CN111526818B - Situation awareness for electrosurgical systems - Google Patents

Abstract

The invention discloses a surgical instrument. The surgical instrument includes an end effector (131000) that includes an ultrasonic blade (131004) and a clamp arm (131002). The clamping arm is movable relative to the ultrasonic blade to transition the end effector between an open configuration and a closed configuration through different stages of closure to clamp tissue between the ultrasonic blade and the clamping arm. The surgical instrument further includes a transducer configured to generate an ultrasonic energy output, a waveguide configured to transmit the ultrasonic energy output to the ultrasonic blade, and a sensor configured to transmit a sensor signal indicative of the closing phase of the end effector. The surgical instrument further includes control circuitry configured to receive the sensor signals and select an operating mode from among operating modes delivering different ultrasonic energy outputs from the transducer based on the received sensor signals.

Description

Translated fromChinese

电外科系统的态势感知Situational Awareness of Electrosurgical Systems

相关申请的交叉引用CROSS-REFERENCE TO RELATED APPLICATIONS

本专利申请按照美国法典第35卷第119条(e)款的规定要求2018年8月23日提交的标题为根据组织位置控制超声外科器械(CONTROLLING AN ULTRASONIC SURGICALINSTRUMENT ACCORDING TO TISSUE LOCATION)的美国临时专利申请62/721,995的优先权，该临时专利的公开内容全文以引用方式并入本文。This patent application claims priority under Section 119(e) of Title 35 of the United States Code to U.S. Provisional Patent Application No. 62/721,995, filed on August 23, 2018, entitled CONTROLLING AN ULTRASONIC SURGICALINSTRUMENT ACCORDING TO TISSUE LOCATION, the disclosure of which is incorporated herein by reference in its entirety.

本专利申请按照美国法典第35卷第119条(e)款的规定要求2018年8月23日提交的标题为电外科系统的态势感知(SITUATIONAL AWARENESS OF ELECTROSURGICAL SYSTEMS)美国临时专利申请62/721,998的优先权，该临时专利申请全文以引用方式并入本文中。This patent application claims priority under 35 U.S.C. 119(e) to U.S. Provisional Patent Application No. 62/721,998, filed on August 23, 2018, entitled SITUATIONAL AWARENESS OF ELECTROSURGICAL SYSTEMS, which is incorporated herein by reference in its entirety.

本专利申请按照美国法典第35卷第119条(e)款的规定要求2018年8月23日提交的标题为由于无意的电容耦合引起的能量中断(INTERRUPTION OF ENERGY DUE TOINADVERTENT CAPACITIVE COUPLING)的美国临时专利申请62/721,999的优先权，该临时专利申请的公开内容全文以引用方式并入本文。This patent application claims priority under 35 U.S.C. § 119(e) to U.S. Provisional Patent Application No. 62/721,999, filed on August 23, 2018, entitled INTERRUPTION OF ENERGY DUE TO INADVERTENT CAPACITIVE COUPLING, the disclosure of which is incorporated herein by reference in its entirety.

本专利申请按照美国法典第35卷第119条(e)款的规定要求2018年8月23日提交的标题为基于能量模态自动调节压力的双极组合式装置(BIPOLAR COMBINATION DEVICETHAT AUTOMATICALLY ADJUSTS PRESSURE BASED ON ENERGY MODALITY)的美国临时专利申请62/721,994的优先权，该临时专利申请的公开内容全文以引用方式并入本文。This patent application claims priority under Section 119(e) of Title 35 of the United States Code to U.S. Provisional Patent Application No. 62/721,994, filed on August 23, 2018, entitled BIPOLAR COMBINATION DEVICETHAT AUTOMATICALLY ADJUSTS PRESSURE BASED ON ENERGY MODALITY, the disclosure of which is incorporated herein by reference in its entirety.

本专利申请按照美国法典第35卷第119条(e)款的规定要求2018年8月23日提交的标题为用于递送组合的电信号的射频能量装置(RADIO FREQUENCY ENERGY DEVICE FORDELIVERING COMBINED ELECTRICAL SIGNALS)的美国临时专利申请62/721,996的优先权，该临时专利申请的公开内容全文以引用方式并入本文。This patent application claims priority under 35 U.S.C. 119(e) to U.S. Provisional Patent Application No. 62/721,996, filed on August 23, 2018, entitled RADIO FREQUENCY ENERGY DEVICE FOR DELIVERING COMBINED ELECTRICAL SIGNALS, the disclosure of which is incorporated herein by reference in its entirety.

本专利申请按照美国法典第35卷第119条(e)款的规定还要求2018年6月30日提交的标题为通过另一装置智能激活能量装置(SMART ACTIVATION OF AN ENERGY DEVICE BYANOTHER DEVICE)的美国临时专利申请62/692,747、2018年6月30日提交的标题为智能能量架构(SMART ENERGY ARCHITECTURE)的美国临时专利申请62/692,748和2018年6月30日提交的标题为智能能量装置(SMART ENERGY DEVICES)的美国临时专利申请62/692,768的优先权，这些临时专利申请中的每个的公开内容全文以引用方式并入本文。This patent application also claims priority under 35 U.S.C. § 119(e) to U.S. Provisional Patent Application No. 62/692,747, filed on June 30, 2018, entitled SMART ACTIVATION OF AN ENERGY DEVICE BY ANOTHER DEVICE, U.S. Provisional Patent Application No. 62/692,748, filed on June 30, 2018, entitled SMART ENERGY ARCHITECTURE, and U.S. Provisional Patent Application No. 62/692,768, filed on June 30, 2018, entitled SMART ENERGY DEVICES, the disclosure of each of which is incorporated herein by reference in its entirety.

本专利申请按照美国法典第35卷第119条(e)款的规定还要求2018年3月20日提交的标题为具有可分离阵列元件的电容耦合的返回路径垫(CAPACITIVE COUPLED RETURNPATH PAD WITH SEPARABLE ARRAY ELEMENTS)的美国临时专利申请62/650,898、2018年3月30日提交的标题为具有优化的感测能力的外科系统(SURGICAL SYSTEMS WITH OPTIMIZEDSENSING CAPABILITIES)的美国临时专利申请序列号62/650,887、2018年3月30日提交的标题为用于交互式外科平台的排烟模块(SMOKE EVACUATION MODULE FOR INTERACTIVESURGICAL PLATFORM)的美国临时专利申请序列号62/650,882和2018年3月30日提交的标题为外科排烟感测和控制(SURGICAL SMOKE EVACUATION SENSING AND CONTROLS)的美国临时专利申请序列号62/650,877的优先权的权益，这些临时专利申请中的每个的公开内容全文以引用方式并入本文。The present application also claims, pursuant to 35 U.S.C. § 119(e), U.S. Provisional Patent Application No. 62/650,898, filed on March 20, 2018, entitled CAPACITIVE COUPLED RETURNPATH PAD WITH SEPARABLE ARRAY ELEMENTS, U.S. Provisional Patent Application Serial No. 62/650,887, filed on March 30, 2018, entitled SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES, U.S. Provisional Patent Application Serial No. 62/650,882, filed on March 30, 2018, entitled SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM, and U.S. Provisional Patent Application Serial No. 62/650,889, filed on March 20, 2018, entitled CAPACITIVE COUPLED RETURNPATH PAD WITH SEPARABLE ARRAY ELEMENTS, U.S. Provisional Patent Application Serial No. 62/650,887, filed on March 30, 2018, entitled SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES, and U.S. Provisional Patent Application Serial No. 62/650,882, filed on March 30, 2018, entitled SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM. No. 62/650,877 filed with the U.S. Patent Office for Smooth EVACUATION SENSING AND CONTROLS, the disclosures of each of which are incorporated herein by reference in their entirety.

本专利申请按照美国法典第35卷第119条(e)款的规定还要求2017年12月28日提交的标题为交互式外科平台(INTERACTIVE SURGICAL PLATFORM)的美国临时专利申请序列号62/611,341、2017年12月28日提交的标题为基于云的医学分析(CLOUD-BASED MEDICALANALYTICS)的美国临时专利申请序列号62/611,340和2017年12月28日提交的标题为机器人辅助的外科平台(ROBOT ASSISTED SURGICAL PLATFORM)的美国临时专利申请序列号62/611,339的优先权的权益，这些临时专利申请中的每个的公开内容全文以引用方式并入本文。This patent application also claims the benefit of priority, pursuant to 35 U.S.C. § 119(e), to U.S. Provisional Patent Application Serial No. 62/611,341, filed on December 28, 2017, entitled INTERACTIVE SURGICAL PLATFORM, U.S. Provisional Patent Application Serial No. 62/611,340, filed on December 28, 2017, entitled CLOUD-BASED MEDICALANALYTICS, and U.S. Provisional Patent Application Serial No. 62/611,339, filed on December 28, 2017, entitled ROBOT ASSISTED SURGICAL PLATFORM, the disclosure of each of which is incorporated herein by reference in its entirety.

背景技术Background Art

在外科环境中，智能能量装置可需要在智能能量架构环境中。In a surgical environment, smart energy devices may need to be in a smart energy architecture environment.

附图说明BRIEF DESCRIPTION OF THE DRAWINGS

各个方面的特征在所附权利要求书中进行了特别描述。然而，通过参考以下结合如下附图所作的说明可最好地理解各个方面(有关手术组织和方法)及其进一步的目的和优点。The features of the various aspects are particularly described in the appended claims. However, the various aspects (relating to surgical organizations and methods) and further objects and advantages thereof may best be understood by reference to the following description taken in conjunction with the following drawings.

图1为根据本公开的至少一个方面的计算机实现的交互式外科系统的框图。1 is a block diagram of a computer-implemented interactive surgical system in accordance with at least one aspect of the present disclosure.

图2为根据本公开的至少一个方面的用于在手术室中执行外科规程的外科系统。2 is a surgical system for performing a surgical procedure in an operating room, according to at least one aspect of the present disclosure.

图3为根据本公开的至少一个方面的与可视化系统、机器人系统和智能器械配对的外科集线器。3 illustrates a surgical hub paired with a visualization system, a robotic system, and a smart instrument, according to at least one aspect of the present disclosure.

图4为根据本公开的至少一个方面的外科集线器壳体和可滑动地接纳在外科集线器壳体的抽屉中的组合发生器模块的局部透视图。4 is a partial perspective view of a surgical hub housing and a combination generator module slidably received in a drawer of the surgical hub housing according to at least one aspect of the present disclosure.

图5为根据本公开的至少一个方面的具有双极、超声和单极触点以及排烟部件的组合发生器模块的透视图。5 is a perspective view of a combination generator module having bipolar, ultrasonic and monopolar contacts and smoke evacuation components according to at least one aspect of the present disclosure.

图6示出了根据本公开的至少一个方面的用于横向模块化外壳的多个横向对接端口的单个功率总线附接件，该横向模块化外壳被配置为容纳多个模块。6 illustrates a single power bus attachment for multiple lateral docking ports of a lateral modular housing configured to accommodate multiple modules, according to at least one aspect of the present disclosure.

图7示出了根据本公开的至少一个方面的被配置为容纳多个模块的竖直模块化外壳。7 illustrates a vertical modular housing configured to house a plurality of modules according to at least one aspect of the present disclosure.

图8示出了根据本公开的至少一个方面的包括模块化通信集线器的外科数据网络，该模块化通信集线器被配置为将位于医疗设施的一个或多个手术室中的模块化装置或专用于外科操作的医疗设施中的任何房间连接到云。8 illustrates a surgical data network including a modular communication hub configured to connect modular devices located in one or more operating rooms of a medical facility or any room in a medical facility dedicated to surgical procedures to the cloud in accordance with at least one aspect of the present disclosure.

图9为根据本公开的至少一个方面的计算机实现的交互式外科系统。9 is a computer-implemented interactive surgical system according to at least one aspect of the present disclosure.

图10示出了根据本公开的至少一个方面的包括耦合到模块化控制塔的多个模块的外科集线器。10 illustrates a surgical hub including multiple modules coupled to a modular control tower according to at least one aspect of the present disclosure.

图11示出了根据本公开的至少一个方面的通用串行总线(USB)网络集线器装置的一个方面。11 illustrates one aspect of a universal serial bus (USB) hub device in accordance with at least one aspect of the present disclosure.

图12示出了根据本公开的至少一个方面的外科器械或工具的控制系统的逻辑图。12 illustrates a logic diagram of a control system for a surgical instrument or tool in accordance with at least one aspect of the present disclosure.

图13示出了根据本公开的至少一个方面的被配置为控制外科器械或工具的各个方面的控制电路。13 illustrates a control circuit configured to control various aspects of a surgical instrument or tool in accordance with at least one aspect of the present disclosure.

图14示出了根据本公开的至少一个方面的被配置为控制外科器械或工具的各个方面的组合逻辑电路。14 illustrates a combinational logic circuit configured to control various aspects of a surgical instrument or tool in accordance with at least one aspect of the present disclosure.

图15示出了根据本公开的至少一个方面的被配置为控制外科器械或工具的各方面的时序逻辑电路。15 illustrates a sequential logic circuit configured to control various aspects of a surgical instrument or tool in accordance with at least one aspect of the present disclosure.

图16示出了根据本公开的至少一个方面的包括多个马达的外科器械或工具，多个马达可被激活以执行各种功能。16 illustrates a surgical instrument or tool including multiple motors that may be activated to perform various functions in accordance with at least one aspect of the present disclosure.

图17为根据本公开的至少一个方面的被配置为操作本文所述的外科工具的机器人外科器械的示意图。17 is a schematic diagram of a robotic surgical instrument configured to operate the surgical tools described herein, according to at least one aspect of the present disclosure.

图18示出了根据本公开的至少一个方面的被编程以控制位移构件的远侧平移的外科器械的框图。18 illustrates a block diagram of a surgical instrument programmed to control distal translation of a displacement member in accordance with at least one aspect of the present disclosure.

图19为根据本公开的至少一个方面的被配置为控制各种功能的外科器械的示意图。19 is a schematic diagram of a surgical instrument configured to control various functions in accordance with at least one aspect of the present disclosure.

图20为根据本公开的至少一个方面的被配置为在包括模块化通信集线器的外科数据网络中执行自适应超声刀控制算法的系统。20 is a system configured to execute an adaptive ultrasonic blade control algorithm in a surgical data network including a modular communication hub in accordance with at least one aspect of the present disclosure.

图21示出根据本公开的至少一个方面的发生器的示例。FIG. 21 illustrates an example of a generator according to at least one aspect of the present disclosure.

图22为根据本公开的至少一个方面的外科系统，该外科系统包括发生器和可与其一起使用的各种外科器械。22 is a surgical system according to at least one aspect of the present disclosure, the surgical system including a generator and various surgical instruments that may be used therewith.

图23为根据本公开的至少一个方面的端部执行器。23 is an end effector according to at least one aspect of the present disclosure.

图24为根据本公开的至少一个方面的图22的外科系统的图示。24 is an illustration of the surgical system of FIG. 22 , according to at least one aspect of the present disclosure.

图25为根据本公开的至少一个方面的示出动态支路电流的模型。25 is a model illustrating dynamical branch currents according to at least one aspect of the present disclosure.

图26为根据本公开的至少一个方面的发生器架构的结构视图。26 is a block diagram of a generator architecture according to at least one aspect of the present disclosure.

图27A-27C为根据本公开的至少一个方面的发生器架构的功能视图。27A-27C are functional views of generator architectures according to at least one aspect of the present disclosure.

图28A-28B为根据本公开的至少一个方面的发生器的结构和功能方面。28A-28B illustrate structural and functional aspects of a generator according to at least one aspect of the present disclosure.

图29为超声驱动电路的一个方面的示意图。29 is a schematic diagram of one aspect of an ultrasound drive circuit.

图30为根据本公开的至少一个方面的耦合到图29中所示超声驱动电路的变压器的示意图。30 is a schematic diagram of a transformer coupled to the ultrasound drive circuit shown in FIG. 29 in accordance with at least one aspect of the present disclosure.

图31为根据本公开的至少一个方面的耦合到测试电路的图30中所示变压器的示意图。31 is a schematic diagram of the transformer shown in FIG. 30 coupled to a test circuit according to at least one aspect of the present disclosure.

图32为根据本公开的至少一个方面的控制电路的示意图。32 is a schematic diagram of a control circuit according to at least one aspect of the present disclosure.

图33示出了根据本公开的至少一个方面的简化的电路框图，其示出了包含在模块化超声外科器械内的另一个电路。33 illustrates a simplified circuit block diagram showing another circuit included within a modular ultrasonic surgical instrument in accordance with at least one aspect of the present disclosure.

图34示出根据本公开的至少一个方面的被划分为多个级的发生器电路。FIG. 34 illustrates a generator circuit divided into multiple stages according to at least one aspect of the present disclosure.

图35示出了根据本公开的至少一个方面的被划分成多个级的发生器电路，其中第一级电路是第二级电路共有的。35 illustrates a generator circuit divided into multiple stages, wherein a first stage circuit is common to a second stage circuit, according to at least one aspect of the present disclosure.

图36为根据本公开的至少一个方面的被配置用于驱动高频电流(RF)的驱动电路的一个方面的示意图。36 is a schematic diagram of one aspect of a drive circuit configured to drive high frequency current (RF) according to at least one aspect of the present disclosure.

图37为根据本公开的至少一个方面的耦合到图34中所示的RF驱动电路的变压器的示意图。37 is a schematic diagram of a transformer coupled to the RF drive circuit shown in FIG. 34 in accordance with at least one aspect of the present disclosure.

图38为根据本公开的一个方面的电路的示意图，该电路包括用于高功率能量/驱动电路和低功率电路的独立功率源。38 is a schematic diagram of a circuit including independent power sources for high power energy/driver circuits and low power circuits according to one aspect of the present disclosure.

图39示出了允许双发生器系统在外科器械的RF发生器和超声发生器能量模态之间切换的控制电路。39 illustrates control circuitry that allows a dual generator system to switch between RF generator and ultrasonic generator energy modes of a surgical instrument.

图40示出了根据本公开的一个方面的外科器械的一个方面的示意图，该外科器械包括与外科器械一起使用的反馈系统。40 illustrates a schematic diagram of an aspect of a surgical instrument including a feedback system for use with the surgical instrument according to an aspect of the present disclosure.

图41示出了根据本公开的至少一个方面的数字合成电路诸如直接数字合成(DDS)电路的基本架构的一个方面，该DDS电路被配置为生成用于外科器械中的电信号波形的多个波形状。41 illustrates one aspect of a basic architecture of a digital synthesis circuit, such as a direct digital synthesis (DDS) circuit, configured to generate multiple waveform shapes for electrical signal waveforms in a surgical instrument in accordance with at least one aspect of the present disclosure.

图42示出了根据本公开的至少一个方面的直接数字合成(DDS)电路的一个方面，该DDS电路被配置为生成用于外科器械中的电信号波形的多个波形状。42 illustrates an aspect of a direct digital synthesis (DDS) circuit configured to generate multiple waveform shapes for electrical signal waveforms used in a surgical instrument in accordance with at least one aspect of the present disclosure.

图43示出了根据本公开的至少一个方面的根据模拟波形(被示出为叠加在离散的时间数字电信号波形之上以用于比较目的)的本公开的至少一个方面的离散时间数字电信号的一个循环。43 illustrates one cycle of a discrete-time digital electrical signal according to at least one aspect of the present disclosure according to an analog waveform (shown superimposed on the discrete-time digital electrical signal waveform for comparison purposes) according to at least one aspect of the present disclosure.

图44为根据本公开的一个方面的控制系统的图示，该控制系统被配置为在闭合构件朝远侧推进以闭合夹持臂从而以期望的速率施加闭合力负载时提供闭合构件的逐渐闭合。44 is an illustration of a control system configured to provide gradual closing of the closure member as it is advanced distally to close the clamp arms thereby applying a closing force load at a desired rate in accordance with one aspect of the present disclosure.

图45示出了根据本公开的一个方面的比例积分微分(PID)控制器反馈控制系统。FIG. 45 illustrates a proportional-integral-derivative (PID) controller feedback control system according to one aspect of the present disclosure.

图46为根据本公开的一个方面的模块化手持式超声外科器械的正视分解图，其示出了从柄部组件移除的左壳半部，从而暴露通信地耦合到多引线柄部端子组件的装置标识符。46 is an exploded front view of a modular handheld ultrasonic surgical instrument showing the left housing half removed from the handle assembly, exposing a device identifier communicatively coupled to the multi-lead handle terminal assembly, in accordance with one aspect of the present disclosure.

图47为根据本公开的至少一个方面的图46中所示的超声外科器械的触发器部分和交换机的细节视图。47 is a detail view of the trigger portion and switch of the ultrasonic surgical instrument shown in FIG. 46 in accordance with at least one aspect of the present disclosure.

图48为根据本公开的至少一个方面的端部执行器从具有处于打开位置的钳口构件的远侧端部的局部放大透视图。48 is an enlarged partial perspective view of an end effector from a distal end with the jaw members in an open position in accordance with at least one aspect of the present disclosure.

图49为根据本公开的至少一个方面的包括多个独立操作的电路区段的分段电路的系统图。49 is a system diagram of a segmented circuit including multiple independently operating circuit segments according to at least one aspect of the present disclosure.

图50为根据本公开的至少一个方面的具有马达控制功能的外科器械的各种部件的电路图。50 is a circuit diagram of various components of a surgical instrument having motor control functionality according to at least one aspect of the present disclosure.

图51示出了根据本公开的至少一个方面的端部执行器的一个方面，该端部执行器包括耦接到位于钳口构件上的RF数据传感器。51 illustrates one aspect of an end effector including an RF data sensor coupled to a jaw member in accordance with at least one aspect of the present disclosure.

图52示出了根据本公开的至少一个方面的图51中所示的柔性电路的一个方面，其中传感器可安装到该柔性电路或与其整体地形成。52 illustrates an aspect of the flexible circuit shown in FIG. 51 , wherein a sensor may be mounted to or integrally formed with the flexible circuit, in accordance with at least one aspect of the present disclosure.

图53为根据本公开的至少一个方面的用于控制超声机电系统的频率并检测其阻抗的替代系统。53 is an alternative system for controlling the frequency and detecting the impedance of an ultrasonic electromechanical system in accordance with at least one aspect of the present disclosure.

图54为根据本公开的至少一个方面的具有端部执行器的多种不同状态和状况的同一超声装置的光谱，其中超声换能器的阻抗的相位和量值被绘制为频率的函数。54 is a spectrum of the same ultrasonic device with various different states and conditions of the end effector in accordance with at least one aspect of the present disclosure, wherein the phase and magnitude of the impedance of the ultrasonic transducer are plotted as a function of frequency.

图55为根据本公开的至少一个方面的一组3D训练数据S的曲线图的图形表示，其中超声换能器阻抗量值和相位被绘制为频率的函数。55 is a graphical representation of a graph of a set of 3D training data S in which ultrasound transducer impedance magnitude and phase are plotted as a function of frequency in accordance with at least one aspect of the present disclosure.

图56为根据本公开的至少一个方面的描绘基于复阻抗特征图案(指纹)来确定钳口状况的控制程序或逻辑配置的逻辑流程图。56 is a logic flow diagram depicting a control procedure or logic configuration for determining jaw condition based on a complex impedance signature pattern (fingerprint) in accordance with at least one aspect of the present disclosure.

图57为根据本公开的至少一个方面的被绘制为压电振动器的虚分量与实分量之间的关系的复阻抗的圆图。57 is a circular graph of complex impedance plotted as a relationship between imaginary and real components of a piezoelectric vibrator in accordance with at least one aspect of the present disclosure.

图58为根据本公开的至少一个方面的被绘制为压电振动器的虚分量与实分量之间的关系的复导纳的圆图。58 is a circular graph of complex admittance plotted as a relationship between imaginary and real components of a piezoelectric vibrator in accordance with at least one aspect of the present disclosure.

图59为55.5kHz超声压电换能器的复导纳的圆图。Figure 59 is a circular diagram of the complex admittance of a 55.5kHz ultrasonic piezoelectric transducer.

图60为根据本公开的至少一个方面的阻抗分析仪的图形显示，其示出了钳口打开且无负载的超声装置的阻抗/导纳圆图，其中红色描绘导纳，蓝色描绘阻抗。60 is a graphical display of an impedance analyzer showing an impedance/admittance graph of an ultrasonic device with jaws open and no load, with admittance depicted in red and impedance depicted in blue, in accordance with at least one aspect of the present disclosure.

图61为根据本公开的至少一个方面的阻抗分析仪的图形显示，其示出了钳口被夹持在干燥羚羊皮上的超声装置的阻抗/导纳圆图，其中红色描绘导纳，蓝色描绘阻抗。61 is a graphical display of an impedance analyzer showing an impedance/admittance graph of an ultrasonic device with its jaws clamped on dry chamois hide, with admittance depicted in red and impedance depicted in blue, according to at least one aspect of the present disclosure.

图62为根据本公开的至少一个方面的阻抗分析仪的图形显示，其示出了钳口末端被夹持在潮湿羚羊皮上的超声装置的阻抗/导纳圆图，其中红色描绘导纳，蓝色描绘阻抗。62 is a graphical display of an impedance analyzer according to at least one aspect of the present disclosure showing an impedance/admittance graph of an ultrasonic device with the jaw tips clamped on moist chamois hide, with admittance depicted in red and impedance depicted in blue.

图63为根据本公开的至少一个方面的阻抗分析仪的图形显示，其示出了钳口被完全夹持在潮湿羚羊皮上的超声装置的阻抗/导纳圆图，其中红色描绘导纳，蓝色描绘阻抗。63 is a graphical display of an impedance analyzer according to at least one aspect of the present disclosure showing an impedance/admittance graph of an ultrasonic device with its jaws fully clamped on moist chamois hide, with admittance depicted in red and impedance depicted in blue.

图64为根据本公开的至少一个方面的阻抗分析仪的图形显示，其示出了其中频率从48kHz扫描到62kHz以捕获钳口打开的超声装置的多个共振的阻抗/导纳图，其中灰色覆盖有助于看到圆。64 is a graphical display of an impedance analyzer showing an impedance/admittance plot where the frequency is swept from 48 kHz to 62 kHz to capture multiple resonances of an ultrasonic device with jaws open, with a gray overlay to aid in seeing the circles, in accordance with at least one aspect of the present disclosure.

图65为根据本公开的至少一个方面的描绘基于阻抗/导纳圆的半径和偏移的估计值来确定钳口状况的控制程序或逻辑配置的过程的逻辑流程图。65 is a logic flow diagram depicting the process of a control program or logic configuration for determining jaw condition based on estimates of the radius and offset of an impedance/admittance circle in accordance with at least one aspect of the present disclosure.

图66A-66B为根据本公开的至少一个方面的具有冷色(蓝色)和暖色(红色)超声刀的相同超声装置的复阻抗光谱，其中66A-66B are complex impedance spectra of the same ultrasonic device with cool (blue) and warm (red) ultrasonic blades, according to at least one aspect of the present disclosure, wherein

图66A为作为具有冷色(蓝色)和暖色(红色)超声刀的相同超声装置的共振频率的函数的阻抗相位角的图形表示；并且FIG66A is a graphical representation of impedance phase angle as a function of resonant frequency for the same ultrasonic device with a cool (blue) and warm (red) ultrasonic blade; and

图66B为作为具有冷色(蓝色)和暖色(红色)超声刀的相同超声装置的共振频率的函数的阻抗量值的图形表示。66B is a graphical representation of impedance magnitude as a function of resonant frequency for the same ultrasonic device with cool (blue) and warm (red) ultrasonic blades.

图67为根据本公开的至少一个方面的卡尔曼滤波器的示意图，其基于在多种频率处测量的跨超声换能器的阻抗来改善温度估计器和状态空间模型。67 is a schematic diagram of a Kalman filter that improves a temperature estimator and state-space model based on impedance measured across an ultrasound transducer at multiple frequencies in accordance with at least one aspect of the present disclosure.

图68为根据本公开的至少一个方面的由图67中所示的卡尔曼滤波器的状态估计器采用以最大化估计的三种概率分布。68 illustrates three probability distributions employed by the state estimator of the Kalman filter shown in FIG. 67 to maximize estimates in accordance with at least one aspect of the present disclosure.

图69A为在没有温度控制的情况下达到490℃的最高温度的超声装置的温度对时间的图形表示。69A is a graphical representation of temperature versus time for an ultrasonic device reaching a maximum temperature of 490° C. without temperature control.

图69B为根据本公开的至少一个方面的在温度控制的情况下达到320℃的最高温度的超声装置的温度对时间的图形表示。69B is a graphical representation of temperature versus time for an ultrasonic device reaching a maximum temperature of 320° C. under temperature control in accordance with at least one aspect of the present disclosure.

图70A-70B为在检测到超声刀的温度突然下降时调节施加到超声换能器的超声功率放入反馈控制的图形表示，其中70A-70B are graphical representations of adjusting the ultrasonic power applied to the ultrasonic transducer into feedback control when a sudden drop in the temperature of the ultrasonic blade is detected, wherein

图70A为作为时间的函数的超声功率的图形表示；并且FIG. 70A is a graphical representation of ultrasound power as a function of time; and

图70B为根据本公开的至少一个方面的作为时间的函数的超声刀温度的曲线图。70B is a graph of ultrasonic blade temperature as a function of time according to at least one aspect of the present disclosure.

图71为根据本公开的至少一个方面的描绘控制超声刀的温度的控制程序或逻辑配置的过程的逻辑流程图。71 is a logic flow diagram depicting a process of a control program or logic configuration for controlling the temperature of an ultrasonic blade in accordance with at least one aspect of the present disclosure.

图72为根据本公开的至少一个方面的描绘外科集线器的态势感知的时间线。72 is a timeline depicting situational awareness of a surgical hub according to at least one aspect of the present disclosure.

图73示出了根据本公开的至少一个方面的电外科器械的端部执行器。73 illustrates an end effector of an electrosurgical instrument in accordance with at least one aspect of the present disclosure.

图74为根据本公开的至少一个方面的描绘由电外科器械的换能器生成的治疗循环的幅值与时间的曲线图。74 is a graph depicting amplitude versus time of a therapy cycle generated by a transducer of an electrosurgical instrument in accordance with at least one aspect of the present disclosure.

图75A示出了图73的端部执行器的各种闭合阶段。FIG. 75A illustrates various stages of closure of the end effector of FIG. 73 .

图75B示出了图73的端部执行器的各种闭合阶段。FIG. 75B illustrates various stages of closure of the end effector of FIG. 73 .

图76为根据本公开的至少一个方面的描绘用于选择电外科器械的能量操作模式的控制程序或逻辑配置的过程的逻辑流程图。76 is a logic flow diagram depicting a process of a control program or logic configuration for selecting an energy operating mode of an electrosurgical instrument in accordance with at least one aspect of the present disclosure.

图77为根据本公开的至少一个方面的描绘用于选择电外科器械的能量操作模式的控制程序或逻辑配置的过程的逻辑流程图。77 is a logic flow diagram depicting a process of a control program or logic configuration for selecting an energy operating mode of an electrosurgical instrument in accordance with at least one aspect of the present disclosure.

图78为根据本公开的至少一个方面的描绘用于选择电外科器械的能量操作模式的控制程序或逻辑配置的过程的逻辑流程图。78 is a logic flow diagram depicting a process of a control program or logic configuration for selecting an energy operating mode of an electrosurgical instrument in accordance with at least one aspect of the present disclosure.

图78A为组织接触电路的示意图，其示出了在与组织接触时完成到一对间隔开的接触板的该电路。78A is a schematic diagram of a tissue contact circuit showing the circuit being completed to a pair of spaced apart contact plates when in contact with tissue.

图79为根据本公开的至少一个方面的描绘用于选择电外科器械的能量操作模式的控制程序或逻辑配置的过程的逻辑流程图。79 is a logic flow diagram depicting a process of a control program or logic configuration for selecting an energy operating mode of an electrosurgical instrument in accordance with at least one aspect of the present disclosure.

图80为根据本公开的至少一个方面的示出包括绝对定位系统的控制电路的示意图。80 is a schematic diagram illustrating a control circuit including an absolute positioning system according to at least one aspect of the present disclosure.

图81为根据本公开的至少一个方面的描绘用于在电外科器械的能量操作模式之间切换的控制程序或逻辑配置的过程的逻辑流程图。81 is a logic flow diagram depicting a process of a control program or logic configuration for switching between energy modes of operation of an electrosurgical instrument in accordance with at least one aspect of the present disclosure.

图82为根据本公开的至少一个方面的描绘用于基于所监测的参数的预定阈值来调节递送到电外科器械的端部执行器夹持的组织的能量和递送到电外科器械的马达的能量的控制程序或逻辑配置的过程的逻辑流程图。82 is a logic flow diagram depicting a process for a control program or logic configuration for regulating energy delivered to tissue clamped by an end effector of an electrosurgical instrument and energy delivered to a motor of an electrosurgical instrument based on predetermined thresholds of monitored parameters in accordance with at least one aspect of the present disclosure.

图83为根据本公开的至少一个方面的描绘用于基于所监测的参数的预定阈值来调节超声外科器械的不同机电系统的控制程序或逻辑配置的过程的逻辑流程图。83 is a logic flow diagram depicting a process for adjusting a control program or logic configuration of different electromechanical systems of an ultrasonic surgical instrument based on predetermined thresholds of monitored parameters in accordance with at least one aspect of the present disclosure.

图84为根据本发明的至少一个方面的表示夹持组织的电外科器械的端部执行器的远侧部分(末端)处的组织阻抗(Z)、功率(P)和力(F)的曲线图，组织阻抗(Z)、功率(P)和力(F)在Y轴上相对于X轴上的时间(t)绘制。84 is a graph of tissue impedance (Z), power (P), and force (F) at a distal portion (tip) of an end effector of an electrosurgical instrument for clamping tissue according to at least one aspect of the present invention, wherein tissue impedance (Z), power (P), and force (F) are plotted on the Y-axis relative to time (t) on the X-axis.

图85为表示在诊断模式(上图)和响应模式(下图)下作为时间(t)的函数的功率(P)的曲线图。85 is a graph showing power (P) as a function of time (t) in diagnostic mode (upper graph) and response mode (lower graph).

图86为根据本公开的至少一个方面的描绘检测和补偿超声刀浸入液体中的控制程序或逻辑配置的过程的逻辑流程图。86 is a logic flow diagram depicting a process for a control program or logic configuration to detect and compensate for immersion of an ultrasonic blade in a liquid in accordance with at least one aspect of the present disclosure.

图87描绘了根据本公开的至少一个方面的递送到端部执行器的功率(p)以及作为闭合驱动器位移的函数的组织温度的图形表示。87 depicts a graphical representation of power delivered to an end effector (p) and tissue temperature as a function of closed drive displacement in accordance with at least one aspect of the present disclosure.

图88为根据本公开的至少一个方面的描绘检测和补偿超声刀浸入液体中的控制程序或逻辑配置的过程的逻辑流程图。88 is a logic flow diagram depicting a process for a control program or logic configuration to detect and compensate for immersion of an ultrasonic blade in a liquid in accordance with at least one aspect of the present disclosure.

图89为根据本公开的至少一个方面的包括四条曲线的曲线图，其中从顶部起的第一条曲线表示电压(V)和电流(I)与时间(t)的关系，第二条曲线表示功率(P)与时间(t)的关系，第三条曲线表示温度(T)与时间(t)的关系，并且第四条曲线表示组织阻抗(Z)与时间(t)的关系。89 is a graph comprising four curves according to at least one aspect of the present disclosure, wherein the first curve from the top represents the relationship between voltage (V) and current (I) and time (t), the second curve represents the relationship between power (P) and time (t), the third curve represents the relationship between temperature (T) and time (t), and the fourth curve represents the relationship between tissue impedance (Z) and time (t).

图90为根据本公开的至少一个方面的描绘利用组织阻抗(Z)的值作为触发条件来朝向由电外科器械的端部执行器向组织施加的组织治疗循环的结束逐步升高电压(V)的控制程序或逻辑配置的过程的逻辑流程图。90 is a logic flow diagram depicting a process of a control program or logic configuration utilizing the value of tissue impedance (Z) as a trigger condition to gradually increase voltage (V) toward the end of a tissue treatment cycle applied to tissue by an end effector of an electrosurgical instrument in accordance with at least one aspect of the present disclosure.

图91为根据本公开的至少一个方面的描绘利用组织温度(T)的值作为触发条件来朝向由电外科器械的端部执行器向组织施加的组织治疗循环的结束逐步升高电压(V)的控制程序或逻辑配置的过程的逻辑流程图。91 is a logic flow diagram depicting a process of a control program or logic configuration utilizing a value of tissue temperature (T) as a trigger condition to gradually increase a voltage (V) toward the end of a tissue treatment cycle applied to tissue by an end effector of an electrosurgical instrument in accordance with at least one aspect of the present disclosure.

图92为根据本公开的至少一个方面的描绘用于基于由组合装置的超声部件监测的温度(T)来调节组合装置的RF部件的功率(P)的控制程序或逻辑配置的过程的逻辑流程图。92 is a logic flow diagram depicting a process for a control program or logic configuration for regulating the power (P) of an RF component of a combination device based on temperature (T) monitored by an ultrasonic component of the combination device in accordance with at least one aspect of the present disclosure.

图93为根据本公开的至少一个方面的包括三条曲线的曲线图，其中从顶部起的第一条曲线表示递送到组合装置的双极RF部件的钳口之间捕获的组织的功率(P)，其中第二条曲线表示由组合装置的超声部件测得的组织温度，并且其中第三条曲线表示超声部件用来确定组织温度的双重非治疗频率。93 is a graph comprising three curves according to at least one aspect of the present disclosure, wherein the first curve from the top represents the power (P) delivered to tissue captured between the jaws of the bipolar RF component of the combination device, wherein the second curve represents the tissue temperature measured by the ultrasonic component of the combination device, and wherein the third curve represents the dual non-therapeutic frequencies used by the ultrasonic component to determine the tissue temperature.

图94为根据本公开的至少一个方面描绘用于基于所测量的组织阻抗来主动地调节RF电外科器械或组合装置的RF部件的RF波形的频率的控制程序或逻辑配置的过程的逻辑流程图。94 is a logic flow diagram depicting a process of a control program or logic configuration for actively adjusting the frequency of an RF waveform of an RF component of an RF electrosurgical instrument or combination device based on measured tissue impedance in accordance with at least one aspect of the present disclosure.

发明内容Summary of the invention

在各种实施方案中，公开了一种外科器械，该外科器械包括端部执行器，该端部执行器包括超声刀和夹持臂。所述夹持臂能够相对于所述超声刀运动，以使所述端部执行器在打开构型和闭合构型之间转变通过不同的闭合阶段，以将组织夹持在所述超声刀和所述夹持臂之间。所述外科器械还包括被配置为生成超声能量输出的换能器、被配置为将所述超声能量输出传输到所述超声刀的波导，以及被配置为传输指示所述端部执行器的所述闭合阶段的传感器信号的传感器。所述外科器械还包括控制电路，所述控制电路被配置为接收所述传感器信号并基于所接收的传感器信号从递送来自所述换能器的不同超声能量输出的操作模式中选择操作模式。In various embodiments, a surgical instrument is disclosed, the surgical instrument comprising an end effector including an ultrasonic blade and a clamping arm. The clamping arm is capable of moving relative to the ultrasonic blade so that the end effector transitions between an open configuration and a closed configuration through different closing stages to clamp tissue between the ultrasonic blade and the clamping arm. The surgical instrument also includes a transducer configured to generate an ultrasonic energy output, a waveguide configured to transmit the ultrasonic energy output to the ultrasonic blade, and a sensor configured to transmit a sensor signal indicating the closing stage of the end effector. The surgical instrument also includes a control circuit configured to receive the sensor signal and select an operating mode from an operating mode that delivers different ultrasonic energy outputs from the transducer based on the received sensor signal.

在各种实施方案中，公开了一种外科器械，该外科器械包括端部执行器，该端部执行器包括超声刀和夹持臂。所述夹持臂能够相对于所述超声刀运动，以使所述端部执行器在打开构型和闭合构型之间转变通过不同的闭合阶段，以将组织夹持在所述超声刀和所述夹持臂之间。闭合阶段包括第一闭合阶段以及第一闭合阶段之后的第二闭合阶段。该外科器械还包括被配置为生成超声能量输出的换能器、被配置为将超声能量输出传输到超声刀的波导，以及被配置为传输指示检测到夹持臂与组织的初始接触的传感器信号的传感器电路。该外科器械还包括控制电路，该控制电路被配置为接收传感器信号，响应于在第一闭合阶段中接收到传感器信号而使换能器生成第一超声能量输出，并且响应于在第二闭合阶段中接收到传感器信号而使换能器生成大于第一超声能量输出的第二超声能量输出。In various embodiments, a surgical instrument is disclosed, the surgical instrument comprising an end effector, the end effector comprising an ultrasonic blade and a clamping arm. The clamping arm is capable of moving relative to the ultrasonic blade so that the end effector transitions between an open configuration and a closed configuration through different closing stages to clamp tissue between the ultrasonic blade and the clamping arm. The closing stage includes a first closing stage and a second closing stage after the first closing stage. The surgical instrument also includes a transducer configured to generate an ultrasonic energy output, a waveguide configured to transmit the ultrasonic energy output to the ultrasonic blade, and a sensor circuit configured to transmit a sensor signal indicating that initial contact of the clamping arm with the tissue is detected. The surgical instrument also includes a control circuit configured to receive a sensor signal, generate a first ultrasonic energy output in response to receiving the sensor signal in the first closing stage, and generate a second ultrasonic energy output greater than the first ultrasonic energy output in response to receiving the sensor signal in the second closing stage.

具体实施方式DETAILED DESCRIPTION

本专利申请的申请人拥有于2018年8月28日提交的以下美国专利申请，这些专利申请中的每个的公开内容全文以引用方式并入本文：The applicant of the present patent application owns the following U.S. patent applications filed on August 28, 2018, the disclosures of each of which are incorporated herein by reference in their entirety:

·美国专利申请案卷号END8536USNP2/180107-2，其标题为超声端部执行器的估计状态及其控制系统(ESTIMATING STATE OF ULTRASONIC END EFFECTOR AND CONTROLSYSTEM THEREFOR)；U.S. Patent Application Docket No. END8536USNP2/180107-2, entitled ESTIMATING STATE OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR;

·美国专利申请案卷号END8560USNP2/180106-2，其标题为超声端部执行器的温度控制及其控制系统(TEMPERATURE CONTROL OF ULTRASONIC END EFFECTOR AND CONTROLSYSTEM THEREFOR)；U.S. Patent Application Docket No. END8560USNP2/180106-2, entitled TEMPERATURE CONTROL OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR;

·美国专利申请案卷号END8561USNP1/180144-1，其标题为用于递送组合的电信号的射频能量装置(RADIO FREQUENCY ENERGY DEVICE FOR DELIVERING COMBINEDELECTRICAL SIGNALS)；U.S. Patent Application Docket No. END8561USNP1/180144-1, entitled RADIO FREQUENCY ENERGY DEVICE FOR DELIVERING COMBINEDELECTRICAL SIGNALS;

·美国专利申请案卷号END8563USNP1/180139-1，其标题为根据组织位置控制超声外科器械(CONTROLLING AN ULTRASONIC SURGICAL INSTRUMENT ACCORDING TO TISSUELOCATION)；U.S. Patent Application Docket No. END8563USNP1/180139-1, entitled CONTROLLING AN ULTRASONIC SURGICAL INSTRUMENT ACCORDING TO TISSUELOCATION;

·美国专利申请案卷号END8563USNP2/180139-2，其标题为根据组织的存在控制超声外科器械的激活(CONTROLLING ACTIVATION OF AN ULTRASONIC SURGICALINSTRUMENT ACCORDING TO THE PRESENCE OF TISSUE)；U.S. Patent Application Docket No. END8563USNP2/180139-2, entitled CONTROLLING ACTIVATION OF AN ULTRASONIC SURGICALINSTRUMENT ACCORDING TO THE PRESENCE OF TISSUE;

·美国专利申请案卷号END8563USNP3/180139-3，其标题为经由超声系统确定组织组分(DETERMINING TISSUE COMPOSITION VIA AN ULTRASONIC SYSTEM)；U.S. Patent Application Docket No. END8563USNP3/180139-3, entitled DETERMINING TISSUE COMPOSITION VIA AN ULTRASONIC SYSTEM;

·美国专利申请案卷号END8563USNP4/180139-4，其标题为根据频移确定超声机电系统的状态(DETERMINING THE STATE OF AN ULTRASONIC ELECTROMECHANICAL SYSTEMACCORDING TO FREQUENCY SHIFT)；U.S. Patent Application Docket No. END8563USNP4/180139-4, entitled DETERMINING THE STATE OF AN ULTRASONIC ELECTROMECHANICAL SYSTEM ACCORDING TO FREQUENCY SHIFT;

·美国专利申请案卷号END8563USNP5/180139-5，其标题为确定超声端部执行器的状态(DETERMINING THE STATE OF AN ULTRASONIC END EFFECTOR)；U.S. Patent Application Docket No. END8563USNP5/180139-5, entitled DETERMINING THE STATE OF AN ULTRASONIC END EFFECTOR;

·美国专利申请案卷号END8564USNP2/180140-2，其标题为用于控制电子外科器械的不同机电系统的机构(MECHANISMS FOR CONTROLLING DIFFERENT ELECTROMECHANICALSYSTEMS OF AN ELECTROSURGICAL INSTRUMENT)；U.S. Patent Application Docket No. END8564USNP2/180140-2, entitled MECHANISMS FOR CONTROLLING DIFFERENT ELECTROMECHANICAL SYSTEMS OF AN ELECTROSURGICAL INSTRUMENT;

·美国专利申请案卷号END8564USNP3/180140-3，其标题为检测端部执行器浸入液体中(DETECTION OF END EFFECTOR IMMERSION IN LIQUID)；U.S. Patent Application Docket No. END8564USNP3/180140-3, entitled DETECTION OF END EFFECTOR IMMERSION IN LIQUID;

·美国专利申请案卷号END8565USNP1/180142-1，其标题为由于不当的电容耦合引起的能量中断(INTERRUPTION OF ENERGY DUE TO INADVERTENT CAPACITIVECOUPLING)；U.S. Patent Application Docket No. END8565USNP1/180142-1, entitled INTERRUPTION OF ENERGY DUE TO INADVERTENT CAPACITIVE COUPLING;

·美国专利申请案卷号END8565USNP2/180142-2，其标题为增加射频以生成无垫单极环路(PAD-LESS)；U.S. Patent Application Docket No. END8565USNP2/180142-2, entitled Adding Radio Frequency to Generate Padless Monopolar Loop (PAD-LESS);

·美国专利申请案卷号END8566USNP1/180143-1，其标题为基于能量模态自动调节压力的双极组合式装置(BIPOLAR COMBINATION DEVICE THAT AUTOMATICALLY ADJUSTSPRESSURE BASED ON ENERGY MODALITY)；以及U.S. Patent Application Docket No. END8566USNP1/180143-1, entitled BIPOLAR COMBINATION DEVICE THAT AUTOMATICALLY ADJUSTSPRESSURE BASED ON ENERGY MODALITY; and

·美国专利申请案卷号END8573USNP1/180145-1，其标题为激活能量装置(ACTIVATION OF ENERGY DEVICES)。US Patent Application Docket No. END8573USNP1/180145-1, entitled ACTIVATION OF ENERGY DEVICES.

本专利申请的申请人拥有于2018年8月23日提交的以下美国专利申请，这些专利申请中的每个的公开内容全文以引用方式并入本文：The applicant of the present patent application owns the following U.S. patent applications filed on August 23, 2018, the disclosures of each of which are incorporated herein by reference in their entirety:

·美国临时专利申请62/721,995，其标题为根据组织位置控制超声外科器械(CONTROLLING AN ULTRASONIC SURGICAL INSTRUMENT ACCORDING TO TISSUE LOCATION)；U.S. Provisional Patent Application No. 62/721,995, entitled CONTROLLING AN ULTRASONIC SURGICAL INSTRUMENT ACCORDING TO TISSUE LOCATION;

·美国临时专利申请62/721,998，其标题为电外科系统的态势感知(SITUATIONALAWARENESS OF ELECTROSURGICAL SYSTEMS)；U.S. Provisional Patent Application No. 62/721,998, entitled SITUATIONAL AWARENESS OF ELECTROSURGICAL SYSTEMS;

·美国临时专利申请62/721,999，其标题为由于无意的电容耦合引起的能量中断(INTERRUPTION OF ENERGY DUE TO INADVERTENT CAPACITIVE COUPLING)；U.S. Provisional Patent Application No. 62/721,999, entitled INTERRUPTION OF ENERGY DUE TO INADVERTENT CAPACITIVE COUPLING;

·美国临时专利申请62/721,994，其标题为基于能量模态自动调节压力的双极组合式装置(BIPOLAR COMBINATION DEVICE THAT AUTOMATICALLY ADJUSTS PRESSURE BASEDON ENERGY MODALITY)；以及U.S. Provisional Patent Application No. 62/721,994, entitled BIPOLAR COMBINATION DEVICE THAT AUTOMATICALLY ADJUSTS PRESSURE BASED ON ENERGY MODALITY; and

·美国临时专利申请62/721,996，其标题为用于递送组合的电信号的射频能量装置(RADIO FREQUENCY ENERGY DEVICE FOR DELIVERING COMBINED ELECTRICAL SIGNALS)。• U.S. Provisional Patent Application No. 62/721,996, entitled RADIO FREQUENCY ENERGY DEVICE FOR DELIVERING COMBINED ELECTRICAL SIGNALS.

本专利申请的申请人拥有于2018年6月30日提交的以下美国专利申请，这些专利申请中的每个的公开内容全文以引用方式并入本文：The applicant of the present patent application owns the following U.S. patent applications filed on June 30, 2018, the disclosures of each of which are incorporated herein by reference in their entirety:

·美国临时专利申请62/692,747，其标题为通过另一装置智能激活能量装置(SMART ACTIVATION OF AN ENERGY DEVICE BY ANOTHER DEVICE)；U.S. Provisional Patent Application No. 62/692,747, entitled SMART ACTIVATION OF AN ENERGY DEVICE BY ANOTHER DEVICE;

·美国临时专利申请62/692,748，其标题为智能能量架构(SMART ENERGYARCHITECTURE)；以及U.S. Provisional Patent Application No. 62/692,748, entitled SMART ENERGY ARCHITECTURE; and

·美国临时专利申请62/692,768，其标题为智能能量装置(SMART ENERGYDEVICES)。• U.S. Provisional Patent Application 62/692,768, entitled SMART ENERGY DEVICES.

本专利申请的申请人拥有于2018年6月29日提交的以下美国专利申请，这些专利申请中的每个的公开内容全文以引用方式并入本文：The applicant of the present patent application owns the following U.S. patent applications filed on June 29, 2018, the disclosures of each of which are incorporated herein by reference in their entirety:

·美国专利申请序列号16/024,090，其标题为具有可分离阵列元件的电容耦合的返回路径垫(CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS)；U.S. Patent Application Serial No. 16/024,090, entitled CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS;

·美国专利申请序列号16/024,057，其标题为根据感测的闭合参数控制外科器械(CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS)；U.S. Patent Application Serial No. 16/024,057, entitled CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS;

·美国专利申请序列号16/024,067，其标题为用于基于手术期间的信息调节端部执行器参数的系统(SYSTEMS FOR ADJUSTING END EFFECTOR PARAMETERS BASED ONPERIOPERATIVE INFORMATION)；U.S. Patent Application Serial No. 16/024,067, entitled SYSTEMS FOR ADJUSTING END EFFECTOR PARAMETERS BASED ON PERIOPERATIVE INFORMATION;

·美国专利申请序列号16/024,075，其标题为用于智能供电的外科缝合的安全系统(SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING)；U.S. Patent Application Serial No. 16/024,075, entitled SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING;

·美国专利申请序列号16/024,083，其标题为用于智能供电的外科缝合的安全系统(SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING)；U.S. Patent Application Serial No. 16/024,083, entitled SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING;

·美国专利申请序列号16/024,094，其标题为用于检测端部执行器组织分布不规则的外科系统(SURGICAL SYSTEMS FOR DETECTING END EFFECTOR TISSUE DISTRIBUTIONIRREGULARITIES)；U.S. Patent Application Serial No. 16/024,094, entitled SURGICAL SYSTEMS FOR DETECTING END EFFECTOR TISSUE DISTRIBUTION IRREGULARITIES;

·美国专利申请序列号16/024,138，其标题为用于检测外科端部执行器接近癌变组织的系统(SYSTEMS FOR DETECTING PROXIMITY OF SURGICAL END EFFECTOR TOCANCEROUS TISSUE)；U.S. Patent Application Serial No. 16/024,138, entitled SYSTEMS FOR DETECTING PROXIMITY OF SURGICAL END EFFECTOR TO CANCEROUS TISSUE;

·美国专利申请序列号16/024,150，其标题为外科器械料筒传感器组件(SURGICAL INSTRUMENT CARTRIDGE SENSOR ASSEMBLIES)；U.S. Patent Application Serial No. 16/024,150, entitled SURGICAL INSTRUMENT CARTRIDGE SENSOR ASSEMBLIES;

·美国专利申请序列号16/024,160，其标题为可变输出料筒传感器组件(VARIABLE OUTPUT CARTRIDGE SENSOR ASSEMBLY)；U.S. Patent Application Serial No. 16/024,160, entitled VARIABLE OUTPUT CARTRIDGE SENSOR ASSEMBLY;

·美国专利申请序列号16/024,124，其标题为具有柔性电极的外科器械(SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE)；U.S. Patent Application Serial No. 16/024,124, entitled SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE;

·美国专利申请序列号16/024,132，其标题为具有柔性电路的外科器械(SURGICAL INSTRUMENT HAVING A FLEXIBLE CIRCUIT)；U.S. Patent Application Serial No. 16/024,132, entitled SURGICAL INSTRUMENT HAVING A FLEXIBLE CIRCUIT;

·美国专利申请序列号16/024,141，其标题为具有组织标记组件的外科器械(SURGICAL INSTRUMENT WITH A TISSUE MARKING ASSEMBLY)；U.S. Patent Application Serial No. 16/024,141, entitled SURGICAL INSTRUMENT WITH A TISSUE MARKING ASSEMBLY;

·美国专利申请序列号16/024,162，其标题为具有优先数据传输能力的外科系统(SURGICAL SYSTEMS WITH PRIORITIZED DATA TRANSMISSION CAPABILITIES)；U.S. Patent Application Serial No. 16/024,162, entitled SURGICAL SYSTEMS WITH PRIORITIZED DATA TRANSMISSION CAPABILITIES;

·美国专利申请序列号16/024,066，其标题为外科排抽感测和马达控制(SURGICAL EVACUATION SENSING AND MOTOR CONTROL)；U.S. Patent Application Serial No. 16/024,066, entitled SURGICAL EVACUATION SENSING AND MOTOR CONTROL;

·美国专利申请序列号16/024,096，其标题为外科排抽传感器布置方式(SURGICAL EVACUATION SENSOR ARRANGEMENTS)；U.S. Patent Application Serial No. 16/024,096, entitled SURGICAL EVACUATION SENSOR ARRANGEMENTS;

·美国专利申请序列号16/024,116，其标题为外科排抽流动路径(SURGICALEVACUATION FLOW PATHS)；U.S. Patent Application Serial No. 16/024,116, entitled SURGICALEVACUATION FLOW PATHS;

·美国专利申请序列号16/024,149，其标题为外科排抽感测和发生器控制(SURGICAL EVACUATION SENSING AND GENERATOR CONTROL)；U.S. Patent Application Serial No. 16/024,149, entitled SURGICAL EVACUATION SENSING AND GENERATOR CONTROL;

·美国专利申请序列号16/024,180，其标题为外科排抽感测和显示(SURGICALEVACUATION SENSING AND DISPLAY)；U.S. Patent Application Serial No. 16/024,180, entitled SURGICALEVACUATION SENSING AND DISPLAY;

·美国专利申请序列号16/024,245，其标题为将排烟系统参数传递至用于交互式外科平台的排烟模块中的集线器或云(COMMUNICATION OF SMOKE EVACUATION SYSTEMPARAMETERS TO HUB OR CLOUD IN SMOKE EVACUATION MODULE FOR INTERACTIVESURGICAL PLATFORM)；U.S. Patent Application Serial No. 16/024,245, entitled COMMUNICATION OF SMOKE EVACUATION SYSTEM PARAMETERS TO HUB OR CLOUD IN SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM;

·美国专利申请序列号16/024,258，其标题为包括用于交互式外科平台的分段控制电路的排烟系统(SMOKE EVACUATION SYSTEM INCLUDING A SEGMENTED CONTROLCIRCUIT FOR INTERACTIVE SURGICAL PLATFORM)；U.S. Patent Application Serial No. 16/024,258, entitled SMOKE EVACUATION SYSTEM INCLUDING A SEGMENTED CONTROLCIRCUIT FOR INTERACTIVE SURGICAL PLATFORM;

·美国专利申请序列号16/024,265，其标题为具有用于过滤器和排烟装置之间的通信的通信电路的外科排抽系统(SURGICAL EVACUATION SYSTEM WITH A COMMUNICATIONCIRCUIT FOR COMMUNICATION BETWEEN A FILTER AND A SMOKE EVACUATION DEVICE)；以及U.S. Patent Application Serial No. 16/024,265, entitled SURGICAL EVACUATION SYSTEM WITH A COMMUNICATION CIRCUIT FOR COMMUNICATION BETWEEN A FILTER AND A SMOKE EVACUATION DEVICE; and

·美国专利申请序列号16/024,273，其标题为双串联大型液滴过滤器和小型液滴过滤器(DUAL IN-SERIES LARGE AND SMALL DROPLET FILTERS)。- U.S. Patent Application Serial No. 16/024,273, entitled DUAL IN-SERIES LARGE AND SMALL DROPLET FILTERS.

本专利申请的申请人拥有于2018年6月28日提交的以下美国临时专利申请，这些临时专利申请中的每个的公开内容全文以引用方式并入本文：The applicant of the present patent application owns the following U.S. provisional patent applications filed on June 28, 2018, the disclosures of each of which are incorporated herein by reference in their entirety:

·美国临时专利申请序列号62/691,228，其标题为一种使用具有具有电外科装置的多个传感器的增强柔性电路的方法(A METHOD OF USING REINFORCED FLEX CIRCUITSWITH MULTIPLE SENSORS WITH ELECTROSURGICAL DEVICES)；U.S. Provisional Patent Application Serial No. 62/691,228, entitled A METHOD OF USING REINFORCED FLEX CIRCUITS WITH MULTIPLE SENSORS WITH ELECTROSURGICAL DEVICES;

·美国临时专利申请序列号62/691,227，其标题为根据感测的闭合参数控制外科器械(CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSUREPARAMETERS)；U.S. Provisional Patent Application Serial No. 62/691,227, entitled CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS;

·美国临时专利申请序列号62/691,230，其标题为具有柔性电极的外科器械(SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE)；U.S. Provisional Patent Application Serial No. 62/691,230, entitled SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE;

·美国临时专利申请序列号62/691,219，其标题为外科排抽感测和马达控制(SURGICAL EVACUATION SENSING AND MOTOR CONTROL)；U.S. Provisional Patent Application Serial No. 62/691,219, entitled SURGICAL EVACUATION SENSING AND MOTOR CONTROL;

·美国临时专利申请序列号62/691,257，其标题为将排烟系统参数传递至用于交互式外科平台的排烟模块中的集线器或云(COMMUNICATION OF SMOKE EVACUATION SYSTEMPARAMETERS TO HUB OR CLOUD IN SMOKE EVACUATION MODULE FOR INTERACTIVESURGICAL PLATFORM)；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;

·美国临时专利申请序列号62/691,262，其标题为具有用于过滤器和排烟装置之间的通信的通信电路的外科排抽系统(SURGICAL EVACUATION SYSTEM WITH ACOMMUNICATION CIRCUIT FOR COMMUNICATION BETWEEN A FILTER AND A SMOKEEVACUATION DEVICE)；以及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 SMOKEEVACUATION DEVICE; and

·美国临时专利申请序列号62/691,251，其标题为双串联大型液滴过滤器和小型液滴过滤器(DUAL IN-SERIES LARGE AND SMALL DROPLET FILTERS)。• U.S. Provisional Patent Application Serial No. 62/691,251, entitled DUAL IN-SERIES LARGE AND SMALL DROPLET FILTERS.

本专利申请的申请人拥有于2018年4月19日提交的以下美国临时专利申请，这些临时专利申请中的每个的公开内容全文以引用方式并入本文：The applicant of the present patent application owns the following U.S. provisional patent applications filed on April 19, 2018, the disclosures of each of which are incorporated herein by reference in their entirety:

·美国临时专利申请序列号62/659,900，其标题为集线器通信方法(METHOD OFHUB COMMUNICATION)。US Provisional Patent Application Serial No. 62/659,900, entitled METHOD OF HUB COMMUNICATION.

本专利申请的申请人拥有于2018年3月30日提交的以下美国临时专利申请，这些临时专利申请中的每个的公开内容全文以引用方式并入本文：The applicant of the present patent application owns the following U.S. provisional patent applications filed on March 30, 2018, the disclosures of each of which are incorporated herein by reference in their entirety:

·2018年3月30日提交的美国临时专利申请62/650,898，其标题为具有可分离阵列元件的电容耦合的返回路径垫(CAPACITIVE COUPLED RETURN PATH PAD WITHSEPARABLE ARRAY ELEMENTS)；U.S. Provisional Patent Application No. 62/650,898, filed on March 30, 2018, entitled CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS;

·美国临时专利申请序列号62/650,887，其标题为具有优化的感测能力的外科系统(SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES)；U.S. Provisional Patent Application Serial No. 62/650,887, entitled SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES;

·美国专利申请序列号62/650,882，其标题为用于交互式外科平台的排烟模块(SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM)；以及U.S. Patent Application Serial No. 62/650,882, entitled SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM; and

·美国专利申请序列号62/650,877，其标题为外科排烟感测和控制(SURGICALSMOKE EVACUATION SENSING AND CONTROLS)。- U.S. Patent Application Serial No. 62/650,877, entitled SURGICALSMOKE EVACUATION SENSING AND CONTROLS.

本专利申请的申请人拥有于2018年3月29日提交的以下美国专利申请，这些临时专利申请中的每个的公开内容全文以引用方式并入本文：The applicant of the present patent application owns the following U.S. patent applications filed on March 29, 2018, the disclosures of each of these provisional patent applications are incorporated herein by reference in their entirety:

·美国专利申请序列号15/940,641，其标题为具有加密通信能力的交互式外科系统(INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES)；U.S. Patent Application Serial No. 15/940,641, entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES;

·美国专利申请序列号15/940,648，其标题为具有条件处理装置和数据能力的交互式外科系统(INTERACTIVE SURGICAL SYSTEMS WITH CONDITION HANDLING OF DEVICESAND DATA CAPABILITIES)；U.S. Patent Application Serial No. 15/940,648, entitled INTERACTIVE SURGICAL SYSTEMS WITH CONDITION HANDLING OF DEVICES AND DATA CAPABILITIES;

·美国专利申请序列号15/940,656，其标题为手术室装置控制和通信的外科集线器协调(SURGICAL HUB COORDINATION OF CONTROL AND COMMUNICATION OF OPERATINGROOM DEVICES)；U.S. Patent Application Serial No. 15/940,656, entitled SURGICAL HUB COORDINATION OF CONTROL AND COMMUNICATION OF OPERATINGROOM DEVICES;

·美国专利申请序列号15/940,666，其标题为手术室中的外科集线器的空间感知(SPATIAL AWARENESS OF SURGICAL HUBS IN OPERATING ROOMS)；U.S. Patent Application Serial No. 15/940,666, entitled SPATIAL AWARENESS OF SURGICAL HUBS IN OPERATING ROOMS;

·美国专利申请序列号15/940,670，其标题为通过智能外科集线器从次级源导出的数据的协作利用(COOPERATIVE UTILIZATION OF DATA DERIVED FROM SECONDARYSOURCES BY INTELLIGENT SURGICAL HUBS)；U.S. Patent Application Serial No. 15/940,670, entitled COOPERATIVE UTILISATION OF DATA DERIVED FROM SECONDARY SOURCES BY INTELLIGENT SURGICAL HUBS;

·美国专利申请序列号15/940,677，其标题为外科集线器控制布置(SURGICALHUB CONTROL ARRANGEMENTS)；U.S. Patent Application Serial No. 15/940,677, entitled SURGICALHUB CONTROL ARRANGEMENTS;

·美国专利申请序列号15/940,632，其标题为数据询问患者记录并创建匿名记录的数据剥离方法(DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS ANDCREATE ANONYMIZED RECORD)；U.S. Patent Application Serial No. 15/940,632, entitled DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD;

·美国专利申请序列号15/940,640，其标题为用于存储待与基于云的分析系统共享的外科装置的参数和状况的通信集线器和存储装置(COMMUNICATION HUB AND STORAGEDEVICE FOR STORING PARAMETERS AND STATUS OF A SURGICAL DEVICE TO BE SHAREDWITH CLOUD BASED ANALYTICS SYSTEMS)；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;

·美国专利申请序列号15/940,645，其标题为在发行器械处生成的自述数据分组(SELF DESCRIBING DATA PACKETS GENERATED AT AN ISSUING INSTRUMENT)；U.S. Patent Application Serial No. 15/940,645, entitled SELF DESCRIBING DATA PACKETS GENERATED AT AN ISSUING INSTRUMENT;

·美国专利申请序列号15/940,649，其标题为用于将装置测量参数与结果互连的数据配对(DATA PAIRING TO INTERCONNECT A DEVICE MEASURED PARAMETER WITH ANOUTCOME)；U.S. Patent Application Serial No. 15/940,649, entitled DATA PAIRING TO INTERCONNECT A DEVICE MEASURED PARAMETER WITH AN OUTCOME;

·美国专利申请序列号15/940,654，其标题为外科集线器态势感知(SURGICALHUB SITUATIONAL AWARENESS)；U.S. Patent Application Serial No. 15/940,654, entitled SURGICALHUB SITUATIONAL AWARENESS;

·美国专利申请序列号15/940,663，其标题为外科系统分布式处理(SURGICALSYSTEM DISTRIBUTED PROCESSING)；U.S. Patent Application Serial No. 15/940,663, entitled SURGICAL SYSTEM DISTRIBUTED PROCESSING;

·美国专利申请序列号15/940,668，其标题为外科集线器数据的聚集和报告(AGGREGATION AND REPORTING OF SURGICAL HUB DATA)；U.S. Patent Application Serial No. 15/940,668, entitled AGGREGATION AND REPORTING OF SURGICAL HUB DATA;

·美国专利申请序列号15/940,671，其标题为用于确定手术室中的装置的外科集线器空间感知(SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATINGTHEATER)；U.S. Patent Application Serial No. 15/940,671, entitled SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEEATER;

·美国专利申请序列号15/940,686，其标题为显示将钉仓与先前线性钉线对准(DISPLAY OF ALIGNMENT OF STAPLE CARTRIDGE TO PRIOR LINEAR STAPLE LINE)；U.S. Patent Application Serial No. 15/940,686, entitled DISPLAY OF ALIGNMENT OF STAPLE CARTRIDGE TO PRIOR LINEAR STAPLE LINE;

·美国专利申请序列号15/940,700，其标题为无菌场交互式控制显示(STERILEFIELD INTERACTIVE CONTROL DISPLAYS)；U.S. Patent Application Serial No. 15/940,700, entitled STERILEFIELD INTERACTIVE CONTROL DISPLAYS;

·美国专利申请序列号15/940,629，其标题为计算机实现的交互式外科系统(COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS)；U.S. Patent Application Serial No. 15/940,629, entitled COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS;

·美国专利申请序列号15/940,704，其标题为使用激光和红绿蓝显色来确定背散射光的特性(USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINEPROPERTIES OF BACK SCATTERED LIGHT)；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;

·美国专利申请序列号15/940,722，其标题为通过使用单色光折射率来表征组织不规则(CHARACTERIZATION OF TISSUE IRREGULARITIES THROUGH THE USE OF MONO-CHROMATIC LIGHT REFRACTIVITY)；以及U.S. Patent Application Serial No. 15/940,722, entitled CHARACTERIZATION OF TISSUE IRREGULARITIES THROUGH THE USE OF MONO-CHROMATIC LIGHT REFRACTIVITY; and

·美国专利申请序列号15/940,742，其标题为双互补金属氧化物半导体(CMOS)阵列成像(DUAL CMOS ARRAY IMAGING)。- U.S. Patent Application Serial No. 15/940,742, entitled DUAL CMOS ARRAY IMAGING.

·美国专利申请序列号15/940,636，其标题为针对外科装置的自适应控制程序更新(ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES)；U.S. Patent Application Serial No. 15/940,636, entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES;

·美国专利申请序列号15/940,653，其标题为针对外科集线器的自适应控制程序更新(ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL HUBS)；U.S. Patent Application Serial No. 15/940,653, entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL HUBS;

·美国专利申请序列号15/940,660，其标题为用于定制和向用户推荐的基于云的医学分析(CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONSTO A USER)；U.S. Patent Application Serial No. 15/940,660, entitled CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER;

·美国专利申请序列号15/940,679，其标题为用于将本地使用趋势与更大数据集的资源采集行为链接的基于云的医学分析(CLOUD-BASED MEDICAL ANALYTICS FORLINKING OF LOCAL USAGE TRENDS WITH THE RESOURCE ACQUISITION BEHAVIORS OFLARGER DATA SET)；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;

·美国专利申请序列号15/940,694，其标题为用于将器械功能分段个性化的医疗设施的基于云的医学分析(CLOUD-BASED MEDICAL ANALYTICS FOR MEDICAL FACILITYSEGMENTED INDIVIDUALIZATION OF INSTRUMENT FUNCTION)；U.S. Patent Application Serial No. 15/940,694, entitled CLOUD-BASED MEDICAL ANALYTICS FOR MEDICAL FACILITY SEGMENTED INDIVIDUALIZATION OF INSTRUMENT FUNCTION;

·美国专利申请序列号15/940,634，其标题为用于安全和认证趋势和反应性测量的基于云的医学分析(CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY ANDAUTHENTICATION TRENDS AND REACTIVE MEASURES)；U.S. Patent Application Serial No. 15/940,634, entitled CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES;

·美国专利申请序列号15/940,706，其标题为云分析网络中的数据处理和优先级(DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK)；以及U.S. Patent Application Serial No. 15/940,706, entitled DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK; and

·美国专利申请序列号15/940,675，其标题为用于耦合的外科装置的云接口(CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES)。• U.S. Patent Application Serial No. 15/940,675, entitled CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES.

·美国专利申请序列号15/940,627，其标题为用于机器人辅助外科平台的驱动布置方式(DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS)；U.S. Patent Application Serial No. 15/940,627, entitled DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;

·美国专利申请序列号15/940,637，其标题为用于机器人辅助外科平台的通信布置方式(COMMUNICATION ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS)；U.S. Patent Application Serial No. 15/940,637, entitled COMMUNICATION ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;

·美国专利申请序列号15/940,642，其标题为用于机器人辅助外科平台的控制(CONTROLS FOR ROBOT-ASSISTED SURGICAL PLATFORMS)；U.S. Patent Application Serial No. 15/940,642, entitled CONTROLS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;

·美国专利申请序列号15/940,676，其标题为用于机器人辅助外科平台的自动工具调节(AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS)；U.S. Patent Application Serial No. 15/940,676, entitled AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;

·美国专利申请序列号15/940,680，其标题为用于机器人辅助外科平台的控制器(CONTROLLERS FOR ROBOT-ASSISTED SURGICAL PLATFORMS)；U.S. Patent Application Serial No. 15/940,680, entitled CONTROLLERS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;

·美国专利申请序列号15/940,683，其标题为用于机器人辅助外科平台的协作外科动作(COOPERATIVE SURGICAL ACTIONS FOR ROBOT-ASSISTED SURGICAL PLATFORMS)；U.S. Patent Application Serial No. 15/940,683, entitled COOPERATIVE SURGICAL ACTIONS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;

·美国专利申请序列号15/940,690，其标题为用于机器人辅助外科平台的显示器布置方式(DISPLAY ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS)；以及U.S. Patent Application Serial No. 15/940,690, entitled DISPLAY ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; and

·美国专利申请序列号15/940,711，其标题为用于机器人辅助外科平台的感测布置方式(SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS)。• U.S. Patent Application Serial No. 15/940,711, entitled SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS.

本专利申请的申请人拥有于2018年3月28日提交的以下美国临时专利申请，这些临时专利申请中的每个的公开内容全文以引用方式并入本文：The applicant of the present patent application owns the following U.S. provisional patent applications filed on March 28, 2018, the disclosures of each of which are incorporated herein by reference in their entirety:

·美国临时专利申请序列号62/649,302，其标题为具有加密通信能力的交互式外科系统(INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATIONCAPABILITIES)；U.S. Provisional Patent Application Serial No. 62/649,302, entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES;

·美国临时专利申请序列号62/649,294，其标题为询问患者记录并创建匿名记录的数据剥离方法(DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS ANDCREATE ANONYMIZED RECORD)；U.S. Provisional Patent Application Serial No. 62/649,294, entitled DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD;

·美国专利申请序列号62/649,300，其标题为外科集线器态势感知(SURGICALHUB SITUATIONAL AWARENESS)；U.S. Patent Application Serial No. 62/649,300, entitled SURGICALHUB SITUATIONAL AWARENESS;

·美国临时专利申请序列号62/649,309，其标题为用于确定手术室中的装置的外科集线器空间感知(SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES INOPERATING THEATER)；U.S. Provisional Patent Application Serial No. 62/649,309, entitled SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES INOPERATING THEATER;

·美国专利申请序列号62/649,310，其标题为计算机实现的交互式外科系统(COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS)；U.S. Patent Application Serial No. 62/649,310, entitled COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS;

·美国临时专利申请序列号62/649,291，其标题为使用激光和红绿蓝显色来确定背散射光的特性(USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINEPROPERTIES OF BACK SCATTERED LIGHT)；U.S. Provisional Patent Application Serial No. 62/649,291, entitled USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT;

·美国专利申请序列号62/649,296，其标题为针对外科装置的自适应控制程序更新(ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES)；U.S. Patent Application Serial No. 62/649,296, entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES;

·美国临时专利申请序列号62/649,333，其标题为用于定制和向用户推荐的基于云的医学分析(CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION ANDRECOMMENDATIONS TO A USER)；U.S. Provisional Patent Application Serial No. 62/649,333, entitled CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER;

·美国临时专利申请序列号62/649,327，其标题为用于安全和认证趋势和反应性测量的基于云的医学分析(CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY ANDAUTHENTICATION TRENDS AND REACTIVE MEASURES)；U.S. Provisional Patent Application Serial No. 62/649,327, entitled CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES;

·美国临时专利申请序列号62/649,315，其标题为云分析网络中的数据处理和优先级(DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK)；U.S. Provisional Patent Application Serial No. 62/649,315, entitled DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK;

·美国专利申请序列号62/649,313，其标题为用于耦合的外科装置的云接口(CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES)；U.S. Patent Application Serial No. 62/649,313, entitled CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES;

·美国专利申请序列号62/649,320，其标题为用于机器人辅助外科平台的驱动布置方式(DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS)；U.S. Patent Application Serial No. 62/649,320, entitled DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;

·美国临时专利申请序列号62/649,307，其标题为用于机器人辅助外科平台的自动工具调节(AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS)；以及U.S. Provisional Patent Application Serial No. 62/649,307, entitled AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; and

·美国临时专利申请序列号62/649,323，其标题为用于机器人辅助外科平台的感测布置方式(SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS)。• U.S. Provisional Patent Application Serial No. 62/649,323, entitled SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS.

本专利申请的申请人拥有于2018年3月8日提交的以下美国临时专利申请，这些临时专利申请中的每个的公开内容全文以引用方式并入本文：The applicant of the present patent application owns the following U.S. provisional patent applications filed on March 8, 2018, the disclosures of each of which are incorporated herein by reference in their entirety:

·美国临时专利申请序列号62/640,417，其标题为超声装置中的温度控制以及为此的控制系统(TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEMTHEREFOR)；以及U.S. Provisional Patent Application Serial No. 62/640,417, entitled TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEMTHEREFOR; and

·美国临时专利申请序列号62/640,415，其标题为估计超声端部执行器的状态以及为此的控制系统(ESTIMATING STATE OF ULTRASONIC END EFFECTOR AND CONTROLSYSTEM THEREFOR)。• U.S. Provisional Patent Application Serial No. 62/640,415, entitled ESTIMATING STATE OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR.

本专利申请的申请人拥有于2017年12月28日提交的以下美国临时专利申请，这些临时专利申请中的每个的公开内容全文以引用方式并入本文：The applicant of the present patent application owns the following U.S. provisional patent applications filed on December 28, 2017, the disclosures of each of which are incorporated herein by reference in their entirety:

·美国临时专利申请序列号62/611,341，临时专利申请序列号62/611,341，其标题为交互式外科平台(INTERACTIVE SURGICAL PLATFORM)；U.S. Provisional Patent Application Serial No. 62/611,341, entitled INTERACTIVE SURGICAL PLATFORM;

·美国临时专利申请序列号62/611,340，其标题为基于云的医学分析(CLOUD-BASED MEDICAL ANALYTICS)；以及U.S. Provisional Patent Application Serial No. 62/611,340, entitled CLOUD-BASED MEDICAL ANALYTICS; and

·美国专利申请序列号62/611,339，其标题为机器人辅助的外科平台(ROBOTASSISTED SURGICAL PLATFORM)。- U.S. Patent Application Serial No. 62/611,339, entitled ROBOTASSISTED SURGICAL PLATFORM.

在详细说明外科装置和发生器的各个方面之前，应该指出的是，示例性示例的应用或使用并不局限于附图和具体实施方式中所示出的部件的构造和布置的细节。示例性示例可单独实施，或与其它方面、变更形式和修改形式结合在一起实施，并可以各种方式实践或执行。此外，除非另外指明，否则本文所用的术语和表达是为了方便读者而对示例性实施例进行描述而所选的，并非为了限制性的目的。而且，应当理解，以下描述的方面中的一个或多个、方面和/或示例的表达可以与以下描述的其它方面、方面和/或示例的表达中的任何一个或多个组合。Before describing in detail various aspects of the surgical device and generator, it should be noted that the application or use of the illustrative examples is not limited to the details of construction and arrangement of components shown in the drawings and detailed description. The illustrative examples may be implemented alone or in combination with other aspects, variations and modifications, and may be practiced or carried out in various ways. In addition, unless otherwise indicated, the terms and expressions used herein are selected for the convenience of the reader to describe the exemplary embodiments and are not for limiting purposes. Moreover, it should be understood that one or more of the aspects, expressions of aspects and/or examples described below may be combined with any one or more of the other aspects, expressions of aspects and/or examples described below.

各个方面涉及改进的超声外科装置、电外科装置和与其一起使用的发生器。超声外科装置的各方面可被配置为用于例如在外科规程期间横切和/或凝结组织。电外科装置的各方面可被配置为用于例如在外科规程期间横切、凝结、定标、焊接和/或干燥组织。Various aspects relate to improved ultrasonic surgical devices, electrosurgical devices, and generators for use therewith. Various aspects of the ultrasonic surgical devices can be configured for use, for example, in transecting and/or coagulating tissue during a surgical procedure. Various aspects of the electrosurgical devices can be configured for use, for example, in transecting, coagulating, targeting, welding, and/or desiccating tissue during a surgical procedure.

参见图1，计算机实现的交互式外科系统100包括一个或多个外科系统102和基于云的系统(例如，可包括耦合到存储装置105的远程服务器113的云104)。每个外科系统102包括与可包括远程服务器113的云104通信的至少一个外科集线器106。在一个示例中，如图1中所示，外科系统102包括可视化系统108、机器人系统110和手持式智能外科器械112，其被配置为彼此通信并且/或者与集线器106通信。在一些方面，外科系统102可包括M数量的集线器106、N数量的可视化系统108、O数量的机器人系统110和P数量的手持式智能外科器械112，其中M、N、O和P为大于或等于一的整数。1 , a computer-implemented interactive surgical system 100 includes one or more surgical systems 102 and a cloud-based system (e.g., a cloud 104 that may include a remote server 113 coupled to a storage device 105). Each surgical system 102 includes at least one surgical hub 106 that communicates with the cloud 104 that may include a remote server 113. In one example, as shown in FIG. 1 , the surgical system 102 includes a visualization system 108, a robotic system 110, and a handheld intelligent surgical instrument 112 that are configured to communicate with each other and/or with the hub 106. In some aspects, the surgical system 102 may include M number of hubs 106, N number of visualization systems 108, O number of robotic systems 110, and P number of handheld intelligent surgical instruments 112, where M, N, O, and P are integers greater than or equal to one.

图3描绘了用于对平躺在外科手术室116中的手术台114上的患者执行外科规程的外科系统102的示例。机器人系统110在外科规程中用作外科系统102的一部分。机器人系统110包括外科医生的控制台118、患者侧推车120(外科机器人)和外科机器人集线器122。当外科医生通过外科医生的控制台120观察外科部位时，患者侧推车117可通过患者体内的微创切口操纵至少一个可移除地耦合的外科工具118。外科部位的图像可通过医疗成像装置124获得，该医疗成像装置可由患者侧推车120操纵以定向成像装置124。机器人集线器122可用于处理外科部位的图像，以随后通过外科医生的控制台118显示给外科医生。FIG3 depicts an example of a surgical system 102 for performing a surgical procedure on a patient lying flat on an operating table 114 in a surgical operating room 116. A robotic system 110 is used as part of the surgical system 102 during a surgical procedure. The robotic system 110 includes a surgeon's console 118, a patient side cart 120 (surgical robot), and a surgical robotic hub 122. While the surgeon views the surgical site through the surgeon's console 120, the patient side cart 117 can manipulate at least one removably coupled surgical tool 118 through a minimally invasive incision in the patient. Images of the surgical site can be obtained through a medical imaging device 124, which can be manipulated by the patient side cart 120 to orient the imaging device 124. The robotic hub 122 can be used to process images of the surgical site for subsequent display to the surgeon through the surgeon's console 118.

其它类型的机器人系统可容易地适于与外科系统102一起使用。适用于本公开的机器人系统和外科工具的各个示例在2017年12月28日提交的标题为机器人辅助的外科平台(ROBOT ASSISTED SURGICAL PLATFORM)的美国临时专利申请序列号62/611,339中有所描述，该专利的公开内容全文以引用方式并入本文。Other types of robotic systems may be readily adapted for use with the surgical system 102. Various examples of robotic systems and surgical tools suitable for use with the present disclosure are described in U.S. Provisional Patent Application Serial No. 62/611,339, filed on December 28, 2017, entitled ROBOT ASSISTED SURGICAL PLATFORM, the disclosure of which is incorporated herein by reference in its entirety.

由云104执行并且适用于本公开的基于云的分析的各个示例描述于2017年12月28日提交的标题为“基于云的医疗分析(CLOUD-BASED MEDICAL ANALYTICS)”的美国临时专利申请序列号62/611,340中，其公开内容全文以引用方式并入本文。Various examples of cloud-based analytics performed by cloud 104 and suitable for use in the present disclosure are described in U.S. Provisional Patent Application Serial No. 62/611,340, entitled “CLOUD-BASED MEDICAL ANALYTICS,” filed on December 28, 2017, the disclosure of which is incorporated herein by reference in its entirety.

在各个方面，成像装置124包括至少一个图像传感器和一个或多个光学部件。合适的图像传感器包括但不限于电荷耦合装置(CCD)传感器和互补金属氧化物半导体(CMOS)传感器。In various aspects, imaging device 124 includes at least one image sensor and one or more optical components. Suitable image sensors include, but are not limited to, charge coupled device (CCD) sensors and complementary metal oxide semiconductor (CMOS) sensors.

成像装置124的光学部件可包括一个或多个照明源和/或一个或多个透镜。一个或多个照明源可被引导以照明外科场地的多部分。一个或多个图像传感器可接收从外科场地反射或折射的光，包括从组织和/或外科器械反射或折射的光。The optical components of the imaging device 124 may include one or more illumination sources and/or one or more lenses. The one or more illumination sources may be directed to illuminate portions of the surgical field. The one or more image sensors may receive light reflected or refracted from the surgical field, including light reflected or refracted from tissue and/or surgical instruments.

一个或多个照明源可被配置为辐射可见光谱中的电磁能以及不可见光谱。可见光谱(有时被称为光学光谱或发光光谱)是电磁光谱中对人眼可见(即，可被其检测)的那部分，并且可被称为可见光或简单光。典型的人眼将对空气中约380nm至约750nm的波长作出响应。One or more illumination sources may be configured to radiate electromagnetic energy in the visible spectrum as well as in the invisible spectrum. The visible spectrum (sometimes referred to as the optical spectrum or the luminescence spectrum) is that portion of the electromagnetic spectrum that is visible to (i.e., detectable by) the human eye and may be referred to as visible light or simply light. A typical human eye will respond to wavelengths in the range of about 380 nm to about 750 nm in air.

不可见光谱(即，非发光光谱)是电磁光谱的位于可见光谱之下和之上的部分(即，低于约380nm且高于约750nm的波长)。人眼不可检测到不可见光谱。大于约750nm的波长长于红色可见光谱，并且它们变为不可见的红外(IR)、微波和无线电电磁辐射。小于约380nm的波长比紫色光谱短，并且它们变为不可见的紫外、x射线和γ射线电磁辐射。The invisible spectrum (i.e., non-luminescent spectrum) is the portion of the electromagnetic spectrum below and above the visible spectrum (i.e., 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 red visible spectrum, and they become invisible infrared (IR), microwaves, and radio electromagnetic radiation. Wavelengths less than about 380 nm are shorter than the violet spectrum, and they become invisible ultraviolet, x-ray, and gamma-ray electromagnetic radiation.

在各个方面，成像装置124被配置为用于微创规程中。适用于本公开的成像装置的示例包括但不限于关节镜、血管镜、支气管镜、胆道镜、结肠镜、细胞检查镜、十二指镜、肠窥镜、食道-十二指肠镜(胃镜)、内窥镜、喉镜、鼻咽-肾内窥镜、乙状结肠镜、胸腔镜和子宫内窥镜。In various aspects, the imaging device 124 is configured for use in minimally invasive procedures. Examples of imaging devices suitable for use in the present disclosure include, but are not limited to, arthroscopy, angioscope, bronchoscope, choledochoscope, colonoscope, cytoscope, duodenoscope, enteroscope, esophago-duodenoscope (gastroscope), endoscope, laryngoscope, nasopharyngeal-renal endoscope, sigmoidoscope, thoracoscope, and hysteroscope.

在一个方面，成像装置采用多光谱监测来辨别形貌和底层结构。多光谱图像是捕获跨电磁波谱的特定波长范围内的图像数据的图像。可通过滤波器或通过使用对特定波长敏感的器械来分离波长，特定波长包括来自可见光范围之外的频率的光，例如IR和紫外。光谱成像可允许提取人眼未能用其红色，绿色和蓝色的受体捕获的附加信息。多光谱成像的使用在2017年12月28日提交的标题为“交互式外科平台(INTERACTIVE SURGICALPLATFORM)”的美国临时专利申请序列号62/611,341的标题“高级成像采集模块(AdvancedImaging Acquisition Module)”下更详细地描述，该专利的公开内容全文以引用方式并入本文。在完成外科任务以对处理过的组织执行一个或多个先前所述测试之后，多光谱监测可以是用于重新定位外科场地的有用工具。In one aspect, the imaging device uses multispectral monitoring to distinguish topography and underlying structure. Multispectral images are images that capture image data within a specific wavelength range across the electromagnetic spectrum. The wavelengths can be separated by filters or by using instruments that are sensitive to specific wavelengths, including light from frequencies outside the visible light range, such as IR and ultraviolet. Spectral imaging allows the extraction of additional information that the human eye fails to capture with its red, green, and blue receptors. The use of multispectral imaging is described in more detail under the title "Advanced Imaging Acquisition Module" of U.S. Provisional Patent Application Serial No. 62/611,341, entitled "INTERACTIVE SURGICALPLATFORM", filed on December 28, 2017, the disclosure of which is incorporated herein by reference in its entirety. After completing the surgical task to perform one or more of the previously described tests on the treated tissue, multispectral monitoring can be a useful tool for repositioning the surgical site.

不言自明的是，在任何外科期间都需要对手术室和外科设备进行严格消毒。在“外科室”(即，手术室或治疗室)中所需的严格的卫生和消毒条件需要所有医疗装置和设备的最高可能的无菌性。该灭菌过程的一部分是需要对接触患者或穿透无菌场的任何物质进行灭菌，包括成像装置124及其附接件和部件。应当理解，无菌场可被认为是被认为不含微生物的指定区域，诸如在托盘内或无菌毛巾内，或者无菌场可被认为是已准备用于外科规程的患者周围的区域。无菌场可包括被恰当地穿着的擦洗的团队构件，以及该区域中的所有家具和固定件。It is self-evident that during any surgical procedure, the operating room and surgical equipment need to be strictly sterilized. The strict sanitary and sterile conditions required in a "surgical room" (i.e., an operating room or treatment room) require the highest possible sterility of all medical devices and equipment. Part of this sterilization process is the need to sterilize any material that contacts the patient or penetrates the sterile field, including the imaging device 124 and its attachments and components. It should be understood that the sterile field can be considered to be a designated area that is considered to be free of microorganisms, such as within a tray or sterile towels, or the sterile field can be considered to be an area around a patient that has been prepared for a surgical procedure. The sterile field can include a scrubbed team member that is appropriately dressed, as well as all furniture and fixtures in the area.

在各个方面，可视化系统108包括一个或多个成像传感器、一个或多个图像处理单元、一个或多个存储阵列、以及一个或多个显示器，其相对于无菌场进行策略布置，如图2中所示。在一个方面，可视化系统108包括用于HL7、PACS和EMR的界面。可视化系统108的各种部件在2017年12月28日提交的标题为“交互式外科平台(INTERACTIVE SURGICALPLATFORM)”的美国临时专利申请序列号62/611,341的标题“高级成像采集模块(AdvancedImaging Acquisition Module)”下有所描述，该专利申请的公开内容全文以引用方式并入本文。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 displays, which are strategically arranged relative to the sterile field, as shown in FIG2. In one aspect, the visualization system 108 includes interfaces for HL7, PACS, and EMR. The various components of the visualization system 108 are described under the title "Advanced Imaging Acquisition Module" of U.S. Provisional Patent Application Serial No. 62/611,341, entitled "INTERACTIVE SURGICALPLATFORM," filed on December 28, 2017, the disclosure of which is incorporated herein by reference in its entirety.

如图2中所示，主显示器119被定位在无菌场中，以对在手术台114处的操作者可见。此外，可视化塔111被定位在无菌场之外。可视化塔111包括彼此背离的第一非无菌显示器107和第二非无菌显示器109。由集线器106引导的可视化系统108被配置为利用显示器107、109和119来将信息流协调到无菌场内侧和外侧的操作者。例如，集线器106可使成像系统108在非无菌显示器107或109上显示由成像装置124记录的外科部位的快照，同时保持外科部位在主显示器119上的实时馈送。非无菌显示器107或109上的快照可允许非无菌操作者例如执行与外科规程相关的诊断步骤。As shown in FIG. 2 , the main display 119 is positioned in the sterile field to be visible to the operator at the operating table 114. In addition, the visualization tower 111 is positioned outside the sterile field. The visualization tower 111 includes a first non-sterile display 107 and a second non-sterile display 109 that are separated from each other. The visualization system 108 guided by the hub 106 is configured to coordinate the flow of information to the operators inside and outside the sterile field using the displays 107, 109, and 119. For example, the hub 106 can cause the imaging system 108 to display a snapshot of the surgical site recorded by the imaging device 124 on the non-sterile display 107 or 109, while maintaining a real-time feed of the surgical site on the main display 119. The snapshot on the non-sterile display 107 or 109 can allow the non-sterile operator to, for example, perform diagnostic steps related to the surgical procedure.

在一个方面，集线器106被进一步配置为将由非无菌操作者在可视化塔111处输入的诊断输入或反馈路由至无菌场内的主显示器119，其中可由操作台上的无菌操作员查看。在一个示例中，输入可以是对显示在非无菌显示器107或109上的快照的修改形式，其可通过集线器106路由到主显示器119。In one aspect, the hub 106 is further configured to route diagnostic input or feedback entered by a non-sterile operator at the visualization tower 111 to a primary display 119 within the sterile field, where it can be viewed by a sterile operator at the operating table. In one example, the input can be a modified form of a snapshot displayed on a non-sterile display 107 or 109, which can be routed to the primary display 119 via the hub 106.

参见图2，外科器械112作为外科系统102的一部分在外科规程中使用。集线器106被进一步配置为协调流向外科器械112的显示器的信息流。例如，在2017年12月28日提交的标题为“交互式外科平台(INTERACTIVE SURGICAL PLATFORM)”的美国临时专利申请序列号62/611,341，其公开内容全文以引用方式并入本文。由非无菌操作者在可视化塔111处输入的诊断输入或反馈可由集线器106路由至无菌场内的外科器械显示器115，其中外科器械112的操作者可观察到该输入或反馈。适用于外科系统102的示例性外科器械描述于2017年12月28日提交的标题为“交互式外科平台(INTERACTIVE SURGICAL PLATFORM)”的美国临时专利申请序列号62/611,341的标题“外科器械硬件(Surgical Instrument Hardware)”下，该专利的公开内容全文以引用方式并入本文。2 , surgical instruments 112 are used in surgical procedures as part of the surgical system 102. The hub 106 is further configured to coordinate the flow of information to the display of the surgical instrument 112. For example, U.S. Provisional Patent Application Serial No. 62/611,341, entitled “INTERACTIVE SURGICAL PLATFORM,” filed on December 28, 2017, the disclosure of which is incorporated herein by reference in its entirety. Diagnostic input or feedback entered by a non-sterile operator at the visualization tower 111 can be routed by the hub 106 to the surgical instrument display 115 within the sterile field, where the operator of the surgical instrument 112 can observe the input or feedback. Exemplary surgical instruments suitable for use with surgical system 102 are described under the title “Surgical Instrument Hardware” in U.S. provisional patent application serial number 62/611,341, entitled “INTERACTIVE SURGICAL PLATFORM,” filed on December 28, 2017, the disclosure of which is incorporated herein by reference in its entirety.

现在参见图3，集线器106被描绘为与可视化系统108、机器人系统110和手持式智能外科器械112通信。集线器106包括集线器显示器135、成像模块138、发生器模块140、通信模块130、处理器模块132和存储阵列134。在某些方面，如图3中所示，集线器106还包括排烟模块126和/或抽吸/冲洗模块128。3 , the hub 106 is depicted in communication with the visualization system 108, the robotic system 110, and the handheld intelligent surgical instrument 112. The hub 106 includes a hub display 135, an imaging module 138, a generator module 140, a communication module 130, a processor module 132, and a storage array 134. In certain aspects, as shown in FIG. 3 , the hub 106 also includes a smoke evacuation module 126 and/or an aspiration/irrigation module 128.

在外科规程期间，施加到组织用于密封和/或切割的能量通常与排烟、抽吸多余的流体和/或冲洗组织相关联。来自不同来源的流体管线、功率管线和/或数据管线通常在外科规程期间缠结。在外科规程期间解决该问题可丢失有价值的时间。断开管线可需要将管线与其相应的模块断开连接，这可需要重置模块。集线器模块化壳体136提供用于管理功率管线、数据管线和流体管线的统一环境，这减小了此类管线之间缠结的频率。During surgical procedures, energy applied to tissue for sealing and/or cutting is often associated with smoke evacuation, suction of excess fluid, and/or flushing of tissue. Fluid lines, power lines, and/or data lines from different sources often become tangled during surgical procedures. Valuable time can be lost in solving this problem during surgical procedures. Disconnecting a line may require disconnecting the line from its corresponding module, which may require resetting the module. The hub modular housing 136 provides a unified environment for managing power lines, data lines, and fluid lines, which reduces the frequency of tangling between such lines.

本公开的各方面提供了用于外科规程的外科集线器，该外科规程涉及在外科部位处将能量施加到组织。外科集线器包括集线器壳体和可滑动地接纳在集线器壳体的对接底座中的组合发生器模块。对接底座包括数据触点和功率触点。组合发生器模块包括座置在单个单元中的超声能量发生器部件、双极RF能量发生器部件和单极RF能量发生器部件中的两个或更多个。在一个方面，组合发生器模块还包括排烟部件，用于将组合发生器模块连接到外科器械的至少一根能量递送缆线、被配置为排出通过向组织施加治疗能量而产生的烟雾、流体和/或颗粒的至少一个排烟部件、以及从远程外科部位延伸至排烟部件的流体管线。Aspects of the present disclosure provide a surgical hub for a surgical procedure involving applying energy to tissue at a surgical site. The surgical hub includes a hub housing and a combination generator module slidably received in a docking base of the hub housing. The docking base includes data contacts and power contacts. The combination generator module includes two or more of an ultrasonic energy generator component, a bipolar RF energy generator component, and a monopolar RF energy generator component seated in a single unit. In one aspect, the combination generator module also includes a smoke exhaust component for connecting the combination generator module to at least one energy delivery cable of a surgical instrument, at least one smoke exhaust component configured to exhaust smoke, fluid, and/or particles generated by applying therapeutic energy to tissue, and a fluid line extending from a remote surgical site to the smoke exhaust component.

在一个方面，流体管线是第一流体管线，并且第二流体管线从远程外科部位延伸至可滑动地接纳在集线器壳体中的抽吸和冲洗模块。在一个方面，集线器壳体包括流体接口。In one aspect, the fluid line is a first fluid line and the second fluid line extends from the remote surgical site to an aspiration and irrigation module slidably received in the hub housing. In one aspect, the hub housing includes a fluid interface.

某些外科规程可需要将多于一种能量类型施加到组织。一种能量类型可更有利于切割组织，而另一种不同的能量类型可更有利于密封组织。例如，双极发生器可用于密封组织，而超声发生器可用于切割密封的组织。本公开的各方面提供了一种解决方案，其中集线器模块化壳体136被配置为容纳不同的发生器，并且有利于它们之间的交互式通信。集线器模块化壳体136的优点之一是能够快速地移除和/或更换各种模块。Certain surgical procedures may require more than one energy type to be applied to tissue. One energy type may be more conducive to cutting tissue, while another different energy type may be more conducive to sealing tissue. For example, a bipolar generator may be used to seal tissue, while an ultrasonic generator may be used to cut sealed tissue. Aspects of the present disclosure provide a solution in which a hub modular housing 136 is configured to accommodate different generators and facilitate interactive communication between them. One of the advantages of the hub modular housing 136 is the ability to quickly remove and/or replace various modules.

本公开的方面提供了在涉及将能量施加到组织的外科规程中使用的模块化外科壳体。模块化外科壳体包括第一能量发生器模块，该第一能量发生器模块被配置为生成用于施加到组织的第一能量，和第一对接底座，该第一对接底座包括第一对接端口，该第一对接端口包括第一数据和功率触点，其中第一能量发生器模块可滑动地运动成与该功率和数据触点电接合，并且其中第一能量发生器模块可滑动地运动出与第一功率和数据触点的电接合，Aspects of the present disclosure provide a modular surgical housing for use in surgical procedures involving application of energy to tissue. The modular surgical housing includes a first energy generator module configured to generate a first energy for application to tissue, and a first docking base including a first docking port including first data and power contacts, wherein the first energy generator module is slidably movable into electrical engagement with the power and data contacts, and wherein the first energy generator module is slidably movable out of electrical engagement with the first power and data contacts,

对上文进行进一步描述，模块化外科壳体还包括第二能量发生器模块，该第二能量发生器模块被配置为生成不同于第一能量的第二能量以用于施加到组织，和第二对接底座，该第二对接底座包括第二对接端口，该第二对接端口包括第二数据和功率触点，其中第二能量发生器模块可滑动地运动成与功率和数据触点电接合，并且其中第二能量发生器可滑动地运动出于第二功率和数据触点的电接触。Further describing the above, the modular surgical shell also includes a second energy generator module, which is configured to generate a second energy different from the first energy for application to tissue, and a second docking base, which includes a second docking port, the second docking port including second data and power contacts, wherein the second energy generator module is slidably movable into electrical engagement with the power and data contacts, and wherein the second energy generator is slidably movable out of electrical contact with the second power and data contacts.

此外，模块化外科壳体还包括在第一对接端口和第二对接端口之间的通信总线，其被配置为有利于第一能量发生器模块和第二能量发生器模块之间的通信。In addition, the modular surgical shell also includes a communication bus between the first docking port and the second docking port, which is configured to facilitate communication between the first energy generator module and the second energy generator module.

参见图3-7，本公开的各方面被呈现为集线器模块化壳体136，其允许发生器模块140、排烟模块126和抽吸/冲洗模块128的模块化集成。集线器模块化壳体136还有利于模块140、126、128之间的交互式通信。如图5中所示，发生器模块140可为具有集成的单极部件、双极部件和超声部件的发生器模块，该部件被支撑在可滑动地插入到集线器模块化壳体136中的单个外壳单元139中。如图5中所示，发生器模块140可被配置为连接到单极装置146、双极装置147和超声装置148。另选地，发生器模块140可包括通过集线器模块化壳体136进行交互的一系列单极发生器模块、双极发生器模块和/或超声发生器模块。集线器模块化壳体136可被配置为有利于多个发生器的插入和对接到集线器模块化壳体136中的发生器之间的交互通信，使得发生器将充当单个发生器。3-7, aspects of the present disclosure are presented as a hub modular housing 136 that allows modular integration of a generator module 140, a smoke evacuation module 126, and a suction/irrigation module 128. The hub modular housing 136 also facilitates interactive communication between the modules 140, 126, 128. As shown in FIG. 5, the generator module 140 may be a generator module having integrated monopolar components, bipolar components, and ultrasonic components, which are supported in a single housing unit 139 that is slidably inserted into the hub modular housing 136. As shown in FIG. 5, the generator module 140 may be configured to connect to a monopolar device 146, a bipolar device 147, and an ultrasonic device 148. Alternatively, the generator module 140 may include a series of monopolar generator modules, bipolar generator modules, and/or ultrasonic generator modules that interact through the hub modular housing 136. The hub modular housing 136 can be configured to facilitate the insertion of multiple generators and interactive communication between the generators docked into the hub modular housing 136 so that the generators will function as a single generator.

在一个方面，集线器模块化壳体136包括具有外部和无线通信接头的模块化功率和通信底板149，以实现模块140、126、128的可移除附接件以及它们之间的交互通信。In one aspect, the hub modular housing 136 includes a modular power and communications backplane 149 with external and wireless communications connectors to enable removable attachment of the modules 140, 126, 128 and interactive communications therebetween.

在一个方面，集线器模块化壳体136包括对接底座或抽屉151(本文也称为抽屉)，其被配置为可滑动地接纳模块140、126、128。图4示出了能够可滑动地接纳在外科集线器壳体136的对接底座151中的外科集线器壳体136和组合发生器模块145的局部透视图。在组合发生器模块145的背面上具有功率和数据触点的对接端口152被配置为当组合发生器模块145滑动到集线器模块壳体136的对应的对接底座151内的适当位置时，将对应的对接端口150与集线器模块化壳体136的对应对接底座151的功率和数据触点接合。在一个方面，组合发生器模块145包括一起集成到单个外壳单元139中的双极、超声和单极模块以及排烟模块，如图5中所示。In one aspect, the hub modular housing 136 includes a docking base or drawer 151 (also referred to herein as a drawer) configured to slidably receive the modules 140, 126, 128. FIG. 4 shows a partial perspective view of the surgical hub housing 136 and the combination generator module 145 that can be slidably received in the docking base 151 of the surgical hub housing 136. The docking port 152 having power and data contacts on the back of the combination generator module 145 is configured to engage the corresponding docking port 150 with the power and data contacts of the corresponding docking base 151 of the hub modular housing 136 when the combination generator module 145 is slid into the appropriate position within the corresponding docking base 151 of the hub module housing 136. In one aspect, the combination generator module 145 includes bipolar, ultrasonic and monopolar modules and a smoke evacuation module integrated together into a single housing unit 139, as shown in FIG. 5.

在各个方面，排烟模块126包括流体管线154，该流体管线154将捕集/收集的烟雾和/或流体从外科部位输送到例如排烟模块126。源自排烟模块126的真空抽吸可将烟雾吸入外科部位处的公用导管的开口中。耦合到流体管线的公用导管可以是端接在排烟模块126处的柔性管的形式。公用导管和流体管线限定朝向接纳在集线器壳体136中的排烟模块126延伸的流体路径。In various aspects, the smoke evacuation module 126 includes a fluid line 154 that delivers captured/collected smoke and/or fluid from the surgical site to, for example, the smoke evacuation module 126. Vacuum suction from the smoke evacuation module 126 can draw smoke into an opening of a common conduit at the surgical site. The common conduit coupled to the fluid line can be in the form of a flexible tube that terminates at the smoke evacuation module 126. The common conduit and the fluid line define a fluid path that extends toward the smoke evacuation module 126 received in the hub housing 136.

在各个方面，抽吸/冲洗模块128耦合到包括吸出流体管线和抽吸流体管线的外科工具。在一个示例中，吸出流体管线和抽吸流体管线为从外科部位朝向抽吸/冲洗模块128延伸的柔性管的形式。一个或多个驱动系统可被配置为冲洗到外科部位的流体和从外科部位抽吸流体。In various aspects, the suction/irrigation module 128 is coupled to a surgical tool including an aspiration fluid line and an aspiration fluid line. In one example, the aspiration fluid line and the aspiration fluid line are in the form of flexible tubes extending from the surgical site toward the suction/irrigation module 128. One or more drive systems can be configured to flush fluid to the surgical site and to aspirate fluid from the surgical site.

在一个方面，外科工具包括轴，该轴具有在其远侧端部处的端部执行器以及与端部执行器、吸出管和冲洗管相关联的至少一种能量处理。吸出管可在其远侧端部处具有入口，并且吸出管延伸穿过轴。类似地，吸出管可延伸穿过轴并且可具有邻近能量递送工具的入口。能量递送工具被配置为将超声能量和/或RF能量递送至外科部位，并且通过初始延伸穿过轴的缆线耦合到发生器模块140。In one aspect, the surgical tool comprises a shaft having an end effector at its distal end and at least one energy treatment associated with the end effector, an aspiration tube, and an irrigation tube. The aspiration tube may have an inlet at its distal end, and the aspiration tube extends through the shaft. Similarly, the aspiration tube may extend through the shaft and may have an inlet adjacent to an energy delivery tool. The energy delivery tool is configured to deliver ultrasonic energy and/or RF energy to a surgical site and is coupled to a generator module 140 by a cable initially extending through the shaft.

冲洗管可与流体源流体连通，并且吸出管可与真空源流体连通。流体源和/或真空源可座置在抽吸/冲洗模块128中。在一个示例中，流体源和/或真空源可独立于抽吸/冲洗模块128座置在集线器壳体136中。在此类示例中，流体接口能够将抽吸/冲洗模块128连接到流体源和/或真空源。The irrigation tube may be in fluid communication with a fluid source, and the aspiration tube may be in fluid communication with a vacuum source. The fluid source and/or vacuum source may be seated in the suction/irrigation module 128. In one example, the fluid source and/or vacuum source may be seated in the hub housing 136 independently of the suction/irrigation module 128. In such examples, a fluid interface is capable of connecting the suction/irrigation module 128 to the fluid source and/or vacuum source.

在一个方面，集线器模块化壳体136上的模块140、126、128和/或其对应的对接底座可包括对准特征件，该对准特征件被配置为将模块的对接端口对准成与其在集线器模块化壳体136的对接底座中的对应端口接合。例如，如图4中所示，组合发生器模块145包括侧支架155，侧支架155被配置为与集线器模块化壳体136的对应的对接底座151的对应支架156可滑动地接合。支架配合以引导组合发生器模块145的对接端口触点与集线器模块化壳体136的对接端口触点电接合。In one aspect, the modules 140, 126, 128 and/or their corresponding docking stations on the hub modular housing 136 may include alignment features configured to align the docking ports of the modules to engage with their corresponding ports in the docking stations of the hub modular housing 136. For example, as shown in FIG4 , the combination generator module 145 includes a side bracket 155 configured to slidably engage with a corresponding bracket 156 of a corresponding docking station 151 of the hub modular housing 136. The bracket cooperates to guide the docking port contacts of the combination generator module 145 into electrical engagement with the docking port contacts of the hub modular housing 136.

在一些方面，集线器模块化壳体136的抽屉151为相同的或大体上相同的大小，并且模块的大小被调节为接纳在抽屉151中。例如，侧支架155和/或156可根据模块的大小而更大或更小。在其它方面，抽屉151的大小不同，并且各自被设计成容纳特定模块。In some aspects, the drawers 151 of the hub modular housing 136 are the same or substantially the same size, and the size of the module is adjusted to be received in the drawer 151. For example, the side brackets 155 and/or 156 can be larger or smaller depending on the size of the module. In other aspects, the drawers 151 are different sizes and each is designed to accommodate a specific module.

此外，可对特定模块的触点进行键控以与特定抽屉的触点接合，以避免将模块插入到具有不匹配触点的抽屉中。Additionally, the contacts of a particular module may be keyed to engage the contacts of a particular drawer to avoid inserting a module into a drawer with mismatched contacts.

如图4中所示，一个抽屉151的对接端口150可通过通信链路157耦合到另一个抽屉151的对接端口150，以有利于座置在集线器模块化壳体136中的模块之间的交互式通信。另选地或附加地，集线器模块化壳体136的对接端口150可有利于座置在集线器模块化壳体136中的模块之间的无线交互通信。可采用任何合适的无线通信，诸如例如Air Titan-Bluetooth。4, the docking port 150 of one drawer 151 may be coupled to the docking port 150 of another drawer 151 via a communication link 157 to facilitate interactive communication between modules seated in the hub modular housing 136. Alternatively or additionally, the docking port 150 of the hub modular housing 136 may facilitate wireless interactive communication between modules seated in the hub modular housing 136. Any suitable wireless communication may be employed, such as, for example, Air Titan-Bluetooth.

图6示出了用于横向模块化外壳160的多个横向对接端口的单个功率总线附接件，该横向模块化外壳160被配置为容纳外科集线器206的多个模块。横向模块化外壳160被配置为横向容纳和互连模块161。模块161可滑动地插入到横向模块化外壳160的对接底座162中，该横向模块化外壳160包括用于互连模块161的底板。如图6中所示，模块161横向布置在横向模块化外壳160中。另选地，模块161可竖直地布置在横向模块化外壳中。FIG6 illustrates a single power bus attachment for multiple lateral docking ports of a lateral modular housing 160 configured to accommodate multiple modules of a surgical hub 206. The lateral modular housing 160 is configured to accommodate and interconnect modules 161 laterally. The modules 161 are slidably inserted into a docking base 162 of the lateral modular housing 160, which includes a bottom plate for interconnecting the modules 161. As shown in FIG6, the modules 161 are arranged laterally in the lateral modular housing 160. Alternatively, the modules 161 may be arranged vertically in the lateral modular housing.

图7示出了被配置为容纳外科集线器106的多个模块165的竖直模块化外壳164。模块165可滑动地插入到竖直模块化外壳164的对接底座或抽屉167中，该竖直模块化外壳164包括用于互连模块165的底板。尽管竖直模块化外壳164的抽屉167竖直布置，但在某些情况下，竖直模块化外壳164可包括横向布置的抽屉。此外，模块165可通过竖直模块化外壳164的对接端口彼此交互。在图7的示例中，提供了用于显示与模块165的操作相关的数据的显示器177。此外，竖直模块化外壳164包括主模块178，该主模块座置可滑动地容纳在主模块178中的多个子模块。FIG. 7 shows a vertical modular housing 164 configured to accommodate a plurality of modules 165 of a surgical hub 106. The modules 165 are slidably inserted into a docking base or drawer 167 of the vertical modular housing 164, which includes a bottom plate for interconnecting the modules 165. Although the drawers 167 of the vertical modular housing 164 are arranged vertically, in some cases, the vertical modular housing 164 may include drawers arranged horizontally. In addition, the modules 165 may interact with each other through the docking ports of the vertical modular housing 164. In the example of FIG. 7, a display 177 is provided for displaying data related to the operation of the modules 165. In addition, the vertical modular housing 164 includes a main module 178, which seats a plurality of sub-modules slidably accommodated in the main module 178.

