US20180085117A1 - Powered surgical instrument - Google Patents

Abstract

A method of operating a surgical instrument is disclosed. The surgical instrument includes an electronic system comprising an electric motor coupled to the end effector; a motor controller coupled to the motor; a parameter threshold detection module configured to monitor multiple parameter thresholds; a sensing module configured to sense tissue compression; a processor coupled to the parameter threshold detection module and the motor controller; and a memory coupled to the processor. The memory stores executable instructions that when executed by the processor cause the processor to monitor multiple levels of action thresholds and monitor speed of the motor and increment a drive unit of the motor, sense tissue compression, and provide rate and control feedback to the user of the surgical instrument.

Description

CROSS-REFERENCE TO RELATED APPLICATION
• This application is a continuation application claiming priority under 35 U.S.C. § 120 to U.S. patent application Ser. No. 14/640,746, entitled POWERED SURGICAL INSTRUMENT, filed Mar. 6, 2015, now U.S. Patent Application Publication No. 2016/0256184, the entire disclosure of which is hereby incorporated by reference herein.
BACKGROUND
• The present disclosure relates to surgical instruments and, in various circumstances, to surgical stapling and cutting instruments and staple cartridges therefor that are designed to staple and cut tissue.
BRIEF DESCRIPTION OF THE DRAWINGS
• The features and advantages of the present disclosure, and the manner of attaining them, will become more apparent and the present disclosure will be better understood by reference to the following description of the present disclosure taken in conjunction with the accompanying drawings, wherein:
• FIG. 1 is a perspective view of a surgical instrument that has an interchangeable shaft assembly operably coupled thereto;
• FIG. 2 is an exploded assembly view of the interchangeable shaft assembly and surgical instrument ofFIG. 1;
• FIG. 3 is another exploded assembly view showing portions of the interchangeable shaft assembly and surgical instrument ofFIGS. 1 and 2;
• FIG. 4 is an exploded assembly view of a portion of the surgical instrument ofFIGS. 1-3;
• FIG. 5 is a cross-sectional side view of a portion of the surgical instrument ofFIG. 4 with the firing trigger in a fully actuated position;
• FIG. 6 is another cross-sectional view of a portion of the surgical instrument ofFIG. 5 with the firing trigger in an unactuated position;
• FIG. 7 is an exploded assembly view of one form of an interchangeable shaft assembly;
• FIG. 8 is another exploded assembly view of portions of the interchangeable shaft assembly ofFIG. 7;
• FIG. 9 is another exploded assembly view of portions of the interchangeable shaft assembly ofFIGS. 7 and 8;
• FIG. 10 is a cross-sectional view of a portion of the interchangeable shaft assembly ofFIGS. 7-9;
• FIG. 11 is a perspective view of a portion of the shaft assembly ofFIGS. 7-10 with the switch drum omitted for clarity;
• FIG. 12 is another perspective view of the portion of the interchangeable shaft assembly ofFIG. 11 with the switch drum mounted thereon;
• FIG. 13 is a perspective view of a portion of the interchangeable shaft assembly ofFIG. 11 operably coupled to a portion of the surgical instrument ofFIG. 1 illustrated with the closure trigger thereof in an unactuated position;
• FIG. 14 is a right side elevational view of the interchangeable shaft assembly and surgical instrument ofFIG. 13;
• FIG. 15 is a left side elevational view of the interchangeable shaft assembly and surgical instrument ofFIGS. 13 and 14;
• FIG. 16 is a perspective view of a portion of the interchangeable shaft assembly ofFIG. 11 operably coupled to a portion of the surgical instrument ofFIG. 1 illustrated with the closure trigger thereof in an actuated position and a firing trigger thereof in an unactuated position;
• FIG. 17 is a right side elevational view of the interchangeable shaft assembly and surgical instrument ofFIG. 16;
• FIG. 18 is a left side elevational view of the interchangeable shaft assembly and surgical instrument ofFIGS. 16 and 17;
• FIG. 18A is a right side elevational view of the interchangeable shaft assembly ofFIG. 11 operably coupled to a portion of the surgical instrument ofFIG. 1 illustrated with the closure trigger thereof in an actuated position and the firing trigger thereof in an actuated position;
• FIG. 19 is a schematic of a system for powering down an electrical connector of a surgical instrument handle when a shaft assembly is not coupled thereto;
• FIG. 20 is an exploded view of one aspect of an end effector of the surgical instrument ofFIG. 1;
• FIGS. 21A-21B is a circuit diagram of the surgical instrument ofFIG. 1 spanning two drawings sheets;
• FIG. 22 illustrates one instance of a power assembly comprising a usage cycle circuit configured to generate a usage cycle count of the battery back;
• FIG. 23 illustrates one aspect of a process for sequentially energizing a segmented circuit;
• FIG. 24 illustrates one aspect of a power segment comprising a plurality of daisy chained power converters;
• FIG. 25 illustrates one aspect of a segmented circuit configured to maximize power available for critical and/or power intense functions;
• FIG. 26 illustrates one aspect of a power system comprising a plurality of daisy chained power converters configured to be sequentially energized;
• FIG. 27 illustrates one aspect of a segmented circuit comprising an isolated control section;
• FIG. 28, which is divided intoFIGS. 28A and 28B, is a circuit diagram of the surgical instrument ofFIG. 1;
• FIG. 29 is a block diagram the surgical instrument ofFIG. 1 illustrating interfaces between thehandle assembly14 and the power assembly and between thehandle assembly14 and the interchangeable shaft assembly;
• FIG. 30 illustrates one aspect of a process for utilizing thresholds to modify operations of a surgical instrument;
• FIG. 31 illustrates an example graph showing modification of operations of a surgical instrument describing a linear function;
• FIG. 32 illustrates an example graph showing modification of operations of a surgical instrument describing a non-linear function;
• FIG. 33 illustrates an example graph showing modification of operations of a surgical instrument based on an expected user input parameter;
• FIG. 34 illustrates an example graph showing modification of velocity of a drive based on detection of a threshold;
• FIG. 35 illustrates an example graph showing modification in connection with operations based on battery current based on detection of a threshold;
• FIG. 36 illustrates an example graph showing modification in connection with operations based on battery voltage based on detection of a threshold;
• FIG. 37 illustrates an example graph showing modification of knife speed based on detection of a cycle threshold;
• FIG. 38 illustrates a logic diagram of a system for evaluating sharpness of a cutting edge of a surgical instrument according to various aspects;
• FIG. 39 illustrates a logic diagram of a system for determining the forces applied against a cutting edge of a surgical instrument by a sharpness testing member at various sharpness levels according to various aspects;
• FIG. 40 illustrates a flow chart of a method for determining whether a cutting edge of a surgical instrument is sufficiently sharp to transect tissue captured by the surgical instrument according to various aspects;
• FIG. 41 illustrates a chart of the forces applied against a cutting edge of a surgical instrument by a sharpness testing member at various sharpness levels according to various embodiments.
• FIG. 42 illustrates a flow chart outlining a method for determining whether a cutting edge of a surgical instrument is sufficiently sharp to transect tissue captured by the surgical instrument according to various embodiments.
• FIG. 43 illustrates one aspect of a process for adapting operations of a surgical instrument;
• FIG. 44 illustrates one aspect of a process for adapting operations of a surgical instrument;
• FIG. 45 illustrates one aspect of a mechanism for adapting operations of a surgical instrument in the context of closure motion and tissue pressure;
• FIG. 46 illustrates one aspect of a mechanism for adapting speed associated with a parameter of a surgical instrument in the context of tissue modification and sensor modification;
• FIG. 47 illustrates one aspect of a mechanism for adapting firing rate associated with a parameter of a surgical instrument in the context of tissue modification and sensor modification;
• FIG. 48 illustrates one aspect of a mechanism for adapting operations associated with a surgical instrument in the context of tissue compression during a clamping phase;
• FIG. 49 illustrates one aspect of a mechanism for adapting operations associated with a surgical instrument in the context of tissue compression during a firing phase;
• FIG. 50 illustrates one aspect of a mechanism for adapting operations associated with a surgical instrument in the context of slowing a firing event where a peak is predicted above a limit;
• FIG. 51 illustrates a portion of tissue having a disparity in thickness;
• FIG. 52 depicts an example medical device that can include one or more aspects of the present disclosure;
• FIG. 53A depicts an example end-effector of a medical device surrounding tissue in accordance with one or more aspects of the present disclosure;
• FIG. 53B depicts an example end-effector of a medical device compressing tissue in accordance with one or more aspects of the present disclosure;
• FIG. 54A depicts example forces exerted by an end-effector of a medical device compressing tissue in accordance with one or more aspects of the present disclosure;
• FIG. 54B also depicts example forces exerted by an end-effector of a medical device compressing tissue in accordance with one or more aspects of the present disclosure;
• FIG. 55 depicts an example tissue compression sensor system in accordance with one or more aspects of the present disclosure;
• FIG. 56 also depicts an example tissue compression sensor system in accordance with one or more aspects of the present disclosure;
• FIG. 57 also depicts an example tissue compression sensor system in accordance with one or more aspects of the present disclosure;
• FIG. 58 depicts an example end-effector channel frame in accordance with one or more aspects of the present disclosure;
• FIG. 59 depicts an example end-effector in accordance with one or more aspects of the present disclosure;
• FIG. 60 also depicts an example end-effector channel frame in accordance with one or more aspects of the present disclosure;
• FIG. 61 also depicts an example end-effector channel frame in accordance with one or more aspects of the present disclosure;
• FIG. 62 also depicts an example end-effector channel frame in accordance with one or more aspects of the present disclosure;
• FIG. 63 depicts an example electrode in accordance with one or more aspects of the present disclosure;
• FIG. 64 depicts an example electrode wiring system in accordance with one or more aspects of the present disclosure;
• FIG. 65 also depicts an example end-effector channel frame in accordance with one or more aspects of the present disclosure;
• FIG. 66 is an example circuit diagram in accordance with one or more aspects of the present disclosure;
• FIG. 67 is also an example circuit diagram in accordance with one or more aspects of the present disclosure;
• FIG. 68 is also an example circuit diagram in accordance with one or more aspects of the present disclosure;
• FIG. 69 is graph depicting an example frequency modulation in accordance with one or more aspects of the present disclosure;
• FIG. 70 is graph depicting a compound RF signal in accordance with one or more aspects of the present disclosure;
• FIG. 71 is graph depicting filtered RF signals in accordance with one or more aspects of the present disclosure;
• FIG. 72 is a plan view of a speed sensor assembly for a surgical instrument power train;
• FIG. 73 is a longitudinal cross section through plane A ofFIG. 71;
• FIG. 74 is a perspective view of a speed sensor assembly for a brushless motor;
• FIG. 75 is a transverse cross section through plane B ofFIG. 73;
• FIG. 76 is a perspective view of a surgical instrument with an articulable, interchangeable shaft;
• FIG. 77 is a side view of the tip of the surgical instrument shown inFIG. 76;
• FIGS. 78A-78E are graphs plotting gap size over time (FIG. 78A), firing current over time (FIG. 78B), tissue compression over time (FIG. 78C), anvil strain over time (FIG. 78D), and trigger force over time (FIG. 78E);
• FIG. 79 is a graph plotting tissue displacement as a function of tissue compression for normal tissues;
• FIG. 80 is a graph plotting tissue displacement as a function of tissue compression to distinguish normal and diseased tissues;
• FIG. 81 illustrates a perspective view of a surgical instrument in accordance with one aspect;
• FIG. 82 illustrates an exploded view of the end effector of the surgical instrument ofFIG. 81 in accordance with one aspect;
• FIG. 83 illustrates a partial side view of a handle of the surgical instrument ofFIG. 81 in accordance with one aspect;
• FIG. 84 illustrates a cross-sectional view of an end effector of the surgical instrument ofFIG. 81 in accordance with one aspect;
• FIG. 85 illustrates a logic diagram of a process in accordance with one aspect;
• FIG. 86 illustrates a logic diagram of a feedback system in accordance with one aspect;
• FIG. 87 illustrates a logic diagram of a feedback system in accordance with one aspect;
• FIG. 88 illustrates a feedback indicator of a feedback system in accordance with one aspect;
• FIG. 89 illustrates a feedback indicator of a feedback system in accordance with one aspect;
• FIG. 90 illustrates a feedback indicator of a feedback system in accordance with one aspect;
• FIG. 91 illustrates a feedback indicator of a feedback system in accordance with one aspect;
• FIG. 92 illustrates a feedback indicator of a feedback system in accordance with one aspect;
• FIG. 93 illustrates a feedback indicator of a feedback system in accordance with one aspect;
• FIG. 94 illustrates a feedback indicator of a feedback system in accordance with one aspect;
• FIG. 95 illustrates a feedback indicator of a feedback system in accordance with one aspect;
• FIG. 96 illustrates a feedback indicator of a feedback system in accordance with one aspect;
• FIG. 97 is a schematic depicting control systems of the modular surgical instrument system ofFIG. 1, according to various aspects of the present disclosure;
• FIG. 98 is a logic diagram of a method for implementing a surgical function with the modular surgical instrument system ofFIG. 1, according to various aspects of the present disclosure;
• FIG. 99 depicts an example medical device that can include one or more aspects of the present disclosure;
• FIG. 100 depicts an example end-effector of a medical device that can include one or more aspects of the present disclosure;
• FIG. 101 also depicts an example end-effector of a medical device that can include one or more aspects of the present disclosure;
• FIG. 102 is a diagram of a smart sensor component in accordance with an aspect the present disclosure;
• FIG. 103 is a logic diagram illustrating one aspect of a process for calibrating a first sensor in response to an input from a second sensor;
• FIG. 104 is a logic diagram illustrating one aspect of a process for adjusting a measurement of a first sensor in response to a plurality of secondary sensors;
• FIG. 105 illustrates one aspect of a circuit configured to convert signals from a first sensor and a plurality of secondary sensors into digital signals receivable by a processor;
• FIG. 106 is a logic diagram illustrating one aspect of a process for selecting the most reliable output from a plurality of redundant sensors;
• FIG. 107 illustrates a sideways cross-sectional view of one aspect of an end effector comprising a magnet and a magnetic field sensor in communication with processor;
• FIGS. 108-110 illustrate one aspect of an end effector that comprises a magnet whereFIG. 108 illustrates a perspective cutaway view of the anvil and the magnet,FIG. 109 illustrates a side cutaway view of the anvil and the magnet, andFIG. 110 illustrates a top cutaway view of the anvil and the magnet;
• FIG. 111 illustrates one aspect of an end effector that is operable to use conductive surfaces at the distal contact point to create an electrical connection;
• FIG. 112 illustrates one aspect of an exploded view of a staple cartridge that comprises a flex cable connected to a magnetic field sensor and processor;
• FIG. 113 illustrates the end effector shown inFIG. 112 with a flex cable and without the shaft assembly;
• FIGS. 114 and 115 illustrate an elongated channel portion of an end effector without the anvil or the staple cartridge, to illustrate how the flex cable shown inFIG. 113 can be seated within the elongated channel;
• FIG. 116 illustrates a flex cable, shown inFIGS. 113-115, alone;
• FIG. 117 illustrates a close up view of the elongated channel shown inFIGS. 114 and 115 with a staple cartridge coupled thereto;
• FIGS. 118 and 119 illustrate one aspect of a distal sensor plug whereFIG. 118 illustrates a cutaway view of the distal sensor plug andFIG. 119 further illustrates the magnetic field sensor and the processor operatively coupled to the flex board such that they are capable of communicating;
• FIG. 120 illustrates an aspect of an end effector with a flex cable operable to provide power to sensors and electronics in the distal tip of the anvil portion;
• FIGS. 121-123 illustrate the operation of the articulation joint and flex cable of the end effector whereFIG. 121 illustrates a top view of the end effector with the end effector pivoted −45 degrees with respect to the shaft assembly,FIG. 122 illustrates a top view of the end effector, andFIG. 123 illustrates a top view of the end effector with the end effector pivoted +45 degrees with respect to the shaft assembly;
• FIG. 124 illustrates cross-sectional view of the distal tip of an aspect of an anvil with sensors and electronics; and
• FIG. 125 illustrates a cutaway view of the distal tip of the anvil.
• FIG. 126 is a partial cross-sectional view of a handle of a surgical instrument comprising a battery and a battery lock in accordance with at least one embodiment;
• FIG. 127 is partial cross-sectional view of the handle ofFIG. 126 illustrating the battery lock in an unlocked configuration;
• FIG. 128 is a partial cross-sectional view of the handle ofFIG. 126 illustrating the battery lock in a locked configuration;
• FIG. 129 is a partial cross-sectional view of a handle of a surgical instrument comprising a battery lockout in accordance with at least one embodiment illustrated in an unlocked configuration;
• FIG. 130 is a partial cross-sectional view of the handle ofFIG. 129 illustrating the battery lockout in a locked-out configuration;
• FIG. 131 is a partial cross-sectional view of a battery lockout in accordance with an alternative embodiment illustrated in a locked-out configuration;
• FIG. 132 depicts a surgical instrument system comprising a motor including a shaft, a gear train, an output shaft operably coupled to the motor shaft, and power generation means mounted to the motor shaft in accordance with at least one embodiment;
• FIG. 133 depicts the motor shaft ofFIG. 132 which includes a strain gauge and means for transmitting information from the motor shaft, i.e., a rotating plane, to a stationary plane mounted to the motor shaft and, in addition, means for interpreting the information being transmitted from the motor shaft;
• FIG. 134 is a perspective view of an end effector of a surgical stapling instrument including a cartridge channel, a staple cartridge positioned in the cartridge channel, and an anvil;
• FIG. 135 is a cross-sectional elevational view of the surgical stapling instrument ofFIG. 134 illustrating a sled and a firing member in an unfired position;
• FIG. 136 is a detail view depicting the sled ofFIG. 135 in a partially advanced position and the firing member in its unfired position;
• FIG. 137 is a perspective view of the staple cartridge ofFIG. 134 prior to being inserted into the cartridge channel ofFIG. 134;
• FIG. 138 is a perspective view of the staple cartridge ofFIG. 134 fully seated in the cartridge channel ofFIG. 134;
• FIG. 139 is a schematic of the staple cartridge and cartridge channel ofFIG. 134 and the sled and the firing member ofFIG. 135 depicting a mis-insertion of the staple cartridge into the cartridge channel and the effect on the sled that such a mis-insertion can cause;
• FIG. 140 is a partial perspective view of an end effector of a surgical stapling instrument in accordance with at least one embodiment including a sensor configured to sense whether a staple cartridge has been mis-inserted in the manner depicted inFIG. 139;
• FIG. 141 is a partial perspective view of an end effector of a surgical stapling instrument in accordance with at least one embodiment including a sensor configured to detect whether the sled has been unintentionally advanced;
• FIG. 142 is a partial perspective view of the end effector ofFIG. 141 illustrating the sled in an unintentionally advanced position;
• FIG. 143 is a cross-sectional view of the sensor ofFIG. 141 in accordance with at least one embodiment; and
• FIG. 144 is a cross-sectional view of the sensor ofFIG. 141 in accordance with at least one alternative embodiment.
DESCRIPTION
• Applicant of the present application owns the following patent applications that were filed on Mar. 6, 2015 and which are each herein incorporated by reference in their respective entireties:
• U.S. patent application Ser. No. 14/640,795, entitled MULTIPLE LEVEL THRESHOLDS TO MODIFY OPERATION OF POWERED SURGICAL INSTRUMENTS; now U.S. Patent Application Publication No. 2016/0256185;
• U.S. patent application Ser. No. 14/640,832, entitled ADAPTIVE TISSUE COMPRESSION TECHNIQUES TO ADJUST CLOSURE RATES FOR MULTIPLE TISSUE TYPES; now U.S. Patent Application Publication No. 2016/0256154;
• U.S. patent application Ser. No. 14/640,935, entitled OVERLAID MULTI SENSOR RADIO FREQUENCY (RF) ELECTRODE SYSTEM TO MEASURE TISSUE COMPRESSION; now U.S. Patent Application Publication No. 2016/0256071;
• U.S. patent application Ser. No. 14/640,831, entitled MONITORING SPEED CONTROL AND PRECISION INCREMENTING OF MOTOR FOR POWERED SURGICAL INSTRUMENTS; now U.S. Patent Application Publication No. 2016/0256153;
• U.S. patent application Ser. No. 14/640,859, entitled TIME DEPENDENT EVALUATION OF SENSOR DATA TO DETERMINE STABILITY, CREEP, AND VISCOELASTIC ELEMENTS OF MEASURES; now U.S. Patent Application Publication No. 2016/0256187;
• U.S. patent application Ser. No. 14/640,817, entitled INTERACTIVE FEEDBACK SYSTEM FOR POWERED SURGICAL INSTRUMENTS; now U.S. Patent Application Publication No. 2016/0256186;
• U.S. patent application Ser. No. 14/640,844, entitled CONTROL TECHNIQUES AND SUB-PROCESSOR CONTAINED WITHIN MODULAR SHAFT WITH SELECT CONTROL PROCESSING FROM HANDLE; now U.S. Patent Application Publication No. 2016/0256155;
• U.S. patent application Ser. No. 14/640,837, entitled SMART SENSORS WITH LOCAL SIGNAL PROCESSING; now U.S. Patent Application Publication No. 2016/0256163;
• U.S. patent application Ser. No. 14/640,780, entitled SURGICAL INSTRUMENT COMPRISING A LOCKABLE BATTERY HOUSING; now U.S. Patent Application Publication No. 2016/0256161;
• U.S. patent application Ser. No. 14/640,765, entitled SYSTEM FOR DETECTING THE MIS-INSERTION OF A STAPLE CARTRIDGE INTO A SURGICAL STAPLER; now U.S. Patent Application Publication No. 2016/0256160; and
• U.S. patent application Ser. No. 14/640,799, entitled SIGNAL AND POWER COMMUNICATION SYSTEM POSITIONED ON A ROTATABLE SHAFT; now U.S. Patent Application Publication No. 2016/0256162.
• Applicant of the present application owns the following patent applications that were filed on Feb. 27, 2015, and which are each herein incorporated by reference in their respective entireties:
• U.S. patent application Ser. No. 14/633,576, entitled SURGICAL INSTRUMENT SYSTEM COMPRISING AN INSPECTION STATION; now U.S. Patent Application Publication No. 2016/0249919;
• U.S. patent application Ser. No. 14/633,546, entitled SURGICAL APPARATUS CONFIGURED TO ASSESS WHETHER A PERFORMANCE PARAMETER OF THE SURGICAL APPARATUS IS WITHIN AN ACCEPTABLE PERFORMANCE BAND; now U.S. Patent Application Publication No. 2016/0249915;
• U.S. patent application Ser. No. 14/633,576, entitled SURGICAL CHARGING SYSTEM THAT CHARGES AND/OR CONDITIONS ONE OR MORE BATTERIES; now U.S. Patent Application Publication No. 2016/0249919;
• U.S. patent application Ser. No. 14/633,566, entitled CHARGING SYSTEM THAT ENABLES EMERGENCY RESOLUTIONS FOR CHARGING A BATTERY; now U.S. Patent Application Publication No. 2016/0249918;
• U.S. patent application Ser. No. 14/633,555, entitled SYSTEM FOR MONITORING WHETHER A SURGICAL INSTRUMENT NEEDS TO BE SERVICED; now U.S. Patent Application Publication No. 2016/0249916;
• U.S. patent application Ser. No. 14/633,542, entitled REINFORCED BATTERY FOR A SURGICAL INSTRUMENT; now U.S. Patent Application Publication No. 2016/0249908;
• U.S. patent application Ser. No. 14/633,548, entitled POWER ADAPTER FOR A SURGICAL INSTRUMENT; now U.S. Patent Application Publication No. 2016/0249909;
• U.S. patent application Ser. No. 14/633,526, entitled ADAPTABLE SURGICAL INSTRUMENT HANDLE; now U.S. Patent Application Publication No. 2016/0249945;
• U.S. patent application Ser. No. 14/633,541, entitled MODULAR STAPLING ASSEMBLY; now U.S. Patent Application Publication No. 2016/0249927; and
• U.S. patent application Ser. No. 14/633,562, entitled SURGICAL APPARATUS CONFIGURED TO TRACK AN END-OF-LIFE PARAMETER; now U.S. Patent Application Publication No. 2016/0249917.
• Applicant of the present application owns the following patent applications that were filed on Dec. 18, 2014 and which are each herein incorporated by reference in their respective entireties:
• U.S. patent application Ser. No. 14/574,478, entitled SURGICAL INSTRUMENT SYSTEMS COMPRISING AN ARTICULATABLE END EFFECTOR AND MEANS FOR ADJUSTING THE FIRING STROKE OF A FIRING MEMBER; now U.S. Patent Application Publication No. 2016/0174977;
• U.S. patent application Ser. No. 14/574,483, entitled SURGICAL INSTRUMENT ASSEMBLY COMPRISING LOCKABLE SYSTEMS; now U.S. Patent Application Publication No. 2016/0174969;
• U.S. patent application Ser. No. 14/575,139, entitled DRIVE ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS; now U.S. Patent Application Publication No. 2016/0174978;
• U.S. patent application Ser. No. 14/575,148, entitled LOCKING ARRANGEMENTS FOR DETACHABLE SHAFT ASSEMBLIES WITH ARTICULATABLE SURGICAL END EFFECTORS; now U.S. Patent Application Publication No. 2016/0174976;
• U.S. patent application Ser. No. 14/575,130, entitled SURGICAL INSTRUMENT WITH AN ANVIL THAT IS SELECTIVELY MOVABLE ABOUT A DISCRETE NON-MOVABLE AXIS RELATIVE TO A STAPLE CARTRIDGE; now U.S. Patent Application Publication No. 2016/0174972;
• U.S. patent application Ser. No. 14/575,143, entitled SURGICAL INSTRUMENTS WITH IMPROVED CLOSURE ARRANGEMENTS; now U.S. Patent Application Publication No. 2016/0174983;
• U.S. patent application Ser. No. 14/575,117, entitled SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS; now U.S. Patent Application Publication No. 2016/0174975;
• U.S. patent application Ser. No. 14/575,154, entitled SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND IMPROVED FIRING BEAM SUPPORT ARRANGEMENTS; now U.S. Patent Application Publication No. 2016/0174973;
• U.S. patent application Ser. No. 14/574,493, entitled SURGICAL INSTRUMENT ASSEMBLY COMPRISING A FLEXIBLE ARTICULATION SYSTEM; now U.S. Patent Application Publication No. 2016/0174970; and
• U.S. patent application Ser. No. 14/574,500, entitled SURGICAL INSTRUMENT ASSEMBLY COMPRISING A LOCKABLE ARTICULATION SYSTEM; now U.S. Patent Application Publication No. 2016/0174971.
• Applicant of the present application owns the following patent applications that were filed on Mar. 1, 2013 and which are each herein incorporated by reference in their respective entireties:
• U.S. patent application Ser. No. 13/782,295, entitled ARTICULATABLE SURGICAL INSTRUMENTS WITH CONDUCTIVE PATHWAYS FOR SIGNAL COMMUNICATION, now U.S. Pat. No. 9,700,309;
• U.S. patent application Ser. No. 13/782,323, entitled ROTARY POWERED ARTICULATION JOINTS FOR SURGICAL INSTRUMENTS, now U.S. Pat. No. 9,782,169;
• U.S. patent application Ser. No. 13/782,338, entitled THUMBWHEEL SWITCH ARRANGEMENTS FOR SURGICAL INSTRUMENTS, now U.S. Patent Application Publication No. 2014/0249557;
• U.S. patent application Ser. No. 13/782,499, entitled ELECTROMECHANICAL SURGICAL DEVICE WITH SIGNAL RELAY ARRANGEMENT, now U.S. Pat. No. 9,358,003;
• U.S. patent application Ser. No. 13/782,460, entitled MULTIPLE PROCESSOR MOTOR CONTROL FOR MODULAR SURGICAL INSTRUMENTS, now U.S. Pat. No. 9,554,794;
• U.S. patent application Ser. No. 13/782,358, entitled JOYSTICK SWITCH ASSEMBLIES FOR SURGICAL INSTRUMENTS, now U.S. Pat. No. 9,326,767;
• U.S. patent application Ser. No. 13/782,481, entitled SENSOR STRAIGHTENED END EFFECTOR DURING REMOVAL THROUGH TROCAR, now U.S. Pat. No. 9,468,438;
• U.S. patent application Ser. No. 13/782,518, entitled CONTROL METHODS FOR SURGICAL INSTRUMENTS WITH REMOVABLE IMPLEMENT PORTIONS, now U.S. Patent Application Publication No. 2014/0246475;
• U.S. patent application Ser. No. 13/782,375, entitled ROTARY POWERED SURGICAL INSTRUMENTS WITH MULTIPLE DEGREES OF FREEDOM, now U.S. Pat. No. 9,398,911; and
• U.S. patent application Ser. No. 13/782,536, entitled SURGICAL INSTRUMENT SOFT STOP, now U.S. Pat. No. 9,307,986.
• Applicant of the present application also owns the following patent applications that were filed on Mar. 14, 2013 and which are each herein incorporated by reference in their respective entireties:
• U.S. patent application Ser. No. 13/803,097, entitled ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE, now U.S. Pat. No. 9,687,230;
• U.S. patent application Ser. No. 13/803,193, entitled CONTROL ARRANGEMENTS FOR A DRIVE MEMBER OF A SURGICAL INSTRUMENT, now U.S. Pat. No. 9,332,987;
• U.S. patent application Ser. No. 13/803,053, entitled INTERCHANGEABLE SHAFT ASSEMBLIES FOR USE WITH A SURGICAL INSTRUMENT, now U.S. Patent Application Publication No. 2014/0263564;
• U.S. patent application Ser. No. 13/803,086, entitled ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK, now U.S. Patent Application Publication No. 2014/0263541;
• U.S. patent application Ser. No. 13/803,210, entitled SENSOR ARRANGEMENTS FOR ABSOLUTE POSITIONING SYSTEM FOR SURGICAL INSTRUMENTS, now U.S. Patent Application Publication No. 2014/0263538;
• U.S. patent application Ser. No. 13/803,148, entitled MULTI-FUNCTION MOTOR FOR A SURGICAL INSTRUMENT, now U.S. Patent Application Publication No. 2014/0263554;
• U.S. patent application Ser. No. 13/803,066, entitled DRIVE SYSTEM LOCKOUT ARRANGEMENTS FOR MODULAR SURGICAL INSTRUMENTS, now U.S. Pat. No. 9,629,623;
• U.S. patent application Ser. No. 13/803,117, entitled ARTICULATION CONTROL SYSTEM FOR ARTICULATABLE SURGICAL INSTRUMENTS, now U.S. Pat. No. 9,351,726;
• U.S. patent application Ser. No. 13/803,130, entitled DRIVE TRAIN CONTROL ARRANGEMENTS FOR MODULAR SURGICAL INSTRUMENTS, now U.S. Pat. No. 9,351,727; and
• U.S. patent application Ser. No. 13/803,159, entitled METHOD AND SYSTEM FOR OPERATING A SURGICAL INSTRUMENT, now U.S. Patent Application Publication No. 2014/0277017.
• Applicant of the present application also owns the following patent application that was filed on Mar. 7, 2014 and is herein incorporated by reference in its entirety:
• U.S. patent application Ser. No. 14/200,111, entitled CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS, now U.S. Pat. No. 9,629,629.
• Applicant of the present application also owns the following patent applications that were filed on Mar. 26, 2014 and are each herein incorporated by reference in their respective entireties:
• U.S. patent application Ser. No. 14/226,106, entitled POWER MANAGEMENT CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS; now U.S. Patent Application Publication No. 2015/0272582;
• U.S. patent application Ser. No. 14/226,099, entitled STERILIZATION VERIFICATION CIRCUIT; now U.S. Patent Application Publication No. 2015/0272581;
• U.S. patent application Ser. No. 14/226,094, entitled VERIFICATION OF NUMBER OF BATTERY EXCHANGES/PROCEDURE COUNT; now U.S. Patent Application Publication No. 2015/0272580;
• U.S. patent application Ser. No. 14/226,117, entitled POWER MANAGEMENT THROUGH SLEEP OPTIONS OF SEGMENTED CIRCUIT AND WAKE UP CONTROL; now U.S. Patent Application Publication No. 2015/0272574;
• U.S. patent application Ser. No. 14/226,075, entitled MODULAR POWERED SURGICAL INSTRUMENT WITH DETACHABLE SHAFT ASSEMBLIES; now U.S. Pat. No. 9,743,929;
• U.S. patent application Ser. No. 14/226,093, entitled FEEDBACK ALGORITHMS FOR MANUAL BAILOUT SYSTEMS FOR SURGICAL INSTRUMENTS; now U.S. Patent Application Publication No. 2015/0272569;
• U.S. patent application Ser. No. 14/226,116, entitled SURGICAL INSTRUMENT UTILIZING SENSOR ADAPTATION; now U.S. Patent Application Publication No. 2015/0272571;
• U.S. patent application Ser. No. 14/226,071, entitled SURGICAL INSTRUMENT CONTROL CIRCUIT HAVING A SAFETY PROCESSOR; now U.S. Pat. No. 9,690,362;
• U.S. patent application Ser. No. 14/226,097, entitled SURGICAL INSTRUMENT COMPRISING INTERACTIVE SYSTEMS; now U.S. Patent Application Publication No. 2015/0272570;
• U.S. patent application Ser. No. 14/226,126, entitled INTERFACE SYSTEMS FOR USE WITH SURGICAL INSTRUMENTS; now U.S. Patent Application Publication No. 2015/0272572;
• U.S. patent application Ser. No. 14/226,133, entitled MODULAR SURGICAL INSTRUMENT SYSTEM; now U.S. Patent Application Publication No. 2015/0272557;
• U.S. patent application Ser. No. 14/226,081, entitled SYSTEMS AND METHODS FOR CONTROLLING A SEGMENTED CIRCUIT; now U.S. Patent Application Publication No. 2015/0277471;
• U.S. patent application Ser. No. 14/226,076, entitled POWER MANAGEMENT THROUGH SEGMENTED CIRCUIT AND VARIABLE VOLTAGE PROTECTION; now U.S. Pat. No. 9,733,663;
• U.S. patent application Ser. No. 14/226,111, entitled SURGICAL STAPLING INSTRUMENT SYSTEM; now U.S. Pat. No. 9,750,499; and
• U.S. patent application Ser. No. 14/226,125, entitled SURGICAL INSTRUMENT COMPRISING A ROTATABLE SHAFT; now U.S. Patent Application Publication No. 2015/0280384.
• Applicant of the present application also owns the following patent applications that were filed on Sep. 5, 2014 and which are each herein incorporated by reference in their respective entireties:
• U.S. patent application Ser. No. 14/479,103, entitled CIRCUITRY AND SENSORS FOR POWERED MEDICAL DEVICE; now U.S. Patent Application Publication No. 2016/0066912;
• U.S. patent application Ser. No. 14/479,119, entitled ADJUNCT WITH INTEGRATED SENSORS TO QUANTIFY TISSUE COMPRESSION; now U.S. Pat. No. 9,724,094;
• U.S. patent application Ser. No. 14/478,908, entitled MONITORING DEVICE DEGRADATION BASED ON COMPONENT EVALUATION; now U.S. Pat. No. 9,737,301;
• U.S. patent application Ser. No. 14/478,895, entitled MULTIPLE SENSORS WITH ONE SENSOR AFFECTING A SECOND SENSOR'S OUTPUT OR INTERPRETATION; now U.S. Pat. No. 9,757,128;
• U.S. patent application Ser. No. 14/479,110, entitled USE OF POLARITY OF HALL MAGNET DETECTION TO DETECT MISLOADED CARTRIDGE; now U.S. Patent Application Publication No. 2016/0066915;
• U.S. patent application Ser. No. 14/479,098, entitled SMART CARTRIDGE WAKE UP OPERATION AND DATA RETENTION; now U.S. Patent Application Publication No. 2016/0066911;
• U.S. patent application Ser. No. 14/479,115, entitled MULTIPLE MOTOR CONTROL FOR POWERED MEDICAL DEVICE; now U.S. Patent Application Publication No. 2016/0066916; and
• U.S. patent application Ser. No. 14/479,108, entitled LOCAL DISPLAY OF TISSUE PARAMETER STABILIZATION; now U.S. Patent Application Publication No. 2016/0066913.
• Applicant of the present application also owns the following patent applications that were filed on Apr. 9, 2014 and which are each herein incorporated by reference in their respective entireties:
• U.S. patent application Ser. No. 14/248,590, entitled MOTOR DRIVEN SURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVE SHAFTS, now U.S. Patent Application Publication No. 2014/0305987;
• U.S. patent application Ser. No. 14/248,581, entitled SURGICAL INSTRUMENT COMPRISING A CLOSING DRIVE AND A FIRING DRIVE OPERATED FROM THE SAME ROTATABLE OUTPUT, now U.S. Pat. No. 9,649,110;
• U.S. patent application Ser. No. 14/248,595, entitled SURGICAL INSTRUMENT SHAFT INCLUDING SWITCHES FOR CONTROLLING THE OPERATION OF THE SURGICAL INSTRUMENT, now U.S. Patent Application Publication No. 2014/0305988;
• U.S. patent application Ser. No. 14/248,588, entitled POWERED LINEAR SURGICAL STAPLER, now U.S. Patent Application Publication No. 2014/0309666;
• U.S. patent application Ser. No. 14/248,591, entitled TRANSMISSION ARRANGEMENT FOR A SURGICAL INSTRUMENT, now U.S. Patent Application Publication No. 2014/0305991;
• U.S. patent application Ser. No. 14/248,584, entitled MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH ALIGNMENT FEATURES FOR ALIGNING ROTARY DRIVE SHAFTS WITH SURGICAL END EFFECTOR SHAFTS, now U.S. Patent Application Publication No. 2014/0305994;
• U.S. patent application Ser. No. 14/248,587, entitled POWERED SURGICAL STAPLER, now U.S. Patent Application Publication No. 2014/0309665;
• U.S. patent application Ser. No. 14/248,586, entitled DRIVE SYSTEM DECOUPLING ARRANGEMENT FOR A SURGICAL INSTRUMENT, now U.S. Patent Application Publication No. 2014/0305990; and
• U.S. patent application Ser. No. 14/248,607, entitled MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH STATUS INDICATION ARRANGEMENTS, now U.S. Patent Application Publication No. 2014/0305992.
• Applicant of the present application also owns the following patent applications that were filed on Apr. 16, 2013 and which are each herein incorporated by reference in their respective entireties:
• U.S. Provisional Patent Application Ser. No. 61/812,365, entitled SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY A SINGLE MOTOR;
• U.S. Provisional Patent Application Ser. No. 61/812,376, entitled LINEAR CUTTER WITH POWER;
• U.S. Provisional Patent Application Ser. No. 61/812,382, entitled LINEAR CUTTER WITH MOTOR AND PISTOL GRIP;
• U.S. Provisional Patent Application Ser. No. 61/812,385, entitled SURGICAL INSTRUMENT HANDLE WITH MULTIPLE ACTUATION MOTORS AND MOTOR CONTROL; and
• U.S. Provisional Patent Application Ser. No. 61/812,372, entitled SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY A SINGLE MOTOR.
• The present disclosure provides an overall understanding of the principles of the structure, function, manufacture, and use of the devices and methods disclosed herein. One or more examples of these aspects are illustrated in the accompanying drawings. Those of ordinary skill in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting examples. The features illustrated or described in connection with one example may be combined with the features of other examples. Such modifications and variations are intended to be included within the scope of the present disclosure.
• Reference throughout the specification to “various aspects,” “some aspects,” “one aspect,” or “an aspect”, or the like, means that a particular feature, structure, or characteristic described in connection with the aspect is included in at least one aspect. Thus, appearances of the phrases “in various aspects,” “in some aspects,” “in one aspect”, or “in an aspect”, or the like, in places throughout the specification are not necessarily all referring to the same aspect. Furthermore, the particular features, structures, or characteristics may be combined in any suitable manner in one or more aspects. Thus, the particular features, structures, or characteristics illustrated or described in connection with one aspect may be combined, in whole or in part, with the features structures, or characteristics of one or more other aspects without limitation. Such modifications and variations are intended to be included within the scope of the present disclosure.
• The terms “proximal” and “distal” are used herein with reference to a clinician manipulating the handle portion of the surgical instrument. The term “proximal” referring to the portion closest to the clinician and the term “distal” referring to the portion located away from the clinician. It will be further appreciated that, for convenience and clarity, spatial terms such as “vertical,” “horizontal,” “up,” and “down” may be used herein with respect to the drawings. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and/or absolute.
• Various example devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, the person of ordinary skill in the art will readily appreciate that the various methods and devices disclosed herein can be used in numerous surgical procedures and applications including, for example, in connection with open surgical procedures. As the present Detailed Description proceeds, those of ordinary skill in the art will further appreciate that the various instruments disclosed herein can be inserted into a body in any way, such as through a natural orifice, through an incision or puncture hole formed in tissue, etc. The working portions or end effector portions of the instruments can be inserted directly into a patient's body or can be inserted through an access device that has a working channel through which the end effector and elongated shaft of a surgical instrument can be advanced.
• FIGS. 1-6 depict a motor-driven surgical cutting andfastening instrument10 that may or may not be reused. In the illustrated examples, theinstrument10 includes ahousing12 that comprises ahandle assembly14 that is configured to be grasped, manipulated and actuated by the clinician. Thehousing12 is configured for operable attachment to aninterchangeable shaft assembly200 that has asurgical end effector300 operably coupled thereto that is configured to perform one or more surgical tasks or procedures. As the present Detailed Description proceeds, it will be understood that the various unique and novel arrangements of the various forms of interchangeable shaft assemblies disclosed herein also may be effectively employed in connection with robotically-controlled surgical systems. Thus, the term “housing” also may encompass a housing or similar portion of a robotic system that houses or otherwise operably supports at least one drive system that is configured to generate and apply at least one control motion which could be used to actuate the interchangeable shaft assemblies disclosed herein and their respective equivalents. The term “frame” may refer to a portion of a handheld surgical instrument. The term “frame” also may represent a portion of a robotically controlled surgical instrument and/or a portion of the robotic system that may be used to operably control a surgical instrument. For example, the interchangeable shaft assemblies disclosed herein may be employed with various robotic systems, instruments, components and methods disclosed in U.S. patent application Ser. No. 13/118,241, entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, now U.S. Pat. No. 9,072,535. U.S. patent application Ser. No. 13/118,241, entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, now U.S. Pat. No. 9,072,535, is incorporated by reference herein in its entirety.
• Thehousing12 depicted inFIGS. 1-3 is shown in connection with aninterchangeable shaft assembly200 that includes anend effector300 that comprises a surgical cutting and fastening device that is configured to operably support a surgicalstaple cartridge304 therein. Thehousing12 may be configured for use in connection with interchangeable shaft assemblies that include end effectors that are adapted to support different sizes and types of staple cartridges, have different shaft lengths, sizes, and types, etc. In addition, thehousing12 also may be effectively employed with a variety of other interchangeable shaft assemblies including those assemblies that are configured to apply other motions and forms of energy such as, for example, radio frequency (RF) energy, ultrasonic energy and/or motion to end effector arrangements adapted for use in connection with various surgical applications and procedures. Furthermore, the end effectors, shaft assemblies, handles, surgical instruments, and/or surgical instrument systems can utilize any suitable fastener, or fasteners, to fasten tissue. For instance, a fastener cartridge comprising a plurality of fasteners removably stored therein can be removably inserted into and/or attached to the end effector of a shaft assembly.
• FIG. 1 illustrates thesurgical instrument10 with aninterchangeable shaft assembly200 operably coupled thereto.FIGS. 2 and 3 illustrate attachment of theinterchangeable shaft assembly200 to thehousing12 or handleassembly14. As shown inFIG. 4, thehandle assembly14 may comprise a pair of interconnectable handlehousing segments16 and18 that may be interconnected by screws, snap features, adhesive, etc. In the illustrated arrangement, thehandle housing segments16,18 cooperate to form apistol grip portion19 that can be gripped and manipulated by the clinician. As will be discussed in further detail below, thehandle assembly14 operably supports a plurality of drive systems therein that are configured to generate and apply various control motions to corresponding portions of the interchangeable shaft assembly that is operably attached thereto.
• Referring now toFIG. 4, thehandle assembly14 may further include aframe20 that operably supports a plurality of drive systems. For example, theframe20 can operably support a “first” or closure drive system, generally designated as30, which may be employed to apply closing and opening motions to theinterchangeable shaft assembly200 that is operably attached or coupled thereto. In at least one form, theclosure drive system30 may include an actuator in the form of aclosure trigger32 that is pivotally supported by theframe20. More specifically, as illustrated inFIG. 4, theclosure trigger32 is pivotally coupled to thehousing14 by apin33. Such arrangement enables theclosure trigger32 to be manipulated by a clinician such that when the clinician grips thepistol grip portion19 of thehandle assembly14, theclosure trigger32 may be easily pivoted from a starting or “unactuated” position to an “actuated” position and more particularly to a fully compressed or fully actuated position. Theclosure trigger32 may be biased into the unactuated position by spring or other biasing arrangement (not shown). In various forms, theclosure drive system30 further includes aclosure linkage assembly34 that is pivotally coupled to theclosure trigger32. As shown inFIG. 4, theclosure linkage assembly34 may include afirst closure link36 and asecond closure link38 that are pivotally coupled to theclosure trigger32 by apin35. Thesecond closure link38 also may be referred to herein as an “attachment member” and include atransverse attachment pin37.
• Still referring toFIG. 4, it can be observed that thefirst closure link36 may have a locking wall or end39 thereon that is configured to cooperate with aclosure release assembly60 that is pivotally coupled to theframe20. In at least one form, theclosure release assembly60 may comprise arelease button assembly62 that has a distally protruding lockingpawl64 formed thereon. Therelease button assembly62 may be pivoted in a counterclockwise direction by a release spring (not shown). As the clinician depresses theclosure trigger32 from its unactuated position towards thepistol grip portion19 of thehandle assembly14, thefirst closure link36 pivots upward to a point wherein the lockingpawl64 drops into retaining engagement with the lockingwall39 on thefirst closure link36 thereby preventing theclosure trigger32 from returning to the unactuated position. SeeFIG. 18. Thus, theclosure release assembly60 serves to lock theclosure trigger32 in the fully actuated position. When the clinician desires to unlock theclosure trigger32 to permit it to be biased to the unactuated position, the clinician simply pivots the closurerelease button assembly62 such that the lockingpawl64 is moved out of engagement with the lockingwall39 on thefirst closure link36. When the lockingpawl64 has been moved out of engagement with thefirst closure link36, theclosure trigger32 may pivot back to the unactuated position. Other closure trigger locking and release arrangements also may be employed.
• Further to the above,FIGS. 13-15 illustrate theclosure trigger32 in its unactuated position which is associated with an open, or unclamped, configuration of theshaft assembly200 in which tissue can be positioned between the jaws of theshaft assembly200.FIGS. 16-18 illustrate theclosure trigger32 in its actuated position which is associated with a closed, or clamped, configuration of theshaft assembly200 in which tissue is clamped between the jaws of theshaft assembly200. Upon comparingFIGS. 14 and 17, the reader will appreciate that, when theclosure trigger32 is moved from its unactuated position (FIG. 14) to its actuated position (FIG. 17), theclosure release button62 is pivoted between a first position (FIG. 14) and a second position (FIG. 17). The rotation of theclosure release button62 can be referred to as being an upward rotation; however, at least a portion of theclosure release button62 is being rotated toward thecircuit board100. Referring toFIG. 4, theclosure release button62 can include anarm61 extending therefrom and amagnetic element63, such as a permanent magnet, for example, mounted to thearm61. When theclosure release button62 is rotated from its first position to its second position, themagnetic element63 can move toward thecircuit board100. Thecircuit board100 can include at least one sensor configured to detect the movement of themagnetic element63. In at least one aspect, amagnetic field sensor65, for example, can be mounted to the bottom surface of thecircuit board100. Themagnetic field sensor65 can be configured to detect changes in a magnetic field surrounding themagnetic field sensor65 caused by the movement of themagnetic element63. Themagnetic field sensor65 can be in signal communication with a microcontroller1500 (FIG. 19), for example, which can determine whether theclosure release button62 is in its first position, which is associated with the unactuated position of theclosure trigger32 and the open configuration of the end effector, its second position, which is associated with the actuated position of theclosure trigger32 and the closed configuration of the end effector, and/or any position between the first position and the second position.
• As used throughout the present disclosure, a magnetic field sensor may be a Hall effect sensor, search coil, fluxgate, optically pumped, nuclear precession, SQUID, Hall-effect, anisotropic magnetoresistance, giant magnetoresistance, magnetic tunnel junctions, giant magnetoimpedance, magnetostrictive/piezoelectric composites, magnetodiode, magnetotransistor, fiber optic, magnetooptic, and microelectromechanical systems-based magnetic sensors, among others.
• In at least one form, thehandle assembly14 and theframe20 may operably support another drive system referred to herein as afiring drive system80 that is configured to apply firing motions to corresponding portions of the interchangeable shaft assembly attached thereto. The firing drive system may80 also be referred to herein as a “second drive system”. The firingdrive system80 may employ anelectric motor82, located in thepistol grip portion19 of thehandle assembly14. In various forms, themotor82 may be a DC brushed driving motor having a maximum rotation of, approximately, 25,000 RPM, for example. In other arrangements, the motor may include a brushless motor, a cordless motor, a synchronous motor, a stepper motor, or any other suitable electric motor. Themotor82 may be powered by apower source90 that in one form may comprise aremovable power pack92. As shown inFIG. 4, for example, thepower pack92 may comprise aproximal housing portion94 that is configured for attachment to adistal housing portion96. Theproximal housing portion94 and thedistal housing portion96 are configured to operably support a plurality ofbatteries98 therein.Batteries98 may each comprise, for example, a Lithium Ion (“LI”) or other suitable battery. Thedistal housing portion96 is configured for removable operable attachment to a controlcircuit board assembly100 which is also operably coupled to themotor82. A number ofbatteries98 may be connected in series may be used as the power source for thesurgical instrument10. In addition, thepower source90 may be replaceable and/or rechargeable.
• As outlined above with respect to other various forms, theelectric motor82 can include a rotatable shaft (not shown) that operably interfaces with agear reducer assembly84 that is mounted in meshing engagement with a with a set, or rack, ofdrive teeth122 on a longitudinally-movable drive member120. In use, a voltage polarity provided by thepower source90 can operate theelectric motor82 in a clockwise direction wherein the voltage polarity applied to the electric motor by the battery can be reversed in order to operate theelectric motor82 in a counter-clockwise direction. When theelectric motor82 is rotated in one direction, thedrive member120 will be axially driven in the distal direction “DD”. When themotor82 is driven in the opposite rotary direction, thedrive member120 will be axially driven in a proximal direction “PD”. Thehandle assembly14 can include a switch which can be configured to reverse the polarity applied to theelectric motor82 by thepower source90. As with the other forms described herein, thehandle assembly14 can also include a sensor that is configured to detect the position of thedrive member120 and/or the direction in which thedrive member120 is being moved.
• Actuation of themotor82 can be controlled by a firingtrigger130 that is pivotally supported on thehandle assembly14. The firingtrigger130 may be pivoted between an unactuated position and an actuated position. The firingtrigger130 may be biased into the unactuated position by aspring132 or other biasing arrangement such that when the clinician releases the firingtrigger130, it may be pivoted or otherwise returned to the unactuated position by thespring132 or biasing arrangement. In at least one form, the firingtrigger130 can be positioned “outboard” of theclosure trigger32 as was discussed above. In at least one form, a firingtrigger safety button134 may be pivotally mounted to theclosure trigger32 bypin35. Thesafety button134 may be positioned between the firingtrigger130 and theclosure trigger32 and have apivot arm136 protruding therefrom. SeeFIG. 4. When theclosure trigger32 is in the unactuated position, thesafety button134 is contained in thehandle assembly14 where the clinician cannot readily access it and move it between a safety position preventing actuation of the firingtrigger130 and a firing position wherein the firingtrigger130 may be fired. As the clinician depresses theclosure trigger32, thesafety button134 and the firingtrigger130 pivot down wherein they can then be manipulated by the clinician.
• As discussed above, thehandle assembly14 can include aclosure trigger32 and afiring trigger130. Referring toFIGS. 14-18A, the firingtrigger130 can be pivotably mounted to theclosure trigger32. Theclosure trigger32 can include anarm31 extending therefrom and the firingtrigger130 can be pivotably mounted to thearm31 about apivot pin33. When theclosure trigger32 is moved from its unactuated position (FIG. 14) to its actuated position (FIG. 17), the firingtrigger130 can descend downwardly, as outlined above. After thesafety button134 has been moved to its firing position, referring primarily toFIG. 18A, the firingtrigger130 can be depressed to operate the motor of the surgical instrument firing system. In various instances, thehandle assembly14 can include a tracking system, such assystem800, for example, configured to determine the position of theclosure trigger32 and/or the position of the firingtrigger130. With primary reference toFIGS. 14, 17, and 18A, thetracking system800 can include a magnetic element, such aspermanent magnet802, for example, which is mounted to anarm801 extending from the firingtrigger130. Thetracking system800 can comprise one or more sensors, such as a firstmagnetic field sensor803 and a secondmagnetic field sensor804, for example, which can be configured to track the position of themagnet802.
• Upon comparingFIGS. 14 and 17, the reader will appreciate that, when theclosure trigger32 is moved from its unactuated position to its actuated position, themagnet802 can move between a first position adjacent the firstmagnetic field sensor803 and a second position adjacent the secondmagnetic field sensor804.
• Upon comparingFIGS. 17 and 18A, the reader will further appreciate that, when the firingtrigger130 is moved from an unfired position (FIG. 17) to a fired position (FIG. 18A), themagnet802 can move relative to the secondmagnetic field sensor804. Thesensors803 and804 can track the movement of themagnet802 and can be in signal communication with a microcontroller on thecircuit board100. With data from thefirst sensor803 and/or thesecond sensor804, the microcontroller can determine the position of themagnet802 along a predefined path and, based on that position, the microcontroller can determine whether theclosure trigger32 is in its unactuated position, its actuated position, or a position therebetween. Similarly, with data from thefirst sensor803 and/or thesecond sensor804, the microcontroller can determine the position of themagnet802 along a predefined path and, based on that position, the microcontroller can determine whether the firingtrigger130 is in its unfired position, its fully fired position, or a position therebetween.
• As indicated above, in at least one form, the longitudinallymovable drive member120 has a rack ofteeth122 formed thereon for meshing engagement with acorresponding drive gear86 of thegear reducer assembly84. At least one form also includes a manually-actuatable “bailout”assembly140 that is configured to enable the clinician to manually retract the longitudinallymovable drive member120 should themotor82 become disabled. Thebailout assembly140 may include a lever orbailout handle assembly14 that is configured to be manually pivoted into ratcheting engagement withteeth124 also provided in thedrive member120. Thus, the clinician can manually retract thedrive member120 by using thebailout handle assembly14 to ratchet thedrive member120 in the proximal direction “PD”. U.S. Patent Application Publication No. 2010/0089970, now U.S. Pat. No. 8,608,045 discloses bailout arrangements and other components, arrangements and systems that also may be employed with the various instruments disclosed herein. U.S. patent application Ser. No. 12/249,117, entitled POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM, U.S. Patent Application Publication No. 2010/0089970, now U.S. Pat. No. 8,608,045, is hereby incorporated by reference in its entirety.
• Turning now toFIGS. 1 and 7, theinterchangeable shaft assembly200 includes asurgical end effector300 that comprises anelongated channel302 that is configured to operably support astaple cartridge304 therein. Theend effector300 may further include ananvil306 that is pivotally supported relative to theelongated channel302. Theinterchangeable shaft assembly200 may further include an articulation joint270 and an articulation lock350 (FIG. 8) which can be configured to releasably hold theend effector300 in a desired position relative to a shaft axis SA-SA. Details regarding the construction and operation of theend effector300, the articulation joint270 and thearticulation lock350 are set forth in U.S. patent application Ser. No. 13/803,086, filed Mar. 14, 2013, entitled ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK, now U.S. Patent Application Publication No. 2014/0263541. The entire disclosure of U.S. patent application Ser. No. 13/803,086, filed Mar. 14, 2013, entitled ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK, now U.S. Patent Application Publication No. 2014/0263541, is hereby incorporated by reference herein. As shown inFIGS. 7 and 8, theinterchangeable shaft assembly200 can further include a proximal housing ornozzle201 comprised ofnozzle portions202 and203. Theinterchangeable shaft assembly200 can further include aclosure tube260 which can be utilized to close and/or open theanvil306 of theend effector300. Primarily referring now toFIGS. 8 and 9, theshaft assembly200 can include aspine210 which can be configured to fixably support ashaft frame portion212 of thearticulation lock350. SeeFIG. 8. Thespine210 can be configured to, one, slidably support a firingmember220 therein and, two, slidably support theclosure tube260 which extends around thespine210. Thespine210 can also be configured to slidably support aproximal articulation driver230. Thearticulation driver230 has a distal end231 that is configured to operably engage thearticulation lock350. Thearticulation lock350 interfaces with anarticulation frame352 that is adapted to operably engage a drive pin (not shown) on the end effector frame (not shown). As indicated above, further details regarding the operation of thearticulation lock350 and the articulation frame may be found in U.S. patent application Ser. No. 13/803,086, now U.S. Patent Application Publication No. 2014/0263541. In various circumstances, thespine210 can comprise aproximal end211 which is rotatably supported in achassis240. In one arrangement, for example, theproximal end211 of thespine210 has athread214 formed thereon for threaded attachment to a spine bearing216 configured to be supported within thechassis240. SeeFIG. 7. Such an arrangement facilitates rotatable attachment of thespine210 to thechassis240 such that thespine210 may be selectively rotated about a shaft axis SA-SA relative to thechassis240.
• Referring primarily toFIG. 7, theinterchangeable shaft assembly200 includes aclosure shuttle250 that is slidably supported within thechassis240 such that it may be axially moved relative thereto. As shown inFIGS. 3 and 7, theclosure shuttle250 includes a pair of proximally-protrudinghooks252 that are configured for attachment to theattachment pin37 that is attached to thesecond closure link38 as will be discussed in further detail below. Aproximal end261 of theclosure tube260 is coupled to theclosure shuttle250 for relative rotation thereto. For example, a U shapedconnector263 is inserted into anannular slot262 in theproximal end261 of theclosure tube260 and is retained withinvertical slots253 in theclosure shuttle250. SeeFIG. 7. Such an arrangement serves to attach theclosure tube260 to theclosure shuttle250 for axial travel therewith while enabling theclosure tube260 to rotate relative to theclosure shuttle250 about the shaft axis SA-SA. Aclosure spring268 is journaled on theclosure tube260 and serves to bias theclosure tube260 in the proximal direction “PD” which can serve to pivot the closure trigger into the unactuated position when the shaft assembly is operably coupled to thehandle assembly14.
• In at least one form, theinterchangeable shaft assembly200 may further include an articulation joint270. Other interchangeable shaft assemblies, however, may not be capable of articulation. As shown inFIG. 7, for example, the articulation joint270 includes a double pivotclosure sleeve assembly271. According to various forms, the double pivotclosure sleeve assembly271 includes an end effectorclosure sleeve assembly272 having upper and lower distally projectingtangs273,274. An end effectorclosure sleeve assembly272 includes ahorseshoe aperture275 and atab276 for engaging an opening tab on theanvil306 in the various manners described in U.S. patent application Ser. No. 13/803,086, filed Mar. 14, 2013, entitled ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK, now U.S. Patent Application Publication No. 2014/0263541, which has been incorporated by reference herein. As described in further detail therein, thehorseshoe aperture275 andtab276 engage a tab on the anvil when theanvil306 is opened. An upperdouble pivot link277 includes upwardly projecting distal and proximal pivot pins that engage respectively an upper distal pin hole in the upperproximally projecting tang273 and an upper proximal pinhole in an upperdistally projecting tang264 on theclosure tube260. A lowerdouble pivot link278 includes upwardly projecting distal and proximal pivot pins that engage respectively a lower distal pin hole in the lower proximally projectingtang274 and a lower proximal pin hole in the lower distally projectingtang265. See alsoFIG. 8.
• In use, theclosure tube260 is translated distally (direction “DD”) to close theanvil306, for example, in response to the actuation of theclosure trigger32. Theanvil306 is closed by distally translating theclosure tube260 and thus the shaftclosure sleeve assembly272, causing it to strike a proximal surface on the anvil360 in the manner described in the aforementioned reference U.S. patent application Ser. No. 13/803,086, now U.S. Patent Application Publication No. 2014/0263541. As was also described in detail in that reference, theanvil306 is opened by proximally translating theclosure tube260 and the shaftclosure sleeve assembly272, causingtab276 and thehorseshoe aperture275 to contact and push against the anvil tab to lift theanvil306. In the anvil-open position, theshaft closure tube260 is moved to its proximal position.
• As indicated above, thesurgical instrument10 may further include anarticulation lock350 of the types and construction described in further detail in U.S. patent application Ser. No. 13/803,086, now U.S. Patent Application Publication No. 2014/0263541, which can be configured and operated to selectively lock theend effector300 in position. Such arrangement enables theend effector300 to be rotated, or articulated, relative to theshaft closure tube260 when thearticulation lock350 is in its unlocked state. In such an unlocked state, theend effector300 can be positioned and pushed against soft tissue and/or bone, for example, surrounding the surgical site within the patient in order to cause theend effector300 to articulate relative to theclosure tube260. Theend effector300 also may be articulated relative to theclosure tube260 by anarticulation driver230.
• As was also indicated above, theinterchangeable shaft assembly200 further includes a firingmember220 that is supported for axial travel within theshaft spine210. The firingmember220 includes an intermediatefiring shaft portion222 that is configured for attachment to a distal cutting portion orknife bar280. The firingmember220 also may be referred to herein as a “second shaft” and/or a “second shaft assembly”. As shown inFIGS. 8 and 9, the intermediatefiring shaft portion222 may include alongitudinal slot223 in the distal end thereof which can be configured to receive atab284 on theproximal end282 of thedistal knife bar280. Thelongitudinal slot223 and theproximal end282 can be sized and configured to permit relative movement therebetween and can comprise a slip joint286. The slip joint286 can permit the intermediatefiring shaft portion222 of thefiring drive220 to be moved to articulate theend effector300 without moving, or at least substantially moving, theknife bar280. Once theend effector300 has been suitably oriented, the intermediatefiring shaft portion222 can be advanced distally until a proximal sidewall of thelongitudinal slot223 comes into contact with thetab284 in order to advance theknife bar280 and fire the staple cartridge positioned within thechannel302 As can be further seen inFIGS. 8 and 9, theshaft spine210 has an elongate opening orwindow213 therein to facilitate assembly and insertion of the intermediatefiring shaft portion222 into theshaft frame210. Once the intermediatefiring shaft portion222 has been inserted therein, a top frame segment215 may be engaged with theshaft frame212 to enclose the intermediatefiring shaft portion222 andknife bar280 therein. Further description of the operation of the firingmember220 may be found in U.S. patent application Ser. No. 13/803,086, now U.S. Patent Application Publication No. 2014/0263541.
• Further to the above, theshaft assembly200 can include aclutch assembly400 which can be configured to selectively and releasably couple thearticulation driver230 to the firingmember220. In one form, theclutch assembly400 includes a lock collar, orsleeve402, positioned around the firingmember220 wherein thelock sleeve402 can be rotated between an engaged position in which thelock sleeve402 couples the articulation driver360 to the firingmember220 and a disengaged position in which the articulation driver360 is not operably coupled to the firingmember200. Whenlock sleeve402 is in its engaged position, distal movement of the firingmember220 can move the articulation driver360 distally and, correspondingly, proximal movement of the firingmember220 can move thearticulation driver230 proximally. Whenlock sleeve402 is in its disengaged position, movement of the firingmember220 is not transmitted to thearticulation driver230 and, as a result, the firingmember220 can move independently of thearticulation driver230. In various circumstances, thearticulation driver230 can be held in position by thearticulation lock350 when thearticulation driver230 is not being moved in the proximal or distal directions by the firingmember220.
• Referring primarily toFIG. 9, thelock sleeve402 can comprise a cylindrical, or an at least substantially cylindrical, body including alongitudinal aperture403 defined therein configured to receive the firingmember220. Thelock sleeve402 can comprise diametrically-opposed, inwardly-facinglock protrusions404 and an outwardly-facinglock member406. The lock protrusions404 can be configured to be selectively engaged with the firingmember220. More particularly, when thelock sleeve402 is in its engaged position, thelock protrusions404 are positioned within adrive notch224 defined in the firingmember220 such that a distal pushing force and/or a proximal pulling force can be transmitted from the firingmember220 to thelock sleeve402. When thelock sleeve402 is in its engaged position, thesecond lock member406 is received within adrive notch232 defined in thearticulation driver230 such that the distal pushing force and/or the proximal pulling force applied to thelock sleeve402 can be transmitted to thearticulation driver230. In effect, the firingmember220, thelock sleeve402, and thearticulation driver230 will move together when thelock sleeve402 is in its engaged position. On the other hand, when thelock sleeve402 is in its disengaged position, thelock protrusions404 may not be positioned within thedrive notch224 of the firingmember220 and, as a result, a distal pushing force and/or a proximal pulling force may not be transmitted from the firingmember220 to thelock sleeve402. Correspondingly, the distal pushing force and/or the proximal pulling force may not be transmitted to thearticulation driver230. In such circumstances, the firingmember220 can be slid proximally and/or distally relative to thelock sleeve402 and theproximal articulation driver230.
• As shown inFIGS. 8-12, theshaft assembly200 further includes aswitch drum500 that is rotatably received on theclosure tube260. Theswitch drum500 comprises ahollow shaft segment502 that has ashaft boss504 formed thereon for receive an outwardlyprotruding actuation pin410 therein. In various circumstances, theactuation pin410 extends through aslot267 into alongitudinal slot408 provided in thelock sleeve402 to facilitate axial movement of thelock sleeve402 when it is engaged with thearticulation driver230. Arotary torsion spring420 is configured to engage theboss504 on theswitch drum500 and a portion of thenozzle housing203 as shown inFIG. 10 to apply a biasing force to theswitch drum500. Theswitch drum500 can further comprise at least partiallycircumferential openings506 defined therein which, referring toFIGS. 5 and 6, can be configured to receivecircumferential mounts204,205 extending from the nozzle halves202,203 and permit relative rotation, but not translation, between theswitch drum500 and theproximal nozzle201. As shown in those Figures, themounts204 and205 also extend throughopenings266 in theclosure tube260 to be seated inrecesses211 in theshaft spine210. However, rotation of thenozzle201 to a point where themounts204,205 reach the end of theirrespective slots506 in theswitch drum500 will result in rotation of theswitch drum500 about the shaft axis SA-SA. Rotation of theswitch drum500 will ultimately result in the rotation ofeth actuation pin410 and thelock sleeve402 between its engaged and disengaged positions. Thus, in essence, thenozzle201 may be employed to operably engage and disengage the articulation drive system with the firing drive system in the various manners described in further detail in U.S. patent application Ser. No. 13/803,086, now U.S. Patent Application Publication No. 2014/0263541.
