devices to handle software applications. The word "cloud" can be used as a metaphor for "the Internet", although the term is not limited as such. Consequently, the term "cloud computing" can be used here to refer to "a type of Internet-based computing", in which different services - such as servers, storage, and applications - are applied to the modular communication central controller 203 and / or computer system 210 located in the operating room (for example, a fixed, mobile, temporary, or operating room or operating space) and devices connected to the modular communication central controller 203 and / or computer system 210 via from Internet. The cloud infrastructure can be maintained by a cloud service provider. In this context, the cloud service provider may be the entity that coordinates the use and control of devices 1a to 1n / 2a to 2m located in one or more operating rooms. Cloud computing services can perform a large number of calculations based on data collected by smart surgical instruments, robots, and other computerized devices located in the operating room. The central controller hardware allows multiple devices or connections to be connected to a computer that communicates with cloud computing and storage resources.

[000160] The application of cloud computer data processing techniques to the data collected by devices 1a to 1n / 2a to 2m, the surgical data network provides better surgical results, reduced costs, and better patient satisfaction. At least some of the devices 1a to 1n / 2a to 2m can be used to view tissue status to assess leakage or perfusion of sealed tissue after a tissue sealing and cutting procedure. At least some of the devices 1a to 1n / 2a to 2m can be used to identify the pathology, such as the effects of disease, with the use of cloud-based computing to examine data including images of body tissue samples for diagnostic purposes. This includes confirmation of the location and margin of the tissue and phenotypes. At least some of the devices 1a to 1n / 2a to 2m can be used to identify anatomical structures of the body using a variety of sensors integrated with imaging devices and techniques such as overlaying images captured by multiple imaging devices. The data collected by devices 1a to 1n / 2a to 2m, including the image data, can be transferred to the cloud 204 or the local computer system 210 or both for data processing and manipulation including image processing and manipulation. The data can be analyzed to improve the results of the surgical procedure by determining whether additional treatment, such as application of endoscopic intervention, emerging technologies, targeted radiation, targeted intervention, accurate robotics at specific tissue sites and conditions, can be followed. This data analysis can additionally use analytical processing of the results, and with the use of standardized approaches they can provide beneficial standardized feedback both to confirm surgical treatments and the surgeon's behavior or to suggest changes to surgical treatments and the surgeon's behavior.

[000161] In an implementation, devices in the operating room 1a to 1n can be connected to the central modular communication controller 203 via a wired channel or a wireless channel depending on the configuration of devices 1a to 1n on a central controller of network. The central network controller 207 can be implemented, in one aspect, as a local network transmission device that acts on the physical layer of the OSI model ("open system interconnection"). The central network controller provides connectivity to devices 1a to 1n located on the same network as the operating room. The central network controller 207 collects data in the form of packets and sends it to the router in half - duplex mode. "The central network controller 207 does not store any media / Internet protocol (MAC / IP) access control for transfer device data Only one of the devices 1a to 1n at a time can send data via the central network controller 207. The central network controller 207 does not have routing tables or intelligence about where to send information and transmits all data from the network through each connection and to a remote server 213 (Figure 9) in the cloud 204. The central network controller 207 can detect basic network errors, such as collisions, but have all (admit that) the information transmitted to multiple input ports it can be a security risk and cause strangulation.

[000162] In another implementation, operating room devices 2a to 2m can be connected to a network switch 209 through a wired or wireless channel. The network key 209 works in the data connection layer of the OSI model. The network switch 209 is a multicast device for connecting devices 2a to 2m located in the same operation center to the network. The network key 209 sends data in frame form to the network router 211 and works in full duplex mode. Multiple devices 2a to 2m can send data at the same time via network key 209. Network key 209 stores and uses MAC addresses of devices 2a to 2m to transfer data.

[000163] The central network controller 207 and / or the network key 209 are coupled to the network router 211 for a connection to the cloud

204. Network router 211 works on the network layer of the OSI model. The network router 211 creates a route to transmit data packets received from the central network controller 207 and / or the network key 211 to a computer with cloud resources for future processing and manipulation of the data collected by any among or all of the devices 1a to 1n / 2a to 2m. The network router 211 can be used to connect two or more different networks located in different locations, such as different operating rooms in the same health care facility or different networks located in different operating rooms of different service facilities of health. Network router 211 sends data in packet form to cloud 204 and works in full duplex mode. Multiple devices can send data at the same time. The network router 211 uses IP addresses to transfer data.

[000164] In one example, the central network controller 207 can be implemented as a central USB controller, which allows multiple USB devices to be connected to a host computer. The central USB controller can expand a single USB port on multiple levels so that more ports are available to connect the devices to the system's host computer. The central network controller 207 can include wired or wireless capabilities to receive information about a wired channel or a wireless channel. In one aspect, a wireless wireless, broadband and short-range wireless USB communication protocol can be used for communication between devices 1a to 1n and devices 2a to 2m located in the operating room.

[000165] In other examples, devices in the operating room 1a to 1n / 2a to 2m can communicate with the central modular communication controller 203 via standard Bluetooth wireless technology for exchanging data over short distances (with the use of short-wavelength UHF radio waves in the 2.4 to 2.485 GHz ISM band) from fixed and mobile devices and build personal area networks (PANs). In other respects, operating room devices 1a to 1n / 2a to 2m can communicate with the central modular communication controller 203 via a number of wireless and wired communication standards or protocols, including, but not limited to a, Wi-Fi (IEEE 802.11 family), WiMAX

(IEEE 802.16 family), IEEE 802.20, long-term evolution (LTE, "long-term evolution"), and Ev-DO, HSPA +, HSDPA +, HSUPA +, EDGE, GSM, GPRS, CDMA, TDMA, DECT, and derivatives of Ethernet, as well as any other wireless and wired protocols that are designated as 3G, 4G, 5G, and beyond. The computing module can include a plurality of communication modules. For example, a first communication module can be dedicated to short-range wireless communications like Wi-Fi and Bluetooth, and a second communication module can be dedicated to longer-range wireless communications like GPS, EDGE, GPRS, CDMA , WiMAX, LTE, Ev-DO, and others.

[000166] The modular communication central controller 203 can serve as a central connection for one or all operating room devices 1a to 1n / 2a to 2m and handles a data type known as frames. The tables carry the data generated by the devices 1a to 1n / 2a to 2m. When a frame is received by the modular central communication controller 203, it is amplified and transmitted to the network router 211, which transfers data to cloud computing resources using a series of wireless communication standards or protocols or wired, as described in the present invention.

[000167] The modular communication central controller 203 can be used as a standalone device or be connected to compatible central network controllers and network switches to form a larger network. The 203 modular communication central controller is, in general, easy to install, configure and maintain, making it a good option for the network of devices 1a to 1n / 2a to 2m from the operating room.

[000168] Figure 9 illustrates an interactive surgical system, implemented by computer 200. The interactive surgical system implemented by computer 200 is similar in many ways to the interactive surgical system, implemented by computer 100. For example, the interactive, implemented, surgical system per computer 200 includes one or more surgical systems 202, which are similar in many respects to surgical systems 102. Each surgical system 202 includes at least one central surgical controller 206 in communication with a cloud 204 which may include a remote server

213. In one aspect, the computer-implemented interactive surgical system 200 comprises a modular control tower 236 connected to multiple operating room devices such as, for example, smart surgical instruments, robots and other computerized devices located in the operating room. As shown in Figure 10, the modular control tower 236 comprises a central modular communication controller 203 coupled to a computer system 210. As illustrated in the example in Figure 9, the modular control tower 236 is coupled to an imaging module 238 which is coupled to an endoscope 239, a generator module 240 which is coupled to a power device 241, a smoke evacuation module 226, a suction / irrigation module 228, a communication module 230, a processor module 232, a storage array 234, an intelligent device / instrument 235 optionally coupled to a screen 237, and a non-contact sensor module 242. Operating room devices are coupled with cloud computing resources and data storage through the tower modular control 236. The central robot controller 222 can also be connected to the modular control tower 236 and cloud computing resources. The devices / instruments 235, visualization systems 208, among others, can be coupled to the modular control tower 236 by means of wired or wireless communication standards or protocols, as described in the present invention. The modular control tower 236 can be coupled to a central controller screen 215 (for example, monitor, screen) to display and overlay images received from the imaging module, device / instrument screen and / or other display systems 208. A The central controller screen can also show the data received from the devices connected to the modular control tower together with images and overlapping images. Figure 10 illustrates a central surgical controller 206 comprising a plurality of modules coupled to the modular control tower 236. The modular control tower 236 comprises a central modular communication controller 203, for example, a network connectivity device, and a computer system 210 to provide local processing, visualization, and imaging, for example. As shown in Figure 10, the modular communication central controller 203 can be connected in a layered configuration to expand the number of modules (for example, devices) that can be connected to the modular communication central controller 203 and transfer data associated with modules to computer system 210, cloud computing resources, or both. As shown in Figure 10, each of the central controllers / network switches in the modular central communication controller 203 includes three downstream ports and one upstream port. The central controller / upstream network key is connected to a processor to provide a communication connection to the cloud computing resources and a local display 217. Communication with the cloud 204 can be done via a channel of wired or wireless communication.

[000169] The central surgical controller 206 employs a non-contact sensor module 242 to measure the dimensions of the operating room and generate a map of the operating room using non-contact measuring devices of the laser or ultrasonic type. An ultrasound-based non-contact sensor module scans the operating room by transmitting an ultrasound explosion and receiving the echo when it bounces outside the perimeter of the operating room walls, as described under the heading "Surgical Hub Spatial Awareness Within an Operating Room "in US Provisional Patent Application Serial No. 62 / 611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed on December 28, 2017, which is hereby incorporated by reference in its entirety, in which the sensor module is configured to determine the size of the operating room and adjust the Bluetooth pairing distance limits. A laser-based non-contact sensor module scans the operating room by transmitting pulses of laser light, receiving pulses of laser light that bounce off the perimeter walls of the operating room, and comparing the phase of the transmitted pulse to the received pulse to determine the size of the operating room and to adjust the Bluetooth pairing distance limits, for example.

[000170] Computer system 210 comprises a processor 244 and a network interface 245. Processor 244 is coupled to a communication module 247, storage 248, memory 249, non-volatile memory 250, and an input / output interface 251 through of a system bus. The system bus can be any of several types of bus structures, including the memory bus or memory controller, a peripheral bus or external bus, and / or a local bus that uses any variety of available bus architectures including, but not limited to, not limited to, 9-bit bus, industry standard architecture (ISA), Micro-Charmel Architecture (MSA), extended ISA (EISA), smart drive electronics (IDE), VESA local bus (VLB), component interconnection peripherals (PCI), USB, accelerated graphics port (AGP),

international memory card association bus for personal computers (PCMCIA, "Personal Computer Memory Card International Association"), small computer systems interface (SCSI), or any other proprietary bus.

[000171] Processor 244 can be any single-core or multi-core processor, such as those known under the ARM Cortex trade name available from Texas Instruments. In one respect, the processor may be a Core Cortex-M4F LM4F230H5QR ARM processor, available from Texas Instruments, for example, which comprises an integrated 256 KB single-cycle flash memory, or other non-volatile memory, up to 40 MHz , a seek-ahead buffer to optimize performance above 40 MHz, a 32 KB single cycle serial random access memory (SRAM), an internal read-only memory (ROM) loaded with the StellarisWare® program, memory only programmable, electrically erasable (EEPROM) reading of 2 KB, one or more pulse width modulation (PWM) modules, one or more analogs of quadrature encoder (QEI) inputs, one or more analog to digital converters (ADC) 12-bit with 12 channels of analog input, details of which are available for the product data sheet.

[000172] In one aspect, processor 244 may comprise a safety controller comprising two controller-based families, such as TMS570 and RM4x, known under the trade name Hercules ARM Cortex R4, also by Texas Instruments. The safety controller can be configured specifically for IEC 61508 and ISO 26262 safety critical applications, among others, to provide advanced integrated safety features while providing scalable performance, connectivity and memory options.

[000173] System memory includes volatile and non-volatile memory. The basic input / output system (BIOS), containing the basic routines for transferring information between elements within the computer system, such as during startup, is stored in non-volatile memory. For example, non-volatile memory can include ROM, programmable ROM (PROM), electrically programmable ROM (EPROM), EEPROM or flash memory. Volatile memory includes random access memory (RAM), which acts as an external cache memory. In addition, RAM is available in many forms such as SRAM, dynamic RAM (DRAM), synchronous DRAM (SDRAM), double data rate SDRAM (DDR SDRAM), enhanced SDRAM (ESDRAM), Synchlink DRAM (SLDRAM), and direct RAM Rambus RAM (DRRAM).

[000174] Computer system 210 also includes removable / non-removable, volatile / non-volatile computer storage media, such as disk storage. Disk storage includes, but is not limited to, devices such as a magnetic disk drive, floppy disk drive, tape drive, Jaz drive, Zip drive, LS-60 drive, flash memory card or memory stick (pen drive). drive). In addition, the storage disc may include storage media separately or in combination with other storage media including, but not limited to, an optical disc drive such as a compact disc ROM (CD-ROM) device recordable (CD-R Drive), rewritable compact disc drive (CD-RW drive), or a versatile digital ROM drive (DVD-ROM). To facilitate the connection of disk storage devices to the system bus, a removable or non-removable interface can be used.

[000175] It should be considered that computer system 210 includes software that acts as an intermediary between users and the basic computer resources described in an appropriate operating environment. Such software includes an operating system. The operating system, which can be stored on disk storage, acts to control and allocate computer system resources. System applications benefit from the management capabilities of the operating system through program modules and program data stored in system memory or on the storage disk. It is to be understood that the various components described in the present invention can be implemented with various operating systems or combinations of operating systems.

[000176] A user enters commands or information into computer system 210 through the input device (s) coupled to the I / O interface 251. Input devices include, but are not limited to, a device pointer such as a mouse, trackball, stylus, touchpad, keyboard, microphone, joystick, game pad, satellite card, scanner, TV tuner card, digital camera, digital video camera, web camera, and the like. These and other input devices connect to the processor via the system bus via the interface port (s). The interface ports include, for example, a serial port, a parallel port, a game port and a USB. Output devices use some of the same types of ports as input devices. In this way, for example, a USB port can be used to provide input to the computer system and to provide information from the computer system to an output device. An output adapter is provided to illustrate that there are some output devices such as monitors, screens, speakers, and printers, among other output devices, that need special adapters. Output adapters include, by way of illustration and not limitation, video and sound cards that provide a means of connection between the output device and the system bus. It should be noted that other devices and / or device systems, such as remote computers, provide input and output capabilities.

[000177] Computer system 210 can operate in a networked environment using logical connections to one or more remote computers, such as cloud computers, or local computers. Remote cloud computers can be a personal computer, server, router, personal network computer, workstation, microprocessor-based device, peer device, or other common network node, and the like, and typically include many or all elements described in relation to the computer system. For the sake of brevity, only one memory storage device is illustrated with the remote computer. Remote computers are logically connected to the computer system via a network interface and then physically connected via a communication connection. The network interface covers communication networks such as local area networks (LANs) and wide area networks (WANs). LAN technologies include fiber distributed data interface (FDDI), copper distributed data interface (CDDI), Ethernet / IEEE 802.3, Token / IEEE 802.5 ring and the like. WAN technologies include, but are not limited to, point-to-point links, circuit switching networks such as digital integrated service networks (ISDN) and variations in them, packet switching networks and digital subscriber lines (DSL).

[000178] In several respects, computer system 210 of Figure 10, imaging module 238 and / or display system 208, and / or processor module 232 of Figures 9 to 10, may comprise an image processor, image processing engine, media processor, or any specialized digital signal processor (DSP) used for processing digital images.

The image processor can employ parallel computing with single multi-data instruction (SIMD) or multiple multi-data instruction (MIMD) technologies to increase speed and efficiency. The digital image processing engine can perform a number of tasks. The image processor can be an integrated circuit system with a multi-core processor architecture.

[000179] Communication connections refer to the hardware / software used to connect the network interface to the bus. Although the communication connection is shown for illustrative clarity within the computer system, it can also be external to computer system 210. The hardware / software required for connection to the network interface includes, for illustrative purposes only, internal and external technologies such as modems, including regular telephone serial modems, cable modems and DSL modems, ISDN adapters, and Ethernet cards.

[000180] Figure 11 illustrates a functional block diagram of an aspect of a USB 300 central network controller device, in accordance with at least one aspect of the present description. In the illustrated aspect, the USB 300 network central controller device uses a TUSB2036 integrated circuit central controller available from Texas Instruments. The central USB network controller 300 is a CMOS device that provides one USB transceiver port 302 and up to three USB transceiver ports downstream 304, 306, 308 in accordance with the USB 2.0 specification. Upstream USB transceiver port 302 is a differential data root port comprising a "minus" (DM0) differential data input paired with a "plus" (DP0) differential data input. The three ports of the downstream USB transceiver 304, 306, 308 are differential data ports, with each port including "more" differential data outputs (DP1-DP3) paired with "less" differential data outputs (DM1-DM3) .

[000181] The USB 300 central network controller device is implemented with a digital state machine instead of a microcontroller, and no firmware programming is required. Fully compatible USB transceivers are integrated into the circuit for the upstream USB transceiver port 302 and all downstream USB transceiver ports 304, 306, 308. The downstream USB transceiver ports 304, 306, 308 support both full speed as low speed automatically configuring the scan rate according to the speed of the device attached to the doors. The USB 300 network central controller device can be configured in bus powered or self powered mode and includes 312 central power logic to manage power.

[000182] The USB 300 network central controller device includes a 310 series interface engine (SIE). The SIE 310 is the front end of the USB 300 central network controller hardware and handles most of the protocol described in chapter 8 of the USB specification. SIE 310 typically comprises signaling down to the transaction level. The functions it handles could include: packet recognition, transaction sequencing, SOP, EOP, RESET, and RESUME signal detection / generation, clock / data separation, data encoding / decoding non-inverted zero (NRZI) , generation and verification of CRC (token and data), generation and verification / decoding of packet ID (PID), and / or series-parallel / parallel-series conversion. The 310 receives a clock input 314 and is coupled to a suspend / resume logic circuit and frame timer 316 and a repeater circuit of the central controller 318 to control communication between the upstream USB transceiver port

302 and the USB transceiver ports downstream 304, 306, 308 through the logic circuits of ports 320, 322, 324. The SIE 310 is coupled to a command decoder 326 through the logic interface to control the commands of a serial EEPROM through a 330 series EEPROM interface.

[000183] In several aspects, the USB 300 central network controller can connect 127 functions configured in up to six logical layers (levels) to a single computer. In addition, the USB 300 central network controller can connect all peripherals using a standardized four-wire cable that provides both communication and power distribution. The power settings are bus-powered and self-powered modes. The USB 300 central network controller can be configured to support four power management modes: a bus-powered central controller with individual port power management or grouped port power management, and the self-powered central controller with power management. individual port power or grouped port power management. In one aspect, using a USB cable, the USB 300 central network controller, the USB upstream transceiver port 302 is plugged into a USB host controller, and the downstream USB transceiver ports 304, 306, 308 are exposed to connect compatible USB devices, and so on. Surgical instrument hardware

[000184] Figure 12 illustrates a logic diagram of a module of a 470 control system of a surgical instrument or tool, according to one or more aspects of the present description. The 470 system comprises a control circuit. The control circuit includes a microcontroller 461 comprising a processor 462 and a memory 468. One or more of the sensors 472, 474, 476, for example,

provide real-time feedback to the 462 processor. A 482 motor, driven by a 492 motor driver, operationally couples a longitudinally movable displacement member to drive the beam element with an i-profile beam. A tracking system 480 is configured to determine the position of the longitudinally movable displacement member. Position information is provided to the 462 processor, which can be programmed or configured to determine the position of the longitudinally movable drive member, as well as the position of a firing member, a firing bar and a profile beam member in i. Additional motors can be provided at the instrument driver interface to control the firing of the beam with an i-profile, the displacement of the closing tube, the rotation of the drive shaft and the articulation. A 473 screen shows a variety of instrument operating conditions and may include touchscreen functionality for data entry. The information displayed on screen 473 can be overlaid with images captured using endoscopic imaging modules.

[000185] In one aspect, the 461 microcontroller can be any single-core or multi-core processor, such as those known under the trade name ARM Cortex available from Texas Instruments. In one respect, the main microcontroller 461 can be an LM4F230H5QR ARM Cortex-M4F processor, available from Texas Instruments, for example, which comprises an integrated 256 KB single cycle flash memory, or other non-volatile memory, up to 40 MHz, a seek-ahead buffer to optimize performance above 40 MHz, a 32 KB single cycle serial random access memory (SRAM), an internal read-only memory (ROM) loaded with the StellarisWare® program, memory programmable and electrically erasable read-only (EEPROM) of 2 KB,

one or more pulse width modulation (PWM) modules, one or more analogs of quadrature encoder (QEI) inputs, and / or one or more 12-bit analog to digital converters (ADC) with 12 channels of analog input , details of which are available for the product data sheet.

[000186] In one aspect, the 461 microcontroller may comprise a safety controller that comprises two families based on controllers, such as TMS570 and RM4x known under the trade name Hercules ARM Cortex R4, also available from Texas Instruments. The safety controller can be configured specifically for IEC 61508 and ISO 26262 safety critical applications, among others, to provide advanced integrated safety features while providing scalable performance, connectivity and memory options.

[000187] The 461 microcontroller can be programmed to perform various functions, such as precise control of the speed and position of the joint and knife systems. In one aspect, the microcontroller 461 includes a processor 462 and a memory 468. The electric motor 482 can be a direct current (DC) motor with brushes with a gearbox and mechanical connections in a hinge or knife system. In one aspect, a motor drive 492 can be an A3941 available from Allegro Microsystems, Inc. Other motor drives can be readily replaced for use in tracking system 480 which comprises an absolute positioning system. A detailed description of an absolute positioning system is given in U.S. Patent Application No. 2017/0296213, entitled SYSTEMS AND METHODS FOR

CONTROLLING A SURGICAL STAPLING AND CUTTING INSTRUMENT, published on October 19, 2017, which is hereby incorporated by reference in its entirety.

[000188] The 461 microcontroller can be programmed to provide precise control of the speed and position of the displacement members and articulation systems. The 461 microcontroller can be configured to compute a response in the 461 microcontroller software. The computed response is compared to a measured response from the real system to obtain an "observed" response, which is used for real decisions based on feedback. The observed response is a favorable and adjusted value, which balances the uniform and continuous nature of the simulated response with the measured response, which can detect external influences in the system.

[000189] In one aspect, motor 482 can be controlled by motor driver 492 and can be used by the instrument's trigger system or surgical tool. In many ways, the 482 motor can be a brushed direct current (DC) drive motor, with a maximum speed of approximately 25,000 RPM, for example. In other arrangements, the 482 motor may include a brushless motor, a wireless motor, a synchronous motor, a stepper motor or any other suitable electric motor. Motor starter 492 may comprise an H bridge starter comprising field effect transistors (FETs), for example. The 482 motor can be powered by a feed assembly releasably mounted on the handle assembly or tool cabinet to provide control power for the instrument or surgical tool. The power pack may comprise a battery that may include several battery cells connected in series, which can be used as the power source to power the instrument or surgical tool. In certain circumstances, the battery cells in the power pack may be replaceable and / or rechargeable. In at least one example, the battery cells can be lithium-ion batteries that can be coupled and separable from the power pack.

[000190] The 492 motor drive can be an A3941, available from Allegro Microsystems, Inc. The 492 A3941 drive is an entire bridge controller for use with external power semiconductor metal oxide field (MOSFET) transistors. , N-channel, specifically designed for inductive loads, such as brushed DC motors. The 492 actuator comprises a single charge pump regulator that provides full door drive (> 10 V) for batteries with voltage up to 7 V and allows the A3941 to operate with a reduced door drive, up to 5.5 V. A capacitor input control can be used to supply the voltage surpassing that supplied by the battery required for the N channel MOSFETs. An internal charge pump for the upper side drive allows operation in direct current (100% duty cycle). The entire bridge can be triggered in fast or slow drop modes using diodes or synchronized rectification. In the slow drop mode, the current can be recirculated by means of FET from the top or from the bottom. The energy FETs are protected from the shoot-through effect through resistors with programmable dead time. Integrated diagnostics provide indication of undervoltage, overtemperature and faults in the power bridge, and can be configured to protect power MOSFETs in most short-circuit conditions. Other motor drives can be readily replaced for use in the tracking system 480 comprising an absolute positioning system.

[000191] Tracking system 480 comprises a controlled motor drive circuit arrangement comprising a position sensor 472, in accordance with at least one aspect of this description. The position sensor 472 for an absolute positioning system provides a unique position signal that corresponds to the location of a displacement member.

In one aspect, the displacement member represents a longitudinally movable drive member comprising a rack of drive teeth for engagement with a corresponding drive gear of a gear reduction assembly.

In other respects, the displacement member represents the firing member, which can be adapted and configured to include a rack of drive teeth.

In yet another aspect, the displacement member represents a firing bar or the I-shaped beam, each of which can be adapted and configured to include a rack of driving teeth.

Consequently, as used in the present invention, the term displacement member is used generically to refer to any movable member of the surgical instrument or tool, such as the driving member, the firing member, the firing bar, the beam with profile in i or any element that can be moved.

In one aspect, the longitudinally movable drive member is coupled to the firing member, the firing bar and the beam with an i-profile.

Consequently, the absolute positioning system can, in effect, track the linear displacement of the beam with an i-profile by tracking the linear displacement of the longitudinally movable drive member.

In several other respects, the displacement member can be coupled to any position sensor 472 suitable for measuring linear displacement.

In this way, the longitudinally movable drive member, the firing member, the firing bar or the I-beam, or combinations thereof, can be coupled to any suitable linear displacement sensor.

Linear displacement sensors can include contact or non-contact displacement sensors.

Linear displacement sensors can comprise Linear Transformers

Variable Differentials (LVDT), Variable Reluctance Differential Transducers (DVRT), a potentiometer, a magnetic detection system comprising a moving magnet and a series linearly arranged in Hall Effect Sensors, a magnetic detection system comprising a fixed magnet and a series of furniture, linearly arranged in Hall Effect Sensors, a mobile optical detection system comprising a mobile light source and a series of linearly arranged photodiodes or photodetectors, an optical detection system comprising a fixed light source and a mobile series of linearly arranged photodiodes or photodetectors, or any combination thereof.

[000192] The 482 electric motor may include a rotary drive shaft, which interfaces operationally with a gear set, which is mounted in gear engaged with a set or rack of drive teeth on the drive member. A sensor element can be operationally coupled to a gear assembly so that a single revolution of the position sensor element 472 corresponds to some linear longitudinal translation of the displacement member. An array of gears and sensors can be connected to the linear actuator by means of a rack and pinion arrangement, or by a rotary actuator, by means of a sprocket or other connection. A power source supplies power to the absolute positioning system and an output indicator can show the output from the absolute positioning system. The drive member represents the longitudinally movable drive member comprising a rack of drive teeth formed thereon for engagement with a corresponding drive gear of the gear reducer assembly. The displacement member represents the longitudinally movable firing member, the firing bar, the I-beam or combinations thereof.

[000193] A single revolution of the sensor element associated with the position sensor 472 is equivalent to a longitudinal linear displacement d1 of the displacement member, where d1 is the longitudinal linear distance by which the displacement member moves from point "a" to point "b" after a single revolution of the sensor element coupled to the displacement member. The sensor arrangement can be connected by means of a gear reduction which results in the position sensor 472 completing one or more revolutions for the complete travel of the displacement member. The 472 position sensor can complete multiple revolutions for the full travel of the displacement member.

[000194] A series of keys, where n is an integer greater than one, can be used alone or in combination with a gear reduction to provide a single position signal for more than one revolution of the 472 position sensor. of the switches is fed back to microcontroller 461 which applies logic to determine a single position signal corresponding to the longitudinal linear displacement d1 + d2 +… dn of the displacement member. The output of the position sensor 472 is supplied to the microcontroller 461. In several embodiments, the position sensor 472 of the sensor arrangement may comprise a magnetic sensor, an analog rotary sensor, such as a potentiometer, or a series of analog Hall effect elements. , which emit a unique combination of position of signs or values.

[000195] The position sensor 472 can comprise any number of magnetic detection elements, such as, for example, magnetic sensors classified according to whether they measure the total magnetic field or the vector components of the magnetic field. The techniques used to produce both types of magnetic sensors cover many aspects of physics and electronics. Technologies used for magnetic field detection include flow meter, saturated flow, optical pumping, nuclear precession, SQUID, Hall effect, anisotropic magnetoresistance, giant magnetoresistance, magnetic tunnel junctions, giant magneto impedance, magnetostrictive / piesoelectric compounds, magneto diode, magnetic transistors, fiber optics, magneto-optics and magnetic sensors based on microelectromechanical systems, among others.

[000196] In one aspect, the position sensor 472 for the tracking system 480 comprising an absolute positioning system comprises a magnetic rotating absolute positioning system. The 472 position sensor can be implemented as an AS5055EQFT single-circuit magnetic rotary position sensor, available from Austria Microsystems, AG. The position sensor 472 interfaces with the 461 microcontroller to provide an absolute positioning system. The 472 position sensor is a low voltage, low power component and includes four effect elements in an area of the 472 position sensor located above a magnet. A high-resolution ADC and an intelligent power management controller are also provided on the integrated circuit. A CORDIC (digital computer for coordinate rotation) processor, also known as the digit-for-digit method and Volder algorithm, is provided to implement a simple and efficient algorithm for calculating hyperbolic and trigonometric functions that require only addition, subtraction, displacement operations bits and lookup table. The angle position, alarm bits and magnetic field information are transmitted via a standard serial communication interface, such as a serial peripheral interface (SPI), to the 461 microcontroller. The 472 position sensor provides 12 or 14 bits of resolution. The position sensor 472 can be an AS5055 integrated circuit supplied in a small 16-pin QFN package whose measurement corresponds to 4x4x0.85 mm.

[000197] The tracking system 480 comprising an absolute positioning system can comprise and / or be programmed to implement a feedback controller, such as a PID, state feedback and adaptive controller. A power source converts the signal from the feedback controller to a physical input to the system, in this case the voltage. Other examples include a voltage, current and force PWM. Other sensors can be provided to measure the parameters of the physical system in addition to the position measured by the position sensor 472. In some respects, the other sensors may include sensor arrangements as described in US Patent No. 9,345,481 entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, granted on May 24, 2016, which is incorporated by reference in its entirety in this document; U.S. Patent Application Serial No. 2014/0263552, entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, published September 18, 2014, is incorporated by reference in its entirety into this document; and U.S. Patent Application Serial No. 15 / 628,175, entitled TECHNIQUES FOR ADAPTIVE

CONTROL OF MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT, submitted on June 20, 2017, is incorporated by reference in its entirety into this document. In a digital signal processing system, an absolute positioning system is coupled to a digital data capture system where the output of the absolute positioning system will have a finite resolution and sampling frequency. The absolute positioning system can comprise a comparison and combination circuit to combine a computed response with a measured response through the use of algorithms, such as a weighted average and a theoretical control loop, that trigger the calculated response towards the measured response. The computed response of the physical system considers properties, such as mass, inertia, viscous friction, resistance to inductance, etc., to predict what the states and exits of the physical system will be, knowing the input.

[000198] The absolute positioning system provides an absolute position of the displacement member by energizing the instrument without retracting or advancing the displacement member to a reset position (zero or initial), as may be necessary with conventional rotary encoders that merely count the number of progressive or regressive steps that the 482 motor has traveled to infer the position of a device actuator, a trigger bar, a knife or the like.

[000199] A 474 sensor, such as, for example, an extensometer or a microextensometer, is configured to measure one or more parameters of the end actuator, such as, for example, the amplitude of the strain exerted on the anvil during a gripping operation, which can be indicative of the closing forces applied to the anvil. The measured deformation is converted into a digital signal and supplied to the 462 processor. Alternatively, or in addition to the 474 sensor, a 476 sensor, such as a load sensor, can measure the closing force applied by the closing drive system. to the anvil. The 476 sensor, such as a load sensor, can measure the firing force applied to a beam with an i-profile in a firing stroke of the instrument or surgical tool. The i-profile beam is configured to engage a wedge slider, which is configured to move the clamp actuators upward to force the clamps to deform in contact with an anvil. The i-profile beam includes a sharp cutting edge that can be used to cut fabric as the i-profile beam is advanced distally by the firing bar. Alternatively, a current sensor 478 can be used to measure the current drained by the 482 motor. The force required to advance the trigger member can correspond to the current drained by the 482 motor, for example. The measured force is converted into a digital signal and supplied to the 462 processor.

[000200] In one form, a 474 extensometer sensor can be used to measure the force applied to the tissue by the end actuator. An extensometer can be attached to the end actuator to measure the force applied to the tissue being treated by the end actuator. A system for measuring forces applied to tissue attached by the end actuator comprises a 474 extensometer sensor, such as, for example, a microextensometer, which is configured to measure one or more parameters of the end actuator, for example. In one aspect, the 474 strain gauge sensor can measure the amplitude or magnitude of the strain exerted on a claw member of an end actuator during a gripping operation, which can be indicative of tissue compression. The measured deformation is converted into a digital signal and supplied to the 462 processor of a 461 microcontroller. A 476 load sensor can measure the force used to operate the knife element, for example, to cut the captured tissue between the anvil and the cartridge of staples. A magnetic field sensor can be used to measure the thickness of the captured tissue. The measurement of the magnetic field sensor can also be converted into a digital signal and supplied to the 462 processor.

[000201] Measurements of tissue compression, tissue thickness and / or force required to close the end actuator on the tissue, as measured by sensors 474, 476, can be used by microcontroller 461 to characterize the selected position of the trigger member and / or the corresponding trigger member speed value. In one case, a 468 memory can store a technique, an equation and / or a look-up table that can be used by the 461 microcontroller in the evaluation.

[000202] The control system 470 of the instrument or surgical tool can also comprise wired or wireless communication circuits for communication with the modular central communication controller shown in Figures 8 to 11.

[000203] Figure 13 illustrates a control circuit 500 configured to control aspects of the instrument or surgical tool, according to at least one aspect of this description. The control circuit 500 can be configured to implement various processes described herein. The control circuit 500 may comprise a microcontroller comprising one or more processors 502 (for example, microprocessor, microcontroller) coupled to at least one memory circuit 504. The memory circuit 504 stores instructions executable on a machine that, when executed by the processor 502, cause the 502 processor to execute machine instructions to implement several of the processes described here. The 502 processor can be any one of a number of single-core or multi-core processors known in the art. The memory circuit 504 may comprise volatile and non-volatile storage media. Processor 502 can include an instruction processing unit 506 and an arithmetic unit 508. The instruction processing unit can be configured to receive instructions from memory circuit 504 of this description.

[000204] Figure 14 illustrates a combinational logic circuit 510 configured to control aspects of the instrument or surgical tool, according to at least one aspect of this description. The combinational logic circuit 510 can be configured to implement various processes described herein. The combinational logic circuit 510 may comprise a finite state machine comprising a combinational logic 512 configured to receive data associated with the instrument or surgical tool at an input 514, process the data by combinational logic 512 and provide an output 516.

[000205] Figure 15 illustrates a sequential logic circuit 520 configured to control aspects of the instrument or surgical tool, according to at least one aspect of this description. Sequential logic circuit 520 or combinational logic 522 can be configured to implement the process described herein. Sequential logic circuit 520 may comprise a finite state machine. Sequential logic circuit 520 may comprise combinational logic 522, at least one memory circuit 524, a clock 529 and, for example. The at least one memory circuit 524 can store a current state of the finite state machine. In certain cases, the sequential logic circuit 520 may be synchronous or asynchronous. Combinational logic 522 is configured to receive data associated with the surgical instrument or tool from an input 526, process the data by combinational logic 522, and provide an output 528. In other respects, the circuit may comprise a combination of a processor (for example , processor 502, Figure 13) and a finite state machine for implementing various processes of the present invention. In other respects, the finite state machine may comprise a combination of a combinational logic circuit (for example, a combinational logic circuit 510, Figure 14) and the sequential logic circuit 520.

[000206] Figure 16 illustrates an instrument or surgical tool that comprises a plurality of motors that can be activated to perform various functions. In certain cases, a first engine can be activated to perform a first function, a second engine can be activated to perform a second function, a third engine can be activated to perform a third function, a fourth engine can be activated to perform a fourth function, and so on. In certain cases, the plurality of motors of the robotic surgical instrument 600 can be individually activated to cause firing, closing, and / or articulation movements in the end actuator. The firing, closing and / or articulation movements can be transmitted to the end actuator through a drive shaft assembly, for example.

[000207] In certain cases, the instrument or surgical tool system may include a 602 firing motor. The 602 firing motor can be operationally coupled to a 604 firing motor drive assembly, which can be configured to transmit movements trigger points, generated by the motor 602 to the end actuator, particularly to move the beam element with i-profile. In certain cases, the firing movements generated by the 602 motor can cause the staples to be implanted from the staple cartridge in the fabric captured by the end actuator and / or the cutting edge of the beam element with an i-profile is advanced to cut the captured tissue, for example. The I-beam member can be retracted by reversing the direction of the 602 motor.

[000208] In certain cases, the surgical instrument or tool may include a closing motor 603. The closing motor 603 can be operationally coupled to a drive assembly of the closing motor 605 that can be configured to transmit closing movements generated by the motor 603 to the end actuator, particularly to move a closing tube to close the anvil and compress the fabric between the anvil and the staple cartridge. Closing movements can cause the end actuator to transition from an open configuration to an approximate configuration to capture tissue, for example. The end actuator can be moved to an open position by reversing the direction of the 603 motor.

[000209] In certain cases, the surgical instrument or tool may include one or more articulation motors 606a, 606b, for example. The motors 606a, 606b can be operationally coupled to the drive assemblies of the articulation motor 608a, 608b, which can be configured to transmit articulation movements generated by the motors 606a, 606b to the end actuator. In certain cases, the articulation movements can cause the end actuator to be articulated in relation to the drive shaft assembly, for example.