在各个方面，成像模块138包括集成视频处理器和模块化光源，并且适于与各种成像装置一起使用。在一个方面，成像装置由可装配有光源模块和相机模块的模块化外壳构成。外壳可为一次性外壳。在至少一个示例中，一次性外壳可移除地耦合到可重复使用的控制器、光源模块和相机模块。光源模块和/或相机模块可根据外科规程的类型选择性地选择。在一个方面，相机模块包括CCD传感器。在另一方面，相机模块包括CMOS传感器。在另一方面，相机模块被配置用于扫描波束成像。同样，光源模块可被配置为递送白光或不同的光，这取决于外科规程。In various aspects, the imaging module 138 includes an integrated video processor and a modular light source and is suitable for use with a variety of imaging devices. In one aspect, the imaging device is composed of a modular housing that can be equipped with a light source module and a camera module. The housing can be a disposable housing. In at least one example, the disposable housing is removably coupled to a reusable controller, light source module, and camera module. The light source module and/or camera module can be selectively selected according to the type of surgical procedure. In one aspect, the camera module includes a CCD sensor. On the other hand, the camera module includes a CMOS sensor. On the other hand, the camera module is configured for scanning beam imaging. Similarly, the light source module can be configured to deliver white light or different light, depending on the surgical procedure.

在外科规程期间，从外科场地移除外科装置并用包括不同相机或不同光源的另一外科装置替换外科装置可为低效的。暂时失去对外科场地的视线可导致不期望的后果。本公开的模块成像装置被配置为允许在外科规程期间中流替换光源模块或相机模块，而不必从外科场地移除成像装置。During a surgical procedure, it may be inefficient to remove a surgical device from the surgical field and replace the surgical device with another surgical device that includes a different camera or a different light source. Temporarily losing sight of the surgical field may lead to undesirable consequences. The modular imaging device of the present disclosure is configured to allow mid-stream replacement of a light source module or a camera module during a surgical procedure without having to remove the imaging device from the surgical field.

在一个方面，成像装置包括包括多个通道的管状外壳。第一通道被配置为可滑动地容纳相机模块，该相机模块可被配置为与第一通道搭扣配合接合。第二通道被配置为可滑动地容纳光源模块，该光源模块可被配置为与第二通道搭扣配合接合。在另一个示例中，相机模块和/或光源模块可在其相应通道内旋转到最终位置。可采用螺纹接合代替搭扣配合接合。In one aspect, an imaging device includes a tubular housing including a plurality of channels. A first channel is configured to slidably receive a camera module, which can be configured to snap-fit into engagement with the first channel. A second channel is configured to slidably receive a light source module, which can be configured to snap-fit into engagement with the second channel. In another example, the camera module and/or the light source module can be rotated into a final position within their respective channels. A threaded engagement can be used in place of a snap-fit engagement.

在各个示例中，多个成像装置被放置在外科场地中的不同位置以提供多个视图。成像模块138可被配置为在成像装置之间切换以提供最佳视图。在各个方面，成像模块138可被配置为集成来自不同成像装置的图像。In various examples, multiple imaging devices are placed at different locations in the surgical field to provide multiple views. The imaging module 138 can be configured to switch between imaging devices to provide the best view. In various aspects, the imaging module 138 can be configured to integrate images from different imaging devices.

适用于本公开的各种图像处理器和成像装置描述于2011年8月9日公布的标题为组合SBI和常规图像处理器(COMBINED SBI AND CONVENTIONAL IMAGE PROCESSOR)美国专利7,995,045中，该专利以引用方式全文并入本文。此外，2011年7月19日公布的标题为SBI运动伪影移除设备和方法(SBI MOTION ARTIFACT REMOVAL APPARATUS AND METHOD)的美国专利7,982,776描述了用于从图像数据中移除运动伪影的各种系统，该专利以引用方式全文并入本文。此类系统可与成像模块138集成。此外，2011年12月15日公布的标题为对固定件体内设备的可控制磁源(CONTROLLABLE MAGNETIC SOURCE TO FIXTUREINTRACORPOREAL APPARATUS)的美国专利申请公布2011/0306840和2014年8月28日公布的标题为用于执行微创外科规程的系统(SYSTEM FOR PERFORMING A MINIMALLY INVASIVESURGICAL PROCEDURE)的美国专利申请公布2014/0243597，以上专利中的每个全文以引用方式并入本文。Various image processors and imaging devices suitable for use with the present disclosure are described in U.S. Patent No. 7,995,045, entitled COMBINED SBI AND CONVENTIONAL IMAGE PROCESSOR, issued on August 9, 2011, which is incorporated herein by reference in its entirety. In addition, U.S. Patent No. 7,982,776, entitled SBI MOTION ARTIFACT REMOVAL APPARATUS AND METHOD, issued on July 19, 2011, describes various systems for removing motion artifacts from image data, which is incorporated herein by reference in its entirety. Such systems may be integrated with imaging module 138. In addition, U.S. patent application publication 2011/0306840, entitled CONTROLLABLE MAGNETIC SOURCE TO FIXTUREINTRACORPOREAL APPARATUS, published on December 15, 2011, and U.S. patent application publication 2014/0243597, entitled SYSTEM FOR PERFORMING A MINIMALLY INVASIVE SURGICAL PROCEDURE, published on August 28, 2014, each of the above patents is incorporated herein by reference in its entirety.

图8示出了包括模块化通信集线器203的外科数据网络201，该模块化通信集线器203被配置为将位于医疗设施的一个或多个手术室中的模块化装置或专门配备用于外科操作的医疗设施中的任何房间连接到基于云的系统(例如，可包括耦合到存储装置205的远程服务器213的云204)。在一个方面，模块化通信集线器203包括与网络路由器通信的网络集线器207和/或网络交换机209。模块化通信集线器203还可耦合到本地计算机系统210以提供本地计算机处理和数据操纵。外科数据网络201可被配置为无源的、智能的或交换的。无源外科数据网络充当数据的管道，从而使其能够从一个装置(或区段)转移到另一个装置(或区段)以及云计算资源。智能外科数据网络包括附加特征件，以使得能够监测穿过外科数据网络的流量并配置网络集线器207或网络交换器209中的每个端口。智能外科数据网络可被称为可管理的集线器或交换器。交换集线器读取每个分组的目标地址，并且然后将分组转发到正确的端口。FIG8 shows a surgical data network 201 including a modular communication hub 203 configured to connect modular devices located in one or more operating rooms of a medical facility or any room in a medical facility that is specifically equipped for surgical operations to a cloud-based system (e.g., a cloud 204 that may include a remote server 213 coupled to a storage device 205). In one aspect, the modular communication hub 203 includes a network hub 207 and/or a network switch 209 that communicates with a network router. The modular communication hub 203 may also be coupled to a local computer system 210 to provide local computer processing and data manipulation. The surgical data network 201 may be configured as passive, intelligent, or switched. A passive surgical data network acts as a conduit for data, enabling it to be transferred from one device (or segment) to another device (or segment) and to cloud computing resources. An intelligent surgical data network includes additional features to enable monitoring of traffic through the surgical data network and configuration of each port in the network hub 207 or network switch 209. The intelligent surgical data network may be referred to as a manageable hub or switch. The switching hub reads the destination address of each packet and then forwards the packet to the correct port.

位于手术室中的模块化装置1a-1n可耦合到模块化通信集线器203。网络集线器207和/或网络交换机209可耦合到网络路由器211以将装置1a-1n连接至云204或本地计算机系统210。与装置1a-1n相关联的数据可经由路由器传输到基于云的计算机，用于远程数据处理和操纵。与装置1a-1n相关联的数据也可被传输至本地计算机系统210以用于本地数据处理和操纵。位于相同手术室中的模块化装置2a-2m也可耦合到网络交换机209。网络交换机209可耦合到网络集线器207和/或网络路由器211以将装置2a-2m连接至云204。与装置2a-2n相关联的数据可经由网络路由器211传输到云204以用于数据处理和操纵。与装置2a-2m相关联的数据也可被传输至本地计算机系统210以用于本地数据处理和操纵。Modular devices 1a-1n located in an operating room may be coupled to a modular communication hub 203. A network hub 207 and/or a network switch 209 may be coupled to a network router 211 to connect devices 1a-1n to a cloud 204 or a local computer system 210. Data associated with devices 1a-1n may be transmitted to a cloud-based computer via a router for remote data processing and manipulation. Data associated with devices 1a-1n may also be transmitted to a local computer system 210 for local data processing and manipulation. Modular devices 2a-2m located in the same operating room may also be coupled to a network switch 209. A network switch 209 may be coupled to a network hub 207 and/or a network router 211 to connect devices 2a-2m to a cloud 204. Data associated with devices 2a-2n may be transmitted to a cloud 204 via a network router 211 for data processing and manipulation. Data associated with devices 2a-2m may also be transmitted to a local computer system 210 for local data processing and manipulation.

应当理解，可通过将多个网络集线器207和/或多个网络交换机209与多个网络路由器211互连来扩展外科数据网络201。模块化通信集线器203可被包含在模块化控制塔中，该模块化控制塔被配置为接纳多个装置1a-1n/2a-2m。本地计算机系统210也可包含在模块化控制塔中。模块化通信集线器203连接到显示器212以显示例如在外科规程期间由装置1a-1n/2a-2m中的一些获得的图像。在各个方面，装置1a-1n/2a-2m可包括例如各种模块，诸如耦合到内窥镜的成像模块138、耦合到基于能量的外科装置的发生器模块140、排烟模块126、抽吸/冲洗模块128、通信模块130、处理器模块132、存储阵列134、连接到显示器的外科装置、和/或可连接到外科数据网络201的模块化通信集线器203的其它模块化装置中的非接触传感器模块。It should be understood that the surgical data network 201 can be expanded by interconnecting multiple network hubs 207 and/or multiple network switches 209 with multiple network routers 211. The modular communication hub 203 can be included in a modular control tower that is configured to accommodate multiple devices 1a-1n/2a-2m. A local computer system 210 can also be included in the modular control tower. The modular communication hub 203 is connected to a display 212 to display images obtained by some of the devices 1a-1n/2a-2m during a surgical procedure, for example. In various aspects, devices 1a-1n/2a-2m may include, for example, various modules, such as an imaging module 138 coupled to an endoscope, a generator module 140 coupled to an energy-based surgical device, a smoke evacuation module 126, a suction/irrigation module 128, a communication module 130, a processor module 132, a storage array 134, a surgical device connected to a display, and/or a non-contact sensor module in other modular devices that can be connected to a modular communication hub 203 of a surgical data network 201.

在一个方面，外科数据网络201可包括将装置1a-1n/2a-2m连接至云的一个或多个网络集线器、一个或多个网络交换机和一个或多个网络路由器的组合。耦合到网络集线器或网络交换机的装置1a-1n/2a-2m中的任何一个或全部可实时收集数据并将数据传输到云计算机中以进行数据处理和操纵。应当理解，云计算依赖于共享计算资源，而不是使用本地服务器或个人装置来处理软件应用程序。可使用“云”一词作为“互联网”的隐喻，尽管该术语不受此限制。因此，本文可使用术语“云计算”来指“基于互联网的计算的类型”，其中将不同的服务(诸如服务器、存储器和应用程序)递送至位于外科室(例如，固定、移动、临时或现场手术室或空间)中的模块化通信集线器203和/或计算机系统210以及通过互联网连接至模块化通信集线器203和/或计算机系统210的装置。云基础设施可由云服务提供方维护。在这种情况下，云服务提供方可为协调位于一个或多个手术室中的装置1a-1n/2a-2m的使用和控制的实体。云计算服务可基于由智能外科器械、机器人和位于手术室中的其它计算机化装置所收集的数据来执行大量计算。集线器硬件使多个装置或连接能够连接到与云计算资源和存储器通信的计算机。In one aspect, the surgical data network 201 may include a combination of one or more network hubs, one or more network switches, and one or more network routers that connect the devices 1a-1n/2a-2m to the cloud. Any or all of the devices 1a-1n/2a-2m coupled to the network hub or network switch can collect data in real time and transmit the data to the cloud computer for data processing and manipulation. It should be understood that cloud computing relies on shared computing resources rather than using local servers or personal devices to process software applications. The term "cloud" can be used as a metaphor for "Internet", although the term is not limited to this. Therefore, the term "cloud computing" can be used herein to refer to "a type of Internet-based computing", in which different services (such as servers, storage, and applications) are delivered to a modular communication hub 203 and/or a computer system 210 located in a surgical room (e.g., a fixed, mobile, temporary, or on-site operating room or space) and a device connected to the modular communication hub 203 and/or the computer system 210 via the Internet. The cloud infrastructure can be maintained by a cloud service provider. In this case, the cloud service provider may be an entity that coordinates the use and control of devices 1a-1n/2a-2m located in one or more operating rooms. Cloud computing services may perform a large number of calculations based on data collected by smart surgical instruments, robots, and other computerized devices located in the operating room. Hub hardware enables multiple devices or connections to connect to a computer that communicates with cloud computing resources and storage.

对由装置1a-1n/2a-2m所收集的数据应用云计算机数据处理技术，外科数据网络提供改善的外科结果、减小的成本和改善的患者满意度。可采用装置1a-1n/2a-2m中的至少一些来观察组织状态以评估在组织密封和切割规程之后密封的组织的渗漏或灌注。可采用装置1a-1n/2a-2m中的至少一些来识别病理学，诸如疾病的影响，使用基于云的计算检查包括用于诊断目的的身体组织样本的图像的数据。这包括组织和表型的定位和边缘确认。可采用装置1a-1n/2a-2m中的至少一些使用与成像装置和技术(诸如重叠由多个成像装置捕获的图像)集成的各种传感器来识别身体的解剖结构。由装置1a-1n/2a-2m收集的数据(包括图像数据)可被传输到云204或本地计算机系统210或两者以用于数据处理和操纵，包括图像处理和操纵。可分析数据以通过确定是否可继续进行进一步治疗(诸如内窥镜式干预、新兴技术、靶向辐射、靶向干预和精确机器人对组织特异性位点和条件的应用)来改善外科规程结果。此类数据分析可进一步采用结果分析处理，并且使用标准化方法可提供有益反馈以确认外科治疗和外科医生的行为，或建议修改外科治疗和外科医生的行为。Applying cloud computer data processing technology to the data collected by the devices 1a-1n/2a-2m, the surgical data network provides improved surgical results, reduced costs and improved patient satisfaction. At least some of the devices 1a-1n/2a-2m can be used to observe tissue status to evaluate leakage or perfusion of sealed tissue after tissue sealing and cutting procedures. At least some of the devices 1a-1n/2a-2m can be used to identify pathology, such as the effects of disease, using cloud-based computing to examine data including images of body tissue samples for diagnostic purposes. This includes positioning and edge confirmation of tissue and phenotype. At least some of the devices 1a-1n/2a-2m can be used to identify the anatomical structure of the body using various sensors integrated with imaging devices and technologies (such as overlapping images captured by multiple imaging devices). The data (including image data) collected by the devices 1a-1n/2a-2m can be transmitted 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 surgical procedure outcomes by determining whether further treatments can be pursued, such as endoscopic interventions, emerging technologies, targeted radiation, targeted interventions, and precision robotic applications to tissue-specific sites and conditions. Such data analysis can be further processed using outcome analysis, and using standardized methods can provide helpful feedback to confirm surgical treatments and surgeons' actions, or suggest modifications to surgical treatments and surgeons' actions.

在一个具体实施中，手术室装置1a-1n可通过有线信道或无线信道连接至模块化通信集线器203，这取决于装置1a-1n至网络集线器的配置。在一个方面，网络集线器207可被实现为在开放式系统互连(OSI)模型的物理层上工作的本地网络广播装置。该网络集线器提供与位于同一手术室网络中的装置1a-1n的连接。网络集线器207以分组的形式收集数据，并以半双工模式将其发送至路由器。网络集线器207不存储用于传输装置数据的任何媒体访问控制/因特网协议(MAC/IP)。装置1a-1n中的仅一个可一次通过网络集线器207发送数据。网络集线器207没有关于在何处发送信息并在每个连接上广播所有网络数据以及通过云204向远程服务器213(图9)广播所有网络数据的路由表或智能。网络集线器207可以检测基本网络错误诸如冲突，但将所有信息广播到多个端口可带来安全风险并导致瓶颈。In one specific implementation, operating room devices 1a-1n can be connected to the modular communication hub 203 via a wired channel or a wireless channel, depending on the configuration of the devices 1a-1n to the network hub. In one aspect, the network hub 207 can be implemented as a local network broadcast device that works on the physical layer of the open system interconnection (OSI) model. The network hub provides a connection with devices 1a-1n located in the same operating room network. The network hub 207 collects data in the form of packets and sends it to the router in half-duplex mode. The network hub 207 does not store any media access control/Internet protocol (MAC/IP) for transmitting device data. Only one of the devices 1a-1n can send data through the network hub 207 at a time. The network hub 207 does not have a routing table or intelligence about where to send information and broadcasts all network data on each connection and broadcasts all network data to the remote server 213 (Figure 9) through the cloud 204. The network hub 207 can detect basic network errors such as collisions, but broadcasting all information to multiple ports can pose a security risk and cause bottlenecks.

在另一个具体实施中，手术室装置2a-2m可通过有线信道或无线信道连接到网络交换机209。网络交换机209在OSI模型的数据链路层中工作。网络交换机209是用于将位于相同手术室中的装置2a-2m连接到网络的多点广播装置。网络交换机209以帧的形式向网络路由器211发送数据并且以全双工模式工作。多个装置2a-2m可通过网络交换机209同时发送数据。网络交换机209存储并使用装置2a-2m的MAC地址来传输数据。In another specific implementation, the operating room devices 2a-2m can be connected to the network switch 209 through a wired channel or a wireless channel. The network switch 209 operates in the data link layer of the OSI model. The network switch 209 is a multicast device for connecting the devices 2a-2m located in the same operating room to the network. The network switch 209 sends data to the network router 211 in the form of a frame and operates in full-duplex mode. Multiple devices 2a-2m can send data simultaneously through the network switch 209. The network switch 209 stores and uses the MAC addresses of the devices 2a-2m to transmit data.

网络集线器207和/或网络交换机209耦合到网络路由器211以连接到云204。网络路由器211在OSI模型的网络层中工作。网络路由器211创建用于将从网络集线器207和/或网络交换机211接收的数据分组传输到基于云的计算机资源的路由，以进一步处理和操纵由装置1a-1n/2a-2m中的任一者或所有收集的数据。可采用网络路由器211来连接位于不同位置的两个或更多个不同的网络，诸如例如同一医疗设施的不同手术室或位于不同医疗设施的不同手术室的不同网络。网络路由器211以分组的形式向云204发送数据并且以全双工模式工作。多个装置可以同时发送数据。网络路由器211使用IP地址来传输数据。The network hub 207 and/or the network switch 209 are coupled to a network router 211 to connect to the cloud 204. The network router 211 operates in the network layer of the OSI model. The network router 211 creates a route for transmitting data packets received from the network hub 207 and/or the network switch 211 to cloud-based computer resources to further process and manipulate data collected by any or all of the devices 1a-1n/2a-2m. The network router 211 can be used to connect two or more different networks located in different locations, such as, for example, different operating rooms in the same medical facility or different networks located in different operating rooms in different medical facilities. The network router 211 sends data to the cloud 204 in the form of packets and operates in full-duplex mode. Multiple devices can send data simultaneously. The network router 211 uses IP addresses to transmit data.

在一个示例中，网络集线器207可被实现为USB集线器，其允许多个USB装置连接到主机。USB集线器可将单个USB端口扩展到多个层级，以便有更多端口可用于将装置连接到主机系统计算机。网络集线器207可包括用于通过有线信道或无线信道接收信息的有线或无线能力。在一个方面，无线USB短距离、高带宽无线无线电通信协议可用于装置1a-1n和位于手术室中的装置2a-2m之间的通信。In one example, the network hub 207 can be implemented as a USB hub that allows multiple USB devices to be connected to a host computer. The USB hub can expand a single USB port to multiple levels so that more ports are available to connect devices to the host system computer. The network hub 207 may include wired or wireless capabilities for receiving information through a wired channel or a wireless channel. In one aspect, a wireless USB short-range, high-bandwidth wireless radio communication protocol can be used for communication between devices 1a-1n and devices 2a-2m located in an operating room.

在其它示例中，手术室装置1a-1n/2a-2m可经由蓝牙无线技术标准与模块化通信集线器203通信，以用于在短距离(使用ISM频带中的2.4至2.485GHz的短波长UHF无线电波)从固定装置和移动装置交换数据以及构建个人局域网(PAN)。在其它方面，手术室装置1a-1n/2a-2m可经由多种无线或有线通信标准或协议与模块化通信集线器203通信，包括但不限于Wi-Fi(IEEE 802.11系列)、WiMAX(IEEE 802.16系列)、IEEE 802.20、长期演进(LTE)和Ev-DO、HSPA+、HSDPA+、HSUPA+、EDGE、GSM、GPRS、CDMA、TDMA、DECT、及其以太网衍生物、以及指定为3G、4G、5G和以上的任何其它无线和有线协议。计算模块可包括多个通信模块。例如，第一通信模块可专用于更短距离的无线通信诸如Wi-Fi和蓝牙，并且第二通信模块可专用于更长距离的无线通信，诸如GPS、EDGE、GPRS、CDMA、WiMAX、LTE、Ev-DO等。In other examples, the operating room devices 1a-1n/2a-2m can communicate with the modular communication hub 203 via the Bluetooth wireless technology standard for exchanging data from fixed and mobile devices over short distances (using short wavelength UHF radio waves in the ISM band of 2.4 to 2.485 GHz) and building a personal area network (PAN). In other aspects, the operating room devices 1a-1n/2a-2m can communicate with the modular communication hub 203 via a variety of wireless or wired communication standards or protocols, including but not limited to Wi-Fi (IEEE 802.11 series), WiMAX (IEEE 802.16 series), IEEE 802.20, Long Term Evolution (LTE) and Ev-DO, HSPA+, HSDPA+, HSUPA+, EDGE, GSM, GPRS, CDMA, TDMA, DECT, and Ethernet derivatives thereof, and any other wireless and wired protocols designated as 3G, 4G, 5G and above. The computing module may include multiple communication modules. For example, the first communication module may be dedicated to shorter range wireless communications such as Wi-Fi and Bluetooth, and the second communication module may be dedicated to longer range wireless communications such as GPS, EDGE, GPRS, CDMA, WiMAX, LTE, Ev-DO, etc.

模块化通信集线器203可用作手术室装置1a-1n/2a-2m中的一者或全部的中心连接，并且处理被称为帧的数据类型。帧携带由装置1a-1n/2a-2m生成的数据。当模块化通信集线器203接收到帧时，其被放大并传输到网络路由器211，该网络路由器211通过使用如本文所述的多个无线或有线通信标准或协议将数据传输到云计算资源。The modular communication hub 203 can serve as a central connection for one or all of the operating room devices 1a-1n/2a-2m and handles data types called frames. The frames carry data generated by the devices 1a-1n/2a-2m. When the modular communication hub 203 receives a frame, it is amplified and transmitted to the network router 211, which transmits the data to the cloud computing resources using multiple wireless or wired communication standards or protocols as described herein.

模块化通信集线器203可用作独立装置或连接到兼容的网络集线器和网络交换机以形成更大的网络。模块化通信集线器203通常易于安装、配置和维护，使得其成为对手术室装置1a-1n/2a-2m进行联网的良好选项。Modular communication hub 203 can be used as a standalone device or connected to compatible network hubs and network switches to form a larger network. Modular communication hub 203 is generally easy to install, configure and maintain, making it a good option for networking operating room devices 1a-1n/2a-2m.

图9示出了计算机实现的交互式外科系统200。计算机实现的交互式外科系统200在许多方面类似于计算机实现的交互式外科系统100。例如，计算机实现的交互式外科系统200包括在许多方面类似于外科系统102的一个或多个外科系统202。每个外科系统202包括与可包括远程服务器213的云204通信的至少一个外科集线器206。在一个方面，计算机实现的交互式外科系统200包括模块化控制塔236，该模块化控制塔236连接到多个手术室装置，诸如例如智能外科器械、机器人和位于手术室中的其它计算机化装置。如图10中所示，模块化控制塔236包括耦合到计算机系统210的模块化通信集线器203。如图9的示例中所示，模块化控制塔236耦合到耦合到内窥镜239的成像模块238、耦合到能量装置241的发生器模块240、排烟器模块226、抽吸/冲洗模块228、通信模块230、处理器模块232、存储阵列234、任选地耦合到显示器237的智能装置/器械235、和非接触传感器模块242。手术室装置经由模块化控制塔236耦合到云计算资源和数据存储。机器人集线器222也可连接到模块化控制塔236和云计算资源。装置/器械235、可视化系统208等等可经由有线或无线通信标准或协议耦合到模块化控制塔236，如本文所述。模块化控制塔236可耦合到集线器显示器215(例如，监测器、屏幕)以显示和叠加从成像模块、装置/器械显示器和/或其它可视化系统208接收的图像。集线器显示器还可结合图像和叠加图像来显示从连接到模块化控制塔的装置接收的数据。FIG. 9 illustrates a computer-implemented interactive surgical system 200. The computer-implemented interactive surgical system 200 is similar in many respects to the computer-implemented interactive surgical system 100. For example, the computer-implemented interactive surgical system 200 includes one or more surgical systems 202 that are similar in many respects to the surgical system 102. Each surgical system 202 includes at least one surgical hub 206 that communicates with a cloud 204 that may include a remote server 213. In one aspect, the computer-implemented interactive surgical system 200 includes a modular control tower 236 that is connected to a plurality of operating room devices, such as, for example, smart surgical instruments, robots, and other computerized devices located in the operating room. As shown in FIG. 10, the modular control tower 236 includes a modular communication hub 203 coupled to a computer system 210. As shown in the example of FIG. 9 , the modular control tower 236 is coupled to an imaging module 238 coupled to an endoscope 239, a generator module 240 coupled to an energy device 241, a smoke evacuator module 226, a suction/irrigation module 228, a communication module 230, a processor module 232, a storage array 234, a smart device/instrument 235 optionally coupled to a display 237, and a non-contact sensor module 242. The operating room devices are coupled to cloud computing resources and data storage via the modular control tower 236. The robotic hub 222 may also be connected to the modular control tower 236 and cloud computing resources. The devices/instruments 235, the visualization system 208, etc. may be coupled to the modular control tower 236 via wired or wireless communication standards or protocols, as described herein. The modular control tower 236 may be coupled to a hub display 215 (e.g., monitor, screen) to display and overlay images received from the imaging module, the device/instrument display, and/or other visualization systems 208. The hub display may also combine graphics and overlay images to display data received from devices connected to the modular control tower.

图10示出了包括耦合到模块化控制塔236的多个模块的外科集线器206。模块化控制塔236包括模块化通信集线器203(例如，网络连接性装置)和计算机系统210，以提供例如本地处理、可视化和成像。如图10中所示，模块化通信集线器203可以分层配置连接以扩展可连接到模块化通信集线器203的模块(例如，装置)的数量，并将与模块相关联的数据传输至计算机系统210、云计算资源或两者。如图10中所示，模块化通信集线器203中的网络集线器/交换机中的每个包括三个下游端口和一个上游端口。上游网络集线器/交换机连接至处理器以提供与云计算资源和本地显示器217的通信连接。与云204的通信可通过有线或无线通信信道进行。FIG. 10 shows a surgical hub 206 including multiple modules coupled to a modular control tower 236. The modular control tower 236 includes a modular communication hub 203 (e.g., a network connectivity device) and a computer system 210 to provide, for example, local processing, visualization, and imaging. As shown in FIG. 10 , the modular communication hub 203 can be hierarchically configured to connect to expand the number of modules (e.g., devices) that can be connected to the modular communication hub 203, and transmit the data associated with the module to the computer system 210, cloud computing resources, or both. As shown in FIG. 10 , each of the network hubs/switches in the modular communication hub 203 includes three downstream ports and one upstream port. The upstream network hub/switch is connected to a processor to provide communication connection with cloud computing resources and a local display 217. Communication with the cloud 204 can be carried out through a wired or wireless communication channel.

外科集线器206采用非接触传感器模块242来测量手术室的尺寸，并且使用超声或激光型非接触测量装置来生成外科室的标测图。基于超声的非接触传感器模块通过传输一阵超声波并在其从手术室的围墙弹回时接收回波来扫描手术室，如在2017年12月28日提交的标题为“交互式外科平台(INTERACTIVE SURGICAL PLATFORM)”的美国临时专利申请序列号62/611,341中的标题“手术室内的外科集线器空间感知(Surgical Hub SpatialAwareness Within an Operating Room)”下所述，该专利全文以引用方式并入本文，其中传感器模块被配置为确定手术室的大小并调节蓝牙配对距离限制。基于激光的非接触传感器模块通过传输激光脉冲、接收从手术室的围墙弹回的激光脉冲，以及将传输脉冲的相位与所接收的脉冲进行比较来扫描手术室，以确定手术室的大小并调节蓝牙配对距离限制。The surgical hub 206 employs a non-contact sensor module 242 to measure the dimensions of the operating room and generates a map of the surgical room using an ultrasound or laser-based non-contact measurement device. The ultrasound-based non-contact sensor module scans the operating room by transmitting a burst of ultrasound waves and receiving an echo as it bounces off the walls of the operating room, as described in U.S. Provisional Patent Application Serial No. 62/611,341, filed on December 28, 2017, entitled “INTERACTIVE SURGICAL PLATFORM,” under the title “Surgical Hub Spatial Awareness Within an Operating Room,” which is incorporated herein by reference in its entirety, wherein the sensor module is configured to determine the size of the operating room and adjust the Bluetooth pairing distance limit. The laser-based non-contact sensor module scans the operating room by transmitting laser pulses, receiving laser pulses that bounce off the walls of the operating room, and comparing the phase of the transmitted pulses with the received pulses to determine the size of the operating room and adjust the Bluetooth pairing distance limit.

计算机系统210包括处理器244和网络接口245。处理器244经由系统总线耦合到通信模块247、存储装置248、存储器249、非易失性存储器250和输入/输出接口251。系统总线可为若干类型的总线结构中的任一者，该总线结构包括存储器总线或存储器控制器、外围总线或外部总线、和/或使用任何各种可用总线架构的本地总线，包括但不限于9位总线、工业标准架构(ISA)、微型Charmel架构(MSA)、扩展ISA(EISA)、智能驱动电子器件(IDE)、VESA本地总线(VLB)、外围部件互连(PCI)、USB、高级图形端口(AGP)、个人计算机存储卡国际协会总线(PCMCIA)、小型计算机系统接口(SCSI)或任何其它外围总线。The computer system 210 includes a processor 244 and a network interface 245. The processor 244 is coupled to a communication module 247, a storage device 248, a memory 249, a non-volatile memory 250, and an input/output interface 251 via a system bus. The system bus may be any of several types of bus structures including a memory bus or memory controller, a peripheral bus or external bus, and/or a local bus using any of a variety of available bus architectures including, but not limited to, a 9-bit bus, Industry Standard Architecture (ISA), Micro Charmel Architecture (MSA), Extended ISA (EISA), Intelligent Drive Electronics (IDE), VESA Local Bus (VLB), Peripheral Component Interconnect (PCI), USB, Advanced Graphics Port (AGP), Personal Computer Memory Card International Association bus (PCMCIA), Small Computer System Interface (SCSI), or any other peripheral bus.

控制器244可为任何单核或多核处理器，诸如由德克萨斯器械公司(TexasInstruments)提供的商品名为ARM Cortex的那些处理器。在一个方面，处理器可为购自例如德克萨斯器械公司(Texas Instruments)LM4F230H5QR ARM Cortex-M4F处理器核心，其包括256KB的单循环闪存或其它非易失性存储器(高达40MHZ)的片上存储器、用于改善40MHz以上的性能的预取缓冲器、32KB单循环序列随机存取存储器(SRAM)、装载有软件的内部只读存储器(ROM)、2KB电可擦除可编程只读存储器(EEPROM)、和/或一个或多个脉宽调制(PWM)模块、一个或多个正交编码器输入(QEI)模拟、具有12个模拟输入信道的一个或多个12位模数转换器(ADC)，其细节可见于产品数据表。Controller 244 may be any single-core or multi-core processor, such as those offered by Texas Instruments under the trade name ARM Cortex. In one aspect, the processor may be a commercially available ARM Cortex-M4F processor core, such as the Texas Instruments LM4F230H5QR, which includes 256KB of single-cycle flash or other non-volatile memory (up to 40 MHz) on-chip memory, a pre-fetch buffer for improved performance above 40 MHz, 32KB of single-cycle sequential random access memory (SRAM), a 32KB MCU loaded with Internal read-only memory (ROM) for software, 2KB electrically erasable programmable read-only memory (EEPROM), and/or one or more pulse width modulation (PWM) modules, one or more quadrature encoder input (QEI) simulations, one or more 12-bit analog-to-digital converters (ADCs) with 12 analog input channels, details of which can be found in the product data sheet.

在一个方面，处理器244可包括安全控制器，该安全控制器包括两个基于控制器的系列(诸如TMS570和RM4x)，已知同样由德克萨斯器械公司(Texas Instruments)生产的商品名为Hercules ARM Cortex R4。安全控制器可被配置为专门用于IEC 61508和ISO 26262安全关键应用等等，以提供先进的集成安全特征件，同时递送可定标的性能、连接性和存储器选项。In one aspect, the processor 244 may include a safety controller including two families based on controllers such as TMS570 and RM4x, known under the trade name Hercules ARM Cortex R4, also produced by Texas Instruments. The safety controller may be configured specifically for IEC 61508 and ISO 26262 safety critical applications, among others, to provide advanced integrated safety features while delivering scalable performance, connectivity, and memory options.

系统存储器包括易失性存储器和非易失性存储器。基本输入/输出系统(BIOS)(包含诸如在启动期间在计算机系统内的元件之间传输信息的基本例程，)存储在非易失性存储器中。例如，非易失性存储器可包括ROM、可编程ROM(PROM)、电可编程ROM(EPROM)、EEPROM或闪存。易失存储器包括充当外部高速缓存存储器的随机存取存储器(RAM)。此外，RAM可以多种形式可用，诸如SRAM、动态RAM(DRAM)、同步DRAM(SDRAM)、双数据速率SDRAM(DDRSDRAM)增强SDRAM(ESDRAM)、同步链路DRAM(SLDRAM)和直接Rambus RAM(DRRAM)。System memory includes volatile memory and non-volatile memory. The basic input/output system (BIOS), which contains basic routines such as transferring information between elements within the computer system during startup, is stored in non-volatile memory. For example, non-volatile memory may include ROM, programmable ROM (PROM), electrically programmable ROM (EPROM), EEPROM, or flash memory. Volatile memory includes random access memory (RAM) that acts as external cache memory. In addition, RAM is available in a variety of forms, such as SRAM, dynamic RAM (DRAM), synchronous DRAM (SDRAM), double data rate SDRAM (DDRSDRAM) enhanced SDRAM (ESDRAM), synchronous link DRAM (SLDRAM) and direct Rambus RAM (DRRAM).

计算机系统210还包括可移除/不可移除的、易失性/非易失性的计算机存储介质，诸如例如磁盘存储器。磁盘存储器包括但不限于诸如装置如磁盘驱动器、软盘驱动器、磁带驱动器、Jaz驱动器、Zip驱动器、LS-60驱动器、闪存存储卡或内存条。此外，磁盘存储器可包括单独地或与其它存储介质组合的存储介质，包括但不限于光盘驱动器诸如光盘ROM装置(CD-ROM)、光盘可记录驱动器(CD-R驱动器)、光盘可重写驱动器(CD-RW驱动器)或数字通用磁盘ROM驱动器(DVD-ROM)。为了有利于磁盘存储装置与系统总线的连接，可使用可移除或非可移除接口。Computer system 210 also includes removable/non-removable, volatile/non-volatile computer storage media, such as, for example, disk storage. Disk storage includes, but is not limited to, devices such as disk drives, floppy disk drives, tape drives, Jaz drives, Zip drives, LS-60 drives, flash memory cards, or memory sticks. In addition, disk storage may include storage media individually or in combination with other storage media, including but not limited to optical disk drives such as CD-ROM devices (CD-ROM), CD-recordable drives (CD-R drives), CD-RW drives, or digital universal disk ROM drives (DVD-ROM). In order to facilitate the connection of the disk storage device to the system bus, a removable or non-removable interface may be used.

应当理解，计算机系统210包括充当用户和在合适的操作环境中描述的基本计算机资源之间的中介的软件。此类软件包括操作系统。可存储在磁盘存储装置上的操作系统用于控制并分配计算机系统的资源。系统应用程序利用操作系统通过存储在系统存储器或磁盘存储装置中的程序模块和程序数据来管理资源。应当理解，本文所述的各种部件可用各种操作系统或操作系统的组合来实现。It should be understood that the computer system 210 includes software that acts as an intermediary between a user and the basic computer resources described in a suitable operating environment. Such software includes an operating system. An operating system that can be stored on a disk storage device is used to control and allocate the resources of the computer system. System applications utilize the operating system to manage resources through program modules and program data stored in system memory or disk storage devices. It should be understood that the various components described herein can be implemented with various operating systems or combinations of operating systems.

用户通过耦合到I/O接口251的一个或多个输入装置将命令或信息输入到计算机系统210中。输入装置包括但不限于指向装置，诸如鼠标、触控球、触笔、触摸板、键盘、麦克风、操纵杆、游戏垫、卫星盘、扫描仪、电视调谐器卡、数字相机、数字摄像机、幅材相机等。这些和其它输入装置经由一个或多个接口端口通过系统总线连接到处理器。一个或多个接口端口包括例如串口、并行端口、游戏端口和USB。一个或多个输出装置使用与一个或多个输入装置相同类型的端口。因此，例如，USB端口可用于向计算机系统提供输入并将信息从计算机系统输出到输出装置。提供了输出适配器来说明在其它输出装置中存在需要特殊适配器的一些输出装置(如监测器、显示器、扬声器和打印机。输出适配器以举例的方式包括但不限于提供输出装置和系统总线之间的连接装置的视频和声卡。应当指出，其它装置或装置诸如一个或多个远程计算机的系统提供了输入能力和输出能力两者。The user inputs commands or information into the computer system 210 through one or more input devices coupled to the I/O interface 251. Input devices include, but are not limited to, pointing devices such as a mouse, a touch ball, a stylus, a touch pad, a keyboard, a microphone, a joystick, a game pad, a satellite dish, a scanner, a TV tuner card, a digital camera, a digital video camera, a web camera, etc. These and other input devices are connected to the processor through the system bus via one or more interface ports. One or more interface ports include, for example, a serial port, a parallel port, a game port, and a USB. One or more output devices use the same type of port as one or more input devices. Thus, for example, a USB port can be used to provide input to a computer system and output information from a computer system to an output device. Output adapters are provided to illustrate that there are some output devices (such as monitors, displays, speakers, and printers) that require special adapters among other output devices. Output adapters include, by way of example, but are not limited to, video and sound cards that provide connection devices between output devices and the system bus. It should be noted that other devices or systems of devices such as one or more remote computers provide both input capabilities and output capabilities.

计算机系统210可使用与一个或多个远程计算机(诸如一个或多个云计算机)或本地计算机的逻辑连接在联网环境中操作。一个或多个远程云计算机可为个人计算机、服务器、路由器、网络PC、工作站、基于微处理器的器具、对等装置或其它公共网络节点等，并且通常包括相对于计算机系统所述的元件中的许多或全部。为简明起见，仅示出了具有一个或多个远程计算机的存储器存储装置。一个或多个远程计算机通过网络接口在逻辑上连接到计算机系统，并且然后经由通信连接物理连接。网络接口涵盖通信网络诸如局域网(LAN)和广域网(WAN)。LAN技术包括光纤分布式数据接口(FDDI)、铜分布式数据接口(CDDI)、以太网/IEEE 802.3、令牌环/IEEE 802.5等。WAN技术包括但不限于点对点链路、电路交换网络如综合业务数字网络(ISDN)及其变体、分组交换网络和数字用户管线(DSL)。Computer system 210 can be operated in a networked environment using a logical connection with one or more remote computers (such as one or more cloud computers) or local computers. One or more remote cloud computers can be personal computers, servers, routers, network PCs, workstations, microprocessor-based appliances, peer devices or other public network nodes, etc., and generally include many or all of the elements described relative to the computer system. For simplicity, only a memory storage device with one or more remote computers is shown. One or more remote computers are logically connected to the computer system through 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 technology includes fiber distributed data interface (FDDI), copper distributed data interface (CDDI), Ethernet/IEEE 802.3, token ring/IEEE 802.5, etc. WAN technology includes but is not limited to point-to-point links, circuit switching networks such as integrated services digital networks (ISDN) and variants thereof, packet switching networks, and digital subscriber lines (DSL).

在各个方面，图10的计算机系统210、成像模块238和/或可视化系统208、和/或图9-10的处理器模块232可包括图像处理器、图像处理引擎、媒体处理器、或用于处理数字图像的任何专用数字信号处理器(DSP)。图像处理器可采用具有单个指令、多数据(SIMD)或多指令、多数据(MIMD)技术的并行计算以提高速度和效率。数字图像处理引擎可执行一系列任务。图像处理器可为具有多核处理器架构的芯片上的系统。In various aspects, the computer system 210 of FIG. 10 , the imaging module 238 and/or the visualization system 208 , and/or the processor module 232 of FIGS. 9-10 may include an image processor, an image processing engine, a media processor, or any dedicated digital signal processor (DSP) for processing digital images. The image processor may employ parallel computing with single instruction, multiple data (SIMD) or multiple instructions, multiple data (MIMD) techniques to improve speed and efficiency. The digital image processing engine may perform a range of tasks. The image processor may be a system on a chip with a multi-core processor architecture.

一个或多个通信连接是指用于将网络接口连接到总线的硬件/软件。虽然示出了通信连接以便在计算机系统内侧进行示例性澄清，但其也可位于计算机系统210的外部。连接到网络接口所必需的硬件/软件仅出于示例性目的包括内部和外部技术，诸如调制解调器，包括常规的电话级调制解调器、电缆调制解调器和DSL调制解调器、ISDN适配器和以太网卡。One or more communication connections refer to the hardware/software used to connect the network interface to the bus. Although the communication connections are shown for exemplary clarity inside the computer system, they can also be located outside the computer system 210. The hardware/software necessary to connect to the network interface includes internal and external technologies such as modems, including conventional telephone-grade modems, cable modems and DSL modems, ISDN adapters, and Ethernet cards for exemplary purposes only.

图11示出了根据本公开的至少一个方面的USB网络集线器300装置的一个方面的功能框图。在例示的方面，USB网络集线器装置300采用得克萨斯器械公司(TexasInstruments)的TUSB2036集成电路集线器。USB网络集线器300是根据USB 2.0规范提供上游USB收发器端口302和多达三个下游USB收发器端口304、306、308的CMOS装置。上游USB收发器端口302为差分根数据端口，其包括与差分数据正(DM0)输入配对的差分数据负(DP0)输入。三个下游USB收发器端口304、306、308为差分数据端口，其中每个端口包括与差分数据负(DM1-DM3)输出配对的差分数据正(DP1-DP3)输出。FIG. 11 shows a functional block diagram of one aspect of a USB network hub 300 device according to at least one aspect of the present disclosure. In the illustrated aspect, the USB network hub device 300 uses the TUSB2036 integrated circuit hub of Texas Instruments. The USB network hub 300 is a CMOS device that provides an upstream USB transceiver port 302 and up to three downstream USB transceiver ports 304, 306, 308 according to the USB 2.0 specification. The upstream USB transceiver port 302 is a differential root data port that includes a differential data negative (DP0) input paired with a differential data positive (DM0) input. The three downstream USB transceiver ports 304, 306, 308 are differential data ports, each of which includes a differential data positive (DP1-DP3) output paired with a differential data negative (DM1-DM3) output.

USB网络集线器300装置用数字状态机而不是微控制器来实现，并且不需要固件编程。完全兼容的USB收发器集成到用于上游USB收发器端口302和所有下游USB收发器端口304、306、308的电路中。下游USB收发器端口304、306、308通过根据附接到端口的装置的速度自动设置转换速率来支持全速度装置和低速装置两者。USB网络集线器300装置可被配置为处于总线供电模式或自供电模式，并且包括用于管理功率的集线器功率逻辑312。The USB network hub 300 device is implemented with a digital state machine rather than a microcontroller, and does not require firmware programming. A fully compatible USB transceiver is 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 devices and low-speed devices by automatically setting the conversion rate according to the speed of the device attached to the port. The USB network hub 300 device can be configured to be in bus-powered mode or self-powered mode, and includes a hub power logic 312 for managing power.

USB网络集线器300装置包括串行接口引擎310(SIE)。SIE 310是USB网络集线器300硬件的前端，并处理USB规范第8章中描述的大多数协议。SIE 310通常包括多达交易级别的信令。其处理的功能可包括：分组识别、事务排序、SOP、EOP、RESET和RESUME信号检测/生成、时钟/数据分离、不返回到零反转(NRZI)数据编码/解码和数位填充、CRC生成和校验(令牌和数据)、分组ID(PID)生成和校验/解码、和/或串行并行/并行串行转换。310接收时钟输入314并且耦合到暂停/恢复逻辑和帧定时器316电路以及集线器中继器电路318，以通过端口逻辑电路320、322、324控制上游USB收发器端口302和下游USB收发器端口304、306、308之间的通信。SIE 310经由接口逻辑耦合到命令解码器326，以经由串行EEPROM接口330来控制来自串行EEPROM的命令。The USB network hub 300 device includes a serial interface engine 310 (SIE). The SIE 310 is the front end of the USB network hub 300 hardware and handles most of the protocols described in Chapter 8 of the USB specification. The SIE 310 typically includes up to transaction-level signaling. The functions it handles may include: packet identification, transaction ordering, SOP, EOP, RESET and RESUME signal detection/generation, clock/data separation, non-return to zero inversion (NRZI) data encoding/decoding and digit filling, CRC generation and verification (token and data), packet ID (PID) generation and verification/decoding, and/or serial-to-parallel/parallel-to-serial conversion. The 310 receives a clock input 314 and is coupled to the pause/resume logic and frame timer 316 circuits and the hub repeater circuit 318 to control the communication between the upstream USB transceiver port 302 and the downstream USB transceiver ports 304, 306, 308 through the port logic circuits 320, 322, 324. SIE 310 is coupled to command decoder 326 via interface logic to control commands from the serial EEPROM via serial EEPROM interface 330 .

在各个方面，USB网络集线器300可将配置在多达六个逻辑层(层级)中的127功能连接至单个计算机。此外，USB网络集线器300可使用提供通信和功率分配两者的标准化四线电缆连接到所有外装置。功率配置为总线供电模式和自供电模式。USB网络集线器300可被配置为支持四种功率管理模式：具有单独端口功率管理或成套端口功率管理的总线供电集线器，以及具有单独端口功率管理或成套端口功率管理的自供电集线器。在一个方面，使用USB电缆将USB网络集线器300、上游USB收发器端口302插入USB主机控制器中，并且将下游USB收发器端口304、306、308暴露以用于连接USB兼容装置等。In various aspects, the USB network hub 300 can connect 127 functions configured in up to six logical layers (hierarchies) to a single computer. In addition, the USB network hub 300 can be connected to all external devices using a standardized four-wire cable that provides both communication and power distribution. The power is configured as a bus-powered mode and a self-powered mode. The USB network hub 300 can be configured to support four power management modes: a bus-powered hub with individual port power management or a complete set of port power management, and a self-powered hub with individual port power management or a complete set of port power management. In one aspect, the USB network hub 300, the upstream USB transceiver port 302 is inserted into the USB host controller using a USB cable, and the downstream USB transceiver ports 304, 306, 308 are exposed for connecting USB compatible devices, etc.

外科器械硬件Surgical Instrument Hardware

图12示出了根据本公开的一个或多个方面的外科器械或工具的控制系统470的逻辑图。系统470包括控制电路。控制电路包括微控制器461，该微控制器包括处理器462和存储器468。例如，传感器472、474、476中的一个或多个向处理器462提供实时反馈。由马达驱动器492驱动的马达482可操作地耦合纵向可运动的位移构件以驱动夹持臂闭合构件。跟踪系统480被配置为确定纵向可运动的位移构件的位置。将位置信息提供给处理器462，该处理器462可被编程或配置为确定可纵向可运动的驱动构件的位置以及闭合构件的位置。可在工具驱动器接口处提供附加的马达以控制闭合管行进、轴旋转、关节运动、或夹持臂闭合、或上述的组合。显示器473显示器械的多种操作条件并且可包括用于数据输入的触摸屏功能。显示在显示器473上的信息可叠加有经由内窥镜式成像模块获取的图像。FIG. 12 shows a logic diagram of a control system 470 of a surgical instrument or tool according to one or more aspects of the present disclosure. The system 470 includes a control circuit. The control circuit includes a microcontroller 461, which includes a processor 462 and a memory 468. For example, one or more of the sensors 472, 474, 476 provide real-time feedback to the processor 462. The motor 482 driven by the motor driver 492 is operably coupled to the longitudinally movable displacement member to drive the clamp arm closing member. The tracking system 480 is configured to determine the position of the longitudinally movable displacement member. The position information is provided to the processor 462, which can be programmed or configured to determine the position of the longitudinally movable drive member and the position of the closing member. Additional motors can be provided at the tool driver interface to control the closure tube travel, shaft rotation, joint movement, or clamp arm closure, or a combination of the above. The display 473 displays a variety of operating conditions of the instrument and may include a touch screen function for data input. The information displayed on the display 473 may be superimposed with an image acquired via an endoscopic imaging module.

在一个方面，微处理器461可为任何单核或多核处理器，诸如已知的由德克萨斯器械公司(Texas Instruments)生产的商品名为ARM Cortex的那些。在一个方面，微控制器461可为购自例如德克萨斯器械公司(Texas Instruments)的LM4F230H5QR ARM Cortex-M4F处理器核心，其包括256KB的单循环闪存或其它非易失性存储器(高达40MHZ)的片上存储器、用于改善40MHz以上的性能的预取缓冲器、32KB单循环SRAM、装载有软件的内部ROM、2KB电EEPROM、一个或多个PWM模块、一个或多个QEI模拟、具有12个模拟输入信道的一个或多个12位ADC，其细节可见于产品数据表。In one aspect, the microprocessor 461 can be any single-core or multi-core processor, such as those known under the trade name ARM Cortex produced by Texas Instruments. In one aspect, the microcontroller 461 can be a LM4F230H5QR ARM Cortex-M4F processor core available from, for example, Texas Instruments, which includes 256KB of single-cycle flash or other non-volatile memory (up to 40 MHz) on-chip memory, a pre-fetch buffer for improved performance above 40 MHz, 32KB of single-cycle SRAM, a 32-bit MCU, and a 32-bit MCU. Internal ROM for software, 2KB electrical EEPROM, one or more PWM modules, one or more QEI analog, one or more 12-bit ADC with 12 analog input channels, details of which can be found in the product data sheet.

在一个方面，微控制器461可包括安全控制器，该安全控制器包括两个基于控制器的系列(诸如TMS570和RM4x)，已知同样由德克萨斯器械公司(Texas Instruments)生产的商品名为Hercules ARM Cortex R4。安全控制器可被配置为专门用于IEC 61508和ISO26262安全关键应用等等，以提供先进的集成安全特征件，同时递送可定标的性能、连接性和存储器选项。In one aspect, the microcontroller 461 may include a safety controller including two families based on controllers such as TMS570 and RM4x, known under the trade name Hercules ARM Cortex R4 also produced by Texas Instruments. The safety controller may be configured specifically for IEC 61508 and ISO26262 safety critical applications, among others, to provide advanced integrated safety features while delivering scalable performance, connectivity, and memory options.

微控制器461可被编程为执行各种功能，诸如精确控制刀、关节运动系统、夹持臂或上述的组合的速度和位置。在一个方面，微控制器461包括处理器462和存储器468。电动马达482可为有刷直流(DC)马达，其具有齿轮箱以及至关节运动或刀系统的机械链路。在一个方面，马达驱动器492可为可购自Allegro微系统公司(Allegro Microsystems,Inc)的A3941。其它马达驱动器可容易地被替换以用于包括绝对定位系统的跟踪系统480中。绝对定位系统的详细描述在2017年10月19日公布的标题为用于控制外科缝合和切割器械的系统和方法(SYSTEMS AND METHODS FOR CONTROLLING A SURGICAL STAPLING AND CUTTINGINSTRUMENT)的美国专利申请公布2017/0296213中有所描述，该专利申请全文以引用方式并入本文。Microcontroller 461 can be programmed to perform various functions, such as accurately controlling the speed and position of a knife, articulation system, clamping arm or the combination thereof. In one aspect, microcontroller 461 includes processor 462 and memory 468. Electric motor 482 can be a brushed DC (DC) motor having a gearbox and a mechanical link to an articulation or knife system. In one aspect, motor driver 492 can be an A3941 available from Allegro Microsystems, Inc. Other motor drivers can be easily replaced for use in tracking system 480 including an absolute positioning system. A detailed description of the absolute positioning system is described in U.S. Patent Application Publication 2017/0296213 entitled SYSTEMS AND METHODS FOR CONTROLLING A SURGICAL STAPLING AND CUTTING INSTRUMENT published on October 19, 2017, which is incorporated herein by reference in its entirety.

微控制器461可被编程为提供对位移构件和关节运动系统的速度和位置的精确控制。微控制器461可被配置为计算微控制器461的软件中的响应。将计算的响应与实际系统的所测量响应进行比较，以获得“观察到的”响应，其用于实际反馈决定。观察到的响应为有利的调谐值，该值使所模拟响应的平滑连续性质与所测量响应均衡，这可检测对系统的外部影响。The microcontroller 461 can be programmed to provide precise control of the speed and position of the displacement member and articulation system. The microcontroller 461 can be configured to calculate the response in the software of the microcontroller 461. The calculated response is compared to the measured response of the actual system to obtain the "observed" response, which is used for actual feedback decisions. The observed response is a favorable tuning value that balances the smooth continuous nature of the simulated response with the measured response, which can detect external influences on the system.

在一个方面，马达482可由马达驱动器492控制并可被外科器械或工具的击发系统采用。在各种形式中，马达482可为具有大约25,000RPM的最大旋转速度的有刷DC驱动马达。在其它布置方式中，马达482可包括无刷马达、无绳马达、同步马达、步进马达或任何其它合适的电动马达。马达驱动器492可包括例如包括场效应晶体管(FET)的H桥驱动器。马达482可通过可释放地安装到柄部组件或工具外壳的功率组件来供电，以用于向外科器械或工具供应控制功率。功率组件可包括电池，该电池可包括串联连接的、可用作功率源以为外科器械或工具提供功率的多个电池单元。在某些情况下，功率组件的电池单元可为可替换的和/或可再充电的电池单元。在至少一个示例中，电池单元可为锂离子电池，其可耦合到功率组件并且可与功率组件分离。In one aspect, the motor 482 can be controlled by a motor driver 492 and can be adopted by the firing system of a surgical instrument or tool. In various forms, the motor 482 can be a brushed DC drive motor with a maximum rotation speed of about 25,000 RPM. In other arrangements, the motor 482 can include a brushless motor, a cordless motor, a synchronous motor, a stepper motor, or any other suitable electric motor. The motor driver 492 can include, for example, an H-bridge driver including a field effect transistor (FET). The motor 482 can be powered by a power assembly that can be releasably mounted to a handle assembly or a tool housing for supplying control power to a surgical instrument or tool. The power assembly can include a battery that can include a plurality of battery cells connected in series that can be used as a power source to provide power to a surgical instrument or tool. In some cases, the battery cell of the power assembly can be a replaceable and/or rechargeable battery cell. In at least one example, the battery cell can be a lithium-ion battery that can be coupled to the power assembly and can be separated from the power assembly.

驱动器492可为可购自Allegro微系统公司(Allegro Microsystems,Inc)的A3941。A3941 492为全桥控制器，其用于与针对电感负载(诸如有刷DC马达)特别设计的外部N信道功率金属氧化物半导体场效应晶体管(MOSFET)一起使用。驱动器492包括独特的电荷泵调整器，其为低至7V的电池电压提供完整的(>10V)栅极驱动并且允许A3941在低至5.5V的减小的栅极驱动下操作。可采用自举电容器来提供N信道MOSFET所需的上述电池供电电压。高边驱动装置的内部电荷泵允许直流(100％占空比)操作。可使用二极管或同步整流在快衰减模式或慢衰减模式下驱动全桥。在慢衰减模式下，电流再循环可穿过高边FET或低边FET。通过电阻器可调式空载时间保护功率FET不被击穿。整体诊断提供欠压、过热和功率桥故障的指示，并且可被配置为在大多数短路条件下保护功率MOSFET。其它马达驱动器可容易地被替换以用于包括绝对定位系统的跟踪系统480中。Driver 492 may be an A3941 available from Allegro Microsystems, Inc. A3941 492 is a full-bridge controller for use with external N-channel power metal oxide semiconductor field effect transistors (MOSFETs) specifically designed for inductive loads such as brushed DC motors. Driver 492 includes a unique charge pump regulator that provides full (>10V) gate drive for battery voltages as low as 7V and allows A3941 to operate at reduced gate drive as low as 5.5V. A bootstrap capacitor may be used to provide the above-mentioned battery supply voltage required for the N-channel MOSFET. The internal charge pump of the high-side driver allows DC (100% duty cycle) operation. A diode or synchronous rectification may be used to drive the full bridge in fast decay mode or slow decay mode. In slow decay mode, current recirculation may pass through the high-side FET or the low-side FET. The power FET is protected from breakdown by a resistor-adjustable dead time. The integral diagnostics provide indications of undervoltage, overtemperature, and power bridge faults, and can be configured to protect the power MOSFETs under most short circuit conditions.Other motor drivers can be easily substituted for use in the tracking system 480 including the absolute positioning system.

跟踪系统480包括根据本公开的一个方面的包括位置传感器472的受控马达驱动电路布置方式。用于绝对定位系统的位置传感器472提供对应于位移构件的位置的独特位置信号。在一个方面，位移构件表示纵向可运动的驱动构件，其包括用于与齿轮减速器组件的对应驱动齿轮啮合接合的驱动齿的齿条。在其它方面，位移构件表示击发构件，该击发构件可被适配和配置为包括驱动齿的齿条。在又一方面，位移构件表示用于打开和闭合夹持臂的纵向位移构件，该纵向位移构件可被适配和配置为包括驱动齿的齿条。在其它方面，位移构件表示夹持臂闭合构件，该夹持臂闭合构件被配置为闭合和打开缝合器的夹持臂、超声或电外科装置的夹持臂、或上述的组合。因此，如本文所用，术语位移构件一般用来指外科器械或工具(诸如驱动构件、夹持臂或任何可被位移的元件)的任何可运动构件。因此，绝对定位系统实际上可通过跟踪纵向可运动的驱动构件的线性位移来跟踪夹持臂的位移。Tracking system 480 includes a controlled motor drive circuit arrangement including position sensor 472 according to one aspect of the present disclosure. Position sensor 472 for absolute positioning system provides a unique position signal corresponding to the position of the displacement member. In one aspect, the displacement member represents a longitudinally movable drive member, which includes a rack of drive teeth for meshing engagement with a corresponding drive gear of a gear reducer assembly. In other aspects, the displacement member represents a firing member, which can be adapted and configured to include a rack of drive teeth. In another aspect, the displacement member represents a longitudinal displacement member for opening and closing the clamping arm, which can be adapted and configured to include a rack of drive teeth. In other aspects, the displacement member represents a clamping arm closing member, which is configured to close and open the clamping arm of the stapler, the clamping arm of an ultrasonic or electrosurgical device, or a combination of the above. Therefore, as used herein, the term displacement member is generally used to refer to any movable member of a surgical instrument or tool (such as a drive member, a clamping arm, or any element that can be displaced). Thus, the absolute positioning system can actually track the displacement of the clamping arm by tracking the linear displacement of the longitudinally movable drive member.

在其它方面，绝对定位系统可被配置为跟踪夹持臂在闭合或打开过程中的位置。在各种其它方面，位移构件可耦合到适于测量线性位移的任何位置传感器472。因此，纵向可运动的驱动构件、或夹持臂或它们的组合可耦合到任何合适的线性位移传感器。线性位移传感器可包括接触式位移传感器或非接触式位移传感器。线性位移传感器可包括线性可变差分变压器(LVDT)、差分可变磁阻换能器(DVRT)、滑动电位计、包括可运动磁体和一系列线性布置的霍尔效应传感器的磁感测系统、包括固定磁体和一系列可运动的线性布置的霍尔效应传感器的磁感测系统、包括可运动光源和一系列线性布置的光电二极管或光电检测器的光学感测系统、包括固定光源和一系列可运动的线性布置的光电二极管或光电检测器的光学感测系统、或它们的任何组合。In other aspects, the absolute positioning system can be configured to track the position of the clamping arm during closing or opening. In various other aspects, the displacement member can be coupled to any position sensor 472 suitable for measuring linear displacement. Therefore, the longitudinally movable drive member, or the clamping arm, or a combination thereof can be coupled to any suitable linear displacement sensor. The linear displacement sensor may include a contact displacement sensor or a non-contact displacement sensor. The linear displacement sensor may include a linear variable differential transformer (LVDT), a differential variable reluctance transducer (DVRT), a sliding potentiometer, a magnetic sensing system including a movable magnet and a series of linearly arranged Hall effect sensors, a magnetic sensing system including a fixed magnet and a series of movable linearly arranged Hall effect sensors, an optical sensing system including a movable light source and a series of linearly arranged photodiodes or photodetectors, an optical sensing system including a fixed light source and a series of movable linearly arranged photodiodes or photodetectors, or any combination thereof.

电动马达482可包括可操作地与齿轮组件交接的可旋转轴，该齿轮组件与驱动齿的组或齿条啮合接合安装在位移构件上。传感器元件可以可操作地耦合到齿轮组件，使得位置传感器472元件的单次旋转对应于位移构件的一些线性纵向平移。传动装置和传感器的布置方式可经由齿条和小齿轮布置方式连接至线性致动器，或者经由直齿齿轮或其它连接连接至旋转致动器。功率源为绝对定位系统供电，并且输出指示器可显示绝对定位系统的输出。位移构件表示纵向可运动驱动构件，该纵向可运动驱动构件包括形成于其上的驱动齿的齿条，以用于与齿轮减速器组件的对应驱动齿轮啮合接合。位移构件表示用于打开和闭合夹持臂的纵向可运动的击发构件。The electric motor 482 may include a rotatable shaft operably interfaced with a gear assembly that is mounted on the displacement member in meshing engagement with a set or rack of drive teeth. The sensor element may be operably coupled to the gear assembly so that a single rotation of the position sensor 472 element corresponds to some linear longitudinal translation of the displacement member. The arrangement of the transmission and sensor may be connected to a linear actuator via a rack and pinion arrangement, or to a rotary actuator via a spur gear or other connection. The power source powers the absolute positioning system, and the output indicator may display the output of the absolute positioning system. The displacement member represents a longitudinally movable drive member that includes a rack of drive teeth formed thereon for meshing engagement with a corresponding drive gear of the gear reducer assembly. The displacement member represents a longitudinally movable firing member for opening and closing the clamping arm.

与位置传感器472相关联的传感器元件的单次旋转等同于位移构件的纵向线性位移d₁，其中d₁为在耦合到位移构件的传感器元件的单次旋转之后位移构件从点“a”运动到点“b”的纵向线性距离。可经由齿轮减速连接传感器布置方式，该齿轮减速使得位置传感器472针对位移构件的全行程仅完成一次或多次旋转。位置传感器472可针对位移构件的全行程完成多次旋转。A single rotation of the sensor element associated with the position sensor 472 is equivalent to a longitudinal linear displacement of the displacement member,_d1 , where_d1 is the longitudinal linear distance the displacement member moves from point "a" to point "b" after a single rotation of the sensor element coupled to the displacement member. The sensor arrangement may be connected via a gear reduction that enables the position sensor 472 to complete only one or more rotations for a full stroke of the displacement member. The position sensor 472 may complete multiple rotations for a full stroke of the displacement member.

可单独或结合齿轮减速采用一系列开关(其中n为大于一的整数)以针对位置传感器472的多于一次旋转提供独特位置信号。开关的状态被馈送回微控制器461，该微控制器461应用逻辑以确定对应于位移构件的纵向线性位移d₁+d₂+…d_n的独特位置信号。位置传感器472的输出被提供给微控制器461。该传感器布置方式的位置传感器472可包括磁性传感器、模拟旋转传感器(如电位差计)、模拟霍尔效应元件的阵列，该霍尔效应元件的阵列输出位置信号或值的独特组合。A series of switches (where n is an integer greater than one) may be employed, alone or in combination with gear reduction, to provide unique position signals for more than one rotation of the position sensor 472. The state of the switches is fed back to the microcontroller 461, which applies logic to determine a unique position signal corresponding to the longitudinal linear displacement_d1 +_d2 +..._dn of the displacement member. The output of the position sensor 472 is provided to the microcontroller 461. The position sensor 472 of this sensor arrangement may include a magnetic sensor, an analog rotation sensor (such as a potentiometer), an array of analog Hall effect elements that output a unique combination of position signals or values.

位置传感器472可包括任何数量的磁性感测元件，诸如例如根据它们是否测量磁场的总磁场或矢量分量而被分类的磁性传感器。用于产生上述两种类型磁性传感器的技术涵盖物理学和电子学的多个方面。用于磁场感测的技术包括探查线圈、磁通门、光泵、核旋、超导量子干涉仪(SQUID)、霍尔效应、各向异性磁电阻、巨磁电阻、磁性隧道结、巨磁阻抗、磁致伸缩/压电复合材料、磁敏二极管、磁敏晶体管、光纤、磁光，以及基于微机电系统的磁性传感器等等。Position sensor 472 may include any number of magnetic sensing elements, such as, for example, magnetic sensors classified according to whether they measure the total magnetic field or the vector component of the magnetic field. The technologies used to produce the above two types of magnetic sensors cover many aspects of physics and electronics. Technologies for magnetic field sensing include probe coils, fluxgates, optical pumps, nuclear spins, superconducting quantum interference devices (SQUIDs), Hall effects, anisotropic magnetoresistance, giant magnetoresistance, magnetic tunnel junctions, giant magnetoimpedance, magnetostrictive/piezoelectric composites, magnetosensitive diodes, magnetosensitive transistors, optical fibers, magneto-optics, and magnetic sensors based on micro-electromechanical systems, among others.

在一个方面，用于包括绝对定位系统的跟踪系统480的位置传感器472包括磁性旋转绝对定位系统。位置传感器472可被实现为AS5055EQFT单片磁性旋转位置传感器，其可购自澳大利亚奥地利微电子公司(Austria Microsystems,AG)。位置传感器472与微控制器461交接，以提供绝对定位系统。位置传感器472为低电压和低功率部件，并且包括位于磁体上的位置传感器472的区域中的四个霍尔效应元件。在芯片上还提供了高分辨率ADC和智能功率管理控制器。提供了坐标旋转数字计算机(CORDIC)处理器(也被称为逐位法和Volder算法)以执行简单有效的算法来计算双曲线函数和三角函数，其仅需要加法、减法、数位位移和表格查找操作。角位置、报警位和磁场信息通过标准串行通信接口(诸如串行外围接口(SPI)接口)传输到微控制器461。位置传感器472提供12或14位分辨率。位置传感器472可为以小QFN 16引脚4×4×0.85mm封装提供的AS5055芯片。In one aspect, the position sensor 472 for the tracking system 480 including the absolute positioning system includes a magnetic rotation absolute positioning system. The position sensor 472 can be implemented as an AS5055EQFT monolithic magnetic rotation position sensor, which can be purchased from Austria Microsystems, AG. The position sensor 472 interfaces with the microcontroller 461 to provide an absolute positioning system. The position sensor 472 is a low voltage and low power component and includes four Hall effect elements in the area of the position sensor 472 located on the magnet. A high resolution ADC and an intelligent power management controller are also provided on the chip. A coordinate rotation digital computer (CORDIC) processor (also known as the bitwise method and Volder algorithm) is provided to perform a simple and efficient algorithm to calculate hyperbolic and trigonometric functions, which only requires addition, subtraction, digit shift and table lookup operations. The angular position, alarm bit and magnetic field information are transmitted to the microcontroller 461 via a standard serial communication interface (such as a serial peripheral interface (SPI) interface). The position sensor 472 provides 12 or 14 bit resolution. The position sensor 472 may be an AS5055 chip provided in a small QFN 16-pin 4×4×0.85 mm package.

包括绝对定位系统的跟踪系统480可包括并且/或者可被编程以实现反馈控制器，诸如PID、状态反馈和自适应控制器。功率源将来自反馈控制器的信号转换为对系统的物理输入：在这种情况下为电压。其它示例包括电压、电流和力的PWM。除了由位置传感器472所测量的位置之外，可提供一个或多个其它传感器来测量物理系统的物理参数。在一些方面，一个或多个其它传感器可包括传感器布置方式，诸如在2016年5月24日发布的标题为钉仓组织厚度传感器系统(STAPLE CARTRIDGE TISSUE THICKNESS)的美国专利9,345,481中所述的那些，该专利全文以引用方式并入本文；2014年9月18日公布的标题为钉仓组织厚度传感器系统(STAPLE CARTRIDGE TISSUE THICKNESS)的美国专利申请公布2014/0263552，该专利全文以引用方式并入本文；以及2017年6月20日提交的标题为用于外科缝合和切割器械的马达速度的自适应控制的技术(TECHNIQUES FOR ADAPTIVE CONTROL OF MOTORVELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT)的美国专利申请序列号15/628,175，该专利申请全文以引用方式并入本文。在数字信号处理系统中，绝对定位系统耦合到数字数据采集系统，其中绝对定位系统的输出将具有有限分辨率和采样频率。绝对定位系统可包括比较和组合电路，以使用算法(诸如加权平均和理论控制环路)将计算响应与测量响应进行组合，该算法驱动计算响应朝向所测量的响应。物理系统的计算响应将特性如质量、惯性、粘性摩擦、电感电阻考虑在内，以通过得知输入预测物理系统的状态和输出。The tracking system 480 including the absolute positioning system may include and/or may be programmed to implement a feedback controller such as a PID, state feedback, and an adaptive controller. The power source converts the signal from the feedback controller into a physical input to the system: in this case, a voltage. Other examples include PWM of voltage, current, and force. In addition to the position measured by the position sensor 472, one or more other sensors may be provided to measure a physical parameter of the physical system. In some aspects, one or more other sensors may include sensor arrangements such as those described in U.S. Patent 9,345,481, entitled STAPLE CARTRIDGE TISSUE THICKNESS, issued on May 24, 2016, which is incorporated herein by reference in its entirety; U.S. Patent Application Publication 2014/0263552, entitled STAPLE CARTRIDGE TISSUE THICKNESS, issued on September 18, 2014, which is incorporated herein by reference in its entirety; and U.S. Patent Application Serial No. 15/628,175, entitled TECHNIQUES FOR ADAPTIVE CONTROL OF MOTORVELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT, filed on June 20, 2017, which is incorporated herein by reference in its entirety. In a digital signal processing system, the absolute positioning system is coupled to a digital data acquisition system, where the output of the absolute positioning system will have a finite resolution and sampling frequency. The absolute positioning system may include comparison and combination circuits to combine the calculated response with the measured response using an algorithm (such as weighted average and theoretical control loop) that drives the calculated response toward the measured response. The calculated response of the physical system takes into account characteristics such as mass, inertia, viscous friction, inductance and resistance to predict the state and output of the physical system by knowing the input.

因此，绝对定位系统在器械上电时提供位移构件的绝对位置，并且不使位移构件回缩或推进至如常规旋转编码器可需要的复位(清零或本位)位置，这些编码器仅对马达482采取的向前或向后的步骤数进行计数以推断装置致动器、驱动棒、刀等等的位置。Thus, the absolute positioning system provides the absolute position of the displacement member when the instrument is powered on, and does not retract or advance the displacement member to a reset (zero or home) position as might be required with conventional rotary encoders, which simply count the number of forward or backward steps taken by the motor 482 to infer the position of the device actuator, drive rod, knife, etc.

传感器474(诸如，例如应变仪或微应变仪)被配置为测量端部执行器的一个或多个参数，诸如例如在夹持操作期间施加在砧座上的应变的幅值，该幅值可以指示施加到砧座的闭合力。将测得的应变转换成数字信号并提供给处理器462。另选地或除了传感器474之外，传感器476(诸如例如，负载传感器)可以测量由闭合驱动系统施加到超声或电外科器械中的缝合器或夹持臂中的砧座的闭合力。传感器476(诸如例如，负载传感器)可测量施加到耦合到外科器械或工具的夹持臂的闭合构件的击发力或由夹持臂施加到位于超声或电外科器械的钳口中的组织的力。另选地，可以采用电流传感器478来测量由马达482消耗的电流。位移构件还可被配置为接合夹持臂以打开或闭合夹持臂。力传感器可被配置为测量组织上的夹持力。推进位移构件所需的力可对应于例如由马达482消耗的电流。将测得的力转换成数字信号并提供给处理器462。Sensor 474 (such as, for example, a strain gauge or micro strain gauge) is configured to measure one or more parameters of the end effector, such as, for example, the magnitude of the strain applied to the anvil during the clamping operation, which can indicate the closing force applied to the anvil. The measured strain is converted into a digital signal and provided to the processor 462. Alternatively or in addition to sensor 474, sensor 476 (such as, for example, a load sensor) can measure the closing force of the anvil in the stapler or clamping arm applied by the closed drive system to the ultrasonic or electrosurgical instrument. Sensor 476 (such as, for example, a load sensor) can measure the firing force applied to the closing member of the clamping arm coupled to the surgical instrument or tool or the force applied by the clamping arm to the tissue in the jaws of the ultrasonic or electrosurgical instrument. Alternatively, a current sensor 478 can be used to measure the current consumed by the motor 482. The displacement member can also be configured to engage the clamping arm to open or close the clamping arm. The force sensor can be configured to measure the clamping force on the tissue. The force required to advance the displacement member may correspond to, for example, the current consumed by the motor 482. The measured force is converted into a digital signal and provided to the processor 462.

在一种形式中，应变仪传感器474可用于测量由端部执行器施加到组织的力。应变计可耦合到端部执行器以测量被端部执行器处理的组织上的力。用于测量施加到由端部执行器抓握的组织的力的系统包括应变仪传感器474，诸如例如微应变仪，其被配置为测量例如端部执行器的一个或多个参数。在一个方面，应变仪传感器474可测量在夹持操作期间施加到端部执行器的钳口构件上的应变的幅值或量值，这可指示组织压缩。将测得的应变转换成数字信号并将其提供到微控制器461的处理器462。负载传感器476可测量用于操作刀元件例如以切割被捕获在砧座和钉仓之间的组织的力。负载传感器476可测量用于操作夹持臂元件例如以捕获夹持臂和超声刀之间的组织或捕获夹持臂和电外科器械的钳口之间的组织的力。可采用磁场传感器来测量捕集的组织的厚度。磁场传感器的测量值也可被转换成数字信号并提供给处理器462。In one form, a strain gauge sensor 474 can be used to measure the force applied to the tissue by the end effector. A strain gauge can be coupled to the end effector to measure the force on the tissue processed by the end effector. A system for measuring the force applied to the tissue grasped by the end effector includes a strain gauge sensor 474, such as, for example, a micro strain gauge, which is configured to measure, for example, one or more parameters of the end effector. In one aspect, the strain gauge sensor 474 can measure the amplitude or magnitude of the strain applied to the jaw member of the end effector during the clamping operation, which can indicate tissue compression. The measured strain is converted into a digital signal and provided to the processor 462 of the microcontroller 461. The load sensor 476 can measure the force used to operate the knife element, for example, to cut the tissue captured between the anvil and the nail magazine. The load sensor 476 can measure the force used to operate the clamp arm element, for example, to capture the tissue between the clamp arm and the ultrasonic blade or the tissue between the clamp arm and the jaws of the electrosurgical instrument. A magnetic field sensor can be used to measure the thickness of the captured tissue. The measurement value of the magnetic field sensor can also be converted into a digital signal and provided to the processor 462.

微控制器461可使用分别由传感器474、476测量的组织压缩、组织厚度和/或闭合端部执行器所需的力的测量来表征击发构件的所选择的位置和/或击发构件的速度的对应值。在一种情况下，存储器468可存储可由微控制器461在评估中所采用的技术、公式和/或查找表。The microcontroller 461 can characterize the corresponding values of the selected position of the firing member and/or the velocity of the firing member using the measurements of tissue compression, tissue thickness, and/or the force required to close the end effector measured by the sensors 474, 476, respectively. In one embodiment, the memory 468 can store techniques, formulas, and/or lookup tables that can be used by the microcontroller 461 in the evaluation.

外科器械或工具的控制系统470还可包括有线或无线通信电路以与模块化通信集线器通信，如图8-11中所示。The control system 470 of the surgical instrument or tool may also include wired or wireless communication circuitry to communicate with the modular communication hub, as shown in FIGS. 8-11 .

图13示出了控制电路500，该控制电路500被配置为控制根据本公开的一个方面的外科器械或工具的各方面。控制电路500可被配置为实现本文所述的各种过程。电路500可包括微控制器，该微控制器包括耦合接到至少一个存储器电路504的一个或多个处理器502(例如，微处理器、微控制器)。存储器电路504存储在由处理器502执行时使处理器502执行机器指令以实现本文所述的各种过程的机器可执行指令。处理器502可为本领域中已知的多种单核或多核处理器中的任一种。存储器电路504可包括易失性存储介质和非易失性存储介质。处理器502可包括指令处理单元506和运算单元508。指令处理单元可被配置为从本公开的存储器电路504接收指令。FIG. 13 shows a control circuit 500 configured to control various aspects of a surgical instrument or tool according to one aspect of the present disclosure. The control circuit 500 may be configured to implement various processes described herein. The circuit 500 may include a microcontroller including one or more processors 502 (e.g., microprocessors, microcontrollers) coupled to at least one memory circuit 504. The memory circuit 504 stores machine executable instructions that cause the processor 502 to execute machine instructions to implement various processes described herein when executed by the processor 502. The processor 502 may be any of a variety of single-core or multi-core processors known in the art. The memory circuit 504 may include a volatile storage medium and a non-volatile storage medium. The processor 502 may include an instruction processing unit 506 and an operation unit 508. The instruction processing unit may be configured to receive instructions from the memory circuit 504 of the present disclosure.

图14示出了组合逻辑电路510，该组合逻辑电路510被配置为控制根据本公开的一个方面的外科器械或工具的各方面。组合逻辑电路510可被配置为实现本文所述的各种过程。组合逻辑电路510可包括有限状态机，该有限状态机包括组合逻辑512，该组合逻辑512被配置为在输入514处接收与外科器械或工具相关联的数据，通过组合逻辑512处理数据并提供输出516。FIG. 14 shows a combinatorial logic circuit 510 configured to control various aspects of a surgical instrument or tool according to one aspect of the present disclosure. The combinatorial logic circuit 510 may be configured to implement various processes described herein. The combinatorial logic circuit 510 may include a finite state machine including combinatorial logic 512 configured to receive data associated with a surgical instrument or tool at an input 514, process the data through the combinatorial logic 512, and provide an output 516.

图15示出了根据本公开的一个方面的被配置为控制外科器械或工具的各个方面的时序逻辑电路520。时序逻辑电路520或组合逻辑522可被配置为实现本文所述的各种过程。时序逻辑电路520可包括有限状态机。时序逻辑电路520可包括例如组合逻辑522、至少一个存储器电路524和时钟529。至少一个存储器电路524可以存储有限状态机的当前状态。在某些情况下，时序逻辑电路520可为同步的或异步的。组合逻辑522被配置为从输入526接收与外科器械或工具相关联的数据，通过组合逻辑522处理数据并提供输出528。在其它方面，电路可包括处理器(例如，处理器502，图13)和有限状态机的组合以实现本文的各种过程。在其它实施方案中，有限状态机可包括组合逻辑电路(例如，组合逻辑电路510，图14)和时序逻辑电路520的组合。FIG. 15 shows a sequential logic circuit 520 configured to control various aspects of a surgical instrument or tool according to one aspect of the present disclosure. The sequential logic circuit 520 or the combinatorial logic 522 may be configured to implement the various processes described herein. The sequential logic circuit 520 may include a finite state machine. The sequential logic circuit 520 may include, for example, combinatorial logic 522, at least one memory circuit 524, and a clock 529. At least one memory circuit 524 may store the current state of the finite state machine. In some cases, the sequential logic circuit 520 may be synchronous or asynchronous. The combinatorial logic 522 is configured to receive data associated with a surgical instrument or tool from an input 526, process the data through the combinatorial logic 522, and provide an output 528. In other aspects, the circuit may include a combination of a processor (e.g., processor 502, FIG. 13) and a finite state machine to implement the various processes herein. In other embodiments, the finite state machine may include a combination of a combinatorial logic circuit (e.g., combinatorial logic circuit 510, FIG. 14) and a sequential logic circuit 520.

图16示出了包括可被激活以执行各种功能的多个马达的外科器械或工具。在某些情况下，第一马达可被激活以执行第一功能，第二马达可被激活以执行第二功能，并且第三马达可被激活以执行第三功能。在某些情况下，机器人外科器械600的多个马达可被单独地激活以导致端部执行器中的击发运动、闭合运动、和/或关节运动。击发运动、闭合运动、和/或关节运动可例如通过轴组件传输到端部执行器。FIG. 16 shows a surgical instrument or tool including multiple motors that can be activated to perform various functions. In some cases, a first motor can be activated to perform a first function, a second motor can be activated to perform a second function, and a third motor can be activated to perform a third function. In some cases, multiple motors of the robotic surgical instrument 600 can be individually activated to cause a firing motion, a closing motion, and/or an articulation motion in an end effector. The firing motion, the closing motion, and/or the articulation motion can be transmitted to the end effector, for example, via a shaft assembly.

在某些情况下，外科器械系统或工具可包括击发马达602。击发马达602可操作地耦合到击发马达驱动组件604，该击发马达驱动组件604可被配置为将由马达602生成的击发运动传输到端部执行器，具体地用于移置夹持臂闭合构件。闭合构件可通过反转马达602的方向而回缩，这也导致夹持臂打开。In some cases, the surgical instrument system or tool may include a firing motor 602. The firing motor 602 may be operably coupled to a firing motor drive assembly 604, which may be configured to transmit the firing motion generated by the motor 602 to the end effector, specifically for displacing the clamp arm closure member. The closure member may be retracted by reversing the direction of the motor 602, which also causes the clamp arm to open.

在某些情况下，外科器械或工具可包括闭合马达603。闭合马达603可以可操作地耦合到闭合马达驱动组件605，该闭合马达驱动组件605被配置为将由马达603生成的闭合运动传输到端部执行器，具体地用于移置闭合管以闭合砧座并且压缩砧座和钉仓之间的组织。闭合马达603可以可操作地耦合到闭合马达驱动组件605，该闭合马达驱动组件被配置为将由马达603生成的闭合运动传输到端部执行器，具体地用于移置闭合管以闭合夹持臂并且压缩夹持臂和电外科装置的超声刀或钳口构件之间的组织。闭合运动可使例如端部执行器从打开配置转变成接近配置以捕获组织。端部执行器可通过反转马达603的方向而转变到打开位置。In some cases, the surgical instrument or tool may include a closing motor 603. The closing motor 603 may be operably coupled to a closing motor drive assembly 605, which is configured to transmit the closing motion generated by the motor 603 to the end effector, specifically for displacing the closing tube to close the anvil and compressing the tissue between the anvil and the staple cartridge. The closing motor 603 may be operably coupled to a closing motor drive assembly 605, which is configured to transmit the closing motion generated by the motor 603 to the end effector, specifically for displacing the closing tube to close the clamping arm and compressing the tissue between the clamping arm and the ultrasonic blade or jaw member of the electrosurgical device. The closing motion may, for example, cause the end effector to transition from an open configuration to a close configuration to capture tissue. The end effector may be transitioned to an open position by reversing the direction of the motor 603.

在某些情况下，外科器械或工具可包括例如一个或多个关节运动马达606a、606b。马达606a、606b可以可操作地耦合到相应的关节运动马达驱动组件608a、608b，该关节运动马达驱动组件可被配置为将由马达606a、606b生成的关节运动传输到端部执行器。在某些情况下，关节运动可使端部执行器相对于轴进行关节运动，例如。In some cases, a surgical instrument or tool may include, for example, one or more articulation motors 606a, 606b. The motors 606a, 606b may be operably coupled to respective articulation motor drive assemblies 608a, 608b, which may be configured to transmit the articulation generated by the motors 606a, 606b to the end effector. In some cases, the articulation may cause the end effector to articulate relative to an axis, for example.

如上所述，外科器械或工具可包括多个马达，该多个马达可被配置为执行各种独立功能。在某些情况下，外科器械或工具的多个马达可被单独地或独立地激活以执行一个或多个功能，而其它马达保持非活动的。例如，关节运动马达606a、606b可被激活以使端部执行器进行关节运动，而击发马达602保持非活动的。另选地，击发马达602可被激活以击发多个钉并且/或者推进切割边缘，而关节运动马达606保持非活动的。此外，闭合马达603可与击发马达602同时激活，以使闭合管或闭合构件朝远侧推进，如下文更详细地描述。As described above, the surgical instrument or tool may include multiple motors that may be configured to perform various independent functions. In some cases, multiple motors of the surgical instrument or tool may be individually or independently activated to perform one or more functions, while other motors remain inactive. For example, articulation motors 606a, 606b may be activated to articulate the end effector, while firing motor 602 remains inactive. Alternatively, firing motor 602 may be activated to fire multiple nails and/or advance the cutting edge, while articulation motor 606 remains inactive. In addition, closing motor 603 may be activated simultaneously with firing motor 602 to advance the closing tube or closing member toward the distal side, as described in more detail below.

在某些情况下，外科器械或工具可包括公共控制模块610，该公共控制模块610可与外科器械或工具的多个马达一起使用。在某些情况下，公共控制模块610每次可调节多个马达中的一个。例如，公共控制模块610可单独地耦合到外科器械的多个马达并且可从外科器械的多个马达分离。在某些情况下，外科器械或工具的多个马达可共用一个或多个公共控制模块诸如公共控制模块610。在某些情况下，外科器械或工具的多个马达可独立地和选择性地接合公共控制模块610。在某些情况下，公共控制模块610可从与外科器械或工具的多个马达中的一个交接切换到与外科器械或工具的多个马达中的另一个交接。In some cases, a surgical instrument or tool may include a common control module 610 that can be used with multiple motors of the surgical instrument or tool. In some cases, the common control module 610 can adjust one of the multiple motors at a time. For example, the common control module 610 can be individually coupled to multiple motors of the surgical instrument and can be separated from the multiple motors of the surgical instrument. In some cases, multiple motors of the surgical instrument or tool can share one or more common control modules such as the common control module 610. In some cases, multiple motors of the surgical instrument or tool can independently and selectively engage the common control module 610. In some cases, the common control module 610 can switch from interfacing with one of the multiple motors of the surgical instrument or tool to interfacing with another of the multiple motors of the surgical instrument or tool.

在至少一个示例中，公共控制模块610可在可操作地接合关节运动马达606a、606b和可操作地接合击发马达602或闭合马达603之间选择性地切换。在至少一个示例中，如图16中所示，开关614可以在多个位置和/或状态之间运动或转变。在第一位置616中，开关614可将公共控制模块610电耦合到击发马达602；在第二位置617中，开关614可将公共控制模块610电耦合到闭合马达603；在第三位置618a中，开关614可将公共控制模块610电耦合到第一关节运动马达606a；并且在第四位置618b中，开关614可将公共控制模块610电耦合到例如第二关节运动马达606b。在某些情况下，单独的公共控制模块610可同时电耦合到击发马达602、闭合马达603和关节运动马达606a、606b。在某些情况下，开关614可为机械开关、机电开关、固态开关、或任何合适的开关机构。In at least one example, the common control module 610 can be selectively switched between operably engaging the articulation motors 606a, 606b and operably engaging the firing motor 602 or the closing motor 603. In at least one example, as shown in FIG. 16, the switch 614 can move or transform between multiple positions and/or states. In the first position 616, the switch 614 can electrically couple the common control module 610 to the firing motor 602; in the second position 617, the switch 614 can electrically couple the common control module 610 to the closing motor 603; in the third position 618a, the switch 614 can electrically couple the common control module 610 to the first articulation motor 606a; and in the fourth position 618b, the switch 614 can electrically couple the common control module 610 to, for example, the second articulation motor 606b. In some cases, a separate common control module 610 can be electrically coupled to the firing motor 602, the closing motor 603, and the articulation motors 606a, 606b at the same time. In some cases, switch 614 may be a mechanical switch, an electromechanical switch, a solid-state switch, or any suitable switching mechanism.

马达602、603、606a、606b中的每个可包括扭矩传感器以测量马达的轴上的输出扭矩。可以任何常规方式感测端部执行器上的力，诸如通过钳口的外侧上的力传感器或通过用于致动钳口的马达的扭矩传感器来感测端部执行器上的力。Each of the motors 602, 603, 606a, 606b may include a torque sensor to measure the output torque on the shaft of the motor. The force on the end effector may be sensed in any conventional manner, such as by a force sensor on the outside of the jaws or by a torque sensor of the motor used to actuate the jaws.

在各种情况下，如图16中所示，公共控制模块610可包括马达驱动器626，该马达驱动器626可包括一个或多个H桥场效应FET。马达驱动器626可例如基于得自微控制器620(“控制器”)的输入来调节从功率源628传输到耦合到公共控制模块610的马达的功率。在某些情况下，当马达耦合到公共控制模块610时，可例如采用微控制器620来确定由马达消耗的电流，如上所述。In various cases, as shown in FIG16 , the common control module 610 may include a motor driver 626, which may include one or more H-bridge field effect FETs. The motor driver 626 may regulate the power delivered from a power source 628 to a motor coupled to the common control module 610, for example, based on input from a microcontroller 620 (“controller”). In some cases, when a motor is coupled to the common control module 610, the microcontroller 620 may be employed, for example, to determine the current consumed by the motor, as described above.

在某些情况下，微控制器620可包括微处理器622(“处理器”)和一个或多个非暂态计算机可读介质或存储单元624(“存储器”)。在某些情况下，存储器624可存储各种程序指令，这些各种程序指令在被执行时可使处理器622执行本文所述的多个功能和/或计算。在某些情况下，存储器单元624中的一个或多个可例如耦合到处理器622。在各个方面，微控制器620可通过有线或无线信道或它们的组合进行通信。In some cases, microcontroller 620 may include a microprocessor 622 ("processor") and one or more non-transitory computer-readable media or storage units 624 ("memory"). In some cases, memory 624 may store various program instructions that, when executed, may cause processor 622 to perform a number of functions and/or calculations described herein. In some cases, one or more of memory units 624 may be coupled to processor 622, for example. In various aspects, microcontroller 620 may communicate via wired or wireless channels, or a combination thereof.

在某些情况下，功率源628可例如用于为微控制器620供电。在某些情况下，功率源628可包括电池(或者“电池组”或“功率组”)，诸如锂离子电池，例如。在某些情况下，电池组可被配置为可释放地安装到柄部以用于给外科器械600供电。多个串联连接的电池单元可用作功率源628。在某些情况下，功率源628可为例如可替换的和/或可再充电的。In some cases, the power source 628 may be used, for example, to power the microcontroller 620. In some cases, the power source 628 may include a battery (or "battery pack" or "power pack"), such as a lithium-ion battery, for example. In some cases, the battery pack may be configured to be releasably mounted to the handle for powering the surgical instrument 600. A plurality of battery cells connected in series may be used as the power source 628. In some cases, the power source 628 may be, for example, replaceable and/or rechargeable.

在各种情况下，处理器622可控制马达驱动器626以控制耦合到公共控制器610的马达的位置、旋转方向、和/或速度。在某些情况下，处理器622可发信号通知马达驱动器626，以停止和/或停用耦合到公共控制器610的马达。应当理解，如本文所用的术语“处理器”包括任何合适的微处理器、微控制器、或将计算机的中央处理单元(CPU)的功能结合在一个集成电路或至多几个集成电路上的其它基础计算装置。处理器622是多用途的可编程装置，该装置接收数字数据作为输入，根据其存储器中存储的指令来处理输入，并且然后提供结果作为输出。因为处理器具有内部存储器，所以是顺序数字逻辑的示例。处理器的操作对象是以二进制数字系统表示的数字和符号。In various cases, the processor 622 may control the motor driver 626 to control the position, rotation direction, and/or speed of the motor coupled to the common controller 610. In some cases, the processor 622 may signal the motor driver 626 to stop and/or deactivate the motor coupled to the common controller 610. It should be understood that the term "processor" as used herein includes any suitable microprocessor, microcontroller, or other basic computing device that combines the functions of the central processing unit (CPU) of a computer on an integrated circuit or at most several integrated circuits. The processor 622 is a multi-purpose programmable device that receives digital data as input, processes the input according to instructions stored in its memory, and then provides a result as output. Because the processor has an internal memory, it is an example of sequential digital logic. The operating objects of the processor are numbers and symbols represented in the binary number system.

在一种情况下，处理器622可为任何单核或多核处理器，诸如已知的由德克萨斯器械公司(Texas Instruments)生产的商品名为ARM Cortex的那些。在某些情况下，微控制器620可为例如可从德州仪器公司(Texas Instruments)购得的LM 4F230H5QR。在至少一个示例中，Texas Instruments LM4F230H5QR为ARM Cortex-M4F处理器芯，其包括：256KB的单循环闪存或其它非易失性存储器(高达40MHZ)的片上存储器、用于改善40MHz以上的性能的预取缓冲器、32KB的单循环SRAM、装载有软件的内部ROM、2KB的EEPROM、一个或多个PWM模块、一个或多个QEI模拟、具有12个模拟输入信道的一个或多个12位ADC、以及易得的其它特征件。可容易地换用其它微控制器，以与模块4410一起使用。因此，本公开不应限于这一上下文。In one case, the processor 622 may be any single-core or multi-core processor, such as those known under the trade name ARM Cortex produced by Texas Instruments. In some cases, the microcontroller 620 may be, for example, the LM 4F230H5QR available from Texas Instruments. In at least one example, the Texas Instruments LM4F230H5QR is an ARM Cortex-M4F processor core that includes: 256KB of single-cycle flash or other non-volatile memory (up to 40 MHz) on-chip memory, a pre-fetch buffer for improved performance above 40 MHz, 32KB of single-cycle SRAM, a 32-bit MCU loaded with The 4410 includes an internal ROM for software, 2KB of EEPROM, one or more PWM modules, one or more QEI simulations, one or more 12-bit ADCs with 12 analog input channels, and other features readily available. Other microcontrollers can be easily substituted for use with module 4410. Therefore, the present disclosure should not be limited to this context.

在某些情况下，存储器624可包括用于控制可耦合到公共控制器610的外科器械600的马达中的每个的程序指令。例如，存储器624可包括用于控制击发马达602、闭合马达603和关节运动马达606a、606b的程序指令。此类程序指令可使得处理器622根据来自外科器械或工具的算法或控制程序的输入来控制击发、闭合和关节运动功能。In some cases, the memory 624 may include program instructions for controlling each of the motors of the surgical instrument 600 that may be coupled to the common controller 610. For example, the memory 624 may include program instructions for controlling the firing motor 602, the closing motor 603, and the articulation motors 606a, 606b. Such program instructions may cause the processor 622 to control the firing, closing, and articulation functions based on input from an algorithm or control program of the surgical instrument or tool.

在某些情况下，一个或多个机构和/或传感器诸如传感器630可以用于警示处理器622应当在特定设定中使用的程序指令。例如，传感器630可警示处理器622使用与击发、闭合和关节运动端部执行器相关联的程序指令。在某些情况下，传感器630可包括例如可以用于感测开关614的位置的位置传感器。因此，处理器622可在例如通过传感器630检测到开关614处于第一位置616时使用与击发耦合到端部执行器的夹持臂的闭合构件相关联的程序指令；处理器622可在例如通过传感器630检测到开关614处于第二位置617时使用与闭合砧座相关联的程序指令；并且处理器622可在例如通过传感器630检测到开关614处于第三位置618a或第四位置618b时使用与使端部执行器进行关节运动相关联的程序指令。In some cases, one or more mechanisms and/or sensors, such as sensor 630, can be used to alert processor 622 of program instructions that should be used in a particular setting. For example, sensor 630 can alert processor 622 to use program instructions associated with firing, closing, and articulating the end effector. In some cases, sensor 630 can include, for example, a position sensor that can be used to sense the position of switch 614. Thus, processor 622 can use program instructions associated with firing a closing member of a clamping arm coupled to an end effector when, for example, sensor 630 detects that switch 614 is in first position 616; processor 622 can use program instructions associated with closing anvil when, for example, sensor 630 detects that switch 614 is in second position 617; and processor 622 can use program instructions associated with articulating the end effector when, for example, sensor 630 detects that switch 614 is in third position 618a or fourth position 618b.

图17是根据本公开的一个方面的被配置为操作本文所述的外科工具的机器人外科器械700的示意图。机器人外科器械700可被编程或配置为控制位移构件的远侧/近侧平移、闭合管的远侧/近侧位移、轴旋转、以及具有单个或多个关节运动驱动连杆的关节运动。在一个方面，外科器械700可被编程或配置为单独地控制击发构件、闭合构件、轴构件、或一个或多个关节运动构件、或它们的组合。外科器械700包括控制电路710，该控制电路710被配置为控制马达驱动的击发构件、闭合构件、轴构件、或一个或多个关节运动构件、或它们的组合。FIG. 17 is a schematic diagram of a robotic surgical instrument 700 configured to operate the surgical tools described herein according to one aspect of the present disclosure. The robotic surgical instrument 700 can be programmed or configured to control distal/proximal translation of a displacement member, distal/proximal displacement of a closure tube, axis rotation, and articulation with a single 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, an axis member, or one or more articulation members, or a combination thereof. The surgical instrument 700 includes a control circuit 710 configured to control a motor-driven firing member, a closing member, an axis member, or one or more articulation members, or a combination thereof.

在一个方面，机器人外科器械700包括控制电路710，该控制电路710被配置为控制端部执行器702的夹持臂716和闭合构件714部分、耦合到超声发生器721激发的超声换能器719的超声刀718、轴740、以及经由多个马达704a-704e的一个或多个关节运动构件742a、742b。位置传感器734可被配置为向控制电路710提供闭合构件714的位置反馈。其它传感器738可被配置为向控制电路710提供反馈。定时器/计数器731向控制电路710提供定时和计数信息。可提供能量源712以操作马达704a-704e，并且电流传感器736向控制电路710提供马达电流反馈。马达704a-704e可通过控制电路710在开环或闭环反馈控制中单独操作。In one aspect, the robotic surgical instrument 700 includes a control circuit 710 configured to control the clamping arm 716 and the closing member 714 portion of the end effector 702, the ultrasonic blade 718 coupled to the ultrasonic transducer 719 excited by the ultrasonic generator 721, the shaft 740, and one or more joint motion members 742a, 742b via a plurality of motors 704a-704e. The position sensor 734 may be configured to provide position feedback of the closing member 714 to the control circuit 710. Other sensors 738 may be configured to provide feedback to the control circuit 710. The timer/counter 731 provides timing and counting information to the control circuit 710. An energy source 712 may be provided to operate the motors 704a-704e, and a current sensor 736 provides motor current feedback to the control circuit 710. The motors 704a-704e may be operated individually in open-loop or closed-loop feedback control by the control circuit 710.

在一个方面，控制电路710可包括用于执行使得一个或多个处理器执行一个或多个任务的指令的一个或多个微控制器、微处理器或其它合适的处理器。在一个方面，定时器/计数器731向控制电路710提供输出信号，诸如耗用时间或数字计数，以将如由位置传感器734确定的闭合构件714的位置与定时器/计数器731的输出相关联，使得控制电路710可确定闭合构件714在相对于起始位置的特定时间(t)或闭合构件714处于相对于起始位置的特定位置时的时间(t)处的位置。定时器/计数器731可被配置为测量所耗用的时间、计数外部事件或时间外部事件。In one aspect, the control circuit 710 may include one or more microcontrollers, microprocessors, or other suitable processors for executing instructions that cause the one or more processors to perform one or more tasks. In one aspect, the timer/counter 731 provides an output signal, such as an elapsed time or a digital count, to the control circuit 710 to correlate the position of the closing member 714 as determined by the position sensor 734 with the output of the timer/counter 731 so that the control circuit 710 can determine the position of the closing member 714 at a specific time (t) relative to the starting position or the time (t) when the closing member 714 is in a specific position relative to the starting position. The timer/counter 731 can be configured to measure elapsed time, count external events, or time external events.

在一个方面，控制电路710可被编程为基于一个或多个组织条件来控制端部执行器702的功能。控制电路710可被编程为直接或间接地感测组织条件，诸如厚度，如本文所述。控制电路710可被编程为基于组织条件选择击发控制程序或闭合控制程序。击发控制程序可描述位移构件的远侧运动。可选择不同的击发控制程序以更好地处理不同的组织状况。例如，当存在更厚的组织时，控制电路710可被编程为以更低的速度和/或以更低的功率平移位移构件。当存在更薄的组织时，控制电路710可被编程为以更高的速度和/或以更高的功率平移位移构件。闭合控制程序可控制由夹持臂716施加到组织的闭合力。其它控制程序控制轴740和关节运动构件742a、742b的旋转。In one aspect, the control circuit 710 can be programmed to control the function of the end effector 702 based on one or more tissue conditions. The control circuit 710 can be programmed to sense tissue conditions, such as thickness, directly or indirectly, as described herein. The control circuit 710 can be programmed to select a firing control program or a closing control program based on the tissue conditions. The firing control program can describe the distal movement of the displacement member. Different firing control programs can be selected to better handle different tissue conditions. For example, when there is thicker tissue, the control circuit 710 can be programmed to translate the displacement member at a lower speed and/or at a lower power. When there is thinner tissue, the control circuit 710 can be programmed to translate the displacement member at a higher speed and/or at a higher power. The closing control program can control the closing force applied to the tissue by the clamping arm 716. Other control programs control the rotation of the shaft 740 and the articulation members 742a, 742b.

在一个方面，控制电路710可生成马达设定点信号。马达设定点信号可被提供给各种马达控制器708a-708e。马达控制器708a-708e可包括一个或多个电路，这些电路被配置为向马达704a-704e提供马达驱动信号，以驱动马达704a-704e，如本文所述。在一些示例中，马达704a-704e可为有刷DC电动马达。例如，马达704a-704e的速度可与相应的马达驱动信号成比例。在一些示例中，马达704a-704e可为无刷DC马达，并且相应的马达驱动信号可包括提供给马达704a-704e的一个或多个定子绕组的PWM信号。而且，在一些示例中，可省略马达控制器708a-708e，并且控制电路710可直接生成马达驱动信号。In one aspect, the control circuit 710 may generate a motor set point signal. The motor set point signal may be provided to various motor controllers 708a-708e. The motor controllers 708a-708e may include one or more circuits configured to provide motor drive signals to the motors 704a-704e to drive the motors 704a-704e as described herein. In some examples, the motors 704a-704e may be brushed DC electric motors. For example, the speed of the motors 704a-704e may be proportional to the corresponding motor drive signals. In some examples, the motors 704a-704e may be brushless DC motors, and the corresponding motor drive signals may include PWM signals provided to one or more stator windings of the motors 704a-704e. Moreover, in some examples, the motor controllers 708a-708e may be omitted, and the control circuit 710 may directly generate the motor drive signals.

在一些示例中，控制电路710可针对位移构件的行程的第一开环部分初始以开环配置操作马达704a-704e中的每个。基于在行程的开环部分期间机器人外科器械700的响应，控制电路710可选择处于闭环配置的击发控制程序。器械的响应可包括在开环部分期间位移构件的平移距离、在开环部分期间耗用的时间、在开环部分期间提供给马达704a-704e中的一者的能量、马达驱动信号的脉冲宽度之和等。在开环部分之后，控制电路710可对位移构件行程的第二部分实现所选择的击发控制程序。例如，在行程的闭环部分期间，控制电路710可基于以闭环方式描述位移构件的位置的平移数据来调制马达704a-704e中的一者，以使位移构件以恒定速度平移。In some examples, the control circuit 710 may initially operate each of the motors 704a-704e in an open-loop configuration for a first open-loop portion of the displacement member's travel. Based on the response of the robotic surgical instrument 700 during the open-loop portion of the travel, the control circuit 710 may select a firing control program in a closed-loop configuration. The response of the instrument may include the translation distance of the displacement member during the open-loop portion, the time elapsed during the open-loop portion, the energy provided to one of the motors 704a-704e during the open-loop portion, the sum of the pulse widths of the motor drive signal, etc. After the open-loop portion, the control circuit 710 may implement the selected firing control program for a second portion of the displacement member's travel. For example, during the closed-loop portion of the travel, the control circuit 710 may modulate one of the motors 704a-704e based on the translation data describing the position of the displacement member in a closed-loop manner to cause the displacement member to translate at a constant speed.

在一个方面，马达704a-704e可从能量源712接收功率。能量源712可为由主交流功率源、电池、超级电容器或任何其它合适的能量源驱动的DC功率源。马达704a-704e可经由相应的传动装置706a-706e机械地耦合到单独的可运动机械元件，诸如闭合构件714、夹持臂716、轴740、关节运动742a和关节运动742b。传动装置706a-706e可包括一个或多个齿轮或其它连杆部件，以将马达704a-704e耦合到可运动机械元件。位置传感器734可感测闭合构件714的位置。位置传感器734可为或包括能够生成指示闭合构件714的位置的位置数据的任何类型的传感器。在一些示例中，位置传感器734可包括编码器，该编码器被配置为在闭合构件714朝远侧和近侧平移时向控制电路710提供一系列脉冲。控制电路710可跟踪脉冲以确定闭合构件714的位置。可使用其它合适的位置传感器，包括例如接近传感器。其它类型的位置传感器可提供指示闭合构件714的运动的其它信号。而且，在一些示例中，可省略位置传感器734。在马达704a-704e是步进马达的情况下，控制电路710可通过聚合马达704已被指示执行的步骤的数量和方向来跟踪闭合构件714的位置。位置传感器734可位于端部执行器702中或器械的任何其它部分处。马达704a-704e中的每个的输出包括用于感测力的扭矩传感器744a-744e，并且具有用于感测驱动轴的旋转的编码器。In one aspect, the motors 704a-704e may receive power from the energy source 712. The energy source 712 may be a DC power source driven by a main AC power source, a battery, a supercapacitor, or any other suitable energy source. The motors 704a-704e may be mechanically coupled to separate movable mechanical elements, such as the closing member 714, the clamping arm 716, the shaft 740, the articulation 742a, and the articulation 742b, via corresponding transmissions 706a-706e. The transmissions 706a-706e may include one or more gears or other connecting rod components to couple the motors 704a-704e to the movable mechanical elements. The position sensor 734 may sense the position of the closing member 714. The position sensor 734 may be or include any type of sensor capable of generating position data indicating the position of the closing member 714. In some examples, the position sensor 734 may include an encoder configured to provide a series of pulses to the control circuit 710 when the closing member 714 is translated toward the distal and proximal sides. The control circuit 710 can track the pulses to determine the position of the closing member 714. Other suitable position sensors can be used, including, for example, proximity sensors. Other types of position sensors can provide other signals indicating the movement of the closing member 714. Moreover, in some examples, the position sensor 734 can be omitted. In the case where the motors 704a-704e are stepper motors, the control circuit 710 can track the position of the closing member 714 by aggregating the number and direction of steps that the motor 704 has been instructed to perform. The position sensor 734 can be located in the end effector 702 or at any other part of the instrument. The output of each of the motors 704a-704e includes a torque sensor 744a-744e for sensing force, and has an encoder for sensing the rotation of the drive shaft.

在一个方面，控制电路710被配置为驱动击发构件诸如端部执行器702的闭合构件714部分。控制电路710向马达控制708a提供马达设定点，该马达控制向马达704a提供驱动信号。马达704a的输出轴耦合到扭矩传感器744a。扭矩传感器744a耦合到传动装置706a，该传动装置706a耦合到闭合构件714。传动装置706a包括可运动的机械元件诸如旋转元件和击发构件，以控制闭合构件714沿端部执行器702的纵向轴线向远侧和近侧的运动。在一个方面，马达704a可耦合到刀齿轮组件，该刀齿轮组件包括刀齿轮减速组，该刀齿轮减速组包括第一刀驱动齿轮和第二刀驱动齿轮。扭矩传感器744a向控制电路710提供击发力反馈信号。击发力信号表示击发或移置闭合构件714所需的力。位置传感器734可被配置为将闭合构件714沿击发行程的位置或击发构件的位置作为反馈信号提供给控制电路710。端部执行器702可包括被配置为向控制电路710提供反馈信号的附加传感器738。当准备好使用时，控制电路710可向马达控制708a提供击发信号。响应于击发信号，马达704a可沿端部执行器702的纵向轴线将击发构件从近侧行程开始位置朝远侧驱动至行程开始位置远侧的行程结束位置。当闭合构件714朝远侧平移时，夹持臂716朝超声刀718闭合。In one aspect, the control circuit 710 is configured to drive a firing member such as a closing member 714 portion of the end effector 702. The control circuit 710 provides a motor set point to a motor control 708a, which provides a drive signal to the 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 closing member 714. The transmission 706a includes a movable mechanical element such as a rotating element and a firing member to control the movement of the closing member 714 along the longitudinal axis of the end effector 702 to the distal and proximal side. In one aspect, the motor 704a can be coupled to a knife gear assembly, which includes a knife gear reduction group, and the knife gear reduction group includes a first knife drive gear and a second knife drive gear. The torque sensor 744a provides a firing force feedback signal to the control circuit 710. The firing force signal represents the force required to fire or displace the closing member 714. The position sensor 734 may be configured to provide the position of the closing member 714 along the firing stroke or the position of the firing member as a feedback signal to the control circuit 710. The end effector 702 may include an additional sensor 738 configured to provide a feedback signal to the control circuit 710. When ready for use, the control circuit 710 may provide a firing signal to the motor control 708a. In response to the firing signal, the motor 704a may drive the firing member from the proximal stroke start position toward the distal end of the stroke start position along the longitudinal axis of the end effector 702. When the closing member 714 translates toward the distal side, the clamping arm 716 closes toward the ultrasonic blade 718.

在一个方面，控制电路710被配置为驱动闭合构件，诸如端部执行器702的夹持臂716部分。控制电路710向马达控制708b提供马达设定点，该马达控制708b向马达704b提供驱动信号。马达704b的输出轴耦合到扭矩传感器744b。扭矩传感器744b耦合到耦合到夹持臂716的传动装置706b。传动装置706b包括可运动机械元件诸如旋转元件和闭合构件，以控制夹持臂716从打开位置和闭合位置的运动。在一个方面，马达704b耦合到闭合齿轮组件，该闭合齿轮组件包括被支撑成与闭合正齿轮啮合接合的闭合减速齿轮组。扭矩传感器744b向控制电路710提供闭合力反馈信号。闭合力反馈信号表示施加到夹持臂716的闭合力。位置传感器734可被配置为将闭合构件的位置作为反馈信号提供给控制电路710。端部执行器702中的附加传感器738可向控制电路710提供闭合力反馈信号。可枢转夹持臂716被定位成与超声刀718相对。当准备好使用时，控制电路710可向马达控制708b提供闭合信号。响应于闭合信号，马达704b推进闭合构件以抓握夹持臂716和超声刀718之间的组织。In one aspect, the control circuit 710 is configured to drive a closing member, such as the clamping arm 716 portion of the end effector 702. The control circuit 710 provides a motor set point to the motor control 708b, which provides a drive signal to the motor 704b. The output shaft of the motor 704b is coupled to a torque sensor 744b. The torque sensor 744b is coupled to a transmission 706b coupled to the clamping arm 716. The transmission 706b includes a movable mechanical element such as a rotating element and a closing member to control the movement of the clamping arm 716 from an open position and a closed position. In one aspect, the motor 704b is coupled to a closing gear assembly, which includes a closing reduction gear set supported to mesh with a closing spur gear. The torque sensor 744b provides a closing force feedback signal to the control circuit 710. The closing force feedback signal represents the closing force applied to the clamping arm 716. The position sensor 734 can be configured to provide the position of the closing member as a feedback signal to the control circuit 710. The additional sensor 738 in the end effector 702 can provide a closing force feedback signal to the control circuit 710. The pivotable clamp arm 716 is positioned opposite the ultrasonic blade 718. When ready for use, the control circuit 710 can provide a closing signal to the motor control 708b. In response to the closing signal, the motor 704b advances the closing member to grasp the tissue between the clamp arm 716 and the ultrasonic blade 718.

