JP7604228B2 - Surgical Ejection Sensor Mechanism - Google Patents

Description

CROSS-REFERENCE TO RELATED APPLICATIONS
This application claims the benefit of priority under 35 U.S.C. §119(e) to U.S. Provisional Patent Application No. 62/691,219, filed June 28, 2018, entitled “SURGICAL EVACUATION SENSING AND MOTOR CONTROL,” the entire disclosure of which is incorporated herein by reference.

This application is a continuation of U.S. Provisional Patent Application No. 62/650,887, entitled "SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES," filed March 30, 2018, and U.S. Provisional Patent Application No. 62/650,877, entitled "SURGICAL SMOK EVACUATION SENSING AND CONTROLS," filed March 30, 2018, and U.S. Provisional Patent Application No. 62/650,877, entitled "SMOK EVACUATION MODULE FOR INTERACTIVE SURGICAL EVACUATION SENSING AND CONTROLS," filed March 30, 2018, the disclosures of each of which are incorporated herein by reference in their entirety under 35 U.S.C. § 119(e). This application claims the benefit of priority to U.S. Provisional Patent Application No. 62/650,882, filed March 30, 2018, entitled "CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS," and U.S. Provisional Patent Application No. 62/650,898, filed March 30, 2018, entitled "CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS."

This application further claims the benefit of priority under 35 U.S.C. §119(e) to U.S. Provisional Patent Application No. 62/640,417, filed March 8, 2018, entitled "TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEM THEREFOR," and U.S. Provisional Patent Application No. 62/640,415, filed March 8, 2018, entitled "ESTIMATING STATE OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM THEREFOR," the disclosures of each of which are incorporated herein by reference in their entirety.

This application further claims the benefit of priority under 35 U.S.C. §119(e) to U.S. Provisional Patent Application No. 62/611,341, entitled "INTERACTIVE SURGICAL PLATFORM," filed December 28, 2017, U.S. Provisional Patent Application No. 62/611,340, entitled "CLOUD-BASED MEDICAL ANALYTICS," filed December 28, 2017, and U.S. Provisional Patent Application No. 62/611,339, entitled "ROBOT ASSISTED SURGICAL PLATFORM," filed December 28, 2017, the disclosures of each of which are incorporated herein by reference in their entirety.

The present invention relates to a surgical system and an evacuation device thereof. The surgical smoke evacuation device is configured to evacuate smoke, as well as fluids and/or particulates, from a surgical site. For example, smoke may be generated at a surgical site during a surgical procedure involving an energy device.

In various embodiments, the surgical drainage system includes a pump, a motor operably coupled to the pump, a flow path fluidly coupled to the pump, and a sensor system. The sensor system includes a first pressure sensor and a second pressure sensor. The first pressure sensor is disposed along the flow path. The second pressure sensor is disposed along the flow path upstream of the first pressure sensor. The surgical drainage system further includes a control circuit configured to determine a pressure differential between the first pressure sensor and the second pressure sensor. The control circuit is further configured to adjust an operating parameter of the motor based on the pressure differential.

In various embodiments, the surgical drainage system includes a pump including a motor, a flow path fluidly coupled to the pump, and a sensor system. The sensor system includes a first pressure sensor and a second pressure sensor. The first pressure sensor is disposed along the flow path to detect a first pressure. The second pressure sensor is disposed along the flow path upstream of the first pressure sensor to detect a second pressure. The surgical drainage system further includes a control circuit configured to determine a ratio of the second pressure to the first pressure and determine an operating state of the surgical drainage system based on the ratio.

In various embodiments, a non-transitory computer readable medium is disclosed that stores computer readable instructions. When executed, the instructions cause a machine to receive a first signal from a first sensor disposed along a flow path through the surgical drainage system, receive a second signal from a second sensor disposed along the flow path through the surgical drainage system, determine an operating condition of the surgical drainage system based on the first signal and the second signal, and adjust an operating parameter of the surgical drainage system based on the operating condition.

The features of the various aspects are set forth in detail in the appended claims, however the various aspects, both as to organization and method of operation, together with further objects and advantages thereof, may best be understood by reference to the following description taken in conjunction with the accompanying drawings in which:
FIG. 1 is a perspective view of an ejector housing of a surgical ejection system, according to at least one aspect of the present disclosure. FIG. 1 is a perspective view of a surgical evacuation electrosurgical tool according to at least one aspect of the present disclosure. FIG. 1 is an elevational view of a surgical evacuation tool releasably secured to an electrosurgical pencil in accordance with at least one aspect of the present disclosure. FIG. 1 is a schematic diagram illustrating internal components within an ejector housing of a surgical ejection system, in accordance with at least one aspect of the present disclosure. 1 is a schematic diagram of an electrosurgical system including a smoke evacuator, according to at least one aspect of the present disclosure. FIG. 1 is a schematic diagram of a surgical drainage system according to at least one aspect of the present disclosure. FIG. 1 is a perspective view of a surgical system including a surgical evacuation system according to at least one aspect of the present disclosure. FIG. 8 is a perspective view of an ejector housing of the surgical ejection system of FIG. 7, in accordance with at least one aspect of the present disclosure. 9 is an elevational cross-sectional view of a socket in the ejector housing of FIG. 8 taken along the plane indicated in FIG. 8 in accordance with at least one aspect of the present disclosure. FIG. 1 is a perspective view of a filter of an exhaust system according to at least one aspect of the present disclosure. 11 is a perspective cross-sectional view of the filter of FIG. 10 taken along a central longitudinal plane of the filter, in accordance with at least one aspect of the present disclosure. 8 is a pump for a surgical drainage system, such as the surgical drainage system of FIG. 7, in accordance with at least one aspect of the present disclosure. FIG. 1 is a perspective view of a portion of a surgical drainage system according to at least one aspect of the present disclosure. FIG. 14 is a front perspective view of a fluid trap of the surgical drainage system of FIG. 13, in accordance with at least one aspect of the present disclosure. FIG. 15 is a rear perspective view of the fluid trap of FIG. 14 in accordance with at least one aspect of the present disclosure. 15 is an elevational cross-sectional view of the fluid trap of FIG. 14, in accordance with at least one aspect of the present disclosure. FIG. 15 is an elevational cross-sectional view of the fluid trap of FIG. 14 with portions removed for clarity, showing liquid trapped within the fluid trap and smoke flowing through the fluid trap, in accordance with at least one embodiment of the present disclosure. FIG. 2 is a schematic diagram of an ejector housing of an ejection system according to at least one aspect of the present disclosure. FIG. 13 is a schematic diagram of an ejector housing of another ejection system in accordance with at least one aspect of the present disclosure. FIG. 1 is a schematic diagram of a photoelectric sensor of a surgical drainage system in accordance with at least one aspect of the present disclosure. FIG. 13 is a schematic diagram of another photoelectric sensor of a surgical drainage system in accordance with at least one aspect of the present disclosure. FIG. 1 is a schematic diagram of an ionization sensor of a surgical drainage system in accordance with at least one aspect of the present disclosure. 1A is a graphical representation of (A) particle count over time and (B) motor speed over time of a surgical drainage system, in accordance with at least one aspect of the present disclosure. 1 is a cross-sectional view of a diverter valve of a surgical drainage system showing the diverter valve in a first position in accordance with at least one aspect of the present disclosure. FIG. 24B is a cross-sectional view of the diverter valve of FIG. 24A in a second position in accordance with at least one aspect of the present disclosure. 1 is a graphical representation of (A) airflow fluid content over time and (B) duty cycle over time of a surgical drainage system, in accordance with at least one aspect of the present disclosure. 13 is a flow chart illustrating a calibration algorithm for a surgical drainage system, in accordance with at least one aspect of the present disclosure. 13 is a flow chart illustrating a calibration algorithm for a surgical drainage system, in accordance with at least one aspect of the present disclosure. 13 is a flow chart illustrating a calibration algorithm for a surgical drainage system, in accordance with at least one aspect of the present disclosure. 13 is a flow chart illustrating an adjustment algorithm for a surgical system, in accordance with at least one aspect of the present disclosure. FIG. 1 is a perspective view of a surgical system according to at least one aspect of the present disclosure. 1 is a flow chart illustrating an algorithm for displaying efficiency data of a surgical drainage system, in accordance with at least one aspect of the present disclosure. 13 is a flow chart illustrating a calibration algorithm for a surgical drainage system, in accordance with at least one aspect of the present disclosure. 1 is a graphical representation of (A) particle count over time and (B) RF current to voltage ratio over time for a surgical system in accordance with at least one aspect of the present disclosure. 13 is a flow chart illustrating an adjustment algorithm for a surgical system, in accordance with at least one aspect of the present disclosure. 1 is a flowchart for controlling a motor based on at least one of a first signal received from a first sensor of the exhaust system and a second signal received from a second sensor of the exhaust system in accordance with at least one aspect of the present disclosure. 1 is a graphical representation of (A) particles counted over time, (B) generator power and voltage over time, and (C) motor speed over time for an exhaust system, in accordance with at least one embodiment of the present disclosure. 1 is a graphical representation of a ratio of a pressure detected by a first sensor to a pressure detected by a second sensor and a pulse width modulation duty cycle of a motor of an exhaust system over time, in accordance with at least one aspect of the present disclosure. 1 is a graphical representation of (A) particles counted over time and (C) air flow rate over time for an exhaust system, in accordance with at least one embodiment of the present disclosure. FIG. 1 is a block diagram of a computer-implemented interactive surgical system in accordance with at least one aspect of the present disclosure. 1 is a surgical system used to perform a surgical procedure in an operating room, according to at least one aspect of the present disclosure. A surgical hub paired with a visualization system, a robotic system, and an intelligent instrument, in accordance with at least one aspect of the present disclosure. FIG. 13 illustrates a partial perspective view of a surgical hub housing and a combination generator module slidably receivable within a drawer of the surgical hub housing, in accordance with at least one aspect of the present disclosure. FIG. 1 is a perspective view of a combination generator module including bipolar, ultrasonic, and monopolar contacts and smoke evacuation components in accordance with at least one aspect of the present disclosure. 1 illustrates individual power bus attachments for multiple lateral docking ports of a lateral modular housing configured to receive multiple modules, in accordance with at least one aspect of the present disclosure. 1 illustrates a vertical modular housing configured to receive a plurality of modules in accordance with at least one aspect of the present disclosure. FIG. 1 illustrates a surgical data network comprising a modular communications hub configured to connect modular devices located in one or more operating rooms of a medical facility, or any room in a medical facility equipped with specialized equipment for surgical procedures, to a cloud, in accordance with at least one aspect of the present disclosure. 1 illustrates a computer-implemented interactive surgical system in accordance with at least one aspect of the present disclosure. 1 illustrates a surgical hub comprising a plurality of modules coupled to a modular control tower in accordance with at least one aspect of the present disclosure. 1 illustrates one aspect of a Universal Serial Bus (USB) network hub device in accordance with at least one aspect of the present disclosure. 1 illustrates a logic diagram of a control system for a surgical instrument or tool, according to at least one aspect of the present disclosure. 1 illustrates a control circuit configured to control an aspect of a surgical instrument or tool in accordance with at least one aspect of the present disclosure. 1 illustrates a combinatorial logic circuit configured to control aspects of a surgical instrument or tool in accordance with at least one aspect of the present disclosure. 1 illustrates a sequential logic circuit configured to control aspects of a surgical instrument or tool in accordance with at least one aspect of the present disclosure. 1 illustrates a surgical instrument or tool with multiple motors that can be activated to perform various functions, in accordance with at least one aspect of the present disclosure. FIG. 1 is a schematic diagram of a robotic surgical instrument configured to manipulate a surgical tool described herein, in accordance with at least one aspect of the present disclosure. FIG. 1 illustrates a block diagram of a surgical instrument programmed to control distal translation of a displacement member, in accordance with at least one aspect of the present disclosure. FIG. 1 is a schematic diagram of a surgical instrument configured to control various functions, in accordance with at least one aspect of the present disclosure. FIG. 1 is a simplified block diagram of a generator configured to provide, among other advantages, inductorless tuning in accordance with at least one aspect of the present disclosure. 21 illustrates an example of a generator, one form of the generator of FIG. 20, in accordance with at least one aspect of the present disclosure. 1 is a timeline illustrating situational awareness of a surgical hub according to one aspect of the present disclosure.

The applicant of this application owns the following U.S. patent applications, filed June 29, 2018, the disclosures of each of which are incorporated by reference in their entirety herein:
U.S. Patent Application Serial No. ____, Attorney Docket No. END8542USNP/170755, entitled "CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS";
U.S. Patent Application Serial No. ____, Attorney Docket No. END8543USNP/170760, entitled "CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS";
U.S. patent application Ser. No. ____, Attorney Docket No. END8543USNP1/170760-1, entitled "SYSTEMS FOR ADJUSTING END EFFECTOR PARAMETERS BASED ON PERIOPERATIVE INFORMATION";
U.S. Patent Application Serial No. ____, Attorney Docket No. END8543USNP2/170760-2, entitled "SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING";
U.S. Patent Application Serial No. ______, Attorney Docket No. END8543USNP3/170760-3, entitled "SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING";
U.S. Patent Application Serial No. ____, Attorney Docket No. END8543USNP4/170760-4, entitled "SURGICAL SYSTEMS FOR DETECTING END EFFECTOR TISSUE DISTRIBUTION IRREGULARITIES";
U.S. Patent Application Serial No. ______, Attorney Docket No. END8543USNP5/170760-5, entitled "SYSTEMS FOR DETECTING PROXIMITY OF SURGICAL END EFFECTOR TO CANCEROUS TISSUE";
U.S. Patent Application Serial No. ______, Attorney Docket No. END8543USNP6/170760-6, entitled "SURGICAL INSTRUMENT CARTRIDGE SENSOR ASSEMBLIES";
U.S. Patent Application Serial No. ______, Attorney Docket No. END8543USNP7/170760-7, entitled "VARIABLE OUTPUT CARTRIDGE SENSOR ASSEMBLY";
U.S. Patent Application Serial No. ______, Attorney Docket No. END8544USNP/170761, entitled "SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE";
U.S. Patent Application Serial No. ______, Attorney Docket No. END8544USNP1/170761-1, entitled "SURGICAL INSTRUMENT HAVING A FLEXIBLE CIRCUIT";
U.S. Patent Application Serial No. ____, Attorney Docket No. END8544USNP2/170761-2, entitled "SURGICAL INSTRUMENT WITH A TISSUE MARKING ASSEMBLY";
U.S. Patent Application Serial No. ______, Attorney Docket No. END8544USNP3/170761-3, entitled "SURGICAL SYSTEMS WITH PRIORITIZED DATA TRANSMISSION CAPABILITIES";
U.S. patent application Ser. No. ____, Attorney Docket No. END8545USNP/170762, entitled "SURGICAL EVACUATION SENSING AND MOTOR CONTROL";
U.S. Patent Application Serial No. ______, Attorney Docket No. END8545USNP2/170762-2, entitled "SURGICAL EVACUATION FLOW PATHS";
U.S. Patent Application Serial No. ____, Attorney Docket No. END8545USNP3/170762-3, entitled "SURGICAL EVACUATION SENSING AND GENERATOR CONTROL";
U.S. Patent Application Serial No. ______, Attorney Docket No. END8545USNP4/170762-4, entitled "SURGICAL EVACUATION SENSING AND DISPLAY";
U.S. patent application Ser. No. ____, Attorney Docket No. END8546USNP/170763, entitled "COMMUNICATION OF SMOKE EVACUATION SYSTEM PARAMETERS TO HUB OR CLOUD IN SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM";
U.S. Patent Application Serial No. ____, Attorney Docket No. END8546USNP1/170763-1, entitled "SMOKE EVACUATION SYSTEM INCLUDING A SEGMENTED CONTROL CIRCUIT FOR INTERACTIVE SURGICAL PLATFORM"
U.S. patent application Ser. No. ____, Attorney Docket No. END8547USNP/170764, entitled "SURGICAL EVACUATION SYSTEM WITH A COMMUNICATION CIRCUIT FOR COMMUNICATION BETWEEN A FILTER AND A SMOKE EVACUATION DEVICE" and U.S. patent application Ser. No. ____, Attorney Docket No. END8548USNP/170765, entitled "DUAL IN-SERIES LARGE AND SMALL DROPLET FILTERS".

The applicant of this application owns the following U.S. provisional patent applications, filed June 28, 2018, the disclosures of each of which are incorporated by reference in their entirety herein:
- U.S. Provisional Patent Application No. 62/691,228, entitled "A METHOD OF USING REINFORCED FLEX CIRCUITS WITH MULTIPLE SENSORS WITH ELECTROSURGICAL DEVICES";
U.S. Provisional Patent Application No. 62/691,227, entitled "CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS";
- U.S. Provisional Patent Application No. 62/691,230, entitled "SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE";
U.S. Provisional Patent Application No. 62/691,219, entitled "SURGICAL EVACUATION SENSING AND MOTOR CONTROL";
U.S. Provisional Patent Application No. 62/691,257, entitled "COMMUNICATION OF SMOKE EVACUATION SYSTEM PARAMETERS TO HUB OR CLOUD IN SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM";
No. 62/691,262, entitled "SURGICAL EVACUATION SYSTEM WITH A COMMUNICATION CIRCUIT FOR COMMUNICATION BETWEEN A FILTER AND A SMOK EVACUATION DEVICE" and U.S. Provisional Patent Application No. 62/691,251, entitled "DUAL IN-SERIES LARGE AND SMALL DROPLET FILTERS."

The applicant of this application owns the following U.S. patent applications, filed March 29, 2018, the disclosures of each of which are incorporated by reference in their entirety herein:
- U.S. Patent Application Serial No. 15/940,641, entitled "INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES";
U.S. Patent Application Serial No. 15/940,648, entitled "INTERACTIVE SURGICAL SYSTEMS WITH CONDITION HANDLING OF DEVICES AND DATA CAPABILITIES";
U.S. Patent Application Serial No. 15/940,656, entitled "SURGICAL HUB COORDINATION OF CONTROL AND COMMUNICATION OF OPERATING ROOM DEVICES";
- U.S. Patent Application Serial No. 15/940,666, entitled "SPECIAL AWARENESS OF SURGICAL HUB IN OPERATING ROOMS";
- U.S. Patent Application Serial No. 15/940,670, entitled "COOPERATORY UTILIZATION OF DATA DERIVED FROM SECONDARY SOURCES BY INTELLIGENT SURGICAL HUBS";
- U.S. Patent Application Serial No. 15/940,677, entitled "SURGICAL HUB CONTROL ARRANGEMENTS";
U.S. Patent Application Serial No. 15/940,632, entitled "DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD";
U.S. patent application Ser. No. 15/940,640, entitled "COMMUNICATION HUB AND STORAGE DEVICE FOR STORING PARAMETERS AND STATUS OF A SURGICAL DEVICE TO BE SHARED WITH CLOUD BASED ANALYTICS SYSTEMS";
U.S. Patent Application Serial No. 15/940,645, entitled "SELF DESCRIBING DATA PACKETS GENERATED AT AN ISSUING INSTRUMENT";
U.S. Patent Application Serial No. 15/940,649, entitled "DATA PAIRING TO INTERCONNECT A DEVICE MEASURED PARAMETER WITH AN OUTCOME";
- U.S. Patent Application Serial No. 15/940,654, entitled "SURGICAL HUB SITUATIONAL AWARENESS";
- U.S. Patent Application Serial No. 15/940,663, entitled "SURGICAL SYSTEM DISTRIBUTED PROCESSING";
- U.S. Patent Application Serial No. 15/940,668, entitled "AGGREGATION AND REPORTING OF SURGICAL HUB DATA";
- U.S. Patent Application Serial No. 15/940,671, entitled "SURGICAL HUB SPECIAL AWARENESS TO DETERMINATION DEVICES IN OPERATING THEATER";
U.S. Patent Application Serial No. 15/940,686, entitled "DISPLAY OF ALIGNMENT OF STAPLE CARTRIDGE TO PRIOR LINEAR STAPLE LINE";
U.S. Patent Application Serial No. 15/940,700, entitled "STERILE FIELD INTERACTIVE CONTROL DISPLAYS";
- U.S. Patent Application Serial No. 15/940,629, entitled "COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS";
U.S. Patent Application Serial No. 15/940,704, entitled "USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINATION PROPERTIES OF BACK SCATTERED LIGHT";
U.S. patent application Ser. No. 15/940,722, entitled "CHARACTERIZATION OF TISSUE IRREGULARITIES THROUGH THE USE OF MONO-CHROMATIC LIGHT REFRACTIONITY" and U.S. patent application Ser. No. 15/940,742, entitled "DUAL CMOS ARRAY IMAGING".

The applicant of this application owns the following U.S. patent applications, filed March 29, 2018, the disclosures of each of which are incorporated by reference in their entirety herein:
U.S. patent application Ser. No. 15/940,636, entitled "ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES";
- U.S. Patent Application Serial No. 15/940,653, entitled "ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL HUBS";
U.S. Patent Application Serial No. 15/940,660, entitled "CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER";
U.S. Patent Application Serial No. 15/940,679, entitled "CLOUD-BASED MEDICAL ANALYTICS FOR LINKING OF LOCAL USAGE TRENDS WITH THE RESOURCE ACQUISITION BEHAVIORS OF LARGE DATA SET";
U.S. Patent Application Serial No. 15/940,694, entitled "CLOUD-BASED MEDICAL ANALYTICS FOR MEDICAL FACILITY SEGMENTED INDIVIDUALIZATION OF INSTRUMENT FUNCTION";
U.S. Patent Application Serial No. 15/940,634, entitled "CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES";
U.S. patent application Ser. No. 15/940,706, entitled "DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK" and U.S. patent application Ser. No. 15/940,675, entitled "CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES."

The applicant of this application owns the following U.S. patent applications, filed March 29, 2018, the disclosures of each of which are incorporated by reference in their entirety herein:
U.S. Patent Application Serial No. 15/940,627, entitled "DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS";
U.S. Patent Application Serial No. 15/940,637, entitled "COMMUNICATION ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS";
U.S. Patent Application Serial No. 15/940,642, entitled "CONTROLLERS FOR ROBOT-ASSISTED SURGICAL PLATFORMS";
U.S. patent application Ser. No. 15/940,676, entitled "AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS";
U.S. Patent Application Serial No. 15/940,680, entitled "CONTROLLERS FOR ROBOT-ASSISTED SURGICAL PLATFORMS";
- U.S. Patent Application Serial No. 15/940,683, entitled "COOPERATORY SURGICAL ACTIONS FOR ROBOT-ASSISTED SURGICAL PLATFORMS";
- U.S. patent application Ser. No. 15/940,690, entitled "DISPLAY ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS"; and - U.S. patent application Ser. No. 15/940,711, entitled "SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS".

The applicant of this application owns the following U.S. provisional patent applications, filed March 28, 2018, the disclosures of each of which are incorporated by reference in their entirety herein:
- U.S. Provisional Patent Application No. 62/649,302, entitled "INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES";
- U.S. Provisional Patent Application No. 62/649,294, entitled "DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD";
- U.S. Provisional Patent Application No. 62/649,300, entitled "SURGICAL HUB SITUATIONAL AWARENESS";
- U.S. Provisional Patent Application No. 62/649,309, entitled "SURGICAL HUB SPECIAL AWARENESS TO DETERMINATION DEVICES IN OPERATING THEATER";
- U.S. Provisional Patent Application No. 62/649,310, entitled "COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS";
U.S. Provisional Patent Application No. 62/649,291, entitled "USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINATION PROPERTIES OF BACK SCATTERED LIGHT";
- U.S. Provisional Patent Application No. 62/649,296, entitled "ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES";
- U.S. Provisional Patent Application No. 62/649,333, entitled "CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER";
U.S. Provisional Patent Application No. 62/649,327, entitled "CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES";
- U.S. Provisional Patent Application No. 62/649,315, entitled "DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK";
- U.S. Provisional Patent Application No. 62/649,313, entitled "CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES";
- U.S. Provisional Patent Application No. 62/649,320, entitled "DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS";
- U.S. Provisional Patent Application No. 62/649,307, entitled "AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS", and - U.S. Provisional Patent Application No. 62/649,323, entitled "SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS".

The applicant of this application owns the following U.S. provisional patent applications, filed April 19, 2018, the disclosures of each of which are incorporated by reference in their entirety herein:
- U.S. Provisional Patent Application No. 62/659,900, entitled "METHOD OF HUB COMMUNICATION."

Before describing the various aspects of the surgical device and generator in detail, it should be noted that the illustrated embodiments are not limited in application or use to the details of construction and arrangement of parts shown in the accompanying drawings and description. The illustrative embodiments may be embodied or incorporated in other aspects, variations, and modifications and may be practiced or carried out in various ways. Moreover, unless otherwise indicated, the terms and phrases used herein have been selected for the convenience of the reader and for the purpose of describing the illustrative embodiments and not for the purpose of limiting them. Furthermore, it should be understood that one or more of the aspects, embodiment of the aspects, and/or embodiments described below can be combined with any one or more of the other aspects, embodiment of the aspects, and/or embodiments described below.

Energy Devices and Smoke Evacuation The present disclosure relates to energy devices and intelligent surgical evacuation systems for evacuating smoke and/or other fluids and/or particulates from a surgical site. Smoke is often generated during surgical procedures utilizing one or more energy devices. Energy devices use energy to affect tissue. In energy devices, energy is supplied by a generator. Energy devices include devices with tissue-contacting electrodes, such as electrosurgical devices with one or more radio frequency (RF) electrodes, and devices with a vibrating surface, such as ultrasonic devices with ultrasonic blades. For electrosurgical devices, the generator is configured to generate an oscillating current to energize the electrodes. For ultrasonic devices, the generator is configured to generate ultrasonic vibrations to energize the ultrasonic blade. The generator is further described herein.

Ultrasonic energy can be utilized to coagulate and cut tissue. Ultrasonic energy coagulates and cuts tissue by vibrating an energy delivery surface (e.g., an ultrasonic blade) that contacts the tissue. The ultrasonic blade can be coupled to a waveguide that transmits vibrational energy from an ultrasonic transducer, which produces mechanical vibrations and is powered by a generator. By vibrating at high frequency (e.g., 55,500 times per second), the ultrasonic blade generates friction and heat between the blade and tissue, i.e., at the blade-tissue interface, which denatures proteins in the tissue to form a sticky coagulant. The pressure exerted on the tissue by the blade surface collapses blood vessels, allowing the coagulant to form a hemostatic seal. The precision of the cutting and coagulation can be controlled, for example, by the clinician's technique and by adjusting the power level, blade edge, tissue traction, and blade pressure.

Ultrasonic surgical instruments are finding increasingly widespread use in surgical procedures due to the specialized performance characteristics of such instruments. Depending on the particular instrument configuration and operating parameters, ultrasonic surgical instruments can provide substantially simultaneous cutting of tissue and hemostasis by coagulation, desirably with minimal trauma to the patient. The cutting action is typically accomplished by an end effector or blade tip at the distal end of the ultrasonic instrument. The ultrasonic end effector transfers ultrasonic energy to tissue brought into contact with the end effector. Ultrasonic instruments of this nature can be configured for open surgical applications, including robotic assisted surgery, laparoscopic surgery, or endoscopic surgery, for example.

Electrical energy can also be utilized for coagulation and/or cutting. Electrosurgical devices typically include a handpiece and an instrument having an end effector (e.g., one or more electrodes) attached to a distal end. The end effector can be positioned against and/or adjacent to tissue such that electrical current is introduced into the tissue. Electrosurgery is widely used and offers many advantages, including the use of a single surgical instrument for both coagulation and cutting.

The electrode or tip of the electrosurgical device is small at the point of contact with the patient to generate a high frequency current with a high current density to produce the surgical effect of coagulating and/or cutting tissue by cauterization. The return electrode carries the same high frequency signal back to the electrosurgical generator after passing through the patient, thus providing a return path for the RF signal.

Electrosurgical devices can be configured for bipolar or monopolar operation. During bipolar operation, current is introduced into tissue by the active electrode of the end effector and returned from the tissue by the return electrode of the end effector, respectively. During monopolar operation, current is introduced into tissue by the active electrode of the end effector and returned via a return electrode (e.g., a ground pad) located separately on or relative to the patient's body. Heat generated by the current flowing through the tissue may form a hemostatic seal within and/or between the tissue and thus may be particularly useful, for example, for sealing blood vessels. The end effector of the electrosurgical device may also include a cutting member movable relative to the tissue and electrode for transecting the tissue.

During application, the electrosurgical device can transmit low frequency RF current through the tissue, which creates ionic agitation or friction (i.e., resistive heating), thereby increasing the temperature of the tissue. A boundary is created between the diseased and surrounding tissue, allowing the clinician to operate with a high level of precision and control without sacrificing adjacent non-target tissue. The low operating temperature of RF energy is useful for simultaneously sealing blood vessels while removing, shrinking, or shaping soft tissue. RF energy can work particularly well on connective tissue, which is primarily composed of collagen and shrinks when exposed to heat. Other electrosurgical instruments include, but are not limited to, irreversible and/or reversible electroporation and/or microwave technologies, among others. The techniques disclosed herein are applicable to ultrasonic, bipolar and/or monopolar RF (electrosurgical), irreversible and/or reversible electroporation, and/or microwave based surgical instruments, among others.