[000210] As described above, the surgical instrument or tool can include a plurality of motors that can be configured to perform various independent functions. In certain cases, the plurality of motors of the instrument or surgical tool can be activated individually or separately to perform one or more functions, while other motors remain inactive. For example, the articulation motors 606a, 606b can be activated to cause the end actuator to be articulated, while the firing motor 602 remains inactive. Alternatively, the firing motor 602 can be activated to fire the plurality of clamps, and / or advance the cutting edge, while the hinge motor 606 remains inactive. In addition, the closing motor 603 can be activated simultaneously with the firing motor 602 to cause the closing tube or the beam element with an i-profile to move distally, as described in more detail later in this document.

[000211] In certain cases, the surgical instrument or tool may include a common control module 610 that can be used with a plurality of the instrument's instruments or surgical tool. In certain cases, the common control module 610 can accommodate one of the plurality of motors at a time. For example, the common control module 610 can be coupled to and separable from the plurality of motors of the robotic surgical instrument individually. In certain cases, a plurality of surgical instrument or tool motors may share one or more common control modules, such as the common control module 610. In certain cases, a plurality of surgical instrument or tool motors may be individually and selectively engaged to the common control module 610. In certain cases, the common control module 610 can be selectively switched between interfacing with one of a plurality of instrument motors or surgical tool to interface with another among the plurality of instrument motors or surgical tool.

[000212] In at least one example, the common control module 610 can be selectively switched between the operating coupling with the 606a, 606B articulation motors, and the operating coupling with the 602 firing motor or the closing motor 603. In at least one example, as shown in Figure 16, a key 614 can be moved or transitioned between a plurality of positions and / or states. In the first position 616, the switch 614 can electrically couple the common control module 610 to the trip motor 602; in a second position 617, the switch 614 can electrically couple the control module 610 to the closing motor 603; in a third position 618a, the switch 614 can electrically couple the common control module 610 to the first articulation motor 606a; and in a fourth position 618b, the switch 614 can electrically couple the common control module 610 to the second articulation motor 606b, for example. In certain cases, separate common control modules 610 can be electrically coupled to the firing motor 602, closing motor 603, and hinge motors 606a, 606b at the same time. In certain cases, key 614 can be a mechanical key, an electromechanical key, a solid state key, or any suitable switching mechanism.

[000213] Each of the 602, 603, 606a, 606b motors can comprise a torque sensor to measure the output torque on the motor drive shaft. The force on an end actuator can be detected in any conventional manner, such as by means of force sensors on the outer sides of the jaws or by a motor torque sensor that drives the jaws.

[000214] In several cases, as shown in Figure 16, the common control module 610 may comprise a motor starter 626 that may comprise one or more H bridge FETs. The motor starter 626 may modulate the energy transmitted from a power source 628 for a motor coupled to the common control module 610, based on input from a microcontroller 620 (the "controller"), for example. In certain cases, the microcontroller 620 can be used to determine the current drawn by the motor, for example, while the motor is coupled to the common control module 610, as described above.

[000215] In certain examples, the microcontroller 620 may include a microprocessor 622 (the "processor") and one or more non-transitory computer-readable media or 624 memory units (the "memory"). In certain cases, memory 624 can store various program instructions which, when executed, can cause processor 622 to perform a plurality of functions and / or calculations described herein. In certain cases, one or more of the memory units 624 can be coupled to the processor 622, for example.

[000216] In certain cases, the power source 628 can be used to supply power to the microcontroller 620, for example. In certain cases, the 628 power source may comprise a battery (or "battery pack" or "power source"), such as a Li ion battery, for example. In certain cases, the battery pack can be configured to be releasably mounted to the handle to supply power to the surgical instrument 600. Several battery cells connected in series can be used as the 628 power source. In certain cases, the power source 628 power supply can be replaceable and / or rechargeable, for example.

[000217] In several cases, the 622 processor can control the motor drive 626 to control the position, direction of rotation and / or speed of a motor that is coupled to the common control module 610. In certain cases, the processor 622 can signal the motor driver 626 to stop and / or disable a motor that is coupled to the common control module 610. It should be understood that the term "processor", as used here, includes any microprocessor, microcontroller or other control device. adequate basic computing that incorporates the functions of a central computer processing unit (CPU) in an integrated circuit or, at most, some integrated circuits. The processor is a programmable multipurpose device that accepts digital data as input, processes it according to instructions stored in its memory, and provides results as output. This is an example of sequential digital logic, as it has internal memory. Processors operate on numbers and symbols represented in the binary numeral system.

[000218] In one example, the 622 processor can be any single-core or multi-core processor, such as those known by the Texas Instruments ARM Cortex trade name. In certain cases, the 620 microcontroller may be an LM 4F230H5QR, available from Texas Instruments, for example. In at least one example, the Texas Instruments LM4F230H5QR is an ARM Cortex-M4F processor core that comprises a 256 KB single cycle flash integrated memory, or other non-volatile memory, up to 40 MHz, an early seek buffer for optimize performance above 40 MHz, a 32 KB single cycle SRAM, an internal ROM loaded with StellarisWare® software, 2 KB EEPROM, one or more PWM modules, one or more QEI analogs, one or more ADCs 12-bit with 12 channels of analog input, among other features that are readily available for the product data sheet. Other microcontrollers can be readily replaced for use with the 4410 module. Consequently, the present description should not be limited in this context.

[000219] In certain cases, memory 624 may include program instructions for controlling each of the motors of the surgical instrument 600 which are attachable to common control module 610. For example, memory 624 may include program instructions for controlling the motor trigger 602, closing motor 603 and hinge motors 606a, 606b. Such program instructions can cause the 622 processor to control the trigger, close, and link functions according to inputs from the instrument or surgical tool control algorithms or programs.

[000220] In certain cases, one or more mechanisms and / or sensors, such as 630 sensors, can be used to alert the 622 processor about the program instructions that must be used in a specific configuration. For example, sensors 630 can alert the 622 processor to use the program instructions associated with triggering, closing, and pivoting the end actuator. In certain cases, sensors 630 may comprise position sensors that can be used to detect the position of switch 614, for example. Consequently, the processor 622 can use the program instructions associated with firing the beam with the i-profile of the end actuator by detecting, through sensors 630, for example, that the key 614 is in the first position 616; the processor 622 can use the program instructions associated with closing the anvil upon detection, through sensors 630, for example, that switch 614 is in second position 617; and processor 622 can use the program instructions associated with the articulation of the end actuator upon detection through sensors 630, for example, that switch 614 is in the third or fourth position 618a, 618b.

[000221] Figure 17 is a schematic diagram of a robotic surgical instrument 700 configured to operate a surgical tool described in the present invention, in accordance with at least one aspect of this description. The robotic surgical instrument 700 can be programmed or configured to control the distal / proximal translation of a displacement member, the distal / proximal displacement of a closing tube, the rotation of the drive shaft, and articulation, either with a single type or multiple articulation drive links. In one aspect, the surgical instrument 700 can be programmed or configured to individually control a firing member, a closing member, a driving shaft member and / or one or more hinge members. The surgical instrument 700 comprises a control circuit 710 configured to control motor-driven firing members, closing members, driving shaft members and / or one or more hinge members.

[000222] In one aspect, the robotic surgical instrument 700 comprises a control circuit 710 configured to control an anvil 716 and an i-profile beam portion 714 (including a sharp cutting edge) of an end actuator 702, a cartridge of removable clamps 718, a drive shaft 740 and one or more hinge members 742a, 742b through a plurality of motors 704a to 704e. A position sensor 734 can be configured to provide i-profile beam position feedback 714 to control circuit 710. Other sensors 738 can be configured to provide feedback to control circuit 710. A timer / counter 731 provides timing information and counting to control circuit 710. A power source 712 can be provided to operate motors 704a to 704e and a current sensor 736 provides motor current feedback to control circuit 710. Motors 704a to 704e can be operated individually control circuit 710 in an open loop or closed loop feedback control.

[000223] In one aspect, the control circuit 710 may comprise one or more microcontrollers, microprocessors or other processors suitable for executing instructions that cause the processor or processors to perform one or more tasks. In one aspect, a timer / counter 731 provides an output signal, such as elapsed time or a digital count, to control circuit 710 to correlate beam position with i 714 profile, as determined by position sensor 734, with the timer / counter output 731 so that the control circuit 710 can determine the position of the i-beam beam 714 at a specific time (t) in relation to an initial position or the time (t) when the beam with profile in i 714 it is in a specific position in relation to an initial position. The timer / counter 731 can be configured to measure elapsed time, count external events or measure the time of external events.

[000224] In one aspect, control circuit 710 can be programmed to control functions of end actuator 702 based on one or more tissue conditions. Control circuit 710 can be programmed to directly or indirectly detect tissue conditions, such as thickness, as described here. Control circuit 710 can be programmed to select a trigger control program or closing control program based on tissue conditions. A trigger control program can describe the distal movement of the displacement member. Different trigger control programs can be selected to better treat different tissue conditions. For example, when a thicker tissue is present, the control circuit 710 can be programmed to move the displacement member at a lower speed and / or with a lower power. When thinner tissue is present, the control circuit 710 can be programmed to move the displacement member at a higher speed and / or with a higher power. A closing control program can control the closing force applied to the tissue by the anvil 716. Other control programs control the rotation of the drive shaft 740 and the hinge members 742a, 742b.

[000225] In one aspect, the control circuit 710 can generate setpoint signals from the motor. Motor setpoint signals can be provided for various motor controllers 708a through 708e. Motor controllers 708a to 708e can comprise one or more circuits configured to provide motor drive signals for motors 704a to 704e to drive motors 704a to 704e, as described here. In some instances, 704a engines

704e can be brushed DC electric motors. For example, the speed of motors 704a to 704e can be proportional to the respective motor start signals. In some examples, motors 704a to 704e may be brushless DC electric motors, and the respective motor drive signals may comprise a PWM signal provided for one or more stator windings of motors 704a to 704e. In addition, in some instances, motor controllers 708a through 708e can be omitted and control circuit 710 can directly generate motor drive signals.

[000226] In one aspect, the control circuit 710 can initially operate each of the motors 704a to 704e in an open circuit configuration for a first open circuit portion of the travel of the displacement member. Based on the response of the robotic surgical instrument 700 during the open circuit portion of the stroke, control circuit 710 can select a trigger control program in a closed circuit configuration. The response of the instrument may include a translation distance from the displacement member during the open circuit portion, a time elapsed during the open circuit portion, the energy supplied to one of the motors 704a to 704e during the open circuit portion, a sum pulse widths of a motor start signal, etc. After the open circuit portion, control circuit 710 can implement the selected trip control program in a second portion of the travel member travel. For example, during a closed circuit portion of the stroke, control circuit 710 can modulate one of the motors 704a to 704e based on translation data that describes a position of the displacement member in a closed circuit manner to translate the limb from displacement at a constant speed.

[000227] In one aspect, motors 704a to 704e can receive power from a 712 power source. Power source 712 can be a DC power source powered by a main alternating current power source, a battery, a supercapacitor or any other suitable energy source. The motors 704a to 704e can be mechanically coupled to individual moving mechanical elements such as the i-profile beam 714, the anvil 716, the drive shaft 740, the joint 742a and the joint 742b, through the respective transmissions 706a to 706e. Transmissions 706a through 706e may include one or more gears or other connecting components for coupling motors 704a to 704e to moving mechanical elements. A 734 position sensor can detect an i-beam beam position 714. The 734 position sensor can be or can include any type of sensor that is capable of generating position data that indicates an i-beam beam position

714. In some examples, the position sensor 734 may include an encoder configured to supply a series of pulses to the control circuit 710 according to the beam with i-profile 714 translated distally and proximally. The control circuit 710 can track the pulses to determine the position of the i-profiled beam 714. Other suitable position sensors can be used, including, for example, a proximity sensor. Other types of position sensors can provide other signals that indicate movement of the beam with i-profile

714. In addition, in some examples, the position sensor 734 may be omitted. When any of the motors 704a to 704e is a stepper motor, the control circuit 710 can track the position of the beam with an i-profile 714 adding the number and direction of the steps that the motor 704 has been instructed to perform. Position sensor 734 can be located on end actuator 702 or any other portion of the instrument. The outputs of each of the engines 704a to 704e include a torque sensor 744a to 744e to detect force and have an encoder to detect the rotation of the drive shaft.

[000228] In one aspect, control circuit 710 is configured to drive a firing member as the beam portion with i-profile beam 714 of end actuator 702. Control circuit 710 provides a motor setpoint for a motor control 708a, which provides a drive signal for motor 704a. The output shaft of the motor 704a is coupled to a torque sensor 744a. The torque sensor 744a is coupled to a transmission 706a which is coupled to the beam with an i-profile 714. The transmission 706a comprises moving mechanical elements, such as rotating elements, and a firing member to control the movement of the profile beam distally and proximally. in i 714 along a longitudinal geometric axis of the end actuator 702. In one aspect, the motor 704a can be coupled to the knife gear assembly, which includes a knife gear reduction assembly that includes a first drive gear and a second knife drive gear. A torque sensor 744a provides a trigger force feedback signal to control circuit 710. The trigger force signal represents the force required to fire or move the i-profile beam 714. A 734 position sensor can be configured to provide the position of the i-profile beam 714 along the firing stroke or the position of the firing member as a feedback signal to control circuit 710. End actuator 702 can include additional sensors 738 configured to provide signals feedback to control circuit 710. When ready for use, control circuit 710 can provide a trip signal to the 708a motor control. In response to the trigger signal, motor 704a can drive the trigger member distally along the longitudinal geometry axis of end actuator 702 from an initial proximal position of the stroke to an end distal position of the stroke relative to the initial position of course. As the firing member moves distally, an i-profile beam 714, with a cutting element positioned at a distal end, advances distally to cut the fabric between the staple cartridge 718 and the anvil 716.

[000229] In one aspect, control circuit 710 is configured to drive a closing member, such as anvil portion 716 of end actuator 702. Control circuit 710 provides a motor setpoint for motor control 708b, which provides a drive signal for motor 704b. The output shaft of the 704b motor is coupled to a 744b torque sensor. The torque sensor 744b is coupled to a transmission 706b which is coupled to the anvil 716. The transmission 706b comprises moving mechanical elements, such as rotating elements and a closing member, to control the movement of the anvil 716 between the open and closed positions. In one aspect, the 704b motor is coupled to a closing gear assembly, which includes a closing reduction gear assembly that is supported in gear engaged with the closing sprocket. The torque sensor 744b provides a closing force feedback signal for control circuit 710. The closing force feedback signal represents the closing force applied to the anvil 716. The position sensor 734 can be configured to provide the position of the closing member as a feedback signal for control circuit 710. Additional sensors 738 on end actuator 702 can provide the feedback signal for closing force to control circuit 710. A pivoting anvil 716 is positioned opposite the staple cartridge 718. When ready for use, control circuit 710 can provide a closing signal to motor control 708b. In response to the closing signal, motor 704b advances a closing member to secure the fabric between the anvil 716 and the staple cartridge 718.

[000230] In one aspect, control circuit 710 is configured to rotate a drive shaft member, such as drive shaft 740, to rotate end actuator 702. Control circuit 710 provides a motor setpoint for a 708c engine control, which provides a drive signal for the 704c engine. The output shaft of the motor 704c is coupled to a torque sensor 744c. The torque sensor 744c is coupled to a transmission 706c which is coupled to the shaft 740. The transmission 706c comprises moving mechanical elements, such as rotary elements, to control the rotation of the drive shaft 740 clockwise or counterclockwise until and above 360 °. In one aspect, the 704c engine is coupled to the rotary drive assembly, which includes a pipe gear segment that is formed over (or attached to) the proximal end of the proximal closing tube for operable engagement by a rotational gear assembly that is supported operationally on the tool mounting plate. The torque sensor 744c provides a rotation force feedback signal for control circuit 710. The rotation force feedback signal represents the rotation force applied to the drive shaft 740. The position sensor 734 can be configured to provide the position of the closing member as a feedback signal to the control circuit 710. Additional sensors 738, such as a drive shaft encoder, can provide the rotational position of the drive shaft 740 to the control circuit 710.

[000231] In one aspect, control circuit 710 is configured to pivot end actuator 702. Control circuit 710 provides a motor set point for 708d motor control,

which provides a drive signal for the 704d motor. The output shaft of the 704d motor is coupled to a 744d torque sensor. The torque sensor 744d is coupled to a transmission 706d which is coupled to a pivot member 742a. The 706d transmission comprises moving mechanical elements, such as pivoting elements, to control the articulation of the 702 ± 65 ° end actuator. In one aspect, the 704d motor is coupled to a pivot nut, which is rotatably seated on the proximal end portion of the distal central column portion and is pivotally driven thereon by a pivot gear assembly. The torque sensor 744d provides a hinge force feedback signal to control circuit 710. The hinge force feedback signal represents the hinge force applied to the end actuator 702. The 738 sensors, as a hinge encoder , can provide the articulation position of end actuator 702 for the control circuit

710.

[000232] In another aspect, the articulation function of the robotic surgical system 700 may comprise two articulation members, or connections, 742a, 742b. These hinge members 742a, 742b are driven by separate disks at the robot interface (the rack), which are driven by the two motors 708d, 708e. When the separate firing motor 704a is provided, each hinge link 742a, 742b can be antagonistically driven with respect to the other link to provide a resistive holding movement and a load to the head when it is not moving and to provide a movement of articulation when the head is articulated. The hinge members 742a, 742b attach to the head in a fixed radius when the head is rotated. Consequently, the mechanical advantage of the push and pull link changes when the head is rotated. This change in mechanical advantage can be more pronounced with other drive systems for the articulation connection.

[000233] In one aspect, the one or more motors 704a to 704e may comprise a brushed DC motor with a gearbox and mechanical connections to a firing member, closing member or articulation member. Another example includes electric motors 704a to 704e that operate the moving mechanical elements such as the displacement member, the articulation connections, the closing tube and the drive shaft. An external influence is an excessive and unpredictable influence on things like tissue, surrounding bodies, and friction in the physical system. This external influence can be called drag, which acts in opposition to one of the electric motors 704a to 704e. External influence, such as drag, can cause the functioning of the physical system to deviate from a desired operation of the physical system.

[000234] In one aspect, the position sensor 734 can be implemented as an absolute positioning system. In one aspect, the 734 position sensor may comprise a magnetic rotary absolute positioning system implemented as a single integrated circuit magnetic rotary position sensor AS5055EQFT, available from Austria Microsystems, AG. The position sensor 734 can interface with the control circuit 710 to provide an absolute positioning system. The position can include multiple Hall effect elements located above a magnet and coupled to a CORDIC processor, also known as the digit by digit method and Volder algorithm, which is provided to implement a simple and efficient algorithm for calculating hyperbolic and trigonometric functions which only require addition, subtraction, bit shift and lookup table operations.

[000235] In one aspect, the control circuit 710 can be in communication with one or more sensors 738. The sensors 738 can be positioned on the end actuator 702 and adapted to work with the robotic surgical instrument 700 to measure the various derived parameters such as span distance in relation to time, compression of the tissue in relation to time, and deformation of the anvil in relation to time. The 738 sensors can comprise a magnetic sensor, a magnetic field sensor, an extensometer, a load cell, a pressure sensor, a force sensor, a torque sensor, an inductive sensor such as an eddy current sensor, a sensor resistive, capacitive sensor, optical sensor and / or any other sensor suitable for measuring one or more parameters of end actuator 702. Sensors 738 may include one or more sensors. Sensors 738 may be located on the staple cartridge platform 718 to determine the location of the tissue using segmented electrodes. The torque sensors 744a to 744e can be configured to detect force such as firing force, closing force, and / or articulation force, among others. Consequently, control circuit 710 can detect (1) the closing load experienced by the distal closing tube and its position, (2) the trigger member on the rack and its position, (3) which portion of the staple cartridge 718 has tissue in it and (4) the load and position on both articulation rods.

[000236] In one aspect, the one or more sensors 738 may comprise an extensometer, such as a microextensometer, configured to measure the magnitude of strain on anvil 716 during a stuck condition. The extensometer provides an electrical signal whose amplitude varies with the magnitude of the deformation. Sensors 738 can comprise a pressure sensor configured to detect a pressure generated by the presence of compressed tissue between the anvil 716 and the staple cartridge 718. Sensors 738 can be configured to detect the impedance of a section of tissue located between the anvil 716 and the staple cartridge 718 which is indicative of the thickness and / or completeness of the fabric located between them.

[000237] In one aspect, the 738 sensors can be implemented as one or more limit switches, electromechanical devices, solid state switches, Hall effect devices, magnetoresistive devices (MR) giant magnetoresistive devices (GMR), magnetometers, among others . In other implementations, the 738 sensors can be implemented as solid state switches that operate under the influence of light, such as optical sensors, infrared sensors, ultraviolet sensors, among others. In addition, the switches can be solid state devices such as transistors (for example, FET, junction FET, MOSFET, bipolar, and the like). In other implementations, the 738 sensors can include driverless electric switches, ultrasonic switches, accelerometers and inertia sensors, among others.

[000238] In one aspect, the sensors 738 can be configured to measure forces exerted on the anvil 716 by the closing drive system. For example, one or more sensors 738 may be at a point of interaction between the closing tube and the anvil 716 to detect the closing forces applied by the closing tube to the anvil 716. The forces exerted on the anvil 716 may be representative of the tissue compression experienced by the tissue section captured between the anvil 716 and the staple cartridge 718. The one or more sensors 738 can be positioned at various points of interaction throughout the closing drive system to detect the closing forces applied to the anvil 716 by the closing drive system. The one or more sensors 738 can be sampled in real time during a gripping operation by the processor of the control circuit 710. The control circuit 710 receives sample measurements in real time to provide and analyze information based on time and evaluate, in real time the closing forces applied to the anvil 716.

[000239] In one aspect, a current sensor 736 can be used to measure the current drawn by each of the 704a to 704e motors. The force required to advance any of the moving mechanical elements such as the i14 beam profile corresponds to the current drained by one of the motors 704a to 704e. The force is converted into a digital signal and supplied to control circuit 710. Control circuit 710 can be configured to simulate the response of the instrument's actual system in the controller software. A displacement member can be actuated to move an i-profile beam 714 on end actuator 702 at or near a target speed. The robotic surgical instrument 700 may include a feedback controller, which may be one or any of the feedback controllers, including, but not limited to, a PID controller, state feedback, linear quadratic (LQR) and / or an adaptive controller , for example. The robotic surgical instrument 700 can include a power source to convert the signal from the feedback controller to a physical input such as case voltage, PWM voltage, frequency modulated voltage, current, torque and / or force, for example. Additional details are described in U.S. Patent Application Serial No. 15 / 636,829, entitled CLOSED LOOP VELOCITY CONTROL TECHNIQUES FOR ROBOTIC SURGICAL INSTRUMENT, filed June 29, 2017, which is hereby incorporated by reference in its entirety.

[000240] Figure 18 illustrates a block diagram of a surgical instrument 750 programmed to control the distal translation of the displacement member, according to at least one aspect of this description. In one aspect, the surgical instrument 750 is programmed to control the distal translation of a displacement member, such as the i-profile beam 764. The surgical instrument 750 comprises an end actuator 752 that can comprise an anvil 766, a beam with i64 profile (including a sharp cutting edge) and a removable staple cartridge 768.

[000241] The position, movement, displacement, and / or translation of a linear displacement member, such as the beam with i 764 profile, can be measured by an absolute positioning system, a sensor arrangement and a sensor position 784. Due to the fact that the i-profile beam 764 is coupled to a longitudinally movable drive member 120, the position of the i-profile beam 764 can be determined by measuring the position of the longitudinally movable driving member which employs the position sensor 784. Consequently, in the following description, the position, displacement and / or translation of the beam with i-profile beam 764 can be obtained by the position sensor 784, as described in the present invention. A control circuit 760 can be programmed to control the translation of the displacement member, such as the i-profile beam 764. The control circuit 760, in some examples, may comprise one or more microcontrollers, microprocessors or other suitable processors the instructions that cause the processor or processors to control the displacement member, for example, the i 764 profile beam, in the manner described. In one aspect, a timer / counter 781 provides an output signal, such as elapsed time or a digital count, to control circuit 760 to correlate the beam position with i 764 profile as determined by the position sensor 784 with the output of timer / counter 781 so that control circuit 760 can determine the position of the beam with i-shaped profile 764 at a specific time (t) in relation to an initial position. The timer / counter 781 can be configured to measure elapsed time, count external events or measure the time of external events.

[000242] Control circuit 760 can generate a setpoint signal for motor 772. The setpoint signal for motor 772 can be supplied to a motor controller 758. Motor controller 758 can comprise one or more circuits configured to provide a motor 774 drive signal to motor 754 to drive motor 754, as described in the present invention. In some instances, the 754 motor may be a brushed DC electric motor. For example, the speed of motor 754 can be proportional to the drive signal of motor 774. In some instances, motor 754 can be a brushless DC electric motor and the motor drive signal 774 can comprise a PWM signal provided for a or more motor stator windings 754. In addition, in some examples, motor controller 758 may be omitted, and control circuit 760 can generate motor drive signal 774 directly.

[000243] The 754 motor can receive power from a power source

762. The 762 power source can be or include a battery, a supercapacitor or any other suitable power source. The 754 motor can be mechanically coupled to the 764 i-beam beam via a 756 transmission. The 756 transmission can include one or more gears or other connecting components to couple the 754 motor to the 764 i-beam beam. A sensor position 784 can detect a position of the beam with i 764 profile. The position sensor 784 can be or can include any type of sensor that is capable of generating position data that indicate a position of the beam with i 764 profile. In some examples, the position sensor 784 may include an encoder configured to provide a series of pulses to the control circuit 760 according to the beam with i 764 profile distally and proximally translated. The control circuit 760 can track pulses to determine the position of the beam with an i 764 profile. Other suitable position sensors can be used, including, for example, a proximity sensor. Other types of position sensors can provide other signals that indicate movement of the beam with i-profile

764. In addition, in some examples, the position sensor 784 may be omitted. When the motor 754 is a stepper motor, the control circuit 760 can track the position of the i profiled beam 764 by adding the number and direction of the steps that the motor 754 has been instructed to perform. The position sensor 784 can be located on end actuator 752 or any other portion of the instrument.

[000244] The control circuit 760 can be in communication with one or more sensors 788. The sensors 788 can be positioned on the end actuator 752 and adapted to work with the surgical instrument 750 to measure the various derived parameters, such as span distance in relation to time, compression of the tissue in relation to time and deformation of the anvil in relation to time. The 788 sensors may comprise a magnetic sensor, a magnetic field sensor, an extensometer, 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 sensor suitable for measuring one or more parameters of the end actuator 752. The 788 sensors may include one or more sensors.

[000245] The one or more sensors 788 may comprise an extensometer, such as a microextensometer, configured to measure the magnitude of strain on the anvil 766 during a stuck condition. The extensometer provides an electrical signal whose amplitude varies with the magnitude of the deformation. The 788 sensors can comprise a pressure sensor configured to detect a pressure generated by the presence of compressed tissue between the anvil 766 and the staple cartridge 768. The 788 sensors can be configured to detect the impedance of a section of tissue located between the anvil 766 and the staple cartridge 768 which is indicative of the thickness and / or completeness of the fabric located between them.

[000246] The 788 sensors can be configured to measure the forces exerted on the anvil 766 by a closing drive system. For example, one or more sensors 788 can be at a point of interaction between a closing tube and anvil 766 to detect the closing forces applied by a closing tube to anvil 766. The forces exerted on anvil 766 can be representative of the tissue compression experienced by the tissue section captured between the anvil 766 and the staple cartridge 768. The one or more sensors 788 can be positioned at various points of interaction throughout the closing drive system to detect the closing forces applied anvil 766 by the closing drive system. The one or more 788 sensors can be sampled in real time during a gripping operation by a processor of the control circuit 760. The control circuit 760 receives sample measurements in real time to provide and analyze information based on time and evaluate, in real time, the closing forces applied to the anvil 766.

[000247] A current sensor 786 can be used to measure the current drained by the 754 motor. The force required to advance the beam with i-profile 764 corresponds to the current drained by the 754 motor. The force is converted into a digital signal and supplied control circuit 760.

[000248] The control circuit 760 can be configured to simulate the response of the real system of the instrument in the controller software.

A displacement member can be actuated to move a beam with an i 764 profile on end actuator 752 at or near a target speed. The surgical instrument 750 may include a feedback controller, which can be one or any of the feedback controllers, including, but not limited to, a PID controller, state feedback, LQR, and / or an adaptive controller, for example. The surgical instrument 750 can include a power source to convert the signal from the feedback controller to a physical input such as case voltage, PWM voltage, frequency modulated voltage, current, torque and / or force, for example.

[000249] The actual drive system of the surgical instrument 750 is configured to drive the displacement member, cutting member or beam with i 764 profile, by a brushed DC motor with gearbox and mechanical connections in a system joint and / or knife. Another example is the 754 electric motor that operates the displacement member and the articulation drive, for example, from an interchangeable drive shaft assembly. An external influence is an excessive and unpredictable influence on things like tissue, surrounding bodies, and friction in the physical system. This external influence can be called drag, which acts in opposition to the 754 electric motor. External influence, like drag, can cause the functioning of the physical system to deviate from a desired operation of the physical system.

[000250] Several exemplifying aspects are directed to a surgical instrument 750 that comprises an end actuator 752 with surgical implements of stapling and cutting driven by motor. For example, a motor 754 can drive a displacement member distally and proximally along a longitudinal geometry axis of end actuator 752. End actuator 752 may comprise a pivot anvil 766 and, when configured for use, a staples 768 positioned opposite the anvil 766. A doctor can hold the tissue between the anvil 766 and the staple cartridge 768, as described in the present invention. When ready to use the 750 instrument, the physician can provide a trigger signal, for example, by pressing a trigger on the 750 instrument. In response to the trigger signal, motor 754 can drive the displacement member distally along the longitudinal geometric axis the end actuator 752 from an initial position of the proximal stroke to an end position of the distal stroke from the initial stroke position. As the displacement member travels distally, an i-profile beam 764, with a cutting element positioned at a distal end, can cut the fabric between the staple cartridge 768 and the anvil 766.

[000251] In several examples, the surgical instrument 750 may comprise a control circuit 760 programmed to control the distal translation of the displacement member, such as the beam with i-profile 764, for example, based on one or more tissue conditions . The control circuit 760 can be programmed to directly or indirectly detect tissue conditions, such as thickness, as described here. Control circuit 760 can be programmed to select a trigger control program based on tissue conditions. A trigger control program can describe the distal movement of the displacement member. Different trigger control programs can be selected to better treat different tissue conditions. For example, when thicker tissue is present, control circuit 760 can be programmed to move the displacement member at a lower speed and / or with a lower power. When a thinner fabric is present, the control circuit 760 can be programmed to move the displacement member at a higher speed and / or with a higher power.

[000252] In some examples, control circuit 760 may initially operate motor 754 in an open circuit configuration for a first open circuit portion of a travel of the displacement member. Based on an instrument response 750 during the open circuit portion of the course, control circuit 760 can select a trip control program. The response of the instrument may include a travel distance of the displacement member during the open circuit portion, a time elapsed during the open circuit portion, the power supplied to the motor 754 during the open circuit portion, a sum of pulse widths a motor start signal, etc. After the open circuit portion, control circuit 760 can implement the selected trigger control program in a second portion of the travel member travel. For example, during the closed loop portion of the stroke, control circuit 760 may modulate motor 754 based on translation data that describes a position of the displacement member in a closed circuit manner to translate the displacement member to a constant speed. Additional details are described in U.S. Patent Application Serial No. 15 / 720,852, entitled SYSTEM AND METHODS FOR CONTROLLING A DISPLAY OF A SURGICAL INSTRUMENT, filed on September 29, 2017, which is hereby incorporated by reference in its entirety.

[000253] Figure 19 is a schematic diagram of a 790 surgical instrument configured to control various functions, according to at least one aspect of this description. In one aspect, the surgical instrument 790 is programmed to control the distal translation of a displacement member, such as the i-profile beam 764. The surgical instrument 790 comprises an end actuator 792 that can comprise an anvil 766, a beam with i 764 profile and a removable staple cartridge 768 that can be interchanged with an RF cartridge 796 (shown in dashed line).

[000254] In one aspect, the 788 sensors can be implemented as a limit switch, electromechanical device, solid state switches, Hall effect devices, MRI devices, GMR devices, magnetometers, among others. In other implementations, 638 sensors can be solid state switches that operate under the influence of light, such as optical sensors, infrared sensors, ultraviolet sensors, among others. In addition, the switches can be solid state devices such as transistors (for example, FET, junction FET, MOSFET, bipolar, and the like). In other implementations, 788 sensors can include driverless electric switches, ultrasonic switches, accelerometers and inertia sensors, among others.

[000255] In one aspect, the position sensor 784 can be implemented as an absolute positioning system comprising a magnetic rotary absolute positioning system implemented as a single integrated circuit magnetic rotary position sensor AS5055EQFT, available from Austria Microsystems, AG. The position sensor 784 can interface with the control circuit 760 to provide an absolute positioning system. The position can include multiple Hall effect elements located above a magnet and coupled to a CORDIC processor, also known as the digit by digit method and Volder algorithm, which is provided to implement a simple and efficient algorithm for calculating hyperbolic and trigonometric functions which only require addition, subtraction, bit shift and lookup table operations.

[000256] In one aspect, the 764 I-beam can be implemented as a knife member comprising a knife body which operationally supports a fabric cutting blade therein and may additionally include anvil hinges or flaps. and channel hitch or base features. In one aspect, the staple cartridge 768 can be implemented as a standard surgical (mechanical) fastener cartridge. In one aspect, the RF cartridge 796 can be implemented as an RF cartridge. These and other sensor arrangements are described in Commonly Owned U.S. Patent Application Serial No. 15 / 628,175, entitled TECHNIQUES

FOR ADAPTIVE CONTROL OF MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT, filed on June 20, 2017, which is hereby incorporated by reference in its entirety.

[000257] The position, movement, displacement and / or translation of a linear displacement member, such as the beam with i 764 profile, can be measured by an absolute positioning system, a sensor arrangement and a sensor of position represented as the position sensor 784. Due to the fact that the i-profile beam 764 is coupled to the longitudinally movable drive member 120, the position of the i-profile beam 764 can be determined by measuring the position of the member longitudinally movable drive that employs the position sensor 784. Consequently, in the following description, the position, displacement and / or translation of the i-profile beam 764 can be obtained by the position sensor 784, as described in the present invention . A control circuit 760 can be programmed to control the translation of the displacement member, such as the beam with i 764 profile, as described in this document. The control circuit 760, in some examples, may comprise one or more microcontrollers, microprocessors or other suitable processors to execute the instructions that cause the processor or processors to control the displacement member, for example, the beam with profile in i 764, in the manner described. In one aspect, a timer / counter 781 provides an output signal, such as elapsed time or a digital count, to control circuit 760 to correlate the beam position with i 764 profile as determined by the position sensor 784 with the output of timer / counter 781 so that control circuit 760 can determine the position of the beam with i-shaped profile 764 at a specific time (t) in relation to an initial position. The timer / counter 781 can be configured to measure elapsed time, count external events or measure the time of external events.

[000258] Control circuit 760 can generate a motor setpoint signal 772. Motor setpoint signal 772 can be supplied to a motor controller 758. Motor controller 758 can comprise one or more circuits configured to provide a motor 774 drive signal to motor 754 to drive motor 754, as described in the present invention. In some instances, the 754 motor may be a DC motor with a brushed DC electric motor. For example, the speed of motor 754 can be proportional to the drive signal of motor 774. In some instances, motor 754 can be a brushless DC electric motor and the motor drive signal 774 can comprise a PWM signal provided for a or more motor stator windings 754. In addition, in some examples, motor controller 758 may be omitted, and control circuit 760 can generate motor drive signal 774 directly.

[000259] The 754 motor can receive power from a power source

762. The 762 power source can be or include a battery, a supercapacitor or any other suitable power source. The engine

754 can be mechanically coupled to the i64 profile beam using a 756 transmission. The 756 transmission can include one or more gears or other connecting components to couple the 754 motor to the i64 profile beam. A position sensor 784 can detect a position of the beam with an i 764 profile. The position sensor 784 can be or can include any type of sensor that is capable of generating position data that indicates a position of the beam with an i 764 profile. In some examples , the position sensor 784 may include an encoder configured to supply a series of pulses to the control circuit 760 according to the beam with i 764 profile distally and proximally translated. The control circuit 760 can track pulses to determine the position of the beam with an i 764 profile. Other suitable position sensors can be used, including, for example, a proximity sensor. Other types of position sensors can provide other signals that indicate movement of the beam with i-profile

764. In addition, in some examples, the position sensor 784 may be omitted. When motor 754 is a stepper motor, control circuit 760 can track the position of the i-profiled beam 764 by adding the number and direction of the steps the motor has been instructed to perform. Position sensor 784 can be located on end actuator 792 or any other portion of the instrument.

[000260] The control circuit 760 can be in communication with one or more sensors 788. The sensors 788 can be positioned on the end actuator 792 and adapted to work with the surgical instrument 790 to measure the various derived parameters, such as span distance in relation to time, compression of the tissue in relation to time and deformation of the anvil in relation to time. The 788 sensors may comprise a magnetic sensor, a magnetic field sensor, an extensometer, 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 sensor suitable for measuring one or more parameters of the end actuator 792. The 788 sensors may include one or more sensors.

[000261] The one or more sensors 788 may comprise an extensometer, such as a microextensometer, configured to measure the magnitude of deformation in the anvil 766 during a stuck condition. The extensometer provides an electrical signal whose amplitude varies with the magnitude of the deformation. The 788 sensors can comprise a pressure sensor configured to detect a pressure generated by the presence of compressed tissue between the anvil 766 and the staple cartridge 768. The 788 sensors can be configured to detect the impedance of a section of tissue located between the anvil 766 and the staple cartridge 768 which is indicative of the thickness and / or completeness of the fabric located between them.

[000262] The 788 sensors can be configured to measure the forces exerted on the anvil 766 by the closing drive system. For example, one or more sensors 788 can be at a point of interaction between a closing tube and anvil 766 to detect the closing forces applied by a closing tube to anvil 766. The forces exerted on anvil 766 can be representative of the tissue compression experienced by the tissue section captured between the anvil 766 and the staple cartridge 768. The one or more sensors 788 can be positioned at various points of interaction throughout the closing drive system to detect the closing forces applied anvil 766 by the closing drive system. The one or more sensors 788 can be sampled in real time during a gripping operation by a processor portion of the control circuit 760. The control circuit 760 receives sample measurements in real time to provide and analyze information based on time and evaluate , in real time, the closing forces applied to the anvil

766.