• As also illustrated inFIGS. 8-12, theshaft assembly200 can comprise aslip ring assembly600 which can be configured to conduct electrical power to and/or from theend effector300 and/or communicate signals to and/or from theend effector300, for example. Theslip ring assembly600 can comprise aproximal connector flange604 mounted to achassis flange242 extending from thechassis240 and adistal connector flange601 positioned within a slot defined in theshaft housings202,203. Theproximal connector flange604 can comprise a first face and thedistal connector flange601 can comprise a second face which is positioned adjacent to and movable relative to the first face. Thedistal connector flange601 can rotate relative to theproximal connector flange604 about the shaft axis SA-SA. Theproximal connector flange604 can comprise a plurality of concentric, or at least substantially concentric,conductors602 defined in the first face thereof. Aconnector607 can be mounted on the proximal side of theconnector flange601 and may have a plurality of contacts (not shown) wherein each contact corresponds to and is in electrical contact with one of theconductors602. Such an arrangement permits relative rotation between theproximal connector flange604 and thedistal connector flange601 while maintaining electrical contact therebetween. Theproximal connector flange604 can include anelectrical connector606 which can place theconductors602 in signal communication with ashaft circuit board610 mounted to theshaft chassis240, for example. In at least one instance, a wiring harness comprising a plurality of conductors can extend between theelectrical connector606 and theshaft circuit board610. Theelectrical connector606 may extend proximally through aconnector opening243 defined in thechassis mounting flange242. SeeFIG. 7. U.S. patent application Ser. No. 13/800,067, entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, filed on Mar. 13, 2013, now U.S. Patent Application Publication No. 2014/0263552, is incorporated by reference in its entirety. U.S. patent application Ser. No. 13/800,025, entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, filed on Mar. 13, 2013, now U.S. Patent Application Publication No. 2014/0263551, is incorporated by reference in its entirety. Further details regardingslip ring assembly600 may be found in U.S. patent application Ser. No. 13/803,086, now U.S. Patent Application Publication No. 2014/0263541.
• As discussed above, theshaft assembly200 can include a proximal portion which is fixably mounted to thehandle assembly14 and a distal portion which is rotatable about a longitudinal axis. The rotatable distal shaft portion can be rotated relative to the proximal portion about theslip ring assembly600, as discussed above. Thedistal connector flange601 of theslip ring assembly600 can be positioned within the rotatable distal shaft portion. Moreover, further to the above, theswitch drum500 can also be positioned within the rotatable distal shaft portion. When the rotatable distal shaft portion is rotated, thedistal connector flange601 and theswitch drum500 can be rotated synchronously with one another. In addition, theswitch drum500 can be rotated between a first position and a second position relative to thedistal connector flange601. When theswitch drum500 is in its first position, the articulation drive system may be operably disengaged from the firing drive system and, thus, the operation of the firing drive system may not articulate theend effector300 of theshaft assembly200. When theswitch drum500 is in its second position, the articulation drive system may be operably engaged with the firing drive system and, thus, the operation of the firing drive system may articulate theend effector300 of theshaft assembly200. When theswitch drum500 is moved between its first position and its second position, theswitch drum500 is moved relative todistal connector flange601. In various instances, theshaft assembly200 can comprise at least one sensor configured to detect the position of theswitch drum500. Turning now toFIGS. 11 and 12, thedistal connector flange601 can comprise amagnetic field sensor605, for example, and theswitch drum500 can comprise a magnetic element, such aspermanent magnet505, for example. Themagnetic field sensor605 can be configured to detect the position of thepermanent magnet505. When theswitch drum500 is rotated between its first position and its second position, thepermanent magnet505 can move relative to themagnetic field sensor605. In various instances,magnetic field sensor605 can detect changes in a magnetic field created when thepermanent magnet505 is moved. Themagnetic field sensor605 can be in signal communication with theshaft circuit board610 and/or thehandle circuit board100, for example. Based on the signal from themagnetic field sensor605, a microcontroller on theshaft circuit board610 and/or thehandle circuit board100 can determine whether the articulation drive system is engaged with or disengaged from the firing drive system.
• Referring again toFIGS. 3 and 7, thechassis240 includes at least one, and preferably two, taperedattachment portions244 formed thereon that are adapted to be received within correspondingdovetail slots702 formed within a distalattachment flange portion700 of theframe20. Eachdovetail slot702 may be tapered or, stated another way, be somewhat V-shaped to seatingly receive theattachment portions244 therein. As can be further seen inFIGS. 3 and 7, ashaft attachment lug226 is formed on the proximal end of theintermediate firing shaft222. As will be discussed in further detail below, when theinterchangeable shaft assembly200 is coupled to thehandle assembly14, theshaft attachment lug226 is received in a firingshaft attachment cradle126 formed in thedistal end125 of thelongitudinal drive member120 as shown inFIGS. 3 and 6, for example.
• Various shaft assemblies employ alatch system710 for removably coupling theshaft assembly200 to thehousing12 and more specifically to theframe20. As shown inFIG. 7, for example, in at least one form, thelatch system710 includes a lock member orlock yoke712 that is movably coupled to thechassis240. In the illustrated example, for example, thelock yoke712 has a U-shape with two spaced downwardly extendinglegs714. Thelegs714 each have apivot lug716 formed thereon that are adapted to be received in correspondingholes245 formed in thechassis240. Such arrangement facilitates pivotal attachment of thelock yoke712 to thechassis240. Thelock yoke712 may include two proximally protruding lock lugs714 that are configured for releasable engagement with corresponding lock detents orgrooves704 in thedistal attachment flange700 of theframe20. SeeFIG. 3. In various forms, thelock yoke712 is biased in the proximal direction by spring or biasing member (not shown). Actuation of thelock yoke712 may be accomplished by alatch button722 that is slidably mounted on alatch actuator assembly720 that is mounted to thechassis240. Thelatch button722 may be biased in a proximal direction relative to thelock yoke712. As will be discussed in further detail below, thelock yoke712 may be moved to an unlocked position by biasing the latch button the in distal direction which also causes thelock yoke712 to pivot out of retaining engagement with thedistal attachment flange700 of theframe20. When thelock yoke712 is in “retaining engagement” with thedistal attachment flange700 of theframe20, the lock lugs716 are retainingly seated within the corresponding lock detents orgrooves704 in thedistal attachment flange700.
• When employing an interchangeable shaft assembly that includes an end effector of the type described herein that is adapted to cut and fasten tissue, as well as other types of end effectors, it may be desirable to prevent inadvertent detachment of the interchangeable shaft assembly from the housing during actuation of the end effector. For example, in use the clinician may actuate theclosure trigger32 to grasp and manipulate the target tissue into a desired position. Once the target tissue is positioned within theend effector300 in a desired orientation, the clinician may then fully actuate theclosure trigger32 to close theanvil306 and clamp the target tissue in position for cutting and stapling. In that instance, thefirst drive system30 has been fully actuated. After the target tissue has been clamped in theend effector300, it may be desirable to prevent the inadvertent detachment of theshaft assembly200 from thehousing12. One form of thelatch system710 is configured to prevent such inadvertent detachment.
• As can be most particularly seen inFIG. 7, thelock yoke712 includes at least one and preferably two lock hooks718 that are adapted to contact correspondinglock lug portions256 that are formed on theclosure shuttle250. Referring toFIGS. 13-15, when theclosure shuttle250 is in an unactuated position (i.e., thefirst drive system30 is unactuated and theanvil306 is open), thelock yoke712 may be pivoted in a distal direction to unlock theinterchangeable shaft assembly200 from thehousing12. When in that position, the lock hooks718 do not contact thelock lug portions256 on theclosure shuttle250. However, when theclosure shuttle250 is moved to an actuated position (i.e., thefirst drive system30 is actuated and theanvil306 is in the closed position), thelock yoke712 is prevented from being pivoted to an unlocked position. SeeFIGS. 16-18. Stated another way, if the clinician were to attempt to pivot thelock yoke712 to an unlocked position or, for example, thelock yoke712 was in advertently bumped or contacted in a manner that might otherwise cause it to pivot distally, the lock hooks718 on thelock yoke712 will contact the lock lugs256 on theclosure shuttle250 and prevent movement of thelock yoke712 to an unlocked position.
• Attachment of theinterchangeable shaft assembly200 to thehandle assembly14 will now be described with reference toFIG. 3. To commence the coupling process, the clinician may position thechassis240 of theinterchangeable shaft assembly200 above or adjacent to thedistal attachment flange700 of theframe20 such that the taperedattachment portions244 formed on thechassis240 are aligned with thedovetail slots702 in theframe20. The clinician may then move theshaft assembly200 along an installation axis IA that is perpendicular to the shaft axis SA-SA to seat theattachment portions244 in “operable engagement” with the correspondingdovetail receiving slots702. In doing so, theshaft attachment lug226 on theintermediate firing shaft222 will also be seated in thecradle126 in the longitudinallymovable drive member120 and the portions ofpin37 on thesecond closure link38 will be seated in the correspondinghooks252 in theclosure yoke250. As used herein, the term “operable engagement” in the context of two components means that the two components are sufficiently engaged with each other so that upon application of an actuation motion thereto, the components may carry out their intended action, function and/or procedure.
• As discussed above, at least five systems of theinterchangeable shaft assembly200 can be operably coupled with at least five corresponding systems of thehandle assembly14. A first system can comprise a frame system which couples and/or aligns the frame or spine of theshaft assembly200 with theframe20 of thehandle assembly14. Another system can comprise aclosure drive system30 which can operably connect theclosure trigger32 of thehandle assembly14 and theclosure tube260 and theanvil306 of theshaft assembly200. As outlined above, the closuretube attachment yoke250 of theshaft assembly200 can be engaged with thepin37 on thesecond closure link38. Another system can comprise thefiring drive system80 which can operably connect thefiring trigger130 of thehandle assembly14 with theintermediate firing shaft222 of theshaft assembly200.
• As outlined above, theshaft attachment lug226 can be operably connected with thecradle126 of thelongitudinal drive member120. Another system can comprise an electrical system which can signal to a controller in thehandle assembly14, such as microcontroller, for example, that a shaft assembly, such asshaft assembly200, for example, has been operably engaged with thehandle assembly14 and/or, two, conduct power and/or communication signals between theshaft assembly200 and thehandle assembly14. For instance, theshaft assembly200 can include anelectrical connector1410 that is operably mounted to theshaft circuit board610. Theelectrical connector1410 is configured for mating engagement with a correspondingelectrical connector1400 on thehandle control board100. Further details regaining the circuitry and control systems may be found in U.S. patent application Ser. No. 13/803,086, the entire disclosure of which was previously incorporated by reference herein. The fifth system may consist of the latching system for releasably locking theshaft assembly200 to thehandle assembly14.
• Referring again toFIGS. 2 and 3, thehandle assembly14 can include anelectrical connector1400 comprising a plurality of electrical contacts. Turning now toFIG. 19, theelectrical connector1400 can comprise afirst contact1401a, asecond contact1401b, a third contact1401c, afourth contact1401d, afifth contact1401e, and asixth contact1401f, for example. While the illustrated example utilizes six contacts, other examples are envisioned which may utilize more than six contacts or less than six contacts.
• As illustrated inFIG. 19, thefirst contact1401acan be in electrical communication with atransistor1408,contacts1401b-1401ecan be in electrical communication with amicrocontroller1500, and thesixth contact1401fcan be in electrical communication with a ground. In certain circumstances, one or more of theelectrical contacts1401b-1401emay be in electrical communication with one or more output channels of themicrocontroller1500 and can be energized, or have a voltage potential applied thereto, when the handle1042 is in a powered state. In some circumstances, one or more of theelectrical contacts1401b-1401emay be in electrical communication with one or more input channels of themicrocontroller1500 and, when thehandle assembly14 is in a powered state, themicrocontroller1500 can be configured to detect when a voltage potential is applied to such electrical contacts. When a shaft assembly, such asshaft assembly200, for example, is assembled to thehandle assembly14, the electrical contacts1401a-1401fmay not communicate with each other. When a shaft assembly is not assembled to thehandle assembly14, however, the electrical contacts1401a-1401fof theelectrical connector1400 may be exposed and, in some circumstances, one or more of the contacts1401a-1401fmay be accidentally placed in electrical communication with each other. Such circumstances can arise when one or more of the contacts1401a-1401fcome into contact with an electrically conductive material, for example. When this occurs, themicrocontroller1500 can receive an erroneous input and/or theshaft assembly200 can receive an erroneous output, for example. To address this issue, in various circumstances, thehandle assembly14 may be unpowered when a shaft assembly, such asshaft assembly200, for example, is not attached to thehandle assembly14.
• In other circumstances, the handle1042 can be powered when a shaft assembly, such asshaft assembly200, for example, is not attached thereto. In such circumstances, themicrocontroller1500 can be configured to ignore inputs, or voltage potentials, applied to the contacts in electrical communication with themicrocontroller1500, i.e.,contacts1401b-1401e, for example, until a shaft assembly is attached to thehandle assembly14. Even though themicrocontroller1500 may be supplied with power to operate other functionalities of thehandle assembly14 in such circumstances, thehandle assembly14 may be in a powered-down state. In a way, theelectrical connector1400 may be in a powered-down state as voltage potentials applied to theelectrical contacts1401b-1401emay not affect the operation of thehandle assembly14. The reader will appreciate that, even thoughcontacts1401b-1401emay be in a powered-down state, theelectrical contacts1401aand1401f, which are not in electrical communication with themicrocontroller1500, may or may not be in a powered-down state. For instance,sixth contact1401fmay remain in electrical communication with a ground regardless of whether thehandle assembly14 is in a powered-up or a powered-down state.
• Furthermore, thetransistor1408, and/or any other suitable arrangement of transistors, such astransistor1410, for example, and/or switches may be configured to control the supply of power from apower source1404, such as abattery90 within thehandle assembly14, for example, to the firstelectrical contact1401aregardless of whether thehandle assembly14 is in a powered-up or a powered-down state. In various circumstances, theshaft assembly200, for example, can be configured to change the state of thetransistor1408 when theshaft assembly200 is engaged with thehandle assembly14. In certain circumstances, further to the below, amagnetic field sensor1402 can be configured to switch the state oftransistor1410 which, as a result, can switch the state oftransistor1408 and ultimately supply power frompower source1404 tofirst contact1401a. In this way, both the power circuits and the signal circuits to theconnector1400 can be powered down when a shaft assembly is not installed to thehandle assembly14 and powered up when a shaft assembly is installed to thehandle assembly14.
• In various circumstances, referring again toFIG. 19, thehandle assembly14 can include themagnetic field sensor1402, for example, which can be configured to detect a detectable element, such as a magnetic element1407 (FIG. 3), for example, on a shaft assembly, such asshaft assembly200, for example, when the shaft assembly is coupled to thehandle assembly14. Themagnetic field sensor1402 can be powered by apower source1406, such as a battery, for example, which can, in effect, amplify the detection signal of themagnetic field sensor1402 and communicate with an input channel of themicrocontroller1500 via the circuit illustrated inFIG. 19. Once themicrocontroller1500 has a received an input indicating that a shaft assembly has been at least partially coupled to thehandle assembly14, and that, as a result, the electrical contacts1401a-1401fare no longer exposed, themicrocontroller1500 can enter into its normal, or powered-up, operating state. In such an operating state, themicrocontroller1500 will evaluate the signals transmitted to one or more of thecontacts1401b-1401efrom the shaft assembly and/or transmit signals to the shaft assembly through one or more of thecontacts1401b-1401ein normal use thereof. In various circumstances, theshaft assembly200 may have to be fully seated before themagnetic field sensor1402 can detect themagnetic element1407. While amagnetic field sensor1402 can be utilized to detect the presence of theshaft assembly200, any suitable system of sensors and/or switches can be utilized to detect whether a shaft assembly has been assembled to thehandle assembly14, for example. In this way, further to the above, both the power circuits and the signal circuits to theconnector1400 can be powered down when a shaft assembly is not installed to thehandle assembly14 and powered up when a shaft assembly is installed to thehandle assembly14.
• In various examples, as may be used throughout the present disclosure, any suitable magnetic field sensor may be employed to detect whether a shaft assembly has been assembled to thehandle assembly14, for example. For example, the technologies used for magnetic field sensing include Hall effect sensor, search coil, fluxgate, optically pumped, nuclear precession, SQUID, Hall-effect, anisotropic magnetoresistance, giant magnetoresistance, magnetic tunnel junctions, giant magnetoimpedance, magnetostrictive/piezoelectric composites, magnetodiode, magnetotransistor, fiber optic, magnetooptic, and microelectromechanical systems-based magnetic sensors, among others.
• Referring toFIG. 19, themicrocontroller1500 may generally comprise a microprocessor (“processor”) and one or more memory units operationally coupled to the processor. By executing instruction code stored in the memory, the processor may control various components of the surgical instrument, such as the motor, various drive systems, and/or a user display, for example. Themicrocontroller1500 may be implemented using integrated and/or discrete hardware elements, software elements, and/or a combination of both. Examples of integrated hardware elements may include processors, microprocessors, microcontrollers, integrated circuits, application specific integrated circuits (ASIC), programmable logic devices (PLD), digital signal processors (DSP), field programmable gate arrays (FPGA), logic gates, registers, semiconductor devices, chips, microchips, chip sets, microcontrollers, system-on-chip (SoC), and/or system-in-package (SIP). 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 certain instances, themicrocontroller1500 may include a hybrid circuit comprising discrete and integrated circuit elements or components on one or more substrates, for example.
• Referring toFIG. 19, themicrocontroller1500 may be an LM 4F230H5QR, available from Texas Instruments, for example. In certain instances, the Texas Instruments LM4F230H5QR is an ARM Cortex-M4F Processor Core comprising on-chip memory of 256 KB single-cycle flash memory, or other non-volatile memory, up to 40 MHz, a prefetch buffer to improve performance above 40 MHz, a 32 KB single-cycle serial random access memory (SRAM), internal read-only memory (ROM) loaded with StellarisWare® software, 2 KB electrically erasable programmable read-only memory (EEPROM), one or more pulse width modulation (PWM) modules, one or more quadrature encoder inputs (QEI) analog, one or more 12-bit Analog-to-Digital Converters (ADC) with 12 analog input channels, among other features that are readily available. Other microcontrollers may be readily substituted for use with the present disclosure. Accordingly, the present disclosure should not be limited in this context.
• As discussed above, thehandle assembly14 and/or theshaft assembly200 can include systems and configurations configured to prevent, or at least reduce the possibility of, the contacts of the handleelectrical connector1400 and/or the contacts of the shaftelectrical connector1410 from becoming shorted out when theshaft assembly200 is not assembled, or completely assembled, to thehandle assembly14. Referring toFIG. 3, the handleelectrical connector1400 can be at least partially recessed within acavity1409 defined in thehandle frame20. The six contacts1401a-1401fof theelectrical connector1400 can be completely recessed within thecavity1409. Such arrangements can reduce the possibility of an object accidentally contacting one or more of the contacts1401a-1401f. Similarly, the shaftelectrical connector1410 can be positioned within a recess defined in theshaft chassis240 which can reduce the possibility of an object accidentally contacting one or more of the contacts1411a-1411fof the shaftelectrical connector1410. With regard to the particular example depicted inFIG. 3, the shaft contacts1411a-1411fcan comprise male contacts. In at least one example, each shaft contact1411a-1411fcan comprise a flexible projection extending therefrom which can be configured to engage a corresponding handle contact1401a-1401f, for example. The handle contacts1401a-1401fcan comprise female contacts. In at least one example, each handle contact1401a-1401fcan comprise a flat surface, for example, against which the male shaft contacts1401a-1401fcan wipe, or slide, against and maintain an electrically conductive interface therebetween. In various instances, the direction in which theshaft assembly200 is assembled to thehandle assembly14 can be parallel to, or at least substantially parallel to, the handle contacts1401a-1401fsuch that the shaft contacts1411a-1411fslide against the handle contacts1401a-1401fwhen theshaft assembly200 is assembled to thehandle assembly14. In various alternative examples, the handle contacts1401a-1401fcan comprise male contacts and the shaft contacts1411a-1411fcan comprise female contacts. In certain alternative examples, the handle contacts1401a-1401fand the shaft contacts1411a-1411fcan comprise any suitable arrangement of contacts.
• In various instances, thehandle assembly14 can comprise a connector guard configured to at least partially cover the handleelectrical connector1400 and/or a connector guard configured to at least partially cover the shaftelectrical connector1410. A connector guard can prevent, or at least reduce the possibility of, an object accidentally touching the contacts of an electrical connector when the shaft assembly is not assembled to, or only partially assembled to, the handle. A connector guard can be movable. For instance, the connector guard can be moved between a guarded position in which it at least partially guards a connector and an unguarded position in which it does not guard, or at least guards less of, the connector. In at least one example, a connector guard can be displaced as the shaft assembly is being assembled to the handle. For instance, if the handle comprises a handle connector guard, the shaft assembly can contact and displace the handle connector guard as the shaft assembly is being assembled to the handle. Similarly, if the shaft assembly comprises a shaft connector guard, the handle can contact and displace the shaft connector guard as the shaft assembly is being assembled to the handle. In various instances, a connector guard can comprise a door, for example. In at least one instance, the door can comprise a beveled surface which, when contacted by the handle or shaft, can facilitate the displacement of the door in a certain direction. In various instances, the connector guard can be translated and/or rotated, for example. In certain instances, a connector guard can comprise at least one film which covers the contacts of an electrical connector. When the shaft assembly is assembled to the handle, the film can become ruptured. In at least one instance, the male contacts of a connector can penetrate the film before engaging the corresponding contacts positioned underneath the film.
• As described above, the surgical instrument can include a system which can selectively power-up, or activate, the contacts of an electrical connector, such as theelectrical connector1400, for example. In various instances, the contacts can be transitioned between an unactivated condition and an activated condition. In certain instances, the contacts can be transitioned between a monitored condition, a deactivated condition, and an activated condition. For instance, themicrocontroller1500, for example, can monitor the contacts1401a-1401fwhen a shaft assembly has not been assembled to thehandle assembly14 to determine whether one or more of the contacts1401a-1401fmay have been shorted. Themicrocontroller1500 can be configured to apply a low voltage potential to each of the contacts1401a-1401fand assess whether only a minimal resistance is present at each of the contacts. Such an operating state can comprise the monitored condition. In the event that the resistance detected at a contact is high, or above a threshold resistance, themicrocontroller1500 can deactivate that contact, more than one contact, or, alternatively, all of the contacts. Such an operating state can comprise the deactivated condition. If a shaft assembly is assembled to thehandle assembly14 and it is detected by themicrocontroller1500, as discussed above, themicrocontroller1500 can increase the voltage potential to the contacts1401a-1401f. Such an operating state can comprise the activated condition.
• The various shaft assemblies disclosed herein may employ sensors and various other components that require electrical communication with the controller in the housing. These shaft assemblies generally are configured to be able to rotate relative to the housing necessitating a connection that facilitates such electrical communication between two or more components that may rotate relative to each other. When employing end effectors of the types disclosed herein, the connector arrangements must be relatively robust in nature while also being somewhat compact to fit into the shaft assembly connector portion.
• Referring toFIG. 20, a non-limiting form of theend effector300 is illustrated. As described above, theend effector300 may include theanvil306 and thestaple cartridge304. In this non-limiting example, theanvil306 is coupled to anelongate channel198. For example,apertures199 can be defined in theelongate channel198 which can receivepins152 extending from theanvil306 and allow theanvil306 to pivot from an open position to a closed position relative to theelongate channel198 andstaple cartridge304. In addition,FIG. 20 shows a firingbar172, configured to longitudinally translate into theend effector300. The firingbar172 may be constructed from one solid section, or in various examples, may include a laminate material comprising, for example, a stack of steel plates. A distally projecting end of the firingbar172 can be attached to an E-beam178 that can, among other things, assist in spacing theanvil306 from astaple cartridge304 positioned in theelongate channel198 when theanvil306 is in a closed position. The E-beam178 can also include a sharpened cutting edge182 which can be used to sever tissue as theE-beam178 is advanced distally by the firingbar172. In operation, theE-beam178 can also actuate, or fire, thestaple cartridge304. Thestaple cartridge304 can include a moldedcartridge body194 that holds a plurality of staples191 resting uponstaple drivers192 within respective upwardly openstaple cavities195. Awedge sled190 is driven distally by theE-beam178, sliding upon acartridge tray196 that holds together the various components of thereplaceable staple cartridge304. Thewedge sled190 upwardly cams thestaple drivers192 to force out the staples191 into deforming contact with theanvil306 while a cutting surface182 of theE-beam178 severs clamped tissue.
• Further to the above, theE-beam178 can includeupper pins180 which engage theanvil306 during firing. The E-beam178 can further includemiddle pins184 and abottom foot186 which can engage various portions of thecartridge body194,cartridge tray196 andelongate channel198. When astaple cartridge304 is positioned within theelongate channel198, aslot193 defined in thecartridge body194 can be aligned with aslot197 defined in thecartridge tray196 and aslot189 defined in theelongate channel198. In use, theE-beam178 can slide through the alignedslots193,197, and189 wherein, as indicated inFIG. 20, thebottom foot186 of the E-beam178 can engage a groove running along the bottom surface ofchannel198 along the length ofslot189, themiddle pins184 can engage the top surfaces ofcartridge tray196 along the length oflongitudinal slot197, and theupper pins180 can engage theanvil306. In such circumstances, theE-beam178 can space, or limit the relative movement between, theanvil306 and thestaple cartridge304 as the firingbar172 is moved distally to fire the staples from thestaple cartridge304 and/or incise the tissue captured between theanvil306 and thestaple cartridge304. Thereafter, the firingbar172 and theE-beam178 can be retracted proximally allowing theanvil306 to be opened to release the two stapled and severed tissue portions (not shown).
• Having described a surgical instrument10 (FIGS. 1-4) in general terms, the description now turns to a detailed description of various electrical/electronic components of thesurgical instrument10. Turning now toFIGS. 21A-21B, where one example of asegmented circuit2000 comprising a plurality of circuit segments2002a-2002gis illustrated. The segmentedcircuit2000 comprising the plurality of circuit segments2002a-2002gis configured to control a powered surgical instrument, such as, for example, thesurgical instrument10 illustrated inFIGS. 1-18A, without limitation. The plurality of circuit segments2002a-2002gis configured to control one or more operations of the poweredsurgical instrument10. Asafety processor segment2002a(Segment 1) comprises asafety processor2004. Aprimary processor segment2002b(Segment 2) comprises aprimary processor2006. Thesafety processor2004 and/or theprimary processor2006 are configured to interact with one or moreadditional circuit segments2002c-2002gto control operation of the poweredsurgical instrument10. Theprimary processor2006 comprises a plurality of inputs coupled to, for example, one ormore circuit segments2002c-2002g, abattery2008, and/or a plurality of switches2058a-2070. The segmentedcircuit2000 may be implemented by any suitable circuit, such as, for example, a printed circuit board assembly (PCBA) within the poweredsurgical instrument10. It should be understood that the term processor as used herein includes any microprocessor, microcontroller, or other basic computing device that incorporates the functions of a computer's central processing unit (CPU) on an integrated circuit or at most a few integrated circuits. The processor is a multipurpose, programmable device that accepts digital data as input, processes it according to instructions stored in its memory, and provides results as output. It is an example of sequential digital logic, as it has internal memory. Processors operate on numbers and symbols represented in the binary numeral system.
• In one aspect, themain processor2006 may be any single core or multicore processor such as those known under the trade name ARM Cortex by Texas Instruments. In one example, thesafety processor2004 may be a safety microcontroller platform comprising two microcontroller-based families such as TMS570 and RM4x known under the trade name Hercules ARM Cortex R4, also by Texas Instruments. Nevertheless, other suitable substitutes for microcontrollers and safety processor may be employed, without limitation. In one example, thesafety processor2004 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.
• In certain instances, themain processor2006 may be an LM 4F230H5QR, available from Texas Instruments, for example. In at least one example, the Texas Instruments LM4F230H5QR is an ARM Cortex-M4F Processor Core comprising on-chip memory of 256 KB single-cycle flash memory, or other non-volatile memory, up to 40 MHz, a prefetch buffer to improve performance above 40 MHz, a 32 KB single-cycle SRAM, internal ROM loaded with StellarisWare® software, 2 KB EEPROM, one or more PWM modules, one or more QEI analog, one or more 12-bit ADC with 12 analog input channels, among other features that are readily available for the product datasheet. Other processors may be readily substituted and, accordingly, the present disclosure should not be limited in this context.
• In one aspect, the segmentedcircuit2000 comprises anacceleration segment2002c(Segment 3). Theacceleration segment2002ccomprises anacceleration sensor2022. Theacceleration sensor2022 may comprise, for example, an accelerometer. Theacceleration sensor2022 is configured to detect movement or acceleration of the poweredsurgical instrument10. In some examples, input from theacceleration sensor2022 is used, for example, to transition to and from a sleep mode, identify an orientation of the powered surgical instrument, and/or identify when the surgical instrument has been dropped. In some examples, theacceleration segment2002cis coupled to thesafety processor2004 and/or theprimary processor2006.
• In one aspect, the segmentedcircuit2000 comprises adisplay segment2002d(Segment 4). Thedisplay segment2002dcomprises a display connector2024 coupled to theprimary processor2006. The display connector2024 couples theprimary processor2006 to a display2028 through one or more display driver integrated circuits2026. The display driver integrated circuits2026 may be integrated with the display2028 and/or may be located separately from the display2028. The display2028 may comprise any suitable display, such as, for example, an organic light-emitting diode (OLED) display, a liquid-crystal display (LCD), and/or any other suitable display. In some examples, thedisplay segment2002dis coupled to thesafety processor2004.
• In some aspects, the segmentedcircuit2000 comprises ashaft segment2002e(Segment 5). Theshaft segment2002ecomprises one or more controls for ashaft2004 coupled to thesurgical instrument10 and/or one or more controls for anend effector2006 coupled to theshaft2004. Theshaft segment2002ecomprises a shaft connector2030 configured to couple theprimary processor2006 to ashaft PCBA2031. Theshaft PCBA2031 comprises a first articulation switch2036, a second articulation switch2032, and ashaft PCBA EEPROM2034. In some examples, theshaft PCBA EEPROM2034 comprises one or more parameters, routines, and/or programs specific to theshaft2004 and/or theshaft PCBA2031. Theshaft PCBA2031 may be coupled to theshaft2004 and/or integral with thesurgical instrument10. In some examples, theshaft segment2002ecomprises a second shaft EEPROM2038. The second shaft EEPROM2038 comprises a plurality of algorithms, routines, parameters, and/or other data corresponding to one ormore shafts2004 and/orend effectors2006 which may be interfaced with the poweredsurgical instrument10.
• In some aspects, the segmentedcircuit2000 comprises aposition encoder segment2002f(Segment 6). Theposition encoder segment2002fcomprises one or more magnetic rotary position encoders2040a-2040b. The one or more magnetic rotary position encoders2040a-2040bare configured to identify the rotational position of amotor2048, ashaft2004, and/or anend effector2006 of thesurgical instrument10. In some examples, the magnetic rotary position encoders2040a-2040bmay be coupled to thesafety processor2004 and/or theprimary processor2006.
• In some aspects, the segmentedcircuit2000 comprises amotor segment2002g(Segment 7). Themotor segment2002gcomprises amotor2048 configured to control one or more movements of the poweredsurgical instrument10. Themotor2048 is coupled to theprimary processor2006 by an H-Bridge driver2042 and one or more H-bridge field-effect transistors (FETs)2044. The H-bridge FETs2044 are coupled to thesafety processor2004. Amotor current sensor2046 is coupled in series with themotor2048 to measure the current draw of themotor2048. Themotor current sensor2046 is in signal communication with theprimary processor2006 and/or thesafety processor2004. In some examples, themotor2048 is coupled to a motor electromagnetic interference (EMI) filter2050.
• In some aspects, the segmentedcircuit2000 comprises apower segment2002h(Segment 8). Abattery2008 is coupled to thesafety processor2004, theprimary processor2006, and one or more of theadditional circuit segments2002c-2002g. Thebattery2008 is coupled to the segmentedcircuit2000 by abattery connector2010 and acurrent sensor2012. Thecurrent sensor2012 is configured to measure the total current draw of the segmentedcircuit2000. In some examples, one ormore voltage converters2014a,2014b,2016 are configured to provide predetermined voltage values to one or more circuit segments2002a-2002g. For example, in some examples, the segmentedcircuit2000 may comprise 3.3V voltage converters2014a-2014band/or5V voltage converters2016. Aboost converter2018 is configured to provide a boost voltage up to a predetermined amount, such as, for example, up to 13V. Theboost converter2018 is configured to provide additional voltage and/or current during power intensive operations and prevent brownout or low-power conditions.
• In some aspects, thesafety segment2002acomprises a motor power interrupt2020. The motor power interrupt2020 is coupled between thepower segment2002hand themotor segment2002g. Thesafety segment2002ais configured to interrupt power to themotor segment2002gwhen an error or fault condition is detected by thesafety processor2004 and/or theprimary processor2006 as discussed in more detail herein. Although the circuit segments2002a-2002gare illustrated with all components of the circuit segments2002a-2002hlocated in physical proximity, one skilled in the art will recognize that a circuit segment2002a-2002hmay comprise components physically and/or electrically separate from other components of the same circuit segment2002a-2002g. In some examples, one or more components may be shared between two or more circuit segments2002a-2002g.
• In some aspects, a plurality of switches2056-2070 are coupled to thesafety processor2004 and/or theprimary processor2006. The plurality of switches2056-2070 may be configured to control one or more operations of thesurgical instrument10, control one or more operations of the segmentedcircuit2000, and/or indicate a status of thesurgical instrument10. For example, a bail-outdoor switch2056 is configured to indicate the status of a bail-out door. A plurality of articulation switches, such as, for example, a left side articulation leftswitch2058a, a left side articulationright switch2060a, a left sidearticulation center switch2062a, a right side articulation leftswitch2058b, a right side articulationright switch2060b, and a right sidearticulation center switch2062bare configured to control articulation of ashaft2004 and/or anend effector2006. A left sidereverse switch2064aand a rightside reverse switch2064bare coupled to theprimary processor2006. In some examples, the left side switches comprising the left side articulation leftswitch2058a, the left side articulationright switch2060a, the left sidearticulation center switch2062a, and the left sidereverse switch2064aare coupled to theprimary processor2006 by a left flex connector2072a. The right side switches comprising the right side articulation leftswitch2058b, the right side articulationright switch2060b, the right sidearticulation center switch2062b, and the rightside reverse switch2064bare coupled to theprimary processor2006 by a right flex connector2072b. In some examples, afiring switch2066, aclamp release switch2068, and a shaft engagedswitch2070 are coupled to theprimary processor2006.
• In some aspects, the plurality of switches2056-2070 may comprise, for example, a plurality of handle controls mounted to a handle of thesurgical instrument10, a plurality of indicator switches, and/or any combination thereof. In various examples, the plurality of switches2056-2070 allow a surgeon to manipulate the surgical instrument, provide feedback to the segmentedcircuit2000 regarding the position and/or operation of the surgical instrument, and/or indicate unsafe operation of thesurgical instrument10. In some examples, additional or fewer switches may be coupled to the segmentedcircuit2000, one or more of the switches2056-2070 may be combined into a single switch, and/or expanded to multiple switches. For example, in one example, one or more of the left side and/or right side articulation switches2058a-2064bmay be combined into a single multi-position switch.
• In one aspect, thesafety processor2004 is configured to implement a watchdog function, among other safety operations. Thesafety processor2004 and theprimary processor2006 of the segmentedcircuit2000 are in signal communication. A microprocessor alive heartbeat signal is provided atoutput2096. Theacceleration segment2002ccomprises anaccelerometer2022 configured to monitor movement of thesurgical instrument10. In various examples, theaccelerometer2022 may be a single, double, or triple axis accelerometer. Theaccelerometer2022 may be employed to measures proper acceleration that is not necessarily the coordinate acceleration (rate of change of velocity). Instead, the accelerometer sees the acceleration associated with the phenomenon of weight experienced by a test mass at rest in the frame of reference of theaccelerometer2022. For example, theaccelerometer2022 at rest on the surface of the earth will measure an acceleration g=9.8 m/s²(gravity) straight upwards, due to its weight. Another type of acceleration thataccelerometer2022 can measure is g-force acceleration. In various other examples, theaccelerometer2022 may comprise a single, double, or triple axis accelerometer. Further, theacceleration segment2002cmay comprise one or more inertial sensors to detect and measure acceleration, tilt, shock, vibration, rotation, and multiple degrees-of-freedom (DoF). A suitable inertial sensor may comprise an accelerometer (single, double, or triple axis), a magnetometer to measure a magnetic field in space such as the earth's magnetic field, and/or a gyroscope to measure angular velocity.
• In one aspect, thesafety processor2004 is configured to implement a watchdog function with respect to one ormore circuit segments2002c-2002h, such as, for example, themotor segment2002g. In this regards, thesafety processor2004 employs the watchdog function to detect and recover from malfunctions of theprimary processor2006. During normal operation, thesafety processor2004 monitors for hardware faults or program errors of theprimary processor2004 and to initiate corrective action or actions. The corrective actions may include placing theprimary processor2006 in a safe state and restoring normal system operation. In one example, thesafety processor2004 is coupled to at least a first sensor. The first sensor measures a first property of the surgical instrument10 (FIGS. 1-4). In some examples, thesafety processor2004 is configured to compare the measured property of thesurgical instrument10 to a predetermined value. For example, in one example, a motor sensor2040ais coupled to thesafety processor2004. The motor sensor2040aprovides motor speed and position information to thesafety processor2004. Thesafety processor2004 monitors the motor sensor2040aand compares the value to a maximum speed and/or position value and prevents operation of themotor2048 above the predetermined values. In some examples, the predetermined values are calculated based on real-time speed and/or position of themotor2048, calculated from values supplied by asecond motor sensor2040bin communication with theprimary processor2006, and/or provided to thesafety processor2004 from, for example, a memory module coupled to thesafety processor2004.
• In some aspects, a second sensor is coupled to theprimary processor2006. The second sensor is configured to measure the first physical property. Thesafety processor2004 and theprimary processor2006 are configured to provide a signal indicative of the value of the first sensor and the second sensor respectively. When either thesafety processor2004 or theprimary processor2006 indicates a value outside of an acceptable range, the segmentedcircuit2000 prevents operation of at least one of thecircuit segments2002c-2002h, such as, for example, themotor segment2002g. For example, in the example illustrated inFIGS. 21A-21B, thesafety processor2004 is coupled to a first motor position sensor2040aand theprimary processor2006 is coupled to a secondmotor position sensor2040b. Themotor position sensors2040a,2040bmay comprise any suitable motor position sensor, such as, for example, a magnetic angle rotary input comprising a sine and cosine output. Themotor position sensors2040a,2040bprovide respective signals to thesafety processor2004 and theprimary processor2006 indicative of the position of themotor2048.
• Thesafety processor2004 and theprimary processor2006 generate an activation signal when the values of the first motor sensor2040aand thesecond motor sensor2040bare within a predetermined range. When either theprimary processor2006 or thesafety processor2004 to detect a value outside of the predetermined range, the activation signal is terminated and operation of at least onecircuit segment2002c-2002h, such as, for example, themotor segment2002g, is interrupted and/or prevented. For example, in some examples, the activation signal from theprimary processor2006 and the activation signal from thesafety processor2004 are coupled to an AND gate. The AND gate is coupled to amotor power switch2020. The AND gate maintains themotor power switch2020 in a closed, or on, position when the activation signal from both thesafety processor2004 and theprimary processor2006 are high, indicating a value of themotor sensors2040a,2040bwithin the predetermined range. When either of themotor sensors2040a,2040bdetect a value outside of the predetermined range, the activation signal from thatmotor sensor2040a,2040bis set low, and the output of the AND gate is set low, opening themotor power switch2020. In some examples, the value of the first sensor2040aand thesecond sensor2040bis compared, for example, by thesafety processor2004 and/or theprimary processor2006. When the values of the first sensor and the second sensor are different, thesafety processor2004 and/or theprimary processor2006 may prevent operation of themotor segment2002g.
• In some aspects, thesafety processor2004 receives a signal indicative of the value of thesecond sensor2040band compares the second sensor value to the first sensor value. For example, in one aspect, thesafety processor2004 is coupled directly to a first motor sensor2040a. Asecond motor sensor2040bis coupled to aprimary processor2006, which provides thesecond motor sensor2040bvalue to thesafety processor2004, and/or coupled directly to thesafety processor2004. Thesafety processor2004 compares the value of the first motor sensor2040 to the value of thesecond motor sensor2040b. When thesafety processor2004 detects a mismatch between the first motor sensor2040aand thesecond motor sensor2040b, thesafety processor2004 may interrupt operation of themotor segment2002g, for example, by cutting power to themotor segment2002g.
• In some aspects, thesafety processor2004 and/or theprimary processor2006 is coupled to a first sensor2040aconfigured to measure a first property of a surgical instrument and asecond sensor2040bconfigured to measure a second property of the surgical instrument. The first property and the second property comprise a predetermined relationship when the surgical instrument is operating normally. Thesafety processor2004 monitors the first property and the second property. When a value of the first property and/or the second property inconsistent with the predetermined relationship is detected, a fault occurs. When a fault occurs, thesafety processor2004 takes at least one action, such as, for example, preventing operation of at least one of the circuit segments, executing a predetermined operation, and/or resetting theprimary processor2006. For example, thesafety processor2004 may open themotor power switch2020 to cut power to themotor circuit segment2002gwhen a fault is detected.
• In one aspect, thesafety processor2004 is configured to execute an independent control algorithm. In operation, thesafety processor2004 monitors the segmentedcircuit2000 and is configured to control and/or override signals from other circuit components, such as, for example, theprimary processor2006, independently. Thesafety processor2004 may execute a preprogrammed algorithm and/or may be updated or programmed on the fly during operation based on one or more actions and/or positions of thesurgical instrument10. For example, in one example, thesafety processor2004 is reprogrammed with new parameters and/or safety algorithms each time a new shaft and/or end effector is coupled to thesurgical instrument10. In some examples, one or more safety values stored by thesafety processor2004 are duplicated by theprimary processor2006. Two-way error detection is performed to ensure values and/or parameters stored by either of theprocessors2004,2006 are correct.
• In some aspects, thesafety processor2004 and theprimary processor2006 implement a redundant safety check. Thesafety processor2004 and theprimary processor2006 provide periodic signals indicating normal operation. For example, during operation, thesafety processor2004 may indicate to theprimary processor2006 that thesafety processor2004 is executing code and operating normally. Theprimary processor2006 may, likewise, indicate to thesafety processor2004 that theprimary processor2006 is executing code and operating normally. In some examples, communication between thesafety processor2004 and theprimary processor2006 occurs at a predetermined interval. The predetermined interval may be constant or may be variable based on the circuit state and/or operation of thesurgical instrument10.
• FIG. 22 illustrates one example of apower assembly2100 comprising ausage cycle circuit2102 configured to monitor a usage cycle count of thepower assembly2100. Thepower assembly2100 may be coupled to asurgical instrument2110. Theusage cycle circuit2102 comprises aprocessor2104 and ause indicator2106. Theuse indicator2106 is configured to provide a signal to theprocessor2104 to indicate a use of the battery back2100 and/or asurgical instrument2110 coupled to thepower assembly2100. A “use” may comprise any suitable action, condition, and/or parameter such as, for example, changing a modular component of asurgical instrument2110, deploying or firing a disposable component coupled to thesurgical instrument2110, delivering electrosurgical energy from thesurgical instrument2110, reconditioning thesurgical instrument2110 and/or thepower assembly2100, exchanging thepower assembly2100, recharging thepower assembly2100, and/or exceeding a safety limitation of thesurgical instrument2110 and/or the battery back2100.
• In some instances, a usage cycle, or use, is defined by one ormore power assembly2100 parameters. For example, in one instance, a usage cycle comprises using more than 5% of the total energy available from thepower assembly2100 when thepower assembly2100 is at a full charge level. In another instance, a usage cycle comprises a continuous energy drain from thepower assembly2100 exceeding a predetermined time limit. For example, a usage cycle may correspond to five minutes of continuous and/or total energy draw from thepower assembly2100. In some instances, thepower assembly2100 comprises ausage cycle circuit2102 having a continuous power draw to maintain one or more components of theusage cycle circuit2102, such as, for example, theuse indicator2106 and/or acounter2108, in an active state.
• Theprocessor2104 maintains a usage cycle count. The usage cycle count indicates the number of uses detected by theuse indicator2106 for thepower assembly2100 and/or thesurgical instrument2110. Theprocessor2104 may increment and/or decrement the usage cycle count based on input from theuse indicator2106. The usage cycle count is used to control one or more operations of thepower assembly2100 and/or thesurgical instrument2110. For example, in some instances, apower assembly2100 is disabled when the usage cycle count exceeds a predetermined usage limit. Although the instances discussed herein are discussed with respect to incrementing the usage cycle count above a predetermined usage limit, those skilled in the art will recognize that the usage cycle count may start at a predetermined amount and may be decremented by theprocessor2104. In this instance, theprocessor2104 initiates and/or prevents one or more operations of thepower assembly2100 when the usage cycle count falls below a predetermined usage limit.
• The usage cycle count is maintained by acounter2108. Thecounter2108 comprises any suitable circuit, such as, for example, a memory module, an analog counter, and/or any circuit configured to maintain a usage cycle count. In some instances, thecounter2108 is formed integrally with theprocessor2104. In other instances, thecounter2108 comprises a separate component, such as, for example, a solid state memory module. In some instances, the usage cycle count is provided to a remote system, such as, for example, a central database. The usage cycle count is transmitted by acommunications module2112 to the remote system. Thecommunications module2112 is configured to use any suitable communications medium, such as, for example, wired and/or wireless communication. In some instances, thecommunications module2112 is configured to receive one or more instructions from the remote system, such as, for example, a control signal when the usage cycle count exceeds the predetermined usage limit.
• In some instances, theuse indicator2106 is configured to monitor the number of modular components used with asurgical instrument2110 coupled to thepower assembly2100. A modular component may comprise, for example, a modular shaft, a modular end effector, and/or any other modular component. In some instances, theuse indicator2106 monitors the use of one or more disposable components, such as, for example, insertion and/or deployment of a staple cartridge within an end effector coupled to thesurgical instrument2110. Theuse indicator2106 comprises one or more sensors for detecting the exchange of one or more modular and/or disposable components of thesurgical instrument2110.
• In some instances, theuse indicator2106 is configured to monitor single patient surgical procedures performed while thepower assembly2100 is installed. For example, theuse indicator2106 may be configured to monitor firings of thesurgical instrument2110 while thepower assembly2100 is coupled to thesurgical instrument2110. A firing may correspond to deployment of a staple cartridge, application of electrosurgical energy, and/or any other suitable surgical event. Theuse indicator2106 may comprise one or more circuits for measuring the number of firings while thepower assembly2100 is installed. Theuse indicator2106 provides a signal to theprocessor2104 when a single patient procedure is performed and theprocessor2104 increments the usage cycle count.
• In some instances, theuse indicator2106 comprises a circuit configured to monitor one or more parameters of thepower source2114, such as, for example, a current draw from thepower source2114. The one or more parameters of thepower source2114 correspond to one or more operations performable by thesurgical instrument2110, such as, for example, a cutting and sealing operation. Theuse indicator2106 provides the one or more parameters to theprocessor2104, which increments the usage cycle count when the one or more parameters indicate that a procedure has been performed.
• In some instances, theuse indicator2106 comprises a timing circuit configured to increment a usage cycle count after a predetermined time period. The predetermined time period corresponds to a single patient procedure time, which is the time required for an operator to perform a procedure, such as, for example, a cutting and sealing procedure. When thepower assembly2100 is coupled to thesurgical instrument2110, theprocessor2104 polls theuse indicator2106 to determine when the single patient procedure time has expired. When the predetermined time period has elapsed, theprocessor2104 increments the usage cycle count. After incrementing the usage cycle count, theprocessor2104 resets the timing circuit of theuse indicator2106.
• In some instances, theuse indicator2106 comprises a time constant that approximates the single patient procedure time. In one example, theusage cycle circuit2102 comprises a resistor-capacitor (RC) timing circuit2506. The RC timing circuit comprises a time constant defined by a resistor-capacitor pair. The time constant is defined by the values of the resistor and the capacitor. In one example, the usage cycle circuit2552 comprises a rechargeable battery and a clock. When thepower assembly2100 is installed in a surgical instrument, the rechargeable battery is charged by the power source. The rechargeable battery comprises enough power to run the clock for at least the single patient procedure time. The clock may comprise a real time clock, a processor configured to implement a time function, or any other suitable timing circuit.
• Referring still toFIG. 22, in some instances, theuse indicator2106 comprises a sensor configured to monitor one or more environmental conditions experienced by thepower assembly2100. For example, theuse indicator2106 may comprise an accelerometer. The accelerometer is configured to monitor acceleration of thepower assembly2100. Thepower assembly2100 comprises a maximum acceleration tolerance. Acceleration above a predetermined threshold indicates, for example, that thepower assembly2100 has been dropped. When theuse indicator2106 detects acceleration above the maximum acceleration tolerance, theprocessor2104 increments a usage cycle count. In some instances, theuse indicator2106 comprises a moisture sensor. The moisture sensor is configured to indicate when thepower assembly2100 has been exposed to moisture. The moisture sensor may comprise, for example, an immersion sensor configured to indicate when thepower assembly2100 has been fully immersed in a cleaning fluid, a moisture sensor configured to indicate when moisture is in contact with thepower assembly2100 during use, and/or any other suitable moisture sensor.
• In some instances, theuse indicator2106 comprises a chemical exposure sensor. The chemical exposure sensor is configured to indicate when thepower assembly2100 has come into contact with harmful and/or dangerous chemicals. For example, during a sterilization procedure, an inappropriate chemical may be used that leads to degradation of thepower assembly2100. Theprocessor2104 increments the usage cycle count when theuse indicator2106 detects an inappropriate chemical.
• In some instances, theusage cycle circuit2102 is configured to monitor the number of reconditioning cycles experienced by thepower assembly2100. A reconditioning cycle may comprise, for example, a cleaning cycle, a sterilization cycle, a charging cycle, routine and/or preventative maintenance, and/or any other suitable reconditioning cycle. Theuse indicator2106 is configured to detect a reconditioning cycle. For example, theuse indicator2106 may comprise a moisture sensor to detect a cleaning and/or sterilization cycle. In some instances, theusage cycle circuit2102 monitors the number of reconditioning cycles experienced by thepower assembly2100 and disables thepower assembly2100 after the number of reconditioning cycles exceeds a predetermined threshold.
• Theusage cycle circuit2102 may be configured to monitor the number ofpower assembly2100 exchanges. Theusage cycle circuit2102 increments the usage cycle count each time thepower assembly2100 is exchanged. When the maximum number of exchanges is exceeded theusage cycle circuit2102 locks out thepower assembly2100 and/or thesurgical instrument2110. In some instances, when thepower assembly2100 is coupled thesurgical instrument2110, theusage cycle circuit2102 identifies the serial number of thepower assembly2100 and locks thepower assembly2100 such that thepower assembly2100 is usable only with thesurgical instrument2110. In some instances, theusage cycle circuit2102 increments the usage cycle each time thepower assembly2100 is removed from and/or coupled to thesurgical instrument2110.
• In some instances, the usage cycle count corresponds to sterilization of thepower assembly2100. Theuse indicator2106 comprises a sensor configured to detect one or more parameters of a sterilization cycle, such as, for example, a temperature parameter, a chemical parameter, a moisture parameter, and/or any other suitable parameter. Theprocessor2104 increments the usage cycle count when a sterilization parameter is detected. Theusage cycle circuit2102 disables thepower assembly2100 after a predetermined number of sterilizations. In some instances, theusage cycle circuit2102 is reset during a sterilization cycle, a voltage sensor to detect a recharge cycle, and/or any suitable sensor. Theprocessor2104 increments the usage cycle count when a reconditioning cycle is detected. Theusage cycle circuit2102 is disabled when a sterilization cycle is detected. Theusage cycle circuit2102 is reactivated and/or reset when thepower assembly2100 is coupled to thesurgical instrument2110. In some instances, the use indicator comprises a zero power indicator. The zero power indicator changes state during a sterilization cycle and is checked by theprocessor2104 when thepower assembly2100 is coupled to asurgical instrument2110. When the zero power indicator indicates that a sterilization cycle has occurred, theprocessor2104 increments the usage cycle count.
• Acounter2108 maintains the usage cycle count. In some instances, thecounter2108 comprises a non-volatile memory module. Theprocessor2104 increments the usage cycle count stored in the non-volatile memory module each time a usage cycle is detected. The memory module may be accessed by theprocessor2104 and/or a control circuit, such as, for example, thecontrol circuit200. When the usage cycle count exceeds a predetermined threshold, theprocessor2104 disables thepower assembly2100. In some instances, the usage cycle count is maintained by a plurality of circuit components. For example, in one instance, thecounter2108 comprises a resistor (or fuse) pack. After each use of thepower assembly2100, a resistor (or fuse) is burned to an open position, changing the resistance of the resistor pack. Thepower assembly2100 and/or thesurgical instrument2110 reads the remaining resistance. When the last resistor of the resistor pack is burned out, the resistor pack has a predetermined resistance, such as, for example, an infinite resistance corresponding to an open circuit, which indicates that thepower assembly2100 has reached its usage limit. In some instances, the resistance of the resistor pack is used to derive the number of uses remaining.
• In some instances, theusage cycle circuit2102 prevents further use of thepower assembly2100 and/or thesurgical instrument2110 when the usage cycle count exceeds a predetermined usage limit. In one instance, the usage cycle count associated with thepower assembly2100 is provided to an operator, for example, utilizing a screen formed integrally with thesurgical instrument2110. Thesurgical instrument2110 provides an indication to the operator that the usage cycle count has exceeded a predetermined limit for thepower assembly2100, and prevents further operation of thesurgical instrument2110.
• In some instances, theusage cycle circuit2102 is configured to physically prevent operation when the predetermined usage limit is reached. For example, thepower assembly2100 may comprise a shield configured to deploy over contacts of thepower assembly2100 when the usage cycle count exceeds the predetermined usage limit. The shield prevents recharge and use of thepower assembly2100 by covering the electrical connections of thepower assembly2100.
• In some instances, theusage cycle circuit2102 is located at least partially within thesurgical instrument2110 and is configured to maintain a usage cycle count for thesurgical instrument2110.FIG. 22 illustrates one or more components of theusage cycle circuit2102 within thesurgical instrument2110 in phantom, illustrating the alternative positioning of theusage cycle circuit2102. When a predetermined usage limit of thesurgical instrument2110 is exceeded, theusage cycle circuit2102 disables and/or prevents operation of thesurgical instrument2110. The usage cycle count is incremented by theusage cycle circuit2102 when theuse indicator2106 detects a specific event and/or requirement, such as, for example, firing of thesurgical instrument2110, a predetermined time period corresponding to a single patient procedure time, based on one or more motor parameters of thesurgical instrument2110, in response to a system diagnostic indicating that one or more predetermined thresholds are met, and/or any other suitable requirement. As discussed above, in some instances, theuse indicator2106 comprises a timing circuit corresponding to a single patient procedure time. In other instances, theuse indicator2106 comprises one or more sensors configured to detect a specific event and/or condition of thesurgical instrument2110.
• In some instances, theusage cycle circuit2102 is configured to prevent operation of thesurgical instrument2110 after the predetermined usage limit is reached. In some instances, thesurgical instrument2110 comprises a visible indicator to indicate when the predetermined usage limit has been reached and/or exceeded. For example, a flag, such as a red flag, may pop-up from thesurgical instrument2110, such as from the handle, to provide a visual indication to the operator that thesurgical instrument2110 has exceeded the predetermined usage limit. As another example, theusage cycle circuit2102 may be coupled to a display formed integrally with thesurgical instrument2110. Theusage cycle circuit2102 displays a message indicating that the predetermined usage limit has been exceeded. Thesurgical instrument2110 may provide an audible indication to the operator that the predetermined usage limit has been exceeded. For example, in one instance, thesurgical instrument2110 emits an audible tone when the predetermined usage limit is exceeded and thepower assembly2100 is removed from thesurgical instrument2110. The audible tone indicates the last use of thesurgical instrument2110 and indicates that thesurgical instrument2110 should be disposed or reconditioned.
• In some instances, theusage cycle circuit2102 is configured to transmit the usage cycle count of thesurgical instrument2110 to a remote location, such as, for example, a central database. Theusage cycle circuit2102 comprises acommunications module2112 configured to transmit the usage cycle count to the remote location. Thecommunications module2112 may utilize any suitable communications system, such as, for example, wired or wireless communications system. The remote location may comprise a central database configured to maintain usage information. In some instances, when thepower assembly2100 is coupled to thesurgical instrument2110, thepower assembly2100 records a serial number of thesurgical instrument2110. The serial number is transmitted to the central database, for example, when thepower assembly2100 is coupled to a charger. In some instances, the central database maintains a count corresponding to each use of thesurgical instrument2110. For example, a bar code associated with thesurgical instrument2110 may be scanned each time thesurgical instrument2110 is used. When the use count exceeds a predetermined usage limit, the central database provides a signal to thesurgical instrument2110 indicating that thesurgical instrument2110 should be discarded.
• Thesurgical instrument2110 may be configured to lock and/or prevent operation of thesurgical instrument2110 when the usage cycle count exceeds a predetermined usage limit. In some instances, thesurgical instrument2110 comprises a disposable instrument and is discarded after the usage cycle count exceeds the predetermined usage limit. In other instances, thesurgical instrument2110 comprises a reusable surgical instrument which may be reconditioned after the usage cycle count exceeds the predetermined usage limit. Thesurgical instrument2110 initiates a reversible lockout after the predetermined usage limit is met. A technician reconditions thesurgical instrument2110 and releases the lockout, for example, utilizing a specialized technician key configured to reset theusage cycle circuit2102.
• In some aspects, the segmentedcircuit2000 is configured for sequential start-up. An error check is performed by each circuit segment2002a-2002gprior to energizing the next sequential circuit segment2002a-2002g.FIG. 23 illustrates one example of a process for sequentially energizing asegmented circuit2270, such as, for example, the segmentedcircuit2000. When abattery2008 is coupled to the segmentedcircuit2000, thesafety processor2004 is energized2272. Thesafety processor2004 performs a self-error check2274. When an error is detected2276a, the safety processor stops energizing thesegmented circuit2000 and generates anerror code2278a. When no errors are detected2276b, thesafety processor2004initiates2278bpower-up of theprimary processor2006. Theprimary processor2006 performs a self-error check. When no errors are detected, theprimary processor2006 begins sequential power-up of each of the remainingcircuit segments2278b. Each circuit segment is energized and error checked by theprimary processor2006. When no errors are detected, the next circuit segment is energized2278b. When an error is detected, thesafety processor2004 and/or the primary process stops energizing the current segment and generates anerror2278a. The sequential start-up continues until all of the circuit segments2002a-2002ghave been energized. In some examples, the segmentedcircuit2000 transitions from sleep mode following a similar sequential power-up process11250.
• FIG. 24 illustrates one aspect of apower segment2302 comprising a plurality of daisy chainedpower converters2314,2316,2318. Thepower segment2302 comprises abattery2308. Thebattery2308 is configured to provide a source voltage, such as, for example, 12V. Acurrent sensor2312 is coupled to thebattery2308 to monitor the current draw of a segmented circuit and/or one or more circuit segments. Thecurrent sensor2312 is coupled to anFET switch2313. Thebattery2308 is coupled to one ormore voltage converters2309,2314,2316. An always onconverter2309 provides a constant voltage to one or more circuit components, such as, for example, amotion sensor2322. The always onconverter2309 comprises, for example, a 3.3V converter. The always onconverter2309 may provide a constant voltage to additional circuit components, such as, for example, a safety processor (not shown). Thebattery2308 is coupled to aboost converter2318. Theboost converter2318 is configured to provide a boosted voltage above the voltage provided by thebattery2308. For example, in the illustrated example, thebattery2308 provides a voltage of 12V. Theboost converter2318 is configured to boost the voltage to 13V. Theboost converter2318 is configured to maintain a minimum voltage during operation of a surgical instrument, for example, the surgical instrument10 (FIGS. 1-4). Operation of a motor can result in the power provided to theprimary processor2306 dropping below a minimum threshold and creating a brownout or reset condition in theprimary processor2306. Theboost converter2318 ensures that sufficient power is available to theprimary processor2306 and/or other circuit components, such as themotor controller2343, during operation of thesurgical instrument10. In some examples, theboost converter2318 is coupled directly one or more circuit components, such as, for example, anOLED display2388.