在一个方面，控制电路710被配置为使轴构件诸如轴740旋转，以使端部执行器702旋转。控制电路710向马达控制708c提供马达设定点，该马达控制708c向马达704c提供驱动信号。马达704c的输出轴耦合到扭矩传感器744c。扭矩传感器744c耦合到耦合到轴740的传动装置706c。传动装置706c包括可运动机械元件诸如旋转元件，以控制轴740顺时针或逆时针旋转高达360°和360°以上。在一个方面，马达704c耦合到旋转传动装置组件，该旋转传动装置组件包括管齿轮区段，该管齿轮区段形成于(或附接到)近侧闭合管的近侧端部上，以通过可操作地支撑在工具安装板上的旋转齿轮组件可操作地接合。扭矩传感器744c向控制电路710提供旋转力反馈信号。旋转力反馈信号表示施加到轴740上的旋转力。位置传感器734可被配置为将闭合构件的位置作为反馈信号提供给控制电路710。附加传感器738诸如轴编码器可向控制电路710提供轴740的旋转位置。In one aspect, the control circuit 710 is configured to rotate an axis member such as the axis 740 to rotate the end effector 702. The control circuit 710 provides a motor set point to a motor control 708c, which provides a drive signal to the motor 704c. The output shaft of the motor 704c is coupled to a torque sensor 744c. The torque sensor 744c is coupled to a transmission 706c coupled to the axis 740. The transmission 706c includes a movable mechanical element such as a rotating element to control the axis 740 to rotate up to 360° and more than 360° clockwise or counterclockwise. In one aspect, the motor 704c is coupled to a rotary transmission assembly including a tube gear segment formed on (or attached to) the proximal end of the proximal closure tube to be operably engaged by a rotary gear assembly operably supported on a tool mounting plate. The torque sensor 744c provides a rotational force feedback signal to the control circuit 710. The rotational force feedback signal represents the rotational force applied to the shaft 740. The position sensor 734 can be configured to provide the position of the closure member as a feedback signal to the control circuit 710. An additional sensor 738 such as a shaft encoder can provide the rotational position of the shaft 740 to the control circuit 710.

在一个方面，控制电路710被配置为使端部执行器702进行关节运动。控制电路710向马达控制708d提供马达设定点，该马达控制708d向马达704d提供驱动信号。马达704d的输出耦合接到扭矩传感器744d。扭矩传感器744d耦合到耦合到关节运动构件742a的传动装置706d。传动装置706d包括可运动的机械元件诸如关节运动元件，以控制端部执行器702±65°的关节运动。在一个方面，马达704d耦合到关节运动螺母，该关节运动螺母可旋转地轴颈连接在远侧脊部的近侧端部部分上并且通过关节运动齿轮组件在其上可旋转地驱动。扭矩传感器744d向控制电路710提供关节运动力反馈信号。关节运动力反馈信号表示施加到端部执行器702的关节运动力。传感器738(诸如关节运动编码器)可向控制电路710提供端部执行器702的关节运动位置。In one aspect, the control circuit 710 is configured to articulate the end effector 702. The control circuit 710 provides a motor set point to a motor control 708d, which provides a drive signal to a motor 704d. The output of the motor 704d is coupled to a torque sensor 744d. The torque sensor 744d is coupled to a transmission 706d coupled to the articulation member 742a. The transmission 706d includes a movable mechanical element such as an articulation element to control the articulation of the end effector 702 ± 65°. In one aspect, the motor 704d is coupled to an articulation nut that is rotatably journaled on a proximal end portion of the distal spine and rotatably driven thereon by an articulation gear assembly. The torque sensor 744d provides an articulation force feedback signal to the control circuit 710. The articulation force feedback signal represents the articulation force applied to the end effector 702. A sensor 738 , such as an articulation encoder, may provide the control circuit 710 with the articulation position of the end effector 702 .

在另一方面，机器人外科系统700的关节运动功能可包括两个关节运动构件或连杆742a、742b。这些关节运动构件742a、742b由机器人接口(齿条)上的单独的盘驱动，所述单独的盘由两个马达708d、708e驱动。当提供单独的击发马达704a时，关节运动连杆742a、742b中的每个可相对于另一个连杆进行拮抗驱动，以便在头部未运动时向头部提供阻力保持运动和负载，并且在头部进行关节运动时提供关节运动。当头部旋转时，关节运动构件742a、742b以固定的半径附接到头部。因此，当头部旋转时，推拉连杆的机械优点发生变化。机械优点的该变化对于其它关节运动连杆驱动系统可更明显。On the other hand, the joint motion function of the robotic surgical system 700 may include two joint motion components or connecting rods 742a, 742b. These joint motion components 742a, 742b are driven by a separate disk on the robot interface (rack), and the separate disk is driven by two motors 708d, 708e. When a separate firing motor 704a is provided, each of the joint motion connecting rods 742a, 742b can be driven in an antagonistic manner relative to another connecting rod so as to provide resistance to the head to maintain motion and load when the head is not moving, and to provide joint motion when the head is articulated. When the head rotates, the joint motion components 742a, 742b are attached to the head with a fixed radius. Therefore, when the head rotates, the mechanical advantage of the push-pull connecting rod changes. This change in mechanical advantage can be more obvious for other joint motion connecting rod drive systems.

在一个方面，一个或多个马达704a-704e可包括具有齿轮箱的有刷DC马达和与击发构件、闭合构件或关节运动构件的机械链路。另一个示例包括操作可运动机械元件诸如位移构件、关节运动连杆、闭合管和轴的电动马达704a-704e。外部影响是事物如组织、周围身体和摩擦对物理系统的未测量的、不可预测的影响。此类外部影响可被称为曳力，其相对电动马达704a-704e中的一个作用。外部影响诸如曳力可导致物理系统的操作偏离物理系统的期望操作。In one aspect, one or more motors 704a-704e may include a brushed DC motor with a gearbox and a mechanical link with a firing member, a closing member, or an articulation member. Another example includes an electric motor 704a-704e that operates a movable mechanical element such as a displacement member, an articulation link, a closing tube, and an axis. External influences are unmeasured, unpredictable effects of things such as tissue, surrounding body, and friction on a physical system. Such external influences may be referred to as drag, which acts relative to one of the electric motors 704a-704e. External influences such as drag may cause the operation of a physical system to deviate from the desired operation of the physical system.

在一个方面，位置传感器734可被实现为绝对定位系统。在一个方面，位置传感器734可包括磁性旋转绝对定位系统，该磁性旋转绝对定位系统被实现为AS5055EQFT单片磁性旋转位置传感器，其可购自澳大利亚奥地利微电子公司(Austria Microsystems,AG)。位置传感器734与控制器710交接，以提供绝对定位系统。位置可包括位于磁体上方并耦合到CORDIC处理器的霍尔效应元件，该CORDIC处理器也被已知为逐位方法和Volder算法，提供该CORDIC处理器以实现用于计算双曲线函数和三角函数的简单有效的算法，双曲线函数和三角函数仅需要加法操作、减法操作、数位位移操作和表格查找操作。In one aspect, the position sensor 734 can be implemented as an absolute positioning system. In one aspect, the position sensor 734 can include a magnetic rotation absolute positioning system implemented as an AS5055EQFT monolithic magnetic rotation position sensor, which can be purchased from Austria Microsystems, AG. The position sensor 734 interfaces with the controller 710 to provide an absolute positioning system. The position can include a Hall effect element located above the magnet and coupled to a CORDIC processor, which is also known as a bitwise method and Volder algorithm, which is provided to implement a simple and efficient algorithm for calculating hyperbolic and trigonometric functions, which only require addition operations, subtraction operations, digit shift operations, and table lookup operations.

在一个方面，控制电路710可与一个或多个传感器738通信。传感器738可定位在端部执行器702上并且适于与机器人外科器械700一起操作以测量各种衍生参数，诸如间隙距离对时间、组织压缩与时间、以及砧座应变与时间。传感器738可包括磁性传感器、磁场传感器、应变仪、负荷传感器、压力传感器、力传感器、扭矩传感器、电感式传感器诸如涡流传感器、电阻式传感器、电容式传感器、光学传感器和/或用于测量端部执行器702的一个或多个参数的任何其它合适的传感器。传感器738可包括一个或多个传感器。传感器738可位于夹持臂716上，以使用分段电极来确定组织位置。扭矩传感器744a-744e可被配置为感测力诸如击发力、闭合力和/或关节运动力等。因此，控制电路710可感测(1)远侧闭合管所经历的闭合负荷及其位置，(2)在齿条处的击发构件及其位置，(3)超声刀718在其上具有组织的部分，以及(4)两个关节运动杆上的负载和位置。In one aspect, the control circuit 710 can communicate with one or more sensors 738. The sensor 738 can be positioned on the end effector 702 and is adapted to operate with the robotic surgical instrument 700 to measure various derived parameters, such as gap distance versus time, tissue compression versus time, and anvil strain versus time. The sensor 738 can include a magnetic sensor, a magnetic field sensor, a strain gauge, a load sensor, a pressure sensor, a force sensor, a torque sensor, an inductive sensor such as an eddy current sensor, a resistive sensor, a capacitive sensor, an optical sensor, and/or any other suitable sensor for measuring one or more parameters of the end effector 702. The sensor 738 can include one or more sensors. The sensor 738 can be located on the clamping arm 716 to determine tissue position using segmented electrodes. The torque sensors 744a-744e can be configured to sense forces such as firing force, closing force, and/or joint motion force, etc. Thus, the control circuit 710 can sense (1) the closure load experienced by the distal closure tube and its position, (2) the firing member at the rack and its position, (3) the portion of the ultrasonic blade 718 on which the tissue is located, and (4) the loads and positions on the two articulation rods.

在一个方面，一个或多个传感器738可包括应变仪，诸如微应变仪，其被配置为在夹持条件期间测量夹持臂716中的应变的量值。应变仪提供电信号，该电信号的幅值随着应变量值而变化。传感器738可包括压力传感器，该压力传感器被配置为检测由夹持臂716和超声刀718之间的压缩组织的存在所生成的压力。传感器738可被配置为检测位于夹持臂716和超声刀718之间的组织区段的阻抗，该阻抗指示位于其间的组织的厚度和/或填充度。In one aspect, one or more sensors 738 may include a strain gauge, such as a micro strain gauge, configured to measure the magnitude of the strain in the clamp arm 716 during the clamping condition. The strain gauge provides an electrical signal whose amplitude varies with the magnitude of the strain. The sensor 738 may include a pressure sensor configured to detect the pressure generated by the presence of compressed tissue between the clamp arm 716 and the ultrasonic blade 718. The sensor 738 may be configured to detect the impedance of the tissue section between the clamp arm 716 and the ultrasonic blade 718, which indicates the thickness and/or filling degree of the tissue located therebetween.

在一个方面，传感器738可实现为一个或多个限位开关、机电装置、固态开关、霍尔效应装置、磁阻(MR)装置、巨磁电阻(GMR)装置、磁力计等等。在其它具体实施中，传感器738可被实现为在光的影响下操作的固态开关，诸如光学传感器、IR传感器、紫外线传感器等等。同样，开关可为固态装置，诸如晶体管(例如，FET、结型FET、MOSFET、双极型晶体管等)。在其它具体实施中，传感器738可包括无电导体开关、超声开关、加速度计和惯性传感器等等。In one aspect, the sensor 738 may be implemented as one or more limit switches, electromechanical devices, solid-state switches, Hall effect devices, magnetoresistive (MR) devices, giant magnetoresistive (GMR) devices, magnetometers, and the like. In other implementations, the sensor 738 may be implemented as a solid-state switch that operates under the influence of light, such as an optical sensor, an IR sensor, an ultraviolet sensor, and the like. Likewise, the switch may be a solid-state device, such as a transistor (e.g., a FET, a junction FET, a MOSFET, a bipolar transistor, and the like). In other implementations, the sensor 738 may include a non-electrical conductor switch, an ultrasonic switch, an accelerometer, an inertial sensor, and the like.

在一个方面，传感器738可被配置为测量由闭合驱动系统施加在夹持臂716上的力。例如，一个或多个传感器738可位于闭合管和夹持臂716之间的交互点处，以检测由闭合管施加到夹持臂716的闭合力。施加在夹持臂716上的力可以表示在夹持臂716和超声刀718之间捕获的组织区段所经受的组织压缩。一个或多个传感器738可沿闭合驱动系统定位在各种交互点处，以检测由闭合驱动系统施加到夹持臂716的闭合力。一个或多个传感器738可在夹持操作期间由控制电路710的处理器实时取样。控制电路710接收实时样本测量值以提供和分析基于时间的信息，并实时评估施加到夹持臂716的闭合力。In one aspect, the sensor 738 may be configured to measure the force applied by the closure drive system to the clamp arm 716. For example, one or more sensors 738 may be located at the interaction point between the closure tube and the clamp arm 716 to detect the closing force applied by the closure tube to the clamp arm 716. The force applied to the clamp arm 716 can represent the tissue compression experienced by the tissue segment captured between the clamp arm 716 and the ultrasonic blade 718. One or more sensors 738 may be positioned at various interaction points along the closure drive system to detect the closing force applied by the closure drive system to the clamp arm 716. One or more sensors 738 may be sampled in real time by the processor of the control circuit 710 during the clamping operation. The control circuit 710 receives real-time sample measurements to provide and analyze time-based information and evaluate the closing force applied to the clamp arm 716 in real time.

在一个方面，电流传感器736可用于测量由马达704a-704e中的每个所消耗的电流。推进可运动的机械元件(诸如闭合构件714)中的任一者所需的力对应于由马达704a-704e中的一个所消耗的电流。将力转换成数字信号并提供给处理器710。控制电路710可以被配置为模拟器械的实际系统在控制器的软件中的响应。可致动位移构件以将端部执行器702中的闭合构件714以目标速度或接近目标速度运动。机器人外科系统700可包括反馈控制器，该反馈控制器可为任何反馈控制器中的一者，包括但不限于例如PID、状态反馈、线性平方(LQR)和/或自适应控制器。机器人外科器械700可包括功率源，以例如将来自反馈控制器的信号转换成物理输入，诸如外壳电压、PWM电压、频率调制电压、电流、扭矩和/或力。附加细节公开于2017年6月29日提交的标题为用于机器人外科器械的闭环速度控制技术(CLOSED LOOP VELOCITY CONTROL TECHNIQUES FOR ROBOTIC SURGICAL INSTRUMENT)的美国专利申请序列号15/636,829中，该专利全文以引用方式并入本文。In one aspect, the current sensor 736 can be used to measure the current consumed by each of the motors 704a-704e. The force required to propel any one of the movable mechanical elements (such as the closing member 714) corresponds to the current consumed by one of the motors 704a-704e. The force is converted into a digital signal and provided to the processor 710. The control circuit 710 can be configured to simulate the response of the actual system of the instrument in the software of the controller. The displacement member can be actuated to move the closing member 714 in the end effector 702 at a target speed or close to the target speed. The robotic surgical system 700 may include a feedback controller, which may be one of any feedback controllers, including but not limited to, for example, PID, state feedback, linear square (LQR) and/or adaptive controllers. The robotic surgical instrument 700 may include a power source to, for example, convert a signal from the feedback controller into a physical input, such as a housing voltage, a PWM voltage, a frequency modulated voltage, a current, a torque and/or a force. Additional details are disclosed in U.S. patent application serial number 15/636,829, filed on June 29, 2017, entitled CLOSED LOOP VELOCITY CONTROL TECHNIQUES FOR ROBOTIC SURGICAL INSTRUMENT, which is incorporated herein by reference in its entirety.

图18示出了根据本公开的一个方面的被配置为控制位移构件的远侧平移的外科器械750的示意图。在一个方面，外科器械750被编程为控制位移构件诸如闭合构件764的远侧平移。外科器械750包括端部执行器752，该端部执行器752可包括夹持臂766、闭合构件764和耦合到由超声发生器771驱动的超声换能器769的超声刀768。18 shows a schematic diagram of a surgical instrument 750 configured to control distal translation of a displacement member according to one aspect of the present disclosure. In one aspect, the surgical instrument 750 is programmed to control distal translation of a displacement member such as a closure member 764. The surgical instrument 750 includes an end effector 752, which may include a clamp arm 766, a closure member 764, and an ultrasonic blade 768 coupled to an ultrasonic transducer 769 driven by an ultrasonic generator 771.

线性位移构件诸如闭合构件764的位置、运动、位移和/或平移可通过绝对定位系统、传感器布置方式和位置传感器784来测量。由于闭合构件764耦合到纵向可运动的驱动构件，因此闭合构件764的位置可通过采用位置传感器784测量纵向可运动的驱动构件的位置来确定。因此，在以下描述中，闭合构件764的位置、位移和/或平移可通过本文所述的位置传感器784来实现。控制电路760可被编程为控制位移构件诸如闭合构件764的平移。在一些示例中，控制电路760可包括一个或多个微控制器、微处理器或其它合适的处理器，以用于执行使一个或多个处理器以所述方式控制位移构件(例如，闭合构件764)的指令。在一个方面，定时器/计数器781向控制电路760提供输出信号，诸如耗用时间或数字计数，以将如由位置传感器784确定的闭合构件764的位置与定时器/计数器781的输出相关联，使得控制电路760可确定闭合构件764在相对于起始位置的特定时间(t)处的位置。定时器/计数器781可被配置为测量所耗用的时间、计数外部事件或时间外部事件。The position, movement, displacement and/or translation of a linear displacement member such as the closing member 764 can be measured by an absolute positioning system, a sensor arrangement and a position sensor 784. Since the closing member 764 is coupled to a longitudinally movable drive member, the position of the closing member 764 can be determined by measuring the position of the longitudinally movable drive member using the position sensor 784. Therefore, in the following description, the position, displacement and/or translation of the closing member 764 can be achieved by the position sensor 784 described herein. The control circuit 760 can be programmed to control the translation of a displacement member such as the closing member 764. In some examples, the control circuit 760 may include one or more microcontrollers, microprocessors or other suitable processors for executing instructions that cause the one or more processors to control the displacement member (e.g., the closing member 764) in the manner described. In one aspect, the timer/counter 781 provides an output signal, such as an elapsed time or a digital count, to the control circuit 760 to correlate the position of the closing member 764 as determined by the position sensor 784 with the output of the timer/counter 781 so that the control circuit 760 can determine the position of the closing member 764 at a particular time (t) relative to the starting position. The timer/counter 781 can be configured to measure elapsed time, count external events, or time external events.

控制电路760可生成马达设定点信号772。马达设定点信号772可被提供给马达控制器758。马达控制器758可包括一个或多个电路，这些电路被配置为向马达754提供马达驱动信号774，以驱动马达754，如本文所述。在一些示例中，马达754可为有刷DC电动马达。例如，马达754的速度可与马达驱动信号774成比例。在一些示例中，马达754可为无刷DC电动马达，并且马达驱动信号774可包括提供给马达754的一个或多个定子绕组的PWM信号。而且，在一些示例中，可省略马达控制器758，并且控制电路760可直接生成马达驱动信号774。The control circuit 760 may generate a motor set point signal 772. The motor set point signal 772 may be provided to the motor controller 758. The motor controller 758 may include one or more circuits configured to provide a motor drive signal 774 to the motor 754 to drive the motor 754 as described herein. In some examples, the motor 754 may be a brushed DC electric motor. For example, the speed of the motor 754 may be proportional to the motor drive signal 774. In some examples, the motor 754 may be a brushless DC electric motor, and the motor drive signal 774 may include a PWM signal provided to one or more stator windings of the motor 754. Moreover, in some examples, the motor controller 758 may be omitted, and the control circuit 760 may directly generate the motor drive signal 774.

马达754可从能量源762处接收功率。能量源762可为或包括电池、超级电容器或任何其它合适的能量源。马达754可经由传动装置756机械耦合到闭合构件764。传动装置756可包括一个或多个齿轮或其它连杆部件，以将马达754耦合到闭合构件764。位置传感器784可感测闭合构件764的位置。位置传感器784可为或包括能够生成指示闭合构件764的位置的位置数据的任何类型的传感器。在一些示例中，位置传感器784可包括编码器，该编码器被配置为在闭合构件764朝远侧和朝近侧平移时向控制电路760提供一系列脉冲。控制电路760可跟踪脉冲以确定闭合构件764的位置。可使用其它合适的位置传感器，包括例如接近传感器。其它类型的位置传感器可提供指示闭合构件764的运动的其它信号。而且，在一些示例中，可省略位置传感器784。在马达754是步进马达的情况下，控制电路760可通过聚合马达754已被指示执行的步骤的数量和方向来跟踪闭合构件764的位置。位置传感器784可位于端部执行器752中或器械的任何其它部分处。The motor 754 may receive power from the energy source 762. The energy source 762 may be or include a battery, a supercapacitor, or any other suitable energy source. The motor 754 may be mechanically coupled to the closing member 764 via the transmission 756. The transmission 756 may include one or more gears or other connecting rod components to couple the motor 754 to the closing member 764. The position sensor 784 may sense the position of the closing member 764. The position sensor 784 may be or include any type of sensor capable of generating position data indicating the position of the closing member 764. In some examples, the position sensor 784 may include an encoder configured to provide a series of pulses to the control circuit 760 when the closing member 764 is translated toward the distal side and toward the proximal side. The control circuit 760 may track the pulses to determine the position of the closing member 764. Other suitable position sensors may be used, including, for example, proximity sensors. Other types of position sensors may provide other signals indicating the movement of the closing member 764. Moreover, in some examples, the position sensor 784 may be omitted. Where motor 754 is a stepper motor, control circuit 760 may track the position of closure member 764 by aggregating the number and direction of steps motor 754 has been instructed to perform. Position sensor 784 may be located in end effector 752 or at any other portion of the instrument.

控制电路760可与一个或多个传感器788通信。传感器788可定位在端部执行器752上并且适于与外科器械750一起操作以测量各种衍生参数，诸如间隙距离与时间、组织压缩与时间以及砧座应变与时间。传感器788可包括例如磁性传感器、磁场传感器、应变仪、压力传感器、力传感器、电感式传感器(诸如涡流传感器)、电阻式传感器、电容式传感器、光学传感器和/或用于测量端部执行器752的一个或多个参数的任何其它合适的传感器。传感器788可包括一个或多个传感器。The control circuit 760 may communicate with one or more sensors 788. The sensor 788 may be positioned on the end effector 752 and adapted to operate with the surgical instrument 750 to measure various derived parameters, such as gap distance versus time, tissue compression versus time, and anvil strain versus time. The sensor 788 may include, for example, a magnetic sensor, a magnetic field sensor, a strain gauge, a pressure sensor, a force sensor, an inductive sensor (such as an eddy current sensor), a resistive sensor, a capacitive sensor, an optical sensor, and/or any other suitable sensor for measuring one or more parameters of the end effector 752. The sensor 788 may include one or more sensors.

在某些情况下，一个或多个传感器788可包括应变仪，诸如微应变仪，其被配置为在夹持条件期间测量夹持臂766中的应变的量值。应变仪提供电信号，该电信号的幅值随着应变量值而变化。传感器788可包括压力传感器，该压力传感器被配置为检测由夹持臂766和超声刀768之间的压缩组织的存在生成的压力。传感器788可被配置为检测位于夹持臂766和超声刀768之间的组织区段的阻抗，该阻抗指示位于其间的组织的厚度和/或填充度。In some cases, one or more sensors 788 may include a strain gauge, such as a micro strain gauge, which is configured to measure the magnitude of the strain in the clamping arm 766 during the clamping condition. The strain gauge provides an electrical signal whose amplitude varies with the magnitude of the strain. The sensor 788 may include a pressure sensor configured to detect the pressure generated by the presence of compressed tissue between the clamping arm 766 and the ultrasonic blade 768. The sensor 788 may be configured to detect the impedance of the tissue section between the clamping arm 766 and the ultrasonic blade 768, which indicates the thickness and/or filling degree of the tissue located therebetween.

传感器788可被配置为测量由闭合驱动系统施加在夹持臂766上的力。例如，一个或多个传感器788可位于闭合管和夹持臂766之间的交互点处，以检测由闭合管施加到夹持臂766的闭合力。施加在夹持臂766上的力可表示在夹持臂766和超声刀768之间捕获的组织区段所经受的组织压缩。一个或多个传感器788可以沿闭合驱动系统定位在各种交互点处，以检测由闭合驱动系统施加到夹持臂766的闭合力。一个或多个传感器788可在夹持操作期间由控制电路760的处理器实时取样。控制电路760接收实时样本测量值以提供和分析基于时间的信息，并实时评估施加到夹持臂766的闭合力。The sensor 788 may be configured to measure the force applied by the closure drive system to the clamp arm 766. For example, one or more sensors 788 may be located at the interaction point between the closure tube and the clamp arm 766 to detect the closing force applied by the closure tube to the clamp arm 766. The force applied to the clamp arm 766 may represent the tissue compression experienced by the tissue segment captured between the clamp arm 766 and the ultrasonic blade 768. One or more sensors 788 may be positioned at various interaction points along the closure drive system to detect the closing force applied by the closure drive system to the clamp arm 766. One or more sensors 788 may be sampled in real time by the processor of the control circuit 760 during the clamping operation. The control circuit 760 receives real-time sample measurements to provide and analyze time-based information and evaluate the closing force applied to the clamp arm 766 in real time.

电流传感器786可以用于测量由马达754消耗的电流。推进闭合构件764所需的力可对应于例如由马达754消耗的电流。将力转换成数字信号并提供给控制电路760。The current sensor 786 may be used to measure the current consumed by the motor 754. The force required to advance the closure member 764 may correspond to, for example, the current consumed by the motor 754. The force is converted into a digital signal and provided to the control circuit 760.

控制电路760可以被配置为模拟器械的实际系统在控制器的软件中的响应。可致动位移构件以将端部执行器752中的闭合构件764以目标速度或接近目标速度运动。外科器械750可包括反馈控制器，该反馈控制器可为任何反馈控制器中的一者，包括但不限于例如PID、状态反馈、LQR和/或自适应控制器。外科器械750可包括功率源，以例如将来自反馈控制器的信号转换为物理输入，诸如外壳电压、PWM电压、频率调制电压、电流、扭矩和/或力。The control circuit 760 can be configured to simulate the response of the actual system of the instrument in the software of the controller. The displacement member can be actuated to move the closing member 764 in the end effector 752 at a target speed or close to the target speed. The surgical instrument 750 may include a feedback controller, which may be one of any feedback controllers, including but not limited to, for example, PID, state feedback, LQR and/or adaptive controllers. The surgical instrument 750 may include a power source to, for example, convert a signal from the feedback controller into a physical input, such as a housing voltage, a PWM voltage, a frequency modulated voltage, a current, a torque and/or a force.

外科器械750的实际驱动系统被配置为通过具有齿轮箱和与关节运动和/或刀系统的机械链路的有刷DC马达驱动位移构件、切割构件或闭合构件764。另一个示例是操作例如可互换轴组件的位移构件和关节运动驱动器的电动马达754。外部影响是事物如组织、周围身体和摩擦对物理系统的未测量的、不可预测的影响。此类外部影响可以被称为与电动马达754相反地作用的曳力。外部影响诸如曳力可导致物理系统的操作偏离物理系统的期望操作。The actual drive system of the surgical instrument 750 is configured to drive the displacement member, cutting member or closing member 764 through a brushed DC motor with a gear box and a mechanical link to the articulation and/or knife system. Another example is an electric motor 754 that operates the displacement member and articulation drive of, for example, an interchangeable shaft assembly. External influences are the unmeasured, unpredictable effects of things such as tissue, surrounding body, and friction on the physical system. Such external influences can be referred to as drag forces that act in opposition to the electric motor 754. External influences such as drag forces can cause the operation of the physical system to deviate from the desired operation of the physical system.

各个示例方面涉及外科器械750，其包括具有马达驱动的外科密封和切割具体实施的端部执行器752。例如，马达754可沿端部执行器752的纵向轴线朝远侧和朝近侧驱动位移构件。端部执行器752可包括可枢转的夹持臂766，并且当被配置为用于使用时，超声刀768与夹持臂766相对定位。临床医生可抓握夹持臂766和超声刀768之间的组织，如本文所述。当准备好使用器械750时，临床医生可例如通过按下器械750的触发器来提供击发信号。响应于击发信号，马达754可沿端部执行器752的纵向轴线将位移构件从近侧行程开始位置朝远侧驱动到行程开始位置远侧的行程结束位置。当位移构件朝远侧平移时，具有定位在远侧端部处的切割元件的闭合构件764可切割超声刀768和夹持臂766之间的组织。Various example aspects relate to a surgical instrument 750, which includes an end effector 752 with a motor-driven surgical sealing and cutting embodiment. For example, a motor 754 can drive a displacement member distally and proximally along the longitudinal axis of the end effector 752. The end effector 752 may include a pivotable clamping arm 766, and when configured for use, an ultrasonic blade 768 is positioned relative to the clamping arm 766. The clinician can grasp the tissue between the clamping arm 766 and the ultrasonic blade 768, as described herein. When the instrument 750 is ready to be used, the clinician can provide a firing signal, for example, by pressing the trigger of the instrument 750. In response to the firing signal, the motor 754 can drive the displacement member from the proximal stroke start position distally to the stroke end position distal to the stroke start position along the longitudinal axis of the end effector 752. When the displacement member is translated distally, a closing member 764 having a cutting element positioned at the distal end can cut the tissue between the ultrasonic blade 768 and the clamping arm 766.

在各个示例中，外科器械750可包括控制电路760，该控制电路760被编程为基于一个或多个组织条件控制位移构件(诸如闭合构件764)的远侧平移。控制电路760可被编程为直接或间接地感测组织条件，诸如厚度，如本文所述。控制电路760可被编程为基于组织条件选择控制程序。控制程序可描述位移构件的远侧运动。可选择不同的控制程序以更好地处理不同的组织条件。例如，当存在更厚的组织时，控制电路760可被编程为以更低的速度和/或以更低的功率平移位移构件。当存在更薄的组织时，控制电路760可被编程为以更高的速度和/或以更高的功率平移位移构件。In various examples, the surgical instrument 750 may include a control circuit 760 that is programmed to control the distal translation of a displacement member, such as a closure member 764, based on one or more tissue conditions. The control circuit 760 may be programmed to sense tissue conditions, such as thickness, directly or indirectly, as described herein. The control circuit 760 may be programmed to select a control program based on the tissue conditions. The control program may describe the distal movement of the displacement member. Different control programs may be selected to better handle different tissue conditions. For example, when thicker tissue is present, the control circuit 760 may be programmed to translate the displacement member at a lower speed and/or at a lower power. When thinner tissue is present, the control circuit 760 may be programmed to translate the displacement member at a higher speed and/or at a higher power.

在一些示例中，控制电路760可针对位移构件的行程的第一开环部分初始以开环构型来操作马达754。基于在行程的开环部分期间器械750的响应，控制电路760可选择击发控制程序。器械的响应可包括在开环部分期间位移构件的平移距离、在开环部分期间耗用的时间、在开环部分期间提供给马达754的能量、马达驱动信号的脉冲宽度之和等。在开环部分之后，控制电路760可对位移构件行程的第二部分实施所选择的击发控制程序。例如，在行程的闭环部分期间，控制电路760可基于以闭环方式描述位移构件的位置的平移数据来调节马达754，以使位移构件以恒定速度平移。附加细节公开于2017年9月29日提交的标题为用于控制外科器械的显示器的系统和方法(SYSTEM AND METHODS FOR CONTROLLING ADISPLAY OF A SURGICAL INSTRUMENT)的美国专利申请序列号15/720,852中，该专利申请全文以引用方式并入本文。In some examples, the control circuit 760 may initially operate the motor 754 in an open-loop configuration for a first open-loop portion of the displacement member's travel. Based on the response of the instrument 750 during the open-loop portion of the travel, the control circuit 760 may select a firing control program. The response of the instrument may include the distance the displacement member was translated during the open-loop portion, the time elapsed during the open-loop portion, the energy provided to the motor 754 during the open-loop portion, the sum of the pulse widths of the motor drive signal, etc. After the open-loop portion, the control circuit 760 may implement the selected firing control program for a second portion of the displacement member's travel. For example, during the closed-loop portion of the travel, the control circuit 760 may adjust the motor 754 based on the translation data describing the position of the displacement member in a closed-loop manner so that the displacement member translates at a constant speed. Additional details are disclosed in U.S. patent application serial number 15/720,852, filed on September 29, 2017, entitled SYSTEM AND METHODS FOR CONTROLLING ADISPLAY OF A SURGICAL INSTRUMENT, which is incorporated herein by reference in its entirety.

图19为根据本公开的一个方面的被配置为控制各种功能的外科器械790的示意图。在一个方面，外科器械790被编程为控制位移构件诸如闭合构件764的远侧平移。外科器械790包括端部执行器792，该端部执行器792可包括夹持臂766、闭合构件764和超声刀768，该超声刀768可与一个或多个RF电极796(以点划线示出)互换或结合一个或多个RF电极796工作。超声刀768耦合到由超声发生器771驱动的超声换能器769。FIG. 19 is a schematic diagram of a surgical instrument 790 configured to control various functions according to one aspect of the present disclosure. In one aspect, the surgical instrument 790 is programmed to control the distal translation of a displacement member such as a closure member 764. The surgical instrument 790 includes an end effector 792, which may include a clamping arm 766, a closure member 764, and an ultrasonic blade 768, which may be interchangeable with one or more RF electrodes 796 (shown in dashed lines) or work in conjunction with one or more RF electrodes 796. The ultrasonic blade 768 is coupled to an ultrasonic transducer 769 driven by an ultrasonic generator 771.

在一个方面，传感器788可被实现为限位开关、机电装置、固态开关、霍尔效应装置、MR装置、GMR装置、磁力计等等。在其它具体实施中，传感器638可被实现为在光的影响下操作的固态开关，诸如光学传感器、IR传感器、紫外线传感器等等。同样，开关可为固态装置，诸如晶体管(例如，FET、结型FET、MOSFET、双极型晶体管等)。在其它具体实施中，传感器788可包括无电导体开关、超声开关、加速度计和惯性传感器等等。In one aspect, the sensor 788 may be implemented as a limit switch, an electromechanical device, a solid-state switch, a Hall effect device, an MR device, a GMR device, a magnetometer, and the like. In other implementations, the sensor 638 may be implemented as a solid-state switch that operates under the influence of light, such as an optical sensor, an IR sensor, an ultraviolet sensor, and the like. Likewise, the switch may be a solid-state device, such as a transistor (e.g., a FET, a junction FET, a MOSFET, a bipolar transistor, and the like). In other implementations, the sensor 788 may include a non-electrical conductor switch, an ultrasonic switch, an accelerometer, an inertial sensor, and the like.

在一个方面，位置传感器784可被实现为绝对定位系统，该绝对定位系统包括被实现为AS5055EQFT单片磁性旋转位置传感器，其可购自澳大利亚奥地利微电子公司(AustriaMicrosystems,AG)。位置传感器784可与控制器760交接，以提供绝对定位系统。位置可包括位于磁体上方并耦合到CORDIC处理器的霍尔效应元件，该CORDIC处理器也被已知为逐位方法和Volder算法，提供该CORDIC处理器以实现用于计算双曲线函数和三角函数的简单有效的算法，双曲线函数和三角函数仅需要加法操作、减法操作、数位位移操作和表格查找操作。In one aspect, the position sensor 784 can be implemented as an absolute positioning system including a monolithic magnetic rotary position sensor implemented as an AS5055EQFT, available from Austria Microsystems, AG. The position sensor 784 can interface with the controller 760 to provide an absolute positioning system. The position can include a Hall effect element located above a magnet and coupled to a CORDIC processor, also known as a bitwise method and Volder algorithm, which is provided to implement a simple and efficient algorithm for calculating hyperbolic and trigonometric functions, which only require addition operations, subtraction operations, bit shift operations, and table lookup operations.

在一些示例中，可省略位置传感器784。在马达754是步进马达的情况下，控制电路760可通过聚合马达已被指示执行的步骤的数量和方向来跟踪闭合构件764的位置。位置传感器784可位于端部执行器792中或器械的任何其它部分处。In some examples, the position sensor 784 may be omitted. Where the motor 754 is a stepper motor, the control circuit 760 may track the position of the closure member 764 by aggregating the number and direction of steps the motor has been instructed to perform. The position sensor 784 may be located in the end effector 792 or at any other portion of the instrument.

控制电路760可与一个或多个传感器788通信。传感器788可定位在端部执行器792上并且适于与外科器械790一起操作以测量各种衍生参数，诸如间隙距离与时间、组织压缩与时间以及砧座应变与时间。传感器788可包括例如磁性传感器、磁场传感器、应变仪、压力传感器、力传感器、电感式传感器(诸如涡流传感器)、电阻式传感器、电容式传感器、光学传感器和/或用于测量端部执行器792的一个或多个参数的任何其它合适的传感器。传感器788可包括一个或多个传感器。The control circuit 760 may communicate with one or more sensors 788. The sensor 788 may be positioned on the end effector 792 and adapted to operate with the surgical instrument 790 to measure various derived parameters, such as gap distance versus time, tissue compression versus time, and anvil strain versus time. The sensor 788 may include, for example, a magnetic sensor, a magnetic field sensor, a strain gauge, a pressure sensor, a force sensor, an inductive sensor (such as an eddy current sensor), a resistive sensor, a capacitive sensor, an optical sensor, and/or any other suitable sensor for measuring one or more parameters of the end effector 792. The sensor 788 may include one or more sensors.

RF能量源794耦合到端部执行器792，并且当RF电极796设置在端部执行器792中以代替超声刀768或结合超声刀768工作时，RF能量源794被施加到RF电极796。例如，超声刀由导电金属制成，并且可用作电外科RF电流的返回路径。控制电路760控制RF能量到RF电极796的递送。The RF energy source 794 is coupled to the end effector 792, and when the RF electrode 796 is set in the end effector 792 to replace the ultrasonic blade 768 or work in conjunction with the ultrasonic blade 768, the RF energy source 794 is applied to the RF electrode 796. For example, the ultrasonic blade is made of conductive metal and can be used as a return path for electrosurgical RF current. The control circuit 760 controls the delivery of RF energy to the RF electrode 796.

附加细节公开于2017年6月28日提交的美国专利申请序列号15/636,096，其标题为可与钉仓和射频仓耦合的外科系统及其使用方法(SURGICAL SYSTEM COUPLABLE WITHSTAPLE CARTRIDGE AND RADIO FREQUENCY CARTRIDGE,AND METHOD OF USING SAME)，该专利全文以引用方式并入本文。Additional details are disclosed in U.S. patent application serial number 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.

自适应超声刀控制算法Adaptive ultrasonic knife control algorithm

在各个方面，智能超声能量装置可包括用于控制超声刀的操作的自适应算法。在一个方面，超声刀自适应控制算法被配置为识别组织类型并调节装置参数。在一个方面，超声刀控制算法被配置为将组织类型参数化。本公开的以下区段描述了一种用于检测组织的胶原/弹性比率以调谐超声刀的远侧末端的幅值的算法。本文结合例如图1-94描述了智能超声能量装置的各个方面。因此，以下对自适应超声刀控制算法的描述应当结合图1-94以及与其相关联的描述来阅读。In various aspects, the intelligent ultrasonic energy device may include an adaptive algorithm for controlling the operation of an ultrasonic scalpel. In one aspect, the ultrasonic scalpel adaptive control algorithm is configured to identify tissue types and adjust device parameters. In one aspect, the ultrasonic scalpel control algorithm is configured to parameterize tissue types. The following section of the present disclosure describes an algorithm for detecting the collagen/elasticity ratio of tissue to tune the amplitude of the distal end of the ultrasonic scalpel. Various aspects of the intelligent ultrasonic energy device are described herein in conjunction with, for example, Figures 1-94. Therefore, the following description of the adaptive ultrasonic scalpel control algorithm should be read in conjunction with Figures 1-94 and the description associated therewith.

组织类型标识和装置参数调节Tissue type identification and device parameter adjustment

在某些外科规程中，期望采用自适应超声刀控制算法。在一个方面，可采用自适应超声刀控制算法来基于与超声刀接触的组织的类型来调节超声装置的参数。在一个方面，超声装置的参数可基于组织在超声端部执行器的钳口内的位置(例如，组织在夹持臂和超声刀之间的位置)来调节。超声换能器的阻抗可用于区分组织在端部执行器的远侧端部或近侧端部中的百分比。超声装置的反应可基于组织类型或组织的压缩率。在另一方面，超声装置的参数可基于所识别的组织类型或参数化来调节。例如，超声刀的远侧末端的机械位移幅值可基于在组织识别过程期间检测到的胶原与弹性蛋白组织的比率而调谐。可使用多种技术检测胶原与弹性蛋白组织的比率，包括红外(IR)表面反射率和比辐射率。由夹持臂和/或夹持臂的行程施加到组织的力以产生间隙和压缩。可采用横跨配备有电极的钳口的电连续性来确定被组织覆盖的钳口的百分比。In certain surgical procedures, it is desirable to use an adaptive ultrasonic blade control algorithm. In one aspect, an adaptive ultrasonic blade control algorithm can be used to adjust the parameters of an ultrasonic device based on the type of tissue in contact with the ultrasonic blade. In one aspect, the parameters of an ultrasonic device can be adjusted based on the position of the tissue in the jaws of an ultrasonic end effector (e.g., the position of the tissue between the clamping arm and the ultrasonic blade). The impedance of an ultrasonic transducer can be used to distinguish the percentage of tissue in the distal end or proximal end of the end effector. The response of the ultrasonic device can be based on the type of tissue or the compressibility of the tissue. On the other hand, the parameters of the ultrasonic device can be adjusted based on the identified tissue type or parameterization. For example, the mechanical displacement amplitude of the distal end of the ultrasonic blade can be tuned based on the ratio of collagen to elastin tissue detected during the tissue identification process. The ratio of collagen to elastin tissue can be detected using a variety of techniques, including infrared (IR) surface reflectivity and specific emissivity. The force applied to the tissue by the clamping arm and/or the stroke of the clamping arm to produce gaps and compression. The electrical continuity across the jaws equipped with electrodes can be used to determine the percentage of the jaws covered by tissue.

图20为根据本公开的至少一个方面的被配置为在包括模块化通信集线器的外科数据网络中执行自适应超声刀控制算法的系统800。在一个方面，发生器模块240被配置为执行如本文参考图53-94所述的一个或多个自适应超声刀控制算法802。在另一方面，装置/器械235被配置为执行如本文参考图53-94所述的一个或多个自适应超声刀控制算法804。在另一方面，装置/器械235和装置/器械235两者均被配置为执行如本文参考图53-94所述的自适应超声刀控制算法802、804。FIG. 20 is a system 800 configured to execute an adaptive ultrasonic blade control algorithm in a surgical data network including a modular communication hub according to at least one aspect of the present disclosure. In one aspect, the generator module 240 is configured to execute one or more adaptive ultrasonic blade control algorithms 802 as described herein with reference to FIGS. 53-94. On the other hand, the device/instrument 235 is configured to execute one or more adaptive ultrasonic blade control algorithms 804 as described herein with reference to FIGS. 53-94. On the other hand, both the device/instrument 235 and the device/instrument 235 are configured to execute the adaptive ultrasonic blade control algorithms 802, 804 as described herein with reference to FIGS. 53-94.

发生器模块240可包括经由功率变压器与非隔离级通信的患者隔离级。功率变压器的二次绕组包含在隔离级中，并且可包括分接配置(例如，中心分接或非中心分接配置)以限定驱动信号输出，该驱动信号输出用于将驱动信号递送至不同的外科器械，诸如例如超声外科器械、RF电外科器械和包括能够单独或同时递送的超声能量模式和RF能量模式的多功能外科器械。具体地，驱动信号输出可将超声驱动信号(例如，420V均方根(RMS)驱动信号)输出到超声外科器械241，并且驱动信号输出可将RF电外科驱动信号(例如，100V RMS驱动信号)输出到RF电外科器械241。本文参照图21-28B描述发生器模块240的各方面。The generator module 240 may include a patient isolation stage that communicates with a non-isolated stage via a power transformer. The secondary winding of the power transformer is contained in the isolation stage and may include a tap configuration (e.g., a center tap or a non-center tap configuration) to define a drive signal output for delivering a drive signal to different surgical instruments, such as, for example, an ultrasonic surgical instrument, an RF electrosurgical instrument, and a multi-function surgical instrument including an ultrasonic energy mode and an RF energy mode that can be delivered separately or simultaneously. Specifically, the drive signal output may output an ultrasonic drive signal (e.g., a 420V root mean square (RMS) drive signal) to an ultrasonic surgical instrument 241, and the drive signal output may output an RF electrosurgical drive signal (e.g., a 100V RMS drive signal) to an RF electrosurgical instrument 241. Various aspects of the generator module 240 are described herein with reference to FIGS. 21-28B.

发生器模块240或装置/器械235或两者耦合到模块化控制塔236，该模块化控制塔236连接到多个手术室装置，诸如例如智能外科器械、机器人和位于手术室中的其它计算机化装置，如参照图8-11所述，例如。The generator module 240 or the device/instrument 235 or both are coupled to a modular control tower 236 that is connected to a plurality of operating room devices, such as, for example, intelligent surgical instruments, robots, and other computerized devices located in the operating room, as described with reference to FIGS. 8-11 , for example.

图21示出了发生器900的示例，其为发生器的一种形式，该发生器被配置为耦合到超声器械并且进一步被配置为在包括模块化通信集线器的外科数据网络中执行自适应超声刀控制算法，如图20中所示。发生器900被配置为将多个能量模态递送至外科器械。发生器900提供用于独立地或同时将能量递送至外科器械的RF信号和超声信号。RF信号和超声信号可单独或组合提供，并且可同时提供。如上所述，至少一个发生器输出可通过单个端口递送多种能量模态(例如，超声、双极或单极RF、不可逆和/或可逆电穿孔和/或微波能量等等)，并且这些信号可分开或同时被递送到端部执行器以处理组织。发生器900包括耦合到波形发生器904的处理器902。处理器902和波形发生器904被配置为基于存储在耦合到处理器902的存储器中的信息来生成各种信号波形，为了本公开清楚起见而未示出该存储器。与波形相关联的数字信息被提供给波形发生器904，该波形发生器904包括一个或多个DAC电路以将数字输入转换成模拟输出。模拟输出被馈送到放大器1106用于信号调节和放大。放大器906的经调节和放大的输出耦合到功率变压器908。信号通过功率变压器908耦合到患者隔离侧中的次级侧。第一能量模态的第一信号被提供给被标记为ENERGY₁和RETURN的端子之间的外科器械。第二能量模态的第二信号耦合到电容器910两端并被提供给被标记为ENERGY₂和RETURN的端子之间的外科器械。应当理解，可输出超过两种能量模态，并且因此下标“n”可被用来指定可提供多达n个ENERGY_n端子，其中n是大于1的正整数。还应当理解，在不脱离本公开的范围的情况下，可提供多达n个返回路径RETURN_n。FIG. 21 shows an example of a generator 900, which is a form of a generator configured to be coupled to an ultrasonic instrument and further configured to execute an adaptive ultrasonic blade control algorithm in a surgical data network including a modular communication hub, as shown in FIG. 20. The generator 900 is configured to deliver multiple energy modes to a surgical instrument. The generator 900 provides RF signals and ultrasonic signals for independently or simultaneously delivering energy to a surgical instrument. The RF signal and the ultrasonic signal may be provided separately or in combination, and may be provided simultaneously. As described above, at least one generator output may deliver multiple energy modes (e.g., ultrasound, bipolar or monopolar RF, irreversible and/or reversible electroporation and/or microwave energy, etc.) through a single port, and these signals may be delivered to the end effector separately or simultaneously to treat tissue. The generator 900 includes a processor 902 coupled to a waveform generator 904. The processor 902 and the waveform generator 904 are configured to generate various signal waveforms based on information stored in a memory coupled to the processor 902, and the memory is not shown for clarity of the present disclosure. The digital information associated with the waveform is provided to the waveform generator 904, which includes one or more DAC circuits to convert the digital input into an analog output. The analog output is fed to the amplifier 1106 for signal conditioning and amplification. The conditioned and amplified output of the amplifier 906 is coupled to the power transformer 908. The signal is coupled to the secondary side in the patient isolation side through the power transformer 908. The first signal of the first energy mode is provided to the surgical instrument between the terminals marked as ENERGY₁ and RETURN. The second signal of the second energy mode is coupled to both ends of the capacitor 910 and provided to the surgical instrument between the terminals marked as ENERGY₂ and RETURN. It should be understood that more than two energy modes can be output, and therefore the subscript "n" can be used to specify that up to n ENERGY_n terminals can be provided, where n is a positive integer greater than 1. It should also be understood that up to n return paths RETURN_n can be provided without departing from the scope of the present disclosure.

第一电压感测电路912耦合到被标记为ENERGY₁和RETURN路径的端子的两端，以测量其间的输出电压。第二电压感测电路924耦合到被标记为ENERGY₂和RETURN路径的端子的两端，以测量其间的输出电压。如图所示，电流感测电路914与功率变压器908的次级侧的RETURN支路串联设置，以测量任一能量模态的输出电流。如果为每种能量模态提供不同的返回路径，则应在每个返回支路中提供单独的电流感测电路。第一电压感测电路912和第二电压感测电路924的输出被提供给相应的隔离变压器916、922，并且电流感测电路914的输出被提供给另一隔离变压器918。功率变压器908(非患者隔离侧)的初级侧上的隔离变压器916、928、922的输出被提供给一个或多个ADC电路926。ADC电路926的数字化输出被提供给处理器902用于进一步处理和计算。可采用输出电压和输出电流反馈信息来调整提供给外科器械的输出电压和电流，并且计算输出阻抗等参数。处理器902和患者隔离电路之间的输入/输出通信通过接口电路920提供。传感器也可通过接口920与处理器902电通信。The first voltage sensing circuit 912 is coupled to both ends of the terminals marked as ENERGY₁ and RETURN paths to measure the output voltage therebetween. The second voltage sensing circuit 924 is coupled to both ends of the terminals marked as ENERGY₂ and RETURN paths to measure the output voltage therebetween. As shown, the current sensing circuit 914 is arranged in series with the RETURN branch on the secondary side of the power transformer 908 to measure the output current of any energy mode. If a different return path is provided for each energy mode, a separate current sensing circuit should be provided in each return branch. The outputs of the first voltage sensing circuit 912 and the second voltage sensing circuit 924 are provided to the corresponding isolation transformers 916, 922, and the output of the current sensing circuit 914 is provided to another isolation transformer 918. The outputs of the isolation transformers 916, 928, 922 on the primary side of the power transformer 908 (non-patient isolation side) are provided to one or more ADC circuits 926. The digitized output of the ADC circuit 926 is provided to the processor 902 for further processing and calculation. The output voltage and output current feedback information can be used to adjust the output voltage and current provided to the surgical instrument and calculate parameters such as output impedance. Input/output communication between the processor 902 and the patient isolation circuit is provided through the interface circuit 920. The sensor can also be in electrical communication with the processor 902 through the interface 920.

在一个方面，阻抗可由处理器902通过将耦合在被标记为ENERGY₁/RETURN的端子两端的第一电压感测电路912或耦合在被标记为ENERGY₂/RETURN的端子两端的第二电压感测电路924的输出除以与功率变压器908的次级侧的RETURN支路串联设置的电流感测电路914的输出来确定。第一电压感测电路912和第二电压感测电路924的输出被提供给单独的隔离变压器916、922，并且电流感测电路914的输出被提供给另一隔离变压器916。来自ADC电路926的数字化电压和电流感测测量值被提供给处理器902以用于计算阻抗。例如，第一能量模态ENERGY₁可为超声能量，并且第二能量模态ENERGY₂可为RF能量。然而，除了超声和双极或单极RF能量模态之外，其它能量模态还包括不可逆和/或可逆电穿孔和/或微波能量等。而且，虽然图21中所示的示例示出了可为两种或更多种能量模态提供单个返回路径RETURN，但在其它方面，可为每种能量模态ENERGY_n提供多个返回路径RETURN_n。因此，如本文所述，超声换能器阻抗可通过将第一电压感测电路912的输出除以电流感测电路914的输出来测量，并且组织阻抗可通过将第二电压感测电路924的输出除以电流感测电路914的输出来测量。In one aspect, the impedance may be determined by the processor 902 by dividing the output of a first voltage sensing circuit 912 coupled across terminals labeled ENERGY₁ /RETURN or a second voltage sensing circuit 924 coupled across terminals labeled ENERGY₂ /RETURN by the output of a current sensing circuit 914 disposed in series with the RETURN branch of the secondary side of the power transformer 908. The outputs of the first voltage sensing circuit 912 and the second voltage sensing circuit 924 are provided to separate isolation transformers 916, 922, and the output of the current sensing circuit 914 is provided to another isolation transformer 916. The digitized voltage and current sense measurements from the ADC circuit 926 are provided to the processor 902 for calculating the impedance. For example, the first energy modality ENERGY₁ may be ultrasonic energy, and the second energy modality ENERGY₂ may be RF energy. However, in addition to ultrasonic and bipolar or monopolar RF energy modalities, other energy modalities include irreversible and/or reversible electroporation and/or microwave energy, among others. 21 illustrates that a single return path RETURN may be provided for two or more energy modalities, in other aspects, multiple return paths RETURN_n may be provided for each energy modality ENERGY_n . Thus, as described herein, the ultrasonic transducer impedance may be measured by dividing the output of the first voltage sensing circuit 912 by the output of the current sensing circuit 914, and the tissue impedance may be measured by dividing the output of the second voltage sensing circuit 924 by the output of the current sensing circuit 914.

如图21中所示，包括至少一个输出端口的发生器900可包括具有单个输出和多个分接头的功率变压器908，以例如根据正在执行的组织处理类型以一种或多种能量模态(诸如超声、双极或单极RF、不可逆和/或可逆电穿孔和/或微波能量等等)的形式向端部执行器提供功率。例如，发生器900可用更高电压和更低电流递送能量以驱动超声换能器，用更低电压和更高电流递送能量以驱动RF电极以用于密封组织，或者用凝结波形递送能量以用于使用单极或双极RF电外科电极。来自发生器900的输出波形可被操纵、切换或滤波，以向外科器械的端部执行器提供频率。超声换能器与发生器900输出的连接将优选地位于被标记为ENERGY₁和RETURN的输出之间，如图21中所示。在一个示例中，RF双极电极与发生器900输出的连接将优选地位于被标记为ENERGY₂和RETURN的输出之间。在单极输出的情况下，优选的连接将是有源电极(例如，光锥(pencil)或其它探头)到ENERGY₂输出的和连接至RETURN输出的合适的返回垫。As shown in FIG. 21, a generator 900 including at least one output port may include a power transformer 908 having a single output and multiple taps to provide power to an end effector in the form of one or more energy modalities (such as ultrasound, bipolar or monopolar RF, irreversible and/or reversible electroporation, and/or microwave energy, etc.) depending on the type of tissue treatment being performed. For example, the generator 900 may deliver energy with a higher voltage and lower current to drive an ultrasonic transducer, deliver energy with a lower voltage and higher current to drive an RF electrode for sealing tissue, or deliver energy with a coagulation waveform for use with monopolar or bipolar RF electrosurgical electrodes. The output waveform from the generator 900 may be manipulated, switched, or filtered to provide a frequency to the end effector of the surgical instrument. The connection of the ultrasonic transducer to the output of the generator 900 will preferably be located between the outputs labeled ENERGY₁ and RETURN, as shown in FIG. 21. In one example, the connection of the RF bipolar electrode to the output of the generator 900 will preferably be located between the outputs labeled ENERGY₂ and RETURN. In the case of a unipolar output, the preferred connection would be the active electrode (eg pencil or other probe) to the ENERGY₂ output and to a suitable return pad to the RETURN output.

附加细节公开于2017年3月30日公布的标题为用于操作用于数字地生成电信号波形的发生器和外壳器械的技术(TECHNIQUES FOR OPERATING GENERATOR FOR DIGITALLYGENERATING ELECTRICAL SIGNAL WAVEFORMS AND SURGICAL INSTRUMENTS)的美国专利申请公布2017/0086914中，该专利申请全文以引用方式并入本文。Additional details are disclosed in U.S. Patent Application Publication No. 2017/0086914, published on March 30, 2017, entitled TECHNIQUES FOR OPERATING GENERATOR FOR DIGITALLY GENERATING ELECTRICAL SIGNAL WAVEFORMS AND SURGICAL INSTRUMENTS, which is incorporated herein by reference in its entirety.

如本说明书通篇所用，术语“无线”及其衍生物可用于描述可通过使用经调制的电磁辐射通过非固体介质来传送数据的电路、装置、系统、方法、技术、通信信道等。该术语并不意味着相关联的装置不包含任何电线，尽管在一些方面它们可能不包含。通信模块可实现多种无线或有线通信标准或协议中的任一种，包括但不限于Wi-Fi(IEEE 802.11系列)、WiMAX(IEEE 802.16系列)、IEEE 802.20、长期演进(LTE)、Ev-DO、HSPA+、HSDPA+、HSUPA+、EDGE、GSM、GPRS、CDMA、TDMA、DECT、蓝牙、及其以太网衍生物、以及被指定为3G、4G、5G和以上的任何其它无线和有线协议。计算模块可包括多个通信模块。例如，第一通信模块可专用于更短距离的无线通信诸如Wi-Fi和蓝牙，并且第二通信模块可专用于更长距离的无线通信诸如GPS、EDGE、GPRS、CDMA、WiMAX、LTE、Ev-DO等。As used throughout this specification, the term "wireless" and its derivatives may be used to describe circuits, devices, systems, methods, techniques, communication channels, etc. that can transmit data through a non-solid medium using modulated electromagnetic radiation. The term does not mean that the associated device does not contain any wires, although in some aspects they may not. The communication module may implement any of a variety of wireless or wired communication standards or protocols, including but not limited to Wi-Fi (IEEE 802.11 series), WiMAX (IEEE 802.16 series), IEEE 802.20, Long Term Evolution (LTE), Ev-DO, HSPA+, HSDPA+, HSUPA+, EDGE, GSM, GPRS, CDMA, TDMA, DECT, Bluetooth, and its Ethernet derivatives, and any other wireless and wired protocols designated as 3G, 4G, 5G and above. The computing module may include multiple communication modules. For example, the first communication module may be dedicated to shorter range wireless communications such as Wi-Fi and Bluetooth, and the second communication module may be dedicated to longer range wireless communications such as GPS, EDGE, GPRS, CDMA, WiMAX, LTE, Ev-DO, etc.

如本文所用，处理器或处理单元是对一些外部数据源(通常为存储器或一些其它数据流)执行操作的电子电路。本文所用术语是指组合多个专门的“处理器”的一个或多个系统(尤其是片上系统(SoC))中的中央处理器(中央处理单元)。As used herein, a processor or processing unit is an electronic circuit that performs operations on some external data source (usually a memory or some other data stream). The term is used herein to refer to a central processing unit (central processing unit) in one or more systems (especially a system on a chip (SoC)) that combines multiple specialized "processors".

如本文所用，片上系统或芯片上系统(SoC或SOC)为集成了计算机或其它电子系统的所有部件的集成电路(也被称为“IC”或“芯片”)。它可包含数字、模拟、混合信号以及通常射频功能—全部在单个基板上。SoC将微控制器(或微处理器)与高级外围装置如图形处理单元(GPU)、Wi-Fi模块或协处理器集成。SoC可包含或可不包含内置存储器。As used herein, a system on a chip or system on a chip (SoC or SOC) is an integrated circuit (also referred to as an "IC" or "chip") that integrates all the components of a computer or other electronic system. It may include digital, analog, mixed signal, and often radio frequency functions - all on a single substrate. A SoC integrates a microcontroller (or microprocessor) with advanced peripherals such as a graphics processing unit (GPU), a Wi-Fi module, or a coprocessor. A SoC may or may not include built-in memory.

如本文所用，微控制器或控制器为将微处理器与外围电路和存储器集成的系统。微控制器(或微控制器单元的MCU)可被实现为单个集成电路上的小型计算机。其可类似于SoC；SoC可包括作为其部件之一的微控制器。微控制器可包含一个或多个核心处理单元(CPU)以及存储器和可编程输入/输出外围装置。以铁电RAM、NOR闪存或OTP ROM形式的程序存储器以及少量RAM也经常包括在芯片上。与个人计算机或由各种分立芯片组成的其它通用应用中使用的微处理器相比，微控制器可用于嵌入式应用。As used herein, a microcontroller or controller is a system that integrates a microprocessor with peripheral circuits and memory. A microcontroller (or MCU for microcontroller unit) can be implemented as a small computer on a single integrated circuit. It can be similar to a SoC; an SoC may include a microcontroller as one of its components. A microcontroller may include one or more core processing units (CPUs) as well as memory and programmable input/output peripherals. Program memory in the form of ferroelectric RAM, NOR flash memory, or OTP ROM, as well as a small amount of RAM, is also often included on the chip. Compared to microprocessors used in personal computers or other general-purpose applications consisting of various discrete chips, microcontrollers can be used for embedded applications.

如本文所用，术语控制器或微控制器可为与外围装置交接的独立式IC或芯片装置。这可为计算机的两个部件或用于管理该装置的操作(以及与该装置的连接)的外部装置上的控制器之间的链路。As used herein, the term controller or microcontroller may be a stand-alone IC or chip device that interfaces with peripheral devices. This may be a link between the two components of a computer or a controller on an external device that manages the operation of the device (and the connection to the device).

如本文所述的处理器或微控制器中的任一者可为任何单核或多核处理器，诸如由德克萨斯器械公司(Texas Instruments)提供的商品名为ARM Cortex的那些。在一个方面，处理器可为例如购自德克萨斯器械公司(Texas Instruments)的LM4F230H5QR ARMCortex-M4F处理器内核，其包括：256KB的单循环闪存或其它非易失性存储器(高达40MHZ)的片上存储器、用于使性能改善超过40MHz的预取缓冲器、32KB的单循环串行随机存取存储器(SRAM)、装载有软件的内部只读存储器(ROM)、2KB的电可擦除可编程只读存储器(EEPROM)、一个或多个脉宽调制(PWM)模块、一个或多个正交编码器输入(QEI)模拟、具有12个模拟输入信道的一个或多个12位模数转换器(ADC)、以及易得的其它特征。Any of the processors or microcontrollers described herein may be any single-core or multi-core processor, such as those offered by Texas Instruments under the trade name ARM Cortex. In one aspect, the processor may be, for example, the LM4F230H5QR ARMCortex-M4F processor core available from Texas Instruments, which includes: 256KB of single-cycle flash or other non-volatile memory (up to 40 MHz) on-chip memory, a pre-fetch buffer for improving performance beyond 40 MHz, 32KB of single-cycle serial random access memory (SRAM), a 32-bit MCU with 100 MHz RAM, ... Internal read-only memory (ROM) for software, 2KB of electrically erasable programmable read-only memory (EEPROM), one or more pulse width modulation (PWM) modules, one or more quadrature encoder input (QEI) simulations, one or more 12-bit analog-to-digital converters (ADCs) with 12 analog input channels, and other features that are readily available.

在一个示例中，处理器可包括安全控制器，该安全控制器包括两个基于控制器的系列，诸如同样由德克萨斯器械公司(Texas Instruments)提供的商品名为Hercules ARMCortex R4的TMS570和RM4x。安全控制器可被配置为专门用于IEC 61508和ISO 26262安全关键应用等等，以提供先进的集成安全特征件，同时递送可定标的性能、连接性和存储器选项。In one example, the processor may include a safety controller including two families based on controllers such as the TMS570 and RM4x also offered by Texas Instruments under the trade name Hercules ARMCortex R4. The safety controller may be configured specifically for IEC 61508 and ISO 26262 safety critical applications, among others, to provide advanced integrated safety features while delivering scalable performance, connectivity, and memory options.

模块化装置包括可接纳在外科集线器内的模块(如结合图3和图9所述)和外科装置或器械，该外科装置或器械可连接到各种模块以便与对应的外科集线器连接或配对。模块化装置包括例如智能外科器械、医疗成像装置、抽吸/冲洗装置、排烟器、能量发生器、呼吸机、吹入器和显示器。本文所述的模块化装置可通过控制算法来控制。控制算法可在模块化装置自身上、在与特定模块化装置配对的外科集线器上或在模块化装置和外科集线器两者上执行(例如，经由分布式计算架构)。在一些示例中，模块化装置的控制算法基于由模块化装置自身感测到的数据来控制装置(即，通过模块化装置之中、之上或连接到模块化装置的传感器)。该数据可与正在手术的患者(例如，组织特性或吹入压力)或模块化装置本身相关(例如，刀被推进的速率、马达电流或能量水平)。例如，外科缝合和切割器械的控制算法可根据刀在其前进时遇到的阻力来控制器械的马达驱动其刀穿过组织的速率。The modular device includes a module (as described in conjunction with FIG. 3 and FIG. 9) and a surgical device or instrument that can be received in a surgical hub, which can be connected to various modules to be connected or paired with a corresponding surgical hub. The modular device includes, for example, an intelligent surgical instrument, a medical imaging device, a suction/irrigation device, a smoke evacuator, an energy generator, a ventilator, an insufflator, and a display. The modular device described herein can be controlled by a control algorithm. The control algorithm can be executed on the modular device itself, on a surgical hub paired with a specific modular device, or on both the modular device and the surgical hub (e.g., via a distributed computing architecture). In some examples, the control algorithm of the modular device controls the device based on data sensed by the modular device itself (i.e., by a sensor in, on, or connected to the modular device). The data can be related to the patient being operated on (e.g., tissue properties or insufflation pressure) or the modular device itself (e.g., the rate at which the knife is advanced, the motor current, or the energy level). For example, the control algorithm of the surgical suturing and cutting instrument can control the rate at which the motor of the instrument drives its knife through the tissue according to the resistance encountered by the knife when it advances.

图22示出了包括发生器1100和可与其一起使用的各种外科器械1104、1106、1108的外科系统1000的一种形式，其中外科器械1104为超声外科器械，外科器械1106为RF电外科器械，并且多功能外科器械1108为超声/RF电外科器械的组合。发生器1100可配置用于与多种外科装置一起使用。根据各种形式，发生器1100可为可配置用于与不同类型的不同外科器械一起使用，该外科器械包括例如超声外科器械1104、RF电外科器械1106以及集成了从发生器1100同时递送的RF能量和超声能量的多功能外科器械1108。尽管在图22的形式中，发生器1100被显示为与外科器械1104、1106、1108分离，然而在一种形式中，发生器1100可与外科器械1104、1106、1108中的任一者整体地形成，以形成一体式外科系统。发生器1100包括位于发生器1100控制台的前面板上的输入装置1110。输入装置1110可包括生成适用于对发生器1100的操作进行编程的信号的任何合适的装置。发生器1100可被配置为用于有线或无线通信。FIG. 22 shows one form of a surgical system 1000 including a generator 1100 and various surgical instruments 1104, 1106, 1108 that can be used therewith, wherein the surgical instrument 1104 is an ultrasonic surgical instrument, the surgical instrument 1106 is an RF electrosurgical instrument, and the multifunctional surgical instrument 1108 is a combination ultrasonic/RF electrosurgical instrument. The generator 1100 can be configured for use with a variety of surgical devices. According to various forms, the generator 1100 can be configurable for use with different surgical instruments of different types, including, for example, an ultrasonic surgical instrument 1104, an RF electrosurgical instrument 1106, and a multifunctional surgical instrument 1108 that integrates RF energy and ultrasonic energy delivered simultaneously from the generator 1100. 22, the generator 1100 is shown as being separate from the surgical instruments 1104, 1106, 1108, however, in one form, the generator 1100 may be integrally formed with any of the surgical instruments 1104, 1106, 1108 to form an integrated surgical system. The generator 1100 includes an input device 1110 located on a front panel of the console of the generator 1100. The input device 1110 may include any suitable device that generates signals suitable for programming the operation of the generator 1100. The generator 1100 may be configured for wired or wireless communication.

发生器1100被配置为驱动多个外科器械1104、1106、1108。第一外科器械为超声外科器械1104并且包括手持件1105(HP)、超声换能器1120、轴1126和端部执行器1122。端部执行器1122包括声学地耦合到超声换能器1120的超声刀1128和夹持臂1140。手持件1105包括用于操作夹持臂1140的触发器1143和用于给超声刀1128供能和驱动超声刀1128或其它功能的切换按钮1134a、1134b、1134c的组合。切换按钮1134a、1134b、1134c可以被配置为用发生器1100给超声换能器1120供能。The generator 1100 is configured to drive a plurality of surgical instruments 1104, 1106, 1108. The first surgical instrument is an ultrasonic surgical instrument 1104 and includes a handpiece 1105 (HP), an ultrasonic transducer 1120, a shaft 1126, and an end effector 1122. The end effector 1122 includes an ultrasonic blade 1128 and a clamp arm 1140 acoustically coupled to the ultrasonic transducer 1120. The handpiece 1105 includes a trigger 1143 for operating the clamp arm 1140 and a combination of switch buttons 1134a, 1134b, 1134c for energizing the ultrasonic blade 1128 and driving the ultrasonic blade 1128 or other functions. The switch buttons 1134a, 1134b, 1134c can be configured to energize the ultrasonic transducer 1120 with the generator 1100.

发生器1100被进一步配置为驱动第二外科器械1106。第二外科器械1106为RF电外科器械，并且包括手持件1107(HP)、轴1127和端部执行器1124。端部执行器1124包括夹持臂1142a、1142b中的电极并穿过轴1127的电导体部分返回。这些电极耦合到发生器1100内的双极能量源并由其供能。手持件1107包括用于操作夹持臂1142a、1142b的触发器1145和用于致动能量开关以给端部执行器1124中的电极供能的能量按钮1135。The generator 1100 is further configured to drive a second surgical instrument 1106. The second surgical instrument 1106 is an RF electrosurgical instrument and includes a hand piece 1107 (HP), a shaft 1127, and an end effector 1124. The end effector 1124 includes electrodes in the clamping arms 1142a, 1142b and returns through the electrical conductor portion of the shaft 1127. These electrodes are coupled to and powered by a bipolar energy source within the generator 1100. The hand piece 1107 includes a trigger 1145 for operating the clamping arms 1142a, 1142b and an energy button 1135 for actuating an energy switch to power the electrodes in the end effector 1124.

发生器1100被进一步配置为驱动多功能外科器械1108。多功能外科器械1108包括手持件1109(HP)、轴1129和端部执行器1125。端部执行器1125包括超声刀1149和夹持臂1146。超声刀1149声学地耦合到超声换能器1120。手持件1109包括用于操作夹持臂1146的触发器1147和用于给超声刀1149供能和驱动超声刀1149或其它功能的切换按钮1137a、1137b、1137c的组合。切换按钮1137a、1137b、1137c可以被配置为用发生器1100给超声换能器1120供能，并且用同样包含在发生器1100内的双极能量源给超声刀1149供能。The generator 1100 is further configured to drive the multifunctional surgical instrument 1108. The multifunctional surgical instrument 1108 includes a handpiece 1109 (HP), a shaft 1129, and an end effector 1125. The end effector 1125 includes an ultrasonic blade 1149 and a clamp arm 1146. The ultrasonic blade 1149 is acoustically coupled to the ultrasonic transducer 1120. The handpiece 1109 includes a trigger 1147 for operating the clamp arm 1146 and a combination of switch buttons 1137a, 1137b, 1137c for energizing the ultrasonic blade 1149 and driving the ultrasonic blade 1149 or other functions. The switch buttons 1137a, 1137b, 1137c can be configured to energize the ultrasonic transducer 1120 with the generator 1100 and energize the ultrasonic blade 1149 with a bipolar energy source also included in the generator 1100.

发生器1100可配置用于与多种外科装置一起使用。根据各种形式，发生器1100可为可配置用于与不同类型的不同外科器械一起使用，该外科器械包括例如超声外科器械1104、RF电外科器械1106和集成了从发生器1100同时递送的RF能量和超声能量的多功能外科器械1108。尽管在图22的形式中，发生器1100被显示为与外科器械1104、1106、1108分开，然而在另一种形式中，发生器1100可与外科器械1104、1106、1108中的任一者整体地形成，以形成一体式外科系统。如上文所讨论的，发生器1100包括位于发生器1100控制台的前面板上的输入装置1110。输入装置1110可包括生成适用于对发生器1100的操作进行编程的信号的任何合适的装置。发生器1100还可包括一个或多个输出装置1112。用于数字生成电信号波形的发生器和外科器械的另外方面描述于美国专利公布US-2017-0086914-A1中，该专利全文以引用方式并入本文。The generator 1100 may be configured for use with a variety of surgical devices. According to various forms, the generator 1100 may be configurable for use with different surgical instruments of different types, including, for example, an ultrasonic surgical instrument 1104, an RF electrosurgical instrument 1106, and a multifunctional surgical instrument 1108 that integrates RF energy and ultrasonic energy delivered simultaneously from the generator 1100. Although in the form of FIG. 22, the generator 1100 is shown as being separate from the surgical instruments 1104, 1106, 1108, in another form, the generator 1100 may be integrally formed with any of the surgical instruments 1104, 1106, 1108 to form an integrated surgical system. As discussed above, the generator 1100 includes an input device 1110 located on the front panel of the console of the generator 1100. The input device 1110 may include any suitable device that generates a signal suitable for programming the operation of the generator 1100. The generator 1100 may also include one or more output devices 1112. Further aspects of a generator and surgical instrument for digitally generating electrical signal waveforms are described in U.S. Patent Publication No. US-2017-0086914-A1, which is incorporated herein by reference in its entirety.

图23为根据本公开的至少一个方面的示例超声装置1104的端部执行器1122。端部执行器1122可包括刀1128，该刀1128可经由波导耦合到超声换能器1120。当由超声换能器1120驱动时，刀1128可振动，并且当与组织进行接触时，可切割和/或凝结组织，如本文所述。根据各个方面，并且如图23中所示，端部执行器1122还可包括夹持臂1140，该夹持臂1140可被配置为与端部执行器1122的刀1128协作行动。利用刀1128，夹持臂1140可包括一组钳口。夹持臂1140可以可枢转地连接在器械部分1104的轴1126的远侧端部处。夹持臂1140可包括夹持臂组织垫1163，该夹持臂组织垫1163可由或其它合适的低摩擦材料形成。可安装垫1163，以用于与刀1128协作，其中夹持臂1140的枢转运动将夹持垫1163定位成与刀1128大体平行并接触。通过该构造，可将待夹持的组织咬合可被抓握在组织垫1163和刀1128之间。组织垫1163可具有锯齿状配置，包括多个轴向间隔开的朝近侧延伸的抓持齿1161，以与刀1128协作增强对组织的抓持。夹持臂1140可从图23中所示的打开位置以任何合适的方式转变到闭合位置(其中夹持臂1140与刀1128接触或接近刀1128)。例如，手持件1105可包括钳口闭合触发器。当由临床医生致动时，钳口闭合触发器可以任何合适的方式枢转夹持臂1140。23 is an end effector 1122 of an example ultrasonic device 1104 according to at least one aspect of the present disclosure. The end effector 1122 may include a knife 1128 that may be coupled to the ultrasonic transducer 1120 via a waveguide. When driven by the ultrasonic transducer 1120, the knife 1128 may vibrate and, when brought into contact with tissue, may cut and/or coagulate tissue as described herein. According to various aspects, and as shown in FIG. 23 , the end effector 1122 may also include a clamping arm 1140 that may be configured to act in coordination with the knife 1128 of the end effector 1122. Utilizing the knife 1128, the clamping arm 1140 may include a set of jaws. The clamping arm 1140 may be pivotally connected at the distal end of the shaft 1126 of the instrument portion 1104. The clamping arm 1140 may include a clamping arm tissue pad 1163 that may be Or other suitable low friction material. Pad 1163 can be installed to cooperate with knife 1128, wherein the pivoting movement of clamping arm 1140 positions clamping pad 1163 to be generally parallel to and in contact with knife 1128. Through this configuration, the tissue to be clamped can be grasped between tissue pad 1163 and knife 1128. Tissue pad 1163 can have a serrated configuration, including a plurality of axially spaced proximally extending grasping teeth 1161 to enhance the grasping of tissue in cooperation with knife 1128. Clamping arm 1140 can be transformed from the open position shown in FIG. 23 to a closed position (wherein clamping arm 1140 is in contact with or close to knife 1128) in any suitable manner. For example, handpiece 1105 can include a jaw closure trigger. When actuated by a clinician, the jaw closure trigger can pivot clamping arm 1140 in any suitable manner.

发生器1100可被激活以按照任何合适的方式将驱动信号提供到换能器1120。例如，发生器1100可包括脚踏开关1430(图24)，该脚踏开关1430经由脚踏开关缆线1432耦合到发生器1100。临床医生可通过压下脚踏开关1430来激活超声换能器1120，并且从而激活超声换能器1120和刀1128。此外，或作为脚踏开关1430的替代，装置1104的一些方面可利用定位于手持件1105上的一个或多个开关，当被激活时，该一个或多个开关可使发生器1100激活换能器1120。在一个方面，例如，一个或多个开关可包括一对切换按钮1134a、1134b、1134c(图22)例如以确定装置1104的操作模式。当切换按钮1134a被压下时，例如，超声发生器1100可将最大驱动信号提供到换能器1120，从而使其产生最大超声能量输出。压下切换按钮1134b可使超声发生器1100将用户可选的驱动信号提供到超声换能器1120，从而使其产生小于最大值的超声能量输出。附加地或另选地，装置1104可包括第二开关以例如指示用于经由端部执行器1122的夹持臂1140操作钳口的钳口闭合触发器的位置。此外，在一些方面，超声发生器1100可基于钳口闭合触发器的位置被激活(例如，当临床医生压下钳口闭合触发器以经由夹持臂1140闭合钳口时，可施加超声能量)。The generator 1100 can be activated to provide a drive signal to the transducer 1120 in any suitable manner. For example, the generator 1100 can include a foot switch 1430 ( FIG. 24 ) coupled to the generator 1100 via a foot switch cable 1432. The clinician can activate the ultrasonic transducer 1120 by depressing the foot switch 1430, and thereby activate the ultrasonic transducer 1120 and the blade 1128. In addition, or as an alternative to the foot switch 1430, some aspects of the device 1104 can utilize one or more switches positioned on the handpiece 1105 that, when activated, can cause the generator 1100 to activate the transducer 1120. In one aspect, for example, the one or more switches can include a pair of toggle buttons 1134a, 1134b, 1134c ( FIG. 22 ), for example, to determine an operating mode of the device 1104. When the toggle button 1134a is depressed, for example, the ultrasonic generator 1100 may provide a maximum drive signal to the transducer 1120, causing it to produce a maximum ultrasonic energy output. Depressing the toggle button 1134b may cause the ultrasonic generator 1100 to provide a user-selectable drive signal to the ultrasonic transducer 1120, causing it to produce an ultrasonic energy output less than the maximum value. Additionally or alternatively, the device 1104 may include a second switch to, for example, indicate the position of a jaw closure trigger for operating the jaws via the clamp arm 1140 of the end effector 1122. Furthermore, in some aspects, the ultrasonic generator 1100 may be activated based on the position of the jaw closure trigger (e.g., when the clinician depresses the jaw closure trigger to close the jaws via the clamp arm 1140, ultrasonic energy may be applied).

附加地或另选地，一个或多个开关可包括切换按钮1134c，该切换按钮1134c在被压下时使发生器1100提供脉冲输出(图22)。脉冲例如可按任何合适的频率和分组提供。在某些方面，例如，脉冲的功率水平可为与切换按钮1134a、1134b相关联的功率水平(最大值、小于最大值)。Additionally or alternatively, the one or more switches may include a toggle button 1134c that, when depressed, causes the generator 1100 to provide a pulsed output (FIG. 22). The pulses may be provided, for example, at any suitable frequency and grouping. In certain aspects, for example, the power level of the pulses may be the power level (maximum, less than maximum) associated with the toggle buttons 1134a, 1134b.

应当理解，装置1104可包括切换按钮1134a、1134b、1134c的任何组合(图22)。例如，装置1104可被配置为仅具有两个切换按钮：用于产生最大超声能量输出的切换按钮1134a和用于以最大功率水平或小于最大功率水平产生脉冲输出的切换按钮1134c。这样，发生器1100的驱动信号输出配置可为五个连续信号，或任何离散数量的单个脉冲信号(1、2、3、4或5)。在某些方面，例如可基于发生器1100中的EEPROM设定和/或一个或多个用户功率水平选择来控制特定的驱动信号配置。It should be understood that the device 1104 may include any combination of toggle buttons 1134a, 1134b, 1134c (FIG. 22). For example, the device 1104 may be configured to have only two toggle buttons: a toggle button 1134a for generating a maximum ultrasonic energy output and a toggle button 1134c for generating a pulsed output at or less than the maximum power level. In this way, the drive signal output configuration of the generator 1100 may be five continuous signals, or any discrete number of single pulse signals (1, 2, 3, 4, or 5). In certain aspects, a particular drive signal configuration may be controlled based on, for example, an EEPROM setting in the generator 1100 and/or one or more user power level selections.

在某些方面，可提供双位开关来替代切换按钮1134c(图22)。例如，装置1104可包括用于以最大功率水平产生连续输出的切换按钮1134a和双位切换按钮1134b。在第一止动位置中，切换按钮1134b可以小于最大功率水平产生连续输出，并且在第二止动位置中，切换按钮1134b可产生脉冲输出(例如，根据EEPROM设定，以最大功率水平或小于最大功率水平)。In some aspects, a two-position switch may be provided in place of the toggle button 1134c (FIG. 22). For example, the device 1104 may include a toggle button 1134a for producing a continuous output at a maximum power level and a two-position toggle button 1134b. In a first detent position, the toggle button 1134b may produce a continuous output at a power level less than the maximum power level, and in a second detent position, the toggle button 1134b may produce a pulsed output (e.g., at a maximum power level or less than the maximum power level, depending on the EEPROM setting).

在一些方面，RF电外科端部执行器1124、1125(图22)也可包括一对电极。电极可例如经由缆线与发生器1100通信。电极可用于例如测量存在于夹持臂1142a、1146和刀1142b、1149之间的组织咬合的阻抗。发生器1100可向电极提供信号(例如，非治疗信号)。例如，可通过监测信号的电流、电压等来发现组织咬合的阻抗。In some aspects, the RF electrosurgical end effectors 1124, 1125 (FIG. 22) may also include a pair of electrodes. The electrodes may communicate with the generator 1100, for example, via a cable. The electrodes may be used, for example, to measure the impedance of the tissue engagement between the clamping arms 1142a, 1146 and the blades 1142b, 1149. The generator 1100 may provide a signal (e.g., a non-therapeutic signal) to the electrodes. For example, the impedance of the tissue engagement may be found by monitoring the current, voltage, etc. of the signal.

在各个方面，发生器1100可包括若干独立的功能元件，诸如模块和/或块，如图24、图22的外科系统1000的图示中所示。不同的功能元件或模块可被配置用于驱动不同种类的外科装置1104、1106、1108。例如，超声发生器模块可驱动超声装置，诸如超声外科装置1104。电外科/RF发生器模块可驱动电外科装置1106。例如，模块可生成用于驱动外科装置1104、1106、1108的相应的驱动信号。在各个方面，超声发生器模块和/或电外科/RF发生器模块各自可与发生器1100整体地形成。另选地，模块中的一个或多个可被设置成电耦合到发生器1100的单独的电路模块。(模块以虚线显示以示出该部分。)此外，在一些方面，电外科/RF发生器模块可与超声发生器模块整体地形成，或反之亦然。In various aspects, the generator 1100 may include several independent functional elements, such as modules and/or blocks, as shown in the illustrations of the surgical system 1000 of FIG. 24 and FIG. 22. Different functional elements or modules may be configured to drive different kinds of surgical devices 1104, 1106, 1108. For example, an ultrasonic generator module may drive an ultrasonic device, such as an ultrasonic surgical device 1104. An electrosurgery/RF generator module may drive an electrosurgery device 1106. For example, a module may generate a corresponding drive signal for driving surgical devices 1104, 1106, 1108. In various aspects, the ultrasonic generator module and/or the electrosurgery/RF generator module may each be integrally formed with the generator 1100. Alternatively, one or more of the modules may be configured as a separate circuit module electrically coupled to the generator 1100. (The modules are shown in dashed lines to illustrate the portion.) In addition, in some aspects, the electrosurgery/RF generator module may be integrally formed with the ultrasonic generator module, or vice versa.

根据所述方面，超声发生器模块可生成特定电压、电流和频率(例如，55,500循环每秒或Hz)的一个或多个驱动信号。该一个或多个驱动信号可被提供至超声装置1104、尤其是可例如如上所述进行操作的换能器1120。在一个方面，发生器1100可被配置为生成特定电压、电流和/或频率输出信号的驱动信号，该驱动信号可在高分辨率、精度和再现性方面进行修改。According to the described aspects, the ultrasonic generator module can generate one or more drive signals of a specific voltage, current, and frequency (e.g., 55,500 cycles per second or Hz). The one or more drive signals can be provided to the ultrasonic device 1104, in particular the transducer 1120, which can be operated, for example, as described above. In one aspect, the generator 1100 can be configured to generate a drive signal of a specific voltage, current, and/or frequency output signal that can be modified in terms of high resolution, accuracy, and reproducibility.

根据所述方面，电外科/RF发生器模块可生成具有足以使用射频(RF)能量执行双极电外科的输出功率的一个或多个驱动信号。在双极电外科应用中，驱动信号可被提供至例如电外科装置1106的电极，如上文所述。因此，发生器1100可被配置为用于通过将足以处理组织(例如，凝结、烧灼、组织焊接等)的电能施加到组织而达到治疗目的。According to the described aspects, the electrosurgery/RF generator module can generate one or more drive signals having an output power sufficient to perform bipolar electrosurgery using radio frequency (RF) energy. In bipolar electrosurgery applications, the drive signals can be provided to, for example, electrodes of an electrosurgical device 1106, as described above. Thus, the generator 1100 can be configured to achieve a therapeutic purpose by applying electrical energy to tissue sufficient to treat the tissue (e.g., coagulation, cauterization, tissue welding, etc.).

发生器1100可包括位于例如发生器1100控制台的前面板上的输入装置2150(图27B)。输入装置2150可包括产生适用于对发生器1100的操作进行编程的信号的任何合适的装置。在操作中，用户可以使用输入装置2150对发生器1100的操作进行编程或以其它方式进行控制。输入装置2150可包括生成可由发生器(例如，由包含在发生器中的一个或多个处理器)用来控制发生器1100的操作(例如，超声发生器模块和/或电外科/RF发生器模块的操作)的信号的任何合适的装置。在各个方面，输入装置2150包括以下中的一种或多种：按钮、开关、指轮、键盘、小键盘、触摸屏监测器、指点装置、到通用或专用计算机的远程连接。在其它方面，输入装置2150例如可包括合适的用户界面，诸如显示于触摸屏监测器上的一个或多个用户界面屏幕，例如。因此，通过输入装置2150，用户可设定发生器的各种操作参数或对其进行编程，诸如例如由超声发生器模块和/或电外科/RF发生器模块生成的一个或多个驱动信号的电流(I)、电压(V)、频率(f)和/或周期(T)。The generator 1100 may include an input device 2150 ( FIG. 27B ) located, for example, on a front panel of the generator 1100 console. The input device 2150 may include any suitable device that generates signals suitable for programming the operation of the generator 1100. In operation, a user may use the input device 2150 to program or otherwise control the operation of the generator 1100. The input device 2150 may include any suitable device that generates signals that can be used by the generator (e.g., by one or more processors contained in the generator) to control the operation of the generator 1100 (e.g., the operation of the ultrasonic generator module and/or the electrosurgery/RF generator module). In various aspects, the input device 2150 includes one or more of the following: a button, a switch, a thumbwheel, a keyboard, a keypad, a touch screen monitor, a pointing device, a remote connection to a general purpose or special purpose computer. In other aspects, the input device 2150 may include, for example, a suitable user interface, such as one or more user interface screens displayed on a touch screen monitor, for example. Thus, through the input device 2150, a user can set or program various operating parameters of the generator, such as, for example, the current (I), voltage (V), frequency (f) and/or period (T) of one or more drive signals generated by the ultrasonic generator module and/or the electrosurgery/RF generator module.

发生器1100还可包括位于例如发生器1100控制台的前面板上的输入装置2140(图27B)。输出装置2140包括用于向用户提供感观反馈的一个或多个装置。此类装置可包括例如视觉反馈装置(例如，LCD显示屏、LED指示器)、音频反馈装置(例如，扬声器、蜂鸣器)或触觉反馈装置(例如，触觉致动器)。The generator 1100 may also include an input device 2140 ( FIG. 27B ) located, for example, on a front panel of a console of the generator 1100. The output device 2140 includes one or more devices for providing sensory feedback to a user. Such devices may include, for example, a visual feedback device (e.g., an LCD display, an LED indicator), an audio feedback device (e.g., a speaker, a buzzer), or a tactile feedback device (e.g., a tactile actuator).

尽管可通过示例来描述发生器1100的某些模块和/或块，但可理解，可使用更多或更少数目的模块和/或块，并仍落入所述方面的范围内。此外，虽然各个方面可按照模块和/或块的形式描述以便于说明，但此类模块和/或块可通过一个或多个硬件部件(例如，处理器、数字信号处理器(DSP)、可编程逻辑装置(PLD)、专用集成电路(ASIC)、电路、寄存器)和/或软件部件(例如，程序、子例程、逻辑)、和/或硬件部件与软件部件的组合加以实施。Although certain modules and/or blocks of the generator 1100 may be described by way of example, it is understood that a greater or lesser number of modules and/or blocks may be used and still fall within the scope of the aspects. In addition, although various aspects may be described in terms of modules and/or blocks for ease of description, such modules and/or blocks may be implemented by one or more hardware components (e.g., processors, digital signal processors (DSPs), programmable logic devices (PLDs), application specific integrated circuits (ASICs), circuits, registers) and/or software components (e.g., programs, subroutines, logic), and/or a combination of hardware components and software components.

在一个方面，超声发生器驱动模块和电外科/RF驱动模块1110(图22)可包括作为固件、软件、硬件或它们的任何组合实现的一个或多个嵌入式应用程序。模块可包括各种可执行模块，诸如软件、程序、数据、驱动器、应用程序接口(API)等。固件可存储在非易失性存储器(NVM)(诸如位屏蔽只读存储器(ROM)或闪速存储器)中。在各种具体实施中，将固件存储在ROM中可保护闪存存储器。NVM可包括其它类型的存储器，包括例如可编程ROM(PROM)、可擦除可编程ROM(EPROM)、电可擦除可编程ROM(EEPROM)或电池支持的随机存取存储器(RAM)(诸如动态RAM(DRAM)、双数据率DRAM(DDRAM)和/或同步DRAM(SDRAM))。In one aspect, the ultrasonic generator drive module and the electrosurgery/RF drive module 1110 (FIG. 22) may include one or more embedded applications implemented as firmware, software, hardware, or any combination thereof. The module may include various executable modules, such as software, programs, data, drivers, application program interfaces (APIs), etc. The firmware may be stored in a non-volatile memory (NVM) such as a bit-masked read-only memory (ROM) or flash memory. In various specific implementations, storing the firmware in a ROM may protect the flash memory. The NVM may include other types of memory, including, for example, a programmable ROM (PROM), an erasable programmable ROM (EPROM), an electrically erasable programmable ROM (EEPROM), or a battery-backed random access memory (RAM) such as a dynamic RAM (DRAM), a double data rate DRAM (DDRAM), and/or a synchronous DRAM (SDRAM)).

在一个方面，模块包括硬件部件，该硬件部件被实现为用于执行程序指令的处理器，该程序指令用于监测装置1104、1106、1108的各种可测量特征并生成用于操作装置1104、1106、1108的对应输出驱动信号。在其中发生器1100与装置1104结合使用的方面中，驱动信号可以切割和/或凝结操作模式驱动超声换能器1120。装置1104和/或组织的电特征可被测量并且用于控制发生器1100的操作方面并且/或者可作为反馈提供给用户。在其中发生器1100与装置1106结合使用的方面中，驱动信号可以切割、凝结和/或脱水模式将电能(例如，RF能量)供应至端部执行器1124。可测量装置1106和/或组织的电特征并将其用于控制发生器1100的操作方面并且/或者可作为反馈向用户提供。在各个方面，如在前文所述，硬件部件可被实现为DSP、PLD、ASIC、电路和/或寄存器。在一个方面，处理器可被配置为存储和执行计算机软件程序指令，以生成用于驱动装置1104、1106、1108的各种部件(例如超声换能器1120和端部执行器1122、1124、1125)的阶跃函数输出信号。In one aspect, the module includes a hardware component implemented as a processor for executing program instructions for monitoring various measurable characteristics of the devices 1104, 1106, 1108 and generating corresponding output drive signals for operating the devices 1104, 1106, 1108. In aspects where the generator 1100 is used in conjunction with the device 1104, the drive signal can drive the ultrasonic transducer 1120 in a cutting and/or coagulation mode of operation. Electrical characteristics of the device 1104 and/or tissue can be measured and used to control operational aspects of the generator 1100 and/or can be provided as feedback to a user. In aspects where the generator 1100 is used in conjunction with the device 1106, the drive signal can supply electrical energy (e.g., RF energy) to the end effector 1124 in a cutting, coagulation, and/or desiccation mode. Electrical characteristics of the device 1106 and/or tissue can be measured and used to control operational aspects of the generator 1100 and/or can be provided as feedback to a user. In various aspects, as previously described, the hardware components can be implemented as DSPs, PLDs, ASICs, circuits, and/or registers. In one aspect, the processor can be configured to store and execute computer software program instructions to generate step function output signals for driving various components of the apparatus 1104, 1106, 1108 (e.g., the ultrasonic transducer 1120 and the end effectors 1122, 1124, 1125).

机电超声系统包括超声换能器、波导和超声刀。机电超声系统具有由超声换能器、波导和超声刀的物理特性限定的初始谐振频率。超声换能器受激于交变电压V_g(t)信号和电流I_g(t)信号的谐振频率等于所述机电超声系统。当超声机电系统处于谐振时，电压V_g(t)信号和电流I_g(t)信号之间的相位差为零。换句话说，在谐振时，感应阻抗等于电容阻抗。当超声刀加热时，超声刀(被建模为等效电容)的顺应性导致机电超声系统的谐振频率偏移。因此，感应阻抗不再等于电容阻抗，从而导致机电超声系统的驱动频率和谐振频率之间不匹配。系统现在运行“非谐振(off-resonance)”。驱动频率和谐振频率之间的失配的表现为施加到超声换能器的电压V_g(t)信号和电流I_g(t)信号之间的相位差。发生器电子器件可以容易地监测电压V_g(t)和电流I_g(t)信号之间的相位差并且可以连续调节驱动频率直到相位差再次为零为止。此时，新驱动频率等于机电超声系统的新谐振频率。相位和/或频率的变化可用作超声刀温度的间接测量值。The electromechanical ultrasonic system includes an ultrasonic transducer, a waveguide and an ultrasonic scalpel. The electromechanical ultrasonic system has an initial resonant frequency defined by the physical properties of the ultrasonic transducer, the waveguide and the ultrasonic scalpel. The resonant frequency of the ultrasonic transducer excited by the alternating voltage V_g (t) signal and the current I_g (t) signal is equal to the electromechanical ultrasonic system. When the ultrasonic electromechanical system is in resonance, the phase difference between the voltage V_g (t) signal and the current I_g (t) signal is zero. In other words, at resonance, the inductive impedance is equal to the capacitive impedance. When the ultrasonic scalpel is heated, the compliance of the ultrasonic scalpel (modeled as an equivalent capacitor) causes the resonant frequency of the electromechanical ultrasonic system to shift. Therefore, the inductive impedance is no longer equal to the capacitive impedance, resulting in a mismatch between the driving frequency and the resonant frequency of the electromechanical ultrasonic system. The system now runs "off-resonance". The mismatch between the driving frequency and the resonant frequency is manifested as the phase difference between the voltage V_g (t) signal and the current I_g (t) signal applied to the ultrasonic transducer. The generator electronics can easily monitor the phase difference between the voltage V_g (t) and current I_g (t) signals and can continuously adjust the drive frequency until the phase difference is zero again. At this point, the new drive frequency is equal to the new resonant frequency of the electromechanical ultrasonic system. The change in phase and/or frequency can be used as an indirect measurement of the ultrasonic blade temperature.

如图25中所示，超声换能器的机电特性可被建模成这样的等效电路，该等效电路包括具有静态电容的第一支路和具有限定谐振器的机电特性的串联连接的电感、电阻和电容的第二“动态”支路。已知的超声发生器可包括调谐电感器，该调谐电感器用于解谐处于谐振频率的静态电容，使得大体上发生器的驱动信号电流中的所有均流入动态支路中。因此，通过使用调谐电感器，发生器的驱动信号电流表示动态支路电流，并且因此发生器能够控制其驱动信号以保持超声换能器的谐振频率。调谐电感器还可变换超声换能器的相阻抗图以改善发生器的频率锁定能力。然而，调谐电感器必须与超声换能器在操作谐振频率下的特定静态电容匹配。换句话讲，具有不同静态电容的不同超声换能器需要不同的调谐电感器。As shown in FIG. 25 , the electromechanical characteristics of an ultrasonic transducer can be modeled as an equivalent circuit including a first branch having a static capacitance and a second "dynamic" branch having a series connection of an inductance, a resistance, and a capacitance that define the electromechanical characteristics of the resonator. A known ultrasonic generator may include a tuning inductor for detuning the static capacitance at the resonant frequency so that substantially all of the generator's drive signal current flows into the dynamic branch. Thus, by using the tuning inductor, the generator's drive signal current represents the dynamic branch current, and the generator is thus able to control its drive signal to maintain the resonant frequency of the ultrasonic transducer. The tuning inductor can also transform the phase impedance diagram of the ultrasonic transducer to improve the generator's frequency locking capability. However, the tuning inductor must be matched to the specific static capacitance of the ultrasonic transducer at the operating resonant frequency. In other words, different ultrasonic transducers with different static capacitances require different tuning inductors.

图25示出了根据一个方面的超声换能器诸如超声换能器1120的等效电路1500。电路1500包括具有限定谐振器的机电特性的串联连接的电感L_s、电阻R_s和电容C_s的第一“动态”支路和具有静态电容的第二电容支路C₀。可在驱动电压V_g(t)下从发生器接收驱动电流I_g(t)，其中动态电流I_m(t)流过第一支路并且电流I_g(t)-I_m(t)流过电容支路。可通过适当地控制I_g(t)和V_g(t)来实现对超声换能器的机电特性的控制。如上所述，已知的发生器架构可包括并联谐振电路中的调谐电感器L_t(在图25中以虚线显示)，该调谐电感器用于将静态电容C₀调谐成谐振频率，使得大体上发生器的电流输出I_g(t)中的所有均流过动态支路。以此方式，通过控制发生器电流输出I_g(t)来实现对动态支路电流I_m(t)的控制。然而，调谐电感器L_t对超声换能器的静态电容C₀是特定的，并且具有不同静态电容的不同超声换能器需要不同的调谐电感器L_t。此外，因为调谐电感器L_t在单个谐振频率下与静态电容C₀的标称值匹配，所以仅在该频率下确保对动态支路电流I_m(t)的精确控制。随着频率随换能器温度的推移而向下偏移，对动态支路电流的精确控制受到损害。FIG. 25 shows an equivalent circuit 1500 of an ultrasonic transducer, such as the ultrasonic transducer 1120, according to one aspect. The circuit 1500 includes a first "dynamic" branch having a series connection of an inductance_Ls , a resistance_Rs, and a capacitance_Cs that define the electromechanical characteristics of the resonator, and a second capacitive branch_C0 having a static capacitance. A drive current_Ig (t) may be received from a generator at a drive voltage_Vg (t), wherein a dynamic current_Im (t) flows through the first branch and a current_Ig (t)_-Im (t) flows through the capacitive branch. Control of the electromechanical characteristics of the ultrasonic transducer may be achieved by appropriately controlling_Ig (t) and_Vg (t). As described above, a known generator architecture may include a tuning inductor_Lt (shown in dashed lines in FIG. 25) in a parallel resonant circuit that is used to tune the static capacitance_C0 to the resonant frequency so that substantially all of the current output_Ig (t) of the generator flows through the dynamic branch. In this way, control of the motional branch current_Im (t) is achieved by controlling the generator current output_Ig (t). However, the tuning inductor_Lt is specific to the static capacitance_C0 of the ultrasonic transducer, and different ultrasonic transducers with different static capacitances require different tuning inductors_Lt. Furthermore, because the tuning inductor_Lt is matched to the nominal value of the static capacitance_C0 at a single resonant frequency, accurate control of the motional branch current_Im (t) is ensured only at that frequency. As the frequency shifts downward with the temperature of the transducer, accurate control of the motional branch current is compromised.

发生器1100的各个方面可不依赖于调谐电感器L_t来监测动态支路电流I_m(t)。相反，发生器1100可使用在施加用于特定超声外科装置1104的功率之间静电容C₀的测量值(连同驱动信号电压和电流反馈数据)，以在动态行进的基础上(例如，实时地)确定动态支路电流I_m(t)的值。因此，发生器1100的此类方面能够提供虚拟调谐，以模拟被调谐的系统或与在任何频率下的静电容C₀的任何值谐振，而非仅在静态电容C₀的标称值所指示的单个谐振频率下谐振。Various aspects of the generator 1100 may not rely on a tuning inductor_Lt to monitor the motional branch current_Im (t). Instead, the generator 1100 may use measurements of the static capacitance_Co between power applications for a particular ultrasonic surgical device 1104 (along with drive signal voltage and current feedback data) to determine the value of the motional branch current_Im (t) on a dynamic, ongoing basis (e.g., in real time). Thus, such aspects of the generator 1100 can provide virtual tuning to simulate a system being tuned or resonating with any value of the static capacitance_Co at any frequency, rather than just resonating at a single resonant frequency dictated by the nominal value of the static capacitance_Co.

图26为发生器1100的一个方面的简化框图，该发生器如上所述除提供其它有益效果之外还提供无电感器调谐。图27A-27C示出了根据一个方面的图26的发生器1100的架构。参照图26，发生器1100可包括患者隔离级1520，该患者隔离级经由功率变压器1560与非隔离级1540通信。功率变压器1560的二次绕组1580包含在隔离级1520中，并且可包括分接配置(例如，中心分接或非中心分接配置)来限定驱动信号输出1600a、1600b、1600c，以用于将驱动信号输出至不同外科装置(诸如例如，超声外科装置1104和电外科装置1106)。具体而言，驱动信号输出1600a、1600b、1600c可将驱动信号(例如，420V RMS驱动信号)输出至超声外科装置1104，并且驱动信号输出1600a、1600b、1600c可将驱动信号(例如，100V RMS驱动信号)输出至电外科装置1106，其中输出1600b对应于功率变压器1560的中心分接头。非隔离级1540可包括功率放大器1620，该功率放大器1620具有连接到功率变压器1560的一次绕组1640的输出。在某些方面，功率放大器1620可包括例如推拉放大器。非隔离级1540还可包括可编程逻辑装置1660，该可编程逻辑装置1660用于向数模转换器(DAC)1680供应数字输出，而该数模转换器1680继而将对应的模拟信号供应至功率放大器1620的输入。在某些方面，可编程逻辑装置1660可包括例如现场可编程门阵列(FPGA)。由于经由DAC 1680控制功率放大器1620的输入，可编程逻辑装置1660可因此控制在驱动信号输出1600a、1600b、1600c处出现的驱动信号的多个参数(例如，频率、波形形状、波形幅值)中的任一者。在某些方面并且如下所述，可编程逻辑装置1660结合处理器(例如，以下所述的处理器1740)可实现多个基于数字信号处理(DSP)的算法和/或其它控制算法，以控制由发生器1100输出的驱动信号的参数。FIG26 is a simplified block diagram of one aspect of a generator 1100 that provides inductor-free tuning, in addition to providing other benefits, as described above. FIGS. 27A-27C illustrate the architecture of the generator 1100 of FIG26 , according to one aspect. Referring to FIG26 , the generator 1100 may include a patient isolation stage 1520 that communicates with a non-isolated stage 1540 via a power transformer 1560. A secondary winding 1580 of the power transformer 1560 is included in the isolation stage 1520 and may include a tapping configuration (e.g., a center tap or a non-center tap configuration) to define drive signal outputs 1600a, 1600b, 1600c for outputting drive signals to different surgical devices (such as, for example, an ultrasonic surgical device 1104 and an electrosurgical device 1106). Specifically, the drive signal outputs 1600a, 1600b, 1600c can output a drive signal (e.g., a 420V RMS drive signal) to the ultrasonic surgical device 1104, and the drive signal outputs 1600a, 1600b, 1600c can output a drive signal (e.g., a 100V RMS drive signal) to the electrosurgical device 1106, where the output 1600b corresponds to the center tap of the power transformer 1560. The non-isolated stage 1540 may include a power amplifier 1620 having an output connected to the primary winding 1640 of the power transformer 1560. In certain aspects, the power amplifier 1620 may include, for example, a push-pull amplifier. The non-isolated stage 1540 may also include a programmable logic device 1660 for supplying a digital output to a digital-to-analog converter (DAC) 1680, which in turn supplies a corresponding analog signal to an input of the power amplifier 1620. In certain aspects, the programmable logic device 1660 may include, for example, a field programmable gate array (FPGA). As the input of the power amplifier 1620 is controlled via the DAC 1680, the programmable logic device 1660 may thus control any of a plurality of parameters (e.g., frequency, waveform shape, waveform amplitude) of the drive signal appearing at the drive signal outputs 1600a, 1600b, 1600c. In certain aspects and as described below, the programmable logic device 1660 in conjunction with a processor (e.g., the processor 1740 described below) may implement a plurality of digital signal processing (DSP) based algorithms and/or other control algorithms to control the parameters of the drive signal output by the generator 1100.

可通过开关模式调整器1700将功率供应至功率放大器1620的功率轨。在某些方面，开关模式调节器1700可包括例如可调式降压调节器。如上所述，非隔离级1540可进一步包括处理器1740，该处理器1740在一个方面可包括DSP处理器诸如ADSP-21469SHARC DSP，其可得自例如马萨诸塞州诺伍德的模拟装置公司(Analog Devices,Norwood,Mass.)。在某些方面，处理器1740可响应于由处理器1740经由模数转换器(ADC)1760从功率放大器1620接收的电压反馈数据来控制开关模式功率转换器1700的操作。在一个方面，例如，处理器1740可经由ADC 1760接收正被功率放大器1620放大的信号(例如，RF信号)的波形包络作为输入。然后，处理器1740可控制开关模式调节器1700(例如，经由脉宽调制(PWM)输出)，使得被供应至功率放大器1620的干线电压跟踪经放大信号的波形包络。通过基于波形包络动态调制功率放大器1620的干线电压，功率放大器1620的效率相对于固定干线电压放大器方案可显著升高。处理器1740可被配置为用于有线或无线通信。Power may be supplied to the power rail of the power amplifier 1620 by the switch-mode regulator 1700. In certain aspects, the switch-mode regulator 1700 may include, for example, an adjustable buck regulator. As described above, the non-isolated stage 1540 may further include a processor 1740, which in one aspect may include a DSP processor such as an ADSP-21469 SHARC DSP, which is available from, for example, Analog Devices, Norwood, Mass. In certain aspects, the processor 1740 may control the operation of the switch-mode power converter 1700 in response to voltage feedback data received by the processor 1740 from the power amplifier 1620 via an analog-to-digital converter (ADC) 1760. In one aspect, for example, the processor 1740 may receive as input via the ADC 1760 a waveform envelope of a signal (e.g., an RF signal) being amplified by the power amplifier 1620. The processor 1740 can then control the switch mode regulator 1700 (e.g., via a pulse width modulation (PWM) output) so that the rail voltage supplied to the power amplifier 1620 tracks the waveform envelope of the amplified signal. By dynamically modulating the rail voltage of the power amplifier 1620 based on the waveform envelope, the efficiency of the power amplifier 1620 can be significantly improved relative to a fixed rail voltage amplifier solution. The processor 1740 can be configured for wired or wireless communication.

在某些方面并且如结合图28A-28B更详细地讨论的，可编程逻辑装置1660结合处理器1740可实现直接数字合成器(DDS)控制方案，以控制由发生器1100输出的驱动信号的波形形状、频率和/或幅值。在一个方面，例如，可编程逻辑装置1660可通过检索(recall)存储于动态更新的查找表(LUT)(诸如可嵌入在FPGA中的RAM LUT)中的波形样本来实现DDS控制算法2680(图28A)。该控制算法尤其可用于如下超声应用，其中超声换能器诸如超声换能器1120可由其谐振频率下的纯正弦式电流驱动。因为其它频率可激发寄生谐振，因此最小化或减小动态支路电流的总失真可相应地最小化或减小不利的谐振效应。因为由发生器1100输出的驱动信号的波形形状受输出驱动电路(例如，功率变压器1560、功率放大器1620)中存在的各种失真源的影响，所以基于驱动信号的电压和电流反馈数据可被输入至算法(诸如由处理器1740实现的误差控制算法)中，该算法通过适当地在动态行进的基础上(例如，实时地)使存储于LUT中的波形样本预先失真或修改来补偿失真。在一种形式中，对LUT样本所施加的预先失真量或程度可基于所计算的动态支路电流和期望的电流波形形状之间的误差而定，其中该误差可在逐一样本的基础上确定。以该方式，预先失真的LUT样本在通过驱动电路进行处理时，可使动态支路驱动信号具有所期望的波形形状(例如，正弦形状)，以最佳地驱动超声换能器。因此，在此类方面，当考虑到失真效应时，LUT波形样本将因此不表示驱动信号的期望波形形状，而是表示最终产生动态支路驱动信号的期望波形形状所需的波形形状。In certain aspects and as discussed in more detail in conjunction with FIGS. 28A-28B , the programmable logic device 1660 in conjunction with the processor 1740 may implement a direct digital synthesizer (DDS) control scheme to control the waveform shape, frequency, and/or amplitude of the drive signal output by the generator 1100. In one aspect, for example, the programmable logic device 1660 may implement a DDS control algorithm 2680 ( FIG. 28A ) by retrieving waveform samples stored in a dynamically updated lookup table (LUT), such as a RAM LUT that may be embedded in an FPGA. The control algorithm may be particularly useful in ultrasound applications where an ultrasonic transducer, such as the ultrasonic transducer 1120, may be driven by a pure sinusoidal current at its resonant frequency. Because other frequencies may excite parasitic resonances, minimizing or reducing the overall distortion of the motional branch current may correspondingly minimize or reduce adverse resonant effects. Because the waveform shape of the drive signal output by the generator 1100 is affected by various sources of distortion present in the output drive circuit (e.g., power transformer 1560, power amplifier 1620), voltage and current feedback data based on the drive signal can be input into an algorithm (such as an error control algorithm implemented by the processor 1740) that compensates for the distortion by pre-distorting or modifying the waveform samples stored in the LUT as appropriate on a dynamic and ongoing basis (e.g., in real time). In one form, the amount or degree of pre-distortion applied to the LUT samples can be based on the error between the calculated motional branch current and the desired current waveform shape, where the error can be determined on a sample-by-sample basis. In this way, the pre-distorted LUT samples, when processed by the drive circuit, can cause the motional branch drive signal to have a desired waveform shape (e.g., a sinusoidal shape) to optimally drive the ultrasonic transducer. Thus, in such aspects, when distortion effects are taken into account, the LUT waveform samples will therefore not represent the desired waveform shape of the drive signal, but rather the waveform shape required to ultimately produce the desired waveform shape of the motional branch drive signal.