[000263] A current sensor 786 can be used to measure the current drained by the 754 motor. The force required to advance the beam with an i-profile 764 corresponds to the current drained by the 754 motor. The force is converted into a digital signal and supplied control circuit 760.

[000264] An RF power source 794 is coupled to the end actuator 792 and is applied to the RF 796 cartridge when the RF 796 cartridge is loaded on the end actuator 792 in place of the staple cartridge 768. The control circuit 760 controls the supply of RF energy to the 796 RF cartridge.

[000265] Additional details are described in US Patent Application Serial No. 15 / 636,096, entitled SURGICAL SYSTEM COUPLABLE WITH STAPLE CARTRIDGE AND RADIO FREQUENCY CARTRIDGE, AND METHOD OF USING SAME, filed June 28, 2017, which is incorporated herein as a reference in its entirety.

[000266] Figure 20 illustrates a 20740 stroke length graph that shows how a control system can modify the stroke length of a closure tube assembly based on the pivot angle θ. Such stroke length modification includes shortening the stroke length to a compensated stroke length (for example, defined along the y axis) as the pivot angle θ increases (for example, defined along the x axis ). The compensated stroke length defines a path length of the closing tube assembly in the distal direction to close the claws of an end actuator, which is dependent on the pivot angle θ and prevents over-displacement of the closing tube assembly that causes damage to the surgical device.

[000267] For example, as shown in the 20740 stroke length chart, the stroke length of the closing tube assembly for closing the jaws is approximately 0.250 inch when the end actuator is not pivoted, and the stroke length compensated is approximately 0.242 inches when the pivot angle θ is approximately 60 degrees. Such measurements are provided as examples only and may include any of a variety of angles and corresponding stroke lengths and compensated stroke lengths without departing from the scope of this description. In addition, the relationship between pivot angles θ and compensated stroke lengths is non-linear and the rate at which the compensated stroke length decreases increases as the pivot angle increases. For example, the decrease in compensated stroke lengths between 45 degrees and 60 degrees of articulation is greater than the decrease in compensated stroke lengths between zero degrees and 15 degrees of articulation. Although with this approach the control system is adjusting the stroke length based on the articulation angle θ to prevent damage to the surgical device (for example, obstruction of the distal end of the closing tube assembly in a distal position), the distal closure is still allowed to advance during the joint, thus potentially closing, at least partially, the claws.

[000268] Figure 21 illustrates a 20750 closure tube assembly positioning graph that shows an aspect in which a control system modifies a longitudinal position of a closure tube assembly based on the pivot angle θ. Such modification of the longitudinal position of the closing tube assembly includes proximally retracting the closing tube assembly by a compensation distance (for example, defined along the y-axis) as the end actuator pivots and based on the angle of articulation θ (for example, defined along the geometric axis x). The compensating distance at which the closing tube assembly is proximally retracted prevents the distal advance of the distal closing tube, thus keeping the claws in the open position during the joint. With the proximal retraction of the closing tube set by the compensation distance during the articulation, the closing tube set can travel the stroke length starting from the proximally retracted position to close the claws by activating the closing set.

[000269] For example, as shown in the 20750 closing tube assembly positioning chart, the compensation distance when the end actuator is not pivoted is zero and the compensation distance when the pivot angle θ is approximately 60 degrees is 0.008 inch. In this example, the closing tube assembly is retracted by a compensating distance of 0.008 inch during articulation. In this way, to close the claws, the closing tube assembly can advance the stroke length starting from this retracted position. Such measurements are provided for example purposes only and may include any of a variety of corresponding compensation angles and distances without departing from the scope of the description. As shown in Figure 21, the relationship between the pivot angle θ and the compensation distance is non-linear and the rate at which the compensation distance extends increases as the pivot angle θ increases. For example, the increase in the compensation distance between 45 degrees and 60 degrees is greater than the increase in the compensation distance between zero degrees and 15 degrees.

[000270] When attaching the patient's tissue, the forces exerted through the gripping device, for example a linear stapler, and the tissue can reach an unacceptably high level. For example, when a constant closing rate is employed, the force can become high enough to cause excessive trauma to the trapped tissue and can cause deformation of the gripping device, so that an acceptable tissue gap is not maintained throughout stapling path. Figure 22 is a graph illustrating the power applied to the tissue during compression at a constant anvil closure rate (ie; no controlled tissue compression (CTC)) versus the power applied to the tissue during compression with a rate of variable anvil closure (ie; with CTC). The closure rate can be adjusted to control tissue compression so that the power imparted to the tissue remains constant over a portion of the compression. The peak power given to the tissue, according to Figure 22, is much lower when a variable anvil closure rate is used. Based on the power conferred, the force exerted by the surgical device (or a parameter related or proportional to the force) can be calculated. In this regard, the power may be limited, so that the force exerted through the surgical device, for example, through the claws of a linear stapler, does not exceed a deformation force or pressure that results in the clamps widening so that the fabric span is not in an acceptable range along the entire stapling length when in the fully closed position. For example, the jaws should be parallel or close enough to this that the fabric gap will remain in the acceptable or target range for all staple positions along the entire length of the jaws. In addition, limiting the power exerted prevents, or at least minimizes, trauma or tissue damage.

[000271] In Figure 22, the total energy exerted in the method without CTC is equal to the total energy exerted in the method with CTC, that is, the areas under the power curves in Figure 22 are the same or substantially the same. The difference in the power profiles used is, however, substantial, as the peak power is much lower in the example with CTC compared to the example without CTC.

[000272] The power limitation is obtained in the example with CTC reducing the closing rate, as illustrated by the line

20760. It is observed that the compression time B ′ is longer than the closing time B. As shown in Figure 22, a device and method that provide a constant closing rate (ie; without CTC) obtain the same 50 lb of compression force in the same 1 mm fabric span as the device and method that provide a variable closure rate (ie; with CTC). Although the device and method that provide a constant closure rate can achieve the compression force in the desired tissue span in a shorter period of time compared to a device and method that use a variable closure rate, this results in the peak of the power applied to the tissue, as shown in Figure 22. In contrast, the example of appearance illustrated with CTC starts by reducing the closing rate to limit the amount of power applied to the tissue below a certain level. By limiting the power applied to the tissue, tissue trauma can be minimized in relation to the system and method that do not use CTC.

[000273] Figure 22 and additional exemplifications are further described in US Patent No. 8,499,992, filed on June 1, 2012, entitled DEVICE AND METHOD FOR CONTROLLING COMPRESSION OF TISSUE, granted on August 6, 2013, whose full description is incorporated herein by way of reference.

[000274] In some aspects, a control system may include a plurality of predefined force limits that assist the control system in determining a beam position with an e-profile and / or articulation angle of a firing drive shaft and the proper control of at least one engine based on such determination. For example, the force limits can change depending on a length of the firing bar path configured to translate the firing drive shaft, and such force limits can be compared to a measured torsional force of the one or more motors in communication with the control system. The comparison of the torsional forces measured against the force limits can provide a reliable way for the control system to determine the location of the beam with an e-profile and / or the end actuator joint. This can enable the control system to properly control one or more motors (for example, reduce or stop torsional loads) to ensure proper firing of the firing assembly and the end actuator linkage, as well as preventing damage to the system as will be described in more detail below.

[000275] Figure 23 illustrates a 20800 force and displacement graph that includes the forces measured in section A that are related to the displacements measured in section B. Both section A and section B have a geometric axis x that defines time ( for example seconds). The y-axis of section B defines a travel offset (for example, in millimeters) of a firing rod and the y-axis of section A defines a force applied to the firing bar to thereby advance the drive axis of shooting. As shown in section A, the travel bar travel on a first 20902 linkage range (for example, approximately the first 12 mm travel) causes the end actuator to pivot. For example, in the 12 mm offset position, the end actuator is fully pivoted to the right and is mechanically unable to pivot further. As a result of being in complete articulation, the torsional force on the engine will increase and the control system can detect a 20802 articulation peak strength that exceeds a predefined 20804 articulation limit, as shown in section A. The control system can include more of a predefined hinge limit 20804 to detect more than one direction of maximum hinge (for example left hinge and right hinge). After the control system detects a 20802 pivot force peak that exceeds the predetermined 20804 pivot limit, the control system can reduce or interrupt the engine's performance, thus at least protecting the engine from damage.

[000276] After the firing bar advances beyond articulation range 20902, a displacement mechanism within the surgical stapler can cause additional distal displacement of the firing bar to cause the distal displacement of the firing drive shaft. For example, as shown in section B, the path between approximately 12 mm and 70 mm of path displacement can cause the beam with an em profile and advance along a 20904 firing stroke and cut the captured tissue between the claws, however, other travel lengths are within the scope of this description. In this example, a maximum firing stroke position 20906 of the beam with a profile in and occurs in the course of 70 mm. At this point, the beam with a profile in and or the knife is contiguous to a distal end of the cartridge or jaw, thus increasing the torsional forces on the motor and causing a peak travel force of the knife 20806, as shown in section A, be detected by the control system. As shown in section A, the control system can include a 20808 motor limit and a 20810 knife travel limit end that branches off from the 20808 motor limit and decreases (for example non-linearly) as the beam with profile in and approaches the maximum trigger stroke position 20906.

[000277] The control system can be configured to monitor the torsional force of the motor detected during at least the last part of the distal path 20907 (for example the last 10 percent of the firing stroke 904) of the beam profiled in and before reach the maximum firing stroke position 20906. While monitoring along the last part of the distal path 20907, the control system can cause the motor to reduce torsional forces, thereby reducing the load on the beam with a profile in and . This can protect the surgical stapler from damage, including the beam with an e-profile, with reduced loads on the beam with an e-profile, as the beam with an e-profile and approaches the maximum firing stroke position 20906, thus reducing the impact of the beam with a profile in and against the distal end of the cartridge or jaw. As mentioned above, this impact can cause a peak travel force of knife 20806, which can exceed the travel limit of knife 20810, but not the motor limit 20808, thus not damaging the motor. In this way, the control system can interrupt the motor operation after the peak travel force of the knife 20806 exceeds the travel limit of the knife 20810 and before the peak travel force of the knife 20806 exceeds the motor limit 20808 protecting thus the engine against damage. In addition, the increasing reduction of the 20810 knife travel limit prevents the control system from thinking preliminarily that the beam with a profile and has reached the maximum firing stroke position 20906.

[000278] After the control system has detected a peak knife path force 20806 that exceeds knife path limit 20810, the control system can confirm a beam position with an e profile (for example, 70 mm displacement and / or at the end of the firing stroke 20904) and can retract the firing bar based on that known displacement position to return the beam with a profile in and to a more proximal position (for example, 0 mm of displacement). At the most proximal position 20908, a peak knife retraction force 20812 that exceeds a predefined knife retraction limit 20814, as shown in section A, can be detected by the control system. At this point, the control system can recalibrate, if necessary, and associate the beam position with an in profile and as being in an initial position, where the subsequent advance of the firing rod in the distal direction (for example, approximately 12 mm in length ) will cause the shifter to disengage the beam with a profile in and from the firing bar. Once disengaged, the firing bar travel in the 20902 pivot range will cause the end actuator to pivot again.

[000279] In this way, the control system can detect torsional forces in the motor that control the path of the firing bar and compare such detected torsional forces with a plurality of limits to determine a beam position with an e-profile or the articulation angle of the end actuator and, thus, properly control the motor to avoid damage to the motor, as well as confirm the positioning of the firing bar and / or beam with an e-profile.

[000280] As described above, pressure or fabric contact sensors determine when the claw members initially come into contact with the "T" fabric. This allows a surgeon to determine the initial thickness of the "T" tissue and / or the thickness of the "T" tissue before gripping. In any of the aspects described above of the surgical instrument, as seen in Figure 24, the contact of the claw members with the "T" tissue closes a "SC" detection circuit that is otherwise open, with the establishment of the contact with a pair of opposite plates "P1, P2" provided on the claw members. Contact sensors can also include sensitive force transducers that determine the amount of force that is applied to the sensor, which can be assumed to be the same amount of force that is applied to the "T" fabric. This force that is applied to the fabric can then be converted into a compression amount of the fabric. Force sensors measure the amount of compression a tissue is under and provide the surgeon with information about the force applied to the "T" tissue. Excessive tissue compression can have a negative impact on the "T" tissue being operated. For example, excessive compression of the "T" tissue can result in tissue necrosis and, in certain procedures, staple line failure. Information regarding the pressure that is applied to the "T" tissue allows a surgeon to better determine that excessive pressure is not being applied to the "T" tissue.

[000281] Any of the contact sensors described here may include, but are not limited to, electrical contacts placed on an internal surface of a claw that, when in contact with the tissue, close a detection circuit that is otherwise , Open. Contact sensors can also include sensitive force transducers that detect when the tissue being attached first resists compression. Force transducers can include, and are not limited to, piezoelectric elements, piezoresistive elements, metallic film or semiconductor strain gauges, inductive pressure sensors, capacitive pressure sensors and potentiometric pressure transducers that use Bourdon tubes, capsules or bellows to drive an arm cleaner in a resistive element.

[000282] In one aspect, any of the aforementioned surgical instruments can include one or more piezoelectric elements to detect a change in pressure that occurs in the claw members. Piezoelectric elements are bidirectional transducers that convert voltage into an electrical potential. The elements may consist of metallized quartz or ceramic. In operation, when the tension is applied to the crystals, there is a change in the load distribution of the material resulting in a generation of tension throughout the material. Piezoelectric elements can be used to indicate when either or both claw members come into contact with the "T" fabric and the amount of pressure exerted on the "T" fabric after a contact is made.

[000283] In one aspect, any of the aforementioned surgical instruments can include or be equipped with one or more metallic strain gauges placed inside or on a portion of their body. Metal strain gauges operate according to the principle that the strength of the material depends on length, width and thickness. Consequently, when the material of the metallic strain gauge undergoes deformation, the strength of the material changes. Thus, a resistor made of this material incorporated into a circuit will convert the deformation into a change in an electrical signal. Desirably, the extensometer can be placed over surgical instruments so that the pressure applied to the tissue has an effect on the extensometer.

[000284] Alternatively, in another aspect, one or more semiconductor extensometers can be used in a similar way to the metallic extensometer described above, although the transduction mode is different. In operation, when a crystal lattice structure of the semiconductor extensometer is deformed as a result of applied stress, the material's resistance changes. This phenomenon is called the piezoresistive effect.

[000285] In yet another aspect, any of the aforementioned surgical instruments may include or be provided with one or more inductive pressure sensors to effect pressure or force transduction in movement of inductive elements in relation to each other.

This movement of the inductive elements in relation to each other alters the general inductance or the inductive coupling. Capacitive pressure transducers similarly perform pressure or force transduction in motion of capacitive elements in relation to each other by changing the general capacitance.

[000286] In yet another aspect, any of the aforementioned surgical instruments can include or be equipped with one or more capacitive pressure transducers to effect pressure or force transduction in movement of capacitive elements in relation to each other by changing a general capacitance.

[000287] In one aspect, any of the aforementioned surgical instruments can include or be equipped with one or more mechanical pressure transducers to effect pressure or force transduction in motion. In use, a movement of a mechanical element is used to deflect a pointer or disc on a meter. This movement of the pointer or disc can be representative of the pressure or force applied to the "T" fabric. Examples of mechanical elements include, and are not limited to, Bourdon tubes, capsules or bellows. For example, mechanical elements can be coupled with other measuring and / or sensing elements, such as a potentiometric pressure transducer. In this example, the mechanical element is coupled to a cleaner on the variable resistor. In use, the pressure or force can be converted by transduction into a mechanical movement that deflects the cleaner in the potentiometer, thus changing the resistance to reflect the pressure or force applied.

[000288] The combination of the above aspects, in particular, the combination of the sensors of contact with the tissue and span, provides the surgeon with feedback information and / or real-time information regarding the condition of the operational site and / or target tissue "T". For example, information regarding the initial thickness of the fabric

"T" can guide the surgeon in selecting an appropriate staple size, information regarding the stuck thickness of the tissue "T" can let the surgeon know if the selected staple will form properly, information regarding the initial thickness and the stuck thickness of the "T" fabric can be used to determine the amount of compression or deformation on the "T" fabric and information regarding the deformation on the "T" fabric can be used in this deformation to avoid compressing the fabric to excessive strain values and / or stapling in the fabric that has undergone excessive deformation.

[000289] Additionally, force sensors can be used to provide the surgeon with the amount of pressure applied to the tissue. The surgeon can use this information to avoid applying excessive pressure to the "T" tissue or stapling to the "T" tissue that has experienced excessive deformation.

[000290] Figure 24 and additional examples are further described in US Patent No. 8,181,839, filed on June 27, 2011, entitled SURGICAL INSTRUMENT EMPLOYING SENSORS, granted on May 5, 2012, the full description of which is incorporated herein reference title.

[000291] Certain aspects are shown and described to provide an understanding of the structure, function, manufacture and use of the devices and methods described. The features shown or described in one example can be combined with the features in other examples and modifications and variations are within the scope of this description.

[000292] The terms "proximal" and "distal" are with reference to a doctor who handles the handle of the surgical instrument, with the term "proximal" referring to the portion closest to the doctor and the term "distal" referring to the portion located farthest from the doctor. For convenience, the spatial terms "vertical", "horizontal", "up"

and "down" used with respect to the drawings are not intended to be limiting and / or absolute, because surgical instruments can be used in many orientations and positions.

[000293] Exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. Such devices and methods, however, can be used in other surgical procedures and applications including open surgical procedures, for example. Surgical instruments can be inserted through a natural orifice or one through an incision or perforation formed in the tissue. The functional portions or portions of the instrument's end actuator can be inserted directly into the body or via an access device that has a working channel through which the end actuator and the elongated drive shaft of the surgical instrument can be advanced.

[000294] Figures 25 to 28 represent a surgical instrument powered by a 150010 motor for cutting and fixing that may or may not be reused. In the illustrated examples, the 150010 surgical instrument includes a 150012 cabinet comprising a 150014 handle assembly that is configured to be picked up, handled and operated by the physician. The 150012 enclosure is configured for operational fixation to an interchangeable drive shaft assembly 150200 that has an end actuator 150300 operationally coupled to it that is configured to perform one or more surgical tasks or procedures. According to the present description, various forms of interchangeable drive shaft assemblies can be effectively used in connection with robotically controlled surgical systems. The term "enclosure" may include an enclosure or a similar portion of a robotic system that houses or otherwise operationally supports at least one drive system configured to generate and apply at least one control motion that can be used to drive the assemblies drive shaft. The term "structure" can refer to a portion of a hand held surgical instrument. The term "structure" can also represent a portion of a robotically controlled surgical instrument and / or a portion of the robotic system that can be used to operationally control the surgical instrument. Interchangeable drive shaft assemblies can be used with various robotic systems, instruments, components and methods described in U.S. Patent No. 9,072,535, entitled SURGICAL

STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, which is hereby incorporated by reference in its entirety.

[000295] Figure 25 is a perspective view of a 150010 surgical instrument that has an interchangeable drive shaft assembly 150200 operably coupled to it, in accordance with at least one aspect of this description. The 150012 enclosure includes an end actuator 150300 that comprises a surgical cutting and clamping device configured to operationally support a 150304 surgical clamp cartridge in it. The 150012 enclosure can be configured for use in connection with interchangeable drive shaft assemblies that include end actuators that are adapted to support different sizes and types of clamp cartridges, and that have different lengths, sizes and types of shaft drive. The 150012 enclosure can be effectively employed with a variety of interchangeable drive shaft assemblies, including assemblies configured to apply other movements and forms of energy such as radio frequency (RF) energy, ultrasonic energy and / or movement to adapted end actuator arrangements for use in connection with various surgical applications and procedures. End actuators, drive shaft assemblies, grips, surgical instruments and / or surgical instrument systems can use any suitable fastener, or fasteners, to secure tissue. For example, a fastener cartridge comprising a plurality of fasteners stored therein removably can be removably inserted into and / or attached to the end actuator of a drive shaft assembly.

[000296] The 150014 handle set can comprise a pair of interconnectable segments of the 150016 and 150018 handle cabinet interconnected by screws, snap-fit features, adhesive, etc. The 150016, 150018 handle segments cooperate to form a portion of the 150019 pistol grip that can be handled and manipulated by the physician. The 150014 handle set operationally supports a plurality of drive systems configured to generate and apply control movements to corresponding portions of the interchangeable drive shaft assembly that is operationally attached to it. A screen can be provided below a cover

150045.

[000297] Figure 26 is an exploded view of a portion of the surgical instrument 150010 of Figure 25, in accordance with at least one aspect of this description. The 150014 handle assembly may include a 150020 frame that operationally supports a plurality of drive systems. The 150020 frame can operationally support a "first" drive system or 150030 closing drive system, which can apply closing and opening movements to the 150200 interchangeable drive shaft assembly. The 150030 closing drive system can include an actuator as a 150032 closing trigger pivotally supported by the structure

150020. The 150032 lock trigger is pivotally coupled to the 150014 handle assembly by a 150033 pivot pin to enable the 150032 lock trigger to be handled by a physician. When the physician holds the 150019 pistol grip portion of the 150014 grip assembly, the closing trigger 150032 can pivot from an initial or "not acted" position to an "acted" position and, more particularly, to a fully compressed position or completely actuated.

[000298] The 150014 handle set and the 150020 frame can operationally support a 150080 trigger drive system configured to apply trigger movements to the corresponding portions of the interchangeable drive shaft assembly attached to it. The 150080 firing drive system can employ an 150082 electric motor located in the 150019 pistol grip portion of the 150014 handle assembly. The 150082 electric motor can be a brushed DC motor having a maximum rotation speed of approximately 25,000 rpm, for example example. In other arrangements, the motor may include a brushless motor, a wireless motor, a synchronous motor, a stepper motor or any other suitable electric motor. The 150082 electric motor can be powered by a 150090 power source which can comprise a 150092 removable power source. The 150092 removable power source can comprise a 150094 proximal enclosure portion that is configured to attach to a 150096 distal enclosure portion. The proximal cabinet portion 150094 and the distal cabinet portion 150096 are configured to operationally support a plurality of 150098 batteries in them. Each of the 150098 batteries can comprise, for example, a lithium-ion battery

(LI) or other suitable battery. The 150096 distal cabinet portion is configured for removable operational attachment to a 150100 control circuit board, which is operationally coupled to the 150082 electric motor. Several 150098 batteries connected in series can power the 150010 surgical instrument. The 150090 power source can be replaceable and / or rechargeable. A 150043 screen, which is located below the 150045 cover, is electrically coupled to the 150100 control circuit board. The 150045 cover can be removed to expose the 150043 screen.

[000299] The 150082 electric motor may include a rotary drive shaft (not shown) that interfaces operationally with a 150084 gear reducer assembly mounted in gear engaged with a set, or a rack, of 150122 drive teeth on a member of longitudinally movable drive 150120. The longitudinally movable drive member 150120 has a rack of drive teeth 150122 formed thereon for engagement with a corresponding drive gear 150086 of the gear reducer set 150084.

[000300] In use, a voltage polarity supplied by the 150090 power source can operate the 150082 electric motor clockwise, and the voltage polarity applied to the electric motor by the battery can be reversed in order to operate the 150082 electric motor at anticlockwise. When the 150082 electric motor is rotated in one direction, the longitudinally movable drive member 150120 will be axially driven in the distal "DD" direction. When the 150082 electric motor is driven in the opposite rotating direction, the longitudinally movable driving member 150120 will be axially driven in a proximal "DP" direction. The 150014 handle set can include a switch that can be configured to reverse the polarity applied to the 150082 electric motor by the power source

150090. The 150014 handle assembly may include a sensor configured to detect the position of the longitudinally movable driving member 150120 and / or the direction in which the longitudinally movable driving member 150120 is being moved.

[000301] The activation of the electric motor 150082 can be controlled by a trigger trigger 150130 that is pivotally supported in the handle set 150014. The trigger trigger 150130 can be pivoted between an unacted position and an acted position.

[000302] Returning to Figure 25, the interchangeable drive shaft assembly 150200 includes an end actuator 150300 comprising an elongated channel 150302 configured to operationally support a surgical staple cartridge 150304 therein. The end actuator 150300 can include an anvil 150306 which is pivotally supported in relation to the elongated channel

150302. The interchangeable drive shaft assembly 150200 can include a 150270 articulation joint. The construction and operation of the 150300 end actuator and 150270 articulation joint are disclosed in US Patent Application publication No. 2014/0263541, entitled ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK, which is hereby incorporated by reference in its entirety. The exchangeable drive shaft assembly 150200 may include a proximal housing or nozzle 150201 comprised of nozzle portions 150202, 150203. The interchangeable drive shaft assembly 150200 may include a closing tube 150260 that extends along a geometric axis of the drive shaft SA that can be used to close and / or open the anvil 150306 of the end actuator 150300.

[000303] Returning to Figure 25, the closing tube 150260 is distally translated (direction "DD") to close the anvil 150306,

for example, in response to the activation of the closing trigger 150032 in the manner described in the aforementioned reference in U.S. Patent Application Publication No. 2014/0263541. Anvil 150306 is opened by means of proximal translation of the closing tube

150260. In the open position of the anvil, the closing tube 150260 is moved to its proximal position.

[000304] Figure 27 is another exploded view of portions of the exchangeable drive shaft assembly 150200, in accordance with at least one aspect of this description. The interchangeable drive shaft assembly 150200 may include a firing member 150220 supported for axial travel within the center column 150210. The firing member 150220 includes an intermediate firing drive shaft 150222 configured to connect to a cutting portion distal or knife bar 150280. The firing member 150220 can be called a "second drive shaft" or a "second drive shaft assembly". The intermediate firing drive axis 150222 can include a longitudinal slot 150223 at a distal end configured to receive a flap 150284 at the proximal end 150282 of the knife bar 150280. The longitudinal slot 150223 and the proximal end 150282 can be configured to allow movement relative therebetween and may comprise a sliding joint 150286. Sliding joint 150286 may allow the intermediate firing drive shaft 150222 of firing member 150220 to pivot end actuator 150300 around pivot joint 150270 without moving, or to the less without moving the knife bar 150280 substantially. When the end actuator 150300 has been properly oriented, the intermediate firing drive axis 150222 can be distally advanced until a proximal side wall of the longitudinal slot 150223 contacts the flap 150284 to advance the knife bar 150280 and fire the cartridge clamps positioned in channel 150302. The central column 150210 has an elongated opening or window 150213 inside it to facilitate the assembly and insertion of the intermediate trigger drive shaft 150222 inside the central column 150210. When the intermediate trigger drive shaft 150222 has been inserted into it, an upper segment of the structure 150215 can be engaged in the structure of the drive shaft 150212 to enclose the intermediate drive drive shaft 150222 and the knife bar

150280. Trigger member 150220 operation can be found in U.S. Patent Application Publication No. 2014/0263541. A center column 150210 can be configured to slide support a firing member 150220 and the closing tube 150260 that extends around the center column 150210. The center column 150210 can slide support a hinge driver 150230.

[000305] The interchangeable drive shaft assembly 150200 may include a clutch assembly 150400 configured to selectively and releasably couple the hinge actuator 150230 to the firing member 150220. The clutch assembly 150400 includes a locking ring or a sleeve locking device 150402 positioned (o) around the firing member 150220, the locking sleeve 150402 can be rotated between an engaged position, where the locking sleeve 150402 couples the hinged actuator 150230 to the firing member 150220, and a disengaged position, where the hinge actuator 150230 is not operationally coupled to the firing member 150220. When the locking sleeve 150402 is in the engaged position, the distal movement of the firing member 150220 can move the hinge actuator 150230 distally and, correspondingly, the proximal movement of the firing member 150220 can move the hinge actuator 150230 proximally. When the locking sleeve 150402 is in the disengaged position, the movement of the firing member 150220 is not transmitted to the hinge driver 150230 and, as a result, the firing member 150220 can move independently of the hinge driver 150230. The mouthpiece 150201 can be employed to operationally engage and disengage the articulation drive system with the trigger drive system in the various ways described in US Patent Application Publication No. 2014/0263541.

[000306] The exchangeable drive shaft assembly 150200 may comprise a slip ring assembly 150600 that can be configured to conduct electrical energy to and from or to the end actuator 150300 and / or communicate signals to the end actuator 150300 and / or from it, for example. The slip ring assembly 150600 can comprise a proximal connector flange 150604 and a distal connector flange 150601 positioned in a slot defined in the nozzle portions 150202, 150203. The proximal connector flange 150604 can comprise a first face and the connector flange distal 150601 can comprise a second face positioned adjacent and movable with respect to the first face. The distal connector flange 150601 can rotate in relation to the proximal connector flange 150604 around the geometric axis of the SA-SA drive axis (Figure 25). The proximal connector flange 150604 can comprise a plurality of concentric or at least substantially concentric conductors 150602, defined on its first face. A 150607 connector can be mounted on the proximal side of the 150601 distal connector flange and can have a plurality of contacts, with each contact corresponding to, and in electrical contact with, one of the 150602 conductors. This arrangement allows for relative rotation between the proximal connector flange 150604 and the distal connector flange 150601, while electrical contact is maintained between them. The 150604 proximal connector flange can include an electrical connector 150606 that can place the 150602 conductors in signal communication with a drive shaft circuit board, for example. In at least one case, an electrical harness comprising a plurality of conductors can extend between electrical connector 150606 and the circuit board of the drive shaft. The electrical connector 150606 can extend proximally through a connector opening defined on the chassis mounting flange. U.S. Patent Application publication No. 2014/0263551, entitled "STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM", is hereby incorporated by reference in its entirety. U.S. Patent Application publication No. 2014/0263552, entitled "STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM", is hereby incorporated by reference in its entirety. Additional details regarding the 150600 slip ring assembly can be found in U.S. Patent Application Publication No. 2014/0263541.

[000307] The exchangeable drive shaft assembly 150200 may include a proximal portion fixedly mounted on the 150014 handle assembly and a distal portion that is rotatable about a longitudinal geometric axis. The distal swivel portion of the drive shaft can be rotated relative to the proximal portion around the slip ring assembly 150600. The distal connector flange 150601 of the slip ring assembly 150600 can be positioned on the distal swivel portion of the drive shaft.

[000308] Figure 28 is an exploded view of an aspect of an end actuator 150300 of the surgical instrument 150010 of Figure 25, in accordance with at least one aspect of this description. The end actuator 150300 can include the anvil 150306 and the surgical staple cartridge 150304. The anvil 150306 can be coupled to an elongated channel 150302. The openings 150199 can be defined in the elongated channel 150302 to receive pins 150152 extending from the anvil 150306 to enable the anvil 150306 to rotate from an open position to a closed position in relation to the elongated channel 150302 and the surgical staple cartridge

150304. A 150172 firing bar is configured to move longitudinally into the 150300 end actuator. The 150172 firing bar can be constructed from a solid section or can include a laminated material comprising a stack of steel plates . The firing bar 150172 comprises an I-beam beam 150178 and a cutting edge 150182 at a distal end thereof. A distal projecting end of the 150172 firing bar can be attached to the i-profile beam 150178 to assist in spacing the anvil 306 from a surgical staple cartridge 150304 positioned in the elongated channel 150302 when the anvil 150306 is in position closed. The i-beam beam 150178 can include a sharp cutting edge 150182 to cut the fabric, as the i-beam beam 150178 is distally advanced by the firing bar 150172. In operation, the i-beam beam 150178 can or fires the surgical staple cartridge

150304. The surgical staple cartridge 150304 may include a molded cartridge body 150194 that holds a plurality of staples 150191 that rest on the staple actuators 150192 in the respective staple cavities open upward

150195. A wedge slider 150190 is distally driven by the I-beam beam 150178, sliding over a cartridge tray 150196 of the surgical staple cartridge 150304. The wedge slide 150190 moves the clamp drivers upwards by cam

150192 to expel the clamps 150191 for deformation contact with the anvil 150306, while the cutting edge 150182 of the I-beam beam 150178 cuts through the trapped fabric.

[000309] The beam with i-profile 150178 can include upper pins 150180 that engage the anvil 150306 during firing. The i-beam beam 150178 can include intermediate pins 150184 and a base (bottom foot) 150186 to engage portions of the cartridge body 150194, the cartridge tray 150196 and the elongated channel 150302. When a 150304 surgical staple cartridge is positioned in the elongated channel 150302, a slot 150193 defined in the cartridge body 150194 can be aligned with a longitudinal slot 150197 defined in the cartridge tray 150196 and a slot 150189 defined in the elongated channel 150302. In use, the i-profile beam 150178 can slide through the aligned longitudinal cracks 150193, 150197 and 150189, and, as shown in Figure 28, the base 150186 of the I-beam beam 150178 can engage a groove positioned along the lower surface of the elongated channel 150302 along the length of the slot 150189, the intermediate pins 150184 can engage the upper surfaces of the cartridge tray 150196 along the length of the longitudinal slot 150197 and the pi the upper 150180 can engage the anvil 150306. The beam with i-profile 150178 can space or limit the relative movement between the anvil 150306 and the surgical staple cartridge 150304, as the firing bar 150172 is distally advanced to fire the staples from the cartridge of 150304 surgical staples and / or make an incision in the tissue captured between the 150306 anvil and the surgical staple cartridge

150304. The firing bar 150172 and the beam with I-profile 150178 can be proximally retracted allowing the anvil 150306 to be opened to release the two stapled and cut fabric portions.

[000310] Figures 29A and 29B are a block diagram of a control circuit 150700 of the surgical instrument 150010 of Figure 25 that comprises two drawing sheets, according to at least one aspect of this description. Referring mainly to Figures 29A and 29B, a 150702 handle assembly can include a 150714 motor, which can be controlled by a 150715 motor driver and can be employed by the surgical instrument trigger system

150010. In several forms, the 150714 motor can be a brushed DC drive motor with a maximum rotation speed of approximately 25,000 rpm. In other provisions, the 150714 motor may include a brushless motor, a wireless motor, a synchronous motor, a stepper motor or any other suitable electric motor. Motor driver 150715 may comprise an H bridge driver comprising field effect transistors (FETs) 150719, for example. The 150714 engine can be powered by the 150706 power pack releasably mounted to the 150200 handle set to provide control power to the 150010 surgical instrument. The 150706 power pack may comprise a battery that may include several battery cells connected in series, which can be used as the power source to power the 150010 surgical instrument. Under certain circumstances, the battery cells in the 150706 power pack can be replaceable and / or rechargeable. In at least one example, the battery cells can be lithium ion batteries that can be separably coupled to the 150706 power pack.

[000311] The drive shaft assembly 150704 can include a drive shaft controller 150722 that can communicate with a safety controller and a power management controller 150716 through an interface, while the drive shaft assembly 150704 and the power supply 150706 are coupled to the handle assembly 150702. For example, the interface may comprise a first interface portion 150725, which may include one or more electrical connectors for coupling coupling with the corresponding electrical connectors of the shaft assembly drive, and a second interface portion 150727, which may include one or more electrical connectors for coupling coupling with the corresponding electrical connectors of the power supply, to allow electrical communication between the controller of the drive shaft assembly 150722 and the power management controller 150716, while the AC shaft assembly onamento 150704 and the power supply 150706 are coupled to the handle assembly 150702. One or more communication signals can be transmitted through the interface to communicate one or more of the power requirements of the fixed interchangeable drive shaft assembly 150704 to the management controller 150716 power supply. In response, the power management controller can modulate the battery power output of the 150706 power pack, as described in more detail below, according to the power requirements of the 150704 fixed drive shaft set. The connectors may comprise switches that can be activated after the mechanical coupling engagement of the 150702 handle assembly to the 150704 drive shaft assembly and / or the 150706 power assembly to enable electrical communication between the 150722 drive shaft assembly controller and the power management controller

150716.

[000312] The interface can facilitate the transmission of one or more communication signals between the energy management controller 150716 and the controller of the drive shaft assembly 150722 by routing these communication signals through a main controller 150717 located in the assembly grip handle 150702, for example. In other circumstances, the interface can facilitate a direct communication line between the power management controller 150716 and the drive shaft assembly controller 150722 through the grip handle 150702, while the drive shaft assembly 150704 and the handle assembly 150706 are attached to the handle assembly

150702.

[000313] The main controller 150717 can be any single-core or multi-core processor, such as those known under the trade name ARM Cortex, available from Texas Instruments. In one respect, the main controller 150717 can be a Core Cortex-M4F LM4F230H5QR ARM processor, available from Texas Instruments, for example, which comprises an integrated 256 KB single cycle flash memory, or other non-volatile memory, up to 40 MHz, a seek-ahead buffer to optimize performance above 40 MHz, a 32 KB single cycle serial random access memory (SRAM), an internal read-only memory (ROM) loaded with the StellarisWare® program, memory 2 KB electrically erasable programmable read-only (EEPROM), one or more pulse width modulation (PWM) modules, one or more quadrature encoder (QEI) analog inputs, one or more analog to digital converters ( 12-bit ADC) with 12 analog input channels, details of which are available for the product data sheet.

[000314] The safety controller can be a safety controller platform that comprises two families based on controllers, such as TMS570 and RM4x, known under the trade name of Hercules ARM Cortex R4, also by Texas

Instruments. The safety controller can be configured specifically for IEC 61508 and ISO 26262 safety critical applications, among others, to provide advanced integrated safety features while providing scalable performance, connectivity and memory options.

[000315] The power supply 150706 may include a power management circuit which may comprise the power management controller 150716, a power modulator 150738 and a current sensor circuit 150736. The power management circuit can be configured to modulate the battery power output based on the power requirements of the drive shaft assembly 150704 while the drive shaft assembly 150704 and the power assembly 150706 are coupled to the handle assembly 150702. The power management controller 150716 can be programmed to control the power modulator 150738 of the power output of the power set 150706 and the current sensor circuit 150736 can be employed to monitor the power output of the power set 150706 to provide feedback to the power management controller 150716 about the battery power output so that the management controller the 150716 power supply can adjust the power output of the 150706 power pack to maintain a desired output. The power management controller 150716 and / or the drive shaft assembly controller 150722 can each comprise one or more processors and / or memory units that can store multiple software modules.