• Theboost converter2318 is coupled to one or more step-down converters to provide voltages below the boosted voltage level. Afirst voltage converter2316 is coupled to theboost converter2318 and provides a first stepped-down voltage to one or more circuit components. In the illustrated example, thefirst voltage converter2316 provides a voltage of 5V. Thefirst voltage converter2316 is coupled to arotary position encoder2340. AFET switch2317 is coupled between thefirst voltage converter2316 and therotary position encoder2340. TheFET switch2317 is controlled by theprocessor2306. Theprocessor2306 opens theFET switch2317 to deactivate theposition encoder2340, for example, during power intensive operations. Thefirst voltage converter2316 is coupled to asecond voltage converter2314 configured to provide a second stepped-down voltage. The second stepped-down voltage comprises, for example, 3.3V. Thesecond voltage converter2314 is coupled to aprocessor2306. In some examples, theboost converter2318, thefirst voltage converter2316, and thesecond voltage converter2314 are coupled in a daisy chain configuration. The daisy chain configuration allows the use of smaller, more efficient converters for generating voltage levels below the boosted voltage level. The examples, however, are not limited to the particular voltage range(s) described in the context of this specification.
• FIG. 25 illustrates one aspect of asegmented circuit2400 configured to maximize power available for critical and/or power intense functions. The segmentedcircuit2400 comprises abattery2408. Thebattery2408 is configured to provide a source voltage such as, for example, 12V. The source voltage is provided to a plurality ofvoltage converters2409,2418. An always-onvoltage converter2409 provides a constant voltage to one or more circuit components, for example, amotion sensor2422 and asafety processor2404. The always-onvoltage converter2409 is directly coupled to thebattery2408. The always-onconverter2409 provides a voltage of 3.3V, for example. The examples, however, are not limited to the particular voltage range(s) described in the context of this specification.
• The segmentedcircuit2400 comprises aboost converter2418. Theboost converter2418 provides a boosted voltage above the source voltage provided by thebattery2408, such as, for example, 13V. Theboost converter2418 provides a boosted voltage directly to one or more circuit components, such as, for example, anOLED display2488 and amotor controller2443. By coupling theOLED display2488 directly to theboost converter2418, the segmentedcircuit2400 eliminates the need for a power converter dedicated to theOLED display2488. Theboost converter2418 provides a boosted voltage to themotor controller2443 and themotor2448 during one or more power intensive operations of themotor2448, such as, for example, a cutting operation. Theboost converter2418 is coupled to a step-down converter2416. The step-down converter2416 is configured to provide a voltage below the boosted voltage to one or more circuit components, such as, for example, 5V. The step-down converter2416 is coupled to, for example, aFET switch2451 and aposition encoder2440. TheFET switch2451 is coupled to theprimary processor2406. Theprimary processor2406 opens theFET switch2451 when transitioning the segmentedcircuit2400 to sleep mode and/or during power intensive functions requiring additional voltage delivered to themotor2448. Opening theFET switch2451 deactivates theposition encoder2440 and eliminates the power draw of theposition encoder2440. The examples, however, are not limited to the particular voltage range(s) described in the context of this specification.
• The step-down converter2416 is coupled to alinear converter2414. Thelinear converter2414 is configured to provide a voltage of, for example, 3.3V. Thelinear converter2414 is coupled to theprimary processor2406. Thelinear converter2414 provides an operating voltage to theprimary processor2406. Thelinear converter2414 may be coupled to one or more additional circuit components. The examples, however, are not limited to the particular voltage range(s) described in the context of this specification.
• The segmentedcircuit2400 comprises abailout switch2456. Thebailout switch2456 is coupled to a bailout door on thesurgical instrument10. Thebailout switch2456 and thesafety processor2404 are coupled to an ANDgate2419. The ANDgate2419 provides an input to aFET switch2413. When thebailout switch2456 detects a bailout condition, thebailout switch2456 provides a bailout shutdown signal to the ANDgate2419. When thesafety processor2404 detects an unsafe condition, such as, for example, due to a sensor mismatch, thesafety processor2404 provides a shutdown signal to the ANDgate2419. In some examples, both the bailout shutdown signal and the shutdown signal are high during normal operation and are low when a bailout condition or an unsafe condition is detected. When the output of the ANDgate2419 is low, theFET switch2413 is opened and operation of themotor2448 is prevented. In some examples, thesafety processor2404 utilizes the shutdown signal to transition themotor2448 to an off state in sleep mode. A third input to theFET switch2413 is provided by acurrent sensor2412 coupled to thebattery2408. Thecurrent sensor2412 monitors the current drawn by thecircuit2400 and opens theFET switch2413 to shut-off power to themotor2448 when an electrical current above a predetermined threshold is detected. TheFET switch2413 and themotor controller2443 are coupled to a bank ofFET switches2445 configured to control operation of themotor2448.
• Amotor current sensor2446 is coupled in series with themotor2448 to provide a motor current sensor reading to acurrent monitor2447. Thecurrent monitor2447 is coupled to theprimary processor2406. Thecurrent monitor2447 provides a signal indicative of the current draw of themotor2448. Theprimary processor2406 may utilize the signal from the motor current2447 to control operation of the motor, for example, to ensure the current draw of themotor2448 is within an acceptable range, to compare the current draw of themotor2448 to one or more other parameters of thecircuit2400 such as, for example, theposition encoder2440, and/or to determine one or more parameters of a treatment site. In some examples, thecurrent monitor2447 may be coupled to thesafety processor2404.
• In some aspects, actuation of one or more handle controls, such as, for example, a firing trigger, causes theprimary processor2406 to decrease power to one or more components while the handle control is actuated. For example, in one example, a firing trigger controls a firing stroke of a cutting member. The cutting member is driven by themotor2448. Actuation of the firing trigger results in forward operation of themotor2448 and advancement of the cutting member. During firing, theprimary processor2406 closes theFET switch2451 to remove power from theposition encoder2440. The deactivation of one or more circuit components allows higher power to be delivered to themotor2448. When the firing trigger is released, full power is restored to the deactivated components, for example, by closing theFET switch2451 and reactivating theposition encoder2440.
• In some aspects, thesafety processor2404 controls operation of the segmentedcircuit2400. For example, thesafety processor2404 may initiate a sequential power-up of the segmentedcircuit2400, transition of the segmentedcircuit2400 to and from sleep mode, and/or may override one or more control signals from theprimary processor2406. For example, in the illustrated example, thesafety processor2404 is coupled to the step-down converter2416. Thesafety processor2404 controls operation of the segmentedcircuit2400 by activating or deactivating the step-down converter2416 to provide power to the remainder of the segmentedcircuit2400.
• FIG. 26 illustrates one aspect of apower system2500 comprising a plurality of daisy chainedpower converters2514,2516,2518 configured to be sequentially energized. The plurality of daisy chainedpower converters2514,2516,2518 may be sequentially activated by, for example, a safety processor during initial power-up and/or transition from sleep mode. The safety processor may be powered by an independent power converter (not shown). For example, in one example, when a battery voltage V_BATTis coupled to thepower system2500 and/or an accelerometer detects movement in sleep mode, the safety processor initiates a sequential start-up of the daisy chainedpower converters2514,2516,2518. The safety processor activates the13V boost section2518. Theboost section2518 is energized and performs a self-check. In some examples, theboost section2518 comprises an integrated circuit2520 configured to boost the source voltage and to perform a self check. A diode D prevents power-up of a5V supply section2516 until theboost section2518 has completed a self-check and provided a signal to the diode D indicating that theboost section2518 did not identify any errors. In some examples, this signal is provided by the safety processor. The examples, however, are not limited to the particular voltage range(s) described in the context of this specification.
• The5V supply section2516 is sequentially powered-up after theboost section2518. The5V supply section2516 performs a self-check during power-up to identify any errors in the5V supply section2516. The5V supply section2516 comprises anintegrated circuit2515 configured to provide a step-down voltage from the boost voltage and to perform an error check. When no errors are detected, the5V supply section2516 completes sequential power-up and provides an activation signal to the 3.3V supply section2514. In some examples, the safety processor provides an activation signal to the 3.3V supply section2514. The 3.3V supply section comprises an integrated circuit2513 configured to provide a step-down voltage from the5V supply section2516 and perform a self-error check during power-up. When no errors are detected during the self-check, the 3.3V supply section2514 provides power to the primary processor. The primary processor is configured to sequentially energize each of the remaining circuit segments. By sequentially energizing thepower system2500 and/or the remainder of a segmented circuit, thepower system2500 reduces error risks, allows for stabilization of voltage levels before loads are applied, and prevents large current draws from all hardware being turned on simultaneously in an uncontrolled manner. The examples, however, are not limited to the particular voltage range(s) described in the context of this specification.
• In one aspect, thepower system2500 comprises an over voltage identification and mitigation circuit. The over voltage identification and mitigation circuit is configured to detect a monopolar return current in the surgical instrument and interrupt power from the power segment when the monopolar return current is detected. The over voltage identification and mitigation circuit is configured to identify ground floatation of the power system. The over voltage identification and mitigation circuit comprises a metal oxide varistor. The over voltage identification and mitigation circuit comprises at least one transient voltage suppression diode.
• FIG. 27 illustrates one aspect of asegmented circuit2600 comprising anisolated control section2602. Theisolated control section2602 isolates control hardware of the segmentedcircuit2600 from a power section (not shown) of the segmentedcircuit2600. Thecontrol section2602 comprises, for example, aprimary processor2606, a safety processor (not shown), and/or additional control hardware, for example, aFET Switch2617. The power section comprises, for example, a motor, a motor driver, and/or a plurality of motor MOSFETS. Theisolated control section2602 comprises acharging circuit2603 and arechargeable battery2608 coupled to a5V power converter2616. Thecharging circuit2603 and therechargeable battery2608 isolate theprimary processor2606 from the power section. In some examples, therechargeable battery2608 is coupled to a safety processor and any additional support hardware. Isolating thecontrol section2602 from the power section allows thecontrol section2602, for example, theprimary processor2606, to remain active even when main power is removed, provides a filter, through therechargeable battery2608, to keep noise out of thecontrol section2602, isolates thecontrol section2602 from heavy swings in the battery voltage to ensure proper operation even during heavy motor loads, and/or allows for real-time operating system (RTOS) to be used by the segmentedcircuit2600. In some examples, therechargeable battery2608 provides a stepped-down voltage to the primary processor, such as, for example, 3.3V. The examples, however, are not limited to the particular voltage range(s) described in the context of this specification.
• FIGS. 28A and 28B illustrate another aspect of acontrol circuit3000 configured to control the poweredsurgical instrument10, illustrated inFIGS. 1-18A. As shown inFIGS. 18A, 28B, thehandle assembly14 may include amotor3014 which can be controlled by amotor driver3015 and can be employed by the firing system of thesurgical instrument10. In various forms, themotor3014 may be a DC brushed driving motor having a maximum rotation of, approximately, 25,000 RPM, for example. In other arrangements, themotor3014 may include a brushless motor, a cordless motor, a synchronous motor, a stepper motor, or any other suitable electric motor. In certain circumstances, themotor driver3015 may comprise an H-Bridge FETs3019, as illustrated inFIGS. 28A and 28B, for example. Themotor3014 can be powered by apower assembly3006, which can be releasably mounted to thehandle assembly14. Thepower assembly3006 is configured to supply control power to thesurgical instrument10. Thepower assembly3006 may comprise a battery which may include a number of battery cells connected in series that can be used as the power source to power thesurgical instrument10. In such configuration, thepower assembly3006 may be referred to as a battery pack. In certain circumstances, the battery cells of thepower assembly3006 may be replaceable and/or rechargeable. In at least one example, the battery cells can be Lithium-Ion batteries which can be separably couplable to thepower assembly3006.
• Examples of drive systems and closure systems that are suitable for use with thesurgical instrument10 are disclosed in U.S. Provisional Patent Application Ser. No. 61/782,866, entitled CONTROL SYSTEM OF A SURGICAL INSTRUMENT, and filed Mar. 14, 2013, the entire disclosure of which is incorporated by reference herein in its entirety. For example, theelectric motor3014 can include a rotatable shaft (not shown) that may operably interface with a gear reducer assembly that can be mounted in meshing engagement with a set, or rack, of drive teeth on a longitudinally-movable drive member. In use, a voltage polarity provided by the battery can operate theelectric motor3014 to drive the longitudinally-movable drive member to effectuate theend effector300. For example, themotor3014 can be configured to drive the longitudinally-movable drive member to advance a firing mechanism to fire staples into tissue captured by theend effector300 from a staple cartridge assembled with theend effector300 and/or advance a cutting member to cut tissue captured by theend effector300, for example.
• As illustrated inFIGS. 28A and 28B and as described below in greater detail, thepower assembly3006 may include a power management controller which can be configured to modulate the power output of thepower assembly3006 to deliver a first power output to power themotor3014 to advance the cutting member while theinterchangeable shaft200 is coupled to the handle assembly14 (FIG. 1) and to deliver a second power output to power themotor3014 to advance the cutting member while theinterchangeable shaft assembly200 is coupled to thehandle assembly14, for example. Such modulation can be beneficial in avoiding transmission of excessive power to themotor3014 beyond the requirements of an interchangeable shaft assembly that is coupled to thehandle assembly14.
• In certain circumstances, theinterface3024 can facilitate transmission of the one or more communication signals between thepower management controller3016 and theshaft assembly controller3022 by routing such communication signals through amain controller3017 residing in the handle assembly14 (FIG. 1), for example. In other circumstances, theinterface3024 can facilitate a direct line of communication between thepower management controller3016 and theshaft assembly controller3022 through thehandle assembly14 while the shaft assembly200 (FIG. 1) and thepower assembly3006 are coupled to thehandle assembly14.
• In one instance, themain microcontroller3017 may be any single core or multicore processor such as those known under the trade name ARM Cortex by Texas Instruments. In one instance, the surgical instrument10 (FIGS. 1-4) may comprise apower management controller3016 such as, for example, a safety microcontroller platform comprising two microcontroller-based families such as TMS570 and RM4x known under the trade name Hercules ARM Cortex R4, also by Texas Instruments. Nevertheless, other suitable substitutes for microcontrollers and safety processor may be employed, without limitation. In one instance, the safety processor2004 (FIG. 21A) 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.
• In certain instances, themicrocontroller3017 may be an LM 4F230H5QR, available from Texas Instruments, for example. In at least one example, the Texas Instruments LM4F230H5QR is an ARM Cortex-M4F Processor Core comprising on-chip memory of 256 KB single-cycle flash memory, or other non-volatile memory, up to 40 MHz, a prefetch buffer to improve performance above 40 MHz, a 32 KB single-cycle serial random access memory (SRAM), internal read-only memory (ROM) loaded with StellarisWare® software, 2 KB electrically erasable programmable read-only memory (EEPROM), one or more pulse width modulation (PWM) modules, one or more quadrature encoder inputs (QEI) analog, one or more 12-bit Analog-to-Digital Converters (ADC) with 12 analog input channels, among other features that are readily available for the product datasheet. The present disclosure should not be limited in this context.
• FIG. 29 is a block diagram the surgical instrument ofFIG. 1 illustrating interfaces between the handle assembly14 (FIG. 1) and the power assembly and between thehandle assembly14 and the interchangeable shaft assembly. As shown inFIG. 29, thepower assembly3006 may include apower management circuit3034 which may comprise thepower management controller3016, apower modulator3038, and acurrent sense circuit3036. Thepower management circuit3034 can be configured to modulate power output of thebattery3007 based on the power requirements of the shaft assembly200 (FIG. 1) while theshaft assembly200 and thepower assembly3006 are coupled to thehandle assembly14. For example, thepower management controller3016 can be programmed to control thepower modulator3038 of the power output of thepower assembly3006 and thecurrent sense circuit3036 can be employed to monitor power output of thepower assembly3006 to provide feedback to thepower management controller3016 about the power output of thebattery3007 so that thepower management controller3016 may adjust the power output of thepower assembly3006 to maintain a desired output.
• It is noteworthy that thepower management controller3016 and/or theshaft assembly controller3022 each may comprise one or more processors and/or memory units which may store a number of software modules. Although certain modules and/or blocks of the surgical instrument14 (FIG. 1) may be described by way of example, it can be appreciated that a greater or lesser number of modules and/or blocks may be used. Further, although various instances may be described in terms of modules and/or blocks to facilitate 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 combinations of hardware and software components.
• In certain instances, the surgical instrument10 (FIGS. 1-4) may comprise anoutput device3042 which may include one or more devices for providing a sensory feedback to a user. Such devices may comprise, for example, visual feedback devices (e.g., an LCD display screen, LED indicators), audio feedback devices (e.g., a speaker, a buzzer) or tactile feedback devices (e.g., haptic actuators). In certain circumstances, theoutput device3042 may comprise adisplay3043 which may be included in the handle assembly14 (FIG. 1). Theshaft assembly controller3022 and/or thepower management controller3016 can provide feedback to a user of thesurgical instrument10 through theoutput device3042. Theinterface3024 can be configured to connect theshaft assembly controller3022 and/or thepower management controller3016 to theoutput device3042. The reader will appreciate that theoutput device3042 can instead be integrated with thepower assembly3006. In such circumstances, communication between theoutput device3042 and theshaft assembly controller3022 may be accomplished through theinterface3024 while theshaft assembly200 is coupled to thehandle assembly14.
• Having described a surgical instrument10 (FIGS. 1-4) andvarious control circuits2000,3000 for controlling the operation thereof, the disclosure now turns to various specific configurations of thesurgical instrument10 and control circuits2000 (or3000).
• In various aspects the present disclosure provides techniques for data storage and usage. In one aspect, data storage and usage is based on multiple levels of action thresholds. Such thresholds include upper and lower ultimate threshold limits, ultimate threshold that shuts down motor or activates return is current, pressure, firing load, torque is exceeded, and alternatively, while running within the limits the device automatically compensates for loading of the motor.
• In one aspect, the instrument10 (described in connection withFIGS. 1-29) can be configured to monitor upper and lower ultimate threshold limits to maintain minimum and maximum closure clamp loads within acceptable limits. If a minimum is not achieved theinstrument10 cannot start or if it drops below minimum a user action is required. If the clamp load is at a suitable level but drops under minimum during firing, theinstrument10 can adjust the speed of the motor or warn the user. If the minimum limit is breached during operation the unit could give a warning that the firing may not be completely as anticipated. Theinstrument10 also can be configured to monitor when the battery voltage drops below the lower ultimate limit the remaining battery power is only direct able towards returning the device to the I-beam parked state. The opening force on the anvil can be employed to sense jams in the end effector. Alternatively, theinstrument10 can be configured to monitor when the motor current goes up or the related speed goes down, then the motor control increases pulse width or frequency modulation to keep speed constant.
• In another aspect, theinstrument10 can (FIG. 1) be configured to detect an ultimate threshold of current draw, pressure, firing load, torque such that when any of these thresholds are exceeded, theinstrument10 shuts down the motor or causes the motor to return the knife to a pre-fired position. A secondary threshold, which is less than the ultimate threshold, may be employed to alter the motor control program to accommodate changes in conditions by changing the motor control parameters. A marginal threshold can be configured as a step function or a ramp function based on a proportionate response to another counter or input. For example, in the case of sterilization, no changes between 0-200 sterilization cycles,slow motor 1% per use from 201-400 sterilization cycles, and prevent use over 400 sterilization cycles. The speed of the motor also can be varied based on tissue gap and current draw.
• There are many parameters that could influence the ideal function of a powered reusable stapler device. Most of these parameters have an ultimate maximum and/or minimum threshold beyond which the device should not be operated. Nevertheless, there are also marginal limits that may influence the functional operation of the device. These multiple limits, from multiple parameters may provide an overlying and cumulative effect on the operations program of the device.
• Accordingly, the present disclosure relates to surgical instruments and, in various circumstances, to surgical stapling and cutting instruments and staple cartridges therefor that are designed to staple and cut tissue.
• Efficient performance of an electromechanical device depends on various factors. One is the operational envelope, i.e., range of parameters, conditions and events in which the device carries out its intended functions. For example, for a device powered by a motor driven by electrical current, there may be an operational region above a certain electrical current threshold where the device runs more inefficiently than desired. Put another way, there may be an upper “speed limit” above which there is decreasing efficiency. Such an upper threshold may have value in preventing substantial inefficiencies or even device degradation.
• There may be thresholds within an operational envelope, however, that may form regions exploitable to enhance efficiency within operational states. In other words, there may be regions where the device can adjust and perform better within a defined operational envelope (or sub-envelope). Such a region can be one between a marginal threshold and an ultimate threshold. In addition, these regions may comprise “sweet spots” or a predetermined optional range or point. These regions also may comprise a large range within which performance is judged to be adequate.
• An ultimate threshold can be defined, above which or below which an action or actions could be taken (or refrained from being taken) such as stopping the device. In addition, a marginal threshold or thresholds can be defined, above which or below which an action or actions could be taken (or refrained from being taken). By way of non-limiting example, a marginal threshold can be set to define where the current draw of the motor exceeds 75% of an ultimate threshold. Exceeding the marginal threshold can result, for example, in the device's beginning to slow motor speed at an increasing rate as it continues to climb toward the ultimate threshold.
• Various mechanisms can be employed to carry out the adjustment(s) taken as a result of exceeding a threshold. For example, the adjustment can reflect a step function. It can also reflect a ramped function. Other functions can be utilized.
• In various aspects, to enhance performance by additional mechanisms, an overlaying threshold can be defined. An overlaying threshold can comprise one or more thresholds defined by multiple parameters. An overlaying threshold can result in one or more thresholds being an input into the generation of another threshold or thresholds. An overlaying threshold can be predetermined or dynamically generated such as at runtime. The overlaying threshold may come into effect when you the threshold is defined by multiple inputs. For example, as the number of sterilization cycles exceeds 300 (the marginal threshold) but not 500 (the ultimate threshold) the device runs the motor slower. Then as the current draw exceeds its 75% marginal threshold it multiples the slow down going even slower.
• FIG. 30 is a logic diagram disclosing aspects of a multiple-level threshold system wherein athreshold rules framework4000. Parameters can be identified4010, such parameters representing quantities, amounts, states, events or more. For example, parameters identified can include one or more of current, voltage, tissue pressure, tissue thickness, jaw closure rate, tissue creep rate, firing load, knife thickness, torque, or battery usage. An ultimate threshold or thresholds for these parameters can be identified4012. For instance, a predetermined current draw can be identified. As but one example, an ultimate electrical current draw threshold may be defined as 100% of a selected current magnitude. There can be an upper ultimate threshold, a lower ultimate threshold, multiple lower or upper ultimate thresholds depending on the circumstances, or a range defining an ultimate threshold. It will be appreciated that an “ultimate” threshold can be defined and/or calibrated in such a way as to remain essentially a unitary threshold but embody various action triggers. A marginal threshold or thresholds can be identified4014. If the marginal threshold is exceeded, a motor control program can alter operations to accommodate change.
• One or more thresholds can be monitored an acted on during a single surgical procedure, wherein the thresholds are independent of each other with no interaction. In addition, there can be an interactive association between thresholds of two or more parameters. For example, a marginal threshold for a parameter based on current draw can be 75% of the ultimate threshold. In addition, in connection with a parameter based on number of sterilization cycles, a marginal threshold may be set at 200 sterilization cycles, and an ultimate threshold atsterilization 400 cycles. Motor use can proceed normally from 0-199 cycles, and then slow by 1% from 200 cycles to 399. Atcycle 400, motor use can be prevented. It will be appreciated, however, that there can be an interactive effect. In other words, because motor speed is reduced by 1% due to exceeding the sterilization cycle threshold, the current draw threshold can be correspondingly adjusted. This interactive effect can result in the motor running more slowly than it would if either input were considered independently.
• Thus, the value of one threshold can be an input into the value of another threshold, or one threshold can be completely independent of another threshold. Where two or more thresholds are activated, it can be considered that there can be an overlaying threshold. As a result, multiple thresholds, defining multiple boundaries and limits, can have an overlaying or cumulative effect on operations of instrument10 (FIGS. 1-4). And, one threshold in a multiple-threshold operation scenario can have a cause-and-effect with another threshold, or there may be no cause-and-effect and the thresholds may exist independent of each other.
• In addition, a threshold can be dynamically set and/or reset depending on conditions experienced during surgery or other conditions. In other words, prior to a given surgical procedure, a module or modules can be preprogrammed into instrument10 (FIGS. 1-4) or uploaded as needed. Also, a threshold can be dynamically determined, or uploaded, during a surgical procedure.
• Turning briefly now toFIG. 1, numerous parameters can be assigned thresholds. Thus, in examples thresholds may be assigned based on tissue gap between theanvil306 andstaple cartridge304, oranvil306 andsecond jaw member302, of anend effector300, and motor speed varied thereby. In addition, in example thresholds based on current can vary motor speed control. Further, in various examples ultimate, marginal and overlaying thresholds can be established in connection with closure clamp loads in furtherance of an acceptable operating range. Plus, in various examples opening force on ananvil306 can help to detect a jam. Further, in various examples if a minimum threshold is not achieved, the system may be prevented from starting or if it drops below a minimum then a user action can be required.
• Still with reference toFIG. 1, in various aspects, it can be determined whether clamp load is acceptable and when clamp load drops under a minimum threshold during firing the speed of the motor can be adjusted and/or the clinician warned. In various examples, when a minimum threshold is exceeded during operation,instrument10 can give a warning that the firing may not be completely as anticipated. Moreover, in various examples thresholds can be assigned wherein if battery charge falls below a threshold then remaining battery charge can be used to return the device to a parked state with respect to the I-beam.
• However, thresholds can be referenced even during operations that do not exceed a threshold. Thus, for example,instrument10 can, while running “within limits”, compensate for the loading of the motor. For instance, if current goes up or related speed goes down, then motor control can increase pulse width or frequency modulation to help to maintain a constant speed. In other words, measures can be taken to improve and/or optimize operations ofinstrument10 even while running “within limits.”
• In addition, dynamically during a surgical procedure, a threshold can be modified, or a new threshold generated. This can occur after several events including adjusting operations of theinstrument10.
• Turning now back toFIG. 30, in various aspects a parameter or parameters are identified4010. Further, an ultimate threshold or thresholds for a given parameter(s) are identified4012. In addition, a marginal threshold or thresholds for a given parameter(s) are identified4014.Measures4010,4012, and4014 can be accomplished prior to the procedure, during the procedure, or both.
• Measurements of a parameter(s) are obtained4016. It can be determined whether the measurement of a given parameter exceeds an upper or lower ultimate threshold for theparameter4018. When the answer is no, it can be determined whether the measurement of a given parameter exceeds an upper or lower marginal threshold for theparameter4020. When the answer is no, operations can be continued4026. And, measurements of a given parameter(s) can be again obtained.
• When, however, the answer is yes to whether the measurement of a given parameter exceeds an upper or lower ultimate threshold for theparameter4018, control can pass to where operations can be adjusted4022. Many types of adjustments can be made. One example is to vary motor speed. It can be determined whether to modify a given threshold and/or generate anew threshold4024. This can occur after operations have been adjusted4022.
• After operations are adjusted, it can be determined whether to modify a threshold or generate a new threshold. For example, a marginal threshold initially set at 75% can be set to a different value. In addition, a new threshold on the same parameter, or a new threshold on a new parameter, can be generated if desired.
• Upon determining whether to modify a threshold or generate a new one, control can pass back to step4016 where measurement of a parameter(s) is obtained. In addition, control can proceed to identify4010 parameters.
• When the answer to whether the measurement exceeds an upper or lower ultimate threshold is no, however, then it can be determined when the measurement exceeds an upper or lower marginal threshold. When the answer is yes, then operations can be adjusted4022 and control proceed as above. When the answer is no, operations can be continued4026 and control proceed to measuring a parameter(s).
• It will be appreciated that the sequence of steps can be varied and is not limited to that specifically disclosed inFIG. 30. As just one example, after obtaining measurement of a parameter(s)4016, it can then be determined whether a marginal threshold is exceeded 4020. In addition, an overlaying threshold can expressly be identified and considered in the course of the flow.
• FIG. 31 is agraphical representation4100 of instrument system parameters versus time depicting how, in one aspect, instrument system parameters can be adjusted in the event that a threshold is reached. Time (t) is shown along a horizontal (x)axis4102 and the instrument System Parameter is shown along a vertical (y)axis4104,marginal threshold4104 andultimate threshold4106. In thegraphical representation4100 depicted inFIG. 34, the y-axis parameter4102 is the one to which a threshold of instrument system parameter is assigned and thex-axis4102 represents time. At a certain time during operation of instrument10 (FIGS. 1-4), as evidenced byfunction4110, a measurement can indicate thatmarginal threshold4106 is reached. At this point, operations of the instrument10 (FIGS. 1-4) can be adjusted. For example, when the y-axis4104 parameter is electrical current draw by a motor, a function can be imposed on the subsequent electrical current draw and limit current in some fashion. In one example, the function can represent alinear progression4112. At a certain time in the course of operation, anultimate threshold4108 can be reached. At this point, electrical current can be discontinued4114. Accordingly, an adjustment mechanism can be accomplished via a linear function. An additional perspective with which to view the operational adjustment is that there can be a square-wave multiplier change.
• FIG. 32 is agraphical representation4120 of instrument system parameter depicting how, in another aspect, a system parameter can be adjusted in the event that a threshold is reached. Time (t) is shown along a horizontal (x)axis4122 and the number of Instrument Operations is shown along a vertical (y)axis4124,marginal threshold4126 andultimate threshold4128. Here the y-axis4124 parameter is the one to which a threshold is assigned. At a certain time during operation of instrument10 (FIGS. 1-4), a measurement can indicate that themarginal threshold4126 is reached during the course ofoperation4130. At this point, operations of theinstrument10 can be adjusted. For example, when the y-axis4124 parameter is electrical current draw by a motor, a limit can be placed on the subsequent current draw representing anon-linear progression4132. At a certain time after this, anultimate threshold4128 can be reached. At this point, current can be discontinued4134. Accordingly, an adjustment mechanism can be accomplished via anon-linear function4132, with a variable slope. An additional perspective with which to view the operational adjustment is that there is an exponential multiplier change; here, the closer the y-axis4124 parameter comes to theultimate threshold4128, the rate at which current increases diminishes.
• FIG. 33 is agraphical representation4140 that represents one aspect wherein a response by instrument10 (FIGS. 1-4) to clinician input (User Input) is detected and then a modification is made. Time (t) is shown along a horizontal (x)axis4142 and User Input is represented along a vertical (y)axis4144. In other words, a clinician, in performing a procedure, can actuate a response byinstrument10 such as depressing closure trigger32 (FIG. 1) which may for examplecause motor operation4146. As motor speed increases there may or not be a threshold reached. At a certain point, however, here represented by thedivergence point4148 ofcurves4150 and4152, it can be determined that motor speed has reached an actual level, or a future level be predicted, that is or will be suboptimal or otherwise undesirable. At this point, rather than following the actual or expectedspeed curve4150,instrument10 can employ a control measure such as an algorithm to adapt or otherwise modify the output, thus regulating the motor. At a certain point, motor actuation can be discontinued4154. In other words,instrument10 can take an actual or expected y-axis parameter and, determining that such actual or expected measurement is excessive, employ an algorithm to modify such parameter. Put another way, measured clinician behavior can comprise a value for a threshold or thresholds.
• FIG. 34 is agraphical representation4160 of instrument system parameters that represents one aspect wherein instrument10 (FIGS. 1-4) detects whether amarginal threshold4166 orultimate threshold4168 is reached, and responds accordingly. Time (t) is shown along the horizontal (x)axis4162 and instrument System Parameters is shown along the vertical (y)axis4164. For example, here the vertical (y)axis4154 parameter can be the velocity of a drive, such as a closure drive system30 (FIG. 1) or firing drive system80 (FIG. 1).Instrument10 can check whether during the course of operation4170 amarginal threshold4166 velocity is reached. When themarginal threshold4166 is reached, a control measure such as an algorithm can be used to adapt or otherwise modify thevelocity4172. The modifiedvelocity4172 can be given by a linear or non-linear function. And, at an ultimate threshold, power to the motor can be discontinued4174.
• It will be appreciated that whereFIG. 33 can represent a situation where an actual or predicted value is evaluated, whether or not an express threshold is provided,FIG. 34 is a graphical representation where thresholds are provided. It can be appreciated, however, that a threshold or thresholds can be implicitly given toFIG. 33 with equivalent results, insofar as a predetermined or dynamically determined value can serve as a functional equivalent of a threshold, or trigger actions associated with a threshold or thresholds. There may be two or more ceiling or floor values that can serve as such threshold functional equivalents.
• Turning to another example using thresholds,FIG. 35 is agraphical representation4180 of battery current versus time, where Time (t) is shown along the horizontal (x)axis4182 and battery current I_BATis shown along the vertical (y)axis4184. In one example battery current I_BAT4184 is monitored under varying operational conditions. As motor speed increases, current drawn4186 from a battery90 (FIG. 4) increases. Current drawn can increase in a non-linear manner depending on several factors; however, instrument10 (FIGS. 1-4) can resolve the current drawn into alinear function4188. The linear function can be based on (1) averaging overall current, (2) be based on a prediction of future current based on past and/or present current, both (1) and (2), or another function.Linear function4188 can be extended out theoretically tolinear function4190, which is an extrapolated extension with the same slope aslinear function4188.
• Oncelinear function4188 reaches amarginal threshold4192, instrument10 (FIGS. 1-4) can take action to modify the response. Here the marginal threshold is given as 75% of anultimate threshold4194 wherein the ultimate threshold represents a motor stall; however, it will be appreciated that the selection of the marginal threshold or ultimate threshold can be made based on multiple factors. In other words,marginal threshold4192 can be reached at time “a”4196. If adjustments are not made, it is expected that motor stall would occur at time “b1”4198. However, due to adjustments made byinstrument10, the actual motor stall will not occur until time “b2”4200. It is possible that a stall might not occur at all, because the more graduated rise may help to prevent such an event.Function4202, which is implemented via a control measure, can be based on slowing the motor, or another adjustment. It can manifest as a stepped, ramped or further function.
• Employing the thresholds herein can give the clinician greater time to react and adapt, maintain a desired efficiency of the instrument, and prolong battery life. Thus, utilizing thresholds can provide multiple benefits in connection with ease of clinician use and protection of the instrument itself.
• Turning to another aspect,FIG. 36 is agraphical representation4210 of battery voltage that shows Time (t) along the horizontal (x)axis4212 and battery voltage V_BATalong the vertical (y)axis4214. In one example a threshold can be set in connection withbattery voltage V_BAT4214. Here amarginal threshold4216 can be set at 8.1V. Additionally, anultimate threshold4218 can be set at 7.0V. During the course of operation of instrument10 (FIGS. 1-4), voltage can decrease over time. The curve described by measuring thevoltage decrease4220 is not necessarily linear. However,instrument10 can resolve the voltage decrease into alinear function4222. The linear function can be based on (1) averaging overall voltage, (2) be based on a prediction of future voltage based on past and/or present voltage, both (1) and (2), or another function.Linear function4222 can be extrapolated out theoretically tolinear function4224, which has the same slope aslinear function4222.
• Oncelinear function4222 reaches amarginal threshold4216,instrument10 can take action to modify the response.Marginal threshold4216 is reached at time “a”4226. If adjustments are not made, it is expected that a depleted battery condition would occur at time “b1”4228. However, due to adjustments made by instrument10 (FIGS. 1-4), the actual depleted battery condition will not occur until time “b2”4230. Again, it is possible that it may not occur at all.Function4232, which can be implemented via a control measure, can be based on slowing the motor, or another adjustment. It can manifest as a stepped, ramped or further function.
• FIG. 37 is agraphical representation4240 of knife speed versus number of cycles where and Cycles is shown along the horizontal (x)axis4242 and Knife Speed is shown along the vertical (y)axis4244. As shown in the example illustrated byFIG. 37, thresholds can be employed to adjust speed of a knife280 (FIG. 8) based on the number of cycles. Relevant cycles can refer to an amount of firings performed by instrument10 (FIGS. 1-4), sterilization cycles performed byinstrument10, or other measured events. An objective of managing instrument operation by this threshold mechanism is to maximize the likelihood that an incision will be effective, taking into account potential blunting of theknife280 edge after multiple uses. In this example, firing of the knife can be initialized based on an expected speed. However, once amarginal threshold4246 is reached based on number of cycles, speed can be reduced fromspeed4248 to4252, such as in a steppedmanner4250. Thus, once marginal threshold4760 is exceeded,knife280 will fire at a progressively lower speed. This will occur for a given number ofcycles4246 untilultimate threshold4254 is reached. At this point, knife speed will be stepped down4256 even more or ofcourse instrument10 can alert the clinician that it may be undesirable to incise with the knife, and can lock out firing. It will be understood thatfunction4248 shows employing a stepped function once athreshold4246 is reached, andfunction4258 shows employing a rampedfunction4260 once athreshold4246 is reached. Additional functions can be employed.
• Further, it will be appreciated that the thresholds given inFIG. 37 have been defined on the x-axis4711, whereas prior figures have shown thresholds on the y-axis4712. It will also be appreciated that there can be an additional axis or axes taken into account, i.e., a z-axis or further axes, wherein the interrelationship of multiple variables can be considered. Further, thresholds from a first parameter can be considered along with thresholds from a second parameter, and one threshold can comprise an input into another threshold, and vice versa.
• When a threshold is exceeded, the clinician can be notified. This can be based on a feedback system. In certain instances, the feedback system may comprise one or more visual feedback systems such as display screens, backlights, and/or LEDs, for example. In certain instances, the feedback system may comprise one or more audio feedback systems such as speakers and/or buzzers, for example. In certain instances, the feedback system may comprise one or more haptic feedback systems, for example. In certain instances, the feedback system may comprise combinations of visual, audio, and/or tactile feedback systems, for example. Such feedback can serve to alert or warn the clinician.
• FIG. 38 illustrates a logic diagram of asystem4311 for evaluating sharpness of a cutting edge182 (FIG. 20) of a surgical instrument10 (FIGS. 1-4) according to various examples.FIG. 38 illustrates asharpness testing system4311 for evaluating sharpness of a cutting edge of asurgical instrument10 according to various examples. In certain instances, thesystem4311 can evaluate the sharpness of the cutting edge182 by testing the ability of the cutting edge182 to be advanced through asharpness testing member4302. For example, thesystem4311 can be configured to observe the time period the cutting edge182 takes to fully transect and/or completely pass through at least a predetermined portion of asharpness testing member4302. If the observed time period exceeds a predetermined threshold, the module4310 may conclude that the sharpness of the cutting edge182 has dropped below an acceptable level, for example.
• In one aspect, thesharpness testing member4302 can be employed to test the sharpness of the cutting edge182 (FIG. 20). In certain instances, thesharpness testing member4302 can be attached to and/or integrated with the cartridge body194 (FIG. 20) of the staple cartridge304 (FIGS. 1, 2, and 20), for example. In certain instances, thesharpness testing member4302 can be disposed in the proximal portion of thestaple cartridge304, for example. In certain instances, thesharpness testing member4302 can be disposed onto a cartridge deck orcartridge body194 of thestaple cartridge304, for example.
• In certain instances, aload cell4335 can be configured to monitor the force (Fx) applied to the cutting edge182 (FIG. 20) while the cutting edge182 is engaged and/or in contact with thesharpness testing member4302, for example. The reader will appreciate that the force (Fx) applied by thesharpness testing member4302 to the cutting edge182 while the cutting edge182 is engaged and/or in contact with thesharpness testing member4302 may depend, at least in part, on the sharpness of the cutting edge182. In certain instances, a decrease in the sharpness of the cutting edge182 can result in an increase in the force (Fx) required for the cutting edge182 to cut or pass through thesharpness testing member4302. Theload cell4335 of thesharpness testing member4302 may be employed to measure the force (Fx) applied to the cutting edge182 while the cutting edge182 travels a predefined distance (D) through thesharpness testing member4302 may be employed to determine the sharpness of the cutting edge182.
• In certain instances, themodule4311 may include a microcontroller4313 (“controller”) which may include a microprocessor4315 (“processor”) and one or more computer readable mediums or memory units4317 (“memory”). In certain instances, thememory4317 may store various program instructions, which when executed may cause theprocessor4315 to perform a plurality of functions and/or calculations described herein. In certain instances, thememory4317 may be coupled to theprocessor4315, for example. Apower source4319 can be configured to supply power to thecontroller4313, for example. In certain instances, thepower source4319 may comprise a battery (or “battery pack” or “power pack”), such as a Li ion battery, for example. In certain instances, the battery pack may be configured to be releasably mounted to thehandle14. A number of battery cells connected in series may be used as thepower source4319. In certain instances, thepower source4319 may be replaceable and/or rechargeable, for example.
• In certain instances, theprocessor4313 can be operably coupled to the feedback system and/or thelockout mechanism4123, for example.
• Themodule4311 may comprise one or more position sensors. Example position sensors and positioning systems suitable for use with the present disclosure are described in U.S. patent application Ser. No. 13/803,210, entitled SENSOR ARRANGEMENTS FOR ABSOLUTE POSITIONING SYSTEM FOR SURGICAL INSTRUMENTS, and filed Mar. 14, 2013, now U.S. Patent Application Publication No. 2014/0263538, the disclosure of which is hereby incorporated by reference herein in its entirety. In certain instances, themodule4311 may include afirst position sensor4321 and asecond position sensor4323. In certain instances, thefirst position sensor4321 can be employed to detect a first position of the cutting edge182 (FIG. 20) at a proximal end of asharpness testing member4302, for example; and thesecond position sensor4323 can be employed to detect a second position of the cutting edge182 at a distal end of asharpness testing member4302, for example.
• In certain instances, theposition sensors4321 and4323 can be employed to provide first and second position signals, respectively, to themicrocontroller4313. It will be appreciated that the position signals may be analog signals or digital values based on the interface between themicrocontroller4313 and theposition sensors4321 and4323. In one example, the interface between themicrocontroller4313 and theposition sensors4321 and4323 can be a standard serial peripheral interface (SPI), and the position signals can be digital values representing the first and second positions of the cutting edge182, as described above.
• Further to the above, theprocessor4315 may determine the time period between receiving the first position signal and receiving the second position signal. The determined time period may correspond to the time it takes the cutting edge182 (FIG. 20) to advance through asharpness testing member4302 from the first position at a proximal end of thesharpness testing member4302, for example, to a second position at a distal end of thesharpness testing member4302, for example. In at least one example, thecontroller4313 may include a time element which can be activated by theprocessor4315 upon receipt of the first position signal, and deactivated upon receipt of the second position signal. The time period between the activation and deactivation of the time element may correspond to the time it takes the cutting edge182 to advance from the first position to the second position, for example. The time element may comprise a real time clock, a processor configured to implement a time function, or any other suitable timing circuit.
• In various instances, thecontroller4313 can compare the time period it takes the cutting edge182 (FIG. 20) to advance from the first position to the second position to a predefined threshold value to assess whether the sharpness of the cutting edge182 has dropped below an acceptable level, for example. In certain instances, thecontroller4313 may conclude that the sharpness of the cutting edge182 has dropped below an acceptable level if the measured time period exceeds the predefined threshold value by 1%, 5%, 10%, 25%, 50%, 100% and/or more than 100%, for example.
• FIG. 39 illustrates a logic diagram of asystem4340 for determining the forces applied against a cutting edge of a surgical instrument10 (FIGS. 1-4) by asharpness testing member4302 at various sharpness levels according to various aspects. Referring toFIG. 39, in various instances, anelectric motor4331 can drive the firing bar172 (FIG. 20) to advance the cutting edge182 (FIG. 20) during a firing stroke and/or to retract the cutting edge182 during a return stroke, for example. Amotor driver4333 can control theelectric motor4331; and a microcontroller such as, for example, themicrocontroller4313 can be in signal communication with themotor driver4333. As theelectric motor4331 advances the cutting edge182, themicrocontroller4313 can determine the current drawn by theelectric motor4331, for example. In such instances, the force required to advance the cutting edge182 can correspond to the current drawn by theelectric motor4331, for example. Referring still toFIG. 39, themicrocontroller4313 of thesurgical instrument10 can determine if the current drawn by theelectric motor4331 increases during advancement of the cutting edge182 and, if so, can calculate the percentage increase of the current.
• In certain instances, the current drawn by theelectric motor4331 may increase significantly while the cutting edge182 (FIG. 20) is in contact with thesharpness testing member4302 due to the resistance of thesharpness testing member4302 to the cutting edge182. For example, the current drawn by theelectric motor4331 may increase significantly as the cutting edge182 engages, passes and/or cuts through thesharpness testing member4302. The reader will appreciate that the resistance of thesharpness testing member4302 to the cutting edge182 depends, in part, on the sharpness of the cutting edge182; and as the sharpness of the cutting edge182 decreases from repetitive use, the resistance of thesharpness testing member4302 to the cutting edge182 will increase. Accordingly, the value of the percentage increase of the current drawn by themotor4331 while the cutting edge is in contact with thesharpness testing member4302 can increase as the sharpness of the cutting edge182 decreases from repetitive use, for example.
• In certain instances, the determined value of the percentage increase of the current drawn by themotor4331 can be the maximum detected percentage increase of the current drawn by themotor4331. In various instances, themicrocontroller4313 can compare the determined value of the percentage increase of the current drawn by themotor4331 to a predefined threshold value of the percentage increase of the current drawn by themotor4331. If the determined value exceeds the predefined threshold value, themicrocontroller4313 may conclude that the sharpness of the cutting edge182 has dropped below an acceptable level, for example.
• In certain instances, as illustrated inFIG. 39, theprocessor4315 can be in communication with the feedback system and/or the lockout mechanism for example. In certain instances, theprocessor4315 can employ the feedback system to alert a user if the determined value of the percentage increase of the current drawn by themotor4331 exceeds the predefined threshold value, for example. In certain instances, theprocessor4315 may employ the lockout mechanism to prevent advancement of the cutting edge182 (FIG. 20) if the determined value of the percentage increase of the current drawn by themotor4331 exceeds the predefined threshold value, for example. In certain instances, thesystem4311 may include afirst position sensor4321 and asecond position sensor4323. The surgical instrument10 (FIGS. 1-4) may include aload cell4335.
• In various instances, themicrocontroller4313 can utilize an algorithm to determine the change in current drawn by theelectric motor4331. For example, a current sensor can detect the current drawn by theelectric motor4331 during the firing stroke. The current sensor can continually detect the current drawn by the electric motor and/or can intermittently detect the current draw by the electric motor. In various instances, the algorithm can compare the most recent current reading to the immediately proceeding current reading, for example. Additionally or alternatively, the algorithm can compare a sample reading within a time period X to a previous current reading. For example, the algorithm can compare the sample reading to a previous sample reading within a previous time period X, such as the immediately proceeding time period X, for example. In other instances, the algorithm can calculate the trending average of current drawn by the motor. The algorithm can calculate the average current draw during a time period X that includes the most recent current reading, for example, and can compare that average current draw to the average current draw during an immediately proceeding time period time X, for example.
• FIG. 40 illustrates a logic diagram4350 of a method for determining whether a cutting edge of a surgical instrument10 (FIGS. 1-4) is sufficiently sharp to transect tissue captured by thesurgical instrument10 according to various aspects. Referring toFIG. 40, the logic diagram4350 depicts a method for evaluating the sharpness of the cutting edge182 (FIG. 20) of thesurgical instrument10; and various responses are outlined in the event the sharpness of the cutting edge182 drops to and/or below an alert threshold and/or a high severity threshold, for example. In various instances, a microcontroller such as, for example, themicrocontroller4313 can be configured to implement themethod4350 depicted inFIG. 40. In certain instances, thesurgical instrument10 may include aload cell4335, as illustrated inFIGS. 38 and 39, and themicrocontroller4313 may be in communication with theload cell4335. In certain instances, theload cell4335 may include a force sensor such as, for example, a strain gauge, which can be operably coupled to the firingbar172, for example. In certain instances, themicrocontroller4313 may employ theload cell4335 to monitor the force (Fx) applied to the cutting edge182 as the cutting edge182 is advanced during a firing stroke.
• In various instances, themethod4350 begins by initiating4352 firing of the surgical instrument10 (FIGS. 1-4). Before, during, and/or after firing of thesurgical instrument10 is initiated4352, a system checks4354 the dullness of the cutting edge182 by monitoring a force (Fx). The reader will appreciate that the force (Fx) is applied by thesharpness testing member4302 to the cutting edge182 while the cutting edge182 is engaged and/or in contact with thesharpness testing member4302, and, the force (Fx) may depend, at least in part, on the sharpness of the cutting edge182. In certain instances, a decrease in the sharpness of the cutting edge182 can result in an increase in the force (Fx) required for the cutting edge182 to cut or pass through thesharpness testing member4302.
• The system senses4356 the force (Fx) applied by thesharpness testing member4302 to the cutting edge182 (FIG. 20). When the force (Fx) sensed4356 stays within an alert threshold range a display will display4358 nothing and firing4360 of the surgical instrument10 (FIGS. 1-4) will proceed. When the force (Fx) sensed4356 is outside the alert threshold range, thesystem4354 will then determine if the force (Fx) is outside a high severity threshold range. The display will display4364 an alert to the user of thesurgical instrument10 that the cutting edge182 is dulling. At this stage, the user is aware that the cutting edge182 is dulling and may need replaced. When the force (Fx) is sensed4362 to be greater than the high severity threshold range, the display displays4366 a warning indicating the force (Fx) applied to the cutting edge182 is greater than the high severity threshold and that the cutting edge182 is dull. If the cutting edge is determined to be dull, a firing lockout system may be engaged. The display may display4368 an optional display sequence to allow the user of thesurgical instrument10 to override the firing lockout system and continue firing4360 thissurgical instrument10.
• In certain instances, the load cell4335 (FIGS. 38, 39) can be configured to monitor the force (Fx) applied to the cutting edge182 (FIG. 20) while the cutting edge182 is engaged and/or in contact with the sharpness testing member4302 (FIGS. 38, 39), for example. The reader will appreciate that the force (Fx) applied by thesharpness testing member4302 to the cutting edge182 while the cutting edge182 is engaged and/or in contact with thesharpness testing member4302 may depend, at least in part, on the sharpness of the cutting edge182. In certain instances, a decrease in the sharpness of the cutting edge182 can result in an increase in the force (Fx) required for the cutting edge182 to cut or pass through thesharpness testing member4302. For example, as illustrated graphically inFIG. 41,graphs4336,4338, and4342 represent, respectively, the force (Fx) applied to the cutting edge182 while the cutting edge182 travels a predefined distance (D) through three identical, or at least substantially identical,sharpness testing members4302. Thegraph4336 corresponds to a first sharpness of the cutting edge182; thegraph4338 corresponds to a second sharpness of the cutting edge182; and thegraph4342 corresponds to a third sharpness of the cutting edge182. The first sharpness is greater than the second sharpness, and the second sharpness is greater than the third sharpness.
• In certain instances, the microcontroller4313 (FIGS. 38, 39) may compare a maximum value of the monitored force (Fx) applied to the cutting edge182 (FIG. 20) to one or more predefined threshold values. In certain instances, as illustrated inFIG. 41, the predefined threshold values may include an alert threshold (F1) and/or a high severity threshold (F2). In certain instances, as illustrated in thegraph4336 ofFIG. 41, the monitored force (Fx) can be less than the alert threshold (F1), for example. In such instances, as illustrated inFIG. 41, the sharpness of the cutting edge182 is at a good level and themicrocontroller4313 may take no action to alert a user as to the status of the cutting edge182 or may inform the user that the sharpness of the cutting edge182 is within an acceptable range.
• In certain instances, as illustrated in thegraph4338 ofFIG. 41, the monitored force (Fx) can be more than the alert threshold (F1) but less than the high severity threshold (F2), for example. In such instances, as illustrated inFIG. 40, the sharpness of the cutting edge182 (FIG. 2) can be dulling but still within an acceptable level. Themicrocontroller4313 may take no action to alert a user as to the status of the cutting edge182. Alternatively, the microcontroller4313 (FIGS. 38, 39) may inform the user that the sharpness of the cutting edge182 is within an acceptable range. Alternatively or additionally, themicrocontroller4313 may determine or estimate the number of cutting cycles remaining in the lifecycle of the cutting edge182 and may alert the user accordingly.
• In certain instances, the memory4317 (FIGS. 38, 39) may include a database or a table that correlates the number of cutting cycles remaining in the lifecycle of the cutting edge182 (FIG. 20) to predetermined values of the monitored force (Fx). The processor4315 (FIGS. 38, 39) may access thememory4317 to determine the number of cutting cycles remaining in the lifecycle of the cutting edge182 which correspond to a particular measured value of the monitored force (Fx) and may alert the user to the number of cutting cycles remaining in the lifecycle of the cutting edge182, for example.
• In certain instances, as illustrated in thegraph4342 ofFIG. 41, the monitored force (Fx) can be more than the high severity threshold (F2), for example. In such instances, as illustrated inFIG. 40, the sharpness of the cutting edge182 can be below an acceptable level. In response, themicrocontroller4313 may employ the feedback system to warn the user that the cutting edge182 is too dull for safe use, for example. In certain instances, themicrocontroller4313 may employ the lockout mechanism to prevent advancement of the cutting edge182 upon detection that the monitored force (Fx) exceeds the high severity threshold (F2), for example. In certain instances, themicrocontroller4313 may employ the feedback system to provide instructions to the user for overriding the lockout mechanism, for example.
• Referring now toFIG. 42, amethod4370 is depicted for determining whether a cutting edge such as, for example, the cutting edge182 (FIG. 20) is sufficiently sharp to be employed in transecting a tissue of a particular tissue thickness that is captured by the end effector300 (FIG. 1), for example. In certain instances, themicrocontroller4313 can be implemented to perform themethod4370 depicted inFIG. 42, for example. As described above, repetitive use of the cutting edge182 may dull or reduce the sharpness of the cutting edge182 which may increase the force required for the cutting edge182 to transect the captured tissue. In other words, the sharpness level of the cutting edge182 can be defined by the force required for the cutting edge182 to transect the captured tissue, for example. The reader will appreciate that the force required for the cutting edge182 to transect a captured tissue also may depend on the thickness of the captured tissue. In certain instances, the greater the thickness of the captured tissue, the greater the force required for the cutting edge182 to transect the captured tissue at the same sharpness level, for example.
• In certain instances, the cutting edge182 (FIG. 20) may be sufficiently sharp for transecting a captured tissue comprising a first thickness but may not be sufficiently sharp for transecting a captured tissue comprising a second thickness greater than the first thickness, for example. In certain instances, a sharpness level of the cutting edge182, as defined by the force required for the cutting edge182 to transect a captured tissue, may be adequate for transecting the captured tissue if the captured tissue comprises a tissue thickness that is in a particular range of tissue thicknesses, for example. In certain instances, the memory4317 (FIGS. 38, 39) can store one or more predefined ranges of tissue thicknesses of tissue captured by theend effector300; and predefined threshold forces associated with the predefined ranges of tissue thicknesses. In certain instances, each predefined threshold force may represent a minimum sharpness level of the cutting edge182 that is suitable for transecting a captured tissue comprising a tissue thickness (Tx) encompassed by the range of tissue thicknesses that is associated with the predefined threshold force. In certain instances, when the force (Fx) required for the cutting edge182 to transect the captured tissue, comprising the tissue thickness (Tx), exceeds the predefined threshold force associated with the predefined range of tissue thicknesses that encompasses the tissue thickness (Tx), the cutting edge182 may not be sufficiently sharp to transect the captured tissue, for example.
• Themethod4370 shown inFIG. 42 begins with clamping4372 the tissue. Once the tissue to be transected is clamped, the thickness of the tissue is sensed4374. After the tissue thickness is sensed4374, firing of the surgical instrument can be initiated4376 by the user. Once the surgical instrument begins firing, the force (Fx) applied to the cutting edge182 (FIG. 20) is sensed4378. The force (Fx) and the tissue thickness (Tx) is then compared4380 to predetermined tissue thickness ranges and force ranges required to adequately transect the predetermined tissue thicknesses. For example, if the force (Fx) sensed is greater than a predetermined force range required to adequately transect tissue at the tissue thickness (Tx) that was sensed for the tissue clamped, a display will display4386 an alert to the user that the cutting edge182 is dulling. When the force (Fx) sensed is within the predetermined force range required to adequately transect tissue at the tissue thickness (Tx) that was sensed for the tissue clamped, the display may display4382 nothing. In both instances, the surgical instrument continues4384 firing to transect the tissue.
• In various aspects, the present disclosure provides techniques for determining tissue compression and additional techniques to control the operation of the instrument10 (described in connection withFIGS. 1-29) in response to the tissue compression. In one example, the cartridges may be configured to define variable compression algorithm which drivesinstrument10 to close differently based on intended tissue type and thickness. In another example, theinstrument10 learns from surgeon use and original tissue compression profile to adapt closure based on load experienced during firing. When theinstrument10 experiences tissue compression loads that are dramatically different that those experienced for this cartridge type the instrument highlights this to the user.
• Active adjustment of a motor control algorithm over time as the instrument become acclimated to the hospital's usage can improve the life expectancy of a rechargeable battery as well as adjust to tissue/procedure requirements of minimizing tissue flow, thus improving staple formation in the tissue seal.
• Accordingly, the present disclosure relates to surgical instruments and, in various circumstances, to surgical stapling and cutting instruments and staple cartridges therefor that are designed to staple and cut tissue. For example, in various aspects the present disclosure provides an endosurgical instrument configured to sense the cartridge type or tissue gap to enable the handle to adjust the closure and firing algorithms to adjust for intended tissue properties. This adaptive algorithm adjustment can “learn” from the user's operations allowing the device to react and benefit two different systems. The first benefit provided by the disclosed adaptive algorithm includes tissue flow and staple formation. As the device learns the users' basic habits and step timings, the device can adjust the closure speed and firing speed to provide a more consistent and reliable output. The second benefit provided by the disclosed adaptive algorithm is related to the battery pack. As the device learns how many firings and what conditions the instrument was used, the device can adjust motor current needs/speed in a predefined manner to prolong battery life. There is a substantially small likelihood that a device used in a hospital that performs predominantly bariatric procedures would be operated in a manner similar to a device used in a hospital that performs mostly colorectal or thoracic procedures. Thus, when the device is used to perform substantially similar procedure, over time, the device is configured to learn and adjust its operational algorithm to maintain within the “ideal” discharge and tissue flow envelopes.