非隔离级1540可进一步包括ADC 1780和ADC 1800，该ADC 1780和ADC 1800经由相应的隔离变压器1820、1840耦合到功率变压器1560的输出，以分别用于对由发生器1100输出的驱动信号的电压和电流进行采样。在某些方面，ADC 1780、1800可被配置为以高速(例如，80Msps)进行采样，以实现对驱动信号进行过采样。在一个方面，例如，ADC 1780、1800的采样速度可实现驱动信号的约200X(根据频率而定)的过采样。在某些方面，可通过经由二路式多路复用器接收输入电压信号和电流信号的单个ADC来执行ADC 1780、1800的采样操作。通过在发生器1100的方面中使用高速采样，除可实现其它事物之外，还可实现对流过动态支路的复杂电流的计算(这在某些方面可用于实现上述基于DDS的波形形状控制)、对采样信号进行精确的数字滤波、以及以高精度计算实际功耗。ADC 1780、1800所输出的电压和电流反馈数据可由可编程逻辑装置1660接收并处理(例如，FIFO缓冲、多路复用)并且被存储于数据存储器中，以供例如DSP处理器1740后续检索。如上所述，电压和电流反馈数据可用作算法的输入用于以动态行进方式使LUT波形样本预先失真或修改。在某些方面，当采集到电压和电流反馈数据对时，这可需要基于由可编程逻辑装置1660输出的对应LUT样本或以其它方式与对应LUT样本相关联，为每个所存储的电压和电流反馈数据对进行编索引。以此方式使LUT样本和电压和电流反馈数据同步有助于预失真算法的准确计时和稳定性。The non-isolated stage 1540 may further include an ADC 1780 and an ADC 1800 coupled to the output of the power transformer 1560 via respective isolation transformers 1820, 1840 for respectively sampling the voltage and current of the drive signal output by the generator 1100. In certain aspects, the ADCs 1780, 1800 may be configured to sample at a high speed (e.g., 80Msps) to enable oversampling of the drive signal. In one aspect, for example, the sampling speed of the ADCs 1780, 1800 may enable oversampling of the drive signal by approximately 200X (depending on the frequency). In certain aspects, the sampling operation of the ADCs 1780, 1800 may be performed by a single ADC that receives the input voltage signal and the current signal via a two-way multiplexer. By using high speed sampling in aspects of the generator 1100, among other things, calculations of complex currents flowing through the motional branches (which in some aspects can be used to implement the DDS-based waveform shape control described above), accurate digital filtering of the sampled signals, and calculation of actual power consumption with high accuracy can be achieved. The voltage and current feedback data output by the ADCs 1780, 1800 can be received and processed (e.g., FIFO buffering, multiplexing) by the programmable logic device 1660 and stored in a data memory for subsequent retrieval by, for example, the DSP processor 1740. As described above, the voltage and current feedback data can be used as input to an algorithm for pre-distorting or modifying LUT waveform samples in a dynamic and ongoing manner. In some aspects, when voltage and current feedback data pairs are acquired, this may require indexing each stored voltage and current feedback data pair based on or otherwise associated with a corresponding LUT sample output by the programmable logic device 1660. Synchronizing the LUT samples and the voltage and current feedback data in this manner facilitates accurate timing and stability of the pre-distortion algorithm.

在某些方面，可使用电压和电流反馈数据来控制驱动信号的频率和/或幅值(例如，电流幅值)。在一个方面，例如，可使用电压和电流反馈数据来确定阻抗相位，例如电压和电流驱动信号之间的相位差。然后，可控制驱动信号的频率以最小化或减小所确定阻抗相位和阻抗相位设定点(例如，0°)之间的差值，从而最小化或减小谐波失真的影响，并且相应地提高阻抗相位测量精确度。相位阻抗和频率控制信号的确定可在处理器1740中实现，例如，其中频率控制信号作为输入被供应至由可编程逻辑装置1660实现的DDS控制算法。In certain aspects, the voltage and current feedback data may be used to control the frequency and/or amplitude (e.g., current amplitude) of the drive signal. In one aspect, for example, the voltage and current feedback data may be used to determine the impedance phase, such as the phase difference between the voltage and current drive signals. The frequency of the drive signal may then be controlled to minimize or reduce the difference between the determined impedance phase and the impedance phase set point (e.g., 0°), thereby minimizing or reducing the effects of harmonic distortion and correspondingly improving the impedance phase measurement accuracy. The determination of the phase impedance and frequency control signal may be implemented in the processor 1740, for example, where the frequency control signal is supplied as an input to a DDS control algorithm implemented by the programmable logic device 1660.

阻抗相位可通过傅立叶分析来确定。在一个方面，可使用如下的快速傅里叶变换(FFT)或离散傅里叶变换(DFT)来确定发生器电压V_g(t)驱动信号和发生器电流I_g(t)驱动信号之间的相位差：The impedance phase can be determined by Fourier analysis. In one aspect, the phase difference between the generator voltage V_g (t) drive signal and the generator current I_g (t) drive signal can be determined using a Fast Fourier Transform (FFT) or Discrete Fourier Transform (DFT) as follows:

在正弦频率下评估傅立叶变换得到：Evaluating the Fourier transform at sinusoidal frequencies yields:

其它方法包括加权最小二乘估计、卡尔曼滤波和基于空间矢量的技术。例如，FFT或DFT技术中的几乎所有处理可在数字域中在例如2信道高速ADC 1780、1800的辅助下执行。在一种技术中，电压信号和电流信号的数字信号样本是用FFT或DFT傅里叶变换的。可通过以下公式计算任何时间点处的相位角Other methods include weighted least squares estimation, Kalman filtering, and space vector based techniques. For example, almost all of the processing in the FFT or DFT techniques can be performed in the digital domain with the assistance of, for example, a 2-channel high speed ADC 1780, 1800. In one technique, digital signal samples of the voltage signal and the current signal are Fourier transformed using an FFT or DFT. The phase angle at any point in time can be calculated by the following formula

其中为相位角，f为频率，t为时间，并且为在t＝0处的相位。in is the phase angle, f is the frequency, t is the time, and is the phase at t=0.

用于确定电压V_g(t)信号和电流I_g(t)信号之间的相位差的另一技术为零点交叉方法并且产生非常精确的结果。对于具有相同频率的电压V_g(t)信号和电流I_g(t)信号，电压信号V_g(t)的每个负到正零点交叉触发脉冲的开始，而电流信号I_g(t)的每个负到正零点交叉触发脉冲的结束。其结果是脉冲串具有与电压信号和电流信号之间的相位角成比例的脉冲宽度。在一个方面，脉冲串可通过平均滤波器以得到相位差的测量值。此外，如果正到负零点交叉也以类似的方式使用，并且结果取平均值，则可减小DC和谐波分量的任何效果。在一个具体实施中，该模拟电压V_g(t)信号和电流I_g(t)信号被转换为数字信号，在模拟信号为正的情况下该数字信号为高的，并且在模拟信号为负的情况下该数字信号为低的。高精度相位估计需要在高值和低值之间进行急剧转变。在一个方面，可采用Schmitt触发器以及RC稳定化网络将模拟信号转换为数字信号。在其它方面，可采用边缘触发RS触发器(flip-flop)和辅助电路。在又一方面，零点交叉技术可采用异或(XOR)门。Another technique for determining the phase difference between the voltage V_g (t) signal and the current I_g (t) signal is the zero crossing method and produces very accurate results. For a voltage V_g (t) signal and a current I_g (t) signal having the same frequency, each negative to positive zero crossing of the voltage signal V_g (t) triggers the beginning of a pulse, while each negative to positive zero crossing of the current signal I_g (t) triggers the end of a pulse. The result is a pulse train having a pulse width proportional to the phase angle between the voltage signal and the current signal. In one aspect, the pulse train can be passed through an averaging filter to obtain a measurement of the phase difference. In addition, if positive to negative zero crossings are also used in a similar manner and the results are averaged, any effects of DC and harmonic components can be reduced. In a specific implementation, the analog voltage V_g (t) signal and the current I_g (t) signal are converted to digital signals, which are high when the analog signal is positive and low when the analog signal is negative. High-precision phase estimation requires sharp transitions between high and low values. In one aspect, a Schmitt trigger and an RC stabilization network may be used to convert an analog signal into a digital signal. In other aspects, an edge-triggered RS flip-flop and auxiliary circuits may be used. In yet another aspect, the zero-crossing technique may use an exclusive-OR (XOR) gate.

用于确定电压信号和电流信号之间的相位差的其它技术包括Lissajous图和对图像的监测；方法，诸如三伏特计法、交叉线圈法、矢量伏特计和矢量阻抗法；以及使用相位标准器械、锁相环路、以及如Peter O’Shea、2000CRC出版有限公司<http://www.engnetbase.com>的“相位测量”(Peter O’Shea,2000CRC Press LLC,<http://www.engnetbase.com>)，该文献以引用方式并入本文。Other techniques for determining the phase difference between the voltage signal and the current signal include Lissajous plots and monitoring of images; methods such as the three-voltmeter method, the cross-coil method, the vector voltmeter, and the vector impedance method; and the use of phase standard instruments, phase-locked loops, and "Phase Measurement" by Peter O'Shea, 2000 CRC Press LLC, <http://www.engnetbase.com>, which is incorporated herein by reference.

在另一方面，例如，可监测电流反馈数据，以便将驱动信号的电流幅值保持在电流幅值设定点。电流幅值设定点可被直接指定或基于特定的电压幅值和功率设定点而间接地确定。在某些方面，可通过处理器1740中的控制算法(诸如例如，比例积分微分(PID)控制算法)来实现对电流幅值的控制。控制算法为了适当控制驱动信号的电流幅值而控制的变量可包括例如存储在可编程逻辑装置1660中的LUT波形样本的定标和/或经由DAC 1860的DAC1680(其为功率放大器1620供应输入)的全标度输出电压。In another aspect, for example, current feedback data may be monitored to maintain the current amplitude of the drive signal at a current amplitude set point. The current amplitude set point may be specified directly or determined indirectly based on a particular voltage amplitude and power set point. In certain aspects, control of the current amplitude may be achieved by a control algorithm in the processor 1740, such as, for example, a proportional integral derivative (PID) control algorithm. The variables controlled by the control algorithm to properly control the current amplitude of the drive signal may include, for example, scaling of LUT waveform samples stored in the programmable logic device 1660 and/or a full-scale output voltage of a DAC 1680 (which supplies an input to the power amplifier 1620) via a DAC 1860.

非隔离级1540可进一步包括处理器1900以用于除别的之外还提供用户界面(UI)功能。在一个方面，处理器1900可包括例如购自加利福尼亚州圣何塞的阿特梅尔公司(Atmel Corporation,San Jose,Calif.)的具有ARM 926EJ-S核心的Atmel AT91SAM9263处理器。处理器1900所支持的UI功能的示例可包括听觉和视觉用户反馈、与外围装置(例如，经由通用串行总线(USB)接口)的通信、与脚踏开关1430的通信、与输入装置2150(例如，触摸屏显示器)的通信、以及与输出装置2140(例如，扬声器)的通信。处理器1900可与处理器1740和可编程逻辑装置(例如，经由串行外围接口(SPI)总线)通信。尽管处理器1900可主要支持UI功能，然而在某些方面，其也可与处理器1740配合以实现风险减缓。例如，处理器1900可被编程用于监测用户输入和/或其它输入(例如，触摸屏输入2150、脚踏开关1430输入、温度传感器输入2160)的各个方面，并且当检测到错误条件时停用发生器1100的驱动输出。The non-isolated stage 1540 may further include a processor 1900 for providing, among other things, user interface (UI) functions. In one aspect, the processor 1900 may include, for example, an Atmel AT91SAM9263 processor with an ARM 926EJ-S core purchased from Atmel Corporation, San Jose, Calif. Examples of UI functions supported by the processor 1900 may include audible and visual user feedback, communication with peripheral devices (e.g., via a universal serial bus (USB) interface), communication with a foot switch 1430, communication with an input device 2150 (e.g., a touch screen display), and communication with an output device 2140 (e.g., a speaker). The processor 1900 may communicate with the processor 1740 and a programmable logic device (e.g., via a serial peripheral interface (SPI) bus). Although the processor 1900 may primarily support UI functions, in some aspects, it may also cooperate with the processor 1740 to achieve risk mitigation. For example, the processor 1900 may be programmed to monitor various aspects of user input and/or other inputs (e.g., touch screen input 2150, foot switch 1430 input, temperature sensor input 2160) and disable the drive output of the generator 1100 when an error condition is detected.

在某些方面，处理器1740(图26、图27A)和处理器1900(图26、图27B)可确定并监测发生器1100的操作状态。对于处理器1740，发生器1100的操作状态例如可指示处理器1740实现的是哪些控制和/或诊断过程。对于处理器1900，发生器1100的操作状态例如可指示用户界面的哪些元素(例如，显示屏、声音)被呈现给用户。处理器1740、1900可独立地保持发生器1100的当前操作状态并识别和评估当前操作状态的可能转变。处理器1740可用作该关系中的主体并确定何时会发生操作状态间的转变。处理器1900可注意到操作状态间的有效转变并可证实特定的转变是否适当。例如，当处理器1740指示处理器1900转变到特定状态时，处理器1900可验证所请求的转变是有效的。在处理器1900确定所请求的状态间转变是无效的情况下，处理器1900可使发生器1100进入失效模式。In certain aspects, the processor 1740 (FIG. 26, FIG. 27A) and the processor 1900 (FIG. 26, FIG. 27B) may determine and monitor the operating state of the generator 1100. For the processor 1740, the operating state of the generator 1100 may indicate, for example, which control and/or diagnostic processes are implemented by the processor 1740. For the processor 1900, the operating state of the generator 1100 may indicate, for example, which elements of the user interface (e.g., display screen, sound) are presented to the user. The processors 1740 and 1900 may independently maintain the current operating state of the generator 1100 and identify and evaluate possible transitions of the current operating state. The processor 1740 may serve as the subject in this relationship and determine when a transition between operating states will occur. The processor 1900 may notice valid transitions between operating states and may verify whether a particular transition is appropriate. For example, when the processor 1740 instructs the processor 1900 to transition to a particular state, the processor 1900 may verify that the requested transition is valid. In the event that the processor 1900 determines that the requested inter-state transition is invalid, the processor 1900 may cause the generator 1100 to enter a failure mode.

非隔离级1540可进一步包括控制器1960(图26、图27B)，以用于监测输入装置2150(例如，用于接通和断开发生器1100的电容式触摸传感器、电容式触摸屏)。在某些方面，控制器1960可包括与处理器1900通信的至少一个处理器和/或其它控制器装置。在一个方面，例如，控制器1960可包括处理器(例如，可从Atmel公司(Atemel)购得的Mega168 8位控制器)，该处理器被配置为监测经由一个或多个电容式触摸传感器提供的用户输入。在一个方面，控制器1960可包括触摸屏控制器(例如，可从Atmel公司(Atemel)购得的QT5480触摸屏控制器)，以控制和管理从电容式触摸屏对触摸数据的采集。The non-isolated stage 1540 may further include a controller 1960 (FIG. 26, FIG. 27B) for monitoring an input device 2150 (e.g., a capacitive touch sensor, a capacitive touch screen for turning the generator 1100 on and off). In certain aspects, the controller 1960 may include at least one processor and/or other controller device in communication with the processor 1900. In one aspect, for example, the controller 1960 may include a processor (e.g., a Mega168 8-bit controller available from Atmel) configured to monitor user input provided via one or more capacitive touch sensors. In one aspect, the controller 1960 may include a touch screen controller (e.g., a QT5480 touch screen controller available from Atmel) to control and manage the collection of touch data from the capacitive touch screen.

在某些方面，当发生器1100处于“功率关”状态时，控制器1960可继续接收操作功率(例如，经由来自发生器1100的功率源(诸如以下讨论的功率源2110(图26))的管线)。以此方式，控制器1960可继续监测输入装置2150(例如，位于发生器1100的前面板上的电容式触摸传感器)，以用于接通和断开发生器1100。当发生器1100处于“功率关”状态时，如果检测到用户“接通/断开”输入装置2150的激活，则控制器1960可唤醒功率源(例如，启用功率源2110的一个或多个DC/DC电压转换器2130(图26)的操作)。因此控制器1960可开始使发生器1100转变到“功率开”状态的序列。相反，当发生器1100处于“功率开”状态时，如果检测到“接通/断开”输入装置2150的激活，则控制器1960可开始使发生器1100转变到“功率关”状态的序列。在某些方面，例如，控制器1960可向处理器1900报告“接通/断开”输入装置2150的激活，处理器1900继而实现所需的过程序列以使发生器1100转变到“功率关”状态。在此类方面，控制器1960可不具有在已建立起“功率关”状态之后从发生器1100移除功率的独立能力。In certain aspects, when the generator 1100 is in the “power off” state, the controller 1960 may continue to receive operating power (e.g., via a line from a power source of the generator 1100, such as the power source 2110 ( FIG. 26 ) discussed below). In this manner, the controller 1960 may continue to monitor the input device 2150 (e.g., a capacitive touch sensor located on the front panel of the generator 1100) for turning the generator 1100 on and off. When the generator 1100 is in the “power off” state, if activation of the user “on/off” input device 2150 is detected, the controller 1960 may wake up the power source (e.g., enable operation of one or more DC/DC voltage converters 2130 ( FIG. 26 ) of the power source 2110). The controller 1960 may thus begin a sequence to transition the generator 1100 to the “power on” state. Conversely, when the generator 1100 is in the "power on" state, if activation of the "on/off" input device 2150 is detected, the controller 1960 may begin a sequence to transition the generator 1100 to the "power off" state. In certain aspects, for example, the controller 1960 may report the activation of the "on/off" input device 2150 to the processor 1900, which in turn implements the required sequence of processes to transition the generator 1100 to the "power off" state. In such aspects, the controller 1960 may not have an independent ability to remove power from the generator 1100 after the "power off" state has been established.

在某些方面，控制器1960可使发生器1100提供听觉或其它感观反馈，以用于警示用户“功率开”或“功率关”序列已开始。可在“功率开”或“功率关”序列开始时以及在与该序列相关联的其它过程开始之前提供此警示。In certain aspects, the controller 1960 can cause the generator 1100 to provide audible or other sensory feedback to alert the user that a "power on" or "power off" sequence has begun. This alert can be provided when a "power on" or "power off" sequence begins and before other processes associated with the sequence begin.

在某些方面，隔离级1520可包括器械接口电路1980，以例如在外科装置的控制电路(例如，包括手持件开关的控制电路)和非隔离级1540的部件(诸如例如，可编程逻辑装置1660、处理器1740、和/或处理器1900)之间提供通信接口。器械接口电路1980可经由保持级1520、1540之间的合适的电隔离程度的通信链路(诸如例如，基于红外(IR)的通信链路)与非隔离级1540的部件交换信息。例如，可使用由隔离变压器供电的低压降电压调整器为器械接口电路1980供应功率，该低压降电压调整器从非隔离级1540被驱动。In certain aspects, the isolation stage 1520 may include an instrument interface circuit 1980 to provide, for example, a communication interface between control circuitry of a surgical device (e.g., control circuitry including a handpiece switch) and components of the non-isolated stage 1540 (such as, for example, the programmable logic device 1660, the processor 1740, and/or the processor 1900). The instrument interface circuit 1980 may exchange information with components of the non-isolated stage 1540 via a communication link (such as, for example, an infrared (IR)-based communication link) that maintains a suitable degree of electrical isolation between the stages 1520, 1540. For example, the instrument interface circuit 1980 may be powered using a low dropout voltage regulator powered by an isolation transformer that is driven from the non-isolated stage 1540.

在一个方面，器械接口电路1980可包括与信号调节电路2020(图26和图27C)通信的可编程逻辑装置2000。信号调节电路2020可被配置为从可编程逻辑装置2000接收周期性信号(例如，2kHz的方波)，以生成具有相同频率的双极询问信号。例如，可使用由差分放大器馈送的双极电流源生成询问信号。询问信号可被发送至外科装置控制电路(例如，通过使用将发生器1100连接到外科装置的缆线中的导电对)并被监测，以确定控制电路的状态或配置。例如，控制电路可包括多个开关、电阻器和/或二极管，以修改询问信号的一个或多个特征(例如，幅值、校正)，使得可基于该一个或多个特征唯一地辨别控制电路的状态或配置。在一个方面，例如，信号调节电路2020可包括ADC，以用于生成由于询问信号通过控制电路而出现在控制电路的输入中的电压信号的样本。然后，可编程逻辑装置2000(或非隔离级1540的部件)可基于ADC样本来确定控制电路的状态或配置。In one aspect, the instrument interface circuit 1980 may include a programmable logic device 2000 in communication with a signal conditioning circuit 2020 (FIGS. 26 and 27C). The signal conditioning circuit 2020 may be configured to receive a periodic signal (e.g., a 2 kHz square wave) from the programmable logic device 2000 to generate a bipolar interrogation signal having the same frequency. For example, the interrogation signal may be generated using a bipolar current source fed by a differential amplifier. The interrogation signal may be sent to a surgical device control circuit (e.g., by using a conductive pair in a cable connecting the generator 1100 to the surgical device) and monitored to determine the state or configuration of the control circuit. For example, the control circuit may include a plurality of switches, resistors, and/or diodes to modify one or more characteristics of the interrogation signal (e.g., amplitude, correction) so that the state or configuration of the control circuit can be uniquely discerned based on the one or more characteristics. In one aspect, for example, the signal conditioning circuit 2020 may include an ADC for generating a sample of a voltage signal that appears at the input of the control circuit as a result of the interrogation signal passing through the control circuit. The programmable logic device 2000 (or a component of the non-isolated stage 1540 ) may then determine the state or configuration of the control circuit based on the ADC samples.

在一个方面，器械接口电路1980可包括第一数据电路接口2040，以实现可编程逻辑装置2000(或器械接口电路1980的其它元件)和设置于外科装置中的或以其它方式与外科装置相关联的第一数据电路之间的信息交换。在某些方面，例如，第一数据电路2060可设置于整体地附接到外科装置手持件的缆线中，或设置于用于使特定的外科装置类型或模型与发生器1100交接的适配器。在某些方面，第一数据电路可包括非易失性存储装置，诸如电可擦除可编程只读存储器(EEPROM)装置。在某些方面并且再次参见图26，第一数据电路接口2040可与可编程逻辑装置2000分开地实现，并且包括合适的电路系统(例如，离散的逻辑装置、处理器)，以实现可编程逻辑装置2000和第一数据电路之间的通信。在其它方面，第一数据电路接口2040可与逻辑装置2000成为整体。In one aspect, the instrument interface circuit 1980 may include a first data circuit interface 2040 to enable information exchange between the programmable logic device 2000 (or other elements of the instrument interface circuit 1980) and a first data circuit disposed in or otherwise associated with the surgical device. In certain aspects, for example, the first data circuit 2060 may be disposed in a cable integrally attached to a surgical device handpiece, or in an adapter for interfacing a specific surgical device type or model with the generator 1100. In certain aspects, the first data circuit may include a non-volatile storage device, such as an electrically erasable programmable read-only memory (EEPROM) device. In certain aspects and again referring to FIG. 26, the first data circuit interface 2040 may be implemented separately from the programmable logic device 2000 and include suitable circuitry (e.g., discrete logic devices, processors) to enable communication between the programmable logic device 2000 and the first data circuit. In other aspects, the first data circuit interface 2040 may be integral with the logic device 2000.

在某些方面，第一数据电路2060可存储与相关联的特定外科装置相关联的信息。此类信息可包括例如型号、序列号、其中已使用外科装置的多个操作、和/或任何其它类型的信息。该信息可被器械接口电路1980(例如，通过可编程逻辑装置2000)读取、被传输至非隔离级1540的部件(例如，至可编程逻辑装置1660、处理器1740和/或处理器1900)，以经由输出装置2140呈现给用户并且/或者控制发生器1100的功能或操作。另外，任何类型的信息均可经由第一数据电路接口2040(例如，使用可编程逻辑装置2000)被发送至第一数据电路2060以存储于其中。此类信息例如可包括其中使用外科装置的操作的更新数目和/或其使用的日期和/或时间。In certain aspects, the first data circuit 2060 may store information associated with an associated particular surgical device. Such information may include, for example, a model number, a serial number, a number of operations in which the surgical device has been used, and/or any other type of information. This information may be read by the instrument interface circuit 1980 (e.g., via the programmable logic device 2000), transmitted to components of the non-isolated stage 1540 (e.g., to the programmable logic device 1660, the processor 1740, and/or the processor 1900) for presentation to a user via the output device 2140 and/or to control the function or operation of the generator 1100. In addition, any type of information may be sent to the first data circuit 2060 via the first data circuit interface 2040 (e.g., using the programmable logic device 2000) for storage therein. Such information may include, for example, an updated number of operations in which the surgical device has been used and/or the date and/or time of its use.

如在前所讨论，外科器械可从手持件拆卸(例如，器械1106可从手持件1107拆卸)以促进器械可互换性和/或处置性。在此类情形中，已知发生器的识别所使用特定器械配置和相应地优化控制和诊断过程的能力可受限。然而，从兼容性角度来看，通过对外科装置器械添加可读数据电路来解决此问题是有问题的。例如，设计外科装置来保持与缺少必备数据读取功能的发生器的向后兼容可由于例如不同的信号方案、设计复杂性和成本而不切实际。器械的其它方面通过使用数据电路来解决这些问题，该数据电路可经济地实现于现有外科器械中并具有最小的设计变化，以保持外科装置与当前发生器平台的兼容性。As previously discussed, surgical instruments may be detachable from handpieces (e.g., instrument 1106 may be detachable from handpiece 1107) to facilitate instrument interchangeability and/or disposability. In such cases, it is known that the ability of a generator to identify the particular instrument configuration being used and to optimize control and diagnostic processes accordingly may be limited. However, addressing this issue by adding readable data circuits to surgical device instruments is problematic from a compatibility perspective. For example, designing a surgical device to maintain backward compatibility with a generator that lacks the requisite data reading functionality may be impractical due to, for example, different signal schemes, design complexity, and cost. Other aspects of the instrument address these issues by using data circuits that can be economically implemented in existing surgical instruments with minimal design changes to maintain compatibility of the surgical device with current generator platforms.

另外，发生器1100的方面可实现与基于器械的数据电路的通信。例如，发生器1100可被配置为与外科装置的器械(例如，器械1104、1106或1108)中所包含的第二数据电路进行通信。器械接口电路1980可包括用于实现该通信的第二数据电路接口2100。在一个方面，第二数据电路接口2100可包括三态数字接口，然而也可使用其它接口。在某些方面，第二数据电路通常可为用于传输和/或接收数据的任何电路。在一个方面，第二数据电路可存储与相关联的特定外科器械相关联的信息。此类信息可包括例如型号、序列号、其中已使用外科器械的多个操作、和/或任何其它类型的信息。附加地或另选地，任何类型的信息均可经由第二数据电路接口2100(例如，使用可编程逻辑装置2000)被发送至第二数据电路以存储于其中。此类信息例如可包括其中使用外科器械的操作的更新数目和/或其使用的日期和/或时间。在某些方面，第二数据电路可传输由一个或多个传感器(例如，基于器械的温度传感器)采集的数据。在某些方面，第二数据电路可从发生器1100接收数据并基于所接收的数据向用户提供指示(例如，LED指示或其它可视指示)。In addition, aspects of the generator 1100 can enable communication with instrument-based data circuits. For example, the generator 1100 can be configured to communicate with a second data circuit included in an instrument (e.g., instrument 1104, 1106, or 1108) of a surgical device. The instrument interface circuit 1980 may include a second data circuit interface 2100 for enabling such communication. In one aspect, the second data circuit interface 2100 may include a tri-state digital interface, however other interfaces may also be used. In certain aspects, the second data circuit may generally be any circuit for transmitting and/or receiving data. In one aspect, the second data circuit may store information associated with an associated specific surgical instrument. Such information may include, for example, a model number, a serial number, a number of operations in which the surgical instrument has been used, and/or any other type of information. Additionally or alternatively, any type of information may be sent to the second data circuit via the second data circuit interface 2100 (e.g., using the programmable logic device 2000) for storage therein. Such information may, for example, include an updated number of operations in which the surgical instrument is used and/or the date and/or time of its use. In certain aspects, the second data circuit can transmit data acquired by one or more sensors (e.g., an instrument-based temperature sensor). In certain aspects, the second data circuit can receive data from the generator 1100 and provide an indication to the user (e.g., an LED indication or other visual indication) based on the received data.

在某些方面，第二数据电路和第二数据电路接口2100可被配置为使得可达成可编程逻辑装置2000和第二数据电路之间的通信而无需为此提供附加的导体(例如，将手持件连接至发生器1100的缆线的专用导体)。在一个方面，例如，可使用实施于现有缆线上的单总线通信方案(诸如用于将询问信号从信号调节电路2020传输到手持件中的控制电路的导体中的一者)而将信息传输至第二数据电路并从第二数据电路传输信息。以此方式，可最小化或减少原本可能必要的外科装置的设计变化或修改。此外，因为可在共用物理信道(具有频带分离或不具有频带分离)上实现不同类型的通信，所以第二数据电路的存在对于不具有必备数据读取功能的发生器而言可为“隐形的”，因此能够实现外科装置器械的向后兼容性。In certain aspects, the second data circuit and the second data circuit interface 2100 may be configured such that communication between the programmable logic device 2000 and the second data circuit may be achieved without providing additional conductors for this purpose (e.g., dedicated conductors of a cable connecting the hand piece to the generator 1100). In one aspect, for example, information may be transmitted to and from the second data circuit using a single bus communication scheme implemented on an existing cable (such as one of the conductors used to transmit an interrogation signal from the signal conditioning circuit 2020 to the control circuit in the hand piece). In this manner, design changes or modifications to the surgical device that may otherwise be necessary may be minimized or reduced. Furthermore, because different types of communications may be achieved on a common physical channel (with or without frequency band separation), the presence of the second data circuit may be "invisible" to a generator that does not have the requisite data reading functionality, thereby enabling backward compatibility of surgical device instruments.

在某些方面，隔离级1520可包括至少一个阻挡电容器2960-1(图27C)，该至少一个阻挡电容器2096-1连接到驱动信号输出件1600b以防止DC电流流向患者。例如，可要求信号阻挡电容器符合医疗规则或标准。尽管相对而言单电容器设计中很少出现失效，然而此类失效可具有负面后果。在一个方面，可设置有与阻挡电容器2960-1串联的第二阻挡电容器2960-2，其中通过例如ADC 2980来检测从阻挡电容器2960-1、2960-2之间的点发生的电流泄漏，以用于对泄漏电流所感应的电压进行采样。该样本例如可由可编程逻辑装置2000接收。基于泄漏电流的变化(如图26的方面中的电压样本所指示)，发生器1100可确定阻挡电容器2960-1、2960-2中的至少一者何时失效。因此，图26的方面相对于具有单个失效点的单个电容器设计具有益处。In certain aspects, the isolation stage 1520 may include at least one blocking capacitor 2960-1 (FIG. 27C) connected to the drive signal output 1600b to prevent DC current from flowing to the patient. For example, the signal blocking capacitor may be required to comply with medical regulations or standards. Although failures are relatively rare in single capacitor designs, such failures may have negative consequences. In one aspect, a second blocking capacitor 2960-2 may be provided in series with the blocking capacitor 2960-1, wherein current leakage from a point between the blocking capacitors 2960-1 and 2960-2 is detected by, for example, an ADC 2980 for sampling a voltage induced by the leakage current. The sample may be received, for example, by the programmable logic device 2000. Based on changes in the leakage current (as indicated by the voltage sample in the aspect of FIG. 26), the generator 1100 may determine when at least one of the blocking capacitors 2960-1 and 2960-2 fails. Therefore, the aspect of FIG. 26 has benefits relative to a single capacitor design with a single failure point.

在某些方面，非隔离级1540可包括功率源2110，以用于在适当的电压和电流下输出DC功率。功率源可包括例如400W的功率源用于输出48VDC的系统电压。如上所述，功率源2110可进一步包括一个或多个DC/DC电压转换器2130，以用于接收功率源的输出，以在发生器1100的各种部件所需的电压和电流下产生DC输出。如以上结合控制器1960所述，当控制器1960检测到用户激活“接通/断开”输入装置2150以启用DC/DC电压转换器2130的操作或唤醒DC/DC电压转换器2130时，DC/DC电压转换器2130中的一个或多个可从控制器1960接收输入。In certain aspects, the non-isolated stage 1540 may include a power source 2110 for outputting DC power at an appropriate voltage and current. The power source may include, for example, a 400W power source for outputting a system voltage of 48VDC. As described above, the power source 2110 may further include one or more DC/DC voltage converters 2130 for receiving the output of the power source to generate a DC output at the voltage and current required by the various components of the generator 1100. As described above in conjunction with the controller 1960, when the controller 1960 detects that the user activates the "on/off" input device 2150 to enable operation of the DC/DC voltage converter 2130 or wake up the DC/DC voltage converter 2130, one or more of the DC/DC voltage converters 2130 may receive input from the controller 1960.

图28A-28B示出了发生器1100的一个方面的某些功能和结构方面。指示来自功率变压器1560的二次绕组1580的电流和电压输出的反馈分别由ADC 1780、1800接收。如图所示，ADC 1780、1800可被实现为2信道ADC，并且可高速(例如，80Msps)对反馈信号进行采样以允许对驱动信号进行过采样(例如，大约200x过采样)。在由ADC 1780、1800处理之前，电流反馈信号和电压反馈信号可在模拟域中适当调节(例如，放大、滤波)。来自ADC 1780、1800的电流和电压反馈样本可被单独缓冲，并且随后被多路复用或交插到可编程逻辑装置1660的块2120内的单个数据流中。在图28A-28B的方面，可编程逻辑装置1660包括FPGA。28A-28B illustrate certain functional and structural aspects of one aspect of the generator 1100. Feedback indicating the current and voltage outputs of the secondary winding 1580 from the power transformer 1560 is received by the ADCs 1780, 1800, respectively. As shown, the ADCs 1780, 1800 may be implemented as 2-channel ADCs, and the feedback signals may be sampled at high speeds (e.g., 80Msps) to allow oversampling of the drive signals (e.g., approximately 200x oversampling). The current feedback signals and the voltage feedback signals may be appropriately conditioned (e.g., amplified, filtered) in the analog domain prior to processing by the ADCs 1780, 1800. The current and voltage feedback samples from the ADCs 1780, 1800 may be buffered separately and then multiplexed or interleaved into a single data stream within the block 2120 of the programmable logic device 1660. In the aspects of FIGS. 28A-28B, the programmable logic device 1660 comprises an FPGA.

多路复用电流和电压反馈样本可由实现在处理器1740的块2144内的并行数据采集端口(PDAP)来接收。PDAP可包括用于实现用于将多路复用反馈样本与存储器地址相关联的多种方法中的任一种的封装单元。在一个方面，例如，对应于由可编程逻辑装置1660输出的特定LUT样本的反馈样本可存储在与LUT样本的LUT地址相关或建立索引的一个或多个存储器地址处。在另一方面，对应于由可编程逻辑装置1660输出的特定LUT样本的反馈样本可与LUT样本的LUT地址一起存储在公共存储器位置处。在任何情况下，反馈样本可被存储为使得可随后确定源自其的特定反馈样本集合的LUT样本的地址。如上所述，以该方式同步LUT样本地址和反馈样本有助于预失真算法的正确定时和稳定性。处理器1740的块2166处实现的直接存储器访问(DMA)控制器可在处理器1740的指定存储器位置2180(例如，内部RAM)处存储反馈样本(以及在适用的情况下存储任何LUT样本地址数据)。The multiplexed current and voltage feedback samples may be received by a parallel data acquisition port (PDAP) implemented within block 2144 of the processor 1740. The PDAP may include a packaging unit for implementing any of a variety of methods for associating multiplexed feedback samples with memory addresses. In one aspect, for example, feedback samples corresponding to a particular LUT sample output by the programmable logic device 1660 may be stored at one or more memory addresses associated with or indexed to the LUT address of the LUT sample. On the other hand, feedback samples corresponding to a particular LUT sample output by the programmable logic device 1660 may be stored at a common memory location together with the LUT address of the LUT sample. In any case, the feedback samples may be stored so that the address of the LUT sample of a particular set of feedback samples derived therefrom can be subsequently determined. As described above, synchronizing the LUT sample addresses and feedback samples in this manner facilitates the correct timing and stability of the pre-distortion algorithm. A direct memory access (DMA) controller implemented at block 2166 of the processor 1740 may store the feedback samples (and any LUT sample address data, if applicable) at a designated memory location 2180 (eg, internal RAM) of the processor 1740 .

处理器1740的块2200可实现预失真算法，以用于在动态行进的基础上预失真或修改存储在可编程逻辑装置1660中的LUT样本。如上所述，LUT样本的预失真可补偿发生器1100的输出驱动电路中存在的各种失真源。预失真的LUT样本在通过驱动电路进行处理时，将因此使驱动信号具有所期望的波形形状(例如，正弦形状)，以最佳地驱动超声换能器。Block 2200 of the processor 1740 may implement a predistortion algorithm for predistorting or modifying the LUT samples stored in the programmable logic device 1660 on a dynamic, ongoing basis. As described above, predistortion of the LUT samples may compensate for various sources of distortion present in the output drive circuit of the generator 1100. The predistorted LUT samples, when processed by the drive circuit, will thus cause the drive signal to have a desired waveform shape (e.g., a sinusoidal shape) to optimally drive the ultrasonic transducer.

在预失真算法的块2220处，确定通过超声换能器的动态支路的电流。可基于例如存储在存储器位置2180处的电流和电压反馈样本(其在适当定标时可表示上文所讨论的图25的模型中的I_g和V_g)、超声换能器静态电容C₀的值、以及驱动频率的已知值，使用基尔霍夫电流定律来确定动态支路电流。可确定与LUT样本相关联的每组所存储的电流和电压反馈样本的动态支路电流样本。At block 2220 of the predistortion algorithm, the current through the motional branch of the ultrasonic transducer is determined. The motional branch current may be determined using Kirchhoff's current law based on, for example, the current and voltage feedback samples stored at memory location 2180 (which, when properly scaled, may represent_Ig and_Vg in the model of FIG. 25 discussed above), the value of the ultrasonic transducer static capacitance_C0 , and the known value of the drive frequency. The motional branch current sample may be determined for each set of stored current and voltage feedback samples associated with the LUT sample.

在预失真算法的块2240处，将在块2220处确定的每个动态支路电流样本与期望的电流波形形状的样本进行比较，以确定比较的样本之间的差值或样本幅值误差。为了该确定，可例如从波形形状LUT 2260供应期望电流波形形状的样本，该波形形状LUT 2260包含期望电流波形形状的一个循环的幅值样本。用于比较的来自LUT 2260的期望电流波形形状的特定样本可由与用于比较的动态支路电流样本相关联的LUT样本地址来决定。因此，运动支路电流对块2240的输入可与其相关联的LUT样本地址的输入同步到块2240。因此，存储在可编程逻辑装置1660中的LUT样本和存储在波形形状LUT 2260中的LUT样本的数量可相等。在某些方面，由存储在波形形状LUT2260中的LUT样本表示的期望电流波形形状可为基本正弦波。其它波形形状可为期望的。例如，可以设想可使用用于驱动在其它频率下与一个或多个其它驱动信号叠加的超声换能器的主纵向运动的基本正弦波，诸如用于驱动用于横向或其它模式的有利振动的至少两个机械谐振的三阶谐波。At block 2240 of the predistortion algorithm, each motional branch current sample determined at block 2220 is compared with a sample of the desired current waveform shape to determine the difference or sample amplitude error between the compared samples. For this determination, a sample of the desired current waveform shape may be supplied, for example, from a waveform shape LUT 2260, which contains amplitude samples of one cycle of the desired current waveform shape. The specific sample of the desired current waveform shape from LUT 2260 for comparison may be determined by the LUT sample address associated with the motional branch current sample for comparison. Therefore, the input of the motional branch current to block 2240 may be synchronized to the input of the LUT sample address associated with it to block 2240. Therefore, the number of LUT samples stored in the programmable logic device 1660 and the number of LUT samples stored in the waveform shape LUT 2260 may be equal. In some aspects, the desired current waveform shape represented by the LUT samples stored in the waveform shape LUT 2260 may be a basic sine wave. Other waveform shapes may be desired. For example, it is contemplated that a fundamental sine wave for driving the primary longitudinal motion of the ultrasonic transducer may be used superimposed with one or more other drive signals at other frequencies, such as a third harmonic for driving at least two mechanical resonances for beneficial vibration in transverse or other modes.

在块2240确定的样本幅值误差的每个值连同其相关联的LUT地址的指示一起被传输到可编程逻辑装置1660的LUT(在图28A中的块2280处示出)。基于样本幅值误差的值及其相关联的地址(以及任选地，先前接收的相同LUT地址的样本幅值误差的值)，LUT 2280(或可编程逻辑装置1660的其它控制块)可预失真或修改存储在LUT地址处的LUT样本的值，使得样本幅值误差减小或最小化。应当理解，在整个LUT地址范围内以迭代方式对每个LUT样本进行此类预失真或修改将导致发生器的输出电流的波形形状匹配或适形于波形形状LUT2260的样本所表示的期望电流波形形状。Each value of the sample amplitude error determined at block 2240 is transmitted to the LUT of the programmable logic device 1660 (shown at block 2280 in FIG. 28A ) along with an indication of its associated LUT address. Based on the value of the sample amplitude error and its associated address (and optionally, the value of the sample amplitude error previously received for the same LUT address), the LUT 2280 (or other control blocks of the programmable logic device 1660) may pre-distort or modify the value of the LUT sample stored at the LUT address such that the sample amplitude error is reduced or minimized. It should be appreciated that performing such pre-distortion or modification on each LUT sample in an iterative manner over the entire LUT address range will result in the waveform shape of the output current of the generator matching or conforming to the desired current waveform shape represented by the samples of the waveform shape LUT 2260.

电流和电压幅值测量值、功率测量值和阻抗测量值可在处理器1740的块2300处基于存储在存储器位置2180处的电流和电压反馈样本来确定。在确定这些量之前，反馈样本可被适当地定标，并且在某些方面，通过合适的滤波器2320进行处理以移除由例如数据采集过程和感应的谐波分量产生的噪声。因此，滤波后的电压和电流样本可大体上表示发生器的驱动输出信号的基频。在某些方面，滤波器2320可为应用于频域的有限脉冲响应(FIR)滤波器。此类方面可使用输出驱动信号电流和电压信号的快速傅里叶变换(FFT)。在某些方面，所得频谱可用于提供附加的发生器功能。在一个方面，例如，第二阶谐波分量和/或第三阶谐波分量相对于基频分量的比率可用作诊断指示符。Current and voltage amplitude measurements, power measurements, and impedance measurements may be determined at block 2300 of the processor 1740 based on current and voltage feedback samples stored at memory location 2180. Prior to determining these quantities, the feedback samples may be appropriately scaled and, in certain aspects, processed through a suitable filter 2320 to remove noise generated by, for example, the data acquisition process and induced harmonic components. Thus, the filtered voltage and current samples may generally represent the fundamental frequency of the drive output signal of the generator. In certain aspects, the filter 2320 may be a finite impulse response (FIR) filter applied to the frequency domain. Such aspects may use a fast Fourier transform (FFT) of the output drive signal current and voltage signals. In certain aspects, the resulting spectrum may be used to provide additional generator functionality. In one aspect, for example, the ratio of the second order harmonic component and/or the third order harmonic component relative to the fundamental frequency component may be used as a diagnostic indicator.

在块2340(图28B)处，可对表示整数循环的驱动信号的一定样本大小的电流反馈样本应用均方根(RMS)计算，以生成表示驱动信号输出电流的测量值I_rms。At block 2340 ( FIG. 28B ), a root mean square (RMS) calculation may be applied to a sample size of the current feedback samples representing an integer number of cycles of the drive signal to generate a measurement value I_rms representing the drive signal output current.

在块2360处，可对表示整数循环的驱动信号的一定样本大小的电压反馈样本应用均方根(RMS)计算，以确定表示驱动信号输出电压的测量值V_rms。At block 2360 , a root mean square (RMS) calculation may be applied to a sample size of the voltage feedback samples representing an integer number of cycles of the drive signal to determine a measured value V_rms representing the drive signal output voltage.

在块2380处，可将电流和电压反馈样本进行逐点相乘，并且可对表示整数循环的驱动信号的样本进行平均计算，以确定发生器的真实输出功率的测量值P_r。At block 2380, the current and voltage feedback samples may be multiplied point-by-point, and the samples representing an integer number of cycles of the drive signal may be averaged to determine a measure of the true output power of the generator,_Pr .

在块2400处，发生器的表观输出功率的测量值P_a可被确定为乘积V_rms·I_rms。At block 2400, a measure of the apparent output power of the generator, Pa_, may be determined as the product_Vrms ·_Irms .

在块2420处，负载电阻量值的测量值Z_m可被确定为商数V_rms/I_rms。At block 2420 , a measurement of the load resistance magnitude Z_m may be determined as a quotient V_rms /I_rms .

在某些方面，在块2340、2360、2380、2400和2420处确定的量I_rms、V_rms、P_r、P_a和Z_m可被发生器1100用于实现多个控制和/或诊断过程中的任一者。在某些方面，这些量中的任一者可经由例如与发生器1100形成整体的输出装置2140或通过合适的通信接口(例如，USB接口)连接到发生器1100的输出装置2140来传送至用户。例如，各种诊断过程可包括但不限于手持件完整性、器械完整性、器械附接完整性、器械过载、接近器械过载、频率锁定失效、过电流条件、过功率条件、电压感测失效、电流感测失效、音频指示失效、视觉指示失效、短路条件、功率递送失效或阻塞电容器失效。In certain aspects, the quantities_Irms ,_Vrms ,_Pr ,_Pa , and_Zm determined at blocks 2340, 2360, 2380, 2400, and 2420 may be used by the generator 1100 to implement any of a number of control and/or diagnostic processes. In certain aspects, any of these quantities may be communicated to a user via, for example, an output device 2140 integral to the generator 1100 or connected to the generator 1100 via a suitable communication interface (e.g., a USB interface). For example, various diagnostic processes may include, but are not limited to, handpiece integrity, instrument integrity, instrument attachment integrity, instrument overload, approaching instrument overload, frequency lock failure, overcurrent condition, overpower condition, voltage sensing failure, current sensing failure, audio indication failure, visual indication failure, short circuit condition, power delivery failure, or blocking capacitor failure.

处理器1740的块2440可实现用于确定和控制由发生器1100驱动的电力负载(例如，超声换能器)的阻抗相位的相位控制算法。如上所述，通过控制驱动信号的频率以最小化或减小所确定的阻抗相位和阻抗相位设定点(例如，0°)之间的差值，可最小化或减小谐波失真的影响，并且相位测量的准确性增加。Block 2440 of the processor 1740 may implement a phase control algorithm for determining and controlling the impedance phase of an electrical load (e.g., an ultrasonic transducer) driven by the generator 1100. As described above, by controlling the frequency of the drive signal to minimize or reduce the difference between the determined impedance phase and an impedance phase set point (e.g., 0°), the effects of harmonic distortion may be minimized or reduced, and the accuracy of the phase measurement increased.

相位控制算法接收存储在存储器位置2180中的电流和电压反馈样本作为输入。在将反馈样本用于相位控制算法之前，反馈样本可被适当定标，并且在某些方面通过合适的滤波器2460(其可与滤波器2320相同)进行处理以移除例如数据采集过程和感应的谐波分量所产生的噪声。因此，滤波后的电压和电流样本可大体上表示发生器的驱动输出信号的基频。The phase control algorithm receives as input the current and voltage feedback samples stored in memory location 2180. Before being used in the phase control algorithm, the feedback samples may be appropriately scaled and processed in some aspects by a suitable filter 2460 (which may be identical to filter 2320) to remove noise generated by, for example, the data acquisition process and induced harmonic components. Thus, the filtered voltage and current samples may generally represent the fundamental frequency of the drive output signal of the generator.

在相位控制算法的块2480处，确定通过超声换能器的动态支路的电流。该确定可与上文结合预失真算法的块2220所述的确定相同。因此，对于与LUT样本相关联的每组所存储的电流和电压反馈样本，块2480的输出可为动态支路电流样本。At block 2480 of the phase control algorithm, the current through the motional branch of the ultrasonic transducer is determined. This determination may be the same as that described above in connection with block 2220 of the predistortion algorithm. Thus, for each set of stored current and voltage feedback samples associated with the LUT samples, the output of block 2480 may be a motional branch current sample.

在相位控制算法的块2500处，基于在块2480处确定的动态支路电流样本的同步输入和对应的电压反馈样本来确定阻抗相位。在某些方面，阻抗相位被确定为在波形上升沿处测量的阻抗相位和在波形的下降沿处测量的阻抗相位的平均值。At block 2500 of the phase control algorithm, an impedance phase is determined based on the synchronized input of the motional branch current samples and the corresponding voltage feedback samples determined at block 2480. In certain aspects, the impedance phase is determined as an average of an impedance phase measured at a rising edge of the waveform and an impedance phase measured at a falling edge of the waveform.

在相位控制算法的块2520处，将在块2220处确定的阻抗相位值与相位设定点2540进行比较，以确定所比较值之间的差值或相位误差。At block 2520 of the phase control algorithm, the impedance phase value determined at block 2520 is compared to a phase set point 2540 to determine the difference or phase error between the compared values.

在相位控制算法的块2560(图28A)处，基于在块2520处确定的相位误差的值和在块2420处确定的阻抗量值，确定用于控制驱动信号的频率的频率输出。频率输出的值可由块2560连续调节并传输至DDS控制块2680(下文讨论)，以便将在框2500处确定的阻抗相位保持在相位设定点处(例如，零相位误差)。在某些方面，阻抗相位可被调整至0°相位设定点。这样，任何谐波失真将围绕电压波形的波峰居中，从而增强相位阻抗确定的准确性。At block 2560 (FIG. 28A) of the phase control algorithm, a frequency output for controlling the frequency of the drive signal is determined based on the value of the phase error determined at block 2520 and the impedance magnitude determined at block 2420. The value of the frequency output may be continuously adjusted by block 2560 and transmitted to a DDS control block 2680 (discussed below) to maintain the impedance phase determined at block 2500 at a phase set point (e.g., zero phase error). In certain aspects, the impedance phase may be adjusted to a 0° phase set point. In this way, any harmonic distortion will be centered around the peaks of the voltage waveform, thereby enhancing the accuracy of the phase impedance determination.

处理器1740的块2580可实现用于调制驱动信号的电流幅值的算法，以便根据用户指定的设定点或根据由发生器1100实现的其它过程或算法所指定的要求来控制驱动信号电流、电压和功率。这些量的控制可例如通过定标LUT 2280中的LUT样本并且/或者通过经由DAC 1860调节DAC 1680(其向功率放大器1620供应输入)的全标度输出电压来实现。块2600(其在某些方面可被实现为PID控制器)可接收来自存储器位置2180的电流反馈样本(其可被适当地定标和滤波)作为输入。可将电流反馈样本与由受控变量(例如，电流、电压或功率)规定的“电流需求”I_d值进行比较，以确定驱动信号是否供应必要的电流。在驱动信号电流为控制变量的方面，电流需求I_d可由电流设定点2620A(I_sp)直接指定。例如，可将电流反馈数据的RMS值(如块2340中所确定)与用户指定的RMS电流设定点I_sp进行比较以确定适当的控制器动作。例如，如果电流反馈数据指示RMS值小于电流设定点I_sp，则DAC1680的LUT定标和/或全标度输出电压可由块2600调节，使得驱动信号电流增加。相反，当电流反馈数据指示RMS值大于电流设定点I_sp时，块2600可调节DAC 1680的LUT定标和/或全标度输出电压以降低驱动信号电流。Block 2580 of the processor 1740 may implement an algorithm for modulating the current amplitude of the drive signal so as to control the drive signal current, voltage, and power according to a user-specified set point or according to requirements specified by other processes or algorithms implemented by the generator 1100. Control of these quantities may be achieved, for example, by scaling LUT samples in the LUT 2280 and/or by adjusting the full-scale output voltage of the DAC 1680 (which supplies input to the power amplifier 1620) via the DAC 1860. Block 2600 (which may be implemented as a PID controller in certain aspects) may receive as input current feedback samples (which may be appropriately scaled and filtered) from memory location 2180. The current feedback samples may be compared to a "current demand" I_d value specified by the controlled variable (e.g., current, voltage, or power) to determine whether the drive signal is supplying the necessary current. In aspects where the drive signal current is the controlled variable, the current demand I_d may be directly specified by the current set point 2620A (I_sp ). For example, the RMS value of the current feedback data (as determined in block 2340) may be compared to the user-specified RMS current set point_Isp to determine the appropriate controller action. For example, if the current feedback data indicates that the RMS value is less than the current set point_Isp , the LUT scaling and/or full-scale output voltage of the DAC 1680 may be adjusted by block 2600 so that the drive signal current increases. Conversely, when the current feedback data indicates that the RMS value is greater than the current set point_Isp , the block 2600 may adjust the LUT scaling and/or full-scale output voltage of the DAC 1680 to reduce the drive signal current.

在驱动信号电压为控制变量的方面，电流需求I_d可例如基于保持在块2420处测量的负载阻抗量值Z_m给出的期望电压设定点2620B(V_sp)所需的电流间接指定(例如，I_d＝V_sp/Z_m)。相似地，在驱动信号功率为控制变量的方面，电流需求I_d可例如基于在块2360处测量的电压V_rms给出的期望设定点2620C(P_sp)所需的电流间接指定(例如，I_d＝P_sp/V_rms)。In aspects where the drive signal voltage is the controlled variable, the current demand I_d may be specified indirectly, for example, based on the current required to maintain a desired voltage set point 2620B (V_sp ) given by the load impedance magnitude Z_m measured at block 2420 (e.g., I_d = V_sp / Z_m ). Similarly, in aspects where the drive signal power is the controlled variable, the current demand I_d may be specified indirectly, for example, based on the current required to maintain a desired set point 2620C (P_sp ) given by the voltage V_rms measured at block 2360 (e.g., I_d = P_sp / V_rms ).

块2680(图28A)可实现DDS控制算法，以用于通过检索存储在LUT2280中的LUT样本来控制驱动信号。在某些方面，DDS控制算法可为数字控制振荡器(NCO)算法，以用于使用点(存储器位置)-跳过技术以固定时钟速率生成波形的样本。NCO算法可实现相位累加器或频率到相位转换器，其用作地址指针以用于从LUT 2280中检索LUT样本。在一个方面，相位累加器可为D步长、模量N的相位累加器，其中D是表示频率控制值的正整数，并且N是LUT 2280中的LUT样本的数量。例如，D＝1的频率控制值可使得相位累加器顺序地指向LUT 2280的每个地址，从而产生复制存储在LUT2280中的波形的波形输出。当D>1时，相位累加器可跳过LUT 2280中的地址，从而产生具有更高频率的波形输出。因此，由DDS控制算法生成的波形的频率可因此通过适当地改变频率控制值来控制。在某些方面，频率控制值可基于在块2440处实现的相位控制算法的输出来确定。块2680的输出可供应DAC 1680的输入，DAC1680继而向功率放大器1620的输入供应对应的模拟信号。Block 2680 (FIG. 28A) may implement a DDS control algorithm for controlling a drive signal by retrieving LUT samples stored in LUT 2280. In certain aspects, the DDS control algorithm may be a digitally controlled oscillator (NCO) algorithm for generating samples of a waveform at a fixed clock rate using a point (memory location)-skipping technique. The NCO algorithm may implement a phase accumulator or a frequency-to-phase converter that serves as an address pointer for retrieving LUT samples from LUT 2280. In one aspect, the phase accumulator may be a phase accumulator of D steps and modulus N, where D is a positive integer representing a frequency control value and N is the number of LUT samples in LUT 2280. For example, a frequency control value of D=1 may cause the phase accumulator to sequentially point to each address of LUT 2280, thereby generating a waveform output that replicates the waveform stored in LUT 2280. When D>1, the phase accumulator may skip addresses in LUT 2280, thereby generating a waveform output with a higher frequency. Thus, the frequency of the waveform generated by the DDS control algorithm can be controlled by appropriately changing the frequency control value. In some aspects, the frequency control value can be determined based on the output of the phase control algorithm implemented at block 2440. The output of block 2680 can supply the input of DAC 1680, which in turn supplies the corresponding analog signal to the input of power amplifier 1620.

处理器1740的块2700可实现开关模式转换器控制算法，以用于基于被放大信号的波形包络动态地调制功率放大器1620的干线电压，从而提高功率放大器1620的效率。在某些方面，波形包络的特征可通过监测功率放大器1620中包含的一个或多个信号来确定。在一个方面，例如，可通过监测根据放大信号的包络调制的漏极电压(例如，MOSFET漏极电压)的最小值来确定波形包络的特征。可例如通过耦合到漏极电压的电压最小值检测器来生成最小电压信号。最小值电压信号可由ADC 1760取样，其中输出最小值电压样本在开关模式转换器控制算法的块2720处被接收。基于最小值电压样本的值，块2740可控制由PWM发生器2760输出的PWM信号，该PWM发生器2760继而控制由开关模式调整器1700供应给功率放大器1620的干线电压。在某些方面，只要最小值电压样本的值小于输入到块2720中的最小值目标2780，则可根据由最小值电压样本表征的波形包络来调制干线电压。例如，当最小值电压样本指示低包络功率水平时，块2740可导致向功率放大器1620供应低干线电压，其中仅当最小值电压样本指示最大包络功率水平时供应全干线电压。当最小值电压样本落在最小值目标2780以下时，块2740可使得干线电压保持在适于确保功率放大器1620的正确操作的最小值。Block 2700 of processor 1740 may implement a switch-mode converter control algorithm for dynamically modulating the rail voltage of power amplifier 1620 based on the waveform envelope of the amplified signal, thereby improving the efficiency of power amplifier 1620. In some aspects, the characteristics of the waveform envelope may be determined by monitoring one or more signals included in power amplifier 1620. In one aspect, for example, the characteristics of the waveform envelope may be determined by monitoring the minimum value of the drain voltage (e.g., MOSFET drain voltage) modulated according to the envelope of the amplified signal. A minimum voltage signal may be generated, for example, by a voltage minimum detector coupled to the drain voltage. The minimum voltage signal may be sampled by ADC 1760, where the output minimum voltage sample is received at block 2720 of the switch-mode converter control algorithm. Based on the value of the minimum voltage sample, block 2740 may control a PWM signal output by PWM generator 2760, which in turn controls the rail voltage supplied to power amplifier 1620 by switch-mode regulator 1700. In certain aspects, the rail voltage may be modulated according to the waveform envelope characterized by the minimum voltage sample as long as the value of the minimum voltage sample is less than the minimum target 2780 input into block 2720. For example, when the minimum voltage sample indicates a low envelope power level, block 2740 may cause a low rail voltage to be supplied to the power amplifier 1620, wherein the full rail voltage is supplied only when the minimum voltage sample indicates a maximum envelope power level. When the minimum voltage sample falls below the minimum target 2780, block 2740 may cause the rail voltage to be maintained at a minimum value suitable for ensuring proper operation of the power amplifier 1620.

图29为根据本公开的至少一个方面的适于驱动超声换能器(诸如超声换能器1120)的电路2900的一个方面的示意图。电路2900包括模拟多路复用器2980。模拟多路复用器2980多路复用来自上游信道SCL-A、SDA-A诸如超声、电池和功率控制电路的各种信号。电流传感器2982与功率源电路的返回支路或接地支路串联耦合，以测量由功率源提供的电流。场效应晶体管(FET)温度传感器2984提供环境温度。如果主程序忽略周期性地对其维护，则脉宽调制(PWM)看门狗定时器2988自动生成系统复位。其由于软件或硬件故障而停摆或冻结时，其被设置成自动复位电路2900。应当理解，电路2900可被配置为用于驱动超声换能器或用于驱动RF电极诸如图36中所示的电路3600的RF驱动器电路，例如。因此，现在返回参考图29，电路2900可用于可互换地驱动超声换能器和RF电极两者。如果同时驱动，则滤波器电路可设置在对应的第一级电路3404(图34)中，以选择超声波形或RF波形。此类滤波技术描述于共同拥有的标题为用于组合式发生器的电路拓扑结构的技术(TECHNIQUES FORCIRCUIT TOPOLOGIES FOR COMBINED GENERATOR)的美国专利公布US-2017-0086910-A1中，其全文以引用方式并入本文。FIG. 29 is a schematic diagram of one aspect of a circuit 2900 suitable for driving an ultrasonic transducer (such as the ultrasonic transducer 1120) according to at least one aspect of the present disclosure. The circuit 2900 includes an analog multiplexer 2980. The analog multiplexer 2980 multiplexes various signals from upstream channels SCL-A, SDA-A such as ultrasound, battery, and power control circuits. A current sensor 2982 is coupled in series with the return branch or ground branch of the power source circuit to measure the current provided by the power source. A field effect transistor (FET) temperature sensor 2984 provides the ambient temperature. A pulse width modulation (PWM) watchdog timer 2988 automatically generates a system reset if the main program neglects to maintain it periodically. It is configured to automatically reset the circuit 2900 when it stalls or freezes due to a software or hardware failure. It should be understood that the circuit 2900 can be configured as an RF driver circuit for driving an ultrasonic transducer or for driving an RF electrode such as the circuit 3600 shown in FIG. 36, for example. Therefore, now returning to reference FIG. 29 , the circuit 2900 can be used to drive both the ultrasonic transducer and the RF electrode interchangeably. If driven simultaneously, a filter circuit can be provided in the corresponding first stage circuit 3404 ( FIG. 34 ) to select the ultrasonic waveform or the RF waveform. Such filtering techniques are described in the commonly owned U.S. Patent Publication US-2017-0086910-A1 entitled TECHNIQUES FORCIRCUIT TOPOLOGIES FOR COMBINED GENERATOR, which is incorporated herein by reference in its entirety.

驱动电路2986提供左超声能量输出和右超声能量输出。表示信号波形的数字信号从控制电路诸如控制电路3200(图32)提供给模拟复用器2980的SCL-A、SDA-A输入。数模转换器2990(DAC)将数字输入转换成模拟输出以驱动耦合到振荡器2994的脉宽调制(PWM)电路2992。PWM电路2992向耦合到第一晶体管输出级2998a的第一栅极驱动电路2996a提供第一信号，以驱动第一超声(LEFT)能量输出。PWM电路2992还向耦合到第二晶体管输出级2998b的第二栅极驱动电路2996b提供第二信号，以驱动第二超声(RIGHT)能量输出。电压传感器2999耦合在超声LEFT/RIGHT输出端子之间以测量输出电压。驱动电路2986、第一驱动电路2996a和第二驱动电路2996b、以及第一晶体管输出级2998a和第二晶体管输出级2998b限定第一级放大器电路。在操作中，控制电路3200(图32)采用电路诸如直接数字合成(DDS)电路4100、4200(图41和图42)生成数字波形4300(图43)。DAC 2990接收数字波形4300并将其转换为模拟波形，该模拟波形由第一级放大器电路接收和放大。The drive circuit 2986 provides a left ultrasonic energy output and a right ultrasonic energy output. A digital signal representing a signal waveform is provided to the SCL-A, SDA-A inputs of the analog multiplexer 2980 from a control circuit such as the control circuit 3200 (FIG. 32). A digital-to-analog converter 2990 (DAC) converts the digital input into an analog output to drive a pulse width modulation (PWM) circuit 2992 coupled to an oscillator 2994. The PWM circuit 2992 provides a first signal to a first gate drive circuit 2996a coupled to a first transistor output stage 2998a to drive a first ultrasonic (LEFT) energy output. The PWM circuit 2992 also provides a second signal to a second gate drive circuit 2996b coupled to a second transistor output stage 2998b to drive a second ultrasonic (RIGHT) energy output. A voltage sensor 2999 is coupled between the ultrasonic LEFT/RIGHT output terminals to measure the output voltage. The drive circuit 2986, the first drive circuit 2996a and the second drive circuit 2996b, and the first transistor output stage 2998a and the second transistor output stage 2998b define a first stage amplifier circuit. In operation, the control circuit 3200 (FIG. 32) generates a digital waveform 4300 (FIG. 43) using circuits such as direct digital synthesis (DDS) circuits 4100, 4200 (FIGs. 41 and 42). The DAC 2990 receives the digital waveform 4300 and converts it into an analog waveform, which is received and amplified by the first stage amplifier circuit.

图30为根据本公开的至少一个方面的联接到图29中所示的电路2900的变压器3000的示意图。变压器3000的超声LEFT/RIGHT输入端子(一次绕组)电耦合到电路2900的超声LEFT/RIGHT输出端子。变压器3000的二次绕组耦合到正电极3074a和负电极3074b。变压器3000的正电极3074a和负电极3074b耦合到超声换能器的正端子(叠堆1)和负端子(叠堆2)。在一个方面，变压器3000具有1:50的匝数比n₁:n₂。FIG30 is a schematic diagram of a transformer 3000 coupled to the circuit 2900 shown in FIG29 according to at least one aspect of the present disclosure. The ultrasonic LEFT/RIGHT input terminal (primary winding) of the transformer 3000 is electrically coupled to the ultrasonic LEFT/RIGHT output terminal of the circuit 2900. The secondary winding of the transformer 3000 is coupled to the positive electrode 3074a and the negative electrode 3074b. The positive electrode 3074a and the negative electrode 3074b of the transformer 3000 are coupled to the positive terminal (stack 1) and the negative terminal (stack 2) of the ultrasonic transducer. In one aspect, the transformer 3000 has a turns ratio_n1 :_n2 of 1:50.

图31是根据本公开的至少一个方面的耦合到测试电路3165的图30中所示的变压器3000的示意图。测试电路3165耦合到正电极3074a和负电极3074b。开关3167与模拟超声换能器的负载的电感器/电容器/电阻器(LCR)负载串联放置。FIG31 is a schematic diagram of the transformer 3000 shown in FIG30 coupled to a test circuit 3165 according to at least one aspect of the present disclosure. The test circuit 3165 is coupled to the positive electrode 3074a and the negative electrode 3074b. A switch 3167 is placed in series with an inductor/capacitor/resistor (LCR) load that simulates the load of an ultrasonic transducer.

图32为根据本公开的至少一个方面的控制电路3200(诸如控制电路3212)的示意图。控制电路3200位于电池组件的外壳内。电池组件是用于各种本地功率源3215的能量源。控制电路包括主处理器3214，主处理器3214通过例如输出SCL-A和SDA-A、SCL-B和SDA-B、SCL-C和SDA-C经由接口主机(interface master)3218耦合到各种下游电路。在一个方面，接口主机3218是通用串行接口，诸如I²C串行接口。主处理器3214被进一步配置为通过通用输入/输出(GPIO)3220驱动开关3224，通过GPIO 3222驱动显示器3226(例如，和LCD显示器)以及各种指示器3228。看门狗处理器3216被设置成控制主处理器3214。开关3230与电池3211串联设置，以在电池组件插入外科器械的柄部组件时激活控制电路3212。FIG. 32 is a schematic diagram of a control circuit 3200 (such as a control circuit 3212) according to at least one aspect of the present disclosure. The control circuit 3200 is located within the housing of a battery assembly. The battery assembly is an energy source for various local power sources 3215. The control circuit includes a main processor 3214, which is coupled to various downstream circuits via an interface master 3218 through, for example, outputs SCL-A and SDA-A, SCL-B and SDA-B, SCL-C and SDA-C. In one aspect, the interface master 3218 is a universal serial interface, such as an I² C serial interface. The main processor 3214 is further configured to drive a switch 3224 through a general purpose input/output (GPIO) 3220, a display 3226 (e.g., and LCD display) and various indicators 3228 through a GPIO 3222. A watchdog processor 3216 is configured to control the main processor 3214. The switch 3230 is arranged in series with the battery 3211 to activate the control circuit 3212 when the battery assembly is inserted into the handle assembly of the surgical instrument.

在一个方面，主处理器3214通过输出端子SCL-A、SDA-A耦合到电路2900(图29)。主处理器3214包括存储器，以用于存储例如发射至电路2900以驱动超声换能器1120的数字化驱动信号或波形的表。在其它方面，主处理器3214可生成数字波形并将其传输至电路2900，或者可存储数字波形以用于稍后传输到电路2900。主处理器3214还可通过输出端子SCL-B、SDA-B提供RF驱动，并且可通过输出端子SCL-C、SDA-C提供各种传感器(例如，霍尔效应传感器，磁流变液(MRF)传感器等)。在一个方面，主处理器3214被配置为感测超声驱动电路系统和/或RF驱动电路系统的存在，以启用适当的软件和用户界面功能。In one aspect, the main processor 3214 is coupled to the circuit 2900 (FIG. 29) via output terminals SCL-A, SDA-A. The main processor 3214 includes a memory for storing, for example, a table of digitized drive signals or waveforms transmitted to the circuit 2900 to drive the ultrasonic transducer 1120. In other aspects, the main processor 3214 may generate and transmit digital waveforms to the circuit 2900, or may store digital waveforms for later transmission to the circuit 2900. The main processor 3214 may also provide RF drive via output terminals SCL-B, SDA-B, and may provide various sensors (e.g., Hall effect sensors, magnetorheological fluid (MRF) sensors, etc.) via output terminals SCL-C, SDA-C. In one aspect, the main processor 3214 is configured to sense the presence of ultrasonic drive circuitry and/or RF drive circuitry to enable appropriate software and user interface functions.

在一个方面，主处理器3214可为例如可购自德克萨斯器械公司(TexasInstruments)的LM 4F230H5QR。在至少一个示例中，德克萨斯器械公司(TexasInstruments)的LM4F230H5QR是ARM Cortex-M4F处理器内核，其包括：256KB的单循环闪存或其它非易失性存储器(高达40MHZ)的片上存储器、用于使性能改善超过40MHz的预取缓冲器、32KB的单循环串行随机存取存储器(SRAM)、装载有软件的内部只读存储器(ROM)、2KB的电可擦除可编程只读存储器(EEPROM)、一个或多个脉宽调制(PWM)模块、一个或多个正交编码器输入(QED模拟、具有12个模拟输入信道的一个或多个12位模数转换器(ADC)、以及易得的其它特征件。可很方便地换用其它处理器，因此，本公开不应限于这一上下文。In one aspect, the main processor 3214 can be, for example, the LM 4F230H5QR available from Texas Instruments. In at least one example, the LM4F230H5QR from Texas Instruments is an ARM Cortex-M4F processor core that includes: 256KB of single-cycle flash or other non-volatile memory (up to 40 MHz) on-chip memory, a pre-fetch buffer for improving performance beyond 40 MHz, 32KB of single-cycle serial random access memory (SRAM), a 32-bit SPI interface, and a 32-bit SPI interface. The processor may include an internal read-only memory (ROM) for software, 2KB of electrically erasable programmable read-only memory (EEPROM), one or more pulse width modulation (PWM) modules, one or more quadrature encoder inputs (QED analog), one or more 12-bit analog-to-digital converters (ADCs) with 12 analog input channels, and other readily available features. Other processors may be readily substituted, and thus, the present disclosure should not be limited to this context.

图33示出了根据本公开的至少一个方面的简化的电路框图，其示出了包含在模块化超声外科器械3334内的另一电路3300。电路3300包括处理器3302、时钟3330、存储器3326、功率源3304(例如，电池)、开关3306(诸如金属氧化物半导体场效应晶体管(MOSFET)功率开关)、驱动电路3308(PLL)、变压器3310、信号平滑电路3312(也被称为匹配电路，并且可为例如储能电路)、感测电路3314、换能器1120、和轴组件(例如，轴组件1126、1129)，该轴组件包括本文中可被简称为波导的端接在超声刀(例如超声刀1128、1149)处的超声传输波导。33 shows a simplified circuit block diagram according to at least one aspect of the present disclosure, which shows another circuit 3300 included in a modular ultrasonic surgical instrument 3334. The circuit 3300 includes a processor 3302, a clock 3330, a memory 3326, a power source 3304 (e.g., a battery), a switch 3306 (such as a metal oxide semiconductor field effect transistor (MOSFET) power switch), a drive circuit 3308 (PLL), a transformer 3310, a signal smoothing circuit 3312 (also referred to as a matching circuit, and can be, for example, a tank circuit), a sensing circuit 3314, a transducer 1120, and a shaft assembly (e.g., shaft assemblies 1126, 1129) that includes an ultrasonic transmission waveguide, which may be referred to herein simply as a waveguide, terminated at an ultrasonic blade (e.g., ultrasonic blades 1128, 1149).

本公开的一个切断对高电压(120伏交流电)输入功率的依赖(一般超声切割装置的特征)的特征是在整个波形成过程期间利用低压开关，并且仅直接在变压器级之前放大驱动信号。因此，在本公开的一个方面，功率仅来源于一个电池或一组电池，其足够小以适配在柄部组件内。本领域的电池技术提供了高度和宽度为几厘米、深度为几毫米的大功率电池。通过组合本公开的特征件以提供自包含和自供电超声装置，可实现制造成本的减少。One feature of the present disclosure that cuts off the reliance on high voltage (120 volts AC) input power (a feature of typical ultrasonic cutting devices) is to utilize a low voltage switch during the entire wave forming process, and only amplify the drive signal directly before the transformer stage. Thus, in one aspect of the present disclosure, power is derived from only one battery or a group of batteries that are small enough to fit within the handle assembly. Battery technology in the art provides high power batteries that are several centimeters in height and width and several millimeters in depth. By combining the features of the present disclosure to provide a self-contained and self-powered ultrasonic device, a reduction in manufacturing costs can be achieved.

功率源3304的输出被馈送至处理器3302并向其供电。处理器3302接收并输出信号，并且如下文将描述的，处理器3302根据定制逻辑或根据由处理器3302执行的计算机程序来工作。如上所述，电路3300还可包括存储器3326，优选地包括随机存取存储器(RAM)，其存储计算机可读指令和数据。The output of the power source 3304 is fed to and powers the processor 3302. The processor 3302 receives and outputs signals, and as will be described below, the processor 3302 operates according to custom logic or according to a computer program executed by the processor 3302. As described above, the circuit 3300 may also include a memory 3326, preferably a random access memory (RAM), which stores computer readable instructions and data.

功率源3304的输出也被引导至具有由处理器3302控制的占空比的开关3306。通过控制开关3306的接通时间，处理器3302能够指定最终递送至换能器1120的功率的总量。在一个方面，开关3306为MOSFET，但其它开关和开关配置也是可适应的。开关3306的输出被馈送至驱动电路3308，该驱动电路3308包含例如相位检测锁相环路(PLL)和/或低通滤波器和/或电压控制振荡器。开关3306的输出由处理器3302取样以分别确定输出信号的电压和电流(V_IN和I_IN)。这些值用于反馈架构中以调节开关3306的脉宽调制。例如，开关3306的占空比可在约20％至约80％的范围内变化，这取决于来自开关3306的期望输出和实际输出。The output of the power source 3304 is also directed to a switch 3306 having a duty cycle controlled by the processor 3302. By controlling the on-time of the switch 3306, the processor 3302 is able to specify the total amount of power ultimately delivered to the transducer 1120. In one aspect, the switch 3306 is a MOSFET, but other switches and switch configurations are also adaptable. The output of the switch 3306 is fed to a drive circuit 3308, which includes, for example, a phase detection phase-locked loop (PLL) and/or a low-pass filter and/or a voltage-controlled oscillator. The output of the switch 3306 is sampled by the processor 3302 to determine the voltage and current (V_IN and I_IN ) of the output signal, respectively. These values are used in a feedback architecture to adjust the pulse width modulation of the switch 3306. For example, the duty cycle of the switch 3306 can vary in the range of about 20% to about 80%, depending on the desired output and actual output from the switch 3306.

从开关3306接收信号的驱动电路3308包括振荡电路(VCO)，该振荡电路将开关3306的输出转变成具有超声频率(例如55kHz)的电信号。如上所述，该超声波形的平滑化型式最终被馈送到超声换能器1120，以沿超声传输波导产生谐振正弦波。The drive circuit 3308 receiving the signal from the switch 3306 includes an oscillator circuit (VCO) that converts the output of the switch 3306 into an electrical signal having an ultrasonic frequency (e.g., 55 kHz). As described above, the smoothed version of the ultrasonic waveform is ultimately fed to the ultrasonic transducer 1120 to generate a resonant sine wave along the ultrasonic transmission waveguide.

驱动电路3308的输出是能够将一个或多个低电压信号升压到更高电压的变压器3310。应当指出的是，在变压器3310之前的上游开关是在低(例如，电池驱动的)电压下执行的，这是迄今为止对于超声切割和烧灼装置而言尚不可能的。这至少部分地归因于装置有利地使用低接通电阻MOSFET开关装置的事实。低接通电阻MOSFET开关是有利的，因为它们产生比传统MOSFET装置更低的开关损耗和更少的热，并且允许更高的电流通过。因此，开关级(预变压器)可被表征为低电压/高电流。为了确保一个或多个放大器MOSFET的低接通电阻，一个或多个MOSFET在例如10V下运行。在此情况下，单独的10VDC功率源可用于给MOSFET栅极供电，这确保MOSFET完全接通并且实现了相当低的接通电阻。在本公开的一个方面，变压器3310将电池电压升压到120V均方根(RMS)。变压器是本领域已知的，并且因此在本文中未详细说明。The output of the drive circuit 3308 is a transformer 3310 capable of boosting one or more low voltage signals to a higher voltage. It should be noted that the upstream switch before the transformer 3310 is performed at a low (e.g., battery-driven) voltage, which has not been possible for ultrasonic cutting and cauterization devices to date. This is at least partially due to the fact that the device advantageously uses a low on-resistance MOSFET switch device. Low on-resistance MOSFET switches are advantageous because they produce lower switching losses and less heat than traditional MOSFET devices and allow higher currents to pass. Therefore, the switch stage (pre-transformer) can be characterized as low voltage/high current. In order to ensure a low on-resistance of one or more amplifier MOSFETs, one or more MOSFETs are operated at, for example, 10V. In this case, a separate 10VDC power source can be used to power the MOSFET gate, which ensures that the MOSFET is fully turned on and achieves a fairly low on-resistance. In one aspect of the present disclosure, the transformer 3310 boosts the battery voltage to 120V root mean square (RMS). Transformers are known in the art and are therefore not described in detail herein.

在所述电路配置中，电路部件劣化可对电路的电路性能产生负面影响。直接影响部件性能的一个因素是热。已知电路通常监测开关温度(例如，MOSFET温度)。然而，由于MOSFET设计的技术进步以及相应的大小减小，MOSFET温度已不再是电路负载和热的有效指示。因此，根据本公开的至少一个方面，感测电路3314感测变压器3310的温度。该温度感测是有利的，因为在装置使用期间变压器3310以或非常接近其最大温度运行。附加的温度将导致芯材料(例如，铁氧体)破裂，并且可发生永久性损坏。本公开可通过例如减小变压器3310中的驱动功率、向用户发出信号、关闭功率、脉冲功率或其它适当响应来响应变压器3310的最大温度。In the circuit configuration, degradation of circuit components may have a negative impact on the circuit performance of the circuit. One factor that directly affects component performance is heat. Known circuits typically monitor switch temperature (e.g., MOSFET temperature). However, due to technological advances in MOSFET design and corresponding size reductions, MOSFET temperature is no longer an effective indication of circuit load and heat. Therefore, according to at least one aspect of the present disclosure, the sensing circuit 3314 senses the temperature of the transformer 3310. This temperature sensing is advantageous because the transformer 3310 operates at or very close to its maximum temperature during device use. Additional temperature will cause the core material (e.g., ferrite) to crack, and permanent damage may occur. The present disclosure may respond to the maximum temperature of the transformer 3310 by, for example, reducing the drive power in the transformer 3310, signaling the user, shutting off the power, pulsing the power, or other appropriate responses.

在本公开的一个方面，处理器3302通信地耦合到端部执行器(例如，1122、1125)，该端部执行器用于将材料放置成与超声刀(例如，1128、1149)物理接触。提供了传感器，该传感器在端部执行器处测量夹持力值(存在于已知范围内)，并且基于所接收的夹持力值，处理器3302改变动态电压V_M。由于高力值与设定的运动速率组合可产生高刀温度，因此温度传感器3332可通信地耦合到处理器3302，其中可操作处理器3302以接收和解释指示来自温度传感器3336的刀的当前温度的信号并且基于所接收的温度来确定刀运动的目标频率。在另一方面，力传感器诸如应变传感器或压力传感器可耦合到触发器(例如，1143、1147)以测量由用户施加到触发器的力。在另一方面，力传感器诸如应变传感器或压力传感器可耦合到开关按钮，使得位移强度对应于由用户施加到开关按钮的力。In one aspect of the present disclosure, the processor 3302 is communicatively coupled to an end effector (e.g., 1122, 1125) that is used to place a material in physical contact with an ultrasonic blade (e.g., 1128, 1149). A sensor is provided that measures a clamping force value (existing within a known range) at the end effector, and based on the received clamping force value, the processor 3302 changes the dynamic voltage V_M. Since high force values combined with a set movement rate can produce high blade temperatures, a temperature sensor 3332 can be communicatively coupled to the processor 3302, wherein the processor 3302 can be operated to receive and interpret a signal indicating the current temperature of the blade from a temperature sensor 3336 and determine a target frequency of blade movement based on the received temperature. In another aspect, a force sensor such as a strain sensor or a pressure sensor can be coupled to a trigger (e.g., 1143, 1147) to measure the force applied to the trigger by a user. In another aspect, a force sensor such as a strain sensor or a pressure sensor can be coupled to a switch button so that the displacement intensity corresponds to the force applied to the switch button by the user.

根据本公开的至少一个方面，耦合到处理器3302的驱动电路3308的PLL部分能够确定波导运动的频率并将该频率传送至处理器3302。当装置被关闭时，处理器3302将该频率值存储在存储器3326中。通过读取时钟3330，处理器3302能够确定在装置被关闭之后的耗用时间，并且如果耗用时间小于预定值，则检索上一个波导运动频率。然后该装置可以以上一个频率启动，这大概是当前负载的最佳频率。In accordance with at least one aspect of the present disclosure, the PLL portion of the driver circuit 3308 coupled to the processor 3302 can determine the frequency of the waveguide motion and transmit the frequency to the processor 3302. When the device is turned off, the processor 3302 stores the frequency value in the memory 3326. By reading the clock 3330, the processor 3302 can determine the elapsed time after the device was turned off, and if the elapsed time is less than a predetermined value, retrieve the last waveguide motion frequency. The device can then start up at the last frequency, which is presumably the optimal frequency for the current load.

具有多级发生器电路的模块化电池供电的手持式外科器械Modular battery-powered handheld surgical instrument with multi-stage generator circuit

在另一方面，本公开提供一种具有多级发生器电路的模块化电池供电的手持式外科器械。本发明公开了一种外科器械，该外科器械包括电池组件、柄部组件和轴组件，其中电池组件和轴组件被配置为机械地和电连接到柄部组件。电池组件包括被配置为生成数字波形的控制电路。柄部组件包括第一级电路，该第一级电路被配置为接收数字波形、将数字波形转换成模拟波形、以及放大模拟波形。轴组件包括第二级电路，该第二级电路耦合到第一级电路以接收、放大模拟波形并将模拟波形施加到负载。In another aspect, the present disclosure provides a modular battery-powered handheld surgical instrument having a multi-stage generator circuit. The present disclosure discloses a surgical instrument comprising a battery assembly, a handle assembly, and a shaft assembly, wherein the battery assembly and the shaft assembly are configured to be mechanically and electrically connected to the handle assembly. The battery assembly includes a control circuit configured to generate a digital waveform. The handle assembly includes a first stage circuit configured to receive a digital waveform, convert the digital waveform into an analog waveform, and amplify the analog waveform. The shaft assembly includes a second stage circuit coupled to the first stage circuit to receive, amplify, and apply the analog waveform to a load.

在一个方面，本公开提供一种外科器械，包括：电池组件，该电池组件包括包括电池的控制电路、耦合到电池的存储器、以及耦合到存储器和电池的处理器，其中处理器被配置为生成数字波形；柄部组件，该柄部组件包括耦合到处理器的第一级电路，该第一级电路包括数模(DAC)转换器和第一级放大器电路，其中DAC被配置为接收数字波形并将数字波形转换成模拟波形，其中第一级放大器电路被配置为接收和放大模拟波形；以及轴组件，该轴组件包括第二级电路，该第二级电路耦合到第一级放大器电路以接收模拟波形、放大模拟波形、以及将模拟波形施加到负载；其中电池组件和轴组件被配置为机械地和电连接到柄部组件。In one aspect, the present disclosure provides a surgical instrument comprising: a battery assembly, the battery assembly including a control circuit including a battery, a memory coupled to the battery, and a processor coupled to the memory and the battery, wherein the processor is configured to generate a digital waveform; a handle assembly, the handle assembly including a first-stage circuit coupled to the processor, the first-stage circuit including a digital-to-analog (DAC) converter and a first-stage amplifier circuit, wherein the DAC is configured to receive a digital waveform and convert the digital waveform into an analog waveform, wherein the first-stage amplifier circuit is configured to receive and amplify the analog waveform; and an axis assembly, the axis assembly including a second-stage circuit coupled to the first-stage amplifier circuit to receive the analog waveform, amplify the analog waveform, and apply the analog waveform to a load; wherein the battery assembly and the axis assembly are configured to be mechanically and electrically connected to the handle assembly.

负载可包括超声换能器、电极或传感器中的任一者、或它们的任何组合。第一级电路可包括第一级超声驱动电路和第一级高频电流驱动电路。控制电路可被配置为独立地或同时驱动第一级超声驱动电路和第一级高频电流驱动电路。第一级超声驱动电路可被配置为耦合到第二级超声驱动电路。第二级超声驱动电路可被配置为耦合到超声换能器。第一级高频电流驱动电路可被配置为耦合到第二级高频驱动电路。第二级高频驱动电路可被配置为耦合到电极。The load may include any one of an ultrasonic transducer, an electrode or a sensor, or any combination thereof. The first stage circuit may include a first stage ultrasonic drive circuit and a first stage high frequency current drive circuit. The control circuit may be configured to drive the first stage ultrasonic drive circuit and the first stage high frequency current drive circuit independently or simultaneously. The first stage ultrasonic drive circuit may be configured to be coupled to a second stage ultrasonic drive circuit. The second stage ultrasonic drive circuit may be configured to be coupled to an ultrasonic transducer. The first stage high frequency current drive circuit may be configured to be coupled to a second stage high frequency drive circuit. The second stage high frequency drive circuit may be configured to be coupled to an electrode.

第一级电路可包括第一级传感器驱动电路。第一级传感器驱动电路可被配置为第二级传感器驱动电路。第二级传感器驱动电路可被配置为耦合到传感器。The first stage circuit may include a first stage sensor driver circuit. The first stage sensor driver circuit may be configured as a second stage sensor driver circuit. The second stage sensor driver circuit may be configured to couple to the sensor.

在另一方面，本公开提供了一种外科器械，包括：电池组件，该电池组件包括包括电池的控制电路、耦合到电池的存储器、以及耦合到存储器和电池的处理器，其中处理器被配置为生成数字波形；柄部组件，该柄部组件包括耦合到处理器的公共第一级电路，该公共第一级电路包括数模(DAC)转换器和公共第一级放大器电路，其中DAC被配置为接收数字波形并将数字波形转换成模拟波形，其中公共第一级放大器电路被配置为接收并放大模拟波形；以及轴组件，该轴组件包括第二级电路，该第二级电路耦合到公共第一级放大器电路以接收模拟波形、放大模拟波形、以及将模拟波形施加到负载；其中电池组件和轴组件被配置为机械地和电连接到柄部组件。On the other hand, the present disclosure provides a surgical instrument comprising: a battery assembly, the battery assembly including a control circuit including a battery, a memory coupled to the battery, and a processor coupled to the memory and the battery, wherein the processor is configured to generate a digital waveform; a handle assembly, the handle assembly including a common first-stage circuit coupled to the processor, the common first-stage circuit including a digital-to-analog (DAC) converter and a common first-stage amplifier circuit, wherein the DAC is configured to receive a digital waveform and convert the digital waveform into an analog waveform, wherein the common first-stage amplifier circuit is configured to receive and amplify the analog waveform; and an axis assembly, the axis assembly including a second-stage circuit coupled to the common first-stage amplifier circuit to receive the analog waveform, amplify the analog waveform, and apply the analog waveform to a load; wherein the battery assembly and the axis assembly are configured to be mechanically and electrically connected to the handle assembly.

负载可包括超声换能器、电极或传感器中的任一者、或它们的任何组合。公共第一级电路可被配置为驱动超声、高频电流或传感器电路。公共第一级驱动电路可被配置为耦合到第二级超声驱动电路、第二级高频驱动电路或第二级传感器驱动电路。第二级超声驱动电路可被配置为耦合到超声换能器，第二级高频驱动电路被配置为耦合到电极，并且第二级传感器驱动电路被配置为耦合到传感器。The load may include any one of an ultrasonic transducer, an electrode, or a sensor, or any combination thereof. The common first stage circuit may be configured to drive an ultrasonic, high frequency current, or sensor circuit. The common first stage drive circuit may be configured to couple to a second stage ultrasonic drive circuit, a second stage high frequency drive circuit, or a second stage sensor drive circuit. The second stage ultrasonic drive circuit may be configured to couple to an ultrasonic transducer, the second stage high frequency drive circuit may be configured to couple to an electrode, and the second stage sensor drive circuit may be configured to couple to a sensor.

在另一方面，本公开提供一种外科器械，该外科器械包括控制电路，该控制电路包括耦合到处理器的存储器，其中处理器被配置为生成数字波形；柄部组件，该柄部组件包括耦合到处理器的公共第一级电路，该公共第一级电路被配置为接收数字波形、将数字波形转换成模拟波形、以及放大模拟波形；以及轴组件，该轴组件包括第二级电路，该第二级电路耦合到公共第一级电路以接收并放大模拟波形；其中轴组件被配置为机械地和电连接到柄部组件。In another aspect, the present disclosure provides a surgical instrument comprising a control circuit including a memory coupled to a processor, wherein the processor is configured to generate a digital waveform; a handle assembly comprising a common first-stage circuit coupled to the processor, the common first-stage circuit configured to receive the digital waveform, convert the digital waveform to an analog waveform, and amplify the analog waveform; and an axis assembly comprising a second-stage circuit coupled to the common first-stage circuit to receive and amplify the analog waveform; wherein the axis assembly is configured to be mechanically and electrically connected to the handle assembly.

公共第一级电路可被配置为驱动超声、高频电流或传感器电路。公共第一级驱动电路可被配置为耦合到第二级超声驱动电路、第二级高频驱动电路或第二级传感器驱动电路。第二级超声驱动电路可被配置为耦合到超声换能器，第二级高频驱动电路被配置为耦合到电极，并且第二级传感器驱动电路被配置为耦合到传感器。The common first stage circuit may be configured to drive an ultrasound, high frequency current, or sensor circuit. The common first stage drive circuit may be configured to couple to a second stage ultrasound drive circuit, a second stage high frequency drive circuit, or a second stage sensor drive circuit. The second stage ultrasound drive circuit may be configured to couple to an ultrasound transducer, the second stage high frequency drive circuit may be configured to couple to an electrode, and the second stage sensor drive circuit may be configured to couple to a sensor.

图34示出了根据本公开的至少一个方面的被划分成第一级电路3404和第二级电路3406的发生器电路3400。在一个方面，本文所述的外科系统1000的外科器械可包括被划分成多个级的发生器电路3400。例如，外科系统1000的外科器械可包括被划分成至少两个电路的发生器电路3400：仅实现RF能量操作、仅实现超声能量操作和/或实现RF能量操作和超声能量操作的组合的第一级电路3404和第二级电路3406。组合式模块化轴组件3414可通过位于柄部组件3412内的公共第一级电路3404和与模块化轴组件3414整体形成的模块化第二级电路3406来供电。如先前在本说明书通篇中结合外科系统1000的外科器械所讨论的，电池组件3410和轴组件3414被配置为机械地和电连接到柄部组件3412。端部执行器组件被配置为机械地和电连接轴组件3414。FIG. 34 illustrates a generator circuit 3400 divided into a first stage circuit 3404 and a second stage circuit 3406 in accordance with at least one aspect of the present disclosure. In one aspect, a surgical instrument of the surgical system 1000 described herein may include a generator circuit 3400 divided into a plurality of stages. For example, a surgical instrument of the surgical system 1000 may include a generator circuit 3400 divided into at least two circuits: a first stage circuit 3404 and a second stage circuit 3406 that implement only RF energy operations, only ultrasonic energy operations, and/or a combination of RF energy operations and ultrasonic energy operations. The combined modular shaft assembly 3414 may be powered by a common first stage circuit 3404 located within the handle assembly 3412 and a modular second stage circuit 3406 integrally formed with the modular shaft assembly 3414. As previously discussed throughout this specification in conjunction with the surgical instruments of the surgical system 1000, the battery assembly 3410 and the shaft assembly 3414 are configured to be mechanically and electrically connected to the handle assembly 3412. The end actuator assembly is configured to mechanically and electrically connect to the shaft assembly 3414.

现在转到图34，发生器电路3400被划分成多个级，该多个级位于外科器械(诸如本文所述的外科系统1000的外科器械)的多个模块化组件中。在一个方面，控制级电路3402可位于外科器械的电池组件3410中。控制级电路3402为如结合图32所述的控制电路3200。控制电路3200包括处理器3214，该处理器3214包括内部存储器3217(图34)(例如，易失性和非易失性存储器)，并且电耦合到电池3211。电池3211分别向第一级电路3404、第二级电路3406和第三级电路3408供应功率。如前所述，控制电路3200使用结合图41和图42所述的电路和技术来生成数字波形4300(图43)。回到图34，数字波形4300可被配置为独立地或同时驱动超声换能器、高频(例如，RF)电极、或它们的组合。如果同时驱动，则滤波器电路可设置在对应的第一级电路3404中以选择超声波形或RF波形。此类滤波技术描述于共同拥有的标题为用于组合式发生器的电路拓扑结构的技术(TECHNIQUES FOR CIRCUIT TOPOLOGIESFOR COMBINED GENERATOR)的美国专利公布US-2017-0086910-A1中，其全文以引用方式并入本文。Turning now to FIG. 34 , a generator circuit 3400 is divided into multiple stages that are located in multiple modular assemblies of a surgical instrument, such as the surgical instrument of the surgical system 1000 described herein. In one aspect, a control stage circuit 3402 may be located in a battery assembly 3410 of the surgical instrument. The control stage circuit 3402 is a control circuit 3200 as described in conjunction with FIG. 32 . The control circuit 3200 includes a processor 3214 that includes an internal memory 3217 ( FIG. 34 ) (e.g., volatile and non-volatile memory) and is electrically coupled to a battery 3211. The battery 3211 supplies power to the first stage circuit 3404, the second stage circuit 3406, and the third stage circuit 3408, respectively. As previously described, the control circuit 3200 generates a digital waveform 4300 ( FIG. 43 ) using the circuits and techniques described in conjunction with FIGS. 41 and 42 . Returning to FIG. 34 , the digital waveform 4300 can be configured to drive the ultrasonic transducer, the high frequency (e.g., RF) electrode, or a combination thereof independently or simultaneously. If driven simultaneously, a filter circuit can be provided in the corresponding first stage circuit 3404 to select the ultrasonic waveform or the RF waveform. Such filtering techniques are described in the commonly owned U.S. Patent Publication US-2017-0086910-A1 entitled TECHNIQUES FOR CIRCUIT TOPOLOGIES FOR COMBINED GENERATOR, which is incorporated herein by reference in its entirety.

第一级电路3404(例如，第一级超声驱动电路3420、第一级RF驱动电路3422和第一级传感器驱动电路3424)位于外科器械的柄部组件3412中。控制电路3200经由控制电路3200的输出SCL-A、SDA-A向第一级超声驱动电路3420提供超声驱动信号。第一级超声驱动电路3420结合图29详细描述。控制电路3200经由控制电路3200的输出SCL-B、SDA-B向第一级RF驱动电路3422提供RF驱动信号。第一级RF驱动电路3422结合图36详细描述。控制电路3200经由控制电路3200的输出SCL-C、SDA-C向第一级传感器驱动电路3424提供传感器驱动信号。一般来讲，第一级电路3404中的每个包括数模(DAC)转换器和第一级放大器区段以驱动第二级电路3406。第一级电路3404的输出被提供给第二级电路的输入3406。The first stage circuit 3404 (e.g., the first stage ultrasonic drive circuit 3420, the first stage RF drive circuit 3422, and the first stage sensor drive circuit 3424) is located in the handle assembly 3412 of the surgical instrument. The control circuit 3200 provides an ultrasonic drive signal to the first stage ultrasonic drive circuit 3420 via the outputs SCL-A and SDA-A of the control circuit 3200. The first stage ultrasonic drive circuit 3420 is described in detail in conjunction with FIG. 29. The control circuit 3200 provides an RF drive signal to the first stage RF drive circuit 3422 via the outputs SCL-B and SDA-B of the control circuit 3200. The first stage RF drive circuit 3422 is described in detail in conjunction with FIG. 36. The control circuit 3200 provides a sensor drive signal to the first stage sensor drive circuit 3424 via the outputs SCL-C and SDA-C of the control circuit 3200. In general, each of the first stage circuits 3404 includes a digital-to-analog (DAC) converter and a first stage amplifier section to drive the second stage circuit 3406. The output of the first stage circuit 3404 is provided to the input 3406 of the second stage circuit.

控制电路3200被配置为检测将哪些模块插入控制电路3200中。例如，控制电路3200被配置为检测位于柄部组件3412中的第一级超声驱动电路3420、第一级RF驱动电路3422、或第一级传感器驱动电路3424是否连接到电池组件3410。同样，第一级电路3404中的每个可检测哪些第二级电路3406连接到其上，并且该信息被提供回控制电路3200以确定要生成的信号波形的类型。类似地，第二级电路3406中的每个可检测哪个第三级电路3408或哪些部件连接到其上，并且该信息被提供回控制电路3200以确定要生成的信号波形的类型。The control circuit 3200 is configured to detect which modules are inserted into the control circuit 3200. For example, the control circuit 3200 is configured to detect whether the first-stage ultrasonic drive circuit 3420, the first-stage RF drive circuit 3422, or the first-stage sensor drive circuit 3424 located in the handle assembly 3412 is connected to the battery assembly 3410. Similarly, each of the first-stage circuits 3404 can detect which second-stage circuits 3406 are connected to it, and this information is provided back to the control circuit 3200 to determine the type of signal waveform to be generated. Similarly, each of the second-stage circuits 3406 can detect which third-stage circuits 3408 or which components are connected to it, and this information is provided back to the control circuit 3200 to determine the type of signal waveform to be generated.

在一个方面，第二级电路3406(例如，超声驱动第二级电路3430、RF驱动第二级电路3432和传感器驱动第二级电路3434)位于外科器械的轴组件3414中。第一级超声驱动电路3420经由输出US-Left/US-Right向第二级超声驱动电路3430提供信号。第二级超声驱动电路3430结合图30和图31详细描述。除了变压器(图30和图31)之外，第二级超声驱动电路3430还可包括滤波器、放大器和信号调节电路。第一级高频(RF)电流驱动电路3422经由输出RF-Left/RF-Right向第二级RF驱动电路3432提供信号。除了变压器和闭锁电容器之外，第二级RF驱动电路3432还可包括滤波器、放大器和信号调节电路。第一级传感器驱动电路3424经由输出Sensor-1/Sensor-2向第二级传感器驱动电路3434提供信号。根据传感器的类型，第二级传感器驱动电路3434可包括滤波器、放大器和信号调节电路。第二级电路3406的输出被提供给第三级电路3408的输入。In one aspect, the second stage circuit 3406 (e.g., ultrasonic drive second stage circuit 3430, RF drive second stage circuit 3432, and sensor drive second stage circuit 3434) is located in the shaft assembly 3414 of the surgical instrument. The first stage ultrasonic drive circuit 3420 provides a signal to the second stage ultrasonic drive circuit 3430 via output US-Left/US-Right. The second stage ultrasonic drive circuit 3430 is described in detail in conjunction with Figures 30 and 31. In addition to the transformer (Figures 30 and 31), the second stage ultrasonic drive circuit 3430 may also include filters, amplifiers, and signal conditioning circuits. The first stage high frequency (RF) current drive circuit 3422 provides a signal to the second stage RF drive circuit 3432 via output RF-Left/RF-Right. In addition to the transformer and the latching capacitor, the second stage RF drive circuit 3432 may also include filters, amplifiers, and signal conditioning circuits. The first stage sensor drive circuit 3424 provides a signal to the second stage sensor drive circuit 3434 via output Sensor-1/Sensor-2. Depending on the type of sensor, the second stage sensor driver circuit 3434 may include filters, amplifiers, and signal conditioning circuits. The output of the second stage circuit 3406 is provided to the input of the third stage circuit 3408 .

在一个方面，第三级电路3408(例如，超声换能器1120、RF电极3074a、3074b和传感器3440)可位于外科器械的各种组件3416中。在一个方面，第二级超声驱动电路3430向超声换能器1120压电叠堆提供驱动信号。在一个方面，超声换能器1120位于外科器械的超声换能器组件中。然而，在其它方面，超声换能器1120可位于柄部组件3412、轴组件3414或端部执行器中。在一个方面，第二级RF驱动电路3432向通常位于外科器械的端部执行器部分中的RF电极3074a、3074b提供驱动信号。在一个方面，第二级传感器驱动电路3434向位于整个外科器械中的各种传感器3440提供驱动信号。In one aspect, the third level circuit 3408 (e.g., ultrasonic transducer 1120, RF electrodes 3074a, 3074b, and sensor 3440) can be located in various components 3416 of the surgical instrument. In one aspect, the second level ultrasonic drive circuit 3430 provides a drive signal to the ultrasonic transducer 1120 piezoelectric stack. In one aspect, the ultrasonic transducer 1120 is located in the ultrasonic transducer assembly of the surgical instrument. However, in other aspects, the ultrasonic transducer 1120 can be located in the handle assembly 3412, the shaft assembly 3414, or the end effector. In one aspect, the second level RF drive circuit 3432 provides a drive signal to the RF electrodes 3074a, 3074b, which are typically located in the end effector portion of the surgical instrument. In one aspect, the second level sensor drive circuit 3434 provides a drive signal to various sensors 3440 located throughout the surgical instrument.

图35示出了根据本公开的至少一个方面的被划分成多个级的发生器电路3500，其中第一级电路3504是第二级电路3506共有的。在一个方面，本文所述的外科系统1000的外科器械可包括被划分成多个级的发生器电路3500。例如，外科系统1000的外科器械可包括被划分成至少两个电路的发生器电路3500：仅实现高频(RF)能量操作、仅实现超声能量操作和/或实现RF能量操作和超声能量操作的组合的第一级放大电路3504和第二级放大电路3506。组合式模块化轴组件3514可通过位于柄部组件3512内的公共第一级电路3504和与模块化轴组件3514整体形成的模块化第二级电路3506供电。如先前在本说明书通篇中结合外科系统1000的外科器械所讨论的，电池组件3510和轴组件3514被配置为机械地和电连接到柄部组件3512。端部执行器组件被配置为机械地和电连接轴组件3514。FIG. 35 illustrates a generator circuit 3500 divided into multiple stages, wherein a first stage circuit 3504 is common to a second stage circuit 3506, in accordance with at least one aspect of the present disclosure. In one aspect, a surgical instrument of the surgical system 1000 described herein may include a generator circuit 3500 divided into multiple stages. For example, a surgical instrument of the surgical system 1000 may include a generator circuit 3500 divided into at least two circuits: a first stage amplifier circuit 3504 and a second stage amplifier circuit 3506 that implement only high frequency (RF) energy operation, only ultrasonic energy operation, and/or a combination of RF energy operation and ultrasonic energy operation. The combined modular shaft assembly 3514 may be powered by the common first stage circuit 3504 located within the handle assembly 3512 and the modular second stage circuit 3506 formed integrally with the modular shaft assembly 3514. As previously discussed in conjunction with the surgical instruments of the surgical system 1000 throughout this specification, the battery assembly 3510 and the shaft assembly 3514 are configured to be mechanically and electrically connected to the handle assembly 3512. The end actuator assembly is configured to mechanically and electrically connect to the shaft assembly 3514.

如图35的示例中所示，外科器械的电池组件3510部分包括第一控制电路3502，该第一控制电路3502包括先前所述的控制电路3200。连接到电池组件3510的柄部组件3512包括公共第一级驱动电路3420。如前所述，第一级驱动电路3420被配置为驱动超声、高频(RF)电流和传感器负载。公共第一级驱动电路3420的输出可驱动第二级电路3506中的任一个，诸如第二级超声驱动电路3430、第二级高频(RF)电流驱动电路3432、和/或第二级传感器驱动电路3434。当轴组件3514连接到柄部组件3512时，公共第一级驱动电路3420检测哪个第二级电路3506位于轴组件3514中。在轴组件3514连接到柄部组件3512时，公共第一级驱动电路3420确定第二级电路3506中的哪一个(例如，第二级超声驱动电路3430、第二级RF驱动电路3432、和/或第二级传感器驱动电路3434)位于轴组件3514中。该信息被提供给位于柄部组件3512中的控制电路3200以便向第二级电路3506提供合适的数字波形4300(图43)以驱动适当的负载，例如超声，RF或传感器。应当理解，识别电路可包括在第三级电路3508中的各种组件3516中，诸如超声换能器1120、电极3074a、3074b、或传感器3440。因此，当第三级电路3508连接到第二级电路3506时，第二级电路3506基于识别信息知道所需的负载的类型。As shown in the example of FIG. 35 , the battery assembly 3510 portion of the surgical instrument includes a first control circuit 3502 that includes the previously described control circuit 3200. The handle assembly 3512 connected to the battery assembly 3510 includes a common first-stage drive circuit 3420. As previously described, the first-stage drive circuit 3420 is configured to drive ultrasound, high-frequency (RF) current, and sensor loads. The output of the common first-stage drive circuit 3420 can drive any of the second-stage circuits 3506, such as a second-stage ultrasound drive circuit 3430, a second-stage high-frequency (RF) current drive circuit 3432, and/or a second-stage sensor drive circuit 3434. When the shaft assembly 3514 is connected to the handle assembly 3512, the common first-stage drive circuit 3420 detects which second-stage circuit 3506 is located in the shaft assembly 3514. When the shaft assembly 3514 is connected to the handle assembly 3512, the common first stage drive circuit 3420 determines which of the second stage circuits 3506 (e.g., the second stage ultrasonic drive circuit 3430, the second stage RF drive circuit 3432, and/or the second stage sensor drive circuit 3434) is located in the shaft assembly 3514. This information is provided to the control circuit 3200 located in the handle assembly 3512 to provide the appropriate digital waveform 4300 (Figure 43) to the second stage circuit 3506 to drive the appropriate load, such as ultrasonic, RF, or sensor. It should be understood that the identification circuit may be included in various components 3516 in the third stage circuit 3508, such as the ultrasonic transducer 1120, the electrodes 3074a, 3074b, or the sensor 3440. Therefore, when the third stage circuit 3508 is connected to the second stage circuit 3506, the second stage circuit 3506 knows the type of load required based on the identification information.

图36为根据本公开的至少一个方面的被配置为驱动高频电流(RF)的电路3600的一个方面的示意图。电路3600包括模拟多路复用器3680。模拟多路复用器3680多路复用来自上游信道SCL-A、SDA-A诸如RF、电池和功率控制电路的各种信号。电流传感器3682与功率源电路的返回支路或接地支路串联耦合，以测量由功率源提供的电流。场效应晶体管(FET)温度传感器3684提供环境温度。如果主程序忽略周期性地对其维护，则脉宽调制(PWM)看门狗定时器3688自动生成系统复位。其由于软件或硬件故障而停摆或冻结时，其被设置成自动复位电路3600。应当理解，例如，电路3600可被配置为用于驱动RF电极或用于驱动超声换能器1120，如结合图29所述。因此，现在返回参考图36，电路3600可用于可互换地驱动超声电极和RF电极两者。FIG. 36 is a schematic diagram of one aspect of a circuit 3600 configured to drive a high frequency current (RF) according to at least one aspect of the present disclosure. The circuit 3600 includes an analog multiplexer 3680. The analog multiplexer 3680 multiplexes various signals from upstream channels SCL-A, SDA-A such as RF, battery, and power control circuits. A current sensor 3682 is coupled in series with a return branch or ground branch of the power source circuit to measure the current provided by the power source. A field effect transistor (FET) temperature sensor 3684 provides ambient temperature. If the main program neglects to maintain it periodically, a pulse width modulation (PWM) watchdog timer 3688 automatically generates a system reset. When it stalls or freezes due to a software or hardware failure, it is set to automatically reset the circuit 3600. It should be understood that, for example, the circuit 3600 can be configured to drive an RF electrode or to drive an ultrasonic transducer 1120, as described in conjunction with FIG. 29. Therefore, now returning to reference Figure 36, circuit 3600 can be used to interchangeably drive both ultrasound electrodes and RF electrodes.

驱动电路3686提供Left RF能量输出和Right RF能量输出端。表示信号波形的数字信号从控制电路诸如控制电路3200(图32)提供给模拟复用器3680的SCL-A、SDA-A输入。数模转换器3690(DAC)将数字输入转换成模拟输出以驱动耦合到振荡器3694的脉宽调制(PWM)电路3692。PWM电路3692向耦合到第一晶体管输出级3698a提供第一栅极驱动电路3696a以驱动第一RF+(Left)能量输出。PWM电路3692还向耦合到第二晶体管输出级3698b提供第二栅极驱动电路3696b以驱动第二RF-(Right)能量输出。电压传感器3699耦合在RFLeft/RF输出端子之间以测量输出电压。驱动电路3686、第一驱动电路3696a和第二驱动电路3696b以及第一晶体管输出级3698a和第二晶体管输出级3698b限定第一级放大器电路。在操作中，控制电路3200(图32)采用电路诸如直接数字合成(DDS)电路4100、4200(图41和图42)生成数字波形4300(图43)。DAC 3690接收数字波形4300并将其转换为模拟波形，该模拟波形由第一级放大器电路接收和放大。The driver circuit 3686 provides a Left RF energy output and a Right RF energy output. A digital signal representing a signal waveform is provided to the SCL-A, SDA-A inputs of the analog multiplexer 3680 from a control circuit such as the control circuit 3200 (FIG. 32). A digital-to-analog converter 3690 (DAC) converts the digital input into an analog output to drive a pulse width modulation (PWM) circuit 3692 coupled to an oscillator 3694. The PWM circuit 3692 provides a first gate drive circuit 3696a coupled to a first transistor output stage 3698a to drive a first RF+ (Left) energy output. The PWM circuit 3692 also provides a second gate drive circuit 3696b coupled to a second transistor output stage 3698b to drive a second RF- (Right) energy output. A voltage sensor 3699 is coupled between the RFLeft/RF output terminals to measure the output voltage. The drive circuit 3686, the first drive circuit 3696a and the second drive circuit 3696b, and the first transistor output stage 3698a and the second transistor output stage 3698b define a first stage amplifier circuit. In operation, the control circuit 3200 (FIG. 32) generates a digital waveform 4300 (FIG. 43) using circuits such as direct digital synthesis (DDS) circuits 4100, 4200 (FIGs. 41 and 42). The DAC 3690 receives the digital waveform 4300 and converts it into an analog waveform, which is received and amplified by the first stage amplifier circuit.

图37是根据本公开的至少一个方面的耦合到图36中所示的电路3600的变压器3700的示意图。变压器3700的RF+/RF输入端子(一次绕组)电耦合到电路3600的RFLeft/RF输出端子。二次绕组的一侧与第一阻挡电容器3706和第二阻挡电容器3708串联耦合。第二闭锁电容器耦合到第二级RF驱动电路3774a正端子。二级绕组的另一侧耦合到第二级RF驱动电路3774b负端子。第二级RF驱动电路3774a正输出耦合到超声刀，并且第二级RF驱动电路负接地端子3774b耦合到外管。在一个方面，变压器具有1:50的匝数比n₁:n₂。FIG37 is a schematic diagram of a transformer 3700 coupled to the circuit 3600 shown in FIG36 according to at least one aspect of the present disclosure. The RF+/RF input terminal (primary winding) of the transformer 3700 is electrically coupled to the RFLeft/RF output terminal of the circuit 3600. One side of the secondary winding is coupled in series with a first blocking capacitor 3706 and a second blocking capacitor 3708. The second blocking capacitor is coupled to the second stage RF drive circuit 3774a positive terminal. The other side of the secondary winding is coupled to the second stage RF drive circuit 3774b negative terminal. The second stage RF drive circuit 3774a positive output is coupled to the ultrasonic blade, and the second stage RF drive circuit negative ground terminal 3774b is coupled to the outer tube. In one aspect, the transformer has a turns ratio_n1 :_n2 of 1:50.