[000316] The surgical instrument 150010 (Figures 25 to 28) can comprise an output device 150742 that can include devices to provide sensory feedback to a user. Such devices may comprise, for example, visual feedback devices (for example, a monitor with an LCD screen, LED indicators), auditory feedback devices (for example, a speaker, a bell) or tactile feedback devices ( eg haptic actuators). In certain circumstances, the output device 150742 may comprise a screen 150743 which may be included in the handle assembly 150702. The drive shaft assembly controller 150722 and / or the power management controller 150716 can provide feedback to a user of the surgical instrument 150010 via output device 150742. The interface can be configured to connect the drive shaft assembly controller 150722 and / or the power management controller 150716 to the output device 150742. The output device 150742 can, in instead, be integrated into the power supply

150706. In these circumstances, communication between the output device 150742 and the drive shaft assembly controller 150722 can be done through the interface, while the drive shaft assembly 150704 is coupled to the handle assembly

150702.

[000317] Control circuit 150700 comprises circuit segments configured to control operations of the energized surgical instrument 150010. A safety controller segment (Segment 1) comprises a safety controller and main controller segment 150717 (Segment 2). The safety controller and / or the main controller 150717 are configured to interact with one or more additional circuit segments, such as an acceleration segment, a display segment, a drive axis segment, an encoder segment, a motor and a power segment. Each of the circuit segments can be coupled to the safety controller and / or the main controller 150717. The main controller 150717 is also coupled to a flash memory. The main controller 150717 also comprises a serial communication interface. Main controller 150717 comprises a plurality of inputs coupled, for example, to one or more circuit segments, a battery and / or a plurality of switches. The segmented circuit can be implemented by any suitable circuit, such as, for example, a printed circuit board (PCBA) assembly within the energized surgical instrument 150010. It should be understood that the term processor, as used here, includes any microprocessor, processor, controller, controllers or other basic computing device that incorporates the functions of a central computer processing unit (CPU) in an integrated circuit or at most some integrated circuits. The main controller 150717 is a programmable multipurpose device that accepts digital data as input, processes it according to the instructions stored in its memory and provides results as output. This is an example of sequential digital logic, as it has internal memory. The control circuit 150700 can be configured to implement one or more of the processes described here.

[000318] The acceleration segment (segment 3) comprises an accelerometer. The accelerometer is configured to detect movement or acceleration of the energized surgical instrument 150010. Input from the accelerometer can be used to transition to and from a suspend mode, identify the orientation of the energized surgical instrument, and / or identify when the surgical instrument is dropped. In some examples, the acceleration segment is coupled to the safety controller and / or the main controller

150717.

[000319] The display segment (Segment 4) comprises a display connector coupled to the main controller 150717. The display connector couples the main controller 717 to a display via one or more drivers of the display integrated circuits. The drivers of the integrated circuits of the display may be integrated with the display and / or may be located separately from the display. The display may comprise any suitable display, such as an organic light-emitting diode (OLED) display, a liquid crystal display (LCD), and / or any other suitable display. In some examples, the screen segment is coupled to the safety controller.

[000320] The drive shaft segment (Segment 5) comprises controls for an interchangeable drive shaft assembly 150200 (Figures 25 and 27) coupled to the surgical instrument 150010 (Figures 25 to 28) and / or one or more controls for a end actuator 150300 coupled to the interchangeable drive shaft assembly 150200. The drive shaft segment comprises a drive shaft connector configured to couple the main controller 150717 to a drive shaft PCBA. The drive shaft PCBA comprises a low power microprocessor with a ferroelectric random access memory (FRAM), a toggle switch, a drive shaft release Hall effect switch, and a drive shaft PCBA EEPROM memory. . The drive shaft PCBA EEPROM comprises one or more parameters, routines and / or specific programs for the 150200 interchangeable drive shaft assembly and / or the drive shaft PCBA. The drive shaft PCBA can be coupled to the interchangeable drive shaft assembly 150200 and / or integral with the surgical instrument 150010. In some instances, the drive shaft segment comprises a second drive shaft EEPROM. The second EEPROM of the drive shaft comprises a plurality of algorithms, routines, parameters and / or other data corresponding to one or more sets of drive shafts 150200 and / or end actuators 150300 that can interface with the powered surgical instrument 150010 .

[000321] The position encoder segment (segment 6) comprises one or more magnetic encoders of the rotation angle position. The one or more magnetic encoders of the rotation angle position are configured to identify the rotational position of the motor 150714, an interchangeable drive shaft assembly 150200 (Figures 25 and 27) and / or an end actuator 150300 of the 150010 surgical instrument ( Figures 25 to 28). In some instances, magnetic encoders of the rotation angle position can be coupled to the safety controller and / or the main controller 150717.

[000322] The motor circuit segment (Segment 7) comprises a motor 150714 configured to control movements of the energized surgical instrument 150010 (Figures 25 to 28). The 150714 motor is coupled to the main microcontroller processor 150717 by an H bridge driver comprising one or more H bridge field effect transistors (FETs) and a motor controller. The H bridge actuator is also coupled to the safety controller. A motor current sensor is coupled in series with the motor to measure the current drain from the motor. The motor current sensor is in signal communication with the main controller 150717 and / or with the safety controller. In some instances, the 150714 motor is coupled to an electromagnetic interference (EMI) filter on the motor.

[000323] The motor controller controls a first motor signal and a second motor signal to indicate the status and position of the motor 150714 to the main controller 150717. The main controller 150717 provides a high pulse width modulation (PWM) signal ), a low PWM signal, a direction signal, a synchronization signal and a motor restart signal to the motor controller via a buffer. The supply segment is configured to supply a segment voltage to each of the circuit segments.

[000324] The power segment (Segment 8) comprises a battery coupled to the safety controller, main controller 150717 and additional circuit segments. The battery is coupled to the circuit segmented by a battery connector and a current sensor. The current sensor is configured to measure the total current drain from the segmented circuit. In some examples, one or more voltage converters are configured to provide predetermined voltage values to one or more circuit segments. For example, in some examples, the segmented circuit may comprise 3.3V voltage converters and / or 5V voltage converters. A voltage amplification converter is configured to provide a voltage rise to a predetermined amount, such as up to 13V. The voltage amplification converter is configured to supply additional voltage and / or current during operations that require a lot of energy and to avoid blackouts or low power conditions.

[000325] A plurality of keys are coupled to the safety controller and / or the main controller 150717. The keys can be configured to control operations of the 150010 surgical instrument (Figures 25 to 28), the segmented circuit and / or indicate a state of the surgical instrument 150010. An ejection port switch and an ejection Hall switch are configured to indicate the status of an ejection port. A plurality of hinge keys, such as a left hinge key for the left side, a right hinge key for the left side, a central hinge key for the left side, a key on the left side left pivot to the right side, a right pivot key to the right side and a central pivot key to the right side are configured to control the articulation of a 150200 interchangeable drive shaft assembly (Figures 25 and 27) and / or the end actuator 150300 (Figures 25 and 28). A reverse key on the left and a reverse key on the right side are coupled to the main controller 150717. The keys on the left side which comprise the key on the left pivot side for the left side, the key on the right pivot side for the left side , the central articulation key for the left side and the reverse key for the left side are coupled to the main controller 150717 by a flex connector on the left. The keys on the right side comprising the key on the left pivot side for the right side, the key on the right pivot side for the right side, the central pivot key for the right side and the reverse key on the right side are coupled to the main controller 150717 by a right-hand bending connector. A trip switch, a gripping release key and a key attached to the drive shaft are coupled to the main controller 150717.

[000326] Any suitable mechanical, electromechanical, or solid state switches can be employed to implement the plurality of switches, in any combination. For example, the keys can be limit switches operated by the movement of components associated with the 150010 surgical instrument (Figures 25 to 28) or the presence of an object. These switches can be used to control various functions associated with the 150010 surgical instrument. A limit switch is an electromechanical device that consists of an actuator mechanically connected to a set of contacts. When an object comes into contact with the actuator, the device operates the contacts to make or break an electrical connection. Limit switches are used in a variety of applications and environments because of their robustness, ease of installation and reliable operation. They can determine the presence or absence, passage, positioning and end of an object's displacement. In other implementations, the switches can be solid state switches that work under the influence of a magnetic field such as Hall effect devices, magnetoresistive devices (MR), giant magnetoresistive devices (GMR), magnetometers, among others. In other implementations, the switches can be solid state switches that operate under the influence of light, such as optical sensors, infrared sensors, ultraviolet sensors, among others. In addition, the switches can be solid state devices such as transistors (for example, FET, junction FET, metal oxide semiconductor FET (MOSFET), bipolar, and the like). Other switches may include wireless switches, ultrasonic switches, accelerometers, inertia sensors, among others.

[000327] Figure 30 is another block diagram of the control circuit 150700 of the surgical instrument of Figure 25 that illustrates interfaces between the handle assembly 150702 and the power assembly 150706 and between the handle assembly 150702 and the shaft assembly interchangeable drive 150704, in accordance with at least one aspect of this description. The handle assembly 150702 may comprise a main controller 150717, a drive shaft assembly connector 150726 and a power assembly connector 150730. The power assembly 150706 may include a connector from the power assembly 150732, a power management circuit power 150734 which can comprise the power management controller 150716, a power modulator 150738 and a current sensor circuit 150736. The drive shaft assembly connectors 150730, 150732 form an interface 150727. The power management circuit 150734 can be configured to modulate the 150707 battery output power based on the power requirements of the 150704 interchangeable drive shaft assembly while the 150704 interchangeable drive shaft assembly and the 150706 power assembly are coupled to the 150702 handle assembly. The controller power management system 150716 can be programmed to control the power modulator 150738 from the power output of the power set 150706 and the current sensor circuit 150736 can be used to monitor the power output of the power set 150706 to provide feedback to the power management controller 150716 about the power output 150707 battery power so that the 150716 power management controller can adjust the power output of the 150706 power pack to maintain a desired output. The drive shaft assembly 150704 comprises a drive shaft processor 150720 coupled to a non-volatile memory 150721 and the drive shaft assembly connector 150728 to electrically couple the drive shaft assembly 150704 to the handle assembly 150702. The connectors of the drive shaft assembly 150726, 150728 form an interface 150725. The main controller 150717, the drive shaft processor 150720 and / or the power management controller 150716 can be configured to implement one or more of the processes described herein.

[000328] The surgical instrument 150010 (Figures 25 to 28) can comprise an output device 150742 for sensory feedback to a user. Such devices may comprise visual feedback devices (for example, an LCD monitor, LED indicators), auditory feedback devices (for example, a speaker, a bell) or tactile feedback devices (for example, actuators haptic). In certain circumstances, the output device 150742 may comprise a screen 150743 which may be included in the handle assembly 150702. The drive shaft assembly controller 150722 and / or the power management controller 150716 can provide feedback to a user of the surgical instrument 150010 via output device 150742. Interface 150727 can be configured to connect the drive shaft assembly controller 150722 and / or the power management controller 150716 to output device 150742. Output device 150742 can be integrated with the power supply 150706. The communication between the output device 150742 and the controller of the drive shaft assembly 150722 can be made through the interface 150725 while the interchangeable drive shaft assembly 150704 is coupled to the handle assembly

150702. Having described a control circuit 150700 (Figures 29A and 29B and 6) to control the operation of the 150010 surgical instrument (Figures 25 to 28), the description now turns to various configurations of the 150010 surgical instrument (Figures 25 to 28) and the control circuit 150700.

[000329] Referring to Figure 31, a surgical stapler 151000 can include a handle component 151002, a drive shaft component 151004 and an end actuator component 151006. The surgical stapler 151000 is constructed and equipped similarly to the surgical instrument for cutting and 150010 motor-driven fastening described in connection with Figure 25. Consequently, for the sake of brevity and clarity, the details of operation and construction will not be repeated here. The 151006 end actuator can be used to compress, cut or staple the fabric. Now with reference to Figure 32, the end actuator 151030 can be positioned by a doctor to encircle the 151032 tissue prior to compression, cutting or stapling. As shown in Figure 32, compression may not be applied to the fabric when preparing the end actuator for use. Now referring to Figure 33, by engaging the handle (for example handle 151002) of the surgical stapler, the doctor can use the end actuator 151030 to compress the tissue 151032. In one aspect, the tissue 151032 can be compressed to its maximum limit, as shown in Figure 33.

[000330] With reference to Figure 34, various forces can be applied to the fabric 151032 by the end actuator 151030. For example, vertical forces F1 and F2 can be applied by the anvil 151034 and the channel structure 151036 of the end actuator 151030 in the measure wherein the 151032 fabric is compressed between the two. Now with reference to Figure 35, diagonal forces and / or lateral forces can also be applied to the fabric 151032 when compressed by the end actuator 151030. For example, the force F3 can be applied. For the purposes of operating a medical device, such as a 151000 surgical stapler, it may be desirable to detect or calculate the various forms of compression being applied to the tissues by the end actuator. For example, knowledge of lateral or vertical compression can enable the end actuator to more precisely or accurately apply a stapling operation, or it can inform the operator of the surgical instrument so that the surgical instrument can be used more safely and properly.

[000331] Compression through tissue 151032 can be determined from an impedance of tissue 151032. At various levels of compression, the Z impedance of tissue 151032 may increase or decrease. By applying a voltage V and a current I to the fabric 151032, the Z impedance of the fabric 151032 can be determined at various levels of compression. For example, impedance Z can be calculated by dividing the voltage V applied by the current I.

[000332] Now with reference to Figure 36, in one aspect, an RF electrode 151038 can be positioned on the end actuator 151030 (for example on a staple cartridge, knife or channel structure of the end actuator 151030). In addition, an electrical contact 151040 can be positioned on the anvil 151034 of the end actuator 151030. In one aspect, the electrical contact can be positioned on the channel structure of the end actuator. As the fabric 151032 is compressed between the anvil 151034 and, for example, the channel structure 151036 of the end actuator 151030, a Z impedance of the fabric 151032 is changed. The vertical fabric compression 151042 caused by the end actuator 151030 can be measured as a function of the Z impedance of the fabric 151032.

[000333] Now with reference to Figure 37, in one aspect, an electrical contact 151044 can be positioned at an opposite end of the anvil 151034 of the end actuator 151030 as the RF electrode 151038 is positioned. As the fabric 151032 is compressed between the anvil 151034 and, for example, the channel structure 151036 of the end actuator 151030, a Z impedance of the fabric 151032 is changed. The lateral tissue compression 151046 caused by the end actuator 151030 can be measured as a function of the Z impedance of the tissue 151032.

[000334] Now with reference to Figure 38, in one aspect, the electrical contact 151050 can be positioned on the anvil 151034 and the electrical contact 151052 can be positioned on the opposite end of the end actuator 151030 in the channel structure

151036. The RF electrode 151048 can be positioned laterally to the center of the end actuator 151030. As the fabric 151032 is compressed between the anvil 151034 and, for example, the channel structure 151036 of the end actuator 151030, a Z impedance of fabric 151032 is changed. The lateral compression or angular compressions 151054 and 151056 on each side of the RF electrode 151048 can be caused by the end actuator 151030 and can be measured depending on different Z impedances of the 151032 tissue, based on the relative positioning of the RF electrode 151048 and electrical contacts 151050 and 151052.

[000335] Now with reference to Figure 39, frequency generator 151222 can receive energy or current from a power source 151221 and can provide one or more RF signals to one or more RF electrodes 151224. As discussed above, the one or more RF electrodes can be positioned in various locations or components on an end actuator or surgical stapler, such as a staple cartridge or channel structure. One or more electrical contacts, such as electrical contacts 151226 or 151228, can be positioned on a channel structure or on an anvil of an end actuator. In addition, one or more filters, such as filters 151230 or 151232, can be communicatively coupled to electrical contacts 151226 or 151228. Filters 151230 and 151232 can filter one or more RF signals provided by the frequency generator 151222 before joining one single return path 151234. A voltage V and a current I associated with one or more RF signals can be used to calculate an impedance Z associated with a tissue that can be compressed and / or communicatively coupled between the one or more RF electrodes 151224 and electrical contacts 151226 or 151228.

[000336] Still with reference to Figure 39, several components of the tissue compression sensor system described here can be located in a handle 151236 of a surgical stapler. For example, as shown in circuit diagram 151220a, frequency generator 151222 can be located on handle 151236 and receive power from power source 151221. In addition, current I1 and current I2 can be measured on a corresponding return path. to electrical contacts 151228 and 151226. Using a voltage V applied between the supply and the return paths, impedances Z1 and Z2 can be calculated. Z1 can correspond to an impedance of a compressed tissue and / or be communicatively coupled between one or more RF electrodes 151224 and electrical contact 151228. Furthermore, Z2 can correspond to an impedance of a compressed tissue and / or be communicatively coupled between one or more RF 151224 electrodes and electrical contact

151226. Applying the formulas and Z1 = V / I1 and Z2 = V / I2, the impedances Z1 and Z2 corresponding to the different levels of compression of a tissue compressed by an end actuator can be calculated.

[000337] Now with reference to Figure 40, one or more aspects of the present description are described in circuit diagram 151250. In one implementation, a power source in a 151252 handle of a surgical stapler can supply power to a frequency generator 151254 The 151254 frequency generator can generate one or more RF signals. The one or more RF signals can be multiplexed or overlaid on a 151256 multiplexer, which can be on a 151258 drive shaft of the surgical stapler. In this way, two or more RF signals can be superimposed (or, for example, grouped or modulated together) and transmitted to the end actuator. One or more RF signals can energize one or more RF 151260 electrodes on an end actuator

151262 (for example positioned in a staple cartridge) of the surgical stapler. A tissue (not shown) can be compressed and / or communicatively coupled between the one or more RF electrodes and one or more electrical contacts 151260. For example, the tissue can be compressed and / or communicatively coupled between the one or more electrodes of RF RF 151260 and electrical contact 151264 positioned on a channel structure of the end actuator 151262 or electrical contact 151266 positioned on an anvil of the end actuator

151262. A filter 151268 can be communicatively coupled to the electrical contact 151264 and a filter 151270 can be communicatively coupled to the electrical contact 151266.

[000338] A voltage V and current I associated with one or more RF signals can be used to calculate an impedance Z associated with a tissue that can be compressed between the staple cartridge (and communicatively coupled to one or more RF electrodes) 151260) and the channel or anvil structure (and communicatively coupled to one or more between electrical contacts 151264 or 151266).

[000339] In one aspect, several components of the tissue compression sensor system described here can be located on a 151258 drive shaft of the surgical stapler. For example, as shown in circuit diagram 151250 (and in addition to the frequency generator 151254), an impedance calculator 151272, a controller 151274, a non-volatile memory 151276 and a communication channel 151278 can be located on the drive axis

151258. In one example, the frequency generator 151254, the impedance calculator 151272, the controller 151274, the non-volatile memory 151276 and the communication channel 151278 can be positioned on a circuit board on the drive shaft 151258.

[000340] The two or more RF signals can be returned over a common path through the electrical contacts. In addition, the two or more RF signals can be filtered before joining the RF signals in the common path to differentiate separate tissue impedances represented by the two or more RF signals. Current I1 and current I2 can be measured on a return path corresponding to electrical contacts 151264 and 151266. Using a voltage V applied between the supply and the return paths, impedances Z1 and Z2 can be calculated. Z1 can correspond to an impedance of a compressed and / or communicatively coupled tissue between one or more RF 151260 electrodes and electrical contact

151264. Furthermore, Z2 can correspond to an impedance of the compressed tissue and / or communicatively coupled between one or more RF electrodes 151260 and electrical contact 151266. With the application of the formulas Z1 = V / I1 and Z2 = V / I2, the impedances Z1 and Z2 corresponding to different compressions of a tissue compressed by a 151262 end actuator can be calculated. In the example, impedances Z1 and Z2 can be calculated using impedance calculator 151272. Impedances Z1 and Z2 can be used to calculate various levels of tissue compression.

[000341] Now with reference to Figure 41, a 151290 frequency graph is shown. The frequency graph 151290 shows a frequency modulation to group two RF signals. The two RF signals can be grouped together before reaching the RF electrodes on an end actuator as described above. For example, an RF signal with frequency 1 and an RF signal with frequency 2 can be grouped together. Now with reference to Figure 42, the resulting grouped RF signal is shown on the frequency graph 151300. The composite signal shown on the frequency graph 151300 includes the two RF signals from the combined frequency graph 151290. Now with reference to Figure 43, a frequency graph 151400 is shown. The frequency graph 151400 shows the RF signals with

Frequencies 1 and 2, after being filtered (through, for example, filters 151268 and 151270). The resulting RF signals can be used to make the impedance calculations or measurements separately or on a return path, as described above.

[000342] In one aspect, filters 151268 and 151270 can be High Q filters, so that the filter range can be narrow (for example Q = 10). Q can be defined using the center frequency (Wo) / Bandwidth (BW) where Q = Wo / BW. In one example, Frequency 1 can be 150 kHz and Frequency 2 can be 300 kHz. A viable impedance measurement range can be 100 kHz - 20 MHz. In many instances, other sophisticated techniques, such as correlation, quadrature detection, etc., can be used to separate RF signals.

[000343] Using one or more of the techniques and features described in the present invention, a single electrode energized in a staple cartridge or a knife isolated from an end actuator can be used to make multiple measurements of tissue compression simultaneously . If two or more RF signals are overlapped or multiplexed (or grouped or modulated), they can be transmitted along a single supply side of the end actuator and can return to the channel structure or anvil of the end actuator. If a filter were constructed on the channel and anvil contacts before they join a common return path, the fabric impedance represented by both paths could be differentiated. This can provide a measure of vertical tissue vs. lateral tissue compression. In addition, this approach can provide compression of proximal and distal tissues depending on the placement of filters and the location of the metallic return paths. A frequency generator and signal processor can be located on one or more integrated circuits on a circuit board or a subplate (which may already exist in a surgical stapler).

[000344] In one aspect, the present description provides an instrument 150010 (described in relation to Figures 25 to 30) configured with various detection systems. Consequently, for the sake of brevity and clarity, the details of operation and construction will not be repeated here. In one aspect, the detection system includes a viscoelasticity / rate of change sensor system to monitor knife acceleration, impedance change rate, and tissue contact change rate. In one example, the rate of change of acceleration of the knife can be used as a measure of the type of fabric. In another example, the rate of change in impedance can be measured with a pulse sensor and can be used as a measure for compressibility. Finally, the rate of change in contact with the tissue can be measured with a sensor based on the firing rate of the knife to measure tissue flow.

[000345] The rate of change of a parameter detected or otherwise established, the amount of time required for a tissue parameter to reach an asymptotic steady state value, is a separate measurement in itself, and can be more valuable than than the detected parameter from which it was derived. To improve the measurement of tissue parameters, such as waiting a predetermined amount of time before making a measurement, the present description provides a new technique for employing the measurement derivative as the rate of change of the tissue parameter.

[000346] The derived technique or measure change rate becomes more useful with the understanding that there is not a single measurement that can be used alone to dramatically improve the formation of the clamp. This is the combination of multiple measures that make the measures valid. In the case of the fabric span, it is useful to know how much of the claw is covered with fabric to make the span measurement relevant. The rate of impedance change measurements can be combined with the strain measurements on the anvil to relate the force and compression applied to the tissue trapped between the claw members of the end actuator such as the anvil and the staple cartridge. The measured rate of change can be used by the endosurgical device to determine the type of tissue and not just the tissue compression. Although stomach and lung tissue are sometimes similar in thickness, and even with similar compression properties, when lung tissue is calcified, an instrument may be able to distinguish these types of tissue using a combination of measurements such as compression, compression , applied force, the tissue contact area, and the compression change rate or span change rate. If any of these measurements are used alone, it may be difficult for the endosurgical device to distinguish one type of tissue from the other. The rate of change in compression can also be useful in allowing the device to determine if the tissue is "normal" or if there is any abnormality. Measuring not only how much time has passed, but the variation of the sensor signals and determining the signal derivative would provide another measure to allow the endosurgical device to measure the signal. Information on the rate of change can also be used to determine when a steady state has been reached to signal the next step in a process. For example, after the tissue is gripped between the end actuator claw members such as the anvil and the staple cartridge, when the tissue compression reaches a stable state (for example about 15 seconds), an indicator or trigger to start device triggering can be enabled.

[000347] Methods, devices, and systems are also provided here for time-dependent evaluation of sensor data to determine the stability, creep, and viscoelastic characteristics of the tissue during the operation of the surgical instrument. A surgical instrument, such as the stapler illustrated in Figure 25, can include a variety of sensors to measure operating parameters, such as the size or distance of the jaw span, the trigger current, tissue compression, the amount of jaw that is covered by the fabric, the deformation of the anvil and the strength of the trigger, to name a few. These detected measurements are important for the automatic control of the surgical instrument and for providing feedback to the physician.

[000348] The examples shown with respect to Figures 30 to 49 can be used to measure the various derived parameters, such as span distance as a function of time, tissue compression as a function of time, and anvil deformation as a function of time. The motor current can be monitored using a current sensor in series with the 2308 battery.

[000349] Turning now to Figure 44, a surgical cutting and clamping instrument driven by a 151310 motor is shown, which may or may not be reused. The 151310 motor-driven surgical cutting and fixing instrument is similarly constructed and equipped as a 150010 motor-driven surgical cutting and fixing instrument described with reference to Figures 25 to 30. In the example illustrated in Figure 44, the 151310 instrument includes a cabinet 151312 which comprises a handle set 151314 which is configured to be picked up, handled and operated by the physician. The 151312 cabinet is configured for operational attachment to a 151500 interchangeable drive shaft assembly that has a 151600 surgical end actuator operably coupled to it that is configured to perform one or more surgical tasks or procedures. Since the motor-driven surgical cutting and fixation instrument

151310 is similarly constructed and equipped as a 150010 motor-driven surgical cutting and fixation instrument described in conjunction with Figures 25 to 30, for the sake of clarity and conciseness, the details of operation and construction will not be repeated in this document.

[000350] Cabinet 151312 shown in Figure 44 is shown in relation to an interchangeable drive shaft assembly 151500 that includes a 151600 end actuator comprising a surgical cutting and clamping device that is configured to operationally support a surgical staple cartridge 151304 in the same. The 151312 enclosure can be configured for use in connection with interchangeable drive shaft assemblies that include end actuators that are adapted to support different sizes and types of clamp cartridges, have different lengths, sizes and types of drive shafts, etc. . In addition, the 151312 cabinet can also be used effectively with a variety of other interchangeable drive shaft assemblies, including those that are configured to apply other motions and forms of energy such as radio frequency (RF) energy, ultrasonic energy and / or movement to end actuator arrangements adapted for use in connection with various applications and surgical procedures. In addition, end actuators, drive shaft assemblies, grips, surgical instruments and / or surgical instrument systems can use any one or more suitable fasteners to hold tissue. For example, a fastener cartridge comprising a plurality of fasteners stored therein removably can be removably inserted into and / or attached to the end actuator of a drive shaft assembly.

[000351] Figure 44 illustrates the surgical instrument 151310 with an interchangeable drive shaft assembly 151500 operationally coupled to it. In the illustrated arrangement, the grip cabinet forms a 151319 pistol grip portion that can be handled and manipulated by the physician. The handle set 151314 operationally supports, inside, a plurality of drive systems, which are configured to generate and apply various control movements to the corresponding portions of the interchangeable drive shaft set that is operationally fixed to it. Trigger 151332 is operationally associated with the gun handle to control several of these control movements.

[000352] Continuing with reference to Figure 44, the interchangeable drive shaft assembly 151500 includes a surgical end actuator 151600 comprising an elongated channel 151302 that is configured to operationally support a clamp cartridge 151304 therein. The end actuator 151600 can additionally include an anvil 151306 which is pivotally supported in relation to the elongated channel 151302.

[000353] The inventors found that derived parameters can be even more useful for the control of a surgical instrument, such as the instrument illustrated in Figure 44, than the detected parameter (s) in which the derived parameter is based. Some non-limiting examples of derived parameters include the rate of change of a detected parameter (eg distance from the claw span) and how long it takes before a tissue parameter reaches a steady state value asymptotic value (eg 15 seconds). Derived parameters, such as rate of change, are particularly useful because they dramatically improve measurement accuracy and also provide information that is not evident,

otherwise, directly from the detected parameters. For example, the rate of change in impedance (that is, tissue compression) can be combined with anvil deformation to relate to compression and strength, which allows the microcontroller to determine the type of tissue and not just the amount compression of the tissue. This example is illustrative only, and any derived parameters can be combined with one or more detected parameters to provide more accurate information about tissue types (eg stomach versus lung), tissue health (calcified versus normal), and device operational status surgical (for example full hold). The different tissues have unique viscoelastic properties and rates of change, making these and other parameters discussed here useful evidence for automatically monitoring and adjusting a surgical procedure.

[000354] Figure 46 is an illustrative graph that shows the gap distance over time, where the gap is the space between the claws that is occupied by the attached tissue. The vertical drive axis (y) is distance and the horizontal drive axis (x) is time. Specifically, with reference to the Figures. 44 and 45, span distance 151340 is the distance between the anvil 151306 and the elongated channel 151302 of the end actuator. In the open position of the claw, at time zero, the gap 151340 between the anvil 151306 and the elongated member is at its maximum distance. The width of the gap 151340 decreases as the anvil 151306 closes, as during the gripping of the fabric. The rate of change in the gap distance may vary, as the fabric has non-uniform resilience. For example, certain types of fabric may initially show rapid compression, resulting in a faster rate of change. However, as the fabric is continuously compressed, the viscoelastic properties of the fabric can cause the rate of change to decrease until the fabric cannot be further compressed, at which point the gap distance remains substantially constant. The span decreases over time, as the fabric is squeezed between the anvil 151306 and the staple cartridge 151304 of the end actuator 151340. The one or more sensors described with respect to Figures 31 to 43 such as, for example, a magnetic field sensor, an extensometer, 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 can be adapted and configured to measure the distance of the gap "d" between the anvil 151306 and the staple cartridge 151304 over time "t" as shown graphically in Figure 46. The rate of change in the distance of the gap "d "over time" t "is the slope of the curve shown in Figure 46, where the slope = Δd / Δt.

[000355] Figure 47 is an illustrative graph showing the trigger current of the claws of the end actuator. The vertical geometric axis (y) is the current and the horizontal geometric axis (x) is time. As discussed in this document, the surgical instrument and / or the microcontroller, as shown and described in conjunction with Figure 25, may include a current sensor that detects the current used during various operations, such as gripping, cutting and / or stapling the fabric. For example, when the resistance of the fabric increases, the instrument's electric motor may need more current to hold, cut and / or staple the fabric. Similarly, if the resistance is less, the electric motor may need less current to hold, cut and / or staple the fabric. As a result, the trigger current can be used as an approximation of tissue resistance. The detected current can be used alone or, more preferably, in conjunction with other measurements to provide feedback on the target tissue. Still referring to Figure 47, during some operations, such as stapling, the tripping current is initially high at time zero, but decreases over time. During other operations of the device, the current may increase over time if the motor draws more current to overcome the increase in mechanical load. In addition, the rate of change of the trigger current can be used as an indicator that the tissue is passing from one state to another. Consequently, the trigger current, and in particular the rate of change of the trigger current, can be used to monitor the operation of the device. The firing current decreases over time as the knife cuts through the fabric. The rate of change in the firing current can vary if the fabric being cut provides more or less resistance due to fabric properties or the sharpening of the knife 151305 (Figure 45). As cutting conditions vary, the work being done by the motor varies and therefore the tripping current will vary over time. A current sensor can be used to measure the trigger current over time while knife 151305 is triggered, as shown graphically in Figure 47. For example, the motor current can be monitored using a current sensor. Current sensors can be adapted and configured to measure the tripping current "i" of the motor over time "t", as plotted in Figure 47. The rate of change in tripping current "i" over time "t" is the slope of the curve shown in Figure 47, where the slope = Δi / Δt.

[000356] Figure 48 is a graph illustrating the impedance over time. The vertical geometric axis (y) is impedance and the horizontal geometric axis (x) is time. At zero time, the impedance is low but increases over time as the pressure for manipulating the tissue (for example, gripping and stapling) increases. The rate of change varies over time, as the fabric between the anvil 151306 and the staple cartridge 151304 of the end actuator 151340 is cut by the knife or is sealed with the use of RF energy between electrodes located between the anvil 151306 and the staple cartridge 151304 of the end actuator 151340. For example, when the fabric is cut, the electrical impedance increases and reaches infinity when the fabric is completely cut by the knife.

In addition, if the 151340 end actuator includes electrodes coupled to an RF power source, the electrical impedance of the tissue increases as energy is distributed through the tissue between the 151306 anvil and the end actuator clamp cartridge 151304 151340. The electrical impedance increases as the energy through the tissue dries the tissue by vaporizing moisture in the tissue.

Eventually, when an adequate amount of energy is applied to the fabric, the impedance increases to a very high or infinite value when the fabric is cut.

In addition, as illustrated in Figure 48, different fabrics can have unique compression properties, such as the compression rate, that distinguishes fabrics.

Tissue impedance can be measured by directing a subtherapeutic RF current through the tissue trapped between the first and second claw members 9014, 9016. One or more electrodes can be positioned on one or both of the anvil 151306 and the staple cartridge 151304. The tissue impedance / compression of the tissue between the anvil 151306 and the staple cartridge 151304 can be measured over time, as represented graphically in Figure 48. The sensors described with respect to Figures 31 to 43 as , for example, a magnetic field sensor, an extensometer, 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, can be adapted and configured to measure impedance / tissue compression. The sensors can be adapted and configured to measure the impedance of the fabric "Z" over time "t", as represented graphically in Figure 48.

[000357] Figure 49 is a graph illustrating the deformation of the anvil 151306 (Figures 44, 45) over time. The vertical geometric axis (y) is deformation and the horizontal geometric axis (x) is time. During stapling, for example, the deformation of the 151306 anvil is initially high, but decreases as the tissue reaches a stable state and exerts less pressure on the anvil

151306. The rate of change in strain of the anvil 151306 can be measured by a pressure sensor or strain gauge positioned on one or both of the anvil 151306 and the staple cartridge 151304 (Figures 44, 45) to measure the pressure or applied strain to the tissue trapped between the anvil 151306 and the staple cartridge 151304. The deformation of the anvil 151306 can be measured over time as shown graphically in Figure 49. The rate of change in deformation "S" over time "t" is the slope of the curve shown in Figure 49, where the slope = ΔS / Δt.

[000358] Figure 50 is a graph illustrating the trigger force over time. The vertical geometric axis (y) is the trigger force and the horizontal geometric axis (x) is time. In certain instances, the trigger force is progressive, to provide the physician with tactile feedback. Therefore, in a zero time, the trigger pressure 151320 (Figure 44) may be at its lowest value and the trigger pressure may increase until the completion of an operation (for example, gripping, cutting or stapling). The rate of change in the trigger force can be measured by a pressure sensor or strain gauge positioned on the trigger 151302 of the handle 151319 of the instrument 151310 (Figure

44) to measure the force required to drive the knife 151305 (Figure 45) through the tissue trapped between the anvil 151306 and the staple cartridge 151304. Trigger force 151332 can be measured over time as shown graphically in Figure 50. The rate of change in the deformation trigger force "F" over time "t 'is the slope of the curve shown in Figure 50, where the slope = ΔF / Δt.

[000359] For example, the stomach and lung tissue can be differentiated, although these tissues are similar in thickness, and may have similar compression properties if the lung tissue is calcified. Lung and stomach tissues can be distinguished by analyzing claw gap distance, tissue compression, force applied, tissue contact area, compression rate, and claw gap change rate. For example, Figure 51 shows a graph of tissue pressure "P" versus tissue displacement for various tissues. The vertical geometric axis (y) is the pressure of the fabric and the horizontal geometric axis (x) is the displacement of the fabric. When tissue pressure reaches a predetermined limit, such as 50 to 100 pounds per square inch (psi), the amount of tissue displacement, as well as the rate of tissue displacement before reaching the limit, can be used to differentiate tissues. For example, blood vessel tissue reaches the predetermined pressure limit with less tissue displacement and with a faster rate of change than colon, lung, or stomach tissue. In addition, the rate of change (pressure in tissue over displacement) for blood vessel tissue is almost asymptotic at a limit of 50 to 100 psi, while the rate of change for the colon, lung and stomach is not asymptotic in a 50 to 100 psi limit. As will be understood, any pressure limit can be used, for example, between 1 and 1,000 psi, more preferably between 10 and 500 psi and most preferably between 50 and 100 psi. In addition, multiple limits or progressive limits can be used to provide more resolution as to the types of tissue that have similar viscoelastic properties.

[000360] The rate of change in compression can also allow the microcontroller to determine whether the tissue is "normal" or whether there is any abnormality, such as calcification. For example, with reference to Figure 52, compression of calcified lung tissue follows a different curve than compression of normal lung tissue. Tissue displacement and tissue displacement change rate, therefore, can be used to diagnose and / or differentiate calcified lung tissue from normal lung tissue.

[000361] In addition, certain measurements detected may benefit from additional sensory inputs. For example, in the case of the claw span, knowing how much of the claw is covered with the fabric can make span measurement more useful and accurate. If a small portion of the claw is covered with tissue, the compression of the tissue may appear to be less than if the entire claw was covered with tissue. In this way, the amount of claw coverage can be taken into account by the microcontroller when analyzing tissue compression and other parameters detected.

[000362] In certain circumstances, elapsed time can also be an important parameter. Measuring the amount of time that has passed, along with detected parameters, and derived parameters (for example, rate of change) provides additional useful information. For example, if the rate of change of the claw span remains constant after a specified period of time (for example, 5 seconds), then the parameter may have reached its asymptotic value.

[000363] Information on the rate of change is also useful in determining when a steady state has been achieved, thereby signaling the next step in a process. For example, during grip, when tissue compression reaches a stable state - for example, negligible rate of change after a specified period of time - the microcontroller can send a signal to the monitor to alert the doctor to start the next step in operation, such as triggering the clamp. Alternatively, the microcontroller can be programmed to automatically start the next stage of operation (for example, triggering the clamp), once a stable state is reached.

[000364] Similarly, the rate of change in impedance can be combined with the strain on the anvil to relate strength and compression. The measured rate of change would allow the device to determine the type of tissue and not just the measurement of the compression value. For example, the stomach and lung sometimes have similar thicknesses, and even more similar compressive properties, if the lung is calcified.