Electrical energy applied by the electrosurgical device can be transmitted from a generator to the instrument. The generator is configured to convert the electricity into a high frequency waveform consisting of an oscillating current that is transmitted to an electrode to affect tissue. The current passes through the tissue to cauterize (a form of coagulation in which the current arcs to the tissue producing tissue charring), desiccate (direct energy application that expels cellular water), and/or cut (indirect energy application that vaporizes cellular fluids resulting in cellular explosion). The response of the tissue to the current is a function of the resistance of the tissue, the current density passing through the tissue, the power output, and the duration of current application. In certain instances, as further described herein, the current waveform can be tailored to affect different surgical functions and/or to accommodate tissues with different properties. For example, different types of tissues - vascular tissue, nervous tissue, muscle, skin, fat, and/or bone - may respond differently to the same waveform.

The electrical energy may be in the form of RF energy, which may be within the frequency ranges set forth in EN60601-2-2:2009+A11:2011, Definition 201.3.218-HIGH FREQUENCY. For example, frequencies in monopolar RF applications are typically limited to less than 5 MHz to minimize problems associated with high frequency leakage currents. Frequencies above 200 kHz may typically be used in monopolar applications to avoid unnecessary stimulation of nerves and muscles resulting from the use of low frequency currents.

In bipolar RF applications, the frequency can be nearly any frequency. In certain instances, such as when a risk analysis indicates that the potential for neuromuscular stimulation has been mitigated to an acceptable level, lower frequencies can be used for bipolar techniques. Generally, 10 mA is recognized as the lower threshold for thermal effects on tissue. Higher frequencies can also be used for bipolar techniques.

In certain examples, the generator can be configured to digitally generate and provide output waveforms to a surgical device, allowing the surgical device to utilize the waveforms for various tissue effects. The generator may be a monopolar generator, a bipolar generator, and/or an ultrasonic generator. For example, a single generator can provide energy to a monopolar device, a bipolar device, an ultrasonic device, or a combined electrosurgical/ultrasonic device. The generator can facilitate tissue-specific effects through waveform shaping and/or can drive RF and ultrasonic energy simultaneously and/or sequentially to a single surgical instrument or multiple surgical instruments.

In one example, the surgical system can include a generator and various surgical instruments usable therewith, including ultrasonic surgical instruments, RF electrosurgical instruments, and hybrid ultrasonic/RF electrosurgical instruments. The generator may be configurable for use with various surgical instruments, as further described in U.S. Patent Application No. 15/265,279, entitled "TECHNIQUES FOR OPERATING GENERATOR FOR DIGITALLY GENERATING ELECTRICAL SIGNAL WAVEFORMS AND SURGICAL INSTRUMENTS," filed September 14, 2016 (now U.S. Patent Application Publication No. 2017/0086914), which is incorporated herein by reference in its entirety.

As described herein, medical procedures for cutting tissue and/or cauterizing blood vessels are often performed by utilizing RF electrical energy that is generated by a generator and transmitted to a patient's tissue via an electrode operated by a clinician. The electrode delivers an electrical discharge to the cytoplasm of the patient's body adjacent to the electrode. This discharge heats the cytoplasm, cutting the tissue and/or cauterizing the blood vessel.

The high temperatures associated with electrosurgery can cause thermal necrosis of tissue adjacent to the electrode. The longer the tissue is exposed to the high temperatures associated with electrosurgery, the greater the likelihood that the tissue will undergo thermal necrosis. In certain instances, thermal necrosis of tissue can reduce the rate at which tissue can be cut and increase the incidence of thermal damage to tissue located away from the cut site, as well as increase post-operative complications, eschar formation, and healing times.

The concentration of the RF energy discharge affects both the efficiency with which the electrode can cut tissue and the likelihood of tissue damage distant from the cut site. With standard electrode geometries, the RF energy tends to be distributed uniformly over a relatively large area adjacent to the intended incision site. A generally uniform distribution of the RF energy discharge increases the likelihood of extraneous charge loss to surrounding tissue, which can increase the likelihood of undesired tissue damage in the surrounding tissue.

A typical electrosurgical generator produces RF electrical energy at a variety of operating frequencies and output power levels. The specific operating frequency and power output of the generator will vary based on the particular electrosurgical generator being used and the needs of the physician during the electrosurgical procedure. The specific operating frequency and power output level can be manually adjusted on the generator by the clinician or other operating room personnel. Properly adjusting these various settings requires significant knowledge, skill, and attention from the clinician or other personnel. Once the clinician makes the desired adjustments to the various settings on the generator, the generator can maintain those output parameters during the electrosurgical procedure. Generally, waveform generators used in electrosurgery are adapted to produce RF waves having output powers ranging from 1-300 W in cutting mode and 1-120 W in coagulation mode, and frequencies ranging from 300-600 kHz. A typical waveform generator is adapted to maintain the selected settings during the electrosurgical procedure. For example, if a clinician sets the generator output power level to 50 W and then contacts the electrodes with a patient to perform electrosurgery, the generator power level will rapidly increase and remain at 50 W. Setting the power level to a particular setting, such as 50 W, will allow the clinician to cut the patient's tissue, but maintaining such a high power level increases the likelihood of thermal necrosis of the patient's tissue.

In some forms, the generator is configured to provide sufficient power to effectively perform electrosurgery in conjunction with electrodes that increase the concentration of RF energy discharge while limiting unwanted tissue damage, reducing post-operative complications, and promoting faster healing. For example, the waveform from the generator can be optimized by a control circuit throughout the surgical procedure. However, the subject matter claimed herein is not limited to aspects that eliminate any disadvantages or that operate only in environments such as those described above. Rather, this background is presented merely to illustrate one example of a technology area in which some aspects described herein may be practiced.

As provided herein, an energy device delivers mechanical and/or electrical energy to a target tissue to treat the tissue (e.g., to cut tissue, cauterize blood vessels, and/or coagulate tissue within and/or near the target tissue). Cutting, cauterizing, and/or coagulating tissue can result in fluids and/or particulates being released into the air. Such fluids and/or particulates released during a surgical procedure may constitute smoke, which may include, for example, carbon particles and/or other particles suspended in the air. In other words, the fluids may include smoke and/or other fluidic substances. Approximately 90% of endoscopic and open surgeries generate some level of smoke. Smoke can be unpleasant to the olfactory senses of the clinician(s), assistant(s), and/or patient(s), can obstruct the clinician(s)'s view of the surgical site, and in certain instances may be unhealthy if inhaled. For example, smoke generated during electrosurgical procedures may contain toxic chemicals including acrolein, acetonitrile, acrylonitrile, acetylene, alkylbenzenes, benzene, butadiene, butene, carbon monoxide, creosol, ethane, ethylene, formaldehyde, free radicals, hydrogen cyanide, isobutene, methane, phenols, polycyclic aromatic hydrocarbons, propene, propylene, pyridene, pyrrole, styrene, toluene, and xylene, as well as dead and live cellular material (including blood fragments), and viruses. Certain substances identified in surgical smoke have been identified as known carcinogens. It is estimated that one gram of tissue cauterized during electrosurgical procedures may be equivalent to the toxic and carcinogenic substances in six unfiltered cigarettes. In addition, exposure to smoke released during electrosurgical procedures has been reported to cause eye and lung irritation in medical personnel.

In addition to the toxicity and odor associated with the substances in surgical smoke, the size of the particulate matter in surgical smoke can be harmful to the respiratory systems of the clinician(s), assistant(s), and/or patient(s). In certain instances, the particulates can be very small. In certain instances, repeated inhalation of very small particulate matter can lead to acute and chronic respiratory conditions.

Many electrosurgical systems employ a surgical evacuation system that captures smoke resulting from the surgical procedure and directs the captured smoke away from the clinician(s) and/or patient through a filter and an exhaust port. For example, the evacuation system can be configured to exhaust smoke generated during an electrosurgical procedure. Although such an evacuation system can be referred to as a "smoke evacuation system," the reader will understand that such an evacuation system can be configured to exhaust more than just smoke from the surgical site. Throughout this disclosure, the "smoke" exhausted by the evacuation system is not limited to simply smoke. Rather, the smoke evacuation systems disclosed herein can be used to exhaust a variety of fluids, including liquids, gases, vapors, smoke, water vapor, or combinations thereof. The fluids may be biological and/or may be introduced to the surgical site from an external source during the procedure. Fluids can include, for example, water, saline, lymph, blood, exudate, and/or purulent discharge. Additionally, the fluids can include particulates or other matter (e.g., cellular matter or debris) that are exhausted by the evacuation system. For example, such particles may become suspended in the fluid.

The exhaust system often includes a pump and a filter. The pump generates suction that draws the smoke into the filter. For example, the suction can be configured to draw smoke from the surgical site to the conduit opening, through the exhaust conduit, and into the exhaust housing of the exhaust system. The exhaust housing 50018 of the surgical exhaust system 50000 is shown in FIG. 1. In one aspect of the present disclosure, the pump and filter are disposed within the exhaust housing 50018. The smoke drawn into the exhaust housing 50018 travels to the filter via the suction conduit 50036, and harmful toxic substances and unpleasant odors are filtered from the smoke as it travels through the filter. The suction conduit may also be referred to as, for example, a vacuum conduit and/or an exhaust conduit and/or a vacuum tube and/or an exhaust tube. The filtered air can then exit the surgical exhaust system as exhaust air. In certain examples, the various exhaust systems disclosed herein can also be configured to deliver fluid to a desired location, such as a surgical site.

2, the suction conduit 50036 from the ejector housing 50018 (FIG. 1) may terminate in a handpiece, such as handpiece 50032. The handpiece 50032 comprises an electrosurgical instrument including an electrode tip 50034 and an exhaust conduit opening near and/or adjacent to the electrode tip 50034. The exhaust conduit opening is configured to capture fluids and/or particulates released during a surgical procedure. In such an example, the exhaust system 50000 is integrated into the electrosurgical instrument 50032. Still referring to FIG. 2, smoke S is drawn into the suction conduit 50036.

In certain examples, the evacuation system 50000 can include a separate surgical tool with a conduit opening and configured to draw smoke into the system. In yet other examples, the tool with the evacuation conduit and opening can be snap-fit onto the electrosurgical tool as shown in FIG. 3. For example, a portion of the suction conduit 51036 can be disposed around (or adjacent to) the electrode tip 51034. In one example, the suction conduit 51036 can be releasably secured to the handpiece 51032 of the electrosurgical tool with the electrode tip 51034 having a clip or other fastener.

Various internal components of the ejector housing 50518 are shown in FIG. 4. In various examples, the internal components of FIG. 4 can also be incorporated into the ejector housing 50018 of FIG. 1. Referring primarily to FIG. 4, the ejection system 50500 includes an ejector housing 50518, a filter 50502, an exhaust mechanism 50520, and a pump 50506. The ejection system 50500 defines a flow path 50504 through the ejector housing 50518 having an inlet port 50522 and an outlet port 50524. The filter 50502, the exhaust mechanism 50520, and the pump 50506 are arranged in series with the flow path 50504 through the ejector housing 50518 between the inlet port 50522 and the outlet port 50524. The inlet port 50522 can be fluidly connected to a suction conduit, such as, for example, the suction conduit 50036 of FIG. 1, which can include a distal conduit opening positionable at the surgical site.

The pump 50506 is configured to create a pressure differential in the flow path 50504 by mechanical action. The pressure differential is configured to draw smoke 50508 from the surgical site into the inlet port 50522 and along the flow path 50504. After the smoke 50508 travels through the filter 50502, the smoke 50508 can be considered filtered smoke or air 50510, which continues through the flow path 50504 and is exhausted through the outlet port 50524. The flow path 50504 includes a first zone 50514 and a second zone 50516. The first zone 50514 is upstream from the pump 50506. The second zone 50516 is downstream from the pump 50506. The pump 50506 is configured to pressurize the fluid in the flow path 50504 such that the fluid in the second zone 50516 has a higher pressure than the fluid in the first zone 50514. A motor 50512 drives the pump 50506. Various suitable motors are described further herein. The exhaust mechanism 50520 is a mechanism that can control the velocity, direction, and/or other characteristics of the filtered smoke 50510 exiting the exhaust system 50500 at the outlet port 50524.

The flow path 50504 through the exhaust system 50500 can be comprised of a tube or other conduit that substantially contains the fluid moving through the flow path 50504 and/or separates it from the fluid outside the flow path 50504. For example, the first zone 50514 of the flow path 50504 may include a tube through which the flow path 50504 extends between the filter 50502 and the pump 50506. The second zone 50516 of the flow path 50504 may also include a tube through which the flow path 50504 extends between the pump 50506 and the exhaust mechanism 50520. The flow path 50504 also extends through the filter 50502, the pump 50506, and the exhaust mechanism 50520 such that the flow path 50504 extends continuously from the inlet port 50522 to the outlet port 50524.

In operation, smoke 50508 can flow into the filter 50502 at the inlet port 50522 and can be pumped by the pump 50506 through the flow path 50504 such that the smoke 50508 is drawn into the filter 50502. The filtered smoke 50510 can then be pumped through the exhaust mechanism 50520 and out the outlet port 50524 of the exhaust system 50500. The filtered smoke 50510 that exits the exhaust system 50500 at the outlet port 50524 is exhaust and can consist of filtered gases that have passed through the exhaust system 50500.

In various examples, the evacuation systems disclosed herein (e.g., evacuation system 50000 and evacuation system 50500) can be incorporated into a computer-implemented interactive surgical system, such as, for example, system 100 (FIG. 39) or system 200 (FIG. 47). In one aspect of the present disclosure, for example, computer-implemented surgical system 100 can include at least one hub 106 and cloud 104. Referring primarily to FIG. 41, hub 106 includes a smoke evacuation module 126. The operation of smoke evacuation module 126 can be controlled by hub 106 based on its situational awareness and/or feedback from its components and/or based on information from cloud 104. Computer-implemented surgical systems 100 and 200, and situational awareness therefor, are further described herein.

Situational awareness encompasses the ability of some aspects of a surgical system to determine or infer information relevant to a surgical procedure from data received from a database and/or an instrument. The information may include the type of procedure being performed, the type of tissue being operated on, or the body cavity that is the subject of the procedure. Contextual information related to a surgical procedure may enable a surgical system to, for example, improve how it controls modular devices (e.g., smoke evacuation systems) that are connected to it and provide contextualized information or suggestions to a clinician during the course of a surgical procedure. Situational awareness is further described herein and in U.S. Provisional Patent Application No. 62/611,341, filed December 28, 2017, entitled "INTERACTIVE SURGICAL PLATFORM," which is incorporated herein by reference in its entirety.

In various examples, the surgical system and/or evacuation system disclosed herein can include a processor. The processor can be programmed to control one or more operating parameters of the surgical system and/or evacuation system, for example, based on sensed and/or aggregated data and/or one or more user inputs. FIG. 5 is a schematic diagram of an electrosurgical system 50300 including a processor 50308. The electrosurgical system 50300 is powered by an AC power source 50302 that provides either 120V or 240V AC. The voltage provided by the AC power source 50302 is directed to an AC/DC converter 50304 that converts the 120V or 240V AC to 360V DC. The 360V DC is then directed to a power converter 50306 (e.g., a buck converter). The power converter 50306 is a step-down DC/DC converter. The power converter 50306 is adapted to step down the input 360V to a desired level within the range of 0 to 150V.

The processor 50308 can be programmed to adjust various aspects, functions, and parameters of the electrosurgical system 50300. For example, the processor 50308 can determine a desired output power level at the electrode tip 50334, which may be similar in many respects to the electrode tip 50034 of FIG. 2 and/or the electrode tip 51034 of FIG. 3, and instruct the power converter 50306 to step down the voltage to a specified level to provide the desired output power. The processor 50308 is coupled to a memory 50310 configured to store machine-executable instructions for operating the electrosurgical system 50300 and/or its subsystems.

A digital-to-analog converter ("DAC") 50312 is connected between the processor 50308 and the power converter 50306. The DAC 50312 is adapted to convert the digital code generated by the processor 50308 into an analog signal (current, voltage, or charge) that governs the voltage step-down performed by the power converter 50306. When the power converter 50306 steps down the 360V to a level determined by the processor 50308, it provides the desired output power level, and the stepped-down voltage is directed to the electrode tip 50334 and then to the return or ground electrode 50335 to achieve electrosurgical treatment of the patient's tissue. The voltage sensor 50314 and the current sensor 50316 are adapted to detect the voltage and current present in the electrosurgical circuit and communicate the detected parameters to the processor 50308, which can then determine whether to adjust the output power level. As mentioned herein, a typical waveform generator is adapted to maintain selected settings throughout an electrosurgical procedure. In other examples, the generator's operating parameters can be optimized during a surgical procedure based on one or more inputs to the processor 5308, such as, for example, inputs from a surgical hub, a cloud, and/or a situational awareness module, as further described herein.

The processor 50308 is coupled to a communication device 50318 for communicating over a network. The communication device includes a transceiver 50320 configured to communicate over a physical wire or wirelessly. The communication device 50318 may further include one or more additional transceivers. The transceivers may include, but are not limited to, a cellular modem, a wireless mesh network transceiver, a Wi-Fi® transceiver, a low power wide area (LPWA) transceiver, and/or a near field communications transceiver (NFC). The communication device 50318 may include or be configured to communicate with a mobile phone, a sensor system (e.g., environmental, location, motion, etc.) and/or a sensor network (wired and/or wireless), a computing system (e.g., a server, a workstation computer, a desktop computer, a laptop computer, a tablet computer (e.g., iPad (registered trademark), Galaxy Tab (registered trademark), etc.), an ultra-portable computer, an ultra-mobile computer, a netbook computer, and/or a sub-notebook computer, etc.). In at least one aspect of the present disclosure, one of these devices may be a coordinator node.

The transceiver 50320 may be configured to receive serial transmit data from the processor 50308 via a corresponding UART, modulate the serial transmit data onto an RF carrier, generate a transmit RF signal, and transmit the transmit RF signal via a corresponding antenna. The transceiver(s) are further configured to receive a receive RF signal including an RF carrier modulated with the serial receive data via a corresponding antenna, demodulate the receive RF signal to extract the serial receive data, and provide the serial receive data to a corresponding UART for providing to the processor. Each RF signal has an associated carrier frequency and an associated channel bandwidth. The channel bandwidth is associated with the carrier frequency, the transmit data, and/or the receive data. Each RF carrier frequency and channel bandwidth is associated with an operating frequency range(s) of the transceiver(s) 50320. Each channel bandwidth is further associated with a wireless communication standard and/or protocol to which the transceiver(s) 50320 may conform. In other words, each transceiver 50320 can support a selected wireless communication standard and/or protocol, for example, an implementation of IEEE 802.11a/b/g/n for Wi-Fi (registered trademark) and/or IEEE 802.15.4 for wireless mesh networking using Zigbee routing.

The processor 50308 is coupled to a sensing and intelligent controller 50324 that is coupled to the smoke evacuator 50326. The smoke evacuator 50326 can include one or more sensors 50327 and can include a pump and a pump motor controlled by a motor driver 50328. The motor driver 50328 is communicatively coupled to the processor 50308 and the pump motor in the smoke evacuator 50326. The sensing and intelligent controller 50324 includes sensor algorithms 50321 and communication algorithms 50322 that facilitate communication between the smoke evacuator 50326 and other devices to adapt their control programs. The sensing and intelligent controller 50324 is configured to evaluate, for example, fluids, particles, and gases extracted via the exhaust conduit 50336 to improve smoke extraction efficiency and/or reduce smoke output of the device, as further described herein. In certain examples, the sensing and intelligent control device 50324 is communicatively coupled to one or more sensors 50327 within the smoke evacuator 50326, one or more internal sensors 50330, and/or one or more external sensors 50332 of the electrosurgical system 50300.

In certain examples, the processor may be located within the ejector housing of the surgical evacuation system. For example, with reference to FIG. 6, the processor 50408 and memory 50410 therefor are located within the ejector housing 50440 of the surgical evacuation system 50400. The processor 50408 is in signal communication with the motor driver 50428, various internal sensors 50430, the display 50442, the memory 50410, and the communication device 50418. The communication device 50418 is similar in many respects to the communication device 50318 described above with respect to FIG. 5. The communication device 50418 may enable the processor 50408 in the surgical evacuation system 50400 to communicate with other devices in the surgical system. For example, the communication device 50418 can enable wired and/or wireless communication to one or more external sensors 50432, one or more surgical devices 50444, one or more hubs 50448, one or more clouds 50446, and/or one or more additional surgical systems and/or tools. The reader will readily appreciate that in certain examples, the surgical evacuation system 50400 of FIG. 6 can be incorporated into the electrosurgical system 50300 of FIG. 5. The surgical evacuation system 50400 also includes a pump 50450 including its pump motor 50451, an evacuation conduit 50436, and an exhaust 50452. The various pumps, evacuation conduits, and exhausts are further described herein. The surgical evacuation system 50400 can also include a sensing and intelligent controller, which can be similar in many respects to the sensing and intelligent controller 50324, for example. For example, such sensing and intelligent control devices may be in signal communication with the processor 50408 and/or one or more of the sensors 50430 and/or the external sensors 50432.

The electrosurgical system 50300 (FIG. 5) and/or the surgical evacuation system 50400 (FIG. 6) can be programmed to monitor one or more parameters of the surgical system and affect surgical functions based on one or more algorithms stored in memory in signal communication with the processor 50308 and/or 50408. Various exemplary aspects disclosed herein can be implemented, for example, by such algorithms.

In one aspect of the disclosure, a processor and sensor system, such as processors 50308 and 50408 and corresponding sensor systems in communication therewith (FIGS. 5 and 6), are configured to sense airflow through a vacuum source to adjust parameters of the smoke evacuation system and/or external devices and/or systems used in conjunction with the smoke evacuation system, such as electrosurgical systems, energy devices, and/or generators. In one aspect of the disclosure, the sensor system can include multiple sensors positioned along an airflow path of the surgical evacuation system. The sensors can measure a pressure difference in the evacuation system to detect a state or condition of the system between the sensors. For example, the system between two sensors can be a filter and the pressure difference can be used to increase the speed of a pump motor when flow through the filter is reduced to maintain flow rate through the system. As another example, the system can be a fluid trap in the evacuation system and the pressure difference can be used to determine the airflow path through the evacuation system. In yet another example, the system can be an inlet and an outlet (or exhaust) of the evacuation system and the pressure difference can be used to determine a maximum suction load in the evacuation system to maintain the maximum suction load below a threshold.

In one aspect of the disclosure, a processor and sensor system, such as processors 50308 and 50408 and corresponding sensor systems in communication therewith (FIGS. 5 and 6), are configured to detect the proportion of aerosols or carbonized particulates, i.e., smoke, in the fluid extracted from the surgical site. For example, the sensing system may include a sensor that detects the size and/or composition of particles used to select an airflow path through the exhaust system. In such an example, the exhaust system may include a first filtration path or first filtration state, and a second filtration path or second filtration state, which may have different characteristics. In one example, the first path includes only a particulate filter, and the second path includes both a fluid filter and a particulate filter. In a particular example, the first path includes a particulate filter, and the second path includes a particulate filter and a finer particulate filter arranged in series. Additional and/or alternative filtration paths are also envisioned.

In one aspect of the disclosure, the processors and sensor systems, such as the processors 50308 and 50408 and corresponding sensor systems in communication therewith (FIGS. 5 and 6), are configured to perform chemical analysis on particles expelled from within the patient's abdominal cavity. For example, the sensing and intelligent controller 50324 may sense particle count and type to adjust the power level of the ultrasonic generator to guide the ultrasonic blade to generate less smoke. In another example, the sensor system may include sensors to detect particle count, temperature, fluid content, and/or contamination percentage of the expelled fluid and communicate the detected characteristic(s) to the generator to adjust the generator output. For example, the smoke evacuation device 50326 and/or the sensing and intelligent controller 50324 therefor may be configured to adjust the exhaust flow rate and/or pump motor speed to a predetermined particulate level and may operatively affect the generator output power or waveform to reduce smoke generated by the end effector.

In one aspect of the disclosure, a processor and sensor system, such as processors 50308 and 50408 and their corresponding sensor systems (FIGS. 5 and 6), are configured to assess particle counts and contamination in an operating room by evaluating one or more characteristics of the ambient air and/or the exhaust air from the eductor housing. The particle count and/or air quality may be displayed on the smoke evacuation system, such as on the eductor housing, for example, to communicate the information to a clinician and/or to establish the effectiveness of the smoke evacuation system and its filter(s).

In one aspect of the disclosure, a processor, such as, for example, processor 50308 or processor 50408 (FIGS. 5 and 6), is configured to compare sample velocity images obtained from the endoscope with the evacuation particle count from the sensing system (e.g., sensing and intelligent control device 50324) to determine correlation and/or adjust the pump revolutions-per-minute (RPM) speed. In one example, activation of the generator may be communicated to the smoke evacuation system, thereby implementing the anticipated required smoke evacuation rate. Activation of the generator may be communicated to the surgical evacuation system, for example, via a surgical hub, a cloud communication system, and/or a direct connection.

In one aspect of the present disclosure, the sensor system and algorithms of the smoke evacuation system (see, e.g., FIGS. 5 and 6) can be configured to control the smoke evacuation system and adapt its motor parameters to adjust the filtration efficiency of the smoke evacuation system based on the needs of the surgical field at a given time. In one example, an adaptive airflow pump speed algorithm is provided to automatically change the motor pump speed based on sensed particulates entering the smoke evacuation system inlet and/or exiting the smoke evacuation system outlet or exhaust. For example, the sensing and intelligent control device 50324 (FIG. 5) can include, for example, a user selectable speed and an automatic mode speed. In the automatic mode speed, the airflow through the evacuation system may be scalable based on the lack of smoke entering the evacuation system and/or filtered particles exiting the smoke evacuation system. In a particular example, the automatic mode speed can provide automatic sensing and compensation for laparoscopic mode.

In one aspect of the present disclosure, the evacuation system can include an electrical and communication architecture (see, e.g., FIGS. 5 and 6) that provides data collection and communication capabilities to improve interactivity with the surgical hub and cloud. In one embodiment, the surgical evacuation system and/or its processors, such as, for example, processor 50308 (FIG. 5) and processor 50408 (FIG. 6), can include a segmented control circuit that is energized in a stepped manner to check for system errors, shorts, and/or safety checks. The segmented control circuit can also be configured to have energized portions and portions that are not energized until the energized portions perform a first function. The segmented control circuit can include circuit elements for identifying and displaying status updates to a user of the attached component. The segmented control circuit also includes circuit elements for operating the motor in a first state in which the motor is activated by the user, and a second state in which the motor is not activated by the user but causes the pump to operate quieter and at a slower speed. The segmented control circuit can, for example, allow for energizing the smoke evacuator in a stepped manner.

The electrical and communication architecture of the evacuation system (see, e.g., Figures 5 and 6) can also provide interconnectivity of the smoke evacuation system with other components in the surgical hub for interaction and communication of data with the cloud. Communication of surgical evacuation system parameters to the surgical hub and/or cloud can be provided to affect the output or operation of other attached devices. The parameters may be operational or may be sensed. Operational parameters include airflow, pressure differential, and air quality. Sensed parameters include particulate concentration, aerosol fraction, and chemical analysis.

In one aspect of the present disclosure, an evacuation system, such as the surgical evacuation system 50400, can also include a housing, replaceable components, a control, and a display. Circuit elements are provided for communicating security identification (ID) between such replaceable components. For example, communication between the filter and the smoke evacuation electronics can be provided to verify component authenticity, remaining life, update parameters within the components, record errors, and/or limit the number and/or type of components that can be identified by the system. In various examples, the communication circuitry can authenticate features for enabling and/or disabling configuration parameters. The communication circuitry can employ encryption and/or error handling schemes to manage security and unique relationships between components and the smoke evacuation electronics. Disposable/reusable components are included in certain examples.

In one aspect of the present disclosure, an evacuation system can provide fluid management as well as extraction filters and airflow configurations. For example, a surgical evacuation system is provided that includes a fluid capture mechanism having first and second sets of extraction or airflow control mechanisms in series with one another to extract large and small fluid droplets, respectively. In a particular example, the airflow path can include a recirculation or secondary fluid channel that runs from downstream of the exhaust port of the primary fluid management chamber back to the primary reservoir.

In one aspect of the present disclosure, a smart pad can be coupled to the electrosurgical system. For example, the ground electrode 50335 of the electrosurgical system 50300 (FIG. 5) can include a smart pad with local sensing integrated into the pad while maintaining capacitive coupling. For example, the capacitively coupled return path pad can have small separable array elements that can be used to sense neural control signals and/or movement at selected anatomical locations to detect the proximity of the monopolar tip to a nerve bundle.

The electrosurgical system may include a signal generator, an electrosurgical instrument, a return electrode, and a surgical evacuation system. The generator may be an RF wave generator that generates RF electrical energy. Connected to the electrosurgical instrument is a utility conduit. The utility conduit includes a cable that transmits electrical energy from the signal generator to the electrosurgical instrument. The utility conduit also includes a vacuum hose that conveys captured/collected smoke and/or fluid away from the surgical site. Such an exemplary electrosurgical system 50601 is shown in FIG. 7. More specifically, the electrosurgical system 50601 includes a generator 50640, an electrosurgical instrument 50630, a return electrode 50646, and an evacuation system 50600. The electrosurgical instrument 50630 includes a handle 50632 and a distal conduit opening 50634 that is fluidly connected to a suction hose 50636 of the evacuation system 50600. The electrosurgical instrument 50630 also includes an electrode powered by the generator 50640. A first electrical connection 50642, e.g., a wire, extends from the electrosurgical instrument 50630 to the generator 50640. A second electrical connection 50644, e.g., a wire, extends from the electrosurgical instrument 50630 to an electrode, i.e., a return electrode 50646. In other examples, the electrosurgical instrument 50630 may be a bipolar electrosurgical instrument. A distal conduit opening 50634 on the electrosurgical instrument 50630 is fluidly connected to a suction hose 50636 that extends to a filter end cap 50603 of a filter installed in the evacuation housing 50618 of the evacuation system 50600.