• Safe and effective surgery requires due knowledge of, and respect for, the tissue involved. Clinicians are mindful that adjustments made during surgery may be beneficial. These adjustments include mechanisms to detect and promote desirable staple formation.
• Endosurgical instruments can generate, monitor and process a substantial amount of data during their use in connection with a surgical procedure. Such data can be obtained from the surgical instrument itself, including battery usage. Additionally, data can be obtained from the properties of the tissue with which the surgical instrument interacts, including properties such as tissue compression. Further, data can be obtained from the clinician's interaction with the surgical instrument itself. The repository of data so obtained can be processed and, where desired, the surgical instrument can be designed to adapt to circumstances so as to promote a safe and effective outcome to the current surgical procedure, as well as lay the foundation for more generalized productive use by multiple clinicians. Such adaptive adjustments—both during a surgical procedure, and wherein the instrument “learns” based on usage patterns drawn from multiple surgical procedures—can provide numerous mechanisms to enhance the overall patient-care environment.
• FIG. 43 illustrates one aspect of a process for adapting operations of a surgical instrument. As shown inFIG. 43, in various examples, anadaptive algorithm framework5000 is provided. A staple cartridge can be identified5060. Control measures, such as algorithms, can be selected5062 based on the cartridge identified. These algorithms may include one or more variable compression algorithms that drives instrument10 (FIGS. 1-4) to close in a different manner based on an expected tissue type and/or thickness. Tissue properties can be identified5064 as an aid to selection of control measures. The clinician can operate 5066instrument10 to carry out a surgical procedure, including but not limited to stapling and/or incising tissue. Control measures can be modified5068, with or without reference to data observed or generated during the course of a surgical procedure.
• A surgical procedure can entail generating a significant amount of data on parameters. By way of non-limiting example, these parameters can include those associated with surgical instrument10 (FIGS. 1-4) itself and its functionality, including but not limited to: speed of closure of the anvil306 (FIG. 1) and staple cartridge304 (FIG. 1), or speed of closure ofanvil306 and second jaw member302 (FIG. 1); gap (e.g., distance) betweenanvil306 andstaple cartridge304, oranvil306 andsecond jaw member302; voltage; current; motor(s') speed; power management, e.g., battery use; or sensor operation and accuracy.
• Additional parameters that may be generated and observed in connection with a surgical procedure can also include those derived from the tissue being operated upon, including but not limited to: tissue compression; tissue thickness; tissue flow; tissue creep; tissue pressure; tissue stabilization; whether end effector300 (FIG. 1) clamps a full or partial bite of tissue, and whether such partial bite is proximal or distal; speed of closure drive system30 (FIG. 1); speed of firing drive system80 (FIG. 4); staple performance; and/or determination if the tissue profile is consistent with healthy tissue or diseased tissue.
• Further parameters that may be generated and observed in connection with a surgical procedure can also include those derived from the clinician, such as frequency of actuating closure trigger32 (FIG. 1) by clinician; force applied onclosure trigger32 by clinician; frequency of actuating firing trigger130 (FIG. 4) by clinician; force applied on firingtrigger130 by clinician; and/or step timing by clinician.
• Even more, parameters can include to what extent the instrument10: experiences tissue compression loads different from those expected for the cartridge type; experiences a wait period (such as for tissue creep) different from that expected; experiences a firing speed different from that expected; has undergone one or more sterilization cycles; and/or experiences different or similar patterns of use based on the clinical setting. For example, there may be meaningful differences among use of the instrument in a setting directed primarily to bariatric, colorectal, or thoracic procedures respectively.
• On top of these, parameters can include accuracy and appropriateness of control measures themselves, such as algorithms, used in connection with operating the instrument. Feedback loops and/or logic paths can be developed that include one or more of algorithms, data based oninstrument operation5070, data based on thetreatment site5072, data based onclinician conduct5074, and more. Added parameters can be considered and developed.
• It will be apparent that there are numerous data resources that can be derived from a single surgical procedure. These data resources can be analyzed in various manners including as a single data point, a plurality of data points, a range or ranges, as a range or ranges, or based on added metrics such as rate of change of current, voltage, speed, or other parameter. Taking into account one, or many, of these data resources can enhance the safety and effectiveness of a single procedure.
• In addition, these data resources can enhance the safety and effectiveness of future procedures by the same clinician to the extent that the surgical instrument can “learn” the basic habits and step timings of the clinician. In addition, data can be aggregated from multiple clinicians, further enabling the successful calibration of the surgical instrument in the context of the surgical procedure. It can be appreciated that the hospital or health center in which the data is compiled can develop a unique profile that can further enhance health outcomes. In addition, battery life can be prolonged, as it is learned how many firings and under what conditions thesurgical instrument10 is used. Thus, arrangements to adapt to numerous battery usage metrics are contemplated in examples.
• Instrument10 (FIGS. 1-4) can determine whether, based on data obtained5070,5072,5074, a control measure is appropriate or not by various mechanisms. One mechanism is by identifying a predetermined value or values. Such value or values can comprise an acceptable, or expected, parameter. If data obtained5070,5072,5074 leads to a determination that an acceptable range has been exceeded, then a new control measure(s) can be identified5076 and control measures can be modified5078 including setting forth a new acceptable value. Exceeding a range can be considered to mean going above a range, below or range, or otherwise going beyond a range. The second control measure can be a minor adaptation of the first control measure, or it can be an entirely new control measure. It will also be appreciated that the predetermined acceptable range can be a single data point, multiple data points, a function or other calculable equation, or any mechanism by which it can be determined that a measurement, property or other metric that can be resolvable into a calculable value differs from an actual, expected or predicted value. It is also understood that a control measure can be compared with another control measure, and the differential effectiveness of each determined, thus forming an input into another determination of whether and which control measures to adopt. Put another way, success of control measures can represent an input.
• In addition, expected values for parameters can be embedded in control measures. In other words, an expected set of values for a tissue property can be embedded in a control measure that has been associated with instrument10 (FIGS. 1-4). Thus, it will be evident that numerous expected values for numerous parameters can be populated into numerous control measures. These expected values can be referenced during operations of the instrument in order to determine control measures carried out byinstrument10. Further, observed values can be detected and analyzed byinstrument10 during operation. These observed values can be referenced and help determine the course of selection of current and future control measures of theinstrument10 during the procedure, and also programmed intoinstrument10 to set new or modified benchmarks to help determine an acceptable range or ranges of control measures. Further predictions can be made during operation of theinstrument10. The predictions can inform the processing and analysis of measurements, can lead to modifying control measures, and generally adapting to operational circumstances.
• Thus, data can be obtained from multiple sources. One source is data based on operation of the instrument (e.g., closure speed)5070. Another source of data can be that derived from the treatment site5072 (e.g., tissue thickness). A further source of data can be that based on clinician conduct5074 (e.g., firing habits). Once thisdata5070,5072,5074 is obtained, the appropriateness of control measures can be assessed5076. For example, a certain tissue type may have been expected, and this tissue type was experienced during the procedure. However, it may be that the exudation resulting from clamping was heavier than anticipated. Also, it may be that the clinician has a habit of applying more pressure than may be desirable on the firing trigger130 (FIG. 1). In short, there may be many data sources that can be consulted to analyze, improve on and potentially optimize efficacy of current and future uses of the instrument. As a result, control measures can be modified5078 during and/or after a procedure for maximum success.
• In one aspect, surgical instrument10 (FIGS. 1-4) can comprise a plurality of modules, based on control mechanisms configurable from a controller and/or other processor, memory, and other systems therein for transmission, communication and processing of data. One of multiple possible modules can be based on a feedback system, as generalized and/or customized for a specific purpose or system. In addition, it will be apparent that there will be a processor4315 (FIGS. 38, 39) and memory4317 (FIGS. 38, 39) in operative communication with thesurgical instrument10 that can permit the functionality discussed herein.
• FIG. 44 illustrates one aspect of a process for adapting operations of a surgical instrument. As depicted inFIG. 44, a module can be attached5160 or otherwise loaded to instrument10 (FIGS. 1-4). The module can contain a program that is selected or uploaded5162. Controls can be activated5164 such that they can be ready to operateinstrument10. During or after usage ofinstrument10, a program, including control measures, can be adapted5166. For example, this can include adjusting the data rate within theinstrument10 or with respect to remote operation of theinstrument10. This can include adjusting speed, such as speed by which anvil306 (FIG. 1) and cartridge304 (FIG. 1) engage in a closure motion. This can also include a pulse from an emitter and sensor or to apply a pulse of electrical current to tissue, and the timing of such pulse. This can include adjusting a program to adapt to acceleration, such as acceleration of theinstrument10 if dropped, or transition from a sleep mode. A program can be adapted to handle an actual and/or expected load based on clamping force.
• Instrument10 (FIGS. 1-4) can be employed to complete anaction5168, for example to carry out a stapling procedure. Data can be recorded5170 in appropriate memory locations ofinstrument10.Sensor behavior5172 can be assessed, such as to what extent a sensor accurately measured and/or measures a parameter. Anticipated data can be assessed5174, including but not limited to tissue properties, wait period and firing speed. Foregoing mechanisms disclosed herein can provide an input to adapt aprogram5166 further. In addition, atissue identification5178 can be performed, based on historical, actual or expected tissue properties, and this can provide an input to adapt aprogram5166 further. In addition,tissue identification5178 properties can be updated. Moreover, measuredsensor input5176 during a procedure can be used as an additional input to adapt aprogram5166 further; such sensor measurements can include those of the gap betweenanvil306 andcartridge304, obtaining a derivative measurement including a derivative of a function, current, or torque.
• FIG. 45 illustrates one aspect of a mechanism for adapting operations of a surgical instrument in the context of closure motion and tissue pressure. In various aspects,closure motion5216 can be adjusted based on a parameter. An example parameter can beaverage tissue pressure5218.FIG. 45 is a diagram that illustrates three phases of carrying out a procedure with instrument10 (FIGS. 1-4). Time (t) is shown along a bottomhorizontal axis5220, a bottom vertical axis representsaverage tissue pressure5218 applied to tissue clamped between the jaw members of the end effector. A top vertical axis representsclosure motion5216 of the anvil306 (FIG. 1) towards the cartridge304 (FIG. 1) to engage tissue therebetween in a closure motion. A top horizontal axis represents closing5210 of the anvil306 (FIG. 1) of end effector to engage a cartridge304 (FIG. 1) or second jaw member302 (FIG. 1),tissue creep5212 wherein material is allowed to exudate from the tissue section held within end effector300 (FIG. 1), and firing5214, which can comprise deploying astaple cartridge304, applying electrosurgical energy, incising tissue, or other suitable surgical event. Ananvil306 can begin to close on asecond jaw member302, which is configured to receive astaple cartridge304 therein. Asanvil306 closes towardcartridge304 during a clamping operation, tissue pressure is determined by one or more mechanisms, such as by reference to one or more sensors. A plurality of sensors may comprise one or more identical sensors and/or different sensors. The plurality of sensors may comprise, for example, magnetic sensors, such as a magnetic field sensor, strain gauges, pressure sensors, inductive sensors, such as an eddy current sensor, resistive sensors, capacitive sensors, optical sensors, and/or any other suitable sensors or combination thereof.
• During theclosing phase5210, theclosure motion5216 versus time of the jaw members is compared withaverage tissue pressure5218 versus time. A first average tissue pressure versus time curve, represented by a dashed line includes three segments, includes afirst segment5286 during theclosing phase5210 of the anvil306 (FIG. 1) towards the cartridge304 (FIG. 1) to apply pressure against the tissue grasped therebetween. Asecond segment5260 represents the tissue pressure during thetissue creep5212 phase where theanvil304 has stopped moving and the tissue is given an opportunity to creep. A third segment represents the tissue pressure during the firing phase during which the staples are deployed to seal the tissue ahead of advancement of the cutting member to cut the tissue.
• A second average tissue pressure versus time curve, represented by a dashed-dot line, represents a typical curve observed when the anvil306 (FIG. 1) is closing too fast5254. This is represented by thefirst segment5152 where the slope P2 of theaverage tissue pressure5218 versus time is too steep during the closuremotion curve segment5230 during the acceleration of the closure motion andcurve segment5234 when theclosure motion5216 remains steady until athreshold5236average tissue slope5218 is detected at which time the closure motion drops to a lower constant value shown bycurve segment5238 at which time the slope of theaverage tissue pressure5216curve segment5256 decreases to reflect theslower closure motion5216.
• A third “ideal” tissue pressure versustime curve5258 having an ideal slope is represented by a solidline curve segment5250.
• Thetissue creep5212 phase is entered after the tissue is grasped and the average tissue pressure reaches a predetermined threshold and theclosure motion5216 stops such that the jaw members, e.g., anvil306 (FIG. 1) and cartridge304 (FIG. 1), hold the tissue therebetween for a predetermined time before initiating the firing5214 phase in which the staples and knife are deployed. During thetissue creep5212 phase the average tissue pressure drops over the time period betweenclosing5210 and firing5214 phases. The dashed-dot curve (adjusted closing too fast curve) and solid curve (ideal closing speed)segments5262 overlap.
• At apredetermined time5248, the firing5214 phase initiates. Atypical firing5214 cycle is represented by the dashed line average tissue pressure curve segment5266. Anideal firing5214 cycle is represented by the solid line average tissuepressure curve segment5264 where the slope P1 increases5270, reaches apeak5272, and then gently decreases5276. When the firing5214 phase moves too rapidly as indicated bycurve segment5240, the slope P2 of the dashed-dot line average tissue pressure curve5266 rises too steeply. When a predetermined slope threshold is detected, the firing speed is maintained constant as represented by firingcurve speed segment5242 and theslope5270 of the dashed-dot line average tissue pressure curve5266 decreases. After a predetermined time, the firing speed drops to a lower speed as represented by the firingspeed curve segment5246. After allowing for system response times, the dashed-dot line coincides with the solid line during thelower firing speed5246.
• Closure motion5216, such as speed of closure, or another measured rate related to closure, can be determined. As the clamping operation progresses, and a parameter increases5230, average tissue pressure is being measured. The parameter in question can be but is not limited to speed. Average tissue pressure can be plotted graphically. A curve5252 described by such graph can be plotted. At a certainpoint closure motion5216 can be steady5232. However, a tissue pressure reading can suggest that the closure motion rate is too fast5254 as indicated by, for example, the slope of curve5252. It can also be the case that the closure motion rate was too fast, or is predicted to be too fast in the future. This can occur during a period where closure rate is steady5232, or during a period where closure rate drops5234 such as where thick, fluid-filled or unexpectedly dense tissue is encountered, among other reasons. Fluid in tissue could cause thickness to increase temporarily, causing undesirable staple deployment. To the extent that it is detected that the slope of averagetissue pressure curve5218 is growing too steep, adjustments can be made. It will also be appreciated that, independent of or in conjunction with slope, a secondary calculation can be made based on the observed parameters suggesting that the closure rate is too fast. An adjustment can be made, such as by decreasing the rate of change ofclosure motion5216. For example, an ideal closing speed can be referenced based on stored control measures or dynamically obtained control measures, or both. An average tissue pressure curve reflecting suchideal closing speed5258 can be referenced.
• Accordingly,curve5258 can influenceclosure motion5216 such that the rate of closure is decreased5238 or otherwise modified to adapt to circumstances encountered during a surgical procedure. It will be understood that an ideal closing speed can represent an optimal closing speed, or one within a range of adequate closing speeds.
• Compression of clamped tissue can precede the firing5214 phase. It may be desired that compression reach a certain average tissue pressure, and/or that the tissue is considered stabilized such that firing5214 can be warranted. A measured tissue pressure can be reached at a point, for example, representing the intersection ofcurve5252 and5250. Upon reaching this point, the tissue can be allowed to stabilize and the exudate seep from the tissue. Tissue, in part because it is composed of solid and liquid material, tends to elongate when compressed; one way to account for this property is “tissue creep”. When tissue is compressed, a certain amount oftissue creep5212 can occur. Affording the compressed tissue an adequate amount of time under certain circumstances to accomplish tissue creep can therefore produce benefits. One benefit can be adequate staple formation. This can contribute to a consistent staple line. Accordingly, a certain time can be given to enabletissue creep5212 prior to firing5214.
• Upon reaching a desirable point, firing5214 can be commenced.Firing5214 can comprise one or more actions or events, including deployment of an I-beam and/or other firing member towards and/or within end effector300 (FIG. 1). An I-beam can comprise a cutting member deployable therein. The cutting member can comprise, for example, an I-Beam configured for simultaneously cutting of a tissue section located between an anvil306 (FIG. 1) and a staple cartridge304 (FIG. 1) and deploying staples from thestaple cartridge304.
• During firing5214, average tissue pressure can ascend along curve5266, comparable with the rate ofclosure motion5216. A slope can be calculated for average tissue pressure during firing5214. The slope can be evaluated to be steeper than desired, perhaps due to an increasing rate of average tissue pressure change in combination with astable firing rate5242. If this condition or another condition provided for is detected, instrument10 (FIGS. 1-4) can have the capability to adapt. Measures can be implemented to modify thefiring curve5268 such that a peak can be reached that would be similar to or identical to that obtainable from a more desirable tissue pressure curve5274.
• Accordingly, similar to adaptive mechanisms employed in connection with closing5210, adaptive measures can be employed in connection with firing5214.
• Tissue-pressure curve5286 can be referenced which can track a desired tissue-creep rate after reference to an ideal closing speed. Tissue-pressure curve5286 can be programmed to operate in conjunction with, or be extrapolated from, theclosing phase5210 orfiring phase5214. Additionally, a given tissue type can be referenced that would give certain characteristics when surgical operations are carried out thereon, suchcharacteristics embodying curve5286. It will be appreciated that various purposes can be fulfilled by referencing tissue-pressure curve5286, or another tissue-pressure curve, that might be considered an “ideal”, desired, or otherwise “reference curve”. Such a reference curve can assist in improvingclosing5210,tissue creep5212, and/or firing5214. Such a reference curve or curves can be stored in instrument10 (FIGS. 1-4) or be developed dynamically, or both, and can account for varying thickness of a tissue portion, and many other factors.
• In accordance with aspects,FIG. 46 illustrates adaptive mechanisms that can influence actual behavior of instrument10 (FIGS. 1-4) in the process of carrying out a surgical procedure.Speed5310 can be enumerated on the vertical (y) axis and time5311 (t) is represented along the horizontal axis.Speed5310 can represent speed of the motor, speed of closure of end effector300 (FIG. 1), speed of firing rate, or another speed. As speed increases5312, sensors can obtain measurements of various parameters. Based on control measures derived from stored algorithms, or dynamically generated algorithms, or both, one or more modifications can be made. One modification can be atissue modification5320 that will influence operation ofinstrument10 such that speed is upwardly or downwardly adjusted in order to obtain a more desirable set of conditions. An additional modification can be asensor modification5330.Sensor modification5330 can influence the characteristics or values of data transmitted to microcontroller1500 (FIG. 19) and operatively associated memory units.Microcontroller1500 can monitor and obtain data from sensors associated with forexample end effector300. Sensor modification can also influence parameter readings at one or more added sensor(s). For example, a primary sensor such as a magnetic field sensor located for example at a distal portion of anvil306 (FIG. 1) can indicate a certain thickness of a bite of tissue; however, reference to a secondary sensor such as a strain gauge can be factored in such that the measured Hall effect voltage can be adjusted. As a result, inputs such astissue modification5320 andsensor modification5330 can influence anactual speed5340 that is adjusted to take into account one or both.
• Additionally, in accordance with aspects,FIG. 47 illustrates adaptive mechanisms that can influence actual behavior of afiring rate5410 in the process of carrying out a surgical procedure.Firing rate5410 can be enumerated on the vertical (y) axis and time5412 (t) is represented along the horizontal (x) axis.Firing rate5410 can represent a rate at which a firing member220 (FIGS. 1 and 7) is longitudinally deployed, a rate at which tissue is incised, and/or a rate at which staples are deployed. In various examples, afiring rate5410 value can ascend, upon actuation of a firing mechanism. Based on control measures derived from predetermined algorithms, or dynamically generated algorithms, or both, one or more modifications can be made to an original program in the memory that can define the firing rate (here, a steady firing rate5420). One modification can be atissue modification5430 that can influence operation of instrument such that speed is upwardly or downwardly adjusted in order to obtain a more desirable set of conditions. An additional modification can be asensor modification5440.Sensor modification5440 can influence the characteristics or values of data transmitted tomicrocontroller1500 from sensors associated with for example end effector300 (FIG. 1).Sensor modification5440 can also influence parameter readings at one or more added sensor(s). For example, a primary sensor such as a magnetic field sensor onend effector300 can indicate a certain thickness of a bite of tissue; however, reference to a secondary sensor such as a strain gauge can be factored in such that the measured Hall effect voltage can be adjusted. As a result, inputs such astissue modification5430 andsensor modification5440 can influence anactual speed5450 that is adjusted to take into account one or both.
• Inputs can be given their actual weight, i.e., without selective weighting. However, in various aspects one or more inputs may not be weighted equally. Certain inputs may be given more weight than other inputs.
• Adequate staple formation is a key consideration. Factors that influence staple formation include finding desirable operational envelopes based on tissue compression.FIGS. 48 and 49 illustrate example scenarios where a parameter such as differential tissue compression, as measured by impedance sensors, can result in adaptive firing procedures.FIG. 48 illustrates clamping5510 operations wheretissue compression5514 is shown along the vertical (y) axis and staple cartridge size5532 (mm) is shown along the horizontal (x) axis. Measurements from an end effector300 (FIG. 1) can embrace a tissue portion of length up to 60 mm in this example, though it can be of a greater length in other examples. Tissue compression within the clampingend effector300 can be measured by impedance sensors positioned, for example, every 6 mm, such as from 6 mm-60 mm. An impedance measurement can be taken at each sensor. During a surgical procedure, tissue can be compressed withinend effector300. Impedance measurements can be taken attimes t15516 andt25518. Attime t15516, acurve5522 can be described toward5520 by monitoring impedance measurements from one more of the impedance sensors (includingimpedance sensors5526,5528 and5530). It will be appreciated that there may be ten impedance sensors as shown in the example, but there may be more or fewer. At a second time,t25518, acurve5524 can be described toward5523 by monitoring the same impedance measurements from one more of the impedance sensors (includingimpedance sensors5526,5528 and5530). Impedance can be measured based on values from one or more of the impedance sensors, along a curve toward5524. Comparing the impedance values for a given sensor from t1 and t2 can reveal a differential based onstaple line length5512. There may be multiple reasons. One reason can be that the clamped tissue exhibits different compression properties at different locations alongstaple line length5512. An additional reason can be that there is a different tissue thickness; in other words, the tissue may exhibit pre-clamping thickness of a profile seen inFIG. 51. Further, tissue creep may have played a role. It is possible that all these reasons contribute to the observed properties, or there are other reasons. In any event, differential tissue compression over time can be observed.
• FIG. 49 can illustrate afiring operation5610, including but not limited to a firing operation based onFIG. 48. InFIG. 49,tissue compression5612 is shown along a vertical (y) axis and staple cartridge size5622 (mm) is shown along the horizontal (x) axis. As the I-beam traverses the tissue,tissue compression5612 measurements are taken by monitoring impedance measurements from one more of the impedance sensors (includingimpedance sensors5618,5620 and5624). During firing,tissue compression5612 can rise to athreshold5630 and then peak attime t35670 relative to I-beam location5614. Subsequently, tissue compression falls betweent35670 and t45672 (e.g., 1 second5660) relative to I-beam location5616. This operation can describe a risingcurve5640 and a falling curve5642. It also may be observed that under certain circumstances a risingcurve5640 can exhibit a convex complexion, and a falling curve a concave complexion5642. It may be predicted that an I-beam may take more time to traverse tissue with certain characteristics, e.g., thicker tissue, diseased tissue, etc. Accordingly, a different tissue compression profile may be prescribed such that tissue compression measurements observe asecond curve5650,5652. In addition,second curve5650,5652 may result where there is a differential thickness of the pre-clamped tissue, such as that seen inFIG. 51.Portion5810 is thinner thanportion5812. Traversing thicker tissue can act to slow the relative speed of the I-Beam, leading to different tissue compression measurements over time, and accordingly variable tissue profiles.
• Accordingly, a differential in tissue compression measurements between t1 and t2 can lead to an adaptive response whereby control measures adjust a curve of tissue compression during afiring phase5610. It will be appreciated, then, that the curve peaking at t4 can represent an adaptive curve based on tissue properties that can lead to improved results from the surgical procedure, battery usage, and other operations where an adaptive response can be used.
• The shape of the curve can have significance. For example, a convex curve can reflect a rising tissue compression profile during afiring phase5610. A concave curve can reflect a falling tissue compression profile during afiring phase5610. A peaktissue compression measurement5670,5672 can fall between respective concave and convex curves. (For purposes of this disclosure, a perspective based on which concavity or convexity is found is based on viewing from a higher value on the y-axis than the peak of the curve.)
• In conjunction withFIGS. 48 and 49, or as independent examples, control measures can wholly or partially adjust firing in order to prevent a parameter from rising above a certain limit.FIG. 50 shows an example scenario. Afirst curve5730,5732 can be a predicted firing profile stored by instrument10 (FIGS. 1-4) for a given type of tissue. It will be seen that the vertical (y) axis parameter, such as tissue compression, over time (t) along the horizontal (x)axis5172 can rise as incurve5730, then fall as incurve5732. However, it is possible that the values associated with the predicted firing profile diverge, during operation, from values actually observed during the surgical procedure. As a result,instrument10 can take measures to adapt. For example, the observed measurements can fall alongcurve5720, with a slower rate of rise but projected higher peak. Thus, the y-axis parameter can continue to rise. Under certain circumstances, it can be predicted that the curve for the y-axis parameter could breach predetermined, or dynamically determined,limit5710 prior to reaching its peak. This prediction can be made based on aslope5722 of the curve, in combination or not with input from thex-axis5172 parameter (e.g., time). If it is determined that the peak is predicted to be above thelimit5726, or other portions ofcurve5724 will breach thelimit5710,instrument10 could adapt firing in order to provide for a slower firing rate. Doing so can result in the y-axis measurement falling along anadaptive curve5728 based on slower firing. The adaptive curve can rise above the limit, or be constrained from doing by adapting operations accordingly.
• FIG. 51 illustrates a portion of tissue prior to clamping. It can be seen that one end of thetissue5810 is thinner than theother end5812. In such circumstances, there can be differential forces and timings exerted by end effector300 (FIG. 1) on the tissue, and by the tissue onend effector300. The thickness disparity can be taken into account by instrument10 (FIGS. 1-4) in adapting to such thickness. It may be the case that this tissue portion is similar to the one considered in connection withFIGS. 48-49. It also may be the case that another tissue portion is illustrated in connection withFIGS. 48-49, to show more general applicability. It may further be the case thatFIG. 50 is a graphical representation of adaptive operations performed in connection with a tissue portion like that inFIG. 51; again, it also may be the case thatFIG. 50 can show more generally adaptive operations in response to detecting measurement of certain parameters during the course of a surgical procedure and adjusting accordingly.
• In various aspects, the present disclosure provides an instrument10 (described in connection withFIGS. 1-29) configured to sense tissue compression when tissue is clamped between the jaw members of the end effector, such as, for example, between the anvil and the staple cartridge. In one example, the instrument10 (FIGS. 1-4) can be configured to sense tissue contact in one of the jaw members such as the anvil and/or the staple cartridge. In another example, theinstrument10 can be configured to sense the pressure applied to the tissue by the jaw members. In yet another example, theinstrument10 can be configured to measure the electrical impedance (resistance) through the tissue between the jaw members. This may be achieved by embedding micro electrodes in at least one of the jaw members to drive a low amplitude, low energy, RF signal through the tissue to enable a nontherapeutic measurement of tissue impedance. The energy level is kept low enough to avoid therapeutic tissue effects such as coagulation, sealing, welding, or cautery. Further, theinstrument10 can include devices to produce two distinct measures from a single set of energized and return paths. In one example, multiple frequency signals can be overlaid to measure impedance in different places simultaneously. This can include a single active electrode with the channel and the anvil grounded through isolated paths with filters for different frequency RF signals. Otherwise, two isolated return paths with independent filters, which are part of the handle electronics system can be used. In another example, the sequential impedance measurements would be multiplexed at variable RF frequencies.
• RF technology has been used in endocutters for some time. The challenge in employing the technology is in the delivery of high density RF energy and shorting between the jaw members of the end effector. Despite the shortcomings of using RF energy therapeutically, RF technology can be effectively employed sub-therapeutically to sense tissue compression rather than actually coagulating, sealing, or cauterizing tissue. In the sub-therapeutic sense, the endosurgical device can employ RF energy to sense internal tissue parameters and adjust the deployment of staples rather and being employed as an adjunct to the stapling operation to assist in sealing the tissue prior to cutting the tissue with a knife.
• RF technology used in endosurgical medical devices, and for example, in RF endocutters, may introduce the challenges of handling high densities of energy and dealing with shorting. However, RF technology may be less challenging if used merely to sense tissue compression rather than, for example, cauterizing tissue. RF technology may be used as a way for medical devices, such as endocutters, to sense internal tissue parameters such as compression, and adjust stapling deployment in response. RF electrode and cautery devices may utilize the same electrodes for sensing tissue impedance as they do to melt tissue. These same electrodes may be implemented with significantly less electrical and power requirements as a tissue compression sensor system.
• RF electrodes and cautery devices can utilize the same electrodes for sensing tissue impedance as they do to weld the tissue by applying energy thereto. Nevertheless, in the an endocutter instrument context, the RF electrodes can be employed to as a tissue compression sensor system with significantly less electronics and power needs relative to a fully equipped electrosurgical device. A single energized electrode on the cartridge, for example, or perhaps an isolated knife, can be used to make multiple tissue compression measurements simultaneously. If multiple RF signals are overlaid or multiplexed they can be transmitted down the single power conductor and then allowed to return on either the channel frame or the anvil of the device. If a filter is provided in the anvil and channel contacts before they join the common return path, the tissue impedance for both paths can be differentiated. This would provide a measure of through tissue versus lateral tissue compression. This filtered approach may be implemented proximal and distal as opposed to vertical and lateral depending on the placement of the filters and the location of the metallic electrically conductive return paths. The smaller frequency generator and signal processor may be implemented in a small package form factor on an existing circuit board or a sub circuit board without the need for extensive extra cost associated with an RF sealing/cauterization system.
• Referring toFIG. 52, an endocutter6000 may include ahandle component6002, ashaft component6004, and an end-effector component6006. The endocutter6000 is similarly constructed and equipped as the motor-driven surgical cutting andfastening instrument10 described in connection withFIGS. 1-29. Accordingly, for conciseness and clarity the details of operation and construction will not be repeated here. The end-effector6006 may be used to compress, cut, or staple tissue. Referring now toFIG. 53A, an end-effector6030 may be positioned by a physician to surroundtissue6032 prior to compression, cutting, or stapling. As shown inFIG. 53A, no compression may be applied to the tissue while preparing to use the end-effector. Referring now toFIG. 53B, by engaging the handle (e.g., handle6002) of the endocutter, the physician may use the end-effector6030 to compress thetissue6032. In one aspect, thetissue6032 may be compressed to its maximum threshold, as shown inFIG. 53B.
• Referring toFIG. 54A, various forces may be applied to thetissue6032 by the end-effector6030. For example, vertical forces F1 and F2 may be applied by theanvil6034 and thechannel frame6036 of the end-effector6030 astissue6032 is compressed between the two. Referring now toFIG. 54B, various diagonal and/or lateral forces also may be applied to thetissue6032 when compressed by the end-effector6030. For example, force F3 may be applied. For the purposes of operating a medical device such as endocutter6000, it may be desirable to sense or calculate the various forms of compression being applied to the tissue by the end-effector. For example, knowledge of vertical or lateral compression may allow the end-effector to more precisely or accurately apply a staple operation or may inform the operator of the endocutter such that the endocutter can be used more properly or safely.
• The compression throughtissue6032 may be determined from an impedance oftissue6032. At various levels of compression, the impedance Z oftissue6032 may increase or decrease. By applying a voltage V and a current I to thetissue6032, the impedance Z of thetissue6032 may be determined at various levels of compression. For example, impedance Z may be calculated by dividing the applied voltage V by the current I.
• Referring now toFIG. 55, in one aspect, anRF electrode6038 may be positioned on the end-effector6030 (e.g., on a staple cartridge, knife, or channel frame of the end-effector6030). Further, anelectrical contact6040 may be positioned on theanvil6034 of the end-effector6030. In one aspect, the electrical contact may be positioned on the channel frame of the end-effector. As thetissue6032 is compressed between theanvil6034 and, for example, thechannel frame6036 of the end-effector6030, an impedance Z of thetissue6032 changes. Thevertical tissue compression6042 caused by the end-effector6030 may be measured as a function of the impedance Z of thetissue6032.
• Referring now toFIG. 56, in one aspect, anelectrical contact6044 may be positioned on an opposite end of theanvil6034 of the end-effector6030 as theRF electrode6038 is positioned. As thetissue6032 is compressed between theanvil6034 and, for example, thechannel frame6036 of the end-effector6030, an impedance Z of thetissue6032 changes. Thelateral tissue compression6046 caused by the end-effector6030 may be measured as a function of the impedance Z of thetissue6032.
• Referring now toFIG. 57, in one aspect,electrical contact6050 may be positioned on theanvil6034 andelectrical contact6052 may be positioned on an opposite end of the end-effector6030 atchannel frame6036.RF electrode6048 may be positioned laterally to the central to the end-effector6030. As thetissue6032 is compressed between theanvil6034 and, for example, thechannel frame6036 of the end-effector6030, an impedance Z of thetissue6032 changes. The lateral compression orangular compressions6054 and6056 on either side of theRF electrode6048 may be caused by the end-effector6030 and may be measured as a function of different impedances Z of thetissue6032, based on the relative positioning of theRF electrode6048 andelectrical contacts6050 and6052.
• In accordance with one or more of the techniques and features described in the present disclosure, and as discussed above, an RF electrode may be used as an RF sensor. Referring now toFIG. 58, in one aspect, anRF sensor6062 may be positioned on a staple cartridge6060 inserted into a channel frame6066 an end-effector. The RF electrode may run from a power line6064 which may be powered by a power source in a handle (e.g., handle6002) of an endocutter.
• Referring now toFIG. 59, in one aspect,RF electrodes6074 and6076 may be positioned on astaple cartridge6072 inserted into achannel frame6078 of end-effector6070. As shown,RF electrode6074 may be placed in a proximal position of the end-effector relative to an endocutter handle. Further,RF electrode6076 may be placed in a distal position of the end-effector relative to the endocutter handle.RF electrodes6074 and6076 may be utilized to measure vertical, lateral, proximal, or distal compression at different points in a tissue based on the position of one or more electrical contacts on the end-effector.
• Referring now toFIG. 60, in one aspect, RF electrodes6084-6116 may be positioned onstaple cartridge6082 inserted into the channel frame6080 (or other component of an end-effector) based on various points for which compression information is desired. Referring now toFIG. 61, in one aspect, RF electrodes6122-6140 may be positioned onstaple cartridge6120 at discrete points for which compression information is desired. Referring now toFIG. 62, RF electrodes6152-6172 may be positioned at different points in multiple zones of a staple cartridge based on how accurate or precise the compression measurements should be. For example, RF electrodes6152-6156 may be positioned inzone6158 ofstaple cartridge6150 depending on how accurate or precise the compression measurements inzone6158 should be. Further, RF electrodes6160-6164 may be positioned inzone6166 ofstaple cartridge6150 depending on how accurate or precise the compression measurements inzone6166 should be. Additionally, RF electrodes6168-6172 may be positioned inzone6174 ofstaple cartridge6150 depending on how accurate or precise the compression measurements inzone6174 should be.
• The RF electrodes discussed herein may be wired through a staple cartridge inserted in the channel frame. Referring now toFIG. 63, in one aspect, an RF electrode may have a stamped “mushroom head”6180 of about 1.0 mm in diameter. While the RF electrode may have the stamped “mushroom head” of about 1.0 mm in diameter, this is intended to be a non-limiting example and the RF electrode may be differently shaped and sized depending on each particular application or design. The RF electrode may be connected to, fastened to, or may form, aconductive wire6182. The conductive wire182 may be about 0.5 mm in diameter, or may have a larger or smaller diameter based on a particular application or design. Further, the conductive wire may have aninsulative coating6184. In one example, the RF electrode may protrude through a staple cartridge, channel frame, knife, or other component of an end-effector.
• Referring now toFIG. 64, the RF electrodes may be wired through a single wall or through multiple walls of a staple cartridge or channel frame of an end-effector. For example, RF electrodes6190-6194 may be wired throughwall6196 of the staple cartridge or channel frame of an end-effector. One or more ofwires6198 may be connected to, fastened to, or be part of, RF electrodes6190-6194 and may run throughwall6196 from a power source in, e.g., a handle of an endocutter.
• Referring now toFIG. 65, the power source may be in communication with the RF electrodes or may provide power to the RF electrodes through a wire or cable. The wire or cable may join each individual wire and lead to the power source. For example, RF electrodes6204-6212 may receive power from a power source through wire orcable6202, which may run throughstaple cartridge6200 or a channel frame of an end-effector. In one example, each of RF electrodes6204-6212 may have its own wire that runs to or through wire orcable6202. Thestaple cartridge6200 or channel frame also may include acontroller6214, such as thecontroller2006 shown in connection withFIGS. 21A, 21B, orother controllers2606 or3017 shown in connection withFIGS. 27-29, for example. It will be appreciated that thecontroller6214 should be suitably sized to fit in thestaple cartridge6200 or channel frame form factor. Also, the controller
• In various aspects, the tissue compression sensor system described herein for use with medical devices may include a frequency generator. The frequency generator may be located on a circuit board of the medical device, such as an endocutter. For example the frequency generator may be located on a circuit board in a shaft or handle of the endocutter. Referring now toFIG. 66, an example circuit diagram6220 in accordance with one example of the present disclosure is shown. As shown,frequency generator6222 may receive power or current from apower source6221 and may supply one or more RF signals to one ormore RF electrodes6224. As discussed above, the one or more RF electrodes may be positioned at various locations or components on an end-effector or endocutter, such as a staple cartridge or channel frame. One or more electrical contacts, such aselectrical contacts6226 or6228 may be positioned on a channel frame or an anvil of an end-effector. Further, one or more filters, such asfilters6230 or6232 may be communicatively coupled to theelectrical contacts6226 or6228 as shown inFIG. 66. Thefilters6230 and6232 may filter one or more RF signals supplied by thefrequency generator6222 before joining asingle return path6234. A voltage V and a current I associated with the one or more RF signals may be used to calculate an impedance Z associated with a tissue that may be compressed and/or communicatively coupled between the one ormore RF electrodes6224 and theelectrical contacts6226 or6228.
• Referring now toFIG. 67, various components of the tissue compression sensor system described herein may be located in ahandle6236 of an endocutter. For example, as shown in circuit diagram6220a,frequency generator6222 may be located in thehandle6236 and receives power frompower source6221. Also, current I1 and current I2 may be measured on a return path corresponding toelectrical contacts6228 and6226. Using a voltage V applied between the supply and return paths, impedances Z1 and Z2 may be calculated. Z1 may correspond to an impedance of a tissue compressed and/or communicatively coupled between one or more ofRF electrodes6224 andelectrical contact6228. Further, Z2 may correspond to an impedance of a tissue compressed and/or communicatively coupled between one or more ofRF electrodes6224 andelectrical contact6226. Applying the formulas Z1=V/I1 and Z2=V/I2, impedances Z1 and Z2 corresponding to different compression levels of a tissue compressed by an end-effector may be calculated.
• Referring now toFIG. 68, one or more aspects of the present disclosure are described in circuit diagram6250. In an implementation, a power source at ahandle6252 of an endocutter may provide power to afrequency generator6254. Thefrequency generator6254 may generate one or more RF signals. The one or more RF signals may be multiplexed or overlaid at amultiplexer6256, which may be in ashaft6258 of the endocutter. In this way, two or more RF signals may be overlaid (or, e.g., nested or modulated together) and transmitted to the end-effector. The one or more RF signals may energize one ormore RF electrodes6260 at an end-effector6262 (e.g., positioned in a staple cartridge) of the endocutter. A tissue (not shown) may be compressed and/or communicatively coupled between the one or more ofRF electrodes6260 and one or more electrical contacts. For example, the tissue may be compressed and/or communicatively coupled between the one ormore RF electrodes6260 and theelectrical contact6264 positioned in a channel frame of the end-effector6262 or theelectrical contact6266 positioned in an anvil of the end-effector6262. Afilter6268 may be communicatively coupled to theelectrical contact6264 and afilter6270 may be communicatively coupled to theelectrical contact6266.
• A voltage V and a current I associated with the one or more RF signals may be used to calculate an impedance Z associated with a tissue that may be compressed between the staple cartridge (and communicatively coupled to one or more RF electrodes6260) and the channel frame or anvil (and communicatively coupled to one or more ofelectrical contacts6264 or6266).
• In one aspect, various components of the tissue compression sensor system described herein may be located in ashaft6258 of the endocutter. For example, as shown in circuit diagram6250 (and in addition to the frequency generator6254), animpedance calculator6272, acontroller6274, anon-volatile memory6276, and acommunication channel6278 may be located in theshaft6258. In one example, thefrequency generator6254,impedance calculator6272,controller6274,non-volatile memory6276, andcommunication channel6278 may be positioned on a circuit board in theshaft6258.
• The two or more RF signals may be returned on a common path via the electrical contacts. Further, the two or more RF signals may be filtered prior to the joining of the RF signals on the common path to differentiate separate tissue impedances represented by the two or more RF signals. Current I1 and current I2 may be measured on a return path corresponding toelectrical contacts6264 and6266. Using a voltage V applied between the supply and return paths, impedances Z1 and Z2 may be calculated. Z1 may correspond to an impedance of a tissue compressed and/or communicatively coupled between one or more ofRF electrodes6260 andelectrical contact6264. Further, Z2 may correspond to an impedance of the tissue compressed and/or communicatively coupled between one or more ofRF electrodes6260 andelectrical contact6266. Applying the formulas Z1=V/I1 and Z2=V/I2, impedances Z1 and Z2 corresponding to different compressions of a tissue compressed by an end-effector6262 may be calculated. In example, the impedances Z1 and Z2 may be calculated by theimpedance calculator6272. The impedances Z1 and Z2 may be used to calculate various compression levels of the tissue.
• Referring now toFIG. 69, afrequency graph6290 is shown. Thefrequency graph6290 shows a frequency modulation to nest two RF signals. The two RF signals may be nested before reaching RF electrodes at an end-effector as described above. For example, an RF signal withFrequency 1 and an RF signal withFrequency 2 may be nested together. Referring now toFIG. 70, the resulting nested RF signal is shown infrequency graph6300. The compound signal shown infrequency graph6300 includes the two RF signals offrequency graph6290 compounded. Referring now toFIG. 71, a frequency graph6310 is shown. Frequency graph6310 shows the RF signals withFrequencies 1 and 2 after being filtered (by, e.g., filters6268 and6270). The resulting RF signals can be used to make separate impedance calculations or measurements on a return path, as described above.
• In one aspect, filters6268 and6270 may be High Q filters such that the filter range may be narrow (e.g., Q=10). Q may be defined by the Center frequency (Wo)/Bandwidth (BW) where Q=Wo/BW. In one example,Frequency 1 may be 150 kHz andFrequency 2 may be 300 kHz. A viable impedance measurement range may be 100 kHz-20 MHz. In various examples, other sophisticated techniques, such as correlation, quadrature detection, etc., may be used to separate the RF signals.
• Using one or more of the techniques and features described herein, a single energized electrode on a staple cartridge or an isolated knife of an end-effector may be used to make multiple tissue compression measurements simultaneously. If two or more RF signals are overlaid or multiplexed (or nested or modulated), they may be transmitted down a single power side of the end-effector and may return on either the channel frame or the anvil of the end-effector. If a filter were built into the anvil and channel contacts before they join a common return path, the tissue impedance represented by both paths could be differentiated. This may provide a measure of vertical tissue vs lateral tissue compression. This approach also may provide proximal and distal tissue compression depending on placement of the filters and location of the metallic return paths. A frequency generator and signal processor may be located on one or more chips on a circuit board or a sub board (which may already exist in an endocutter).
• In various aspects, the present disclosure provides techniques for monitoring the speed and precision incrementing of the drive motor in the instrument10 (described in connection withFIGS. 1-29). In one example, a magnet can be placed on a planet frame of one of the stages of gear reduction with an inductance sensor on the gear housing. In another example, placing the magnet and magnetic field sensor on the last stage would provide the most precise incremental movement monitoring.
• Conventional motor control systems employ encoders to detect the location and speed of the motor in hand held battery powered endosurgical instruments such as powered endocutter/stapler devices. Precision operation of endocutter/stapler devices relies in part on the ability to verify the motor operation under load. Simple sensor implementations may be employed to achieve verify the motor operation under load.
• Accordingly, the present disclosure includes a magnetic body on one of the planetary carriers of a gear reduction system or employs brushless motor technology. Both approaches involve the placement of an inductance sensor on the outside housing of the motor or planetary gear system. In the case of a brushless motor, there are electromagnetic field coils (windings, inductors, etc.) arrayed radially around the center magnetic shaft of the motor. The coils are sequentially activated and deactivated to drive the central motor shaft. One or more inductance sensors can be placed outside of the motor and adjacent to at least some of the coils to sense the activation/deactivation cycles of the motor windings to determine the number times the shaft has been rotated. Alternatively, a permanent magnet can be placed on one of the planetary carriers and the inductance sensor can be placed adjacent to the radial path of the planetary carrier to measure the number of times that stage of the gear train is rotated. This implementation can be applied to any rotational components in the system with increasingly more resolution possible in regions with a relatively large number of rotations during function, or as the rotational components become closer (in terms of number of connections) to the end effector depending on the design. The gear train sensing method may be preferred since it actually measures rotation of one of the stages whereas the motor sensing method senses the number of times the motor has been commanded to energize, rather than the actual shaft rotation. For example, if the motor is stalled under high load, the motor sensing method would not be able to detect the lack of rotation because it senses only the energizing cycles not shaft rotation. Nevertheless, both techniques can be employed in a cost effective manner to sense motor rotation.
• During stapling, for example, tissue is firmly clamped between opposing jaws before a staple is driven into the clamped tissue. Tissue compression during clamping can cause fluid to be displaced from the compressed tissue, and the rate or amount of displacement varies depending on tissue type, tissue thickness, the surgical operation (e.g., clamping pressure and clamping time). In various instances, fluid displacement between the opposing jaws of an end effector may contribute to malformation (e.g., bending) of staples between the opposing jaws. Accordingly, in various instances, it may be desirable to control the firing stroke, e.g., to control the firing speed, in relationship to the detected fluid flow, or lack thereof, intermediate opposing jaws of a surgical end effector.
• Accordingly, also provided herein are methods, devices, and systems for monitoring speed and incremental movement of a surgical instrument drive train, which in turn provides information about the operational velocity of the device (e.g., jaw closure, stapling). In accordance with the present examples, the instrument10 (FIGS. 1-4) does not include a motor encoder. Rather, theinstrument10 is equipped with amotor7012 shown inFIG. 72, which illustrates a speed sensor assembly for apower train7010 of themotor7012, in accordance with an illustrative example. The speed sensor assembly can include amotor7012 having anoutput shaft7014 that is coupled directly or indirectly to a drive shaft. In some examples, the output shaft is connected to a gear reduction assembly, such as theplanetary gear train7020 shown inFIG. 72.
• With continued reference toFIG. 72, the speed sensor assembly further includes at least onesensor7016 that detects the rotational speed of any suitable component of the system. For example, the sensor may be a proximity sensor, such as an induction sensor, which detects movement of one or moredetectable elements7018 affixed to any rotating part of the gear reduction assembly. InFIG. 72, which is exemplary, the detectable element is affixed to the laststage annular gear7034cand the sensor is positioned adjacent the radial path of the detectable element so as to detect movement of the detectable element.FIG. 72 is exemplary only—rotating components vary depending on design—and the sensor(s) can be affixed to any rotating component of the gear reduction assembly. For example, in another example, a detectable element is associated with the carrier gear of the final stage or even the drive gear. In some examples, a detectable element is located outside of the gear reduction assembly, such as on the driveshaft between gear reduction assembly and the end effector. In some example, a detectable element is located on a rotating component in the final gear reduction at the end effector.
• With continued reference toFIG. 72, in oneaspect motor7012 is rotationally coupled to a gear reduction assembly, such as aplanetary gear train7020. However, any suitable gear reduction or transmission can be used and/or the motor can be coupled directly to a drive shaft (e.g., direct drive). The planetary gear train can include 1, 2, 3, 4, 5, or more stages. The planetary gear train illustrated inFIG. 72 has three stages. The planetary gear train is driven by a sun gear (7042 inFIG. 73) attached directly or indirectly to themotor output shaft7014. The sun gear drives one or more first stage planet gears7032a, which in turn engage a first stageannular gear7034a. Any number of planet gears can be used such as, for example, 1, 2, 3, 4, 5 or more planet gears. First stage planet gears7032acommunicate with afirst stage carrier7036a, which includes or connects to a second stage sun gear (7038ainFIG. 73) that drives the second stage.
• Similar to the first stage, the second stage includes one ormore planet gears7032b, anannular gear7034b, and acarrier7036bthat includes or connects to a third stage sun gear (7038binFIG. 73) that drives the third stage. Likewise, the third stage includes one ormore planet gears7032c, anannular gear7034c, and acarrier7036c. The final stage in the planetary gear train assembly is connected to adrive gear7040, which can be the final effector in the gear reduction assembly, depending on design. The use of three planetary gear stages is exemplary only. Any suitable type of gear reduction assembly can be used in accordance with the present disclosure.
• Thesensor7016 can be mounted in or near the gear reduction assembly in, near, or adjacent the radial path ofdetectable element7018. The sensor can be any suitable sensor type capable of detecting rotational speed without an encoder. The sensor is used in conjunction with a detectable element capable of being detected by the sensor. For example, in some examples, the sensor is an inductance sensor and the detectable element is a metallic element. The inductance sensor can be configured to detect a change in inductance caused by a metallic object or magnet passing adjacent the inductive sensor. In some examples, the sensor is a magnetic field sensor, and the detectable element is a magnetic element. A magnetic field sensor can be configured to detect changes in a magnetic field surrounding the magnetic field sensor caused by the movement of the magnetic element.
• Detectable elements can be affixed or integral with any rotating part or particular stage of the gear reduction assembly to measure the number of times that the part or stage rotates. For example, a single detectable element could be placed ondrive gear7040. Each complete rotation of the drive gear would cause the detectable element to pass the sensor one time, resulting in one detected rotation. In some examples, multipledetectable elements7018 can be used within the same gear reduction assembly, by placing a plurality of detectable elements (e.g., 2, 3, 4, 5 or more) on the same component (e.g., a gear) and/or by placing one or more detectable elements on a plurality of different components (e.g., on two different gears). Placing multiple sensors equally spaced on a single component can provide refined information about incremental rotations. Similarly, resolution of speed monitoring can be increased by placing a detectable element(s) on a component that rotates more quickly relative to other components and/or by placing the detectable element closer (in terms of number of connections) to the end effector depending on the design. Using multiple detectable elements on different components provides a redundant, fail-safe system should one sensor or detectable element fail.
• Sensors should be located close enough to detectable elements to ensure that each revolution of a detectable element is captured by its associated sensor. Multiple sensors can be placed in the same radial path of a detectable element. In addition, if detectable elements are placed on a plurality of different components (e.g., two different gears), a sensor can be placed adjacent the radial path of each detectable element. Thesensor7016 is in data communication with acontroller7011 such as the microcontroller1500 (FIG. 19) or microcontroller2006 (FIGS. 21A, 21B), processor2104 (FIG. 22), orcontroller2606 and3017 shown inFIGS. 27-29, which is programmed to translate the number and/or rate of detection events into a speed reading useful to the user, such as using the speed indicator display shown inFIGS. 88-90.
• FIG. 73 shows a longitudinal cross section through plane A ofFIG. 72. Clearly visible inFIG. 73 is sun gear7042 coupled tooutput shaft7014.
• FIG. 74 illustrates a speed sensor assembly for7050 for directly sensing the rotational speed of abrushless motor7060, in accordance with an illustrative aspect. A brushless motor typically comprises electromagnetic field coils7062,7064 arrayed radially around a central magnetic shaft (7066 inFIG. 75). Negative7062 and positive7064 coils are alternately arranged around the central magnetic shaft, and these coils are sequentially activated and deactivated to drive the central magnetic shaft. One ormore sensors7016 can be placed adjacent these coils on the outside of the motor to monitor motor speed. Thesensor induction field7068 is affected each time an electromagnetic field coil passes the sensor. The sensor is in data communication with acontroller7011, such as the microcontroller1500 (FIG. 19) or microcontroller2006 (FIGS. 21A, 21B), processor2104 (FIG. 22), orcontroller2606 and3017 shown inFIGS. 27-29, for example, which is programmed to translate the number and/or rate of detection events into a speed reading useful to the user, such as using a speed indicator display shown inFIGS. 88-90.
• If the motor stalls, for example under high load, thesensor7016 may still detect activation of the coils, which thesensor7016 would interpret as motor rotation even though the motor is stalled. As a result, under certain operational circumstances, motor speed could be an inaccurate readout for operational tool speed. In one example, speed is measured using one ormore sensors7016 on the gear reduction assembly because this measures the actual speed of the gear assembly, or a stage of the gear assembly, rather than the speed of the motor. In addition, the closer the detectable element(s) and associated sensor(s) are to the end effector, the more likely the sensed speed accurately reflects operational tool speed. The ability to verify motor operation under load is important for precision operation of surgical instruments, such as staplers.
• FIG. 75 illustrates a transverse cross section through plane B of the motor assembly shown inFIG. 74. The centralmagnetic shaft7066 is visible inFIG. 75.
• Sensor7016 is in data communication with acontroller7011, such as the microcontroller1500 (FIG. 19) or microcontroller2006 (FIGS. 21A, 21B), processor2104 (FIG. 22), orcontroller2606 and3017 shown inFIGS. 27-29, which is programmed to translate the number and/or rate of detection events into a speed reading useful to the user. Thecontroller7011 also can regulate motor speed to ensure safe operating parameters and/or to ensure that a constant speed and/or acceleration are maintained for particular surgical applications.
• Various functions may be implemented utilizing the circuitry previously described, For example, the motor may be controlled with amotor controller7011 similar those described in connection withFIGS. 21A, 21B, 24, 25, 28A, 28B, and 29, where the encoder is replaced with the monitoring speed control and precision incrementing of motor systems for powered surgical instruments described in connection withFIGS. 72-75. For example, theposition encoder2340 shown inFIG. 24 can be replaced with thesensor7016 shown inFIGS. 72-75 coupled to themicrocontroller2306 inFIG. 24. Similarly, theposition encoder2440 shown inFIG. 25 can be replaced with thesensor7016 shown inFIGS. 72-75 coupled to themicrocontroller2406 inFIG. 25.
• In one aspect, the present disclosure provides an instrument10 (described in connection withFIGS. 1-29) configured with various sensing systems. Accordingly, for conciseness and clarity the details of operation and construction will not be repeated here. In one aspect, the sensing system includes a viscoelasticity/rate of change sensing system to monitor knife acceleration, rate of change of impedance, and rate of change of tissue contact. In one example, the rate of change of knife acceleration can be used as a measure of for tissue type. In another example, the rate of change of impedance can be measures with a pulse sensor ad can be employed as a measure for compressibility. Finally, the rate of change of tissue contact can be measured with a sensor based on knife firing rate to measure tissue flow.
• The rate of change of a sensed parameter or stated otherwise, how much time is necessary for a tissue parameter to reach an asymptotic steady state value, is a separate measurement in itself and may be more valuable than the sensed parameter it was derived from. To enhance measurement of tissue parameters such as waiting a predetermined amount of time before making a measurement, the present disclosure provides a novel technique for employing the derivate of the measure such as the rate of change of the tissue parameter.
• The derivative technique or rate of change measure becomes most useful with the understanding that there is no single measurement that can be employed alone to dramatically improve staple formation. It is the combination of multiple measurements that make the measurements valid. In the case of tissue gap it is helpful to know how much of the jaw is covered with tissue to make the gap measure relevant. Rate of change measures of impedance may be combined with strain measurements in the anvil to relate force and compression applied to the tissue grasped between the jaw members of the end effector such as the anvil and the staple cartridge. The rate of change measure can be employed by the endosurgical device to determine the tissue type and not merely the tissue compression. Although stomach and lung tissue sometimes have similar thicknesses, and even similar compressive properties when the lung tissue is calcified, an instrument may be able to distinguish these tissue types by employing a combination of measurements such as gap, compression, force applied, tissue contact area, and rate of change of compression or rate of change of gap. If any of these measurements were used alone, the endosurgical it may be difficult for the endosurgical device to distinguish one tissue type form another. Rate of change of compression also may be helpful to enable the device to determine if the tissue is “normal” or if some abnormality exists. Measuring not only how much time has passed but the variation of the sensor signals and determining the derivative of the signal would provide another measurement to enable the endosurgical device to measure the signal. Rate of change information also may be employed in determining when a steady state has been achieved to signal the next step in a process. For example, after clamping the tissue between the jaw members of the end effector such as the anvil and the staple cartridge, when tissue compression reaches a steady state (e.g., about 15 seconds), an indicator or trigger to start firing the device can be enabled.
• Also provided herein are methods, devices, and systems for time dependent evaluation of sensor data to determine stability, creep, and viscoelastic characteristics of tissue during surgical instrument operation. Asurgical instrument10, such as the stapler illustrated inFIG. 1, can include a variety of sensors for measuring operational parameters, such as jaw gap size or distance, firing current, tissue compression, the amount of the jaw that is covered by tissue, anvil strain, and trigger force, to name a few. These sensed measurements are important for automatic control of the surgical instrument and for providing feedback to the clinician.
• The examples shown in connection withFIGS. 52-71 may be employed to measure the various derived parameters such as gap distance versus time, tissue compression versus time, and anvil strain versus time. Motor current may be monitored employing thecurrent sensor2312 in series with thebattery2308 as described in connection withFIG. 24, thecurrent sensor2412 in series with thebattery2408 shown inFIG. 25, or thecurrent sensor3026 inFIG. 29.