[000365] The combination of one or more parameters detected with derived parameters provides a more reliable and accurate assessment of the types of tissue and tissue health and enables better monitoring, device control and feedback to the physician.

[000366] Figure 53 illustrates an embodiment of an end actuator 152000 comprising a first sensor 152008a and a second sensor 152008b. The end actuator 152000 is similar to the end actuator 150300 described above. The end actuator 152000 comprises a first claw member, or anvil, 152002 pivotally coupled to a second claw member 152004. The second claw member 152004 is configured to receive a 152006 staple cartridge inside it. The 152006 staple cartridge comprises a plurality of clips (not shown). The plurality of staples is implantable from the staple cartridge 152006 during a surgical operation. The end actuator 152000 comprises a first sensor 152008a. The first sensor 152008a is configured to measure one or more parameters of the end actuator 152000. In one embodiment, for example, the first sensor 152008a is configured to measure the span 152010 between the anvil 152002 and the second claw member 152004. The first sensor 152008a may comprise, for example, a Hall effect sensor configured to detect a magnetic field generated by a magnet 152012 incorporated into the second claw member 152004 and / or the staple cartridge 152006. As another example, in one embodiment, the first sensor 152008a is configured to measure one or more forces exerted on the anvil 152002 by the second claw member 152004 and / or tissue trapped between the anvil 152002 and the second claw member 152004.

[000367] The end actuator 152000 comprises a second sensor 152008b. The second sensor 152008b is configured to measure one or more parameters of the end actuator 152000. For example, in several embodiments, the second sensor 152008b can comprise an extensometer configured to measure the magnitude of the deformation on the anvil 152002 during a stuck condition. The extensometer provides an electrical signal whose amplitude varies with the magnitude of the deformation. In various embodiments, the first sensor 152008a and / or the second sensor 152008b may comprise, for example, a magnetic sensor such as a Hall effect sensor, an extensometer, a pressure sensor, a force sensor, a sensor inductive sensor, such as an eddy current sensor, a resistive sensor, a capacitive sensor, an optical sensor and / or any other sensor suitable for measuring one or more parameters of the 152000 end actuator. The first sensor 152008a and the second sensor 152008b can be arranged in a series configuration and / or in a parallel configuration. In a series configuration, the second sensor 152008b can be configured to directly affect the output of the first sensor 152008a. In a parallel configuration, the second sensor 152008b can be configured to indirectly affect the output of the first sensor 152008a.

[000368] In one embodiment, the one or more parameters measured by the first sensor 152008a are related to the one or more parameters measured by the second sensor 152008b. In one embodiment, for example, the first sensor 152008a is configured to measure the gap 152010 between the anvil 152002 and the second claw member 152004. The span 152010 is representative of the thickness and / or compressibility of a section of fabric stuck between the anvil 152002 and the staple cartridge 152006. The first sensor 152008a may comprise, for example, a Hall effect sensor configured to detect a magnetic field generated by the magnet 152012 coupled to the second claw member 152004 and / or the staple cartridge 152006. Single-site measurement accurately describes the thickness of compressed tissue for a full calibrated tissue bite, but can provide inaccurate results when a partial tissue bite is placed between the 152002 anvil and the second claw member

152004. A partial tissue bite, whether a proximal partial bite or a distal partial bite, alters the grip geometry of the anvil 152002.

[000369] In some embodiments, the second sensor 152008b is configured to detect one or more parameters indicative of a type of tissue bite, for example, a total bite, a partial proximal bite and / or a partial distal bite. The measurement of the second sensor 152008b can be used to adjust the measurement of the first sensor 152008a to accurately represent the true thickness of compressed tissue from a partial bite in a proximal or distal position. In one embodiment, for example, the second sensor 152008b comprises an extensometer such as, for example, a microextensometer, configured to monitor the extent of strain on the anvil during a stuck condition. The amplitude of the deformation of the anvil 152002 is used to modify the output of the first sensor 152008a, for example, a Hall effect sensor, to accurately represent the true thickness of compressed tissue from a partial bite in a proximal or distal position. The first sensor 152008a and the second sensor 152008b can be measured in real time during a gripping operation. Real-time measurement allows time-based information to be analyzed, for example, by a primary processor (for example 462 processor (Figure 12), for example), and used to select one or more algorithms and / or lookup tables to recognize tissue characteristics and grip positioning to dynamically adjust tissue thickness measurements.

[000370] In some embodiments, the thickness measurement of the first sensor 152008a can be provided to an output device of a surgical instrument 150010 coupled to the end actuator 152000. For example, in one embodiment, the end actuator 152000 is coupled to the surgical instrument 150010 comprising a screen (for example screen 473 (Figure 12), for example). The measurement of the first sensor 152008a is provided to a processor, for example, the primary processor. The primary processor adjusts the measurement of the first sensor 152008a based on the measurement of the second sensor 152008b to reflect the true fabric thickness of a section of fabric stuck between the anvil 152002 and the staple cartridge

152006. The primary processor issues the adjusted fabric thickness measurement and an indication of total or partial bite to the screen. An operator can determine whether staples are deployed to the 152006 staple cartridge based on the values shown.

[000371] In some embodiments, the first sensor 152008a and the second sensor 152008b can be located in different environments, for example, the first sensor 152008a being located inside a patient, in a treatment site, and the second sensor 152008b being externally situated in relation to the patient. The second sensor 152008b can be configured to calibrate and / or modify the output of the first sensor 152008a. The first sensor 152008a and / or the second sensor 152008b can comprise, for example, an environmental sensor. Environmental sensors can comprise, for example, temperature sensors, humidity sensors, pressure sensors and / or any other suitable environmental sensor.

[000372] Figure 54 is a logic diagram illustrating a modality of a 152020 process for adjusting the measurement of a first sensor 152008a based on the input from a second sensor 152008b. A first signal 152022a is captured by the first sensor 152008a. The first signal 152022a can be conditioned based on one or more predetermined parameters, for example, a smoothing function, a look-up table and / or any other suitable conditioning parameters. A second signal 152022b is captured by the second sensor 152008b. The second signal 152022b can be conditioned based on one or more predetermined conditioning parameters. The first signal 152022a and the second signal 152022b are supplied to a processor, such as the primary processor. The processor adjusts the measurement of the first sensor 152008a, as represented by the first signal 152022a, based on the second signal 152022b from the second sensor. In one embodiment, for example, the first sensor 152008a comprises a Hall effect sensor and the second sensor 152008b comprises an extensometer. The distance measurement of the first sensor 152008a is adjusted by the amplitude of the strain measured by the second sensor 152008b to determine the completeness of the tissue bite on the end actuator 152000. The adjusted measurement is shown 152026 for an operator, for example, by means of a screen incorporated into the surgical instrument 150010.

[000373] Figure 55 is a logic diagram illustrating a modality of a 152030 process for determining a lookup table for a first sensor 152008a based on the input from a second sensor 152008b. The first sensor 152008a captures a signal 152022a indicative of one or more parameters of the end actuator 152000. The first signal 152022a can be conditioned based on one or more predetermined parameters, for example, a smoothing function, a look-up table and / or any other suitable conditioning parameters. A second signal 152022b is captured by the second sensor 152008b. The second signal 152022b can be conditioned based on one or more predetermined conditioning parameters. The first signal 152022a and the second signal 152022b are supplied to a processor, such as the primary processor. The processor selects a lookup table from one or more lookup tables 152034a, 152034b available based on the value of the second signal. The selected look-up table is used to convert the first signal into a measurement of tissue thickness between the anvil 152002 and the staple cartridge 152006. The adjusted measurement is shown 152026 to an operator, for example, via an embedded screen to the 150010 surgical instrument.

[000374] Figure 56 is a logic diagram illustrating an embodiment of a 152040 process for calibrating a first sensor 152008a in response to an input from a second sensor 152008b. The first sensor 152008a is configured to capture a signal 152022a indicative of one or more parameters of the end actuator 152000. The first signal 152022a can be conditioned based on one or more predetermined parameters such as a smoothing function, a table consultation and / or any other suitable conditioning parameters. A second signal 152022b is captured by the second sensor 152008b. The second signal 152022b can be conditioned based on one or more predetermined conditioning parameters. The first signal 152022a and the second signal 152022b are supplied to a processor, such as the primary processor. The primary processor calibrates 152042 the first signal 152022a in response to the second signal 152022b. The first signal 152022a is calibrated 152042 to reflect the completeness of the tissue bite on the end actuator 152000. The calibrated signal is shown 152026 to an operator, for example, through a screen incorporated into the 150010 surgical instrument.

[000375] Figure 57 is a logic diagram illustrating an embodiment of a process 152050 for determining and showing the thickness of a section of tissue stuck between the anvil 152002 and the staple cartridge 152006 of the end actuator 152000. The process 152050 comprises obtaining a Hall effect voltage 152052, for example, by means of a Hall effect sensor located at the distal end of the anvil

152002. The Hall effect voltage 152052 is supplied to a 152054 analog-to-digital converter and converted into a digital signal. The digital signal is supplied to a processor, such as the primary processor. The primary processor calibrates 152056 the curve input of the Hall effect voltage signal 152052. An extensometer 152058, such as a microextensometer, is configured to measure one or more parameters of the end actuator 152000, such as the amplitude of the strain exerted on the anvil 152002 during a gripping operation. The measured strain is converted 152060 to a digital signal and supplied to the processor, such as the primary processor. The primary processor uses one or more algorithms and / or look-up tables to adjust the Hall effect stress 152052 in response to the strain measured by the extensometer 152058 to reflect the true thickness and completeness of the fabric bite attached by the anvil 152002 and the staple cartridge

152006. The adjusted thickness is shown 152026 for an operator, for example, through a screen incorporated into the surgical instrument

150010.

[000376] In some embodiments, the surgical instrument may additionally comprise a 152082 load cell or sensor. The 152082 load sensor may be located, for example, on the drive shaft assembly 150200, described above, or in the 150012 cabinet, also described above. Figure 58 is a logic diagram illustrating an embodiment of a process 152070 for determining and showing the thickness of a section of tissue stuck between the anvil 152002 and the staple cartridge 152006 of the end actuator 152000. The process comprises obtaining an effect tension Hall 152072, for example, by means of a Hall effect sensor located at the distal end of the anvil 152002. The Hall effect voltage 152072 is supplied to an analog-to-digital converter 152074 and converted into a digital signal. The digital signal is supplied to a processor, such as the primary processor. The primary processor calibrates 152076 the curve input of the Hall effect voltage signal 152072. An extensometer 152078, such as a microextensometer, is configured to measure one or more parameters of the end actuator 152000, such as the amplitude of the strain exerted on the anvil 152002 during a gripping operation. The measured strain is converted 152080 to a digital signal and supplied to the processor, such as the primary processor. The load sensor 152082 measures the grip force of the anvil 152002 against the staple cartridge 152006. The measured grip force is converted 152084 into a digital signal and supplied to the processor, such as the primary processor. The primary processor uses one or more algorithms and / or look-up tables to adjust the Hall effect stress 152072 in response to strain measured by the extensometer 152082 and the grip strength measured by the load sensor 152082 to reflect the true thickness and completeness of the bite of tissue held by the anvil 152002 and the staple cartridge 152006. The adjusted thickness is shown 152026 for an operator, for example, through a screen incorporated into the surgical instrument 150010.

[000377] Figure 59 is a graph 152090 illustrating an adjusted thickness measurement for Hall effect 152092 compared to an unmodified thickness measurement for Hall effect 152094. As shown in Figure 59, the measurement for thickness unmodified Hall effect 152094 indicates a thicker tissue measurement, as the single sensor is not able to compensate for the distal / proximal partial bites that result in incorrect thickness measurements. The adjusted thickness measurement 152092 is generated, for example, by the process 152050 illustrated in Figure 57. The adjusted thickness effect for Hall effect 152092 is calibrated based on input from one or more additional sensors, such as an extensometer. The adjusted Hall effect thickness 152092 reflects the true thickness of the fabric between an anvil 152002 and a staple cartridge 152006.

[000378] Figure 60 illustrates an embodiment of an end actuator 152100 comprising a first sensor 152108a and a second sensor 152108b. End actuator 152100 is similar to end actuator 152000 illustrated in Figure 53. End actuator 152100 comprises a first claw member, or anvil, 152102 pivotally coupled to a second claw member 152104. The second claw member 152104 is configured to receive a staple cartridge 152106 inside. The end actuator 152100 comprises a first sensor 152108a coupled to the anvil 152102. The first sensor 152108a is configured to measure one or more parameters of the end actuator 152100, such as the span 152110 between the anvil 152102 and the staple cartridge 152106. The span 152110 can correspond, for example, to a thickness of tissue stuck between the anvil 152102 and the staple cartridge 152106. The first sensor 152108a can comprise any sensor suitable for measuring one or more end actuator parameters. In various embodiments, for example, the first sensor 152108a may comprise a magnetic sensor, such as a Hall effect sensor, an extensometer, a pressure sensor, an inductive sensor, such as a stray current sensor, a resistive sensor, a capacitive sensor , an optical sensor and / or any other suitable sensor.

[000379] In some embodiments, the end actuator 152100 comprises a second sensor 152108b. The second sensor 152108b is coupled to the second claw member 152104 and / or the staple cartridge 152106. The second sensor 152108b is configured to detect one or more parameters of the end actuator 152100. For example, in some embodiments, the second sensor 152108b is configured to detect one or more conditions of the instrument, such as a color of the staple cartridge 152106 coupled to the second claw member 152104, a length of the staple cartridge 152106, a hold condition of the end actuator 152100, the number number of uses / number of uses remaining for end actuator 152100 and / or staple cartridge 152106, and / or any other appropriate instrument condition. The second sensor 152108b can comprise any sensor suitable for detecting one or more conditions of the instrument, such as a magnetic sensor, such as a Hall effect sensor, an extensometer, a pressure sensor, an inductive sensor, such as a current sensor parasite, a resistive sensor, a capacitive sensor, an optical sensor and / or any other suitable sensor.

[000380] The end actuator 152100 can be used in conjunction with any of the processes shown in Figures 54 to

57. In one embodiment, for example, the input from the second sensor 152108b can be used to calibrate the input from the first sensor 152108a. The second sensor 152108b can be configured to detect one or more parameters of the staple cartridge 152106, such as the color and / or the length of the staple cartridge 152106. The detected parameters, such as the color and / or the length of the cartridge of staples 152106, can correspond to one or more properties of the cartridge, such as the height of the cartridge platform, the thickness of useful / ideal fabric for the staple cartridge and / or the pattern of the staples in the 152106 staple cartridge The known parameters of the staple cartridge 152106 can be used to adjust the thickness measurement provided by the first sensor 152108a. For example, if the staple cartridge 152106 has a higher platform height, the thickness measurement provided by the first sensor 152108a can be reduced to compensate for the additional platform height. The adjusted thickness can be displayed to an operator, for example, through a screen attached to the 150010 surgical instrument.

[000381] Figure 61 illustrates an embodiment of an end actuator 152150 comprising a first sensor 152158 and a plurality of second sensors 152160a, 152160b. End actuator 152150 comprises a first claw member, or anvil, 152152 and a second claw member 152154. The second claw member 152154 is configured to receive a staple cartridge 152156. Anvil 152152 is pivotally movable relative to the second claw member 152154 for securing fabric between anvil 152152 and staple cartridge 152156. The anvil comprises a first sensor 152158. The first sensor 152158 is configured to detect one or more parameters of the end actuator 152150, such as the span 152110 between the anvil 152152 and the staple cartridge 152156. The span 152110 can correspond, for example, to a thickness of tissue stuck between the anvil 152152 and the staple cartridge 152156. The first sensor 152158 can comprise any sensor suitable for measuring one or more end actuator parameters. In various embodiments, for example, the first 152158 sensor may comprise a magnetic sensor, such as a Hall effect sensor, an extensometer, a pressure sensor, an inductive sensor, such as a stray current sensor, a resistive sensor, a capacitive sensor , an optical sensor and / or any other suitable sensor.

[000382] In some embodiments, the end actuator 152150 comprises a plurality of secondary sensors 152160a, 152160b. The secondary sensors 152160a, 152160b are configured to detect one or more parameters of the end actuator 152150. For example, in some embodiments, the secondary sensors 152160a, 152160b are configured to measure the amplitude of the strain exerted on the anvil 152152 during a procedure grasp. In various embodiments, the secondary sensors 152160a, 152160b can comprise a magnetic sensor, such as a Hall effect sensor, an extensometer, a pressure sensor, an inductive sensor, such as a eddy current sensor, a resistive sensor, a capacitive sensor, an optical sensor and / or any other suitable sensor. Secondary sensors 152160a, 152160b can be configured to measure one or more identical parameters at different locations on anvil 152152, different parameters at identical locations on anvil 152152 and / or different parameters at different locations on anvil 152152.

[000383] Figure 62 is a logic diagram illustrating an embodiment of a process 152170 for adjusting a measurement of a first sensor 152158 in response to a plurality of secondary sensors 152160a, 152160b. In one embodiment, the Hall effect voltage is obtained 152172, for example, by a Hall effect sensor. The Hall effect voltage is converted to 152174 by an analog-to-digital converter. The converted Hall effect voltage signal is calibrated 152176. The calibrated curve represents the thickness of a section of tissue located between the anvil 152152 and the staple cartridge 152156. A plurality of secondary measurements are obtained 152178a, 152178b by a plurality of sensors secondary, such as a plurality of strain gauges. The input of the extensometers is converted 152180a, 152180b into one or more digital signals, for example, by a plurality of µ deformation conversion electronic circuits (µStrain). The calibrated Hall effect voltage and the plurality of secondary measurements are supplied to a processor, such as the primary processor. The primary processor uses secondary measurements to adjust 13182 the Hall effect voltage, for example, by applying an algorithm and / or using one or more look-up tables. The adjusted Hall effect tension represents the true thickness and completeness of the tissue bite attached by the anvil 152152 and the staple cartridge 152156. The adjusted thickness is shown 152026 to an operator, for example, through a screen incorporated into the 150010 surgical instrument .

[000384] Figure 63 illustrates a modality of a circuit 152190 configured to convert signals from the first sensor 152158 and the plurality of secondary sensors 152160a, 152160b into digital signals receivable by a processor, such as the primary processor. Circuit 152190 comprises an analog-to-digital converter 152194. In some embodiments, the analog-to-digital converter 152194 comprises an 18-bit, 4-channel analog-to-digital converter. Those skilled in the art will recognize that the 152194 analog-to-digital converter can comprise any suitable number of channels and / or bits to convert one or more analog signal inputs to digital. Circuit 152190 comprises one or more level displacement resistors 152196 configured to receive an input from the first sensor 152158 such as, for example, a Hall effect sensor. Level displacement resistors 152196 adjust the input of the first sensor, shifting the value to a higher or lower voltage, depending on the input. Level displacement resistors 152196 provide the level displacement input of the first sensor 152158 to the analog-to-digital converter.

[000385] In some embodiments, a plurality of secondary sensors 152160a, 152160b is coupled to a plurality of bridges 152192a, 152192b in circuit 152190. The plurality of bridges 152192a, 152192b can provide filtering of the input from the plurality of secondary sensors 152160a, 152160b . After filtering the input signals, the plurality of bridges 152192a, 152192b supplies the inputs from the plurality of secondary sensors 152160a, 152160b to the analog-to-digital converter 152194. In some embodiments, a switch 152198 coupled to one or more level displacement resistors can be coupled to the analog-to-digital converter 152194. Switch 152198 is configured to calibrate one or more of the input signals, for example, an input from a Hall effect sensor. Switch 152198 can be engaged to provide one or more level shift signals to adjust the input of one or more of the sensors, for example, to calibrate the input of a Hall effect sensor. In some embodiments, adjustment is not necessary, and key 152198 is left in the open position to decouple the level displacement resistors. The switch 152198 is coupled to the analog-to-digital converter 152194. The analog-to-digital converter 152194 provides an output to one or more processors, such as the primary processor. The primary processor calculates one or more parameters of the end actuator 152150 based on the input from the 152194 analog-to-digital converter. In one embodiment, for example, the primary processor calculates a thickness of the tissues between the 152152 anvil and the staple cartridge 152156, based on input from one or more sensors 152158, 152160a, 152160b.

[000386] Figure 64 illustrates an embodiment of an end actuator 152200 comprising a plurality of sensors 152208a through 152208d. The end actuator 152200 comprises an anvil 152202 pivotably coupled to a second claw member 152204. The second claw member 152204 is configured to receive a staple cartridge 152206 inside it. The anvil 152202 comprises a plurality of sensors 152208a to 152208d on the same. The plurality of sensors 152208a to 152208d is configured to detect one or more parameters of the end actuator 152200 such as, for example, the anvil 152202. The plurality of sensors 152208a to 152208d can comprise one or more identical sensors and / or different sensors. The plurality of sensors 152208a to 152208d may comprise, for example, magnetic sensors, such as a Hall effect sensor, strain gauges, pressure sensors, inductive sensors, such as eddy current sensor, resistive sensors, capacitive sensors, optical sensors and / or any other suitable sensor or combinations thereof. In one embodiment, for example, the plurality of sensors 152208a through 152208d may comprise a plurality of extensometers.

[000387] In one embodiment, the plurality of sensors 152208a to 152208d makes it possible to implement a robust process for detecting tissue thickness. By detecting various parameters along the length of the anvil 152202, the plurality of sensors 152208a to 152208d allows a surgical instrument, such as the 150010 surgical instrument, to calculate the thickness of the tissues in the claws, regardless of the bite, for example , a partial or total bite. In some embodiments, the plurality of sensors 152208a to 152208d comprises a plurality of extensometers. The plurality of extensometers is configured to measure the deformation at various points on the anvil

152202. The amplitude and / or the slope of the deformation at each of the various points on the anvil 152202 can be used to determine the thickness of the tissue arranged between the anvil 152202 and the staple cartridge 152206. The plurality of extensometers can be configured to optimize the maximum amplitude and / or the angular coefficient differences based on the grip dynamics in order to determine the thickness, the positioning of the fabric and / or the material properties of the fabric. Time-based monitoring of the plurality of sensors 152208a through 152208d during gripping enables a processor, such as the primary processor, to use algorithms and look-up tables to recognize tissue characteristics and gripping positions and dynamically adjust the actuator. end 152200 and / or the fabric trapped between the anvil 152202 and the staple cartridge 152206.

[000388] Figure 65 is a logic diagram illustrating an embodiment of a 152220 process for determining one or more tissue properties based on a plurality of sensors 152208a through 152208d. In one embodiment, a plurality of sensors 152208a to 152208d generate 152222a to 152222d a plurality of signals indicative of one or more parameters of the end actuator 152200. The plurality of generated signals is converted 152224a to 152224d into digital signals and supplied to a processor. In one embodiment, for example, comprising the plurality of strain gauges, a plurality of µ deformation conversion (microdeformation) electronic circuits converts 152224a to 152224d the extensometer signals into digital signals. The digital signals are supplied to a processor, such as the primary processor. The primary processor determines 152226 one or more characteristics of the fabric based on the plurality of signals. The processor can determine one or more characteristics of the tissue by applying an algorithm and / or a look-up table. One or more tissue characteristics are shown to an operator 3026, for example, by means of a screen incorporated into the 150010 surgical instrument.

[000389] Figure 66 illustrates an embodiment of an end actuator 152250 comprising a plurality of sensors 152260a to 152260d coupled to a second claw member 3254. The end actuator 152250 comprises an anvil 152252 pivotally coupled to a second claw member 152254 The anvil 152252 is movable relative to the second claw member 152254 to hold one or more materials together, such as a section of fabric 152264. The second claw member 152254 is configured to receive a 152256 staple cartridge. first sensor 152258 is coupled to the anvil 152252. The first sensor is configured to detect one or more parameters of the end actuator 152150, such as the gap 152110 between the anvil 152252 and the staple cartridge 152256. The gap 152110 can correspond, for example, to a thickness of tissue stuck between the anvil 152252 and the staple cartridge 152256. The first sensor 152258 can comprise any suitable sensor to measure one or more parameters of the end actuator. In several modalities, for example, the first sensor 152258 can comprise a magnetic sensor, such as a Hall effect sensor, an extensometer, a pressure sensor, an inductive sensor, such as a parasitic current sensor, a resistive sensor, a capacitive sensor , an optical sensor and / or any other suitable sensor.

[000390] A plurality of secondary sensors 152260a to 152260d is coupled to the second claw member 152254. The plurality of secondary sensors 152260a to 152260d can be formed integrally with the second claw member 152254 and / or the staple cartridge 152256. In one For example, the plurality of secondary sensors 152260a to 152260d is arranged on an outer row of the staple cartridge 152256 (see Figure 67). The plurality of secondary sensors 152260a to 152260d is configured to detect one or more parameters of the end actuator 152250 and / or a section of fabric 152264 stuck between the anvil 152252 and the staple cartridge 152256. The plurality of secondary sensors 152260a to 152260d can understand any sensors suitable for detecting one or more parameters of the end actuator 152250 and / or the tissue section 152264, such as magnetic sensors, such as a Hall effect sensor, strain gauges, pressure sensors, inductive sensors, such as a sensor eddy current, resistive sensors, capacitive sensors, optical sensors and / or any other suitable sensors or combinations thereof. The plurality of secondary sensors 152260a to 152260d can comprise identical sensors and / or different sensors.

[000391] In some embodiments, the plurality of secondary sensors 152260a to 152260d comprises elements with dual purpose of sensors and tissue stabilizers. The plurality of secondary sensors 152260a to 152260d comprise electrodes and / or detection geometries configured to create a stabilized tissue condition when the plurality of secondary sensors 152260a to 152260d is engaged with a section of tissue 152264, such as during an operation of grasping. In some embodiments, one or more of the plurality of secondary sensors 152260a to 152260d can be replaced by non-detecting tissue stabilizing elements. Secondary sensors 152260a to 152260d create a stabilized tissue condition by controlling tissue flow, staple formation and / or other tissue conditions during a hold, stapling and / or other treatment process.

[000392] Figure 67 illustrates an embodiment of a staple cartridge 152270 comprising a plurality of sensors 152272a to 152272 h integrally formed therein. The staple cartridge 152270 comprises a plurality of rows containing a plurality of holes for storing staples therein. One or more of the holes in the outer row 152278 are replaced by a sensor out of the plurality of sensors 152272a through 152272h. A cut-out section is shown to illustrate a 152272f sensor coupled to a 152276b sensor wire. The sensor wires 152276a, 152276b can comprise a plurality of wires for coupling the plurality of sensors 152272a to 152272h to one or more circuits of a surgical instrument such as, for example, the surgical instrument 150010. In some embodiments, one or more of the plurality of sensors 152272a to 152272h comprise dual purpose elements of sensors and tissue stabilizers having electrodes and / or detection geometries configured to provide tissue stabilization. In some embodiments, the plurality of sensors 152272a to 152272h can be replaced by and / or copopulated with a plurality of tissue stabilizing elements. Tissue stabilization can be provided, for example, by controlling the flow of tissue and / or forming staples during a gripping and / or stapling process. The plurality of sensors 152272a to 152272h provide signals to one or more circuits of the 150010 surgical instrument to improve feedback on stapling performance and / or tissue thickness detection.

[000393] Figure 68 is a logic diagram illustrating an embodiment of a process 152280 for determining one or more parameters of a section of tissue 152264 attached to an end actuator such as the end actuator 152250 illustrated in Figure 66. In one embodiment, a first sensor 152258 is configured to detect one or more parameters of the end actuator 152250 and / or a tissue section 152264 located between the anvil 152252 and the staple cartridge 152256. A first signal is generated 152282 by the first 152258 sensors. The first signal is indicative of one or more parameters detected by the first sensor

152258. One or more secondary sensors 152260 are configured to detect one or more parameters of end actuator 152250 and / or tissue section 152264. Secondary sensors 152260 can be configured to detect the same parameters, additional parameters or parameters other than those detected by the first sensor 152258. Secondary signals 152284 are generated by secondary sensors 152260. Secondary signals 152284 are indicative of one or more parameters detected by secondary sensors 152260. The first signal and secondary signals are provided to a processor such as the primary processor. The processor adjusts 152286 the first signal generated by the first sensor 152258 based on the input generated by the secondary sensors 152260. The adjusted signal can be indicative, for example, of the true thickness of a section of tissue 152264 and the completeness of the bite. The set signal is shown 152026 to an operator, for example, by means of a screen incorporated into the surgical instrument 150010.

[000394] Figure 69 illustrates an embodiment of an end actuator 152300 comprising a plurality of redundant sensors 152308a, 152308b. The end actuator 152300 comprises a first claw member, or anvil, 152302 pivotally coupled to a second claw member 152304. The second claw member 152304 is configured to receive a staple cartridge 152306 inside it. The anvil 152302 is movable with respect to the staple cartridge 152306 for holding a material, such as a section of fabric, between the anvil 152302 and the staple cartridge 152306. A plurality of sensors 152308a, 152308b is coupled to the anvil. The plurality of sensors 152308a, 152308b is configured to detect one or more parameters of the end actuator 152300 and / or a section of fabric located between the anvil 152302 and the staple cartridge 152306. In some embodiments, the plurality of sensors 152308a, 152308b is configured to detect a gap 152310 between the anvil 152302 and the staple cartridge 152306. The gap 152310 can correspond, for example, to the thickness of the fabric between the anvil 152302 and the staple cartridge 152306. The plurality of sensors 152308a, 152308b can detect span 152310 by, for example, detecting a magnetic field generated by a magnet 152312 coupled to the second claw member 152304.

[000395] In some embodiments, the plurality of sensors 152308a, 152308b comprises redundant sensors. The redundant sensors are configured to detect the same properties as the 152300 end actuator and / or a tissue section located between the anvil 152302 and the staple cartridge 152306. The redundant sensors can comprise, for example, Hall effect sensors configured for detect the gap 152310 between the anvil 152302 and the staple cartridge 152306. Redundant sensors provide signals representative of one or more parameters that enable a processor, such as the primary processor, to evaluate multiple inputs and determine the most reliable input . In some embodiments, redundant sensors are used to reduce noise, false signals and / or deviations. Each of the redundant sensors can be measured in real time during prehension, allowing time-based information to be analyzed and algorithms and / or query tables to dynamically recognize tissue characteristics and prehension positioning. The entry of one or more of the redundant sensors can be adjusted and / or selected to identify the true thickness of the tissue and the bite of a section of tissue located between the anvil 152302 and the staple cartridge 152306.

[000396] Figure 70 is a logic diagram illustrating a modality of a 152320 process for selecting the most reliable output from a plurality of redundant sensors such as, for example, the plurality of sensors 152308a, 152308b illustrated in Figure 69. In one embodiment, a first signal is generated by a first sensor

152308a. The first signal is converted 152322a by an analog-to-digital converter. One or more additional signals are generated by one or more redundant 152308b sensors. The one or more additional signals are converted 152322b by an analog-to-digital converter. The converted signals are supplied to a processor, such as the primary processor. The primary processor evaluates 152324 redundant inputs to determine the most reliable output. The most reliable output can be selected based on one or more parameters, such as algorithms, look-up tables, inputs from additional sensors and / or instrument conditions. After selecting the most reliable output, the processor can adjust the output based on one or more additional sensors to reflect, for example, the true thickness and bite of a section of tissue located between the anvil 152302 and the staple cartridge 152306. A most reliable adjusted output is shown to an operator 3026, for example, through a screen incorporated into the 150010 surgical instrument.

[000397] Figure 71 illustrates an embodiment of an end actuator 152350 comprising a sensor 152358 comprising a specific sample rate to limit or eliminate false signals. The end actuator 152350 comprises a first claw member, or anvil, 152352 hingedly coupled to a second claw member 152354. The second claw member 152354 is configured to receive a 152356 staple cartridge inside. The staple cartridge 152356 contains a plurality of clamps that can be applied to a section of fabric between the anvil 152352 and the staple cartridge 152356. A sensor 152358 is coupled to the anvil 152352. The sensor 152358 is configured to detect one or more parameters of the end actuator 152350 as, for example, the gap 152364 between the anvil

152352 and the staple cartridge 152356. The span 152364 may correspond to the thickness of a material such as a section of fabric and / or the completeness of a bite of material between the anvil 152352 and the staple cartridge 152356. O sensor 152358 can comprise any sensor suitable for detecting one or more parameters of the end actuator 152350 such as, for example, a magnetic sensor, such as a Hall effect sensor, an extensometer, a pressure sensor, an inductive sensor, such as a eddy current, a resistive sensor, a capacitive sensor, an optical sensor and / or any other suitable sensor.

[000398] In one embodiment, sensor 152358 comprises a magnetic sensor configured to detect a magnetic field generated by an electromagnetic source 152360 coupled to the second claw member 152354 and / or to the staple cartridge 152356. The electromagnetic source 152360 generates a magnetic field detected by the sensor 152358. The strength of the detected magnetic field can correspond, for example, to the thickness and / or the completeness of a bite of tissue located between the anvil 152352 and the staple cartridge 152356. In some embodiments, the electromagnetic source 152360 generates a signal at a frequency known as, for example, 1 MHz. In other modalities, the signal generated by the electromagnetic source 152360 can be adjustable based, for example, on the type of staple cartridge 152356 installed on the second claw member 152354, in one or more additional sensors, an algorithm and / or one or more parameters.

[000399] In one embodiment, a 152362 signal processor is coupled to the 152350 end actuator, such as anvil 152352. The 152362 signal processor is configured to process the signal generated by sensor 152358 to eliminate false signals and to reinforce the input from the sensor 152358. In some embodiments, the signal processor 152362 can be separately located from the end actuator 152350 as, for example, in the handle 150014 of the surgical instrument 150010. In some embodiments, the signal processor 152362 is integrally formed com and / or comprises an algorithm performed by a general processor, such as the primary processor. The signal processor 152362 is configured to process the signal from sensor 152358 at a frequency substantially equal to the frequency of the signal generated by the electromagnetic source 152360. In one embodiment, for example, the electromagnetic source 152360 generates a signal at a frequency of 1 MHz The signal is detected by the sensor

152358. The 152358 sensor generates a signal indicative of the detected magnetic field, which is supplied to the 152362 signal processor. The signal is processed by the 3362 signal processor at a frequency of 1 MHz to eliminate false signals. The processed signal is supplied to a processor, such as the primary processor. The primary processor correlates the received signal to one or more parameters of the end actuator 152350, such as, for example, the gap 152364 between the anvil 152352 and the staple cartridge 152356.

[000400] Figure 72 is a logic diagram illustrating a modality of a 152370 process for generating a thickness measurement for a section of tissue located between an anvil and a staple cartridge of an end actuator, such as the end 152350 illustrated in Figure 71. In a process mode 152370, a signal is generated 152372 by a modulated electromagnetic source 152360. The generated signal can comprise, for example, a 1 MHz signal. A 152358 magnetic sensor is configured to detect 152374 the signal generated by the electromagnetic source 152360. The magnetic sensor 152358 generates a signal indicative of the detected magnetic field and supplies the signal to a 152362 signal processor. The 152362 signal processor processes 152376 the signal to remove noise, false signals and / or to reinforce the signal. The processed signal is supplied to an analog-to-digital converter for conversion 152378 into a digital signal. The digital signal can be calibrated 152380, for example, by applying a lookup table and / or a calibration curve input algorithm. Signal processing 152376, conversion 152378 and calibration 152380 can be performed by one or more circuits. The calibrated signal is shown to a user 152026, for example, through a screen integrally formed with the surgical instrument

150010.

[000401] Figures 73 and 74 illustrate an embodiment of a 152400 end actuator comprising a 152408 sensor for identifying 152406 clip cartridges of different types. The end actuator 152400 comprises a first claw member, or anvil, 152402 pivotably coupled to a second claw member or elongated channel 152404. The elongated channel 152404 is configured to operationally support a 152406 staple cartridge therein. The end actuator 152400 additionally comprises sensor 152408 located in the proximal area. The 152408 sensor can be any one of an optical sensor, a magnetic sensor, an electrical sensor or any other suitable sensor.

[000402] The sensor 152408 can be operable to detect a property of the staple cartridge 152406 and thus identify the type of the staple cartridge 152406. Figure 74 illustrates an example where the sensor 152408 is a 152410 emitter and optical detector. The staple cartridge body 152406 can be of different colors, so the color identifies the type of staple cartridge 152406. An emitter and optical detector 152410 can be operable to interrogate the color of the body of the staple cartridge 152406. In the example shown, the emitter and optical detector 152410 can detect white 152412 by receiving the light reflected in the red, green and blue spectra in equal intensity. The emitter and optical detector 152410 can detect red 152414 by receiving very little light reflected in the green and blue spectra, while receiving light in the red spectrum in greater intensity.

[000403] Alternatively or additionally, the 152410 emitter and optical detector, or another suitable 152408 sensor, can interrogate and identify some other symbol or other mark on the 152406 staple cartridge. The symbol or mark can be any one of a bar code , a format or character, a color-coded emblem, or any other appropriate markings. The information read by the sensor 152408 can be communicated to a microcontroller in the surgical device 150010 such as, for example, a microcontroller (for example microcontroller 461 (Figure 12), for example). The microcontroller can be configured to communicate information about the staple cartridge 152406 to the instrument operator. For example, the identified staple cartridge 152406 may not be suitable for a given application; in that case, the instrument operator may be informed, and / or an instrument function is inadequate. In this instance, the microcontroller can optionally be configured to disable a function of the surgical instrument that can be disabled. Alternatively or in addition, the microcontroller can be configured to inform the operator of the 150010 surgical instrument about the parameters of the staple cartridge type 152406 identified, for example, the length of the staple cartridge 152406, or information about the staples, such as height and the length.

[000404] Figure 75 illustrates an aspect of a segmented flexible circuit 153430 configured to attach securely to a claw member 153434 of an end actuator. The segmented flexible circuit 153430 comprises a distal segment 153432a and side segments 153432b, 153432c that include individually addressable sensors to provide detection of the presence of local tissue. Segments 153432a, 153432b, 153432c are individually addressable for detecting tissue and for measuring tissue parameters based on individual sensors located within each of segments 153432a, 153432b, 153432c. The segments 153432a, 153432b, 153432c of the segmented flexible circuit 153430 are mounted on the claw member 153434 and are electrically coupled to a power source, such as an electrical circuit through conductive electrical elements 153436. A Hall effect sensor 153438, or any sensor suitable magnet, is located at a distal end of the claw member 153434. The Hall effect sensor 153438 operates in conjunction with a magnet to provide a measurement of an aperture defined by the claw member 153434 that might otherwise be called a tissue gap, as shown in particular in Figure 77. The 153430 segmented flexible circuit can be used to measure tissue thickness, strength, displacement, compression, tissue impedance and tissue location within a end actuator.