In other examples, the distal conduit opening 50634 of the evacuation system 50600 may be on a handpiece or tool separate from the electrosurgical instrument 50630. For example, the evacuation system 50600 may include a surgical tool that is not coupled to the generator 50640 and/or does not include a tissue-energizing surface. In certain examples, the distal conduit opening 50634 of the evacuation system 50600 may be releasably attached to the electrosurgical tool. For example, the evacuation system 50600 may include a clip-on or snap-on conduit that terminates in a distal conduit opening, which may be releasably attached to the surgical tool (see, e.g., FIG. 3).

The electrosurgical instrument 50630 is configured to deliver electrical energy to a target tissue of a patient to cut tissue and/or cauterize blood vessels in and/or near the target tissue, as described herein. Specifically, an electrical discharge is provided to the patient by the electrode tip to cause heating of the patient's cellular tissue in close contact with or adjacent to the electrode tip. Heating of the tissue occurs to a suitably high temperature such that electrosurgical procedures can be performed using the electrosurgical instrument 50630. A return electrode 50646 is either applied to the patient or placed in close proximity to the patient (depending on the type of return electrode) to complete the circuit and provide a return electrical path to the generator 50640 for the energy entering the patient's body.

Heating of a patient's endoplasm with the electrode tip, or cauterization of a blood vessel to prevent bleeding, often results in the emission of smoke where the cauterization is performed, as described further herein. In such instances, the exhaust system 50600 is configured to capture smoke emitted during a surgical procedure, as the exhaust conduit opening 50634 is near the electrode tip. Vacuum suction can draw the smoke through the electrosurgical instrument 50630, into the conduit opening 50634, and into the suction hose 50636 toward the ejector housing 50618 of the exhaust system 50600.

8, the ejector housing 50618 of the ejection system 50600 (FIG. 7) is shown. The ejector housing 50618 includes a socket 50620 that is sized and structured to receive a filter. The ejector housing 50618 can fully or partially enclose the internal components of the ejector housing 50618. The socket 50620 includes a first receptacle 50622 and a second receptacle 50624. A transition surface 50626 extends between the first receptacle 50622 and the second receptacle 50624.

9, the socket 50620 is depicted along the cross-sectional plane shown in FIG. 8. The socket 50620 includes a first end 50621 open to receive a filter and a second end 50623 in communication with the flow path 50699 through the ejector housing 50618. A filter 50670 (FIGS. 10 and 11) may be removably disposed with the socket 50620. For example, the filter 50670 may be inserted into and removed from the first end 50621 of the socket 50620. The second receptacle 50624 is configured to receive a connecting nipple of the filter 50670.

Surgical exhaust systems often use filters to remove unwanted contaminants from the smoke before it is released as exhaust. In certain instances, the filters may be replaceable. The reader will appreciate that the filter 50670 shown in FIGS. 10 and 11 may be used in the various exhaust systems disclosed herein. The filter 50670 may be a replaceable and/or disposable filter.

The filter 50670 includes a front cap 50672, a rear cap 50674, and a filter body 50676 disposed therebetween. The front cap 50672 includes a filter inlet 50678, which in certain instances is configured to receive smoke directly from a suction hose 50636 (FIG. 7) or other smoke source. In some aspects of the disclosure, the front cap 50672 can be replaced by a fluid trap (e.g., fluid trap 50760 shown in FIGS. 14-17) that directs smoke directly from the smoke source and removes at least a portion of the fluid therefrom before passing the partially treated smoke into the filter body 50676 for further processing. For example, the filter inlet 50678 can be configured to receive smoke via an exhaust port of the fluid trap, such as port 50766 of the fluid trap 50760 (FIGS. 14-17), and transmit the partially treated smoke to the filter 50670.

As smoke enters the filter 50670, it can be filtered by components housed within the filter body 50676. The filtered smoke can then exit the filter 50670 through a filter outlet 50680 defined within a rear cap 50674 of the filter 50670. When the filter 50670 is associated with an exhaust system, suction created within the exhaust housing 50618 of the exhaust system 50600 can be transferred to the filter 50670 via the filter outlet 50680 to draw smoke through the internal filtering components of the filter 50670. Filters often include particulate filters and charcoal filters. Particulate filters can be, for example, high-efficiency particulate air (HEPA) filters or ultra-low penetration air (ULPA) filters. ULPA filtration utilizes a depth filter similar to a labyrinth. Particulates can be filtered using at least one of the following methods: direct blocking (particles over 1.0 microns are trapped because they are too large to pass through the fibers of the media filter), inertial impaction (particles between 0.5 and 1.0 microns collide with the fibers and are retained there), and diffusion blocking (particles smaller than 0.5 microns are trapped by the effects of Brownian random thermal motion as the particles "search" for and attach to the fibers).

Charcoal filters are configured to remove toxic gases and/or odors generated by surgical smoke. In various examples, the charcoal may be "activated," meaning that it has been treated with a heating process to expose active absorption sites. The charcoal may be from activated virgin coconut shells, for example.

11, the filter 50670 includes a coarse media filter layer 50684 followed by a fine particulate filter layer 50686. In other examples, the filter 50670 may consist of a single type of filter. In still other examples, the filter 50670 may include three or more filter layers and/or three or more different types of filter layers. After the particulate matter is removed by the filter layers 50684 and 50686, the smoke is drawn through a carbon reservoir 50688 in the filter 50670 to remove gaseous contaminants in the smoke, such as, for example, volatile organic compounds. In various examples, the carbon reservoir 50688 may include a charcoal filter. The filtered smoke, now substantially free of particulate matter and gaseous contaminants, is drawn through the filter outlet 50680 into the exhaust system 50600 for further processing and/or removal.

The filter 50670 includes multiple dams between components of the filter body 50676. For example, the first dam 50690 is disposed intermediate the filter inlet 50678 (FIG. 10) and the first particulate filter, such as the coarse media filter 50684. The second dam 50692 is disposed intermediate the second particulate filter, such as the fine particulate filter 50686, and the carbon reservoir 50688. Additionally, the third dam 50694 is disposed intermediate the carbon reservoir 50688 and the filter exhaust 50680. The dams 50690, 50692, and 50694 can include gaskets or O-rings that are configured to prevent movement of components within the filter body 50676. In various examples, the size and shape of the dams 50690, 50692, and 50694 can be selected to prevent expansion of the filter components in the direction of the applied suction.

The coarse media filter 50684 can include, for example, a low air resistance filter material such as fiberglass, polyester, and/or pleated filters configured to remove a majority of particulate matter larger than 10 μm. In some aspects of the present disclosure, this includes filters that remove at least 85% of particulate matter larger than 10 μm, more than 90% of particulate matter larger than 10 μm, more than 95% of particulate matter larger than 10 μm, more than 99% of particulate matter larger than 10 μm, more than 99.9% of particulate matter larger than 10 μm, or more than 99.99% of particulate matter larger than 10 μm.

Additionally or alternatively, the coarse media filter 50684 can include a low air resistance filter that removes a majority of particulate matter larger than 1 μm. In some aspects of the present disclosure, this includes a filter that removes at least 85% of particulate matter larger than 1 μm, more than 90% of particulate matter larger than 1 μm, more than 95% of particulate matter larger than 1 μm, more than 99% of particulate matter larger than 1 μm, more than 99.9% of particulate matter larger than 1 μm, or more than 99.99% of particulate matter larger than 1 μm.

The fine particulate filter 50686 can include any filter with a higher efficiency than the coarse media filter 50684. This includes, for example, a filter that can filter a higher percentage of particles of the same size as the coarse media filter 50684 and/or that can filter particles of a smaller size than the coarse media filter 50684. In some aspects of the disclosure, the fine particulate filter 50686 can include a HEPA filter or a ULPA filter. Additionally or alternatively, the fine particulate filter 50686 can be pleated to increase its surface area. In some aspects of the disclosure, the coarse media filter 50684 includes a pleated HEPA filter and the fine particulate filter 50686 includes a pleated ULPA filter.

After particulate filtration, the smoke enters a downstream portion of the filter 50670 that includes a carbon reservoir 50688. The carbon reservoir 50688 is defined by porous partitions 50696 and 50698 disposed between the intermediate dam 50692 and the end dam 50694, respectively. In some aspects of the disclosure, the porous partitions 50696 and 50698 are rigid and/or inflexible and define a fixed spatial volume for the carbon reservoir 50688.

The carbon reservoir 50688 can include additional sorbents that act either cumulatively with or independently of the carbon particles to remove gaseous contaminants. Additional sorbents can include sorbents such as, for example, magnesium oxide and/or copper oxide, which can act to adsorb gaseous contaminants such as, for example, carbon monoxide, ethylene oxide, and/or ozone. In some aspects of the disclosure, the additional sorbents are dispersed throughout the reservoir 50688 and/or disposed in separate layers above, below, or within the reservoir 50688.

Referring again to FIG. 4, the evacuation system 50500 includes a pump 50506 in an evacuation housing 50518. Similarly, the evacuation system 50600 shown in FIG. 7 can include a pump disposed in the evacuation housing 50618 that can generate suction to draw smoke from the surgical site through the suction hose 50636 and through a filter 50670 (FIGS. 10 and 11). In operation, the pump can generate a pressure differential in the evacuation housing 50618 that moves the smoke into the filter 50670 and out of the exhaust mechanism (e.g., exhaust mechanism 50520 in FIG. 4) at the outlet of the flow path. The filter 50670 is configured to extract harmful, contaminating, or otherwise unwanted particulates from the smoke.

The pump may be disposed in line with the flow path through the ejector housing 50618, such that gas flowing through the ejector housing 50618 enters the pump at one end and exits the pump at the other end. The pump may provide a sealed positive displacement flow path. In various examples, the pump may create a sealed positive displacement flow path by trapping (sealing) a first volume of gas and reducing the volume to a second, smaller volume as the gas moves through the pump. Reducing the volume of the trapped gas increases the pressure of the gas. The second, pressurized volume of gas may be released from the pump at the pump outlet. For example, the pump may be a compressor. More specifically, the pump may include a hybrid regenerative blower, a claw pump, a lobe compressor, and/or a scroll compressor. A positive displacement compressor may provide improved compression ratios and operating pressures while limiting vibration and noise generated by the ejector system 50600. Additionally or alternatively, the ejector system 50600 may include a fan for moving the fluid.

12 shows an example of a positive displacement compressor, e.g., a scroll compressor pump 50650. The scroll compressor pump 50650 includes a stator scroll 50652 and a moving scroll 50654. The stator scroll 50652 can be fixed in position while the moving scroll 50654 orbits eccentrically. For example, the moving scroll 50654 can orbit eccentrically to rotate about the central longitudinal axis of the stator scroll 50652. As shown in FIG. 12, the central longitudinal axes of the stator scroll 50652 and the moving scroll 50654 extend perpendicular to the plane of view of the scrolls 50652, 50654. The stator scroll 50652 and the moving scroll 50654 are interleaved with each other to form separate sealed compression chambers 50656.

During use, gas can enter the scroll compressor pump 50650 at the inlet 50658. As the moving scroll 50654 orbits relative to the stator scroll 50652, the inlet gas is first trapped in the compression chamber 50656. The compression chamber 50656 is configured to move a separate volume of gas along the spiral shape of the scrolls 50652 and 50654 toward the center of the scroll compressor pump 50650. The compression chamber 50656 defines an enclosed space in which gas resides. Furthermore, as the moving scroll 50654 moves the trapped gas toward the center of the stator scroll 50652, the compression chamber 50656 decreases in volume. This decrease in volume increases the pressure of the gas in the compression chamber 50656. The gas in the sealed compression chamber 50656 is trapped while the volume is decreasing, thus pressurizing the gas. When the pressurized gas reaches the center of the scroll compressor pump 50650, the pressurized gas is released through the outlet 50659.

13, a portion of the evacuation system 50700 is shown. The evacuation system 50700 may be similar in many respects to the evacuation system 50600 (FIG. 7). For example, the evacuation system 50700 includes an evacuation housing 50618 and a suction hose 50636. Referring again to FIG. 7, the evacuation system 50600 is configured to generate suction, thereby drawing smoke from a distal end of the suction hose 50636 into the evacuation housing 50618 for processing. Notably, the suction hose 50636 is not connected to the evacuation housing 50618 via the filter end cap 50603 of FIG. 13. Rather, the suction hose 50636 is connected to the evacuation housing 50618 via a fluid trap 50760. A filter similar to the filter 50670 may be disposed in a socket in the evacuation housing 50618 behind the fluid trap 50760.

The fluid trap 50760 is a first processing point that extracts and holds at least a portion of the fluid (e.g., liquid) from the smoke before relaying the partially treated smoke to the exhaust system 50700 for further processing and filtering. The exhaust system 50700 is configured to process, filter, and otherwise clean the smoke to reduce or eliminate unpleasant odors or other problems associated with smoke generation in an operating room (or other operating environment), as described herein. In certain examples, by extracting liquid droplets and/or aerosols from the smoke before it is further processed by the exhaust system 50700, the fluid trap 50760 can, among other things, increase the efficiency of the exhaust system 50700 and/or increase the life of a filter associated therewith.

14-17, the fluid trap 50760 is shown removed from the ejector housing 50618 (FIG. 13). The fluid trap 50760 includes an inlet port 50762 defined in a front cover or surface 50764 of the fluid trap 50760. The inlet port 50762 can be configured to releasably receive the suction hose 50636 (FIG. 13). For example, an end of the suction hose 50636 can be at least partially inserted into the inlet port 50762 and secured therebetween with an interference fit. In various examples, the interference fit can be a fluid-tight and/or air-tight fit such that substantially all of the smoke passing through the suction hose 50636 is transferred into the fluid trap 50760. In some cases, other mechanisms for connecting or joining the suction hose 50636 to the inlet port 50762 can be used, such as, for example, a latch-based compression fit, an O-ring, a threaded connection of the suction hose 50636 to the inlet port 50762, and/or other connection mechanisms.

In various examples, the fluid-tight and/or air-tight fit between the suction hose 50636 and the fluid trap 50760 is configured to prevent leakage of fluids and/or other substances in the exhausted smoke at or near the junction of these components. In some cases, the suction hose 50636 can be associated with the inlet port 50762 via an intermediate coupling device, such as, for example, an O-ring and/or an adapter, to further ensure an air-tight and/or fluid-tight connection between the suction hose 50636 and the fluid trap 50760.

As described above, the fluid trap 50760 includes an exhaust port 50766. The exhaust port extends away from the back cover or surface 50768 of the fluid trap 50760. The exhaust port 50766 defines an open channel between the interior chamber 50770 of the fluid trap 50760 and the external environment. In some cases, the exhaust port 50766 is sized and shaped to be in close association with a surgical evacuation system or a component thereof. For example, the exhaust port 50766 may be sized and shaped to be in association with and to convey at least partially treated smoke from the fluid trap 50760 to a filter housed within the evacuation housing 50618 (FIG. 13). In certain examples, the exhaust port 50766 can extend away from the front plate, top surface, or side surface of the fluid trap 50760.

In certain examples, the exhaust port 50766 includes a membrane that spaces the exhaust port 50766 from the ejector housing 50618. Such a membrane can act to prevent water or other liquids collected in the fluid trap 50760 from passing through the exhaust port 50766 and into the ejector housing 50618 while allowing air, water, and/or steam to freely enter the ejector housing 50618. For example, a high flow microporous polytetrafluoroethylene (PTFE) can be positioned downstream of the exhaust port 50766 and upstream of the pump to protect the pump or other components of the ejection system 50700 from damage and/or contamination.

The fluid trap 50760 also includes a gripping area 50772 that is positioned and dimensioned to assist a user in handling the fluid trap 50760 and/or connecting the fluid trap 50760 with the suction hose 50636 and/or the ejector housing 50618. The gripping area 50772 is depicted as being an elongated recess. However, the reader will readily appreciate that the gripping area 50772 may include, for example, at least one recess, groove, protrusion, tassel, and/or ring, which may be sized and shaped to accommodate a user's finger or otherwise provide a gripping surface.

16 and 17, the interior chamber 50770 of the fluid trap 50760 is shown. The relative arrangement of the inlet port 50762 and the exhaust port 50766 is configured to facilitate the extraction and retention of fluids from the smoke as it enters the fluid trap 50760. In certain examples, the inlet port 50762 can have a notched cylindrical shape that can direct the smoke and associated fluids toward the fluid reservoir 50774 of the fluid trap 50760 or otherwise directionally away from the exhaust port 50766. Examples of such fluid flows are shown by arrows A, B, C, D, and E in FIG. 17.

As shown, smoke enters the fluid trap 50760 through the inlet port 50762 (indicated by arrow A) and exits the fluid trap 50760 through the exhaust port 50766 (indicated by arrow E). Due at least in part to the geometry of the inlet port (e.g., the longer upper sidewall 50761 and the shorter lower sidewall 50763), smoke entering the inlet port 50762 is initially directed primarily downward into the fluid reservoir 50774 of the fluid trap 50760 (indicated by arrow B). As the smoke continues to be drawn downward into the fluid trap 50760 along arrows A and B, the initially downwardly directed smoke rotates downward and is directed laterally away from its source, traveling toward the top of the fluid trap 50760 and out of the exhaust port 50766 in a substantially opposite but parallel path (indicated by arrows D and E).

The directional flow of smoke through the fluid trap 50760 can ensure that liquid in the smoke is extracted and retained in the lower portion of the fluid trap 50760 (e.g., the fluid reservoir 50774). Furthermore, the relative location of the exhaust port 50766 vertically above the inlet port 50762 when the fluid trap 50760 is in an upright position is configured to substantially not impede the flow of fluid into and out of the fluid trap 50760 while simultaneously inhibiting the inadvertent transport of liquid through the exhaust port 50766 by the flow of smoke. Additionally, in certain examples, the configuration of the inlet port 50762 and the outlet port 50766, and/or the size and shape of the fluid trap 50760 itself, can enable the fluid trap 50760 to be hermetic.

In various examples, the exhaust system can include a number of sensors and an intelligent controller, for example, as further described herein with respect to FIG. 5 and FIG. 6. In one aspect of the present disclosure, the exhaust system can include one or more temperature sensors, one or more fluid detection sensors, one or more pressure sensors, one or more particle sensors, and/or one or more chemical sensors. The temperature sensor can be positioned to detect the temperature of a fluid at the surgical site traveling through the surgical exhaust system and/or being exhausted from the surgical exhaust system into the operating room. The pressure sensor can be positioned to detect a pressure within the exhaust system, such as in an ejector housing. For example, the pressure sensor can be positioned upstream of the filter, between the filter and the pump, and/or downstream of the pump. In certain examples, the pressure sensor can be positioned to detect a pressure in the ambient environment outside the exhaust system. Similarly, the particle sensor can be positioned to detect particles within the exhaust system, such as in an ejector housing. The particle sensor can be, for example, upstream of the filter, between the filter and the pump, and/or downstream of the pump. In various examples, the particle sensor can be positioned to detect particles in the ambient environment, for example, to determine air quality within the operating room.

The ejector housing 50818 of the ejection system 50800 is shown diagrammatically in FIG. 18. The ejector housing 50818 may be similar in many respects to, for example, the ejector housings 50018 and/or 50618 and/or may be incorporated into the various ejection systems disclosed herein. The ejector housing 50818 includes a number of sensors, which are further described herein. The reader will understand that a particular ejector housing may not include each sensor shown in FIG. 18 and/or may include additional sensor(s). Similar to the ejector housings 50018 and 50618 disclosed herein, the ejector housing 50818 of FIG. 18 includes an inlet 50822 and an outlet 50824. The fluid trap 50860, the filter 50870, and the pump 50806 are aligned in series along the flow path 50804 through the ejector housing 50818 between the inlet 50822 and the outlet 50824.

The ejector housing may include modular and/or replaceable components, as further described herein. For example, the ejector housing may include a socket or receptacle 50871 sized to receive a modular fluid trap and/or a replaceable filter. In certain examples, as shown in FIG. 18, the fluid trap and filter may be incorporated into a single replaceable module 50859. More specifically, the fluid trap 50860 and the filter 50870 form a replaceable module 50859, which may be modular and/or replaceable, and may be removably installed in a receptacle 50871 in the ejector housing 50818. In other examples, the fluid trap 50860 and the filter 50870 may be separate and distinct modular components that may be assembled together and/or installed separately in the ejector housing 50818.

With further reference to the ejector housing 50818, the ejector housing 50818 includes multiple sensors for detecting various parameters therein and/or parameters of the surrounding environment. Additionally or alternatively, one or more modular components installed within the ejector housing 50818 may include one or more sensors. For example, with further reference to FIG. 18, the replaceable module 50859 includes multiple sensors for detecting various parameters therein.

In various examples, the ejector housing 50818 and/or a modular component(s) compatible with the ejector housing 50818 can include a processor, such as processors 50308 and 50408 (FIGS. 5 and 6, respectively), configured to receive inputs from one or more sensors and/or communicate outputs to one or more systems and/or drivers. Various processors for use with the ejector housing 50818 are further described herein.

During operation, smoke from the surgical site can be drawn from the inlet 50822 through the fluid trap 50860 into the ejector housing 50818. The flow path 50804 through the ejector housing 50818 of FIG. 18 can include a sealed conduit or tube 50805 extending between various in-line components. In various examples, the smoke can flow through a fluid detection sensor 50830 and a chemical sensor 50832 to a diverter valve 50834, further described herein. A fluid detection sensor, such as the sensor 50830, can detect fluid particles in the smoke. In one example, the fluid detection sensor 50830 can be a continuity sensor. For example, the fluid detection sensor 50830 can include two spaced apart electrodes and a sensor for detecting the degree of continuity between them. For example, when no fluid is present, the continuity can be zero or substantially zero. The chemical sensor 50832 can detect a chemical characteristic of the smoke.

At the diverter valve 50834, the fluid can be directed into the condenser 50835 of the fluid trap 50860, and the smoke can continue toward the filter 50870. A baffle 50864 is positioned within the condenser 50835 to promote condensation of fluid droplets from the smoke into a reservoir within the fluid trap 50860. The fluid detection sensor 50836 can ensure that any fluid within the ejector housing is completely, or at least substantially, captured within the fluid trap 50860.

With further reference to FIG. 18, the smoke can then be directed to flow into a filter 50870 of the replaceable module 50859. At the inlet to the filter 50870, the smoke can flow through a particle sensor 50838 and a pressure sensor 50840. In one form, the particle sensor 50838 can include a laser particle counter, as further described herein. The smoke can be filtered through a pleated ultra-low penetration air (ULPA) filter 50842 and a charcoal filter 50844, as shown in FIG. 18.

Upon exiting the filter, the filtered smoke can flow past a pressure sensor 50846 and then continue along a flow path 50804 in the eductor housing 50818 toward the pump 50806. Moving through the pump 50806, the filtered smoke can flow past an outlet particle sensor 50848 and a pressure sensor 50850 to the eductor housing 50818. In one form, the particle sensor 50848 can include a laser particle counter, as described further herein. The eductor housing 50818 of FIG. 18 also includes an air quality particle sensor 50852 and an ambient pressure sensor 50854 to detect various characteristics of the surrounding environment, such as the environment in the operating room. In at least one form, the air quality particle sensor or the external/ambient air particle sensor 50852 can include a laser particle counter. The various sensors shown in FIG. 18 are further described herein. Additionally, in various examples, alternative sensing means can be utilized in the smoke evacuation systems disclosed herein. For example, alternative sensors for counting particles and/or determining particulate concentrations in a fluid are further disclosed herein.

In various examples, the fluid trap 50860 shown in FIG. 18 can be configured to prevent trapped fluid from spilling and/or leaking. For example, the geometry of the fluid trap 50860 may be selected to prevent trapped fluid from spilling and/or leaking. In certain examples, the fluid trap 50860 can include a splatter screen, such as a baffle and/or screen 50862, to prevent trapped fluid from splashing out of the fluid trap 50860. In one or more examples, the fluid trap 50860 can include a sensor to detect the volume of fluid in the fluid trap and/or determine whether the fluid trap 50860 is filled to capacity. The fluid trap 50860 can include a valve to empty the fluid therefrom. The reader will readily appreciate that a variety of alternative fluid trap configurations and geometries can be used to capture fluid drawn into the ejector housing 50818.

In certain examples, the filter 50870 can include additional and/or lesser levels of filtration. For example, the filter 50870 can include one or more filtration layers selected from the group of a coarse media filter, a fine media filter, and a sorbent-based filter. The coarse media filter can be a low air resistance filter that can be constructed of, for example, fiberglass, polyester, and/or pleated filters. The fine media filter can be a high efficiency particulate air (HEPA) filter and/or a ULPA filter. The sorbent-based filter can be, for example, an activated carbon filter. The reader will readily appreciate that a variety of alternative filter configurations and geometries can be used to filter smoke drawn along the flow path through the ejector housing 50818.

In one or more examples, the pump 50806 shown in FIG. 18 can be replaced and/or used in combination with another compressor and/or pump, such as, for example, a hybrid regenerative blower, a claw pump, and/or a lobe compressor. The reader will readily appreciate that a variety of alternative pump configurations and geometries can be used to create suction in the flow passage 50804 to draw smoke into the eductor housing 50818.

Various sensors in the ejection system, such as the sensors shown in FIG. 18, can be in communication with a processor. The processor can be incorporated into the ejection system and/or can be a component of another surgical instrument and/or surgical hub. Various processors are further described herein. The on-board processor can be configured to adjust one or more operating parameters of the ejector system (e.g., a motor for the pump 50806) based on input from the sensor(s). Additionally or alternatively, the on-board processor can be configured to adjust one or more operating parameters of another device, such as an electrosurgical tool and/or an imaging device, based on input from the sensor(s).

19, an alternative ejector housing 50918 of the ejection system 50900 is shown. The ejector housing 50918 of FIG. 19 may be similar in many respects to the ejector housing 50818 of FIG. 18. For example, the ejector housing 50918 defines a flow path 50904 between an inlet 50922 to the ejector housing 50918 and an outlet 50924 of the ejector housing 50918. Intermediate the inlet 50922 and the outlet 50924 are disposed in series a fluid trap 50960, a filter 50970, and a pump 50906. The ejector housing 50918 may include a socket or receptacle 50971 sized to receive a modular fluid trap and/or a replaceable filter, similar to the receptacle 50871, for example. At the diverter valve 50934, the fluid can be directed into a condenser 50935 of the fluid trap 50960 and the smoke can continue towards the filter 50970. In certain examples, the fluid trap 50960 can include a baffle, such as baffle 50964, and/or a splatter screen, such as screen 50962, to prevent trapped fluid from splashing out of the fluid trap 50960. The filter 50970 includes a pleated ultra-low permeation air (ULPA) filter 50942 and a charcoal filter 50944. Sealed conduits or tubes 50905 extend between the various in-line components. The ejector housing 50918 also includes sensors 50830, 50832, 50836, 50838, 50840, 50846, 50848, 50850, 50852, and 50854, which are further described herein and shown in FIGS. 18 and 19.

19, the ejector housing 50918 also includes a centrifugal blower arrangement 50980 and a recirculation valve 50990. The recirculation valve 50990 can be selectively opened and closed to recirculate fluid through the fluid trap 50960. For example, if the fluid detection sensor 50836 detects fluid, the recirculation valve 50990 can be opened so that the fluid is directed away from the filter 50970 and back into the fluid trap 50960. If the fluid detection sensor 50836 does not detect fluid, the valve 50990 can be closed so that the smoke is directed into the filter 50970. As the fluid is recirculated through the recirculation valve 50990, the fluid may be drawn through the recirculation conduit 50982. The centrifugal blower arrangement 50980 engages the recirculation conduit 50982 to generate a recirculation suction force within the recirculation conduit 50982. More specifically, when the recirculation valve 50990 is opened and the pump 50906 is activated, the suction force generated by the pump 50906 downstream of the filter 50970 can cause a rotation of a first centrifugal blower or cage 50984, which can be transmitted to a second centrifugal blower or cage 50986, which draws fluid that is recirculated through the recirculation valve 50990 and into the fluid trap 50960.

In various aspects of the present disclosure, the control schematics of FIGS. 5 and 6 can be utilized with the various sensor systems and ejector housings of FIGS. 18 and 19.

Smoke exhausted from a surgical site may include liquids, aerosols, and/or gases, and/or may include materials of different chemical and/or physical properties, such as, for example, particulate matter and particles of different sizes and/or densities. Different types of materials exhausted from a surgical site may affect the efficiency of a surgical evacuation system and its pump. Additionally, certain types of materials may require the pump to draw excessive power and/or may cause damage to the motor for the pump.

The power supplied to the pump can be modulated to control the smoke flow rate through the exhaust system based on input from one or more sensors along the flow path. The output from the sensors can indicate, for example, the condition or quality of the smoke exhaust system and/or one or more characteristics of the exhausted smoke, such as the type(s) and ratio of material, chemical properties, density, and/or particulate size. In one aspect of the disclosure, the pressure difference between two pressure sensors in the exhaust system can indicate the condition of the area between them, such as, for example, the condition of a filter, a fluid trap, and/or the overall system. Based on the sensor input, the operating parameters of the pump motor can be adjusted by changing the current and/or duty cycle supplied to the motor, which is configured to change the motor speed.

In one aspect of the present disclosure, the efficiency of the filter can be improved and/or the motor can be protected from burnout by adjusting the smoke flow rate through the exhaust system.

The surgical exhaust system may include one or more particle counters or sensors for detecting the size and/or concentration of particulates in the smoke. Referring again to FIGS. 18 and 19, particle sensors 50838 and 50848 are shown. The reader will readily appreciate that a variety of particle measurement means are possible. For example, the particle sensor may be an optical sensor, a laser sensor, a photoelectric sensor, an ionization sensor, an electrostatic sensor, and/or combinations thereof. Various particle sensors are further described herein.