图38为根据本公开的至少一个方面的电路3800的示意图，该电路3800包括用于高功率能量/驱动电路和低功率电路的独立功率源。功率源3812包括一次电池组，该一次电池组包括通过开关3818连接到电路3800中的第一主电池3815和第二主电池3817(例如，锂离子电池)，和二次电池组，该二次电池组包括二次电池3820，当功率源3812插入电池组件中时，二次电池3820通过开关3823连接到电路中。二次电池3820为具有抗γ或其它辐射消毒的部件部分的防下跌电池。例如，可结合电池组件内的开关模式功率源3827和任选的充电电路以允许二次电池3820降低一次电池3815、3817的电压下跌。这保证了外科开始时易于引入无菌场地中的完全充电的单元。一次电池3815、3817可用于直接为马达控制电路3826和能量电路3832供电。马达控制电路3826被配置为控制马达，诸如马达3829。功率源/电池组3812可包括双类型电池组件，其包括一次Li离子电池3815、3817和具有专用能量单元3820的二次NiMH电池3820，以控制来自专用能量单元3815、3817的柄部电子电路3830以运行马达控制电路3826和能量电路3832。在这种情况下，当涉及驱动能量电路3832和/或马达控制电路3826的一次电池3815、3817下降时，电路3810从涉及驱动柄部电子电路3830的二次电池3820拉取。在一个各个方面，电路3810可包括单向二极管，该单向二极管将不允许电流沿相反方向流动(例如，从涉及驱动能量电路和/或马达控制电路的电池流向涉及驱动电子电路的马达控制电路)。FIG38 is a schematic diagram of a circuit 3800 according to at least one aspect of the present disclosure, the circuit 3800 including independent power sources for high power energy/drive circuits and low power circuits. The power source 3812 includes a primary battery pack including a first main battery 3815 and a second main battery 3817 (e.g., lithium ion batteries) connected to the circuit 3800 via a switch 3818, and a secondary battery pack including a secondary battery 3820, which is connected to the circuit via a switch 3823 when the power source 3812 is inserted into the battery assembly. The secondary battery 3820 is a drop-proof battery with component parts that are resistant to gamma or other radiation sterilization. For example, a switch-mode power source 3827 and an optional charging circuit within the battery assembly can be combined to allow the secondary battery 3820 to reduce the voltage drop of the primary batteries 3815, 3817. This ensures a fully charged unit that is easy to introduce into the sterile field at the beginning of surgery. The primary batteries 3815, 3817 may be used to directly power the motor control circuit 3826 and the energy circuit 3832. The motor control circuit 3826 is configured to control a motor, such as motor 3829. The power source/battery pack 3812 may include a dual type battery assembly including primary Li-ion batteries 3815, 3817 and secondary NiMH batteries 3820 with a dedicated energy cell 3820 to control the handle electronic circuit 3830 from the dedicated energy cell 3815, 3817 to run the motor control circuit 3826 and the energy circuit 3832. In this case, when the primary batteries 3815, 3817 involved in driving the energy circuit 3832 and/or the motor control circuit 3826 are down, the circuit 3810 draws from the secondary batteries 3820 involved in driving the handle electronic circuit 3830. In various aspects, circuit 3810 may include a unidirectional diode that will not allow current to flow in the reverse direction (e.g., from a battery involving a drive energy circuit and/or a motor control circuit to a motor control circuit involving a drive electronics circuit).

另外，可提供包括开关模式功率源3827的γ友好充电电路，该开关模式功率源3827使用二极管和真空管部件以最小化预定水平下的电压下跌。在包括为NiMH电压(3个NiMH单元)的分隔的最小下跌电压的情况下，可消除开关模式功率源3827。另外，可提供模块化系统，其中辐射硬化部件位于模块中，使得模块可通过辐射消毒来灭菌。其它非辐射硬化部件可包括在其它模块化部件以及在模块化部件之间进行的连接中，使得部件部分一起操作，如同部件一起位于同一电路板上一样。如果仅期望两个NiMH单元，则基于二极管和真空管的开关模式功率源3827允许一次性一级电池组内的可消毒电子器件。In addition, a gamma-friendly charging circuit may be provided that includes a switch mode power source 3827 that uses diode and vacuum tube components to minimize voltage drop below a predetermined level. In the case of a minimum drop voltage that includes separation of NiMH voltages (3 NiMH cells), the switch mode power source 3827 may be eliminated. In addition, a modular system may be provided in which radiation hardened components are located in modules so that the modules can be sterilized by radiation sterilization. Other non-radiation hardened components may be included in other modular components and connections made between modular components so that the components partially operate together as if the components were located together on the same circuit board. If only two NiMH cells are desired, the diode and vacuum tube based switch mode power source 3827 allows for sterilizable electronics within a disposable primary battery pack.

现在转到图39，其示出了根据本公开的至少一个方面的用于操作与外科器械一起使用的电池3901供电的RF发生器电路3902的控制电路3900。外科器械被配置为使用超声振动和高频电流两者来对活组织进行外科凝结/切割处理，并且使用高频电流对活组织进行外科凝结处理。Turning now to FIG. 39 , a control circuit 3900 is shown for operating a battery 3901 powered RF generator circuit 3902 for use with a surgical instrument in accordance with at least one aspect of the present disclosure. The surgical instrument is configured to perform surgical coagulation/cutting treatments on living tissue using both ultrasonic vibrations and high frequency currents, and to perform surgical coagulation treatments on living tissue using high frequency currents.

图39示出了控制电路3900，该控制电路3900允许双发生器系统在外科系统1000的外科器械的RF发生器电路3902模态和超声发生器电路3920模态之间切换。在一个方面，检测RF信号中的电流阈值。当组织的阻抗低时，当RF能量用作组织的治疗源时，穿过组织的高频电流是高的。根据一个方面，可将位于外科系统1000的外科器械上的视觉指示器3912或灯配置为在该高电流周期期间处于接通状态。当电流低于阈值时，视觉指示器3912处于断开状态。因此，光电晶体管3914可被配置为检测从接通状态到断开状态的转变，并解离RF能量，如图39中所示的控制电路3900中所示。因此，当释放能量按钮并且打开能量开关3926时，控制电路3900被复位并且RF发生器电路3902和超声发生器电路3920两者被保持切断。FIG. 39 shows a control circuit 3900 that allows a dual generator system to switch between the RF generator circuit 3902 mode and the ultrasonic generator circuit 3920 mode of the surgical instrument of the surgical system 1000. In one aspect, a current threshold in the RF signal is detected. When the impedance of the tissue is low, when RF energy is used as a therapeutic source for the tissue, the high frequency current passing through the tissue is high. According to one aspect, a visual indicator 3912 or light located on the surgical instrument of the surgical system 1000 can be configured to be in an on state during this high current period. When the current is below the threshold, the visual indicator 3912 is in an off state. Therefore, the phototransistor 3914 can be configured to detect the transition from the on state to the off state and dissociate the RF energy, as shown in the control circuit 3900 shown in FIG. Therefore, when the energy button is released and the energy switch 3926 is turned on, the control circuit 3900 is reset and both the RF generator circuit 3902 and the ultrasonic generator circuit 3920 are kept off.

参考图39，在一个方面，提供了一种管理RF发生器电路3902和超声发生器电路3920的方法。RF发生器电路3902和/或超声发生器电路3920可位于例如多功能电外科器械1108的柄部组件1109、超声换能器/RF发生器组件1120、电池组件、轴组件1129和/或喷嘴中。如果能量开关3926切断(例如，开路)，则控制电路3900保持在复位状态。因此，当能量开关3926打开时，控制电路3900被复位，并且RF发生器电路3902和超声发生器电路3920两者均被关闭。当能量开关3926被挤压并且能量开关3926被接合(例如，闭合)时，RF能量被递送至组织，并且由电流感测升压变压器3904操作的视觉指示器3912将在组织阻抗低时点亮。来自视觉指示器3912的光提供逻辑信号以将超声发生器电路3920保持在断开状态。一旦组织阻抗增加到高于阈值并且穿过组织的高频电流降低到低于阈值，则视觉指示器3912关闭并且光转变到断开状态。由该转变生成的逻辑信号关闭继电器3908，由此关闭RF发生器电路3902并且打开超声发生器电路3920，以完成凝结和切割循环。Referring to FIG. 39 , in one aspect, a method for managing an RF generator circuit 3902 and an ultrasonic generator circuit 3920 is provided. The RF generator circuit 3902 and/or the ultrasonic generator circuit 3920 may be located, for example, in the handle assembly 1109, the ultrasonic transducer/RF generator assembly 1120, the battery assembly, the shaft assembly 1129, and/or the nozzle of the multifunctional electrosurgical instrument 1108. If the energy switch 3926 is cut off (e.g., open circuit), the control circuit 3900 remains in a reset state. Thus, when the energy switch 3926 is turned on, the control circuit 3900 is reset, and both the RF generator circuit 3902 and the ultrasonic generator circuit 3920 are turned off. When the energy switch 3926 is squeezed and the energy switch 3926 is engaged (e.g., closed), RF energy is delivered to the tissue, and the visual indicator 3912 operated by the current sensing step-up transformer 3904 will light up when the tissue impedance is low. The light from the visual indicator 3912 provides a logic signal to maintain the ultrasonic generator circuit 3920 in the off state. Once the tissue impedance increases above the threshold and the high frequency current passing through the tissue decreases below the threshold, the visual indicator 3912 turns off and the light transitions to the off state. The logic signal generated by this transition closes the relay 3908, thereby turning off the RF generator circuit 3902 and turning on the ultrasonic generator circuit 3920 to complete the coagulation and cutting cycle.

仍参照图39，在一个方面，双发生器电路配置针对一种模态采用电池3901供电的板载RF发生器电路3902，并且采用第二、板载超声发生器电路3920，该超声发生器电路3920可板载于多功能电外科器械1108的柄部组件1109、电池组件、轴组件1129、喷嘴、和/或超声换能器/RF发生器组件1120。超声发生器电路3920也是电池3901操作的。在各个方面，RF发生器电路3902和超声发生器电路3920可为柄部组件1109的集成部件或可分离部件。根据各个方面，具有双RF发生器电路3902/超声发生器电路3920作为柄部组件1109的一部分可消除复杂布线的需要。RF发生器电路3902/超声发生器电路3920可被配置为在同时利用无绳发生器系统的能力的同时提供现有发生器的全部能力。Still referring to FIG. 39 , in one aspect, the dual generator circuit configuration employs an onboard RF generator circuit 3902 powered by a battery 3901 for one modality, and employs a second, onboard ultrasonic generator circuit 3920, which may be onboard the handle assembly 1109, the battery assembly, the shaft assembly 1129, the nozzle, and/or the ultrasonic transducer/RF generator assembly 1120 of the multifunctional electrosurgical instrument 1108. The ultrasonic generator circuit 3920 is also operated by the battery 3901. In various aspects, the RF generator circuit 3902 and the ultrasonic generator circuit 3920 may be an integrated component or a separable component of the handle assembly 1109. According to various aspects, having dual RF generator circuits 3902/ultrasonic generator circuits 3920 as part of the handle assembly 1109 may eliminate the need for complex wiring. The RF generator circuit 3902/ultrasonic generator circuit 3920 may be configured to provide the full capabilities of an existing generator while simultaneously utilizing the capabilities of a cordless generator system.

任一类型的系统可具有用于彼此不通信的模态的独立控件。外科医生分别并根据他们的判断来激活RF和超声。另一种方法将是提供完全集成的通信方案，该方案共享按钮、组织状态、器械操作参数(诸如钳口闭合、力等)和用于管理组织处理的算法。该集成的各种组合可被实现为提供适当水平的功能和性能。Either type of system may have separate controls for the modalities that do not communicate with each other. The surgeon activates RF and ultrasound separately and at their discretion. Another approach would be to provide a fully integrated communication solution that shares buttons, tissue status, instrument operating parameters (such as jaw closure, force, etc.), and algorithms for managing tissue treatment. Various combinations of this integration may be implemented to provide appropriate levels of functionality and performance.

如上所述，在一个方面，控制电路3900包括电池3901供电的RF发生器电路3902，其包括电池作为能量源。如图所示，RF发生器电路3902耦合到本文称为电极3906a、3906b(即，有源电极3906a和返回电极3906b)的两个导电表面，并且被配置为用RF能量(例如，高频电流)驱动电极3906a、3906b。升压变压器3904的第一绕组3910a与双极RF发生器电路3902的一个极和返回电极3906b串联连接。在一个方面，第一绕组3910a和返回电极3906b连接到双极RF发生器电路3902的负极。双极RF发生器电路3902的另一极通过继电器3908的开关触点3909连接到有源电极3906a，或包括电枢的任何合适的电磁开关装置，电磁体3936使该电枢运动以操作开关触点3909。当电磁体3936通电时，开关触点3909闭合，并且当电磁体3936断电时，开关触点3909打开。当开关触点闭合时，RF电流流过位于电极3906a、3906b之间的导电组织(未示出)。应当理解，在一个方面，有源电极3906a连接到双极RF发生器电路3902的正极。As described above, in one aspect, the control circuit 3900 includes an RF generator circuit 3902 powered by a battery 3901, which includes a battery as an energy source. As shown, the RF generator circuit 3902 is coupled to two conductive surfaces referred to herein as electrodes 3906a, 3906b (i.e., active electrode 3906a and return electrode 3906b), and is configured to drive electrodes 3906a, 3906b with RF energy (e.g., high frequency current). The first winding 3910a of the step-up transformer 3904 is connected in series with one pole of the bipolar RF generator circuit 3902 and the return electrode 3906b. In one aspect, the first winding 3910a and the return electrode 3906b are connected to the negative pole of the bipolar RF generator circuit 3902. The other pole of the bipolar RF generator circuit 3902 is connected to the active electrode 3906a through the switch contact 3909 of the relay 3908, or any suitable electromagnetic switching device including an armature, which is moved by the electromagnet 3936 to operate the switch contact 3909. When the electromagnet 3936 is energized, the switch contact 3909 is closed, and when the electromagnet 3936 is de-energized, the switch contact 3909 is open. When the switch contact is closed, RF current flows through the conductive tissue (not shown) located between the electrodes 3906a, 3906b. It should be understood that in one aspect, the active electrode 3906a is connected to the positive pole of the bipolar RF generator circuit 3902.

视觉指示电路3905包括升压变压器3904、串联电阻器R2和视觉指示器3912。视觉指示器3912可适于与外科器械1108和其它电外科系统和工具(诸如本文所述的那些)一起使用。升压变压器3904的第一绕组3910a与返回电极3906b串联连接，并且升压变压器3904的第二绕组3910b与电阻器R2串联，并且视觉指示器3912包括例如NE-2型霓虹灯泡。The visual indicator circuit 3905 includes a step-up transformer 3904, a series resistor R2, and a visual indicator 3912. The visual indicator 3912 may be suitable for use with the surgical instrument 1108 and other electrosurgical systems and tools such as those described herein. The first winding 3910a of the step-up transformer 3904 is connected in series with the return electrode 3906b, and the second winding 3910b of the step-up transformer 3904 is connected in series with the resistor R2, and the visual indicator 3912 includes, for example, a NE-2 type neon bulb.

在操作中，当继电器3908的开关触点3909打开时，有源电极3906a与双极RF发生器电路3902的正极断开连接，并且没有电流流过组织、返回电极3906b和升压变压器3904的第一绕组3910a。因此，视觉指示器3912未通电并且不发光。当继电器3908的开关触点3909闭合时，有源电极3906a连接到双极RF发生器电路3902的阳极，从而使电流能够流过组织、返回电极3906b和升压变压器3904的第一绕组3910a以在组织上操作，例如切割和烧灼组织。In operation, when the switch contacts 3909 of the relay 3908 are open, the active electrode 3906a is disconnected from the positive pole of the bipolar RF generator circuit 3902, and no current flows through the tissue, the return electrode 3906b, and the first winding 3910a of the step-up transformer 3904. Therefore, the visual indicator 3912 is not powered and does not illuminate. When the switch contacts 3909 of the relay 3908 are closed, the active electrode 3906a is connected to the anode of the bipolar RF generator circuit 3902, thereby enabling current to flow through the tissue, the return electrode 3906b, and the first winding 3910a of the step-up transformer 3904 to operate on the tissue, such as cutting and cauterizing the tissue.

作为位于有源电极3906a和返回电极3906b之间的组织的阻抗的函数，第一电流流过第一绕组3910a，从而在升压变压器3904的第一绕组3910a上提供第一电压。在升压变压器3904的第二绕组3910b上感应升压的第二电压。二次电压出现在电阻器R2上，并且在穿过组织的电流大于预定阈值时使视觉指示器3912通电，从而使霓虹灯泡点亮。应当理解，电路和部件值是示例性的，而不限于此。当继电器3908的开关触点3909闭合时，电流流过组织并且打开视觉指示器3912。As a function of the impedance of the tissue located between the active electrode 3906a and the return electrode 3906b, a first current flows through the first winding 3910a, thereby providing a first voltage on the first winding 3910a of the step-up transformer 3904. A stepped-up second voltage is induced on the second winding 3910b of the step-up transformer 3904. The secondary voltage appears across the resistor R2 and energizes the visual indicator 3912 when the current through the tissue is greater than a predetermined threshold, thereby illuminating the neon bulb. It should be understood that the circuit and component values are exemplary and not limiting. When the switch contacts 3909 of the relay 3908 are closed, current flows through the tissue and turns on the visual indicator 3912.

现在转到控制电路3900的能量开关3926部分，当能量开关3926处于打开位置时，将逻辑高施加到第一逆变器3928的输入，并且将逻辑低施加到与门3932的两个输入中的一个。因此，与门3932的输出低，并且晶体管3934断开以防止电流流过电磁体3936的绕组。当电磁体3936处于断电状态时，继电器3908的开关触点3909保持打开并且防止电流流过电极3906a、3906b。第一逆变器3928的逻辑低输出也被施加到第二逆变器3930，从而使输出变高并复位触发器3918(例如，D型触发器)。此时，将Q输出变低以关闭超声发生器电路3920并且输出变高并且被施加到与门3932的另一个输入。Turning now to the energy switch 3926 portion of the control circuit 3900, when the energy switch 3926 is in the open position, a logic high is applied to the input of the first inverter 3928, and a logic low is applied to one of the two inputs of the AND gate 3932. Therefore, the output of the AND gate 3932 is low, and the transistor 3934 is disconnected to prevent current from flowing through the winding of the electromagnet 3936. When the electromagnet 3936 is in the de-energized state, the switch contacts 3909 of the relay 3908 remain open and prevent current from flowing through the electrodes 3906a, 3906b. The logic low output of the first inverter 3928 is also applied to the second inverter 3930, causing the output to go high and reset the flip-flop 3918 (e.g., a D-type flip-flop). At this point, the Q output is turned low to turn off the ultrasonic generator circuit 3920 and The output goes high and is applied to the other input of AND gate 3932.

当用户按压器械柄部上的能量开关3926以将能量施加到电极3906a、3906b之间的组织上时，能量开关3926闭合并在第一逆变器3928的输入处施加逻辑低，该第一逆变器3928将逻辑高施加到与门3932的其它输入，从而使与门3932的输出变高并打开晶体管3934。在接通状态下，晶体管3934传导并吸收流过电磁体3936的绕组的电流，以使电磁体3936通电并闭合继电器3908的开关触点3909。如上所述，当开关触点3909闭合时，当组织位于电极3906a、3906b之间时，电流可流过电极3906a、3906b和升压变压器3904的第一绕组3910a。When the user presses the energy switch 3926 on the instrument handle to apply energy to the tissue between the electrodes 3906a, 3906b, the energy switch 3926 closes and applies a logic low at the input of the first inverter 3928, which applies a logic high to the other input of the AND gate 3932, causing the output of the AND gate 3932 to go high and turn on the transistor 3934. In the on state, the transistor 3934 conducts and sinks current flowing through the winding of the electromagnet 3936 to energize the electromagnet 3936 and close the switch contacts 3909 of the relay 3908. As described above, when the switch contacts 3909 are closed, current can flow through the electrodes 3906a, 3906b and the first winding 3910a of the step-up transformer 3904 when tissue is located between the electrodes 3906a, 3906b.

如上所述，流过电极3906a、3906b的电流的量值取决于位于电极3906a、3906b之间的组织的阻抗。最初，组织阻抗低，并且穿过组织和第一绕组3910a的电流的量值高。因此，施加在第二绕组3910b上的电压足够高以接通视觉指示器3912。由视觉指示器3912发出的光打开光电晶体管3914，其使逆变器3916的输入拉低，并且使逆变器3916的输出变高。施加到触发器3918的CLK的高输入不影响触发器3918的Q或输出，并且Q输出保持低，且输出保持高。因此，当视觉指示器3912保持通电时，超声发生器电路3920被关闭，并且多功能电外科器械的超声换能器3922和超声刀3924未被激活。As described above, the magnitude of the current flowing through the electrodes 3906a, 3906b depends on the impedance of the tissue located between the electrodes 3906a, 3906b. Initially, the tissue impedance is low, and the magnitude of the current passing through the tissue and the first winding 3910a is high. Therefore, the voltage applied to the second winding 3910b is high enough to turn on the visual indicator 3912. The light emitted by the visual indicator 3912 turns on the phototransistor 3914, which pulls the input of the inverter 3916 low, and causes the output of the inverter 3916 to go high. The high input of CLK applied to the flip-flop 3918 does not affect the Q or output, and the Q output remains low, and The output remains high. Thus, when the visual indicator 3912 remains powered, the ultrasonic generator circuit 3920 is turned off, and the ultrasonic transducer 3922 and ultrasonic blade 3924 of the multifunctional electrosurgical instrument are not activated.

当电极3906a、3906b之间的组织干燥时，由于流过组织的电流所生成的热，组织的阻抗增加并且穿过组织的电流降低。当穿过第一绕组3910a的电流降低时，第二绕组3910b上的电压也降低，并且当电压降至操作可视指示器3912所需的最小阈值以下时，视觉指示器3912和光电晶体管3914关闭。当光电晶体管3914关闭时，逻辑高被施加到逆变器3916的输入并且逻辑低被施加到触发器3918的CLK输入以为到Q输出的逻辑高和到输出的逻辑低计时。在Q输出处的逻辑高接通超声发生器电路3920以激活超声换能器3922和超声刀3924，从而开始切割位于电极3906a、3906a之间的组织。其同时或接近同时与超声发生器电路3920接通，输出触发器3918变低并且使与门3932的输出变低并且关闭晶体管3934，从而使电磁铁3936断电并打开继电器3908的开关触点3909以切断流经电极3906a、3906b的电流。When the tissue between the electrodes 3906a, 3906b dries, the impedance of the tissue increases and the current through the tissue decreases due to the heat generated by the current flowing through the tissue. When the current through the first winding 3910a decreases, the voltage on the second winding 3910b also decreases, and when the voltage drops below the minimum threshold required to operate the visual indicator 3912, the visual indicator 3912 and the phototransistor 3914 turn off. When the phototransistor 3914 is off, a logic high is applied to the input of the inverter 3916 and a logic low is applied to the CLK input of the flip-flop 3918 to generate a logic high to the Q output and a logic low to the Q output. The logic high at the Q output turns on the ultrasonic generator circuit 3920 to activate the ultrasonic transducer 3922 and the ultrasonic blade 3924, thereby starting to cut the tissue between the electrodes 3906a, 3906a. It is turned on simultaneously or nearly simultaneously with the ultrasonic generator circuit 3920, The output flip-flop 3918 goes low and causes the output of the AND gate 3932 to go low and turn off the transistor 3934, thereby de-energizing the electromagnet 3936 and opening the switch contacts 3909 of the relay 3908 to cut off the current flowing through the electrodes 3906a, 3906b.

当继电器3908的开关触点3909打开时，没有电流流过的电极3906a、3906b、组织和升压变压器3904的第一绕组3910a。因此，在第二绕组3910b上没有产生电压，并且没有电流流过视觉指示器3912。When the switch contacts 3909 of the relay 3908 are open, no current flows through the electrodes 3906a, 3906b, the tissue, and the first winding 3910a of the step-up transformer 3904. Therefore, no voltage is generated on the second winding 3910b, and no current flows through the visual indicator 3912.

当用户挤压器械柄部上的能量开关3926以保持能量开关3926闭合时，触发器3918的Q输出和输出保持相同。因此，当无电流从双极RF发生器电路3902流过电极3906a、3906b时，超声刀3924保持激活并继续切割端部执行器的钳口之间的组织。当用户释放器械柄部上的能量开关3926时，能量开关3926打开并且第一逆变器3928的输出变低，并且第二逆变器3930的输出变高以复位触发器3918，从而使Q输出变低并关闭超声发生器电路3920。与此同时，输出变高并且电路现在处于断开状态并且准备好被用户致动器械柄部上的能量开关3926以关闭能量开关3926、将电流施加到位于电极3906a、3906b之间的组织，并重复如上所述的施加RF能量和超声能量到组织的循环。When the user squeezes the energy switch 3926 on the instrument handle to keep the energy switch 3926 closed, the Q output of the trigger 3918 and The output remains the same. Therefore, when no current flows from the bipolar RF generator circuit 3902 through the electrodes 3906a, 3906b, the ultrasonic knife 3924 remains activated and continues to cut tissue between the jaws of the end effector. When the user releases the energy switch 3926 on the instrument handle, the energy switch 3926 turns on and the output of the first inverter 3928 goes low, and the output of the second inverter 3930 goes high to reset the flip-flop 3918, thereby causing the Q output to go low and turning off the ultrasonic generator circuit 3920. At the same time, The output goes high and the circuit is now in the open state and is ready for the user to actuate the energy switch 3926 on the instrument handle to close the energy switch 3926, apply current to the tissue located between the electrodes 3906a, 3906b, and repeat the cycle of applying RF energy and ultrasonic energy to the tissue as described above.

图40示出了外科系统4000的图示，该外科系统4000表示外科系统1000的一个方面，包括用于与外科系统1000的外科器械中的任一者一起使用的反馈系统，该反馈系统可包括或实现本文所述的特征件中的许多个。外科系统4000可包括耦合到外科器械的发生器4002，该外科器械包括端部执行器4006，该端部执行器4006可在临床医生操作触发器4010时被激活。在各个方面，端部执行器4006可包括超声刀以递送超声振动从而对活组织进行外科凝结/切割处理。在其它方面，端部执行器4006可包括耦合到电外科高频电流源以对活组织进行外科凝结或烧灼处理的导电元件，以及具有锋利边缘的机械刀或用于对活组织进行切割处理的超声刀。当触发器4010被致动时，力传感器4012可产生指示被施加到触发器4010的力的量的信号。除了力传感器4012之外或代替力传感器4012，外科器械可包括位置传感器4013，该位置传感器4013可生成指示触发器4010的位置的信号(例如，触发器已被按压或以其它方式致动的程度)。在一个方面，位置传感器4013可为定位有外部管状护套或往复式管状致动构件的传感器，该往复式管状致动构件位于外科器械的外部管状护套内。在一个方面，传感器可为响应于磁场而改变其输出电压的霍尔效应传感器或任何合适的换能器。霍尔效应传感器可用于接近开关、定位、速度检测和电流感测应用。在一个方面，霍尔效应传感器作为模拟换能器操作，从而直接返回电压。利用已知的磁场，可确定其与霍尔板的距离。FIG. 40 shows a diagram of a surgical system 4000 that represents one aspect of the surgical system 1000, including a feedback system for use with any of the surgical instruments of the surgical system 1000, which may include or implement many of the features described herein. The surgical system 4000 may include a generator 4002 coupled to a surgical instrument that includes an end effector 4006 that may be activated when a clinician operates a trigger 4010. In various aspects, the end effector 4006 may include an ultrasonic blade to deliver ultrasonic vibrations to perform surgical coagulation/cutting treatments on living tissue. In other aspects, the end effector 4006 may include a conductive element coupled to an electrosurgical high-frequency current source to perform surgical coagulation or cauterization treatments on living tissue, as well as a mechanical blade with a sharp edge or an ultrasonic blade for cutting treatments on living tissue. When the trigger 4010 is actuated, the force sensor 4012 may generate a signal indicating the amount of force applied to the trigger 4010. In addition to or in place of the force sensor 4012, the surgical instrument may include a position sensor 4013 that can generate a signal indicating the position of the trigger 4010 (e.g., the extent to which the trigger has been pressed or otherwise actuated). In one aspect, the position sensor 4013 can be a sensor positioned with an outer tubular sheath or a reciprocating tubular actuating member that is located within the outer tubular sheath of the surgical instrument. In one aspect, the sensor can be a Hall effect sensor or any suitable transducer that changes its output voltage in response to a magnetic field. Hall effect sensors can be used for proximity switches, positioning, speed detection, and current sensing applications. In one aspect, the Hall effect sensor operates as an analog transducer, returning a voltage directly. Using a known magnetic field, its distance from the Hall plate can be determined.

控制电路4008可接收来自传感器4012和/或4013的信号。控制电路4008可包括任何合适的模拟电路或数字电路部件。控制电路4008还可与发生器4002和/或换能器4004通信，以基于施加到触发器4010的力和/或触发器4010的位置和/或上述外部管状护套相对于位于外部管状护套内的往复式管状致动构件的位置(例如，如通过霍尔效应传感器和磁体组合测量的)来调制递送至端部执行器4006的功率和/或端部执行器4006的发生器水平或超声刀幅值。例如，随着更多的力被施加到触发器4010，可将更多的功率和/或更高的超声刀幅值递送至端部执行器4006。根据各个方面，力传感器4012可被多位开关替换。The control circuit 4008 may receive signals from the sensors 4012 and/or 4013. The control circuit 4008 may include any suitable analog circuit or digital circuit components. The control circuit 4008 may also communicate with the generator 4002 and/or the transducer 4004 to modulate the power delivered to the end effector 4006 and/or the generator level or ultrasonic blade amplitude of the end effector 4006 based on the force applied to the trigger 4010 and/or the position of the trigger 4010 and/or the position of the above-mentioned outer tubular sheath relative to the reciprocating tubular actuating member located within the outer tubular sheath (e.g., as measured by a Hall effect sensor and a magnet combination). For example, as more force is applied to the trigger 4010, more power and/or a higher ultrasonic blade amplitude may be delivered to the end effector 4006. According to various aspects, the force sensor 4012 may be replaced by a multi-position switch.

根据各个方面，端部执行器4006可包括夹具或夹持机构。当触发器4010最初被致动时，夹持机构可闭合，从而将组织夹持在夹持臂和端部执行器4006之间。当施加到触发器的力增加时(例如，如由力传感器4012感测的)，控制电路4008可增加由换能器4004递送至端部执行器4006的功率和/或端部执行器4006中产生的发生器水平或超声刀幅值。在一个方面，如由位置传感器4013感测的触发器位置或如由位置传感器4013感测的夹具或夹持臂位置(例如，用霍尔效应传感器)可由控制电路4008用于设定端部执行器4006的功率和/或幅值。例如，当触发器进一步朝完全致动位置运动时，或者夹具或夹持臂进一步朝超声刀(或端部执行器4006)运动时，端部执行器4006的功率和/或幅值可增加。According to various aspects, the end effector 4006 may include a clamp or clamping mechanism. When the trigger 4010 is initially actuated, the clamping mechanism may close, thereby clamping the tissue between the clamping arm and the end effector 4006. When the force applied to the trigger increases (e.g., as sensed by the force sensor 4012), the control circuit 4008 may increase the power delivered to the end effector 4006 by the transducer 4004 and/or the generator level or ultrasonic blade amplitude generated in the end effector 4006. In one aspect, the trigger position as sensed by the position sensor 4013 or the clamp or clamping arm position as sensed by the position sensor 4013 (e.g., with a Hall effect sensor) may be used by the control circuit 4008 to set the power and/or amplitude of the end effector 4006. For example, as the trigger moves further toward the fully actuated position, or as the clamp or clamp arm moves further toward the ultrasonic blade (or end effector 4006), the power and/or amplitude of the end effector 4006 may increase.

根据各个方面，外科系统4000的外科器械还可包括用于指示递送至端部执行器4006的功率的量的一个或多个反馈装置。例如，扬声器4014可发出指示端部执行器功率的信号。根据各个方面，扬声器4014可发出一系列脉冲声音，其中该声音的频率指示功率。除了扬声器4014之外或代替扬声器4014，外科器械可包括视觉显示器4016。视觉显示器4016可根据任何合适的方法来指示端部执行器功率。例如，视觉显示器4016可包括一系列LED，而端部执行器功率由发光的LED的数目来指示。扬声器4014和/或视觉显示4016可由控制电路4008驱动。根据各个方面，外科器械可包括连接至触发器4010的棘轮装置。棘轮装置可在向触发器4010施加更多的力时生成听觉声音，从而提供对端部执行器功率的间接指示。外科器械可包括可增强安全性的其它特征件。例如，控制电路4008可被设置成防止将超过预定阈值的功率递送到端部执行器4006。此外，控制电路4008可实现指示(例如，通过扬声器4014或视觉显示器4016)端部执行器功率的变化的时间和递送端部执行器功率的变化的时间之间的延迟。这样即可给予临床医生充分的警告：即将递送到端部执行器4006的超声功率的水平将会改变。According to various aspects, the surgical instrument of the surgical system 4000 may also include one or more feedback devices for indicating the amount of power delivered to the end effector 4006. For example, the speaker 4014 may emit a signal indicating the power of the end effector. According to various aspects, the speaker 4014 may emit a series of pulsed sounds, wherein the frequency of the sound indicates the power. In addition to the speaker 4014 or in place of the speaker 4014, the surgical instrument may include a visual display 4016. The visual display 4016 may indicate the end effector power according to any suitable method. For example, the visual display 4016 may include a series of LEDs, and the end effector power is indicated by the number of LEDs that are illuminated. The speaker 4014 and/or the visual display 4016 may be driven by the control circuit 4008. According to various aspects, the surgical instrument may include a ratchet device connected to the trigger 4010. The ratchet device may generate an audible sound when more force is applied to the trigger 4010, thereby providing an indirect indication of the power of the end effector. The surgical instrument may include other features that may enhance safety. For example, the control circuit 4008 can be configured to prevent power from being delivered to the end effector 4006 that exceeds a predetermined threshold. In addition, the control circuit 4008 can implement a delay between the time a change in end effector power is indicated (e.g., via the speaker 4014 or visual display 4016) and the time the change in end effector power is delivered. This can give the clinician ample warning that the level of ultrasonic power that is about to be delivered to the end effector 4006 will change.

在一个方面，外科系统1000的超声或高频电流发生器可被配置为数字地生成电信号波形，使得期望的使用存储在查找表中的预定数量的相位点来数字化波形。相位点可存储在限定于存储器、场可编程门阵列(FPGA)或任何合适的非易失性存储器中的表中。图41示出了数字合成电路诸如直接数字合成(DDS)电路4100的基本架构的一个方面，该DDS电路4100被配置为生成电信号波形的多个波形状。发生器软件和数字控件可命令FPGA扫描查找表4104中的地址，该查找表4104继而向馈送功率放大器的DAC电路4108提供变化的数字输入值。可根据感兴趣的频率扫描地址。使用此查找表4104能够生成各种类型的波形，该波形可同时被馈送到组织或换能器、RF电极中、同时被馈送到多个换能器中、同时被馈送到多个RF电极中、或被馈送到RF器械和超声器械的组合中。此外，可从发生器创建、存储和向组织施加表示多个波形状的多个查找表4104。In one aspect, the ultrasonic or high frequency current generator of the surgical system 1000 can be configured to digitally generate an electrical signal waveform so that the desired waveform is digitized using a predetermined number of phase points stored in a lookup table. The phase points can be stored in a table defined in a memory, a field programmable gate array (FPGA), or any suitable non-volatile memory. FIG. 41 shows an aspect of the basic architecture of a digital synthesis circuit such as a direct digital synthesis (DDS) circuit 4100, which is configured to generate multiple wave shapes of electrical signal waveforms. The generator software and digital control can command the FPGA to scan the address in the lookup table 4104, which in turn provides a varying digital input value to the DAC circuit 4108 feeding the power amplifier. The address can be scanned according to the frequency of interest. Using this lookup table 4104, various types of waveforms can be generated, which can be fed to tissue or transducers, RF electrodes, multiple transducers, multiple RF electrodes, or a combination of RF instruments and ultrasonic instruments at the same time. Additionally, multiple lookup tables 4104 representing multiple wave shapes may be created, stored, and applied to the tissue from the generator.

波形信号可被配置为控制超声换能器和/或RF电极或其倍数(例如，两个或更多个超声换能器和/或两个或更多个RF电极)的输出电流、输出电压、或输出功率中的至少一者。另外，在外科器械包括超声部件的情况下，波形信号可被配置为驱动至少一个外科器械的超声换能器的至少两个振动模式。因此，发生器可被配置为向至少一个外科器械提供波形信号，其中波形信号对应于表中多个波形状中的至少一个波形状。另外，提供给两个外科器械的波形信号可包括两个或更多个波形状。该表可包括与多个波形状相关联的信息，并且该表可存储在发生器内。在一个方面或示例中，该表可为可存储在发生器的FPGA中的直接数字合成表。可通过方便对波形状进行分类的任何方式来寻址该表。根据一个方面，根据波形信号的频率来寻址该表(其可为直接数字合成表)。另外，与所述多个波形状相关联的信息可作为数字信息存储在表中。The waveform signal may be configured to control at least one of the output current, output voltage, or output power of an ultrasonic transducer and/or an RF electrode or multiples thereof (e.g., two or more ultrasonic transducers and/or two or more RF electrodes). In addition, in the case where the surgical instrument includes an ultrasonic component, the waveform signal may be configured to drive at least two vibration modes of the ultrasonic transducer of at least one surgical instrument. Therefore, the generator may be configured to provide a waveform signal to at least one surgical instrument, wherein the waveform signal corresponds to at least one of the plurality of waveform shapes in the table. In addition, the waveform signal provided to the two surgical instruments may include two or more waveform shapes. The table may include information associated with a plurality of waveform shapes, and the table may be stored in the generator. In one aspect or example, the table may be a direct digital synthesis table that may be stored in an FPGA of the generator. The table may be addressed in any manner that facilitates classification of the waveform shape. According to one aspect, the table (which may be a direct digital synthesis table) is addressed according to the frequency of the waveform signal. In addition, the information associated with the plurality of waveform shapes may be stored in the table as digital information.

模拟电信号波形可被配置为控制超声换能器和/或RF电极或其倍数(例如，两个或更多个超声换能器和/或两个或更多个RF电极)的输出电流、输出电压或输出功率中的至少一者。另外，在外科器械包括超声部件的情况下，模拟电信号波形可被配置为驱动至少一个外科器械的超声换能器的至少两个振动模式。因此，发生器电路可被配置为向至少一个外科器械提供模拟电信号波形，其中模拟电信号波形对应于存储在查找表4104中的多个波形状中的至少一个波形状。另外，提供给两个外科器械的模拟电信号波形可包括两个或更多个波形状。查找表4104可包括与多个波形状相关联的信息，并且查找表4104可存储在发生器电路或外科器械内。在一个方面或示例中，查找表4104可为直接数字合成表，其可存储在发生器电路或外科器械的FPGA中。查找表4104可通过方便地对波形状进行分类的任何方式来寻址。根据一个方面，查找表4104(其可为直接数字合成表)根据期望的模拟电信号波形的频率来寻址。另外，与所述多个波形状相关联的信息可作为数字信息存储在查找表4104中。The analog electrical signal waveform may be configured to control at least one of the output current, output voltage, or output power of an ultrasonic transducer and/or an RF electrode or multiples thereof (e.g., two or more ultrasonic transducers and/or two or more RF electrodes). In addition, in the case where the surgical instrument includes an ultrasonic component, the analog electrical signal waveform may be configured to drive at least two vibration modes of the ultrasonic transducer of at least one surgical instrument. Therefore, the generator circuit may be configured to provide an analog electrical signal waveform to at least one surgical instrument, wherein the analog electrical signal waveform corresponds to at least one of the multiple waveform shapes stored in the lookup table 4104. In addition, the analog electrical signal waveform provided to the two surgical instruments may include two or more waveform shapes. The lookup table 4104 may include information associated with multiple waveform shapes, and the lookup table 4104 may be stored in the generator circuit or the surgical instrument. In one aspect or example, the lookup table 4104 may be a direct digital synthesis table that may be stored in an FPGA of the generator circuit or the surgical instrument. The lookup table 4104 may be addressed by any method that conveniently classifies the waveform shapes. According to one aspect, the lookup table 4104 (which may be a direct digital synthesis table) is addressed according to the frequency of the desired analog electrical signal waveform. In addition, information associated with the plurality of waveform shapes may be stored in the lookup table 4104 as digital information.

随着在器械和通信系统中广泛使用数字技术，从参考频率源生成多个频率的数字控制方法已经演进，并且被称为直接数字合成。基础架构示于图41中。在该简化框图中，DDS电路耦合到发生器电路的处理器、控制器、或逻辑装置，并且耦合到位于外科系统1000的发生器电路中的存储器电路。DDS电路4100包括地址计数器4102、查找表4104、寄存器4106、DAC电路4108和滤波器4112。稳定时钟f_c由地址计数器4102接收，并且寄存器4106驱动可编程只读存储器(PROM)，该可编程只读存储器将正弦波(或其它任意波形)的一个或多个整数循环存储在查找表4104中。当地址计数器4102步进通过存储器位置时，存储在查找表4104中的值被写入寄存器4106，该寄存器4106耦合到DAC电路4108。在查找表4104的存储器位置处的信号的对应数字幅值驱动DAC电路4108，该DAC电路4108继而生成模拟输出信号4110。模拟输出信号4110的光谱纯度主要由DAC电路4108确定。相位噪声基本上是基准时钟f_c的相位噪声。从DAC电路4108输出的第一模拟输出信号4110被滤波器4112滤波，并且由滤波器4112输出的第二模拟输出信号4114被提供给放大器，该放大器具有耦合到发生器电路的输出的输出。第二模拟输出信号具有频率f_输出。With the widespread use of digital technology in instruments and communication systems, digital control methods for generating multiple frequencies from a reference frequency source have evolved and are known as direct digital synthesis. The basic architecture is shown in FIG41. In this simplified block diagram, the DDS circuit is coupled to a processor, controller, or logic device of the generator circuit and to a memory circuit located in the generator circuit of the surgical system 1000. The DDS circuit 4100 includes an address counter 4102, a lookup table 4104, a register 4106, a DAC circuit 4108, and a filter 4112. A stable clock_fc is received by the address counter 4102, and the register 4106 drives a programmable read-only memory (PROM) that stores one or more integer cycles of a sine wave (or other arbitrary waveform) in the lookup table 4104. As the address counter 4102 steps through the memory location, the value stored in the lookup table 4104 is written to the register 4106, which is coupled to the DAC circuit 4108. The corresponding digital amplitude of the signal at the memory location of the lookup table 4104 drives a DAC circuit 4108, which in turn generates an analog output signal 4110. The spectral purity of the analog output signal 4110 is primarily determined by the DAC circuit 4108. The phase noise is substantially the phase noise of the reference clock_fc . The first analog output signal 4110 output from the DAC circuit 4108 is filtered by a filter 4112, and the second analog output signal 4114 output by the filter 4112 is provided to an amplifier having an output coupled to the output of the generator circuit. The second analog output signal has a frequency_fout .

因为DDS电路4100是取样数据系统，所以必须考虑取样中涉及的问题：量化噪声、混叠、滤波等。例如，DAC电路4108输出频率的更高阶谐波折返回到Nyquist带宽中，使得它们不可滤波，而基于锁相环路(PLL)的合成器的输出的高阶谐波可被滤波。查找表4104包含整数个循环的信号数据。可通过改变基准时钟频率f_c或通过重新编程PROM来改变最终输出频率f_输出。Because the DDS circuit 4100 is a sampled data system, the issues involved in sampling must be considered: quantization noise, aliasing, filtering, etc. For example, higher order harmonics of the DAC circuit 4108 output frequency fold back into the Nyquist bandwidth, making them unfilterable, while higher order harmonics of the output of a phase-locked loop (PLL) based synthesizer can be filtered. Lookup table 4104 contains an integer number of cycles of signal data. The final output frequency_fout can be changed by changing the reference clock frequency_fc or by reprogramming the PROM.

DDS电路4100可包括多个查找表4104，其中查找表4104存储由预定数量的样本表示的波形，其中样本限定波形的预定形状。因此，可将具有独特形状的多个波形存储在多个查找表4104中，以基于器械设置或组织反馈提供不同的组织处理。波形的示例包括用于表面组织凝结的高波峰因数RF电信号波形、用于更深组织渗透的低波峰因数RF电信号波形、以及促进有效触摸凝结的电信号波形。在一个方面，DDS电路4100可创建多个波形状查找表4104，并且在组织处理过程期间(例如，基于用户或传感器输入的“即时(on-the-fly)”或虚拟实时)，基于期望的组织效应和/或组织反馈，在存储在单独查找表4104中的不同波形状之间切换。The DDS circuit 4100 may include a plurality of lookup tables 4104, wherein the lookup tables 4104 store waveforms represented by a predetermined number of samples, wherein the samples define a predetermined shape of the waveform. Thus, a plurality of waveforms having unique shapes may be stored in the plurality of lookup tables 4104 to provide different tissue treatments based on instrument settings or tissue feedback. Examples of waveforms include high crest factor RF electrical signal waveforms for surface tissue coagulation, low crest factor RF electrical signal waveforms for deeper tissue penetration, and electrical signal waveforms that promote effective touch coagulation. In one aspect, the DDS circuit 4100 may create a plurality of waveform shape lookup tables 4104 and switch between different waveform shapes stored in separate lookup tables 4104 based on desired tissue effects and/or tissue feedback during a tissue treatment process (e.g., "on-the-fly" or virtual real-time based on user or sensor input).

因此，波形状之间的切换可基于例如组织阻抗和其它因素。在其它方面，查找表4104可存储电信号波形，该电信号波形被成形为使每个循环递送到组织中的功率最大化(即，梯形或方波)。在其它方面，查找表4104可存储以此类方式同步的波形，该方式使得外科系统1000的多功能外科器械在递送RF驱动信号和超声驱动信号时的功率递送最大化。在其它方面，查找表4104可存储电信号波形，以同时驱动超声能量和RF治疗能量、和/或子治疗能量，同时维持超声锁定。特定于不同器械的定制波形状及其组织效应可存储在发生器电路的非易失性存储器中或外科系统1000的非易失性存储器(例如，EEPROM)中，并且在将多功能外科器械连接到发生器电路时被提取。如在许多高波峰因数“凝结”波形中使用的指数衰减正弦曲线的示例示于图43中。Thus, the switching between wave shapes can be based on, for example, tissue impedance and other factors. In other aspects, the lookup table 4104 can store electrical signal waveforms that are shaped to maximize the power delivered to the tissue per cycle (i.e., a trapezoidal or square wave). In other aspects, the lookup table 4104 can store waveforms synchronized in such a manner that the multifunctional surgical instrument of the surgical system 1000 maximizes power delivery when delivering RF drive signals and ultrasonic drive signals. In other aspects, the lookup table 4104 can store electrical signal waveforms to simultaneously drive ultrasonic energy and RF treatment energy, and/or sub-treatment energy while maintaining ultrasonic lock. Customized wave shapes specific to different instruments and their tissue effects can be stored in the non-volatile memory of the generator circuit or in the non-volatile memory (e.g., EEPROM) of the surgical system 1000 and extracted when the multifunctional surgical instrument is connected to the generator circuit. An example of an exponentially decaying sinusoidal curve as used in many high crest factor "coagulation" waveforms is shown in FIG. 43.

DDS电路4100的更灵活和有效的具体实施采用被称为数字控制振荡器(NCO)的数字电路。更灵活和有效的数字合成电路诸如DDS电路4200的框图示于图42中。在该简化框图中，DDS电路4200耦合到发生器的处理器、控制器、或逻辑装置，并且连接到位于发生器中或外科系统1000的外科器械中的任一者中的存储器电路。DDS电路4200包括负载寄存器4202、并行增量相位寄存器4204、加法器电路4216、相位寄存器4208、查找表4210(相位到幅值转换器)、DAC电路4212、和滤波器4214。加法器电路4216和相位寄存器4208形成相累加器4206的一部分。时钟频率f_c被施加到相位寄存器4208和DAC电路4212。负载寄存器4202接收将输出频率指定为参考时钟频率信号f_c的分数的调谐字。负载寄存器4202的输出以调谐字M提供给并行增量相位寄存器4204。A more flexible and efficient implementation of the DDS circuit 4100 employs a digital circuit known as a digitally controlled oscillator (NCO). A block diagram of a more flexible and efficient digital synthesis circuit such as a DDS circuit 4200 is shown in FIG. 42. In this simplified block diagram, the DDS circuit 4200 is coupled to a processor, controller, or logic device of the generator and is connected to a memory circuit located in the generator or in any of the surgical instruments of the surgical system 1000. The DDS circuit 4200 includes a load register 4202, a parallel incremental phase register 4204, an adder circuit 4216, a phase register 4208, a lookup table 4210 (phase to amplitude converter), a DAC circuit 4212, and a filter 4214. The adder circuit 4216 and the phase register 4208 form part of the phase accumulator 4206. The clock frequency_fc is applied to the phase register 4208 and the DAC circuit 4212. The load register 4202 receives a tuning word that specifies the output frequency as a fraction of the reference clock frequency signal_fc . The output of the load register 4202 is provided to the parallel incremental phase register 4204 in the tuning word M.

DDS电路4200包括生成时钟频率f_c的采样时钟、相位累加器4206和查找表4210(例如，相位到幅值转换器)。每个时钟循环f_c更新一次相位累加器4206的内容。当更新相位累加器4206的时间时，通过加法器电路4216将存储在并联增量相位寄存器4204中的数字M添加至相位寄存器4208中的数字。假设并联增量相位寄存器4204中的数字为00…01并且相位累加器4206的初始内容为00…00。相位累加器4206每个时钟循环更新00…01。如果相位累加器4206为232位宽，则在相位累加器4206返回至00…00之前需要232个时钟循环(超过40亿)，并且重复该循环。DDS circuit 4200 includes a sampling clock that generates a clock frequency_fc , a phase accumulator 4206, and a lookup table 4210 (e.g., a phase to amplitude converter). The contents of phase accumulator 4206 are updated once every clock cycle_fc . When the time of updating phase accumulator 4206 is, the number M stored in parallel incremental phase register 4204 is added to the number in phase register 4208 by adder circuit 4216. Assume that the numbers in parallel incremental phase register 4204 are 00...01 and the initial contents of phase accumulator 4206 are 00...00. Phase accumulator 4206 is updated 00...01 every clock cycle. If phase accumulator 4206 is 232 bits wide, 232 clock cycles (over 4 billion) are required before phase accumulator 4206 returns to 00...00, and the cycle is repeated.

将相位累加器4206的截断的输出4218提供到相位到幅值转换器查找表4210，并且查找表4210的输出耦合到DAC电路4212。相位累加器4206的截断的输出4218充当正弦(或余弦)查找表的地址。查找表中的地址对应于从0°到360°的正弦波上的相位点。查找表4210包含正弦波的一个完整循环的对应数字幅值信息。因此，查找表4210将来自相位累加器4206的相位信息映射到数字幅值字，该数字幅值字继而驱动DAC电路4212。DAC电路的输出为第一模拟信号4220并且通过滤波器4214进行滤波。滤波器4214的输出为第二模拟信号4222，该模拟信号被提供给耦合到发生器电路的输出的功率放大器。The truncated output 4218 of the phase accumulator 4206 is provided to a phase to amplitude converter lookup table 4210, and the output of the lookup table 4210 is coupled to a DAC circuit 4212. The truncated output 4218 of the phase accumulator 4206 serves as the address of the sine (or cosine) lookup table. The address in the lookup table corresponds to a phase point on a sine wave from 0° to 360°. The lookup table 4210 contains the corresponding digital amplitude information for one complete cycle of the sine wave. Therefore, the lookup table 4210 maps the phase information from the phase accumulator 4206 to a digital amplitude word, which in turn drives the DAC circuit 4212. The output of the DAC circuit is a first analog signal 4220 and is filtered by a filter 4214. The output of the filter 4214 is a second analog signal 4222, which is provided to a power amplifier coupled to the output of the generator circuit.

在一个方面，电信号波形可被数字化为1024(210)个相位点，但波形状可被数字化为256(28)至281,474,976,710,656(248)范围内的任何合适数量的2n相位点，其中n为正整数，如表1中所示。电信号波形可被表示为A_n(θ_n)，其中点n处的归一化幅值A由被称为点n处的相位点的相位角θ_n表示。离散相位点的数量n确定DDS电路4200(以及图41中所示的DDS电路4100)的调谐分辨率。In one aspect, the electrical signal waveform may be digitized into 1024 (210) phase points, but the waveform may be digitized into any suitable number of 2n phase points in the range of 256 (28) to 281,474,976,710,656 (248), where n is a positive integer, as shown in Table 1. The electrical signal waveform may be represented as_An (_θn ), where the normalized amplitude A at point n is represented by a phase angle_θn referred to as the phase point at point n. The number of discrete phase points n determines the tuning resolution of the DDS circuit 4200 (and the DDS circuit 4100 shown in FIG. 41).

表1指定被数字化为多个相位点的电信号波形。Table 1 specifies the waveform of an electrical signal digitized into a plurality of phase points.

NN阶段点数2ⁿStage Points 2ⁿ8825625610101,0241,02412124,0964,096141416,38416,384161665,53665,5361818262,144262,14420201,048,5761,048,57622twenty two4,194,3044,194,30424twenty four16,777,21616,777,216262667,108,86467,108,8642828268,435,456268,435,456…………32324,294,967,2964,294,967,296…………4848281,474,976,710,656281,474,976,710,656…………

表1Table 1

发生器电路算法和数字控制电路扫描查找表4210中的地址，该查找表4210继而向馈送滤波器4214和功率放大器的DAC电路4212提供变化的数字输入值。可根据感兴趣的频率扫描地址。使用查找表能够生成各种类型的形状，这些形状可被DAC电路4212转换为模拟输出信号、通过滤波器4214进行滤波、通过耦合到发生器电路的输出的功率放大器放大、或者以RF能量的形式被馈送至组织、或者以超声振动的形式被馈送至组织，该超声振动以热的形式将能量递送至组织。放大器的输出可例如被施加到RF电极、被同时施加到多个RF电极、被施加到超声换能器、被同时施加到多个超声换能器、或者被施加到RF和超声换能器的组合。此外，可从发生器电路创建、存储多个波形表并将其施加到组织。The generator circuit algorithm and digital control circuit scan the address in the lookup table 4210, which in turn provides a varying digital input value to the DAC circuit 4212 that feeds the filter 4214 and the power amplifier. The address can be scanned according to the frequency of interest. Using the lookup table, various types of shapes can be generated, which can be converted into analog output signals by the DAC circuit 4212, filtered by the filter 4214, amplified by the power amplifier coupled to the output of the generator circuit, or fed to the tissue in the form of RF energy, or fed to the tissue in the form of ultrasonic vibrations, which deliver energy to the tissue in the form of heat. The output of the amplifier can be applied to an RF electrode, to multiple RF electrodes simultaneously, to an ultrasonic transducer, to multiple ultrasonic transducers simultaneously, or to a combination of RF and ultrasonic transducers. In addition, multiple waveform tables can be created, stored and applied to the tissue from the generator circuit.

返回参考图41，对于n＝32和M＝1，相位累加器4206在其溢出和重新启动之前步进通过232个可能的输出。对应的输出波频率等于输入时钟频率除以232。如果M＝2，则相位寄存器1708“翻转(rolls over)”两倍快，并且输出频率加倍。这可被归纳如下。Referring back to FIG. 41 , for n=32 and M=1, the phase accumulator 4206 steps through 232 possible outputs before it overflows and restarts. The corresponding output wave frequency is equal to the input clock frequency divided by 232. If M=2, the phase register 1708 "rolls over" twice as fast, and the output frequency is doubled. This can be summarized as follows.

对于被配置为累积n位的相为累加器4206(在大多数DDS系统中n通常在24至32的范围内，但如前所述n可选自广泛的选项)，存在2ⁿ个可能的相位点。增量相位寄存器中的数字字M表示相位累加器每时钟循环递增的量。如果f_c为时钟频率，则输出正弦波的频率等于：For a phase accumulator 4206 configured to accumulate n bits (n is typically in the range of 24 to 32 in most DDS systems, but as previously described n can be selected from a wide range of options), there are²ⁿ possible phase points. The digital word M in the incremental phase register represents the amount by which the phase accumulator increments per clock cycle. If_fc is the clock frequency, the frequency of the output sine wave is equal to:

上述公式被称为DDS“调谐公式”。注意，系统的频率分辨率等于对于n＝32，该分辨率大于四十亿分之一。在DDS电路4200的一个方面，不是所有来自相位累加器4206的位被传递到查找表4210，而是被截断，仅留下例如前13至15个最高有效位(MSB)。这减小了查找表4210的大小并且不影响频率分辨率。相位截断仅向最终输出添加小但可接受量的相位噪声。The above equation is called the DDS “tuning equation.” Note that the frequency resolution of the system is equal to For n=32, the resolution is greater than one part in four billion. In one aspect of the DDS circuit 4200, instead of all bits from the phase accumulator 4206 being passed to the lookup table 4210, they are truncated, leaving only, for example, the first 13 to 15 most significant bits (MSBs). This reduces the size of the lookup table 4210 and does not affect the frequency resolution. The phase truncation only adds a small but acceptable amount of phase noise to the final output.

电信号波形可通过预定频率下的电流、电压或功率来表征。另外，在外科系统1000的外科器械中的任一个包括超声部件的情况下，电信号波形可被配置为驱动至少一个外科器械的超声换能器的至少两个振动模式。因此，发生器电路可被配置为向至少一个外科器械提供电信号波形，其中电信号波形通过存储在查找表4210(或图41的查找表4104)中的预定的波形状来表征。此外，电信号波形可为两个或更多个波形状的组合。查找表4210可包括与多个波形状相关联的信息。在一个方面或示例中，查找表4210可由DDS电路4200生成，并且可被称为直接数字合成表。DDS通过首先在板载存储器中存储大量重复波形来工作。波形(正弦、三角形、正方形、任意)的循环可由如表1中所示的预定数量的相位点表示并被存储到存储器中。一旦波形被存储到存储器中，其就可以在非常精确的频率下生成。直接数字合成表可被存储在发生器电路的非易失性存储器中并且/或者可用发生器电路中的FPGA电路来实现。查找表4210可通过方便对波形状进行分类的任何合适的技术来寻址。根据一个方面，查找表4210根据电信号波形的频率来寻址。另外，与所述多个波形状相关联的信息可作为数字信息或作为查找表4210的一部分存储在存储器中。The electrical signal waveform may be characterized by current, voltage, or power at a predetermined frequency. In addition, in the case where any of the surgical instruments of the surgical system 1000 includes an ultrasonic component, the electrical signal waveform may be configured to drive at least two vibration modes of the ultrasonic transducer of at least one surgical instrument. Therefore, the generator circuit may be configured to provide an electrical signal waveform to at least one surgical instrument, wherein the electrical signal waveform is characterized by a predetermined wave shape stored in the lookup table 4210 (or the lookup table 4104 of FIG. 41). In addition, the electrical signal waveform may be a combination of two or more wave shapes. The lookup table 4210 may include information associated with multiple wave shapes. In one aspect or example, the lookup table 4210 may be generated by the DDS circuit 4200 and may be referred to as a direct digital synthesis table. The DDS works by first storing a large number of repetitive waveforms in an onboard memory. The cycle of the waveform (sine, triangle, square, arbitrary) may be represented by a predetermined number of phase points as shown in Table 1 and stored in the memory. Once the waveform is stored in the memory, it can be generated at a very precise frequency. The direct digital synthesis table may be stored in a non-volatile memory of the generator circuit and/or may be implemented with an FPGA circuit in the generator circuit. The lookup table 4210 may be addressed by any suitable technique that facilitates classification of the waveform shapes. According to one aspect, the lookup table 4210 is addressed according to the frequency of the electrical signal waveform. Additionally, information associated with the plurality of waveform shapes may be stored in a memory as digital information or as part of the lookup table 4210.

在一个方面，发生器电路可被配置为同时向至少两个外科器械提供电信号波形。发生器电路还可被配置为经由发生器电路的输出信道同时向两个外科器械提供电信号波形，该电信号波形可通过两个或更多个波形来表征。例如，在一个方面，电信号波形包括用于驱动超声换能器的第一电信号(例如，超声驱动信号)、第二RF驱动信号、和/或它们的组合。此外，电信号波形可包括多个超声驱动信号、多个RF驱动信号、和/或多个超声驱动信号和RF驱动信号的组合。In one aspect, the generator circuit can be configured to provide an electrical signal waveform to at least two surgical instruments simultaneously. The generator circuit can also be configured to provide an electrical signal waveform to two surgical instruments simultaneously via an output channel of the generator circuit, and the electrical signal waveform can be characterized by two or more waveforms. For example, in one aspect, the electrical signal waveform includes a first electrical signal (e.g., an ultrasonic drive signal) for driving an ultrasonic transducer, a second RF drive signal, and/or a combination thereof. In addition, the electrical signal waveform may include multiple ultrasonic drive signals, multiple RF drive signals, and/or a combination of multiple ultrasonic drive signals and RF drive signals.

此外，操作根据本公开的发生器电路的方法包括生成电信号波形并向外科系统1000的外科器械中的任一个提供所生成的电信号波形，其中生成电信号波形包括从存储器接收与电信号波形相关联的信息。所生成的电信号波形包括至少一个波形状。此外，向至少一个外科器械提供所生成的电信号波形包括同时向至少两个外科器械提供电信号波形。In addition, a method of operating a generator circuit according to the present disclosure includes generating an electrical signal waveform and providing the generated electrical signal waveform to any one of the surgical instruments of the surgical system 1000, wherein generating the electrical signal waveform includes receiving information associated with the electrical signal waveform from a memory. The generated electrical signal waveform includes at least one waveform shape. In addition, providing the generated electrical signal waveform to at least one surgical instrument includes providing the electrical signal waveform to at least two surgical instruments simultaneously.

如本文所述的发生器电路可允许生成各种类型的直接数字合成表。由发生器电路生成的适用于处理多种组织的RF/电外科信号的波形状的示例包括具有高波峰因数的RF信号(其可用于RF模式下的表面凝结)、低波峰因数RF信号(其可用于更深的组织渗透)、以及促进有效的触摸凝结的波形。发生器电路还可采用直接数字合成查找表4210来生成多个波形状，并且可基于期望的组织效应在特定的波形状之间快速切换。切换可基于组织阻抗和/或其它因素。The generator circuit as described herein may allow for the generation of various types of direct digital synthesis tables. Examples of waveform shapes of RF/electrosurgical signals suitable for treating a variety of tissues generated by the generator circuit include RF signals with high crest factors (which may be used for surface coagulation in RF mode), low crest factor RF signals (which may be used for deeper tissue penetration), and waveforms that promote effective touch coagulation. The generator circuit may also employ a direct digital synthesis lookup table 4210 to generate multiple waveform shapes, and may quickly switch between specific waveform shapes based on the desired tissue effect. The switching may be based on tissue impedance and/or other factors.

除了传统的正弦/余弦波形状之外，发生器电路还可被配置为产生使每个循环中进入组织的功率最大化的一个或多个波形状(即，梯形或方波)。发生器电路可提供一个或多个波形状，该一个或多个波形状被同步以在同时驱动RF信号和超声信号时使递送至负载的功率最大化并保持超声锁定，前提条件是发生器电路包括能够同时驱动RF信号和超声信号的电路拓扑结构。另外，专用于器械及其组织效应的定制波形状可存储在非易失性存储器(NVM)或器械EEPROM中，并且可在将外科系统1000的外科器械中的任一个连接至发生器电路时被提取。In addition to traditional sine/cosine wave shapes, the generator circuit can also be configured to generate one or more wave shapes (i.e., trapezoidal or square waves) that maximize the power entering the tissue in each cycle. The generator circuit can provide one or more wave shapes that are synchronized to maximize the power delivered to the load and maintain ultrasonic lock when driving RF signals and ultrasonic signals simultaneously, provided that the generator circuit includes a circuit topology capable of driving RF signals and ultrasonic signals simultaneously. In addition, customized wave shapes specific to the instrument and its tissue effect can be stored in non-volatile memory (NVM) or instrument EEPROM and can be retrieved when any of the surgical instruments of the surgical system 1000 is connected to the generator circuit.

DDS电路4200可包括多个查找表4104，其中查找表4210存储由预定数量的相位点(也可称为样本)表示的波形，其中相位点限定波形的预定形状。因此，可将具有独特形状的多个波形存储在多个查找表4210中，以基于器械设置或组织反馈提供不同的组织处理。波形的示例包括用于表面组织凝结的高波峰因数RF电信号波形、用于更深组织渗透的低波峰因数RF电信号波形、以及促进有效触摸凝结的电信号波形。在一个方面，DDS电路4200可创建多个波形状查找表4210，并且在组织处理过程期间(例如，基于用户或传感器输入的“即时(on-the-fly)”或虚拟实时)，基于期望的组织效应和/或组织反馈，在存储在不同查找表4210中的不同波形状之间切换。The DDS circuit 4200 may include a plurality of lookup tables 4104, wherein the lookup table 4210 stores waveforms represented by a predetermined number of phase points (also referred to as samples), wherein the phase points define a predetermined shape of the waveform. Thus, a plurality of waveforms having unique shapes may be stored in the plurality of lookup tables 4210 to provide different tissue treatments based on instrument settings or tissue feedback. Examples of waveforms include high crest factor RF electrical signal waveforms for surface tissue coagulation, low crest factor RF electrical signal waveforms for deeper tissue penetration, and electrical signal waveforms that promote effective touch coagulation. In one aspect, the DDS circuit 4200 may create a plurality of waveform shape lookup tables 4210 and switch between different waveform shapes stored in different lookup tables 4210 during a tissue treatment process (e.g., "on-the-fly" or virtually real-time based on user or sensor input) based on desired tissue effects and/or tissue feedback.

因此，波形状之间的切换可基于例如组织阻抗和其它因素。在其它方面，查找表4210可存储电信号波形，该电信号波形被成形为使每个循环递送到组织中的功率最大化(即，梯形或方波)。在其它方面，查找表4210可存储以此类方式同步的波形状，该方式为当递送RF信号和超声驱动信号时，它们通过外科系统1000的外科器械中的任一者使功率递送最大化。在其它方面，查找表4210可存储电信号波形，以同时驱动超声能量和RF治疗能量、和/或子治疗能量，同时维持超声锁定。一般来讲，输出波形状可为正弦波、余弦波、脉冲波、方波等的形式。然而，特定于不同器械的更复杂且定制的波形及其组织效应可存储在发生器电路的非易失性存储器或外科器械的非易失性存储器(例如，EEPROM)中，并且在将外科器械连接到发生器电路时被提取。定制波形状的一个示例如是在许多高波峰因数“凝结”波形中使用的指数衰减正弦曲线，如图43中所示。Thus, switching between waveform shapes may be based on, for example, tissue impedance and other factors. In other aspects, the lookup table 4210 may store electrical signal waveforms that are shaped to maximize the power delivered to the tissue per cycle (i.e., a trapezoidal or square wave). In other aspects, the lookup table 4210 may store waveforms that are synchronized in such a way that when the RF signal and the ultrasonic drive signal are delivered, they maximize power delivery through any of the surgical instruments of the surgical system 1000. In other aspects, the lookup table 4210 may store electrical signal waveforms to simultaneously drive ultrasonic energy and RF treatment energy, and/or sub-treatment energy, while maintaining ultrasonic lock. In general, the output waveform shape may be in the form of a sine wave, a cosine wave, a pulse wave, a square wave, etc. However, more complex and customized waveforms specific to different instruments and their tissue effects may be stored in a non-volatile memory of the generator circuit or a non-volatile memory of the surgical instrument (e.g., an EEPROM) and retrieved when the surgical instrument is connected to the generator circuit. An example of a custom wave shape is the exponentially decaying sinusoid used in many high crest factor “coagulation” waveforms, as shown in FIG. 43 .

图43示出了模拟波形4304的根据本公开的至少一个方面的离散时间数字电信号波形4300的一个循环(显示为叠加在离散时间数字电信号波形4300上以用于比较)。水平轴表示时间(t)，而垂直轴表示数字相位点。数字电信号波形4300是例如期望模拟波形4304的数字离散时间型式。通过存储幅值相位点4302来生成数字电信号波形4300，该幅值相位点4302表示一个循环或周期T_o上每个时钟循环T_clk的幅值。数字电信号波形4300通过任何合适的数字处理电路在一个周期T_o上生成。幅值相位点是存储在存储器电路中的数字字。在图41、图42中所示的示例中，数字字是能够以26位或64位的分辨率存储幅值相位点的六位字。应当理解，图41、图42中所示的示例用于示例性目的，并且在实际具体实施中，分辨率可更高。在一个循环T_o上的数字幅值相位点4302作为在查找表4104、4210中的一串字串存储在存储器中，如结合图41、图42所述，例如。为了生成模拟波形4304的模拟型式，从存储器按时钟循环T_clk从0至T_o依次读取幅值相位点4302，并且由DAC电路4108、4212转换，也结合图41、图42所述。可通过将数字电信号波形4300的幅值相位点4302从0至T_o反复读取尽可能多的循环或周期来生成附加的循环。模拟波形4304的平滑模拟型式通过用滤波器4112、4214(图41和图42)滤波DAC电路4108、4212的输出来实现。将滤波的模拟输出信号4114、4222(图41和图42)施加到功率放大器的输入。FIG. 43 shows one cycle of a discrete-time digital electrical signal waveform 4300 of an analog waveform 4304 according to at least one aspect of the present disclosure (shown superimposed on the discrete-time digital electrical signal waveform 4300 for comparison). The horizontal axis represents time (t), and the vertical axis represents digital phase points. The digital electrical signal waveform 4300 is, for example, a digital discrete-time version of the desired analog waveform 4304. The digital electrical signal waveform 4300 is generated by storing amplitude phase points 4302, which represent the amplitude of each clock cycle T_clk over one cycle or period T_o . The digital electrical signal waveform 4300 is generated over one period T_o by any suitable digital processing circuit. The amplitude phase points are digital words stored in a memory circuit. In the examples shown in FIGS. 41 and 42 , the digital words are six-bit words capable of storing amplitude phase points at a resolution of 26 or 64 bits. It should be understood that the examples shown in FIGS. 41 and 42 are for exemplary purposes, and in actual implementations, the resolution may be higher. The digital amplitude phase points 4302_over one cycle To are stored in memory as a string in a lookup table 4104, 4210, as described in conjunction with FIGS. 41 and 42, for example. To generate an analog version of the analog waveform 4304, the amplitude phase points 4302 are sequentially read from memory at clock cycles_Tclk from 0 to_To and converted by DAC circuits 4108, 4212, also described in conjunction with FIGS. 41 and 42. Additional cycles may be generated by repeatedly reading the amplitude phase points 4302 of the digital electrical signal waveform 4300 from 0 to_To for as many cycles or periods as possible. A smoothed analog version of the analog waveform 4304 is achieved by filtering the output of the DAC circuits 4108, 4212 with filters 4112, 4214 (FIGS. 41 and 42). The filtered analog output signals 4114, 4222 (FIGS. 41 and 42) are applied to the input of the power amplifier.

图44为根据本公开的一个方面的控制系统12950的示意图，该控制系统12950被配置为在位移构件朝远侧推进并且耦合到夹持臂(例如，砧座)时提供闭合构件(例如，闭合管)的逐渐闭合，以以期望的速率降低闭合构件上的闭合力负载并减小击发构件上的击发力负载。在一个方面，控制系统12950可被实现为嵌套PID反馈控制器。PID控制器是控制环路反馈机构(控制器)，其用于将误差值连续地计算期望的设定点和测量的过程变量之间的差值，并基于比例、积分和导数项(有时分别表示为P、I和D)施加校正。嵌套PID控制器反馈控制系统12950包括初级(外部)反馈环路12954中的主控制器12952和次级(内部)反馈环路12956中的次级控制器12955。主控制器12952可为如图45中所示的PID控制器12972，并且次级控制器12955也可为如图45中所示的PID控制器12972。主控制器12952控制初级过程12958，并且次级控制器12955控制次级过程12960。初级过程12958的输出12966为从主设定点SP₁减去第一求和器12962。第一求和器12962产生施加到主控制器12952的单个和输出信号。主控制器12952的输出为次级设定点SP₂。次级过程12960的输出12968为从次级设定点SP₂减去第二求和器12964。FIG. 44 is a schematic diagram of a control system 12950 according to one aspect of the present disclosure, the control system 12950 being configured to provide a gradual closure of a closing member (e.g., a closing tube) when the displacement member is advanced distally and coupled to a clamping arm (e.g., anvil) to reduce the closing force load on the closing member and reduce the firing force load on the firing member at a desired rate. In one aspect, the control system 12950 can be implemented as a nested PID feedback controller. A PID controller is a control loop feedback mechanism (controller) that is used to continuously calculate the difference between a desired set point and a measured process variable as an error value, and to apply corrections based on proportional, integral, and derivative terms (sometimes represented as P, I, and D, respectively). The nested PID controller feedback control system 12950 includes a primary controller 12952 in a primary (external) feedback loop 12954 and a secondary controller 12955 in a secondary (internal) feedback loop 12956. The primary controller 12952 may be a PID controller 12972 as shown in FIG. 45, and the secondary controller 12955 may also be a PID controller 12972 as shown in FIG. 45. The primary controller 12952 controls the primary process 12958, and the secondary controller 12955 controls the secondary process 12960. The output 12966 of the primary process 12958 is the first summer 12962 subtracted from the primary set point SP_1. The first summer 12962 produces a single sum output signal applied to the primary controller 12952. The output of the primary controller 12952 is the secondary set point SP_2. The output 12968 of the secondary process 12960 is the second summer 12964 subtracted from the secondary set point SP₂ .

在控制闭合管的位移的情形中，控制系统12950可被配置为使得主设定点SP₁为期望的闭合力值，并且主控制器12952被配置为从耦合到闭合马达的输出的扭矩传感器接收闭合力并且确定闭合马达的设定点SP₂马达速度。在其它方面，闭合力可用应变仪、测力传感器或其它合适的力传感器来测量。将闭合马达速度设定点SP₂与闭合管的实际速度进行比较，该实际速度由次级控制器12955确定。闭合管的实际速度可通过比较测量闭合管与位置传感器的位移并用计时器/计数器测量耗用的时间来测量。可采用其它技术诸如线性编码器或旋转编码器来测量闭合管的位移。次级过程12960的输出12968为闭合管的实际速度。将该闭合管速度输出12968提供给初级过程12958，该初级过程12958确定作用于闭合管上的力并反馈回到加法器12962，该加法器12962从主设定点SP₁减去测量的闭合力。主设定点SP₁可为上限阈值或下限阈值。基于加法器12962的输出，主控制器12952控制闭合马达的速度和方向。次级控制器12955基于由次级过程12960测量的闭合管的实际速度和次级设定点SP₂来控制闭合马达的速度，该速度基于实际击发力与击发力上限阈值和下限阈值的比较。In the case of controlling the displacement of the closing tube, the control system 12950 can be configured so that the main set point SP₁ is the desired closing force value, and the main controller 12952 is configured to receive the closing force from the torque sensor coupled to the output of the closing motor and determine the set point SP₂ motor speed of the closing motor. In other aspects, the closing force can be measured with a strain gauge, a load cell or other suitable force sensor. The closing motor speed set point SP₂ is compared with the actual speed of the closing tube, which is determined by the secondary controller 12955. The actual speed of the closing tube can be measured by comparing the displacement of the closing tube with the position sensor and measuring the time consumed with a timer/counter. Other technologies such as linear encoders or rotary encoders can be used to measure the displacement of the closing tube. The output 12968 of the secondary process 12960 is the actual speed of the closing tube. The closing tube velocity output 12968 is provided to the primary process 12958, which determines the force acting on the closing tube and is fed back to the adder 12962, which subtracts the measured closing force from the main set point SP_1. The main set point SP₁ can be an upper threshold or a lower threshold. Based on the output of the adder 12962, the main controller 12952 controls the speed and direction of the closing motor. The secondary controller 12955 controls the speed of the closing motor based on the actual speed of the closing tube measured by the secondary process 12960 and the secondary set point SP₂ , which is based on a comparison of the actual firing force with the upper and lower firing force thresholds.

图45示出了根据本公开的一个方面的PID反馈控制系统12970。主控制器12952或次级控制器12955或两者可被实现为PID控制器12972。在一个方面，PID控制器12972可包括比例元件12974(P)、积分元件12976(I)和导数元件12978(D)。P元件12974、I元件12976、D元件12978的输出由求和器12986求和，该求和器12986向过程12980提供控制变量μ(t)。过程12980的输出为过程变量y(t)。求和器12984计算期望的设定点r(t)和测量的过程变量y(t)之间的差值。PID控制器12972连续地计算误差值e(t)(例如，闭合力阈值和测得的闭合力之间的差值)作为期望的设定点r(t)(例如，闭合力阈值)和测量的过程变量y(t)(例如，闭合管的速度和方向)之间的差值，并且基于分别由比例元件12974(P)、积分元件12976(I)和导数元件12978(D)计算出的比例、积分和导数项来施加校正。PID控制器12972尝试通过调节控制变量μ(t)(例如，闭合管的速度和方向)来最小化随时间推移的误差e(t)。FIG. 45 illustrates a PID feedback control system 12970 according to one aspect of the present disclosure. The primary controller 12952 or the secondary controller 12955 or both may be implemented as a PID controller 12972. In one aspect, the PID controller 12972 may include a proportional element 12974 (P), an integral element 12976 (I), and a derivative element 12978 (D). The outputs of the P element 12974, the I element 12976, and the D element 12978 are summed by a summer 12986, which provides a control variable μ(t) to a process 12980. The output of the process 12980 is a process variable y(t). The summer 12984 calculates the difference between the desired set point r(t) and the measured process variable y(t). The PID controller 12972 continuously calculates an error value e(t) (e.g., the difference between the closing force threshold and the measured closing force) as the difference between the desired set point r(t) (e.g., the closing force threshold) and the measured process variable y(t) (e.g., the speed and direction of the closing tube), and applies corrections based on proportional, integral, and derivative terms calculated by proportional element 12974 (P), integral element 12976 (I), and derivative element 12978 (D), respectively. The PID controller 12972 attempts to minimize the error e(t) over time by adjusting the control variable μ(t) (e.g., the speed and direction of the closing tube).

根据PID算法，“P”元件12974计算误差的当前值。例如，如果误差为大的且为正的，那么控制输出也将为大的和正的。根据本公开，误差项e(t)在闭合管的期望闭合力和所测量的闭合力之间是不同的。“I”元件12976计算误差的过去值。例如，如果当前输出不够强，那么误差的积分会随着时间推移而累积，并且控制器将通过施加更强的动作进行响应。“D”元件12978基于其当前的变化率计算该误差的未来可能趋势。例如，在继续上述P示例的情况下，当大的正控制输出成功地使误差更接近于零时，它也将进程置于最近的将来的大的负误差的路径中。在这种情况下，导数变为负，并且D模块减小动作的强度以防止该过冲。According to the PID algorithm, the "P" element 12974 calculates the current value of the error. For example, if the error is large and positive, then the control output will also be large and positive. According to the present disclosure, the error term e(t) is the difference between the desired closing force of the closing tube and the measured closing force. The "I" element 12976 calculates the past value of the error. For example, if the current output is not strong enough, then the integral of the error will accumulate over time, and the controller will respond by applying a stronger action. The "D" element 12978 calculates the possible future trend of the error based on its current rate of change. For example, continuing with the above P example, when a large positive control output successfully brings the error closer to zero, it also puts the process on the path of a large negative error in the near future. In this case, the derivative becomes negative, and the D module reduces the intensity of the action to prevent the overshoot.

应当理解，可根据反馈控制系统12950、12970来监测和控制其它变量和设定点。例如，本文所述的自适应闭合构件速度控制算法可测量以下参数中的至少两个：击发构件行程位置、击发构件负载、切割元件的位移、切割元件的速度、闭合管行程位置、闭合管负载等等。It should be appreciated that other variables and set points may be monitored and controlled in accordance with the feedback control systems 12950, 12970. For example, the adaptive closure member velocity control algorithm described herein may measure at least two of the following parameters: firing member stroke position, firing member load, displacement of the cutting element, velocity of the cutting element, closure tube stroke position, closure tube load, and the like.

超声外科装置诸如超声手术刀，因其独特的性能特征而用于外科规程的多种应用中。根据具体的装置配置和操作参数，超声外科装置可大体上同时提供组织的横切和通过凝结止血，从而有利地使患者创伤最小化。超声外科装置可包括包含超声换能器的手持件，以及耦合到超声换能器的器械，该超声换能器具有安装在远侧的端部执行器(例如，刀末端)以切割并密封组织。在一些情况下，器械可永久性地附连到手持件。在其它情况下，器械可为可从手持件拆卸的，如在一次性器械或可互换器械的情况下。端部执行器将超声能量传输到与端部执行器进行接触的组织，以实现切割和密封动作。具有该性质的超声外科装置可被配置用于开放性外科用途、腹腔镜式或内窥镜式外科规程，包括机器人辅助的规程。Ultrasonic surgical devices, such as ultrasonic scalpels, are used in a variety of applications in surgical procedures because of their unique performance characteristics. Depending on the specific device configuration and operating parameters, ultrasonic surgical devices can generally provide tissue transection and hemostasis by coagulation at the same time, thereby advantageously minimizing patient trauma. Ultrasonic surgical devices may include a handpiece including an ultrasonic transducer, and an instrument coupled to the ultrasonic transducer, the ultrasonic transducer having an end effector (e.g., a knife tip) mounted at the distal end to cut and seal tissue. In some cases, the instrument may be permanently attached to the handpiece. In other cases, the instrument may be detachable from the handpiece, such as in the case of disposable instruments or interchangeable instruments. The end effector transmits ultrasonic energy to tissue in contact with the end effector to achieve cutting and sealing actions. Ultrasonic surgical devices with this property can be configured for open surgical use, laparoscopic or endoscopic surgical procedures, including robot-assisted procedures.

超声能量使用低于电外科规程中所用的温度来切割并凝结组织，并且可通过与手持件连通的超声发生器将超声能量传输到端部执行器。在以高频振动(例如，每秒55,500个循环)的情况下，超声刀使组织中的蛋白变性，以形成粘性凝固物。刀表面施加在组织上的压力使血管塌缩并使该凝固物形成止血密封。外科医生可通过由端部执行器施加到组织的力、施加该力的时间以及端部执行器的选定偏移水平来控制切割速度和凝结。Ultrasonic energy uses a lower temperature than that used in electrosurgical procedures to cut and coagulate tissue, and can be transmitted to the end effector by an ultrasonic generator connected to the handpiece. Under high-frequency vibration (e.g., 55,500 cycles per second), the ultrasonic knife denatures the protein in the tissue to form a viscous coagulant. The pressure exerted by the surface of the knife on the tissue collapses the blood vessels and forms a hemostatic seal with the coagulant. The surgeon can control the cutting speed and coagulation by the force applied to the tissue by the end effector, the time of applying the force, and the selected offset level of the end effector.

超声换能器可被建模成等效电路，该等效电路包括具有静态电容的第一支路和具有串联连接的电感、电阻和电容的第二“动态”支路，该电感、电阻和电容限定谐振器的机电特性。已知的超声发生器可包括调谐电感器，该调谐电感器用于解谐处于谐振频率的静态电容，使得大体上发生器的驱动信号电流中的全部均流入动态支路中。因此，通过使用调谐电感器，发生器的驱动信号电流表示动态支路电流，并且因此发生器能够控制其驱动信号以保持超声换能器的谐振频率。调谐电感器还可变换超声换能器的相阻抗图以改善发生器的频率锁定能力。然而，调谐电感器必须与超声换能器在操作谐振频率下的特定静态电容匹配。换句话讲，具有不同静态电容的不同超声换能器需要不同的调谐电感器。The ultrasonic transducer can be modeled as an equivalent circuit including a first branch having a static capacitance and a second "dynamic" branch having an inductance, a resistance and a capacitance connected in series, which define the electromechanical characteristics of the resonator. A known ultrasonic generator may include a tuning inductor for detuning the static capacitance at the resonant frequency so that substantially all of the generator's drive signal current flows into the dynamic branch. Thus, by using the tuning inductor, the generator's drive signal current represents the dynamic branch current, and the generator is thus able to control its drive signal to maintain the resonant frequency of the ultrasonic transducer. The tuning inductor can also transform the phase impedance diagram of the ultrasonic transducer to improve the generator's frequency locking capability. However, the tuning inductor must be matched to the specific static capacitance of the ultrasonic transducer at the operating resonant frequency. In other words, different ultrasonic transducers with different static capacitances require different tuning inductors.

另外，在一些超声发生器架构中，发生器的驱动信号呈现非对称谐波失真，这使阻抗量值和相位测量复杂化。例如，阻抗相位测量的准确性可由于电流和电压信号中的谐波失真而减小。Additionally, in some ultrasonic generator architectures, the generator's drive signal exhibits asymmetric harmonic distortion, which complicates impedance magnitude and phase measurements. For example, the accuracy of impedance phase measurements can be reduced due to harmonic distortion in current and voltage signals.

此外，噪声环境中的电磁干扰会降低发生器保持对超声换能器的共振频率的锁定的能力，从而增加无效控制算法输入的可能性。Additionally, electromagnetic interference in noisy environments can degrade the generator's ability to maintain lock to the resonant frequency of the ultrasonic transducer, increasing the likelihood of invalid control algorithm inputs.

用于将电能施加到组织以治疗和/或破坏组织的电外科装置也在外科规程中得到日益广泛的应用。电外科装置包括手持件和具有远侧安装的端部执行器(例如，一个或多个电极)的器械。该端部执行器可抵靠组织定位，使得电流被引入组织中。电外科装置可被配置为用于双极或单极操作。在双极操作期间，电流分别通过端部执行器的有源电极和返回电极被引入到组织中并从组织返回。在单极操作期间，电流通过端部执行器的有源电极被引入组织中并且通过单独定位在患者身体上的返回电极(例如，接地垫)返回。流过组织的电流所产生的热可在组织内和/或在组织之间形成止血密封，并因此可尤其适用于例如密封血管。电外科装置的端部执行器还可包括能够相对于组织运动的切割构件以及用于横切组织的电极。Electrosurgical devices for applying electrical energy to tissue to treat and/or destroy tissue are also increasingly used in surgical procedures. Electrosurgical devices include a handpiece and an instrument having a distally mounted end effector (e.g., one or more electrodes). The end effector can be positioned against the tissue so that current is introduced into the tissue. The electrosurgical device can be configured for bipolar or monopolar operation. During bipolar operation, current is introduced into the tissue and returned from the tissue through the active electrode and return electrode of the end effector, respectively. During monopolar operation, current is introduced into the tissue through the active electrode of the end effector and returned through a return electrode (e.g., a ground pad) positioned separately on the patient's body. The heat generated by the current flowing through the tissue can form a hemostatic seal within the tissue and/or between the tissues, and can therefore be particularly suitable for, for example, sealing blood vessels. The end effector of the electrosurgical device may also include a cutting member capable of moving relative to the tissue and an electrode for transecting the tissue.

由电外科装置施加的电能可通过与手持件连通的发生器传输至器械。电能可为射频(RF)能量的形式。RF能量是可在300kHz至1MHz的频率范围内的电能形式，如EN60601-2-2:2009+A11:2011，定义201.3.218-高频中所述。例如，单极RF应用中的频率通常被限制为小于5MHz。然而，在双极RF应用中，频率几乎可为任何值。单极应用通常使用高于200kHz的频率，以便避免由于使用低频电流而产生不希望的对神经和肌肉的刺激。如果风险分析显示神经肌肉刺激的可能性已减轻至可接受的水平，则双极技术可使用更低频率。通常，不使用高于5MHz的频率以最小化与高频渗漏电流相关联的问题。通常认为，10mA是组织热效应的下限阈值。The electrical energy applied by the electrosurgical device can be transmitted to the instrument by a generator in communication with the handpiece. The electrical energy can be in the form of radio frequency (RF) energy. RF energy is a form of electrical energy that can be in the frequency range of 300kHz to 1MHz, as described in EN60601-2-2:2009+A11:2011, definition 201.3.218-high frequency. For example, the frequency in monopolar RF applications is generally limited to less than 5MHz. However, in bipolar RF applications, the frequency can be almost any value. Monopolar applications generally use frequencies above 200kHz in order to avoid unwanted stimulation of nerves and muscles due to the use of low-frequency currents. If a risk analysis shows that the potential for neuromuscular stimulation has been reduced to an acceptable level, lower frequencies can be used in bipolar techniques. Typically, frequencies above 5MHz are not used to minimize problems associated with high-frequency leakage currents. It is generally believed that 10mA is the lower threshold for tissue thermal effects.

在其操作期间，电外科装置可穿过组织传输低频RF能量，这会引起离子振荡或摩擦，并实际上引起电阻性加热，从而升高组织的温度。由于可在受影响的组织和周围组织之间形成尖锐边界，因此外科医生能够以高精确度水平进行操作，并在不损伤相邻的非目标组织的情况下进行控制。RF能量的低操作温度可适用于在密封血管的同时移除软组织、收缩软组织、或对软组织塑型。RF能量可尤其良好地适用于结缔组织，该结缔组织主要由胶原构成，并在接触热时收缩。During its operation, an electrosurgical device transmits low-frequency RF energy through tissue, which causes ion oscillations or friction and actually causes resistive heating, thereby raising the temperature of the tissue. Because a sharp boundary can be formed between the affected tissue and the surrounding tissue, the surgeon can operate with a high level of precision and control without damaging adjacent non-target tissue. The low operating temperature of RF energy can be useful for removing soft tissue while sealing blood vessels, shrinking soft tissue, or shaping soft tissue. RF energy can be particularly well suited for connective tissue, which is primarily composed of collagen and shrinks when exposed to heat.

由于其独特的驱动信号、感测和反馈需求，超声和电外科装置通常需要不同的发生器。另外，在其中器械为一次性的或可与手持件互换的情形中，超声和电外科发生器识别所用特定器械配置以及相应地优化控制和诊断过程的能力受限。此外，发生器的非隔离电路和患者隔离电路之间的电容耦合，尤其是在使用更高电压和频率的情况下，可导致患者暴露于不可接受的泄漏电流水平。Ultrasonic and electrosurgical devices typically require different generators due to their unique drive signal, sensing, and feedback requirements. In addition, in situations where the instruments are disposable or interchangeable with handpieces, the ability of ultrasonic and electrosurgical generators to identify the specific instrument configuration used and optimize control and diagnostic processes accordingly is limited. Furthermore, capacitive coupling between the non-isolated circuitry of the generator and the patient-isolated circuitry, especially when using higher voltages and frequencies, can result in patient exposure to unacceptable levels of leakage current.

此外，由于其独特的驱动信号、感测和反馈需要，超声和电外科装置通常需要用于不同发生器的不同用户界面。在此类常规超声和电外科装置中，一个用户界面被配置为与超声器械一起使用，而另一个用户界面可被配置为与电外科器械一起使用。此类用户界面包括手和/或脚激活的用户界面，诸如手激活交换器和/或脚激活交换器。由于在随后的公开中设想了与超声外科器械和电外科器械一起使用的组合发生器的各个方面，因此还设想了被配置为与超声和/或电外科器械发生器一起操作的附加用户界面。In addition, due to their unique drive signals, sensing and feedback needs, ultrasonic and electrosurgical devices generally require different user interfaces for different generators. In such conventional ultrasonic and electrosurgical devices, one user interface is configured for use with an ultrasonic instrument, while another user interface may be configured for use with an electrosurgical instrument. Such user interfaces include hand and/or foot activated user interfaces, such as a hand activated switch and/or a foot activated switch. As various aspects of a combined generator for use with an ultrasonic surgical instrument and an electrosurgical instrument are contemplated in the subsequent disclosure, additional user interfaces configured to operate with an ultrasonic and/or electrosurgical instrument generator are also contemplated.

在后续公开中设想用于向用户或其它机器提供反馈的附加用户界面，以提供指示超声和/或电外科器械的操作模式或状态的反馈。提供用于操作超声和/或电外科器械的组合的用户和/或机器反馈将需要向用户提供感觉反馈以及向机器提供电/机械/机电反馈。在后续公开中设想并入用于组合超声和/或电外科器械的视觉反馈装置(例如，LCD显示屏、LED指示器)、音频反馈装置(例如，扬声器、蜂鸣器)或触觉反馈装置(例如，触觉致动器)的反馈装置。Additional user interfaces for providing feedback to a user or other machine are contemplated in subsequent disclosures to provide feedback indicating the operating mode or state of the ultrasonic and/or electrosurgical instrument. Providing combined user and/or machine feedback for operating an ultrasonic and/or electrosurgical instrument will require providing sensory feedback to the user and electrical/mechanical/electromechanical feedback to the machine. Feedback devices incorporating visual feedback devices (e.g., LCD display screens, LED indicators), audio feedback devices (e.g., speakers, buzzers), or tactile feedback devices (e.g., tactile actuators) for combined ultrasonic and/or electrosurgical instruments are contemplated in subsequent disclosures.

其它电外科器械包括但不限于不可逆和/或可逆电穿孔、和/或微波技术等等。因此，本文所公开的技术可适用于超声、双极或单极RF(电外科)、不可逆和/或可逆电穿孔、和/或基于微波的外科器械等等。Other electrosurgical instruments include, but are not limited to, irreversible and/or reversible electroporation, and/or microwave technology, etc. Thus, the technology disclosed herein may be applicable to ultrasonic, bipolar or monopolar RF (electrosurgery), irreversible and/or reversible electroporation, and/or microwave-based surgical instruments, etc.

各个方面涉及改进的超声外科装置、电外科装置和与其一起使用的发生器。超声外科装置的各方面可被配置为用于例如在外科规程期间横切和/或凝结组织。电外科装置的各方面可被配置为用于例如在外科规程期间横切、凝结、定标、焊接和/或干燥组织。Various aspects relate to improved ultrasonic surgical devices, electrosurgical devices, and generators for use therewith. Various aspects of the ultrasonic surgical devices can be configured for use, for example, in transecting and/or coagulating tissue during a surgical procedure. Various aspects of the electrosurgical devices can be configured for use, for example, in transecting, coagulating, targeting, welding, and/or desiccating tissue during a surgical procedure.

发生器的各方面利用发生器驱动信号电流和电压的高速模数取样(例如，大约200次过采样，这取决于频率)以及数字信号处理，以提供优于已知发生器架构的许多优点和益处。在一个方面，例如，基于电流和电压反馈数据、超声换能器静态电容的值和驱动信号频率的值，发生器可确定超声换能器的动态支路电流。这提供了实质上调谐的系统的益处，并且模拟了以任何频率与静态电容的任何值(例如，图25中的C₀)进行调谐或共振的系统的存在。因此，可通过调谐静态电容的效应而不需要调谐电感器来实现对动态支路电流的控制。另外，消除调谐电感器可不使发生器的频率锁定能力劣化，因为频率锁定可通过适当地处理电流和电压反馈数据来实现。Aspects of the generator utilize high speed analog-to-digital sampling (e.g., approximately 200 times oversampling, depending on frequency) of the generator drive signal current and voltage, as well as digital signal processing, to provide numerous advantages and benefits over known generator architectures. In one aspect, for example, based on current and voltage feedback data, the value of the ultrasonic transducer static capacitance, and the value of the drive signal frequency, the generator may determine the motional branch current of the ultrasonic transducer. This provides the benefit of a substantially tuned system and simulates the presence of a system that is tuned or resonant at any frequency with any value of static capacitance (e.g., C₀ in FIG. 25 ). Thus, control of the motional branch current may be achieved by tuning the effect of the static capacitance without the need for a tuning inductor. Additionally, eliminating the tuning inductor may not degrade the frequency locking capability of the generator, as frequency locking may be achieved by appropriately processing the current and voltage feedback data.

发生器驱动信号电流和电压的高速模数取样以及数字信号处理也可实现样本的精确数字滤波。例如，发生器的各方面可利用低通数字滤波器(例如，有限脉冲响应(FIR)滤波器)，该低通数字滤波器在基本驱动信号频率和二阶谐波之间衰减，以减小电流和电压反馈样本中的非对称谐波失真和EMI感应噪声。滤波的电流和电压反馈样本大体上表示基本驱动信号频率，因此能够相对于基本驱动信号频率进行更精确的阻抗相位测量，并且能够改善发生器维持谐振频率锁定的能力。通过将下降沿测量值和上升沿相位测量值取平均值，并且通过将测量的阻抗相位调整至0°，可进一步增强阻抗相位测量的准确性。High speed analog-to-digital sampling of the generator drive signal current and voltage and digital signal processing can also enable accurate digital filtering of the samples. For example, aspects of the generator can utilize a low-pass digital filter (e.g., a finite impulse response (FIR) filter) that attenuates between the fundamental drive signal frequency and the second-order harmonics to reduce asymmetric harmonic distortion and EMI induced noise in the current and voltage feedback samples. The filtered current and voltage feedback samples are substantially representative of the fundamental drive signal frequency, thus enabling more accurate impedance phase measurements relative to the fundamental drive signal frequency and improving the generator's ability to maintain resonant frequency lock. The accuracy of the impedance phase measurement can be further enhanced by averaging the falling edge and rising edge phase measurements and by adjusting the measured impedance phase to 0°.

发生器的各个方面还可利用发生器驱动信号电流和电压的高速模数取样以及数字信号处理，来以高精度地确定实际功率消耗和其它量。这可允许发生器实现多种可用的算法，诸如例如，控制随着组织的阻抗变化而递送至组织的功率的量并控制功率递送以保持恒定的组织阻抗增加率。这些算法中的一些用于确定发生器驱动信号电流信号和电压信号之间的相位差。在谐振时，电流信号和电压信号之间的相位差为零。当超声系统脱离共振时，该相位改变。可采用各种算法来检测相位差并调节驱动频率，直到超声系统返回谐振，即，电流信号和电压信号之间的相位差为零。相位信息也可用于推断超声刀的条件。如下文所详细讨论的，相位作为超声刀的温度的函数而改变。因此，可采用相位信息来控制超声刀的温度。这可例如通过当超声刀运行过热时减小递送到超声刀的功率，并且当超声刀运行过冷时增加递送到超声刀的功率来实现。Various aspects of the generator can also utilize high-speed analog-to-digital sampling of the generator drive signal current and voltage and digital signal processing to determine actual power consumption and other quantities with high accuracy. This allows the generator to implement a variety of available algorithms, such as, for example, controlling the amount of power delivered to the tissue as the impedance of the tissue changes and controlling power delivery to maintain a constant rate of increase in tissue impedance. Some of these algorithms are used to determine the phase difference between the generator drive signal current signal and the voltage signal. At resonance, the phase difference between the current signal and the voltage signal is zero. When the ultrasonic system is out of resonance, the phase changes. Various algorithms can be used to detect the phase difference and adjust the drive frequency until the ultrasonic system returns to resonance, that is, the phase difference between the current signal and the voltage signal is zero. Phase information can also be used to infer the condition of the ultrasonic blade. As discussed in detail below, the phase changes as a function of the temperature of the ultrasonic blade. Therefore, phase information can be used to control the temperature of the ultrasonic blade. This can be achieved, for example, by reducing the power delivered to the ultrasonic blade when the ultrasonic blade is running too hot, and increasing the power delivered to the ultrasonic blade when the ultrasonic blade is running too cold.

发生器的各个方面可具有驱动超声外科装置和电外科装置两者必需的宽频范围和增加的输出功率。电外科装置的更低电压、更高电流需求可通过宽带功率变压器上的专用分接头来满足，从而消除对单独功率放大器和输出变压器的需要。此外，发生器的感测和反馈电路可支撑大的动态范围，该动态范围满足超声和电外科应用两者的需要，并且具有极小的失真。Various aspects of the generator may have a wide frequency range and increased output power necessary to drive both ultrasonic and electrosurgical devices. The lower voltage, higher current requirements of electrosurgical devices may be met by dedicated taps on a broadband power transformer, eliminating the need for a separate power amplifier and output transformer. In addition, the sensing and feedback circuitry of the generator may support a large dynamic range that meets the needs of both ultrasonic and electrosurgical applications with minimal distortion.

各个方面可为发生器提供简单、经济的手段，以使用现有的多导体发生器/手持件电缆读取并任选地写入设置在附接到手持件的器械中的数据电路(例如，单线总线装置，诸如以商品名“1-Wire”已知的单线协议EEPROM)。这样，发生器能够从附接到手持件的器械检索和处理器械特定数据。这可使发生器能够提供更好的控制和改进的诊断和错误检测。另外，发生器向器械写入数据的能力在例如跟踪器械使用和捕获操作数据方面提供了可能的新功能。此外，频带的使用允许包含总线装置的器械与现有发生器向后兼容。Various aspects may provide a simple, economical means for a generator to read and optionally write data circuits disposed in an instrument attached to a handpiece (e.g., a single-wire bus device, such as a single-wire protocol EEPROM known under the trade name "1-Wire") using an existing multi-conductor generator/handpiece cable. In this way, the generator is able to retrieve and process instrument-specific data from an instrument attached to the handpiece. This may enable the generator to provide better control and improved diagnostics and error detection. Additionally, the ability of the generator to write data to the instrument provides possible new functionality in, for example, tracking instrument usage and capturing operational data. Furthermore, the use of a frequency band allows instruments incorporating a bus device to be backward compatible with existing generators.

发生器的公开方面提供由发生器的非隔离电路和患者隔离电路之间的非预期电容耦合引起的泄漏电流的有源消除。除了减小患者风险之外，泄漏电流的减少还可减少电磁辐射。The disclosed aspects of the generator provide active cancellation of leakage current caused by unintended capacitive coupling between the non-isolated circuitry of the generator and the patient-isolated circuitry. In addition to reducing patient risk, the reduction in leakage current can also reduce electromagnetic emissions.

通过下文的具体实施方式，本公开的各方面的这些和其它益处将显而易见。These and other benefits of various aspects of the present disclosure will be apparent from the detailed description that follows.

应当理解，本文使用的术语“近侧”和“远侧”是相对于抓持手持件组件的临床医生而言的。因此，端部执行器相对于更近侧的手持件为远侧。还应当理解，为方便和清晰起见，本文关于临床医生握持手持件组件的情况也使用空间术语诸如“顶部”和“底部”。然而，外科装置在许多取向和位置中使用，并且这些术语并非旨在为限制性的和绝对的。It should be understood that the terms "proximal" and "distal" as used herein are relative to a clinician grasping the handpiece assembly. Thus, an end effector is distal relative to a more proximal handpiece. It should also be understood that for convenience and clarity, spatial terms such as "top" and "bottom" are also used herein with respect to a clinician grasping the handpiece assembly. However, surgical devices are used in many orientations and positions, and these terms are not intended to be limiting and absolute.

图46为根据本公开的一个方面的模块化手持式超声外科器械6480的正视分解图，其示出了从柄部组件6482移除的左壳半部分，从而暴露了通信地耦合到多引线柄部端子组件的装置标识符。在本公开的附加方面，使用智能或智能电池给模块化手持式超声外科器械6480供电。然而，智能电池不限于模块化手持式超声外科器械6480，并且如将解释的，可用于多种装置中，这些装置可具有或可不具有彼此不同的功率要求(例如，电流和电压)。根据本公开的一个方面，智能电池组件6486有利地能够识别其电耦合到的特定装置。它通过加密或未加密的识别方法执行该操作。例如，智能电池组件6486可具有连接部分，诸如连接部分6488。柄部组件6482还可设置有通信地耦合到多引线柄部端子组件6491并且能够操作以传送关于柄部组件6482的至少一片信息的装置标识符。该信息可与已使用柄部组件6482的次数、已使用超声换能器/发生器组件6484(当前与柄部组件6482断开连接)的次数、已使用波导轴组件6490(当前连接到柄部组件6482)的次数、当前连接到柄部组件6482的波导轴组件6490的类型、当前连接到柄部组件6482的超声换能器/发生器组件6484的类型或身份、和/或许多其它特征有关。当智能电池组件6486插入柄部组件6482中时，智能电池组件6486内的连接部分6488与柄部组件6482的装置标识符进行通信接触。柄部组件6482通过硬件、软件或它们的组合能够将信息传输到智能电池组件6486(无论是通过自启动还是响应来自智能电池组件6486的请求)。该通信标识符由智能电池组件6486的连接部分6488接收。在一个方面，一旦智能电池组件6486接收到信息，就可操作通信部分以控制智能电池组件6486的输出，从而符合装置的具体功率要求。FIG. 46 is a front exploded view of a modular handheld ultrasonic surgical instrument 6480 according to one aspect of the present disclosure, showing the left shell half removed from the handle assembly 6482, thereby exposing a device identifier that is communicatively coupled to the multi-lead handle terminal assembly. In an additional aspect of the present disclosure, a smart or intelligent battery is used to power the modular handheld ultrasonic surgical instrument 6480. However, the smart battery is not limited to the modular handheld ultrasonic surgical instrument 6480, and as will be explained, can be used in a variety of devices that may or may not have different power requirements (e.g., current and voltage) from each other. According to one aspect of the present disclosure, the smart battery assembly 6486 is advantageously capable of identifying a specific device to which it is electrically coupled. It performs this operation through an encrypted or unencrypted identification method. For example, the smart battery assembly 6486 may have a connection portion, such as a connection portion 6488. The handle assembly 6482 may also be provided with a device identifier that is communicatively coupled to the multi-lead handle terminal assembly 6491 and is operable to transmit at least one piece of information about the handle assembly 6482. This information may relate to the number of times the handle assembly 6482 has been used, the number of times the ultrasonic transducer/generator assembly 6484 (currently disconnected from the handle assembly 6482) has been used, the number of times the waveguide shaft assembly 6490 (currently connected to the handle assembly 6482) has been used, the type of waveguide shaft assembly 6490 currently connected to the handle assembly 6482, the type or identity of the ultrasonic transducer/generator assembly 6484 currently connected to the handle assembly 6482, and/or many other features. When the smart battery assembly 6486 is inserted into the handle assembly 6482, the connecting portion 6488 within the smart battery assembly 6486 makes communicative contact with the device identifier of the handle assembly 6482. The handle assembly 6482 is capable of transmitting information to the smart battery assembly 6486 (whether by self-initiation or in response to a request from the smart battery assembly 6486) through hardware, software, or a combination thereof. The communication identifier is received by the connecting portion 6488 of the smart battery assembly 6486. In one aspect, once the smart battery assembly 6486 receives the information, the communication portion can be operated to control the output of the smart battery assembly 6486 to meet the specific power requirements of the device.

在一个方面，通信部分包括处理器6493和存储器6497，其可为独立部件或单个部件。处理器6493与存储器组合能够为模块化手持式超声外科器械6480提供智能功率管理。这一方面是尤其有利的，因为超声装置(诸如模块化手持式超声外科器械6480)具有对于模块化手持式超声外科器械6480而言可为独特的功率要求(频率、电流和电压)。事实上，模块化手持式超声外科器械6480可对一个尺寸或类型的外管6494具有特定的功率要求或限制，并且对于具有不同尺寸、形状和/或配置的第二类型的波导可具有第二不同的功率要求。In one aspect, the communication portion includes a processor 6493 and a memory 6497, which may be separate components or a single component. The processor 6493 in combination with the memory can provide intelligent power management for the modular handheld ultrasonic surgical instrument 6480. This aspect is particularly advantageous because ultrasonic devices, such as the modular handheld ultrasonic surgical instrument 6480, have power requirements (frequency, current, and voltage) that may be unique to the modular handheld ultrasonic surgical instrument 6480. In fact, the modular handheld ultrasonic surgical instrument 6480 may have a specific power requirement or limitation for one size or type of outer tube 6494, and may have a second, different power requirement for a second type of waveguide having a different size, shape, and/or configuration.

因此，根据本公开的至少一个方面的智能电池组件6486允许电池组件在若干外科器械之间使用。由于智能电池组件6486能够识别其附接至哪个装置并且能够相应地改变其输出，因此利用智能电池组件6486的各种不同外科器械的操作者不再需要担心他们正试图安装在正在使用的电子装置内的功率源。在其中电池组件需要在复杂外科规程期间与另一个外科器械置换或互换的操作环境中，这是尤其有利的。Thus, the smart battery assembly 6486 according to at least one aspect of the present disclosure allows the battery assembly to be used between several surgical instruments. Since the smart battery assembly 6486 is able to identify which device it is attached to and can change its output accordingly, operators of various different surgical instruments utilizing the smart battery assembly 6486 no longer need to worry about the power source they are trying to install within the electronic device being used. This is particularly advantageous in operating environments where the battery assembly needs to be replaced or interchanged with another surgical instrument during a complex surgical procedure.

在本公开的另一方面，智能电池组件6486在存储器6497中存储每次使用特定装置的记录。该记录对于评估装置的可用寿命或允许寿命的结束可为有用的。例如，一旦装置被使用20次，则连接至装置的智能电池组件6486中的此类电池将拒绝向其供电，因为该装置被定义为“不再可靠”的外科器械。可靠性是基于多个因素确定的。一个因素可以是磨损，其可以多种方式估计，包括装置已被使用或激活的次数。在使用一定次数之后，装置的部件可变得磨损并且超过部件之间的公差。例如，智能电池组件6486可感测由柄部组件6482接收的按钮推动的次数，并且可确定何时达到或超过了按钮推动的最大次数。智能电池组件6486还可监测按钮机构的阻抗，该阻抗可例如在柄部被例如盐水污染时发生变化。In another aspect of the present disclosure, the smart battery assembly 6486 stores a record in the memory 6497 of each use of a particular device. This record may be useful for assessing the useful life of the device or the end of the permitted life. For example, once a device has been used 20 times, such a battery in the smart battery assembly 6486 connected to the device will refuse to power it because the device is defined as a "no longer reliable" surgical instrument. Reliability is determined based on multiple factors. One factor may be wear, which can be estimated in a variety of ways, including the number of times the device has been used or activated. After a certain number of uses, components of the device may become worn and exceed tolerances between components. For example, the smart battery assembly 6486 may sense the number of button pushes received by the handle assembly 6482, and may determine when the maximum number of button pushes has been reached or exceeded. The smart battery assembly 6486 may also monitor the impedance of the button mechanism, which may change, for example, when the handle is contaminated with, for example, saline.

这种磨损可在规程期间导致不可接受的失效。在一些方面，智能电池组件6486可识别哪些部件在装置中组合在一起，并且甚至识别该部件已经历了多少次使用。例如，如果智能电池组件6486是根据本公开的智能电池，则在用户尝试使用复合装置之前，其可很好地识别柄部组件6482、波导轴组件6490、以及超声换能器/发生器组件6484。智能电池组件6486内的存储器6497可例如记录超声换能器/发生器组件6484被操作的时间以及其操作的方式、何时进行操作和操作持续时间。如果超声换能器/发生器组件6484具有独立标识符，则智能电池组件6486可跟踪超声换能器/发生器组件6484的使用，并且一旦柄部组件6482或超声换能器/发生器组件6484超过其最大使用次数，就拒绝向超声换能器/发生器组件6484供电。超声换能器/发生器组件6484、柄部组件6482、波导轴组件6490或其它部件也可包括记录该信息的存储器芯片。这样，智能电池组件6486中的任意数量的智能电池可与任何数量的超声换能器/发生器组件6484、缝合器、血管密封器等一起使用，并且仍然能够确定超声换能器/发生器组件6484、缝合器、血管密封器等的总使用次数或总使用时间、或总致动时间等或充电或放电循环。智能功能性可驻留在电池组件6486外部，并且可驻留在例如柄部组件6482、超声换能器/发生器组件6484和/或轴组件6490中。Such wear and tear can lead to unacceptable failures during a procedure. In some aspects, the smart battery assembly 6486 can identify which components are combined together in the device and even how many times the component has been used. For example, if the smart battery assembly 6486 is a smart battery according to the present disclosure, it can well identify the handle assembly 6482, the waveguide shaft assembly 6490, and the ultrasonic transducer/generator assembly 6484 before the user attempts to use the composite device. The memory 6497 within the smart battery assembly 6486 can, for example, record the time when the ultrasonic transducer/generator assembly 6484 is operated and the manner in which it is operated, when it is operated, and the duration of operation. If the ultrasonic transducer/generator assembly 6484 has an independent identifier, the smart battery assembly 6486 can track the use of the ultrasonic transducer/generator assembly 6484 and deny power to the ultrasonic transducer/generator assembly 6484 once the handle assembly 6482 or the ultrasonic transducer/generator assembly 6484 exceeds its maximum number of uses. The ultrasonic transducer/generator assembly 6484, the handle assembly 6482, the waveguide shaft assembly 6490, or other components may also include a memory chip that records this information. In this way, any number of smart batteries in the smart battery assembly 6486 can be used with any number of ultrasonic transducer/generator assemblies 6484, suturers, vessel sealers, etc., and still be able to determine the total number of uses or total use time, or total actuation time, etc., or charge or discharge cycles of the ultrasonic transducer/generator assembly 6484, suturer, vessel sealer, etc. The smart functionality may reside outside the battery assembly 6486 and may reside in, for example, the handle assembly 6482, the ultrasonic transducer/generator assembly 6484, and/or the shaft assembly 6490.