[000405] Figure 76 illustrates an aspect of a segmented flexible circuit 153440 configured to be mounted on a claw member 153444 of an end actuator. The segmented flexible circuit 153440 comprises a distal segment 153442a and side segments 153442b, 153442c that include individually addressable sensors for tissue control. Segments 153442a, 153442b, 153442c are individually addressable for treating tissue and for reading individual sensors located within each of segments 153442a, 153442b, 153442c. Segments 153442a,

153442b, 153442c of the segmented flexible circuit 153440 are mounted on the claw member 153444 and are electrically coupled to a power source, through conductive electrical elements

153446. A Hall effect sensor 153448, or other suitable magnetic sensor, is provided at a distal end of the claw member

153444. The Hall effect sensor 153448 operates in conjunction with a magnet to provide a measurement of an aperture defined by the claw member 153444 of the fabric end or span actuator, as shown in particular in Figure 77. In addition, a plurality of Asymmetric side temperature sensors 153450a, 153450b are mounted on or formally integral to the segmented flexible circuit 153440 to provide feedback on the temperature of the fabric to the control circuit. The 153440 segmented flexible circuit can be used to measure tissue thickness, force, displacement, compression, tissue impedance and tissue location within an end actuator.

[000406] Figure 77 illustrates an aspect of a 153460 end actuator configured to measure a GT fabric span. The end actuator 153460 comprises a claw member 153462 and a claw member 153444. Flexible circuit 153440, as described in Figure 76, is mounted on claw member 153444. Flexible circuit 153440 comprises a Hall effect sensor 153448 that operates with a magnet 153464 mounted on the claw member 153462 to measure the span of GT fabric. This technique can be used to measure the defined gap between the jaw member 153444 and the jaw member 153462. The jaw member 153462 can be a staple cartridge.

[000407] Figure 78 illustrates an aspect of a 153470 end actuator comprising a segmented flexible circuit

153468. The end actuator 153470 comprises a claw member 153472 and a clip cartridge 153474. The segmented flexible circuit 153468 is mounted on the claw member 153472. Each of the sensors arranged within segments 1 to 5 is configured to detect the presence of tissue positioned between claw member 153472 and staple cartridge 153474 and represents tissue zones 1 through 5. In the configuration shown in Figure 78, end actuator 153470 is shown in an open position ready to receive or secure tissue between the claw member 153472 and the staple cartridge 153474. The segmented flexible circuit 153468 can be used to measure tissue thickness, force, displacement, compression, tissue impedance and tissue location within the actuator endpoint 153470.

[000408] Figure 79 illustrates end actuator 153470 shown in Figure 78 with claw member 153472 securing fabric 153476 between claw members 153472, for example, the anvil and the staple cartridge. As shown in Figure 79, tissue 153476 is positioned between segments 1 to 3 and represents tissue zones 1 to 3. Consequently, tissue 153476 is detected by sensors in segments 1 to 3 and the absence of tissue (void) is detected in section 153469 by segments 4 and 5. Information regarding the presence and absence of 153476 tissue positioned within certain segments 1 to 3 and 4 and 5, respectively, is communicated to a control circuit, as described here, through example, of interface circuits. The control circuit is configured to detect the tissue located in segments 1 to 3. It will be recognized that segments 1 to 5 can contain any suitable magnetic sensors of temperature, force / pressure and / or Hall effect to measure the parameters of tissue located in certain segments 1 to 5 and electrodes to supply energy to the tissue located in certain segments 1 to 5. The 153468 segmented flexible circuit can be used to measure tissue thickness, strength, displacement, compression, tissue impedance and the location of the tissue inside the 153470 end actuator.

[000409] Figure 80 is a diagram of an absolute positioning system 153100 that can be used with an instrument or surgical system, according to the present description. The absolute positioning system 153100 comprises a controlled motor drive circuit arrangement comprising a sensor arrangement 153102, in accordance with at least one aspect of this description. The sensor arrangement 153102 of an absolute positioning system 153100 provides a unique position signal corresponding to the location of a displacement member 153111. In one aspect, displacement member 153111 represents the longitudinally movable drive member coupled to the cutting instrument or knife (for example a cutting instrument, a beam with an i-profile and / or a beam with an i-profile 153514 (Figure 82)). In other respects, the displacement member 153111 represents a firing member coupled to the cutting instrument or knife, which can be adapted and configured to include a rack of driving teeth. In yet another aspect, the displacement member represents a firing bar or an I-beam, each of which can be adapted and configured to include a rack of driving teeth.

[000410] Consequently, as used in the present invention, the term "displacement member" is used generically to refer to any movable member of a robotic surgical instrument or system, as described herein, as a trigger member, a firing member , a firing bar, cutting instrument, knife and / or beam with an i-profile or any element that can be moved. Consequently, the absolute positioning system 153100 can, in effect, track the displacement of the beam with i-profile 153514 of the cutting instrument (Figure 82) by tracking the displacement of a longitudinally movable drive member. In several other aspects, the displacement member 153111 can be coupled to any suitable sensor for measuring displacement. In this way, the longitudinally movable drive member, the firing member, the firing bar or the I-beam, or combinations thereof, can be coupled to any suitable displacement sensor. Displacement sensors can include contact or non-contact displacement sensors. The displacement sensors can comprise linear variable differential transformers ("LVDT"), linear variable differential reluctance transducers ("DVRT" - differential variable reluctance transducers), a slide pot, a magnetic detection system that comprises a magnetic detection system mobile magnet and a series of linearly movable Hall effect sensors, a magnetic detection system comprising a fixed magnet and a series of linearly movable Hall effect sensors, an optical detection system comprising a source of movable light and a series of photodiodes or photodetectors arranged in a linearly mobile manner, or an optical detection system comprising a fixed light source and a series of photodiodes or photodetectors arranged in a linearly mobile manner, or any combination thereof.

[000411] An electric motor 153120 can include a rotary drive shaft 153116 that interfaces operationally with a gear set 153114 that is mounted in gear engaged with a set, or a rack, of drive teeth on the displacement member 153111. One sensor element 153126 can be operationally coupled to gear set 153114, so that a single revolution of sensor element 153126 corresponds to some linear longitudinal translation of displacement member 153111. An array of gears and sensors 153118 can be connected to the linear actuator from a rack and pinion arrangement, or to a rotary actuator by means of a cylindrical gear or other connection. A 153129 power source supplies power to the 153100 absolute positioning system and an 153128 output indicator can show the output from the 153100 absolute positioning system.

[000412] A single revolution of sensor element 153126 associated with position sensor 153112 is equivalent to a longitudinal displacement d1 of displacement member 153111, where d1 is the longitudinal distance by which displacement member 153111 moves from point "a" to point "b" after a single revolution of the sensor element 153126 coupled to the displacement member

153111. The sensor arrangement 153102 can be connected by means of a gear reduction which results in the completion of one or more revolutions, by the position sensor 153112, of the full travel of the displacement member 153111. The position sensor 153112 can complete multiple revolutions of the full stroke of displacement member 153111.

[000413] A series of keys 153122a to 153122n, where n is an integer greater than one, can be used alone or in combination with gear reduction to provide a single position signal for more than one revolution of the 153112 position sensor. The status of keys 153122a to 153122n is fed back to a controller 153110 that applies logic to determine a single position signal that corresponds to the longitudinal displacement d1 + d2 +… dn of displacement member 153111. Output 153124 from position sensor 153112 is provided to controller 153110. The position sensor 153112 of the sensor arrangement 153102 can comprise a magnetic sensor, an analog rotary sensor, such as a potentiometer, an array of analog Hall effect elements, which emit a unique combination of position signals or values. Controller 153110 may be contained in a master controller or may be contained in a cabinet of the tool mounting portion of an instrument or surgical system, in accordance with the present description.

[000414] The absolute positioning system 153100 provides an absolute position of the displacement member 153111 with the energization of the instrument or surgical system without retracting or advancing the displacement member 153111 to the reset position (zero or initial), as may be necessary with conventional rotary encoders that merely count the number of progressive or regressive steps that the 153120 motor has traveled to infer the position of a device actuator, a drive bar, a knife and the like.

[000415] The 153110 controller can be programmed to perform various functions, such as precise control of the speed and position of the joint and knife systems. In one aspect, the 153110 controller includes a 153108 processor and a 153106 memory. The 153120 electric motor can be a brushed DC motor with a gearbox and mechanical connections in a hinge or knife system. In one aspect, a 153110 motor driver can be an A3941 available from Allegro Microsystems, Inc. Other motor drivers can be readily replaced for use in the 153100 absolute positioning system.

[000416] Controller 153110 can be programmed to provide precise control of the speed and position of displacement member 153111 and articulation systems. The controller

153110 can be configured to compute a response in the 153110 controller software. The computed response is compared to a measured response from the real system to obtain an "observed" response, which is used for real decisions based on feedback. The observed response is a favorable and adjusted value, which balances the uniform and continuous nature of the simulated response with the measured response, which can detect external influences in the system.

[000417] The absolute positioning system 153100 can comprise and / or be programmed to implement a feedback controller, such as a PID, state feedback and adaptive controller. A 153129 power source converts the signal from the feedback controller to a physical input to the system, in this case, voltage. Other examples include pulse width modulation (PWM) of voltage, current and force. Other 153118 sensors can be provided to measure the physical parameters of the physical system, in addition to the position measured by the position sensor 153112. In a digital signal processing system, an absolute positioning system 153100 is coupled to a digital data capture system where the output of the absolute positioning system 153100 will have a finite sampling frequency and resolution. The 153100 absolute positioning system can comprise a comparison and combination circuit to combine a computed response with a measured response using algorithms such as a weighted average and a theoretical control circuit that drives a computed response towards the measured response. The computed response of the physical system considers properties, such as mass, inertia, viscous friction, resistance to inductance, etc., to predict what the states and exits of the physical system will be, knowing the input.

[000418] The 153110 motor driver can be an A3941, available from Allegro Microsystems, Inc. The A3941 153110 driver is an entire bridge controller for use with semiconductor metal oxide field effect transistors (MOSFETs - metal oxide semiconductor) field effect transistors) of external power, N channel, specifically designed for inductive loads, such as brushed DC motors. The 153110 actuator comprises a single charge pump regulator that provides full door drive (> 10 V) for batteries with voltage up to 7 V and allows the A3941 to operate with a reduced door drive, up to 5.5 V. A capacitor Input control can be used to supply the voltage supplied by the above battery required for the N channel MOSFETs. An internal charge pump for the upper side drive allows operation in direct current (100% duty cycle). The entire bridge can be triggered in fast or slow drop modes using diodes or synchronized rectification. In the slow drop mode, the current can be recirculated by means of FET from the top or from the bottom. Power FETs are protected from the shoot-through effect through programmable dead-time resistors. The integrated diagnostics provide indication of undervoltage, overtemperature and faults in the power bridge and can be configured to protect power MOSFETs in most short-circuit conditions. Other motor drives can be readily replaced for use in the 153100 absolute positioning system.

[000419] Figure 81 is a diagram of a position sensor 153200 of an absolute positioning system 153100 'comprising a magnetic rotating absolute positioning system, in accordance with at least one aspect of this description. The 153100 ’absolute positioning system is similar in many respects to the 153100 absolute positioning system. The 153200 position sensor can be implemented as a single integrated circuit magnetic rotary position sensor AS5055EQFT, available from

Austria Microsystems, AG. The 153200 position sensor interfaces with the 153110 controller to provide the 153100 absolute positioning system. The 153200 position sensor is a low voltage and low power component and includes four Hall effect elements 153228A, 153228B, 153228C, 153228D in an area 153230 of the position sensor 153200 which is located above a magnet positioned on a rotating element associated with a displacement member, such as a knife drive gear and / or a closing drive gear, so that the displacement of a firing member and / or a closing member can be accurately tracked. A 153232 high-resolution ADC converter and a 153238 intelligent power management controller are also provided on the integrated circuit. A CORDIC 153236 (Coordinate Rotation Digital Computer) processor, also known as the digit-by-digit method and Volder algorithm, is provided to implement a simple and efficient algorithm for calculating hyperbolic and trigonometric functions that require only operations addition, subtraction, bit offset and lookup table. The angular position, alarm bits and magnetic field information are transmitted via a standard serial communication interface, such as a SPI 153234 interface, to the 153110 controller. The 153200 position sensor provides 12 or 14 bits of resolution. The 153200 position sensor can be an AS5055 integrated circuit supplied in a small 16-pin QFN package whose measurement corresponds to 4x4x0.85 mm.

[000420] Hall effect elements 153228A, 153228B, 153228C, 153228D are located directly above the rotating magnet. The Hall effect is a well-known effect and for convenience it will not be described here in detail, however, in general, the Hall effect produces a voltage difference (the Hall voltage) through an electrical conductor transverse to an electric current in the conductor and a magnetic field perpendicular to the current. The Hall coefficient is defined as the ratio between the induced electric field and the product of the current density by the applied magnetic field. It is a characteristic of the material from which the conductor is made, since its value depends on the type, number and properties of the load carriers that make up the chain. In the AS5055 153200 position sensor, Hall effect elements 153228A, 153228B, 153228C, 153228D are capable of producing a voltage signal that is indicative of the absolute position of the magnet in terms of the angle relative to a single revolution of the magnet. This angle value, which is a single position signal, is calculated by the CORDIC 153236 processor and stored integrated with the AS5055 153200 position sensor in a register or a memory. The angle value that is indicative of the position of the magnet during a revolution is provided to the 153110 controller in a variety of techniques, for example, by energizing or upon request from the 153110 controller.

[000421] The AS5055 153200 position sensor requires only a few external components to operate when connected to the controller

153110. Six wires are required for a simple application using a single power supply: two wires for power and four wires 153240 for the SPI 153234 interface with the 153110 controller. A seventh connection can be added to send an interrupt signal to the 153110 controller. to inform you that a new valid angle can be read. Upon energization, the AS5055 153200 position sensor performs a complete energization sequence, including an angle measurement. The completion of this cycle is indicated as an INT 153242 output and the angle value is stored in an internal register. Once this output is configured, the AS5055 153200 position sensor goes into suspended mode. The 153110 controller can respond to the INT request on the INT 153242 output by reading the angle value from the position sensor AS5055 153200 via the SPI 153234 interface. Once the angle value is read by the 153110 controller, the INT 153242 output is released again. The sending of a "read angle" command via the SPI 153234 interface via controller 153110 to the position sensor 153200 also automatically energizes the integrated circuit and initiates another angle measurement. As soon as the 153110 controller has finished reading the angle value, the INT 153242 output is released and a new result is stored in the angle register. The completion of this angle measurement is again indicated by the definition of the INT 153242 output and a corresponding flag in the status record.

[000422] Due to the measurement principle of the AS5055 153200 position sensor, only a single angle measurement is performed in a very short time (~ 600 µs) after each energization sequence. As soon as an angle measurement is completed, the AS5055 153200 position sensor enters the de-energized state. There is no filter of the angle value by digital average implemented in the integrated circuit, as this would require more than one angle measurement and, consequently, a longer energization time, which is not desired in low power applications. The angle variation can be reduced by averaging multiple angle samples on the 153110 controller. For example, an average of four samples reduces the variation by 6 dB (50%).

[000423] Figure 82 is a cross-sectional view of a 153502 end actuator showing a beam firing stroke with an I-profile 153514 in relation to the 153526 fabric trapped inside the 153502 end actuator, according to at least one aspect of this description. The 153502 end actuator is configured to operate with any of the surgical instruments or systems, in accordance with the present description. The end actuator 153502 comprises an anvil 153516, an elongated channel 153503 with a staple cartridge 153518 positioned in the elongated channel 153503. A firing bar 153520 is translatable distally and proximally along a longitudinal geometric axis 153515 of the end actuator 153502. When the 153502 end actuator is not pivoted, the 153502 end actuator is in line with the drive shaft of the instrument. An i-beam beam 153514 comprising a cutting edge 153509 is shown on a distal portion of the firing bar 153520. A wedge slide 153513 is positioned on the staple cartridge 153518. As the i-beam beam 153514 is moved distally , the cutting edge 153509 comes into contact and can cut the fabric 153526 positioned between the anvil 153516 and the staple cartridge 153518. In addition, the beam with i-profile 153514 comes into contact with the wedge slider 153513 and pushes it away, causing the wedge slider 153513 to contact the 153511 staple actuators. The 153511 staple actuators can be guided into the 153505 staples, causing the 153505 staples to advance through the fabric and into the 153507 pockets defined in anvil 153516, which format the staples 153505.

[000424] A firing stroke of the beam with an I-profile 153514 example is illustrated by a graphic 153529 aligned with the end actuator 153502. The 153526 example fabric is shown also aligned with the end actuator 153502. The course of the firing member it can comprise an initial position of the stroke 153527 and an end position of the stroke 153528. During a firing stroke of the beam with i-profile 153514, the beam with i-profile 153514 can be advanced distally from the initial position of the stroke 153527 to the final position of the 153528 course. The beam with i-profile 153514 is shown in an example location from an initial position of the course

153527. The 153529 I-beam beam travel member 153529 graph illustrates five travel member regions of the 153517, 153519, 153521, 153523, 153525 travel member. In a first 153517 trip travel region, the beam with i 153514 profile can start advancing distally. In the first firing stroke region 153517, the i-profile beam 153514 can contact the wedge slider 153513 and start moving it distally. Although, in the first region, however, cutting edge 153509 may not come into contact with the fabric and the wedge slider 153513 may not come into contact with a clamp driver 153511. After the static friction is overcome, the force to drive the i-profile beam 153514 in the first region 153517 can be substantially constant.

[000425] In the second stroke region of firing member 153519, cutting edge 153509 can start to contact and cut the fabric 153526. In addition, the wedge slider 153513 can start contacting the 153511 clamp drivers to drive the clamps 153505. The force to drive the beam with i-profile 153514 can start to gradually increase. As shown, the fabric initially found can be compressed and / or thinner due to the way the anvil 153516 rotates in relation to the staple cartridge 153518. In the third stroke region of the firing member 153521, the cutting edge 153509 can continuously come into contact contact and cut the fabric 153526 and the wedge slider 153513 can repeatedly come into contact with the clip drivers

153511. The force to drive the beam with i-profile 153514 can reach the plateau in the third region 153521. In the fourth region of firing stroke 153523, the force to drive the beam with i-profile 153514 may start to decrease. For example, the fabric in the portion of the end actuator 153502 corresponding to the fourth firing region 153523 may be less compressed than the fabric closest to the pivot point of the anvil 153516, requiring less force to cut. In addition, the cutting edge 153509 and the wedge slider 153513 can reach the end of the fabric 153526 while in the fourth region 153523. When the beam with i-profile 153514 reaches the fifth region 153525, the fabric 153526 may be completely cut. The wedge slider 153513 can come into contact with one or more staple drivers 153511 at or near the end of the fabric. The force to advance the i-profile beam 153514 through the fifth region 153525 can be reduced and, in some instances, it may be similar to the force to drive the i-profile beam 153514 in the first region 153517. At the conclusion of the member course the I-beam beam 153514 can reach the final position of the travel 153528. The positioning of the travel regions of the shooting member 153517, 153519, 153521, 153523, 153525 in Figure 82 is just an example. In some examples, different regions can start at different positions along the longitudinal geometric axis of the end actuator 153515, for example, based on the positioning of the fabric between the anvil 153516 and the staple cartridge 153518.

[000426] As discussed above and with reference now to Figures 80 to 82, the electric motor 153120 positioned on a master controller of the surgical instrument can be used to advance and / or retract the trigger system of the drive shaft assembly, including the beam with i-profile 153514, in relation to the end actuator 153502 of the drive shaft assembly in order to staple and / or incise the tissue captured inside the end actuator 153502. The beam with i-profile 153514 can be advanced or retracted at a desired speed, or within a desired speed range. Controller 153110 can be configured to control the speed of the beam with i-profile 153514. Controller 153110 can be configured to predict the speed of the beam with i-profile 153514 based on various parameters of the energy supplied to the electric motor 153120, such as voltage and / or current, for example, and / or other operating parameters of the 153120 electric motor or external influences. The controller 153110 can be configured to predict the current speed of the beam with i-profile 153514 based on the previous values of current and / or voltage supplied to the electric motor 153120 and / or the previous states of the system, such as speed, acceleration and / or position. The 153110 controller can be configured to detect the speed of the i-profile beam 153514 using the absolute positioning sensor system described here. The controller can be configured to compare the predicted speed of the i-profile beam 153514 and the detected speed of the i-profile beam 153514 to determine if the energy for the electric motor 153120 should be increased in order to increase the speed of the beam with profile in i 153514 and / or decreased, in order to decrease the speed of the beam with profile in i 153514.

[000427] The force acting on the beam with i 153514 profile can be determined using various techniques. The strength of the i-beam beam 153514 can be determined by measuring the motor current 153120, where the motor current 153120 is based on the load experienced by the i-beam beam 153514 as it advances distally. The strength of the 153514 i-profile beam can be determined by placing an extensometer on the drive member, on the firing member, on the 153514 i-profile beam, on the firing bar and / or at a proximal end of the cutting edge 153509. The strength of the i-profile beam 153514 can be determined by monitoring the actual position of the i-profile beam 153514 moving at an expected speed based on the current set speed of the 153120 motor after a predetermined elapsed period T1 has elapsed and comparing the actual position of the i-beam beam 153514 in relation to the expected position of the i-beam beam 153514 based on the current adjusted speed of the motor 153120 at the end of the T1 period. Thus, if the actual position of the i-profile beam 153514 is less than the expected position of the i-profile beam 153514, the force on the i-profile beam 153514 is greater than a nominal force. On the other hand, if the actual position of the i-profile beam 153514 is greater than the expected position of the i-profile beam 153514, the force on the i-profile beam 153514 is less than the nominal force. The difference between the actual and expected positions of the beam with i 153514 profile is proportional to the deviation of the force in the beam with i 153514 beam in relation to the nominal force.

[000428] Before turning to a description of closed loop control techniques for the closing tube and firing member, the description briefly turns to Figure 83. Figure 83 is a 153600 graph representing two plots of closure (FTC) 153606, 153608 representing the force applied to a closing member to close on thick and thin tissue during a closing phase and a 153601 graph representing two plots of firing force (FTF) 153622, 153624 representing the force applied to a firing member to fire through thick, thin tissue during a firing phase. Referring to Figure 83, graph 153600 represents an example of the force applied to thick and thin tissue during a closing stroke to close the end actuator 153502 in relation to the tissue trapped between the anvil 153516 and the staple cartridge 153518, where the closing force is plotted as a function of time. Closing force plots 153606, 153608 are plotted on two geometric axes. A vertical geometric axis 153602 indicates the closing force (FTC) of the end actuator 153502 in Newtons (N).

A horizontal geometric axis 153604 indicates time in seconds and is identified as t0 to t13 for the sake of clarity of the description.

The first closing force plot 153606 is an example of the force applied to the thick tissue during a closing stroke to close the end actuator 153502 in relation to the tissue stuck between the anvil 153516 and the staple cartridge 153518 and a second plot 153608 is an example of the force applied to the fine fabric during a closing stroke to close the end actuator 153502 in relation to the tissue trapped between the anvil 153516 and the staple cartridge 153518. The first and second plots of closing force 153606, 153608 are divided into three phases, a closing course (CLOSING), a waiting period (WAITING) and a triggering course (SHOOTING). During the closing stroke, a closing tube is distally translated (direction "DD") to move the anvil 153516, for example, in relation to the staple cartridge 153518 in response to the closing stroke acting by a closing motor.

In other cases, the closing stroke involves the movement of the staple cartridge 153518 in relation to an anvil 153516 in response to the activation of the closing motor, and in other cases, the closing stroke involves the movement of the staple cartridge 153518 and the anvil 153516 in response to the activation of the closing motor.

With reference to the first closing force plot 153606, during the closing stroke, the closing force 153610 increases from 0 to a maximum force F1 from time t0 to t1. With reference to the second closing force graph 153608, during the closing stroke, the closing force 153616 increases from 0 to a maximum force F 3 from time t0 to t1. The relative difference between the maximum forces F1 and F3 is due to the difference in the closing force required for the thick tissue in relation to the thin tissue, where a greater force is required to close the anvil on the thick tissue in relation to the thin tissue.

[000429] The first and second clamping force plots 153606, 153608 indicate that the clamping force on end actuator 153502 increases during an initial hold time period ending in a time (t1). The closing force reaches a maximum force (F1, F3) in time (t1). The initial hold period can be about one second, for example. A waiting period can be applied before starting a trip course. The waiting period allows fluid to escape from the compressed tissue through the end actuator 153502, which reduces the thickness of the compressed tissue by producing a smaller gap between the anvil 153516 and the staple cartridge 153518 and a reduced closing force at the end of the waiting period. With reference to the first closing force plot 153606, there is a nominal drop in closing force 153612 from F1 to F2 during the waiting period between t1 and t4. Similarly, with reference to the second closing force plot 153608, the closing force 153618 nominally falls from F3 to F4 during the waiting period between t1 and t4. In some examples, a waiting period (t1 to t4) selected from a range of about 10 seconds to about 20 seconds is typically used. In the example of the first and second closing force plot 153606, 153608, a time period of about 15 seconds is used. The waiting period is followed by the trigger stroke, which typically lasts for a selected period of time from a range of about 3 seconds, for example, to about 5 seconds, for example. The closing force decreases as the beam with i-profile 153514 is advanced in relation to the end actuator through the firing stroke. As indicated by the closing force 153614, 153620 of the first and second plots of closing force 153606, 153608, respectively, the closing force 153614, 153620 exerted on the closing tube drops precipitously close to time t4 until close to time t5. The time t4 represents the moment when the beam with i-profile 153514 is coupled to the anvil 153516 and begins to assume the closing load. Consequently, the closing force decreases as the firing force increases as shown by the first and second firing force plots 153622, 153624.

[000430] Figure 83 also represents a graph 153601 of the first and second firing force plots 153622, 153624 that plots the applied force to advance the beam with i-profile 153514 during the firing stroke of an instrument or system according to the present description. The plots of the firing force 153622, 153624 are plotted on two geometric axes. A vertical geometric axis 153626 indicates the firing force, in Newtons (N), applied to advance the beam with an i-profile 153514 during the firing stroke. The beam with i-profile 153514 is configured to advance a knife or cutting element and motivate the drivers to implant staples during the firing stroke. A horizontal geometric axis 153605 indicates the time in seconds on the same time scale as the horizontal geometric axis 153604 of the upper graph 153600.

[000431] As previously described, the force of the closing tube drops precipitously from time t4 until close to time t5, which represents the moment when the beam with i-profile 153514 is coupled to anvil 153516 and begins to receive load and the closing force decreases as the firing force increases, as shown by the first and second plots of the firing force 153622, 153624. As the i-profile beam 153514 is advanced from the initial position of the course in the time t4 to the final stroke positions between t8 and t9 for plotting the trigger force 153624 for thin fabric and at t13 for plotting the trigger force 153622 for thick fabric. As the i-beam beam 153514 is distally advanced during the firing stroke, the closing assembly delivers control of the staple cartridge 153518 and the anvil 153516 to the firing assembly, which causes the firing force to increase and the closing force decreases.

[000432] In the firing force plot of the thick tissue 153622, during the firing period (SHOOTING), plot 153622 is divided into three distinct segments. A first segment 153628 indicates the firing force, as it increases from 0 in t4 to a peak force F1 'just before t5. The first segment 153628 is the firing force during the initial phase of the firing stroke in which the i-profile beam 153514 advances distally from the top of the closing ramp until the i-profile beam 153514 comes into contact with the fabric. A second segment 153630 indicates the firing force during a second phase of the firing stroke in which the i-profile beam 153514 is advancing distally by implanting staples and cutting the fabric. During the second phase of the firing stroke, the firing force drops from F1 ’to F2’ around t12. A third segment 153632 indicates the firing force during the third and final phase of the firing stroke in which the beam with i-profile 153514 leaves the fabric and advances to the end of the course in a non-woven zone. During the third phase of the firing stroke, the firing force drops from F2 'to zero (0) close to t13 where the beam with an i-profile 153514 reaches the end of its stroke. In summary, during the firing stroke, the firing force increases dramatically as the i-profile beam 153514 enters a fabric zone, consistently decreases in the fabric zone during the stapling and cutting operation and falls dramatically as that the beam with i-profile 153514 leaves the fabric zone and enters a non-fabric zone at the end of the course.

[000433] The fine tissue firing force plot 153624 follows a similar pattern to the thick tissue firing force plot

153622. Thus, during the first phase of the firing stroke, the firing force 153634 increases dramatically from 0 to F3 'close to t5. During the second phase of the firing stroke, firing force 153636 consistently drops from F3 'to F4' around t8. During the final phase of the firing stroke, firing force 153638 drops dramatically from F’4 to 0 between t8 and t9.

[000434] To overcome the vertiginous drop in the closing force from time t4 until close to time t5, which represents the moment when the beam with i-profile 153514 is coupled to the anvil 153516 and begins to receive load and the closing force decreases as the firing force increases, as shown by the first and second firing force plots 153622, 153624, the closing tube can be distally advanced while the firing member, such as the i-profile beam 153514, advances distally . The closing tube is represented as a transmission element that applies a closing force to the 153516 anvil. As described here, a control circuit applies motor set points to the motor control that applies a motor control signal to the motor to drive the transmission element and advance the closing tube distally to apply a closing force to the 153516 anvil. A torque sensor coupled to an engine output shaft 2504b can be used to measure the force applied to the closing tube. In other respects, the closing force can be measured with an extensometer, load cell or other suitable force sensors.

[000435] Figure 84 is a diagram of a 153950 control system configured to provide progressive closure of a closing member (for example a closing tube) when the firing member (for example the i-profile beam 153514)

advances distally and attaches to a gripping arm (for example anvil 153516) to lower the load of the closing force on the closing member at a desired rate and to decrease the load of the shooting force on the shooting member, according to at least one aspect of this description. In one aspect, the 153950 control system can be implemented as a grouped PID feedback controller. A PID controller is a feedback loop from the control circuit (controller) to continuously calculate an error value such as the difference between a desired setpoint and a measured process variable and apply a correction based on proportional, integral and derived terms (sometimes indicated P, I, and D respectively). The 153950 PID controller feedback feedback system includes a primary controller 153952, on a primary feedback (external) circuit 153954, and a secondary controller 153955, on a secondary feedback (internal) circuit 153956. The primary controller 153952 can be a PID controller 153972, as shown in Figure 84, and the secondary controller 153955 can also be a PID controller 153972 as shown in Figure 85. Primary controller 153952 controls a primary process 153958 and secondary controller 153955 controls a secondary process 153960. Output 153966 of primary process 153958 (OUTPUT) is subtracted from a primary setpoint SP1 by a first adder 153962. The first adder 153962 produces a single sum output signal that is applied to the primary controller 153952. The output of the primary controller 153952 is the secondary setpoint SP2. Output 153968 of secondary process 153960 is subtracted from a secondary setpoint SP2 by a second adder 153964.

[000436] In the context of controlling the displacement of the closing tube, the 153950 control system can be configured so that the primary setpoint SP1 is a desired closing force value and the primary controller 153952 is configured to receive the force of the torque sensor coupled to the output of the closing motor and determine a motor speed from setpoint SP2 to the closing motor. In other respects, the closing force can be measured with strain gauges, load cells, or other suitable force sensors. The SP2 closing motor speed setpoint is compared to the actual closing tube speed, which is determined by the secondary controller 153955. The actual closing tube speed can be measured by comparing the displacement of the closing tube with the position sensor and the measurement of the time elapsed with the timer / counter. Other techniques, such as linear or rotary encoders, can be used to measure the displacement of the closing tube. Output 153968 of secondary process 153960 is the actual speed of the closing tube. This speed output of the closing tube 153968 is provided to the primary processor 153958 which determines the force acting on the closing tube and is fed back to the adder 153962, which subtracts the measured closing force from the primary setpoint SP1. The main setpoint SP1 can be an upper limit or a lower limit. Based on the output of adder 153962, primary controller 153952 controls the speed and direction of the closing tube motor, as described here. The secondary controller 153955 controls the speed of the closing motor based on the actual speed of the closing tube measured by the secondary process 153960 and the secondary setpoint SP2, which is based on a comparison of the upper and lower limits of the firing force with the actual firing force.

[000437] Figure 85 illustrates a PID 153970 feedback control system, in accordance with at least one aspect of this description. Primary controller 153952 or secondary controller 153955, or both, can be implemented as a PID controller 153972. In one aspect, PID controller 153972 can comprise a proportional element 153974 (P), an integral element 153976 (I) and an element of derivative 153978 (D). The outputs of elements P, I and D 153974, 153976, 153978 are added by an adder 153986, which provides the control variable u (t) to the process

153980. Process output 153980 is the process variable y (t). A 153984 adder calculates the difference between a desired setpoint r (t) and a measured process variable y (t). The PID controller 153972 continuously calculates an error value e (t) (for example the difference between the limit of the closing force and the measured closing force) as the difference between a desired setpoint r (t) (for example the closing force limit) and a process variable measured y (t) (eg speed and direction of the closing tube) and applies a correction based on the proportional, integral and derivative terms calculated by the proportional element 153974 (P), by integral element 153976 (I) and derivative element 153978 (D), respectively. The PID controller 153972 tries to minimize the error e (t) over time by adjusting the control variable u (t) (for example, speed and direction of the closing tube).

[000438] According to the PID algorithm, the "P" element 153974 represents the present error values. For example, if the error is large and positive, the control output will also be large and positive. According to the present description, the error term e (t) is the difference between the desired closing force and the measured closing force of the closing tube. The "I" element 153976 represents the values passed from the error. For example, if the current output is not strong enough, the integral of the error will accumulate over time, and the controller will respond by applying a stronger action. The "D" element 153978 represents possible future trends of the error, based on its current rate of change. For example, continuing example P above, when the large positive control output manages to bring the error closer to zero, it also puts the process in a major negative error mode in the near future. In this case, the derivative becomes negative and module D reduces the force of the action to avoid this excess.

[000439] It will be understood that other variables and set points can be monitored and controlled according to the feedback control systems 153950, 153970. For example, the adaptive closing member speed control algorithm described here can mediate at least two of the following parameters: the location of the trigger member, the load of the trigger member, the displacement of the cutting element, the speed of the cutting element, the location of the closing pipe, the loading of the closing pipe , among others.

[000440] Figure 86 is a logic flow diagram representing a 153990 process of a control program or a logical configuration for determining the speed of a closing member, in accordance with at least one aspect of the present description. A control circuit of a surgical instrument or system, according to the present description, is configured to determine 153992 the actual closing force of a closing member. The control circuit compares 153994 the actual closing force to a limit closing force and determines 153996 a setpoint speed for displacing the closing member based on the comparison. The control circuit controls 153998 the actual speed of the closing member based on the setpoint speed.

[000441] Referring now to Figures 84 and 85, in one aspect, the control circuit comprises a 153950 integral and derivative proportional feedback (PID) control system,

153970. The PID feedback loop control system 153950, 153970 comprises a primary PID feedback loop 153954 and a secondary PID feedback loop 153956. The primary feedback loop 153954 determines a first error between the actual closing force of the closing member and a limit closing force SP1 and defines the speed setpoint of the closing member SP2 based on the first error. Secondary feedback loop 153956 determines a second error between the actual speed of the closing member and the setpoint speed of the closing member and sets the speed of the closing member based on the second error.

[000442] In one aspect, the closing force limit SP1 comprises an upper limit and a lower limit. Setpoint SP2 speed is configured to advance the closing member distally when the actual closing force is less than the lower limit and the setpoint speed is configured to retract the closing member proximally when the actual closing force is greater than the lower limit. In one aspect, the setpoint speed is set to hold the closing member in place when the actual closing force is between the upper and lower limits.

[000443] In one aspect, the control system additionally comprises a force sensor (for example, any of the sensors 472, 474, 476 (Figure 12), for example) coupled to the control circuit. The force sensor is configured to measure the closing force. In one aspect, the force sensor comprises a torque sensor coupled to an output drive shaft of a motor coupled to the closing member. In one aspect, the force sensor comprises an extensometer coupled to the closing member. In one aspect, the force sensor comprises a load cell coupled to the closing member. In one aspect, the control system comprises a position sensor coupled to the closing member, the position sensor being configured to measure the position of the closing member.

[000444] In one aspect, the control system comprises a first motor configured to couple with the closing member and the control circuit is configured to advance the closing member during at least a portion of a firing stroke.

[000445] The functions or processes 153990 described in the present invention can be performed by any of the processing circuits described herein. Aspects of the motorized surgical instrument can be practiced without the specific details described here. Some aspects were shown as block diagrams instead of details.

[000446] Parts of this description can be presented in terms of instructions that operate on data stored in a computer's memory. An algorithm refers to a self-consistent sequence of steps that lead to the desired result, where a "step" refers to the manipulation of physical quantities that can take the form of electrical or magnetic signals that can be stored, transferred, combined, compared and handled in any other way. These signs can be called bits, values, elements, symbols, characters, terms, numbers. These terms and similar terms can be associated with the appropriate physical quantities and are merely convenient identifications applied to these quantities.

[000447] In general, the aspects described here, which can be implemented, individually and / or collectively, by a wide range of hardware, software, firmware, or any combination thereof, can be seen as being composed of several types of "electrical circuits". Consequently, the term "electrical circuit" includes electrical circuits that have at least one isolated electrical circuit, electrical circuits that have at least one integrated circuit, electrical circuits that have at least one integrated circuit for a specific application, electrical circuits that form a general-purpose computing configured by a computer program (for example, a general-purpose computer or processor configured by a computer program that at least partially performs processes and / or devices described herein, electrical circuits that form a memory device (for example, forms of random access memory) and / or electrical circuits that form a communications device (for example, a modem, routers or optical-electrical equipment) .These aspects can be implemented in analog or digital form, or combinations thereof .