In various examples, the speed of the motor, and therefore the speed of the pump, may be adjusted based on particulate concentration detected by one or more particle sensors in the surgical evacuation system. For example, when the particle sensor(s) detect an increase in particle concentration in the flow path, which may correspond to an increase in the amount of smoke in the flow path, the speed of the motor may be increased to increase the speed of the pump to draw more fluid from the surgical site into the smoke evacuation system. Similarly, when the particle sensor(s) detect a decrease in particle concentration in the flow path, which may correspond to a decrease in the amount of smoke in the flow path, the speed of the motor may be decreased to decrease the speed of the pump to reduce suction from the surgical site. Additional and alternative adjustment algorithms for the surgical evacuation system are further described herein. Additionally, in certain examples, based on sensor data from the smoke evacuation system, a generator in the surgical system may be controlled to adjust the amount of smoke generated at the surgical site, as further described herein.

In addition to the particle sensor located along the flow path of the surgical exhaust system, the system can include one or more sensors for detecting particulate concentrations in an ambient room, e.g., an operating room or surgical suite. Referring again to FIGS. 18 and 19, the air quality particle sensor 50852 is located on an exterior surface of the exhaust housing 50818. Alternative locations for the air quality particle sensor 50852 are also contemplated.

In at least one example, the particle sensor can be located downstream of the filter, and in certain examples, at or near the outlet of the filter. For example, the particle sensor 50848 is located downstream of the filter 50870 and the pump 50806 in the smoke exhaust system 50800, and downstream of the filter 50970 and the pump 50906 in the smoke exhaust system 50900. Because the particle sensor 50848 is located downstream of the filter(s) 50870, 50970, the particle sensor is configured to verify that the filter(s) 50870, 50970 have removed sufficient particulates from the smoke. In various examples, such a sensor may be adjacent to the exhaust outlets 50824, 50924 of the ejector housings 50818, 50918, respectively. In one aspect of the present disclosure, an electrostatic particle sensor can be utilized. For example, the exhaust outlets 50824, 50924 can include an electrostatic particulate sensor through which the exhaust passes downstream of a filtration system before being exhausted into the operating room.

The particulate concentration detected by one or more sensors of the surgical evacuation system may be communicated to the clinician in many different ways. For example, the ejector housing 50818, 50918 and/or the evacuation device (e.g., the electrosurgical instrument 50032 of FIG. 2) may include an indicator, such as one or more lights and/or a display screen. For example, an LED on the ejector housing 50818, 50819 may change color (e.g., from blue to red) depending on the volume of particles detected by the sensor(s). In other examples, the indicator may include an alarm or warning, which may be, for example, tactile, audible, and/or visual. In such examples, the clinician(s) in the operating room may be notified by the indicator(s) when the particulate concentration in the ambient air detected by the air quality sensor (e.g., the particle sensor 50852) exceeds a threshold amount.

In certain examples, the surgical evacuation system may include an optical sensor. The optical sensor may include an electronic sensor that coversts light or changes in light into an electronic signal. The optical sensor may utilize light scattering to detect and count particles in the smoke to determine the concentration of particles in the smoke. In various examples, the light is laser based. For example, in one example, a laser light source is configured to illuminate the particles as they move through the detection chamber. When a particle passes through the beam of the laser, the light source is obscured, redirected, and/or absorbed. The scattered light is recorded by a photodetector, and the recorded light is analyzed. For example, the recorded light may be converted into an electrical signal indicative of the size and amount of particles, which corresponds to the particulate concentration in the smoke. The particulate concentration in the smoke may be calculated in real time, for example, by a laser optical sensor. In one aspect of the present disclosure, at least one of the particle sensors 50838, 50848, 50852 is a laser optical sensor.

Photoelectric sensors for detecting particles in smoke may be through-beam sensors, reflective sensors, or diffuse sensors. A reflective photoelectric sensor 51000 is shown in FIG. 20. Referring to FIG. 20, the reflective photoelectric sensor 51000 is a light scattering sensor in which a light beam 51002 emitted from a light source 51006 through a lens 51012 is offset from a light detector or photocell 51004. For example, the light detector 51004 in FIG. 20 is offset 90 degrees from the light source 51006. When smoke S obscures the light beam 51002 between the light source 51006 and the light catcher 51008, the light is reflected and the reflected light 51010 is scattered toward the lens 51014 and onto the light detector 51004. The light detector 51004 converts the light into an electrical signal (current) corresponding to the particulate concentration in the smoke S. The output signal can be provided to a processor 51016, which may be similar in many respects to the processors 50308 and/or 50408 shown in Figures 5 and 6, respectively, which can affect operating parameters of a motor based on the electrical signal and the corresponding particulate concentration. For example, the output signal from the reflective photoelectric sensor 51000 can be an input to a control algorithm for the motor and/or to a surgical hub.

21 shows a pass-through photoelectric sensor 51100. As shown in FIG. 21, a line of sight extends between the light source 51102 and the photodetector 51104. In such an example, the intensity of light reaching the photodetector 51104 can be converted into an electrical signal (current) corresponding to the particulate concentration in the smoke S. The output signal can be provided to a processor 51106 coupled to a 24V DC power source, which may be similar in many respects to the processors 50308 and/or 50408 shown in FIGS. 5 and 6. The processor 51106 can affect the operating parameters of the motor based on the electrical signal and the corresponding particulate concentration. For example, the output signal from the photoelectric sensor 51100 can be an input to a control algorithm for the motor and/or an input to a surgical hub.

In a photoelectric sensor of a surgical drainage system, such as sensor 51000 of FIG. 20 and/or sensor 51100 of FIG. 21, wavelengths of light can be selected to tune the sensor 51000 for a particular type of smoke while ignoring other types of smoke. In certain instances, multiple sensors and/or multiple wavelengths can be used to tune the sensor 51000 to the correct combination or combinations. Water vapor, and even dense water vapor, absorbs certain wavelengths of light. For example, water vapor absorbs infrared light instead of reflecting it. Due to these absorption properties of water vapor, infrared light can be useful in the presence of water vapor to accurately count particles in the fluid within the surgical drainage system.

In a particular example, an ionization sensor can be used to detect particles in smoke. An ionization sensor contains two electrodes and a radioactive material that converts air molecules into positive and negative ions. The positive ions migrate toward the negative electrode and the negative ions migrate toward the positive electrode. As smoke passes between the electrodes, it binds with the ions, thereby interrupting the circuit. The drop in current through the circuit can be converted into an electrical signal (current) that corresponds to the volume of smoke passing between the electrodes.

The ionization sensor 51200 is shown in FIG. 22. The ionization sensor 51200 utilizes americium-241 to ionize air in an enclosed area. The sensor 51200 includes a small ionization chamber 51202 having two spaced apart electrodes 51204. The ionization chamber 51202 can be made of, for example, polyvinyl chloride or polystyrene, and the electrodes 51204 can be, for example, spaced apart about 1 cm in the ionization chamber 51202. An americium-241 source 51208 can provide americium-241 to the ionization chamber 51202. About 0.3 μg of americium-241 can be embedded, for example, in a gold foil matrix sandwiched between a silver backing and a 2 micron thick layer of palladium laminate. Americium-241 has a half-life of 432 years and can decay by emitting alpha radiation 51206. The gold foil matrix is configured to retain the radioactive material while still allowing alpha radiation 51206 to pass through. In various examples, alpha radiation is preferred over beta and gamma radiation because it easily ionizes air particles, has low penetrating power, and can be easily contained.

During ionization, electrons are knocked off of oxygen and nitrogen molecules, thereby creating charged ions. The charged ions are attracted to the oppositely charged electrode, thus forming a current in the chamber. Because the smoke particulates 51210 are larger than air molecules, the ionized particles collide with and combine with the smoke particulates. The combined particles act as recombination centers and neutralize the ions, thereby reducing the amount of ionized particles in the ionization chamber 51202 and reducing the overall current. The reduction in current can be converted into an electrical signal corresponding to the volume of smoke passing between the electrodes 51204. The output signal can be provided to a processor, such as the processor 50308 and/or the processor 50408 shown in FIGS. 5 and 6, respectively, which can affect, for example, the operating parameters of the motor. For example, the output signal from the ionization sensor 51200 can be an input to a control algorithm for the motor and/or an input to the surgical hub, as further described herein.

In various examples, dual ionization chambers can be used. The first chamber, acting as a sensing chamber, can be open to the atmosphere and affected by particulate matter, humidity, and atmospheric pressure. The second chamber can be isolated from smoke and particulate matter. The second chamber is located outside the smoke flow path but is still affected by humidity and atmospheric pressure. By using two chambers, changes in humidity and atmospheric pressure can be minimized because the output from both chambers are equally affected and cancel each other out. For example, dual ionization chambers can be useful in smoke evacuation systems to compensate for pressure and humidity fluctuations, since humidity and pressure can change significantly during a surgical procedure depending on the type of surgical procedure, the surgical device(s) used, and the type of tissue encountered.

In certain examples, a combinatorial approach can be utilized to determine the particulate concentration in the smoke. For example, multiple different types of smoke detectors or sensors can be utilized. Such sensors can be arranged in series with the flow path. For example, multiple particle sensors can be arranged along flow path 50804 of FIG. 18 and/or flow path 50904 of FIG. 19. The various sensors can provide inputs to pump motor control algorithms, such as the various tuning algorithms described herein.

In certain examples, the surgical exhaust system can be configured to adjust the sensor parameters to more accurately detect particulates in the smoke. The adjustment of the sensor parameters can depend on the type of surgical device, the type of surgical procedure, and/or the type of tissue. Surgical devices often generate a predictable type of smoke. For example, in certain procedures, the predictable type of smoke can be smoke with a high water vapor content. In such examples, an infrared photoelectric sensor can be used because infrared light is substantially absorbed and not reflected by water vapor. Additionally or alternatively, the predictable type of smoke can be smoke having particles of a particular size or concentration. Based on the expected size of the particles, the sensor can be adjusted to more accurately determine the particulate concentration in the smoke.

In certain examples, situational awareness can facilitate adjustment of sensor parameters. Information related to situational awareness can be provided to the surgical evacuation system by a clinician, an intelligent electrosurgical instrument in signal communication with the surgical evacuation system, a robotic system, a hub, and/or a cloud. For example, the hub can include a situational awareness module that can aggregate data from various sensor and/or input systems, including, for example, a smoke evacuation system. Sensors and/or inputs throughout the computer-implemented interactive surgical system can be used to determine and/or confirm, for example, the surgical device utilized in the surgical procedure, the type and/or step of the surgical procedure, and/or the type of tissue. In certain examples, situational awareness can predict the type of smoke that will be generated at a particular time. For example, the situational awareness module can determine the type of surgical procedure and steps therein to determine what type of smoke is likely to be generated. Sensors can be adjusted based on the type of smoke expected.

In certain examples, one or more of the particle sensors disclosed herein may be a fluid detection sensor. For example, the particle sensor may be arranged and configured to determine whether aerosols and/or liquid droplets are present in the emitted smoke. In one aspect of the present disclosure, the size and/or concentration of the detected particles may correspond to aerosols, liquid droplets, solid matter, and/or combinations thereof. In certain examples, the situational awareness may determine and/or confirm whether the detected particles are aerosols or solid matter. For example, a situational awareness module in signal communication with a processor (e.g., processor 50308 of FIG. 5 and/or processor 50408 of FIG. 6) may signal the identification of particles in the fluid.

23, a graphical representation of particle count 51300 and motor speed 51302 over time for a surgical drainage system, such as surgical drainage system 50400 (FIG. 6) is shown. The target motor speed 51304 may be predefined and stored in a memory of a processor (see, e.g., FIGS. 5 and 6) in signal communication with the motor. In various examples, the processor may be configured to maintain the target motor speed 51304 under normal operating conditions. For example, the target motor speed 51304 may be stored in memory 50410 (FIG. 6) and the processor 50408 (FIG. 6) may be configured to maintain the target motor speed 51304 under normal operating conditions. In such examples, when the surgical drainage system 50400 (FIG. 6) is activated, the motor 50451 may operate at the target motor speed 51304 and may continue to operate at the target motor speed 51304 unless one or more conditions are detected and/or communicated to the processor 50408.

In certain examples, the processor 50408 can be in signal communication with a particle sensor configured to detect particulate concentration in the inhaled smoke in real time. Various examples of particulate concentration sensors, such as laser particle counter sensors, are described herein. In one aspect of the disclosure, particle sensors 50838 (FIGS. 18 and 19) located at the inlet to the filter 50870 in FIG. 18 and the inlet to the filter 50970 in FIG. 19 can be in signal communication with the processor 50408 (FIG. 6). For example, the laser particle sensor 50838 can correspond to one of the sensors 50430 in FIG. 6.

In various examples, when the particle sensor 50838 (FIGS. 18 and 19) detects that the particulate concentration (e.g., parts per million of particulate matter in the fluid) has fallen below a threshold amount 51306, the processor 50408 can instruct the motor driver 50428 to reduce the speed of the motor 50451. For example, at time _t1 in FIG. 23, the particle count or particulate concentration 51300 has fallen below the threshold amount 51306. Because the particle count 51300 has fallen below the threshold amount 51306, the motor speed 51302 may be reduced until it is below the target motor speed 51304. If the particle sensor 50838 (FIGS. 18 and 19) subsequently detects that the particle count 51300 again exceeds the threshold amount 51306, such as at time _t2 , the processor 50408 can instruct the motor driver 50428 to increase the speed of the motor 50451 to resume the target motor speed 51304. The particulate concentration can correspond to the size of the particles in the smoke. For example, the smoke can contain smaller particles between time _t1 and time _t2 . Reducing the speed of the motor 50451 can reduce the suction created by the pump 50450, thereby ensuring that smaller particles are not sucked through the filters of the surgical drainage system 50400. For example, reducing the motor speed or reducing the pump pressure can ensure that the filtration system has adequate time and ability to capture particulates and that the fine media filter can capture the smaller particles. In other words, a slower speed can improve the filtration efficiency of the surgical drainage system 50400.

In certain examples, the speed of the motor 50451 driving the pump 50450 can be adjusted based on a particle sensor located downstream of the filter. For example, referring back to FIGS. 18 and 19, the particle sensor 50848 is located downstream of the filter 50870 in FIG. 18 and downstream of the filter 50970 in FIG. 19. Because the particle sensor 50848 is located downstream of the filter assembly, the particle sensor 50848 is configured to detect particulates in the exhaust air from, for example, the surgical exhaust system 50800 or the exhaust system 50900. In other words, such a particle sensor 50848 is configured to detect particulates passing through the exhaust housing 50818, 50918 and being exhausted into the ambient air. The particle sensor 50848 is located adjacent to the outlets 50824, 50924 of the exhaust housings 50818, 50918, respectively. In one example, when the particulate concentration in the exhaust (e.g., the particulate concentration detected by particle sensor 50848) exceeds a predefined threshold amount, processor 50308 (FIG. 5) and/or processor 50408 (FIG. 6) can implement adjustments to the pump. For example, referring again to FIG. 6, the speed of motor 50451 can be adjusted to improve the filtration efficiency of the surgical drainage system 50400.

The motor speed can be adjusted by limiting the current supplied to the motor and/or by varying the duty cycle of the motor. For example, a pulse modulation circuit can adjust the pulse length and/or frequency using pulse width modulation and/or pulse frequency modulation.

Additionally or alternatively, if the number of particles in the exhaust air exceeds a predefined threshold amount that may be dangerous or harmful to the operator(s) and clinician(s) in the operating room, the exhausted fluid may be diverted through one or more filters in the surgical exhaust system. For example, if the particle sensor 50838 detects a number of particles in the exhaust air that exceeds a threshold amount, the processor 50308 (FIG. 5) and/or the processor 50408 (FIG. 6) may open a valve downstream of the filter, thereby recirculating the exhaust air and injecting the recirculated exhaust air into the flow path upstream of the filter. In certain examples, the valve may, for example, inject the recirculated exhaust air into an alternative flow path that includes one or more additional and/or different filters.

In certain examples, the surgical evacuation system may include an override option whereby the evacuation system continues to operate and/or continues to operate at a default power level despite exceeding a set threshold. For example, in override mode, the surgical evacuation system may continue to operate and evacuate particles even if a particle sensor downstream of the filter detects a particulate concentration above a threshold amount. An operator in the operating room may activate the override function or mode, for example, by activating a switch, toggle, button, or other actuator on the evacuation housing and/or by an input to the surgical hub.

27, a flow chart illustrating an adjustment algorithm 52300 for a surgical evacuation system is shown. Various surgical evacuation systems disclosed herein may utilize the adjustment algorithm 52300 of FIG. 27. Additionally, the reader will readily appreciate that in certain instances, the adjustment algorithm 52300 may be combined with one or more additional adjustment algorithms described herein. Adjustments to the surgical evacuation system may be implemented by a processor in signal communication with a motor of an evacuation pump (see, e.g., the processor and pump of FIGS. 5 and 6). For example, a processor 50408 may implement the adjustment algorithm 52300. Such a processor may also be in signal communication with one or more sensors within the surgical evacuation system.

In various examples, the surgical drainage system may initially operate in a standby mode 52302 as shown in FIG. 27, in which the motor operates at low power as shown in block 52310 to sample fluid from the surgical site. For example, in standby mode 52302, a small sample of fluid may be drained from the surgical site by the surgical drainage system. Standby mode 52302 may be the default mode of the drainage system.

If a particle sensor upstream of the filter (e.g., particle sensor 50838) detects a particle count or particulate concentration greater than a threshold X, as shown in block 52312, the surgical evacuation system can enter an auto-evac mode 52304. In the auto-evac mode 52304, the motor speed can be increased in block 52314 to draw additional smoke from the surgical site. For example, the particle count or particulate concentration can increase above a threshold amount X when an electrosurgical procedure is initiated or when a particular electrosurgical power level is activated. In certain examples, the speed of the motor can be adjusted during the auto-evac mode 52304 based on the detected particulate concentration. For example, as the particulate concentration detected by the particle sensor 50838 increases, the motor speed can be increased accordingly. In certain examples, the default motor speed can correspond to a default range of particulate concentration detected by the particle sensor 50838.

27, if a particle sensor downstream of the filter (e.g., particle sensor 50848) detects a particle count or particulate concentration below threshold amount Y at block 52316, the motor may resume low power mode at block 52310 and/or may be further adjusted at block 52314 as provided herein. Additionally, if the downstream particle sensor 50848 detects a particle count or particulate concentration greater than threshold amount Y and less than threshold amount Z at block 52318, the motor speed may be reduced at block 52320 to improve the efficiency of the filter. For example, particulate concentrations detected by particle sensor 50848 between thresholds Y and Z may correspond to small particles passing through the filter of the smoke exhaust system.

27, if the particle sensor 50848 downstream of the filter detects a particle count greater than a threshold amount Z at block 52318, the motor can be turned off at block 52322 to terminate the drainage procedure, and the surgical drainage system can enter an override mode 52306. For example, the threshold Z can correspond to an air quality risk to clinicians and/or other personnel in the operating room. In certain examples, the operator can selectively override the shutdown function, as provided further herein, such that the motor continues to operate at block 52310. For example, the surgical drainage system can return to a standby mode 52302, where a sample of fluid is drained from the surgical site and monitored by the surgical drainage system.

In certain examples, the power level of the pump may be a function of a pressure differential across at least a portion of the surgical drainage system. For example, the surgical drainage system may include at least two pressure sensors. Referring again to FIGS. 18 and 19, the ambient pressure sensor 50854 is configured to detect pressure in the ambient chamber. The pressure sensor 50840 is configured to detect pressure in a flow path 50804 intermediate the fluid trap 50860 and the filter or filtration system 50870 of FIG. 18, and to detect pressure in a flow path 50904 intermediate the fluid trap 50960 and the filter system 50970 of FIG. 19. Additionally, the pressure sensor 50846 is configured to detect pressure in a flow path 50804 intermediate the filtration system 50870 and the pump 50806 of FIG. 18, and intermediate the filtration system 50970 and the pump 50906 of FIG. Finally, pressure sensor 50850 is configured to detect pressure within flow paths 50804 and 50904 at exhaust ports or outlets 50824 and 50924, respectively. The reader will readily appreciate that a particular smoke evacuation system may include fewer or more pressure sensors than the four pressure sensors 50840, 50846, 50850, and 50854 shown in FIGS. 18 and 19. Additionally, pressure sensors may be located in alternative locations throughout the surgical evacuation system. For example, one or more pressure sensors may be located within the smoke evacuation device, for example, along an evacuation conduit extending between the evacuation device and the housing, and within the housing, such as upstream of a fluid trap and/or in a different layer in the middle of a filtration system.

28, a flow chart illustrating an adjustment algorithm 52400 for a surgical evacuation system is shown. In various examples, the surgical evacuation systems disclosed herein may utilize the adjustment algorithm of FIG. 28. Additionally, the reader will readily appreciate that in certain examples, the adjustment algorithm 52400 of FIG. 28 may be combined with one or more additional adjustment algorithms described herein. Adjustments to the surgical evacuation system may be implemented by a processor in signal communication with a motor of an evacuation pump (see, e.g., the processor and pump of FIGS. 5 and 6). For example, the processor 50408 may implement the adjustment algorithm 52400. The processor may also be in signal communication with one or more pressure sensors within the surgical evacuation system.

In various examples, the processor 50408 is configured to obtain a pressure measurement P1 from a first pressure sensor at block 52402 and a second pressure measurement P2 from a second pressure sensor at block 52404. The first and second pressure sensors may be provided by, for example, the sensor 50430 of FIG. 6. The processor 50408 is configured to compare the measurements P1 and P2 at block 52406 to determine a pressure difference between the first and second pressure sensors. In one example, if the pressure difference is less than or equal to a threshold amount X, such as at block 52408, the speed of the pump may be maintained. Conversely, if the pressure difference is greater than the threshold amount X, such as at block 52410, the speed of the pump may be adjusted. The adjustments to the motor operating parameters are configured to adjust the speed of the pump. The adjustment algorithm 52400 may be repeated continuously and/or at regular intervals. In certain examples, a clinician may trigger the implementation of the adjustment algorithm 52400.

The flow rate of smoke through an exhaust system can be a function of the pressure differential. In one example, if the pressure differential across the exhaust system increases significantly, the flow rate through the system can also increase. The actual flow rate can be predicted based on the pressure differential and the motor speed. Thus, by monitoring the pressure differential, the flow rate can be more accurately determined.

In addition, a blockage in the flow path can correspond to an increase in the pressure difference. For example, as the filter traps particles from the smoke, the pressure difference across the filter can increase for a given pump speed. In response to a predefined pressure drop across the filter, the speed of the motor and the corresponding pump can be increased to maintain the flow rate of smoke through the system despite the blockage in the filter. For example, referring again to FIG. 18 and FIG. 19, a first pressure sensor (e.g., pressure sensor 50840) can be positioned upstream of the filter and a second pressure sensor (e.g., pressure sensor 50846) can be positioned downstream of the filter. The pressure difference between pressure sensor 50840 and pressure sensor 50846 can correspond to the pressure drop across the filter. As the filter traps particles in the smoke, the trapped particles can block the flow path, thereby increasing the pressure difference across the filter. In response to the increase in pressure difference, the processor can adjust the operating parameters of the motor to maintain the flow rate across the system. For example, the speed of the motor and the corresponding pump can be increased to compensate for a partially blocked filter in the flow path.

In another example, the predetermined pressure drop can correspond to an occlusion in the exhaust conduit. In one embodiment, the motor speed and corresponding pump speed can be reduced to avoid tissue damage, for example, when the exhaust conduit becomes occluded with tissue. Reducing the pump speed in such an example can be configured to avoid potential tissue trauma.

In another example, a first pressure sensor can be located upstream of the fluid trap and a second pressure sensor can be located downstream of the fluid trap (e.g., pressure sensor 50840). The pressure difference between the sensors can correspond to the pressure drop across the fluid trap, which can correspond to the flow rate and/or flow path through the fluid trap. The pressure difference across the fluid trap can also be estimated by other sensors in the fluid evacuation system. In certain examples, it is desirable to reduce the flow rate through the fluid trap to ensure sufficient removal of liquid from the smoke before it enters the downstream filter(s) and pump. In such examples, the pressure difference may be reduced by reducing the speed of the motor and the corresponding pump.

In yet another example, a first pressure sensor can be located at an inlet to the surgical drainage system or its ejector housing , and a pressure sensor (e.g., pressure sensor 50850) can be located at an outlet of the surgical drainage system. The pressure difference between the sensors can correspond to a pressure drop across the surgical drainage system. In certain examples, by monitoring the pressure drop across the system, the maximum suction load of the system can be maintained below a threshold amount. When the pressure drop exceeds a threshold amount, the processor can adjust the operating parameters of the motor (e.g., slow down the motor) to reduce the pressure difference.

In one example, the chemical sensor 50832 can detect the pH of a substance in physical contact with the sensor, such as, for example, a fluid splashed onto the sensor 50832. In one aspect of the present disclosure, the chemical sensor 50832 can detect the glucose content and/or oxygen content in the fluid. In a particular example, the chemical sensor 50382 can be configured to detect cancerous by-products. If cancerous by-products are detected, parameters of the exhaust system can be adjusted to reduce the likelihood of such by-products entering the operating room. In one example, the pump speed can be reduced, for example, to improve the efficiency of the filters in the exhaust system. In another example, the exhaust system can be turned off to ensure that cancerous by-products are not exhausted into the operating room.

Fluids extracted from a surgical site by a surgical drainage system may include liquids and various particulates. The combination of different types and/or conditions of matter in the evacuated fluid may make the evacuated fluid difficult to filter. Additionally or alternatively, certain types and/or conditions of matter may be harmful to certain filters. For example, the presence of liquid droplets in the smoke may damage certain filters, and the presence of larger particulates in the smoke may clog certain fine particulate filters.

The sensors can be configured to detect parameters of the fluid traveling through the drainage system. Based on the parameters detected by the sensor(s), the surgical drainage system can direct the drained fluid along an appropriate flow path. For example, fluids containing a percentage of droplets above a certain threshold parameter can be directed through a fluid trap. As another example, fluids containing particulates above a threshold size can be directed through a coarse media filter, while fluids containing particulates below the threshold size can bypass the coarse media filter and be directed to a fine media filter.

By providing an alternative flow path through the surgical drainage system, the surgical drainage system and its filter(s) may operate more efficiently and be less susceptible to damage and/or blockage. The usable life of the filter may also be extended. As provided herein, a filter may include one or more filtration layers, and in certain examples, a filtration system may include one or more filters.

The diverter valve 52934 of the surgical drainage system is shown in detail in FIGS. 24A and 24B. In one aspect of the disclosure, the diverter valves 50834 and 50934 shown in the surgical drainage systems 50800 and 50900 of FIGS. 18 and 19, respectively, can include a diverter valve 52934. The diverter valve 52934 includes a ball valve 52396 operatively configured to direct fluid from the inlet pathway 52942 along either the first pathway 52940 or the second pathway 52938. In various examples, the ball valve 52396 can be an electrically actuated ball valve with a controller. For example, a processor of the surgical drainage system, such as the processor 50408 (FIG. 6), can send a signal to the ball valve controller to initiate rotation of the ball valve 52396 to alter the flow path of the smoke. When the diverter valve 52934 is in a first position (FIG. 24A), the intake of smoke through the diverter valve 52934 is directed along a first path 52940. When the diverter valve 52934 is in a second position (FIG. 24B), the intake of smoke through the diverter valve 52934 is directed along a second path 52938.

The first path 52940 can correspond to a flow path when no liquid is detected in the smoke or when the detected liquid-to-gas ratio or aerosol percentage is below a threshold. The second path 52938 can correspond to a flow path when liquid, e.g., aerosol, is detected in the smoke or when the detected liquid-to-gas ratio or aerosol percentage is equal to or greater than a threshold. In certain aspects of the present disclosure, the first path 52940 can bypass the fluid trap and the second path 52938 can direct the smoke through the fluid trap to capture fluid from the smoke before it is directed into a filter. Selecting a flow path based on the percentage of aerosol can improve the efficiency of the surgical evacuation system.

In other examples, the diverter valve 52934 may include three or more fluid path outlets. Further, the fluid paths may bypass/recirculate the fluid relative to the fluid trap and/or direct the smoke along different filtration paths including different configurations of fluid traps, condensers, and/or particulate filters depending on the detected parameters of the fluid.

18 and 19, the fluid detection sensor 50830 is configured to detect the presence of aerosols or liquid-to-gas ratio in smoke. For example, the fluid detection sensor 50830 of FIG. 18 is disposed at the inlet 50822 of the ejector housing 50818. In other examples, the fluid detection sensor 50830 can be disposed near the inlet 50822 and/or upstream of the filter 50870 and/or a socket for receiving the filter 50870. Examples of fluid detection sensors are further described herein. For example, the fluid detection sensor 50830 can include one or more of the particle sensors further disclosed herein. Additionally or alternatively, in one aspect of the present disclosure, the fluid detection sensor 50830 includes a continuity sensor.

In one example, if the fluid detection sensor 50830 detects a liquid to gas ratio above a threshold, the intake air can be diverted to a condenser before entering the particulate filter. The condenser can be configured to condense small droplets in the flow path. In various examples, the condenser can include a honeycomb structure. The condenser can include multiple baffles or other structures that are configured for liquid to condense. As the smoke flows through the condenser, the liquid can condense on the internal baffles and can be directed to drip downward into the fluid reservoir.