• Turning now toFIG. 76, a motor-driven surgical cutting andfastening instrument8010 is depicted that may or may not be reused. The motor-driven surgical cutting andfastening instrument8010 is similarly constructed and equipped as the motor-driven surgical cutting andfastening instrument10 described in connection withFIGS. 1-29. In the example illustrated inFIG. 76, theinstrument8010 includes ahousing8012 that comprises ahandle assembly8014 that is configured to be grasped, manipulated and actuated by the clinician. Thehousing8012 is configured for operable attachment to aninterchangeable shaft assembly8200 that has asurgical end effector8300 operably coupled thereto that is configured to perform one or more surgical tasks or procedures. Since the motor-driven surgical cutting andfastening instrument8010 is similarly constructed and equipped as the motor-driven surgical cutting andfastening instrument10 described in connection withFIGS. 1-29, for conciseness and clarity the details of operation and construction will not be repeated here.
• Thehousing8012 depicted inFIG. 76 is shown in connection with aninterchangeable shaft assembly8200 that includes anend effector8300 that comprises a surgical cutting and fastening device that is configured to operably support asurgical staple cartridge8304 therein. Thehousing8012 may be configured for use in connection with interchangeable shaft assemblies that include end effectors that are adapted to support different sizes and types of staple cartridges, have different shaft lengths, sizes, and types, etc. In addition, thehousing8012 also may be effectively employed with a variety of other interchangeable shaft assemblies including those assemblies that are configured to apply other motions and forms of energy such as, for example, radio frequency (RF) energy, ultrasonic energy and/or motion to end effector arrangements adapted for use in connection with various surgical applications and procedures. Furthermore, the end effectors, shaft assemblies, handles, surgical instruments, and/or surgical instrument systems can utilize any suitable fastener, or fasteners, to fasten tissue. For instance, a fastener cartridge comprising a plurality of fasteners removably stored therein can be removably inserted into and/or attached to the end effector of a shaft assembly.
• FIG. 76 illustrates thesurgical instrument8010 with aninterchangeable shaft assembly8200 operably coupled thereto. In the illustrated arrangement, the handle housing forms apistol grip portion8019 that can be gripped and manipulated by the clinician. Thehandle assembly8014 operably supports a plurality of drive systems therein that are configured to generate and apply various control motions to corresponding portions of the interchangeable shaft assembly that is operably attached thereto.Trigger8032 is operably associated with the pistol grip for controlling various of these control motions.
• With continued reference toFIG. 76, theinterchangeable shaft assembly8200 includes asurgical end effector8300 that comprises anelongated channel8302 that is configured to operably support astaple cartridge8304 therein. Theend effector8300 may further include ananvil8306 that is pivotally supported relative to theelongated channel8302.
• The inventors have discovered that derived parameters can be even more useful for controlling a surgical instrument, such as the instrument illustrated inFIG. 76, than the sensed parameter(s) upon which the derived parameter is based. Non-limiting examples of derived parameters include the rate of change of a sensed parameter (e.g., jaw gap distance) and how much time elapses before a tissue parameter reaches an asymptotic steady state value (e.g., 15 seconds). Derived parameters, such as rate of change, are particularly useful because they dramatically improve measurement accuracy and also provide information not otherwise evident directly from sensed parameters. For example, impedance (i.e., tissue compression) rate of change can be combined with strain in the anvil to relate compression and force, which enables the microcontroller to determine the tissue type and not merely the amount of tissue compression. This example is illustrative only, and any derived parameters can be combined with one or more sensed parameters to provide more accurate information about tissue types (e.g., stomach vs. lung), tissue health (calcified vs. normal), and operational status of the surgical device (e.g., clamping complete). Different tissues have unique viscoelastic properties and unique rates of change, making these and other parameters discussed herein useful indicia for monitoring and automatically adjusting a surgical procedure.
• FIGS. 78A-78E show exemplary sensed parameters as well as parameters derived therefrom.FIG. 78A is an illustrative graph showing gap distance over time, where the gap is the space between the jaws being occupied by clamped tissue. The vertical (y) axis is distance and the horizontal (x) axis is time. Specifically, referring toFIGS. 76 and 77, thegap distance8040 is the distance between theanvil8306 and theelongate channel8302 of the end effector. In the open jaw position, at time zero, thegap8040 between theanvil8306 and the elongate member is at its maximum distance. The width of thegap8040 decreases as theanvil8306 closes, such as during tissue clamping. The gap distance rate of change can vary because tissue has non-uniform resiliency. For example, certain tissue types may initially show rapid compression, resulting in a faster rate of change. However, as tissue is continually compressed, the viscoelastic properties of the tissue can cause the rate of change to decrease until the tissue cannot be compressed further, at which point the gap distance will remain substantially constant. The gap decreases over time as the tissue is squeezed between theanvil8306 and thestaple cartridge8304 of theend effector8040. The one or more sensors described in connection withFIGS. 50-68 andFIG. 84 may be adapted and configured to measure the gap distance “d” between theanvil8306 and thestaple cartridge8304 over time “t” as represented graphically inFIG. 78A. The rate of change of the gap distance “d” over time “t” is the Slope of the curve shown inFIG. 78A, where Slope=Δd/Δt.
• FIG. 78B is an illustrative graph showing firing current of the end effector jaws. The vertical (y) axis is current and the horizontal (x) axis is time. As discussed herein, the surgical instrument and/or the microcontroller, as shown inFIGS. 21-29, thereof can include a current sensor that detects the current utilized during various operations, such as clamping, cutting, and/or stapling tissue. For example, when tissue resistance increases, the instrument's electric motor can require more current to clamp, cut, and/or staple the tissue. Similarly, if resistance is lower, the electric motor can require less current to clamp, cut, and/or staple the tissue. As a result, firing current can be used as an approximation of tissue resistance. The sensed current can be used alone or more preferably in conjunction with other measurements to provide feedback about the target tissue. Referring still toFIG. 78B, during some operations, such as stapling, firing current initially is high at time zero but decreases over time. During other device operations, current may increase over time if the motor draws more current to overcome increasing mechanical load. In addition, the rate of change of firing current is can be used as an indicator that the tissue is transitioning from one state to another state. Accordingly, firing current and, in particular, the rate of change of firing current can be used to monitor device operation. The firing current decreases over time as the knife cuts through the tissue. The rate of change of firing current can vary if the tissue being cut provides more or less resistance due to tissue properties or sharpness of the knife8305 (FIG. 77). As the cutting conditions vary, the work being done by the motor varies and hence will vary the firing current over time. A current sensor may be may be employed to measure the firing current over time while theknife8305 is firing as represented graphically inFIG. 78B. For example, the motor current may be monitored employing thecurrent sensor2312 in series with thebattery2308 as described in connection withFIG. 24, thecurrent sensor2412 in series with thebattery2408 shown inFIG. 25, or thecurrent sensor3026 shown inFIG. 29. Thecurrent sensors2312,2314,3026 may be adapted and configured to measure the motor firing current “i” over time “t” as represented graphically inFIG. 78B. The rate of change of the firing current “i” over time “t” is the Slope of the curve shown inFIG. 78B, where Slope=Δi/At.
• FIG. 78C is an illustrative graph of impedance over time. The vertical (y) axis is impedance and the horizontal (x) axis is time. At time zero, impedance is low but increases over time as tissue pressure increases under manipulation (e.g., clamping and stapling). The rate of change varies over time as because as the tissue between theanvil8306 and thestaple cartridge8304 of theend effector8040 is severed by the knife or is sealed using RF energy between electrodes located between theanvil8306 and thestaple cartridge8304 of theend effector8040. For example, as the tissue is cut the electrical impedance increases and reaches infinity when the tissue is completely severed by the knife. Also, if theend effector8040 includes electrodes coupled to an RF energy source, the electrical impedance of the tissue increases as energy is delivered through the tissue between theanvil8306 and thestaple cartridge8304 of theend effector8040. The electrical impedance increase as the energy through the tissue dries out the tissue by vaporizing moistures in the tissue. Eventually, when a suitable amount of energy is delivered to the tissue, the impedance increases to a very high value or infinity when the tissue is severed. In addition, as illustrated inFIG. 78C, different tissues can have unique compression properties, such as rate of compression, that distinguish tissues. The tissue impedance can be measured by driving a sub-therapeutic RF current through the tissue grasped between the first andsecond jaw members9014,9016. One or more electrodes can be positioned on either or both theanvil8306 and thestaple cartridge8304. The tissue compression/impedance of the tissue between theanvil8306 and thestaple cartridge8304 can be measured over time as represented graphically inFIG. 78C. The sensors described in connection withFIGS. 50-68 and 84 may be adapted and configured to measure tissue compression/impedance. The sensors may be adapted and configured to measure tissue impedance “Z” over time “t” as represented graphically inFIG. 78C. The rate of change of the tissue impedance “Z” over time “t” is the Slope of the curve shown inFIG. 78C, where Slope=ΔZ/Δt.
• FIG. 78D is an illustrative graph of anvil8306 (FIGS. 76, 77) strain over time. The vertical (y) axis is strain and the horizontal (x) axis is time. During stapling, for example,anvil8306 strain initially is high but decreases as the tissue reaches a steady state and exerts less pressure on theanvil8306. The rate of change ofanvil8306 strain can be measured by a pressure sensor or strain gauge positioned on either or both theanvil8306 and the staple cartridge8304 (FIGS. 76, 77) to measure the pressure or strain applied to the tissue grasped between theanvil8306 and thestaple cartridge8304. Theanvil8306 strain can be measured over time as represented graphically inFIG. 78D. The rate of change of strain “S” over time “t” is the Slope of the curve shown inFIG. 78D, where Slope=ΔS/Δt.
• FIG. 78E is an illustrative graph of trigger force over time. The vertical (y) axis is trigger force and the horizontal (x) axis is time. In certain examples, trigger force is progressive, to provide the clinician tactile feedback. Thus, at time zero, trigger8020 (FIG. 76) pressure may be at its lowest and trigger pressure may increase until completion of an operation (e.g., clamping, cutting, or stapling). The rate of change trigger force can be measured by a pressure sensor or strain gauge positioned on thetrigger8302 of thehandle8019 of the instrument8010 (FIG. 76) to measure the force required to drive the knife8305 (FIG. 77) through the tissue grasped between theanvil8306 and thestaple cartridge8304. Thetrigger8032 force can be measured over time as represented graphically inFIG. 78E. The rate of change of strain trigger force “F” over time “t” is the Slope of the curve shown inFIG. 78E, where Slope=ΔF/Δt.
• For example, stomach and lung tissue can be differentiated even though these tissues can have similar thicknesses, and can have similar compressive properties if the lung tissue is calcified. Stomach and lung tissues can be distinguished by analyzing jaw gap distance, tissue compression, force applied, tissue contact area, compression rate of change, and jaw gap rate of change. For example,FIG. 79 shows a graph of tissue pressure “P” versus tissue displacement for various tissues. The vertical (y) axis is tissue pressure and the horizontal (x) axis is tissue displacement. When tissue pressure reaches a predetermined threshold, such as 50-100 pounds per square inch (psi), the amount of tissue displacement as well as the rate of tissue displacement before reaching the threshold can be used to differentiate tissues. For instance, blood vessel tissue reaches the predetermined pressure threshold with less tissue displacement and with a faster rate of change than colon, lung, or stomach tissue. In addition, the rate of change (tissue pressure over displacement) for blood vessel tissue is nearly asymptotic at a threshold of 50-100 psi, whereas the rate of change for colon, lung, and stomach is not asymptotic at a threshold of 50-100 psi. As will be appreciated, any pressure threshold can be used such as, for example, between 1 and 1000 psi, more preferably between 10 and 500 psi, and more preferably still between 50 and 100 psi. In addition, multiple thresholds or progressive thresholds can be used to provide further resolution of tissue types that have similar viscoelastic properties.
• Compression rate of change also can enable the microcontroller to determine if the tissue is “normal” or if some abnormality exists, such as calcification. For example, referring toFIG. 80, compression of calcified lung tissue follows a different curve than compression of normal lung tissue. Tissue displacement and rate of change of tissue displacement therefore can be used to diagnose and/or differentiate calcified lung tissue from normal lung tissue.
• In addition, certain sensed measurements may benefit from additional sensory input. For example, in the case of jaw gap, knowing how much of the jaw is covered with tissue can make the gap measurement more useful and accurate. If a small portion of the jaw is covered in tissue, tissue compression may appear to be less than if the entire jaw is covered in tissue. Thus, the amount of jaw coverage can be taken into account by the microcontroller when analyzing tissue compression and other sensed parameters.
• In certain circumstances, elapsed time also can be an important parameter. Measuring how much time has passed, together with sensed parameters, and derivative parameters (e.g., rate of change) provides further useful information. For example, if jaw gap rate of change remains constant after a set period of time (e.g., 5 seconds), then the parameter may have reached its asymptotic value.
• Rate of change information also is useful in determining when a steady state has been achieved, thus signaling a next step in a process. For example, during clamping, when tissue compression reaches a steady state—e.g., no significant rate of change occurs after a set period of time—the microcontroller can send a signal to the display alerting the clinician to start the next step in the operation, such as staple firing. Alternatively, the microcontroller can be programmed to automatically start the next stage of operation (e.g., staple firing) once a steady state is reached.
• Similarly, impedance rate of change can be combined with strain in the anvil to relate force and compression. The rate of change would allow the device to determine the tissue type rather than merely measure the compression value. For example, stomach and lung sometimes have similar thicknesses, and even similar compressive properties if the lung is calcified.
• The combination of one or more sensed parameters with derived parameters provides more reliable and accurate assessment of tissue types and tissue health, and allows for better device monitoring, control, and clinician feedback.
• Turning briefly toFIG. 84, theend effector9012 is one aspect of the end effector8300 (FIG. 76) that may be adapted to operate with surgical instrument8010 (FIG. 76) to measure the various derived parameters such as gap distance versus time, tissue compression versus time, and anvil strain versus time. Accordingly, theend effector9012 shown inFIG. 84 may include one or more sensors configured to measure one or more parameters or characteristics associated with theend effector9012 and/or a tissue section captured by theend effector9012. In the example illustrated inFIG. 84, theend effector9012 comprises afirst sensor9020 and asecond sensor9026. In various examples, thefirst sensor9020 and/or thesecond sensor9026 may comprise, for example, a magnetic sensor such as, for example, a magnetic field sensor, a strain gauge, a pressure sensor, a force sensor, an inductive sensor such as, for example, 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 theend effector9012.
• In certain instances, thefirst sensor9020 and/or thesecond sensor9026 may comprise, for example, a magnetic field sensor embedded in thefirst jaw member9014 and configured to detect a magnetic field generated by amagnet9024 embedded in thesecond jaw member9016 and/or thestaple cartridge9018. The strength of the detected magnetic field may correspond to, for example, the thickness and/or fullness of a bite of tissue located between thejaw members9014,9016. In certain instances, thefirst sensor9020 and/or thesecond sensor9026 may comprise a strain gauge, such as, for example, a micro-strain gauge, configured to measure the magnitude of the strain in theanvil9014 during a clamped condition. The strain gauge provides an electrical signal whose amplitude varies with the magnitude of the strain.
• In some aspects, one or more sensors of theend effector9012 such as, for example, thefirst sensor9020 and/or thesecond sensor9026 may comprise a pressure sensor configured to detect a pressure generated by the presence of compressed tissue between thejaw members9014,9016. In some examples, one or more sensors of theend effector9012 such as, for example, thefirst sensor9020 and/or thesecond sensor9026 are configured to detect the impedance of a tissue section located between thejaw members9014,9016. The detected impedance may be indicative of the thickness and/or fullness of tissue located between thejaw members9014,9016.
• In one aspect, one or more of the sensors of theend effector9012 such as, for example, thefirst sensor9012 is configured to measure thegap9022 between theanvil9014 and thesecond jaw member9016. In certain instances, thegap9022 can be representative of the thickness and/or compressibility of a tissue section clamped between thejaw members9014,9016. In at least one example, thegap9022 can be equal, or substantially equal, to the thickness of the tissue section clamped between thejaw members9014,9016. In one example, one or more of the sensors of theend effector9012 such as, for example, thefirst sensor9020 is configured to measure one or more forces exerted on theanvil9014 by thesecond jaw member9016 and/or tissue clamped between theanvil9014 and thesecond jaw member9016. The forces exerted on theanvil9014 can be representative of the tissue compression experienced by the tissue section captured between thejaw members9014,9016. In one embodiment, thegap9022 between theanvil9014 and thesecond jaw member9016 can be measured by positioning a magnetic field sensor on theanvil9014 and positioning a magnet on thesecond jaw member9016 such that thegap9022 is proportional to the signal detected by the magnetic field sensor and the signal is proportional to the distance between the magnet and the magnetic field sensor. It will be appreciated that the location of the magnetic field sensor and the magnet may be swapped such that the magnetic field sensor is positioned on thesecond jaw member9016 and the magnet is placed on theanvil9014.
• One or more of the sensors such as, for example, thefirst sensor9020 and/or thesecond sensor9026 may be measured in real-time during a clamping operation. Real-time measurement allows time based information to be analyzed, for example, by a processor, and used to select one or more algorithms and/or look-up tables for the purpose of assessing, in real-time, a manual input of an operator of thesurgical instrument9010. Furthermore, real-time feedback can be provided to the operator to assist the operator in calibrating the manual input to yield a desired output.
• In various aspects, the present disclosure provides an instrument10 (as described in connection withFIGS. 1-29) configured to provide rate and control feedback to the surgeon. In one example, the instrument10 (FIGS. 1-4) comprises an energy device to provide rate/impedance feedback. In another example, theinstrument10 provides time dependency such as time between steps and/or rate of firing. In another example, theinstrument10 is configured with a display that the surgeon can monitor for error resolution. In one implementation, the display may be a flexible roll up display is contained within handle (no external display) in the event of failure user unrolls display to determine steps to release.
• The present disclosure provides a novel feedback system for surgical instruments to enable the surgeon to balance the motor controlled speed of knife actuation with the thickness and stiffness of the tissue grasped between the jaw members of the end effector such as the anvil and the staple cartridge. The present technique for adjusting the knife actuation speed based on the thickness of the tissue and tissue flow can improve the consistency of staple formation to form a stapled seal.
• Accordingly, the present disclosure provides the surgeon a feedback mechanism on the shaft or the handle of the endosurgical device. The feedback comprises a combination of the speed of the advancement of the knife, the tissue compression (impedance), the tissue gap (d), and force to advance (motor current draw). This combination can be displayed on an indicator comprising multiple zones, such as 5-9 zones, for example, with the mid zone indicating the most ideal speed for the force and tissue compression being handled. The more compression the slower the speed to keep the indicator balanced in the center. This would provide a surgeon a repeatable relative measure to judge thickness and tissue flow and the surgeon could then decide how far out of balance the endosurgical device can be operated within certain conditions in order to achieve overall good results. The present feedback mechanism also would provide the surgeon a good evaluation when the tissue and/or firing conditions are out of the ordinary to enable the surgeon to proceed cautiously with the operation during that particular firing. The feedback mechanism also can enable the surgeon to learn the best technique for firing the endosurgical device with limited to no in servicing.
• Turning to the figures,FIG. 81 illustrates asurgical instrument9010. Thesurgical instrument9010 is similar in many respects to other surgical instruments described in the present disclosure. For example, thesurgical instrument9010 is similarly constructed and equipped as the motor-driven surgical cutting andfastening instrument10 described in connection withFIGS. 1-29. Therefore, for conciseness and clarity the details of operation and construction will not be repeated here. Accordingly, thesurgical instrument9010, like other surgical instruments described in the present disclosure, comprises anend effector9012. In the example illustrated inFIGS. 81-82, theend effector9012 comprises a first jaw member, or anvil,9014 pivotally coupled to asecond jaw member9016 to capture tissue between thefirst jaw member9014 and thesecond jaw member9016. Thesecond jaw member9016 is configured to receive astaple cartridge9018 therein. Thestaple cartridge9018 comprises a plurality ofstaples9042. The plurality of staples9402 is deployable from thestaple cartridge9018 during a surgical operation.
• In alternative aspects, theend effector9012 can be configured to seal tissue captured between thefirst jaw member9014 and thesecond jaw member9016. For example, thefirst jaw member9014 and thesecond jaw member9016 may each include an electrically conductive member. The electrically conductive members may cooperate to transmit energy through tissue captured therebetween to treat and/or seal the tissue. A power source such as, for example, a battery can be configured to provide the energy.
• In certain instances, as illustrated inFIG. 81, thesurgical instrument9010 can be a motor-driven surgical cutting and fastening instrument that may or may not be reused. In the illustrated example, theinstrument9010 includes ahousing9028 that comprises ahandle9030 that is configured to be grasped, manipulated and actuated by the clinician. In the example illustrated inFIG. 81, thehousing9028 is operably coupled to ashaft assembly9032 that has asurgical end effector9012 configured to perform one or more surgical tasks or procedures.
• Thehousing9028 depicted inFIG. 81 is shown in connection with ashaft assembly9032 that includes anend effector9012 that comprises a surgical cutting and fastening device that is configured to operably support asurgical staple cartridge9018 therein. Thehousing9028 may be configured for use in connection with shaft assemblies that include end effectors that are adapted to support different sizes and types of staple cartridges, have different shaft lengths, sizes, and types, etc. In addition, thehousing9028 also may be effectively employed with a variety of other shaft assemblies including those assemblies that are configured to apply other motions and forms of energy such as, for example, radio frequency (RF) energy, ultrasonic energy and/or motion to end effector arrangements adapted for use in connection with various surgical applications and procedures.
• Referring toFIG. 82, a non-limiting form of theend effector9012 is illustrated. As described above, theend effector9012 may include theanvil9014 and thestaple cartridge9018. In this non-limiting example, theanvil9014 is coupled to anelongate channel9034. In addition,FIG. 82 shows afiring bar9036, configured to longitudinally translate into theend effector9012. A distally projecting end of thefiring bar9036 can be attached to an E-beam9038 that can, among other things, assist in spacing theanvil9014 from astaple cartridge9018 positioned in theelongate channel9034 when theanvil9014 is in a closed position. The E-beam9038 can also include a sharpenedcutting member9040 which can be used to sever tissue as theE-beam9038 is advanced distally by thefiring bar9036. In operation, the E-beam9038 can also actuate, or fire, thestaple cartridge9018. Thestaple cartridge9018 can include a plurality ofstaples9042. Awedge sled9044 is driven distally by theE-beam9038 to force out thestaples9042 into deforming contact with theanvil9012 while a cuttingmember9040 of theE-beam9038 severs clamped tissue.
• In one aspect, as illustrated inFIGS. 81-83, a motor can be operably coupled to thefiring bar9036. The motor can be powered by a power source such as, for example, abattery9039. Thebattery9039 may supply power to themotor9082 to motivate thefiring bar9036 to advance the E-beam9038 to fire thestaples9042 into tissue captured between theanvil9014 and thestaple cartridge9018 and/or advance the cuttingmember9040 to sever the captured tissue. Actuation of themotor9082 can be controlled by afiring trigger9094 that is pivotally supported on thehandle9030. Thefiring trigger9094 can be depressed by an operator of thesurgical instrument9010 to activate themotor9082.
• In one instance, thefiring trigger9094 can be depressed or actuated between a plurality of positions each yielding a different output value. For example, actuating thefiring trigger9094 to a first position may yield a first output value, and actuating thefiring trigger9094 to a second position after the first position may yield a second output value greater than the first output value. In certain instances, the greater thefiring trigger9094 is depressed or actuated, the greater the output value. In certain instances, the output is a characteristic of motion of thefiring bar9036 and/or the cuttingmember9040. In one instance, the output can be the speed of the cuttingmember9040 during advancement of the cuttingmember9040 in a firing stroke. In such instance, actuating thefiring trigger9094 to a first position may cause the cuttingmember9040 to travel at a first speed, and actuating thefiring trigger9094 to a second position may cause the cuttingmember9040 to travel at a second speed different from the first speed. In certain instances, the greater thefiring trigger9094 is depressed or actuated, the greater the speed of travel of the cuttingmember9040.
• In the aspect illustrated inFIG. 83, atracking system9080 is configured to determine the position of thefiring trigger9094. Thetracking system9080 can include a magnetic element, such aspermanent magnet9086, for example, which is mounted to anarm9084 extending from thefiring trigger9094. Thetracking system9080 can comprise one or more sensors, such as a firstmagnetic field sensor9088 and a secondmagnetic field sensor9090, for example, which can be configured to track the position of themagnet9086. Thesensors9088 and9090 can track the movement of themagnet9086 and can be in signal communication with a microcontroller such as, for example, the microcontroller9061 (FIG. 87). With data from thefirst sensor9088 and/or thesecond sensor9090, themicrocontroller9061 can determine the position of themagnet9086 along a predefined path and, based on that position, themicrocontroller9061 can determine an output of themotor9082. In certain instances, amotor driver9092 can be in communication with themicrocontroller9061, and can be configured to drive themotor9082 in accordance with an operator's manual input as detected by thetracking system9080.
• In certain instances, the magnetic field sensors can be configured to detect movement of thefiring trigger9094 through a firing stroke instead of, or in addition to, detecting discrete positions along the firing stroke. The strength of the magnetic field generated by the permanent magnet, as detected by the magnetic field sensors, changes as thepermanent magnet9086 is moved with thefiring trigger9094 through the firing stroke. The change in the strength of the magnetic field can be indicative of a characteristic of motion of thefiring trigger9094, which can detected by a microcontroller as a manual input.
• Theend effector9012 may include one or more sensors configured to measure one or more parameters or characteristics associated with theend effector9012 and/or a tissue section captured by theend effector9012. In the example illustrated inFIG. 84, theend effector9012 comprises afirst sensor9020 and asecond sensor9026. In various examples, thefirst sensor9020 and/or thesecond sensor9026 may comprise, for example, a magnetic sensor such as, for example, a magnetic field sensor, a strain gauge, a pressure sensor, a force sensor, an inductive sensor such as, for example, 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 theend effector9012.
• In certain instances, thefirst sensor9020 and/or thesecond sensor9026 may comprise, for example, a magnetic field sensor embedded in thefirst jaw member9014 and configured to detect a magnetic field generated by amagnet9024 embedded in thesecond jaw member9016 and/or thestaple cartridge9018. The strength of the detected magnetic field may correspond to, for example, the thickness and/or fullness of a bite of tissue located between thejaw members9014,9016. In certain instances, thefirst sensor9020 and/or thesecond sensor9026 may comprise a strain gauge, such as, for example, a micro-strain gauge, configured to measure the magnitude of the strain in theanvil9014 during a clamped condition. The strain gauge provides an electrical signal whose amplitude varies with the magnitude of the strain.
• In some aspects, one or more sensors of theend effector9012 such as, for example, thefirst sensor9020 and/or thesecond sensor9026 may comprise a pressure sensor configured to detect a pressure generated by the presence of compressed tissue between thejaw members9014,9016. In some examples, one or more sensors of theend effector9012 such as, for example, thefirst sensor9020 and/or thesecond sensor9026 are configured to detect the impedance of a tissue section located between thejaw members9014,9016. The detected impedance may be indicative of the thickness and/or fullness of tissue located between thejaw members9014,9016.
• In one aspect, one or more of the sensors of theend effector9012 such as, for example, thefirst sensor9012 is configured to measure thegap9022 between theanvil9014 and thesecond jaw member9016. In certain instances, thegap9022 can be representative of the thickness and/or compressibility of a tissue section clamped between thejaw members9014,9016. In at least one example, thegap9022 can be equal, or substantially equal, to the thickness of the tissue section clamped between thejaw members9014,9016. In one example, one or more of the sensors of theend effector9012 such as, for example, thefirst sensor9020 is configured to measure one or more forces exerted on theanvil9014 by thesecond jaw member9016 and/or tissue clamped between theanvil9014 and thesecond jaw member9016. The forces exerted on theanvil9014 can be representative of the tissue compression experienced by the tissue section captured between thejaw members9014,9016. In one embodiment, thegap9022 between theanvil9014 and thesecond jaw member9016 can be measured by positioning a magnetic field sensor on theanvil9014 and positioning a magnet on thesecond jaw member9016 such that thegap9022 is proportional to the signal detected by the magnetic field sensor and the signal is proportional to the distance between the magnet and the magnetic field sensor. It will be appreciated that the location of the magnetic field sensor and the magnet may be swapped such that the magnetic field sensor is positioned on thesecond jaw member9016 and the magnet is placed on theanvil9014.
• One or more of the sensors such as, for example, thefirst sensor9020 and/or thesecond sensor9026 may be measured in real-time during a clamping operation. Real-time measurement allows time based information to be analyzed, for example, by a processor, and used to select one or more algorithms and/or look-up tables for the purpose of assessing, in real-time, a manual input of an operator of thesurgical instrument9010. Furthermore, real-time feedback can be provided to the operator to assist the operator in calibrating the manual input to yield a desired output.
• FIG. 85 is a logic diagram illustrating one aspect of aprocess9046 for assessing, in real-time, a manual input of an operator of thesurgical instrument9010 and providing real-time feedback to the operator as to the adequacy of the manual input. In the example illustrated inFIG. 85, the process starts at step or block9050 where one or more parameters of theend effector9012 are measured. Next atstep9052, a manual input of an operator of thesurgical instrument9010 is assessed. In one example, a value representative of the manual input is determined. Next atstep9054, the determined value is evaluated or assessed for a position, rank, and/or status with respect to a desired zone or range. The measurement of the parameters of theend effector9012 and the determined value can be employed to select or determine the position, rank, and/or status associated with the determined value. In a followingstep9056 of theprocess9046, the position, rank, and/or status associated with the determined value is reported to the operator of thesurgical instrument9010. The real-time feedback allows the operator to adjust the manual input until a position, rank, and/or status within the desired zone or range is achieved. For example, the operator may change the manual input by increasing or decreasing the manual input while monitoring the real-time feedback until the position, rank, and/or status associated with a determined value that corresponds to a present manual input is within the desired zone or range.
• FIG. 86 is a logic diagram illustrating one aspect of a real-time feedback system9060 for assessing, in real-time, amanual input9064 of an operator of thesurgical instrument9010 and providing to the operator real-time feedback as to the adequacy of themanual input9064. With reference toFIGS. 81-86, in the example illustrated inFIG. 86, the real-time feedback system9060 is comprised of a circuit. The circuit includes amicrocontroller9061 comprising aprocessor9062. A sensor such as, for example, thesensor9020 is employed by theprocessor9062 to measure a parameter of theend effector9012. In addition, theprocessor9062 can be configured to determine or receive a value representative of amanual input9064 of an operator of thesurgical instrument9010. Themanual input9064 can be continuously assessed by theprocessor9062 for as long as themanual input9064 is being provided by the operator. Theprocessor9062 can be configured to monitor a value representative of themanual input9064. Furthermore, theprocessor9062 is configured to assign, select, or determine a position, rank, and/or status for the determined value with respect to a desired zone or range. The measurement of the parameter of theend effector9012 and the determined value can be employed by theprocessor9062 to select or determine the position, rank, and/or status associated with the determined value, as described in greater detail below. A change in themanual input9064 yields a change in the determined value which, in turn, yields a change in the position, rank, and/or status assigned to the determined value with respect to the desired zone or range.
• As illustrated inFIG. 86, the real-time feedback system9060 may further include afeedback indicator9066 which can be adjusted between a plurality of positions, ranks, and/or statuses inside and outside a desired zone or range. In one example, theprocessor9062 may select a first position (P1), rank, and/or status that characterizes themanual input9064 based on a measurement (M1) of a parameter of theend effector9012 and a first determined value (V1) representing a first manual input (I1). In certain instances, the first position (P1), rank, and/or status may fall outside the desired zone or range. In such instances, the operator may change themanual input9064 from the first manual input (I1) to a second manual input (I2) by increasing or decreasing themanual input9064, for example. In response, theprocessor9062 may adjust thefeedback indicator9066 from the first position (P1), rank, and/or status to a second position (P2), rank, and/or status, which characterizes the change to themanual input9064. Theprocessor9062 may select the second position (P2), rank, and/or status based on the measurement (M1) of the parameter of theend effector9012 and a second determined value (V2) representing a second manual input (I2). In certain instances, the second position (P2), rank, and/or status may fall inside the desired zone or range. In such instances, the operator may maintain the second manual input (I2) for a remainder of a treatment cycle or procedure, for example.
• In the aspect illustrated inFIG. 86, themicrocontroller9061 includes a storage medium such as, for example, amemory unit9068. Thememory unit9068 may be configured to store correlations between measurements of one or more parameters of theend effector9012, values representing manual inputs, and corresponding positions, ranks, and/or statuses characterizing themanual input9064 with respect to a desired zone or range. In one example, thememory unit9068 may store the correlation between the measurement (M1), the first determined value (V1), and the first manual input (I1), and the correlation between the measurement (M1), the second determined value (V2), and the second manual input (I2). In one example, thememory unit9068 may store an algorism, an equation, or a look-up table for determining correlations between measurements of one or more parameters of theend effector9012, values representing manual inputs, and corresponding positions, ranks, or statuses with respect to a desired zone or range. Theprocessor9062 may employ such algorism, equation, and/or look-up table to characterize amanual input9064 provided by an operator of thesurgical instrument9010 and provide feedback to the operator as to the adequacy of themanual input9064.
• FIG. 87 is a logic diagram illustrating one aspect of a real-time feedback system9070. Thesystem9070 is similar in many respects to thesystem9060. For example, like thesystem9060, thesystem9070 is configured for assessing, in real-time, a manual input of an operator of thesurgical instrument9010 and providing to the operator real-time feedback as to the adequacy of the manual input. Furthermore, like thesystem9060, thesystem9070 is comprised of a circuit that may include themicrocontroller9061.
• In the aspect illustrated inFIG. 87, astrain gauge9072, such as, for example, a micro-strain gauge, is configured to measure one or more parameters of theend effector9012, such as, for example, the amplitude of the strain exerted on theanvil9014 during a clamping operation, which can be indicative of the tissue compression. The measured strain is converted to a digital signal and provided to theprocessor9062. Aload sensor9074 can measure the force to advance the cuttingmember9040 to cut tissue captured between theanvil9014 and thestaple cartridge9018. Alternatively, a current sensor (not shown) can be employed to measure the current drawn by themotor9082. The force required to advance thefiring bar9036 can correspond to the current drawn by themotor9082, for example. The measured force is converted to a digital signal and provided to theprocessor9062. Amagnetic field sensor9076 can be employed to measure the thickness of the captured tissue, as described above. The measurement of themagnetic field sensor9076 is also converted to a digital signal and provided to theprocessor9062.
• In the aspect illustrated inFIG. 87, thesystem9070 further includes thetracking system9080 which can be configured to determine the position of the firing trigger9094 (FIG. 83). As described above, thefiring trigger9094 can be depressed or actuated by moving thefiring trigger9094 between a plurality of positions, each corresponding to one of a plurality of values of a characteristic of motion of thefiring bar9036 and/or the cuttingmember9040 during a firing stroke. As describe above, a characteristic of motion can be a speed of advancement of thefiring bar9036 and/or the cuttingmember9040 during the firing stroke. In certain instances, amotor driver9092 can be in communication with themicrocontroller9061, and can be configured to drive themotor9082 in accordance with an operator's manual input as detected by thetracking system9080.
• Further to the above, thesystem9070 may include afeedback indicator9066. In one aspect, thefeedback indicator9066 can be disposed in thehandle9030. Alternatively, the feedback indicator can be disposed in theshaft assembly9032, for example. In any event, themicrocontroller9061 may employ thefeedback indicator9066 to provide feedback to an operator of thesurgical instrument9010 with regard to the adequacy of a manual input such as, for example, a selected position of thefiring trigger9094. To do so, themicrocontroller9061 may assess the selected position of thefiring trigger9094 and/or the corresponding value of the speed of thefiring bar9036 and/or the cuttingmember9040. The measurements of the tissue compression, the tissue thickness, and/or the force required to advance thefiring bar9036, as respectively measured by thesensors9072,9074, and9076, can be used by themicrocontroller9061 to characterize the selected position of thefiring trigger9094 and/or the corresponding value of the speed of thefiring bar9036 and/or the cuttingmember9040. In one instance, thememory9068 may store an algorism, an equation, and/or a look-up table which can be employed by themicrocontroller9061 in the assessment. In one example, the measurements of thesensors9072,9074, and/or9076 can be used to select or determine a position, rank, and/or a status that characterizes the selected position of thefiring trigger9094 and/or the corresponding value of the speed of thefiring bar9036 and/or the cuttingmember9040. The determined position, rank, and/or status can be communicated to the operator via thefeedback indicator9066.
• The reader will appreciate that an optimal speed of thefiring bar9036 and/or the cuttingmember9040 during a firing stroke can depend on several parameters of theend effector9012 such as, for example, the thickness of the tissue captured by theend effector9012, the tissue compression, and/or the force required to advance thefiring bar9036 and, in turn, the cuttingmember9040. As such, measurements of these parameters can be leveraged by themicrocontroller9061 in assessing whether a current speed of advancement of the cuttingmember9040 through the captured tissue is within an optimal zone or range.
• In one aspect, as illustrated inFIGS. 88-90, thefeedback indicator9066 includes adial9096 and apointer9098 movable between a plurality positions relative to thedial9096. Thedial9096 is divided to define an optimal zone, a so-called “TOO FAST” zone, and a so-called “TOO SLOW” zone. Thepointer9098 can be set to one of a plurality of positions within the three zones. In one example, as illustrated inFIG. 88, the pointer is set to a position in the “TOO SLOW” zone to alert the operator that a selected speed of advancement of the cuttingmember9040 through the tissue captured by theend effector9012 is below an optimal or a desired zone. As described above, such a characterization of the selected speed can be performed by themicrocontroller9061 based on one or more measurements of one or more parameters of theend effector9012. In another example, perhaps after the operator increases the speed of the cuttingmember9040 in response to the previous alert, the pointer is moved to a new position in the “TOO FAST” zone, as illustrated inFIG. 89, to alert the operator that a newly selected speed of the cuttingmember9040 exceeds the optimal zone. The operator may continue to adjust the speed of the cuttingmember9040 by adjusting the position of thefiring trigger9094 until the pointer lands in the optimal zone, as illustrated inFIG. 90. At such point, the operator may maintain the current position of thefiring trigger9094 for the remainder of the firing stroke.
• In certain instances, thedial9096 and thepointer9098 can be replaced with a digital indicator. In one example, the digital indicator includes a screen that illustrates the above-identified three zones. A digital pointer can be transitioned between a plurality of positions on the screen to provide feedback to the operator in accordance with the present disclosure. In certain instances, as illustrated inFIGS. 91-93, thefeedback indicator9066 includes a plurality of zones with a middle zone indicating an optimal or ideal speed of the cuttingmember9040. In the example illustrated inFIG. 91, nine zones are illustrated. However, in alternative examples, thefeedback indicator9066 may include five or seven zones, for example. As illustrated inFIG. 91, the plurality of zones can be color coded. For example, the middle zone can be in green. The first two zones to the right and the first two zones to the left of the middle zone can be in yellow. The remaining zones can be in red. In certain instances, as illustrated inFIG. 91, the nine zones can be numbered with the numbers −4, −3, −2, 0, +1, +2, +3, and +4, respectively from left to right. In at least one example, the plurality of zones can be numbered and color coded.
• In any event, as illustrated inFIGS. 92-95, apointer9100 is movable between a plurality of positions to point to one of the nine zones. An operator of thesurgical instrument9010 may squeeze thefiring trigger9094 while monitoring the position of thepointer9100. Depending on the position taken by thepointer9100, the operator may reduce or increase the pressure on thetrigger9094 until thepointer9100 rests in the middle or optimal zone. At such point, the operator may maintain the current pressure on thefiring trigger9094 for the remainder of the firing stroke. In certain instances, as illustrated inFIG. 96, thefeedback indicator9066 may alert the operator that the firing stroke is completed.
• In certain instances, as described above, thejaw members9014,9016 include electrically conductive layers configured to deliver energy to tissue captured between thejaw members9014,9016. An energy trigger or actuator can be moved or depressed between a plurality of positions or settings, in a similar manner to thefiring trigger9094, to deliver the energy to the tissue. The level or intensity of the energy delivered to the tissue may depend on the selected position. For example, depressing the energy trigger to a first position may yield a first energy level, and depressing the energy trigger to a second position, different from the first position, may yield a second energy level different from the first energy level. A tracking system, like thetracking system9080, can track the position of the energy trigger and report such manual input to themicrocontroller9061. Alternatively, the resulting energy level can be monitored and reported to themicrocontroller9061. A current sensor or a voltage sensor, for example, can be employed to monitor the resulting energy level.
• In any event, themicrocontroller9061 may be configured to characterize the selected position of the energy trigger and/or the resulting energy level in view of one or more measured parameters of theend effector9012 and/or one or more characteristics of the captured tissue such as tissue thickness, tissue compression, and/or tissue impedance. One or more sensors can be employed to obtain measurements of one or parameters of the end effector and/or one or more characteristics of the captured tissue, which can be reported in real-time to themicrocontroller9061. In response, themicrocontroller9061 may characterize the selected position of the energy trigger and/or the resulting energy level by selecting or determining a position, rank, and/or status of the selected position of the energy trigger and/or the resulting energy level with respect to a desired zone or range. As described above, thememory unit9068 can include an algorism, equation, and/or look-up table for determining the position, rank, and/or status of the selected position of the energy trigger and/or the resulting energy level. Furthermore, the position, rank, and/or status can be reported to the operator of the energy trigger in real-time via a feedback indicator, similar to thefeedback indicator9066, for example.
• One of the advantages of the feedback methods and systems of the present disclosure is that they reduce the number of variables that an operator need to consider while providing a manual input such as, for example, actuating thefiring trigger9094. As such, the operator is relieved from having to manually consider each of the measured parameters of theend effector9012 to estimate the adequacy of a manual input and/or an output value resulting from the manual input such as the speed of the cuttingmember9040. Instead, a current manual input and/or an output value of the manual input can be automatically characterized by themicrocontroller9061 in view of all the measured parameters of theend effector9012 to provide the operator with one consolidated real-time feedback through thefeedback indicator9066. The operator may then focus on such feedback and adjust the manual input to achieve an optimal result.
• Further to the above, the feedback methods and systems of the present disclosure would give the operator a repeatable relative measure to judge the adequacy of a manual input. In addition, the operator could decide for themselves how far beyond an optimal zone, with respect to such relative measure, they are willing to reach comfortably to achieve a good outcome. Furthermore, the feedback methods and systems of the present disclosure would also give the operator a warning if the firing was out of the ordinary so that additional caution may be exercised. Furthermore, by focusing on the one consolidated real-time feedback, an operator can learn quicker the best way to fire a surgical instrument.
• The present disclosure also provides novel techniques for modular reload to identify itself and define a program of operation of a motor controller to actuate the module.
• One technique includes defining a table of programs and configuring a module to communicate to the handle which software programs (or other machine executable instructions) to select and execute. By way of contrast, other techniques are contemplated that do not include no operating programs in the handle portion of the endosurgical device and instead store the program in the module itself and uploads the program at the time of attachment for the handle to execute. In another technique, no programs would be executed in the handle. The handle would contain the motor controller, the actuation buttons, and even the power controller, but not the operating programs. The module would contain all the upper level logic and a sub-processor to execute the program such that each module includes a main processor and the program specific to that reload. When the shaft is attached to the handle, the processor becomes energized and it identifies the handle to which it is attached. Once identified the handle is slaved to the modular reload with the module giving and processing all commands. When a button is depressed, for example, the module responds and determines the next action and then communicates to the slaved motor controller how far and how fast to move and when to stop. With the inclusion of the master processor in the module there also should be a relatively high bandwidth communication bus between the module and the handle to enable the necessary communication traffic. This can be accomplished by holding the rotary shaft component of the modular attachment within a station frame attachment component such that the stationary part houses the processor and control program. Therefore, the communication bus does not have to also serve as a slip ring contact set.
• As described herein, a surgical system can include modular components, which can be attached and/or combined together to form a surgical instrument. Such modular components can be configured to communicate and interact to affect surgical functions. Referring again to the surgical instrument10 (FIGS. 1-4), thesurgical instrument10 includes a first modular component14 (FIG. 1), e.g., ahandle assembly14, and a second modular component200 (FIG. 1), e.g., an attachment assembly that includes an elongate shaft260 (FIG. 1) and an end effector300 (FIG. 1), which are described herein. Thehandle assembly14 and theattachment assembly200 can be assembled together to form the modularsurgical instrument10 or at least a portion thereof. Optionally, a different modular component may be coupled to thehandle assembly14, such as an attachment having different dimensions and/or features than those of the attachment assembly200 (FIG. 1), for example. For example, alternative attachments can be interchangeable with theattachment assembly200. In various instances, thesurgical instrument10 can include additional modular components, such as a modular battery90 (FIG. 4), for example.
• The modular surgical instrument10 (FIGS. 1-4) can include a control system that is designed and configured to control various elements and/or functions of thesurgical instrument10. For example, the handle assembly14 (FIG. 1) and the attachment assembly200 (FIG. 1) can each comprise a circuit board100 (FIG. 4),610 (FIG. 7), respectively, having at least one control system. The control systems of themodular components14,200 can communicate and/or cooperate. In certain instances, a table of control modules can be accessible to the controller in thehandle assembly14 of thesurgical system10. The controller in theattachment assembly200 can instruct thehandle assembly14 to select and implement at least one of the control module(s) from the table. In such instances, the controller in thehandle assembly14 can access and run the control module(s). In other instances, the controller in theattachment assembly200 can include at least one control module. The appropriate control module(s) can be uploaded to the controller in thehandle assembly14, which can run the control module(s). In such instances, the controller in thehandle assembly14 can also access and run the control module(s). Additionally or alternatively, various control module(s) in thehandle assembly14 and/or theattachment assembly200 can be updated. For example, the controller in thehandle assembly14 can be configured to download updated and/or modified control module(s) from the controller in theattachment assembly200. U.S. patent application Ser. No. 14/226,133, entitled MODULAR SURGICAL INSTRUMENT SYSTEM, filed Mar. 26, 2014, now U.S. Patent Application Publication No. 2015/0272557, which describes various surgical systems and control systems thereof, is hereby incorporated by reference herein in its entirety.
• In still other instances, a processor of the surgical instrument10 (FIGS. 1-4) can comprise a master processor, and another processor of thesurgical instrument10 can comprise a slave processor. An operating system and/or a plurality of control modules can be accessible to the master processor. The operating system and/or the control modules can affect at least one surgical function with and/or by an element or subsystem of thesurgical instrument10, for example. A control module can comprise software, firmware, a program, a module, and/or a routine, for example, and/or can include multiple software, firmware, programs, control modules, and/or routines, for example. The control modules can affect a surgical function based on a pre-programmed routine, operator input, and/or system feedback, for example. In various instances, the master processor can be configured to direct information and/or commands to the slave processor. Moreover, the slave processor can be configured to receive information and/or commands from the master processor. The slave processor can act in response to the commands from the master processor. In various instances, the slave processor may not include a control module(s) and/or operating system, and the actions of the slave processor can be attributed to command(s) from the master processor and the control module(s) accessible to the master processor. As described herein, the control system in the attachment assembly200 (FIG. 1) of thesurgical instrument system10 can include a master processor, and the control system in the handle assembly14 (FIG. 1) of thesurgical instrument system10 can include at least one slave processor, for example.
• Referring again to the surgical instrument10 (FIGS. 1-4), thehandle assembly14 can be compatible with different attachments, which can be configured to affect different surgical functions. The various attachments can be interchangeable, and the different surgical functions can correspond to different tissue types and/or different surgical procedures, for example. Because different attachments can be configured to affect different surgical functions, control modules specific to the particular attachments can be stored on the respective attachments. For example, the attachment assembly200 (FIG. 1) can store the specific control module(s) for operating theattachment assembly200. Additionally, theattachment assembly200 can include the upper level logic and sub-processor to run the control module(s). In such instances, the processor in theattachment assembly200 can comprise a master control system and/or master processor that is configured to command a slave processor in thehandle assembly14 to implement the control module(s) stored on theattachment assembly200.
• Because each attachment includes the specific control module(s) for its operation and because the processor in the attachment comprises the master processor, the modularsurgical instrument10 is configured to run the most appropriate and up-to-date control module(s) for the particular attachment. Additionally, as updated and/or revised attachments and/or control module(s) therefor and designed and implemented, the updated and/or revised attachments are designed to properly work with handle assemblies that have less recent updates and/or revisions. In other words, updated and/or revised attachments can be retrofit to operate properly with existing and/or out-of-date handle assemblies.
• As described herein, the handle assembly14 (FIG. 1) includes afiring drive system80 that includes a motor82 (FIG. 4). Thehandle assembly14 also includes a battery90 (FIG. 90), a handle circuit board100 (FIG. 4), and an electrical connector1400 (FIG. 4). A motor controller, such as the motor controller2043 (FIGS. 21A and 21B), for example, which is described herein, can be configured to control the operation of themotor82. For example, themotor controller2043 can initiate rotation of themotor82 and/or can control the direction and/or speed of motor rotation.
• As described herein, the attachment assembly200 (FIG. 1) can include ashaft circuit board610 and an electrical connector1410 (FIG. 7). The electrical connector1410 (FIG. 3) on theattachment assembly200 can be configured to engage the electrical connector1400 (FIG. 4) on the handle assembly14 (FIG. 1) to provide a conduit and/or conductive pathway for transferring power and/or information between thehandle assembly14 and theattachment assembly200. Theelectrical connectors1400,1410 can be mounted to stationary components of the surgical instrument10 (FIGS. 1-4). Referring toFIG. 3, for example, theelectrical connection1410 in theattachment assembly200 is mounted to theshaft chassis244, which remains stationary relative to theintermediate firing shaft222. Because theelectrical connections1400,1410 are stationary relative to each other, theconnections1400,1410 can provide a high bandwidth communication bus to enable traffic between theconnections1400,1410.
• In various instances, when the attachment assembly200 (FIG. 1) is attached to the handle assembly14 (FIG. 1), the electrical connectors1400 (FIG. 3),1410 (FIG. 3) can be engaged and the battery90 (FIG. 4) in thehandle assembly14 can power thehandle assembly14 and theattachment assembly200. For example, thebattery90 can provide power to the shaft circuit board610 (FIG. 7) when theattachment assembly200 is coupled to thehandle assembly14. In various instances, thebattery90 can automatically power theshaft circuit board610 and/or components thereof when theattachment assembly200 is connected to thehandle assembly14.
• Referring now toFIG. 97, a schematic depicting the various control systems for a modular surgical instrument system, such as the surgical instrument10 (FIGS. 1-4), for example, is depicted. Afirst control system10000 can be positioned in a modular attachment, such as the attachment assembly200 (FIG. 1), and asecond control system10014 can be positioned in a modular handle, such as the handle assembly14 (FIG. 1). Theattachment control system10000 includes amaster processor10012, which is configured to issue commands to a slave processor. For example, thehandle control system10014 includes aslave processor10018, which can be slaved to themaster processor10012 in themodular attachment200. In various instances, theslave processor10018 can correspond to a motor controller, such as the motor controller2043 (FIGS. 21A and 21B), for example. In such instances, themotor controller2043 in thehandle assembly14 of thesurgical instrument10 can be slaved to themaster processor10012 in themodular attachment200. For example, themaster processor10012 can issue commands to themotor controller2043, which can affect actuation of the motor82 (FIG. 4), for example, and can control the direction and/or speed of motor rotation.
• Referring still toFIG. 97, thecontrol system10000 in themodular attachment200 can also include at least onesensor10010, which can be in communication with themaster processor10012 in the modular attachment200 (FIG. 1). Various exemplary sensors for detecting conditions within theshaft260, within the end effector300 (FIGS. 1 and 2), and/or at the surgical site are described herein. In certain instances, themaster processor10012 can select a control module and/or program to run based on feedback from thesensors10010. For example, the thickness, density, and/or temperature of tissue detected by one of thesensors10010 can be communicated to themaster processor10012 and the operating module(s) and/or program selected by themaster processor10012 can account for the detected condition(s) within theend effector300.
• Thehandle control system10014 depicted inFIG. 97 also includes adisplay processor10016, which can be similar to thedisplay segment2002dof segmented circuit2000 (FIGS. 21A and 21B), for example. In certain instances, thedisplay processor10016 can be configured to control the information provided to and presented by a display. In various examples, the display can be integrally formed on the handle assembly14 (FIG. 1) of the surgical instrument system10 (FIG. 1). In still other instances, the display can be separate and/or remote from thehandle assembly14 and the attachment assembly200 (FIG. 1). In at least one instance, thedisplay processor10016 is a slave to themaster processor10012 in theattachment assembly200. For example, themaster processor10012 can send commands to thedisplay processor10016 and thedisplay processor10016 can implement the commands.
• Referring still toFIG. 97, thecontrol system10014 in the handle assembly14 (FIG. 1) can include asafety coprocessor10020, which can be similar to the safety processor2004 (FIGS. 21A and 21B), for example. In various instances, thesafety coprocessor10020 can be in signal communication with themaster processor10012 in the modular attachment200 (FIG. 1). Themaster processor10012 can issue commands to thesafety coprocessor10020, which can be specific to the modular attachment and/or the surgical functions performed by the particular modular attachment. For example, themaster processor10012 can initiate the safety operations of thesafety coprocessor10020. In various instances, after the safety operations of thesafety coprocessor10020 have been initiated, thesafety coprocessor10020 can run independently and can notify themaster processor10012 if a triggering event occurs.
• Thecontrol system10014 in the handle assembly14 (FIG. 1) can be coupled to abattery10022, which can be similar to the battery90 (FIG. 4) positioned in thehandle assembly14 and the battery2008 (FIGS. 21A and 21B) in thepower segment2002h(FIGS. 21A and 21B) of the segmentedcircuit2000, which are described herein. Thebattery10022 can power thecontrol system10014 in thehandle assembly14. Moreover, when theattachment assembly200 is connected to thehandle assembly14, thebattery10022 can power themaster control system10000 in the attachment assembly200 (FIG. 1). For example, thebattery10022 can power themaster processor10012 in theattachment assembly200. In various instances, when theattachment assembly200 is attached to thehandle assembly14, thebattery10022 can automatically power themaster processor10012. For example, current can flow to themaster processor10012 via the electrical connector1400 (FIGS. 3 and 4) in thehandle assembly14 and the electrical connector1410 (FIG. 7) in theattachment assembly200.
• In various instances, themaster processor10012 can include a plurality of control modules, which are specific to the surgical functions and/or components of the attachment assembly200 (FIG. 1). The control modules can be accessible to and/or integral with themaster processor10012. In various circumstances, themaster processor10012 can include multiple tiers and/or levels of command and the control modules can be organized into multiple tiers. For example, themaster processor10012 can include a first tier of control modules, a second tier of control modules, and/or a third tier of control modules. Control modules of the first tier can be configured to issue commands to the control modules of the second tier, for example, and the control modules of the second tier can be configured to issue commands to the control modules of the third tier. In various instances, themaster processor10012 can include less than three tiers and/or more than three tiers, for example.
• The control module(s) in the first tier can comprise high-level software, or a clinical algorithm. Such a clinical algorithm can control the high-level functions of the surgical instrument10 (FIGS. 1-4), for example. In certain instances, the control module(s) in the second tier can comprise intermediate software, or framework module(s), which can control the intermediate-level functions of thesurgical instrument10, for example. In certain instances, the clinical algorithm of the first tier can issue abstract commands to the framework module(s) of the second tier to control thesurgical instrument10. Furthermore, the control modules in the third tier can comprise firmware modules, for example, which can be specific to a particular hardware component, or components, of thesurgical instrument10. For example, the firmware modules can correspond to a particular cutting element, firing bar, trigger, sensor, and/or motor of thesurgical instrument10, and/or can correspond to a particular subsystem of thesurgical instrument10, for example. In various instances, a framework module can issue commands to a firmware module to implement a surgical function with the corresponding hardware component. Accordingly, the various control modules of thesurgical system10 can communicate and/or cooperate during a surgical procedure.
• Themaster processor10012 can include and/or access the control modules of various tiers, which can affect different surgical functions. In certain instances, themotor controller10018 may not include any control modules, and control modules may not be accessible to themotor controller10018. For example, themotor controller10018 may not include an operating system, framework module, and/or firmware module. In such instances, themotor controller10018 can be slaved to themaster processor10012, and themotor controller10018 can be configured to implement the commands issued by themaster processor10012.
• As described herein, themaster control system1000 in theattachment assembly200 can communicate with thecontrol system10014 in the handle assembly14 (FIG. 1) to affect a surgical function. In use, referring primarily now toFIG. 98, modular components of a surgical instrument, such as thehandle assembly14 and the attachment assembly200 (FIG. 1), can be attached11000. Thereafter, at least one function can be initiated by a master processor, such as the master processor10012 (FIG. 97), for example, which can include the control module(s) and/or operating program(s) specific to the attachment assembly200 (FIG. 1) and the surgical function(s) to be performed by theattachment assembly200.
• With reference primarily to bothFIGS. 97 and 98, a battery, such as thebattery10022 can power11010 themaster processor10012. As described herein, when the attachment assembly200 (FIG. 1) is properly coupled to the handle assembly14 (FIG. 1), thebattery10022 in thehandle assembly14 can power themaster processor10012. Thepowered master processor10012 can identify11016 at least one slave processor, such as theslave processors10016 and10018, for example. After themaster processor10012 identifies11016 at least one of the slave processor(s)10016,10018, themaster processor10012 can issue commands to the slave processor(s)10016,10018. The commands can be based on a pre-programmed routine found in a control module accessible to themaster processor10012.
• In various instances, themaster processor10012 can request information from other systems and/or controllers in the surgical instrument10 (FIGS. 1-4). For example, themaster processor10012 can request information from a slaved processor. In certain instances, themaster processor10012 can request information from an input system, such as an actuation button and/or trigger on the handle assembly14 (FIG. 1). Additionally or alternatively, themaster processor10012 can request information from a sensor and/or feedback system. For example, themaster processor10012 can communicate with at least onesensor10010 to obtain information on at least one condition in thesurgical instrument10 and/or surgical site. Themaster processor10012 can receive11012 information and/or inputs.