当计数超声换能器/发生器组件6484的使用以智能地终止超声换能器/发生器组件6484的寿命时，外科器械准确地区分外科规程中超声换能器/发生器组件6484的实际使用的完成和由于例如外科规程中的电池更换或暂时延迟而引起的超声换能器/发生器组件6484的致动的瞬时损耗。因此，作为简单计数超声换能器/发生器组件6484的激活次数的替代方案，可实现实时时钟(RTC)电路以跟踪超声换能器/发生器组件6484实际上被关闭的时间量。从所测量的时间长度来看，如果关闭足够显著而被认为是一次实际使用的结束，或者关闭时间太短而不被认为是一次使用的结束，则可通过适当的逻辑来确定。因此，在一些应用中，该方法可比简单的“基于激活的”算法更准确地确定超声换能器/发生器组件6484的使用寿命，该“基于激活的”算法例如可提供在外科规程中发生十次“激活”，并且因此十次激活应当指示计数器增加一个。一般来讲，该类型和系统的内部时钟将防止误用被设计为欺骗简单的“基于激活的”算法的装置，并且在仅由于合法原因而需要超声换能器/发生器组件6484或智能电池组件6486的简单去配合的情况下，将防止完全使用的不正确记录。When counting the use of the ultrasonic transducer/generator assembly 6484 to intelligently terminate the life of the ultrasonic transducer/generator assembly 6484, the surgical instrument accurately distinguishes between the completion of the actual use of the ultrasonic transducer/generator assembly 6484 in the surgical procedure and the instantaneous loss of actuation of the ultrasonic transducer/generator assembly 6484 due to, for example, battery replacement or temporary delays in the surgical procedure. Therefore, as an alternative to simply counting the number of activations of the ultrasonic transducer/generator assembly 6484, a real-time clock (RTC) circuit can be implemented to track the amount of time that the ultrasonic transducer/generator assembly 6484 is actually turned off. From the measured length of time, it can be determined by appropriate logic if the shutdown is significant enough to be considered the end of an actual use, or if the shutdown time is too short to be considered the end of a use. Therefore, in some applications, this method can more accurately determine the service life of the ultrasonic transducer/generator assembly 6484 than a simple "activation-based" algorithm, which, for example, can provide that ten "activations" occur in a surgical procedure, and therefore ten activations should indicate that the counter is increased by one. Generally speaking, the internal clock of this type and system will prevent misuse of devices designed to deceive simple "activation-based" algorithms, and will prevent incorrect recording of usage altogether in situations where simple demodulation of the ultrasonic transducer/generator assembly 6484 or smart battery assembly 6486 is required only for legitimate reasons.

虽然外科器械6480的超声换能器/发生器组件6484是可重复使用的，但在一个方面，可设置使用的有限次数，因为在清洁和消毒期间外科器械6480经受苛刻的条件。更具体地讲，电池组被配置为消毒的。无论用于外表面的材料如何，使用的实际材料的预期寿命有限。该寿命由各种特征确定，这些特征可包括例如电池组实际上已被消毒的次数、电池组被制造的时间、以及电池组已被再充电的次数。另外，电池单元自身的寿命是有限的。本公开的软件采用了本公开的算法，该算法验证超声换能器/发生器组件6484和智能电池组件6486的使用次数，并且在达到或超过该使用次数时禁用装置。可以用可能的灭菌方法中的每个对电池组外部进行分析。基于最严苛的消毒过程，可限定允许的最大消毒次数，并且该次数可存储在智能电池组件6486的存储器中。如果假设充电器为未消毒的并且在充电后使用智能电池组件6486，则可将充电计数定义为等于该特定电池组所遇到的消毒次数。Although the ultrasonic transducer/generator assembly 6484 of the surgical instrument 6480 is reusable, in one aspect, a limited number of uses may be set because the surgical instrument 6480 is subjected to harsh conditions during cleaning and disinfection. More specifically, the battery pack is configured to be sterilized. Regardless of the material used for the outer surface, the expected life of the actual material used is limited. This life is determined by various features, which may include, for example, the number of times the battery pack has actually been sterilized, the time when the battery pack was manufactured, and the number of times the battery pack has been recharged. In addition, the life of the battery cell itself is limited. The software of the present disclosure uses an algorithm of the present disclosure, which verifies the number of uses of the ultrasonic transducer/generator assembly 6484 and the smart battery assembly 6486, and disables the device when the number of uses is reached or exceeded. The outside of the battery pack can be analyzed with each of the possible sterilization methods. Based on the most stringent disinfection process, the maximum number of disinfections allowed can be limited, and the number can be stored in the memory of the smart battery assembly 6486. If it is assumed that the charger is not sterilized and the smart battery assembly 6486 is used after charging, the charge count can be defined to be equal to the number of sterilizations encountered by that particular battery pack.

在一个方面，电池组中的硬件可被禁用，以最小化或消除由于在软件禁用电池组之后从电池单元连续漏出而引起的安全问题。在某些低电压条件下，可存在电池内部硬件无法禁用电池的情况。在此类情况下，在一方面，充电器可用于“杀死”电池。由于电池微控制器在其充电器中处于关闭状态的事实，可使用未消毒的、基于系统管理总线(SMB)的可电擦除可编程只读存储器(EEPROM)在电池微控制器和充电器之间交换信息。因此，可使用串行EEPROM来存储即使在电池微控制器关闭时也能够写入和读取的信息，这在尝试与充电器或其它外围装置交换信息时是非常有益的。该示例EEPROM可被配置为包含足够的存储器寄存器以存储至少(a)应禁用电池时的使用计数限制(电池使用计数)、(b)电池已经历的规程的数量(电池规程计数)、和/或(c)电池已经历的充电次数(充电计数)等等。EEPROM中存储的信息中的一些(诸如使用计数寄存器和电荷计数寄存器)存储在EEPROM的写保护部分中，以防止用户更改信息。在一方面，用对应的位反转次要检测器存储使用和计数器以检测数据损坏。In one aspect, the hardware in the battery pack can be disabled to minimize or eliminate safety issues caused by continuous leakage from the battery cells after the software disables the battery pack. Under certain low voltage conditions, there may be situations where the battery's internal hardware cannot disable the battery. In such cases, in one aspect, the charger can be used to "kill" the battery. Due to the fact that the battery microcontroller is in a closed state in its charger, an unsterilized, system management bus (SMB)-based electrically erasable programmable read-only memory (EEPROM) can be used to exchange information between the battery microcontroller and the charger. Therefore, a serial EEPROM can be used to store information that can be written and read even when the battery microcontroller is turned off, which is very beneficial when trying to exchange information with a charger or other peripheral device. The example EEPROM can be configured to contain enough memory registers to store at least (a) the use count limit when the battery should be disabled (battery use count), (b) the number of procedures that the battery has undergone (battery procedure count), and/or (c) the number of charges that the battery has undergone (charge count), etc. Some of the information stored in the EEPROM, such as the use count register and the charge count register, is stored in a write-protected portion of the EEPROM to prevent users from changing the information. In one aspect, a sum counter is stored with a corresponding bit reversal secondary detector to detect data corruption.

SMBus管线中的任何残余电压都可能损坏微控制器并损坏SMBus信号。因此，为了确保电池控制器的SMBus管线在微控制器关闭时不承载电压，在外部SMBus管线和电池微控制器板之间提供继电器。Any residual voltage in the SMBus lines can damage the microcontroller and corrupt the SMBus signals. Therefore, to ensure that the battery controller's SMBus lines do not carry voltage when the microcontroller is off, a relay is provided between the external SMBus lines and the battery microcontroller board.

在智能电池组件6486的充电期间，当例如当采用恒定电流/恒定电压充电方案时，流入电池的电流以渐缩方式降至给定阈值以下时，确定智能电池组件6486内的电池的“充电结束”状况。为了准确地检测该“充电结束”条件，电池微控制器和降压板在电池充电期间被断电并关闭，以减少可由板引起的并且可干扰渐缩电流检测的任何电流消耗。另外，在充电期间微控制器和降压板断电，以防止SMBus信号产生任何损坏。During charging of the smart battery assembly 6486, an "end of charge" condition of the battery within the smart battery assembly 6486 is determined when the current flowing into the battery drops below a given threshold in a tapering manner, such as when a constant current/constant voltage charging scheme is employed. In order to accurately detect this "end of charge" condition, the battery microcontroller and buck board are powered down and shut down during battery charging to reduce any current draw that may be caused by the board and that may interfere with the tapering current detection. Additionally, the microcontroller and buck board are powered down during charging to prevent any corruption of the SMBus signals.

关于充电器，在一个方面，防止智能电池组件6486以除正确插入位置之外的任何方式插入充电器中。因此，智能电池组件6486的外部设置有充电器保持特征件。用于将智能电池组件6486牢固地保持在充电器中的杯被配置为具有匹配锥度几何形状的轮廓，以防止智能电池组件6486以除正确(预期)方式之外的任何方式意外插入。还设想到，智能电池组件6486的存在可由充电器本身检测到。例如，充电器可被配置为检测来自电池保护电路的SMBus变压器以及位于保护板中的电阻器的存在。在此类情况下，充电器将能够控制暴露在充电器的管脚处的电压，直到智能电池组件6486在充电器上正确地座置或处于适当位置。这是因为充电器的管脚处的暴露的电压将存在电气短路可能管脚两端发生的危险和风险，并且使得充电器不经意地开始充电。With respect to the charger, in one aspect, the smart battery assembly 6486 is prevented from being inserted into the charger in any manner other than the correct insertion position. Therefore, the exterior of the smart battery assembly 6486 is provided with a charger retention feature. The cup for firmly retaining the smart battery assembly 6486 in the charger is configured to have a profile with a matching taper geometry to prevent the smart battery assembly 6486 from being accidentally inserted in any manner other than the correct (expected) manner. It is also contemplated that the presence of the smart battery assembly 6486 can be detected by the charger itself. For example, the charger can be configured to detect the presence of an SMBus transformer from a battery protection circuit and a resistor located in a protection board. In such cases, the charger will be able to control the voltage exposed at the pins of the charger until the smart battery assembly 6486 is correctly seated or in position on the charger. This is because the exposed voltage at the pins of the charger will present the danger and risk of an electrical short circuit possibly occurring across the pins, and causing the charger to inadvertently start charging.

在一些方面，智能电池组件6486可通过音频和/或视觉反馈来向用户进行通信。例如，智能电池组件6486可导致LED以预先设定的方式点亮。在此情况下，即使超声换能器/发生器组件6484中的微控制器控制LED，微控制器也直接从智能电池组件6486接收待执行的指令。In some aspects, the smart battery assembly 6486 can communicate to the user via audio and/or visual feedback. For example, the smart battery assembly 6486 can cause an LED to illuminate in a pre-set manner. In this case, even if the microcontroller in the ultrasonic transducer/generator assembly 6484 controls the LED, the microcontroller receives instructions to be executed directly from the smart battery assembly 6486.

在本公开的又一个方面，超声换能器/发生器组件6484中的微控制器在不使用持续预定的时间段时进入睡眠模式。有利的是，当处于睡眠模式时，微控制器的时钟速度减小，从而显著地削减电流消耗。由于处理器继续ping等待以感测输入，因此继续消耗一些电流。有利的是，当微控制器处于该节电睡眠模式时，微控制器和电池控制器可直接控制LED。例如，解码器电路可被构建到超声换能器/发生器组件6484中并连接至通信管线，使得当超声换能器/发生器组件6484微控制器为“关闭”或处于“睡眠模式”时，LED可由处理器6493独立地控制。这是一种节电特征，其无需唤醒超声换能器/发生器组件6484中的微控制器。通过允许关闭发生器，同时仍然能够有效控制用户界面指示器，来节省功率。In yet another aspect of the present disclosure, the microcontroller in the ultrasonic transducer/generator assembly 6484 enters a sleep mode when it is not used for a predetermined period of time. Advantageously, when in sleep mode, the clock speed of the microcontroller is reduced, thereby significantly cutting current consumption. Since the processor continues to ping and wait to sense input, some current continues to be consumed. Advantageously, when the microcontroller is in this power-saving sleep mode, the microcontroller and the battery controller can directly control the LED. For example, a decoder circuit can be built into the ultrasonic transducer/generator assembly 6484 and connected to the communication pipeline so that when the ultrasonic transducer/generator assembly 6484 microcontroller is "off" or in "sleep mode", the LED can be independently controlled by the processor 6493. This is a power-saving feature that does not require waking up the microcontroller in the ultrasonic transducer/generator assembly 6484. Power is saved by allowing the generator to be turned off while still being able to effectively control the user interface indicator.

另一方面，当不使用时，减缓一个或多个微控制器以节省功率。例如，可减小两个微控制器的时钟频率以节省功率。为了保持同步操作，微控制器协调其相应时钟频率的变化，以在需要全速度操作时在约同一时间进行减少以及然后的随后频率增加。例如，当进入空闲模式时，时钟频率降低，并且在退出空闲模式时，频率增加。On the other hand, when not in use, one or more microcontrollers are slowed down to save power. For example, the clock frequency of two microcontrollers can be reduced to save power. To maintain synchronous operation, the microcontrollers coordinate changes in their respective clock frequencies to make reductions and then subsequent frequency increases at about the same time when full speed operation is required. For example, when entering idle mode, the clock frequency is reduced, and when exiting idle mode, the frequency is increased.

在另一个方面，智能电池组件6486能够确定其单元内剩余的可用功率的量，并且如果其确定有足够的电池功率以在整个预期规程中可预见地操作装置，则被编程为仅操作与其附接的外科器械。例如，如果单元内没有足够的功率来操作外科器械20秒，则智能电池组件6486能够保持在非操作状态。根据一个方面，智能电池组件6486确定在其最近的前述功能(例如，外科切割)结束时电池内剩余的功率的量。因此，在该方面，如果例如在该规程期间，智能电池组件6486确定单元的功率不足，则其将不允许执行后续功能。另选地，如果智能电池组件6486确定在规程期间存在足够的功率用于后续规程并且低于该阈值，则其不会中断正在进行的规程，而是将允许其完成，并且然后防止附加的规程发生。In another aspect, the smart battery assembly 6486 is capable of determining the amount of available power remaining within its cell and is programmed to only operate the surgical instrument attached thereto if it determines that there is sufficient battery power to foreseeably operate the device throughout the intended procedure. For example, if there is not enough power within the cell to operate the surgical instrument for 20 seconds, the smart battery assembly 6486 is capable of remaining in a non-operating state. According to one aspect, the smart battery assembly 6486 determines the amount of power remaining within the battery at the end of its most recent preceding function (e.g., surgical cutting). Thus, in this aspect, if, for example, during the procedure, the smart battery assembly 6486 determines that the cell is insufficiently powered, it will not allow subsequent functions to be performed. Alternatively, if the smart battery assembly 6486 determines that there is sufficient power for subsequent procedures during the procedure and is below the threshold, it will not interrupt the ongoing procedure, but will allow it to complete and then prevent additional procedures from occurring.

以下解释了最大程度地使用具有本公开的智能电池组件6486的装置的优点。在该示例中，一组不同的装置具有不同的超声传输波导管。根据定义，波导可具有相应的最大允许功率限制，其中超过该功率极限使波导过压并最终使其破裂。来自该组波导的一个波导将自然具有最小的最大功率容差。由于先前技术的电池缺乏智能电池功率管理，因此先前技术的电池的输出必须受到预想与装置/电池使用的设定中最小/最薄/最脆弱的波导的最小最大允许功率输入的值的限制。即使稍后可将更大的、更厚的波导附接到该柄部并且根据定义允许施加更大的力时也是如此。对于最大电池功率，也存在该限制。例如，如果一个电池被设计用于在多个装置中使用，则其最大输出功率将受限于待使用该电池的装置中的任一者的最低最大功率等级。利用此配置，一个或多个装置或装置配置将无法最大程度地利用电池，因为电池不知道特定装置的具体限制。The following explains the advantages of maximizing the use of devices with the intelligent battery assembly 6486 of the present disclosure. In this example, a group of different devices have different ultrasonic transmission waveguides. By definition, the waveguides may have corresponding maximum allowable power limits, where exceeding the power limit overstresses the waveguide and eventually ruptures it. One waveguide from the group of waveguides will naturally have the smallest maximum power tolerance. Since the batteries of the prior art lack intelligent battery power management, the output of the batteries of the prior art must be limited by the value of the minimum maximum allowable power input of the smallest/thinnest/most fragile waveguide in the setting of the device/battery used. This is true even when a larger, thicker waveguide can be attached to the handle later and a larger force can be applied by definition. This limitation also exists for the maximum battery power. For example, if a battery is designed for use in multiple devices, its maximum output power will be limited to the lowest maximum power rating of any of the devices to which the battery is to be used. With this configuration, one or more devices or device configurations will not be able to maximize the use of the battery because the battery does not know the specific limitations of a particular device.

在一个方面，智能电池组件6486可用于智能地绕过上述超声装置限制。智能电池组件6486可为一个装置或特定装置配置产生一个输出，并且同一智能电池组件6486稍后可针对第二装置或装置配置产生不同的输出。该通用的智能电池外科系统非常适合在空间和时间非常珍贵的现代手术室。通过使智能电池组操作许多不同的装置，护士可以容易地管理这些电池组的存储、检索和库存。有利的是，在一个方面，根据本公开的智能电池系统可采用一种类型的充电站，从而增加使用的简便性和效率并降低外科室充电装置的成本。In one aspect, the smart battery assembly 6486 can be used to intelligently bypass the above-mentioned ultrasonic device limitations. The smart battery assembly 6486 can produce one output for one device or a specific device configuration, and the same smart battery assembly 6486 can later produce a different output for a second device or device configuration. This universal smart battery surgical system is very suitable for modern operating rooms where space and time are very precious. By having smart battery packs operate many different devices, nurses can easily manage the storage, retrieval and inventory of these battery packs. Advantageously, in one aspect, the smart battery system according to the present disclosure can adopt a type of charging station, thereby increasing the ease and efficiency of use and reducing the cost of charging devices in surgical rooms.

此外，其它外科器械(诸如电动缝合器)可具有与模块化手持式超声外科器械6480不同的功率要求。根据本公开的各个方面，智能电池组件6486可与一系列外科器械中的任一个一起使用，并且可被制造成将其自身的功率输出定制为其安装在其中的特定装置。在一个方面，该功率调节通过控制开关模式功率源的占空比(诸如降压、降压-升压、升压或与智能电池组件6486整体形成或以其它方式耦合到智能电池组件6486并受其控制的其它配置来执行。在其它方面，智能电池组件6486可在装置操作期间动态地改变其功率输出。例如，在血管密封装置中，功率管理提供改善的组织密封。在这些装置中，需要大的恒定电流值。总功率输出需要动态地调节，因为当组织被密封时，其阻抗改变。本公开的各方面提供具有可变最大电流限制的智能电池组件6486。基于应用或装置的要求，当前限制可从一个应用(或装置)改变到另一个应用(或装置)。In addition, other surgical instruments (such as electric staplers) may have different power requirements than the modular handheld ultrasonic surgical instrument 6480. According to various aspects of the present disclosure, the smart battery assembly 6486 can be used with any of a range of surgical instruments and can be manufactured to customize its own power output to the specific device in which it is installed. In one aspect, the power regulation is performed by controlling the duty cycle of a switch mode power source (such as buck, buck-boost, boost, or other configurations integrally formed with the smart battery assembly 6486 or otherwise coupled to the smart battery assembly 6486 and controlled by it. In other aspects, the smart battery assembly 6486 can dynamically change its power output during device operation. For example, in vascular sealing devices, power management provides improved tissue sealing. In these devices, large constant current values are required. The total power output needs to be dynamically adjusted because the impedance of the tissue changes as it is sealed. Various aspects of the present disclosure provide a smart battery assembly 6486 with a variable maximum current limit. Based on the requirements of the application or device, the current limit can be changed from one application (or device) to another application (or device).

根据本公开的至少一个方面，图47为图46中所示超声外科器械6480的触发器6483部分和开关的详细视图。触发器6483可操作地耦合到端部执行器6492的钳口构件6495。超声刀6496在激活激活开关6485时由超声换能器/发生器组件6484供电。现在继续图46并且还参见图47，触发器6483和激活开关6485被示出为柄部组件6482的部件。触发器6483激活端部执行器6492，该端部执行器6492与波导轴组件6490的超声刀6496具有协作关联，以使端部执行器钳口构件6495和超声刀6496之间能够与组织和/或其它物质发生各种类型的接触。端部执行器6492的钳口构件6495通常为枢转钳口，其用于抓握或夹持到设置在钳口和超声刀6496之间的组织上。在一个方面，在触发器被完全压下时，在触发器中提供可听反馈。噪声可在闭合时由触发器按扣的薄金属部件生成。该特征件向用户反馈添加可听分量，该可听分量告知用户钳口完全压缩抵靠波导并且正在施加足够的夹持压力以完成血管密封。在另一方面，力传感器诸如应变仪或压力传感器可耦合到触发器6483以测量由用户施加到触发器6483的力。在另一方面，力传感器诸如应变仪或压力传感器可耦合到开关6485按钮，使得位移强度对应于由用户施加到开关6485按钮的力。In accordance with at least one aspect of the present disclosure, FIG. 47 is a detailed view of a trigger 6483 portion and a switch of the ultrasonic surgical instrument 6480 shown in FIG. 46. The trigger 6483 is operably coupled to the jaw member 6495 of the end effector 6492. The ultrasonic blade 6496 is powered by the ultrasonic transducer/generator assembly 6484 when the activation switch 6485 is activated. Now continuing with FIG. 46 and also referring to FIG. 47, the trigger 6483 and the activation switch 6485 are shown as components of the handle assembly 6482. The trigger 6483 activates the end effector 6492, which has a cooperative association with the ultrasonic blade 6496 of the waveguide shaft assembly 6490 to enable various types of contact between the end effector jaw member 6495 and the ultrasonic blade 6496 with tissue and/or other substances. The jaw member 6495 of the end effector 6492 is typically a pivoting jaw that is used to grasp or clamp onto tissue disposed between the jaw and the ultrasonic blade 6496. In one aspect, audible feedback is provided in the trigger when the trigger is fully depressed. The noise may be generated by a thin metal component of the trigger snap when closed. This feature adds an audible component to the user feedback that the jaws are fully compressed against the waveguide and that sufficient clamping pressure is being applied to complete the vessel seal. On the other hand, a force sensor such as a strain gauge or a pressure sensor may be coupled to the trigger 6483 to measure the force applied to the trigger 6483 by the user. On the other hand, a force sensor such as a strain gauge or a pressure sensor may be coupled to the switch 6485 button so that the displacement intensity corresponds to the force applied to the switch 6485 button by the user.

当被压下时，激活开关6485将模块化手持式超声外科器械6480置于超声操作模式下，该超声操作模式在波导轴组件6490处引起超声运动。在一个方面，压下激活开关6485导致开关内的电触点闭合，从而完成智能电池组件6486和超声换能器/发生器组件6484之间的电路，以便将电能施加到超声换能器，如前所述。在另一方面，压下激活开关6485关闭至智能电池组件6486的电触点。当然，在本文中，电路中的闭合电触点的描述仅是开关操作的示例性一般描述。存在许多可供选择的方面，这些方面可包括打开触点或处理器控制的功率递送，其从开关接收信息并基于信息引导对应的电路反应。When depressed, the activation switch 6485 places the modular handheld ultrasonic surgical instrument 6480 in an ultrasonic operating mode that causes ultrasonic motion at the waveguide shaft assembly 6490. In one aspect, depressing the activation switch 6485 causes electrical contacts within the switch to close, thereby completing a circuit between the smart battery assembly 6486 and the ultrasonic transducer/generator assembly 6484 so that electrical energy is applied to the ultrasonic transducer, as previously described. In another aspect, depressing the activation switch 6485 closes the electrical contacts to the smart battery assembly 6486. Of course, in this document, the description of closed electrical contacts in a circuit is merely an exemplary general description of switch operation. There are many alternative aspects that may include open contacts or processor-controlled power delivery that receives information from the switch and directs a corresponding circuit reaction based on the information.

图48是从远侧端部观察的根据本公开的至少一个方面的端部执行器6492的局部放大透视图，其中钳口构件6495处于打开位置。参见图48，其示出了波导轴组件6490的远侧端部6498的透视局部视图。波导轴组件6490包括围绕波导的一部分的外管6494。波导6499的超声刀6496部分从外管6494的远侧端部6498突出。在医疗规程期间接触组织并将其超声能量传递到组织的是超声刀6496部分。波导轴组件6490还包括耦合到外管6494和内管(在该视图中不可见)的钳口构件6495。钳口构件6495连同波导6499的内管和外管以及超声刀6496部分可被称为端部执行器6492。如下文将解释的，外管6494和未示出的内管相对于彼此纵向滑动。当外管6494和未示出的内管之间的相对运动发生时，钳口构件6495在枢转点上枢转，从而导致钳口构件6495打开和闭合。当闭合时，钳口构件6495在位于钳口构件6495和超声刀6496之间的组织上施加夹紧力，从而确保正面和有效的刀到组织接触。FIG. 48 is a partially enlarged perspective view of an end effector 6492 according to at least one aspect of the present disclosure, viewed from the distal end, with the jaw member 6495 in an open position. Referring to FIG. 48 , a perspective partial view of the distal end 6498 of the waveguide shaft assembly 6490 is shown. The waveguide shaft assembly 6490 includes an outer tube 6494 surrounding a portion of the waveguide. The ultrasonic blade 6496 portion of the waveguide 6499 protrudes from the distal end 6498 of the outer tube 6494. It is the ultrasonic blade 6496 portion that contacts the tissue during the medical procedure and transmits its ultrasonic energy to the tissue. The waveguide shaft assembly 6490 also includes a jaw member 6495 coupled to the outer tube 6494 and the inner tube (not visible in this view). The jaw member 6495, together with the inner and outer tubes of the waveguide 6499 and the ultrasonic blade 6496 portion, can be referred to as an end effector 6492. As will be explained below, the outer tube 6494 and the inner tube, not shown, slide longitudinally relative to each other. When relative movement between the outer tube 6494 and the inner tube (not shown) occurs, the jaw member 6495 pivots on the pivot point, causing the jaw member 6495 to open and close. When closed, the jaw member 6495 applies a clamping force on the tissue between the jaw member 6495 and the ultrasonic blade 6496, thereby ensuring positive and effective blade-to-tissue contact.

图49为根据本公开的至少一个方面的分段电路7401的系统图7400，该分段电路包括多个独立操作的电路区段7402、7414、7416、7420、7424、7428、7434、7440。分段电路7401的多个电路区段中的电路区段包括一个或多个电路和存储在一个或多个存储器装置中的一组或多组机器可执行指令。电路区段的一个或多个电路耦合到以通过一个或多个有线或无线连接介质进行电通信。多个电路区段被配置为在三种模式之间转变，该三种模式包括睡眠模式、待机模式和操作模式。FIG. 49 is a system diagram 7400 of a segmented circuit 7401 according to at least one aspect of the present disclosure, the segmented circuit comprising a plurality of independently operated circuit segments 7402, 7414, 7416, 7420, 7424, 7428, 7434, 7440. A circuit segment of the plurality of circuit segments of the segmented circuit 7401 comprises one or more circuits and one or more sets of machine executable instructions stored in one or more memory devices. One or more circuits of the circuit segment are coupled to for electrical communication via one or more wired or wireless connection media. The plurality of circuit segments are configured to transition between three modes, the three modes comprising a sleep mode, a standby mode, and an operating mode.

在所示的一个方面，多个电路区段7402、7414、7416、7420、7424、7428、7434、7440首先以待机模式启动、其次转变到睡眠模式，并且再次转变到操作模式。然而，在其它方面，多个电路区段可从三种模式中的任一种转变到三种模式中的任何其它模式。例如，多个电路区段可从待机模式直接转变到操作模式。基于处理器对机器可执行指令的执行，电压控制电路7408可将独立电路区段置于特定状态。该状态包括断电状态、低能量状态和通电状态。断电状态对应于睡眠模式，低能量状态对应于待机模式，并且通电状态对应于操作模式。可通过例如使用电位计来实现向低能量状态的转变。In one aspect shown, multiple circuit sections 7402, 7414, 7416, 7420, 7424, 7428, 7434, 7440 are first started in standby mode, then transitioned to sleep mode, and then transitioned to operating mode. However, in other aspects, multiple circuit sections can transition from any of the three modes to any other of the three modes. For example, multiple circuit sections can transition directly from standby mode to operating mode. Based on the execution of machine executable instructions by the processor, the voltage control circuit 7408 can place independent circuit sections in a specific state. The state includes a power-off state, a low energy state, and a power-on state. The power-off state corresponds to the sleep mode, the low energy state corresponds to the standby mode, and the power-on state corresponds to the operating mode. The transition to the low energy state can be achieved by, for example, using a potentiometer.

在一个方面，多个电路区段7402、7414、7416、7420、7424、7428、7434、7440可根据通电顺序从休眠模式或待机模式转变到操作模式。多个电路区段还可根据断电序列从操作模式转变到待机模式或睡眠模式。通电序列和断电序列可为不同的。在一些方面，通电序列包括仅将多个电路区段中的电路区段的子集通电。在一些方面，断电序列包括仅使多个电路区段的电路区段的子集断电。In one aspect, the plurality of circuit sections 7402, 7414, 7416, 7420, 7424, 7428, 7434, 7440 may transition from a sleep mode or a standby mode to an operational mode according to a power-on sequence. The plurality of circuit sections may also transition from an operational mode to a standby mode or a sleep mode according to a power-off sequence. The power-on sequence and the power-off sequence may be different. In some aspects, the power-on sequence includes only powering on a subset of the circuit sections of the plurality of circuit sections. In some aspects, the power-off sequence includes only powering off a subset of the circuit sections of the plurality of circuit sections.

返回参考图49中的系统图7400，分段电路7401包括多个电路区段，该多个电路区段包括转变电路区段7402、处理器电路区段7414、柄部电路区段7416、通信电路区段7420、显示电路区段7424、马达控制电路区段7428、能量处理电路区段7434和轴电路区段7440。转变电路区段包括唤醒电路7404、升压电流电路7406、电压控制电路7408、安全控制器7410和POST控制器7412。转变电路区段7402被配置为实现断电和通电序列、安全检测协议和POST。Referring back to the system diagram 7400 in FIG49 , the segmented circuit 7401 includes a plurality of circuit sections including a transition circuit section 7402, a processor circuit section 7414, a handle circuit section 7416, a communication circuit section 7420, a display circuit section 7424, a motor control circuit section 7428, an energy processing circuit section 7434, and an axis circuit section 7440. The transition circuit section includes a wake-up circuit 7404, a boost current circuit 7406, a voltage control circuit 7408, a safety controller 7410, and a POST controller 7412. The transition circuit section 7402 is configured to implement power-off and power-on sequences, safety detection protocols, and POST.

在一些方面，唤醒电路7404包括加速度计按钮传感器7405。在各方面，转变电路区段7402被配置为处于通电状态，而分段电路7401的多个电路区段中的其它电路区段被配置为处于低能量状态、断电状态或通电状态。加速度计按钮传感器7405可监测本文所述的外科器械6480的运动或加速度。例如，该运动可为外科器械的取向或旋转的变化。外科器械可通过例如外科器械的用户而相对于三维Euclidean空间在任何方向上运动。当加速度计按钮传感器7405感测运动或加速度时，加速度计按钮传感器7405向电压控制电路7408发送信号，以使电压控制电路7408向处理器电路区段7414施加电压，以将处理器和易失性存储器转变到通电状态。在各方面，在电压控制电路7409向处理器和易失性存储器施加电压之前，处理器和易失性存储器处于通电状态。在操作模式下，处理器可开始通电序列或断电序列。在各个方面，加速度计按钮传感器7405还可将信号发送至处理器，以使处理器开始通电序列或断电序列。在一些方面，当大多数单独的电路区段处于低能量状态或断电状态时，处理器开始通电序列。在其它方面，当大多数单独的电路区段处于通电状态时，处理器开始断电序列。In some aspects, the wake-up circuit 7404 includes an accelerometer button sensor 7405. In various aspects, the transition circuit segment 7402 is configured to be in a powered state, while other circuit segments of the plurality of circuit segments of the segmented circuit 7401 are configured to be in a low energy state, a powered off state, or a powered state. The accelerometer button sensor 7405 can monitor the movement or acceleration of the surgical instrument 6480 described herein. For example, the movement can be a change in the orientation or rotation of the surgical instrument. The surgical instrument can be moved in any direction relative to the three-dimensional Euclidean space by, for example, a user of the surgical instrument. When the accelerometer button sensor 7405 senses movement or acceleration, the accelerometer button sensor 7405 sends a signal to the voltage control circuit 7408 so that the voltage control circuit 7408 applies a voltage to the processor circuit segment 7414 to transition the processor and the volatile memory to a powered state. In various aspects, before the voltage control circuit 7409 applies a voltage to the processor and the volatile memory, the processor and the volatile memory are in a powered state. In the operational mode, the processor may initiate a power-on sequence or a power-off sequence. In various aspects, the accelerometer button sensor 7405 may also send a signal to the processor to cause the processor to initiate a power-on sequence or a power-off sequence. In some aspects, the processor initiates a power-on sequence when most of the individual circuit segments are in a low energy state or a power-off state. In other aspects, the processor initiates a power-off sequence when most of the individual circuit segments are in a power-on state.

附加地或另选地，加速度计按钮传感器7405可感测外科器械的预定附近内的外部运动。例如，加速度计按钮传感器7405可感测本文所述的外科器械6480的用户使用户的手在预定附近运动。当加速度计按钮传感器7405感测到该外部运动时，加速度计按钮传感器7405可向电压控制电路7408发送信号并且将信号发送至处理器，如前所述。在接收到所发送的信号之后，处理器可开始通电序列或断电序列以使一个或多个电路区段在三种模式之间转变。在各方面，发送至电压控制电路7408的信号被发送以验证处理器处于操作模式。在一些方面，加速度计按钮传感器7405可感测外科器械何时已掉落，并基于所感测的掉落向处理器发送信号。例如，信号可指示独立电路区段的操作中的错误。一个或多个传感器可感测受影响的独立电路区段的损坏或故障。基于所感测的损坏或故障，POST控制器7412可对对应的独立电路区段执行POST。Additionally or alternatively, the accelerometer button sensor 7405 may sense external motion within a predetermined vicinity of the surgical instrument. For example, the accelerometer button sensor 7405 may sense that a user of the surgical instrument 6480 described herein moves the user's hand within a predetermined vicinity. When the accelerometer button sensor 7405 senses the external motion, the accelerometer button sensor 7405 may send a signal to the voltage control circuit 7408 and send the signal to the processor, as described above. After receiving the sent signal, the processor may start a power-on sequence or a power-off sequence to transition one or more circuit segments between three modes. In various aspects, the signal sent to the voltage control circuit 7408 is sent to verify that the processor is in an operating mode. In some aspects, the accelerometer button sensor 7405 may sense when the surgical instrument has been dropped and send a signal to the processor based on the sensed drop. For example, the signal may indicate an error in the operation of an independent circuit segment. One or more sensors may sense damage or failure of the affected independent circuit segment. Based on the sensed damage or failure, the POST controller 7412 may perform POST on the corresponding independent circuit segment.

通电序列或断电序列可基于加速度计按钮传感器7405来限定。例如，加速度计按钮传感器7405可感测指示对多个电路区段中的特定电路区段的选择的特定运动或运动序列。基于所感测的运动或一系列感测的运动，加速度计按钮传感器7405可在处理器处于通电状态时将包括对多个电路区段中的一个或多个电路区段的指示的信号发射至处理器。基于该信号，处理器确定包括所选择的一个或多个电路区段的通电序列。附加地或另选地，本文所述的外科器械6480的用户可基于与外科器械的图形用户界面(GUI)的交互来选择电路区段的数量和次序以限定通电序列或断电序列。The power-on sequence or the power-off sequence may be defined based on the accelerometer button sensor 7405. For example, the accelerometer button sensor 7405 may sense a specific motion or sequence of motions indicating the selection of a specific circuit segment in a plurality of circuit segments. Based on the sensed motion or a series of sensed motions, the accelerometer button sensor 7405 may transmit a signal including an indication of one or more circuit segments in a plurality of circuit segments to the processor when the processor is in a powered-on state. Based on the signal, the processor determines a power-on sequence including the selected one or more circuit segments. Additionally or alternatively, a user of the surgical instrument 6480 described herein may select the number and order of circuit segments to define the power-on sequence or the power-off sequence based on interaction with a graphical user interface (GUI) of the surgical instrument.

在各个方面，加速度计按钮传感器7405可仅在加速度计按钮传感器7405检测到本文所述的外科器械6480的运动或在预定阈值以上的预定附近内的外部运动时向电压控制电路7408发送信号和向处理器发送信号。例如，仅在感测到运动5秒或更多秒的情况下或者在外科器械运动5英寸或更多英寸的情况下，才可发送信号。在其它方面，加速度计按钮传感器7405可仅在加速度计按钮传感器7405检测到外科器械的摆动运动时向电压控制电路7408发送信号并且向处理器发送信号。预定阈值减少外科器械的电路区段的意外转变。如前所述，该转变可包括根据通电序列转变到操作模式、根据断电序列转变到低能量模式、或根据断电序列转变到睡眠模式。在一些方面，外科器械包括可由外科器械的用户致动的致动器。致动由加速度计按钮传感器7405感测。致动器可为滑块、拨动开关或瞬时接触开关。基于所感测的致动，加速度计按钮传感器7405可向电压控制电路7408发送信号并向处理器发送信号。In various aspects, the accelerometer button sensor 7405 may send a signal to the voltage control circuit 7408 and a signal to the processor only when the accelerometer button sensor 7405 detects the motion of the surgical instrument 6480 described herein or external motion within a predetermined vicinity above a predetermined threshold. For example, a signal may be sent only when the motion is sensed for 5 seconds or more or when the surgical instrument moves 5 inches or more. In other aspects, the accelerometer button sensor 7405 may send a signal to the voltage control circuit 7408 and a signal to the processor only when the accelerometer button sensor 7405 detects the swinging motion of the surgical instrument. The predetermined threshold reduces the accidental transition of the circuit section of the surgical instrument. As previously described, the transition may include transitioning to an operating mode according to a power-on sequence, transitioning to a low energy mode according to a power-off sequence, or transitioning to a sleep mode according to a power-off sequence. In some aspects, the surgical instrument includes an actuator that can be actuated by a user of the surgical instrument. The actuation is sensed by the accelerometer button sensor 7405. The actuator may be a slider, a toggle switch, or a momentary contact switch. Based on the sensed actuation, the accelerometer button sensor 7405 may send a signal to the voltage control circuit 7408 and to the processor.

升压电流电路7406耦合到电池。升压电流电路7406是电流放大器(诸如继电器或晶体管)，并且被配置为放大独立电路区段的电流的量值。电流的初始量值对应于由电池提供给分段电路7401的源电压。合适的中继系统包括螺线管。合适的晶体管包括场效应晶体管(FET)、MOSFET和双极结晶体管(BJT)。升压电流电路7406可放大对应于在本文所述的外科器械6480的操作期间需要更多电流消耗的独立电路区段或电路的电流的量值。例如，当外科器械的马达需要更多输入功率时，可提供对马达控制电路区段7428的电流的增加。提供给独立电路区段的电流的增加可导致另一个电路区段或多个电路区段的电流的对应减小。附加地或另选地，电流的增加可对应于由与电池结合操作的附加电压源提供的电压。The boost current circuit 7406 is coupled to the battery. The boost current circuit 7406 is a current amplifier (such as a relay or a transistor) and is configured to amplify the magnitude of the current of the independent circuit segment. The initial magnitude of the current corresponds to the source voltage provided by the battery to the segmented circuit 7401. Suitable relay systems include solenoids. Suitable transistors include field effect transistors (FETs), MOSFETs, and bipolar junction transistors (BJTs). The boost current circuit 7406 can amplify the magnitude of the current corresponding to the independent circuit segment or circuit that requires more current consumption during the operation of the surgical instrument 6480 described herein. For example, when the motor of the surgical instrument requires more input power, an increase in the current of the motor control circuit segment 7428 can be provided. The increase in the current provided to the independent circuit segment can result in a corresponding decrease in the current of another circuit segment or multiple circuit segments. Additionally or alternatively, the increase in current can correspond to a voltage provided by an additional voltage source operating in conjunction with the battery.

电压控制电路7408耦合到电池。电压控制电路7408被配置为向多个电路区段提供电压或从多个电路区段移除电压。电压控制电路7408被进一步配置为增大或减小提供给分段电路7401的多个电路区段的电压。在各个方面，电压控制电路7408包括组合逻辑电路，诸如用于选择输入、多个电子开关和多个电压转换器的多路复用器(MUX)。多个电子开关中的电子开关可被配置为在打开和闭合配置之间切换以将单独电路区段从电池断开或将单独电路区段连接至电池。多个电子开关可为固态装置诸如晶体管或其它类型的开关，诸如无线开关、超声开关、加速度计、惯性传感器等等。组合逻辑电路被配置为选择用于切换到打开配置的单独电子开关，以使得能够将电压施加到对应的电路区段。组合逻辑电路被进一步配置为选择用于切换到闭合配置的单独电子开关，以使得能够从对应的电路区段移除电压。通过选择多个单独的电子开关，组合逻辑电路可实现断电序列或通电序列。多个电压转换器可向多个电路区段提供升压电压或降压电压。电压控制电路7408还可包括微处理器和存储器装置。The voltage control circuit 7408 is coupled to the battery. The voltage control circuit 7408 is configured to provide voltage to or remove voltage from multiple circuit sections. The voltage control circuit 7408 is further configured to increase or decrease the voltage provided to multiple circuit sections of the segmented circuit 7401. In various aspects, the voltage control circuit 7408 includes a combinational logic circuit, such as a multiplexer (MUX) for selecting inputs, multiple electronic switches, and multiple voltage converters. The electronic switches in the multiple electronic switches can be configured to switch between open and closed configurations to disconnect a separate circuit section from the battery or connect a separate circuit section to the battery. The multiple electronic switches can be solid-state devices such as transistors or other types of switches, such as wireless switches, ultrasonic switches, accelerometers, inertial sensors, and the like. The combinational logic circuit is configured to select a separate electronic switch for switching to an open configuration so that a voltage can be applied to the corresponding circuit section. The combinational logic circuit is further configured to select a separate electronic switch for switching to a closed configuration so that a voltage can be removed from the corresponding circuit section. By selecting multiple individual electronic switches, the combinational logic circuit can implement a power-off sequence or a power-on sequence. Multiple voltage converters can provide boosted voltage or bucked voltage to multiple circuit sections. The voltage control circuit 7408 may also include a microprocessor and a memory device.

安全控制器7410被配置为对电路区段执行安全检查。在一些方面，当一个或多个单独电路区段处于操作模式时，安全控制器7410执行安全检查。可执行安全检查以确定电路区段的功能或操作中是否存在任何错误或缺陷。安全控制器7410可监测多个电路区段的一个或多个参数。安全控制器7410可通过将一个或多个参数与预定义的参数进行比较来验证多个电路区段的身份和操作。例如，如果选择RF能量模态，则安全控制器7410可验证轴的关节运动参数匹配预定义的关节运动参数以验证本文所述的外科器械6480的RF能量模态的操作。在一些方面，安全控制器7410可通过传感器监测外科器械的一个或多个特性之间的预定的关系以检测故障。当一个或多个特性与预定关系不一致时，可发生故障。当安全控制器7410确定存在故障、存在错误或该多个电路区段的一些操作未被验证时，安全控制器7410防止或禁用引起故障、错误或验证失效的特定电路区段的操作。The safety controller 7410 is configured to perform safety checks on circuit segments. In some aspects, the safety controller 7410 performs safety checks when one or more individual circuit segments are in an operating mode. A safety check may be performed to determine if there are any errors or defects in the function or operation of the circuit segment. The safety controller 7410 may monitor one or more parameters of multiple circuit segments. The safety controller 7410 may verify the identity and operation of multiple circuit segments by comparing one or more parameters with predefined parameters. For example, if the RF energy modality is selected, the safety controller 7410 may verify that the joint motion parameters of the axis match the predefined joint motion parameters to verify the operation of the RF energy modality of the surgical instrument 6480 described herein. In some aspects, the safety controller 7410 may monitor a predetermined relationship between one or more characteristics of the surgical instrument through a sensor to detect a fault. When one or more characteristics are inconsistent with the predetermined relationship, a fault may occur. When the safety controller 7410 determines that there is a fault, an error, or some operations of the multiple circuit segments are not verified, the safety controller 7410 prevents or disables the operation of the specific circuit segment that causes the fault, error, or verification failure.

POST控制器7412执行POST以验证多个电路区段的正确操作。在一些方面，在电压控制电路7408将电压施加到单独电路区段以将单个电路区段从待机模式或睡眠模式转变到操作模式之前，对该多个电路区段中的单独电路区段执行POST。如果单个电路区段未通过POST，则特定电路区段不会从待机模式或睡眠模式转变到操作模式。柄部电路段7416的POST可包括例如测试柄部控制传感器7418是否感测到本文所述的外科器械6480的柄部控件的致动。在一些方面，POST控制器7412可将信号发射到加速度计按钮传感器7405，以验证作为POST的一部分的单独电路区段的操作。例如，在接收信号之后，加速度计按钮传感器7405可促使外科器械的用户将外科器械运动到多个变化位置以确保外科器械的操作。加速度计按钮传感器7405还可监测作为POST的一部分的电路区段或电路区段的电路的输出。例如，加速度计按钮传感器7405可感测由马达7432生成的增量马达脉冲以验证操作。马达控制电路7430的马达控制器可用于控制马达7432以生成增量马达脉冲。The POST controller 7412 performs POST to verify the correct operation of multiple circuit segments. In some aspects, before the voltage control circuit 7408 applies voltage to the individual circuit segment to transition the individual circuit segment from standby mode or sleep mode to operating mode, POST is performed on the individual circuit segment of the multiple circuit segments. If the individual circuit segment does not pass POST, the specific circuit segment will not transition from standby mode or sleep mode to operating mode. The POST of the handle circuit segment 7416 may include, for example, testing whether the handle control sensor 7418 senses the actuation of the handle control of the surgical instrument 6480 described herein. In some aspects, the POST controller 7412 may transmit a signal to the accelerometer button sensor 7405 to verify the operation of the individual circuit segment as part of the POST. For example, after receiving the signal, the accelerometer button sensor 7405 may prompt the user of the surgical instrument to move the surgical instrument to multiple change positions to ensure the operation of the surgical instrument. The accelerometer button sensor 7405 may also monitor the output of the circuit segment or the circuit of the circuit segment as part of the POST. For example, the accelerometer button sensor 7405 can sense incremental motor pulses generated by the motor 7432 to verify operation. The motor controller of the motor control circuit 7430 can be used to control the motor 7432 to generate incremental motor pulses.

在各个方面，本文所述的外科器械6480可包括附加的加速度计按钮传感器。POST控制器7412还可执行存储在电压控制电路7408的存储器装置中的控制程序。控制程序可使得POST控制器7412发射从多个电路区段请求匹配的加密参数的信号。未能从单独电路区段接收匹配的加密参数向POST控制器7412指示对应的电路区段已损坏或发生故障。在一些方面，如果POST控制器7412基于POST确定处理器已损坏或发生故障，则POST控制器7412可向一个或多个次级处理器发送信号以使得一个或多个次级处理器执行该处理器不能执行的关键功能。在一些方面，如果POST控制器7412基于POST确定一个或多个电路区段不能正常工作，则在锁定未通过POST或不正确操作的那些电路区段的同时，POST控制器7412可开始正确操作的那些电路区段的降低的性能模式。锁定电路区段可类似于处于待机模式或睡眠模式的电路区段起作用。In various aspects, the surgical instrument 6480 described herein may include an additional accelerometer button sensor. The POST controller 7412 may also execute a control program stored in a memory device of the voltage control circuit 7408. The control program may cause the POST controller 7412 to transmit a signal requesting matching encryption parameters from multiple circuit sections. Failure to receive matching encryption parameters from a separate circuit section indicates to the POST controller 7412 that the corresponding circuit section is damaged or malfunctioning. In some aspects, if the POST controller 7412 determines based on the POST that the processor is damaged or malfunctioning, the POST controller 7412 may send a signal to one or more secondary processors to cause the one or more secondary processors to perform a critical function that the processor cannot perform. In some aspects, if the POST controller 7412 determines based on the POST that one or more circuit sections are not functioning properly, the POST controller 7412 may start a reduced performance mode for those circuit sections that are operating correctly while locking those circuit sections that have not passed the POST or are not operating correctly. Locking a circuit section may function similarly to a circuit section in a standby mode or a sleep mode.

处理器电路区段7414包括处理器和易失性存储器。处理器被配置为开始通电序列或断电序列。为了开始通电序列，处理器将通电信号发射到电压控制电路7408，以使电压控制电路7408根据通电序列向所述多个电路区段中的多个或子集施加电压。为了开始断电序列，处理器将断电信号发射到电压控制电路7408，以使电压控制电路7408根据断电序列从所述多个电路区段中的多个或子集移除电压。The processor circuit section 7414 includes a processor and a volatile memory. The processor is configured to start a power-on sequence or a power-off sequence. To start the power-on sequence, the processor transmits a power-on signal to the voltage control circuit 7408 so that the voltage control circuit 7408 applies voltage to multiple or a subset of the multiple circuit sections according to the power-on sequence. To start the power-off sequence, the processor transmits a power-off signal to the voltage control circuit 7408 so that the voltage control circuit 7408 removes voltage from multiple or a subset of the multiple circuit sections according to the power-off sequence.

柄部电路区段7416包括柄部控制传感器7418。柄部控制传感器7418可感测本文所述的外科器械6480的一个或多个柄部控件的致动。在各个方面，一个或多个柄部控件包括夹具控件、释放按钮、关节运动开关、能量激活按钮和/或任何其它合适的柄部控件。用户可激活能量激活按钮以在RF能量模式、超声能量模式或RF能量模式和超声能量模式的组合之间进行选择。柄部控制传感器7418还可有利于将模块化柄部附接到外科器械。例如，柄部控制传感器7418可感测模块化柄部与外科器械的正确附接，并且向外科器械的用户指示感测到的附接。LCD显示器7426可提供感测到的附接的图形指示。在一些方面，柄部控制传感器7418感测一个或多个柄部控件的致动。基于所感测的致动，处理器可开始通电序列或断电序列。The handle circuit section 7416 includes a handle control sensor 7418. The handle control sensor 7418 can sense the actuation of one or more handle controls of the surgical instrument 6480 described herein. In various aspects, the one or more handle controls include a clamp control, a release button, an articulation switch, an energy activation button, and/or any other suitable handle control. The user can activate the energy activation button to select between an RF energy mode, an ultrasonic energy mode, or a combination of an RF energy mode and an ultrasonic energy mode. The handle control sensor 7418 can also facilitate attaching a modular handle to a surgical instrument. For example, the handle control sensor 7418 can sense the correct attachment of the modular handle to the surgical instrument and indicate the sensed attachment to the user of the surgical instrument. The LCD display 7426 can provide a graphical indication of the sensed attachment. In some aspects, the handle control sensor 7418 senses the actuation of one or more handle controls. Based on the sensed actuation, the processor can start a power-on sequence or a power-off sequence.

通信电路区段7420包括通信电路7422。通信电路7422包括通信接口以有利于多个电路区段中的单独电路区段之间的信号通信。在一些方面，通信电路7422为本文所述的外科器械6480的模块化部件提供用于电通信的路径。例如，模块化轴和模块化换能器在一起附接到外科器械的柄部时，可通过通信电路7422将控制程序上载到柄部。The communication circuit section 7420 includes a communication circuit 7422. The communication circuit 7422 includes a communication interface to facilitate signal communication between individual circuit sections in the plurality of circuit sections. In some aspects, the communication circuit 7422 provides a path for electrical communication for the modular components of the surgical instrument 6480 described herein. For example, when the modular shaft and the modular transducer are attached together to the handle of the surgical instrument, the control program can be uploaded to the handle through the communication circuit 7422.

显示电路区段7424包括LCD显示器7426。LCD显示器7426可包括液晶显示屏、LED指示器等。在一些方面，LCD显示器7426为有机发光二极管(OLED)屏幕。显示器可放置在本文所述的外科器械6480上，嵌入或远离该外科器械定位。例如，可将显示器放置在外科器械的柄部上。显示器被配置为向用户提供感觉反馈。在各个方面，LCD显示器7426还包括背光源。在一些方面，外科器械还可包括音频反馈装置诸如扬声器或蜂鸣器以及触觉反馈装置诸如触觉致动器。The display circuit section 7424 includes an LCD display 7426. The LCD display 7426 may include a liquid crystal display screen, an LED indicator, etc. In some aspects, the LCD display 7426 is an organic light emitting diode (OLED) screen. The display may be placed on the surgical instrument 6480 described herein, embedded in or positioned away from the surgical instrument. For example, the display may be placed on the handle of the surgical instrument. The display is configured to provide sensory feedback to the user. In various aspects, the LCD display 7426 also includes a backlight. In some aspects, the surgical instrument may also include an audio feedback device such as a speaker or a buzzer and a tactile feedback device such as a tactile actuator.

马达控制电路区段7428包括耦合到马达7432的马达控制电路7430。马达7432通过驱动器和晶体管(诸如FET)耦合到处理器。在各个方面，马达控制电路7430包括马达电流传感器，该马达电流传感器与处理器进行信号通信以向处理器提供指示马达的电流消耗的测量值的信号。处理器将信号发射至显示器。显示器接收信号并显示马达7432的电流消耗的测量值。处理器可例如使用该信号来监测马达7432的电流消耗存在于可接受范围内，以将电流消耗与多个电路区段的一个或多个参数进行比较，并且确定患者治疗部位的一个或多个参数。在各个方面，马达控制电路7430包括用于控制马达的操作的马达控制器。例如，马达控制电路7430控制各种马达参数，诸如通过调节马达7432的速度、扭矩和加速度。该调节基于通过马达电流传感器测量穿过马达7432的电流来完成。The motor control circuit section 7428 includes a motor control circuit 7430 coupled to a motor 7432. The motor 7432 is coupled to the processor via a driver and a transistor (such as a FET). In various aspects, the motor control circuit 7430 includes a motor current sensor that communicates signals with the processor to provide the processor with a signal indicating a measured value of the current consumption of the motor. The processor transmits the signal to a display. The display receives the signal and displays the measured value of the current consumption of the motor 7432. The processor may, for example, use the signal to monitor whether the current consumption of the motor 7432 is within an acceptable range, to compare the current consumption with one or more parameters of multiple circuit sections, and to determine one or more parameters of the patient treatment site. In various aspects, the motor control circuit 7430 includes a motor controller for controlling the operation of the motor. For example, the motor control circuit 7430 controls various motor parameters, such as by adjusting the speed, torque, and acceleration of the motor 7432. The adjustment is based on measuring the current passing through the motor 7432 by the motor current sensor.

在各个方面，马达控制电路7430包括力传感器以测量由马达7432生成的力和扭矩。马达7432被配置为致动本文所述的外科器械6480的机构。例如，马达7432被配置为控制外科器械的轴的致动以实现夹持、旋转和关节运动功能。例如，马达7432可致动轴以实现用外科器械的钳口进行夹持运动。马达控制器可确定由钳口夹持的材料是组织还是金属。马达控制器也可确定钳口夹持材料的程度。例如，马达控制器可基于感测的马达电流或马达电压的导数来确定钳口是如何打开或闭合的。在一些方面，马达7432被配置为致动换能器以使换能器向柄部施加扭矩或控制外科器械的关节运动。马达电流传感器可与马达控制器交互以设定马达电流限制。当电流满足预定义的阈值限制时，马达控制器开始马达控制操作中的对应变化。例如，超过马达电流限制使得马达控制器降低马达的电流消耗。In various aspects, the motor control circuit 7430 includes a force sensor to measure the force and torque generated by the motor 7432. The motor 7432 is configured to actuate the mechanism of the surgical instrument 6480 described herein. For example, the motor 7432 is configured to control the actuation of the axis of the surgical instrument to achieve clamping, rotation and joint movement functions. For example, the motor 7432 can actuate the axis to achieve clamping movement with the jaws of the surgical instrument. The motor controller can determine whether the material clamped by the jaws is tissue or metal. The motor controller can also determine the degree of the jaws clamping the material. For example, the motor controller can determine how the jaws are opened or closed based on the derivative of the sensed motor current or motor voltage. In some aspects, the motor 7432 is configured to actuate the transducer so that the transducer applies torque to the handle or controls the joint movement of the surgical instrument. The motor current sensor can interact with the motor controller to set the motor current limit. When the current meets the predefined threshold limit, the motor controller starts the corresponding change in the motor control operation. For example, exceeding the motor current limit causes the motor controller to reduce the current consumption of the motor.

能量处理电路区段7434包括RF放大器和安全电路7436以及超声信号发生器电路7438，以实现本文所述的外科器械6480的能量模块化功能。在各个方面，RF放大器和安全电路7436被配置为通过生成RF信号来控制外科器械的RF模态。超声信号发生器电路7438被配置为通过生成超声信号来控制超声能量模态。RF放大器和安全电路7436以及超声信号发生器电路7438可结合操作以控制RF能量模态和超声能量模态的组合。The energy processing circuit section 7434 includes an RF amplifier and safety circuit 7436 and an ultrasonic signal generator circuit 7438 to implement the energy modularization functionality of the surgical instrument 6480 described herein. In various aspects, the RF amplifier and safety circuit 7436 is configured to control the RF modality of the surgical instrument by generating an RF signal. The ultrasonic signal generator circuit 7438 is configured to control the ultrasonic energy modality by generating an ultrasonic signal. The RF amplifier and safety circuit 7436 and the ultrasonic signal generator circuit 7438 can operate in combination to control a combination of the RF energy modality and the ultrasonic energy modality.

轴电路区段7440包括轴模块控制器7442、模块化控制致动器7444、一个或多个端部执行器传感器7446和非易失性存储器7448。轴模块控制器7442被配置为控制包括待由处理器执行的控制程序的多个轴模块。该多个轴模块实现轴模态，诸如超声、超声和RF的组合、RF I刀和RF可相对钳口。轴模块控制器7442可通过选择对应的轴模块来选择轴模态，以供处理器执行。模块化控制致动器7444被配置为根据所选择的轴模态致动轴。在开始致动之后，轴根据特定于所选择的轴模态和所选择的端部执行器模态的一个或多个参数、例程或程序来使端部执行器进行关节运动。位于端部执行器处的一个或多个端部执行器传感器7446可包括力传感器、温度传感器、电流传感器或运动传感器。一个或多个端部执行器传感器7446基于由端部执行器实现的能量模态来发射关于端部执行器的一个或多个操作的数据。在各个方面，能量模态包括超声能量模态、RF能量模态、或超声能量模态和RF能量模态的组合。非易失性存储器7448存储轴控制程序。控制程序包括特定于轴的一个或多个参数、例程或程序。在各个方面，非易失性存储器7448可为ROM、EPROM、EEPROM或闪存。非易失性存储器7448存储对应于本文所述的外科器械6480的所选择轴的轴模块。轴模块可由轴模块控制器7442在非易失性存储器7448中改变或升级，这取决于待在操作中使用的外科器械轴。The shaft circuit section 7440 includes a shaft module controller 7442, a modular control actuator 7444, one or more end effector sensors 7446, and a non-volatile memory 7448. The shaft module controller 7442 is configured to control a plurality of shaft modules including a control program to be executed by a processor. The plurality of shaft modules implement shaft modalities, such as ultrasound, a combination of ultrasound and RF, RF I knife, and RF relative jaws. The shaft module controller 7442 can select the shaft modality by selecting the corresponding shaft module for execution by the processor. The modular control actuator 7444 is configured to actuate the shaft according to the selected shaft modality. After starting actuation, the shaft causes the end effector to perform articulation according to one or more parameters, routines, or programs specific to the selected shaft modality and the selected end effector modality. The one or more end effector sensors 7446 located at the end effector may include a force sensor, a temperature sensor, a current sensor, or a motion sensor. The one or more end effector sensors 7446 transmit data about one or more operations of the end effector based on the energy modality implemented by the end effector. In various aspects, the energy modality includes an ultrasonic energy modality, an RF energy modality, or a combination of an ultrasonic energy modality and an RF energy modality. The non-volatile memory 7448 stores an axis control program. The control program includes one or more parameters, routines, or programs specific to the axis. In various aspects, the non-volatile memory 7448 can be a ROM, EPROM, EEPROM, or flash memory. The non-volatile memory 7448 stores an axis module corresponding to a selected axis of the surgical instrument 6480 described herein. The axis module can be changed or upgraded in the non-volatile memory 7448 by the axis module controller 7442, depending on the surgical instrument axis to be used in the operation.

图50为根据本公开的至少一个方面的具有马达控制功能的外科器械的各种部件的电路7925的示意图。在各个方面，本文所述的外科器械6480包括驱动机构7930，该驱动机构7930被配置为驱动轴和/或齿轮部件，以便执行与外科器械6480相关联的各种操作。在一个方面，驱动机构7930包括旋转动力传动系统(drivetrain)7932，其被配置为使端部执行器例如围绕纵向轴线相对于柄部外壳旋转。驱动机构7930还包括闭合动力传动系统7934，其被配置为闭合钳口构件以利用端部执行器抓握组织。此外，驱动机构7930包括击发动力传动系统7936，该击发动力传动系统被配置为打开和闭合端部执行器的夹持臂部分以利用端部执行器抓握组织。FIG. 50 is a schematic diagram of a circuit 7925 of various components of a surgical instrument with motor control functionality according to at least one aspect of the present disclosure. In various aspects, the surgical instrument 6480 described herein includes a drive mechanism 7930 configured to drive a shaft and/or gear components to perform various operations associated with the surgical instrument 6480. In one aspect, the drive mechanism 7930 includes a rotational drivetrain 7932 configured to rotate the end effector relative to the handle housing, for example, about a longitudinal axis. The drive mechanism 7930 also includes a closing drivetrain 7934 configured to close the jaw member to grasp tissue with the end effector. In addition, the drive mechanism 7930 includes a firing drivetrain 7936 configured to open and close the clamping arm portion of the end effector to grasp tissue with the end effector.

驱动机构7930包括可位于外科器械的柄部组件中的选择器齿轮箱组件7938。靠近选择器齿轮箱组件7938的是功能选择模块，其包括第一马达7942，该第一马达7942用于使齿轮元件在选择器齿轮箱组件7938内选择性地运动，以选择性地将动力传动系统7932、7934、7936中的一个定位成与任选的第二马达7944和马达驱动电路7946(以点划线示出，以指示第二马达7944和马达驱动电路7946为任选部件)的输入驱动部件接合。The drive mechanism 7930 includes a selector gearbox assembly 7938 that can be located in the handle assembly of the surgical instrument. Proximate to the selector gearbox assembly 7938 is a function selection module that includes a first motor 7942 for selectively moving a gear element within the selector gearbox assembly 7938 to selectively position one of the power transmission systems 7932, 7934, 7936 to engage an input drive component of an optional second motor 7944 and motor drive circuit 7946 (shown in dotted lines to indicate that the second motor 7944 and motor drive circuit 7946 are optional components).

仍然参见图50，马达7942、7944分别耦合到马达控制电路7946、7948，该马达控制电路被配置为控制马达7942、7944的操作，包括电能从功率源7950到马达7942、7944的流动。功率源7950可为DC电池(例如，可再充电的铅基、镍基、锂离子基电池等)、或适合向外科器械提供电能的任何其它功率源。50 , motors 7942, 7944 are coupled to motor control circuits 7946, 7948, respectively, which are configured to control the operation of motors 7942, 7944, including the flow of electrical energy from a power source 7950 to motors 7942, 7944. Power source 7950 may be a DC battery (e.g., a rechargeable lead-based, nickel-based, lithium-ion-based battery, etc.), or any other power source suitable for providing electrical energy to a surgical instrument.

外科器械还包括微控制器7952(“控制器”)。在某些情况下，控制器7952可包括微处理器7954(“处理器”)和一个或多个计算机可读介质或存储器单元7956(“存储器”)。在某些情况下，存储器7956可存储各种程序指令，所述各种程序指令在被执行时可使处理器7954执行本文所述的多个功能和/或计算。功率源7950可被配置为例如向控制器7952供电。The surgical instrument also includes a microcontroller 7952 ("controller"). In some cases, the controller 7952 may include a microprocessor 7954 ("processor") and one or more computer-readable media or memory units 7956 ("memory"). In some cases, the memory 7956 may store various program instructions that, when executed, may cause the processor 7954 to perform the various functions and/or calculations described herein. The power source 7950 may be configured to, for example, provide power to the controller 7952.

处理器7954可与马达控制电路7946通信。另外，存储器7956可存储程序指令，该程序指令在由处理器7954响应于用户输入7958或反馈元件7960执行时，可使马达控制电路7946促动马达7942生成至少一个旋转运动，从而使选择器齿轮箱组件7938内的齿轮元件选择性地运动以选择性地定位动力传动系统7932、7934和7936中的一者，并使其运动成与第二马达7944的输入驱动部件接合。此外，处理器7954可与马达控制电路7948通信。存储器7956还可存储程序指令，该程序指令在由处理器7954响应于用户输入7958执行时，可使马达控制电路7948促动马达7944以生成至少一个旋转运动，从而驱动例如与第二马达7948的输入驱动部件接合的动力传动系统。The processor 7954 can communicate with the motor control circuit 7946. In addition, the memory 7956 can store program instructions that, when executed by the processor 7954 in response to the user input 7958 or the feedback element 7960, can cause the motor control circuit 7946 to actuate the motor 7942 to generate at least one rotational motion, thereby selectively moving the gear element within the selector gear box assembly 7938 to selectively position one of the drivetrains 7932, 7934, and 7936 and move it into engagement with the input drive component of the second motor 7944. In addition, the processor 7954 can communicate with the motor control circuit 7948. The memory 7956 can also store program instructions that, when executed by the processor 7954 in response to the user input 7958, can cause the motor control circuit 7948 to actuate the motor 7944 to generate at least one rotational motion, thereby driving the drivetrain engaged with the input drive component of the second motor 7948, for example.

控制器7952和/或本公开的其它控制器可使用集成的和/或分立的硬件元件、软件元件和/或两者的组合来实现。集成硬件元件的示例可包括处理器、微处理器、微控制器、集成电路、ASIC、PLD、DSP、FPGA、逻辑门、寄存器、半导体装置、芯片、微芯片、芯片组、微控制器、片上系统(SoC)、和/或单列直插式封装(SIP)。分立硬件元件的示例可包括电路和/或电路元件，诸如逻辑门、场效应晶体管、双极型晶体管、电阻器、电容器、电感器和/或继电器。在某些情况下，例如，控制器7952可包括混合电路，该混合电路在一个或多个基板上包括分立的和集成的电路元件或部件。Controller 7952 and/or other controllers of the present disclosure can be implemented using integrated and/or discrete hardware elements, software elements and/or a combination of the two. Examples of integrated hardware elements may include processors, microprocessors, microcontrollers, integrated circuits, ASICs, PLDs, DSPs, FPGAs, logic gates, registers, semiconductor devices, chips, microchips, chipsets, microcontrollers, systems on chips (SoCs), and/or single in-line packages (SIPs). Examples of discrete hardware elements may include circuits and/or circuit elements, such as logic gates, field effect transistors, bipolar transistors, resistors, capacitors, inductors and/or relays. In some cases, for example, controller 7952 may include a hybrid circuit that includes discrete and integrated circuit elements or components on one or more substrates.

在某些情况下，控制器7952和/或本公开的其它控制器可为例如购自德克萨斯器械公司(Texas Instruments)的LM 4F230H5QR。在某些情况下，Texas InstrumentsLM4F230H5QR为ARM Cortex-M4F处理器芯，其包括：256KB的单循环闪存或其它非易失性存储器(高达40MHZ)的片上存储器、用于改善40MHz以上的性能的预取缓冲器、32KB的单循环SRAM、装载有软件的内部ROM、2KB的EEPROM、一个或多个PWM模块、一个或多个QEI模拟、具有12个模拟输入信道的一个或多个12位ADC、以及易得的其它特征件。可很方便地换用其它微控制器，来与本公开联合使用。因此，本公开不应限于这一上下文。In some cases, controller 7952 and/or other controllers of the present disclosure may be, for example, LM 4F230H5QR available from Texas Instruments. In some cases, the Texas Instruments LM4F230H5QR is an ARM Cortex-M4F processor core, which includes: 256KB of single-cycle flash or other non-volatile memory (up to 40MHZ) on-chip memory, a pre-fetch buffer for improved performance above 40MHz, 32KB of single-cycle SRAM, a The present invention provides an internal ROM for software, 2KB of EEPROM, one or more PWM modules, one or more QEI simulations, one or more 12-bit ADCs with 12 analog input channels, and other features that are readily available. Other microcontrollers can be easily substituted for use in conjunction with the present disclosure. Therefore, the present disclosure should not be limited to this context.

在各种情况下，本文所述的各种步骤中的一个或多个可由包括组合逻辑电路或时序逻辑电路的有限状态机执行，其中组合逻辑电路或时序逻辑电路耦合到至少一个存储电路。至少一个存储电路存储有限状态机的当前状态。组合或时序逻辑电路被配置为能够使有限状态机到达这些步骤。时序逻辑电路可为同步的或异步的。在其它情况下，例如，本文所述的各种步骤中的一个或多个可通过包括处理器7958和有限状态机的组合的电路来执行。In various cases, one or more of the various steps described herein may be performed by a finite state machine including a combinational logic circuit or a sequential logic circuit, wherein the combinational logic circuit or the sequential logic circuit is coupled to at least one storage circuit. At least one storage circuit stores the current state of the finite state machine. The combinational or sequential logic circuit is configured to enable the finite state machine to reach these steps. The sequential logic circuit may be synchronous or asynchronous. In other cases, for example, one or more of the various steps described herein may be performed by a circuit including a combination of a processor 7958 and a finite state machine.

在各种情况下，能够评估外科器械的功能性状态以确保其功能正常可能是有利的。例如，如上所述的驱动机构(被配置为包括各种马达、动力传动系统和/或齿轮部件，以便执行外科器械的各种操作)可能随着时间的推移而磨损。这可在正常使用中发生，并且在一些情况下，驱动机构由于滥用情况可能磨损得更快。在某些情况下，外科器械可被配置为执行自我评估以确定驱动机构及其各种部件的状态(例如，健康状况)。In various situations, it may be advantageous to be able to assess the functional status of a surgical instrument to ensure that it is functioning properly. For example, a drive mechanism as described above (configured to include various motors, drivetrains, and/or gear components to perform various operations of the surgical instrument) may wear over time. This may occur with normal use, and in some cases, the drive mechanism may wear more rapidly due to abusive conditions. In some cases, a surgical instrument may be configured to perform a self-assessment to determine the status (e.g., health) of the drive mechanism and its various components.

例如，自我评估可用于确定外科器械在再次消毒之前何时能够执行其功能或何时应替换和/或修理部件中的一些。可以各种方式实现对驱动机构及其部件(包括但不限于旋转动力传动系统7932、闭合动力传动系统7934和/或击发动力传动系统7936)的评估。与预测性能的偏差量值可用于确定所感测的故障的可能性和此类失效的严重性。可以使用多个度量，包括：可重复预测事件的周期性分析、超出预期阈值的峰值或下降，以及失效的宽度。For example, the self-assessment can be used to determine when the surgical instrument is able to perform its function before resterilization or when some of the components should be replaced and/or repaired. The evaluation of the drive mechanism and its components (including but not limited to the rotational drivetrain 7932, the closing drivetrain 7934, and/or the firing drivetrain 7936) can be achieved in various ways. The magnitude of the deviation from the predicted performance can be used to determine the likelihood of the sensed fault and the severity of such failure. Multiple metrics can be used, including: periodic analysis of repeatable predicted events, peaks or dips beyond expected thresholds, and the width of the failure.

在各种情况下，可使用正常运行的驱动机构或其一个或多个部件的特征波形来评估驱动机构或其一个或多个部件的状态。一个或多个振动传感器可相对于正常运行的驱动机构或其一个或多个部件布置，以记录在正常运行的驱动机构或其一个或多个部件的操作期间发生的各种振动。记录的振动可用于创建特征波形。可将未来波形与特征波形进行比较，以评估驱动机构及其部件的状态。In various cases, a characteristic waveform of a normally operating drive mechanism or one or more components thereof may be used to assess the state of the drive mechanism or one or more components thereof. One or more vibration sensors may be arranged relative to the normally operating drive mechanism or one or more components thereof to record various vibrations occurring during operation of the normally operating drive mechanism or one or more components thereof. The recorded vibrations may be used to create a characteristic waveform. Future waveforms may be compared to the characteristic waveform to assess the state of the drive mechanism and its components.

仍然参见图50，外科器械7930包括动力传动系统失效检测模块7962，其被配置为记录和分析动力传动系统7932、7934和/或7936中的一者或多者的一个或多个声学输出。处理器7954可与模块7962通信或以其它方式控制该模块。如下面更详细地描述，模块7962可体现为各种装置，诸如电路系统、硬件、计算机程序产品(其包括存储可由处理设备(例如，处理器7954)执行的计算机可读程序指令的计算机可读介质(例如，存储器7956))、或它们的一些组合。在一些方面，处理器36可包括模块7962或以其它方式控制该模块。Still referring to FIG. 50 , the surgical instrument 7930 includes a drivetrain failure detection module 7962 that is configured to record and analyze one or more acoustic outputs of one or more of the drivetrains 7932, 7934, and/or 7936. The processor 7954 may communicate with or otherwise control the module 7962. As described in more detail below, the module 7962 may be embodied as various devices, such as circuit systems, hardware, a computer program product (which includes a computer-readable medium (e.g., memory 7956) storing computer-readable program instructions that can be executed by a processing device (e.g., processor 7954)), or some combination thereof. In some aspects, the processor 36 may include the module 7962 or otherwise control the module.

现在转到图51，端部执行器8400包括位于钳口构件8402上的RF数据传感器8406、8408a、8408b。端部执行器8400包括钳口构件8402和超声刀8404。钳口构件8402被示出为夹持位于钳口构件8402和超声刀8404之间的组织8410。第一传感器8406位于钳口构件8402的中心部分。第二传感器8408a和第三传感器8408b位于钳口构件8402的侧向部分上。传感器8406、8408a、8408b与柔性电路8412(更具体地示于图52中)安装或整体形成，该柔性电路被配置为固定地安装到钳口构件8402。Turning now to FIG. 51 , the end effector 8400 includes RF data sensors 8406, 8408a, 8408b located on the jaw member 8402. The end effector 8400 includes a jaw member 8402 and an ultrasonic blade 8404. The jaw member 8402 is shown as clamping a tissue 8410 located between the jaw member 8402 and the ultrasonic blade 8404. The first sensor 8406 is located in the central portion of the jaw member 8402. The second sensor 8408a and the third sensor 8408b are located on the lateral portion of the jaw member 8402. The sensors 8406, 8408a, 8408b are mounted or integrally formed with a flexible circuit 8412 (more specifically shown in FIG. 52 ), which is configured to be fixedly mounted to the jaw member 8402.

端部执行器8400为用于外科器械的示例端部执行器。传感器8406、8408a、8408b经由接口电路电连接到控制电路诸如控制电路7400(图63)。传感器8406、8408a、8408b为电池供电的，并且由传感器8406、8408a、8408b所生成的信号被提供到控制电路的模拟和/或数字处理电路。End effector 8400 is an example end effector for a surgical instrument. Sensors 8406, 8408a, 8408b are electrically connected to a control circuit such as control circuit 7400 (FIG. 63) via an interface circuit. Sensors 8406, 8408a, 8408b are battery powered, and the signals generated by sensors 8406, 8408a, 8408b are provided to analog and/or digital processing circuits of the control circuit.

在一个方面，第一传感器8406为用于测量通过钳口构件8402施加到组织8410的法向力F3的力传感器。第二传感器8408a和第三传感器8408b包括用于将RF能量施加到组织8410、测量组织阻抗、向下力F1、横向力F2以及温度等参数的一个或多个元件。电极8409a、8409b电耦合到功率源并将RF能量施加到组织8410。在一个方面，第一传感器8406以及第二传感器8408a和第三传感器8408b为用于测量力或每单位面积的力的应变仪。应当理解，向下力F1、横向力F2以及法向力F3的测量可通过确定力传感器8406、8408a、8408b作用其上的表面积而容易地转换成压力。另外，如本文具体描述的那样，柔性电路8412可包括嵌入在柔性电路8412的一个或多个层中的温度传感器。一个或多个温度传感器可对称地或非对称地布置，并向超声驱动电路和RF驱动电路的控制电路提供组织8410的温度反馈。In one aspect, the first sensor 8406 is a force sensor for measuring the normal force F3 applied to the tissue 8410 by the jaw member 8402. The second sensor 8408a and the third sensor 8408b include one or more elements for applying RF energy to the tissue 8410, measuring parameters such as tissue impedance, downward force F1, lateral force F2, and temperature. Electrodes 8409a, 8409b are electrically coupled to a power source and apply RF energy to the tissue 8410. In one aspect, the first sensor 8406 and the second sensor 8408a and the third sensor 8408b are strain gauges for measuring force or force per unit area. It should be understood that the measurement of the downward force F1, lateral force F2, and normal force F3 can be easily converted into pressure by determining the surface area on which the force sensors 8406, 8408a, 8408b act. In addition, as described in detail herein, the flexible circuit 8412 may include a temperature sensor embedded in one or more layers of the flexible circuit 8412. One or more temperature sensors may be arranged symmetrically or asymmetrically and provide temperature feedback of the tissue 8410 to the control circuits of the ultrasound drive circuit and the RF drive circuit.

图52示出了图51中所示的柔性电路8412的一个方面，其中传感器8406、8408a、8408b可安装到该柔性电路或与其整体地形成。柔性电路8412被配置为固定地附接至钳口构件8402。特别地如图52中所示，非对称温度传感器8414a、8414b被安装到柔性电路8412以能够测量组织8410(图51)的温度。FIG52 illustrates an aspect of the flexible circuit 8412 shown in FIG51 to which sensors 8406, 8408a, 8408b may be mounted or integrally formed. The flexible circuit 8412 is configured to be fixedly attached to the jaw member 8402. In particular, as shown in FIG52, asymmetric temperature sensors 8414a, 8414b are mounted to the flexible circuit 8412 to enable measurement of the temperature of the tissue 8410 (FIG51).

图53为根据本公开的至少一个方面的用于控制超声机电系统132002的频率并检测其阻抗的替代系统132000。系统132000可被结合到发生器中。联接到存储器132026的处理器132004对可编程计数器132006编程以调谐至超声机电系统132002的输出频率f_o。输入频率由晶体振荡器132008生成，并且被输入到固定计数器132010中以将频率定标至合适的值。固定计数器132010和可编程计数器132006的输出被施加到相位/频率检测器132012。相位/频率检测器132012的输出被施加到放大器/有源滤波器电路132014以生成施加到电压控制振荡器132016(VCO)的调谐电压V_t。VCO 132016将输出频率f_o施加到超声机电系统132002的超声换能器部分，本文所示将其建模为等效电路。施加到超声换能器的电压信号和电流信号由电压传感器132018和电流传感器132020监测。FIG. 53 is an alternative system 132000 for controlling the frequency of an ultrasonic electromechanical system 132002 and detecting its impedance according to at least one aspect of the present disclosure. The system 132000 can be incorporated into a generator. A processor 132004 connected to a memory 132026 programs a programmable counter 132006 to tune to the output frequency f_o of the ultrasonic electromechanical system 132002. The input frequency is generated by a crystal oscillator 132008 and is input to a fixed counter 132010 to scale the frequency to a suitable value. The outputs of the fixed counter 132010 and the programmable counter 132006 are applied to a phase/frequency detector 132012. The output of the phase/frequency detector 132012 is applied to an amplifier/active filter circuit 132014 to generate a tuning voltage V_t applied to a voltage controlled oscillator 132016 (VCO). The VCO 132016 applies the output frequency f_o to the ultrasonic transducer portion of the ultrasonic electromechanical system 132002, which is modeled as an equivalent circuit as shown herein. The voltage signal and current signal applied to the ultrasonic transducer are monitored by a voltage sensor 132018 and a current sensor 132020.

电压传感器132018和电流传感器132020的输出被施加到另一个相位/频率检测器132022以确定如电压传感器132018和电流传感器13020所测量的电压和电流之间的相位角。相位/频率检测器132022的输出被施加到高速模数转换器132024(ADC)的一个信道，并且通过其提供给处理器132004。任选地，电压传感器132018和电流传感器132020的输出可被施加到双信道ADC 132024的相应信道并且被提供给处理器132004用于零点交叉、FFT或本文所述的其它算法，以用于确定施加到超声机电系统132002的电压信号和电流信号之间的相位角。The outputs of the voltage sensor 132018 and the current sensor 132020 are applied to another phase/frequency detector 132022 to determine the phase angle between the voltage and current as measured by the voltage sensor 132018 and the current sensor 13020. The output of the phase/frequency detector 132022 is applied to one channel of a high speed analog-to-digital converter 132024 (ADC) and provided thereto to the processor 132004. Optionally, the outputs of the voltage sensor 132018 and the current sensor 132020 may be applied to respective channels of a dual channel ADC 132024 and provided to the processor 132004 for zero crossing, FFT, or other algorithms described herein for determining the phase angle between the voltage signal and the current signal applied to the ultrasonic electromechanical system 132002.

任选地调谐电压V_t(该电压与输出频率f_o成比例)可经由ADC 132024反馈回处理器132004。这将向处理器132004提供与输出频率f_o成比例的反馈信号，并且可以使用该反馈来调节并控制输出频率f_o。Optionally the tuning voltage_Vt (which is proportional to the output frequency_f0 ) can be fed back to the processor 132004 via the ADC 132024. This will provide the processor 132004 with a feedback signal proportional to the output frequency_f0 , and this feedback can be used to adjust and control the output frequency_f0 .

估计钳口的状态(垫烧穿、钉、断裂刀、钳口中的骨、钳口中的组织)Estimate the status of the jaws (burn-through pads, nails, broken blades, bone in the jaws, tissue in the jaws)

超声能量递送的挑战在于，在错误的材料或错误的组织上施加超声声音会导致装置失效，例如夹臂垫烧穿或超声刀断裂。还希望在不在钳口中添加附加传感器的情况下检测什么位于超声装置的端部执行器的钳口中以及钳口的状态。将传感器定位在超声端部执行器的钳口中具有可靠性、成本和复杂性方面的挑战。The challenge with ultrasonic energy delivery is that applying ultrasonic sound to the wrong material or the wrong tissue can lead to device failure, such as burn-through of the clamp arm pad or breakage of the ultrasonic blade. It is also desirable to detect what is in the jaws of the end effector of an ultrasonic device and the state of the jaws without adding additional sensors in the jaws. Positioning sensors in the jaws of an ultrasonic end effector has challenges in reliability, cost, and complexity.

根据本公开的至少一个方面，可采用超声光谱智能刀算法技术基于被配置为驱动超声换能器刀的超声换能器的阻抗来估计钳口的状态(夹持臂垫烧穿、钉、断裂刀、钳口中的骨、钳口中的组织、钳口闭合时的背切等)。绘制阻抗Z_g(t)、量值|Z|和相位作为频率f的函数。According to at least one aspect of the present disclosure, an ultrasonic spectroscopy intelligent knife algorithm technology can be used to drive an ultrasonic transducer knife based on the impedance of the ultrasonic transducer. to estimate the state of the jaws (burn-through of the clamp arm pad, nail, broken knife, bone in the jaws, tissue in the jaws, back-cutting when the jaws are closed, etc.). Plot the impedance Z_g (t), magnitude |Z|, and phase as a function of frequency f.

动态力学分析(DMA，也称为动态力学光谱学或简称为力学光谱学)是一种用于研究和表征材料的技术。将正弦应力施加到材料上，并测量材料中的应变，从而可以确定材料的复数模量。应用于超声装置的光谱学包括通过频率扫描(复合信号或传统频率扫描)来激发超声刀的末端，以及测量在每个频率下产生的复阻抗。将超声换能器在一定频率范围内的复阻抗测量值用于分类器或模型中，以推断超声端部执行器的特征。在一个方面，本公开提供了一种用于确定超声端部执行器(夹持臂、钳口)的状态以驱动超声装置中的自动化(诸如禁用功率以保护装置、执行自适应算法、检索信息、识别组织等)的技术。Dynamic mechanical analysis (DMA, also known as dynamic mechanical spectroscopy or simply mechanical spectroscopy) is a technique used to study and characterize materials. Sinusoidal stress is applied to the material and the strain in the material is measured, so that the complex modulus of the material can be determined. Spectroscopy applied to ultrasonic devices includes exciting the end of the ultrasonic blade by frequency scanning (composite signal or traditional frequency scanning) and measuring the complex impedance generated at each frequency. The complex impedance measurements of the ultrasonic transducer over a certain frequency range are used in a classifier or model to infer the characteristics of the ultrasonic end effector. In one aspect, the present disclosure provides a technology for determining the state of an ultrasonic end effector (clamping arm, jaws) to drive automation in an ultrasonic device (such as disabling power to protect the device, executing adaptive algorithms, retrieving information, identifying tissue, etc.).

图54为根据本公开的至少一方面的具有端部执行器的多种不同状态和状况的超声装置的光谱132030，其中阻抗Z_g(t)、量值|Z|和相位被绘制为频率f的函数。光谱图132030在三维空间中绘制，其中频率(Hz)沿x轴绘制，相位(Rad)沿y轴绘制，量值(欧姆)沿z轴绘制。FIG. 54 is a spectrum 132030 of an ultrasonic device having a plurality of different states and conditions of an end effector according to at least one aspect of the present disclosure, wherein impedance Z_g (t), magnitude |Z|, and phase is plotted as a function of frequency f. The spectrum 132030 is plotted in three-dimensional space, with frequency (Hz) plotted along the x-axis, phase (Rad) plotted along the y-axis, and magnitude (Ohms) plotted along the z-axis.

在不同条件和状态的频率范围内，对不同钳口咬合和装置状态的频谱分析会产生不同的复杂阻抗特征图案(指纹)。当绘制时，每个状态或条件在3D空间中都具有不同的特征图案。这些特征图案可用于估计端部执行器的条件和状态。图54示出了空气132032、夹持臂垫132034、羚羊皮132036、钉132038和断裂刀132040的光谱。羚羊皮132036可用于表征不同类型的组织。Spectral analysis of different jaw occlusions and device states produces different complex impedance signature patterns (fingerprints) over a frequency range of different conditions and states. When plotted, each state or condition has a different signature pattern in 3D space. These signature patterns can be used to estimate the condition and state of the end effector. FIG. 54 shows the spectra of air 132032, clamp arm pad 132034, chamois leather 132036, nail 132038, andfracture blade 132040. Chamois leather 132036 can be used to characterize different types of tissue.

可以通过在超声换能器上施加低功率电信号以产生超声刀的非治疗激发来评估光谱图132030。低功率电信号可以以扫描或复合傅立叶级数的形式施加，以使用FFT在串联(扫描)或并联(复合信号)频率范围内测量超声换能器上的阻抗The spectrogram 132030 can be evaluated by applying a low power electrical signal to the ultrasonic transducer to produce non-therapeutic excitation of the ultrasonic blade. The low power electrical signal can be applied in the form of a sweep or complex Fourier series to measure the impedance on the ultrasonic transducer over a series (sweep) or parallel (complex signal) frequency range using FFT

新数据的分类方法Classification methods for new data

对于每种特征图案，可以将参数线拟合为使用多项式、傅立叶级数或方便的任何其它形式的参数公式进行训练所使用的数据。然后接收新的数据点，并通过使用从该新的数据点到已拟合为特征图案训练数据的轨迹的欧几里得垂直距离度该新的数据点进行分类。该新的数据点到每个轨迹(每个轨迹表示不同状态或状况)的垂直距离用于将该点分配给某一状态或状况。For each characteristic pattern, a parameter line can be fitted to the data used for training using a polynomial, Fourier series, or any other form of parameter formula that is convenient. A new data point is then received and classified by using the Euclidean perpendicular distance from the new data point to the track that has been fitted to the characteristic pattern training data. The perpendicular distance of the new data point to each track (each track represents a different state or condition) is used to assign the point to a certain state or condition.

可以将训练数据中每个点到拟合曲线的距离的概率分布用于估计正确分类的新数据点的概率。这实质上在拟合轨迹的每个新数据点处在垂直于拟合轨迹的平面中构造了二维概率分布。然后，可以基于新数据点的正确分类概率将该新数据点包括在训练集中，以形成自适应学习分类器，该分类器可以轻松检测状态的高频变化，但可以适应系统性能缓慢发生的偏差，诸如装置变脏或垫磨损。The probability distribution of the distance from each point in the training data to the fitted curve can be used to estimate the probability of a new data point being correctly classified. This essentially constructs a two-dimensional probability distribution in a plane perpendicular to the fitted trajectory at each new data point in the fitted trajectory. The new data point can then be included in the training set based on its probability of correct classification to form an adaptive learning classifier that can easily detect high frequency changes in state but can adapt to slowly occurring deviations in system performance, such as dirty devices or worn pads.

图55为根据本公开的至少一个方面的一组3D训练数据集(S)的曲线图132042的图形表示，其中超声换能器阻抗Z_g(t)、量值|Z|和相位被绘制为频率f的函数。3D训练数据集(S)曲线132042在三维空间中以图形方式描绘，其中相位(Rad)沿x轴绘制，频率(Hz)沿y轴绘制，量值(欧姆)沿z轴绘制，并且参数傅立叶级数被拟合到3D训练数据集(S)。用于数据分类的方法基于3D训练数据集(S0用于生成曲线图132042)。FIG. 55 is a graphical representation of a graph 132042 of a set of 3D training data sets (S) in which ultrasound transducer impedance Z_g (t), magnitude |Z|, and phase Plotted as a function of frequency f. The 3D training data set (S) curve 132042 is graphically depicted in three-dimensional space, where phase (Rad) is plotted along the x-axis, frequency (Hz) is plotted along the y-axis, magnitude (Ohms) is plotted along the z-axis, and a parameter Fourier series is fitted to the 3D training data set (S). The method for data classification is based on the 3D training data set (S0 used to generate the curve graph 132042).

拟合到3D训练数据集(S)的参数傅立叶级数由下式给出：The parameter Fourier series fitted to the 3D training dataset (S) is given by:

对于新点从到的垂直距离由下式找到：For new points from arrive The vertical distance is found by:

当：when:

则：but:

D＝D_⊥D＝D_⊥

概率分布D可用于估计属于组S的数据点的概率。The probability distribution D can be used to estimate the data points belonging to group S probability.

控制control

基于在激活超声换能器/超声刀之前、期间或之后测量的数据分类，可以实现多种自动化任务和安全措施。类似地，也可以在一定程度上推断位于端部执行器中的组织的状态以及超声刀的温度，并将它们用于更好地向用户通知超声装置的状态或保护关键结构等。在提交于2018年3月8日的共同拥有的美国临时专利申请号62/640,417(其标题为超声装置中的温度控制及其控制系统(TEMPERATURE CONTROL IN ULTRASONIC DEVICE ANDCONTROL SYSTEM THEREFOR)，其以引用方式全文并入本文)中描述了超声刀的温度控制。Based on the classification of data measured before, during or after activating the ultrasonic transducer/ultrasonic blade, a variety of automated tasks and safety measures can be implemented. Similarly, the state of the tissue located in the end effector and the temperature of the ultrasonic blade can also be inferred to a certain extent, and used to better inform the user of the state of the ultrasonic device or protect critical structures, etc. The temperature control of the ultrasonic blade is described in the commonly owned U.S. Provisional Patent Application No. 62/640,417 filed on March 8, 2018 (titled TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEM THEREFOR, which is incorporated herein by reference in its entirety).

类似地，当超声刀极有可能接触夹持臂垫时(例如，它们之间没有组织)，或者如果超声刀有可能已经断裂或超声刀有可能接触金属(例如，钉)，则可以减少功率递送。此外，如果钳口闭合并且在超声刀和夹持臂垫之间没有检测到任何组织，则不允许反向切割。Similarly, when the ultrasonic blade is likely to contact the clamp arm pad (e.g., no tissue between them), or if the ultrasonic blade is likely to have broken or the ultrasonic blade is likely to contact metal (e.g., nails), power delivery can be reduced. In addition, if the jaws are closed and no tissue is detected between the ultrasonic blade and the clamp arm pad, reverse cutting is not allowed.

整合其它数据以改进分类Integrate other data to improve classification

可以将该系统与传感器、用户、患者指标、环境因素等提供的其它信息结合使用，方式是通过使用概率函数和卡尔曼滤波器将来自该过程的数据与上述数据进行组合。给定不同置信度的大量不确定测量结果，卡尔曼滤波器确定状态或状况发生的最大可能性。由于该方法允许将概率分配给新分类的数据点，因此该算法的信息可以利用卡尔曼滤波器中的其它测量值或估计值来实现。The system can be used in conjunction with other information provided by sensors, user, patient indicators, environmental factors, etc. by combining the data from the process with the above data using probability functions and Kalman filters. Given a large number of uncertain measurements with different confidence levels, the Kalman filter determines the most likely state or condition to have occurred. Since the method allows probabilities to be assigned to newly classified data points, the information of the algorithm can be implemented using other measurements or estimates in the Kalman filter.

图56为根据本公开的至少一个方面的描绘基于复阻抗特征图案(指纹)来确定钳口状况的控制程序或逻辑配置的逻辑流程图132044。在基于复阻抗特征图案(指纹)确定钳口状况之前，用参考复阻抗特征图案或表征各种钳口状况的训练数据集(S)(包括但不限于如图82中所示的空气132032、夹持臂垫132034、羚羊皮132036、钉132038、断裂刀132040，以及各种组织类型和状况)填充数据库。可将羚羊皮(干燥或湿润、全字节或末端)用于表征不同类型的组织。如下获得用于生成参考复阻抗特征图案或训练数据集(S)的数据点：通过向超声换能器施加子治疗驱动信号，将驱动频率在预定范围频率内从共振以下扫描到共振以上，测量每个频率下的复阻抗并记录数据点。然后使用多种数值方法(包括多项式曲线拟合、傅立叶级数和/或参数公式)将数据点拟合为曲线。本文描述了拟合为参考复阻抗特征图案或训练数据集(S)的参数傅里叶级数。FIG. 56 is a logic flow diagram 132044 of a control program or logic configuration for determining jaw conditions based on a complex impedance signature pattern (fingerprint) according to at least one aspect of the present disclosure. Prior to determining jaw conditions based on the complex impedance signature pattern (fingerprint), a database is populated with reference complex impedance signature patterns or training data sets (S) characterizing various jaw conditions (including but not limited to air 132032, clamp arm pad 132034, chamois skin 132036, nail 132038,fracture blade 132040, and various tissue types and conditions as shown in FIG. Chamois skin (dry or wet, full byte or end) can be used to characterize different types of tissue. Data points for generating reference complex impedance signature patterns or training data sets (S) are obtained as follows: by applying a sub-therapy drive signal to an ultrasonic transducer, sweeping the drive frequency from below resonance to above resonance within a predetermined range of frequencies, measuring the complex impedance at each frequency and recording data points. The data points are then fitted to a curve using a variety of numerical methods (including polynomial curve fitting, Fourier series and/or parametric formulas). This article describes the parametric Fourier series fit to a reference complex impedance signature or training data set (S).

一旦生成参考复阻抗特征图案或训练数据集(S)，超声器械就测量新的数据点，对新的点进行分类，并确定是否应将新的数据点添加到参考复阻抗特征图案或训练数据集(S)。Once the reference complex impedance signature pattern or training data set (S) is generated, the ultrasonic instrument measures new data points, classifies the new points, and determines whether the new data points should be added to the reference complex impedance signature pattern or training data set (S).

现在转到图56的逻辑流程图，在一个方面，处理器或控制电路测量132046超声换能器的复阻抗，其中复阻抗定义为处理器或控制电路接收132048复阻抗测量数据点，并将该复阻抗测量数据点与参考复阻抗特征图案中的数据点进行比较132050。处理器或控制电路基于比较分析的结果对该复阻抗测量数据点进行分类132052，并基于比较分析的结果分配132054端部执行器的状态。Turning now to the logic flow diagram of FIG. 56 , in one aspect, the processor or control circuit measures 132046 the complex impedance of the ultrasound transducer, where the complex impedance is defined as The processor or control circuit receives 132048 the complex impedance measurement data point and compares the complex impedance measurement data point to data points in a reference complex impedance signature pattern 132050. The processor or control circuit classifies 132052 the complex impedance measurement data point based on the results of the comparative analysis and assigns 132054 a state of the end effector based on the results of the comparative analysis.

在一个方面，处理器或控制电路从联接到处理器的数据库或存储器接收参考复阻抗特征图案。在一个方面，处理器或控制电路如下生成参考复阻抗特征图案。联接到处理器或控制电路的驱动电路向超声换能器施加非治疗驱动信号，该非治疗驱动信号以初始频率开始，以最终频率结束，并且处于其间的多个频率下。处理器或控制电路测量每个频率下的超声换能器的阻抗，并存储与每个阻抗测量值相对应的数据点。处理器或控制电路曲线拟合多个数据点，以生成表示参考复阻抗特征图案的三维曲线，其中量值|Z|和相位被绘制为频率f的函数。曲线拟合包括多项式曲线拟合、傅立叶级数和/或参数公式。In one aspect, a processor or control circuit receives a reference complex impedance signature pattern from a database or memory connected to the processor. In one aspect, the processor or control circuit generates the reference complex impedance signature pattern as follows. A drive circuit connected to the processor or control circuit applies a non-therapeutic drive signal to the ultrasonic transducer, the non-therapeutic drive signal starting with an initial frequency, ending with a final frequency, and at multiple frequencies in between. The processor or control circuit measures the impedance of the ultrasonic transducer at each frequency and stores a data point corresponding to each impedance measurement. The processor or control circuit curve fits the multiple data points to generate a three-dimensional curve representing the reference complex impedance signature pattern, where the magnitude |Z| and phase is plotted as a function of frequency f. Curve fitting includes polynomial curve fitting, Fourier series and/or parametric formulas.

在一个方面，处理器或控制电路接收新的阻抗测量数据点，并使用从该新的阻抗测量数据点到已拟合为参考复阻抗特征图案的轨迹的欧几里得垂直距离来对该新的阻抗测量数据点进行分类。处理器或控制电路估计对新的阻抗测量数据点进行正确分类的概率。处理器或控制电路基于所估计的对新的阻抗测量数据点进行正确分类的概率将新的阻抗测量数据点添加到参考复阻抗特征图案。在一个方面，处理器或控制电路基于训练数据集(S)对数据进行分类，其中训练数据集(S)包括多个复阻抗测量数据，并且曲线使用参数傅里叶级数来拟合训练数据集(S)，其中S在本文定义，并且其中将概率分布用于估计属于组S的新的阻抗测量数据点的概率。In one aspect, a processor or control circuit receives a new impedance measurement data point and uses the Euclidean perpendicular distance from the new impedance measurement data point to the trajectory that has been fitted to the reference complex impedance characteristic pattern to classify the new impedance measurement data point. The processor or control circuit estimates the probability of correctly classifying the new impedance measurement data point. The processor or control circuit adds the new impedance measurement data point to the reference complex impedance characteristic pattern based on the estimated probability of correctly classifying the new impedance measurement data point. In one aspect, the processor or control circuit classifies the data based on a training data set (S), wherein the training data set (S) includes a plurality of complex impedance measurement data, and the curve fits the training data set (S) using a parameter Fourier series, wherein S is defined herein, and wherein a probability distribution is used to estimate the probability of a new impedance measurement data point belonging to group S.

基于模型的钳口分类器状态Model-based jaw classifier status

人们已经对将位于超声装置的钳口内的物质(包括组织的类型和状况)进行分类产生了兴趣。在各个方面，可以表明利用高数据采样和精细图案识别，这种分类是可能的。该方法基于作为频率的函数的阻抗(其中在3D中绘制量值、相位和频率，图案看起来像图54和55中所示的带)以及图56的逻辑流程图。本公开提供了基于针对压电换能器的成熟模型的替代智能刀算法方法。There has been interest in classifying material located within the jaws of an ultrasonic device, including the type and condition of tissue. In various aspects, it can be shown that such classification is possible using high data sampling and fine pattern recognition. The method is based on impedance as a function of frequency (where magnitude, phase, and frequency are plotted in 3D, and the pattern looks like the bands shown in Figures 54 and 55) and the logic flow diagram of Figure 56. The present disclosure provides an alternative smart knife algorithm approach based on a well-established model for piezoelectric transducers.

举例来说，已知等效电集总参数模型是物理压电换能器的精确模型。它基于机械共振附近切线的Mittag-Leffler展开。当复阻抗或复导纳被绘制为虚分量与实分量之间的关系时，形成圆。图57为根据本公开的至少一个方面的被绘制为压电振动器的虚分量与实分量之间的关系的复阻抗的圆图132056。For example, it is known that the equivalent electrical lumped parameter model is an accurate model of the physical piezoelectric transducer. It is based on the Mittag-Leffler expansion of the tangent line near the mechanical resonance. When the complex impedance or complex admittance is plotted as the relationship between the imaginary component and the real component, a circle is formed. FIG57 is a circular graph 132056 of the complex impedance plotted as the relationship between the imaginary component and the real component of a piezoelectric vibrator according to at least one aspect of the present disclosure.

图58为根据本公开的至少一个方面的被绘制为压电振动器的虚分量与实分量之间的关系的复导纳的圆图132058。图57和58中描绘的圆取自IEEE 177标准，该标准以引用方式全文并入本文。表1-4取自IEEE 177标准，并且为了完整起见在本文公开。FIG58 is a circular graph 132058 of the complex admittance plotted as the relationship between the imaginary component and the real component of a piezoelectric vibrator according to at least one aspect of the present disclosure. The circles depicted in FIGS57 and 58 are taken from the IEEE 177 standard, which is incorporated herein by reference in its entirety. Tables 1-4 are taken from the IEEE 177 standard and are disclosed herein for completeness.

当频率从共振以下扫描到共振以上时，形成圆。并非以3D方式拉伸圆，而是确定圆并估计圆的半径(r)和偏移(a，b)。然后将这些值与给定状况下的既定值进行比较。这些状况可能是：1)钳口打开且无任何东西，2)末端咬合，3)钳口完全咬合且有钉。如果扫描生成多个共振，则每个共振将存在不同特征的圆。如果共振分开，则每个圆将在下一个圆之前被绘制出来。并非用一系列近似值拟合3D曲线，而是用圆拟合数据。可以使用处理器来计算半径(r)和偏移(a，b)，该处理器被编程为执行下述多种数学或数字技术。可通过捕获圆的图像来估计这些值，并且使用图像处理技术来估计定义圆的半径(r)和偏移(a，b)。As the frequency sweeps from below resonance to above resonance, a circle is formed. Rather than stretching the circle in 3D, the circle is determined and the radius (r) and offset (a, b) of the circle are estimated. These values are then compared to established values for a given condition. These conditions may be: 1) the jaws are open and nothing is in them, 2) the ends are occluded, 3) the jaws are fully occluded and there are nails. If the scan generates multiple resonances, there will be circles with different characteristics for each resonance. If the resonances are separated, each circle will be drawn before the next circle. Rather than fitting a 3D curve with a series of approximate values, a circle is fitted to the data. The radius (r) and offset (a, b) can be calculated using a processor that is programmed to perform a variety of mathematical or digital techniques described below. These values can be estimated by capturing an image of the circle, and using image processing techniques to estimate the radius (r) and offset (a, b) that define the circle.

图59为下文指定的集总参数输入和输出的55.5kHz超声压电换能器的复导纳的圆图132060。将集总参数模型的值用于生成复导纳。在模型中施加中等负载。在MathCad中生成的所得导纳圆示于图59中。当频率从54kHz扫描到58kHz时，形成圆图132060。FIG. 59 is a circular graph 132060 of the complex admittance of a 55.5kHz ultrasonic piezoelectric transducer for the lumped parameter input and output specified below. The values of the lumped parameter model are used to generate the complex admittance. A medium load is applied to the model. The resulting admittance circle generated in MathCad is shown in FIG. 59. A circular graph 132060 is formed when the frequency is swept from 54kHz to 58kHz.

集总参数输入值为：The lumped parameter input values are:

Co＝3.0nFCo＝3.0nF

Cs＝8.22pFCs＝8.22pF

Ls＝1.0HLs＝1.0H

Rs＝450ΩRs＝450Ω

基于输入的模型输出为：The output of the model based on the input is:

将输出值用于绘制示于图59中的圆图132060。圆图132060具有半径(r)，并且中心132062从原点132064偏移(a，b)，如下所示：The output values are used to draw the circular graph 132060 shown in Figure 59. The circular graph 132060 has a radius (r) and a center 132062 offset from the origin 132064 by (a, b) as shown below:

r＝1.012*10³r＝1.012*10³

a＝1.013*10³a＝1.013*10³

b＝-954.585b＝-954.585

根据本公开的至少一个方面，需要下面指定的总和A-E来估计图59中给出的示例的圆图132060。存在若干算法来计算对圆的拟合。圆由其半径(r)和距原点的中心偏移(a，b)定义：According to at least one aspect of the present disclosure, the sums A-E specified below are needed to estimate the example circle map 132060 given in Figure 59. There are several algorithms to calculate the fit to the circle. A circle is defined by its radius (r) and the center offset (a, b) from the origin:

r²＝(x-a)²+(y-b)²r² =(xa)² +(yb)²

修改后的最小二乘法(Umbach和Jones)很方便，因为对于a、b和r存在简单的封闭形式解决方案。The modified least squares method (Umbach and Jones) is convenient because there are simple closed-form solutions for a, b, and r.

变量“a”上的插入符号表示对真实值的估计。A、B、C、D和E是根据数据计算出的各种乘积的总和。为了完整起见，将它们包括在本文中，如下所示：The caret on the variable "a" indicates an estimate of the true value. A, B, C, D, and E are sums of various products calculated from the data. For completeness, they are included in this article as follows:

Z1,i为实分量的第一矢量，称为电导；Z1,i is the first vector of the real component, called the conductance;

Z2,i为虚分量的第二矢量，称为电纳；并且Z2,i is the second vector of the imaginary component, called susceptance; and

Z3,i为第三矢量，表示计算导纳的频率。Z3,i is the third vector, indicating the frequency at which the admittance is calculated.

本公开将适用于超声系统并且可能应用于电外科系统，即使电外科系统不依赖于共振。The present disclosure will be applicable to ultrasonic systems and potentially to electrosurgical systems even though electrosurgical systems do not rely on resonance.

图60-64示出了从阻抗分析仪获取的图像，其示出了端部执行器钳口处于各种打开或闭合构型和负载的超声装置的阻抗/导纳圆图。根据本公开的至少一个方面，实线形式的圆图描绘了阻抗，而虚线形式的圆图描绘了导纳。举例来说，通过将超声装置连接到阻抗分析仪来生成阻抗/导纳圆图。将阻抗分析仪的显示设置为复阻抗和复导纳，这可以从阻抗分析仪的前面板中选择。例如，如下文结合图60所述，可在超声端部执行器的钳口处于打开位置并且超声装置处于未负载状态的情况下获得初始显示。阻抗分析仪的自动缩放显示功能可用于生成复阻抗和导纳圆图。同一显示器用于具有不同负载状况的超声装置的后续运行，如后续图60-64中所示。可使用LabVIEW应用程序上载数据文件。在另一种技术中，可利用照相机诸如智能手机照相机(像iPhone或Android)来捕获显示图像。这样，显示器的图像可能包括一些“梯形失真”，并且通常可能看起来不平行于屏幕。使用该技术，显示器上的圆图痕迹将在捕获的图像中看起来失真。利用该方法，可以对位于超声端部执行器的钳口中的材料进行分类。60-64 show images acquired from an impedance analyzer showing impedance/admittance circular graphs of an ultrasonic device with the end effector jaws in various open or closed configurations and loads. According to at least one aspect of the present disclosure, the circular graph in solid form depicts impedance, while the circular graph in dashed form depicts admittance. For example, an impedance/admittance circular graph is generated by connecting an ultrasonic device to an impedance analyzer. The display of the impedance analyzer is set to complex impedance and complex admittance, which can be selected from the front panel of the impedance analyzer. For example, as described below in conjunction with FIG. 60, an initial display can be obtained with the jaws of the ultrasonic end effector in an open position and the ultrasonic device in an unloaded state. The automatic scaling display function of the impedance analyzer can be used to generate complex impedance and admittance circular graphs. The same display is used for subsequent runs of the ultrasonic device with different load conditions, as shown in subsequent FIG. 60-64. The data file can be uploaded using a LabVIEW application. In another technique, a camera such as a smartphone camera (like an iPhone or Android) can be used to capture the display image. In this way, the image of the display may include some "keystone distortion" and may generally not appear parallel to the screen. Using this technique, the circular pattern trace on the display will appear distorted in the captured image. Using this method, the material located in the jaws of the ultrasonic end effector can be classified.

复阻抗和复导纳就是彼此的倒数。不能通过观察两者来添加任何新信息。另一个考虑因素包括确定使用复阻抗或复导纳时估计对噪声的敏感程度。Complex impedance and complex admittance are simply the reciprocals of each other. No new information can be added by looking at both. Another consideration involves determining how sensitive the estimate is to noise when using complex impedance or complex admittance.

在图60-64中所示的示例中，阻抗分析仪的范围被设置为仅捕获主共振。通过在更宽范围的频率内进行扫描，可能会遇到更多共振，并且可形成多个圆图。可通过具有串联连接的电感Ls、电阻Rs和电容Cs(它们定义共振器的机电性能)的第一“动态”分支以及具有静态电容C0的第二电容分支来对超声换能器的等效电路进行建模。在接下来的60-64中所示的阻抗/导纳图中，等效电路的分量值为：In the example shown in Figures 60-64, the range of the impedance analyzer is set to capture only the main resonance. By scanning over a wider range of frequencies, more resonances may be encountered and multiple circular graphs may be formed. The equivalent circuit of the ultrasonic transducer can be modeled by a first "dynamic" branch having a series connection of inductance Ls, resistance Rs and capacitance Cs (which define the electromechanical properties of the resonator) and a second capacitive branch having a static capacitance C0. In the impedance/admittance graphs shown in the following 60-64, the component values of the equivalent circuit are:

Ls＝L1＝1.1068HLs＝L1＝1.1068H

Rs＝R1＝311.352ΩRs＝R1＝311.352Ω

Cs＝C1＝7.43265pFCs＝C1＝7.43265pF

C0＝C0＝3.64026nFC0＝C0＝3.64026nF

施加到超声换能器的振荡器电压为500mV，频率从55kHz扫描到56kHz。阻抗(Z)标度为200Ω/div，并且导纳(Y)标度为500μS/div。可在圆图上由阻抗光标和导纳光标指示的位置处获得可表征阻抗(Z)和导纳(Y)圆图的值的测量结果。The oscillator voltage applied to the ultrasonic transducer is 500mV, and the frequency is swept from 55kHz to 56kHz. The impedance (Z) scale is 200Ω/div, and the admittance (Y) scale is 500μS/div. Measurement results that characterize the values of the impedance (Z) and admittance (Y) circular graphs can be obtained at the positions indicated by the impedance cursor and the admittance cursor on the circular graph.