18, the internal diverter valve 50834 is positioned to direct the smoke intake to bypass the condenser 50835 so that the smoke flows directly to the filter 50870. In bypassing the condenser 50835, the surgical drainage system 50800 can require less power from the motor driving the pump (see, e.g., motor 50451 and pump 50450 in FIG. 6). Now referring to FIG. 19, the diverter valve 50934 is positioned to direct the smoke into the condenser 50935 in the fluid trap 50960 before the smoke flows into the filter 50970. Conversely, if the fluid detection sensor 50830 detects a liquid to gas ratio below the threshold, the intake can bypass the condenser 50935 and be directed directly to the filter 50970.

In various examples, the fluid detection sensor 50830 can detect the presence of smoke in the flow path. For example, the fluid detection sensor 50830 can include a particle sensor. Detection of particles, or detection of a particulate concentration above a threshold, can indicate that smoke is present in the flow path. In certain examples, the fluid detection sensor may not distinguish between solid particles (e.g., carbon) and aerosol particles. In other examples, the fluid detection sensor 50830 can also detect the presence of aerosols. For example, the fluid detection sensor can include a continuity sensor, such as described herein, that can determine, for example, whether a detected particle is an aerosol.

In various examples, the surgical exhaust system can include additional or alternative flow paths. For example, the surgical exhaust system can include a high particulate flow path and a low particulate flow path. For example, if a particle sensor, such as particle sensor 50838 (FIGS. 18 and 19), detects a particulate concentration at or above a threshold valve, the inhaled smoke can be diverted to a particulate filter. Conversely, if a laser particle sensor detects a particulate concentration below the threshold, the inhaled smoke can bypass the particulate filter. Similarly, the different flow paths can correspond to different sizes and/or types of particles. For example, if a larger particle is detected by particle sensor 50838, the smoke can be directed along a different path than if a smaller particle is detected. For example, the surgical exhaust system can include different types of particulate filters (e.g., large media filters and fine media filters) and can utilize different filtration methods, such as direct blocking, inertial impaction, and diffusion blocking, based on the detected size (or size range) of the particle. The different flow paths can be selected to optimize fluid extraction and/or particulate filtration of the smoke while minimizing power draw and/or stress on the motor. In certain examples, the default flow path may be a more direct flow path, and upon detection of a fluid parameter above a threshold limit, the fluid may be diverted to a less direct flow path. The less direct flow path may require more power.

In various examples, the motor of the surgical evacuation system may be adjusted based on the characteristics of the inhaled smoke and/or the filters installed in the surgical evacuation system. Referring again to the schematic diagram shown in FIG. 6, the processor 50408 is in signal communication with a motor driver 50428 coupled to a motor 50451 for the pump 50450. The processor 50408 can be configured to adjust the motor 50451 based on the characteristics of the smoke and/or the filters installed. In one example, the processor 50408 can receive inputs corresponding to a volume of aerosol suspended in the smoke and/or a liquid volume in the flow path, including a volume of droplets in contact with or resting on the tubing of the surgical evacuation system. Various sensors for detecting the fluid density of the inhaled smoke, such as, for example, a continuity sensor, are further described herein.

The liquid-to-gas ratio of the smoke can affect the efficiency of the smoke pump. For example, the liquid or liquids in the smoke can be less compressible than the gas in the smoke, which can affect the efficiency of the pump. In addition, different types of pumps can operate differently in the presence of aerosols. In certain instances, the pump speed can be accelerated, while in other instances, the pump speed can be slowed down. To optimize the efficiency of the pump for each liquid-to-gas ratio, the processor can be configured to adjust the motor driving the pump. In other words, the control program of the motor can operatively adjust the pump speed based on the detected liquid-to-gas ratio in the flow path.

Certain pumps can efficiently handle fluids with high liquid-to-gas ratios such that the efficiency of the pump either remains the same or increases. For example, certain scroll pumps can handle aerosols in the smoke path. In such instances, with incompressible (or less compressible) fluids, the rotational speed of the pump may be reduced to increase the vacuum air handling. Other pumps may be more sensitive to fluids with high liquid-to-gas ratios and therefore can be slowed down to limit the pressure differential through the fluid trap.

In various examples, the sensor can be configured to detect the flow rate through the surgical drainage system. For example, an optical sensor can be configured to measure the flow rate of particles in the surgical drainage system. In certain examples, the detected flow rate through the surgical drainage system can be utilized to manage the suction speed of the compressor. An algorithm can determine an appropriate suction speed based on the flow rate and/or one or more detected parameters of the smoke (e.g., particulate concentration, liquid-to-gas ratio, etc.). For example, when smoke having a high liquid-to-gas ratio enters the surgical drainage system, the motor speed can be reduced to reduce the flow rate through the surgical drainage system including its fluid traps so that more liquid can be extracted from the smoke before it enters the pump. Liquid can damage certain pumps. For example, lobe pumps and regenerative blowers can be damaged if liquid in the smoke is allowed to enter.

25 shows a graphical representation of the airflow fluid content and duty cycle over time for a surgical evacuation system, such as surgical evacuation system 50800 (FIG. 18) and/or 50900 (FIG. 19). The fluid content can include aerosols and droplets within the evacuation system, and can be detected, for example, by fluid detection sensors 50830 and 50836 (FIGS. 18 and 19). Referring again to FIG. 25, at the beginning of the procedure, the fluid detection sensors 50830 and 50836 detect the same or substantially the same content in the smoke. In other words, the fluid content upstream of the respective fluid traps 50860, 50960 is the same or substantially the same as the fluid content downstream of the respective fluid traps 50860, 50960. The fluid content detected by both sensors 50830 and 50836 continues to rise as the procedure continues.

At time _t1 , the fluid content detected by both sensors 50830 and 50836 exceeds a fluid content threshold (C _T ) 52102, and the smoke is diverted through a fluid trap, such as fluid trap 50860 and/or 50960, to prevent damage to the filtration system. Fluid content threshold C _T 52102 may correspond to a volume or percentage of fluid and/or aerosols that would be harmful to the filtration system. Referring primarily to exhaust system 50900 of FIG. 19, recirculation valve 50990 may be opened (as shown in FIG. 19) to allow the fluid to be diverted back into the condenser 50935 of fluid trap 50960 before entering filter 50970. By recirculating the fluid, additional droplets may be removed from the fluid. As a result, referring again to FIG. 25, the fluid content detected by fluid detection sensor 50836 located upstream of filter 50970 may be reduced to below fluid content threshold C _T 52102. In various examples, the airflow path through the ejector housing may be adjusted at time _t1 to maintain the motor duty cycle, as shown in FIG.

25, as the smoke is recirculated through the fluid trap which captures some of the aerosol and/or droplets, the downstream fluid detection sensor 50836 begins to detect less liquid content in the smoke. However, the upstream fluid detection sensor 50830 continues to detect an increasing amount of liquid in the smoke. Further, at time _t2 , the downstream fluid detection sensor 50836 again detects a fluid content above the fluid content threshold C _T 52102. To address the increasing fluid content despite the recirculation of the smoke through the fluid trap, the duty cycle of the pump motor is reduced at time _t2 , reducing the speed of the pump so that more liquid can be extracted from the smoke before it enters the pump. As the pump adjusts to the reduced duty cycle, the fluid trap can more effectively capture the aerosol and/or droplets in the smoke, and the fluid content detected by the fluid detection sensor 50836 begins to decrease until it eventually falls below the fluid content threshold C _T 52102.

In certain examples, the volume of fluid in the fluid trap and/or the levelness of the housing can be used to determine whether the internal fluid level is approaching a threshold limit that may correspond to reaching the anti-spill baffle and/or the outlet port of the fluid trap to the particulate filter. Liquid can damage and/or reduce the efficiency of the particulate filter, as described further herein. To prevent liquid from entering the particulate filter, the processor can adjust the motor to minimize the likelihood of drawing liquid into the particulate filter. For example, the processor can instruct the motor to slow down when a predetermined volume of liquid has entered the fluid trap and/or when liquid in the trap reaches a set marker or level in the housing above a predetermined safety level.

In various examples, the motor control program may be further influenced by using the pressure differential between pressure sensors in the evacuation system, such as pressure sensors 50840 and 50846 (FIG. 19) in the surgical evacuation system 50900. For example, based on the pressure differential across the filter 50970 and the speed of the motor of the pump 50906, the processor of the surgical evacuation system 50900 may be configured to predict the actual flow rate through the filter 50970. Additionally, the flow rate may be adjusted (e.g., by adjusting the motor speed) to limit the flow rate and reduce the likelihood that fluid will be drawn from the reservoir in the fluid trap 50960 into the filter 50970.

As described herein, the surgical evacuation system can include one or more sensors configured to detect the presence of aerosols in the smoke (e.g., liquid to gas ratio) and one or more sensors configured to detect the presence of carbonized particulates in the smoke (e.g., parts per million measurements). By determining whether the extracted fluid is primarily steam, primarily smoke, and/or corresponding ratios of each, the surgical evacuation system can provide useful information to the clinician, the intelligent electrosurgical instrument, the robotic system, the hub, and/or the cloud. For example, the steam to smoke ratio can indicate the extent of tissue welding and/or collagen cauterization. In various examples, the energy algorithms of the electrosurgical instrument and its generator can be adjusted based on the steam to smoke ratio.

In one aspect of the disclosure, if the extracted fluid is primarily vapor or has a high aerosol percentage, the processor can adjust the amplitude and/or power of an ultrasonic generator, such as generator 800 (FIG. 58). For example, the processor of the smoke evacuation system can be communicatively coupled to the generator 800. In one example, if the power is too high for a particular surgical scenario, excessive vapor or aerosol may be generated. In such an example, the power level of the generator can be decreased to reduce the generation of vapor/aerosol by the energy tool. In another example, for a higher particle ratio, the processor can adjust the power level of the generator. For example, the power level can be decreased for a particle ratio above a threshold. In a particular example, the voltage can be adjusted to reduce particulates generated by the energy tool.

26, an adjustment algorithm 52200 for a surgical evacuation system is shown. Various surgical evacuation systems disclosed herein may utilize the adjustment algorithm 52200. Additionally, the reader will readily appreciate that in certain instances, the adjustment algorithm 52200 may be combined with one or more additional adjustment algorithms described herein. The adjustments to the surgical evacuation system may be implemented by a processor in signal communication with a motor of an evacuation pump (see, e.g., the processor and pump of Figs. 5 and 6). For example, the adjustment algorithm 52200 may be implemented by a processor 50408 in signal communication with a motor driver 50428 and/or a controller for a diverter valve, as further described herein. The processor is configured to monitor characteristics of the evacuation smoke utilizing various sensors. In one aspect of the present disclosure, with reference to Fig. 26, the processor is configured to determine whether the inhalation smoke includes particles and aerosols above a threshold.

At the beginning of the adjustment algorithm 52200, a standard flow rate can be initiated at block 52202 and one or more characteristics of the inhaled smoke can be monitored at block 52204. At block 52206, a sensor can be configured to check for particles in the fluid. If no particles are detected by the sensor, at block 52202, the standard flow rate and/or power level can be maintained. In one example, the standard flow rate can be a minimum flow rate or an idle flow rate, as described further herein. If particles are detected at block 52206 and it is determined that the particles are not aerosol particles at block 52208, a first adjustment to the flow rate and/or power level can be implemented at block 52210. For example, the flow rate and power level can be increased to increase the evacuation of particles, i.e., smoke, from the surgical site. In a particular example, if the particles are determined to be aerosol particles at block 52208, or if a portion of the particles are aerosol particles, a second adjustment can be implemented.

In one aspect of the disclosure, the second adjustment may depend on the percentage of aerosols in the smoke. For example, if the percentage of aerosols is determined to be greater than a first threshold amount, such as X% in block 52212 of FIG. 26, the smoke may be directed to the fluid trap in block 52214. Conversely, if the aerosol concentration in the smoke is equal to or less than the threshold amount X%, the smoke may be directed to bypass the fluid trap in block 52216. Conduits and valves for directing fluid flow in the smoke evacuation system are further described herein. In certain examples, the flow rate and/or power levels may be adjusted to sufficiently draw fluid along a selected flow path, such as toward and/or around the fluid trap. In one aspect of the disclosure, additional power and/or suction may be required to draw fluid into the fluid trap.

26, upon exiting the fluid trap, if aerosol particles are further detected in the smoke at block 52218, and if the aerosol concentration is greater than a second threshold amount, such as Y% in FIG. 26, at block 52220, the flow rate can be decreased at block 52224 to ensure proper extraction of the aerosol from the smoke. Conversely, if the aerosol concentration downstream of the fluid trap is equal to or less than the second threshold amount, Y%, at block 52222, the flow rate can be maintained. As shown in FIG. 26, once the adjustment algorithm 52200 has redirected the flow path and/or adjusted and/or maintained the flow rate, the adjustment algorithm can return to block 52204 to continue monitoring one or more parameters of the smoke evacuation system. In certain examples, the adjustment algorithm 52200 can be cycled continuously such that smoke characteristics are continuously monitored and/or transmitted to the processor in real time or near real time. In other examples, the adjustment algorithm 52200 can be repeated at predetermined times and/or intervals.

In certain examples, the surgical drainage system can further include a chemical sensor, such as chemical sensor 50832 (FIGS. 18 and 19). Chemical sensor 50832 is located near the inlet 50822 of the surgical drainage system 50800 and near the inlet 50922 of the surgical drainage system 50900. Chemical sensor 50832 is configured to detect a chemical characteristic of particles exhausted by the surgical drainage system. For example, chemical sensor 50832 can identify the chemical composition of particles in smoke exhausted from the abdominal cavity of a patient during an electrosurgical procedure. Different types of chemical sensors can be utilized to determine the type of material extracted by the surgical drainage system. In certain examples, the smoke evacuation system can be controlled based on what is being extracted from the surgical site, such as by what is being detected by chemical sensor 50832.

Chemical analysis of the extracted fluid and/or particles can be used to adjust generator functions, such as the function of the generator 800 (FIG. 58). For example, the generator functions can be adjusted based on the detection of cancerous material by the chemical sensor 50832. In certain examples, if cancerous material is no longer detected by the chemical sensor 50832, the clinician can be alerted that all cancerous material has been removed and/or the generator can cease operation of the energy device. Alternatively, if cancerous material is detected by the chemical sensor 50832, the clinician can be alerted and the generator can optimize operation of the energy device to remove the cancerous material.

In certain examples, the generator function may be adjusted based on tissue characteristics detected by the surgical system. Referring primarily to FIG. 29, a flow chart illustrating an adjustment algorithm 52500 for a surgical system is shown. Various surgical systems disclosed herein may utilize the adjustment algorithm 52500. Additionally, the reader will readily appreciate that in certain examples, the adjustment algorithm 52500 may be combined with one or more additional adjustment algorithms described herein. Adjustments to the surgical system may be implemented by a processor (see, e.g., processor 50308 in FIG. 5). In various aspects of the present disclosure, to determine the type of tissue, the processor 50308 (FIG. 5) may be configured to receive information from multiple sources.

29, one or more sensors 52502 in the surgical drainage system can provide information to the processor 50308 (FIG. 5). Still referring primarily to FIG. 28, the particle sensor(s) 52502a, chemical sensor(s) 52502b, and/or fluid detection sensor(s) 52502c of the surgical drainage system, which may be similar to the sensors shown in FIGS. 18 and 19, for example, can provide data indicative of tissue type to the processor 50308. In addition, external sensor(s) 52504 can provide information to the processor 50308. The external sensor 52504 may be remote to the surgical drainage system, but may be located on other surgical devices involved in the surgical procedure. For example, the one or more external sensor(s) 52504 can be located on a surgical instrument, a robotic tool, and/or an endoscope. In certain examples, the internal sensors 52502 and the external sensors 52504 can provide information to a situational awareness module or surgical hub, which can provide situational awareness 52506 to the various sensors 52502, 52504. Further, the situational awareness 52506 can inform the processor 50308 regarding the various sensor data. Based on the situational awareness 52506 and the data from the sensors 52502, 52504, the type of tissue can be determined by the processor 50308 (FIG. 5) at block 52510.

In certain examples, the ratio of elastin to collagen of the extracted material can be determined from the tissue type. For example, elastin can correspond to a first melting temperature and collagen can correspond to a second melting temperature higher than the first melting temperature. If the external sensor 52504 is configured to detect a parameter of the electric motor corresponding to the clamp arm speed and/or clamp speed, the external sensor 52504 can indicate the melting temperature of the tissue and therefore the ratio of elastin to collagen. Elastin and collagen also define different refractive indices and absorptivities. In certain examples, an infrared spectrometer and/or a refractive camera sensor can be utilized to determine and/or confirm the tissue type.

In certain examples, the energy modality can be adjusted based on the type of tissue detected (elastin, collagen, and/or the ratio of elastin to collagen). For example, a particular energy device may be more efficient at dissolving collagen than elastin, but the energy modality can be adjusted to better dissolve elastin. In other examples, it may be desirable to dissolve collagen and preserve elastin. Additionally or alternatively, the ratio of elastin to collagen can indicate the type of physical structure, such as a vein or artery, which can be communicated to the system's situational awareness 52506. For example, if collagen is detected at block 52510, energy modality A can be performed at block 52512. In other examples, if elastin is detected at block 52510, energy modality C can be performed at block 52516. In yet other examples, if a combination of collagen and elastic is detected at block 52510, energy modality B can be performed at block 52514. The reader will readily appreciate that additional and/or alternative energy modalities are envisioned. For example, different modalities may be utilized depending on the particular ratio of elastin to collagen and/or based on the surgical procedure and/or steps being performed.

In various surgical procedures using energy devices to treat tissue, fluids and/or particles may be released, thereby contaminating the atmosphere within and/or surrounding the surgical site, as further described herein. To improve visibility of the atmosphere at the surgical site, for example, the contaminants may be drawn into a smoke evacuation system. Furthermore, when the contaminants are directed along an airflow path in the smoke evacuation system, airborne fluids and/or particles may be filtered to improve air quality. Depending on the efficiency of the smoke evacuation system and/or the amount of smoke and/or contaminants generated following activation of the electrosurgical instrument, smoke may accumulate in the atmosphere within and/or surrounding the surgical site. Such accumulation of contaminants may, for example, impede a clinician's ability to view the surgical site.

In one aspect of the present disclosure, a surgical system can include a smoke evacuation system including a particle sensor, an electrosurgical instrument, and a generator. Such a smoke evacuation system can monitor particulate concentrations as the electrosurgical instrument applies energy to tissue during a surgical procedure. For example, when a clinician requests that the electrosurgical instrument be powered, the generator is configured to provide the requested power. A processor within the surgical system is configured to analyze the monitored particulate concentration and the power requested by the clinician from the generator. If the power requested by the clinician creates contaminants that would result in a particulate concentration above a predetermined threshold, the processor can prevent the generator from providing the requested power. Instead, in such an example, the generator can provide power at a level that would return the particulate concentration below the predetermined threshold.

In such an example, the clinician(s) and/or assistant(s) do not need to individually monitor particulate concentrations and adjust energy modalities accordingly. Instead, the instruments and devices of the surgical system can communicate among themselves to instruct the generator to deliver a particular power level in a particular situation based on input from sensors in the smoke evacuation system. The reader will readily appreciate that situational awareness can further inform the generator's decision-making process. Various algorithms for implementing the aforementioned monitoring processes and/or adjustments are further disclosed herein.

The surgical system may include an electrosurgical device, a generator configured to power the electrosurgical device, and a smoke evacuation system. The smoke evacuation system may include a sensor system configured to monitor the size and/or concentration of particulates in the smoke and/or intake air exhaust conduit. Referring again to FIGS. 18 and 19, a particle sensor 50838 is shown. The particle sensor 50838 is an internal sensor located at a location along the flow path 50804 (FIG. 18) and the flow path 50904 (FIG. 19). In various examples, the particle sensor 50838 is located at a point on the flow path 50804, 50904 prior to filtration by the filter system 50870, 50970, respectively. However, the internal particle sensor 50838 may be located at any suitable location along the flow path 50804, 50904 to monitor contaminated air entering from the surgical site. In various examples, the smoke evacuation system 50800 and/or 50900 can include two or more internal particle sensors 50838 located at various locations along the flow path 50804 and/or 50904, respectively. The reader will readily appreciate that a variety of particle measurement means are possible. For example, the particulate concentration sensor may be an optical sensor, a laser sensor, a photoelectric sensor, an ionization sensor, an electrostatic sensor, and/or any suitable combination thereof. Various sensors are further described herein.

The electrosurgical generator is a major component in the electrosurgical circuit to generate the electrosurgical waveforms. The generator is configured to convert electricity into a high frequency waveform and generate a voltage for the flow of electrosurgical current. In various examples, the generator is configured to generate various waveforms, each of which produces a different effect on tissue. A "cutting current" cuts tissue but provides little hemostasis. A "coagulation current" provides coagulation with limited tissue incision and increased depth of heating. A "blend current" is an intermediate current between the cutting current and the coagulation current, but the blend current is generally not a combination of the cutting current and the coagulation current. Rather, the blend current may be a cutting current where the time that the current actually flows is reduced from 100 percent to about 50 percent of the time. In various examples, the generator can automatically monitor tissue impedance and adjust the power output to the energy device to provide an efficient and precise cutting effect at the lowest possible setting in order to reduce tissue damage.

An additional mode of electrosurgical cutting, known as Advanced Cutting Effect (ACE), provides the clinician with a scalpel-like cutting effect that produces little to no thermal necrosis and no hemostasis. When the generator is placed in ACE mode, a constant voltage is maintained at the tip of the electrode on the end effector. An active electrode on the end of the end effector delivers RF current from the generator to the surgical site. By utilizing ACE mode, the clinician has the ability to achieve comparable wound healing results using an electrosurgical device on the skin, often without the use of specific surgical instruments such as scalpels, needles, and/or any surgical instruments that may cause wounds and/or punctures to the patient, and/or without any personnel handling them.

In various aspects of the present disclosure, the electrosurgical device includes an ACE cutting system.

Throughout the duration of a surgical procedure, contaminants and/or smoke may be generated. If the air in and/or around the surgical site is not efficiently filtered by a smoke evacuation system, contaminants may condense in the air, making it difficult for clinicians and/or assistants to view the surgical site. Additional concerns regarding smoke in the operating room are further disclosed herein. In various examples, a processor in the surgical system may store information in memory specific to the amount of smoke and/or contaminants generated when a clinician uses a particular surgical instrument for a particular duration. Such information may be stored directly in the memory of the processor in the centralized hub and/or in the cloud. In various examples, the processor and memory shown in Figures 5 and 6 may be used to store such information.

In various examples, a communication path is established between the smoke evacuation system and the generator to control the power provided to the electrosurgical instrument. Such power is controlled to effectively direct the electrosurgical instrument to produce less smoke and/or emit less contaminants, as well as to allow efficient filtering of the surgical site. In various examples, the components of the surgical system may communicate with each other directly. In various examples, the components of the surgical system communicate with each other via a centralized hub, for example, as further described herein with respect to FIGS. 39-60. The reader will readily appreciate that any suitable communication path may be used.

Once the surgical procedure begins and the electrosurgical instrument is activated, a sensor in the smoke evacuation system is configured to monitor a parameter related to air quality. Such parameters may include, for example, particle count and/or concentration, temperature, fluid content, and/or percent contamination. The sensor is configured to communicate the monitored parameter to the processor. In various examples, the sensor automatically communicates the monitored parameter after detection. In various examples, the sensor communicates the monitored parameter to the processor after the sensor is interrogated. However, the reader will understand that any suitable method of communicating the monitored information may be used. In various examples, the sensor continuously communicates the monitored information to the processor. However, the reader will understand that any suitable sample rate may be used. The monitored information may be communicated, for example, in real time or near real time.

In various examples, the processor stores information regarding the predetermined threshold. The predetermined threshold varies based on the parameters monitored by the sensors of the smoke evacuation system. For example, when the sensors are monitoring particle counts and/or concentrations, such a threshold can indicate a level of particles in the atmosphere of the surgical site that effectively and/or unsafely obstructs the clinician's view of the surgical site. In other examples, the threshold can correspond to a filtration system in the evacuation housing and the ability of the filtration system to adequately filter particles. For example, if the particulate concentration is above a certain threshold, the filtration may not be able to adequately filter particulates from the smoke, and toxic materials may pass through the evacuation system and/or block and/or clog its filters. When the processor receives information regarding the monitored parameters from the sensors of the smoke evacuation system, the processor is configured to compare the monitored parameter(s) with the predetermined threshold(s) to ensure that the threshold(s) were not exceeded.

In various examples, if the processor recognizes that a predetermined threshold has been exceeded and/or is close to being exceeded, the processor can control various motor functions of the smoke evacuation system. The processor can adjust the flow rate of the smoke evacuation system by increasing or decreasing the speed of the motor to more efficiently filter contaminants from the surgical site. For example, if a sensor communicates information to the processor indicating that a particulate threshold has been reached, the processor can increase the speed of the motor to draw more fluid, and possibly more contaminants, from the surgical site into the smoke evacuation system for filtering.

In various examples, if the processor recognizes that a predetermined threshold has been exceeded and/or is close to being exceeded, the processor can vary the power supplied by the generator to the electrosurgical instrument. For example, if a sensor communicates information to the processor indicating that the particle threshold has been reached, the processor will prevent the generator from supplying any additional requested power to the handheld electrosurgical instrument. Once the smoke evacuation system filters contaminants from the atmosphere to a level that falls below the particle threshold, the processor can then allow the generator to supply the requested power to the handheld electrosurgical instrument.

33 is a graphical representation of the correlation between detected particle count and power level over a period of time during a surgical procedure. The top graph 53300 represents the particle count and/or particulate concentration detected by the internal particle sensor 50838 (FIGS. 18 and 19) as particles and contaminants are filtered from the surgical site into the smoke evacuation system 50800 and/or 50900. The particulate concentration C _T represents a predetermined particle count and/or concentration threshold in the volume of evacuated fluid. The bottom graph 53302 represents the power level(s) reached during the surgical procedure, including the power requested by the clinician via the handheld electrosurgical instrument (dashed line) and the power actually delivered by the generator of the surgical system (solid line). The power level(s) is defined as the ratio of RF current to voltage of the electrosurgical system.

A baseline particulate concentration 53304 is detected prior to the start of a surgical procedure at time t< _t1 . When the clinician and/or assistant activates the electrosurgical instrument at time _t1 , the clinician and/or assistant requests that a particular power level be provided to perform a particular function. Such functions include incising and/or cutting tissue within the surgical site. The application of power to the tissue generates smoke and/or contaminants that can be directed, for example, into a smoke evacuation system to improve visibility within the surgical site. At time _t1 , the generator provides the requested power. The detected particulate concentration is below the threshold C _T. However, the internal particle sensor 50838 begins to detect an increase in particulate concentration at time _t2 following activation of the electrosurgical instrument at time _t1 .

In the graphical representation of FIG. 33, the clinician does not request additional power until time _t3 . An "off" time 53306 between _t1 and _t3 may allow, for example, tissue to cool and cause some degree of hemostasis. As can be seen in FIG. 33, the detected particulate concentration and power level decrease between time _t2 and time _t3 . At time _t3 , the clinician requests a higher power level that, when delivered by the generator, causes an increase in particulate concentration at time _t4 . Finally, the clinician requests a power level that causes the particulate concentration to rise near a predetermined threshold C _T at time _t5 . In some cases, exceeding the threshold C _T may indicate poor visibility within the surgical site due to contamination and/or particulate buildup, an inefficient smoke evacuation system, and/or an inoperable smoke evacuation system.

In response to the particulate concentration rising above the particle threshold C _T at time _t5 , the surgical system processor is configured to adjust the generator's delivered power to bring the particulate concentration back below the particle threshold C _T. As shown in FIG. 33, the power delivered by the generator differs from the power requested by the hand piece when the particulate threshold C _T was reached and/or exceeded due to the higher power requested by the hand piece. Once the particulate concentration returns to the threshold C _T and/or drops below the threshold C _T , such as at time _t6 , the generator again delivers a power level as requested by the handheld electrosurgical instrument. Additionally, as the power requested by the hand piece decreases after time _t6 , the particulate concentration detected by the particle sensor 50838 also decreases.

34 illustrates a representation of instructions 53400 stored by a memory of a surgical system, such as the memory of FIGS. 5 and 6. In various examples, the surgical systems disclosed herein can utilize the instructions 53400. For example, the instructions 53400 can include an adjustment algorithm for the surgical system. Additionally, the reader will readily appreciate that in certain examples, the instructions 53400 can be combined with one or more additional algorithms and/or instructions described herein. The instructions 53400 can be implemented by a processor, such as the processor 50308 of FIG. 5.

At block 53402 of instructions 53400, the processor may receive a request for power from the electrosurgical instrument. For example, the electrosurgical instrument may include a handheld device and/or a robotic tool. The requested power may be provided by a user via, for example, a controller and/or a control console. As described above, the sensor is configured to monitor parameters associated with the fluid passing through the evacuation system. Such parameters may include, for example, particle size, temperature, fluid content, and/or percentage of contamination. The processor is configured to receive the monitored parameters from the sensor. In various examples, the processor receives such information in response to interrogating the sensor, as shown at block 53404. In various examples, the sensor automatically communicates the information upon detection. The processor then determines whether the received information exceeds a predetermined threshold at block 53406. If the threshold is exceeded and/or is approaching being exceeded, the processor is configured to prevent the generator from providing any or all of the requested power to the electrosurgical instrument at block 53408. In other examples, the generator waveform can be adjusted to reduce smoke generated by the surgical device at block 53410, as further described herein.

In various examples, the generator can provide power at a level that does not cause the threshold to be exceeded. If the threshold is not exceeded, the processor is configured to enable the generator to provide the requested power to the electrosurgical instrument at block 53410. In various examples, the processor is configured to receive information from the smoke evacuation system sensor throughout the duration of the surgical procedure or at least as long as the processor receives a request from the electrosurgical instrument for the delivery of power.