• Themaster processor10012 can issue at least one command to at least oneslave processor10016,10018 atstep11018. In certain instances, the command(s) can be based on the control module(s) accessible to themaster processor10012 and/or the feedback and/or input received atstep11012. For example, themaster processor10012 can command the slavedmotor controller10018 to operate the motor82 (FIG. 4) in thehandle assembly14 at a particular power level, in a particular direction, and/or for a particular duration. The control sequence of themotor82 can be determined and provided by a control module in the attachment assembly200 (FIG. 1). As a result, the control sequence can correspond to theparticular attachment assembly200 and the surgical function to be performed by thatattachment assembly200.
• Atstep11014, the slavedprocessors10016 and/or10018 can implement the command(s) from themaster processor10012. In various instances, themaster processor10012 can request information from various slaved systems during and/or throughout implementation of the control sequence. In certain instances, based on the updated information, themaster processor10012 can issue a new and/revised command and/or commands. Additionally or alternatively, themaster processor10012 can issue additional commands to the slaved processor(s) throughout the operation of the surgical instrument10 (FIGS. 1-4).
• The present disclosure provides additional techniques to overcome challenges with conventional modular endosurgical devices. Two of these techniques, in the context of modular endocutters, include wire contacts to transmit power and receive signals from an end effector shaft configured to rotate, and the ability to upgrade the modular attachment with new tech and sensors while allowing the handle to readily accept the new tech.
• The ability for the sensors in the end-effector to have the signal processing capability built into the sensor itself helps improve both of these issues. In one aspect, the sensor can be configured to supply the handle with processed information rather than supplying the handle with raw data to minimize the impact of newer sensors and the number of wires necessary to run them. In one aspect, a series of smart sensors can be placed in parallel along a single power line with the shaft of the device as the return path and using current draw “signal” the handle to stop, or start, or end etc. In accordance with this technique, the handle does not need to know what the sensor actually is or how to interpret the processed information being fed back to the controller. Likewise, the current draw can be monitored using a standard Morse Code like encoding technique on the power line to enable the handle to know what the issue is and which sensor identified the issue without any pairing or other couple communication requirement.
• Medical devices may be modular devices that include several separate components. For example, an endocutter such asendocutter12010 as shown inFIG. 99 may include several large and small separate components. Theendocutter12010 is similarly constructed and equipped as the motor-driven surgical cutting andfastening instrument10 described in connection withFIGS. 1-29. Accordingly, for conciseness and clarity the details of operation and construction will not be repeated here.Endocutter12010 may include ahandle component12012, ashaft component12014, and an end-effector component12016. Each of the handle, the shaft, and the end-effector may include smaller but separate components such as sensors, transducers, motors, switches, controllers, processors etc., which may be programmable and interoperable with one another. In this way,endocutter12010 may be a modular medical device.
• In general, modular devices may have several challenges to overcome. For example,modular endocutter12010 may require multiple wire contacts configured to transmit power and receive signals. A power source, such as a battery90 (FIG. 4), may transfer power to one or more sensors, transducers, motors, switches, controllers, processors, or other modular components of the endocutter through various wires and wire contacts. One or more of these modular components may receive signals from one another in order to perform various calculations, processes, or actions to operate the endocutter. For example, a sensor in end-effector12016 may be powered from a battery inhandle12012 through a wire inshaft12014 and may send back signals or data to a microprocessor or microcontroller inhandle12012 through a different wire inshaft12014. Theshaft12014 may be only a half inch in diameter and may have the ability to rotate, which may lead to challenges when swapping or upgrading modular components such as sensors.
• In some systems, a sensor in the end-effector may send data to the handle. The data may require signal processing or other processing by one or more components in the handle in order to be used to operate the endocutter. Adding a new sensor or upgrading an existing sensor may require new wires to enable communication with the one or more components (e.g., a microprocessor) in the handle. Having to add new wires or wire contacts may negatively impact the ability to use new sensors or upgrade existing sensors and may be undesirable. The ability to upgrade the modular components (e.g., sensors) in, for example, the end-effector12016, with new technology such as more advanced sensors, while allowing components in the handle12012 (e.g., a microcontroller12024) to readily accept output from the new sensors without adding new wires or new wire contacts may be desirable.
• In one aspect of the present disclosure, one or more sensors in the end-effector (e.g., end-effector12016) may have local or built-in signal processing capability. These sensors may be referred to as smart sensors. Rather than supplying the handle or one or more components therein with data that may require further processing, smart sensors with local signal processing may supply the handle with already processed data or information that can be used to operate the endocutter while minimizing or eliminating further processing.
• For example, the end-effector12016 may include asensor12020 andsignal processing component12022. Thesignal processing component12022 may correspond to the sensor12020 (i.e., may be configured to process data from sensor12020). In one example, thesignal processing component12022 may be specially designed or configured to process signals or data received from thesensor12020. Further, thesignal processing component12022 may generate processed information based on the signals or data received fromsensor12020. In this way, thesignal processing component12022 may process data received from thesensor12020 of a surgical instrument (i.e., the endocutter12010) locally to the sensor and into information usable by the surgical instrument.
• The handle12012 (or a component therein) may be configured to receive the processed information from thesignal processing component12022. For example, thesignal processing component12022 may transmit the processed information to handle12012 via shaft12014 (through, e.g., one or more wires). In this way, the processed information may be transmitted from thesignal processing component12022 to a controller12024 (e.g., a microcontroller) of the surgical instrument (e.g., the endocutter12010). Further, the surgical instrument (e.g., the endocutter12010) may be controlled based on the processed information from thesignal processing component12022. For example, the end-effector12016 may be stopped or started or a process of theendocutter12010 may be ended based on the processed information. In one example, thecontroller12024 may stop or start the end-effector based on the processed information.
• Thesignal processing component12022 and thesensor12020 may be part of asingle module12018. Thesingle module12018 may be positioned in the end-effector12016 and may be a modular component easily swapped into or out of the end-effector12016. Thesensor12020 may be, for example, a magnetic field sensor, a magnetic sensor, an inductive sensor, a capacitive sensor, or another type of sensor used in medical devices or endocutters. Thesignal processing component12022 may be the microcontroller2006 (FIGS. 21A, 21B) or microcontroller3017 (FIGS. 28A, 28B).
• In one aspect, the signal processing component may be asensor circuit12036 as shown inFIG. 100. Thesensor circuit12036 may be any suitable circuit configured to read signals from a sensor component such as aninductive coil12032. Thesensor circuit12036 may be in communication with or be communicatively coupled to a sensor component in the end-effector12030. For example, thesensor circuit12036 may be communicatively coupled to aninductive coil12032 via a wire orcable12038. Theinductive coil12032 may produce amagnetic field12034 and may be located at a distal end of ananvil12040 of the end-effector12030. Thesensor circuit12036 may receive data or signals from the sensor component (e.g., inductive coil12032) and may process the data or signals to generate processed information which may be used to operate the end-effector12030.
• While thesensor circuit12036 is shown outside of the end-effector12030 and theanvil12040 inFIG. 100 for ease of disclosure, thesensor circuit12036 may be local to the sensor component (e.g., inductive coil12032) or may be part of a single module including the sensor component and the sensor circuit, such assingle module12018 ofFIG. 99. For example, as shown inFIG. 101, asensor circuit12052 also may be positioned at a distal end of ananvil12056 of an end-effector12050. Thesensor circuit12052 may be local to, and in communication with, a sensing component such asmagnet12054.
• Referring back toFIG. 99, thehandle12012 may include acontroller12024 which may be configured to control or otherwise operate theendocutter12010. In one example, thecontroller12012 may be a microcontroller and may be configured to receive the processed information from thesignal processing component12022 or thesingle module12018. For example theshaft12014 may be configured to communicatively couple thesignal processing component12022 of the end-effector12016 and thehandle12012. Themicrocontroller12024 in thehandle12012 may be in wired communication with thesignal processing component12022 viashaft12014. In one example, thesignal processing component12022 may be in wireless communication with themicrocontroller12024 or with another component inhandle12012. While thecontroller12024 may be configured to receive the processed information from thesignal processing component12022 or thesingle module12018, this is not intended to be a limitation of the present disclosure as various other components (e.g., a microprocessor, display, interface, switch, etc.) inhandle12012 may be configured to receive the processed information from thesignal processing component12022 or thesingle module12018.
• In one aspect, a plurality of smart sensors may be positioned on a power line of an end-effector and may be communicatively coupled to a handle of an endocutter. The smart sensors may be positioned in series or parallel with respect to the power line. Referring now toFIG. 14,smart sensors12060 and12062 may be in communication with a signal processing component or amicroprocessor12064 which may be local to the smart sensors. Both thesmart sensors12060 and12062 and themicroprocessor12064 may be located at the end-effector (represented by dashed-box12066). For example,smart sensor12060 may output signals or data to anoperational amplifier12068 and anADC converter12070, which may condition the signals or data for input intomicroprocessor12064. Similarly,smart sensor12062 may output signals or data to anoperational amplifier12072 and anADC converter12074, which may condition the signals or data for input intomicroprocessor12064.
• Smart sensors12060 and/or12062 may be different types of sensors or the same type of sensor, which may be, for example, magnetic field sensors, magnetic sensors, inductive sensors, capacitive sensors, or other types of sensors used in medical devices or endocutters.Component12064, previously referred to as a microprocessor, also may be a computational core, FPGA (field programmable gate array), logic unit (e.g., logic processor or logic controller), signal processing unit, or other type of processor. Themicroprocessor12064 may be in communication with a memory, such asnon-volatile memory12076, which may store calculation data, equipment information such as a type of cartridge inserted in the end-effector12066, tabular data, or other reference data that may enable themicroprocessor12064 to process signals or data received from one or more of thesmart sensors12060 or12062 for use in operating the end-effector12066 or an endocutter.
• Further, ashaft12078 may include a return path through which at least one of the plurality of smart sensors (e.g.,smart sensors12060 or12062) and thehandle12080 are communicatively coupled. The shaft may include one or more wires which may transfer information from themicroprocessor12064 to thehandle12080 for operation of the end-effector12066 or endocutter. In one example, the information from themicroprocessor12064 may be communicated to the handle12080 (by way ofshaft12078 or directly without use of shaft12078) over one or more of: a wired-line, a single-wired line, a multi-wired line, a wireless communication protocol such as Bluetooth, an optical line, or an acoustic line.
• In one aspect, at least one of a plurality of smart sensors positioned at an end-effector may include a signal processing component. For example, the signal processing component may be built into the smart sensor or may be locally coupled to the smart sensor as shown insingle module12018 ofFIG. 99. The signal processing component may be configured to process data received from a sensor component (e.g., sensor component12020) of at least one of the plurality of smart sensors. A controller12024 (e.g., a microcontroller) at the handle may be communicatively coupled to at least one of the plurality of smart sensors.
• In one aspect, a smart sensor may be configured for local signal processing in a medical device. The smart sensor may include at least one sensor component (e.g., sensor component12020) and at least one processing component (e.g., processing component12022). The processing component may be configured to receive data from the at least one sensor component and to process the data into information for use by the medical device. The medical device may be, for example, an endocutter, however this is not intended to be a limitation of the present disclosure. It should be understood that the techniques and features discussed herein for smart sensors with local signal processing may be used in any medical device where processing of sensor signals or data is used for operation of the medical device.
• Further, a controller (e.g.,controller12024, microcontroller) in the medical device may be configured to receive the information (i.e., processed signals or data) from the at least one processing component (e.g., processing component12022). As discussed above, the medical device may be a surgical instrument such as an endocutter and the smart sensor may be configured for local signal processing in the surgical instrument. Local signal processing may refer to, for example, processing signals or data from a sensor component at a processing component coupled to the sensor, where the resulting processed information may be used by a separate component. For example, thecontroller12024 may be positioned in thehandle12012 of the surgical instrument (i.e., the endocutter12010) and the smart sensor may be configured to be positioned in a separate component (i.e., the end-effector12016) of the surgical instrument (i.e., the endocutter12010), separate from thehandle12012. Thus, thecontroller12024 may be positioned at thehandle12012 of the surgical instrument and thesignal processing component12022 and thesensor12020 may be located in a component separate from the handle12012 (e.g., end-effector12016).
• In this way, the handle orcontroller12024 need not have information about the smart sensor, knowledge of what the smart sensor is doing, or capability to interpret data feed back from the smart sensor. This is because theprocessing component12022 may transform or condition the data from the smart sensor and generate information from the data directly usable by the handle orcontroller12024. The information generated by the processing component may be used directly, without the data from the smart sensor needing to be processed in another part of the medical device (e.g., near thehandle12012 or controller12024). Thus, the surgical instrument may be controlled based on the (processed) information from the signal processing component local to the sensor.
• In one aspect, a current draw on a power line communicatively coupled to the signal processing component12022 (i.e., local to the sensor12020) may be monitored. The current draw may be monitored by a microprocessor or other monitoring device at theshaft12014 or thehandle12012, or at another microprocessor or other monitoring device separate from thesignal processing component12022. For example, the monitoring may be a standard Morse Code type monitoring of the current draw on the power line. An issue with the surgical instrument based on the current draw and a particular sensor may be determined by the separate microprocessor at, e.g., thehandle12012. In this way, the monitoring may allow the handle (or a processor or controller therein) to be informed of various issues related to signals or data received by one or more sensor and which particular sensor identified the issue, without a further communication requirement (e.g., pairing, or other coupled communication).
• Turning now toFIG. 103, which is a logic diagram illustrating one aspect of aprocess13040 for calibrating afirst sensor13008ain response to an input from asecond sensor13008b. Thefirst sensor13008ais configured to capture13022aa signal indicative of one or more parameters of theend effector13000. Thefirst signal13022amay be conditioned based on one or more predetermined parameters, such as, for example, a smoothing function, a look-up table, and/or any other suitable conditioning parameters. A second signal is captured13022bby thesecond sensor13008b. Thesecond signal13022bmay be conditioned based on one or more predetermined conditioning parameters. Thefirst signal13022aand thesecond signal13022bare provided to a processor, such as, for example, the primary processor2006 (FIGS. 21A-21B). Theprimary processor2006 calibrates13042 thefirst signal13022ain response to thesecond signal13022b. Thefirst signal13022ais calibrated13042 to reflect the fullness of the bite of tissue in theend effector13000. The calibrated signal is displayed13026 to an operator by, for example, a display12026 embedded in the surgical instrument10 (FIGS. 1-6).
• FIG. 104 is a logic diagram illustrating one aspect of aprocess13170 for adjusting a measurement of afirst sensor13158 in response to a plurality ofsecondary sensors13160a,13160. In one example, a Hall effect voltage is obtained13172, for example, by a magnetic field sensor. The Hall effect voltage is converted13174 by an analog to digital convertor. The converted Hall effect voltage signal is calibrated13176. The calibrated curve represents the thickness of a tissue section located between the anvil13152 and the staple cartridge13156. A plurality of secondary measurements is obtained13178a,13178bby a plurality of secondary sensors, such as, for example, a plurality of strain gauges. The input of the strain gauges is converted13180a,13180binto one or more digital signals, for example, by a plurality of electronic μStrain conversion circuits. The calibrated Hall effect voltage and the plurality of secondary measurements are provided to a processor, such as, for example, the primary processor2006 (FIGS. 21A-21B). The primary processor utilizes the secondary measurements to adjust13182 the Hall effect voltage, for example, by applying an algorithm and/or utilizing one or more look-up tables. The adjusted Hall effect voltage represents the true thickness and fullness of the bite of tissue clamped by the anvil13152 and the staple cartridge13156. The adjusted thickness is displayed13026 to an operator by, for example, a display12026 embedded in the surgical instrument10 (FIGS. 1-6).
• FIG. 105 illustrates one aspect of acircuit13190 configured to convert signals from thefirst sensor13158 and the plurality ofsecondary sensors13160a,13160binto digital signals receivable by a processor, such as, for example, the primary processor2006 (FIGS. 21A-21B). Thecircuit13190 comprises an analog-to-digital convertor13194. In some examples, the analog-to-digital convertor13194 comprises a 4-channel, 18-bit analog to digital convertor. Those skilled in the art will recognize that the analog-to-digital convertor13194 may comprise any suitable number of channels and/or bits to convert one or more inputs from analog to digital signals. Thecircuit13190 comprises one or morelevel shifting resistors13196 configured to receive an input from thefirst sensor13158, such as, for example, a magnetic field sensor. Thelevel shifting resistors13196 adjust the input from the first sensor, shifting the value to a higher or lower voltage depending on the input. Thelevel shifting resistors13196 provide the level-shifted input from thefirst sensor13158 to the analog-to-digital convertor.
• In some aspects, a plurality ofsecondary sensors13160a,13160bare coupled to a plurality ofbridges13192a,13192bwithin thecircuit13190. The plurality ofbridges13192a,13192bmay provide filtering of the input from the plurality ofsecondary sensors13160a,13160b. After filtering the input signals, the plurality ofbridges13192a,13192bprovide the inputs from the plurality ofsecondary sensors13160a,13160bto the analog-to-digital convertor13194. In some examples, aswitch13198 coupled to one or more level shifting resistors may be coupled to the analog-to-digital convertor13194. Theswitch13198 is configured to calibrate one or more of the input signals, such as, for example, an input from a magnetic field sensor. Theswitch13198 may be engaged to provide one or more level shifting signals to adjust the input of one or more of the sensors, such as, for example, to calibrate the input of a magnetic field sensor. In some examples, the adjustment is not necessary, and theswitch13198 is left in the open position to decouple the level shifting resistors. Theswitch13198 is coupled to the analog-to-digital convertor13194. The analog-to-digital convertor13194 provides an output to one or more processors, such as, for example, the primary processor2006 (FIGS. 21A-21B). Theprimary processor2006 calculates one or more parameters of the end effector13150 based on the input from the analog-to-digital convertor13194. For example, in one example, theprimary processor2006 calculates a thickness of tissue located between the anvil13152 and the staple cartridge13156 based on input from one ormore sensors13158,13160a,13160b.
• FIG. 106 is a logic diagram illustrating one aspect of aprocess13320 for selecting the most reliable output from a plurality of redundant sensors, such as, for example, the plurality ofsensors13308a,13308b. In one example, a first signal is generated by afirst sensor13308a. The first signal is converted13322aby an analog-to-digital convertor. One or more additional signals are generated by one or moreredundant sensors13308b. The one or more additional signals are converted13322bby an analog-to-digital convertor. The converted signals are provided to a processor, such as, for example, the primary processor2006 (FIGS. 21A-21B). Theprimary processor2006 evaluates13324 the redundant inputs to determine the most reliable output. The most reliable output may be selected based on one or more parameters, such as, for example, algorithms, look-up tables, input from additional sensors, and/or instrument conditions. After selecting the most reliable output, the processor may adjust the output based on one or more additional sensors to reflect, for example, the true thickness and bite of a tissue section located between the anvil13302 and the staple cartridge13306. The adjusted most reliable output is displayed13026 to an operator by, for example, a display2026 embedded in the surgical instrument10 (FIGS. 1-6).
• FIG. 107 illustrates one aspect of anend effector13000 comprising amagnet13008 and amagnetic field sensor13010 in communication with aprocessor13012. Theend effector13000 is similar to the end effector300 (FIG. 1) described above in connection with surgical instrument10 (FIGS. 1-6). Theend effector13000 comprises a first jaw member, oranvil13002, pivotally coupled to a second jaw member, orelongated channel13004. Theelongated channel13004 is configured to operably support astaple cartridge13006 therein. Thestaple cartridge13006 is similar to the staple cartridge304 (FIG. 1) described above in connection with surgical instrument10 (FIGS. 1-6). Theanvil13008 comprises amagnet13008. The staple cartridge comprises amagnetic field sensor13010 and aprocessor13012. Themagnetic field sensor13010 is operable to communicate with theprocessor13012 through aconductive coupling13014. Themagnetic field sensor13010 is positioned within thestaple cartridge13006 to operatively couple with themagnet13008 when theanvil13002 is in a closed position. Themagnetic field sensor13010 can be configured to detect changes in the magnetic field surrounding themagnetic field sensor13010 caused by the movement of or location ofmagnet13008.
• FIGS. 108-110 illustrate one aspect of an end effector that comprises a magnet whereFIG. 108 illustrates a perspective cutaway view of theanvil13102 and themagnet13058a, in an optional location.FIG. 109 illustrates a side cutaway view of theanvil13102 and themagnet13058a, in an optional location.FIG. 110 illustrates a top cutaway view of theanvil13102 and themagnet13058a, in an optional location.
• FIG. 111 illustrates one aspect of anend effector13200 that is operable to use conductive surfaces at the distal contact point to create an electrical connection. Theend effector13200 is similar to the end effector300 (FIG. 1) described above in connection with surgical instrument10 (FIGS. 1-6). Theend effector13200 comprises ananvil13202, anelongated channel13204, and astaple cartridge13206. Theanvil13202 further comprises amagnet13208 and aninside surface13210, which further comprises a number of staple-formingindents13212. In some examples, theinside surface13210 of theanvil13202 further comprises a firstconductive surface13214 surrounding the staple-formingindents13212. The firstconductive surface13214 can come into contact with second conductive surfaces13222 on thestaple cartridge13206. The cartridge body comprises a number of staple cavities designed to hold staples (not pictured). In some examples the staple cavities further comprise staple cavity extensions that protrude above the surface of the cartridge body. The staple cavity extensions can be coated with the second conductive surfaces. Because the staple cavity extensions protrude above the surface of the cartridge body, the second conductive surfaces will come into contact with the firstconductive surfaces13214 when theanvil13202 is in a closed position. In this manner theanvil13202 can form an electrical contact with thestaple cartridge13206.
• FIG. 112 illustrates one aspect of astaple cartridge13606 that comprises aflex cable13630 connected to amagnetic field sensor13610 andprocessor13612. Thestaple cartridge13606 is similar to thestaple cartridge13606 is similar to the staple cartridge306 (FIG. 1) described above in connection with surgical instrument10 (FIGS. 1-6).FIG. 112 is an exploded view of thestaple cartridge13606. The staple cartridge comprises13606 acartridge body13620, awedge sled13618, acartridge tray13622, and aflex cable13630. Theflex cable13630 further compriseselectrical contacts13632 at the proximal end of thestaple cartridge13606, placed to make an electrical connection when thestaple cartridge13606 is operatively coupled with an end effector, such asend effector13800 described below. Theelectrical contacts13632 are integrated with cable traces13634, which extend along some of the length of thestaple cartridge13606. The cable traces13634 connect13636 near the distal end of thestaple cartridge13606 and this connection13636 joins with aconductive coupling13614. Amagnetic field sensor13610 and aprocessor13612 are operatively coupled to theconductive coupling13614 such that themagnetic field sensor13610 and theprocessor13612 are able to communicate.
• FIG. 113 illustrates one aspect of anend effector13800 with aflex cable13830 operable to provide power to astaple cartridge13806 that comprises adistal sensor plug13816. Theend effector13800 is similar to the end effector300 (FIG. 1) described above in connection with surgical instrument10 (FIGS. 1-6). Theend effector13800 comprises a first jaw member oranvil13802, a second jaw member orelongated channel13804, and astaple cartridge13806 operatively coupled to theelongated channel13804. Theend effector13800 is operatively coupled to a shaft assembly. The shaft assembly is similar to shaft assembly200 (FIG. 1) described above in connection with surgical instrument10 (FIGS. 1-6). The shaft assembly further comprises a closure tube that encloses the exterior of the shaft assembly. In some examples the shaft assembly further comprises an articulation joint13904, which includes a double pivot closure sleeve assembly. The double pivot closure sleeve assembly includes an end effector closure sleeve assembly that is operable to couple with theend effector13800.
• FIGS. 114 and 115 illustrate theelongated channel13804 portion of theend effector13800 without theanvil13802 or the staple cartridge, to illustrate how theflex cable13830 can be seated within theelongated channel13804. In some examples, theelongated channel13804 further comprises athird aperture13824 for receiving theflex cable13830. Within the body of theelongated channel13804 the flex cable splits13834 to formextensions13836 on either side of theelongated channel13804.FIG. 115 further illustrates thatconnectors13838 can be operatively coupled to theflex cable extensions13836.
• FIG. 116 illustrates theflex cable13830 alone. As illustrated, theflex cable13830 comprises asingle coil13832 operative to wrap around the articulation joint13904 (FIG. 113), and asplit13834 that attaches toextensions13836. The extensions can be coupled toconnectors13838 that have on their distalfacing surfaces prongs13840 for coupling to thestaple cartridge13806, as described below.
• FIG. 117 illustrates a close up view of theelongated channel13804 shown inFIGS. 114 and 115 with astaple cartridge13804 coupled thereto. Thestaple cartridge13804 comprises acartridge body13822 and acartridge tray13820. In some examples thestaple cartridge13806 further compriseselectrical traces13828 that are coupled toproximal contacts13856 at the proximal end of thestaple cartridge13806. Theproximal contacts13856 can be positioned to form a conductive connection with theprongs13840 of theconnectors13838 that are coupled to theflex cable extensions13836. Thus, when thestaple cartridge13806 is operatively coupled with theelongated channel13804, theflex cable13830, through theconnectors13838 and the connector prongs13840, can provide power to thestaple cartridge13806.
• FIGS. 118 and 119 illustrate one aspect of adistal sensor plug13816.FIG. 118 illustrates a cutaway view of thedistal sensor plug13816. As illustrated, thedistal sensor plug13816 comprises amagnetic field sensor13810 and aprocessor13812. Thedistal sensor plug13816 further comprises aflex board13814. As further illustrated inFIG. 119, themagnetic field sensor13810 and theprocessor13812 are operatively coupled to theflex board13814 such that they are capable of communicating.
• FIG. 120 illustrates one aspect of anend effector13950 with aflex cable13980 operable to provide power to sensors and electronics in thedistal tip13952 of theanvil13961 portion. Theend effector13950 comprises a first jaw member oranvil13961, a second jaw member orelongated channel13954, and astaple cartridge13956 operatively coupled to the elongated channel. Theend effector13950 is operatively coupled to ashaft assembly13960. Theshaft assembly13960 further comprises aclosure tube13962 that encloses theshaft assembly13960. In some examples theshaft assembly13960 further comprises an articulation joint13964, which includes a double pivotclosure sleeve assembly13966.
• In various aspects, theend effector13950 further comprises aflex cable13980 that is configured to not interfere with the function of thearticulation joint13964. In some examples, theclosure tube13962 comprises afirst aperture13968 through which theflex cable13980 can extend. In some examples,flex cable13980 further comprises a loop orcoil13982 that wraps around the articulation joint13964 such that theflex cable13980 does not interfere with the operation of the articulation joint13964, as further described below. In some examples, theflex cable13980 extends along the length of theanvil13961 to asecond aperture13970 in the distal tip of theanvil13961.
• FIGS. 121-123 illustrate the operation of the articulation joint13964 andflex cable13980 of theend effector13950.FIG. 121 illustrates a top view of theend effector13952 with theend effector13950 pivoted −45 degrees with respect to theshaft assembly13960. As illustrated, thecoil13982 of theflex cable13980 flexes with the articulation joint13964 such that theflex cable13980 does not interfere with the operation of thearticulation joint13964.FIG. 122 illustrates a top view of theend effector13950. As illustrated, thecoil13982 wraps around the articulation joint13964 once.FIG. 123 illustrates a top view of theend effector13950 with theend effector13950 pivoted +45 degrees with respect to theshaft assembly13960. As illustrated, thecoil13982 of theflex cable13980 flexes with the articulation joint13964 such that theflex cable13980 does not interfere with the operation of thearticulation joint13964.
• FIG. 124 illustrates cross-sectional view of the distal tip of one aspect of ananvil13961 with sensors andelectronics13972. Theanvil13961 comprises aflex cable13980, as described with respect toFIGS. 121-123. As illustrated inFIG. 124, theanvil13961 further comprises asecond aperture13970 through which theflex cable13980 can pass such that theflex cable13980 can enter ahousing13974 in the within theanvil13961. Within thehousing13974 theflex cable13980 can operably couple to sensors andelectronics13972 located within thehousing13974 and thereby provide power to the sensors andelectronics13972.
• FIG. 125 illustrates a cutaway view of the distal tip of theanvil13961.FIG. 125 illustrates one aspect of thehousing13974 that can contain sensors andelectronics13972 as illustrated byFIG. 124.
• A surgical instrument can be powered by a battery. In at least one embodiment, the handle of the surgical instrument comprises a battery cavity and the battery can be inserted into and removed from the battery cavity. In certain embodiments, the surgical instrument can comprise a shaft assembly which includes a battery cavity and a battery removably positioned in the battery cavity. When the battery is seated in the battery cavity, the battery can supply power to the handle. The battery and/or the handle, for example, can comprise a releasable lock which releasably holds the battery in the battery cavity. In various instances, the releasable lock comprises a latch which can be depressed by the user of the surgical instrument to unlock the battery and permit the battery to be removed from the battery cavity. In various instances, the battery can be removed from the handle and replaced with another battery. U.S. Patent Application Publication No. 2012/0071711, entitled SURGICAL INSTRUMENTS AND BATTERIES FOR SURGICAL INSTRUMENTS, which was filed on Sep. 17, 2010, now U.S. Pat. No. 9,289,212, and U.S. Pat. No. 8,632,525, entitled POWER CONTROL ARRANGEMENTS FOR SURGICAL INSTRUMENTS AND BATTERIES, which was filed on Sep. 17, 2010, are incorporated by reference herein in their respective entireties.
• Referring now toFIGS. 126-128, asurgical instrument14000 comprises ahandle14010 including ahousing14011 and abattery cavity14012 defined in thehousing14011. Thesurgical instrument14000 further comprises an end effector configured to deploy staples from a staple cartridge; however, thesurgical instrument14000 can comprise any suitable end effector. Thehandle14010 further comprises a firingmember14050 which is movable proximally and distally to articulate the end effector of thesurgical instrument14000 about an articulation joint. The firingmember14050 is also movable distally to fire staples from the staple cartridge and retractable proximally after the staples have been fired.FIGS. 126-128 depict the firingmember14050 in an unfired position. The firingmember14050 is movable proximally and distally by an electric motor and/or a hand crank, for example, and is translatable within a proximally-extendingchamber14016. Thechamber14016 comprises aproximal end14013 which encloses the firingmember14050 and extends proximally into thebattery cavity14012. Thechamber14016 is sized and configured to provide aclearance gap14055 for the firingmember14050 which, in at least one instance, permits the firingmember14050 to be retracted proximally from its unfired position in order to articulate the end effector. In other instances, as discussed in greater detail further below, thechamber14016 comprises an open proximal end.
• Thesurgical instrument14000 further comprises abattery14020 which is positionable in thebattery cavity14012 to supply power to thehandle14010. Thebattery14020 comprises abattery housing14021 having anouter surface14022. Thebattery cavity14012 and theouter surface14022 of thebattery14020 are configured such that thebattery14020 is closely received in thebattery cavity14012. In at least one instance, thebattery cavity14012 and theouter surface14022 are configured such that thebattery14020 can be inserted into thebattery cavity14012 in only one orientation, or in a limited number of orientations. Thebattery14020 comprises aclearance aperture14026 defined therein configured to receive thechamber14016 when the battery14020 is positioned in thebattery cavity14012. Thehandle14010 further comprises one or more electrical contacts14014 (FIG. 131) which are engaged by corresponding electrical contacts14024 (FIG. 131) defined on thebattery14020 when thebattery14020 is fully seated in thebattery cavity14012. Moreover, aproximal end14025 of thebattery14020 is flush, or at least substantially flush, with thehandle housing14011 when thebattery14020 is fully seated in thebattery cavity14012. When thebattery14020 is not fully seated in thebattery cavity14012, thebattery contacts14024 may not be engaged with thehandle contacts14014 and, in such a position, thebattery14020 cannot supply power to thehandle14010.
• In various embodiments, thebattery14020 is the only power source available to thehandle14010. In other embodiments, more than one power source is available to thehandle14010. In at least one such embodiment, thebattery14020 is the primary power source for thehandle14010. Regardless of the embodiment utilized, thebattery14020 can provide a large portion of, if not all of, the power needed by thehandle14010. In the event that thebattery14020 were to be disconnected from thehandle14010 and/or removed from thebattery cavity14012 during a surgical procedure, thehandle14010 would become unpowered and/or underpowered. In some instances, removing thebattery14020 from thebattery cavity14012 may be preferred or required to replace a depletedbattery14020 with a fully-chargedbattery14020, for instance. In other instances, removing thebattery14020 from thebattery cavity14012 during a critical point of the surgical procedure may not be preferred, such as when thefiring member14050 is being advanced distally to fire the staples from the staple cartridge, for example. In at least one such instance, a sudden loss of power may render acontrol circuit14015 and/ordisplay screen14040 of thehandle14010 inoperable, for example. In light of the above, thehandle14010 includes a battery lock, or means which can prevent thebattery14020 from becoming electrically de-coupled from thehandle14010 and/or removed from thebattery cavity14012 at certain points during the operation of thehandle14010. There are other reasons for locking thebattery14020 in thehandle14010. For instance, thebattery14020 can be locked to thehandle14010 so that thehandle14010 and/orbattery14020 can be disposed of safely.
• Referring again toFIGS. 126-128, thehandle14010 comprises one or moredeployable locks14017. Eachlock14017 is movable between an undeployed, or unlocked, position (FIG. 127) and a deployed, or locked, position (FIGS. 126 and 128). Eachlock14017 comprises a cantilever beam extending from a sidewall of thechamber14016; however, any suitable configuration could be utilized. Eachlock14017 comprises a proximal end mounted to a sidewall of thechamber14016 and a distal end which is movable relative to the proximal end. The proximal end of eachlock14017 can be pivotably attached to a sidewall of thechamber14016. Thelocks14017, and/or the sidewalls of thechamber14016, can be comprised of a resilient material and can be configured to deflect when a biasing force is applied thereto. Eachlock14017 comprises acam surface14018 defined on the distal end thereof.
• Thehandle14010 further includes alock actuator14030 configured to move thelocks14017 between their undeployed position (FIG. 127) to their deployed position (FIG. 128). Thelock actuator14030 comprises a solenoid; however, thelock actuator14030 could comprise any suitable actuator, such as an electric motor, for example. Thelock actuator14030 comprises awire coil14034 mounted in thehandle housing14011 and, in addition, anarmature14032 movable relative to thewire coil14034. Thearmature14032 comprises anelongate aperture14031 defined therein which is sized and configured to permit thefiring member14050 to slide therein. In various instances, a clearance gap can be present between thefiring member14050 and thearmature14032.
• Thearmature14032 is comprised of a ferrous material, for example, and thewire coil14034 is comprised of a conductive wire, such as copper wire, for example. When electrical current flows through thewire coil14034 in a first direction, the field generated by the flowing current pushes thearmature14032 from a first, or distal, position (FIG. 127) to a second, or proximal, position (FIG. 128). Thearmature14032 comprises aproximal end14038 configured to engage thecam surfaces14018 of thelocks14017 when thearmature14032 is moved proximally and deflect thelocks14017 outwardly, as illustrated inFIG. 128. When electrical current flows through thewire coil14034 in a second, or opposite, direction, the field generated by the flowing current pushes thearmature14032 from its second, or proximal, position (FIG. 128) to its first, or distal, position (FIG. 127). When thearmature14032 is moved distally, theproximal end14038 of thearmature14032 is disengaged from thecam surfaces14018 of thelocks14017 and thelocks14017 can then resiliently deflect inwardly back to their undeployed positions. Thelocks14017 can comprise any suitable configuration and, in at least one instance, thelocks14017 are integrally-molded with thechamber14016 and can be attached to thechamber14016 in a living-hinge arrangement, for example. In other instances, thelocks14017 can comprise separate components which are mounted to thechamber14016, for example.
• Further to the above, eachlock14017 comprises alock shoulder14019 which is displaced outwardly when thelocks14017 are displaced outwardly, as described above. When thelocks14017 are moved into their deployed positions, as illustrated inFIG. 128, thelock shoulders14019 of thelocks14017 are moved behindlock shoulders14029 defined in thebattery housing14021. When thelock shoulders14019 are positioned behind thelock shoulders14029 of thebattery14020 by thelock actuator14030, thebattery14020 cannot be disengaged from thehandle14010. As a result, thebattery contacts14024 remain engaged with thehandle contacts14014 and the power supplied to thehandle14010 by thebattery14020 may not be interrupted. In the event that the user of thesurgical instrument14000 pulls on thebattery14020 when thebattery lock14030 has been actuated, thelock shoulders14029 of thebattery14020 can abut thelock shoulders14019 of thelock arms14017. Moreover, thearmature14032 can buttress and support thelock arms14017 in their deployed positions such thatbattery contacts14024 do not break contact with thehandle contacts14014. It is envisioned that some relative movement between thebattery14020 and thehandle14010 may occur even though thebattery lock14030 has been actuated; however, such movement is insufficient to electrically decouple thebattery14020 from thehandle14010.
• Thearmature14032 comprises astop14033 defined on the distal end thereof which is configured to limit the proximal travel of thearmature14032. In at least one embodiment, thestop14033 is configured to contact thewire coil14034, as illustrated inFIG. 128. In various instances, thewire coil14034 can remain energized to hold thearmature14032 in its proximal, or locked, position (FIG. 128). In certain instances, thearmature14032 can be held in place by friction forces between thearmature14032 and the walls of thechamber14026, for example, even though thewire coil14034 is not being energized. Similar to the above, thehandle14010 can include a distal stop configured to limit the distal movement of thearmature14032. As mentioned above, thewire coil14034 of thelock actuator14030 can be energized to actively move thearmature14032 proximally and distally; however, thelock actuator14030 can include a biasing member, such as a spring, for example, which can be configured to bias thearmature14032 in either the proximal direction or the distal direction. For instance, in at least one embodiment, thewire coil14034 is energized to move thearmature14032 proximally and a return spring is configured to move thearmature14032 distally after thewire coil14034 is no longer energized. Alternatively, in at least one embodiment, thewire coil14034 is energized to move thearmature14032 distally and a return spring is configured to move thearmature14032 proximally after thewire coil14034 is no longer energized.
• As discussed above, thelock actuator14030 can be selectively actuated to deploy thelocks14017 and de-actuated to retract thelocks14017. Thelock actuator14030 is in signal communication with thecontrol circuit14015 which can control the actuation of thelock actuator14030. Thecontrol circuit14015 can include a microprocessor which can determine when to activate and de-activate thelock actuator14030. The microprocessor can be configured to evaluate one or more operating parameters of thesurgical instrument14000 to determine whether to activate or de-activate thelock actuator14030. For instance, the microprocessor can be configured to evaluate the voltage and/or current of thebattery14020 to determine whether thebattery14020 is sufficiently charged to operate thehandle14010 and, if thebattery14020 has a sufficient charge, activate thelock actuator14030 to deploy thelocks14017, or, if thebattery14020 does not have a sufficient charge, de-activate thelock actuator14030 to permit thebattery14020 to be removed from thehandle14010.
• Alternatively, thecontrol circuit14015 can utilize thelock actuator14030 to prevent thebattery14020 from being removed from thehandle14010 in the event that thecontrol circuit14015 determines that thehandle14010 has exceeded its useful life. Thecontrol circuit14015 can determine that thehandle14010 has exceeded its useful life if the firing system of thehandle14010 has been operated a certain number of times and/or if thehandle14010 has been sterilized a certain number of times, for example. In certain instances, thelock actuator14030 can prevent thebattery14020 from being moved relative to thehandle14010. In at least one such instance, thecontrol circuit14015 of thehandle14010 can utilize thedisplay screen14040 to indicate to the user that thebattery14020 has been locked in position and that thehandle14010 should be either disposed of or serviced. In certain instances, thebattery14020 can include indicia thereon and thelock actuator14030 can be configured to permit thebattery14020 to be translated a limited distance to expose the indicia when a clinician pulls on thebattery14020. The indicia can be on the side of thebattery housing14021 and can visible above thehandle housing14011 after thebattery14020 has been displaced. The indicia can have a contrasting color to other portions of thebattery housing14021, for example, and/or written instructions to the user of thesurgical instrument14000 such as the word “dispose” and/or “service”, for example. In certain instances, thebattery housing14021 can include detention features which can engage thehandle housing14011 and hold thebattery14020 in its displaced position.
• In certain embodiments, further to the above, a battery housing can comprise a two-part housing—a first portion which includes thebattery cells14023 and theelectrical contacts14024 and a second portion which is separable from the first portion, for example. In ordinary use, the first portion and the second portion of the battery housing are connected together and are unmovable relative to one another. The first portion can include a gripping portion, such as theproximal end14025, for example, which allows the user of thesurgical instrument14000 to grab the battery housing and remove both portions of the battery housing simultaneously. If thecontrol circuit14015 has determined that thehandle14010 has reached its end of life, thecontrol circuit14015 can actuate a lock actuator which engages and holds the second portion of the battery housing. When the user of thesurgical instrument14000 attempts to remove thebattery14020 from thebattery cavity14012 of thehandle14010 after the lock actuator has been actuated, the first portion of the battery housing can separate from the second portion thereby leaving the second portion behind in thebattery cavity14012. As a result of the second portion being locked within and unremovable from thebattery cavity14012, anew battery14020 is not positionable in thebattery cavity14012. In various instances, the first portion and/or the second portion of such a battery housing can include indicia thereon explaining to the user of thesurgical instrument14000 that thehandle14010 is no longer usable. Such indicia may only be visible after the first housing portion has separated from the second housing portion. In certain instances, the first housing portion and the second housing portion can be connected by a ribbon which is exposed, or unfurled, when the first housing portion detaches from the second housing portion. The ribbon can include instructions thereon for handling, disposing, and/or refurbishing thehandle14010. When thehandle14010 is refurbished, the lock actuator can be reset and the second housing portion can be removed from thebattery cavity14012.
• Further to the above, the handle and/or the battery can comprise an exposable portion which can be exposed by the control system when the control system determines that the handle and/or the battery is no longer suitable for use. The exposable portion can be displaced and/or otherwise exposed by an actuator operated by the control system. The exposable portion can include indicia, such as words and/or a contrasting color, for example, which only become visible when the control system has deactivated the handle and/or the battery in at least one way.
• In various embodiments, thehandle14010 can include an override button in communication with the microprocessor which, when actuated, can instruct the microprocessor to deactivate the lock actuator and permit the battery to be removed. Other embodiments may not include such an override button.
• In various instances, a surgical instrument may become unsuitable for use in a surgical procedure. A handle of a surgical instrument can become unsuitable for use when the handle has exceeded its intended number of uses, for example. A handle of a surgical instrument may also become unsuitable for use when it experiences excessive force loading and/or electrical faults, for example. Moreover, a handle of a surgical instrument may become unsuitable for use when another component of the surgical instrument is incorrectly attached to the handle and/or an incorrect component is attached to the handle. When the control system of the handle determines that the handle may be unsuitable for use, the control system may employ a battery lockout which can prevent a battery from being operably coupled to the handle, as described in greater detail further below.
• A handle14110 is depicted inFIGS. 129 and 130. The handle14110 is similar to thehandle14010 in many respects. The handle14110 comprises ahandle housing14111 which includes abattery cavity14012 configured to receive abattery14020, as described above. Thehandle housing14111 further comprises achamber14116 configured to receive the firingmember14050 which, similar to thechamber14016, extends into thebattery cavity14012. The handle14110 further comprises one or moredeployable lockout arms14117. Eachlockout14117 is movable between an undeployed position (FIG. 129) and a deployed position (FIG. 130). Eachlockout14117 comprises a cantilever beam extending from a sidewall of thechamber14116; however, any suitable configuration could be utilized. Eachlockout14117 comprises a distal end mounted to a sidewall of thechamber14116 and a proximal end which is movable relative to the distal end. The distal end of eachlockout14117 can be pivotably attached to a sidewall of thechamber14116. Thelockouts14117, and/or the sidewalls of thechamber14116, can be comprised of a resilient material and can be configured to deflect when a biasing force is applied thereto. Eachlockout14117 comprises acam surface14118 defined on the proximal end thereof.
• The handle14110 further includes alock actuator14030 configured to move thelockouts14117 from their undeployed position (FIG. 129) to their deployed position (FIG. 130). Thelock actuator14030 comprises a solenoid; however, thelock actuator14030 could comprise any suitable actuator, such as a motor, for example. Thelock actuator14030 comprises awire coil14034 mounted in thehandle housing14111 and, in addition, anarmature14032 movable relative to thewire coil14034. Thearmature14032 comprises anelongate aperture14031 defined therein which is sized and configured to permit the firingmember14050 to slide therein. In various instances, a clearance gap can be present between the firingmember14050 and thearmature14032.
• Thearmature14032 is comprised of a ferrous material, for example, and thewire coil14034 is comprised of a conductive wire, such as copper wire, for example. When electrical current flows through thewire coil14034 in a first direction, the field generated by the flowing current pushes thearmature14032 from a first, or distal, position (FIG. 129) to a second, or proximal, position (FIG. 130). Thearmature14032 comprises aproximal end14038 configured to engage the cam surfaces14118 of thelockouts14117 when thearmature14032 is moved proximally and deflect thelockouts14117 outwardly, as illustrated inFIG. 130. When electrical current flows through thewire coil14034 in a second, or opposite, direction, the field generated by the flowing current pushes thearmature14032 from its second, or proximal, position (FIG. 130) to its first, or distal, position (FIG. 129). When thearmature14032 is moved distally, theproximal end14038 of thearmature14032 is disengaged from the cam surfaces14118 of thelockouts14117 and thelockouts14117 can then resiliently deflect inwardly back to their undeployed positions.
• Further to the above, eachlockout14117 comprises alock shoulder14119 which is displaced outwardly when thelockouts14117 are displaced outwardly, as described above. When thelockouts14117 are moved into their deployed positions, as illustrated inFIG. 130, the lock shoulders14119 of thelockouts14117 are moved in front oflock shoulders14028 defined in thebattery housing14021. When the lock shoulders14119 are positioned in front of the lock shoulders14028 of thebattery14020 by thelock actuator14030, thebattery14020 cannot be fully seated in the handle14110. As a result, thebattery contacts14024 cannot engage thehandle contacts14014 and thebattery14020 cannot supply power to the handle14110. In the event that the user of thehandle14100 pushes on thebattery14020 when the battery lockout14130 has been actuated, thearmature14032 can buttress and support thelockouts14117 in their deployed positions.
• Ahandle14210 is depicted inFIG. 131. Thehandle14210 is similar to thehandle14010 and/or the handle14110 in many respects. Thehandle14210 comprises ahandle housing14211 including abattery cavity14012 configured to receive abattery14020. Thehandle housing14211 further comprises achamber14216 configured to receive the firingmember14050 which, similar to thechamber14016 and thechamber14116, extends into thebattery cavity14012. Thechamber14216 of thehandle14210, however, comprises an openproximal end14213. As illustrated inFIG. 131, the openproximal end14213 is sized and configured to permit the firingmember14050 to extend therethrough. When the control system of thehandle14210 has determined that thehandle14210 is not suitable for use, further to the above, the control system can operate the electric motor which advances and retracts the firingmember14050 to position the firingmember14050 in a lockout position, i.e., a position in which the firingmember14050 prevents theelectrical contacts14024 of thebattery14020 from engaging theelectrical contacts14014 of thehandle14210. As illustrated inFIG. 131, the firingmember14050 can be retracted to a position in which theproximal end14025 of thebattery14020, for example, contacts the firingmember14050 before thebattery14020 is sufficiently seated enough in thebattery cavity14012 to supply power to thehandle14210.
• In at least one alternative embodiment, a handle of a surgical instrument system can include a battery cavity and at least one first electrical contact and at least one second electrical contact positioned in the battery cavity which are in communication with the control system of the handle. When the battery is fully seated in the battery cavity, the battery is electrically coupled with the first electrical contact and can fully power the handle. Similar to the above, the handle can include a battery lockout system which can be activated to prevent the battery from being fully seated in the battery cavity. Moreover, the battery lockout system can prevent the battery from being electrically coupled with the first electrical contact when the battery lockout system is activated. In contrast to the battery lockout systems described above, however, the battery lockout system of the current embodiment can permit the battery to be electrically coupled with the second electrical contact even though the battery lockout has been activated. In such instances, the control system of the handle can utilize the power supplied to the second electrical contact by the battery to operate the handle in a limited function mode.
• In a limited function mode, further to the above, the control system may only be able to perform diagnostic functions to assess the condition of the handle and/or communicate the condition of the handle to the user. In at least one limited function mode, the control system may not be able to operate the electric motor to advance the firingmember14050 distally but it may be able to operate the electric motor to retract the firingmember14050 proximally, for example. The control system may also operate the display and/or permit the control buttons which interface with the display to be operated when the handle is being operated in a limited function mode, for example.
• In at least one embodiment, further to the above, the first handle contact can be positioned deeper in the battery cavity than the second handle contact. In at least one such instance, the battery can include a battery contact which can engage the first handle contact or the second handle contact, depending on the depth in which the battery is inserted into the battery cavity. In at least one instance, the battery can comprise a first battery contact configured to engage the first handle contact when the battery is inserted to a first depth and a second battery contact configured to engage the second handle contact when the battery is inserted to a second depth which is different than the first depth.
• In certain embodiments, further to the above, the firingmember14050 can be pushed proximally into thebattery cavity14012 to displace thebattery14020 proximally and electrically decouple thebattery14020 from thehandle14210. In such instances, the firingmember14050 can displace thebattery14020 proximally such that thebattery contacts14024 are no longer engaged with thehandle contacts14014. The control system of the handle can decouple thebattery14020 from the handle when the control system has determined that the handle is no longer suitable for use. In certain other embodiments, further to the above, the firingmember14050 can push a battery from a first position in which the battery is electrically coupled to a first electrical contact to a second position in which the battery is electrically decoupled from the first electrical contact and electrically coupled to a second electrical contact. Similar to the above, the control system of the handle may only use the power supplied to the second electrical contact to perform a limited number of functions. In such instances, the control system can switch itself between a fully-functional operating mode and a limited-function operating mode. In various instances, the handle housing can include a catch feature which can prevent the battery from being electrically decoupled from the second electrical contact and/or pushed entirely out of the battery cavity in the handle housing.
• As discussed herein, the firingmember14050 can enter into a battery cavity to prevent a battery from being fully installed into a handle and/or contact a battery to at least partially displace the battery out of the battery cavity. In various other instances, the firingmember14050 itself may not block a battery cavity and/or push a battery proximally; rather, the proximal movement of the firingmember14050 out of its ordinary range of motion can trip a spring-loaded mechanism which can block a battery cavity and/or push a battery proximally, for example. In at least one instance, the spring-loaded mechanism can include at least one pre-stretched and/or at least one pre-compressed spring member that is released when tripped by the firingmember14050, for example. Such a spring-loaded mechanism can also deploy an indicator, for example, when it is tripped which can indicate to the user that the handle has entered into a different operating mode. In certain embodiments, the control system of a handle may actuate a spring-loaded mechanism directly without using the firingmember14050 to trip the spring-loaded mechanism. While a spring could be utilized to store energy and deliver that energy to a cocked actuator to perform the functions discussed herein, any suitable device capable of storing and releasing energy could be utilized. In various instances, the device can be pre-energized or pre-loaded when the handle is supplied to the user.
• In addition to or in lieu of the above, the control system of a handle can move the firingmember14050, either proximally or distally, to an inoperative position to render the handle unusable if the control system detects a defect in the handle and/or otherwise determines that the handle should not be used. In at least one instance, the firingmember14050 can be moved, either proximally or distally, to a position in which the electric motor becomes mechanically decoupled from the firingmember16050 and the electric motor can no longer move the firingmember14050 proximally or distally, for example. In another instance, the firingmember14050 can be moved, either proximally or distally, to a position in which the firingmember14050 impedes the operability of another system of the handle, such as a closing system used to close an end effector of the surgical instrument. In certain instances, the firingmember14050 can be moved, either proximally or distally, to a position in which a modular shaft assembly cannot be operably coupled to the handle and/or the firingmember14050. In some instances, the firingmember14050 can be moved, either proximally or distally, to a position in which a modular shaft assembly cannot be operably de-coupled from the handle and/or the firingmember14050. In view of the above, the firingmember14050 of a handle can be moved out of a typical operating range of positions to render the handle inoperable in at least one capacity.
• Further to the above, the firingmember14050 is movable within a firing operating range to fire staples from a staple cartridge and/or an articulation operating range to articulate the end effector of the surgical instrument. In certain embodiments, the firingmember14050 is movable within a clamping operating range to close an end effector and/or clamp tissue within the end effector. The firing operating range, the articulation operating range, and/or the clamping operating range can comprise the typical operating range of positions discussed above. As also discussed above, the firingmember14050 can be moved out of this typical operating range to change the operating state of the handle in some manner. In at least one embodiment, the firingmember14050 can be moved proximally out of its typical operating range to cycle or index a use counter after every time that the handle has been used. The use counter can be cycled mechanically and/or electronically. The use counter can be in communication with the processor of the handle which can utilize data from the use counter to determine whether the handle is still suitable for use. The control system of the handle, including the handle microprocessor, the use counter, and/or one or more sensors configured to monitor the electric motor which drives the firingmember14050, for example, can be part of a diagnostic system which determines whether the handle is suitable for use.
• The exemplary embodiments illustrated inFIGS. 126-131 depict two lock arms or two lockout arms, as the case may be; however, one lock arm, or lockout arm, could be used. Moreover, more than two lock arms, or lockout arms, could be used. The lock arms, or lockout arms, of the exemplary embodiments are deployed simultaneously; however, other embodiments are envisioned in which they are deployed sequentially. Furthermore, the embodiment ofFIGS. 126-128, which comprises a battery lock system, could be combined with the embodiment ofFIGS. 129 and 130 and/or the embodiment ofFIG. 131, which comprise battery lockout systems. In various embodiments, a single system can perform the battery lock and battery lockout functions described herein.
• As discussed above, a surgical instrument can include a handle, a shaft assembly, and an end effector. The handle can include an electric motor having a rotatable output shaft which is operably coupled to a drive shaft in the shaft assembly. The output shaft can rotate the drive shaft or, alternatively, the rotary motion of the output shaft can be converted to translational motion before being transmitted to the drive shaft. In either event, a property of the output shaft can be measured while it is driving the drive shaft. Various embodiments can include one or more sensors, for example, positioned relative to the output shaft which can measure the motion of the drive shaft, for example. Such sensors are positioned off-board with respect to the shaft. Such embodiments can be useful; however, the off-board positioning of the sensors can limit the properties of the drive shaft which can be detected and/or the manner in which the properties of the drive shaft are detected. Various embodiments are discussed below which comprise one or more sensors which are positioned on the output shaft which can detect a property of the drive shaft. Such sensors are positioned on-board with respect to the shaft. Also discussed below are embodiments which can include a control circuit mounted to the shaft and/or means for transmitting power to the control circuit.
• Referring now toFIGS. 132 and 133, asurgical instrument system15000 comprises anelectric motor15010 including arotatable shaft15020. Theelectric motor15010 can comprise any suitable electric motor, such as a direct current (DC) electric motor, for example. Theelectric motor15010 is mounted in a handle of a surgical instrument; however, theelectric motor15010 can be mounted in any suitable portion of a surgical instrument, such as the shaft assembly extending from the handle, for example. In certain other embodiments, theelectric motor15010 can be part of a robotically-controlled assembly. In any event, themotor shaft15020 is rotatably supported by any suitable number of bearings such that theshaft15020 is rotatable by theelectric motor15010 about a longitudinal axis15021.
• Referring primarily toFIG. 132, thesurgical instrument system15000 further comprises adrive system15030 operably coupled with themotor shaft15020. Thedrive system15030 is positioned in the handle of the surgical instrument; however, thedrive system15030 may be positioned in any suitable portion of the surgical instrument, such as the shaft assembly extending from the handle, for example. In certain other embodiments, thedrive system15030 can be part of a robotically-controlled assembly. In any event, thedrive system15030 comprises atransmission15031 and anoutput shaft15032. Thetransmission15031 is configured to transmit rotary motion between themotor shaft15020 to theoutput shaft15032. Thetransmission15031 comprises a plurality of intermeshed gears, for example. In various instances, the gears of thetransmission15031 are configured such that the rotational velocity of theoutput shaft15032 is different than the rotational velocity of themotor shaft15020. In at least one such instance, the rotational velocity of theoutput shaft15032 is less than the rotational velocity of themotor shaft15020. In various alternative embodiments, the gears of thetransmission15031 are configured such that the rotational velocity of theoutput shaft15032 is the same as the rotational velocity of themotor shaft15020.
• Referring again toFIGS. 132 and 133, thesurgical instrument system15000 further comprises asensor15050 mounted to theoutput shaft15020. Thesensor15050 comprises a strain gauge; however, any suitable sensor could be utilized. For instance, thesensor15050 could comprise an accelerometer, for example. Thestrain gauge15050 is mounted to theoutside surface15023 of theoutput shaft15020. Thestrain gauge15050 comprises a substrate, or backing,15052 comprised of an insulative material which is flexible and conformable to theoutside surface15023 of theshaft15020. Thebacking15052 is attachable to theoutside surface15023 of theshaft15020 by any suitable adhesive, such as cyanoacrylate, for example. Thestrain gauge15050 further comprises ametallic wire15053 mounted to thesubstrate15052. When theshaft15020 experiences a load and is elastically and/or plastically deformed by the load, themetallic wire15053 is also deformed by the load and, as a result, the electrical resistance of themetallic wire15053 changes. This change in resistance, usually measured using a Wheatstone bridge, is related to the strain, or deformation, being experienced by theshaft15020 by a ratio known as a gauge factor.
• When an electrical conductor, such as themetallic wire15053, for example, is stretched within the limits of its elasticity such that it does not break or permanently deform, the electrical conductor will become narrower and longer which increases its electrical resistance from end-to-end. Conversely, when the electrical conductor is compressed such that it does not buckle, it will broaden and shorten which decreases its electrical resistance from end-to-end. The electrical conductor of a resistive strain gauge often comprises a long, thin conductive strip arranged in a continuous zig-zag pattern of parallel lines. These parallel lines of the conductive strip are usually spaced close together such that a large length of the conductive strip is positioned over a small area. Owing to the large length of the conductive strip, a small amount of stress in the direction of the orientation of the parallel lines results in a multiplicatively larger strain measurement over the effective length of the conductor—and hence a multiplicatively larger change in resistance—than would be observed with a single straight-line conductive wire. From the measured electrical resistance of thestrain gauge15050, the amount of stress being applied to themotor shaft15020 may be inferred.