钳口的状态：打开且无负载Jaw state: open and without load

图60为根据本公开的至少一个方面的阻抗分析仪的图形显示132066，其示出了钳口打开且无负载的超声装置的复阻抗(Z)/导纳(Y)圆图132068、132070，其中实线形式的圆图132068描绘了复阻抗，并且虚线形式的圆图132070描绘了复导纳。施加到超声换能器的振荡器电压为500mV，频率从55kHz扫描到56kHz。阻抗(Z)标度为200Ω/div，并且导纳(Y)标度为500μS/div。可在圆图132068、132070上由阻抗光标132072和导纳光标132074指示的位置处获得可表征复阻抗(Z)和复导纳(Y)圆图132068、132070的值的测量结果。因此，阻抗光标132072位于阻抗圆图132068的等于约55.55kHz的一部分处，并且导纳光标132074位于导纳圆图132070的等于约55.29kHz的一部分处。如图60中所描绘，阻抗光标132072的位置对应于以下值：FIG. 60 is a graphical display 132066 of an impedance analyzer according to at least one aspect of the present disclosure, showing complex impedance (Z)/admittance (Y) graphs 132068, 132070 of an ultrasonic device with jaws open and no load, wherein the graph 132068 in solid form depicts complex impedance and the graph 132070 in dashed form depicts complex admittance. The oscillator voltage applied to the ultrasonic transducer is 500 mV and the frequency is swept from 55 kHz to 56 kHz. The impedance (Z) scale is 200 Ω/div and the admittance (Y) scale is 500 μS/div. Measurements that can characterize the values of the complex impedance (Z) and complex admittance (Y) graphs 132068, 132070 can be obtained at the locations indicated by the impedance cursor 132072 and the admittance cursor 132074 on the graphs 132068, 132070. Thus, the impedance cursor 132072 is located at a portion of the impedance circle graph 132068 equal to approximately 55.55 kHz, and the admittance cursor 132074 is located at a portion of the admittance circle graph 132070 equal to approximately 55.29 kHz. As depicted in FIG. 60 , the position of the impedance cursor 132072 corresponds to the following values:

R＝1.66026ΩR＝1.66026Ω

X＝-697.309ΩX＝-697.309Ω

其中R为电阻(实值)，并且X为电抗(虚值)。类似地，导纳光标132074的位置对应于以下值：Where R is the resistance (real value) and X is the reactance (imaginary value). Similarly, the position of the admittance cursor 132074 corresponds to the following values:

G＝64.0322μSG＝64.0322μS

B＝1.63007mSB＝1.63007mS

其中G为电导(实值)，并且B为电纳(虚值)。where G is the conductance (real value) and B is the susceptance (imaginary value).

钳口的状态：被夹持在干燥羚羊皮上The jaws are clamped on dry chamois skin.

图61为根据本公开的至少一个方面的阻抗分析仪的图形显示132076，其示出了端部执行器的钳口被夹持在干燥羚羊皮上的超声装置的复阻抗(Z)/导纳(Y)圆图132078、132080，其中阻抗圆图132078以实线示出，并且导纳圆图132080以虚线示出。施加到超声换能器的电压为500mV，频率从55kHz扫描到56kHz。阻抗(Z)标度为200Ω/div，并且导纳(Y)标度为500μS/div。61 is a graphical display 132076 of an impedance analyzer according to at least one aspect of the present disclosure, showing complex impedance (Z)/admittance (Y) graphs 132078, 132080 of an ultrasonic device with the jaws of the end effector clamped on dry chamois skin, wherein the impedance graph 132078 is shown in solid lines and the admittance graph 132080 is shown in dashed lines. The voltage applied to the ultrasonic transducer is 500 mV, and the frequency is swept from 55 kHz to 56 kHz. The impedance (Z) scale is 200 Ω/div, and the admittance (Y) scale is 500 μS/div.

可在圆图132078、132080上由阻抗光标132082和导纳光标132084指示的位置处获得可表征复阻抗(Z)和复导纳(Y)圆图132078、132080的值的测量结果。因此，阻抗光标132082位于阻抗圆图132078的等于约55.68kHz的一部分处，并且导纳光标132084位于导纳圆图132080的等于约55.29kHz的一部分处。如图61中所描绘，阻抗光标132082的位置对应于以下值：Measurements that may characterize values of the complex impedance (Z) and complex admittance (Y) graphs 132078, 132080 may be obtained at locations on the graphs 132078, 132080 indicated by the impedance cursor 132082 and the admittance cursor 132084. Thus, the impedance cursor 132082 is located at a portion of the impedance graph 132078 equal to approximately 55.68 kHz, and the admittance cursor 132084 is located at a portion of the admittance graph 132080 equal to approximately 55.29 kHz. As depicted in FIG. 61 , the location of the impedance cursor 132082 corresponds to the following values:

R＝434.577ΩR＝434.577Ω

X＝-758.772ΩX＝-758.772Ω

其中R为电阻(实值)，并且X为电抗(虚值)。类似地，导纳光标132084的位置对应于以下值：Where R is the resistance (real value) and X is the reactance (imaginary value). Similarly, the position of the admittance cursor 132084 corresponds to the following values:

G＝85.1712μSG＝85.1712μS

B＝1.49569mSB＝1.49569mS

其中G为电导(实值)，并且B为电纳(虚值)。where G is the conductance (real value) and B is the susceptance (imaginary value).

钳口的状态：末端被夹持在潮湿羚羊皮上The jaws are clamped on the wet chamois leather.

图62为根据本公开的至少一个方面的阻抗分析仪的图形显示132086，其示出了钳口末端被夹持在潮湿羚羊皮上的超声装置的复阻抗(Z)/导纳(Y)圆图132098、132090，其中阻抗圆图132088以实线示出，并且导纳圆图132090以虚线示出。施加到超声换能器的电压为500mV，频率从55kHz扫描到56kHz。阻抗(Z)标度为200Ω/div，并且导纳(Y)标度为500μS/div。62 is a graphical display 132086 of an impedance analyzer according to at least one aspect of the present disclosure, showing complex impedance (Z)/admittance (Y) graphs 132098, 132090 of an ultrasonic device with the jaws tip clamped on moist chamois hide, wherein the impedance graph 132088 is shown in solid lines and the admittance graph 132090 is shown in dashed lines. The voltage applied to the ultrasonic transducer was 500 mV and the frequency was swept from 55 kHz to 56 kHz. The impedance (Z) scale was 200 Ω/div and the admittance (Y) scale was 500 μS/div.

可在圆图132088、132090上由阻抗光标132092和导纳光标132094指示的位置处获得可表征复阻抗(Z)和复导纳(Y)圆图132088、132090的值的测量结果。因此，阻抗光标132092位于阻抗圆图132088的等于约55.68kHz的一部分处，并且导纳光标132094位于导纳圆图132090的等于约55.29kHz的一部分处。如图63中所描绘，阻抗光标132092对应于以下值：Measurements that may characterize values of the complex impedance (Z) and complex admittance (Y) graphs 132088, 132090 may be obtained at locations on the graphs 132088, 132090 indicated by the impedance cursor 132092 and the admittance cursor 132094. Thus, the impedance cursor 132092 is located at a portion of the impedance graph 132088 equal to approximately 55.68 kHz, and the admittance cursor 132094 is located at a portion of the admittance graph 132090 equal to approximately 55.29 kHz. As depicted in FIG. 63 , the impedance cursor 132092 corresponds to the following values:

R＝445.259ΩR＝445.259Ω

X＝-750.082ΩX＝-750.082Ω

其中R为电阻(实值)，并且X为电抗(虚值)。类似地，导纳光标132094对应于以下值：Where R is the resistance (real value) and X is the reactance (imaginary value). Similarly, the admittance cursor 132094 corresponds to the following values:

G＝96.2179μSG＝96.2179μS

B＝1.50236mSB＝1.50236mS

其中G为电导(实值)，并且B为电纳(虚值)。where G is the conductance (real value) and B is the susceptance (imaginary value).

钳口的状态：被完全夹持在潮湿羚羊皮上The jaws are fully clamped on the wet chamois leather.

图63为根据本公开的至少一个方面的阻抗分析仪的图形显示132096，其示出了钳口被完全夹持在潮湿羚羊皮上的超声装置的复阻抗(Z)/导纳(Y)圆图132098、132100，其中阻抗圆图132098以实线示出，并且导纳圆图132100以虚线示出。施加到超声换能器的电压为500mV，频率从55kHz扫描到56kHz。阻抗(Z)标度为200Ω/div，并且导纳(Y)标度为500μS/div。63 is a graphical display 132096 of an impedance analyzer according to at least one aspect of the present disclosure, showing complex impedance (Z)/admittance (Y) graphs 132098, 132100 of an ultrasonic device with its jaws fully clamped on moist chamois hide, wherein the impedance graph 132098 is shown in solid lines and the admittance graph 132100 is shown in dashed lines. The voltage applied to the ultrasonic transducer was 500 mV and the frequency was swept from 55 kHz to 56 kHz. The impedance (Z) scale was 200 Ω/div and the admittance (Y) scale was 500 μS/div.

可在圆图132098、1332100上由阻抗光标13212和导纳光标132104指示的位置处获得可表征阻抗和导纳圆图132098、132100的值的测量结果。因此，阻抗光标132102位于阻抗圆图132098的等于约55.63kHz的一部分处，并且导纳光标132104位于导纳圆图132100的等于约55.29kHz的一部分处。如图63中所描绘，阻抗光标132102对应于电阻R的值(实值，未示出)和电抗X的值(虚值，也未示出)。Measurements that may characterize the values of the impedance and admittance graphs 132098, 132100 may be obtained at locations on the graphs 132098, 132100 indicated by the impedance cursor 13212 and the admittance cursor 132104. Thus, the impedance cursor 132102 is located at a portion of the impedance graph 132098 equal to approximately 55.63 kHz, and the admittance cursor 132104 is located at a portion of the admittance graph 132100 equal to approximately 55.29 kHz. As depicted in FIG63 , the impedance cursor 132102 corresponds to a value of the resistance R (real value, not shown) and a value of the reactance X (imaginary value, also not shown).

类似地，导纳光标132104对应于以下值：Similarly, the admittance cursor 132104 corresponds to the following values:

G＝137.272μSG＝137.272μS

B＝1.48481mSB＝1.48481mS

其中G为电导(实值)，并且B为电纳(虚值)。where G is the conductance (real value) and B is the susceptance (imaginary value).

钳口的状态：打开且无负载Jaw state: open and without load

图64为根据本公开的至少一个方面的阻抗分析仪的图形显示132106，其示出了阻抗(Z)/导纳(Y)圆图，其中频率从48kHz扫描到62kHz，以捕获钳口打开且无负载的超声装置的多个共振，其中由虚线所示的矩形132108表示的区域是为了帮助看到以实线示出的阻抗圆图132110a、132110b、132110c以及导纳圆图132112a、132112b、132112c。施加到超声换能器的电压为500mV，频率从48kHz扫描到62kHz。阻抗(Z)标度为500Ω/div，并且导纳(Y)标度为500μS/div。64 is a graphical display 132106 of an impedance analyzer according to at least one aspect of the present disclosure, showing an impedance (Z)/admittance (Y) graph, wherein the frequency is swept from 48 kHz to 62 kHz to capture multiple resonances of an ultrasonic device with jaws open and no load, wherein the area represented by a rectangle 132108 shown in dashed lines is to aid in seeing the impedance graphs 132110a, 132110b, 132110c and the admittance graphs 132112a, 132112b, 132112c shown in solid lines. The voltage applied to the ultrasonic transducer is 500 mV, and the frequency is swept from 48 kHz to 62 kHz. The impedance (Z) scale is 500 Ω/div, and the admittance (Y) scale is 500 μS/div.

可在阻抗和导纳圆图132110a-c、132112a-c上由阻抗光标132114和导纳光标132116指示的位置处获得可表征阻抗和导纳圆图132110a-c、132112a-c的值的测量结果。因此，阻抗光标132114位于阻抗圆图132110a-c的等于约55.52kHz的一部分处，并且导纳光标132116位于导纳圆图132112a-c的等于约59.55kHz的一部分处。如图64中所描绘，阻抗光标132114对应于以下值：Measurements that may characterize the values of the impedance and admittance graphs 132110a-c, 132112a-c may be obtained at locations on the impedance and admittance graphs 132110a-c, 132112a-c indicated by the impedance cursor 132114 and the admittance cursor 132116. Thus, the impedance cursor 132114 is located at a portion of the impedance graph 132110a-c equal to approximately 55.52 kHz, and the admittance cursor 132116 is located at a portion of the admittance graph 132112a-c equal to approximately 59.55 kHz. As depicted in FIG. 64 , the impedance cursor 132114 corresponds to the following values:

R＝1.86163kΩR＝1.86163kΩ

X＝-536.229ΩX＝-536.229Ω

其中R为电阻(实值)，并且X为电抗(虚值)。类似地，导纳光标132116对应于以下值：Where R is the resistance (real value) and X is the reactance (imaginary value). Similarly, the admittance cursor 132116 corresponds to the following values:

G＝649.956μSG＝649.956μS

B＝2.51975mSB＝2.51975mS

其中G为电导(实值)，并且B为电纳(虚值)。where G is the conductance (real value) and B is the susceptance (imaginary value).

因为在阻抗分析仪的整个扫描范围内只有400个样本，所以只有几个关于共振的点。因此，右侧的圆变得不规则。但这仅仅是因为阻抗分析仪和用于覆盖多个共振的设置。Because there are only 400 samples over the full scan range of the impedance analyzer, there are only a few points about resonance. Therefore, the circle on the right becomes irregular. But this is only because of the impedance analyzer and the setup used to cover multiple resonances.

当存在多个共振时，有更多信息可用于改进分类器。可以针对遇到的每个共振计算圆图132110a-c、132112a-c拟合，以保持算法快速运行。因此，一旦在扫描期间存在复导纳的交点(表示圆)，就可以计算拟合。When multiple resonances are present, more information is available to improve the classifier. A circle graph 132110a-c, 132112a-c fit can be calculated for each resonance encountered to keep the algorithm running fast. Thus, once there is an intersection of the complex admittances (representing a circle) during a scan, a fit can be calculated.

益处包括基于数据的钳口中分类器和超声系统的熟知模型。圆的计数和特征在视觉系统中是众所周知的。因此，容易进行数据处理。例如，存在一种封闭形式的解决方案，可以计算圆的半径和轴偏移。该技术可能相对较快。Benefits include a well-known model of the classifier in the jaws and the ultrasonic system based on the data. The count and characteristics of the circle are well known in the vision system. Therefore, data processing is easy. For example, there is a closed form solution that can calculate the radius and axis offset of the circle. The technique can be relatively fast.

表2为用于压电换能器的集总参数模型的符号列表(来自IEEE 177标准)。Table 2 is a list of symbols for the lumped parameter model of a piezoelectric transducer (from the IEEE 177 standard).

表2Table 2

表3是传输网络的符号列表(来自IEEE 177标准)。Table 3 is a list of symbols for the transmission network (from the IEEE 177 standard).

*是指实根；忽略复根。* refers to real roots; complex roots are ignored.

表3Table 3

表4是各种特征频率的解决方案列表(来自IEEE 177标准)。Table 4 is a list of solutions for various characteristic frequencies (from IEEE 177 standard).

各种特征频率的解决方案Solutions for various characteristic frequencies

*是指实根；忽略复根* refers to real roots; complex roots are ignored

表4Table 4

表5是三类压电材料的损耗。Table 5 shows the losses of three types of piezoelectric materials.

针对各种类型的压电振动器所期望的比率Q^r/r的最小值Minimum value of the ratio Q^r /r expected for various types of piezoelectric vibrators

表5Table 5

表6示出了钳口状况，即基于由所测量的变量Re、Ge、Xe、Be表示的圆的复阻抗/导纳、半径(re)和偏移(ae和be)的实时测量值的估计参数，以及基于由参考变量Rref、Gref、Xref、Bref表示的参考圆的复阻抗/导纳、半径(rr)和偏移(ar，br)的实时测量值的参考圆图的参数，如图60-64中所述。然后将这些值与给定状况下的既定值进行比较。这些状况可能是：1)钳口打开且无任何东西，2)末端咬合，3)钳口完全咬合且有钉。如下对超声换能器的等效电路进行建模，并且频率从55kHz扫描到56kHz：Table 6 shows the jaw conditions, i.e., estimated parameters based on real-time measurements of the complex impedance/admittance, radius (re) and offset (ae and be) of a circle represented by the measured variables Re, Ge, Xe, Be, and parameters of a reference circle diagram based on real-time measurements of the complex impedance/admittance, radius (rr) and offset (ar, br) of a reference circle represented by reference variables Rref, Gref, Xref, Bref, as described in Figures 60-64. These values are then compared to established values for a given condition. These conditions may be: 1) the jaws are open and nothing is in them, 2) the end is occluded, 3) the jaws are fully occluded and there is a nail. The equivalent circuit of the ultrasonic transducer is modeled as follows, and the frequency is swept from 55kHz to 56kHz:

Ls＝L1＝1.1068HLs＝L1＝1.1068H

Rs＝R1＝311.352ΩRs＝R1＝311.352Ω

Cs＝C1＝7.43265pF，并且Cs = C1 = 7.43265pF, and

C0＝C0＝3.64026nF。C0=C0=3.64026nF.

表6Table 6

在使用中，超声发生器扫描频率，记录测量的变量，并确定估计值Re、Ge、Xe、Be。然后将这些估计值与存储在存储器中(例如，存储在查询表中)的参考变量Rref、Gref、Xref、Bref进行比较，并确定钳口状况。表6中所示的参考钳口状况仅仅是示例。可对更多或更少的参考钳口状况进行分类并将其存储在存储器中。可以将这些变量用于估计阻抗/导纳圆的半径和偏移。In use, the ultrasonic generator sweeps the frequency, records the measured variables, and determines the estimated values Re, Ge, Xe, Be. These estimated values are then compared with the reference variables Rref, Gref, Xref, Bref stored in the memory (e.g., stored in a lookup table), and the jaw condition is determined. The reference jaw conditions shown in Table 6 are only examples. More or fewer reference jaw conditions can be classified and stored in the memory. These variables can be used to estimate the radius and offset of the impedance/admittance circle.

图65为根据本公开的至少一个方面的描绘基于阻抗/导纳圆的半径(r)和偏移(a，b)的估计值来确定钳口状况的控制程序或逻辑配置的过程的逻辑流程图132120。最初，基于如结合图60-64和表6所述的参考钳口状况用参考值填充数据库或查找表。设置参考钳口状况，并将频率从共振以下的值扫描到共振以上的值。将定义对应的阻抗/导纳圆图的参考值Rref、Gref、Xref、Bref存储在数据库或查找表中。在使用期间，在控制程序或逻辑配置的控制下，发生器或器械的处理器或控制电路使频率从共振以下扫描132122到共振以上。处理器或控制电路测量并记录132124定义对应的阻抗/导纳圆图的变量Re、Ge、Xe、Be(例如，将它们存储在存储器中)，并将它们与存储在数据库或查找表中的参考值Rref、Gref、Xref、Bref进行比较132126。处理器或控制电路基于比较结果确定132128(例如，估计)端部执行器钳口状况。FIG. 65 is a logic flow diagram 132120 of a control program or logic configuration depicting a process for determining a jaw condition based on estimates of the radius (r) and offset (a, b) of an impedance/admittance circle in accordance with at least one aspect of the present disclosure. Initially, a database or lookup table is populated with reference values based on a reference jaw condition as described in conjunction with FIGS. 60-64 and Table 6. The reference jaw condition is set and the frequency is swept from a value below resonance to a value above resonance. The reference values Rref, Gref, Xref, Bref defining the corresponding impedance/admittance circle graph are stored in the database or lookup table. During use, under the control of the control program or logic configuration, a processor or control circuit of a generator or instrument sweeps 132122 the frequency from below resonance to above resonance. The processor or control circuit measures and records 132124 the variables Re, Ge, Xe, Be defining the corresponding impedance/admittance circle graph (e.g., stores them in a memory), and compares 132126 them to the reference values Rref, Gref, Xref, Bref stored in the database or lookup table. The processor or control circuit determines 132128 (eg, estimates) a condition of the end effector jaws based on the comparison.

温度推断Temperature inference

图66A-66B为根据本公开的至少一个方面的具有冷(室温)超声刀和热超声刀的相同超声装置的复阻抗光谱的图形表示133000、133010。如本文所用，冷超声刀是指室温下的超声刀，而热超声刀是指在使用中摩擦加热后的超声刀。图66A为作为具有冷超声刀和热超声刀的相同超声装置的共振频率f_o的函数的阻抗相位角的图形表示133000，并且图66B为作为具有冷超声刀和热超声刀的相同超声装置的共振频率f_o的函数的阻抗量值|Z|的图形表示133010。阻抗相位角和阻抗量值|Z|在共振频率f_o处处于最小值。66A-66B are graphical representations 133000, 133010 of complex impedance spectra of the same ultrasonic device with a cold (room temperature) ultrasonic blade and a hot ultrasonic blade according to at least one aspect of the present disclosure. As used herein, a cold ultrasonic blade refers to an ultrasonic blade at room temperature, while a hot ultrasonic blade refers to an ultrasonic blade after friction heating during use. FIG. 66A is a graph showing the impedance phase angle as a function of the resonant frequency f_o of the same ultrasonic device with a cold ultrasonic blade and a hot ultrasonic blade. FIG. 66B is a graphical representation 133000 of the impedance magnitude |Z| as a function of the resonant frequency f_o of the same ultrasonic device with a cold ultrasonic blade and a hot ultrasonic blade. Impedance Phase Angle The impedance magnitude |Z| is at its minimum at the resonant frequency f_o .

超声换能器阻抗Z_g(t)可被测量为驱动信号发生器电压V_g(t)驱动信号和电流I_g(t)驱动信号的比率：The ultrasonic transducer impedance Z_g (t) can be measured as the ratio of the drive signal generator voltage V_g (t) drive signal and the current I_g (t) drive signal:

如图66A中所示，当超声刀为冷的(例如，在室温下)并且未摩擦加热时，超声装置的机电共振频率f_o为大约55,500Hz，并且超声换能器的激发频率被设定为55,500Hz。因此，当超声换能器在机电共振频率f_o下被激发并且超声刀为冷的时，相位角处于最小值或大约0Rad，如由冷刀曲线图133002所指示的。如图66B中所示，当超声刀为冷的并且超声换能器在机电共振频率f_o下被激发时，阻抗量值|Z|为800Ω，例如阻抗量值|Z|处于最小阻抗处，并且驱动信号幅值由于超声机电系统的串联共振等效电路而处于最大值处，如图25中所描绘。As shown in FIG. 66A , when the ultrasonic blade is cold (e.g., at room temperature) and not frictionally heated, the electromechanical resonant frequency f_o of the ultrasonic device is approximately 55,500 Hz, and the excitation frequency of the ultrasonic transducer is set to 55,500 Hz. Therefore, when the ultrasonic transducer is excited at the electromechanical resonant frequency f_o and the ultrasonic blade is cold, the phase angle At a minimum or approximately 0 Rad, as indicated by the cold blade graph 133002. As shown in FIG. 66B , when the ultrasonic blade is cold and the ultrasonic transducer is excited at the electromechanical resonance frequency f_o , the impedance magnitude |Z| is 800Ω, for example, the impedance magnitude |Z| is at a minimum impedance, and the drive signal amplitude is at a maximum due to the series resonance equivalent circuit of the ultrasonic electromechanical system, as depicted in FIG. 25 .

现在返回参考图66A和图66B，当超声换能器在55,500Hz的机电共振频率f_o下由发生器电压V_g(t)信号和发生器电流I_g(t)信号驱动时，发生器电压V_g(t)信号和发生器电流I_g(t)信号之间的相位角为零，阻抗量值|Z|处于最小阻抗处(例如，800Ω)，并且信号幅值由于超声机电系统的串联共振等效电路而处于峰值或最大值。当超声刀的温度增加时，由于在使用中生成的摩擦热，超声装置的机电谐振频率f_o’减小。因为超声换能器仍在55,500Hz的先前(冷刀)机电共振频率f_o下由发生器电压V_g(t)信号和发生器电流I_g(t)信号驱动，所以超声装置非共振f_o’操作，从而引起发生器电压V_g(t)信号和发生器电流I_g(t)信号之间的相位角偏移。相对于55,500Hz的先前的(冷刀)机电谐振频率，还存在阻抗量值|Z|的增大和驱动信号的峰值量值的下降。因此，可通过在机电共振频率f_o由于超声刀的温度变化而改变时测量发生器电压V_g(t)信号和发生器电流I_g(t)信号之间的相位角来推断超声刀的温度。Referring now back to FIGS. 66A and 66B , when the ultrasonic transducer is driven by the generator voltage V_g (t) signal and the generator current I_g (t) signal at the electromechanical resonance frequency f_o of 55,500 Hz, the phase angle between the generator voltage V_g (t) signal and the generator current I_g (t) signal is is zero, the impedance magnitude |Z| is at the minimum impedance (e.g., 800Ω), and the signal amplitude is at a peak or maximum value due to the series resonant equivalent circuit of the ultrasonic electromechanical system. When the temperature of the ultrasonic blade increases, the electromechanical resonant frequency f_o ' of the ultrasonic device decreases due to the friction heat generated during use. Because the ultrasonic transducer is still driven by the generator voltage V_g (t) signal and the generator current I_g (t) signal at the previous (cold blade) electromechanical resonant frequency f_o of 55,500 Hz, the ultrasonic device operates at a non-resonant f_o ', thereby causing the phase angle between the generator voltage V_g (t) signal and the generator current I_g (t) signal to be 0. There is also an increase in the impedance magnitude |Z| and a decrease in the peak magnitude of the drive signal relative to the previous (cold blade) electromechanical resonant frequency of 55,500 Hz. Therefore, the phase angle between the generator voltage V_g (t) signal and the generator current I_g (t) signal can be measured when the electromechanical resonant frequency f_o changes due to temperature changes of the ultrasonic blade. To infer the temperature of the ultrasonic knife.

如前所述，机电超声系统包括超声换能器、波导和超声刀。超声换能器可被建模成等效串联谐振电路(参见图25)，该等效串联谐振电路包括具有静态电容的第一支路和具有限定谐振器的机电特性的串联连接的电感、电阻和电容的第二“动态”支路。机电超声系统具有由超声换能器、波导和超声刀的物理特性限定的初始机电谐振频率。超声换能器由等于机电谐振频率(例如，机电超声系统的谐振频率)的频率下的交流电压V_g(t)信号和电流I_g(t)信号激发。当机电超声系统在共振频率下被激发时，电压V_g(t)信号和电流I_g(t)信号之间的相位角为零。As previously described, the electromechanical ultrasonic system includes an ultrasonic transducer, a waveguide, and an ultrasonic scalpel. The ultrasonic transducer can be modeled as an equivalent series resonant circuit (see FIG. 25 ), which includes a first branch having a static capacitance and a second "dynamic" branch having a series connection of an inductor, a resistor, and a capacitor that defines the electromechanical properties of the resonator. The electromechanical ultrasonic system has an initial electromechanical resonant frequency defined by the physical properties of the ultrasonic transducer, the waveguide, and the ultrasonic scalpel. The ultrasonic transducer is excited by an alternating voltage V_g (t) signal and a current I_g (t) signal at a frequency equal to the electromechanical resonant frequency (e.g., the resonant frequency of the electromechanical ultrasonic system). When the electromechanical ultrasonic system is excited at the resonant frequency, the phase angle between the voltage V_g (t) signal and the current I_g (t) signal is is zero.

换句话说，在谐振时，机电超声系统的模拟电感阻抗等于机电超声系统的模拟电容阻抗。当超声刀例如由于与组织的摩擦接合而加热时，超声刀(被建模为模拟电容)的顺应性导致机电超声系统的谐振频率偏移。在本示例中，当超声刀的温度增加时，机电超声系统的谐振频率降低。因此，机电超声系统的模拟电感阻抗不再等于机电超声系统的模拟电容阻抗，从而导致机电超声系统的驱动频率与新谐振频率之间失配。因此，利用热超声刀，机电超声系统“非谐振”操作。驱动频率和共振频率之间失配表现为施加到超声换能器的电压V_g(t)信号和电流I_g(t)信号之间的相位角In other words, at resonance, the simulated inductive impedance of the electromechanical ultrasonic system is equal to the simulated capacitive impedance of the electromechanical ultrasonic system. When the ultrasonic blade is heated, for example due to frictional engagement with tissue, the compliance of the ultrasonic blade (modeled as a simulated capacitor) causes the resonant frequency of the electromechanical ultrasonic system to shift. In this example, when the temperature of the ultrasonic blade increases, the resonant frequency of the electromechanical ultrasonic system decreases. Therefore, the simulated inductive impedance of the electromechanical ultrasonic system is no longer equal to the simulated capacitive impedance of the electromechanical ultrasonic system, resulting in a mismatch between the drive frequency and the new resonant frequency of the electromechanical ultrasonic system. Therefore, using a thermal ultrasonic blade, the electromechanical ultrasonic system operates "non-resonantly". The mismatch between the drive frequency and the resonant frequency is manifested as a phase angle between the voltage V_g (t) signal and the current I_g (t) signal applied to the ultrasonic transducer

如先前所讨论，发生器电子器件可以容易地监测施加到超声换能器的电压V_g(t)信号和电流I_g(t)信号之间的相位角相位角可通过傅立叶分析、加权最小二乘估计、卡尔曼滤波、基于空间矢量的技术、零点交叉方法、Lissajous图、三伏特计法、交叉线圈法、矢量伏特计和矢量阻抗法、相位标准器械、锁相环路等来确定。发生器可连续地监测相位角并调节驱动频率，直到相位角变为零。此时，新驱动频率等于机电超声系统的新谐振频率。相位角和/或发生器驱动频率的变化可用作超声刀的温度的间接或推断的测量值。As previously discussed, the generator electronics can easily monitor the phase angle between the voltage V_g (t) signal and the current I_g (t) signal applied to the ultrasonic transducer. Phase Angle It can be determined by Fourier analysis, weighted least squares estimation, Kalman filtering, space vector based techniques, zero crossing method, Lissajous plot, three voltmeter method, cross coil method, vector voltmeter and vector impedance method, phase standard instrument, phase locked loop, etc. The generator can continuously monitor the phase angle And adjust the drive frequency until the phase angle becomes zero. At this point, the new driving frequency is equal to the new resonant frequency of the electromechanical ultrasonic system. Phase angle And/or changes in the generator drive frequency can be used as an indirect or inferred measurement of the temperature of the ultrasonic blade.

多种技术可用于从这些光谱中的数据估计温度。最值得注意的是，可以采用时间变化的非线性状态空间公式组来对超声刀的温度与所测量的阻抗之间的动态关系进行建模A variety of techniques can be used to estimate temperature from data in these spectra. Most notably, a set of time-varying nonlinear state-space equations can be used to model the dynamic relationship between the temperature of the ultrasonic blade and the measured impedance.

在发生器驱动频率范围内，其中发生器驱动频率的范围特定于装置模型。Within a range of generator drive frequencies, where the range of generator drive frequencies is specific to the device model.

温度估计方法Temperature estimation method

估计或推断超声刀的温度的一个方面可包括三个步骤。首先，限定取决于时间和能量的温度和频率的状态空间模型。为了将温度建模为频率内容的函数，使用一组非线性状态空间公式来对机电谐振频率与超声刀的温度之间的关系进行建模。其次，应用卡尔曼滤波器来提高温度估计器和状态空间模型随时间变化的准确性。再次，在卡尔曼滤波器的反馈环路中提供状态估计器以控制施加到超声换能器以及因此超声刀的功率，从而调整超声刀的温度。下文描述了这三个步骤。One aspect of estimating or inferring the temperature of an ultrasonic scalpel may include three steps. First, a state-space model of temperature and frequency that depends on time and energy is defined. In order to model temperature as a function of frequency content, a set of nonlinear state-space formulas are used to model the relationship between the electromechanical resonant frequency and the temperature of the ultrasonic scalpel. Secondly, a Kalman filter is applied to improve the accuracy of the temperature estimator and the state-space model over time. Thirdly, a state estimator is provided in the feedback loop of the Kalman filter to control the power applied to the ultrasonic transducer and therefore the ultrasonic scalpel, thereby adjusting the temperature of the ultrasonic scalpel. These three steps are described below.

步骤1Step 1

第一步是限定取决于时间和能量的温度和频率的状态空间模型。为了将温度建模为频率内容的函数，使用一组非线性状态空间公式来对机电谐振频率与超声刀的温度之间的关系进行建模。在一个方面，状态空间模型由下式给出：The first step is to define a state-space model of temperature and frequency that depends on time and energy. In order to model temperature as a function of frequency content, a set of nonlinear state-space formulas are used to model the relationship between the electromechanical resonant frequency and the temperature of the ultrasonic blade. In one aspect, the state-space model is given by:

状态空间模型表示相对于固有频率F_n(t)、温度T(t)、能量E(t)和时间t的机电超声系统的固有频率的变化率和超声刀的温度的变化率。表示可测量且可观察的变量(诸如机电超声系统的固有频率F_n(t)、超声刀的温度T(t)、施加到超声刀的能量E(t)和时间t)的可观察性。超声刀的温度T(t)可观察为估计值。The state-space model represents the natural frequency of the electromechanical ultrasonic system with respect to the natural frequency_Fn (t), temperature T(t), energy E(t), and time t The rate of change and the temperature of the ultrasonic knife The rate of change. Observability refers to measurable and observable variables such as the natural frequency_Fn (t) of the electromechanical ultrasonic system, the temperature T(t) of the ultrasonic blade, the energy E(t) applied to the ultrasonic blade, and time t. The temperature T(t) of the ultrasonic blade can be observed as an estimated value.

步骤2Step 2

第二步是应用卡尔曼滤波器来改善温度估计器和状态空间模型。图67为根据以下公式基于阻抗来改善温度估计器和状态空间模型的卡尔曼滤波器133020的图示：The second step is to apply a Kalman filter to improve the temperature estimator and state-space model. FIG67 is a diagram of a Kalman filter 133020 that improves the temperature estimator and state-space model based on impedance according to the following formula:

其表示根据本公开的至少一个方面的在多种频率下测量的跨超声换能器的阻抗。It represents the impedance across the ultrasound transducer measured at various frequencies according to at least one aspect of the present disclosure.

可采用卡尔曼滤波器133020来改善温度估计的性能，并且允许增加外部传感器、模型或先前的信息以改善噪声数据中的温度预测。卡尔曼滤波器133020包括调整器133022和设备(plant)133024。在对照理论中，设备133024是过程和致动器的组合。设备133024被称为具有传递函数，该传递函数指示系统的输入信号和输出信号之间的关系。调整器133022包括状态估计器133026和控制器K 133028。状态调整器133026包括反馈环路133030。状态调整器133026接收y、装置133024的输出作为输入并且反馈变量u。状态估计器133026是与系统状态的真值会聚的内部反馈系统。状态估计器133026的输出为全反馈控制变量包括机电超声系统的固有频率F_n(t)、超声刀的温度T(t)、施加到超声刀的能量E(t)、相位角和时间t。到控制器K 133028的输入为并且控制器K 133028的输出u被馈送回到状态估计器133026和设备133024的t。Kalman filter 133020 can be used to improve the performance of temperature estimation and allow the addition of external sensors, models or previous information to improve temperature prediction in noisy data. Kalman filter 133020 includes regulator 133022 and plant 133024. In control theory, plant 133024 is a combination of process and actuator. Plant 133024 is said to have a transfer function, which indicates the relationship between the input signal and the output signal of the system. Regulator 133022 includes state estimator 133026 and controller K 133028. State regulator 133026 includes feedback loop 133030. State regulator 133026 receives y, the output of device 133024 as input and feedback variable u. State estimator 133026 is an internal feedback system that converges with the true value of the system state. The output of state estimator 133026 is a full feedback control variable The natural frequency_Fn (t) of the electromechanical ultrasonic system, the temperature T(t) of the ultrasonic blade, the energy E(t) applied to the ultrasonic blade, the phase angle and time t. The input to the controller K 133028 is And the output u of controller K 133028 is fed back to the state estimator 133026 and t of device 133024.

卡尔曼滤波(也称为线性二次估计(LQE))是一种算法，该算法使用随时间推移观察到的一系列测量值(包含统计噪声和其它不准确性)，并通过估计每个时帧的变量的联合概率分布并因此计算实际测量的最大似然估计来产生未知变量的估计。该算法以两步过程中工作。在预测步骤中，卡尔曼滤波器133020产生当前状态变量的估计以及它们的不确定性。一旦观察到下一次测量的结果(必然因一定数量的误差(包括随机噪声)而损坏)，则使用加权平均值来更新这些估计，给出的权重越高，就以越高的确定性进行估计。该算法是递归的并且可实时运行，仅使用当前输入测量值和先前计算的状态及其不确定性矩阵；不需要附加的过去的信息。Kalman filtering (also known as linear quadratic estimation (LQE)) is an algorithm that uses a series of measurements observed over time (containing statistical noise and other inaccuracies) and generates estimates of unknown variables by estimating the joint probability distribution of the variables for each time frame and thus calculating the maximum likelihood estimate of the actual measurement. The algorithm works in a two-step process. In the prediction step, the Kalman filter 133020 generates estimates of the current state variables and their uncertainties. Once the results of the next measurement are observed (necessarily corrupted by a certain amount of error (including random noise)), these estimates are updated using a weighted average, and the higher the weight given, the higher the certainty of the estimate. The algorithm is recursive and can be run in real time, using only the current input measurements and the previously calculated state and its uncertainty matrix; no additional past information is required.

卡尔曼滤波器133020使用机电超声系统的动力学模型、该系统已知的对照输入、以及向超声换能器施加的信号的固有频率和相位角的多个时序测量值(观测值)(例如，超声换能器的电阻抗的量值和相位)来形成机电超声系统的变化量的(其状态)的估计，以优于仅使用一个单独测量获得的估计地预测机电超声系统的超声刀部分的温度。因此，卡尔曼滤波器133020是包括传感器和数据融合以提供超声刀的温度的最大似然估计的算法。The Kalman filter 133020 uses a dynamic model of the electromechanical ultrasonic system, known control inputs to the system, and multiple time-series measurements (observations) of the natural frequency and phase angle of the signal applied to the ultrasonic transducer (e.g., the magnitude and phase of the electrical impedance of the ultrasonic transducer) to form an estimate of the changing quantity of the electromechanical ultrasonic system (its state) to predict the temperature of the ultrasonic blade portion of the electromechanical ultrasonic system better than the estimate obtained using only one single measurement. Therefore, the Kalman filter 133020 is an algorithm that includes sensors and data fusion to provide a maximum likelihood estimate of the temperature of the ultrasonic blade.

卡尔曼滤波器133020有效地处理由于向超声换能器施加的信号的噪声测量而导致的不确定性，以测量固有频率和相移数据，并且还有效地处理由于随机外部因素造成的不确定性。卡尔曼滤波器133020以系统的预测状态和使用加权平均值的新测量的平均值产生机电超声系统的状态的估计。加权值提供更好的(即，较小的)估计的不确定性，并且比未加权的值更“可信任”。权重可由协方差、对系统状态预测的估计不确定性的测量来计算。加权平均值的结果是位于预测状态和测量状态之间的新状态估计，并且具有比单独一个更好的估计不确定性。此过程在每一步重复，其中新的估计及其协方差告知在以下迭代中使用的预测。卡尔曼滤波器133020的该递归性质仅需要机电超声系统的状态的上一个“最佳猜测”而不是整个历史来计算新状态。The Kalman filter 133020 effectively handles the uncertainty caused by the noisy measurement of the signal applied to the ultrasonic transducer to measure the natural frequency and phase shift data, and also effectively handles the uncertainty caused by random external factors. The Kalman filter 133020 generates an estimate of the state of the electromechanical ultrasonic system with the average of the predicted state of the system and the new measurement using the weighted average. The weighted value provides a better (i.e., smaller) estimated uncertainty and is more "trustworthy" than the unweighted value. The weights can be calculated by the covariance, a measure of the estimated uncertainty of the system state prediction. The result of the weighted average is a new state estimate that is between the predicted state and the measured state, and has a better estimated uncertainty than a single one. This process is repeated at each step, where the new estimate and its covariance inform the prediction used in the following iteration. This recursive nature of the Kalman filter 133020 only requires the last "best guess" of the state of the electromechanical ultrasonic system instead of the entire history to calculate the new state.

测量和电流状态估计的相对确定性是重要的考虑因素，并且常见的是讨论滤波器在卡尔曼滤波器133020的增益K方面的响应。卡尔曼增益K是赋予测量值和电流状态估计的相对权重，并且可被“调谐”以实现特定性能。利用高增益K，卡尔曼滤波器133020对最近的测量值施加更多的权重，并因此更响应地遵循它们。使用低增益K，卡尔曼滤波器133020更密切地遵循模型预测。在极端情况下，接近一的高增益将导致估计轨迹较具跳跃性，而接近零的低增益将使噪声平滑但降低响应能力。The relative certainty of the measurements and current state estimates are important considerations, and it is common to discuss the response of the filter in terms of the gain K of the Kalman filter 133020. The Kalman gain K is the relative weight given to the measurements and the current state estimate, and can be "tuned" to achieve specific performance. With a high gain K, the Kalman filter 133020 places more weight on recent measurements and therefore follows them more responsively. With a low gain K, the Kalman filter 133020 follows the model predictions more closely. In extreme cases, a high gain close to one will result in a more jumpy estimated trajectory, while a low gain close to zero will smooth out noise but reduce responsiveness.

当执行卡尔曼滤波器133020的实际计算时(如下所述)，状态估计和协方差被编码为矩阵以处理单组计算中涉及的多个维度。这允许表示在转变模型或协方差中的任一者中的不同状态变量(诸如位置、速度和加速度)之间的线性关系。使用卡尔曼滤波器133020并不假定误差是高斯。但是，在所有误差都是高斯分布的特殊情况下，卡尔曼滤波器133020产生精确的条件概率估计。When performing the actual calculations of the Kalman filter 133020 (described below), the state estimates and covariances are encoded as matrices to handle the multiple dimensions involved in a single set of calculations. This allows the linear relationship between different state variables (such as position, velocity, and acceleration) to be represented in either the transition model or the covariance. Using the Kalman filter 133020 does not assume that the errors are Gaussian. However, in the special case where all errors are Gaussian distributed, the Kalman filter 133020 produces accurate conditional probability estimates.

步骤3Step 3

第三步使用卡尔曼滤波器133020的反馈环路133032中的状态估计器133026来控制施加到超声换能器并且因此施加到超声刀的功率，以调节超声刀的温度。The third step uses the state estimator 133026 in the feedback loop 133032 of the Kalman filter 133020 to control the power applied to the ultrasonic transducer and therefore to the ultrasonic blade to regulate the temperature of the ultrasonic blade.

图68为根据本公开的至少一个方面的图67中所示的卡尔曼滤波器133020的状态估计器133026用来最大化估计值的三个概率分布的图形描绘133040。概率分布包括先前的概率分布133042、预测(状态)概率分布133044和观察概率分布133046。根据本公开的至少一个方面，三个概率分布133042、133044、1330467用于对施加到超声换能器的功率的反馈控制，以基于在多种频率下测量的跨超声换能器的阻抗来调整温度。在施加到超声换能器以基于阻抗调整温度的功率进行反馈控制中使用的估计器由以下表达式给出：FIG68 is a graphical depiction 133040 of three probability distributions used by the state estimator 133026 of the Kalman filter 133020 shown in FIG67 to maximize estimated values in accordance with at least one aspect of the present disclosure. The probability distributions include a prior probability distribution 133042, a predicted (state) probability distribution 133044, and an observed probability distribution 133046. In accordance with at least one aspect of the present disclosure, the three probability distributions 133042, 133044, 1330467 are used for feedback control of power applied to an ultrasonic transducer to adjust temperature based on impedance across the ultrasonic transducer measured at multiple frequencies. The estimator used in feedback control of power applied to an ultrasonic transducer to adjust temperature based on impedance is given by the following expression:

其为根据本公开的至少一个方面的在多种频率下测量的跨超声换能器的阻抗。It is the impedance across the ultrasound transducer measured at multiple frequencies according to at least one aspect of the present disclosure.

先前的概率分布133042包括由以下表达式限定的状态方差：The previous probability distribution 133042 includes a state variance defined by the following expression:

状态方差用于预测系统的下一个状态，该状态表示为预测(状态)概率分布133044。观察概率分布133046是观察方差σ_m用于限定增益的系统的状态的实际观察的概率分布，该增益由以下表达式给出：State variance is used to predict the next state of the system, which is represented as the prediction (state) probability distribution 133044. The observation probability distribution 133046 is the probability distribution of the actual observation of the state of the system with observation variance σ_m used to define the gain, which is given by the following expression:

反馈控制Feedback Control

降低功率输入以确保温度(如由状态估计器和卡尔曼滤波器所估计的)被控制。The power input is reduced to ensure that the temperature (as estimated by the state estimator and Kalman filter) is controlled.

在一个方面，初始概念证明假设机电超声系统的固有频率与超声刀的温度之间存在静态线性关系。通过降低作为机电超声系统的固有频率的函数的功率(即，用反馈控制调整温度)，可直接控制超声刀末端的温度。在该示例中，超声刀的远侧末端的温度可被控制为不超过Teflon垫的熔点。In one aspect, the initial proof of concept assumes that there is a static linear relationship between the natural frequency of the electromechanical ultrasonic system and the temperature of the ultrasonic blade. By reducing the power as a function of the natural frequency of the electromechanical ultrasonic system (i.e., adjusting the temperature with feedback control), the temperature of the ultrasonic blade tip can be directly controlled. In this example, the temperature of the distal tip of the ultrasonic blade can be controlled to not exceed the melting point of the Teflon pad.

图69A为不具有温度反馈控制的超声装置的温度与时间关系的图形表示133050。超声刀的温度(℃)沿竖直轴线显示，并且时间(秒)沿水平轴线显示。用位于超声装置的钳口中的羚羊皮进行测试。一个钳口为超声刀，而另一个钳口为具有TEFLON垫的夹持臂。超声刀在谐振频率下被激发，同时与夹持在超声刀和夹持臂之间的羚羊皮摩擦接合。随着时间的推移，超声刀的温度(℃)由于与羚羊皮的摩擦接合而增大。随着时间的推移，超声刀的温度分布133052增大，直到在220℃的温度处约19.5秒后切割羚羊皮样本为止，如在点133054处所指示。在没有温度反馈控制的情况下，在切割羚羊皮样本之后，超声刀的温度增加到远高于TEFLON熔点的温度～380℃至高达～490℃。在点133056处，超声刀的温度达到490℃的最大温度，直至TEFLON垫完全熔融。在垫完全消失之后，超声刀的温度从点133056处的峰值温度略微下降。FIG. 69A is a graphical representation 133050 of the temperature versus time relationship of an ultrasonic device without temperature feedback control. The temperature (° C.) of the ultrasonic blade is shown along the vertical axis, and time (seconds) is shown along the horizontal axis. The test was conducted with chamois skin located in the jaws of the ultrasonic device. One jaw is an ultrasonic blade, and the other jaw is a clamping arm with a TEFLON pad. The ultrasonic blade is excited at a resonant frequency while frictionally engaging the chamois skin clamped between the ultrasonic blade and the clamping arm. Over time, the temperature (° C.) of the ultrasonic blade increases due to frictional engagement with the chamois skin. Over time, the temperature profile 133052 of the ultrasonic blade increases until the chamois skin sample is cut after about 19.5 seconds at a temperature of 220° C., as indicated at point 133054. Without temperature feedback control, after cutting the chamois skin sample, the temperature of the ultrasonic blade increases to a temperature far above the melting point of TEFLON, from 380° C. to as high as 490° C. At point 133056, the temperature of the ultrasonic blade reaches a maximum temperature of 490°C until the TEFLON pad is completely melted. After the pad completely disappears, the temperature of the ultrasonic blade drops slightly from the peak temperature at point 133056.

图69B为根据本发明的至少一个方面的具有温度反馈控制的超声装置的温度与时间关系的曲线图。超声刀的温度(℃)沿竖直轴线显示，并且时间(秒)沿水平轴线显示。用位于超声装置的钳口中的羚羊皮样本进行测试。一个钳口为超声刀，而另一个钳口为具有TEFLON垫的夹持臂。超声刀在谐振频率下被激发，同时与夹持在超声刀和夹持臂垫之间的羚羊皮摩擦接合。随着时间的推移，超声刀的温度分布133062增加，直到在220℃的温度处约23秒后切割羚羊皮样本为止，如在点133064处所指示。在温度反馈控制的情况下，如在点133066处所指示，超声刀的温度增加高达约380℃的最大温度，刚好低于TEFLON的熔点，并且然后如一般在区域133068处所指示降低到约330℃的平均值，从而防止TEFLON垫熔融。FIG69B is a graph of the temperature versus time of an ultrasonic device with temperature feedback control according to at least one aspect of the present invention. The temperature (°C) of the ultrasonic blade is shown along the vertical axis, and time (seconds) is shown along the horizontal axis. The test was conducted with a chamois leather sample located in the jaws of the ultrasonic device. One jaw is an ultrasonic blade, and the other jaw is a clamping arm with a TEFLON pad. The ultrasonic blade is excited at a resonant frequency while frictionally engaging the chamois leather clamped between the ultrasonic blade and the clamping arm pad. Over time, the temperature profile 133062 of the ultrasonic blade increases until the chamois leather sample is cut after about 23 seconds at a temperature of 220°C, as indicated at point 133064. In the case of temperature feedback control, as indicated at point 133066, the temperature of the ultrasonic blade increases up to a maximum temperature of about 380°C, just below the melting point of TEFLON, and then decreases to an average value of about 330°C as generally indicated at region 133068, thereby preventing the TEFLON pad from melting.

智能超声刀技术的应用Application of intelligent ultrasonic knife technology

当将超声刀浸入流体填充的外科场所中时，超声刀在激活期间冷却，使得密封和切割与其接触的组织的效果较低。超声刀的冷却可导致较长的激活时间和/或止血问题，因为未将足够的热递送至组织。为了克服超声刀的冷却，可需要更多的能量递送以缩短横切时间并且在这些流体浸没条件下实现合适的止血。使用频率温度反馈控制系统，如果检测到超声刀在某个温度以下开始或在某个温度处保持一段时间，则可增加发生器的输出功率以补偿由于外科场所中存在的血液/盐水/其它流体引起的冷却。When the ultrasonic scalpel is immersed in a fluid-filled surgical site, the ultrasonic scalpel cools during activation, making it less effective in sealing and cutting tissues in contact with it. Cooling of the ultrasonic scalpel can lead to longer activation times and/or hemostasis problems because not enough heat is delivered to the tissue. In order to overcome the cooling of the ultrasonic scalpel, more energy delivery may be required to shorten the transection time and achieve proper hemostasis under these fluid immersion conditions. Using a frequency temperature feedback control system, if it is detected that the ultrasonic scalpel starts below a certain temperature or remains at a certain temperature for a period of time, the output power of the generator can be increased to compensate for the cooling caused by the blood/saline/other fluids present in the surgical site.

因此，本文所述的频率温度反馈控制系统可改善超声装置的性能，尤其是在超声刀部分地或完全地定位或浸入流体填充的外科场所中时。本文所述的频率温度反馈控制系统使流体填充外科场所中超声装置性能的长激活时间和/或潜在问题最小化。Therefore, the frequency temperature feedback control system described herein can improve the performance of the ultrasonic device, especially when the ultrasonic blade is partially or completely positioned or immersed in a fluid-filled surgical field. The frequency temperature feedback control system described herein minimizes the long activation time and/or potential problems with the performance of the ultrasonic device in the fluid-filled surgical field.

如前所述，超声刀的温度可通过检测由以下表达式给出的超声换能器的阻抗来推断：As mentioned previously, the temperature of the ultrasonic blade can be inferred by detecting the impedance of the ultrasonic transducer given by the following expression:

或换句话讲，通过检测施加到超声换能器的电压V_g(t)信号和电流I_g(t)信号之间的相位角来推断。相位角信息也可用于推断超声刀的条件。如本文所具体讨论，相位角作为超声刀的温度的函数而变化。因此，相位角信息可用于控制超声刀的温度。这可例如通过当超声刀运行过热时降低递送到超声刀的功率，并且当超声刀运行过冷时增加递送到超声刀的功率来实现。图70A-70B为用于在检测到超声刀的温度骤降时调节施加到超声换能器的超声功率的温度反馈控制的图形表示。Or in other words, by detecting the phase angle between the voltage V_g (t) signal and the current I_g (t) signal applied to the ultrasonic transducer To infer. Phase angle The information can also be used to infer the condition of the ultrasonic knife. As discussed in detail in this article, the phase angle As a function of the temperature of the ultrasonic blade, the phase angle The information can be used to control the temperature of the ultrasonic blade. This can be achieved, for example, by reducing the power delivered to the ultrasonic blade when the ultrasonic blade is running too hot, and increasing the power delivered to the ultrasonic blade when the ultrasonic blade is running too cold. Figures 70A-70B are graphical representations of temperature feedback control for adjusting the ultrasonic power applied to the ultrasonic transducer when a sudden drop in the temperature of the ultrasonic blade is detected.

图70A为根据本公开的至少一个方面的作为时间的函数的超声功率输出133070的图形表示。超声发生器的功率输出沿竖直轴线显示，并且时间(秒)沿水平轴线显示。图70B为根据本公开的至少一个方面的作为时间的函数的超声刀温度133080的图形表示。超声刀温度沿竖直轴线显示，并且时间(秒)沿水平轴线显示。超声刀的温度随着施加恒定功率133072而增加，如图70A中所示。在使用期间，超声刀的温度突然下降。这可由多种条件引起，然而，在使用期间，可推断超声刀的温度在其浸入流体填充的外科场所(例如，血液、盐水、水等)中时下降。在时间t₀处，超声刀的温度降至期望的最小温度133082以下，并且频率温度反馈控制算法检测温度下降并开始增加或“坡升(ramp up)”功率，如通过递送到超声刀的功率斜坡133074所示，以开始将超声刀的温度升高至期望的最小温度133082以上。FIG. 70A is a graphical representation of ultrasonic power output 133070 as a function of time according to at least one aspect of the present disclosure. The power output of the ultrasonic generator is shown along the vertical axis, and time (seconds) is shown along the horizontal axis. FIG. 70B is a graphical representation of ultrasonic blade temperature 133080 as a function of time according to at least one aspect of the present disclosure. The ultrasonic blade temperature is shown along the vertical axis, and time (seconds) is shown along the horizontal axis. The temperature of the ultrasonic blade increases with the application of constant power 133072, as shown in FIG. 70A. During use, the temperature of the ultrasonic blade suddenly drops. This can be caused by a variety of conditions, however, during use, it can be inferred that the temperature of the ultrasonic blade drops when it is immersed in a fluid-filled surgical site (e.g., blood, saline, water, etc.). At time t₀ , the temperature of the ultrasonic blade drops below the desired minimum temperature 133082, and the frequency temperature feedback control algorithm detects the temperature drop and begins to increase or "ramp up" power, as shown by the power ramp 133074 delivered to the ultrasonic blade, to begin raising the temperature of the ultrasonic blade above the desired minimum temperature 133082.

参考图70A和图70B，超声发生器输出基本上是恒定功率133072，只要超声刀的温度保持在期望的最小温度133082以上。在t₀处，发生器或器械或两者中的处理器或控制电路检测到超声刀的温度下降到期望的最低温度133072以下，并且开始频率温度反馈控制算法以将超声刀的温度升高到最小期望温度133082以上。因此，发生器功率在对应于t₀处检测到超声刀的温度的突然下降的t₁处开始坡升133074。在频率温度反馈控制算法下，功率继续坡升133074，直到超声刀的温度高于期望的最小温度133082为止。70A and 70B , the ultrasonic generator output is substantially constant power 133072 as long as the temperature of the ultrasonic blade remains above the desired minimum temperature 133082. At_t0 , the processor or control circuit in the generator or instrument or both detects that the temperature of the ultrasonic blade has dropped below the desired minimum temperature 133072, and starts a frequency temperature feedback control algorithm to raise the temperature of the ultrasonic blade above the minimum desired temperature 133082. Therefore, the generator power begins to ramp up 133074 at_t1 corresponding to the sudden drop in the temperature of the ultrasonic blade detected at_t0 . Under the frequency temperature feedback control algorithm, the power continues to ramp up 133074 until the temperature of the ultrasonic blade is above the desired minimum temperature 133082.

图71为根据本公开的至少一个方面的描绘控制超声刀的温度的控制程序或逻辑配置的过程的逻辑流程图133090。根据该过程，发生器或器械或两者的处理器或控制电路执行结合图70A和图70B讨论的频率-温度反馈控制算法的一个方面，以将功率水平施加133092到超声换能器从而在超声刀处实现期望的温度。发生器监测133094被施加以驱动超声换能器的电压V_g(t)信号和电流I_g(t)信号之间的相位角基于相位角发生器使用本文结合图66A-68所述的技术来推断133096超声刀的温度。发生器通过将超声刀的推断温度与预定的期望温度进行比较来确定133098超声刀的温度是否低于期望的最小温度。然后发生器基于比较来调节施加到超声换能器的功率电平。例如，当超声刀的温度达到或高于期望的最小温度时，该方法沿“否”分支继续，并且当超声刀的温度低于所期望的最小温度时，该过程沿“是”分支继续。当超声刀的温度低于期望的最小温度时，发生器例如通过增加电压V_g(t)信号和/或电流I_g(t)信号来增加133100到超声换能器的功率水平，以升高超声刀的温度并继续增加施加到超声换能器的功率水平，直到超声刀的温度增加到最小期望温度以上为止。FIG. 71 is a logic flow diagram 133090 of a process for a control program or logic configuration for controlling the temperature of an ultrasonic blade according to at least one aspect of the present disclosure. According to the process, a processor or control circuit of the generator or instrument or both executes one aspect of the frequency-temperature feedback control algorithm discussed in conjunction with FIG. 70A and FIG. 70B to apply 133092 a power level to the ultrasonic transducer to achieve a desired temperature at the ultrasonic blade. The generator monitors 133094 the phase angle between the voltage V_g (t) signal and the current I_g (t) signal applied to drive the ultrasonic transducer. Based on phase angle The generator uses the techniques described herein in conjunction with FIGS. 66A-68 to infer 133096 the temperature of the ultrasonic blade. The generator determines 133098 whether the temperature of the ultrasonic blade is below the desired minimum temperature by comparing the inferred temperature of the ultrasonic blade with a predetermined desired temperature. The generator then adjusts the power level applied to the ultrasonic transducer based on the comparison. For example, when the temperature of the ultrasonic blade reaches or exceeds the desired minimum temperature, the method continues along the "no" branch, and when the temperature of the ultrasonic blade is below the desired minimum temperature, the process continues along the "yes" branch. When the temperature of the ultrasonic blade is below the desired minimum temperature, the generator increases 133100 the power level of the ultrasonic transducer, for example by increasing the voltage V_g (t) signal and/or the current I_g (t) signal, to increase the temperature of the ultrasonic blade and continue to increase the power level applied to the ultrasonic transducer until the temperature of the ultrasonic blade increases above the minimum desired temperature.

态势感知Situational Awareness

现在参考图72，示出了描绘集线器诸如外科集线器106或206的态势感知的时间轴5200。时间轴5200是说明性的外科规程以及外科集线器106、206可以从外科规程中每个步骤从数据源接收的数据导出的背景信息。时间轴5200描绘了护士、外科医生和其它医疗人员在肺段切除规程期间将采取的典型步骤，从建立手术室开始到将患者转移到术后恢复室为止。Referring now to FIG72 , a timeline 5200 is shown depicting the situational awareness of a hub, such as a surgical hub 106 or 206. The timeline 5200 is an illustrative surgical procedure and background information that the surgical hub 106, 206 can derive from data received from data sources at each step in the surgical procedure. The timeline 5200 depicts typical steps that nurses, surgeons, and other medical personnel would take during a segmentectomy procedure, starting with setting up the operating room and ending with transferring the patient to a postoperative recovery room.

态势感知外科集线器106、206在整个外科规程过程中从数据源接收数据，包括每次医疗人员利用与外科集线器106、206配对的模块化装置时生成的数据。外科集线器106、206可以从配对的模块化装置和其它数据源接收该数据，并且在接收新数据时不断导出关于正在进行的规程的推论(即，背景信息)，诸如在任何给定时间执行规程的哪个步骤。外科集线器106、206的态势感知系统能够例如记录与用于生成报告的过程相关的数据，验证医务人员正在采取的步骤，提供可能与特定过程步骤相关的数据或提示(例如，经由显示屏)，基于背景调节模块化装置(例如，激活监测器，调节医学成像装置的视场(FOV)，或者改变超声外科器械或RF电外科器械的能量水平)，以及采取上述任何其它此类动作。The situational awareness surgical hub 106, 206 receives data from data sources throughout the surgical procedure, including data generated each time a medical professional utilizes a modular device paired with the surgical hub 106, 206. The surgical hub 106, 206 can receive this data from paired modular devices and other data sources, and continually derive inferences (i.e., contextual information) about the ongoing procedure as new data is received, such as which step of the procedure is being performed at any given time. The situational awareness system of the surgical hub 106, 206 can, for example, record data related to the procedure for generating a report, verify the steps being taken by the medical professional, provide data or prompts that may be related to a particular procedure step (e.g., via a display screen), adjust the modular device based on the context (e.g., activate a monitor, adjust the field of view (FOV) of a medical imaging device, or change the energy level of an ultrasonic surgical instrument or RF electrosurgical instrument), and take any other such actions described above.

作为该示例性规程中的第一步5202，医院工作人员从医院的EMR数据库中检索患者的EMR。基于EMR中的选择的患者数据，外科集线器106、206确定待执行的规程是胸腔规程。As a first step 5202 in this exemplary procedure, hospital staff retrieves the patient's EMR from the hospital's EMR database. Based on the selected patient data in the EMR, the surgical hub 106, 206 determines that the procedure to be performed is a thoracic procedure.

第二步5204，工作人员扫描用于规程的进入的医疗用品。外科集线器106、206与在各种类型的规程中使用的用品列表交叉引用扫描的用品，并确认供应的混合物对应于胸腔规程。另外，外科集线器106、206还能够确定规程不是楔形规程(因为进入的用品缺乏胸腔楔形规程所需的某些用品，或者在其它方面不对应于胸腔楔形规程)。In a second step 5204, the staff scans the incoming medical supplies for the procedure. The surgical hub 106, 206 cross-references the scanned supplies with a list of supplies used in various types of procedures and confirms that the mix supplied corresponds to a thoracic procedure. Additionally, the surgical hub 106, 206 can also determine that the procedure is not a wedge procedure (because the incoming supplies lack certain supplies required for a thoracic wedge procedure, or otherwise do not correspond to a thoracic wedge procedure).

第三步5206，医疗人员经由可通信地连接到外科毂集线器106、206的扫描器来扫描患者带。然后，外科集线器106、206可基于所扫描的数据来确认患者的身份。In a third step 5206, the medical personnel scans the patient belt via a scanner communicatively connected to the surgical hub 106, 206. The surgical hub 106, 206 may then confirm the identity of the patient based on the scanned data.

第四步5208，医务工作人员打开辅助设备。所利用的辅助设备可根据外科规程的类型和外科医生待使用的技术而变化，但在此示例性情况下，它们包括排烟器、吹入器和医学成像装置。当激活时，作为其初始化过程的一部分，作为模块化装置的辅助设备可以自动与位于模块化装置特定附近的外科集线器106、206配对。然后，外科集线器106、206可通过检测在该术前阶段或初始化阶段期间与其配对的模块化装置的类型来导出关于外科规程的背景信息。在该具体示例中，外科集线器106、206确定外科规程是基于配对模块化装置的该特定组合的VATS规程。基于来自患者的EMR的数据的组合，规程中使用的医疗用品的列表以及连接到集线器的模块化装置的类型，外科集线器106、206通常可推断外科小组将执行的具体规程。一旦外科集线器106、206知道正在执行什么具体规程，则外科集线器106、206便可从存储器或云中检索该规程的步骤，并且然后交叉参照其随后从所连接的数据源(例如，模块化装置和患者监测装置)接收的数据，以推断外科团队正在执行的外科规程的什么步骤。In the fourth step 5208, the medical staff turns on the auxiliary equipment. The auxiliary equipment utilized may vary depending on the type of surgical procedure and the technique to be used by the surgeon, but in this exemplary case, they include smoke evacuators, insufflators, and medical imaging devices. When activated, as part of its initialization process, the auxiliary equipment, which is a modular device, can be automatically paired with a surgical hub 106, 206 located in a specific vicinity of the modular device. The surgical hub 106, 206 can then derive background information about the surgical procedure by detecting the type of modular device paired with it during this preoperative phase or initialization phase. In this specific example, the surgical hub 106, 206 determines that the surgical procedure is a VATS procedure based on this specific combination of paired modular devices. Based on a combination of data from the patient's EMR, a list of medical supplies used in the procedure, and the type of modular device connected to the hub, the surgical hub 106, 206 can generally infer the specific procedure that the surgical team will perform. Once the surgical hub 106, 206 knows what specific procedure is being performed, the surgical hub 106, 206 can retrieve the steps of that procedure from memory or the cloud and then cross-reference data that it subsequently receives from connected data sources (e.g., modular devices and patient monitoring devices) to infer what steps of the surgical procedure are being performed by the surgical team.

第五步5210，工作人员成员将EKG电极和其它患者监测装置附接到患者。EKG电极和其它患者监测装置能够与外科集线器106、206配对。当外科集线器106、206开始从患者监测装置接收数据时，外科集线器106、206因此确认患者在手术室中。In a fifth step 5210, a staff member attaches EKG electrodes and other patient monitoring devices to the patient. The EKG electrodes and other patient monitoring devices can be paired with the surgical hub 106, 206. When the surgical hub 106, 206 begins receiving data from the patient monitoring devices, the surgical hub 106, 206 thus confirms that the patient is in the operating room.

第六步5212，医疗人员诱导患者麻醉。外科集线器106、206可基于来自模块化装置和/或患者监测装置的数据(包括例如EKG数据、血压数据、呼吸机数据、或它们的组合)推断患者处于麻醉下。在第六步5212完成时，肺分段切除规程的术前部分完成，并且手术部分开始。In a sixth step 5212, the medical personnel induces anesthesia in the patient. The surgical hub 106, 206 may infer that the patient is under anesthesia based on data from the modular device and/or the patient monitoring device (including, for example, EKG data, blood pressure data, ventilator data, or a combination thereof). Upon completion of the sixth step 5212, the preoperative portion of the lung segmental resection procedure is completed and the surgical portion begins.

第七步5214，折叠正在操作的患者肺部(同时通气切换到对侧肺)。例如，外科集线器106、206可从呼吸机数据推断出患者的肺已经塌缩。外科集线器106、206可推断规程的手术部分已开始，因为其可将患者的肺部塌缩的检测与规程的预期步骤(可先前访问或检索)进行比较，从而确定使肺塌缩是该特定规程中的手术步骤。In a seventh step 5214, collapse the patient's lung being operated on (while ventilation is switched to the contralateral lung). For example, the surgical hub 106, 206 may infer from the ventilator data that the patient's lung has collapsed. The surgical hub 106, 206 may infer that the surgical portion of the protocol has begun because it may compare the detection of the patient's lung collapsing to the expected steps of the protocol (which may have been previously accessed or retrieved) to determine that collapsing the lung is a surgical step in that particular protocol.

第八步5216，插入医疗成像装置(例如，内窥镜)，并启动来自医疗成像装置的视频。外科集线器106、206通过其与医疗成像装置的连接来接收医疗成像装置数据(即，视频或图像数据)。在接收到医疗成像装置数据之后，外科集线器106、206可确定外科规程的腹腔镜式部分已开始。另外，外科集线器106、206可确定正在执行的特定规程是分段切除术，而不是叶切除术(注意，楔形规程已经基于外科集线器106、206基于在规程的第二步5204处所接收的数据而排除)。来自医疗成像装置124(图2)的数据可用于以多种不同的方式确定与正在执行的规程类型相关的背景信息，包括通过确定医疗成像装置相对于患者解剖结构的可视化取向的角度，监测所利用的医疗成像装置的数量(即，被激活并与外科集线器106、206配对)，以及监测所利用的可视化装置的类型。例如，一种用于执行VATS肺叶切除术的技术将摄像机放置在隔膜上方的患者胸腔的下前拐角中，而一种用于执行VATS分段切除术的技术将摄像机相对于分段裂缝放置在前肋间位置。例如，使用模式识别或机器学习技术，可对态势感知系统进行训练，以根据患者解剖结构的可视化识别医疗成像装置的定位。作为另一个示例，一种用于执行VATS肺叶切除术的技术利用单个医疗成像装置，而用于执行VATS分段切除术的另一种技术利用多个摄像机。作为另一示例，一种用于执行VATS分段切除术的技术利用红外光源(其可作为可视化系统的一部分可通信地耦合到外科集线器)以可视化不用于VATS肺部切除术中的分段裂隙。通过从医疗成像装置跟踪这些数据中的任何或所有，外科集线器106、206因此可确定正在进行的外科规程的具体类型和/或用于特定类型的外科规程的技术。In the eighth step 5216, a medical imaging device (e.g., an endoscope) is inserted and the video from the medical imaging device is started. The surgical hub 106, 206 receives medical imaging device data (i.e., video or image data) through its connection to the medical imaging device. After receiving the medical imaging device data, the surgical hub 106, 206 can determine that the laparoscopic portion of the surgical procedure has begun. In addition, the surgical hub 106, 206 can determine that the specific procedure being performed is a segmented resection, rather than a lobectomy (note that the wedge procedure has been excluded based on the surgical hub 106, 206 based on the data received at the second step 5204 of the procedure). The data from the medical imaging device 124 (Figure 2) can be used to determine contextual information related to the type of procedure being performed in a variety of different ways, including by determining the angle of the medical imaging device relative to the visualization orientation of the patient's anatomy, monitoring the number of medical imaging devices utilized (i.e., activated and paired with the surgical hub 106, 206), and monitoring the type of visualization device utilized. For example, one technique for performing a VATS lobectomy places a camera in the lower anterior corner of the patient's thorax above the diaphragm, while a technique for performing a VATS segmentectomy places the camera in an anterior intercostal position relative to the segmental fissure. For example, using pattern recognition or machine learning techniques, a situational awareness system can be trained to identify the positioning of a medical imaging device based on visualization of the patient's anatomy. As another example, a technique for performing a VATS lobectomy utilizes a single medical imaging device, while another technique for performing a VATS segmentectomy utilizes multiple cameras. As another example, a technique for performing a VATS segmentectomy utilizes an infrared light source (which can be communicatively coupled to the surgical hub as part of a visualization system) to visualize a segmental fissure that is not used in a VATS pulmonary resection. By tracking any or all of this data from the medical imaging device, the surgical hub 106, 206 can therefore determine the specific type of surgical procedure being performed and/or the technique used for a particular type of surgical procedure.

第九步5218，外科团队开始规程的解剖步骤。外科集线器106、206可推断外科医生正在解剖以调动患者的肺，因为其从RF发生器或超声发生器接收指示正在击发能量器械的数据。外科集线器106、206可将所接收的数据与外科规程的检索步骤交叉，以确定在过程中的该点处(即，在先前讨论的规程步骤完成之后)击发的能量器械对应于解剖步骤。在某些情况下，能量器械可为安装到机器人外科系统的机械臂的能量工具。In step nine 5218, the surgical team begins the dissection step of the protocol. The surgical hub 106, 206 may infer that the surgeon is dissecting to mobilize the patient's lung because it receives data from the RF generator or ultrasonic generator indicating that an energy instrument is being fired. The surgical hub 106, 206 may interleave the received data with the retrieval step of the surgical protocol to determine that the energy instrument fired at this point in the process (i.e., after the previously discussed protocol steps are completed) corresponds to the dissection step. In some cases, the energy instrument may be an energy tool mounted to a robotic arm of a robotic surgical system.

第十步5220，外科团队继续进行规程的结扎步骤。外科集线器106、206可推断外科医生正在结扎动脉和静脉，因为其从外科缝合和切割器械接收指示器械正在被击发的数据。与先前步骤相似，外科集线器106、206可通过将来自外科缝合和切割器械的数据的接收与该过程中的检索步骤进行交叉引用来推导该推论。在某些情况下，外科器械可以是安装到机器人外科系统的机器人臂的外科工具。In step 10 5220, the surgical team proceeds with the ligation step of the procedure. The surgical hub 106, 206 may infer that the surgeon is ligating the artery and vein because it receives data from the surgical stapling and cutting instrument indicating that the instrument is being fired. Similar to the previous step, the surgical hub 106, 206 may derive this inference by cross-referencing the receipt of data from the surgical stapling and cutting instrument with the retrieval step in the process. In some cases, the surgical instrument may be a surgical tool mounted to a robotic arm of a robotic surgical system.

第十一步5222，执行规程的分段切除术部分。外科集线器106、206可推断外科医生正在基于来自外科缝合和切割器械的数据(包括来自其仓的数据)横切软组织。仓数据可对应于例如由器械击发的钉的大小或类型。由于不同类型的钉用于不同类型的组织，因此仓数据可指示正被缝合和/或横切的组织的类型。在这种情况下，被击发的钉的类型用于软组织(或其它类似的组织类型)，这允许外科集线器106、206推断规程的分段切除术部分正在进行。Eleventh step 5222, perform the segmentation resection portion of the procedure. The surgical hub 106, 206 may infer that the surgeon is transecting soft tissue based on data from the surgical stapling and cutting instrument (including data from its bin). The bin data may correspond to, for example, the size or type of staples fired by the instrument. Since different types of staples are used for different types of tissue, the bin data may indicate the type of tissue being sutured and/or transected. In this case, the type of staple fired is for soft tissue (or other similar tissue types), which allows the surgical hub 106, 206 to infer that the segmentation resection portion of the procedure is in progress.

然后执行第十二步5224节点解剖步骤。外科集线器106、206可基于从发生器接收的指示正在击发RF或超声器械的数据来推断外科团队正在解剖节点并且执行泄漏测试。对于该特定规程，在横切软组织后使用的RF或超声器械对应于节点解剖步骤，该步骤允许外科集线器106、206进行此类推论。应当指出的是，外科医生根据规程中的具体步骤定期在外科缝合/切割器械和外科能量(即，RF或超声)器械之间来回切换，因为不同器械更好地适于特定任务。因此，其中使用缝合/切割器械和外科能量器械的特定序列可指示外科医生正在执行的规程的步骤。此外，在某些情况下，机器人工具可用于外科规程中的一个或多个步骤，并且/或者手持式外科器械可用于外科规程中的一个或多个步骤。一个或多个外科医生可例如在机器人工具和手持式外科器械之间交替和/或可同时使用装置。在第十二步5224完成时，切口被闭合并且规程的术后部分开始。Then perform the twelfth step 5224 node dissection step. The surgical hub 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 indicating that the RF or ultrasonic instrument is being fired. For this particular procedure, the RF or ultrasonic instrument used after transecting the soft tissue corresponds to the node dissection step, which allows the surgical hub 106, 206 to make such inferences. It should be noted that the surgeon regularly switches back and forth between surgical suturing/cutting instruments and surgical energy (i.e., RF or ultrasonic) instruments according to the specific steps in the procedure because different instruments are better suited for specific tasks. Therefore, the specific sequence in which the suturing/cutting instruments and surgical energy instruments are used can indicate the steps of the procedure being performed by the surgeon. In addition, in some cases, robotic tools can be used for one or more steps in the surgical procedure, and/or handheld surgical instruments can be used for one or more steps in the surgical procedure. One or more surgeons can, for example, alternate between robotic tools and handheld surgical instruments and/or can use the device simultaneously. When the twelfth step 5224 is completed, the incision is closed and the postoperative portion of the procedure begins.

第十三步5226，反向麻醉患者。例如，外科集线器106、206可基于例如呼吸机数据(即，患者的呼吸率开始增加)推断出患者正在从麻醉中醒来。Thirteenth step 5226, reverse anesthesia to the patient. For example, the surgical hub 106, 206 may infer that the patient is waking up from anesthesia based on, for example, ventilator data (ie, the patient's breathing rate begins to increase).

最后，第十四步5228是医疗人员从患者移除各种患者监测装置。因此，当集线器从患者监测装置丢失EKG、BP和其它数据时，外科集线器106、206可推断患者正在被转移到恢复室。如从该示例性规程的描述可以看出，外科集线器106、206可根据从可通信地耦合到外科集线器106、206的各种数据源接收的数据来确定或推断给定外科规程的每个步骤何时发生。Finally, the fourteenth step 5228 is for the medical staff to remove the various patient monitoring devices from the patient. Thus, the surgical hub 106, 206 can infer that the patient is being transferred to a recovery room when the hub loses EKG, BP, and other data from the patient monitoring devices. As can be seen from the description of this exemplary procedure, the surgical hub 106, 206 can determine or infer when each step of a given surgical procedure occurs based on data received from various data sources that are communicatively coupled to the surgical hub 106, 206.

态势感知进一步描述于2017年12月28日提交的标题为交互式外科平台(INTERACTIVE SURGICAL PLATFORM)的美国临时专利申请序列号62/611,341中，该专利申请全文以引用方式并入本文。在某些情况下，机器人外科系统(包括本文所公开的各种机器人外科系统)的操作可由集线器106、206基于其态势感知和/或来自其部件的反馈和/或基于来自云102的信息来控制。Situational awareness is further described in U.S. Provisional Patent Application Serial No. 62/611,341, filed on December 28, 2017, entitled INTERACTIVE SURGICAL PLATFORM, which is incorporated herein by reference in its entirety. In some cases, the operation of a robotic surgical system (including various robotic surgical systems disclosed herein) may be controlled by the hub 106, 206 based on its situational awareness and/or feedback from its components and/or based on information from the cloud 102.

电外科系统的态势感知Situational Awareness of Electrosurgical Systems

电外科器械用于通过向组织施加能量来治疗各种组织类型。如结合图22-24所述，电外科器械(例如，外科器械1104、1106、1108)可连接到发生器1100，并且包括被配置为抓握组织并向组织传输治疗能量的端部执行器(例如，端部执行器1122、1124、1125)。Electrosurgical instruments are used to treat various tissue types by applying energy to the tissue. As described in conjunction with Figures 22-24, electrosurgical instruments (e.g., surgical instruments 1104, 1106, 1108) can be connected to the generator 1100 and include end effectors (e.g., end effectors 1122, 1124, 1125) configured to grasp tissue and transmit therapeutic energy to the tissue.

在各个方面，端部执行器可以用于通过在组织例如血管被端部执行器抓握的同时向血管施加能量来密封、焊接或凝结血管。由于血管通常被保护性组织包围，因此必须将组织分开以暴露血管，从而实现有效的密封。但是，组织分离所需的能量比组织密封或凝结所需的能量低。而且，要分离的组织的量根据例如血管的解剖位置、组织的状态以及所进行的外科手术的类型而有所不同。In various aspects, an end effector can be used to seal, weld, or coagulate a blood vessel by applying energy to the vessel while the tissue, such as a blood vessel, is grasped by the end effector. Since the blood vessel is generally surrounded by protective tissue, the tissue must be separated to expose the blood vessel in order to achieve effective sealing. However, the energy required for tissue separation is lower than the energy required for tissue sealing or coagulation. Moreover, the amount of tissue to be separated varies depending on, for example, the anatomical location of the blood vessel, the state of the tissue, and the type of surgical procedure being performed.

一种治疗包括血管在内的组织的技术包括在密封和/或横切血管之前，分离血管的内肌肉层并使其远离动脉外膜层运动。为了更有效地分离血管的组织层，可以生成足以分离组织但不足以凝结或密封组织的低水平能量并将其传输到组织。随后，采用高水平能量来密封或凝结组织。One technique for treating tissue, including blood vessels, includes separating and moving the inner muscle layer of a vessel away from the adventitia layer of the artery before sealing and/or transecting the vessel. To more effectively separate the tissue layers of the vessel, a low level of energy sufficient to separate the tissue but insufficient to coagulate or seal the tissue can be generated and delivered to the tissue. Subsequently, a high level of energy is used to seal or coagulate the tissue.

对被端部执行器抓握的组织成功进行能量治疗取决于针对端部执行器的每个闭合阶段选择合适的能量操作模式。此外，端部执行器的闭合阶段可通过各种态势参数诸如组织类型、解剖位置和/或组分来确定。结合图72在标题“态势感知”下描述了各种合适的态势参数。Successful energy treatment of tissue grasped by the end effector depends on selecting the appropriate energy operation mode for each closing stage of the end effector. In addition, the closing stage of the end effector can be determined by various situation parameters such as tissue type, anatomical location and/or composition. Various suitable situation parameters are described in conjunction with Figure 72 under the heading "Situation Awareness".

本公开的各方面呈现了用于针对电外科器械的端部执行器的不同闭合阶段选择不同能量模式的各种过程。该选择可以至少部分地基于一个或多个态势参数进行。Aspects of the present disclosure present various processes for selecting different energy modes for different closing stages of an end effector of an electrosurgical instrument.The selection may be made based at least in part on one or more posture parameters.

在各个方面，在闭合期间组织与端部执行器相互作用提供了可以用于选择或调节用于治疗组织的能量模式的一个或多个态势参数。图73示出了端部执行器131000从轴131001延伸并且经历闭合运动以抓握组织“T”。端部执行器131000包括第一钳口131002和第二钳口131004。第一钳口131002和第二钳口131004中的至少一者能够相对于另一个运动以抓握它们之间的组织。在各个方面，闭合阶段可以由第一钳口131002相对于第二钳口131004的一个或多个角位置或者第一钳口131002和第二钳口131004之间的一个或多个角距离来限定。In various aspects, the interaction of tissue with the end effector during closing provides one or more state parameters that can be used to select or adjust the energy mode for treating tissue. FIG. 73 shows that the end effector 131000 extends from the shaft 131001 and undergoes a closing motion to grasp tissue "T". The end effector 131000 includes a first jaw 131002 and a second jaw 131004. At least one of the first jaw 131002 and the second jaw 131004 can move relative to the other to grasp tissue between them. In various aspects, the closing stage can be defined by one or more angular positions of the first jaw 131002 relative to the second jaw 131004 or one or more angular distances between the first jaw 131002 and the second jaw 131004.

在图73的示例中，第一钳口131002能够相对于第二钳口131004运动，以使端部执行器在打开构型和闭合构型之间转变通过不同的闭合阶段，以将组织夹持在钳口131002、131004之间。图73描绘了两个闭合阶段。在第一闭合阶段，第一钳口131002从打开构型运动角距离θ1。73, the first jaw 131002 is movable relative to the second jaw 131004 to transition the end effector between an open configuration and a closed configuration through different closing stages to clamp tissue between the jaws 131002, 131004. Figure 73 depicts two closing stages. In the first closing stage, the first jaw 131002 moves an angular distance θ1 from the open configuration.

在第一闭合阶段之后紧接着是第二闭合阶段，第二闭合阶段从端部执行器131000的打开构型延伸角距离θ2。尽管在图73的示例中仅描绘了两个闭合阶段，但是可使根据本公开的端部执行器转变通过多于或少于两个闭合阶段。The first closed stage is followed by a second closed stage that extends an angular distance θ2 from the open configuration of the end effector 131000. Although only two closed stages are depicted in the example of FIG73, an end effector according to the present disclosure may be transitioned through more or less than two closed stages.

图75A和图75B为端部执行器131000经历闭合运动以分离、密封和横切组织“T”的示意图。在图75A中，端部执行器131000处于第一闭合阶段，并且已经建立了与组织“T”的初始接触。在图75B中，第一钳口131002已经完成了第一闭合阶段，并且即将开始第二闭合阶段。75A and 75B are schematic diagrams of the end effector 131000 undergoing a closing motion to separate, seal, and transect tissue "T". In FIG. 75A, the end effector 131000 is in a first closing stage and has established initial contact with tissue "T". In FIG. 75B, the first jaw 131002 has completed the first closing stage and is about to begin the second closing stage.

参考图74，曲线图131010描绘了施加到图75A和图75B的组织“T”的第一治疗循环131012。时间表示在x轴上，而幅度表示在y轴上。第一治疗循环131012包括初始组织分离能量模式，该模式通过在第一闭合阶段中向组织“T”施加第一能量来实现组织分离。第一治疗循环131012还包括组织密封能量模式，该模式通过在第二闭合阶段中向组织“T”施加大于第一能量的第二能量来实现组织密封。Referring to FIG74, a graph 131010 depicts a first treatment cycle 131012 applied to the tissue "T" of FIGS. 75A and 75B. Time is represented on the x-axis and amplitude is represented on the y-axis. The first treatment cycle 131012 includes an initial tissue separation energy mode that achieves tissue separation by applying a first energy to the tissue "T" in a first closing phase. The first treatment cycle 131012 also includes a tissue sealing energy mode that achieves tissue sealing by applying a second energy greater than the first energy to the tissue "T" in a second closing phase.

在图74的曲线图131010中还描绘了第二治疗循环131014。第二治疗循环131014仅包括组织密封能量模式。换句话讲，在第二治疗循环131014中，组织密封能量模式不遵循初始组织分离能量模式。第二治疗循环131014适用于不需要组织分离的某些情况。A second treatment cycle 131014 is also depicted in the graph 131010 of FIG74. The second treatment cycle 131014 includes only the tissue sealing energy pattern. In other words, in the second treatment cycle 131014, the tissue sealing energy pattern does not follow the initial tissue separation energy pattern. The second treatment cycle 131014 is suitable for certain situations where tissue separation is not required.

图76为描绘用于选择电外科器械的能量操作模式的控制程序或逻辑配置的过程131020的逻辑流程图。过程131020检测131022端部执行器131000的闭合阶段。过程131020还基于检测到的端部执行器131000的闭合阶段在递送不同能量输出的能量模式之间进行选择131024。在一个示例中，在第一闭合阶段中选择递送第一能量输出的第一能量模式，而在第二闭合阶段中选择递送大于第一能量输出的第二能量输出的第二能量模式。第一能量输出足以分离组织“T”但不足以密封组织“T”，而第二能量输出足以密封组织“T”。76 is a logic flow diagram depicting a process 131020 of a control program or logic configuration for selecting an energy operation mode of an electrosurgical instrument. The process 131020 detects 131022 the closing stage of the end effector 131000. The process 131020 also selects 131024 between energy modes that deliver different energy outputs based on the detected closing stage of the end effector 131000. In one example, a first energy mode that delivers a first energy output is selected in a first closing stage, and a second energy mode that delivers a second energy output greater than the first energy output is selected in a second closing stage. The first energy output is sufficient to separate tissue "T" but insufficient to seal tissue "T", while the second energy output is sufficient to seal tissue "T".

在某些方面，本公开的一个或多个过程可以由电外科器械的控制电路(诸如外科器械700的控制电路710、外科器械750的控制电路760和/或外科器械790的控制电路760)执行。在某些方面，如图13中所示，用于执行本公开的一个或多个过程的控制电路500可包括联接到至少一个存储器电路504的一个或多个处理器502(例如，微处理器、微控制器)，该至少一个存储器电路存储程序指令，这些程序指令在被处理器502执行时使得处理器502执行所述一个或多个过程。另选地，本公开的一个或多个过程可以由图14、15中描绘的一个或多个控制电路执行。在某些方面，电外科器械可包括存储用于执行本公开的一个或多个过程的一个或多个算法的非暂态存储介质。In some aspects, one or more processes of the present disclosure may be performed by a control circuit of an electrosurgical instrument, such as control circuit 710 of surgical instrument 700, control circuit 760 of surgical instrument 750, and/or control circuit 760 of surgical instrument 790. In some aspects, as shown in FIG. 13, a control circuit 500 for performing one or more processes of the present disclosure may include one or more processors 502 (e.g., microprocessors, microcontrollers) coupled to at least one memory circuit 504, the at least one memory circuit storing program instructions that, when executed by the processor 502, cause the processor 502 to perform the one or more processes. Alternatively, one or more processes of the present disclosure may be performed by one or more control circuits depicted in FIGS. 14 and 15. In some aspects, an electrosurgical instrument may include a non-transitory storage medium storing one or more algorithms for performing one or more processes of the present disclosure.

图77为描绘用于选择电外科器械的能量操作模式的控制程序或逻辑配置的过程131030的另一个逻辑流程图。过程131030基于指示端部执行器131000的闭合阶段的传感器信号从递送不同能量输出的操作模式中选择操作模式。在一个示例中，图77的过程由连接到一个或多个传感器的控制电路执行，所述一个或多个传感器被配置为生成指示端部执行器131000的闭合阶段的传感器信号。传感器信号由控制电路接收131032，该控制电路基于所接收的传感器信号从递送不同能量输出的操作模式中选择能量操作模式。例如，控制电路确定131034所接收的传感器信号是否指示端部执行器131000处于第一闭合阶段。如果是，则控制电路选择第一操作模式，该模式使第一能量输出被递送131036到组织“T”。如果所接收的传感器信号未指示端部执行器处于第一闭合阶段，则控制电路进一步确定131038所接收的传感器信号是否指示端部执行器131000处于第二闭合阶段。如果是，则控制电路选择第二操作模式，该模式使大于第一能量输出的第二能量输出被递送131039到组织“T”。FIG. 77 is another logic flow diagram depicting a process 131030 of a control program or logic configuration for selecting an energy operation mode of an electrosurgical instrument. The process 131030 selects an operation mode from operation modes that deliver different energy outputs based on a sensor signal indicating a closing stage of the end effector 131000. In one example, the process of FIG. 77 is performed by a control circuit connected to one or more sensors that are configured to generate a sensor signal indicating a closing stage of the end effector 131000. The sensor signal is received 131032 by the control circuit, which selects an energy operation mode from operation modes that deliver different energy outputs based on the received sensor signal. For example, the control circuit determines 131034 whether the received sensor signal indicates that the end effector 131000 is in a first closing stage. If so, the control circuit selects a first operation mode that causes a first energy output to be delivered 131036 to the tissue "T". If the received sensor signal does not indicate that the end effector is in the first closed stage, the control circuit further determines 131038 whether the received sensor signal indicates that the end effector 131000 is in the second closed stage. If so, the control circuit selects a second operating mode that causes a second energy output greater than the first energy output to be delivered 131039 to the tissue "T".

在各个示例中，超声外科器械的控制电路被配置为响应于夹持构件从第一闭合阶段转变到第二闭合阶段而使换能器改变超声能量输出的量值。In various examples, control circuitry of an ultrasonic surgical instrument is configured to cause the transducer to change an amount of ultrasonic energy output in response to the clamp member transitioning from a first closed stage to a second closed stage.

在各个示例中，控制电路被配置为将能量输出的量值变化与从第一闭合阶段到第二闭合阶段的转变关联起来。在各个示例中，第二能量输出足以密封和凝结组织，而第一能量输出足以分离组织但不足以密封和凝结组织。尽管在图77的示例中仅描绘了两种能量操作模式，但是根据本公开的电外科器械可包括多于或少于两种能量操作模式，每种对应于端部执行器131000的预定闭合阶段。在各个示例中，组织分离模式由比组织凝结和密封模式低的幅度和/或频率限定。In various examples, the control circuit is configured to associate a change in the magnitude of the energy output with a transition from a first closing stage to a second closing stage. In various examples, the second energy output is sufficient to seal and coagulate tissue, while the first energy output is sufficient to separate tissue but insufficient to seal and coagulate tissue. Although only two energy operation modes are depicted in the example of FIG. 77 , an electrosurgical instrument according to the present disclosure may include more or less than two energy operation modes, each corresponding to a predetermined closing stage of the end effector 131000. In various examples, the tissue separation mode is defined by a lower amplitude and/or frequency than the tissue coagulation and sealing mode.

图78为描绘用于选择电外科器械的能量操作模式的控制程序或逻辑配置的过程131040的另一个逻辑流程图。过程131040在许多方面类似于图76的过程。另外，过程131040确定131042当第一钳口131002在打开构型和闭合构型之间运动通过闭合阶段时何时实现与组织“T”的初始接触(参见图75A)。更具体地，在电外科器械的能量操作模式之间进行选择基于其中检测到与组织“T”的初始接触的闭合阶段。FIG. 78 is another logic flow diagram depicting a process 131040 of a control program or logic configuration for selecting an energy operation mode of an electrosurgical instrument. The process 131040 is similar in many respects to the process of FIG. 76 . Additionally, the process 131040 determines 131042 when initial contact with tissue “T” is achieved when the first jaw 131002 moves through the closing phase between the open configuration and the closed configuration (see FIG. 75A ). More specifically, the selection between energy operation modes of the electrosurgical instrument is based on the closing phase in which initial contact with tissue “T” is detected.

在各个方面，可以通过组织接触电路来检测初始组织接触，该组织接触电路包括第一钳口电极和第二钳口电极。第一钳口电极联接到电外科能量源的一个极，并且第二钳口电极联接到电外科能量源的相对极。当组织同时与第一钳口电极和第二钳口电极接触时，组织接触电路处于闭合构型，从而允许非治疗信号在钳口131002、131004之间传递。因此，当组织位于钳口131002、131004之间时，建立电连续性，而当没有组织位于钳口131002、131004之间时，没有建立电连续性。In various aspects, initial tissue contact can be detected by a tissue contact circuit that includes a first jaw electrode and a second jaw electrode. The first jaw electrode is coupled to one pole of an electrosurgical energy source, and the second jaw electrode is coupled to an opposite pole of the electrosurgical energy source. When tissue is in contact with the first jaw electrode and the second jaw electrode simultaneously, the tissue contact circuit is in a closed configuration, thereby allowing non-therapeutic signals to pass between jaws 131002, 131004. Thus, when tissue is located between jaws 131002, 131004, electrical continuity is established, and when no tissue is located between jaws 131002, 131004, electrical continuity is not established.

在各个方面，当钳口131002、131004对其间捕获的组织“T”施加足够的压缩以使感测电路“SC”闭合时，实现初始组织接触。In various aspects, initial tissue contact is achieved when the jaws 131002, 131004 apply sufficient compression to the tissue "T" captured therebetween to close the sensing circuit "SC".

图78A为示例性组织接触电路的示意图，其示出了在与组织接触时完成到一对间隔开的接触板的该电路。钳口131002、131004与组织“T”的接触通过建立与设置在钳口131002、131004上的一对相对的板“P1、P2”的接触来闭合原本断开的感测电路“SC”。感测电路“SC”的闭合使传感器信号被传输到控制电路(例如，图13-14、图17-19)。传感器信号指示已经建立初始组织接触。在提交于2011年6月27日的美国专利号8,181,839(标题为采用传感器的外科器械(SURGICAL INSTRUMENT EMPLOYING SENSORS)，其发布于2012年5月5日，其全部公开内容以引用方式并入本文)中进一步描述了图78A和其它示例。FIG. 78A is a schematic diagram of an exemplary tissue contact circuit, which shows the circuit completed to a pair of spaced apart contact plates when in contact with tissue. The contact of jaws 131002, 131004 with tissue "T" closes the originally disconnected sensing circuit "SC" by establishing contact with a pair of opposing plates "P1, P2" disposed on jaws 131002, 131004. The closure of sensing circuit "SC" causes a sensor signal to be transmitted to a control circuit (e.g., FIGS. 13-14, 17-19). The sensor signal indicates that initial tissue contact has been established. FIG. 78A and other examples are further described in U.S. Patent No. 8,181,839 filed on June 27, 2011 (titled SURGICAL INSTRUMENT EMPLOYING SENSORS, which was issued on May 5, 2012, and the entire disclosure of which is incorporated herein by reference).

图79为描绘用于基于其中检测到与组织“T”的初始接触的闭合阶段来选择电外科器械的能量操作模式的控制程序或逻辑配置的过程131050的另一个逻辑流程图。过程131050包括接收131052第一传感器信号和第二传感器信号。在一个示例中，过程131050由连接到至少一个第一传感器的控制电路(例如，图13-14、图17-19)执行，该第一传感器被配置为生成指示端部执行器131000的闭合阶段的传感器信号。控制电路还连接到至少一个第二传感器，该第二传感器被配置为生成指示检测到与组织“T”的初始接触的传感器信号。来自第一传感器和第二传感器的传感器信号被传输到控制电路。FIG. 79 is another logic flow diagram depicting a process 131050 of a control program or logic configuration for selecting an energy operation mode of an electrosurgical instrument based on a closing phase in which initial contact with tissue "T" is detected. Process 131050 includes receiving 131052 a first sensor signal and a second sensor signal. In one example, process 131050 is performed by a control circuit (e.g., FIGS. 13-14, 17-19) connected to at least one first sensor configured to generate a sensor signal indicating a closing phase of end effector 131000. The control circuit is also connected to at least one second sensor configured to generate a sensor signal indicating that initial contact with tissue "T" is detected. The sensor signals from the first sensor and the second sensor are transmitted to the control circuit.

过程131050进一步确定131054第一传感器信号是否指示端部执行器131000处于第一闭合阶段。如果是，则过程131050进一步确定131056第二传感器信号是否指示已经建立初始组织接触。The process 131050 further determines 131054 whether the first sensor signal indicates that the end effector 131000 is in the first closed stage. If so, the process 131050 further determines 131056 whether the second sensor signal indicates that initial tissue contact has been established.

如果第一传感器信号指示端部执行器131000处于第一闭合阶段，并且第二传感器信号指示已经建立初始组织接触，则第一能量输出被递送131058到组织“T”。在一个示例中，控制电路选择第一操作模式，该模式使第一能量输出被递送131058到组织“T”。If the first sensor signal indicates that the end effector 131000 is in the first closed stage, and the second sensor signal indicates that initial tissue contact has been established, the first energy output is delivered 131058 to the tissue "T". In one example, the control circuit selects a first operating mode that causes the first energy output to be delivered 131058 to the tissue "T".

相反，如果端部执行器131000不处于第一闭合阶段，则过程131050进一步确定131060端部执行器131000是否处于第二闭合阶段。如果是，则过程131050进一步确定131062第二传感器信号是否指示在第二闭合阶段已经建立初始组织接触。Conversely, if the end effector 131000 is not in the first closure stage, the process 131050 further determines 131060 whether the end effector 131000 is in the second closure stage. If so, the process 131050 further determines 131062 whether the second sensor signal indicates that initial tissue contact has been established in the second closure stage.

如果第一传感器信号指示端部执行器131000处于第二闭合阶段，并且第二传感器信号指示在第二闭合阶段已建立初始组织接触，则大于第一能量输出的第二能量输出被递送131064到组织“T”。在一个示例中，控制电路选择第二操作模式，该模式使第二能量输出被递送131064到组织“T”。If the first sensor signal indicates that the end effector 131000 is in the second closing stage, and the second sensor signal indicates that initial tissue contact has been established in the second closing stage, a second energy output greater than the first energy output is delivered 131064 to the tissue "T". In one example, the control circuit selects a second operating mode that causes the second energy output to be delivered 131064 to the tissue "T".

换句话讲，在第一闭合阶段中检测到与组织的初始接触使得控制电路使第一能量输出被递送到组织“T”，而在第二闭合阶段中检测到与组织的初始接触使得控制电路使第二能量输出被递送到组织“T”。如上所述，在各个方面，第二能量输出足以密封和凝结组织，而第一能量输出足以分离组织但不足以密封和凝结组织。In other words, detecting initial contact with tissue in the first closure phase causes the control circuit to cause a first energy output to be delivered to the tissue "T", while detecting initial contact with tissue in the second closure phase causes the control circuit to cause a second energy output to be delivered to the tissue "T". As described above, in various aspects, the second energy output is sufficient to seal and coagulate the tissue, while the first energy output is sufficient to separate the tissue but insufficient to seal and coagulate the tissue.

在各个方面，如上面更详细地描述，闭合阶段可以由第一钳口131002相对于第二钳口131004的角位置或角位置范围来限定。在某些情况下，第一闭合阶段和第二闭合阶段在打开构型中的跨度可覆盖钳口131002、131004之间的最大角距离的预定部分。端部执行器131000通过使第一钳口131002相对于第二钳口131004运动最大角距离来完成完整闭合循环。In various aspects, as described in more detail above, the closing stage can be defined by the angular position or range of angular positions of the first jaw 131002 relative to the second jaw 131004. In some cases, the span of the first closing stage and the second closing stage in the open configuration can cover a predetermined portion of the maximum angular distance between the jaws 131002, 131004. The end effector 131000 completes a complete closing cycle by moving the first jaw 131002 relative to the second jaw 131004 by the maximum angular distance.

在一个示例中，第一闭合阶段的跨度覆盖第一角距离，并且第二闭合阶段的跨度覆盖第二角距离。在一个示例中，第一角距离和第二角距离相等或至少基本上相等。在一个示例中，第二角距离直接跟随第一角距离。另选地，在另一个示例中，第一角距离与第二角距离间隔开。在一个示例中，第一角距离与第二角距离之比选自例如约一半至约二的范围。In one example, the span of the first closed stage covers a first angular distance, and the span of the second closed stage covers a second angular distance. In one example, the first angular distance and the second angular distance are equal or at least substantially equal. In one example, the second angular distance directly follows the first angular distance. Alternatively, in another example, the first angular distance is spaced apart from the second angular distance. In one example, the ratio of the first angular distance to the second angular distance is selected from a range of, for example, about half to about two.

在一个示例中，第一闭合阶段的跨度覆盖最大角距离的前一半，并且第二闭合阶段的跨度覆盖最大角距离的后一半。因此，根据过程131050，在端部执行器131000的完整闭合循环的多达50％的任何点处检测到初始组织接触会产生第一能量输出，而在超过50％标记的点处检测到初始组织接触会产生第二能量输出。In one example, the span of the first closure phase covers the first half of the maximum angular distance, and the span of the second closure phase covers the second half of the maximum angular distance. Thus, according to process 131050, detecting initial tissue contact at any point up to 50% of the complete closure cycle of the end effector 131000 results in a first energy output, while detecting initial tissue contact at a point beyond the 50% mark results in a second energy output.

角位置不是端部执行器131000的闭合阶段的唯一识别特征。如下面结合图80所述，端部执行器131000的闭合运动由纵向可运动驱动构件131110驱动。纵向可运动驱动构件131110的纵向位置是闭合阶段的另一个识别特征。纵向可运动驱动构件131110的纵向运动对应于第一钳口131002相对于第二钳口131004的角运动，并且由绝对定位系统7000监测。Angular position is not the only identifying feature of the closing phase of the end effector 131000. As described below in conjunction with FIG. 80, the closing motion of the end effector 131000 is driven by the longitudinally movable drive member 131110. The longitudinal position of the longitudinally movable drive member 131110 is another identifying feature of the closing phase. The longitudinal motion of the longitudinally movable drive member 131110 corresponds to the angular motion of the first jaw 131002 relative to the second jaw 131004 and is monitored by the absolute positioning system 7000.

在各个示例中，电外科器械的控制电路(例如，图13-14、图17-19)包括存储介质，该存储介质尤其存储端部执行器131000的闭合阶段的信息特征，诸如闭合阶段的起点、闭合阶段的终点、第一钳口131002的与闭合阶段相关联的一个或多个角位置和/或纵向可运动驱动构件131110的与闭合阶段相关联的一个或多个纵向位置。In various examples, the control circuit of the electrosurgical instrument (e.g., Figures 13-14, 17-19) includes a storage medium that stores, among other things, information characteristics of the closing phase of the end actuator 131000, such as the starting point of the closing phase, the end point of the closing phase, one or more angular positions of the first jaw 131002 associated with the closing phase, and/or one or more longitudinal positions of the longitudinally movable drive member 131110 associated with the closing phase.

如图80中所示，绝对定位系统7000被配置为跟踪端部执行器131000的闭合。依靠所存储的信息和绝对定位系统7000的输出，电外科器械的控制电路(例如，图13-14、图17-19)可以在端部执行器131000在打开构型和闭合构型之间转变时确定其闭合阶段。80 , the absolute positioning system 7000 is configured to track the closure of the end effector 131000. Relying on the stored information and the output of the absolute positioning system 7000, the control circuitry of the electrosurgical instrument (e.g., FIGS. 13-14 , 17-19 ) can determine the closure stage of the end effector 131000 as it transitions between the open and closed configurations.

在某些方面，驱动系统被配置为施加驱动运动以促动端部执行器131000通过闭合阶段。驱动系统可采用电动马达131102。在各种形式中，马达131102可为例如最大旋转为大约25,000RPM的DC有刷驱动马达。在其它布置方式中，马达131102可包括无刷马达、无绳马达、同步马达、步进马达或任何其它合适的电动马达。电池1104(或“功率源”或“功率组”)诸如锂离子电池例如可向控制电路且最终向马达131102提供电力。In certain aspects, the drive system is configured to apply a drive motion to actuate the end effector 131000 through the closing stage. The drive system may employ an electric motor 131102. In various forms, the motor 131102 may be, for example, a DC brushed drive motor with a maximum rotation of approximately 25,000 RPM. In other arrangements, the motor 131102 may include a brushless motor, a cordless motor, a synchronous motor, a stepper motor, or any other suitable electric motor. A battery 1104 (or "power source" or "power pack") such as a lithium-ion battery, for example, may provide power to the control circuit and ultimately to the motor 131102.

电动马达131102可以包括可操作地与齿轮减速器组件7014交接的可旋转轴7016，该齿轮减速器组件被安装成与纵向可运动驱动构件131110上的一组驱动齿或齿条啮合接合。在使用中，电池1104所提供的电压极性可以沿顺时针方向操作电动马达131102，其中由电池1104施加到电动马达131102的电压极性可以被反转，以便沿逆时针方向操作电动马达131102。当沿一个方向旋转电动马达131102时，将沿远侧方向“D”轴向驱动纵向可运动驱动构件131110，从而使第一钳口131002通过闭合阶段从打开构型运动到闭合构型。当沿相反的旋转方向驱动马达131102时，将沿近侧方向“P”轴向驱动驱动构件131110，从而使第一钳口131002转变回打开构型。The electric motor 131102 can include a rotatable shaft 7016 that operably interfaces with a gear reducer assembly 7014 that is mounted to mesh with a set of drive teeth or racks on the longitudinally movable drive member 131110. In use, the voltage polarity provided by the battery 1104 can operate the electric motor 131102 in a clockwise direction, wherein the voltage polarity applied to the electric motor 131102 by the battery 1104 can be reversed to operate the electric motor 131102 in a counterclockwise direction. When the electric motor 131102 is rotated in one direction, the longitudinally movable drive member 131110 will be axially driven in the distal direction "D", thereby moving the first jaw 131002 from an open configuration to a closed configuration through a closing stage. When the motor 131102 is driven in the opposite rotational direction, the drive member 131110 will be axially driven in the proximal direction "P", thereby converting the first jaw 131002 back to an open configuration.

图80为根据一个实施方案的绝对定位系统7000的示意图，该绝对定位系统包括微控制器7004控制的马达驱动电路布置，该布置包括传感器布置7002。与绝对定位系统7000和/或传感器布置7002相关联的电动和电子电路元件由控制电路板组件支撑。微控制器7004通常包括存储器7006以及可操作地与其联接的微处理器7008(“处理器”)。处理器7008控制马达驱动器7010电路，以控制马达131102的位置和速率。马达131102可操作地联接到传感器布置7002和绝对位置传感器7012布置，以针对纵向可运动驱动构件131110的每个可能位置以及因此得到的第一钳口131002的每个可能位置向微控制器7004提供唯一位置信号。FIG80 is a schematic diagram of an absolute positioning system 7000 according to one embodiment, the absolute positioning system including a motor drive circuit arrangement controlled by a microcontroller 7004, the arrangement including a sensor arrangement 7002. The electric and electronic circuit elements associated with the absolute positioning system 7000 and/or the sensor arrangement 7002 are supported by a control circuit board assembly. The microcontroller 7004 typically includes a memory 7006 and a microprocessor 7008 ("processor") operably coupled thereto. The processor 7008 controls the motor driver 7010 circuit to control the position and rate of the motor 131102. The motor 131102 is operably coupled to the sensor arrangement 7002 and the absolute position sensor 7012 arrangement to provide a unique position signal to the microcontroller 7004 for each possible position of the longitudinally movable drive member 131110 and each possible position of the first jaw 131002 obtained thereby.

唯一位置信号经由反馈元件7024提供给微控制器7004。应当理解，唯一位置信号可为基于位置传感器7012和微控制器7004之间的接口的模拟信号或数字值。在一个方面，位置传感器7012和微控制器7004之间的接口是标准串行外围接口(SPI)，并且唯一位置信号是表示传感器元件7026在一转内的位置的数字值。可以将表示传感器元件7026在一转内的绝对位置的值存储在存储器7006中。传感器元件7026的绝对位置反馈值对应于第一钳口131002的位置。The unique position signal is provided to the microcontroller 7004 via the feedback element 7024. It should be understood that the unique position signal can be an analog signal or a digital value based on the interface between the position sensor 7012 and the microcontroller 7004. In one aspect, the interface between the position sensor 7012 and the microcontroller 7004 is a standard serial peripheral interface (SPI), and the unique position signal is a digital value representing the position of the sensor element 7026 within one revolution. The value representing the absolute position of the sensor element 7026 within one revolution can be stored in the memory 7006. The absolute position feedback value of the sensor element 7026 corresponds to the position of the first jaw 131002.

此外，可提供其它传感器7018以测量与绝对定位系统7000相关联的其它参数。还可提供一个或多个显示指示器7020，这些显示指示器可包括发声部件。Additionally, other sensors 7018 may be provided to measure other parameters associated with the absolute positioning system 7000. One or more display indicators 7020 may also be provided, which may include audible components.

传感器布置7002提供对应于纵向可运动驱动构件131110的位置的唯一位置信号。电动马达131102可以包括可操作地与齿轮组件7014交接的可旋转轴7016，该齿轮组件被安装成与纵向可运动驱动构件131110上的一组驱动齿或齿条啮合接合。传感器元件7026可以可操作地联接到齿轮组件7014，使得传感器元件7026的单转对应于纵向可运动驱动构件131110的一些线性纵向平移。The sensor arrangement 7002 provides a unique position signal corresponding to the position of the longitudinally movable drive member 131110. The electric motor 131102 may include a rotatable shaft 7016 operably interfacing with a gear assembly 7014 mounted in meshing engagement with a set of drive teeth or a rack on the longitudinally movable drive member 131110. The sensor element 7026 may be operably coupled to the gear assembly 7014 such that a single rotation of the sensor element 7026 corresponds to some linear longitudinal translation of the longitudinally movable drive member 131110.

绝对定位系统7000的传感器布置7002采用位置传感器7012，该位置传感器针对与位置传感器7012相关联的传感器元件的单转中的每个旋转位置生成唯一位置信号。因此，与位置传感器7012相关联的传感器元件的单转相当于纵向可运动驱动构件131110的纵向线性位移d1。换句话讲，d1为联接到纵向可运动驱动构件131110的传感器元件的单转之后纵向可运动驱动构件131110从点“a”运动到点“b”的纵向线性距离。可单独或结合齿轮减速采用一系列开关7022a至7022n(其中n为大于一的整数)以针对位置传感器7012的不止一次旋转提供独特位置信号。开关7022a-7022n的状态被馈送回到微控制器7004，该微控制器应用逻辑来确定对应于纵向可运动驱动部件131110的纵向线性位移d1+d2+…dn的唯一位置信号，该唯一位置信号对应于第一钳口131002在打开构型和闭合构型之间的唯一位置。The sensor arrangement 7002 of the absolute positioning system 7000 employs a position sensor 7012 that generates a unique position signal for each rotational position in a single revolution of the sensor element associated with the position sensor 7012. Thus, a single revolution of the sensor element associated with the position sensor 7012 is equivalent to a longitudinal linear displacement d1 of the longitudinally movable drive member 131110. In other words, d1 is the longitudinal linear distance that the longitudinally movable drive member 131110 moves from point "a" to point "b" after a single revolution of the sensor element coupled to the longitudinally movable drive member 131110. A series of switches 7022a to 7022n (where n is an integer greater than one) may be employed alone or in combination with gear reduction to provide unique position signals for more than one revolution of the position sensor 7012. The states of switches 7022a-7022n are fed back to the microcontroller 7004, which applies logic to determine a unique position signal corresponding to the longitudinal linear displacement d1+d2+…dn of the longitudinally movable drive component 131110, which corresponds to a unique position of the first jaw 131002 between the open configuration and the closed configuration.