In various surgical procedures, radio frequency (RF) power can be used to cut tissue and coagulate bleeding. When RF power is used to treat tissue, fluids and/or particulates can be released, thereby contaminating the air in and/or around the surgical site. To improve visibility of the surgical site for the clinician, for example, contaminated air inside the surgical site can be drawn into a smoke evacuation system. As the contaminated air is directed along an airflow path, suspended fluids and/or particulates can be filtered from the contaminated air. The filtered air eventually exits the evacuation system via an exit port and is released into the atmosphere of the operating room. Depending on the efficiency and/or effectiveness of the smoke evacuation system, the filtered air may still contain fluids and/or particulates when released into the atmosphere of the operating room. The remaining contaminants can be unpleasant, for example, to the olfactory senses of the clinician(s), assistant(s), and/or patient(s), and the contaminants can be unhealthy if inhaled in certain instances.

The smoke evacuation system may include a sensor system configured to monitor the detected size and/or concentration of particulates in the air at various points along the airflow path, including locations external to the evacuation system and internal to the evacuation system. In one aspect of the present disclosure, the smoke evacuation system may determine the efficiency of the evacuation system based on comparing particulate concentrations external to the evacuation system and internal to the evacuation system and/or by monitoring particulate concentrations over time. Additionally, the smoke evacuation system may alert a clinician(s) via a display to contaminated air in the operating room.

The clinician(s) may be aware of the level of contaminants, such as fluids and/or particulates, suspended in the air of the operating room. An indication of airborne contaminants may indicate the air quality in the operating room and may alert the clinician(s) and/or assistant(s) that the smoke extraction system requires adjustment and/or maintenance.

The smoke evacuation system can include a sensor system configured to monitor the size and/or concentration of particles in the air. Referring again to FIGS. 18 and 19, particle sensors 50838 and 50852 are shown. The particle sensors 50838 are internal sensors located at a location along the flow path. In various examples, the particle sensors 50838 are located at a point on the pre-filtered flow path 50804 (FIG. 18), 50904 (FIG. 19). However, the internal particle sensors 50838 can be located at any suitable location along the respective flow paths 50804, 50904 to monitor contaminated air entering from the surgical site. In various examples, the smoke evacuation system 50800, 50900 can include two or more internal particle sensors 50838 located at various locations along the respective flow paths 50804, 50904.

The particle sensor 50852 is an external sensor located on the exterior surface of the smoke evacuation system 50800 (FIG. 18), 50900 (FIG. 19). In various examples, the smoke evacuation system 50800, 50900 can include two or more external particle sensors 50852. In various examples, the external particle sensor 50852 is located in a recess in the housing of the smoke evacuation system 50800, 50900. However, the external particle sensor 50852 can be located on any suitable surface to detect the air quality in the operating room. In various examples, the external particle sensor 50852 is located near the inlet 50822 (FIG. 18), 50922 (FIG. 19) of the smoke evacuation system 50800, 50900, respectively, to ensure that unfiltered air does not leak from the operating site into the atmosphere of the operating room. In various examples, the external particle sensor 50852 is located near the exit ports 50824 (FIG. 18), 50924 (FIG. 19) of the smoke exhaust systems 50800, 50900, respectively, to analyze the air exiting the smoke exhaust systems 50800, 50900.

The reader will readily appreciate that the external particle sensor(s) 50852 can be located in any suitable location to adequately monitor the operating room atmosphere. In addition, the reader will readily appreciate that a variety of particle measurement means are possible. For example, the particle sensor 50852 can be any suitable particulate concentration sensor, such as an optical sensor, a laser sensor, a photoelectric sensor, an ionization sensor, an electrostatic sensor, and/or any suitable combination thereof. Various sensors are further described herein.

In various examples, the smoke evacuation system's sensor system is configured to assess particle size and/or concentration of contamination in the operating room and display the detected air quality. Display of such information can, for example, communicate the effectiveness of the smoke evacuation system. In various examples, the communicated information can include detailed information regarding the filter(s) in the smoke evacuation system to prevent contaminated air and/or smoke from accumulating in the operating room atmosphere. The smoke evacuation system can be configured to sense, for example, particulate concentration, temperature, fluid content, and/or percentage of contamination and communicate it to the generator to adjust its output, as further described herein. In one aspect of the present disclosure, the smoke evacuation system can be configured to adjust its flow rate and/or motor speed to operatively affect the generator's output power or waveform to reduce the amount of smoke generated by the end effector at a given particle level.

In various examples, the sensor system described herein can be used to detect whether airborne contaminants and/or smoke are being properly and efficiently removed by the filter(s) in the smoke evacuation system. By detecting the air quality level(s) in the operating room, the smoke evacuation system is configured to prevent high levels of pollution from accumulating in the atmosphere of the operating room. The parameters monitored by the sensor system can be used to inform a clinician whether the smoke evacuation system is functioning and/or performing its intended purpose. In various examples, the monitored parameters can be used by a clinician and/or assistant to determine that a filter in the smoke evacuation system needs to be repaired and/or replaced. For example, if the external sensor 50852 (FIGS. 18 and 19) detects a particle size and/or concentration of contaminants above a predetermined and/or acceptable threshold, the clinician is instructed to determine whether a filter in the smoke evacuation system needs to be repaired and/or replaced.

In various examples, as described above, a processor within the smoke evacuation system compares the detected parameters of the external sensor with the parameters detected by the internal sensor. In various examples, the smoke evacuation system includes multiple internal sensors located at various points along the flow path, such as after each individual filter. The reader will appreciate that the internal sensors may be positioned at any point throughout the flow path to provide a meaningful comparison of filter efficiency. Using this detected information, the clinician may determine that a filter at a particular location is not effectively removing contaminants and/or smoke from the air. In such examples, the clinician is directed to the exact location of the filter (or filtration layer) that requires attention for repair and/or replacement.

In various examples, the sensor system is configured to assess the dilution of contaminants and/or particles in the operating room air. As described herein, the internal sensor(s) can be located at any suitable location along the flow path. If the internal sensor is located near the exit port of the smoke evacuation system and downstream of the filter(s), the internal sensor is effectively measuring the size and/or concentration of particles released into the operating room air. In other words, the internal sensor is configured to detect particles and/or contaminants that were not captured during the filtration process. The external sensor is configured to monitor the concentration and/or size of the diluted particles throughout the operating room air. The difference between the readings of the internal and external sensors can be significant to determine the air quality of a particular operating room.

The size and/or concentration of particles released into the atmosphere may have different effects on air quality in the operating room based on parameters such as, for example, the size of the operating room and/or the ventilation in the operating room. In one example, the size and/or concentration of particles released may have a more detrimental effect on air quality when released in a smaller operating room than the same size and/or concentration of particles released in a larger operating room. In various examples, the presence and/or efficiency of a ventilation system in the operating room may affect how air quality fluctuates in response to the release of particles from the smoke evacuation system. For example, in operating rooms without a ventilation system or with an inefficient ventilation system, particles released from the smoke evacuation system may accumulate to potentially harmful levels more quickly, causing unsatisfactory air quality in the operating room.

In various examples, the information detected by the sensor system can be used to control one or more motor functions of the smoke evacuation system. Prior to the start of the surgical procedure, the external sensor can detect an initial air quality level. The air quality can be continuously monitored throughout the surgical procedure. However, the reader will understand that the air quality can be monitored at any suitable speed. The external sensor communicates the detected information to a processor of the smoke evacuation system (e.g., processors 50308 and 50408 of Figures 5 and 6, respectively). The processor uses the initial air quality level as a baseline to compare with the continuously detected air quality level. If the processor determines that the air quality level(s) detected by the external sensor 50852 are indicative of higher contaminant particle size and/or concentration in the air of the operating room, the processor instructs the motor to operate at a higher level. By operating the motor at an increased speed, more polluted air and/or smoke is drawn from the surgical site into the smoke evacuation system 50800, 50900 for filtration. In various examples, the processor stores instructions to increase the flow rate of contaminated air and/or smoke directed into the smoke evacuation system 50800, 50900 during a procedure when the internal sensor 50838 determines that a smoke-generating cautery device and/or other electrosurgical device is active. By detecting activation of a smoke-generating surgical device, the smoke evacuation system 50800, 50900 prevents high levels of contamination from building up in the operating room atmosphere via the motor control unit.

In various examples, the motor speed level is automatically controlled when the processor determines that the atmosphere in the operating room has an unacceptable air quality level. In various examples, the motor speed level is automatically controlled when the processor determines that a smoke-generating surgical device has been activated. For example, when the external sensor 50852 detects a pollution level in the atmosphere of the operating room above a predetermined threshold, the processor can automatically command the motor to operate at a faster speed. Then, when the external sensor 50852 detects a pollution level falling below the predetermined threshold, the processor automatically reduces the speed of the motor. In various examples, the motor speed level is manually controlled after the clinician is notified of the unacceptable air quality level. In various examples, the motor speed level is manually controlled after the clinician activates a smoke-generating surgical device. The reader will understand that any suitable combination of automatic and/or manual control can be implemented and/or incorporated into the control algorithm of the smoke evacuation system 50800, 50900.

In various examples, the processor of the smoke evacuation system can recognize when the external sensor 50852 detects unacceptable and/or increased contamination levels in the operating room atmosphere. Such detection indicates that the smoke evacuation system 50800, 50900 is inefficient. The detected inefficiency can indicate that one or more filters are not functioning and/or need to be replaced. When a clinician is notified of a non-functioning filter, the clinician can ensure that replacement filters are in inventory for future maintenance to prevent delay(s).

In various examples, the smoke evacuation system can be used in combination with a camera scope during a surgical procedure to efficiently manage the evacuation of contaminants and/or smoke from a surgical site. For example, the smoke evacuation system 50800, 50900 can be used in combination with an imaging module 238 and an endoscope 239 (FIG. 47). In one aspect of the present disclosure, a surgical hub, such as the hub 206 (FIG. 48), can coordinate communication between the imaging module 238 and a surgical evacuation system, such as the smoke evacuation device 226 (FIG. 48). The camera scope is configured to monitor for visual obstructions in the air by capturing a series of images at a particular sample rate. The collected images are transmitted to a processor (e.g., processors 50308, 50408, respectively, of FIGS. 5 and 6) for evaluation. In various examples, the processor is also configured to receive monitored data from a sensor system, which can include an internal sensor 50838 and/or an external sensor 50852, as described herein. The processor is configured to compare the images received from the camera scope with the particle count and/or concentration received from the sensor system to determine a correlation or correlations to improve the efficiency of smoke and/or contamination removal from the atmosphere of the surgical site and/or operating room.

In such examples, the visual obstruction determined by the camera scope and the particle number and/or concentration determined by the sensor system are compared to reconcile the particle number measurements with the speed of the smoke evacuation system motor. Upon comparing the data collected from the sensor system and the camera scope, the processor may take any of a number of steps. For example, based on the comparison, the processor may decide to turn on the smoke evacuation system, increase the smoke evacuation system motor speed, decrease the smoke evacuation system motor speed, and/or turn off the smoke evacuation system. In various examples, the comparison is made automatically. However, the reader will understand that such a comparison may be made after manual activation.

In various examples, the images captured by the camera scope and the particle count and/or concentration detected by the sensor system can be stored in memory as a baseline comparison. In future surgical procedures, the clinician and/or assistant can use the images collected by the camera scope alone to confirm the density of the smoke and/or contaminants. In such examples, visual obstructions detected by the camera scope are associated with a particular particle count and/or concentration. After the processor analyzes the air, the processor can take any of a number of steps. For example, based on the analyzed images captured by the camera scope in view of the stored baseline comparison, the processor can decide to turn on the smoke evacuation system, increase the motor speed of the smoke evacuation system, decrease the motor speed of the smoke evacuation system, and/or turn off the smoke evacuation system.

In various examples, situational awareness can further inform the decision-making processes described herein. For example, images from a scope may be meaningful in the context of a particular surgical procedure and/or steps thereof, which may be configured and/or determined based on the situational awareness of the smoke evacuation system and/or a hub in communication therewith. For example, more smoke may be expected during a particular surgical procedure and/or particular steps thereof and/or when treating a particular type of tissue.

In various examples, the smoke evacuation system wirelessly communicates with other surgical devices and/or hubs located in the operating room to improve the efficiency of smoke evacuation during a surgical procedure. For example, activation of a generator of a surgical device may be communicated to a centralized hub that forwards the information to the smoke evacuation system. The centralized hub may detect current through the surgical energy device and/or sense changes in the generator's power draw for communication to the smoke evacuation system. In various examples, the centralized hub may store information related to the surgical procedure and/or the activated surgical device. Such information may include, for example, an expected amount of smoke generated during a particular surgical procedure, and information related to a particular surgical device and/or tissue composition of a particular patient may be used to determine the expected amount. Receiving such information may enable the smoke evacuation system to predict a particular smoke evacuation rate to more efficiently move smoke and/or contaminants away from the surgical site. The reader will appreciate that various surgical devices may communicate information directly to the smoke evacuation system and/or indirectly through the centralized hub. The centralized hub may be, for example, a surgical hub, such as surgical hub 206 (FIG. 48).

In various examples, the smoke evacuation system is in wired communication with other surgical devices and/or hubs located in the operating room to improve the efficiency of smoke evacuation during a surgical procedure. Such wired communication can be established via a cable interconnection between the generator and the smoke evacuation system for communication of generator activation. For example, an activation indication signal cable may be connected between the generator of the surgical device and the smoke evacuation system. When the generator is activated and a signal is received via the wired connection, the smoke evacuation system is automatically activated.

The wireless and/or wired communication between the surgical device generator and/or the centralized hub and/or the smoke evacuation system can include information regarding the activated surgical device. Such information can include, for example, information regarding the current operating mode of the surgical device and/or a particular energy setting and/or intensity of delivery. In various examples, when such information is communicated from the surgical device, the memory of the centralized hub and/or the smoke evacuation system is configured to store such information for future use. For example, the centralized hub can store information regarding the surgical device used during a particular procedure, as well as the average smoke and/or contaminant count and/or concentration. In future surgical procedures, when the same (or similar) surgical device is activated in the same (or similar) surgical procedure treating the same (or similar) type of tissue, the centralized hub can communicate such information to the smoke evacuation system prior to the accumulation of smoke and/or contaminants.

In various examples, the smoke evacuation system is configured to notify a clinician of a detected level of contamination in the operating room atmosphere. The smoke evacuation system may utilize a sensor system to monitor differences between particle sizes and/or concentrations detected by a first internal sensor and a second external sensor. In various examples, the monitored parameters of the sensor system may be used to alert a clinician and/or assistant if the detected level of contamination exceeds a predetermined threshold.

In various examples, the processor directs the display to show the parameters monitored by the sensor system. In various examples, the display is located outside the housing of the smoke evacuation system. The processor can also communicate the monitored parameters to other surgical instruments and/or hubs located in the operating room to aid in situational awareness of the interactive surgical system. In this manner, the other surgical instruments and/or hubs can be used together more efficiently. In situations where the monitored parameters are communicated throughout the operating room, the clinician and/or assistants can view contamination warnings from various displays around the operating room. The monitored parameters can be displayed on multiple monitors in the operating room in addition to the display on the smoke evacuation system. The reader will understand that any suitable combination of displays can be used to communicate the detected air quality in the operating room.

30 illustrates a smoke evacuation system 53000 configured to monitor the air quality of the ambient air in a surgical suite and alert a clinician when the detected air quality exceeds a predetermined threshold and/or becomes potentially harmful. The smoke evacuation system 53000 is similar in many respects to the smoke evacuation system 50600 (FIG. 7). For example, the smoke evacuation system 53000 includes a generator 50640, a first electrical connection 50642, a surgical instrument 50630, and a suction hose 50636. As shown in FIG. 30, in various examples, the smoke evacuation system 53000 includes a display or air quality indicator screen 53002. The air quality indicator screen 53002 is configured to display information detected by a sensor system, such as a sensor system including one or more of sensors 50830, 50832, 50836, 50838, 50840, 50846, 50848, 50850, 50852, further described herein and shown in FIGS. 18 and 19. A processor, such as processor 50308 and/or 50408 (FIGS. 5 and 6), can be in signal communication with the sensor system and the air quality indicator screen 53002. In various examples, the air quality indicator screen 53002 is configured to display a contaminant particle count monitored by an external sensor 50852 to verify that contaminants are not circulating in the operating room atmosphere at harmful levels.

In various examples, the smoke evacuation system 53000 includes a latch door 53004 accessible to a clinician to replace and/or replace filters contained within the evacuation housing of the smoke evacuation system 53000. For example, by monitoring particulate concentrations passing through the smoke evacuation system 53000, the processor may determine that one or more filters are substantially clogged and approaching the end of their useful life and therefore in need of replacement. In such an example, the clinician may open the latch door 53004 and replace the one or more filters. As further described herein, the particular filter and/or filter(s) in need of replacement may be identified based on the relative placement of internal sensors within the smoke evacuation system 53000.

In various examples, a processor, such as processor 50308 and/or 50408 (FIGS. 5 and 6), is configured to communicate detected smoke parameters, such as particle size and/or concentration, to the display 53002. The display 53002 is configured to display such detected information in any suitable manner. For example, the display 53002 may show the pollution levels detected by each of the internal and external sensors throughout the sensor system. In various examples, the display 53002 is configured to display information only if the air quality does not meet a predetermined threshold. In various examples, the display 53002 includes a touch screen that allows the clinician to determine which information to display and/or where the information is displayed.

In various examples, the display 53002 includes a graphical interface, an LCD screen, and/or a touch screen. The reader will appreciate that any suitable means of displaying detected information and/or combinations thereof may be used in the smoke evacuation system 53000. For example, an LED light may be used as the display 53002. When the processor 50308 and/or 50408 (FIGS. 5 and 6) determines that unacceptable air quality exists in the operating room, the processor 50308 and/or 50408 is configured to activate the LED light.

31 illustrates a representation of instructions 53100 stored by a memory of a surgical evacuation system, such as, for example, memories 50310 and 50410 of FIGS. 5 and 6. In various examples, the surgical evacuation systems disclosed herein may utilize the instructions 53100 of FIG. 31. Additionally, the reader will readily appreciate that, in certain examples, the instructions 53100 of FIG. 31 may be combined with one or more additional algorithms and/or instructions described herein. The instructions 53100 stored in memory may be executed by a processor, such as, for example, processors 50308 and/or 50408 of FIGS. 5 and 6.

31, as described above, an internal sensor, such as sensor 50838 (FIGS. 18 and 19), is configured to monitor an internal parameter, such as particle size and/or concentration of the fluid. As the fluid flows through the flow path, particles and/or contaminants are filtered before the fluid exits the surgical drainage system. An external sensor, such as sensor 50852 (FIGS. 18 and 19), located on the external housing of the surgical drainage system, is configured to monitor an external parameter as the filtered fluid exits the surgical drainage system. Such an external parameter may include, for example, particle size and/or concentration in the air in the operating room.

At block 53102 of instructions 53100, the processor is configured to query the internal and external sensors for the detected internal and external parameters, respectively. In various examples, the processor queries the internal and external sensors for this information continuously; however, any suitable sample rate may be used. The processor is then configured to analyze the information received from the internal and external sensors to determine an efficiency level of the surgical evacuation system at block 53104. After determining the efficiency level of the surgical evacuation system, the processor is configured to display the determined efficiency level on a display at block 53106. Such display may include the raw information received from the internal and external sensors, the efficiency level determined by the processor, and/or an alert to the clinician if the efficiency level is below a predetermined threshold. A level below a predetermined threshold may indicate, for example, that a filter needs to be changed and/or that particles are not being efficiently filtered and are accumulating in the air of the operating room.

32 illustrates a representation of instructions 53200 stored by a memory of a surgical evacuation system, similar to that depicted in FIG. 31. In various examples, the surgical evacuation systems disclosed herein may utilize the instructions of FIG. 32. Additionally, the reader will readily appreciate that in certain examples, the instructions of FIG. 32 may be combined with one or more additional algorithms and/or instructions described herein. The instructions may be stored in a memory and executed by a processor, such as, for example, memory 50310 and/or 50410 and/or processor 50308 and/or 50408 of FIGS. 5 and 6.

32, prior to the start of the surgical procedure at block 53202, the processor is configured to query an external sensor, such as sensor 50852 (FIGS. 18 and 19), for a baseline air quality parameter. The baseline air quality parameter is indicative of the air quality in the operating room prior to the surgical procedure. At block 53204, the processor is configured to continuously query the internal sensor to recognize that the surgical procedure is in progress. After the processor determines that the surgical procedure is being performed, the processor continuously queries the external sensor at block 53206. If the processor determines that the air quality detected by the external sensor is deteriorating, such as at block 53208, the processor is configured to increase the speed of the motor at block 53210 to direct more fluid into the surgical drainage system. If the detected air quality is the same as the baseline air quality, such as at block 53212, the processor is configured to maintain the speed of the motor at block 53214. For example, if the detected air quality has improved from the baseline air quality, such as at block 53216, the processor is configured to maintain or decrease the speed of the motor at block 53218. In various examples, the processor continuously queries the internal and external sensors for information. However, any suitable sample rate may be used.

Smoke evacuation systems play an important role in electrosurgical systems by removing harmful toxic materials and/or unpleasant odors from the operating room. However, the control and regulation of certain smoke evacuation systems can be lacking, which can result in, for example, reduced motor life and/or deteriorated filter life.

In one aspect of the disclosure, a sensor can be positioned and configured to detect the presence of particles in a fluid moving through various points in a flow path of the exhaust system. In some aspects of the disclosure, a control circuit can be utilized to vary the speed of a motor driving a pump of the exhaust system based on the detected particulate concentration at various points along the flow path. Additionally or alternatively, a control circuit can be utilized to vary the speed of the motor based on the detected pressure at various points in the flow path.

Efficient regulation of the motor speed of the exhaust system can increase motor life and/or increase filter life. Further benefits include, for example, potential energy savings and reduced noise in the operating room.

As described herein, electrosurgical instruments deliver energy to a patient's target tissue to cut the tissue and/or cauterize blood vessels in and/or near the target tissue. Cutting and cauterization can result in smoke being released into the air. In various examples, the smoke can be unpleasant, obstructive to the practitioner's vision, and unhealthy if inhaled, as described further herein. The electrosurgical system can employ an exhaust system that captures the resulting smoke, directs the captured smoke through one or more filters, and exhausts the filtered smoke. More specifically, the smoke can travel through the exhaust system via a vacuum tube. Harmful toxic substances and unpleasant odors can be filtered from the smoke as it travels through one or more of the filters in the exhaust system. The filtered air can then exit the exhaust system as exhaust via an exhaust port.

In various aspects of the disclosure, the evacuation system includes a filter receptacle or socket. The filter receptacle is configured to receive the filter. The evacuation system also includes a pump having a sealed positive displacement flow path and a motor driving the pump. The sealed positive displacement flow path of the pump can include one or more circulation paths for the fluid within the pump. In one aspect of the disclosure, the pump has a first operating pressure and a second operating pressure. In certain examples, the pump can compress the incoming fluid to create a pressure differential along the flow path, as further described herein.

As shown in FIG. 4, the exhaust system 50500 includes a pump 50506 coupled to and driven by a motor 50512. As described herein, the pump 50506 may be a positive displacement pump, such as, for example, a positive displacement reciprocating pump, a positive displacement rotary pump, or a positive displacement linear pump. In various examples, the pump 50506 may be, for example, a hybrid regenerative blower, a claw pump, a lobe compressor, or a scroll compressor. In one aspect of the disclosure, the motor 50512 may be a permanent magnet synchronous direct current (DC) motor. Some aspects may include a brushless DC motor.

According to aspects of the present disclosure, the motor 50512 can be adjusted and/or controlled for a variety of reasons, including, for example, to maintain flow rate, increase motor efficiency, increase motor life, increase pump life, increase filter life, and/or conserve energy. When the exhaust system's control circuitry (see, for example, the control schematics of FIGS. 5 and 6 ) recognizes a particular condition, such as, for example, a blockage in the flow path, an undesirable pressure, and/or an undesirable particle count, the control circuitry can adjust the motor 50512 to adjust or maintain the flow rate, thereby, for example, increasing motor efficiency, increasing motor life, increasing pump life, increasing filter life, and/or conserving energy.

In one aspect of the disclosure, with reference to FIG. 6, the processor may be internal to the ejection system. For example, the processor 50408 may be internal to the ejector housing 50618 of FIG. 7. In other aspects of the disclosure, the processor may be near the exterior of the ejection system 50600. For example, an external processor 50308 is shown in FIG. 5. The external processor may be a processor in the surgical hub. In yet another aspect, the internal processor and the external processor may communicate to cooperatively control the motor 50512.

According to one aspect of the disclosure, the motor 50512 may be adjusted by the control circuitry to increase motor efficiency. For example, referring to the exhaust system of FIGS. 18 and 19, the fluid detection sensor 50830 is disposed upstream of the filter(s) and filter receptacle. In various examples, the fluid detection sensor 50830 is configured to detect fluid upstream of the filter(s). For example, the fluid detection sensor 50830 is configured to detect whether aerosols or liquid droplets are present in the exhausted smoke. Based on the output from the fluid detection sensor 50830, the control circuitry can adjust control parameters of the smoke exhaust system, such as, for example, adjusting power to a valve and/or a motor.

In certain examples, the evacuation system can detect whether a fluid (e.g., smoke) is present in the flow path. In certain examples, the fluid detection sensor 50830 can automatically scan for fluid or a particular type of fluid when a clinician begins treatment of patient tissue using the electrosurgical instrument, such as when the electrosurgical instrument 50630 (FIG. 7) is activated by the generator 50640 (FIG. 7). Alternatively, or in combination with the fluid detection sensor 50830, a separate sensor, such as, for example, an end effector or an imaging device of the surgical instrument, can be configured to detect the fluid(s) at the surgical site. In one example, the separate sensor may be located near the tip of the electrosurgical instrument 50630. When the fluid detected by one or more of the fluid detection sensor(s) is below a threshold value, the control circuit can adjust the motor speed of the pump to a level sufficient to monitor the presence of the fluid or a particular type of fluid. The motor speed in such examples may be a minimum motor speed or an idle motor speed that allows an accurate reading at the fluid detection sensor(s). Alternatively, the motor speed can be reduced to zero and periodically increased to a minimum or idle motor speed to monitor for the presence of a fluid or a particular type of fluid.

Upon detection of fluid by the fluid detection sensor, or a fluid level above a threshold, the control circuitry can adjust the speed of the motor 50512 to a level sufficient to completely drain the fluid from the surgical site. In one embodiment, a cloud such as cloud 104 (FIG. 39) and/or cloud 204 (FIG. 46) can track and/or store motor speed levels established as sufficient to efficiently drain fluid for the same or similar surgical procedures. In such an embodiment, the control circuitry can access and/or reference the historical motor speed levels stored in the cloud when setting the appropriate motor speed level for that surgical procedure.

Additionally or alternatively, the speed of the motor can be adjusted based on the particulate concentration detected along the flow path. For example, referring back to FIGS. 18 and 19, the exhaust systems 50800 and 50900 include laser particle sensors 50838 and 50848 along the respective flow paths 50804 and 50904. The particle sensor 50838 is positioned upstream of the filters 50842, 50844, and the receptacle 50871 in the surgical exhaust system 50800, and upstream of the filters 50942, 50944, and the receptacle 50971 in the surgical exhaust system 50900. The particle sensor 50838 is configured to detect and/or count particles upstream of the filter(s). The particle sensor 50848 is disposed downstream of the filter(s) 50842, 50844, and receptacle 50871 in the surgical drainage system 50800, and downstream of the filter(s) 50942, 50944, and receptacle 50971 in the surgical drainage system 50900. The particle sensor 50848 is configured to detect and/or count particles downstream of the filter(s).

In such examples, the exhaust system 50800, 50900 can detect (e.g., via a laser particle counter sensor) whether a fluid (e.g., smoke containing particulate matter) is present. For example, the sensor(s) can detect the concentration of particulate matter in the smoke. In certain examples, the laser particle counter sensor(s) can automatically scan and count particles when the practitioner begins to treat patient tissue using the electrosurgical instrument, such as when the electrosurgical instrument 50630 is activated by the generator 50640.

When the particulate concentration detected by the particle sensor 50838 is below a threshold, the control circuitry can adjust the motor speed to a level sufficient to sample the particulate concentration in the flow path. For example, the motor speed can be set to a minimum or idle motor speed that allows an accurate reading at the sensor. In an alternative embodiment, the motor speed can be reduced to zero and periodically increased to a minimum or idle motor speed level sufficient to monitor for the presence of fluid (e.g., particulate concentration in the smoke above a threshold). In such an embodiment, upon detecting a particulate concentration above a threshold, the control circuitry can adjust the speed of the motor 50512 (FIG. 4) to a level sufficient to fully evacuate the smoke and filter particulates from the surgical site. Again, the cloud can track and/or store motor speed levels established to be sufficient to efficiently evacuate fluid for the same or similar surgical procedures based on the particulate concentration detected by the sensor. In such an embodiment, the control circuitry can access and/or reference such historical motor speed levels when setting the appropriate motor speed level for that surgical procedure.

In one aspect of the present disclosure, the motor 50512 is more efficient because it will either be off (i.e., zero motor speed) or operating at a predetermined minimum or idle speed unless a fluid and/or threshold particulate concentration is detected. In such an example, energy can be conserved and noise in the operating room can be minimized. Furthermore, if a fluid and/or threshold particulate concentration is detected, the motor 50512 can be operated at an efficient motor speed, i.e., a motor speed that has been established as sufficient to efficiently evacuate fluid and/or particles based on historical data. This is an improvement over other manual methods that set motor speed levels based on subjective assessment (e.g., a particular clinician's experience) and/or simply adjust the evacuation system and/or increase motor speed levels based on visual and/or olfactory cues (e.g., seeing and/or smelling smoke).