• Thesurgical instrument system15000 further comprises acontrol system15040 which is positioned on themotor shaft15020. Thecontrol system15040 includes acircuit board15046 mounted to themotor shaft15020. Thecircuit board15046 can be comprised of a printed circuit board and/or a flexible laminate, for example, and can be attached to theoutside surface15023 of theshaft15020 utilizing one or more adhesives, for example. Thecontrol system15040 can include a control circuit on thecircuit board15046. The control circuit comprises, among other things, a microprocessor15047 and at least onememory chip15048 in signal communication with the microprocessor15047. Thestrain gauge15050 is also in signal communication with the microprocessor15047 which is configured to detect the resistance change in themetallic wire15053 of thestrain gauge15050, as discussed above. When theshaft15020 is rotated to operate the end effector articulation system, the tissue-clamping system, and/or the staple-firing system of a surgical instrument, for example, theshaft15020 will experience forces and/or torques T that create strain within theshaft15020 which is detected by thestrain gauge15050 and the microprocessor15047, as discussed in greater detail further below. The microprocessor15047 can include the Wheatstone bridge discussed above.
• Thestrain gauge15050, further to the above, can comprise any suitable strain gauge. For instance, thestrain gauge15050 can comprise a semiconductor strain gauge, a piezoresistor, a nano-particle based strain gauge, a fiber optic strain gauge, and/or a capacitive strain gauge, for example. Certain strain gauges are configured to measure strain along one axis while other strain gauges are configured to measure strain along more than one axis, such as two axes or three axes, for example. More than one strain gauge can be used to assess the strain of the shaft5020. For example, a first strain gauge can be used to assess the strain of the shaft5020 along a first axis and a second strain gauge can be used to assess the strain of the shaft5020 along a second axis. In at least one such instance, a first strain gauge can be positioned and arranged to measure the strain along the longitudinal axis5021 of the shaft5020 and a second strain gauge can be positioned and arranged to measure the strain around the circumference of the shaft5020. The strain measured along the circumferential axis of the shaft5020 is orthogonal to the strain measured along the longitudinal axis; however, other embodiments are envisioned in which the first axis and the second axis are transverse, but not orthogonal to one another. In various instances, one or more strain gauges can be utilized to evaluate the total, or overall, strain being experienced by theshaft15020 at a particular location on theshaft15020. In certain instances, a plurality of strain gauges can be utilized to evaluate the strain of theshaft15020 at a plurality of locations on theshaft15020.
• Thestrain gauge15050 can be utilized to evaluate the strain, and the stress, being experienced by theshaft15020. When theshaft15020 is being utilized to drive an articulation system, a large increase in strain can indicate that the end effector of the surgical instrument may not be articulating properly. Similarly, a large increase in strain can indicate that the firing member of the surgical instrument may have become stuck when theshaft15020 is being utilized to drive a firing system. The microprocessor15047, and/or any other microprocessor of the surgical instrument, can be programmed to interpret the strain data and utilize the strain data to interpret whether the operation of the surgical instrument should be modified. For example, a strain reading supplied by thestrain gauge15050 to the microprocessor15047 when theshaft15020 is being utilized to articulate an end effector may exceed a maximum articulation strain threshold and, in such instances, the microprocessor15047, for example, can be programmed to interrupt the operation of themotor15010 driving theshaft15020 when the strain reading exceeds the maximum articulation strain threshold. The same strain reading, if provided when theshaft15020 is being utilized to fire staples from the end effector, may or may not exceed a maximum firing strain threshold. If the strain reading does not exceed the maximum firing strain threshold, then the microprocessor15047 may not interrupt the operation of theelectric motor15010. If the strain reading exceeds the maximum firing strain threshold, then the microprocessor15047 may interrupt the operation of themotor15010. In certain instances, the maximum firing strain threshold is different than the maximum articulation strain threshold while, in other instances, they may be the same.
• In some instances, further to the above, interrupting themotor15010 may mean that the microprocessor15047, and/or any other microprocessor of the surgical instrument, immediately pauses themotor15010 until receiving an input from the user of the surgical instrument. Such an input can be a command to reverse the operation of themotor15010 or a command to override the interruption of themotor15010 and restart themotor15010 to complete the articulation or firing process, as the case may be. In certain instances, interrupting themotor15010 may mean slowing themotor15010 down which can give the microprocessor15047, for example, a longer period of time to evaluate the loading conditions being experienced by theshaft15020. If the increase in strain represents a transient, or temporary, increase and the measured strain drops back below the relevant threshold, the microprocessor15047 may not interrupt themotor15010. If the microprocessor15047 has slowed themotor15010 in response to an elevated strain reading, the microprocessor15047 may restore the original speed of themotor15010 after the strain drops back below the relevant threshold. In other instances, the microprocessor15047 may continue to operate themotor15010 at the slower speed even though the strain has dropped back below the relevant threshold. If, however, the elevated strain reading above the relevant threshold persists, the microprocessor15047 can operate themotor15010 at the slower speed and/or pause themotor15010 after a predetermined period of time has elapsed. In the event that the measured strain continues to increase over the threshold, the microprocessor15047 can be programmed to stop themotor15010.
• As discussed above, the microprocessor15047 is positioned on the shaft5020. In order for the microprocessor15047 to control themotor15010 driving theshaft15020, the microprocessor15047 needs to be able to communicate with themotor15010. In at least one instance, a slip ring system can be utilized to transmit one or more signals from the microprocessor15047 to themotor15010. The slip ring system can also be utilized to transmit and/or one or more signals from themotor15010, and/or sensors monitoring themotor15010, to the microprocessor15047. In certain instances, atransmitter15060 can be utilized to transmit data between the microprocessor15047 and themotor15010. Thetransmitter15060 is mounted to theshaft15020 and rotates with theshaft15020. Thetransmitter15060 is in signal communication with the microprocessor15047 and, in at least one instance, can comprise a wireless frequency emitter configured to generate a wireless signal utilizing data provided by the microprocessor15047. The frequency emitter can be in communication with the microprocessor15047 via one or more power wires and/or one or more signal wires which are mounted to theshaft15020. Alternatively, as described in greater detail further below, thetransmitter15060 can comprise an impedance field generator.
• When thetransmitter15060 comprises a wireless frequency emitter, the surgical instrument can comprise awireless frequency receiver15070 configured to receive the signal emitted by the frequency emitter. Thefrequency receiver15070 is positioned in the handle of the surgical instrument; however, thefrequency receiver15070 can be positioned in any suitable location in the surgical instrument. In various instances, thefrequency receiver15070 is in signal communication with themotor15010 such that the data transmitted within the wireless signal and received by thefrequency receiver15070 can directly control themotor15010. In other instances, thefrequency receiver15070 is in signal communication with asecond microprocessor15080 in the surgical instrument. Thesecond microprocessor15080 is positioned in the handle of the surgical instrument; however, thesecond microprocessor15080 can be positioned in any suitable location in the surgical instrument. Thesecond microprocessor15080 can utilize the data transmitted from the microprocessor15047, and/or any other data from one or more suitable inputs, to control themotor15010. Thesecond microprocessor15080 is in signal communication with themotor15010 via one or more signal and/orpower wires15082, for example. Thesecond microprocessor15080 can also be programmed to control themotor15010 in the manner described above. In various instances, themicroprocessors15047 and15080 can co-operate to control themotor15010.
• Thecontrol system15040, thesensor15050, and thetransmitter15060 comprise an on-board detection system configured to detect and evaluate one or more conditions of theshaft15020. In the embodiment described above, the condition of theshaft15020 is the operating load being experienced by theshaft15020 and thesensor15050 comprises a strain gauge configured to detect the operating load; however, any suitable condition of theshaft15020 can be detected by one or more on-board sensors positioned on theshaft15020. Moreover, the microprocessor15047 can be configured to arrange the data provided to the microprocessor15047 from a plurality of sensors into two or more signals and the wireless frequency emitter can be configured to emit those signals to thefrequency receiver15070. Such signals can then be provided to themicroprocessor15080 which can control themotor15010 in response to the signals that it has received. One or more signal multiplexers and demultiplexers could be utilized.
• While a wireless frequency emitter can be useful to communicate data between a rotating plane, i.e., theshaft15020, and a fixed plane, i.e., the handle of the surgical instrument, for example, thetransmitter15060 can be configured to communicate data in any suitable manner. In at least one embodiment, as mentioned above, thetransmitter15060 can comprise an impedance field generator. In at least one instance, the impedance field generator can comprise an impedance coil mounted to theoutside surface15023 of theshaft15020. The impedance field generator can be configured to generate a field which can be sensed by afield sensor15070 positioned in the handle, for example. Similar to the above, the impedance field generator moves within a rotating plane and the field sensor is positioned within a fixed plane.
• Further to the above, the magnitude of the field generated by the impedance field generator corresponds to the magnitude of the strain detected by thestrain gauge15050. For instance, higher emitted field intensities can be associated with larger strains while lower emitted field intensities can be associated with smaller strains. In at least one instance, the magnitude of the field emitted by the impedance field generator can be directly proportional to the magnitude of the strain detected by thestrain gauge15050. In such an embodiment, the field sensor can measure the intensity of the field created by the impedance field generator and communicate such information to themicroprocessor15080, for example. Themicroprocessor15080 can comprise a calibration table which relates the data received from the field sensor to the load being experienced by themotor shaft15020. Themicroprocessor15080 can also be configured to adjust the speed of theelectric motor15010 in response to the data received from thestrain gauge15050 and the impedance field generator. For instance, themicroprocessor15080 can slow theelectric motor15010 when the measured strain is high. Themicroprocessor15080 can also utilize any other suitable data to adjust the performance characteristics of theelectric motor15010. Such data could include the current draw of themotor15010, the impedance of the tissue being stapled, the tissue gap between the anvil and the staple cartridge, and/or the strain that the anvil is experiencing, for example.
• The impedance field generator described above transmits data between a movingshaft15020 and the handle without the use of electrical contacts. As a result, it can be said that the impedance field generator communicates data from theshaft15020 to the handle ‘wirelessly’; however, it can also be stated that the impedance field generator is being used to affect a measurement that is being made adjacent to the movingshaft15020 which is then turned into a data stream and interpreted.
• As the reader will appreciate, thecontrol system15040, thesensor15050, and thetransmitter15060 may require electrical power to operate. In at least one instance, one or more batteries can be mounted toshaft15020 which can supply power to thecontrol system15040, thesensor15050, and/or thetransmitter15060, for example. In addition to or in lieu of a battery, power can be supplied to thecontrol system15040, thesensor15050, and/or thetransmitter15060, for example, via a slip ring system, such as the one described above, for example. In addition to or in lieu of the above, power can be transmitted wirelessly to thecontrol system15040, thesensor15050, and/or thetransmitter15060, for example. In at least one such instance, the surgical instrument can include amagnet15041 configured to generate amagnetic field15042 which induces a current in awire coil15043 wound around theshaft15020 when theshaft15020 is rotated by theelectric motor15010. Thewire coil15043 is in electrical communication with thecontrol system15040 such that the current induced within thewire coil15043 can supply power to the microprocessor15047, thestrain gauge sensor15050, and/or thetransmitter15060, for example. In at least one such instance, thewire coil15043 comprises a first end15044 and asecond end15045 mounted to contacts on theboard15046.
• Themagnet15041 comprises a permanent magnet; however, themagnet15041 can comprise any suitable magnet, such as an electromagnet, for example. When themagnet15041 comprises a permanent magnet, themagnet15041 can continuously generate themagnetic field15042. Thepermanent magnet15041 is securely positioned in the surgical instrument such that the orientation and/or magnitude of themagnetic field15042 does not change. Thewire coil15043 comprises a copper, or copper alloy, wire wrapped around theoutside surface15023 of theshaft15020; however, thewire coil15043 can be comprised of any suitable conductive material, such as aluminum, for example. Thewire coil15043 can be wrapped around theshaft15020 any suitable number of times. Moreover, thewire coil15043 can be positioned on theshaft15020 at a location in which the intensity of themagnetic field15042 is high, or at its highest. In at least one instance, thewire coil15043 can be wrapped around theshaft15020 such that thewire coil15043 is aligned, or at least substantially aligned, with a polar axis of themagnetic field15042. Generally, the current that is generated within thewire coil15043 is directly proportional to the number of times that thewire coil15043 is wound around theshaft15020. Moreover, the current that is generated within thewire coil15043 is directly proportional to the speed in which theshaft15020 is rotated.
• As discussed above, themagnet15041 can comprise an electromagnet. Theelectromagnet15041 can be powered by a battery of the surgical instrument, for example, to generate themagnetic field15042. Theelectromagnet15041 can be selectively activated, or energized, to selectively generate themagnetic field15042. For instance, theelectromagnet15041 can be energized only when theshaft15020 is being rotated by themotor15010. In such instances, theelectromagnet15041 will not be energized when theshaft15020 is not rotating. Such instances may be useful when prolonged pauses in the operation of theshaft15020 are anticipated or are in the process of occurring. In at least one instance, theelectromagnet15041 may be energized prior toshaft15020 being rotated by themotor15010. In certain instances, theelectromagnet15041 may be de-energized after theshaft15020 has stopped rotating. Such approaches can assure that the motion of theshaft15020 can be fully utilized to induce current within thewire coil15043. In various instances, theelectromagnet15041 may be energized whether or not theshaft15020 is rotating. Such instances may be useful when only short pauses in the operation of theshaft15020 are anticipated or are in the process of occurring.
• When theshaft15020 is not rotating, further to the above, themagnetic field15042 does not induce a current within thewire coil15043 and, as a result, thecontrol system15040, thesensor15050, and thetransmitter15060 are not being powered by themagnetic field15042. In at least one such instance, the microprocessor15047 can enter into a sleep mode. When themotor15010 begins to rotate theshaft15020, thewire coil15043 is rotated within themagnetic field15042 and a current is generated within thewire coil15043. Thewire coil15043 can be in electrical communication with an input gate in the microprocessor15047 and can apply a voltage potential to the input gate which can, one, power the microprocessor15047 and, two, cause the microprocessor15047 to awaken from its sleep mode. In such an embodiment, as a result, thecontrol system15040 can be in a sleep mode when theshaft15020 is not rotating and an active, or fully-powered, operating mode when theshaft15020 is rotating.
• In various instances, thecontrol system15040 can include and/or can have access to a power source when theshaft15020 is not rotating. In such instances, the microprocessor15047 can enter a low-power mode. In at least one instance, thecontrol system15040 can include one or more capacitive elements, such as supercapacitors, for example, that can be configured to store electrical power when theshaft15020 is being rotated and current from thewire coil15043 is being supplied to thecontrol system15040. When theshaft15020 is no longer rotating and current from thewire coil15043 is no longer being supplied to thecontrol circuit15040, the capacitive elements can supply electrical power to the microprocessor15047, and/or any other portion of thecontrol system15040, and prevent the microprocessor15047, and/orcontrol system15040, from entering into a completely unpowered state, at least for a period of time. Such capacitive elements could also release power to the microprocessor15047, and/or any other portion of thecontrol system15040, thestrain gauge15050, and/or thetransmitter15060 when theshaft15020 is rotating at a slow speed, i.e., a speed which is insufficient to generate the power necessary to operate such components in their fully-powered operating mode. In addition to or in lieu of the above, a battery mounted to theshaft15020 can supply power to the microprocessor15047, and/or any other portion of thecontrol system15040, thestrain gauge15050, and/or thewireless transmitter15060 when theshaft15020 is not rotating. Such a battery could also provide power to the microprocessor15047, and/or any other portion of thecontrol system15040, thestrain gauge15050, and/or thetransmitter15060 when theshaft15020 is rotating slowly and/or when such components are otherwise underpowered, for example.
• Further to the above, theshaft15020 may be stopped for a multitude of reasons. For instance, the user of the surgical instrument may choose to pause or stop the advancement of a firing member to assess whether the firing stroke of the firing member could or should be completed and, in such circumstances, theshaft15020, which advances the firing member, may be paused or stopped. As discussed above, a current is not induced in thewire coil15043 when theshaft15020 is not rotating; however, it may be desirable to power thecontrol system15040, thesensor15050, and/or thetransmitter15060 in order to collect, evaluate, and/or transmit data from thesensor15050 while theshaft15020 is not being rotated. A secondary power source described above is capable of facilitating such an operating state of the surgical instrument. In at least one alternative embodiment, a current can be induced in thewire coil15043 even though theshaft15020 is not rotating. For instance, a plurality ofelectromagnets15041 can be positioned around thewire coil15043 which can be selectively energized to create a rotatingmagnetic field15042. In such an embodiment, themagnetic field15042 can be rotated relative to thewire coil15043 to induce a current in thewire coil15043 and power thecontrol system15040, thesensor15050, and/or thetransmitter15060 even though theshaft15020 has been stopped.
• In use, further to the above, a power source, such as a battery, for example, can be utilized to power theelectric motor15010 and rotate theshaft15020. As described above, the rotation of thewire coil15043 within amagnetic field15042 generates a current within thewire coil15043 which supplies power to thecontrol circuit15040, thesensor15050, and/or thetransmitter15060 positioned on theshaft15020. In such instances, this on-board shaft system re-captures a portion of the energy expended to rotate theshaft15020 and utilizes that energy to sense, evaluate, and/or monitor the performance of theshaft15020.
• Various examples disclosed herein have been discussed in connection with themotor shaft15020; however, such examples could be applied to any rotatable shaft and/or rotatable system, such as theshaft15032, for example. Moreover, the examples disclosed herein could be applied to the rotatable shaft and/or rotatable system of any suitable surgical instrument. For instance, the examples disclosed herein could be applied to a robotic system, such as the DAVINCI robotic surgical system manufactured by Intuitive Surgical, Inc., for example. The entire disclosure of U.S. patent application Ser. No. 13/118,241, entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, now U.S. Pat. No. 9,072,535, is incorporated by reference herein. The examples disclosed herein could also be applied to non-surgical applications, such as the crankshaft and/or camshaft of a motor, for example.
• A portion of asurgical stapling instrument16000 is illustrated inFIGS. 134-139. Thestapling instrument16000 is usable with a manually-operated system and/or a robotically-controlled system, for example. Thestapling instrument16000 comprises ashaft16010 and anend effector16020 extending from theshaft16010. Theend effector16020 comprises acartridge channel16030 and astaple cartridge16050 positioned in thecartridge channel16030. Referring primarily toFIGS. 137 and 138, thestaple cartridge16050 comprises acartridge body16051 and aretainer16057 attached to thecartridge body16051. Thecartridge body16051 is comprised of a plastic material, for example, and theretainer16057 is comprised of metal, for example; however, thecartridge body16051 and theretainer16057 can be comprised of any suitable material. Thecartridge body16051 comprises adeck16052 configured to support tissue, alongitudinal slot16056, and a plurality ofstaple cavities16053 defined in thedeck16052. Referring primarily toFIGS. 135 and 136,staples16055 are removably positioned in thestaple cavities16053 and are supported bystaple drivers16054 which are also movably positioned in thestaple cavities16053. Theretainer16057 extends around the bottom of thecartridge body16051 to keep thestaple drivers16054 and/or thestaples16055 from falling out of the bottom of thestaple cavities16053. Thestaple drivers16054 and thestaples16055 are movable between an unfired position (FIG. 135) and a fired position by asled16060. Thesled16060 is movable between a proximal, unfired position (FIG. 135) toward a distal, fired position to eject thestaples16055 from thestaple cartridge16050, as illustrated inFIG. 136. Thesled16060 comprises one or more rampedsurfaces16064 which are configured to slide under thestaple drivers16054. Theend effector16020 further comprises ananvil16040 configured to deform thestaples16055 when thestaples16055 are ejected from thestaple cartridge16050. In various instances, theanvil16040 can comprise formingpockets16045 defined therein which are configured to deform thestaples16055.
• Theshaft16010 comprises aframe16012 and anouter sleeve16014 which is movable relative to theframe16012. Thecartridge channel16030 is mounted to and extends from theshaft frame16012. Theouter sleeve16014 is operably engaged with theanvil16040 and is configured to move theanvil16040 between an open position (FIG. 134) and a closed position (FIG. 135). In use, theanvil16040 is movable toward astaple cartridge16050 positioned in thecartridge channel16030 to clamp tissue against thedeck16052 of thestaple cartridge16050. In various alternative embodiments, thecartridge channel16030 and thestaple cartridge16050 are movable relative to theanvil16040 to clamp tissue therebetween. In either event, theshaft16010 further comprises a firingmember16070 configured to push thesled16060 distally. The firingmember16070 comprises aknife edge16076 which is movable within thelongitudinal slot16056 and is configured to incise the tissue positioned intermediate theanvil16040 and thestaple cartridge16050 as the firingmember16070 is advanced distally to eject thestaples16055 from thestaple cartridge16050. The firingmember16070 further comprises afirst cam16071 configured to engage thecartridge channel16030 and asecond cam16079 configured to engage theanvil16040 and hold theanvil16040 in position relative to thestaple cartridge16050. Thefirst cam16071 is configured to slide under thecartridge channel16030 and thesecond cam16079 is configured to slide within anelongate slot16049 defined in theanvil16040.
• Further to the above, thestaple cartridge16050 is a replaceable staple cartridge. When astaple cartridge16050 has been at least partially used, it can be removed from thecartridge channel16030 and replaced with anotherstaple cartridge16050, or any other suitable staple cartridge. Each newstaple cartridge16050 comprises acartridge body16051,staple drivers16054,staples16055, and asled16060. The firingmember16070 is part of theshaft16010. When astaple cartridge16050 is removed from thecartridge channel16030, the firingmember16070 remains with theshaft16010. That said, theshaft16010 itself may be replaceable as well; however, such areplacement shaft16010 could still be used in the manner described herein. In at least one such instance, thesurgical instrument system16000 could comprise a handle, ashaft16010 replaceably attached to the handle, and astaple cartridge16050 replaceably positioned in thecartridge channel16030 extending from theshaft16010, for example.FIG. 137 depicts astaple cartridge16050 positioned over anopening16031 defined in thecartridge channel16030 andFIG. 138 depicts thestaple cartridge16050 fully seated in thecartridge channel16030; however, it should be appreciated that several components of theend effector16020, such as theanvil16040, for example, and the firingmember16070 have been removed fromFIGS. 137 and 138 to demonstrate the general premise of astaple cartridge16050 being inserted into thecartridge channel16030. It should be appreciated, however, that astaple cartridge16050 is often inserted into thecartridge channel16030 through thedistal end16038 of thechannel16030. In such instances, theproximal end16059 of thestaple cartridge16050 is aligned with thedistal end16038 of thecartridge channel16030 and thestaple cartridge16050 is then moved proximally to align theproximal end16059 of thestaple cartridge16050 with theproximal end16039 of thecartridge channel16030 and, correspondingly, align thedistal end16058 of thestaple cartridge16050 with thedistal end16038 of thecartridge channel16030. Thecartridge channel16030 comprises adatum16033 configured to stop the proximal insertion of thestaple cartridge16050. More particularly, thecartridge body16051 comprises adatum shoulder16034 defined thereon configured to abut thedatum16033 when thestaple cartridge16050 has been inserted to the proper depth; however, it is possible for thestaple cartridge16050 to be inserted into thecartridge channel16030 in a number of ways which can prevent thedatum shoulder16034 from contacting thedatum16033.
• Regardless of the manner used to position astaple cartridge16050 in thecartridge channel16030, it is desired to position thesled16060 of thestaple cartridge16050 directly in front of the firingmember16070 when thestaple cartridge16050 is positioned in thecartridge channel16030. When thesled16060 is positioned directly in front of the firingmember16070, thesled16060 can keep the firingmember16070 from falling into a lockout when the firingmember16070 is advanced distally. More specifically, referring toFIG. 135, thesled16060 includes asupport shoulder16067 which is configured to support asupport tab16077 extending distally from the firingmember16070 and hold alock shoulder16078 of the firingmember16070 above a lockout window16037 (FIG. 137) defined in thecartridge channel16030. If thesled16060 has been advanced distally prior to thestaple cartridge16050 being fully seated in thecartridge channel16030, as illustrated inFIG. 136, thesupport tab16077 of the firingmember16070 will not be supported, or supportable, by thesupport shoulder16067 of thesled16060 and, as a result, thelock shoulder16078 of the firingmember16070 will enter thelockout window16037 when the firingmember16070 is advanced distally. In fact, theshaft16010 includes a biasingspring16018 resiliently engaged with atop surface16072 of the firingmember16070 which biases the firingmember16070 toward thelockout window16037. The entire disclosures of U.S. Pat. No. 7,143,923, entitled SURGICAL STAPLING INSTRUMENT HAVING A FIRING LOCKOUT FOR AN UNCLOSED ANVIL, which issued on Dec. 5, 2006; U.S. Pat. No. 7,044,352, SURGICAL STAPLING INSTRUMENT HAVING A SINGLE LOCKOUT MECHANISM FOR PREVENTION OF FIRING, which issued on May 16, 2006; U.S. Pat. No. 7,000,818, SURGICAL STAPLING INSTRUMENT HAVING SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS, which issued on Feb. 21, 2006; U.S. Pat. No. 6,988,649, SURGICAL STAPLING INSTRUMENT HAVING A SPENT CARTRIDGE LOCKOUT, which issued on Jan. 24, 2006; and U.S. Pat. No. 6,978,921, SURGICAL STAPLING INSTRUMENT INCORPORATING AN E-BEAM FIRING MECHANISM, which issued on Dec. 27, 2005, are incorporated by reference herein. The above being said, it may be difficult for the clinician inserting thestaple cartridge16050 into thecartridge channel16030 to determine whether thesled16060 has been accidentally, or prematurely, pushed forward prior to inserting, and/or during the insertion of, thestaple cartridge16050 into thecartridge channel16030. As described in detail further below, thesurgical instrument system16000 comprises means for assessing whether thesled16060 has been prematurely advanced when thestaple cartridge16050 is positioned in thecartridge channel16030.
• When moving astaple cartridge16050 proximally to insert thestaple cartridge16050 in thecartridge channel16030, as described above, thesled16060 can be accidentally or unintentionally bumped and pushed distally from its unfired position (FIG. 135) to a partially-fired position (FIG. 136). More particularly, referring now toFIG. 139, thesled16060 in thestaple cartridge16050 can contact the firingmember16070 in theshaft16010 in the event that thestaple cartridge16050 is mis-inserted into thecartridge channel16030, i.e., inserted too far proximally into thecartridge channel16030, which can move thesled16060 distally a distance X. Even though the clinician may subsequently place thestaple cartridge16050 in its proper position in thecartridge channel16030, thesled16060 will have already been pushed out of its proper position in thestaple cartridge16050 and, as a result, the firingmember16070 will enter the lockout when the firingmember16070 is advanced distally. Accordingly, thesurgical instrument system16000 will be unable to fire thestaple cartridge16050. Turning now toFIG. 140, thesurgical instrument system16000 comprises a mis-insertion sensor16090 configured to detect when astaple cartridge16050 has been over-inserted, or moved too far proximally within theend effector16020, at some point during the process of inserting thestaple cartridge16050 into thecartridge channel16030.
• Further to the above, the mis-insertion sensor16090 is in signal communication with a control system of thesurgical instrument system16000. The control system can include a microprocessor and the mis-insertion sensor16090 can be in signal communication with the microprocessor via at least onesignal wire16092 and/or a wireless signal transmitter and receiver system, for example. The mis-insertion sensor16090 can comprise any suitable sensor. In at least one instance, the mis-insertion sensor16090 can comprise a contact switch which is in an open condition when astaple cartridge16050 is not in contact with thesensor16090 and a closed condition when astaple cartridge16050 is in contact with thesensor16090. The mis-insertion sensor16090 is positioned in thecartridge channel16030 such that, if thestaple cartridge16050 is inserted properly in thecartridge channel16030, thestaple cartridge16050 will not contact the mis-insertion sensor16090. In various instances, the control system of thesurgical instrument system16000 can include an indicator which can indicate to the user of thesurgical instrument system16000 that the mis-insertion sensor16090 and the microprocessor have not detected a mis-insertion of astaple cartridge16050.
• In the event that thestaple cartridge16050 is over-inserted into thecartridge channel16030 and thestaple cartridge16050 contacts the mis-insertion sensor16090, further to the above, the microprocessor can detect the closure of thesensor16090 and take an appropriate action. Such an appropriate action may include warning the user of thesurgical instrument system16000 that thestaple cartridge16050 has been over-inserted and that thesled16060 of thestaple cartridge16050 may have been moved distally pre-maturely. In at least one instance, thesurgical instrument system16000 can include an indicator which, when illuminated, can indicate to the user that the condition of thestaple cartridge16050 positioned in thecartridge channel16030 is unreliable and that it should be removed and replaced with anotherstaple cartridge16050. In addition to or in lieu of the above, thesurgical instrument system16000 can include a display screen, for example, which could communicate this information to the user of thesurgical instrument system16000. In addition to or in lieu of the above, the microprocessor can deactivate the closure system of thesurgical instrument system16000 to prevent theanvil16040 from being moved into a closed position when the microprocessor has determined that astaple cartridge16050 has been over-inserted into thecartridge channel16030 and/or that the condition of thestaple cartridge16050 positioned in thecartridge channel16030 is unreliable. By preventing theanvil16040 from closing, in the embodiments where thesurgical instrument system16000 comprises an endoscopic surgical stapler, for example, theend effector16020 of thesurgical instrument system16000 cannot be inserted through a trocar into a patient and, thus, thesurgical instrument system16000 can require the user to replace thestaple cartridge16050 before thesurgical instrument16000 can be used.
• When the mis-insertion sensor16090 comprises a contact switch, further to the above, thesensor16090 can be positioned in any suitable location in thecartridge channel16030 in which astaple cartridge16050 would make contact with thesensor16090 if thestaple cartridge16050 is mis-inserted. As illustrated inFIG. 140, the mis-insertion sensor16090 can be positioned on either side of alongitudinal slot16036 extending through thecartridge channel16030, for example. As discussed above, however, the mis-insertion sensor16090 can comprise any suitable type of sensor and, as a result, thesensor16090 can be positioned in any suitable position in theend effector16020 and/orshaft16010, depending on the type of sensor that is being used. For instance, the mis-insertion sensor16090 can comprise a Hall Effect sensor, for example, which can emit a magnetic field and detect changes to that magnetic field when thestaple cartridge16050 is inserted into thecartridge channel16030. In various instances, a large disturbance to the magnetic field can indicate that thestaple cartridge16050 is close to thesensor16090. If the disturbance to the magnetic field exceeds a threshold level, then the microprocessor can determine that thestaple cartridge16050 was positioned too close to thesensor16090 during the insertion of thestaple cartridge16050 into thecartridge channel16030 and, as a result, thestaple cartridge16050 has been over-inserted into thecartridge channel16030 at some point. In at least one instance, thecartridge body16051, theretainer16057, and/or thesled16060 can include one or more magnetic elements which can be configured to disturb the magnetic field of thesensor16090, for example.
• In addition to or in lieu of the above, referring now toFIGS. 141 and 142, thesurgical instrument system16000 can comprise asensor16080 configured to directly detect whether thesled16060 is in its correct, or unfired, position when thestaple cartridge16050 is positioned in thecartridge channel16030. Thesensor16080 is positioned in arecess16032 defined in thecartridge channel16030; however, thesensor16080 can be positioned in any suitable location. Thesensor16080 is aligned with the proximal end of thesled16060 when thesled16060 is in its unfired position, as illustrated inFIG. 141. In such instances, thesled16060 is positioned over thesensor16080 and is in contact with thesensor16080. Thesensor16080 comprises a contact switch which is in a closed condition when thesled16060 is engaged with thesensor16080, for example. In various instances, thesensor16080 can comprise a continuity sensor, for example. When thesled16060 is advanced distally, thesled16060 is no longer aligned with or in contact with thesensor16080. In such instances, the contact switch of thesensor16080 is in an open condition. Thesensor16080 is in signal communication with the microprocessor of the control system of thesurgical instrument system16000 via at least onesignal wire16082 and/or a wireless signal transmitter and receiver system, for example. When astaple cartridge16050 is inserted into the channel, thesensor16080 and the microprocessor can evaluate whether thesled16060 is in its unfired position and, if it is not, take an appropriate action, such as the appropriate actions discussed above, for example.
• Referring now toFIG. 143, thesensor16080 comprises afirst contact16084 and asecond contact16085. Thesecond contact16085 comprises a free end positioned over thefirst contact16084 which is movable between an open position in which agap16086 is present between thesecond contact16085 and thefirst contact16084 and a closed position in which thesecond contact16085 is deflected into contact with thefirst contact16084. Thefirst contact16084 and thesecond contact16085 are comprised of an electrically conductive material, such as copper, for example, and, when thesecond contact16085 is in contact with thefirst contact16084, thesensor16080 closes a circuit which permits current to flow therethrough. Thesensor16080 further comprises aflexible housing16083 which surrounds the ends of thefirst contact16084 and thesecond contact16085. Thehousing16083 comprises a sealed deformable membrane; however, any suitable configuration could be used. Thehousing16083 is comprised of an electrically insulative material, such as plastic, for example. When thesled16060 contacts thesensor16080, as discussed above, thesled16060 can push thehousing16083 downwardly and deflect thesecond contact16085 toward thefirst contact16084 to close thesensor16080. If thesled16060 has been advanced distally prior to thestaple cartridge16050 being fully seated in thecartridge channel16030, thesled16060 will not deflect thehousing16083 and thesecond contact16085 downwardly. As a result of the above, thesensor16080 can not only detect whether astaple cartridge16050 is present in thecartridge channel16030, but it can also detect whether thestaple cartridge16050 has been at least partially fired.
• In addition to or in lieu of the above, thesensor16080 can comprise any suitable sensor, such as a Hall Effect sensor, for example, which is configured to emit a magnetic field and detect changes to the magnetic field. Thesled16060 can include a magnetic element mounted thereto, such as on the bottom of thesled16060, for example, and, when thestaple cartridge16050 is positioned in thecartridge channel16030, the magnetic element can disrupt the magnetic field emitted by thesensor16080. Thesensor16080 and the microprocessor of the surgical instrument control system can be configured to evaluate the magnitude in which the magnetic field has been disrupted and correlate the disruption of the magnetic field with the position of thesled16060. Such an arrangement may be able to determine whether thesled16060 is in an acceptable range of positions. For instance, the microprocessor may assess whether the disturbance of the magnetic field has exceeded a threshold and, if it has, the microprocessor can indicate to the user that thestaple cartridge16050 is suitable for use and, if the threshold has not been exceeded, the microprocessor can take a suitable action, as described above.
• In addition to or in lieu of assessing whether a staple cartridge has been inserted to its proper depth in thecartridge channel16030, thesensor16080 can be configured to assess whether astaple cartridge16050 has been fully seated in thecartridge channel16030. For instance, referring again toFIG. 143, thesled16060 may deflect thesecond contact16085 enough to contact thefirst contact16084 only when thestaple cartridge16050 is fully seated in thestaple channel16030. When thesensor16080 comprises a Hall Effect sensor, for example, the threshold disturbance that thesled16060 must create to indicate that thestaple cartridge16050 is suitable for use may not only require that thestaple cartridge16050 be inserted to its proper depth in thecartridge channel16030 and that thesled16060 be in its unfired position but it may also require that thestaple cartridge16050 be in its fully seated condition. Referring now toFIG. 144, analternative sensor16080′ is depicted which comprises a pressure sensitive switch. Thesensor16080′ comprises a variableresistive element16086′ positioned intermediate thefirst contact16084 and thesecond contact16085. In at least one instance, the variableresistive element16086′ can comprise a semi-conductive spacer, for example. The resistance of the variableresistive element16086′ is a function of the pressure, or force, being applied to it. For instance, if a low pressure is applied to the variableresistive element16086′ then the variableresistive element16086′ will have a low resistance and, correspondingly, if a high pressure is applied to theresistive element16086′ then theresistive element16086′ will have a high resistance. The microprocessor can be configured to correlate the resistance of theresistive element16086′ with the pressure being applied to thesensor16080′ and, ultimately, correlate the pressure being applied to thesensor16080′ with the height in which thestaple cartridge16050 is seated in thecartridge channel16030. Once the resistance of theresistive element16086′ has exceeded a threshold resistance, the microprocessor can determine that thestaple cartridge16050 is ready to be fired. If, however, the resistance of theresistive element16086′ is below the threshold resistance, the microprocessor can determine that thestaple cartridge16050 has not been fully seated in thecartridge channel16030 and take an appropriate action.
• The present disclosure will now be described in connection with various examples and various combinations of such examples as described hereinbelow.
• 1. One example provides an electronic system for a surgical instrument, the electronic system comprising: an electric motor coupled to the end effector; a motor controller coupled to the motor; a parameter threshold detection module configured to monitor multiple parameter thresholds; a sensing module configured to sense tissue compression; a processor coupled to the parameter threshold detection module and the motor controller; and a memory coupled to the processor, the memory storing executable instructions that when executed by the processor cause the processor to monitor multiple levels of action thresholds and monitor speed of the motor and increment a drive unit of the motor, sense tissue compression, and provide rate and control feedback to the user of the surgical instrument.
• 2. Another example provides the electronic system of example 1, wherein the processor provides automatic compensation for motor load when thresholds detected by the parameter threshold detection module are within acceptable limits.
• 3. Another example provides the electronic system of example 1 or 2, wherein the parameter threshold detection module is configured to detect battery current and speed of the motor such that when the battery current increases or the speed of the motor decreases the motor controller increase a pulse width or frequency modulation to maintain the speed of the motor constant.
• 4. Another example provides the electronic system of any one of examples 1-3, wherein the parameter threshold detection module is configured to detect minimum and maximum threshold limits to control operation of the surgical instrument.
• 5. Another example provides the electronic system of example 4, wherein the parameter threshold detection module is configured to detect end effector closing force, end effector opening force, and speed of the motor.
• 6. Another example provides the electronic system of example 5, wherein when the end effector closing force decreases while a knife is translating through a knife channel in the end effector, the processor is configured to control the speed of the motor.
• 7. Another example provides the electronic system of example 5 or 6, wherein when the end effector closing force decreases while a knife is translating through a knife channel, the processor is configured to activate an alarm.
• 8. Another example provides the electronic system of any one of examples 4-7, wherein the processor is configured to activate the motor only after a minimum parameter threshold is detected.
• 9. Another example provides the electronic system of any one of examples 1-8, wherein the parameter threshold detection module is configured to detect an ultimate threshold associated with current draw, end effector pressure applied to tissue, firing load, or torque, wherein when the ultimate threshold is exceeded, the processor is configured to shut down the motor or cause the motor to retract the knife.
• 10. Another example provides the electronic system of example 9, wherein the parameter threshold detection module is configured to detect a secondary threshold which is less than the ultimate threshold, wherein control parameters are changed by the processor to accommodate the change in operation.
• 11. Another example provides the electronic system of example 9 or 10, wherein the parameter threshold detection module is configured to detect a marginal threshold in the form of either a step function or ramp function based on a proportional response to another input to the parameter threshold detection module.
• 12. Yet another example provides an electronic system for a surgical instrument, the electronic system comprising: an electric motor coupled to the end effector; a motor controller coupled to the motor; a sensing module configured to sense tissue compression; a processor coupled to the parameter threshold detection module and the motor controller; and a memory coupled to the processor, the memory storing executable instructions that when executed by the processor cause the processor to monitor the sensing module, wherein the sensing module is configured to sense multiple tissue parameters.
• 13. Another example provides the electronic system of example 12, wherein the sensing module is configured to sense tissue compression.
• 14. Another example provides the electronic system of example 12 or 13, wherein the sensing module is configured to sense tissue impedance.
• 15. Another example provides the electronic system of example 14, wherein the sensing module is coupled to electrodes to measure tissue impedance via sub-therapeutic RF energy.
• 16. Another example provides the electronic system of example 15, wherein the sensing module is configured to read overlaid multiple frequency signals to measure impedance in different locations simultaneously.
• 17. Another example provides the electronic system of example 15 or 16, wherein the sensing module comprises a multiplexor to measure impedance at variable RF frequencies sequentially.
• 18. Another example provides the electronic system of any one of examples 12-17, wherein the sensing module is configured to sense tissue pressure.
• 19. Another example provides the electronic system of any one of examples 12-18, wherein the sensing module is configured to sense tissue contact.
• 20. Another example provides the electronic system of any one of examples 12-19, wherein the sensing module is configured to sense viscoelasticity rate of change.
• 21. Yet another example provides an electronic system for a surgical instrument, the electronic system comprising: an electric motor coupled to the end effector; a motor controller coupled to the motor; a sensing module configured to sense tissue compression; a feedback module configured to provide rate and control feedback to a user of the surgical instrument; a processor coupled to the parameter threshold detection module and the motor controller; and a memory coupled to the processor, the memory storing executable instructions that when executed by the processor cause the processor to monitor the sensing module, wherein the sensing module is configured to sense multiple tissue parameters and provide feedback over the feedback module to a user of the instrument.
• In accordance with various examples, the surgical instruments described herein may comprise one or more processors (e.g., microprocessor, microcontroller) coupled to various sensors. In addition, to the processor(s), a storage (having operating logic) and communication interface, are coupled to each other.
• As described earlier, the sensors may be configured to detect and collect data associated with the surgical device. The processor processes the sensor data received from the sensor(s).
• The processor may be configured to execute the operating logic. The processor may be any one of a number of single or multi-core processors known in the art. The storage may comprise volatile and non-volatile storage media configured to store persistent and temporal (working) copy of the operating logic.
• In various aspects, the operating logic may be configured to perform the initial processing, and transmit the data to the computer hosting the application to determine and generate instructions. For these examples, the operating logic may be further configured to receive information from and provide feedback to a hosting computer. In alternate examples, the operating logic may be configured to assume a larger role in receiving information and determining the feedback. In either case, whether determined on its own or responsive to instructions from a hosting computer, the operating logic may be further configured to control and provide feedback to the user.
• In various aspects, the operating logic may be implemented in instructions supported by the instruction set architecture (ISA) of the processor, or in higher level languages and compiled into the supported ISA. The operating logic may comprise one or more logic units or modules. The operating logic may be implemented in an object oriented manner. The operating logic may be configured to be executed in a multi-tasking and/or multi-thread manner. In other examples, the operating logic may be implemented in hardware such as a gate array.
• In various aspects, the communication interface may be configured to facilitate communication between a peripheral device and the computing system. The communication may include transmission of the collected biometric data associated with position, posture, and/or movement data of the user's body part(s) to a hosting computer, and transmission of data associated with the tactile feedback from the host computer to the peripheral device. In various examples, the communication interface may be a wired or a wireless communication interface. An example of a wired communication interface may include, but is not limited to, a Universal Serial Bus (USB) interface. An example of a wireless communication interface may include, but is not limited to, a Bluetooth interface.
• For various aspects, the processor may be packaged together with the operating logic. In various examples, the processor may be packaged together with the operating logic to form a SiP. In various examples, the processor may be integrated on the same die with the operating logic. In various examples, the processor may be packaged together with the operating logic to form a System on Chip (SoC).
• Various aspects may be described herein in the general context of computer executable instructions, such as software, program modules, and/or engines being executed by a processor. Generally, software, program modules, and/or engines include any software element arranged to perform particular operations or implement particular abstract data types. Software, program modules, and/or engines can include routines, programs, objects, components, data structures and the like that perform particular tasks or implement particular abstract data types. An implementation of the software, program modules, and/or engines components and techniques may be stored on and/or transmitted across some form of computer-readable media. In this regard, computer-readable media can be any available medium or media useable to store information and accessible by a computing device. Some examples also may be practiced in distributed computing environments where operations are performed by one or more remote processing devices that are linked through a communications network. In a distributed computing environment, software, program modules, and/or engines may be located in both local and remote computer storage media including memory storage devices. A memory such as a random access memory (RAM) or other dynamic storage device may be employed for storing information and instructions to be executed by the processor. The memory also may be used for storing temporary variables or other intermediate information during execution of instructions to be executed by the processor.
• Although some aspects may be illustrated and described as comprising functional components, software, engines, and/or modules performing various operations, it can be appreciated that such components or modules may be implemented by one or more hardware components, software components, and/or combination thereof. The functional components, software, engines, and/or modules may be implemented, for example, by logic (e.g., instructions, data, and/or code) to be executed by a logic device (e.g., processor). Such logic may be stored internally or externally to a logic device on one or more types of computer-readable storage media. In other examples, the functional components such as software, engines, and/or modules may be implemented by hardware elements that may include processors, microprocessors, circuits, circuit elements (e.g., transistors, resistors, capacitors, inductors, and so forth), integrated circuits, ASICs, PLDs, DSPs, FPGAs, logic gates, registers, semiconductor device, chips, microchips, chip sets, and so forth.
• Examples of software, engines, and/or modules may include software components, programs, applications, computer programs, application programs, system programs, machine programs, operating system software, middleware, firmware, software modules, routines, subroutines, functions, methods, procedures, software interfaces, application program interfaces (API), instruction sets, computing code, computer code, code segments, computer code segments, words, values, symbols, or any combination thereof. Determining whether one example is implemented using hardware elements and/or software elements may vary in accordance with any number of factors, such as desired computational rate, power levels, heat tolerances, processing cycle budget, input data rates, output data rates, memory resources, data bus speeds and other design or performance constraints.
• One or more of the modules described herein may comprise one or more embedded applications implemented as firmware, software, hardware, or any combination thereof. One or more of the modules described herein may comprise various executable modules such as software, programs, data, drivers, application APIs, and so forth. The firmware may be stored in a memory of the controller and/or the controller which may comprise a nonvolatile memory (NVM), such as in bit-masked ROM or flash memory. In various implementations, storing the firmware in ROM may preserve flash memory. The NVM may comprise other types of memory including, for example, programmable ROM (PROM), erasable programmable ROM (EPROM), EEPROM, or battery backed RAM such as dynamic RAM (DRAM), Double-Data-Rate DRAM (DDRAM), and/or synchronous DRAM (SDRAM).
• In some cases, various aspects may be implemented as an article of manufacture. The article of manufacture may include a computer readable storage medium arranged to store logic, instructions and/or data for performing various operations of one or more examples. In various examples, for example, the article of manufacture may comprise a magnetic disk, optical disk, flash memory or firmware containing computer program instructions suitable for execution by a general purpose processor or application specific processor. The examples, however, are not limited in this context.
• The functions of the various functional elements, logical blocks, modules, and circuits elements described in connection with the examples disclosed herein may be implemented in the general context of computer executable instructions, such as software, control modules, logic, and/or logic modules executed by the processing unit. Generally, software, control modules, logic, and/or logic modules comprise any software element arranged to perform particular operations. Software, control modules, logic, and/or logic modules can comprise routines, programs, objects, components, data structures and the like that perform particular tasks or implement particular abstract data types. An implementation of the software, control modules, logic, and/or logic modules and techniques may be stored on and/or transmitted across some form of computer-readable media. In this regard, computer-readable media can be any available medium or media useable to store information and accessible by a computing device. Some examples also may be practiced in distributed computing environments where operations are performed by one or more remote processing devices that are linked through a communications network. In a distributed computing environment, software, control modules, logic, and/or logic modules may be located in both local and remote computer storage media including memory storage devices.
• Additionally, it is to be appreciated that the aspects described herein illustrate example implementations, and that the functional elements, logical blocks, modules, and circuits elements may be implemented in various other ways which are consistent with the described examples. Furthermore, the operations performed by such functional elements, logical blocks, modules, and circuits elements may be combined and/or separated for a given implementation and may be performed by a greater number or fewer number of components or modules. As will be apparent to those of skill in the art upon reading the present disclosure, each of the individual examples described and illustrated herein has discrete components and features which may be readily separated from or combined with the features of any of the other several aspects without departing from the scope of the present disclosure. Any recited method can be carried out in the order of events recited or in any other order which is logically possible.
• It is worthy to note that any reference to “one example” or “an example” means that a particular feature, structure, or characteristic described in connection with the example is comprised in at least one example. The appearances of the phrase “in one example” or “in one aspect” in the specification are not necessarily all referring to the same example.
• Unless specifically stated otherwise, it may be appreciated that terms such as “processing,” “computing,” “calculating,” “determining,” or the like, refer to the action and/or processes of a computer or computing system, or similar electronic computing device, such as a general purpose processor, a DSP, ASIC, FPGA or other programmable logic device, discrete gate or transistor logic, discrete hardware components, or any combination thereof designed to perform the functions described herein that manipulates and/or transforms data represented as physical quantities (e.g., electronic) within registers and/or memories into other data similarly represented as physical quantities within the memories, registers or other such information storage, transmission or display devices.
• It is worthy to note that some aspects may be described using the expression “coupled” and “connected” along with their derivatives. These terms are not intended as synonyms for each other. For example, some aspects may be described using the terms “connected” and/or “coupled” to indicate that two or more elements are in direct physical or electrical contact with each other. The term “coupled,” however, also may mean that two or more elements are not in direct contact with each other, but yet still co-operate or interact with each other. With respect to software elements, for example, the term “coupled” may refer to interfaces, message interfaces, API, exchanging messages, and so forth.
• It should be appreciated that any patent, publication, or other disclosure material, in whole or in part, that is said to be incorporated by reference herein is incorporated herein only to the extent that the incorporated material does not conflict with existing definitions, statements, or other disclosure material set forth in this disclosure. As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated by reference herein, but which conflicts with existing definitions, statements, or other disclosure material set forth herein will only be incorporated to the extent that no conflict arises between that incorporated material and the existing disclosure material.
• The present disclosure applies to conventional endoscopic and open surgical instrumentation as well as application in robotic-assisted surgery.
• Aspects of the devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. Examples may, in either or both cases, be reconditioned for reuse after at least one use. Reconditioning may include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, examples of the device may be disassembled, and any number of the particular pieces or parts of the device may be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, examples of the device may be reassembled for subsequent use either at a reconditioning facility, or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will appreciate that reconditioning of a device may utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.
• By way of example only, aspects described herein may be processed before surgery. First, a new or used instrument may be obtained and when necessary cleaned. The instrument may then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and instrument may then be placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons. The radiation may kill bacteria on the instrument and in the container. The sterilized instrument may then be stored in the sterile container. The sealed container may keep the instrument sterile until it is opened in a medical facility. A device also may be sterilized using any other technique known in the art, including but not limited to beta or gamma radiation, ethylene oxide, plasma peroxide, or steam.
• One skilled in the art will recognize that the herein described components (e.g., operations), devices, objects, and the discussion accompanying them are used as examples for the sake of conceptual clarity and that various configuration modifications are contemplated. Consequently, as used herein, the specific exemplars set forth and the accompanying discussion are intended to be representative of their more general classes. In general, use of any specific exemplar is intended to be representative of its class, and the non-inclusion of specific components (e.g., operations), devices, and objects should not be taken limiting.
• With respect to the use of substantially any plural and/or singular terms herein, those having skill in the art can translate from the plural to the singular and/or from the singular to the plural as is appropriate to the context and/or application. The various singular/plural permutations are not expressly set forth herein for sake of clarity.
• The herein described subject matter sometimes illustrates different components contained within, or connected with, different other components. It is to be understood that such depicted architectures are merely examples and that in fact many other architectures may be implemented which achieve the same functionality. In a conceptual sense, any arrangement of components to achieve the same functionality is effectively “associated” such that the desired functionality is achieved. Hence, any two components herein combined to achieve a particular functionality can be seen as “associated with” each other such that the desired functionality is achieved, irrespective of architectures or intermedial components. Likewise, any two components so associated can also be viewed as being “operably connected,” or “operably coupled,” to each other to achieve the desired functionality, and any two components capable of being so associated can also be viewed as being “operably couplable,” to each other to achieve the desired functionality. Specific examples of operably couplable include but are not limited to physically matable and/or physically interacting components, and/or wirelessly interactable, and/or wirelessly interacting components, and/or logically interacting, and/or logically interactable components.
• Some aspects may be described using the expression “coupled” and “connected” along with their derivatives. It should be understood that these terms are not intended as synonyms for each other. For example, some aspects may be described using the term “connected” to indicate that two or more elements are in direct physical or electrical contact with each other. In another example, some aspects may be described using the term “coupled” to indicate that two or more elements are in direct physical or electrical contact. The term “coupled,” however, also may mean that two or more elements are not in direct contact with each other, but yet still co-operate or interact with each other.
• In some instances, one or more components may be referred to herein as “configured to,” “configurable to,” “operable/operative to,” “adapted/adaptable,” “able to,” “conformable/conformed to,” etc. Those skilled in the art will recognize that “configured to” can generally encompass active-state components and/or inactive-state components and/or standby-state components, unless context requires otherwise.
• While particular aspects of the present subject matter described herein have been shown and described, it will be apparent to those skilled in the art that, based upon the teachings herein, changes and modifications may be made without departing from the subject matter described herein and its broader aspects and, therefore, the appended claims are to encompass within their scope all such changes and modifications as are within the true scope of the subject matter described herein. It will be understood by those within the art that, in general, terms used herein, and especially in the appended claims (e.g., bodies of the appended claims) are generally intended as “open” terms (e.g., the term “including” should be interpreted as “including but not limited to,” the term “having” should be interpreted as “having at least,” the term “includes” should be interpreted as “includes but is not limited to,” etc.). It will be further understood by those within the art that when a specific number of an introduced claim recitation is intended, such an intent will be explicitly recited in the claim, and in the absence of such recitation no such intent is present. For example, as an aid to understanding, the following appended claims may contain usage of the introductory phrases “at least one” and “one or more” to introduce claim recitations. However, the use of such phrases should not be construed to imply that the introduction of a claim recitation by the indefinite articles “a” or “an” limits any particular claim containing such introduced claim recitation to claims containing only one such recitation, even when the same claim includes the introductory phrases “one or more” or “at least one” and indefinite articles such as “a” or “an” (e.g., “a” and/or “an” should typically be interpreted to mean “at least one” or “one or more”); the same holds true for the use of definite articles used to introduce claim recitations.
• In addition, even when a specific number of an introduced claim recitation is explicitly recited, those skilled in the art will recognize that such recitation should typically be interpreted to mean at least the recited number (e.g., the bare recitation of “two recitations,” without other modifiers, typically means at least two recitations, or two or more recitations). Furthermore, in those instances where a convention analogous to “at least one of A, B, and C, etc.” is used, in general such a construction is intended in the sense one having skill in the art would understand the convention (e.g., “a system having at least one of A, B, and C” would include but not be limited to systems that have A alone, B alone, C alone, A and B together, A and C together, B and C together, and/or A, B, and C together, etc.). In those instances where a convention analogous to “at least one of A, B, or C, etc.” is used, in general such a construction is intended in the sense one having skill in the art would understand the convention (e.g., “a system having at least one of A, B, or C” would include but not be limited to systems that have A alone, B alone, C alone, A and B together, A and C together, B and C together, and/or A, B, and C together, etc.). It will be further understood by those within the art that typically a disjunctive word and/or phrase presenting two or more alternative terms, whether in the description, claims, or drawings, should be understood to contemplate the possibilities of including one of the terms, either of the terms, or both terms unless context dictates otherwise. For example, the phrase “A or B” will be typically understood to include the possibilities of “A” or “B” or “A and B.”
• With respect to the appended claims, those skilled in the art will appreciate that recited operations therein may generally be performed in any order. Also, although various operational flows are presented in a sequence(s), it should be understood that the various operations may be performed in other orders than those which are illustrated, or may be performed concurrently. Examples of such alternate orderings may include overlapping, interleaved, interrupted, reordered, incremental, preparatory, supplemental, simultaneous, reverse, or other variant orderings, unless context dictates otherwise. Furthermore, terms like “responsive to,” “related to,” or other past-tense adjectives are generally not intended to exclude such variants, unless context dictates otherwise.
• In summary, numerous benefits have been described which result from employing the concepts described herein. The foregoing disclosure has been presented for purposes of illustration and description. It is not intended to be exhaustive or limiting to the precise form disclosed. Modifications or variations are possible in light of the above teachings. The one or more examples were chosen and described in order to illustrate principles and practical application to thereby enable one of ordinary skill in the art to utilize the various examples and with various modifications as are suited to the particular use contemplated. It is intended that the claims submitted herewith define the overall scope.