[000448] The previously mentioned description presented aspects of the devices and / or processes through the use of block diagrams, flowcharts, and / or examples, which may contain one or more functions and / or operation. Each function and / or operation within such block diagrams, flowcharts or examples can be implemented, individually and / or collectively, by a wide range of hardware, software, firmware or virtually any combination thereof. In one aspect, several portions of the subject described here can be implemented using application specific integrated circuits (ASICs), field programmable gate arrays (FPGAs - Field Programmable Gate Arrays), digital signal processors ( DSPs - digital signal processors), programmable logic devices (PLDs -

Programmable Logic Devices), circuits, registers and / or software components, for example programs, subroutines, logic and / or combinations of hardware and software components. Logic gates or other integrated formats. Some aspects described here, in whole or in part, can be implemented in an equivalent way in integrated circuits, such as one or more computer programs running on one or more computers (for example, as one or more programs operating on one or more computer systems). computer), as one or more programs operating on one or more processors (for example, as one or more programs operating on one or more microprocessors), as firmware, or virtually as any combination thereof, and to design the circuitry and / or writing the code for the software and firmware would be within the scope of practice of a person skilled in the art in the light of this description.

[000449] The mechanisms of the subject described can be distributed as a program product in a variety of ways, and an illustrative aspect of the subject described here is applicable regardless of the specific type of signal transmission media used to effectively perform the distribution. Examples of a signal transmission medium include, but are not limited to, the following: recordable type media such as a floppy disk, a hard disk drive, a compact disc (CD), a digital video disc (DVD), a tape digital, computer memory, etc .; and transmission-type media, such as digital and / or analog communication media (for example, a fiber optic cable, a waveguide, a wired communication link, a wireless communication link (for example, transmitter, receiver, transmission logic, reception logic, etc.).

[000450] The previously mentioned description of one or more aspects has been presented for purposes of illustration and description.

This description is not intended to be exhaustive or to limit the invention to the precise form described. Modifications or variations are possible in light of the above teachings. These aspects were chosen and described in order to illustrate the principles and practical application, thus allowing the person skilled in the art to use the various aspects and with various modifications, as they are convenient to the specific use contemplated. It is intended that the claims presented in the annex define the global scope. Situational recognition

[000451] Situational recognition is the ability of some aspects of a surgical system to determine or infer information related to a surgical procedure from data received from databases and / or instruments. The information may include the type of procedure being performed, the type of tissue being operated on or the body cavity that is the object of the procedure. With contextual information related to the surgical procedure, the surgical system can, for example, improve the way in which it controls the modular devices (for example a robotic arm and / or a robotic surgical tool) that are connected to it and provide information or contextualized suggestions to the surgeon during the course of the surgical procedure.

[000452] Now with reference to Figure 87, a timeline 5200 is represented representing the situational recognition of a central controller, such as the central surgical controller 106 or 206, for example. Timeline 5200 is an illustrative surgical procedure and the contextual information that the central surgical controller 106, 206 can derive from data received from data sources at each stage in the surgical procedure. Timeline 5200 represents the typical steps that would be taken by nurses, surgeons, and other medical personnel during the course of a pulmonary segmentectomy procedure, starting with the setup of the operating room and ending with the transfer of the patient to an operating room. postoperative recovery.

[000453] Situational recognition of a central surgical controller 106, 206 receives data from data sources throughout the course of the surgical procedure, including data generated each time medical personnel use a modular device that is paired with the operating room 106 , 206. Central surgical controller 106, 206 can receive this data from paired modular devices and other data sources and continuously derive inferences (ie, contextual information) about the ongoing procedure as new data is received, such as which stage of the procedure. procedure is being performed at any given time. The situational recognition system of the central surgical controller 106, 206 is capable of, for example, recording data related to the procedure to generate reports, checking the steps being taken by medical personnel, providing data or warnings (for example, through a display) that may be relevant to the specific step of the procedure, adjust the modular devices based on the context (for example, activate monitors, adjust the field of view (FOV) of the medical imaging device, or change the energy level of a ultrasonic surgical instrument or RF electrosurgical instrument), and take any other action described above.

[000454] In the first step 5202, in this illustrative procedure, members of the hospital team retrieve the electronic patient record (PEP) from the hospital's PEP database. Based on patient selection data in the PEP, the central surgical controller 106, 206 determines that the procedure to be performed is a thoracic procedure.

[000455] In the second step 5204, the team members scan the incoming medical supplies for the procedure. Central surgical controller 106, 206 cross-references the scanned supplies with a list of supplies that are used in various types of procedures and confirms that the supply mix corresponds to a thoracic procedure. In addition, the central surgical controller 106, 206 is also able to determine that the procedure is not a wedge procedure (because the inlet supplies have an absence of certain supplies that are necessary for a thoracic wedge procedure or, otherwise, that inlet supplies do not correspond to a thoracic wedge procedure).

[000456] In the third step 5206, medical personnel scan the patient's band with a scanner that is communicably connected to the central surgical controller 106, 206. The central surgical controller 106, 206 can then confirm the patient's identity based on the scanned data .

[000457] In the fourth step 5208, the medical staff turns on the auxiliary equipment. The auxiliary equipment being used may vary according to the type of surgical procedure and the techniques to be used by the surgeon, but in this illustrative case they include a smoke evacuator, an insufflator and a medical imaging device. When activated, auxiliary equipment that is modular devices can automatically pair with the central surgical controller 106, 206 which is located within a specific neighborhood of modular devices as part of their initialization process. The central surgical controller 106, 206 can then derive contextual information about the surgical procedure by detecting the types of modular devices that correspond with it during that preoperative or initialization phase. In this particular example, the central surgical controller 106, 206 determines that the surgical procedure is a VATS (video-assisted thoracic surgery) procedure based on this specific combination of paired modular devices. Based on the combination of data from the electronic patient record (PEP), the list of medical supplies to be used in the procedure, and the type of modular devices that connect to the central controller, the central surgical controller 106, 206 can, in general , infer the specific procedure that the surgical team will perform. After the central surgical controller 106, 206 recognizes which specific procedure is being performed, the central surgical controller 106, 206 can then retrieve the steps of that process from a memory or from the cloud and then cross the data it subsequently receives from the connected data sources (for example, modular devices and patient monitoring devices) to infer which stage of the surgical procedure the surgical team is performing.

[000458] In the fifth step 5210, the team members fix the electrocardiogram (ECG) electrodes and other patient monitoring devices on the patient. ECG electrodes and other patient monitoring devices are able to pair with central surgical controller 106, 206. As central surgical controller 106, 206 begins to receive data from patient monitoring devices, central surgical controller 106, 206 thus confirming that the patient is in the operating room.

[000459] In the sixth step 5212, the medical personnel induced anesthesia in the patient. Central surgical controller 106, 206 can infer that the patient is under anesthesia based on data from modular devices and / or patient monitoring devices, including ECG data, blood pressure data, ventilator data, or combinations of themselves, for example. After the completion of the sixth step 5212, the preoperative portion of the lung segmentectomy procedure is completed and the operative portion begins.

[000460] In the seventh step 5214, the lung of the patient being operated on is retracted (while ventilation is switched to the contralateral lung). The central surgical controller 106, 206 can infer from the ventilator data that the patient's lung has been retracted, for example. Central surgical controller 106, 206 can infer that the operative portion of the procedure started when it can compare the detection of the patient's lung collapse at the expected stages of the procedure (which can be accessed or retrieved earlier) and thus determine that the retraction of the patient lung is the first operative step in this specific procedure.

[000461] In the eighth step 5216, the medical imaging device (for example, a display device) is inserted and the video from the medical imaging device is started. Central surgical controller 106, 206 receives data from the medical imaging device (i.e., video or image data) through its connection to the medical imaging device. Upon receipt of data from the medical imaging device, the central surgical controller 106, 206 can determine that the portion of the laparoscopic surgical procedure has started. In addition, the central surgical controller 106, 206 can determine that the specific procedure being performed is a segmentectomy, rather than a lobectomy (note that a wedge procedure has already been discarded by the central surgical controller 106, 206 based on the data received in the second step 5204 of the procedure). The data from the medical imaging device 124 (Figure 2) can be used to determine contextual information about the type of procedure being performed in a number of different ways,

including by determining the angle at which the medical imaging device is oriented in relation to visualizing the patient's anatomy, monitoring the number or medical imaging devices being used (ie, which are activated and paired with the operating room 106, 206 ), and monitor the types of display devices used. For example, a technique for performing a VATS lobectomy places the camera in the lower anterior corner of the patient's chest cavity above the diaphragm, while a technique for performing a VATS segmentectomy places the camera in an anterior intercostal position in relation to the segment fissure. With the use of standard recognition or machine learning techniques, for example, the situational recognition system can be trained to recognize the positioning of the medical imaging device according to the visualization of the patient's anatomy. As another example, a technique for performing a VATS lobectomy uses a single medical imaging device, while another technique for performing a VATS segmentectomy uses multiple cameras. As yet another example, a technique for performing a VATS segmentectomy uses an infrared light source (which can be communicated to the central surgical controller as part of the visualization system) to visualize the segment crack, which is not used in a lobectomy VATS. By tracking any or all of these data from the medical imaging device, the central surgical controller 106, 206 can thus determine the specific type of surgical procedure being performed and / or the technique being used for a specific type of procedure surgical.

[000462] In the ninth step 5218 of the procedure, the surgical team starts the dissection step. Central surgical controller 106, 206 can infer that the surgeon is in the process of dissecting to mobilize the patient's lung because he receives data from the RF or ultrasonic generator that indicate that an energy instrument is being fired. The central surgical controller 106, 206 can cross-check the received data with the steps retrieved from the surgical procedure to determine that an energy instrument being fired at that point in the process (that is, after the completion of the previously discussed steps of the procedure) corresponds to the step of dissection. In certain cases, the energy instrument may be a power tool mounted on a robotic arm in a robotic surgical system.

[000463] In the tenth step 5220 of the procedure, the surgical team proceeds to the connection step. Central surgical controller 106, 206 can infer that the surgeon is ligating the arteries and veins because he receives data from the surgical stapling and cutting instrument indicating that the instrument is being fired. Similar to the previous step, the central surgical controller 106, 206 can derive this inference by crossing the reception data of the stapling and surgical cutting instrument with the steps recovered in the process. In certain cases, the surgical instrument can be a surgical tool mounted on a robotic arm of a robotic surgical system.

[000464] In the eleventh step 5222, the segmentectomy portion of the procedure is performed. Central surgical controller 106, 206 can infer that the surgeon is transecting the parenchyma based on data from the surgical stapling and cutting instrument, including data from its cartridge. The cartridge data can correspond to the size or type of clamp being triggered by the instrument, for example. As different types of staples are used for different types of fabrics, the cartridge data can thus indicate the type of fabric being stapled and / or transected. In this case, the type of clamp that is fired is used for the parenchyma (or other similar types of tissue), which allows the central surgical controller 106, 206 to infer which segmentectomy portion of the procedure is being performed.

[000465] In the twelfth step 5224, the node dissection step is then performed. The central surgical controller 106, 206 can infer that the surgical team is dissecting the node and performing a leak test based on the data received from the generator that indicates which ultrasonic or RF instrument is being fired. For this specific procedure, an RF or ultrasonic instrument being used after the parenchyma has been transected corresponds to the node dissection step, which allows the central surgical controller 106, 206 to make this inference. It should be noted that surgeons regularly switch between surgical stapling / cutting instruments and surgical energy instruments (that is, RF or ultrasonic) depending on the specific step in the procedure because different instruments are better suited for specific tasks. Therefore, the specific sequence in which the cutting / stapling instruments and surgical energy instruments are used can indicate which stage of the procedure the surgeon is performing. In addition, in certain cases, robotic tools can be used for one or more steps in a surgical procedure and / or Hand held surgical instruments can be used for one or more steps in the surgical procedure. The surgeon can switch between robotic tools and hand-held surgical instruments and / or can use the devices simultaneously, for example. After the completion of the twelfth stage 5224, the incisions are closed and the post-operative portion of the process begins.

[000466] In the thirteenth stage 5226, the patient's anesthesia is reversed. The central surgical controller 106, 206 can infer that the patient is emerging from anesthesia based on ventilator data (i.e., the patient's respiratory rate begins to increase), for example.

[000467] Finally, in the fourteenth step 5228 is that medical personnel remove the various patient monitoring devices from the patient. Central surgical controller 106, 206 can thus infer that the patient is being transferred to a recovery room when the central controller loses ECG, blood pressure and other data from patient monitoring devices. As can be seen from the description of this illustrative procedure, the central surgical controller 106, 206 can determine or infer when each step of a given surgical procedure is taking place according to the data received from the various data sources that are communicably coupled to the controller central surgery 106, 206.

[000468] Situational recognition is further described in U.S. Patent Application No. 15 / 940,654, entitled SURGICAL HUB SITUATIONAL AWARENESS, filed on March 29, 2018, which is hereby incorporated by reference in its entirety. In certain cases, the operation of a robotic surgical system, including the various robotic surgical systems described here, for example, can be controlled by the central controller 106, 206 based on its situational recognition and / or feedback from its components and / or based on information from cloud 104. Surgical instrument cartridge sensor assemblies Cartridge sensor assemblies

[000469] Typical sensor sets used in surgical instruments are only able to passively detect tissue and physical environmental conditions, which can limit the amount, type and details of the data they are able to detect. Aspects of this description provide a solution, the cartridges for use with surgical instruments include active sensors that can be used to dynamically assess tissue by stimulating or disturbing tissue during the course of a surgical procedure and then detecting the corresponding response in the tissue. By applying a stimulus to the tissue through an active sensor incorporated into the cartridge, the surgical instrument can detect additional or different information than could have been detected using passive sensors.

[000470] Figure 88 illustrates a perspective view of a staple cartridge 27000 that includes an active sensor 27006, in accordance with at least one aspect of the present description. The staple cartridge 27000 can be received inside an end actuator 150300 of a surgical instrument 150010, like the surgical instrument 150010 described in relation to Figure 25. In one aspect, the staple cartridge 27006 includes an active sensor 27006, which, in turn, it includes an active element 27002 and a sensor 27004. The active sensor 27006 is configured to actively disturb or stimulate its environment, through the active element 27002, and then measure the corresponding environmental response, through the 27004 sensor. The sensor Active 27006 differs from passive sensors, which are configured to passively measure your environment.

[000471] The active element 27002 is configured to provide a stimulus for a tissue attached by the end actuator 150300 into which the 27000 staple cartridge is inserted (ie, a tissue positioned or attached between the 27008 cartridge platform and the anvil 150306 of the end actuator 150300). The 27004 sensor is configured to detect a tissue parameter associated with the disturbance or stimulus applied to the tissue and thus determine the change in the tissue parameter resulting from the stimulus. In one aspect, the active element 27002 and the sensor 27004 are incorporated together or otherwise associated with each other to form an active sensor 27006 as a single integral unit. In another aspect, the active element 27002 and the sensor 27004 are positioned separately from each other or in the cartridge or otherwise dissociated from each other to form an active sensor 27006 as a distributed unit.

[000472] Figure 89 illustrates a block diagram of a 27010 circuit, in accordance with at least one aspect of the present description. In one aspect, the 27000 cartridge includes a 27010 circuit, which includes an active element 27002, a sensor 27004, a control circuit 27012 that is communicatively connected to each of the active element 27002 and the sensor 27004, and a power source 27014 which is connected to the control circuit 27012 to supply power to it. The 27010 circuit and / or the 27012 control circuit may include, for example, wired circuits, programmable circuits, state machine circuits, firmware that stores instructions executed by programmable circuits and any combination thereof. In one aspect, control circuit 27012 can be configured to activate active element 27002, cause active element 27002 to discharge or provide stimulus to tissue trapped by the end actuator, or otherwise to control the state of the element active

27002. The control circuit 27014 can be configured to activate the 27004 sensor, receive data or an electrical signal indicative of a tissue property from the 27004 sensor, or otherwise control the 27004 sensor. In several respects, one or both between the active element 27002 and the sensor 27004 can be exposed or positioned on the 27008 cartridge 27000 platform to come into contact with a fabric positioned against the 27008 cartridge platform, as shown in Figure 88. In one aspect, the circuit 27010 shown in Figure 89 can be incorporated as a flexible circuit. In one aspect, circuit 27010 is a circuit separate from a cartridge circuit and / or a channel circuit, such as the cartridge circuit and the channel circuit described in US Patent Application No. 15 / 636,096, filed on 28 June 2017, entitled SURGICAL SYSTEM

COUPLABLE WITH STAPLE CARTRIDGE AND RADIO FREQUENCY CARTRIDGE, AND METHOD OF USING SAME, which is hereby incorporated by reference in its entirety. In such aspects, circuit 27010 may or may not be communicably coupled to the cartridge circuit and / or channel circuit. In another aspect, the 27010 circuit is integrated with the cartridge circuit and / or channel circuit.

[000473] In one aspect, the active element 27002 comprises a heating element and the sensor 27004 comprises a temperature sensor (for example a temperature measurement matrix). In this regard, the active element 27002 is configured to provide a stimulus (disturbance) in the form of heat or thermal energy to a tissue attached by the end actuator 150300 and / or positioned against the 27008 cartridge platform. In addition, the 27004 sensor is configured to detect the physiological response of the tissue to which the thermal energy of the active element 27002 is applied. The 27012 control circuit can therefore be configured to evaluate the tissue's physiological response using data and / or signals received from the 27004 sensor.

[000474] In one aspect, the active element 27002 is configured to apply thermal energy to a predetermined or situated area of tissue attached by the end actuator 150300 and / or positioned against the 27008 cartridge platform. For example, the heating element may comprise a heat sink (for example, constructed from aluminum and / or copper) that is configured to convert electrical energy (for example, from the 27014 power source) into heat to apply thermal energy to a predetermined or situated area. adjacent fabric or located in the heat sink. In another aspect, the active element 27002 is configured to apply thermal energy across the entire surface of the 27008 cartridge platform or a larger portion of it. For example, the heating element may comprise a flexible heating grid embedded in one or more of the layers of the cartridge circuit. In such aspects, the heating grid can be configured to enable all or a large portion of the 27000 cartridge to emit thermal energy. Alternatively or additionally, the heating grid can be configured so that several regions of the heating grid can be activated to produce thermal energy. In this example, the heating grid can also be used to apply thermal energy to localized or predefined heating areas with a specified amount of thermal energy output to apply to a fabric.

[000475] The application of thermal energy to a tissue can be used to derive a variety of physiological information related to the tissue. For example, the rate at which a fabric's temperature rises is a function of its water content. Consequently, the application of thermal energy to a fabric can be used to determine the total water content of the fabric by detecting the rate at which the temperature of the fabric increases in response to the applied thermal energy. The water content of a fabric, in turn, corresponds, for example, to the type of fabric. In addition, the application of thermal energy to different portions of a fabric can be used to determine the location (or locations) of fabric with high or low water content by comparing the rates at which the temperatures of the different portions of the fabric increase in response applied thermal energy.

[000476] In one aspect, the active element 27002 comprises a pressure application element and the sensor 27004 comprises a tissue compression sensor. The pressure-applied element can include, for example, a magnetic or electroactive polymer which, when energized, is configured to deform in shape and thus apply local pressure to a specific area of tissue located against it. The pressure application element can be arranged on, for example, the cartridge platform 27008 so that the pressure application element comes into contact and applies pressure to a fabric located against it. The tissue compression sensor can include, for example, an impedance sensor configured to measure a tissue impedance. As the tissue impedance can match the thickness of the tissue (i.e., tissue compression), monitoring the time rate change of the tissue impedance can be used to monitor the change in the viscoelastic properties of the tissue over time in response to the pressure stimulus. Such viscoelastic properties of the fabric can include, for example, tissue creep and stability. The tissue compression sensor can also include, for example, a force sensor (for example a load cell or force sensitive resistor) configured to detect a force or pressure exerted on the fabric or a span sensor (for example a Hall effect sensor) configured to detect the gap or distance between the claws (for example the anvil 150306 and / or the channel 150302 of the surgical instrument 150010 shown in Figure 25) of the end actuator 150300, which, in turn, corresponds the degree to which a tissue trapped by the 150300 end actuator is being compressed.

[000477] Magnetic or electroactive polymers can be configured to deform in a predetermined manner according to the way in which they are manufactured. In one aspect, the control circuit 27012 can be configured to receive measurements from the 27004 sensor in relation to tissue compression while the added pressure is applied to determine accelerated tissue creep aspects. In one aspect, the control circuit 27012 can be configured to receive measurements from the 27004 sensor related to tissue pressure after the added pressure is relieved to assess the tissue recovery characteristics of the tissue.

[000478] Applying pressure to a tissue can be used to derive a variety of physiological information related to the tissue. For example, the viscoelastic properties shown by a fabric correspond to its type of fabric. In other words, different types of fabric each show consistent viscoelastic properties. Consequently, applying pressure to a fabric can be used to determine the viscoelastic properties of a fabric by detecting the rate at which the fabric compresses, the rate at which the fabric returns to its previous shape when pressure is removed and others viscoelastic properties. Additional details regarding the monitoring of the viscoelastic properties of the tissue can be found under the heading "Surgical Instrument Hardware" and in U.S. Patent Publication No. 2016/0256156, filed September 14, 2015, entitled TIME

DEPENDENT EVALUATION OF SENSOR DATA TO DETERMINE STABILITY, CREEP, AND VISCOELASTIC ELEMENTS OF MEASURES, which is hereby incorporated by reference in its entirety.

[000479] Figure 90 illustrates a logic flow diagram of a 27050 process for determining a type of tissue. In the following description of process 27050, reference should also be made to Figure

89. The illustrated process can be performed, for example, by a 27012 control circuit. Consequently, the 27012 control circuit that executes the 27050 process makes the active element

27002 apply 27052 a stimulus to a tissue trapped in the end actuator 150300 or the same. The stimulus may include, for example, heat or pressure. Consequently, control circuit 27012 detects 27054 a change in the property of the tissue detected by the sensor 27004, with the property of the tissue detected by the sensor 27004 corresponding to the stimulus given to the tissue by the active element 27002. The tissue property detected by the sensor 27004 include, for example, the temperature of the fabric or the viscoelastic properties of the fabric. Consequently, control circuit 27012 determines 27056 the tissue type of the trapped tissue by characterizing the resulting change in the detected property of the tissue in response to the application of the stimulus. The type of tissue may include, for example, the type of physiological tissue (for example lung tissue or stomach tissue) or the type of tissue that shows specific tissue characteristics (for example, a tissue that has a specific water content).

[000480] In aspects where the cartridge is a flexible circuit, the flexible circuit may include reinforced sections for fixing sensors, integrated circuits and other electronic components. In one aspect, the control circuit can be arranged on a rigid substrate having positive attachment points on the molded cartridge. In another aspect, the control circuits or integrated circuits could be arranged on a reinforced semi-rigid section of the flexible circuit, where the circuit is designed to be attached to the cartridge (for example, through adhesion to be disposed between the layers of the cartridge or between the end actuator channel and the cartridge). In another aspect, distal portions of the flexible circuit could include sensors 27004 or detection matrices for use with 27012 control circuits (which may or may not be equally placed on reinforced or semi-rigid sections of the circuit).

[000481] Figure 91 is a perspective view of a 27100 cartridge that includes hydrophobic areas 27102, in accordance with at least one aspect of the present description. In one aspect, a cartridge (for example a stapling cartridge or an RF energy cartridge) can include hydrophobic areas 27102 arranged on the 27104 cartridge platform. Hydrophobic areas 27102 can be configured to exclude contact from the liquid, unless that a direct pressure from a fabric is forced to come into contact with the hydrophobic areas 27102. The hydrophobic areas 27102 may include, for example, regions constructed from one or more hydrophobic materials that are arranged along the cartridge platform

27104. In addition, it should be noted that although the 27200 cartridge is represented as a staple cartridge, the 27200 cartridge also includes RF cartridges and any other such cartridges.

[000482] In one aspect, the location of the hydrophobic area (or areas) 27102 may be positioned adjacent to, positioned around, or otherwise correspond to the locations of the various cartridge sensors. For example, a cartridge 27100 may include hydrophobic areas 27102 that correspond to the locations of a first electrode disposed on the end actuator 150300 that is configured to receive an RF signal from a corresponding second electrode, as in the aspects discussed in relation to Figures 36 to 43. As the positions of the hydrophobic areas 27102 correspond to the positions of the electrodes illustrated in Figures 36 to 38 (that is, the RF electrodes 151038, 151048 and / or the electrical contacts 151040, 151044, 151050, 151052), hydrophobic areas 27102 thus avoid contact of the liquid against the electrodes, unless a tissue is directly forced into contact with them. As the electrodes use the liquid to transmit the RF signal, the control circuit attached to the electrodes, such as the 151250 circuit (Figure 40), is configured to measure only the pressurized areas of the tissue.

[000483] In another aspect, the hydrophobic areas 27012 arranged on or otherwise integrated with RF or other energy cartridges that are configured to conduct fluids out of a tissue in order to cut and / or clot the tissue. In this respect, the cartridge sensors can be positioned over, within or adjacent to the hydrophobic regions 27102. In aspects where the cartridge sensors include impedance sensors configured to detect tissue impedance, the hydrophobic regions 27102 can make the sensors impedance more likely to detect resistive aspects of the tissue as it merges, as opposed to detecting the fluid being conducted from the tissue.

[000484] In one aspect, cartridge flexible circuits and / or flexible end actuator circuits can include graphic overlays (e.g. printed images or icons) positioned on or in various locations on the 27100 cartridge and / or the 150300 end actuator Graphical overlays could be positioned to indicate, for example, where detection occurs in the flexible circuit or where the fabric must be located in relation to the flexible circuit to be detected.

[000485] In one aspect, cartridge flexible circuits and / or end actuator flexible circuits may include floating flexible circuit detection arrays that are configured to allow sensors to be in contact with the fabric during the movement of the fabric in the 27100 cartridge, rather than the fabric moving relative to the detection matrix. Floating flexible circuit arrays can include, for example, a floating or movable layer that is configured to move relative to a fixed layer to maintain contact with the fabric. The floating layer and the fixed layer can be electrically connected so that the movement of the floating layer does not interrupt the electrical connection with the fixed layer. Additional details related to the floating circuit detection matrices can be found under the heading "Surgical Instrument Hardware".

[000486] In one aspect, the cartridge circuit may include an impedance circuit that is configured to apply a non-therapeutic level of electrical energy to the tissue (i.e., a degree of electrical energy that has little or no therapeutic effect) and then proportionally detect tissue compression, as discussed in relation to Figures 36 to 43. The cartridge circuit and / or a surgical instrument control circuit can be configured to monitor the force to close (FTC) the end actuator and correlating the FTC to the impedance changes in the tissue to determine the tissue configuration, tissue type and / or tissue characteristics. The fabric configuration, fabric type and / or fabric characteristics can then be used to determine the appropriate limits for force to fire (FTF), advance speed and / or creep rate to indicate stability.

[000487] The techniques described above increase the amount and details of data that are detectable by the sensor sets of the surgical instrument and improve the ability of the surgical instrument to differentiate between tissue types based on the tissue responses to the applied stimulus. Cartridge identification and status detection

[000488] Surgical instrument cartridges may have multiple and / or duplicating means for storing or retransmitting data (i.e., data elements) associated with the cartridge. The data associated with the cartridge can include, for example, the type of cartridge, the characteristics of the cartridge and whether the cartridge was previously fired. Data redundancy is beneficial to avoid total data loss if there is an error with one of the data elements or one of the data elements is destroyed. However, if one of the data elements stores data incorrectly, fails to store data, or has an error in transmitting the data, then an unsolvable conflict between the data elements can be created. When the surgical instrument or another system attempts to recover data from the cartridge, the data conflict can cause errors in the surgical instrument or another system to recover the data. The aspects of the present description have a solution, and the surgical instruments are configured to resolve conflicts between the data storage elements, prioritizing one of the data elements in relation to the other data elements. In this way, the prioritized data element will replace the other data elements, avoiding conflicts in an attempt to select the cartridge data suitable for use by the control circuit of the surgical instrument or other system.

[000489] Figure 92 is a perspective view of a 27200 cartridge that includes a pair of data elements, in accordance with at least one aspect of the present description. In one aspect, data elements include features, characteristics and / or devices that are associated with the 27200 cartridge and are capable of storing, representing and / or relaying data associated with the cartridge. The data elements can include, for example, a data storage element 27202 that is configured to store data related to the cartridge and a representative data resource 27204 that is configured to represent data related to the cartridge. In some respects, data that can be broadly characterized as automatic identification and data capture technologies (AIDC). Although the cartridge shown in Figure 92 includes two data elements, in alternative aspects, the cartridge can include one or more of two data elements in various combinations of data storage elements and representative data features of the cartridge. In addition, it should be noted that although the 27200 cartridge is represented as a staple cartridge, the 27200 cartridge also includes RF cartridges and any other such cartridges.

[000490] In several respects, the representative data resource 27204 can include, for example, a physical or visually identifiable resource or structure that is associated with or disposed of the 27200 cartridge. In such an aspect, the representative data resource 27204 can include the material with which the cartridge body 27205 is constructed and / or the thickness of the cartridge body 27205. The material and / or the thickness of the cartridge body 27205 can be different for the various types of cartridge to create switched resistance bands for each type of cartridge, which can then be detected by a sensor 27224 (Figure 93) associated with the end actuator 150300 of the surgical instrument 150302. The sensor 27224 to detect the material and / or the cartridge body thickness 27205 can be arranged in the channel 150302 of the end actuator 150300, for example. In such aspects, the 150300 end actuator could be electrically isolated.

[000491] In another such aspect, the representative data resource 27204 can include a layer of material or a structure arranged on the 27206 cartridge platform (for example, at the proximal end of the 27206 cartridge platform) that is configured to influence the phase initial grip strength. For example, in Figure 92, the representative data feature 27204 includes a structure that generally extends orthogonally from the proximal end of the 27206 cartridge platform so that the anvil 150306 of the end actuator 150300 contacts the structure as it is that the anvil 150306 closed by gripping. The force, as the anvil 150306 comes into contact with the representative data resource 27204, can then be detected by a control circuit 27222 (Figure 93) through, for example, a current sensor 786 (Figure 18) that detects the motor current (which corresponds to the force exerted by the anvil 150306 as the anvil 150306 is closed by actuation by the motor 754). The material and / or geometry of the resource (or resources) representative of data 27204 disposed on the 27206 cartridge platform can be customized for each of the various types of cartridge to produce different detectable responses in the force to close (FTC) the anvil 150306 A control circuit 27222 coupled to a sensor capable of detecting the representative data resource 27204 can, in this way, determine the type of cartridge according to the degree or level of the maximum FTC, the characteristics of the FTC response (for example, the shape of the FTC curve plotted in relation to time, as represented in several graphs described under the heading "Surgical Instrument Hardware", as in Figure 83) and other such characteristics of the FTC detected over time. For example, a first type of cartridge can include a representative data resource 27204 that is constructed from a rigid material and a second type of cartridge can include a representative data resource 27204 that is constructed from a flexible material. Depending on the type of FTC response detected by control circuit 27222, control circuit 27222 can thus determine whether anvil 150306 is in contact with a flexible or rigid structure, since anvil 150306 is closed and, thus, determine whether the 27200 cartridge is the first type of cartridge or the second type of cartridge, respectively.

[000492] In several aspects, the data storage element 27202 can, for example, be associated with or disposed of the 27200 cartridge and be configured to transmit data stored by the data storage element 27202 through a wired connection or without thread. In one aspect, the data storage element 27202 comprises an RFID microtransponder or RFID integrated circuit that includes a digital signature. In yet another such aspect, the data storage elements comprise a battery-assisted passive RFID tag. A battery-assisted passive RFD tag can show improved bandwidth and signal compared to RFID microtransponders and / or RFID integrated circuits. In this regard, the RFID tag can include a writable section that could be used to store data associated with the 27200 cartridge, as if the 27200 cartridge was fired. The data can be written to the recordable section 27200 of the cartridge by means of a circuit, such as a control circuit of the 27200 cartridge or the surgical instrument. The recordable section could then subsequently be read by a sensor on the surgical instrument, so that the surgical instrument can determine, for example, that the 27200 cartridge should not be fired again.

[000493] In aspects where the data storage element 27202 includes an RFID tag that uses ultra-high frequencies and higher frequencies, the RFID tag can have more than one radio wavelength away from the reader (sensor ) of the surgical instrument. Therefore, simply transmitting the RF signal may not be enough to communicate the data from the RFID tag. In these respects, the RFID tag can be configured to perform backscattering of a signal. Active RFID tags can contain transmitters and receivers that are functionally separate, and RFID tags do not need to respond at a frequency related to the reader's interrogation signal.

[000494] In another aspect, the data storage element 27202 can include a wire integrated circuit configured to store identification data. The data storage element 27202 can be configured to transmit or provide the stored identification data to the surgical instrument, after the 27200 cartridge is inserted into the end actuator or in response to receiving a query from the surgical instrument. In such aspects, the integrated circuit of a wire may include a writable section that could be used to store data associated with the 27200 cartridge, as if the 27200 cartridge was fired. In another of these aspects, the data storage elements comprise an integrated circuit (IC) that performs a specific communication protocol, such as an I-Square-C (ie, I-two-C), SPI, or another bus multi-master, multislave, package-switched, single-ended, serial computer. Several additional details related to wired electrical connections between the 27200 cartridge and the surgical instrument can be found in U.S. Patent Application No. 15 / 636,096, filed June 28, 2017, entitled

SURGICAL SYSTEM COUPLABLE WITH STAPLE CARTRIDGE AND RADIO FREQUENCY CARTRIDGE, AND METHOD OF USING SAME, which is hereby incorporated by reference in its entirety.

[000495] Although Figure 92 represents a cartridge 27200 that includes a single representative data resource 27204 and a single data storage element 27202, it should be noted that different aspects of the cartridge 27200 may include various combinations of the aforementioned data elements. In other words, various aspects of the 27200 cartridge can include combinations of multiple representative data resources 27204, multiple data storage elements 27202, different types of data storage elements 27202 and / or representative data resources 27204, and so on. .

[000496] The data storage element 27202 can store or represent a variety of data related to the 27200 cartridge, including, for example, data that identifies the type of cartridge and data that identifies characteristics of the cartridge (for example the size of the cartridge) . In one aspect, the data storage element 27202 can be configured to store an Electronic Product Code (EPC). In aspects where the data storage element is an RFID tag, the EPC can be recorded on the tag by an RFID printer and can contain, for example, a 96-bit data string. The data string can include, for example, a header (for example, eight bits) that identifies the protocol version; an organization number (for example, 28 bits) that identifies the organization that manages the data for this tag (which can be assigned by the EPC Global consortium); an object class (for example, 24 bits) that identifies the type of product; and a unique serial number (for example, 36 bits) for a specific tag. The object class and unique serial number fields can be defined by the organization that issued the tag. Similar to a URL, the EPC number can be used as a key in a global database to uniquely identify a specific product.

[000497] Figure 93 illustrates a block diagram of a 27220 sensor assembly for detecting and / or receiving data from data elements associated with a 27200 cartridge, in accordance with at least one aspect of the present description. In the following description of the 27220 sensor assembly, reference should also be made to Figure 92. The 27220 sensor assembly may be included or communicably coupled to a surgical instrument that is configured to receive a 27200 cartridge. In one aspect, the sensor 27220 includes a control circuit 27222 communicably connected to a sensor 27224 configured to detect a representative data resource 27204 representing cartridge data and an I / O interface 27228 that is configured to receive data from a data storage element 27202 which stores cartridge data.

In one aspect, the sensor assembly 27220 may be a component of a circuit, or be integrated with it, arranged in channel 150302 (Figure 25) of end actuator 150300, such as the channel circuit described in US Patent Application no. 15 / 636,096. In another aspect, the sensor assembly 27220 may be distinct or separate from the channel circuit, such as the channel circuit described in U.S. Patent Application No. 15 / 636,096. The control circuit 27222 is additionally connected to a power source to extract energy from it.

The 27224 sensor can include any type of sensor that is capable of identifying a specific physical or visual resource that identifies the 27200 cartridge. In one aspect, the 27224 sensor can include a current sensor (for example, current sensor 786 discussed together with Figures 18 and 19) that is configured to detect the current drained by the 754 motor (Figure 18) during at least the initial or gripping portion of the trigger member travel, thus allowing the 27222 control circuit to determine the FTC and thus, determine if the anvil 150306 of the end actuator 150300 is encountering a physical feature arranged on the cartridge 27200 that identifies the type of cartridge, as described above.

In another aspect, the sensor 27224 may include an optical sensor (for example sensor 152408 discussed in conjunction with Figures 73 and 74) configured to detect an icon, a color, a barcode or other mark or series of markings arranged about the 27200 cartridge that identify the type of cartridge.

In one aspect, the I / O interface 27228 may include bus wires (for example, electrical cartridge and channel contacts described in US Patent Application No. 15 / 636,096) configured to electrically connect to a storage element. data 27202 which stores data to receive data stored therein using a wired communication protocol (for example, I-square-C). In another aspect, the 27228 I / O interface can include a wireless transmitter configured to wirelessly connect to a 27202 data storage element that stores data to receive data stored on it using a wireless communication protocol (for example, Bluetooth).

[000498] Other aspects of the 27220 sensor assembly may include various combinations of 27224 sensors configured to detect representative data resources 27204 and I / O interfaces 27228 configured to receive data from 27202 data storage elements associated with a 2700 cartridge, including multiple 27224 sensors (of the same or different types), multiple 27228 I / O interfaces (of the same or different types), no 27228 I / O interface, no 27224 sensor and all combinations thereof. The specific combination of sensors 27224 and / or I / O interfaces 27228 included in sensor assembly 27220 to detect data associated with cartridge 27200 corresponds to the combination of data elements used by cartridge 27200 to store cartridge data.

[000499] Figure 94 illustrates a logic flow diagram of a 27300 process for resolving data identification conflicts, in accordance with at least one aspect of the present description. In the following description of process 27300, reference should also be made to Figures 92 and 93. The illustrated process 27300 can be performed, for example, by the control circuit 27222 of the sensor set 27220 shown in Figure 93.