According to various aspects of the present disclosure, motor parameters, such as, for example, the speed of the motor, can be adapted to adjust (e.g., increase) the efficiency of the exhaust system and its filters based on the needs at the surgical site. As described herein, if smoke detected at the surgical site is below a threshold, it may be inefficient for the exhaust system to unnecessarily filter a volume of air. In such an example, the motor speed can be decreased, reduced to zero, or maintained at zero, thereby decreasing, reducing to zero, or maintaining at zero, respectively, the volume of air filtered by the exhaust box. Efficient use of the exhaust system ultimately extends the useful life of the exhaust system and/or its components (e.g., fluid traps, filters, motors, pumps, etc.) and reduces the associated repair and/or replacement costs of the exhaust system and/or its components. Stress and wear caused by constantly running the motor at full speed or above full speed is avoided. Additionally, the motor driving the pump in the exhaust system may generate various levels of operating noise and/or vibration noise. Such operating noises and/or vibration noises may be undesirable in an operating room and/or environment, for example, because they may impede communication between surgical staff and/or may annoy and/or distract surgical staff.

In certain instances, it may not be desirable to reduce the motor speed to zero. For example, an electric motor, such as a permanent magnet synchronous DC motor, may require a large starting torque from a dead stop for use with the various pumps described herein. Referring again to FIG. 4, the pump 50506 creates a pressure differential between the fluid entering the pump 50506 and the fluid exiting the pump 50506. This pressure differential or compression ratio of the pump 50506 may result in a high starting torque for the motor 50512 to start and rotate the pump 50506. In one embodiment, the pump 50506 may comprise a blower (e.g., a hybrid regenerative blower). In such an aspect, the blower may operate, for example, at a compression ratio of about 1.1 to 1.2 to deliver a larger volume of fluid (e.g., relative to a fan or compressor) at an operating pressure of about 1.5 psig to 1.72 psig. In another embodiment, the pump 50506 can include a compressor (e.g., scroll compressor pump 50650 of FIG. 12). In such an embodiment, the compressor can operate at a compression ratio of, for example, greater than about 2 to deliver a smaller volume of fluid (e.g., for a fan or blower) at an operating pressure greater than about 2.72 psig.

Aspects of the present disclosure are directed to systems and methods for improving filter assembly life. A filter assembly can include multiple filtration layers. For example, referring again to FIG. 11, a filter assembly includes a coarse media filter 50684, a fine particulate filter 50686, and a carbon reservoir 50688.

According to various aspects of the present disclosure, a first pressure sensor (e.g., pressure sensor 50840 of FIGS. 18 and 19) can be disposed upstream of the filter receptacle in the flow path, and a second pressure sensor (e.g., pressure sensor 50846 of FIGS. 18 and 19) can be disposed downstream of the filter receptacle in the flow path. In such an example, the first pressure sensor is configured to detect a first pressure and transmit a signal indicative of the first pressure to the control circuit. Similarly, the second pressure sensor is configured to detect a second pressure and transmit a signal indicative of the second pressure to the control circuit. Further, the control circuit receiving the signal indicative of the first pressure and the signal indicative of the second pressure is configured to calculate a pressure difference between the first pressure sensor and the second pressure sensor. The control circuit can utilize the calculated pressure difference in various ways. In a first example, the control circuit can adjust the motor speed based on the pressure difference. In a second example, the control circuit can indicate that maintenance is needed based on the pressure difference. For example, an indicator may be displayed on the evacuation system interface and/or the surgical hub interface. The control circuitry can calculate the pressure differential continuously, in real-time, periodically, or when system computational resources are available.

4, in certain examples, particles entering the flow path 50504 of the exhaust system 50500 may cause an internal blockage. For example, the particles may at least partially clog and/or block a portion of the flow path 50504. In one example, the filter 50502 may become clogged with particles. The blockage may occur suddenly or over time as the exhaust system operates. A blockage in the exhaust system 50500 may cause a pressure difference in the flow path 50504 to rise as the flow is impeded. To maintain the desired flow rate and compensate for the blockage, the pump 50506 and/or the motor 50512 may require more power and/or an increase in speed. However, the increase in speed and/or power may reduce the efficiency of the motor 50512 and/or the pump 50506. Furthermore, operating the motor 50512 and/or the pump 50506 at an increased speed to compensate for the blockage may reduce their lifespan. In other examples, to compensate for the blockage, the control circuitry can adjust the motor 50512 as described further herein.

In one aspect of the present disclosure, the control circuitry can send a drive signal to provide a regulated current to the motor 50512. The delivery of a desired current can be achieved by varying the duty cycle of the pulse width modulation of the electrical input to the motor 50512. In such an aspect, by increasing the duty cycle of the current input to the motor, the motor speed can be increased, and by decreasing the duty cycle of the current input to the motor, the motor speed can be decreased.

In one aspect of the disclosure, the exhaust system can include a relief valve in the flow path to release excess resistance pressure in the exhaust system. The relief valve can be in fluid communication with the ambient environment, for example. Relief of excess resistance pressure by such a relief valve can prevent the motor 50512 from having to compensate or attempting to compensate for the excess resistance pressure. In various aspects of the disclosure, such a relief valve is configured to operate (e.g., open and/or close) upon receiving a signal from the control circuit.

In various aspects of the present disclosure, the control circuitry can recognize a blockage based on sensors disposed within the exhaust system. For example, referring again to FIGS. 18 and 19, the pressure sensor 50840 is positioned and configured to detect pressure upstream of the one or more filter(s), and the pressure sensor 50846 is positioned and configured to detect pressure downstream of the one or more filter(s). The pressure sensor 50840 is further configured to transmit a signal indicative of the detected pressure to the control circuitry. Similarly, the pressure sensor 50846 is configured to transmit a signal indicative of the detected pressure to the control circuitry. In such an example, the control circuitry can determine that a portion of the filter assembly is at least partially blocked based on the pressure detected at 50846 and/or the calculated pressure difference between 50840 and 50846. In various aspects of the present disclosure, the control circuitry may determine that the filter assembly is blocked, for example, when (A) the pressure detected by the pressure sensor 50846 exceeds a certain threshold, (B) the calculated pressure difference between the pressure sensor 50840 and the pressure sensor 50846 exceeds a certain threshold, (C) the pressure detected by the pressure sensor 50846 exceeds a certain threshold established for the filter(s), and/or (D) the calculated pressure difference between the pressure sensor 50840 and the pressure sensor 50846 exceeds a certain threshold established for the filter(s). In one example, the control circuitry is configured to access and/or reference a predicted pressure for the filter(s) based on historical data stored in a cloud, such as cloud 104 (FIG. 39) and/or cloud 204 (FIG. 46).

18 and 19, the pressure sensor 50850 is positioned and configured to detect pressure at or near the outlet of the exhaust system. In addition, the pressure sensor 50850 is configured to transmit a signal to the control circuit indicative of the pressure detected at or near the outlet. In such an example, the control circuit can determine that the flow path through the exhaust system downstream of the filter(s) is at least partially blocked based on the pressure detected at the pressure sensor 50846 and/or the calculated pressure difference between the pressure sensor 50846 and the pressure sensor 50850. In various aspects of the present disclosure, the control circuit can determine that the flow path is blocked, for example, if the pressure detected at the pressure sensor 50846 exceeds a certain threshold and/or if the pressure difference between the pressure sensor 50846 and the pressure sensor 50850 exceeds a certain threshold. The pressure difference generated by the pump can be taken into account when comparing the pressure difference between the pressure sensor 50846 and the pressure sensor 50850. In one example, the control circuitry can access and/or reference a predicted pressure for the flow path based on historical data stored in a cloud, such as cloud 104 (FIG. 39) and/or cloud 204 (FIG. 46).

The speed of the motor 50512 can correspond to the current being supplied to the motor 50512. In one aspect of the disclosure, the control circuit can decrease the pulse width modulation (PWM) duty cycle of the current input to the motor 50512 to decrease the rotational speed of the pump 50506, and/or increase the PWM duty cycle of the current input to the motor 50512 to increase the rotational speed of the pump 50506. As described herein, adjustments to the PWM duty cycle can be configured to maintain the flow rate substantially constant over a range of inlet pressures (e.g., as measured by pressure sensor 50840) and/or a range of outlet pressures (e.g., as measured by pressure sensor 50850).

Referring now to FIG. 37, the control circuitry can track and/or plot the ratio of the pressure detected by the upstream pressure sensor 50840 to the pressure detected by the downstream pressure sensor 50846 (the upstream to downstream pressure ratio) over time. For example, the control circuitry (FIGS. 5 and 6) including the processors 50308 and/or 50408 can determine the pressure ratio and make various adjustments to the surgical drainage system based on the pressure ratio.

In one example, referring to the graphical representation 54200 of FIG. 37, the pressure difference between the upstream pressure sensor 50840 and the downstream pressure sensor 50846 may increase as the filter becomes occluded. In one aspect of the present disclosure, as the downstream pressure measured by the pressure sensor 50846 decreases and/or the upstream pressure measured by the pressure sensor 50840 increases, the pressure ratio may increase. The pressure at the pressure sensor 50840 may be equal or substantially equal to the pressure at the surgical site (e.g., within the patient's body). The pressure at the pressure sensor 50846 may be the pressure drawn by the pump. The increase in the pressure ratio may correspond to an occlusion between the downstream pressure sensor 50846 and the upstream pressure sensor 50840, such as an occlusion in the filter(s). For example, as the filter becomes occluded, the pressure at the pressure sensor 50840 may remain the same or substantially the same (pressure at the surgical site) and the pressure at the pressure sensor 50846 may decrease as the pump continues to pull a vacuum.

The ratio of upstream to downstream pressure can indicate filter life. For example, a low ratio can indicate that the filter does not need to be replaced, and a high ratio can indicate that the filter needs to be replaced.

The progression from a new and unblocked filter at time _t0 to a nearly blocked filter at time _t2 is shown in FIG. 37. As shown in FIG. 37, the ratio of the upstream and downstream pressures (the pressure at the upstream pressure sensor 50840 and the downstream pressure sensor 50846) starts at a non-zero ratio, which may be due to baseline pressure differences from airflow through the filter components and materials. The ratio remains relatively constant from time _t0 until just before time _t1 . At time _t1 , the upstream and downstream pressure ratio increases at a relatively constant rate with a slope of α until the upstream and downstream pressure ratio reaches an exchange ratio R″. Once the exchange ratio R″ is reached and/or exceeded, the filter is considered substantially blocked and should be replaced, for example to avoid damage to the motor and/or pump. In one example, the control circuitry can access and/or reference the exchange ratio R″ for a given filter installed or located in the filter receptacle of the exhaust system via the cloud. For example, the replacement ratio R" may be stored in memory 50410 accessible to the processor 50408 of FIG. 6. Alternatively, the replacement ratio R" may be user defined and/or based on historical local and/or global pressure data in the cloud. In various aspects of the present disclosure, the control circuitry may utilize the tracked and/or plotted ratio to display a filter life metric (e.g., 40% remaining) on a user interface of the evacuation system and/or surgical hub.

With further reference to FIG. 37, the control circuitry may further track and/or plot the duty cycle of the pulse width modulation (PWM) of the motor of the exhaust system over time. For example, if the filter(s) is considered relatively new after time _t0 until just before time _t1 , the PWM duty cycle of the motor is set to a relatively low constant duty cycle or percentage. At time _t1 , which corresponds to the partial blockage ratio R', the control circuitry may be configured to increase the PWM duty cycle of the motor at a relatively constant rate with a slope of ^α1 . The increase in duty cycle may be selected to compensate for the filter blockage. As blockages in the filter continue to accumulate during use, the duty cycle may be increased accordingly to compensate for the filter blockage. In various examples, the slope ^α1 may track the slope α as shown in FIG. 37. The control circuitry may access and/or reference the partial blockage ratio associated with a given filter installed in the filter receptacle of the exhaust system via a cloud, such as cloud 104 (FIG. 39) and/or cloud 204 (FIG. 46). Alternatively, the partial occlusion ratio may be user defined and/or based on historical local and/or global pressure data in the cloud.

In one aspect of the present disclosure, the pump speed can be increased so that the pump draws more air through the exhaust system by increasing the duty cycle of the motor. In other words, an increase in the pressure differential across the filter can trigger a corresponding increase in the PWM duty cycle of the motor for the pump.

The pump of the evacuation system is configured to transport or affect the movement of a fluid along the flow path by mechanical action. During operation, the pump can increase the pressure of the fluid as it moves. The pump can have two or more operating pressures. In one aspect of the disclosure, the pump can operate at a first operating pressure that results in a first flow rate of the fluid through the flow path, and the pump can operate at a second operating pressure that results in a second flow rate of the fluid through the flow path. The first and second flow rates of the fluid through the flow path can be the same or substantially similar, regardless of the difference between the first and second operating pressures of the pump. In one example, as obstructions build up in the flow path, the pump can operate at a higher operating pressure to maintain a constant flow rate.

With further reference to the graphical representation 54200 of FIG. 37, the control circuit can increase the PWM duty cycle of the motor to increase the current supplied to the motor and increase the operating pressure of the pump. The control circuit can adjust the duty cycle based on, for example, the detected pressure(s), pressure differential(s), and/or a ratio of the detected pressures. The increased operating pressure can be configured to compensate for a blockage, such as a blockage in the filter beginning around time _t1 of FIG. 37, while maintaining a constant flow rate of fluid through the flow path. In such an example, the control circuit can control the load on the pump, for example, as the filter becomes clogged with particles.

In various aspects of the present disclosure, the control circuitry can increase the current supplied to the motor up to an established motor current threshold. In one aspect, the control circuitry can increase the established motor current threshold to achieve the pressure differential necessary to maintain a desired flow rate. For example, the pressure differential and desired flow rate can be maintained despite a blockage in the flow path.

In another aspect of the present disclosure, the control circuitry can decrease the established motor current threshold for various reasons. For example, the control circuitry can decrease the established motor current threshold to prevent inadvertent tissue damage at the surgical site. For example, when a surgical port is occluded by patient tissue, the control circuitry can decrease the motor current to reduce pressure in the system and suction applied to the tissue. In one example, the control circuitry can access and/or reference the established motor current threshold via a cloud, such as cloud 104 (FIG. 39) and/or cloud 204 (FIG. 46). Alternatively, the established motor current threshold may be user defined and/or based on history of local and/or global data in the cloud.

In various aspects of the present disclosure, the control circuitry can provide increased power and/or motor speed for a limited period of time based on feedback from the pressure sensor. During this time, the pressure(s) and/or an indication of the occlusion may be communicated to a user, for example, via an interface in the operating room. In one example, the clinician can address the occlusion by removing the occlusion and/or changing one or more filter(s) in the filter receptacle. The limited period of time can be determined based on data stored in the cloud, such as, for example, historical data regarding periods of operation at increased power levels and/or speeds prior to motor and/or pump failure. After the limited period of time, the power and/or speed can be reduced, as further described herein, until the occlusion is appropriately addressed.

According to various aspects of the disclosure, the control circuitry of the evacuation system can send drive signals to provide increased or decreased current to the motor of the evacuation system to adjust the speed of the motor and/or the speed of the pump. In one example, the control circuitry can send drive signals to achieve a burst speed upon start-up of the evacuation system and/or transition between power levels. For example, the burst speed can be configured to draw the evacuation system to a specified level at the beginning of an active evacuation mode. The specified level can correspond to, for example, a specified flow rate and/or a specified pressure. In various examples, the burst speed can efficiently draw the evacuation system to a specified level in an energy efficient manner.

In one example, the burst speed set by the control circuitry is different from the constant operating speed set by the control circuitry. For example, after initial start-up of the exhaust system and/or upon setting an increased power level of the exhaust system, the control circuitry can send a drive signal to supply increased current to the motor to increase the motor speed to the burst speed for a short period of time. The burst speed may be, for example, a motor speed that is at least 20% higher than the constant motor speed required to achieve the desired flow rate. In one aspect of the present disclosure, the burst speed is at least 50% or at least 100% higher than the constant motor speed required to achieve the desired flow rate.

Referring now to the graphical representation 54300 of Fig. 38, there is shown the air flow rate and particle count over time for a surgical evacuation system. The control circuitry of the surgical evacuation systems 50800 and 50900 (Figs. 18 and 19) can adjust the air flow rate, for example, as shown graphically in Fig. 38. More specifically, the air flow rate includes burst speeds 54302 and 54304 for the motors of the surgical evacuation system. For example, the burst speeds may be the motor speeds required to achieve a higher than desired air flow rate for a short period of time. 38, burst rate 54302 may be the motor speed required to achieve an air flow rate that is at least 20% higher than the desired air flow rate _V1 between times _t1 and _t2 over a portion (e.g., 1/5) of the period between times _t1 and _t2 , and similarly burst rate 54304 may be the motor speed required to achieve an air flow rate that is at least 20% higher than the desired air flow rate _V2 between times _t2 and _t3 over a portion (e.g., 1/4) of the period between times _t2 and _t3 . In various examples, the air flow rate may depend on the number of particles in the exhaust system, as described further herein.

According to various aspects of the disclosure, the transition of the exhaust system from a first airflow rate to a second airflow rate can be accompanied by an increase in the airflow rate immediately before or after the transition and before an adjustment to the second airflow rate. For example, the first airflow rate and the second airflow rate can correspond to a constant or substantially constant motor speed and, correspondingly, a constant or substantially constant airflow rate. Referring again to the graphical representation of FIG. 38, the airflow rate is substantially constant between times _t1 and _t2 , and again between times _t2 and _t3 , except for the burst rates 54302 and 54304 immediately after times _t1 and _t2 , respectively. The substantially constant airflow rates shown in FIG. 38 can correspond to corresponding constant motor speeds in corresponding operating modes of the exhaust system.

With further reference to FIG. 38 , at time t ₀ , the air flow rate may be a non-zero value between V ₀ and V ₁ , which may correspond to a motor speed in a “quiet” mode 54310. In the “quiet” mode 54310, the evacuation system may be configured to sample fluid from the surgical site. The sampled fluid may be utilized to determine, for example, an operational state of the smoke evacuation system, the energy device, and/or another component of the surgical system. At time t ₁ , the evacuation system may enter an “active” mode 54312. In certain examples, the “active” mode 54312 may be triggered by one or more sensors in the evacuation system, as further described herein. The increase in air flow rate to a rate V ₁ at time t ₁ and/or to a rate V ₂ at time t ₂ may be accompanied by a further increase in air flow rate immediately following the transition or initiation to the new speed level. More specifically, the air flow rate spikes immediately after time t ₁ of FIG. 38 and prior to the subsequent adjustment at time t ₂ . Additionally, the airflow velocity spikes just after time _t2 as the airflow transitions from velocity _v1 to velocity _v2 in the second "active" mode 54314.

Additionally or alternatively, a reduction in the power level of the exhaust system from a first air flow rate to a second air flow rate can be accompanied by an initial increase in air flow rate immediately prior to the reduction. For example, when reducing the air flow rate from a first constant or substantially constant level to a second constant or substantially constant level, the air flow rate can experience an air flow rate spike similar to that shown in FIG. 38. In one example, the control circuit can affect an air flow rate spike immediately prior to returning to a constant "quiet mode" motor speed from the "active mode". In various examples, the burst rate prior to the quiet mode can flush smoke out of the surgical system and/or the exhaust system, for example.

According to aspects of the present disclosure, various particle sensors, such as particle sensors 50838 and 50848 of FIGS. 18 and 19, can be positioned and configured to count particles flowing through and/or within the exhaust systems 50800 and 50900. Similarly, air quality particle sensors, such as particle sensor 50852 of FIGS. 18 and 19, can be positioned and configured to count particles in the ambient air around the exhaust systems 50800 and 50900 and/or within the operating room. Various particle sensors (e.g., particle sensors 50838, 50848, 50852, etc.) can be further configured to send a signal indicative of particle concentration to a control circuit, for example to adjust air flow rate.

Referring again to FIG. 38 , the motor of the exhaust system can operate at a constant “quiet” mode 54310 speed between time t ₀ and time t ₁ . Between time t ₀ and time t ₁ , at least one particle sensor (e.g., particle sensor 50838 and/or 50848) can actively count particles flowing through the exhaust system. In certain examples, at least one particle sensor (e.g., particle sensor 50852) can actively count particles in the ambient air. In at least one example, the control circuitry can compare the particles counted by particle sensor 50838 and/or particle sensor 50848 to the particles counted by particle sensor 50852. The control circuitry can determine, for example, that the particulate concentration detected by particle sensor 50838 and/or particle sensor 50848 is above a first threshold, such as threshold C ₁ of FIG. 38 . Threshold C ₁ can correspond, for example, to a particulate concentration level and/or ratio of particles counted at various sensors along the flow path. In response to the particle concentration exceeding a first threshold _C1 , the control circuit may increase the motor speed at time _t1 from a "quiet" mode 54310 associated with a first non-zero air flow rate to a second motor speed, or to an "active" mode 54312 associated with a second air flow rate (e.g., _V1 ). As described above, the increase in air flow rate may be accompanied by an air flow rate spike or burst 54302 shortly after time _t1 .

38, the control circuitry may continue to detect particulate concentrations from at least one of the particle sensors 50838, 50848, and/or 50852 while maintaining the motor speed associated with the air flow rate _V1 from time _t1 to time _t2 . At time _t2 , the control circuitry may determine that the particle concentration and/or ratio detected by at least one of the particle sensors 50838, 50848, and/or 50852 exceeds a second threshold, such as threshold _C2 of FIG. 38. The threshold _C2 may correspond to a particulate concentration level and/or ratio of particles counted at various sensors along the flow path that is greater than the first threshold _C1 . In response to exceeding the second threshold _C2 at time _t2 , the control circuitry is configured to increase the motor speed from the air flow rate _V1 or motor speed associated with the first "active" mode 54314 to the increased air flow rate _V2 or motor speed associated with the second "active" mode 54314. Again, the increase from air flow rate _V1 to air flow rate _V2 may be accompanied by an air flow rate spike or burst 54304 shortly after time _t2 .

In various examples, the control circuitry can continue to receive inputs indicative of particulate concentration by particle sensors 50838, 50848, and/or 50852 while maintaining the motor speed associated with airflow rate _V2 , for example, between time _t2 and time _t3 . At time _t3 , the control circuitry can determine that the particulate concentration and/or ratio detected by at least one of particle sensors 50838, 50848, and/or 50852 has decreased to below a first threshold _C1 . In response, the control circuitry can decrease the motor speed from the motor speed associated with airflow rate _V2 back to a "quiet" mode speed associated with the first non-zero airflow rate. As discussed above, in certain examples, the decrease from airflow rate _V2 back to the non-zero airflow rate can be accompanied by an airflow rate spike shortly after time _t3 . The control circuitry can, for example, continue to detect and/or compare particulate concentrations detected by particle sensors 50838, 50848, and/or 50852 while maintaining the "quiet" mode speed after time _t3 .

In various aspects of the present disclosure, the motor may be a variable speed motor. For example, motor 50512 (FIG. 4) may be a variable speed motor. In such an example, the speed of the motor may be controlled based on an externally measured parameter. For example, the speed of the variable speed motor may be increased, decreased, or maintained based on a parameter measured external to the exhaust system.

According to aspects of the present disclosure, the motor 50512 (FIG. 4) can be adjusted by varying the supply of current to the motor 50512. For example, a first amount of current can be supplied to the motor 50512 to operate the motor 50512 at a first operating level. Alternatively, a second amount of current can be supplied to the motor 50512 to operate the motor 50512 at a second operating level. More specifically, varying the supply of current can be accomplished by varying the pulse width modulation (PWM) duty cycle of the electrical input to the motor 50512. In other aspects, the current can be varied by adjusting the frequency of the current supplied to the motor. In various aspects of the present disclosure, the motor 50512 is coupled to a rotating mechanism or pump 50506 (e.g., a compressor, blower, etc. as described herein) such that reducing the duty cycle or frequency of the current input to the motor 50512 reduces the rotational speed of the pump 50506. Similarly, the rotational speed of the pump 50506 can be increased by increasing the duty cycle or frequency of the current input to the motor 50512.

In various aspects of the present disclosure, a lower operating level of the motor 50512 may be advantageous over turning the motor 50512 completely off when evacuation and/or suction is not required, and then switching the motor 50512 back on when suction is required. For example, a clinician may only need to use suction intermittently during an extended procedure. In such an aspect, turning the motor 50512 on from a completely off state requires a high starting torque to overcome the static inertia of the motor 50512. Repeatedly turning the motor 50512 on from a completely off mode in this manner may be inefficient and reduce the lifespan of the motor 50512. Alternatively, employing a lower operating level may allow the motor 50512 to remain on during intermittent use of the evacuation system during surgery, allowing adjustment to a higher operating level (e.g., when additional suction is required) without requiring a higher torque to overcome the static inertia of the motor.

In various aspects of the present disclosure, a range of variation can be established or predetermined for the motor parameters. In one example, a motor speed range can be predetermined for a variable speed motor. In various aspects, a control circuit as described above can determine that a particular flow rate or an increase or decrease in flow rate is required at the surgical site based on feedback from one or more sensors. For example, the processor 50308 and/or 50408 in the control circuit can be configured to receive input from one or more sensors and make adjustments to the flow rate based at least in part on the sensor input(s). The adjustments can be determined in real time or near real time.

In one aspect, the control circuitry can determine the need for adjustments to the motor based on measurements detected by sensors in the surgical system, such as at least one sensor positioned and configured to detect fluid (e.g., fluid detection sensor 50830, FIGS. 18 and 19) and/or particles in the fluid (e.g., particle sensors 50838 and/or 50848, FIGS. 18 and 19), and/or a separate sensor on the electrosurgical instrument (e.g., electrosurgical instrument 50630, FIG. 7) positionable at or near the surgical site. In response to the determined need, the control circuitry can send a drive signal to provide a drive current to the motor 50512 (FIG. 4) to adjust its speed to an adjusted motor speed. This adjusted motor speed can correspond to a particular flow rate desired.

Alternatively, depending on the determined need, the control circuitry may send a drive signal to provide a drive current to the motor 50512 to increase or decrease the motor speed to a speed within a predetermined motor speed range. In such an example, the control circuitry limits the increase or decrease in the speed of the variable speed motor to within the predetermined motor speed range. This adjusted motor speed may or may not correspond to a desired adjusted flow rate. For example, the predetermined motor speed range may not allow the control circuitry to adjust the motor speed to achieve the desired flow rate.

In another aspect of the present disclosure, the motor speed may be selected by a clinician in the operating room, such as when the motor is operating in a manual mode. For example, the clinician can manually change the variable speed motor to a desired motor speed via a user interface. The user interface may be, for example, on the housing of the evacuation system and/or the surgical hub interface. In various aspects, the user interface can display externally measured parameters (e.g., smoke and/or particle volume measured via a sensor at or near the surgical site) to the clinician, and the clinician can manually set the motor speed based on the externally measured parameters. In such aspects, the user interface can send a drive signal to provide a drive current to the motor to set, increase, or decrease the motor speed to the selected motor speed.

In one aspect of the present disclosure, the control circuitry can modify the first drive signal to a second drive signal based on pressure conditions detected and/or measured within the exhaust system. For example, referring again to FIG. 18 and FIG. 19, the pressure sensors 50840, 50846, 50850, and 50854 can transmit their corresponding pressures to the control circuitry, and the control circuitry can modify the first drive signal to a second drive signal based on one or more of the detected pressures. Notably, in such an aspect, the actual motor speed may not be equal to the motor speed selected by the user via the user interface. For example, if the pressure measured within the exhaust system exceeds a threshold pressure, allowing an increased motor speed associated with the user-selected motor speed may damage the motor and/or other components of the exhaust system. Thus, the control circuitry can override the user-selected motor speed to prevent damage to the exhaust system and its components.

In another aspect of the present disclosure, the motor speed may be automatically selected by the control circuit, such as when the motor is operating in an automatic mode. In such an aspect, the control circuit may send a drive signal to provide a drive current to the motor to set, increase, or decrease the motor speed to an appropriate motor speed based on an externally measured parameter(s) (e.g., smoke and/or particle amount measured at or near the surgical site). In an alternative aspect, the control circuit may send a drive signal to provide a drive current to the motor to set, increase, or decrease the motor speed based on parameters measured within the exhaust system, including at least one of pressure and particulate concentration detected by various internal sensors. In one example, the pressure sensors 50840, 50846, 50850, and 50854 may transmit their corresponding detected and/or measured pressures to the control circuit. Additionally or alternatively, the particle sensors 50838, 50848, and 50852 may transmit their corresponding detected and/or measured particle counts to the control circuit.

35, an adjustment algorithm 54000 for a surgical evacuation system is shown. Various surgical evacuation systems disclosed herein may utilize the adjustment algorithm 54000 of FIG. 35. Additionally, the reader will readily appreciate that in certain instances, the adjustment algorithm 54000 may be combined with one or more additional adjustment algorithms described herein. Adjustments to the surgical evacuation system may be implemented by a processor in signal communication with a motor of an evacuation pump (see, e.g., the processor and pump of FIGS. 5 and 6). For example, a processor 50408 may implement the adjustment algorithm 54000. Such a processor may also be in signal communication with one or more sensors within the surgical evacuation system.