Claims (5)

1-20. (canceled)

21. A surgical instrument, comprising:

a handle, comprising:

a battery; and

a motor configured to output a rotary motion when supplied with power from said battery;

a shaft extending from said handle;

an end effector extending from said shaft, wherein said end effector comprises:

an anvil; and

a staple cartridge comprising a plurality of staples removably stored therein;

a firing member configured to advance through said end effector during a firing stroke in response to said rotary motion;

a microcontroller in signal communication with said motor, wherein said microcontroller comprises a processor;

an electrical load sensor configured to measure the force on said firing member during said firing stroke, wherein said electrical load sensor is configured to communicate the measured force to said processor; and

a feedback display in signal communication with said processor, wherein said feedback display comprises a plurality of zones indicative of the measured force on said firing member, and wherein said plurality of zones comprises:

a first zone which indicates the firing member is being advanced in a first operating state;

a second zone which indicates the firing member is being advanced in a second operating state, wherein said second operating state is different than said first operating state; and

a third zone which indicates the firing member is being advanced in a third operating state, wherein said third operating state is different than said first operating state and said second operating state.

22. The surgical instrument ofclaim 21, wherein said feedback display further comprises a pointer and an arcuate shaped dial, and wherein said first zone, said second zone, and said third zone are defined within said arcuate shaped dial.

23. A surgical instrument, comprising:

a handle, comprising:

a battery; and

a motor configured to output a rotary motion when supplied with power from said battery;

a shaft extending from said handle;

an end effector extending from said shaft, wherein said end effector comprises:

an anvil; and

a staple cartridge comprising a plurality of staples removably stored therein;

a firing member configured to advance through said end effector during a firing stroke in response to said rotary motion;

a microcontroller in signal communication with said motor, wherein said microcontroller comprises a processor;

a current sensor configured to measure the current draw of said motor during said firing stroke, wherein said current sensor is configured to communicate the measured current draw to said processor; and

a feedback display in signal communication with said processor, wherein said feedback display comprises a plurality of zones indicative of the measured current received by said processor from said current sensor, and wherein said plurality of zones comprises:

a first zone which indicates the firing member is being advanced at a first rate;

a second zone which indicates the firing member is being advanced at a second rate, wherein said second rate is different than said first rate; and

a third zone which indicates the firing member is being advanced at a third rate, wherein said third rate is different than said first rate and said second rate.

24. The surgical instrument ofclaim 23, wherein said feedback display further comprises a pointer and an arcuate shaped dial, and wherein said first zone, said second zone, and said third zone are defined within said arcuate shaped dial.

Images