[000500] Consequently, the control circuit 27222 that executes the illustrated process 27300 determines 27302, 27304 the cartridge data (that is, data that identifies the 27200 cartridge and / or data related to the characteristics of the 27200 cartridge) associated with a first element data and a second data element. In aspects where the first data element is a representative data resource, as in Figure 92, the control circuit 27222 determines the 27302 data of the cartridge by detecting the presence and identity of the representative data resource 27204 through a 27224 sensor, as described above, and then retrieve the appropriate cartridge data corresponding to the identified data representative resource 27204. The cartridge data can be retrieved from, for example, a look-up table. In aspects where the second data element is a data storage element 27202, as in Figure 92, the control circuit 27222 determines the cartridge data by receiving the stored cartridge data from the data storage element 27202.

[000501] Consequently, the control circuit 27222 determines 27306 whether the cartridge data from the two sources (that is, the first data element and the second data element) correspond to each other. If the data from the two sources corresponds to each other, then process 27300 continues along the SIM branch and control circuit 27222 selects one of the two corresponding data and proceeds accordingly. If the data from the two sources does not correspond to each other, then process 27300 continues along the NO branch and the 27222 control circuit determines which of the two data elements has a higher priority and consequently selects the 27310 cartridge data from the highest priority data storage element.

The prioritization between different types of data elements can be programmed by the manufacturer or defined by a user, for example. The selected data can, for example, be stored in a 264 memory (Figure 16) of the surgical instrument for subsequent use, used in a control algorithm to control one or more operations of the surgical instrument, or otherwise used by a circuit control of the surgical instrument.

[000502] The techniques described above allow data redundancy in the cartridges without creating unresolvable processing conflicts. Variable output cartridge sensor assembly Backward compatible sensor assembly

[000503] As new versions of surgical instruments and their associated modular components (for example, stapler cartridges) are developed, older versions of surgical instruments may become incompatible with newer versions of modular components due to additional features or alternatives that are incorporated into the modular components, the sensor architecture of the modular components being changed and other such updates that are being developed for the modular components. Therefore, the release of an updated modular component that is no longer compatible with the previous version (or versions) of the associated surgical instrument can reduce the effective life of the surgical instrument, even if the surgical instrument is otherwise fully functioning. Aspects of the present description provide a solution, the modular components of which can include sensors configured to emit data in two or more different modes or formats. A first output format of the sensors can be compatible with current versions of the surgical instrument, while a second output format of the sensors can be compatible with previous versions of the surgical instrument (that is, the second output format can mimic the output format of a previous version of the modular device). Modular components can be further configured to determine whether they are connected to an outdated or updated version of the surgical instrument and then have their sensors output data in a format that is compatible with the version of the surgical instrument.

[000504] Figure 95 illustrates a block diagram of a 28000 circuit that includes a variable output sensor 28004, in accordance with at least one aspect of the present description. In one aspect, circuit 28000 includes a control circuit 28002 that is communicably coupled to a sensor 28004. In one aspect, sensor 28004 can be configured to output data in a first mode 28006a or in a second mode 28006b. Circuit 28000 additionally includes a power source 28008 connected to control circuit 28002 to supply power to it. In one aspect, when the 28004 sensor is in the first 28006a output mode, the sensor data feed emitted by the 28004 sensor is configured for use by the current version of a surgical instrument, such as a 150010 surgical instrument described in connection with Figure 25 In one aspect, when sensor 28004 is in second output mode 28006b, the sensor data feed from sensor 28004 is configured for use by an older or earlier version of a surgical instrument. In many respects, the sensor data feed of the first 28006a output mode can, for example, provide more complete data, more bulky data or data that is in an updated or alternative format suitable for use with the current version of the surgical instrument in question. compared to the sensor data feed of the second output mode

28006b. In several respects, the sensor data feed of the second output mode 28006b can, for example, provide data that is in a simpler format or different from the sensor data feed of the first output mode 28006a. In several respects, the sensor data feed of the first output mode 28006a may be incompatible with an older version of the surgical instrument and / or the sensor data feed of the second output mode 28006b may be incompatible with a current version or latest version of the surgical instrument.

[000505] In one aspect, circuit 28000 can be included with a 150304 cartridge (Figure 25), such as a stapler cartridge or an RF cartridge, which is configured to be received by a 150300 end actuator (Figure 25) a 150010 surgical instrument (Figure 25). Circuit 28000 and / or control circuit 28002 can be communicated to control circuit 760 (Figures 18 and 19) of surgical instrument 150010 after cartridge 150304 is inserted into end actuator 15300 or otherwise connected to the surgical instrument 150010. In one aspect, circuit 28000 and / or control circuit 28002 of cartridge 150304 can be connected communicatively to control circuit 760 of surgical instrument 150010 through corresponding electrical contacts that connect the cartridge 150304 and the surgical instrument 150010 after the cartridge 150304 is received inside the end actuator 150300, as described in US Patent Application No. 15 / 636,096, filed on June 28, 2017, entitled SURGICAL SYSTEM COUPLABLE WITH STAPLE CARTRIDGE AND RADIO FREQUENCY CARTRIDGE, AND METHOD OF USING SAME, which is incorporated herein by reference in its entirety.

[000506] In one aspect, the 28004 sensor can comprise a matrix of magnesium resistance and impedance that is configured to provide better accuracy in measuring the magnetic field that is detected, as well as some data related to contact with the tissue, in comparison with a Hall effect sensor. In this example, the sensor 28004 comprises a first output mode 28006a which can emit the magnitude resistance and impedance data feeds to provide an intelligent span detection metric. The magnetoresistance and impedance data feeds of the first 28006a output mode of the 28004 sensor could, for example, be combined with the use of an algorithm (for example, performed by the control circuit 28002 of the 150304 cartridge) as an output signal. The sensor 28004 can additionally comprise a second output mode 28006b which can output a signal equivalent to a Hall effect sensor output. However, when the 28000 circuit of the modular component (for example a 150304 cartridge) comprising the 28004 sensor detects that it is being used with an older generation surgical instrument, the 28000 circuit can be configured to make the 28004 sensor calculate and output the sensor data feed of the second 28006b output mode, which mimics the output of a Hall effect sensor for the measurement of the gap being detected. In this way, the 28000 circuit can enable the 28004 sensor to also be compatible with older generation surgical instruments that are programmed to receive a data feed and / or a signal from a Hall effect sensor.

[000507] In another aspect, the 28004 sensor can comprise a smaller Hall effect sensor or another type of proximity sensor that is configured to replace a position or limit switch. Similar to what was described above, when the 28000 circuit of the modular component (for example, a 150304 cartridge) detects that it is being used with an older generation surgical instrument, the 28000 circuit can be configured to make the 28004 sensor calculate and issue a sensor data feed that mimics the output of a simulated key lock, thus enabling the 28004 sensor to also be compatible with older generation surgical instruments that are programmed to receive a data and / or signal feed from a position or limit switch.

[000508] Figure 96 illustrates a logic diagram of a 28050 process for controlling an output mode of a 28004 sensor, in accordance with at least one aspect of the present description. In the following description of the 28050 process, reference should also be made to Figure

95. The illustrated process 28050 can be performed, for example, by the control circuit 28002. The sensor 28004 controlled by the 28050 process can be included with a modular component intended to be connected or otherwise associated with a 150010 surgical instrument, like a stapler cartridge.

[000509] Consequently, the control circuit 28002 that performs the illustrated process 28050 determines 28052 whether the version of the modular component matches, or is otherwise compatible with, the version of the surgical instrument 150010. The control circuit 28002 can determine whether the modular device and the 150010 surgical instrument are compatible, for example, when retrieving a version number, EPC, or other identifier from the 150010 surgical instrument (for example, when the modular device is connected to the surgical instrument), and then , retrieve a lookup table (for example, stored in a modular component memory) that lists versions of the 150010 surgical instrument that are compatible with the modular component. If the modular component and the 150010 surgical instrument are compatible, then the process

28050 continues along the SIM branch and the 280002 control circuit causes the 28004 sensor to output data in a first 28006a data mode. If the modular component and the 150010 surgical instrument are not compatible, then the 28050 process continues along the NO branch and the 28002 control circuit causes the 28004 sensor to output data in a second 28006b data mode.

[000510] In one aspect, the sensor data stream emitted by the 28004 sensor when the 28004 sensor is in the first 28006a output mode can only be incompatible with older versions of surgical instruments when the data moves outside certain tolerances or limits. In this regard, control circuit 28002 can be configured to cause sensor 28004 to output data in the second output mode 28006b only when the sensor data stream moves outside the acceptable limits for the older version of the surgical instrument.

[000511] The techniques described above allow outdated versions of surgical instruments to use newer or current versions of modular components without losing any functionality and provide surgical instruments with a longer effective life without forcing users to upgrade to newer versions of instruments when new versions of the corresponding modular components are released. Circuit manufacturing

[000512] In one aspect, all circuits (for example, flexible circuits) for modular components (for example, cartridges) are manufactured with all the sensor technology used by the various types and versions of the modular components. Once manufactured, laser trimming techniques can then be used to enable / disable sensors and features, as well as calibrate the sensors.

[000513] In one aspect, circuits are manufactured using etching and selective deposition techniques for non-conductive coatings, including, for example, non-conductive metal oxide coatings, as described in US Patent No. 5,942,333, filed on 27 March 1995, entitled NON-CONDUCTIVE COATINGS FOR UNDERWATER CONNECTOR BACKSHELLS, which is hereby incorporated by reference; polyurethane and other polymer coatings; and ceramic coatings sprayed with plasma.

[000514] In one aspect, circuits are manufactured using conductive 3D printing trajectory techniques for cartridges and other modular components. Such techniques may include, for example, dissolvable 3D printing channels that can be impregnated with conductive epoxy or vapor deposition or with the use of graphene.

[000515] In one aspect, circuits are manufactured by laser countersink openings in the circuit that have a known or predetermined dimension. For example, laser countersink could create through holes or partial deep holes that penetrate only one of more layers in the circuit. As another example, laser countersinking could create several small openings in the circuit surface to allow only certain amounts of fluid or certain size particles to permeate the surface. Circuits manufactured in this way can be useful for the various sensor or detection arrangements described here. Detection of internal instrument parameters

[000516] In one aspect, the surgical instrument 150010 and / or a system communicably coupled to the surgical instrument 150010 (for example, a central surgical controller 106 with which the surgical instrument 150010 is paired, as described above in relation to Figures 1 to 11) can be configured to detect internal parameters of the 150010 surgical instrument. The internal parameters detected by the 150010 surgical instrument can be used to better understand how the instrument is operating to adjust parameters during operation. For example, the 150010 surgical instrument can be configured to detect the closing actuation (for example, the motor current and FTC), the triggering actuation (for example, the motor current and FTF), the joint (for example, the angular position of the end actuator), the rotation of the drive shaft or end actuator, the closed loop actuating strokes of the drive components and the local loading of drive components (resulting in the ability to run the drive system load control without taking into account clearance and tolerances). Device feedback display capabilities

[000517] The surgical instruments described here, like the surgical instruments described under the title "Surgical Instrument Hardware", can be additionally configured to detect and show specific tissue data, such as margin perimeter, adhesions, tissue fragility, perfusion level and vascularization.

[000518] In one aspect, a 150010 surgical instrument (Figure 25) can be configured to show collateral contact of the claws with anatomy and tissues around the perimeter of the device. In other words, the surgical instrument can be configured to show the position of the claws or provide feedback when the claws make inadvertent contact with the tissue surrounding the intended operating site. Various aspects of the surgical instrument can be configured to detect collateral tissue contact, and tissue contact more generally, through piezoelectric sensors, thin conductive films, impedance sensors and / or photoacoustic sensors,

as will be discussed in more detail below.

[000519] In one aspect, a surgical instrument can be configured to assess the viability of the insured tissue using one or more sensors. Figure D10 illustrates an end actuator 28100 comprising a first sensor 28102 and a second sensor 28104, in accordance with at least one aspect of the present description. The 28100 end actuator may include one or more sensors 28102, 28104 configured to detect pCO2, blood flow and / or pathology of a tissue trapped by the end actuator 3000, such as optical sensors, piezoacoustic sensors, impedance sensors and / or photoacoustic sensors . Additional details related to several such sensors and sensor assemblies can be found under the heading "Surgical Instrument Hardware."

[000520] In one aspect, a surgical instrument is configured to assess ventilation or the pCO2 content of the insured tissue through, for example, capnography. In this respect, the surgical instrument includes an infrared (IR) emitting source (for example, an LED), such as the 28106 light sources represented in Figure 98, and a sensor (photodetector), such as one or more among the 28102 sensors, 28104 represented in Figure 97, which receives the IR light transmitted through the insured tissue to measure the absorbance of the IR light in the tissue. The degree of absorbance of the IV light indicates the proportion of CO2 that is present in the tissue (more absorbance equals more CO2). In one aspect, the IR light source can be arranged on the anvil 28108 and the photodetector can be arranged on the cartridge 28110. In another aspect, the IR light source can be arranged on the 28110 cartridge and the photodetector can be arranged on the anvil 28108 (as shown in Figures 97 and 98).

[000521] In one aspect, a surgical instrument is configured to assess the perfusion or blood flow in the held tissue through,

for example, pulse oximetry. In this regard, the surgical instrument includes one or more light sources, for example an LED, which are configured to emit light of two different wavelengths, such as, for example, IR and red. Such light sources can be, for example, the light sources 28106 shown in Figure 98. In several cases, the surgical instrument additionally includes a sensor, for example a photosensor, as one or more of the sensors 28102, 28104 shown in Figure 97 , which receives the light transmitted through the insured tissue to measure the absorbance of the light in the tissue. As the two wavelengths of light, for example red and IV, are passed through the tissue, the change in absorbance of both wavelengths correlates with the oxygen saturation in the tissue. This is due to the fact that oxygenated hemoglobin absorbs more IR light and deoxygenated hemoglobin absorbs more red light. In one aspect, the surgical instrument can use a reflexive pulse oximetry technique to measure oxygen saturation, for example, light sources 28106 are placed on anvil 28108 and sensors are placed on anvil 28108 or on the cartridge 28110. In such cases where the sensors 28102, 28104 are disposed on the anvil 28108, a reflective cartridge can be used. In several cases, the reflective cartridge comprises a 28110 cartridge that has a layer or reflective material disposed on the 28112 cartridge platform. In another aspect, the surgical instrument may use a transmission pulse oximetry technique, for For example, light sources 28106 are arranged on anvil 28108 and sensors 28102, 28104 are arranged on the cartridge

28110. These aspects provide the ability to detect local oxygen saturation, such as whether the tissue is losing oxygen and can indicate whether the tissue is being over-compressed. In several cases, these aspects can be used to help identify the ideal compression force for staple firing if the staple firing is capable of occurring in unfixed fabric spans and / or provides triggering / non-proceeding data on the trigger.

[000522] In one aspect, a surgical instrument is configured to assess the perfusion of blood flow in the insured tissue through, for example, general photoplethysmography. In this regard, the surgical instrument includes one or more light sources, such as an LED, which are configured to emit light, such as the light sources 28106 shown in Figure 98. In several cases, the surgical instrument additionally includes a sensor, such as a photodetector. Such sensors may include, for example, the one or more of the sensors 28102, 28104 shown in Figure 97. The sensors 28102, 28104 can be configured to receive light transmitted through the fabric held by the light sources 28106 to measure the absorbance of the light on the fabric. As light is transmitted through the tissue by the 28106 light sources, the pulsating blood in the tissue will cause a change in the amount or degree of light absorbed, which can then be detected by the sensor (or sensors) 28102, 28104. The frequency waveform of the received light correlates to the pulse and the amplitude correlates to the pulse pressure. In one aspect, the surgical instrument can use a reflexive photoplethysmography technique to measure blood flow, with, for example, light sources 28106 being arranged on the anvil 28108 and sensors 28102, 28104 are placed on the anvil 28108 or on cartridge 28110. In cases where sensors 28102, 28104 are placed on anvil 28108, a reflective cartridge can be used. The reflective cartridge may comprise a 28110 cartridge having a layer or reflective material disposed on the 28112 cartridge platform. In another aspect, the surgical instrument may use a transmission photoplethysmography technique, with, for example, light sources 28106 are placed on the anvil 28108 and the sensors 28102, 28104 are placed on the cartridge 28110. These aspects provide local perfusion detection, as if blood is flowing through a main vessel, before performing a staple firing course. , and can indicate whether the tissue is being undercompressed. In addition, these aspects can provide continuity / non-continuity data on the trip.

[000523] In one aspect, a surgical instrument is configured to assess tissue pathology or the location of the insured tissue using, for example, piezoacoustic sensors or a thin film coating. The surgical instrument may include piezoacoustic sensors, such as one or more of the sensors 28102, 28104 shown in Figure 97, or a thin film coating (for example, of a conductive material) that is disposed, for example, on the cartridge

28110. An example of a thin film coating may include, for example, a conductive material. Piezoacoustic sensors and thin film coating are configured to measure changes in tissue properties to determine the content / characteristics and / or pathology of the tissue prior to a staple firing course. The use of a conductive material to assess tissue conditions is discussed in more detail under the heading "Surgical Instrument Hardware", as in connection with Figures 66 and 67, for example. Piezoacoustic sensors and / or thin film coating can be used to measure and / or distinguish between calcifications and non-calcifications in the tissue, plates and non-plates in the tissue and / or fibrous and non-fibrous tissue.

[000524] In one aspect, a surgical instrument is configured to assess tissue pathology or the location of the insured tissue using, for example, electrical impedance sensors. The surgical instrument can include impedance sensors, such as one or more of the sensors 28102, 28104 shown in Figure 97. In one aspect, the impedance sensors can be located in a different location or different locations along the anvil 28108 and / or the cartridge 28110. In this respect, impedance sensors can be used to determine whether there is tissue positioned at or against that location (or locations) other than the anvil 28108 and / or cartridge 28110. In another aspect, the impedance sensors may be located in multiple locations along the length of the anvil 28108 and / or the cartridge

28110. In this respect, impedance sensors can be used to determine the presence of tissue at any of the points along the anvil 28108 and / or the cartridge 28110. In one aspect, the multiple locations of the impedance sensors can each , understand a region of isolation and conduction. More details about impedance sensors can be found under the heading "Surgical Instrument Hardware", as in connection with Figures 36 to 43, for example.

[000525] In one aspect, a surgical instrument is configured to assess tissue pathology and / or the location of the insured tissue using, for example, photoacoustic sensors and / or a thin film coating. The surgical instrument may include photoacoustic sensors, such as one or more of the sensors 28102, 28104 shown in Figure 97, or a thin film coating that is disposed, for example, on the 28110 cartridge. The thin film coating may include, for example, example, a conductive material. The surgical instrument may include an optical laser system based on an adjustable parametric oscillator with a broadband ultrasound detector. In this regard, the surgical instrument may include fiber optics to transmit light. The handle unit may include a control and / or analysis unit attached to it or integral with it. Photoacoustic sensors and thin film coating are configured to measure changes in tissue properties resulting from the parametric oscillator to determine tissue characteristics and / or pathology before a staple firing stroke. The use of a conductive material to assess tissue conditions is discussed in more detail under the heading "Surgical Instrument Hardware", as in connection with Figures 66 and 67, for example. Photoacoustic sensors or thin film coating can be used to measure and / or distinguish between calcifications and non-calcifications in the tissue, plaques and non-plaques in the tissue and / or fibrous and non-fibrous tissue.

[000526] In several examples, in addition to detection of proximity to cancerous tissue, an end actuator of the present description can also be configured to target specific types of cancer in specific tissues. As indicated in the publication of the journal by Altenberg B and Greulich KO, Genomics 84 (2004) pgs. 1.014 to 1.020, which is incorporated by reference in its entirety, certain cancers are characterized by an overexpression of glycolysis genes, while other cancers are not characterized by an overexpression of glycolysis genes. Consequently, an end actuator of the present description can be equipped with an array of sensors with a high specificity for cancerous tissue characterized by an overexpression of glycolysis genes such as lung cancer or liver cancer.

[000527] In several respects, the sensor readings from a sensor array, according to the present description, are communicated by the surgical instrument to a central surgical controller (for example central surgical controller 106, 206) for further analysis and / or for situational recognition. Examples

[000528] Various aspects of the subject described in this document are defined in the following numbered examples:

[000529] Example 1. A modular component is used with a surgical instrument. The modular component comprises a sensor; and a control circuit coupled to the sensor. The control circuit is configured to: determine whether a version of the modular component corresponds to a version of the surgical instrument in the event that the modular component is coupled to the surgical instrument; and causing the sensor to emit the data detected by the sensor in one of a first output mode or a second output mode according to the possibility that the version of the modular component corresponds to the version of the surgical instrument; the data from the first output mode being compatible with a first version of the surgical instrument and the data from the second output mode being compatible with a second version of the surgical instrument.

[000530] Example 2. The modular component of Example 1, the modular component comprising a staple cartridge.

[000531] Example 3. The modular component of Example 1 or 2, the first version comprising a current version of the surgical instrument and the second version comprising an earlier version of the surgical instrument.

[000532] Example 4. The modular component of any one of Examples 1 to 3, being that: the first output mode corresponds to a magnetoresistance and impedance data feed; and the second output mode corresponds to a Hall effect data feed.

[000533] Example 5. The modular component of any of Examples 1 to 3, where: the first output mode corresponds to a Hall effect data feed; and the second output mode corresponds to a limit switch data feed.

[000534] Example 6. A modular component for use with a surgical instrument, the modular component comprising: a sensor; and a control circuit coupled to the sensor. The control circuit is configured to: receive data from the sensor; determine whether a modular component version matches a surgical instrument version in the event that the modular component is coupled to the surgical instrument; and converting the data output from a first format to a second format according to the possibility that the modular component version corresponds to the surgical instrument version; the first format is compatible with a first version of the surgical instrument and the second format is compatible with a second version of the surgical instrument.

[000535] Example 7. The modular component of Example 6, the modular component comprising a staple cartridge.

[000536] Example 8. The modular component of Example 6 or 7, the first version comprising a current version of the surgical instrument and the second version comprising an earlier version of the surgical instrument.

[000537] Example 9. The modular component of any one of Examples 6 to 8, being that: the first format corresponds to a magnetoresistance and impedance data feed; and the second format corresponds to a Hall effect data feed.

[000538] Example 10. The modular component of any of Examples 6 to 8, where: the first format corresponds to a Hall effect data feed; and the second format corresponds to a limit key data feed.

[000539] Example 11. A surgical system comprises a surgical instrument; and a modular component connectable to the surgical instrument, the modular component comprising:

a sensor; and a control circuit coupled to the sensor. The control circuit is configured to: determine whether a version of the modular component corresponds to a version of the surgical instrument in the event that the modular component is coupled to the surgical instrument; and causing the sensor to emit the data detected by the sensor in one of a first output mode or a second output mode according to the possibility that the version of the modular component corresponds to the version of the surgical instrument; the data from the first output mode being compatible with a first version of the surgical instrument and the data from the second output mode being compatible with a second version of the surgical instrument.

[000540] Example 12. The surgical system of Example 11, the modular component comprising a staple cartridge.

[000541] Example 13. The surgical system of Example 11 or 12, the first version comprising a current version of the surgical instrument and the second version comprising an earlier version of the surgical instrument.

[000542] Example 14. The surgical system of any of Examples 11 to 13, being that: the first output mode corresponds to a magnitude resistance and impedance data feed; and the second output mode corresponds to a Hall effect data feed.

[000543] Example 15. The surgical system of any of Examples 11 to 13, where: the first output mode corresponds to a Hall effect data feed; and the second output mode corresponds to a limit switch data feed.

[000544] Example 16. The surgical system of any of Examples 11 to 15, the surgical instrument comprising a surgical stapler.

[000545] The previous detailed description presented various forms of devices and / or processes through the use of block diagrams, flowcharts and / or examples. Although these block diagrams, flowcharts and / or examples contain one or more functions and / or operations, it will be understood by those skilled in the art that each function and / or operation within these block diagrams, flowcharts and / or examples can be implemented, individually and / or collectively, through a wide range of hardware, software, firmware or virtually any combination thereof. Those skilled in the art will recognize, however, that some aspects of the aspects described here, in whole or in part, can be implemented in an equivalent manner in integrated circuits, such as one or more computer programs running on one or more computers (for example, as one or more programs running on one or more computer systems), as one or more programs running on one or more processors (for example, as one or more programs running on one or more microprocessors), as firmware, or virtually as any combination of them, and that designing the circuitry and / or writing the code for the software and firmware would be within the scope of practice of those skilled in the art, in the light of this description. In addition, those skilled in the art will understand that the mechanisms of the subject described herein can be distributed as one or more program products in a variety of ways and that an illustrative form of the subject described here is applicable regardless of the specific type of transmission medium. signals used to effectively carry out the distribution.

[000546] The instructions used to program the logic to execute various aspects described can be stored in a memory in the system, such as dynamic random access memory (DRAM), cache, flash memory or other storage. In addition, instructions can be distributed over a network or through other computer-readable media. Thus, machine-readable media can include any mechanism to store or transmit information in a machine-readable form (for example, a computer), but is not limited to, floppy disks, optical discs, read-only compact disc ( CD-ROMs), and optical discs- dynamo discs, read-only memory (ROM), random access memory (RAM), erasable programmable read-only memory (EPROM), electrically erasable programmable read-only memory (EEPROM), cards magnetic or optical, flash memory, or machine-readable tangible storage media used to transmit information over the Internet via an electrical, optical, acoustic cable or other forms of propagation signals (for example, carrier waves, infrared signal, digital signals, etc.). Consequently, computer-readable non-transitory media includes any type of machine-readable media suitable for storing or transmitting instructions or electronic information in a machine-readable form (for example, a computer).

[000547] As used in any aspect of the present invention, the term "control circuit" can refer to, for example, a set of wired circuits, programmable circuits (for example, a computer processor comprising one or more cores individual instruction processing units, processing unit, processor, microcontroller, microcontroller unit, controller, digital signal processor (DSP), programmable logic device (PLD), programmable logic matrix (PLA), or field programmable port arrangement ( FPGA)), state machine circuits, firmware that stores instructions executed by the programmable circuit, and any combination thereof. The control circuit can, collectively or individually, be incorporated as an electrical circuit that is part of a larger system, for example, an integrated circuit (IC), an application-specific integrated circuit (ASIC), an on-chip system (SoC ), desktop computers, laptop computers, tablet computers, servers, smart headsets, etc. Consequently, as used in the present invention, "control circuit" includes, but is not limited to, electrical circuits that have at least one discrete electrical circuit, electrical circuits that have at least one integrated circuit, electrical circuits that have at least one circuit integrated for specific application, electrical circuits that form a general purpose computing device configured by a computer program (for example, a general purpose computer configured by a computer program that at least partially executes processes and / or devices described herein, or a microprocessor configured by a computer program that at least partially performs the processes and / or devices described here), electrical circuits that form a memory device (for example, forms of random access memory), and / or electrical circuits that form a communications device (for example, a modem, communication key, or eq optical-electrical equipment). Those skilled in the art will recognize that the subject described here can be implemented in an analog or digital way, or in some combination of these.

[000548] As used in any aspect of the present invention, the term "logic" can refer to an application, software, firmware and / or circuit configured to perform any of the aforementioned operations. The software may be incorporated as a software package, code, instructions, instruction sets and / or data recorded on the computer-readable non-transitory storage media. The firmware can be embedded as code, instructions or instruction sets and / or data that are hard-coded (for example, non-volatile) in memory devices.

[000549] As used in any aspect of the present invention, the terms "component", "system", "module" and the like may refer to a computer-related entity, be it hardware, a combination of hardware and software, software or software running.

[000550] As used here in one aspect of the present invention, an "algorithm" refers to the self-consistent sequence of steps that lead to the desired result, where a "step" refers to the manipulation of physical quantities and / or logical states that can, although they do not necessarily need to, take the form of electrical or magnetic signals that can be stored, transferred, combined, compared and manipulated in any other way. It is common use to call these signs bits, values, elements, symbols, characters, terms, numbers or the like. These terms and similar terms may be associated with the appropriate physical quantities and are merely convenient identifications applied to these quantities and / or states.

[000551] A network can include a packet switched network. Communication devices may be able to communicate with each other using a selected packet switched network communications protocol. An exemplary communications protocol may include an Ethernet communications protocol that may be able to allow communication using a transmission control protocol / Internet protocol (TCP / IP). The Ethernet protocol can conform to or be compatible with the Ethernet standard published by the Institute of Electrical and Electronics Engineers (IEEE) entitled "IEEE 802.3 Standard", published in December 2008 and / or later versions of this standard. Alternatively or in addition, communication devices may be able to communicate with each other using an X.25 communications protocol. The X.25 communications protocol can conform or be compatible with a standard promulgated by the International Telecommunication Union-Telecommunication Standardization Sector (ITU-T). Alternatively or in addition, communication devices may be able to communicate with each other using a frame-relay communications protocol. The frame-relay communications protocol can conform to or be compatible with a standard promulgated by the Consultative Committee for International Telegraph and Telephone (CCITT) and / or the American National Standards Institute (ANSI). Alternatively or additionally, transceivers may be able to communicate with each other using an ATM communication protocol ("asynchronous transfer mode"). The ATM communication protocol can conform to or be compatible with an ATM standard published by the ATM forum entitled "ATM-MPLS Network Interworking 2.0" published in August 2001, and / or later versions of that standard. Obviously, different and / or post-developed connection-oriented network communication protocols are also contemplated in the present invention.

[000552] Unless otherwise stated, as is evident from the preceding description, it is understood that, throughout the preceding description, discussions that use terms such as "processing", or "computation", or "calculation", or " determination ", or" display ", or similar, refers to the action and processes of a computer system, or similar electronic computing device, that manipulates and transforms data represented in the form of physical (electronic) quantities in records and data computer system memories in other data similarly represented in the form of physical quantities in the memories or records of the computer system, or other similar information storage, transmission or display devices.

[000553] One or more components in the present invention may be called "configured for", "configurable for", "operable / operational for", "adapted / adaptable for", "capable of", "conformable / conformed for", etc. Those skilled in the art will recognize that "configured for" may, in general, cover components in an active state and / or components in an inactive state and / or components in a standby state, except when the context determines otherwise.

[000554] The terms "proximal" and "distal" are used in the present invention with reference to a physician who handles the handle portion of the surgical instrument. The term "proximal" refers to the portion closest to the doctor, and the term "distal" refers to the portion located opposite the doctor. It will also be understood that, for the sake of convenience and clarity, spatial terms such as "vertical", "horizontal", "up" and "down" can be used in the present invention with respect to the drawings. However, surgical instruments can be used in many orientations and positions, and these terms are not intended to be limiting and / or absolute.

[000555] Persons skilled in the art will recognize that, in general, the terms used here, and especially in the appended claims (for example, bodies of the appended claims) are generally intended as "open" terms (for example, the term "including" should be interpreted as "including, but not limited to", the term "having" should be interpreted as "having, at least", the term "includes" should be interpreted as "includes, but is not limited to ", etc.). It will also be understood by those skilled in the art that, when a specific number of a claim statement entered is intended, that intention will be expressly mentioned in the claim and, in the absence of such mention, no intention will be present. For example, as an aid to understanding, the following appended claims may contain the use of the introductory phrases "at least one" and "one or more" to introduce claim statements. However, the use of such phrases should not be interpreted as implying that the introduction of a claim statement by the indefinite articles "one, ones" or "one, ones" limits any specific claim containing the mention of the claim entered to claims that contain only such a mention, even when the same claim includes the introductory phrases "one or more" or "at least one" and indefinite articles, such as "one, ones" or "one, ones" (for example, "one, ones" and / or "one, ones" should typically be interpreted as meaning "at least one" or "one or more"); the same goes for the use of defined articles used to introduce claims.

[000556] The terms "understands" (and any form of understands, such as "understands" and "that understands"), "has" (and any form of has, such as "has" and "that has"), "includes" (and any form of includes, such as "includes" and "which includes") and "contains" (and any form of contains, such as "contains" and "which contains") are unrestricted linking verbs. As a result, a surgical system, device or apparatus that "comprises", "has", "includes" or "contains" one or more elements has those one or more elements, but is not limited to having only those one or more elements. Likewise, an element of a surgical system, device or apparatus that "comprises", "has", "includes" or "contains" one or more resources has those one or more resources, but is not limited to having only those one or more features.

[000557] Furthermore, even if a specific number of an introduced claim statement is explicitly mentioned, those skilled in the art will recognize that that statement must typically be interpreted as meaning at least the number mentioned (for example, the mere mention of "two mentions ", without other modifiers, typically means at least two mentions, or two or more mentions). In addition, in cases where a convention analogous to "at least one of A, B and C, etc." is used, in general this construction is intended to have the meaning in which the convention would be understood by (for example, "a system that has 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 cases where a convention analogous to "at least one of A, B or C, etc." is used, in general this construction is intended to have the meaning in which the convention would be understood by (for example, "a system that have 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.). It will be further understood by those skilled in the art that typically a disjunctive word and / or phrase presenting two or more alternative terms, whether in the description, in the claims or in the drawings, should be understood as contemplating the possibility of including one of the terms, any of the terms or both terms, except where the context dictates something different. For example, the phrase "A or B" will typically be understood to include the possibilities of "A" or "B" or "A and B".

[000558] With respect to the attached claims, those skilled in the art will understand that the operations mentioned in them can, in general, be performed in any order. In addition, although several operational flow diagrams are presented in one or more sequences, it must be understood that the various operations can be performed in other orders than those shown, or can be performed simultaneously. Examples of such alternative orderings may include overlapping, merged, interrupted, reordered, incremental, preparatory, supplementary, simultaneous, inverse or other variant orders, unless the context otherwise requires. In addition, terms such as "responsive to", "related to" or other adjectival participles are not intended in general to exclude these variants, unless the context otherwise requires.

[000559] It is worth noting that any reference to "one (1) aspect", "one aspect", "an exemplification" or "one (1) exemplification", and the like means that a particular feature, structure or feature described in connection with the aspect is included in at least one aspect. Thus, the use of expressions such as "in one (1) aspect", "in one aspect", "in an exemplification", "in one (1) exemplification", in several places throughout this specification does not necessarily refer the same aspect. In addition, specific resources, structures or characteristics can be combined in any appropriate way in one or more aspects.

[000560] Any patent application, patent, non-patent publication or other description material mentioned in this specification and / or mentioned in any order data sheet is hereby incorporated by reference, to the extent that the materials incorporated are not inconsistent with that. Accordingly, and to the extent necessary, the description as explicitly presented herein replaces any conflicting material incorporated by reference to the present invention. Any material, or portion thereof, which is incorporated herein by reference, but which conflicts with the definitions, statements, or other description materials contained herein, will be incorporated here only to the extent that there is no conflict between the embedded material and the existing description material.

[000561] In short, numerous benefits have been described that result from the use of the concepts described in this document. The previously mentioned description of one or more modalities has been presented for purposes of illustration and description. This description is not intended to be exhaustive or to limit the invention to the precise form described. Modifications or variations are possible in light of the above teachings. The one or more modalities were chosen and described in order to illustrate the principles and practical application to, thus, allow those skilled in the art to use the various modalities and with various modifications, as they are convenient to the specific use contemplated. It is intended that the claims presented in the annex define the global scope.

Claims (16)

1. Modular component for use with a surgical instrument, characterized by comprising: a sensor; and a control circuit coupled to the sensor, the control circuit being configured to: determine whether a version of the modular component corresponds to a version of the surgical instrument in the event that the modular component is coupled to the surgical instrument; and causing the sensor to emit the data detected by the sensor in one of a first output mode or a second output mode according to the possibility that the version of the modular component corresponds to the version of the surgical instrument; wherein data from the first output mode is compatible with a first version of the surgical instrument and data from the second output mode is compatible with a second version of the surgical instrument. Modular component according to claim 1, characterized in that it comprises a staple cartridge. 3. Modular component, according to claim 1, characterized in that the first version comprises a current version of the surgical instrument and the second version comprises a previous version of the surgical instrument. 4. Modular component, according to claim 1, characterized by: the first output mode corresponds to a magnetoresistance and impedance data feed; and the second output mode corresponds to a Hall effect data feed. 5. Modular component, according to claim 1, characterized by: the first output mode corresponds to a Hall effect data feed; and the second output mode corresponds to a limit switch data feed. 6. Modular component for use with a surgical instrument, characterized by comprising: a sensor; and a control circuit coupled to the sensor, the control circuit being configured to: receive data output from the sensor; determine whether a modular component version matches a surgical instrument version in the event that the modular component is coupled to the surgical instrument; and converting the data output from a first format to a second format according to the possibility that the modular component version corresponds to the surgical instrument version; wherein the first format is compatible with a first version of the surgical instrument and the second format is compatible with a second version of the surgical instrument. Modular component according to claim 6, characterized in that it comprises a staple cartridge. 8. Modular component according to claim 6, characterized in that the first version comprises a current version of the surgical instrument and the second version comprises a previous version of the surgical instrument. Modular component, according to claim 6, characterized in that: the first format corresponds to a magnitude resistance and impedance data feed; and the second format corresponds to a Hall effect data feed. Modular component, according to claim 6, characterized in that: the first format corresponds to a Hall effect data feed; and the second format corresponds to a limit key data feed. 11. Surgical system, characterized by comprising: a surgical instrument; and a modular component connectable to the surgical instrument, the modular component comprising: a sensor; and a control circuit coupled to the sensor, the control circuit being configured to: determine whether a version of the modular component corresponds to a version of the surgical instrument in the event that the modular component is coupled to the surgical instrument; and causing the sensor to emit the data detected by the sensor in one of a first output mode or a second output mode according to the possibility that the version of the modular component corresponds to the version of the surgical instrument; wherein data from the first output mode is compatible with a first version of the surgical instrument and data from the second output mode is compatible with a second version of the surgical instrument. Surgical system according to claim 11, characterized in that the modular component comprises a staple cartridge. 13. Surgical system according to claim 11, characterized in that the first version comprises a current version of the surgical instrument and the second version comprises a previous version of the surgical instrument. 14. Surgical system, according to claim 11, characterized by: the first output mode corresponds to a magnetoresistance and impedance data feed; and the second output mode corresponds to a Hall effect data feed. Surgical system according to claim 11, characterized in that: the first output mode corresponds to a Hall effect data feed; and the second output mode corresponds to a limit switch data feed. 16. Surgical system according to claim 11, characterized in that the surgical instrument comprises a surgical stapler.