在各个方面，传感器布置7002的位置传感器7012可包括例如一个或多个磁性传感器、模拟旋转传感器(如电位差计)、模拟霍尔效应元件阵列等，它们输出位置信号或值的唯一组合。In various aspects, the position sensor 7012 of the sensor arrangement 7002 may include, for example, one or more magnetic sensors, analog rotation sensors (such as potentiometers), analog Hall effect element arrays, etc., which output a unique combination of position signals or values.

在各个方面，用手动驱动纵向可运动驱动构件131110的手动触发器代替马达131102。手动触发器可以是超声外科器械的柄部的一部分。在此类方面，绝对定位系统7000被配置为跟踪纵向可运动驱动构件131110的手动推进和缩回。In various aspects, the motor 131102 is replaced with a manual trigger that manually drives the longitudinally movable drive member 131110. The manual trigger can be part of the handle of the ultrasonic surgical instrument. In such aspects, the absolute positioning system 7000 is configured to track the manual advancement and retraction of the longitudinally movable drive member 131110.

在各个方面，微控制器7004可被编程为执行各种功能，诸如对第一钳口131002的速度和位置进行精确控制。利用已知的物理特性，微控制器7004可以被设计成确定第一钳口131002的位置和/或第一钳口131002在其整个运动范围内的运动速率，这可以进一步用于确定第一钳口131002的当前闭合阶段。在提交于2013年3月14日的美国专利申请序列号13/803,210(标题为用于外科器械的绝对定位系统的传感器布置(SENSOR ARRANGEMENTSFOR ABSOLUTE POSITIONING SYSTEM FOR SURGICAL INSTRUMENTS)，其以引用方式全文据此并入本文)中公开了关于绝对定位系统的其它细节。In various aspects, the microcontroller 7004 can be programmed to perform various functions, such as precisely controlling the speed and position of the first jaw 131002. Using known physical properties, the microcontroller 7004 can be designed to determine the position of the first jaw 131002 and/or the rate of movement of the first jaw 131002 throughout its range of motion, which can be further used to determine the current closure stage of the first jaw 131002. Additional details about the absolute positioning system are disclosed in U.S. patent application serial number 13/803,210 filed on March 14, 2013 (titled SENSOR ARRANGEMENTS FOR ABSOLUTE POSITIONING SYSTEM FOR SURGICAL INSTRUMENTS), which is hereby incorporated by reference in its entirety.

在某些方面，闭合阶段由可以存储在控制电路(例如，图13-15、图17-19)的存储介质中的预定位置定义或表征。位置传感器7012将指示纵向可运动驱动构件131110沿其运动范围的位置的传感器信号传输到控制电路。由于纵向可运动驱动构件131110的位置对应于第一钳口131002的位置，因此控制电路可基于所接收的传感器信号以及存储在存储介质中的预定位置数据来评估端部执行器131000的闭合阶段。In some aspects, the closing stage is defined or characterized by a predetermined position that can be stored in a storage medium of the control circuit (e.g., FIGS. 13-15 , 17-19 ). The position sensor 7012 transmits a sensor signal indicating the position of the longitudinally movable drive member 131110 along its range of motion to the control circuit. Since the position of the longitudinally movable drive member 131110 corresponds to the position of the first jaw 131002, the control circuit can evaluate the closing stage of the end effector 131000 based on the received sensor signal and the predetermined position data stored in the storage medium.

例如，第一闭合阶段的跨度可覆盖第一位置范围，而第二闭合阶段的跨度可覆盖超出第一位置范围的第二位置范围。因此，来自位置传感器7012的指示纵向可运动驱动构件131110的位置在第一位置范围内的传感器信号使处理器7008确定端部执行器131000处于第一闭合阶段，并因此选择第一能量操作模式。在另一方面，来自位置传感器7012的指示纵向可运动驱动构件131110的位置在第二位置范围内的传感器信号使处理器7008确定端部执行器131000处于第二闭合阶段，并因此选择不同于第一能量操作模式的第二能量操作模式。如上所述，第二能量操作模式可产生足以密封和凝结组织的第二能量输出，而第一能量操作模式可产生足以分离组织但不足以密封和凝结组织的第一能量输出。For example, the span of the first closing stage may cover a first position range, while the span of the second closing stage may cover a second position range beyond the first position range. Therefore, the sensor signal from the position sensor 7012 indicating that the position of the longitudinally movable drive member 131110 is within the first position range causes the processor 7008 to determine that the end effector 131000 is in the first closing stage, and thus selects the first energy operation mode. On the other hand, the sensor signal from the position sensor 7012 indicating that the position of the longitudinally movable drive member 131110 is within the second position range causes the processor 7008 to determine that the end effector 131000 is in the second closing stage, and thus selects a second energy operation mode different from the first energy operation mode. As described above, the second energy operation mode may generate a second energy output sufficient to seal and coagulate tissue, while the first energy operation mode may generate a first energy output sufficient to separate tissue but insufficient to seal and coagulate tissue.

端部执行器131000的闭合阶段的另一个识别特征包括闭合速度。马达131102(图80)可以被配置为以恒定速度促动纵向驱动第一钳口131002的可运动驱动构件131110。然而，随着第一钳口131002与组织“T”相互作用，闭合速度可根据与第一钳口131002相互作用的组织“T”部分的特征而变化。因此，闭合速度的变化可以是端部执行器131000的闭合阶段的识别特征。闭合速度可随着端部执行器131000从一个组织部分转变到另一个组织部分(例如，从适合组织分离的组织部分转变到适合组织密封的组织部分)而改变。第一钳口131002的运动速率的变化可以指示组织密封和凝结之前的组织分离的完成。Another identification feature of the closing stage of the end effector 131000 includes the closing speed. The motor 131102 (Figure 80) can be configured to actuate the movable drive member 131110 of the first jaw 131002 at a constant speed to drive the longitudinal direction. However, as the first jaw 131002 interacts with the tissue "T", the closing speed may vary according to the characteristics of the tissue "T" portion interacting with the first jaw 131002. Therefore, the change in closing speed can be an identification feature of the closing stage of the end effector 131000. The closing speed can change as the end effector 131000 transitions from one tissue portion to another (e.g., from a tissue portion suitable for tissue separation to a tissue portion suitable for tissue sealing). The change in the movement rate of the first jaw 131002 can indicate the completion of tissue separation before tissue sealing and coagulation.

在某些方面，闭合阶段由可以存储在控制电路(例如，图13-15、图17-19)的存储介质中的预定运动速率定义或表征。可以基于位置传感器7012的传感器信号来确定纵向可运动驱动构件131110的运动速率，其对应于第一钳口131002的运动速率。在某些方面，纵向可运动驱动构件131110的运动速率的变化指示从第一闭合阶段到第二闭合阶段的转变，这可使控制电路从第一能量操作模式切换到第二能量操作模式。In some aspects, the closing phase is defined or characterized by a predetermined movement rate that can be stored in a storage medium of the control circuit (e.g., FIGS. 13-15 , 17-19 ). The movement rate of the longitudinally movable drive member 131110 can be determined based on the sensor signal of the position sensor 7012, which corresponds to the movement rate of the first jaw 131002. In some aspects, a change in the movement rate of the longitudinally movable drive member 131110 indicates a transition from the first closing phase to the second closing phase, which can cause the control circuit to switch from the first energy operation mode to the second energy operation mode.

端部执行器131000的闭合阶段的另一个识别特征包括夹持负载。像闭合速度一样，由端部执行器131000施加在组织“T”上的负载可根据与第一钳口131002相互作用的组织“T”部分的特征而变化。因此，夹持负载的变化可以是端部执行器131000的闭合阶段的识别特征。夹持负载可随着端部执行器131000从一个组织部分转变到另一个组织部分(例如，从适合组织分离的组织部分转变到适合组织密封的组织部分)而改变。夹持负载的变化可以指示组织密封和凝结之前的组织分离的完成。Another identifying feature of the closing phase of the end effector 131000 includes a clamping load. Like the closing speed, the load applied by the end effector 131000 on the tissue "T" can vary depending on the characteristics of the portion of the tissue "T" interacting with the first jaw 131002. Therefore, a change in the clamping load can be an identifying feature of the closing phase of the end effector 131000. The clamping load can change as the end effector 131000 transitions from one tissue portion to another (e.g., from a tissue portion suitable for tissue separation to a tissue portion suitable for tissue sealing). The change in the clamping load can indicate the completion of tissue separation prior to tissue sealing and coagulation.

图81为根据本公开的至少一个方面的描绘用于在电外科器械的能量操作模式之间切换的控制程序或逻辑配置的过程131070的逻辑流程图。过程131070包括检测131072端部执行器131000的闭合速度和夹持负载。可以经由绝对定位系统7000监测闭合速度。可以使用传感器8406、8408a、8408b来确定夹持负载，如结合图51、52所述。传感器8406、8408a、8408b经由接口电路电连接到控制电路，诸如控制电路7400(图49)。过程131070还包括确定131074闭合速度是否已经改变超过预定阈值。执行过程131070的控制电路的存储介质可存储预定阈值的值。可以将当前闭合速度与预定阈值进行比较，以确定当前闭合速度是否达到或超过预定阈值。过程131070还确定131076夹持负载是否已经改变超过预定阈值。执行过程131070的控制电路的存储介质可存储预定阈值的值。可以将当前夹持负载与预定阈值进行比较，以确定当前夹持负载是否达到或超过预定阈值。这两个事件中的任何一个发生都会使过程131070从组织分离能量模式切换131078到组织密封能量模式。FIG. 81 is a logic flow diagram of a process 131070 of a control program or logic configuration for switching between energy operation modes of an electrosurgical instrument according to at least one aspect of the present disclosure. The process 131070 includes detecting 131072 the closing speed and clamping load of the end effector 131000. The closing speed can be monitored via the absolute positioning system 7000. The clamping load can be determined using sensors 8406, 8408a, 8408b, as described in conjunction with FIGS. 51 and 52. The sensors 8406, 8408a, 8408b are electrically connected to a control circuit, such as the control circuit 7400 (FIG. 49), via an interface circuit. The process 131070 also includes determining 131074 whether the closing speed has changed by more than a predetermined threshold. The storage medium of the control circuit executing the process 131070 can store the value of the predetermined threshold. The current closing speed can be compared with the predetermined threshold to determine whether the current closing speed reaches or exceeds the predetermined threshold. The process 131070 also determines 131076 whether the clamp load has changed by more than a predetermined threshold. The storage medium of the control circuitry executing the process 131070 may store the value of the predetermined threshold. The current clamp load may be compared to the predetermined threshold to determine whether the current clamp load has reached or exceeded the predetermined threshold. The occurrence of either of these two events causes the process 131070 to switch 131078 from the tissue separation energy mode to the tissue sealing energy mode.

在各种情况下，端部执行器131000可以是适于与超声外科器械1104一起使用的超声端部执行器、适于与RF电外科器械1106一起使用的RF端部执行器或适于与多功能外科器械1108一起使用的组合端部执行器的形式，如结合图17-19、图22-24所述。器械1104、1106、1108中的任何一个都可以被配置为执行过程131020、131030、131040、131050、131070中的一个或多个，如上所述。In various cases, the end effector 131000 can be in the form of an ultrasonic end effector suitable for use with an ultrasonic surgical instrument 1104, an RF end effector suitable for use with an RF electrosurgical instrument 1106, or a combined end effector suitable for use with a multifunctional surgical instrument 1108, as described in conjunction with Figures 17-19, 22-24. Any of the instruments 1104, 1106, 1108 can be configured to perform one or more of the processes 131020, 131030, 131040, 131050, 131070, as described above.

在端部执行器131000是超声端部执行器的形式的示例中，钳口131002、131004可以是夹持构件和超声刀的形式。夹持构件可以相对于超声刀运动以将组织抓握在它们之间。如上面更详细地描述，超声发生器可被激活以将功率施加到超声换能器，该超声换能器经由超声波导在声学上联接到超声刀。In an example where the end effector 131000 is in the form of an ultrasonic end effector, the jaws 131002, 131004 can be in the form of a clamping member and an ultrasonic blade. The clamping member can move relative to the ultrasonic blade to grasp the tissue between them. As described in more detail above, the ultrasonic generator can be activated to apply power to the ultrasonic transducer, which is acoustically coupled to the ultrasonic blade via an ultrasonic waveguide.

在各个方面，可首先在第一闭合阶段期间设置第一超声频率，以在第二闭合阶段期间在施加第二超声频率之前以机械方式分离血管的肌肉组织层，从而切割和密封血管。In various aspects, a first ultrasonic frequency may be initially set during a first sealing stage to mechanically separate the muscle tissue layer of the blood vessel before applying a second ultrasonic frequency during a second sealing stage to cut and seal the blood vessel.

超声发生器模块被编程为在第一闭合阶段期间输出第一驱动频率f1，其中第一频率f1是显著偏离的共振频率，例如fo/2、2fo或其它结构共振频率，其中fo是共振频率(例如，55.5kHz)。第一频率f1结合夹持力向超声刀提供低水平的机械振动作用，以机械方式分离血管的肌肉组织层(子治疗)而不引起共振时通常发生的显著发热现象。在第二闭合阶段期间，超声发生器模块被编程为自动将驱动频率切换到共振频率fo以横切和密封血管。The ultrasonic generator module is programmed to output a first drive frequency f1 during the first closing phase, wherein the first frequency f1 is a significantly deviated resonant frequency, such as fo/2, 2fo or other structural resonant frequencies, where fo is the resonant frequency (e.g., 55.5kHz). The first frequency f1 combines with the clamping force to provide a low level of mechanical vibration to the ultrasonic blade to mechanically separate the muscle tissue layer of the blood vessel (sub-treatment) without causing significant heating phenomena that usually occur during resonance. During the second closing phase, the ultrasonic generator module is programmed to automatically switch the drive frequency to the resonant frequency fo to transect and seal the blood vessel.

在各个方面，超声外科器械连接到与基于云的系统相互作用的外科集线器，如结合图1-11所述。在此类情况下，电外科器械的控制电路可接收关于由外科集线器和/或基于云的系统收集的各种态势参数的输入。此类输入在选择合适的能量操作模式时可能是有用的。此外，可以使换能器生成的能量水平具体地适应于所治疗的组织的类型。态势参数包括但不限于组织类型、组织解剖位置和/或组织组分。例如，肝脏或其它实体器官中组织分离所需的能量可能不同于其它器官。此外，可以增加用于组织分离的能量水平以适应如外科集线器所报道的组织粘附或其它不定结缔组织。在标题“态势感知”下描述了有关外科集线器、基于云的系统和各种外科器械的态势感知的其它细节。In various aspects, ultrasonic surgical instruments are connected to a surgical hub that interacts with a cloud-based system, as described in conjunction with FIGS. 1-11. In such cases, the control circuit of the electrosurgical instrument may receive inputs about various situation parameters collected by the surgical hub and/or the cloud-based system. Such inputs may be useful in selecting a suitable energy operation mode. In addition, the energy level generated by the transducer may be specifically adapted to the type of tissue being treated. Situation parameters include, but are not limited to, tissue type, tissue anatomical location, and/or tissue component. For example, the energy required for tissue separation in the liver or other solid organs may be different from that in other organs. In addition, the energy level used for tissue separation may be increased to adapt to tissue adhesion or other adventitious connective tissues as reported by the surgical hub. Other details of situation awareness related to the surgical hub, cloud-based systems, and various surgical instruments are described under the heading "Situation Awareness".

控制电外科器械的不同机电系统Control of different electromechanical systems for electrosurgical instruments

各种外科器械包括端部执行器，该端部执行器夹持组织并向被夹持的组织施加RF能量、超声能量或RF能量和超声能量的组合，如结合图22-24所述。最佳的组织治疗是通过仔细调制对组织的能量施加以及组织压缩来实现的，而这些是通过影响彼此对组织的效果的单独系统实现的。例如，对组织的能量施加可能受到组织含水量的影响，含水量受到施加到组织的压缩的影响。增加施加到组织的压缩会增加组织含水量流出被端部执行器夹持的组织的速度，进而影响组织导电性。Various surgical instruments include an end effector that clamps tissue and applies RF energy, ultrasonic energy, or a combination of RF energy and ultrasonic energy to the clamped tissue, as described in conjunction with Figures 22-24. Optimal tissue treatment is achieved by carefully modulating the application of energy to the tissue and the compression of the tissue, which are achieved by separate systems that influence each other's effects on the tissue. For example, the application of energy to the tissue may be affected by the water content of the tissue, which is affected by the compression applied to the tissue. Increasing the compression applied to the tissue increases the rate at which the tissue water content flows out of the tissue clamped by the end effector, thereby affecting the conductivity of the tissue.

本公开的各方面提供了用于调制电外科器械的系统的各种过程，这些系统单独作用于组织，但对组织具有相关影响。使用同一参数来调制电外科器械的对组织具有相关影响的单独系统确保了系统对组织的效果的一致性。换句话讲，依靠同一参数来协调这类系统的操作可以实现对组织更好相关的效果。Various aspects of the present disclosure provide various processes for modulating systems of electrosurgical instruments that act on tissue individually but have correlated effects on the tissue. Using the same parameters to modulate the individual systems of electrosurgical instruments that have correlated effects on tissue ensures consistency in the effects of the systems on the tissue. In other words, relying on the same parameters to coordinate the operation of such systems can achieve better correlated effects on tissue.

在某些方面，公开的一个或多个过程可以由电外科器械的控制电路(诸如外科器械700的控制电路710和/或外科器械750、790的控制电路760)执行。在某些方面，如图13中所示，用于执行一个或多个过程的控制电路可包括联接到至少一个存储器电路504的一个或多个处理器502(例如，微处理器、微控制器)，该至少一个存储器电路存储程序指令，这些程序指令在被处理器502执行时使得处理器502执行所述一个或多个过程。另选地，一个或多个过程可以由图14、15中描绘的一个或多个控制电路执行。在某些方面，电外科器械可包括存储用于执行一个或多个过程的一种或多种算法的非暂态存储介质。In some aspects, one or more processes disclosed may be performed by a control circuit of an electrosurgical instrument, such as the control circuit 710 of surgical instrument 700 and/or the control circuit 760 of surgical instruments 750, 790. In some aspects, as shown in FIG. 13, the control circuit for performing one or more processes may include one or more processors 502 (e.g., microprocessors, microcontrollers) coupled to at least one memory circuit 504, the at least one memory circuit storing program instructions that, when executed by the processor 502, cause the processor 502 to perform the one or more processes. Alternatively, one or more processes may be performed by one or more control circuits depicted in FIGS. 14, 15. In some aspects, an electrosurgical instrument may include a non-transitory storage medium storing one or more algorithms for performing one or more processes.

图82为根据本公开的至少一个方面的描绘用于调制外科器械(例如，外科器械700、750、790、1104、1106、1108)的系统的控制程序或逻辑配置的过程131100的逻辑流程图。过程131100监测131101外科器械的参数。在各个示例中，电外科器械包括端部执行器131000。在某些示例中，该参数是由端部执行器131000抓握的组织的阻抗。在另一个示例中，该参数是所抓握的组织的温度。82 is a logic flow diagram depicting a process 131100 of a control program or logic configuration for modulating a system of surgical instruments (e.g., surgical instruments 700, 750, 790, 1104, 1106, 1108) in accordance with at least one aspect of the present disclosure. The process 131100 monitors 131101 a parameter of a surgical instrument. In various examples, the electrosurgical instrument includes an end effector 131000. In some examples, the parameter is the impedance of tissue grasped by the end effector 131000. In another example, the parameter is the temperature of the grasped tissue.

过程131100进一步响应于达到或超过131106参数的上限预定阈值而引起递送到组织的能量的变化131104。过程131100进一步响应于达到或超过131109参数的下限预定阈值而引起递送到外科器械的马达(例如，马达603、704a、754)的能量的变化131108。马达可操作地联接到端部执行器131000，使得递送到马达的能量使马达使端部执行器131000朝向闭合构型转变。因此，过程131100响应于达到或超过131109参数的下限预定阈值而实现端部执行器闭合的变化。The process 131100 further causes a change 131104 in energy delivered to the tissue in response to reaching or exceeding an upper predetermined threshold of the parameter 131106. The process 131100 further causes a change 131108 in energy delivered to a motor (e.g., motor 603, 704a, 754) of the surgical instrument in response to reaching or exceeding a lower predetermined threshold of the parameter 131109. The motor is operably coupled to the end effector 131000 such that the energy delivered to the motor causes the motor to transition the end effector 131000 toward a closed configuration. Thus, the process 131100 effects a change in end effector closure in response to reaching or exceeding a lower predetermined threshold of the parameter 131109.

在图82的示例中，通过改变递送到马达的能量来实现端部执行器闭合的变化。在其它情况下，例如可以通过齿轮箱组件来不同地实现端部执行器闭合的变化。离合器机构可以被配置为接合齿轮箱组件或与其脱离接合，以便增加或减小联接到马达的驱动轴的速度，继而引起端部执行器闭合的期望变化。In the example of FIG. 82 , the change in end effector closure is achieved by varying the energy delivered to the motor. In other cases, the change in end effector closure may be achieved differently, such as by a gearbox assembly. The clutch mechanism may be configured to engage or disengage the gearbox assembly in order to increase or decrease the speed of the drive shaft coupled to the motor, which in turn causes the desired change in end effector closure.

在组织阻抗(Z)是监测参数的情况下，可以通过如结合图18、19、21、78A所述的一个或多个传感器来监测组织阻抗(Z)。例如，端部执行器131000可以配备有图78A的组织接触电路，其中组织“T”被夹持在板P1、P2之间。可以基于下式计算组织阻抗(Z_组织)：Where tissue impedance (Z) is a monitored parameter, the tissue impedance (Z) may be monitored by one or more sensors as described in conjunction with FIGS. 18, 19, 21, 78A. For example, the end effector 131000 may be equipped with the tissue contact circuit of FIG. 78A, wherein tissue "T" is clamped between plates P1, P2. The tissue impedance (_Ztissue ) may be calculated based on the following formula:

其中V是电压，I是电流，并且Z_感测电路是如图78A中所示的感测电路“SC”的预定阻抗。在各个示例中，如结合图21所示，可通过将第二电压感测电路924的输出除以电流感测电路914的输出来测量组织阻抗(Z)。Where V is voltage, I is current, and Z_{sensing circuit} is a predetermined impedance of the sensing circuit "SC" as shown in FIG78A. In various examples, as shown in conjunction with FIG21, the tissue impedance (Z) can be measured by dividing the output of the second voltage sensing circuit 924 by the output of the current sensing circuit 914.

在组织阻抗(Z)为监测参数的情况下，可以通过一个或多个温度传感器来监测组织阻抗(Z)。另选地，可以确定组织温度，如上文结合图51-53所述，其中柔性电路8412可包括嵌入柔性电路8412的一层或多层中的温度传感器。一个或多个温度传感器可对称地或非对称地布置，并向超声驱动电路和/或RF驱动电路的控制电路提供组织8410温度反馈。在其它示例中，如结合图66A-66B所示，相位角和/或发生器驱动频率的变化可以用作超声刀的温度的间接或推断测量结果，该测量结果继而可以用于估计或推断被抓握在超声端部执行器的超声刀和夹持构件之间的组织的温度。Where tissue impedance (Z) is the monitored parameter, tissue impedance (Z) may be monitored by one or more temperature sensors. Alternatively, tissue temperature may be determined, as described above in conjunction with FIGS. 51-53 , where the flexible circuit 8412 may include a temperature sensor embedded in one or more layers of the flexible circuit 8412. The one or more temperature sensors may be arranged symmetrically or asymmetrically and provide tissue 8410 temperature feedback to the control circuitry of the ultrasound drive circuit and/or the RF drive circuit. In other examples, as shown in conjunction with FIGS. 66A-66B , the phase angle And/or changes in the generator drive frequency can be used as an indirect or inferred measurement of the temperature of the ultrasonic blade, which in turn can be used to estimate or infer the temperature of the tissue grasped between the ultrasonic blade and the clamping member of the ultrasonic end effector.

图83为根据本公开的至少一个方面的描绘用于调制电外科器械(例如，外科器械700、750、790、1104、1108)的系统的控制程序或逻辑配置的过程131120的另一个逻辑流程图。过程131120监测131121与电外科器械相关联的参数。如上文结合过程131120所述，该参数可以是与电外科器械相关联的阻抗或温度。过程131120进一步响应于达到或超过131126参数的上限预定阈值而引起电外科器械的第一机电系统的变化131124。过程131120进一步响应于达到或超过131129参数的下限预定阈值而引起电外科器械的不同于第一机电系统的第二机电系统的变化131128。FIG. 83 is another logic flow diagram depicting a process 131120 of a control program or logic configuration for a system for modulating an electrosurgical instrument (e.g., surgical instruments 700, 750, 790, 1104, 1108) in accordance with at least one aspect of the present disclosure. The process 131120 monitors 131121 a parameter associated with the electrosurgical instrument. As described above in connection with the process 131120, the parameter may be an impedance or a temperature associated with the electrosurgical instrument. The process 131120 further causes a change 131124 in a first electromechanical system of the electrosurgical instrument in response to reaching or exceeding 131126 an upper predetermined threshold value of the parameter. The process 131120 further causes a change 131128 in a second electromechanical system of the electrosurgical instrument that is different from the first electromechanical system in response to reaching or exceeding 131129 a lower predetermined threshold value of the parameter.

图84为示出结合包括图23的超声端部执行器1122的超声外科器械实施过程131120的曲线图131130。第一机电系统由换能器1120和超声刀1128表示，该超声片经由波导在声学上联接到超声换能器1120。超声换能器1120可以用发生器1100通电。当被超声换能器1120驱动时，超声刀1128可振动，并且当与组织接触时，可切割和/或凝结组织，如本文所述。FIG84 is a graph 131130 illustrating an implementation 131120 of an ultrasonic surgical instrument incorporating the ultrasonic end effector 1122 of FIG23. The first electromechanical system is represented by the transducer 1120 and an ultrasonic blade 1128, which is acoustically coupled to the ultrasonic transducer 1120 via a waveguide. The ultrasonic transducer 1120 can be energized with the generator 1100. When driven by the ultrasonic transducer 1120, the ultrasonic blade 1128 can vibrate and, when in contact with tissue, can cut and/or coagulate tissue as described herein.

第二机电系统由端部执行器1122的马达驱动的夹持臂1140表示。结合图46-50更详细地描述了超声外科器械的夹持臂的机动化运动。夹持臂1140可以可操作地联接到马达，该马达可驱动夹持臂1140使端部执行器1122在打开构型和闭合构型之间转变，以将组织夹持在夹持臂1122和超声刀1128之间。The second electromechanical system is represented by a clamping arm 1140 driven by the motor of the end effector 1122. The motorized movement of the clamping arm of the ultrasonic surgical instrument is described in more detail in conjunction with Figures 46-50. The clamping arm 1140 can be operably connected to a motor that can drive the clamping arm 1140 to transform the end effector 1122 between an open configuration and a closed configuration to clamp tissue between the clamping arm 1122 and the ultrasonic blade 1128.

参考图84，曲线图131130包括示出在Y轴上相对于X轴上的时间(t)绘制的组织阻抗(Z)、功率(P)和力(F)的三条曲线131132、131134、131136。力(F)在端部执行器1122的远侧部分(末端)确定。上限阈值和下限阈值在阻抗曲线131132中定义。在t₁和t₄处，当阻抗(Z)达到或超过阻抗曲线131132中定义的上限阈值时，在功率曲线131134中调节功率(P)。因此，递送到第一电外科系统的换能器1120的能量由阻抗(Z)参数的上限阈值控制。在t₂和t₃处，当阻抗值达到或超过阻抗曲线131132中定义的下限阈值时，在力曲线131136中调节末端力(F)。因此，由夹持构件1122施加到组织上的力由阻抗(Z)参数的下限阈值控制。Referring to FIG. 84 , a graph 131130 includes three curves 131132, 131134, 131136 showing tissue impedance (Z), power (P), and force (F) plotted on the Y-axis relative to time (t) on the X-axis. The force (F) is determined at the distal portion (tip) of the end effector 1122. An upper threshold and a lower threshold are defined in the impedance curve 131132. At_t1 and_t4 , when the impedance (Z) reaches or exceeds the upper threshold defined in the impedance curve 131132, the power (P) is adjusted in the power curve 131134. Thus, the energy delivered to the transducer 1120 of the first electrosurgical system is controlled by the upper threshold of the impedance (Z) parameter. At_t2 and_t3 , when the impedance value reaches or exceeds the lower threshold defined in the impedance curve 131132, the tip force (F) is adjusted in the force curve 131136. Thus, the force applied to the tissue by the clamping member 1122 is controlled by the lower threshold of the impedance (Z) parameter.

在各个示例中，当组织阻抗(Z)达到或超过下限阈值时，可以改变递送到马达的电流(I)，以便实现由夹持构件1122施加到组织上的力变化。在至少一个示例中，如图84中所示，当组织阻抗(Z)达到或超过下限预定阈值时，可以增加马达电流(I)以增加施加到组织的夹持力。In various examples, when the tissue impedance (Z) reaches or exceeds a lower threshold, the current (I) delivered to the motor can be changed to achieve a change in the force applied to the tissue by the clamping member 1122. In at least one example, as shown in FIG. 84, when the tissue impedance (Z) reaches or exceeds a lower predetermined threshold, the motor current (I) can be increased to increase the clamping force applied to the tissue.

由于超声外科器械的夹持臂的枢转运动，施加到在钳口之间定位在近侧的组织的压缩比施加到在钳口之间定位在远侧的组织更多。钳口的远侧部分处组织压缩减小可将钳口的远侧部分处组织的热通量降低到有效治疗组织所需的阈值水平以下。Due to the pivoting motion of the clamp arm of the ultrasonic surgical instrument, more compression is applied to tissue positioned proximally between the jaws than to tissue positioned distally between the jaws. Reduced tissue compression at the distal portion of the jaws can reduce the heat flux to the tissue at the distal portion of the jaws below a threshold level required to effectively treat the tissue.

在各个方面，夹持臂可以配备有组织感测电路，该组织感测电路被配置为确定夹持在端部执行器的钳口之间的组织的位置。在提交于2011年6月27日的美国专利号8,181,839(标题为采用传感器的外科器械(SURGICAL INSTRUMENT EMPLOYING SENSORS)，其发布于2012年5月5日，其全部公开内容以引用方式并入本文)中进一步描述了合适的组织感测电路的示例。在提交于2018年3月30日的美国临时申请号62/650,887(标题为具有优化感测能力的外科系统(SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES)，其以引用方式全文据此并入本文)中也描述了各种组织感测技术。在至少一个示例中，组织感测电路包括间隔开的两个电极。当组织与两个电极接触时，组织感测电路闭合，使指示组织存在的传感器信号被传输到控制电路(例如，图13-14、图17-19)。In various aspects, the clamping arm can be equipped with a tissue sensing circuit that is configured to determine the position of the tissue clamped between the jaws of the end effector. Examples of suitable tissue sensing circuits are further described in U.S. Patent No. 8,181,839, filed on June 27, 2011, entitled SURGICAL INSTRUMENT EMPLOYING SENSORS, which was issued on May 5, 2012, and the entire disclosure of which is incorporated herein by reference. Various tissue sensing technologies are also described in U.S. Provisional Application No. 62/650,887, filed on March 30, 2018, entitled SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES, which is hereby incorporated herein by reference in its entirety. In at least one example, the tissue sensing circuit includes two electrodes spaced apart. When tissue is in contact with the two electrodes, the tissue sensing circuit is closed, causing a sensor signal indicative of the presence of tissue to be transmitted to the control circuit (eg, FIGS. 13-14 , 17 - 19 ).

可以基于检测到的组织位置来调节夹持臂负载。例如，在组织集中在钳口的远侧部分的情况下，可以施加较高的负载。可以维持较高的夹持臂负载，直到钳口的远侧部分处的夹持组织几乎完全凝结为止。然后减小夹持臂负载，以避免将超声刀驱动到夹持臂的垫中。在一个示例中，可以维持较高的夹持臂负载，至高达夹持臂和超声刀之间的预定角距离。一旦夹持臂达到或超过预定角距离，就减小夹持臂负载。The clamp arm load can be adjusted based on the detected tissue position. For example, in the case where the tissue is concentrated in the distal portion of the jaws, a higher load can be applied. The higher clamp arm load can be maintained until the clamped tissue at the distal portion of the jaws is almost completely coagulated. The clamp arm load is then reduced to avoid driving the ultrasonic blade into the pad of the clamp arm. In one example, a higher clamp arm load can be maintained up to a predetermined angular distance between the clamp arm and the ultrasonic blade. Once the clamp arm reaches or exceeds the predetermined angular distance, the clamp arm load is reduced.

在某些方面，结合组合装置，可以将RF能量与夹持臂负载的调制混合，以便提供足够的热通量来凝结集中在钳口的远侧末端部分处的组织。In certain aspects, in conjunction with a combined device, RF energy may be mixed with modulation of the clamp arm load to provide sufficient heat flux to coagulate tissue concentrated at the distal tip portion of the jaws.

检测端部执行器在液体中的出现Detecting the presence of an end effector in a liquid

与超声刀浸入液体相关联的频率响应类似于与夹持在夹持构件和超声刀之间的厚组织相关联的频率响应。为了避免发生器错误地触发特定于厚组织的组织治疗，希望检测超声刀何时浸入液体中。The frequency response associated with the ultrasonic blade being immersed in liquid is similar to the frequency response associated with thick tissue clamped between the clamping member and the ultrasonic blade. In order to avoid the generator from erroneously triggering tissue treatment specific to thick tissue, it is desirable to detect when the ultrasonic blade is immersed in liquid.

如上面结合图70A-71所述，超声外科器械或包括超声部件的组合电外科器械被配置为通过检测其超声刀的温度显著低于预定阈值来检测超声刀在液体(例如，血液、盐水、水等)中的浸入。As described above in conjunction with Figures 70A-71, an ultrasonic surgical instrument or a combined electrosurgical instrument including an ultrasonic component is configured to detect immersion of an ultrasonic blade in a liquid (e.g., blood, saline, water, etc.) by detecting that the temperature of its ultrasonic blade is significantly below a predetermined threshold.

如前所述，超声刀的温度可通过检测由以下表达式给出的超声换能器的阻抗来推断：As mentioned previously, the temperature of the ultrasonic blade can be inferred by detecting the impedance of the ultrasonic transducer given by the following expression:

或换句话讲，通过检测施加到超声换能器的电压V_g(t)信号和电流I_g(t)信号之间的相位角来推断。相位角信息也可用于推断超声刀的条件。如本文所具体讨论，相位角作为超声刀的温度的函数而变化。因此，相位角信息可用于控制超声刀的温度。Or in other words, by detecting the phase angle between the voltage V_g (t) signal and the current I_g (t) signal applied to the ultrasonic transducer To infer. Phase angle The information can also be used to infer the condition of the ultrasonic knife. As discussed in detail in this article, the phase angle As a function of the temperature of the ultrasonic blade, the phase angle The information can be used to control the temperature of the ultrasonic scalpel.

图70A-70B为用于在检测到超声刀的温度骤降时调节施加到超声换能器的超声功率的温度反馈控制的图形表示。超声刀的温度随着施加功率133072而增加，如图70A中所示。在使用期间，超声刀的温度突然下降。可推断当超声刀浸入充满流体的外科区域(例如，血液、盐水、水等)中时，其温度会下降。Figures 70A-70B are graphical representations of temperature feedback control for adjusting the ultrasonic power applied to the ultrasonic transducer when a sudden drop in the temperature of the ultrasonic blade is detected. The temperature of the ultrasonic blade increases with the applied power 133072, as shown in Figure 70A. During use, the temperature of the ultrasonic blade suddenly drops. It can be inferred that when the ultrasonic blade is immersed in a surgical area filled with fluid (e.g., blood, saline, water, etc.), its temperature will drop.

超声刀浸入液体中会导致超声刀产生的一部分热量散失到液体中。因此，浸入增加了进行有效治疗诸如组织凝结所需的热通量。为了将热通量调制到足以进行有效治疗的水平，发生器对递送到超声换能器的功率进行调制。Immersing the ultrasonic scalpel in a liquid causes a portion of the heat generated by the ultrasonic scalpel to be lost to the liquid. Therefore, immersion increases the heat flux required for effective treatment such as tissue coagulation. In order to modulate the heat flux to a level sufficient for effective treatment, the generator modulates the power delivered to the ultrasonic transducer.

在某些情况下，可采用RF能量和超声能量的混合来将热通量调节到足以进行有效治疗的水平。在某些情况下，可以对施加到外科器械的超声刀和夹持臂之间的组织的压缩力进行调制，以将热通量调节到足以进行有效治疗的水平。In some cases, a mixture of RF energy and ultrasonic energy may be used to adjust the heat flux to a level sufficient for effective treatment. In some cases, the compressive force applied to the tissue between the ultrasonic blade and the clamping arm of the surgical instrument may be modulated to adjust the heat flux to a level sufficient for effective treatment.

在另一方面，如图85中所示，可以根据波导/换能器的频率响应推断对超声刀浸入液体中的检测。On the other hand, as shown in Figure 85, detection of immersion of the ultrasonic blade in liquid can be inferred from the frequency response of the waveguide/transducer.

参考图85，功率(P)在诊断模式下(如曲线131140所示)和在响应模式下(如曲线131142中所示)被绘制为时间的函数。功率(P)绘制在竖直轴上，而时间(t)绘制在水平轴上。波导/换能器在液体中的频率响应与波导/换能器在空气中的理想频率响应不同，并且低于预定阈值曲线131141。当超声刀浸入液体中时，波导/换能器的频率响应曲线131143变平，而不是具有进行有效组织治疗的理想频率响应曲线131145中预期的特征增加和平坦区域。Referring to FIG. 85 , power (P) is plotted as a function of time in diagnostic mode (as shown in curve 131140) and in response mode (as shown in curve 131142). Power (P) is plotted on the vertical axis and time (t) is plotted on the horizontal axis. The frequency response of the waveguide/transducer in the liquid is different from the ideal frequency response of the waveguide/transducer in the air and is below a predetermined threshold curve 131141. When the ultrasonic scalpel is immersed in the liquid, the frequency response curve 131143 of the waveguide/transducer flattens, rather than having the characteristic increase and flat area expected in the ideal frequency response curve 131145 for effective tissue treatment.

图86为根据本公开的至少一个方面的描绘检测和补偿超声刀浸入液体中的控制程序或逻辑配置的过程131150的逻辑流程图。过程131150监测131152随时间推移递送到组织的功率，并将其与预定阈值进行比较。如图85中所示，过程131150可采样预定时间段内的功率变化(δP/δt)，并将其与预定阈值斜率进行比较。如果所确定的斜率(δp/δt)低于阈值斜率，则可以推断超声刀浸入使刀润湿/冷却的液体中，从而增加了刀进行有效治疗所需的热通量(曲线131145)。为了进行补偿131156，将更多的功率(曲线131147)递送到换能器。当通过液体的润湿效果进行调节时，将所增加的功率选择为足以产生理想频率响应(曲线131145)。但是，如果所确定的斜率(δp/δt)大于阈值斜率，则按计划继续到超声换能器的功率递送。FIG86 is a logic flow diagram of a process 131150 of a control program or logic configuration for detecting and compensating for the immersion of an ultrasonic blade in a liquid according to at least one aspect of the present disclosure. Process 131150 monitors 131152 the power delivered to the tissue over time and compares it with a predetermined threshold. As shown in FIG85 , process 131150 may sample the power change (δP/δt) over a predetermined time period and compare it with a predetermined threshold slope. If the determined slope (δp/δt) is lower than the threshold slope, it can be inferred that the ultrasonic blade is immersed in a liquid that wets/cools the blade, thereby increasing the heat flux required for the blade to perform effective treatment (curve 131145). In order to compensate 131156, more power (curve 131147) is delivered to the transducer. When adjusted by the wetting effect of the liquid, the increased power is selected to be sufficient to produce an ideal frequency response (curve 131145). However, if the determined slope (δp/δt) is greater than the threshold slope, power delivery to the ultrasound transducer continues as planned.

如图85的曲线131142中所示，响应于检测到超声端部执行器浸入流体中，将修改的功率曲线131147递送到组织。修改的功率曲线131147补偿了液体浸没。在曲线131142的示例中，修改的功率(P)曲线131147将递送到换能器的功率增加了预定因子/百分比，以便实现期望的功率曲线131145。As shown in curve 131142 of FIG85, in response to detecting that the ultrasonic end effector is immersed in the fluid, a modified power curve 131147 is delivered to the tissue. The modified power curve 131147 compensates for the liquid immersion. In the example of curve 131142, the modified power (P) curve 131147 increases the power delivered to the transducer by a predetermined factor/percentage to achieve the desired power curve 131145.

在另一方面，可以通过端部执行器中的液体感测电路来确定对端部执行器浸入液体中的检测。液体感测电路可在端部执行器上包括两个电极，这两个电极可以定位在单独的钳口上。另选地，电极可以定位同一钳口上。电极之间液体的存在完成了传输信号的电路，该信号可以用于检测端部执行器在液体中的浸入。响应于如上所述的检测，可以对递送给超声换能器的功率进行调制以补偿端部执行器浸入液体中的润湿/冷却效果。In another aspect, detection of immersion of the end effector in liquid can be determined by liquid sensing circuitry in the end effector. The liquid sensing circuitry can include two electrodes on the end effector, which can be positioned on separate jaws. Alternatively, the electrodes can be positioned on the same jaw. The presence of liquid between the electrodes completes a circuit that transmits a signal that can be used to detect immersion of the end effector in liquid. In response to detection as described above, the power delivered to the ultrasonic transducer can be modulated to compensate for the wetting/cooling effect of immersing the end effector in liquid.

根据端部执行器浸入液体中的程度和/或液体的温度，可以选择一种算法来补偿散失到液体中的热量，以便实现对组织的有效治疗。在至少一个示例中，可以如上所述对递送到超声换能器的功率(P)进行调制，以抵消浸没的影响。另选地，可以将压缩力施加到夹持臂和超声刀之间的组织，以抵消浸没的影响。在各个方面，可以对功率(P)和组织压缩两者进行调制，以抵消液体浸没的影响。混合的RF和超声能量模式也可以用于最小化浸没的影响，并且可以与增加超声功率、RF功率或夹持臂压力结合使用，以实现对组织的有效治疗。Depending on the degree of immersion of the end effector in the liquid and/or the temperature of the liquid, an algorithm can be selected to compensate for the heat lost to the liquid in order to achieve effective treatment of the tissue. In at least one example, the power (P) delivered to the ultrasonic transducer can be modulated as described above to offset the effects of immersion. Alternatively, a compressive force can be applied to the tissue between the clamping arm and the ultrasonic blade to offset the effects of immersion. In various aspects, both the power (P) and tissue compression can be modulated to offset the effects of liquid immersion. Mixed RF and ultrasonic energy modes can also be used to minimize the effects of immersion and can be used in conjunction with increasing ultrasonic power, RF power, or clamping arm pressure to achieve effective treatment of the tissue.

参考图87，曲线图131160描绘了作为控制端部执行器131000到闭合构型的转变的闭合驱动器(例如，图18、19的闭合构件764)位移的函数的由电外科器械的端部执行器131000(图73)递送到组织的功率(P)和由端部执行器131000抓握的组织的温度(T)。如本文所述，端部执行器131000通过抓握组织并向所抓握的组织施加RF能量和/或超声能量来治疗组织。87, a graph 131160 depicts the power (P) delivered to tissue by the end effector 131000 (FIG. 73) of an electrosurgical instrument and the temperature (T) of tissue grasped by the end effector 131000 as a function of the displacement of a closing actuator (e.g., closing member 764 of FIGS. 18, 19) that controls the transition of the end effector 131000 to a closed configuration. As described herein, the end effector 131000 treats tissue by grasping the tissue and applying RF energy and/or ultrasonic energy to the grasped tissue.

除上述之外，闭合驱动器可操作地联接到钳口131002、131004中的至少一者，并且可运动以使端部执行器131000在打开构型和闭合构型之间转变，以将组织夹持在钳口131002、131004之间。因此，闭合驱动器的运动可表示端部执行器131000的闭合运动或与其关联。因此，由端部执行器131000施加到钳口131002、131004之间捕获的组织的压缩力与闭合驱动器位移之间存在相关性。Further to the above, the closure driver may be operably coupled to at least one of the jaws 131002, 131004 and may be moved to transition the end effector 131000 between an open configuration and a closed configuration to clamp tissue between the jaws 131002, 131004. Thus, the movement of the closure driver may represent or be associated with the closing movement of the end effector 131000. Thus, there is a correlation between the compressive force applied by the end effector 131000 to the tissue captured between the jaws 131002, 131004 and the displacement of the closure driver.

曲线图131160表示端部执行器131000的组织治疗循环。功率(P)表示在左侧竖直轴上，温度(T)表示在右侧竖直轴上，而闭合驱动器位移或平移(δ)表示在水平轴上。曲线图131160的水平轴上的每个δ表示闭合驱动器从起始位置行进的距离。Graph 131160 represents a tissue treatment cycle of the end effector 131000. Power (P) is represented on the left vertical axis, temperature (T) is represented on the right vertical axis, and closure actuator displacement or translation (δ) is represented on the horizontal axis. Each δ on the horizontal axis of graph 131160 represents the distance traveled by the closure actuator from the starting position.

组织治疗循环的阶段由闭合驱动器位置定义。在各个方面，希望在组织治疗循环的一个或多个阶段将组织维持在期望的温度处或期望的温度范围内。可以对递送到组织的功率(P)进行调节，以保持对组织温度的严格控制。The phases of the tissue treatment cycle are defined by the closed actuator position. In various aspects, it is desirable to maintain the tissue at a desired temperature or within a desired temperature range during one or more phases of the tissue treatment cycle. The power (P) delivered to the tissue can be adjusted to maintain tight control of the tissue temperature.

在图87的示例中，初始阶段131162描绘了当闭合驱动器平移到δ1时，功率(P)逐渐增加到功率水平(P1)。然后在第一阶段131164将功率(P)保持在对应于约60℃的温度的功率水平(P1)。在该温度处，组织经历胶原蛋白变性。接近第一阶段131164结束，在第二阶段131166开始时又将功率水平升高到功率水平(P2)，其对应于60℃和100℃之间的温度。接近第二阶段131166结束，又将功率水平升高到功率水平(P4)，其被配置为使组织达到和/或超过100℃的温度。In the example of FIG. 87 , the initial stage 131162 depicts that when the closed drive is translated to δ1, the power (P) is gradually increased to a power level (P1). The power (P) is then maintained at a power level (P1) corresponding to a temperature of about 60° C. in the first stage 131164. At this temperature, the tissue undergoes collagen denaturation. Near the end of the first stage 131164, the power level is increased to a power level (P2) at the beginning of the second stage 131166, which corresponds to a temperature between 60° C. and 100° C. Near the end of the second stage 131166, the power level is increased to a power level (P4), which is configured to cause the tissue to reach and/or exceed a temperature of 100° C.

在水平轴上，第一阶段131164限定在δ1处的第一位置和δ2处的第二位置之间。当闭合驱动器平移到δ2处的第二位置时，将功率(P)保持在功率水平(P1)。将组织温度维持在60℃，以促进胶原蛋白变性。On the horizontal axis, the first stage 131164 is defined between a first position at δ1 and a second position at δ2. When the closing actuator translates to the second position at δ2, the power (P) is maintained at the power level (P1). The tissue temperature is maintained at 60°C to promote collagen denaturation.

第二阶段131166限定在δ2处的第二位置和δ3处的第三位置之间。当闭合驱动器平移到δ3处的第三位置时，将功率(P)保持在功率水平(P2)。在第二阶段131166期间，希望将组织温度保持在60℃和100℃之间，以尽量避免可能由100℃下所产生的蒸汽引起的对周围组织的附带损伤。但是，在某些情况下，如曲线图131160的曲线部分131168所示，组织温度可在闭合驱动器达到δ_最大之前过早地升高到100℃。在各个方面，如图87中所示，设定预定功率阈值(P3)，以防止组织过早地达到100℃的沸腾温度。The second stage 131166 is defined between a second position at δ2 and a third position at δ3. When the closing actuator translates to the third position at δ3, the power (P) is maintained at a power level (P2). During the second stage 131166, it is desirable to maintain the tissue temperature between 60°C and 100°C to minimize collateral damage to surrounding tissue that may be caused by steam generated at 100°C. However, in some cases, as shown in curve portion 131168 of graph 131160, the tissue temperature may rise to 100°C prematurely before the closing actuator reaches δmax. In various aspects, as shown in FIG. 87, a predetermined power threshold (P3) is set to prevent the tissue from prematurely reaching a boiling_temperature of 100°C.

图88为描绘当夹持臂转变到δ_最大处的闭合构型时将组织温度保持在100℃以下的控制程序或逻辑配置的过程131170的逻辑流程图。过程131170监测131172闭合驱动器位置和/或位移。在一个示例中，闭合驱动器位置和/或位移可以通过如结合图80更详细地描述的绝对定位系统7000来监测。FIG88 is a logic flow diagram depicting a process 131170 of a control program or logic configuration for maintaining tissue temperature below 100° C. when the clamp arm transitions to the closed configuration at delta_max . The process 131170 monitors 131172 the closing actuator position and/or displacement. In one example, the closing actuator position and/or displacement may be monitored by the absolute positioning system 7000 as described in more detail in conjunction with FIG80 .

过程131170还监测131172组织温度，该温度例如可以基于超声刀的温度来估计。如果端部执行器131000是超声端部执行器或组合端部执行器的形式，则超声刀温度可以通过检测由以下表达式给出的超声换能器的阻抗来确定：The process 131170 also monitors 131172 tissue temperature, which can be estimated based on the temperature of the ultrasonic blade, for example. If the end effector 131000 is in the form of an ultrasonic end effector or a combined end effector, the ultrasonic blade temperature can be determined by detecting the impedance of the ultrasonic transducer given by the following expression:

或换句话讲，通过检测施加到超声换能器的电压V_g(t)信号和电流I_g(t)信号之间的相位角来推断，如本文所述。另选地，端部执行器131000可以配备有用于测量组织温度的一个或多个温度传感器。Or in other words, by detecting the phase angle between the voltage V_g (t) signal and the current I_g (t) signal applied to the ultrasonic transducer Alternatively, the end effector 131000 can be equipped with one or more temperature sensors for measuring tissue temperature.

基于所监测的温度和位置信息，过程131170确定131174组织的温度是否将在闭合驱动器达到或超过δ_最大之前过早地达到或超过100℃，如曲线图131160的曲线部分131168所示。如果是，则过程131170将功率(P)调节131176到低于或等于预定功率阈值(P3)的水平，以便阻止组织的温度(T)在闭合驱动器达到或超过δ_最大之前达到100℃，如曲线部分131169中所示。Based on the monitored temperature and position information, the process 131170 determines 131174 whether the temperature of the tissue will prematurely reach or exceed 100° C. before the closed actuator reaches or exceeds Delta_Max , as shown in curve portion 131168 of graph 131160. If so, the process 131170 adjusts 131176 the power (P) to a level less than or equal to a predetermined power threshold (P3) in order to prevent the temperature (T) of the tissue from reaching 100° C. before the closed actuator reaches or exceeds Delta_Max , as shown in curve portion 131169.

在某些方面，过程131170可以至少部分地由控制电路(图13)执行，该控制电路包括联接到至少一个存储器电路504的一个或多个处理器502(例如，微处理器、微控制器)，该至少一个存储器电路存储程序指令，这些程序指令在被处理器502执行时使得处理器502执行过程131170。例如，控制电路可从绝对定位系统7000接收闭合驱动器位置信息。组织温度可以由处理器502根据温度传感器读数或所确定的超声刀温度来确定，如本文所述。In certain aspects, process 131170 can be performed at least in part by a control circuit (FIG. 13) comprising one or more processors 502 (e.g., microprocessors, microcontrollers) coupled to at least one memory circuit 504 storing program instructions that, when executed by the processor 502, cause the processor 502 to perform process 131170. For example, the control circuit can receive closure drive position information from the absolute positioning system 7000. Tissue temperature can be determined by the processor 502 based on temperature sensor readings or determined ultrasonic blade temperature, as described herein.

除上述之外，例如可以通过根据第二阶段131166结束时的位置、功率和/或温度数据计算温度轨迹来确定131174组织的温度是否将在关闭驱动器达到或超过δ_最大过早地达到或超过100℃。在一个示例中，例如，处理器502可以用于根据存储在存储器电路504中的一个或多个表和/或公式来计算温度轨迹。In addition to the above, it can be determined 131174 whether the temperature of the tissue will reach or exceed 100° C. prematurely before the driver is turned off by reaching or exceeding delta_max , for example, by calculating a temperature trajectory based on the position, power, and/or temperature data at the end of the second stage 131166. In one example, the processor 502 can be used to calculate the temperature trajectory based on one or more tables and/or formulas stored in the memory circuit 504, for example.

在各个方面，过程131170可以由图14、15中描绘的一个或多个控制电路执行。在某些方面，电外科器械可包括存储用于执行过程131170的一种或多种算法的非暂态存储介质。In various aspects, process 131170 can be performed by one or more control circuits depicted in FIGS. 14, 15. In certain aspects, an electrosurgical instrument can include a non-transitory storage medium storing one or more algorithms for performing process 131170.

在至少一个示例中，如图87中所示，在小于δ_最大的预定阈值位置δ3处达到或超过介于60℃和100℃之间的预定阈值温度T₁可以指示组织的温度将在闭合驱动器达到或超过δ_最大之前过早地达到或超过100℃。因此，如果所确定的温度在预定位置阈值δ3处大于或等于预定阈值温度T₁，则过程131170确定131174组织的温度将在闭合驱动器达到或超过δ_最大之间过早地达到或超过100℃。In at least one example, as shown in FIG87, reaching or exceeding a predetermined threshold temperature_T1 between 60° C. and 100° C. at a predetermined threshold position δ3 less_than δmax can indicate that the temperature of the tissue will prematurely reach or exceed 100° C._before the closing actuator reaches or exceeds δmax. Thus, if the determined temperature is greater than or equal to the predetermined threshold temperature_T1 at the predetermined position threshold δ3, the process 131170 determines 131174 that the temperature of the tissue will prematurely reach or exceed 100° C. before the closing actuator reaches or exceeds_δmax .

参考图89，曲线图131180包括四条曲线131182、131184、131186、131188。曲线131182表示电压(V)和电流(I)与时间(t)的关系，曲线131184表示功率(P)与时间(t)的关系，曲线131186表示温度(T)与时间(t)的关系，而曲线131188表示组织阻抗(Z)与时间(t)的关系。在曲线131188中，描绘了阻抗浴缸(例如，组织阻抗相对于时间最初减小、然后稳定且最终增加，该曲线类似于浴缸形状)。89, the graph 131180 includes four curves 131182, 131184, 131186, 131188. Curve 131182 represents the relationship between voltage (V) and current (I) and time (t), curve 131184 represents the relationship between power (P) and time (t), curve 131186 represents the relationship between temperature (T) and time (t), and curve 131188 represents the relationship between tissue impedance (Z) and time (t). In curve 131188, an impedance bathtub is depicted (e.g., tissue impedance initially decreases with respect to time, then stabilizes and finally increases, and the curve resembles a bathtub shape).

在此，时间零表示在外科部位向组织施加电外科能量的第一时间点。Y轴表示当向组织施加基本上恒定水平的功率(P)时(如曲线131184的对应部分中所示)存在的组织阻抗(Z)的水平。在时间零处，组织表现出初始阻抗水平(Z初始)。初始阻抗水平(Z初始)可基于关于组织的天然生理特性诸如密度、水分量以及其组织的类型。在短时间段内，阻抗水平实际上随着功率连续施加到组织而略微下降。最终达到最小阻抗水平(Z最小)。从此处开始，总阻抗水平增加。Here, time zero represents the first time point at which electrosurgical energy is applied to tissue at a surgical site. The Y-axis represents the level of tissue impedance (Z) that exists when a substantially constant level of power (P) is applied to the tissue (as shown in the corresponding portion of curve 131184). At time zero, the tissue exhibits an initial impedance level (Z initial). The initial impedance level (Z initial) can be based on natural physiological properties of the tissue such as density, amount of moisture, and type of tissue. Over a short period of time, the impedance level actually decreases slightly as power is continuously applied to the tissue. A minimum impedance level (Z min) is eventually reached. From this point on, the overall impedance level increases.

随着组织阻抗(Z)在时间(t1)内朝向最小组织阻抗(Z最小)减小，电流(I)增加且电压(V)减小。曲线131182中描绘的电流曲线对应于电压曲线L1。为了清楚起见，省略了对应于电压曲线L2和L3的电流曲线。在初始时间段(t1)期间，组织的温度逐渐升高到100℃。一旦组织中的水开始蒸发，组织阻抗(Z)就会显著增加，从而导致通过组织的电流(I)衰减。随着组织阻抗(Z)升高到100Ω，组织温度也升高到110℃，这构成了某些组织油的沸点。As tissue impedance (Z) decreases toward minimum tissue impedance (Zmin) over time (t1), current (I) increases and voltage (V) decreases. The current curve depicted in curve 131182 corresponds to voltage curve L1. For clarity, current curves corresponding to voltage curves L2 and L3 are omitted. During the initial time period (t1), the temperature of the tissue gradually increases to 100°C. Once the water in the tissue begins to evaporate, the tissue impedance (Z) increases significantly, causing the current (I) passing through the tissue to decay. As tissue impedance (Z) increases to 100Ω, the tissue temperature also increases to 110°C, which constitutes the boiling point of some tissue oils.

为了实现有效的组织治疗，希望将组织保持在预定最高温度以下。为了防止组织的温度超过预定最高阈值温度，如电压(V)曲线L2和L3中所示升高电压(V)。增加电压(V)防止了组织的温度超过预定阈值温度，如对应于电压曲线L3的温度曲线L3”中所示，或者至少快速地使组织的温度恢复到预定阈值温度以下，如对应于电压曲线L2的温度曲线L2”中所示。相比之下，在不增加电压(V)的情况下，如电压曲线L1中所示，组织的组织温度显著升高超过预定阈值温度，如对应的温度曲线L1”中所示。In order to achieve effective tissue treatment, it is desirable to maintain the tissue below a predetermined maximum temperature. In order to prevent the temperature of the tissue from exceeding a predetermined maximum threshold temperature, the voltage (V) is increased as shown in the voltage (V) curves L2 and L3. Increasing the voltage (V) prevents the temperature of the tissue from exceeding the predetermined threshold temperature, as shown in the temperature curve L3" corresponding to the voltage curve L3, or at least quickly restores the temperature of the tissue to below the predetermined threshold temperature, as shown in the temperature curve L2" corresponding to the voltage curve L2. In contrast, without increasing the voltage (V), as shown in the voltage curve L1, the tissue temperature of the tissue significantly increases above the predetermined threshold temperature, as shown in the corresponding temperature curve L1".

在至少一个示例中，如图89中所示，预定最高温度为约130℃。为了将组织保持在预定最高温度以下，升高电压(V)以便减缓温度的进一步升高，并最终逆转温度的升高。In at least one example, as shown in Fig. 89, the predetermined maximum temperature is about 130° C. To maintain the tissue below the predetermined maximum temperature, the voltage (V) is increased to slow further increases in temperature, and eventually reverse the increase in temperature.

在图89的示例中，当组织阻抗(Z)达到100Ω时，组织温度达到约110℃，并且当组织阻抗(Z)达到450Ω时，组织温度(T)达到约130℃。In the example of FIG. 89 , when the tissue impedance (Z) reaches 100Ω, the tissue temperature reaches approximately 110° C., and when the tissue impedance (Z) reaches 450Ω, the tissue temperature (T) reaches approximately 130° C.

过程131190(图90)和131200(图91)描绘了使用组织阻抗(Z)和温度(T)的此类值作为触发条件来朝向如图89中所示的由端部执行器131000施加的组织治疗循环的结束升高电压(V)的控制程序或逻辑配置。本公开设想了可以用作触发条件来升高电压(V)的组织阻抗(Z)和组织温度(T)的其它值。在各个示例中，如图89的曲线131188中所示，阈值组织阻抗(Z)可以为约100Ω。在其它示例中，阈值组织阻抗(Z)可以为约450Ω。在各个示例中，如图89的曲线131186中所示，阈值温度(T)可以为约110℃。在其它示例中，阈值温度(T)可以为约130℃。Processes 131190 (FIG. 90) and 131200 (FIG. 91) depict a control program or logic configuration that uses such values of tissue impedance (Z) and temperature (T) as trigger conditions to increase the voltage (V) toward the end of a tissue treatment cycle applied by the end effector 131000 as shown in FIG. 89. The present disclosure contemplates other values of tissue impedance (Z) and tissue temperature (T) that can be used as trigger conditions to increase the voltage (V). In various examples, as shown in curve 131188 of FIG. 89, the threshold tissue impedance (Z) can be about 100Ω. In other examples, the threshold tissue impedance (Z) can be about 450Ω. In various examples, as shown in curve 131186 of FIG. 89, the threshold temperature (T) can be about 110°C. In other examples, the threshold temperature (T) can be about 130°C.

在一个示例中，如图90的过程131190所示，可以监测131192组织阻抗(Z)，并将其用于确定131194何时触发电压(V)增加131196。如本文结合图78A所述，例如，感测电路可以用于确定组织阻抗(Z)。超声驱动电路和/或RF驱动电路的控制电路(例如，图13-15)可以用于基于从感测电路接收的输入来执行过程131190。In one example, as shown in process 131190 of FIG. 90 , tissue impedance (Z) can be monitored 131192 and used to determine 131194 when to trigger a voltage (V) increase 131196. As described herein in conjunction with FIG. 78A , for example, a sensing circuit can be used to determine tissue impedance (Z). Control circuitry (e.g., FIGS. 13-15 ) of an ultrasonic drive circuit and/or RF drive circuit can be used to perform process 131190 based on input received from the sensing circuit.

在另一个示例中，如图91的过程131200所示，可以监测131202组织温度(T)，并将其用于确定131204何时触发电压(V)增加131206。如本文结合图66A-68所述，发生器基于被施加以驱动超声换能器的电压Vg(t)信号和电流Ig(t)信号之间的相位角来推断超声刀的温度。另选地，可以确定组织温度，如上文结合图51-53所述，其中柔性电路8412可包括嵌入柔性电路8412的一层或多层中的温度传感器。一个或多个温度传感器可对称地或非对称地布置，并向超声驱动电路和/或RF驱动电路的控制电路(例如，图13-15)提供组织8410温度反馈。控制电路可以用于基于温度反馈来执行过程131200。In another example, as shown in process 131200 of FIG. 91 , tissue temperature (T) may be monitored 131202 and used to determine 131204 when to trigger a voltage (V) increase 131206. As described herein in conjunction with FIGS. 66A-68 , the generator generates a voltage (V) signal based on the phase angle between the voltage Vg(t) signal and the current Ig(t) signal applied to drive the ultrasonic transducer. To infer the temperature of the ultrasonic blade. Alternatively, the tissue temperature can be determined, as described above in conjunction with Figures 51-53, where the flexible circuit 8412 may include a temperature sensor embedded in one or more layers of the flexible circuit 8412. One or more temperature sensors may be arranged symmetrically or asymmetrically and provide tissue 8410 temperature feedback to the control circuit (e.g., Figures 13-15) of the ultrasonic drive circuit and/or the RF drive circuit. The control circuit can be used to perform process 131200 based on the temperature feedback.

在各个示例中，电压(V)以台阶方式增加，如电压曲线L2、L3所示。在其它示例中，电压(V)可以逐渐增加。In various examples, the voltage (V) increases in a step-wise manner, as shown by voltage curves L2 and L3. In other examples, the voltage (V) may increase gradually.

在至少一个示例中，设定两个不同的上限温度来影响功率水平。除了最大温度阈值外，还可以使用主要和次要最小关闭温度阈值。In at least one example, two different upper temperature limits are set to affect the power level.In addition to the maximum temperature threshold, primary and secondary minimum shutdown temperature thresholds may also be used.

超声和射频外科器械组合Ultrasonic and radiofrequency surgical instrument combination

如上所述，端部执行器131000(图73)可以适于与组合电外科器械一起使用，该组合电外科器械通过单独或结合超声振动施加射频(RF)能量来提供组织治疗。在美国专利公布2017/0202609(标题为弯曲端部执行器在钳口和刀之间具有非对称接合的模块化电池供电的手持式外科器械(Modular Battery Powered Hand-Held Surgical Instrument WithCurved End Effectors Having Asymmetric Engagement Between Jaw and Blade)，其全文以引用方式并入)中更详细地讨论了被配置为驱动超声换能器以及端部执行器的RF电极的发生器的示例。As described above, the end effector 131000 (FIG. 73) can be adapted for use with a combination electrosurgical instrument that provides tissue treatment by applying radio frequency (RF) energy alone or in combination with ultrasonic vibrations. An example of a generator configured to drive an ultrasonic transducer and an RF electrode of an end effector is discussed in more detail in U.S. Patent Publication 2017/0202609 (titled Modular Battery Powered Hand-Held Surgical Instrument With Curved End Effectors Having Asymmetric Engagement Between Jaw and Blade, which is incorporated by reference in its entirety).

在各个方面，包括超声部件和RF部件的端部执行器131000被配置为基于由超声部件执行的组织温度测量来调制RF部件的一个或多个参数。因此，可以在非治疗诊断模式下利用超声部件，而在治疗模式下利用RF部件，以实时调节RF部件的一个或多个参数。In various aspects, the end effector 131000 including the ultrasonic component and the RF component is configured to modulate one or more parameters of the RF component based on the tissue temperature measurement performed by the ultrasonic component. Thus, the ultrasonic component can be utilized in a non-therapeutic diagnostic mode, while the RF component is utilized in a therapeutic mode to adjust one or more parameters of the RF component in real time.

图92为描绘用于在非治疗诊断模式下利用超声部件而在治疗模式下利用RF部件的控制程序或逻辑配置的过程131210。92 is a flowchart depicting a process 131210 for a control program or logic configuration for utilizing ultrasound components in a non-therapeutic diagnostic mode and utilizing RF components in a therapeutic mode.

过程131210监测131212超声刀的温度。过程131210进一步确定131214超声刀的温度是大于还是等于预定阈值温度。如果是，则过程131210调节RF部件的功率(P)以减少递送到组织的能量。The process 131210 monitors 131212 the temperature of the ultrasonic blade. The process 131210 further determines 131214 whether the temperature of the ultrasonic blade is greater than or equal to a predetermined threshold temperature. If so, the process 131210 adjusts the power (P) of the RF component to reduce the energy delivered to the tissue.

如结合图66A-68所述，发生器基于被施加以驱动超声换能器的电压Vg(t)信号和电流Ig(t)信号之间的相位角来推断超声刀的温度。由于超声刀的温度对应于由组合装置的端部执行器131000捕获的组织的温度，因此超声部件可以用于诊断非治疗模式，以监测组织温度并提供反馈信息以便调节RF部件的功率水平。As described in conjunction with FIGS. 66A-68 , the generator is based on the phase angle between the voltage Vg(t) signal and the current Ig(t) signal applied to drive the ultrasonic transducer. Since the temperature of the ultrasonic blade corresponds to the temperature of the tissue captured by the end effector 131000 of the combined device, the ultrasonic component can be used in a diagnostic non-therapeutic mode to monitor tissue temperature and provide feedback information to adjust the power level of the RF component.

图93为根据本公开的至少一个方面的示出执行过程131210的曲线图131220。曲线图131220包括三条曲线131222、131224、131226，它们在竖直轴上分别描绘了功率(P)、温度(T)和相位。曲线131222表示递送到组合装置的端部执行器131000的钳口131002、131004之间捕获的组织的功率(P)与时间(t)的关系。曲线131224表示端部执行器131000的超声刀的温度(T)与时间(t)的关系。曲线131226表示超声部件用来确定超声刀的温度以及进而确定组织的温度(如结合图66A-68更详细地描述)的双重非治疗频率。超声部件可以被配置为检测组织温度转变到或超过预定阈值温度(T_阈值)，如曲线131224中所示。然后可以调节RF部件的功率(P)水平(从P1调节到P2)，以防止温度过高，如曲线131222中所示。FIG. 93 is a graph 131220 showing an implementation of process 131210 according to at least one aspect of the present disclosure. Graph 131220 includes three curves 131222, 131224, 131226, which depict power (P), temperature (T), and phase on the vertical axis, respectively. Curve 131222 represents the power (P) delivered to the tissue captured between the jaws 131002, 131004 of the end effector 131000 of the combined device and the relationship between time (t). Curve 131224 represents the temperature (T) of the ultrasonic blade of the end effector 131000 and the relationship between time (t). Curve 131226 represents the dual non-therapeutic frequency used by the ultrasonic component to determine the temperature of the ultrasonic blade and thereby determine the temperature of the tissue (as described in more detail in conjunction with FIGS. 66A-68). The ultrasonic component can be configured to detect that the tissue temperature transitions to or exceeds a predetermined threshold temperature (T_threshold ), as shown in curve 131224. The power (P) level of the RF components can then be adjusted (from P1 to P2) to prevent the temperature from being too high, as shown in curve 131222.

在至少一个示例中，调节RF部件的功率(P)水平，以将组织温度保持在100℃以下，从而防止蒸汽对周围组织引起附带损伤，同时仍使组合装置的端部执行器131000所抓握的组织中的胶原蛋白局部凝结。在至少一个示例中，调节RF部件的功率(P)水平，以将组织温度保持在130℃以下，从而防止在此类温度处可能发生的组织炭化。在至少一个示例中，由超声部件提供的温度反馈允许RF部件根据组织治疗循环期间的组织相位转变来调节功率斜率。In at least one example, the power (P) level of the RF component is adjusted to maintain the tissue temperature below 100°C to prevent the steam from causing collateral damage to surrounding tissue while still locally coagulating collagen in the tissue grasped by the end effector 131000 of the combined device. In at least one example, the power (P) level of the RF component is adjusted to maintain the tissue temperature below 130°C to prevent tissue charring that may occur at such temperatures. In at least one example, the temperature feedback provided by the ultrasonic component allows the RF component to adjust the power slope according to the tissue phase transition during the tissue treatment cycle.

在各个方面，一种过程包括用于基于温度区分超声刀的各区段的控制程序或逻辑配置。该过程将超声刀的非常热的较小区段与中等热的较大区段分开。在至少一个方面，该过程包括施加通过55.5Khz(其为标准频率)的多个频率，并且然后另选地使用例如150KHz的3倍频率来确定两个不同的共振频率，这将允许确定超声刀的具有非常热的温度的一小部分，或者超声刀的具有中等热的温度的较大一部分。In various aspects, a process includes a control program or logic configuration for distinguishing between various sections of an ultrasonic blade based on temperature. The process separates very hot smaller sections of the ultrasonic blade from medium hot larger sections. In at least one aspect, the process includes applying multiple frequencies through 55.5Khz (which is a standard frequency), and then alternatively using a 3 times frequency of, for example, 150KHz to determine two different resonant frequencies, which will allow the determination of a small portion of the ultrasonic blade with a very hot temperature, or a larger portion of the ultrasonic blade with a medium hot temperature.

图94为根据本公开的至少一个方面描绘用于基于所测量的组织阻抗来调节RF电外科器械或组合装置的RF部件的RF波形的频率的控制程序或逻辑配置的过程131230的逻辑流程图。在至少一个示例中，在组织治疗循环的初始部分之前或期间测量131232组织阻抗，并且将该测量值用于在施加到组织的RF波形的预定高频131234和低频131236选项之间进行选择131231。94 is a logic flow diagram depicting a process 131230 of a control program or logic configuration for adjusting the frequency of an RF waveform of an RF component of an RF electrosurgical instrument or combination device based on measured tissue impedance in accordance with at least one aspect of the present disclosure. In at least one example, tissue impedance is measured 131232 before or during an initial portion of a tissue treatment cycle, and the measurement is used to select 131231 between predetermined high frequency 131234 and low frequency 131236 options for the RF waveform applied to the tissue.

过程131230解决了低功率传输状况。如果确定所测量的组织阻抗等于或低于预定阈值，则选择高频RF波形用于治疗循环。高频RF波形被配置为驱动组织阻抗更高以解决低功率传输。但是，如果确定所测量的组织阻抗大于或等于预定阈值，则选择低频RF波形用于治疗循环。在各个方面，组织阻抗可以通过如结合图18、21、78A所述的一个或多个传感器来测量。Process 131230 addresses the low power transmission condition. If the measured tissue impedance is determined to be equal to or below a predetermined threshold, a high frequency RF waveform is selected for the treatment cycle. The high frequency RF waveform is configured to drive the tissue impedance higher to address the low power transmission. However, if the measured tissue impedance is determined to be greater than or equal to the predetermined threshold, a low frequency RF waveform is selected for the treatment cycle. In various aspects, tissue impedance can be measured by one or more sensors as described in conjunction with Figures 18, 21, and 78A.

在各个方面，本公开的一个或多个过程可以由电外科器械的控制电路(诸如外科器械700的控制电路710、外科器械750的控制电路760和/或外科器械790的控制电路760)执行。在某些方面，如图13中所示，用于执行本公开的一个或多个过程的控制电路可包括联接到至少一个存储器电路504的一个或多个处理器502(例如，微处理器、微控制器)，该至少一个存储器电路存储程序指令，这些程序指令在被处理器502执行时使得处理器502执行所述一个或多个过程。另选地，本公开的一个或多个过程可以由图14、15中描绘的一个或多个控制电路执行。在某些方面，电外科器械可包括存储用于执行本公开的一个或多个过程的一个或多个算法的非暂态存储介质。In various aspects, one or more processes of the present disclosure may be performed by a control circuit of an electrosurgical instrument, such as control circuit 710 of surgical instrument 700, control circuit 760 of surgical instrument 750, and/or control circuit 760 of surgical instrument 790. In certain aspects, as shown in FIG. 13, a control circuit for performing one or more processes of the present disclosure may include one or more processors 502 (e.g., microprocessors, microcontrollers) coupled to at least one memory circuit 504 that stores program instructions that, when executed by the processor 502, cause the processor 502 to perform the one or more processes. Alternatively, one or more processes of the present disclosure may be performed by one or more control circuits depicted in FIGS. 14 and 15. In certain aspects, an electrosurgical instrument may include a non-transitory storage medium storing one or more algorithms for performing one or more processes of the present disclosure.

本文所述主题的各个方面在以下编号的实施例中陈述：Various aspects of the subject matter described herein are set forth in the following numbered examples:

实施例1-一种外科器械，该外科器械包括端部执行器，该端部执行器包括超声刀和夹持臂。所述夹持臂能够相对于所述超声刀运动，以使所述端部执行器在打开构型和闭合构型之间转变通过不同的闭合阶段，以将组织夹持在所述超声刀和所述夹持臂之间。所述外科器械还包括被配置为生成超声能量输出的换能器、被配置为将所述超声能量输出传输到所述超声刀的波导，以及被配置为传输指示所述端部执行器的所述闭合阶段的传感器信号的传感器。所述外科器械还包括控制电路，所述控制电路被配置为接收所述传感器信号并基于所接收的传感器信号从递送来自所述换能器的不同超声能量输出的操作模式中选择操作模式。Embodiment 1-A surgical instrument comprises an end effector comprising an ultrasonic blade and a clamping arm. The clamping arm is capable of moving relative to the ultrasonic blade so that the end effector transitions between an open configuration and a closed configuration through different closing stages to clamp tissue between the ultrasonic blade and the clamping arm. The surgical instrument also includes a transducer configured to generate an ultrasonic energy output, a waveguide configured to transmit the ultrasonic energy output to the ultrasonic blade, and a sensor configured to transmit a sensor signal indicating the closing stage of the end effector. The surgical instrument also includes a control circuit configured to receive the sensor signal and select an operating mode from operating modes that deliver different ultrasonic energy outputs from the transducer based on the received sensor signal.

实施例2-如实施例1的外科器械，其中，操作模式包括被配置为引起组织分离但不引起组织凝结的低能量操作模式以及被配置为引起组织凝结的高能量操作模式。Example 2 - A surgical instrument as in Example 1, wherein the operating modes include a low energy operating mode configured to cause tissue separation but not tissue coagulation and a high energy operating mode configured to cause tissue coagulation.

实施例3-如实施例1或2的外科器械，其中，闭合阶段包括初始闭合阶段，该初始闭合阶段的跨度覆盖夹持臂的运动范围的直至预定阈值的初始部分。Example 3 - A surgical instrument as in Example 1 or 2, wherein the closing phase includes an initial closing phase having a span covering an initial portion of the range of motion of the clamping arm up to a predetermined threshold.

实施例4-如实施例3的外科器械，其中，控制电路被配置为在初始闭合阶段中选择递送第一超声能量输出的第一操作模式。Example 4 - A surgical instrument as in Example 3, wherein the control circuit is configured to select a first operating mode that delivers a first ultrasonic energy output during an initial closing phase.

实施例5-如实施例4的外科器械，其中，控制电路被配置为在超过预定阈值的情况下切换到第二操作模式，该第二操作模式递送大于第一超声能量输出的第二超声能量输出。Example 5 - A surgical instrument as in Example 4, wherein the control circuit is configured to switch to a second operating mode when a predetermined threshold is exceeded, the second operating mode delivering a second ultrasonic energy output greater than the first ultrasonic energy output.

实施例6-如实施例1-5中任一项的外科器械，其中，在操作模式之间进行选择还基于至少一个态势参数。Example 6 - A surgical instrument as in any of Examples 1-5, wherein selection between operating modes is also based on at least one posture parameter.

实施例7-如实施例6的外科器械，其中，至少一个态势参数包括组织的类型。Example 7 - A surgical instrument as in Example 6, wherein at least one status parameter includes the type of tissue.

实施例8-如实施例6或7的外科器械，其中，至少一个态势参数包括组织的解剖学位置。Example 8 - A surgical instrument as in Example 6 or 7, wherein at least one posture parameter includes the anatomical location of the tissue.

实施例9-如实施例6-8中任一项的外科器械，其中，至少一个态势参数包括组织的组分。Example 9 - A surgical instrument as in any of Examples 6-8, wherein at least one state parameter includes the composition of the tissue.

实施例10-如实施例1-9中任一项的外科器械，其中，闭合阶段中的每个闭合阶段由夹持臂和超声刀之间的角距离范围限定。Example 10 - A surgical instrument as in any one of Examples 1-9, wherein each of the closing stages is defined by a range of angular distances between the clamping arm and the ultrasonic blade.

实施例11-如实施例1-10中任一项的外科器械，还包括驱动构件，该驱动构件被配置为促动夹持构件运动通过闭合阶段，并且其中闭合阶段中的每个闭合阶段由驱动构件的位置范围限定。Example 11 - The surgical instrument of any of Examples 1-10, further comprising a drive member configured to actuate movement of the clamping member through closing stages, and wherein each of the closing stages is defined by a range of positions of the drive member.

实施例12-一种外科器械，该外科器械包括端部执行器，该端部执行器包括超声刀和夹持臂。所述夹持臂能够相对于所述超声刀运动，以使所述端部执行器在打开构型和闭合构型之间转变通过不同的闭合阶段，以将组织夹持在所述超声刀和所述夹持臂之间。闭合阶段包括第一闭合阶段以及第一闭合阶段之后的第二闭合阶段。该外科器械还包括被配置为生成超声能量输出的换能器、被配置为将超声能量输出传输到超声刀的波导，以及被配置为传输指示检测到夹持臂与组织的初始接触的传感器信号的传感器电路。该外科器械还包括控制电路，该控制电路被配置为接收传感器信号，响应于在第一闭合阶段中接收到传感器信号而使换能器生成第一超声能量输出，并且响应于在第二闭合阶段中接收到传感器信号而使换能器生成大于第一超声能量输出的第二超声能量输出。Example 12 - A surgical instrument comprising an end effector comprising an ultrasonic blade and a clamping arm. The clamping arm is capable of moving relative to the ultrasonic blade so that the end effector transitions between an open configuration and a closed configuration through different closing stages to clamp the tissue between the ultrasonic blade and the clamping arm. The closing stage comprises a first closing stage and a second closing stage after the first closing stage. The surgical instrument also includes a transducer configured to generate an ultrasonic energy output, a waveguide configured to transmit the ultrasonic energy output to the ultrasonic blade, and a sensor circuit configured to transmit a sensor signal indicating that initial contact of the clamping arm with the tissue is detected. The surgical instrument also includes a control circuit configured to receive a sensor signal, cause the transducer to generate a first ultrasonic energy output in response to receiving the sensor signal in the first closing stage, and cause the transducer to generate a second ultrasonic energy output greater than the first ultrasonic energy output in response to receiving the sensor signal in the second closing stage.

实施例13-如实施例12的外科器械，其中，控制电路被进一步配置为响应于从第一闭合阶段转变到第二闭合阶段而使换能器从第一超声能量输出切换到第二超声能量输出。Example 13 - A surgical instrument as in Example 12, wherein the control circuit is further configured to cause the transducer to switch from the first ultrasonic energy output to the second ultrasonic energy output in response to a transition from the first closed stage to the second closed stage.

实施例14-如实施例12或13的外科器械，其中，第一超声能量输出被配置为引起组织分离但不引起组织凝结，并且其中第二超声能量输出被配置为引起组织凝结。Example 14 - A surgical instrument as in Example 12 or 13, wherein the first ultrasonic energy output is configured to cause tissue separation but not tissue coagulation, and wherein the second ultrasonic energy output is configured to cause tissue coagulation.

实施例15-如实施例12-14中任一项的外科器械，其中，第一闭合阶段的跨度覆盖夹持臂的运动范围的直至预定阈值的第一部分。Example 15 - A surgical instrument as in any of Examples 12-14, wherein the span of the first closing stage covers a first portion of the range of motion of the clamping arm up to a predetermined threshold.

实施例16-如实施例15的外科器械，其中，第二闭合阶段的跨度覆盖夹持臂的运动范围的超过预定阈值的第二部分。Example 16 - A surgical instrument as in Example 15, wherein the span of the second closure phase covers a second portion of the range of motion of the clamping arm that exceeds a predetermined threshold.

实施例17-如实施例15或16的外科器械，其中，控制电路被进一步配置为响应于夹持臂转变超过阈值而使换能器从第一超声能量输出切换到第二超声能量输出。Example 17 - A surgical instrument as in Example 15 or 16, wherein the control circuit is further configured to switch the transducer from the first ultrasonic energy output to the second ultrasonic energy output in response to the clamp arm transition exceeding a threshold.

实施例18-如实施例12-17中任一项的外科器械，其中，第一超声能量输出和第二超声能量输出中的至少一者进一步由至少一个态势参数确定。Example 18 - A surgical instrument as in any of Examples 12-17, wherein at least one of the first ultrasonic energy output and the second ultrasonic energy output is further determined by at least one situation parameter.

实施例19-如实施例18的外科器械，其中，至少一个态势参数包括组织的类型。Example 19 - A surgical instrument as in Example 18, wherein at least one status parameter includes the type of tissue.

实施例20-如实施例18或19的外科器械，其中，至少一个态势参数包括组织的解剖学位置。Example 20 - A surgical instrument as in Example 18 or 19, wherein at least one posture parameter includes the anatomical location of the tissue.

实施例21-如实施例18-20中任一项的外科器械，其中，至少一个态势参数包括组织的组分。Example 21 - A surgical instrument as in any of Examples 18-20, wherein at least one state parameter includes the composition of the tissue.

尽管已举例说明和描述了多个形式，但是申请人的意图并非将所附权利要求的范围约束或限制在此类细节中。在不脱离本公开的范围的情况下，可实现对这些形式的许多修改、变化、改变、替换、组合和等同物，并且本领域技术人员将想到这些形式的许多修改、变化、改变、替换、组合和等同物。此外，另选地，可将与所描述的形式相关联的每个元件的结构描述为用于提供由所述元件执行的功能的器件。另外，在公开了用于某些部件的材料的情况下，也可使用其它材料。因此，应当理解，上述具体实施方式和所附权利要求旨在涵盖属于本发明所公开的形式范围内的所有此类修改形式、组合和变型形式。所附权利要求旨在涵盖所有此类修改、变化、改变、替换、修改和等同物。Although multiple forms have been illustrated and described, it is not the intention of the applicant to restrict or limit the scope of the appended claims to such details. Without departing from the scope of the present disclosure, many modifications, changes, alterations, substitutions, combinations and equivalents to these forms can be realized, and those skilled in the art will think of many modifications, changes, alterations, substitutions, combinations and equivalents to these forms. In addition, alternatively, the structure of each element associated with the described form can be described as a device for providing the function performed by the element. In addition, in the case of disclosing materials for certain parts, other materials can also be used. Therefore, it should be understood that the above-mentioned specific embodiments and the appended claims are intended to cover all such modifications, combinations and variants within the scope of the forms disclosed by the present invention. The appended claims are intended to cover all such modifications, changes, alterations, substitutions, modifications and equivalents.

上述具体实施方式已经由使用框图、流程图和/或示例阐述了装置和/或方法的各种形式。只要此类框图、流程图和/或示例包含一个或多个功能和/或操作，本领域的技术人员就要将其理解为此类框图、流程图和/或示例中的每个功能和/或操作都可以单独和/或共同地通过多种硬件、软件、固件或实际上它们的任何组合来实施。本领域的技术人员将会认识到，本文公开的形式中的一些方面可作为在一台或多台计算机上运行的一个或多个计算机程序(如，作为在一个或多个计算机系统上运行的一个或多个程序)，作为在一个或多个处理器上运行的一个或多个程序(如，作为在一个或多个微处理器上运行的一个或多个程序)，作为固件，或作为实际上它们的任何组合全部或部分地在集成电路中等效地实现，并且根据本发明，设计电子电路和/或编写软件和/或硬件的代码将在本领域技术人员的技术范围内。另外，本领域的技术人员将会认识到，本文所述主题的机制能够作为多种形式的一个或多个程序产品进行分布，并且本文所述主题的示例性形式适用，而不管用于实际进行分布的信号承载介质的具体类型是什么。The above specific embodiments have been described in various forms of devices and/or methods using block diagrams, flow charts and/or examples. As long as such block diagrams, flow charts and/or examples contain one or more functions and/or operations, those skilled in the art will understand that each function and/or operation in such block diagrams, flow charts and/or examples can be implemented individually and/or collectively by a variety of hardware, software, firmware or any combination thereof. Those skilled in the art will recognize that some aspects of the forms disclosed herein can be implemented equivalently in integrated circuits as one or more computer programs running on one or more computers (e.g., as one or more programs running on one or more computer systems), as one or more programs running on one or more processors (e.g., as one or more programs running on one or more microprocessors), as firmware, or as any combination thereof, in whole or in part, and according to the present invention, designing electronic circuits and/or writing software and/or hardware codes will be within the technical scope of those skilled in the art. In addition, those skilled in the art will recognize that the mechanisms of the subject matter described herein can be distributed as one or more program products in a variety of forms, and the exemplary forms of the subject matter described herein are applicable regardless of the specific type of signal-bearing medium used to actually distribute.

用于编程逻辑以执行各种所公开的方面的指令可存储在系统内的存储器内，诸如动态随机存取存储器(DRAM)、高速缓存、闪存存储器或其它存储器。此外，指令可经由网络或通过其它计算机可读介质来分发。因此，机器可读介质可包括用于存储或传输以机器(例如，计算机)可读形式的信息的机构，但不限于软盘、光学盘、光盘、只读存储器(CD-ROM)、磁光盘、只读存储器(ROM)、随机存取存储器(RAM)、可擦除可编程只读存储器(EPROM)、电可擦除可编程只读存储器(EEPROM)、磁卡或光卡、闪存存储器、或经由电信号、光学信号、声学信号或其它形式的传播信号(例如，载波、红外信号、数字信号等)在因特网上传输信息时使用的有形的、机器可读存储装置。因此，非暂态计算机可读介质包括适于以机器(例如，计算机)可读的形式存储或传输电子指令或信息的任何类型的有形机器可读介质。Instructions for programming logic to perform various disclosed aspects may be stored in a memory within the system, such as a dynamic random access memory (DRAM), a cache, a flash memory, or other memory. In addition, the instructions may be distributed via a network or through other computer-readable media. Therefore, a machine-readable medium may include a mechanism for storing or transmitting information in a machine (e.g., computer) readable form, but is not limited to a floppy disk, an optical disk, an optical disk, a read-only memory (CD-ROM), a magneto-optical disk, a read-only memory (ROM), a random access memory (RAM), an erasable programmable read-only memory (EPROM), an electrically erasable programmable read-only memory (EEPROM), a magnetic card or an optical card, a flash memory, or a tangible, machine-readable storage device used when transmitting information on the Internet via an electrical signal, an optical signal, an acoustic signal, or other form of propagation signal (e.g., a carrier wave, an infrared signal, a digital signal, etc.). Therefore, a non-transitory computer-readable medium includes any type of tangible machine-readable medium suitable for storing or transmitting electronic instructions or information in a machine (e.g., computer) readable form.

如本文任一方面所用，术语“控制电路”可指例如硬连线电路系统、可编程电路系统(例如，计算机处理器，该计算机处理器包括一个或多个单独指令处理内核、处理单元，处理器、微控制器、微控制器单元、控制器、数字信号处理器(DSP)、可编程逻辑装置(PLD)、可编程逻辑阵列(PLA)、场可编程门阵列(FPGA))、状态机电路系统、存储由可编程电路系统执行的指令的固件、以及它们的任何组合。控制电路可共同或单独实现为形成更大系统的一部分的电路系统，例如集成电路(IC)、专用集成电路(ASIC)、片上系统(SoC)、台式计算机、膝上型计算机、平板计算机、服务器、智能电话等。因此，如本文所用，“控制电路”包括但不限于具有至少一个离散电路的电子电路、具有至少一个集成电路的电子电路、具有至少一个专用集成电路的电子电路、形成由计算机程序配置的通用计算装置(例如，由至少部分地实行本文所述的过程和/或装置的计算机程序配置的通用计算机，或由至少部分地实行本文所述的过程和/或装置的计算机程序配置的微处理器)的电子电路、形成存储器装置(例如，形成随机存取存储器)的电子电路和/或形成通信装置(例如，调节解调器、通信开关或光电设备)的电子电路。本领域的技术人员将会认识到，可以模拟或数字方式或它们的一些组合实施本文所述的主题。As used in any aspect of this document, the term "control circuitry" may refer to, for example, hardwired circuitry, programmable circuitry (e.g., a computer processor including one or more separate instruction processing cores, a processing unit, a processor, a microcontroller, a microcontroller unit, a controller, a digital signal processor (DSP), a programmable logic device (PLD), a programmable logic array (PLA), a field programmable gate array (FPGA)), state machine circuitry, firmware that stores instructions executed by the programmable circuitry, and any combination thereof. The control circuitry may be implemented collectively or individually as circuitry that forms part of a larger system, such as an integrated circuit (IC), an application specific integrated circuit (ASIC), a system on a chip (SoC), a desktop computer, a laptop computer, a tablet computer, a server, a smart phone, etc. Thus, as used herein, "control circuitry" includes, but is not limited to, electronic circuitry having at least one discrete circuit, electronic circuitry having at least one integrated circuit, electronic circuitry having at least one application specific integrated circuit, electronic circuitry forming a general purpose computing device configured by a computer program (e.g., a general purpose computer configured by a computer program that at least partially implements the processes and/or devices described herein, or a microprocessor configured by a computer program that at least partially implements the processes and/or devices described herein), electronic circuitry forming a memory device (e.g., forming a random access memory), and/or electronic circuitry forming a communication device (e.g., a modem, a communication switch, or an optoelectronic device). Those skilled in the art will recognize that the subject matter described herein may be implemented in analog or digital form, or some combination thereof.

如本文的任何方面所用，术语“逻辑”可指被配置为执行前述操作中的任一者的应用程序、软件、固件和/或电路系统。软件可体现为记录在非暂态计算机可读存储介质上的软件包、代码、指令、指令集和/或数据。固件可体现为在存储器装置中硬编码(例如，非易失性)的代码、指令或指令集和/或数据。As used in any aspect of this document, the term "logic" may refer to an application, software, firmware, and/or circuitry configured to perform any of the foregoing operations. Software may be embodied as a software package, code, instructions, instruction sets, and/or data recorded on a non-transitory computer-readable storage medium. Firmware may be embodied as code, instructions, instruction sets, and/or data hard-coded (e.g., non-volatile) in a memory device.

如本文任一方面所用，术语“部件”、“系统”、“模块”等可指计算机相关实体、硬件、硬件和软件的组合、软件或执行中的软件。As used in any aspect of this document, the terms "component," "system," "module" and the like may refer to a computer-related entity, hardware, a combination of hardware and software, software, or software in execution.

如本文任一方面中所用，“算法”是指导致所需结果的有条理的步骤序列，其中“步骤”是指物理量和/或逻辑状态的操纵，物理量和/或逻辑状态可(但不一定)采用能被存储、转移、组合、比较和以其它方式操纵的电或磁信号的形式。常用于指这些信号，如位、值、元素、符号、字符、术语、数字等。这些和类似的术语可与适当的物理量相关联并且仅仅是应用于这些量和/或状态的方便的标签。As used in any aspect herein, an "algorithm" refers to a self-consistent sequence of steps leading to a desired result, wherein the "steps" refer to manipulations of physical quantities and/or logical states which may, but need not, take the form of electrical or magnetic signals capable of being stored, transferred, combined, compared, and otherwise manipulated. References to such signals are often made to bits, values, elements, symbols, characters, terms, numbers, and the like. These and similar terms may be associated with the appropriate physical quantities and are merely convenient labels applied to such quantities and/or states.

网络可包括分组交换网络。通信装置可能够使用所选择的分组交换网络通信协议来彼此通信。一个示例性通信协议可包括可允许使用传输控制协议/因特网协议(TCP/IP)进行通信的以太网通信协议。以太网协议可符合或兼容电气和电子工程师学会(IEEE)于2008年12月发布的名为“IEEE 802.3标准”的以太网标准和/或本标准的更高版本。另选地或附加地，通信装置可能够使用X.25通信协议彼此通信。X.25通信协议可符合或符合国际电信联盟电信标准化部门(ITU-T)颁布的标准。另选地或附加地，通信装置可能够使用帧中继通信协议彼此通信。帧中继通信协议可符合或符合国际电话和电话协商委员会(CCITT)和/或美国国家标准学会(ANSI)发布的标准。另选地或附加地，收发器可能够使用异步传输模式(ATM)通信协议彼此通信。ATM通信协议可符合或兼容ATM论坛于2001年8月发布的名为“ATM-MPLS网络互通2.0”的ATM标准和/或该标准的更高版本。当然，本文同样设想了不同的和/或之后开发的连接取向的网络通信协议。The network may include a packet switching network. The communication devices may be able to communicate with each other using the selected packet switching network communication protocol. An exemplary communication protocol may include an Ethernet communication protocol that allows communication using a transmission control protocol/Internet protocol (TCP/IP). The Ethernet protocol may comply with or be compatible with the Ethernet standard entitled "IEEE 802.3 Standard" issued by the Institute of Electrical and Electronics Engineers (IEEE) in December 2008 and/or a higher version of this standard. Alternatively or additionally, the communication devices may be able to communicate with each other using an X.25 communication protocol. The X.25 communication protocol may comply with or comply with the standards promulgated by the International Telecommunication Union Telecommunication Standardization Sector (ITU-T). Alternatively or additionally, the communication devices may be able to communicate with each other using a frame relay communication protocol. The frame relay communication protocol may comply with or comply with the standards issued by the International Telephone and Telephone Consultation Committee (CCITT) and/or the American National Standards Institute (ANSI). Alternatively or additionally, the transceivers may be able to communicate with each other using an asynchronous transfer mode (ATM) communication protocol. The ATM communication protocol may conform to or be compatible with the ATM standard entitled "ATM-MPLS Network Interworking 2.0" released by the ATM Forum in August 2001 and/or a later version of the standard. Of course, different and/or later developed connection-oriented network communication protocols are also contemplated herein.

除非上述公开中另外明确指明，否则可以理解的是，在上述公开中，使用术语如“处理”、“估算”、“计算”、“确定”、“显示”的讨论是指计算机系统或类似的电子计算装置的动作和进程，其操纵表示为计算机系统的寄存器和存储器内的物理(电子)量的数据并将其转换成相似地表示为计算机系统存储器或寄存器或其它此类信息存储、传输或显示装置内的物理量的其它数据。Unless otherwise expressly indicated in the above disclosure, it is understood that discussions using terms such as "processing," "computing," "calculating," "determining," and "displaying" in the above disclosure refer to the actions and processes of a computer system or similar electronic computing device that manipulates data represented as physical (electronic) quantities within the computer system's registers and memories and transforms it into other data similarly represented as physical quantities within the computer system's memories or registers or other such information storage, transmission, or display devices.

一个或多个部件在本文中可被称为“被配置为”、“可配置为”、“可操作/可操作地”、“适于/可适于”、“能够”、“可适形/适形于”等。本领域的技术人员将会认识到，除非上下文另有所指，否则“被配置为”通常可涵盖活动状态的部件和/或未活动状态的部件和/或待机状态的部件。One or more components may be referred to herein as being "configured to", "configurable to", "operable/operably", "suitable/adaptable to", "capable of", "conformable/conformable to", etc. Those skilled in the art will recognize that, unless the context indicates otherwise, "configured to" may generally encompass components in an active state and/or components in an inactive state and/or components in a standby state.

术语“近侧”和“远侧”在本文中是相对于操纵外科器械的柄部部分的临床医生来使用的。术语“近侧”是指最靠近临床医生的部分，术语“远侧”是指远离临床医生定位的部分。还应当理解，为简洁和清楚起见，本文可结合附图使用诸如“竖直”、“水平”、“上”和“下”等空间术语。然而，外科器械在许多方向和位置中使用，并且这些术语并非限制性的和/或绝对的。The terms "proximal" and "distal" are used herein relative to a clinician manipulating the handle portion of a surgical instrument. The term "proximal" refers to the portion closest to the clinician, and the term "distal" refers to the portion positioned away from the clinician. It should also be understood that for brevity and clarity, spatial terms such as "vertical," "horizontal," "upper," and "lower" may be used herein in conjunction with the accompanying drawings. However, surgical instruments are used in many orientations and positions, and these terms are not restrictive and/or absolute.

本领域的技术人员将认识到，一般而言，本文、以及特别是所附权利要求(例如，所附权利要求的正文)中所使用的术语通常旨在为“开放”术语(例如，术语“包括”应解释为“包括但不限于”，术语“具有”应解释为“至少具有”，术语“包含”应解释为“包含但不限于”等)。本领域的技术人员还应当理解，如果所引入权利要求叙述的具体数目为预期的，则这样的意图将在权利要求中明确叙述，并且在不存在这样的叙述的情况下，不存在这样的意图。例如，为有助于理解，下述所附权利要求可含有对介绍性短语“至少一个”和“一个或多个”的使用以引入权利要求。然而，对此类短语的使用不应视为暗示通过不定冠词“一个”或“一种”引入权利要求表述将含有此类引入权利要求表述的任何特定权利要求限制在含有仅一个这样的表述的权利要求中，甚至当同一权利要求包括介绍性短语“一个或多个”或“至少一个”和诸如“一个”或“一种”(例如，“一个”和/或“一种”通常应解释为意指“至少一个”或“一个或多个”)的不定冠词时；这也适用于对用于引入权利要求表述的定冠词的使用。Those skilled in the art will recognize that, in general, the terms used herein, and in particular in the appended claims (e.g., the body of the appended claims), are generally intended to be "open" terms (e.g., the term "including" should be interpreted as "including but not limited to", the term "having" should be interpreted as "having at least", the term "comprising" should be interpreted as "including but not limited to", etc.). Those skilled in the art will also understand that if a specific number of an introduced claim recitation is intended, such an intent will be explicitly recited in the claim, and in the absence of such a recitation, no such intent is present. For example, to aid understanding, the following appended claims may contain use of the introductory phrases "at least one" and "one or more" to introduce claims. However, the use of such phrases should not be construed as implying that the introduction of a claim recitation by the indefinite article "a" or "an" limits any particular claim containing such introduced claim recitation to claims containing only one such recitation, even when the same claim includes the introductory phrases "one or more" or "at least one" and an indefinite article such as "a" or "an" (e.g., "a" and/or "an" should generally be interpreted as meaning "at least one" or "one or more"); this also applies to the use of definite articles used to introduce claim recitations.

另外，即使明确叙述引入权利要求叙述的特定数目，本领域的技术人员应当认识到，此种叙述通常应解释为意指至少所叙述的数目(例如，在没有其它修饰语的情况下，对“两个叙述”的裸叙述通常意指至少两个叙述、或两个或更多个叙述)。此外，在其中使用类似于“A、B和C中的至少一者等”的惯例的那些情况下，一般而言，此类构造意在具有本领域的技术人员将理解所述惯例的意义(例如，“具有A、B和C中的至少一者的系统”将包括但不限于具有仅A、仅B、仅C、A和B一起、A和C一起、B和C一起和/或A、B和C一起等的系统)。在其中使用类似于“A、B或C中的至少一者等”的惯例的那些情况下，一般而言，此类构造意在具有本领域的技术人员将理解所述惯例的意义(例如，“具有A、B或C中的至少一者的系统”应当包括但不限于具有仅A、仅B、仅C、A和B一起、A和C一起、B和C一起和/或A、B和C一起等的系统)。本领域的技术人员还应当理解，通常，除非上下文另有指示，否则无论在具体实施方式、权利要求或附图中呈现两个或更多个替代术语的转折性词语和/或短语应理解为涵盖包括所述术语中的一者、所述术语中的任一个或这两个术语的可能性。例如，短语“A或B”通常将被理解为包括“A”或“B”或“A和B”的可能性。In addition, even if a specific number of claim recitations is explicitly recited, those skilled in the art will recognize that such recitation should generally be interpreted to mean at least the recited number (e.g., a bare recitation of "two recitations" without other modifiers generally means at least two recitations, or two or more recitations). In addition, in those cases where a convention similar to "at least one of A, B, and C, etc." is used, generally, such construction is intended to have the meaning that those skilled in the art will understand the convention (e.g., "a system having at least one of A, B, and C" will include, but is not limited to, systems having only A, only B, only C, A and B together, A and C together, B and C together, and/or A, B, and C together, etc.). In those cases where a convention similar to "at least one of A, B, or C, etc." is used, generally, such construction is intended to have the meaning that those skilled in the art will understand the convention (e.g., "a system having at least one of A, B, or C" will include, but is not limited to, systems having only A, only B, only C, A and B together, A and C together, B and C together, and/or A, B, and C together, etc.). Those skilled in the art will also understand that, generally, unless the context indicates otherwise, transitional words and/or phrases presenting two or more alternative terms in the detailed description, claims, or drawings should be understood to include the possibility of including one of the terms, any one of the terms, or both of the terms. For example, the phrase "A or B" will generally be understood to include the possibility of "A" or "B" or "A and B".

对于所附的权利要求，本领域的技术人员将会理解，其中表述的操作通常可以任何顺序进行。另外，尽管以一个或多个序列出了各种操作流程图，但应当理解，可以不同于所示顺序的其它顺序执行各种操作，或者可同时执行所述各种操作。除非上下文另有规定，否则此类替代排序的示例可包括重叠、交错、中断、重新排序、增量、预备、补充、同时、反向，或其它改变的排序。此外，除非上下文另有规定，否则像“响应于”、“相关”这样的术语或其它过去式的形容词通常不旨在排除此类变体。For the attached claims, those skilled in the art will appreciate that the operations described therein can generally be performed in any order. In addition, although various operational flow charts are shown in one or more sequences, it should be understood that various operations can be performed in other orders different from the order shown, or the various operations can be performed simultaneously. Unless the context otherwise dictates, examples of such alternative orderings may include overlapping, interlaced, interrupted, reordered, incremental, preparatory, supplementary, simultaneous, reverse, or other altered orderings. In addition, unless the context otherwise dictates, terms such as "responsive to", "related to" or other past tense adjectives are generally not intended to exclude such variants.

值得一提的是，任何对“一个方面”、“一方面”、“一范例”、“一个范例”的提及均意指结合所述方面所述的具体特征件、结构或特征包括在至少一个方面中。因此，在整个说明书的各种位置出现的短语“在一个方面”、“在一方面”、“在一范例中”、“在一个范例中”不一定都指同一方面。此外，具体特征件、结构或特征可在一个或多个方面中以任何合适的方式组合。It is worth mentioning that any reference to "one aspect", "an aspect", "an example", or "an example" means that the specific features, structures, or characteristics described in conjunction with the aspect are included in at least one aspect. Therefore, the phrases "in one aspect", "in an aspect", "in an example", or "in an example" appearing in various places throughout the specification do not necessarily refer to the same aspect. In addition, specific features, structures, or characteristics may be combined in any suitable manner in one or more aspects.

本说明书提及和/或在任何申请数据表中列出的任何专利申请，专利，非专利公布或其它公开材料均以引用方式并入本文，只要所并入的材料在此不一致。因此，并且在必要的程度下，本文明确列出的公开内容代替以引用方式并入本文的任何冲突材料。据称以引用方式并入本文但与本文列出的现有定义、陈述或其它公开材料相冲突的任何材料或其部分，将仅在所并入的材料和现有的公开材料之间不产生冲突的程度下并入。Any patent application, patent, non-patent publication or other public material referred to in this specification and/or listed in any application data sheet is incorporated herein by reference to the extent that the incorporated material is inconsistent herewith. Therefore, and to the extent necessary, the disclosure explicitly listed herein supersedes any conflicting material incorporated herein by reference. Any material or portion thereof that is alleged to be incorporated herein by reference but conflicts with existing definitions, statements or other public material listed herein will be incorporated only to the extent that there is no conflict between the incorporated material and the existing public material.

概括地说，已经描述了由采用本文所述的概念产生的许多有益效果。为了举例说明和描述的目的，已经提供了一个或多个形式的上述具体实施方式。这些具体实施方式并非意图为详尽的或限定到本发明所公开的精确形式。可以按照上述教导内容对本发明进行修改或变型。选择和描述的一个或多个形式是为了说明原理和实际应用，从而使本领域的普通技术人员能够利用适用于预期的特定用途的各种形式和各种修改形式。与此一同提交的权利要求书旨在限定完整范围。In summary, many of the benefits resulting from the use of the concepts described herein have been described. For purposes of illustration and description, one or more of the above specific embodiments have been provided. These specific embodiments are not intended to be exhaustive or limited to the precise forms disclosed by the invention. The invention may be modified or varied in accordance with the above teachings. The one or more forms selected and described are intended to illustrate the principles and practical applications so that one of ordinary skill in the art can utilize various forms and various modifications suitable for the intended specific use. The claims submitted herewith are intended to define the full scope.

Claims (19)

1. A surgical instrument, comprising:

a proximal end effector, the end effector comprising:

an ultrasonic knife; and

a clamping arm movable relative to the ultrasonic blade to transition the end effector between an open configuration and a closed configuration through different stages of closure to clamp tissue between the ultrasonic blade and the clamping arm;

a transducer configured to generate an ultrasonic energy output;

a waveguide configured to transmit the ultrasonic energy output to the ultrasonic blade;

a drive member configured to actuate movement of the clamp arm through the different closing phases;

a sensor comprising at least one first sensor and at least one second sensor configured to transmit a sensor signal indicative of the closing phase of the end effector; and

a control circuit configured to:

defining each of the different closing phases based on a range of positions of the drive member;

receiving a sensor parameter in the sensor signal;

Detecting, by the at least one first sensor, a first sensor parameter indicative of one of the different closure phases of the end effector;

detecting, by the at least one second sensor, a second sensor parameter, wherein the second sensor parameter indicates whether the clamping arm has established initial contact with tissue in a closing phase indicated by the first sensor parameter;

receiving data from at least one data source, wherein the data determines situation parameters of tissue corresponding to a surgical procedure;

determining a closing phase of the end effector based on the first sensor parameter in the sensor signal, wherein the first sensor parameter is a unique position of a drive member selected from a range of positions of the drive member corresponding to the different closing phases; and

based on the received sensor signals and the situation parameters of the tissue corresponding to the surgical procedure, an operational mode is selected from the operational modes delivering different ultrasound energy outputs from the transducers.

2. The surgical instrument of claim 1, wherein the modes of operation comprise:

A low energy mode of operation configured to cause tissue separation but not tissue coagulation; and

a high energy mode of operation configured to cause coagulation of the tissue.

3. The surgical instrument of claim 1, wherein the closing phase comprises an initial closing phase having a span that covers an initial portion of the range of motion of the clamp arm up to a predetermined threshold.

4. The surgical instrument of claim 3, wherein the control circuit is configured to select a first mode of operation that delivers a first ultrasonic energy output during the initial closing phase.

5. The surgical instrument of claim 4, wherein the control circuit is configured to switch to a second mode of operation that delivers a second ultrasonic energy output that is greater than the first ultrasonic energy output if the predetermined threshold is exceeded.

6. The surgical instrument of claim 1, wherein selecting between modes of operation is based on at least one of the situational parameters.

7. The surgical instrument of claim 6, wherein at least one of the situational parameters comprises a type of tissue.

8. The surgical instrument of claim 6, wherein at least one of the situational parameters includes an anatomical location of tissue.

9. The surgical instrument of claim 6, wherein at least one of the situational parameters comprises a composition of tissue.

10. A surgical instrument, comprising:

an end effector, the end effector comprising:

an ultrasonic knife; and

a clamping arm movable relative to the ultrasonic blade to transition the end effector between an open configuration and a closed configuration through different closing stages to clamp tissue between the ultrasonic blade and the clamping arm, wherein the different closing stages comprise:

a first closing phase; and

a second closing phase subsequent to the first closing phase;

a transducer configured to generate an ultrasonic energy output;

a waveguide configured to transmit the ultrasonic energy output to the ultrasonic blade;

a drive member configured to actuate movement of the clamp arm through the different closing phases;

a sensor circuit configured to transmit a sensor signal indicative of detection of initial contact of the clamping arm with the tissue; and

A control circuit configured to:

defining each of the different closing phases by a range of angular distances between the clamping arm and the ultrasonic blade and a range of positions of the drive member;

receiving a position parameter indicative of one of the different closure phases of the end effector;

receiving the sensor signal indicative of initial contact of the clamping arm with the tissue;

receiving data from at least one data source, wherein the data determines situation parameters of tissue corresponding to a surgical procedure;

determining a closing phase of the end effector based on the position parameters, wherein the position parameters include one of the positions of the drive member within a predetermined range corresponding to one of the different closing phases;

causing the transducer to generate a first ultrasonic energy output in response to receiving the sensor signal, the location parameter, and a situational parameter of tissue corresponding to the surgical procedure in the first closure phase; and

the transducer is caused to generate a second ultrasonic energy output that is greater than the first ultrasonic energy output in response to receiving the sensor signal, the location parameter, and a situational parameter of tissue corresponding to the surgical procedure in the second closure phase.

11. The surgical instrument of claim 10, wherein the control circuit is further configured to switch the transducer from the first ultrasonic energy output to the second ultrasonic energy output in response to transitioning from the first closed phase to the second closed phase.

12. The surgical instrument of claim 10, wherein the first ultrasonic energy output is configured to cause tissue separation but not tissue coagulation, and wherein the second ultrasonic energy output is configured to cause the tissue coagulation.

13. The surgical instrument of claim 10, wherein the span of the first closing phase covers a first portion of the range of motion of the clamp arm up to a predetermined threshold.

14. The surgical instrument of claim 13, wherein a span of the second closing phase covers a second portion of the range of motion of the clamp arm that exceeds the predetermined threshold.

15. The surgical instrument of claim 13, wherein the control circuit is further configured to switch the transducer from the first ultrasonic energy output to the second ultrasonic energy output in response to the clamp arm transitioning beyond the predetermined threshold.

16. The surgical instrument of claim 10, wherein at least one of the first ultrasonic energy output and the second ultrasonic energy output is further determined by the received first sensor signal indicative of one of the different closure phases and at least one of the situational parameters.

17. The surgical instrument of claim 16, wherein at least one of the situational parameters comprises a type of tissue.

18. The surgical instrument of claim 16, wherein at least one of the situational parameters includes an anatomical location of tissue.

19. The surgical instrument of claim 16, wherein at least one of the situational parameters comprises a composition of tissue.