In one example, the control circuit 54008 may be communicatively coupled to a first particulate sensor 54010, which may be similar to the particulate sensor 50838 of FIGS. 18 and 19, and may transmit a first signal including the detected and/or measured particulate count at block 54002. Additionally, the control circuit 54008 may be coupled to a second particulate sensor 54012, which may be similar in many respects to the particulate sensor 50848 of FIGS. 18 and 19, and may transmit a second signal including the detected and/or measured particulate count at block 54004 to the control circuit. The control circuit 54008 may then transmit a drive signal at block 54006 to apply the determined drive current to a motor of the exhaust system at block 54016. For example, the control circuit 54008 may be similar in many respects to the control schematic of FIGS. 5 and 6, and may include a processor communicatively coupled to a memory. In yet another aspect, any combination of sensors 50840, 50846, 50850, 50854, 50838, 50848, and 50852 (FIGS. 18 and 19) can transmit their corresponding sensed and/or measured parameters to the control circuit 54008. In such an alternative aspect, the control circuit can determine an appropriate motor speed based on the internally measured parameters. In either case, in various examples, the user interface can display the current motor speed.

In various aspects of the present disclosure, the appropriate motor speed may be an ideal motor speed determined based on historical data stored in a cloud, such as cloud 104 (FIG. 39) and/or cloud 204 (FIG. 46). The ideal motor speed may be, for example, the most efficient speed given the measured external and/or internal parameter(s). In other aspects, the appropriate motor speed may be an ideal motor speed determined such that all measured pressures are below a threshold pressure. In other words, to avoid damage to exhaust system components and to minimize particulate concentrations, such as those measured by particle sensor 50848. In further aspects, the motor speed automatically selected by the control circuitry may be manually adjusted. In such a manual override mode, the user may select a desired motor speed different from the automatically selected motor speed. In such aspects, the user interface may display the selected motor speed. In further aspects of the present disclosure, the user interface may display the ideal motor speed determined by the control circuitry such that the user is notified that a lower (or higher) than ideal motor speed and/or flow rate has been set and/or selected.

In yet another aspect of the present disclosure, the externally measured parameters provided to the control circuitry can include a power level of the electrosurgical signal provided by a generator to the electrosurgical instrument, such as by the generator 50640 of FIG. 6 to the electrosurgical instrument 50630. In such an aspect, the control circuitry can increase the motor speed in proportion to an increase in the power level. For example, various power level increases can be correlated to increases in smoke levels in a cloud database. Similarly, the control circuitry can decrease the motor speed in proportion to a decrease in the power level. Here, in an alternative aspect, the motor speed can be set in the exhaust system (e.g., automatically and/or manually as described herein). Furthermore, in such an aspect, the power level set by the generator 50640 can affect the set motor speed. In one aspect, the manually set motor speed can be changed based on the power level set by the generator 50640. In another aspect, the automatically set motor speed can be changed based on the power level set by the generator 50640.

36 shows a graphical representation 54100 of particle count, power, voltage, and motor speed of a surgical evacuation system, such as evacuation systems 50800 and 50900. The control circuitry of the evacuation system is configured to adjust the motor speed based on externally measured parameters and internally measured parameters. In one aspect of the present disclosure, the control circuitry of FIGS. 5 and 6 can perform the illustrated motor speed adjustments. In FIG. 36, the externally measured parameter is the power level of the electrosurgical signal provided by a generator used in the surgical procedure to the electrosurgical instrument (e.g., electrosurgical instrument 50630 by generator 50640 of FIG. 7). The internally measured parameter is the particle count detected by the evacuation system, such as, for example, laser particle count counter 50838 of FIGS. 18 and 19. The reader will readily appreciate that in certain instances, the motor speed can be adjusted based on one of the externally measured parameters or the internally measured parameters. In certain instances, additional internal or external parameters can be utilized to adjust the motor speed.

At time _t0 , the motor speed is zero, the power level delivered to the electrosurgical instrument is zero, and the number of particles detected by the particle sensor 50838 is zero. At time _t1 , a first power level is delivered by the generator to the electrosurgical instrument. In one example, the first power level can correspond to a coagulation mode. Concurrent with or immediately following the increase in power level at time _t1 , the control circuitry sends a drive signal to provide an activation current to the motor. The activation current results in a burst of motor speed 54102 before the motor settles to a baseline (e.g., idle) motor speed 54104 between _t1 and _t2 . The baseline motor speed 54104 can correspond, for example, to a minimum torque required to turn a pump. For example, as the time approaches _t2 , the motor speed can correspond to a sleep or quiet mode, and the smoke evacuator is powered in anticipation of smoke generation. At time _t1 , the particle sensor 50838 does not affect the motor speed.

At time _t2 , the particle sensor 50838 detects a first spike 54106 in the particulate concentration that increases the particle count above a minimum threshold 54110 corresponding to an "active" mode for smoke evacuation. In response to this first spike 54106, shortly after time _t2 , the control circuitry increases the flow rate through the evacuation system from the "quiet" mode to the "active" mode, for example by sending a second drive signal to the motor to provide an increased current. In response to the increased flow rate, the particulate concentration counted by the particle sensor 50838 begins to decrease between times _t2 and _t3 . The control circuitry actively monitors the output from the particle sensor 50838, and as the particulate concentration decreases, sends a third drive signal to provide a reduced current to the motor 50512 in proportion to the decreasing particulate concentration detected by the particle sensor 50838. In other words, the motor speed between times _t2 and _t3 is proportional to the particulate concentration detected by the particle sensor 50838.

At time _t3 , the first power level provided by the generator 50640, which remained relatively constant between times _t1 and _t3 , is increased from the first power level 54112 to a second power level 54114. In one embodiment, the second power level 54114 may correspond to a cutting mode. In response to the increase in the generator power level, immediately after time _t3 , the control circuitry sends a third drive signal to provide an increased current to the motor to again increase the flow rate through the exhaust system. For example, the motor speed may be changed in response to the change in the waveform at time _t3 . Additionally, due to the increased power level, the particle sensor 50838 detects a second spike 54108 in counted particles. The third drive signal may address the increased particulate concentration in the smoke. In response to the increase in motor speed, the particles counted by the particle sensor 50838 decrease between times _t3 and _t4 . Again, the control circuit actively monitors the particle sensor 50838 and sends a fourth drive signal to supply a reduced current to the motor in proportion to the decrease in particulate concentration detected by the particle sensor 50838.

At time _t4 , the second power level 54114 provided by the generator, which remained relatively constant between times _t3 and _t4 , decreases at a constant rate between times _t4 and _t5 . Correspondingly, after time _t4 , the particulate concentration detected by the particle sensor 50838 also decreases. In fact, the particulate concentration decreases to a level just below the minimum threshold 54110 and above the stop threshold 54118 between times _t4 and _t5 , and remains relatively constant near the stop threshold 54118 until time _t5 . In one example, this may correspond to the evacuation of residual smoke from the surgical site. The control circuit continues to monitor the particle sensor 50838 between times _t4 and _t5 , and sends a subsequent drive signal to reduce the current to the motor in proportion to the decrease in particulate concentration between times _t4 and _t5 .

At time _t5 , a third spike 54116 in particulate concentration can be detected by the particle sensor 50838, again increasing the particle count above the minimum threshold 54110. In one example, the additional smoke generated during the surgical procedure and detected by the particle sensor 50838 can be the result of tissue conditions. For example, additional smoke can be generated as tissue dries out during the procedure. In response to the increase in smoke at time _t5 , the generator waveform can be automatically adjusted to minimize smoke. For example, a third power level can be provided by the generator. Additionally, the voltage, which remained at a relatively constant first level between time _t1 and time _t5 , decreases after time _t5 to a relatively constant second level until time _t6 . In a particular example, the waveform adjustment 54122 at time _t5 , where the power increases and the voltage decreases, can be configured to generate less smoke.

In response to the adjustment of the power level to the generator at time _t5 , the particulate concentration detected by the particle sensor 50838 steadily decreases between times _t5 and _t6 . At time _t6 , the generator power level and voltage decreases to zero, which corresponds to a power-off condition, such as at the completion of a surgical procedure. Additionally, the particulate concentration detected by the particle sensor 50838 falls below the shutdown threshold 54118 at time _t6 . In response, the control circuitry sends a drive signal to provide a reduced current to the motor and reduces the motor speed to a sleep or quiet mode 54120.

In various examples, the evacuation system can automatically sense and compensate for the use of a laparoscope. For example, the evacuation system can automatically detect the laparoscopic mode of the surgical system. In laparoscopic surgery, a patient's body cavity is insufflated with gas (e.g., carbon dioxide) to inflate the cavity and create a working space and/or viewing space for the surgeon during the surgical procedure. Inflating the cavity creates a pressurized cavity. In such examples, the evacuation systems disclosed herein can be configured to sense the pressurized cavity and adjust parameters of the evacuation system parameters, such as, for example, motor speed, in response to parameters of the pressurized cavity.

For example, referring again to FIGS. 18 and 19, the pressure sensor 50840 can detect pressures above a certain threshold pressure, which may correspond to pressures traditionally utilized for insufflation. In such an example, the control circuitry can first determine whether the surgical procedure being performed is a laparoscopic procedure. In a particular example, the smoke evacuation system control circuitry (e.g., processors 50308 and/or 50408 of FIGS. 5 and 6) can query a communicatively coupled surgical hub and/or cloud to determine whether a laparoscopic procedure is being performed. For example, situational awareness can determine and/or confirm whether a laparoscopic procedure is being performed, as described further herein.

In certain examples, an external control circuit, such as, for example, a control circuit associated with a surgical hub, can query the communicatively coupled cloud. In another aspect, a user interface of the evacuation system can receive input from a practitioner. The control circuit can receive a signal from the user interface indicating that the surgical procedure being performed is a laparoscopic procedure. If not, the control circuit can determine if the filter is clogged and/or partially clogged as described herein. If not, the control circuit can adjust the pressure detected by the pressure sensor 50840 by a predetermined amount to achieve a laparoscopically adjusted pressure at the sensor 50840. This laparoscopically adjusted pressure at the sensor 50840 can be utilized in accordance with various aspects described herein in lieu of the actual pressure detected by the sensor 50840. In such aspects, this can avoid inappropriate and/or premature indications that the filter is clogged and/or partially clogged. Additionally, such adjustments can avoid unnecessary motor speed adjustments.

According to various aspects, the evacuation system can further sense such a pressurized cavity and adjust evacuation system parameters (e.g., motor speed) in response to a determination that the surgical procedure being performed is a laparoscopic procedure. In such aspects, after a pressure sensor, such as, for example, pressure sensor 50840, detects that the evacuation system is being used in a pressurized environment, the control circuit can send a drive signal to change one or more operating parameters of the motor to an effective evacuation speed for a laparoscopic procedure. In one example, the baseline (e.g., idle) motor speed and/or upper limit motor speed can be adjusted down to compensate for the applied pressure provided by the pressurized cavity (e.g., via the distal conduit opening 50634 near the tip of the surgical instrument 50630 and the suction hose 50636, see FIG. 7). In such an example, after a pressure sensor, such as, for example, pressure sensor 50840, detects that the evacuation system is being used in a pressurized environment, the control circuit can set a secondary threshold and/or monitor an established secondary threshold for pressure loss at the pressure sensor.

If the pressure detected at the pressure sensor 50840 falls below such a secondary threshold, the evacuation system may adversely affect air delivery at the surgical site. For example, adjustments to the motor speed may cause the pressure at the pressure sensor 50840 to fall below the secondary threshold. In certain examples, a separate pressure sensor may be placed on the electrosurgical instrument (i.e., within the body cavity during a laparoscopic procedure) to initially detect the pressurized cavity during laparoscopic surgery and/or to monitor the pressure within the body cavity. In such aspects, such a pressure sensor would send a signal to the control circuitry to appropriately adjust the evacuation system parameters (e.g., motor speed) as described herein.

The reader will readily appreciate that the various surgical evacuation systems and components described herein can be incorporated into a computer-implemented interactive surgical system, a surgical hub, and/or a robotic system. For example, the surgical evacuation system can communicate data to and/or receive data from a surgical hub, a robotic system, and/or a computer-implemented interactive surgical system. Various examples of computer-implemented interactive surgical systems, robotic systems, and surgical hubs are further described below.

Computer Implemented Interactive Surgical System Referring to FIG. 39, a computer implemented interactive surgical system 100 includes one or more surgical systems 102 and a cloud based system (e.g., cloud 104 which may include a remote server 113 coupled to a storage device 105). Each surgical system 102 includes at least one surgical hub 106 in communication with the cloud 104 which may include the remote server 113. In one example, as shown in FIG. 39, the surgical systems 102 include a visualization system 108, a robotic system 110, and a handheld intelligent surgical instrument 112 configured to communicate with each other and/or with the hub 106. In some aspects, the surgical system 102 may include M hubs 106, N visualization systems 108, O robotic systems 110, and P handheld intelligent surgical instruments 112, where M, N, O, and P are integers equal to or greater than 1.

Figure 40 shows an example of a surgical system 102 used to perform a surgical procedure on a patient lying on an operating table 114 in a surgical room 116. A robotic system 110 is used as part of the surgical system 102 in the surgical procedure. The robotic system 110 includes a surgeon's console 118, a patient side cart 120 (surgical robot), and a surgical robot hub 122. The patient side cart 120 can manipulate at least one detachably coupled surgical tool 117 during minimally invasive incision of the patient's body while the surgeon views the surgical site via the surgeon's console 118. Images of the surgical site can be obtained by a medical imaging device 124, which can be manipulated by the patient side cart 120 to orient the imaging device 124. The robotic hub 122 can be used to process images of the surgical site for subsequent display to the surgeon via the surgeon's console 118.

Other types of robotic systems can be readily adapted for use with the surgical system 102. Various examples of robotic systems and surgical tools suitable for use with the present disclosure are described in U.S. Provisional Patent Application No. 62/611,339, entitled "ROBOT ASSISTED SURGICAL PLATFORM," filed December 28, 2017, the entire disclosure of which is incorporated herein by reference.

Various examples of cloud-based analytics performed by cloud 104 and suitable for use with the present disclosure are described in U.S. Provisional Patent Application No. 62/611,340, entitled "CLOUD-BASED MEDICAL ANALYTICS," filed December 28, 2017, the entire disclosure of which is incorporated herein by reference.

In various aspects, the imager 124 includes at least one image sensor and one or more optical components. Suitable image sensors include, but are not limited to, charge-coupled device (CCD) sensors and complementary metal-oxide semiconductor (CMOS) sensors.

The optical components of the imaging device 124 may include one or more illumination sources and/or one or more lenses. The one or more illumination sources may be directed to illuminate a portion of the surgical field. The one or more image sensors may receive light reflected or refracted from the surgical field, including light reflected or refracted from tissue and/or surgical instruments.

The one or more illumination sources may be configured to emit electromagnetic energy in the visible and invisible spectrum. The visible spectrum, sometimes called the optical spectrum or emission spectrum, is the portion of the electromagnetic spectrum that is visible to (i.e., detectable by) the human eye and is sometimes called visible light, or simply light. A typical human eye responds to wavelengths in air between about 380 nm and about 750 nm.

The invisible spectrum (i.e., the non-radiative spectrum) is the portion of the electromagnetic spectrum that lies below and above the visible spectrum (i.e., wavelengths below about 380 nm and above about 750 nm). The invisible spectrum is not detectable by the human eye. Wavelengths above about 750 nm are longer than the red visible spectrum, which are invisible infrared (IR), microwave, and wireless electromagnetic radiation. Wavelengths below about 380 nm are shorter than the violet spectrum, which are invisible ultraviolet, x-ray, and gamma ray electromagnetic radiation.

In various aspects, the imaging device 124 is configured for use in minimally invasive surgery. Examples of imaging devices suitable for use with the present disclosure include, but are not limited to, arthroscopes, angioscopes, bronchoscopes, cholangioscopes, colonoscopes, cytoscopes, duodenoscopes, enteroscopes, esophagogastroduodenoscopes (gastroscopes), endoscopes, laryngoscopes, nasopharyngo-neproscopes, sigmoidoscopes, thoracoscopes, and ureteroscopes.

In one aspect, the imaging device uses multispectral monitoring to distinguish between topography and underlying structure. Multispectral imaging captures image data within specific wavelength ranges across the electromagnetic spectrum. The wavelengths can be separated by filters or by using instruments sensitive to light from specific wavelengths including frequencies beyond the visible light range, e.g., IR and ultraviolet light. Spectral imaging can allow for the extraction of additional information that the human eye cannot capture with its red, green, and blue receptors. The use of multispectral imaging is described in detail in the "Advanced Imaging Acquisition Module" section of U.S. Provisional Patent Application No. 62/611,341, entitled "INTERACTIVE SURGICAL PLATFORM," filed December 28, 2017, the entire disclosure of which is incorporated herein by reference. Multispectral monitoring can be a useful tool to reposition the surgical field after a surgical procedure is completed to perform one or more of the above-mentioned tests on the treated tissue.

It is self-evident that any surgical procedure requires rigorous sterilization of the operating room and surgical equipment. The strict sanitary and sterile conditions required in the "surgical theater", i.e., operating room or treatment room, require the utmost sterility of all medical devices and equipment. Part of that sterilization process is the need to sterilize everything that comes into contact with the patient or enters the sterile field, including the imaging device 124 and its accessories and components. It will be understood that the sterile field may be considered a specific area that is deemed free of microorganisms, such as in a tray or on a sterile towel, or the sterile field may be considered the area immediately surrounding the patient who is prepared for the surgical procedure. The sterile field may include cleaned team members in appropriate clothing, as well as all the equipment and fixtures in the area.

In various aspects, the visualization system 108 includes one or more imaging sensors strategically positioned relative to the sterile field, as shown in FIG. 40, one or more image processing units, one or more storage arrays, and one or more displays. In one aspect, the visualization system 108 includes HL7, PACS, and EMR interfaces. Various components of the visualization system 108 are described in the "Advanced Imaging Acquisition Module" section of U.S. Provisional Patent Application No. 62/611,341, entitled "INTERACTIVE SURGICAL PLATFORM," filed December 28, 2017, the entire disclosure of which is incorporated herein by reference.

As shown in FIG. 40, the primary display 119 is positioned within the sterile field so as to be visible to an operator positioned at the operating table 114. In addition, the visualization tower 111 is positioned outside the sterile field. The visualization tower 111 includes a first non-sterile display 107 and a second non-sterile display 109 facing away from each other. The visualization system 108, guided by the hub 106, is configured to coordinate information flow to operators inside and outside the sterile field using the displays 107, 109, and 119. For example, the hub 106 can cause the visualization system 108 to display snapshots of the surgical site recorded by the imaging device 124 on the non-sterile displays 107 or 109 while maintaining a live image of the surgical site on the primary display 119. The snapshots on the non-sterile displays 107 or 109 can, for example, enable the non-sterile operator to perform diagnostic steps related to the surgical procedure.

In one aspect, the hub 106 is also configured to send diagnostic input or feedback entered by a non-sterile operator located in the visualization tower 111 in the sterile field to the primary display 119 in the sterile field for viewing by a sterile operator located at the operating table. In one example, the input may be in the form of a correction to a snapshot displayed on the non-sterile display 107 or 109 that can be sent by the hub 106 to the primary display 119.

40, a surgical instrument 112 is used as part of the surgical system 102 in a surgical procedure. The hub 106 is also configured to coordinate information flow to the display of the surgical instrument 112, for example in U.S. Provisional Patent Application No. 62/611,341, filed December 28, 2017, entitled "INTERACTIVE SURGICAL PLATFORM," the entire disclosure of which is incorporated herein by reference. Diagnostic input or feedback entered by a non-sterile operator at the visualization tower 111 may be sent by the hub 106 to the surgical instrument display 115 in the sterile field, where the diagnostic input or feedback may be viewed by the operator of the surgical instrument 112. Exemplary surgical instruments suitable for use with the surgical system 102 are described, for example, in the section entitled "Surgical Instrument Hardware" and in U.S. Provisional Patent Application No. 62/611,341, filed December 28, 2017, entitled "INTERACTIVE SURGICAL PLATFORM," the entire disclosure of which is incorporated herein by reference.

41, the hub 106 is shown in communication with a visualization system 108, a robotic system 110, and a handheld intelligent surgical instrument 112. The hub 106 includes a hub display 135, an imaging module 138, a generator module 140, a communication module 130, a processor module 132, and a storage array 134. In certain aspects, as shown in FIG. 41, the hub 106 further includes a smoke evacuation module 126 and/or a suction/irrigation module 128.

During a surgical procedure, the application of energy to tissue for sealing and/or cutting is typically accompanied by smoke evacuation, aspiration of excess fluid, and/or irrigation of tissue. Fluid, power, and/or data lines from different sources often become tangled during a surgical procedure. Valuable time may be lost during a surgical procedure addressing this issue. Untangling the lines may require unplugging the lines from their corresponding modules, which may require resetting the modules. The hub's modular housing 136 provides a unified environment for managing power, data, and fluid lines, reducing the frequency of such line tangling.

Aspects of the present disclosure present a surgical hub for use in a surgical procedure involving the application of energy to tissue at a surgical site. The surgical hub includes a hub housing and a combination generator module slidably receivable within a docking station of the hub housing. The docking station includes data and power contacts. The combination generator module includes two or more of an ultrasonic energy generator component, a bipolar RF energy generator component, and a monopolar RF energy generator component housed within a single unit. In one aspect, the combination generator module further includes a smoke evacuation component, at least one energy delivery cable for connecting the combination generator module to a surgical instrument, at least one smoke evacuation component configured to evacuate smoke, fluid, and/or particulates generated by the application of therapeutic energy to tissue, and a fluid line extending from a remote surgical site to the smoke evacuation component.

In one aspect, the fluid line is a first fluid line and a second fluid line extends from a remote surgical site to an aspiration and irrigation module that is slidably received within the hub housing. In one aspect, the hub housing includes a fluid interface.

Certain surgical procedures may require the application of more than one energy type to tissue. One energy type may be more beneficial for cutting tissue, while another different energy type may be more beneficial for sealing tissue. For example, a bipolar generator may be used to seal tissue, while an ultrasonic generator may be used to cut the sealed tissue. Aspects of the present disclosure present a solution in which the modular housing 136 of the hub is configured to house and facilitate bidirectional communication between various generators. One advantage of the modular housing 136 of the hub is that it allows for quick removal and/or replacement of various modules.

Aspects of the present disclosure present a modular surgical housing for use in a surgical procedure involving application of energy to tissue. The modular surgical housing includes a first energy generator module configured to generate a first energy for application to tissue, and a first docking station including a first docking port including first data and power contacts, where the first energy generator module is slidably movable into electrical engagement with the power and data contacts, and the first energy generator module is slidably movable out of electrical engagement with the first power and data contacts.

In addition to the above, the modular surgical housing further includes a second energy generator module configured to generate a second energy for application to tissue, different from the first energy, and a second docking station including a second docking port including second data and power contacts, the second energy generator module being slidably movable into electrical engagement with the power and data contacts, and the second energy generator module being slidably movable out of electrical engagement with the second power and data contacts.

Additionally, the modular surgical housing further includes a communication bus between the first docking port and the second docking port configured to facilitate communication between the first energy generator module and the second energy generator module.

41-45, aspects of the disclosure are presented regarding a hub modular housing 136 that allows for modular integration of the generator module 140, the smoke evacuation module 126, and the suction/irrigation module 128. The hub modular housing 136 further facilitates bidirectional communication between the modules 140, 126, 128. As shown in FIG. 43, the generator module 140 may be a generator module that includes integrated monopolar, bipolar, and ultrasonic components supported in a single housing unit 139 that is slidably insertable into the hub modular housing 136. As shown in FIG. 42, the generator module 140 may be configured to connect to a monopolar device 146, a bipolar device 147, and an ultrasonic device 148. Alternatively, the generator module 140 may include a series of monopolar, bipolar, and/or ultrasonic generator modules that interact via the hub modular housing 136. The hub modular housing 136 may be configured to facilitate insertion of multiple generators and bidirectional communication between the generators docked to the hub modular housing 136 such that the multiple generators function as a single generator.

In one aspect, the hub's modular housing 136 includes a modular power and communications backplane 149 with external and wireless communication headers to enable removable attachment of and bidirectional communication between the modules 140, 126, 128.

In one aspect, the hub modular housing 136 includes a docking station or drawer 151, also referred to herein as a drawer, configured to slidably receive the modules 140, 126, 128. FIG. 43 shows a partial perspective view of the surgical hub housing 136 and a combination generator module 145 slidably receivable in the docking station 151 of the surgical hub housing 136. A docking port 152 having power and data contacts on the rear side of the combination generator module 145 is configured to engage the corresponding docking port 150 with the power and data contacts of the corresponding docking station 151 of the hub modular housing 136 when the combination generator module 145 is slid into position in the corresponding docking station 151 of the hub modular housing 136. In one aspect, the combination generator module 145 includes bipolar, ultrasonic, and monopolar modules and a smoke evacuation module integrated together in a single housing unit 139, as shown in FIG. 43.

In various aspects, the smoke evacuation module 126 includes fluid lines 154 that transport captured/collected smoke and/or fluid away from the surgical site, for example, to the smoke evacuation module 126. Vacuum suction generated from the smoke evacuation module 126 can draw the smoke into an opening in a utility conduit at the surgical site. The utility conduit coupled to the fluid lines may be in the form of a flexible tube that terminates at the smoke evacuation module 126. The utility conduit and fluid lines define a fluid path that extends toward the smoke evacuation module 126, which is received within the hub housing 136.

In various aspects, the aspiration/irrigation module 128 is coupled to a surgical tool that includes aspiration and suction fluid lines. In one embodiment, the aspiration and suction fluid lines are in the form of flexible tubing that extends from the surgical site toward the aspiration/irrigation module 128. One or more drive systems can be configured to cause irrigation and suction of fluids to and from the surgical site.

In one aspect, the surgical tool includes a shaft having an end effector at its distal end, at least one energy treatment portion associated with the end effector, a suction tube, and an irrigation tube. The suction tube can have an inlet port at its distal end, and the suction tube extends through the shaft. Similarly, the irrigation tube can extend through the shaft and have an inlet port proximate to the energy delivery instrument. The energy delivery instrument is configured to deliver ultrasonic and/or RF energy to the surgical site and is initially coupled to the generator module 140 by a cable extending through the shaft.

The irrigation tube can be in fluid communication with a fluid source and the suction tube can be in fluid communication with a vacuum source. The fluid source and/or vacuum source can be housed within the aspiration/irrigation module 128. In one embodiment, the fluid source and/or vacuum source can be housed within the hub housing 136 separate from the aspiration/irrigation module 128. In such an embodiment, the fluid interface can be configured to connect the aspiration/irrigation module 128 to the fluid source and/or vacuum source.

In one aspect, the modules 140, 126, 128 and/or their corresponding docking stations on the hub's modular housing 136 may include alignment features configured to align the docking ports of the modules to engage with their counterparts in the docking stations of the hub's modular housing 136. For example, as shown in FIG. 42, the combination generator module 145 includes a side bracket 155 configured to slidably engage with a corresponding bracket 156 of the corresponding docking station 151 of the hub's modular housing 136. The brackets cooperate to guide the docking port contacts of the combination generator module 145 into electrical engagement with the docking port contacts of the hub's modular housing 136.

In some aspects, the drawers 151 of the hub's modular housing 136 are the same or substantially the same size, and the modules are sized to be received within the drawers 151. For example, the side brackets 155 and/or 156 may be larger or smaller depending on the size of the module. In other aspects, the drawers 151 are different sizes, each designed to accommodate a particular module.

Furthermore, the contacts of a particular module may be keyed to engage with the contacts of a particular drawer to prevent inserting the module into a drawer with incompatible contacts.

As shown in FIG. 43, the docking port 150 of one drawer 151 may be coupled to the docking port 150 of another drawer 151 via a communication link 157 to facilitate two-way communication between modules housed within the hub's modular housing 136. Alternatively or additionally, the docking port 150 of the hub's modular housing 136 may facilitate wireless two-way communication between modules housed within the hub's modular housing 136. Any suitable wireless communication may be used, such as, for example, Air Titan-Bluetooth.

FIG. 44 illustrates individual power bus attachments of multiple lateral docking ports of a lateral modular housing 160 configured to receive multiple modules of a surgical hub 206. The lateral modular housing 160 is configured to laterally receive and interconnect modules 161. The modules 161 are slidably inserted into a docking station 162 of the lateral modular housing 160 that includes a backplane for interconnecting the modules 161. As shown in FIG. 44, the modules 161 are arranged laterally within the lateral modular housing 160. Alternatively, the modules 161 may be arranged vertically within the lateral modular housing.

45 illustrates a vertical modular housing 164 configured to receive a plurality of modules 165 of a surgical hub 106. The modules 165 are slidably inserted into a docking station or drawer 167 of the vertical modular housing 164 that includes a backplane for interconnecting the modules 165. Although the drawer 167 of the vertical modular housing 164 is vertically oriented, in certain cases the vertical modular housing 164 may include a horizontally oriented drawer. Additionally, the modules 165 may interact with each other via a docking port of the vertical modular housing 164. In the embodiment of FIG. 45, a display 177 is provided for displaying data related to the operation of the modules 165. Additionally, the vertical modular housing 164 includes a master module 178 that houses a plurality of sub-modules that are slidably received within the master module 178.

In various aspects, the imaging module 138 includes an integrated video processor and a modular light source and is adapted for use with various imaging devices. In one aspect, the imaging device is configured with a modular housing that can be assembled with a light source module and a camera module. The housing can be a disposable housing. In at least one embodiment, the disposable housing is removably coupled with a reusable controller, a light source module, and a camera module. The light source module and/or the camera module can be selectively selected depending on the type of surgical procedure. In one aspect, the camera module includes a CCD sensor. In another aspect, the camera module includes a CMOS sensor. In another aspect, the camera module is configured for imaging of a scanned beam. Similarly, the light source module can be configured to deliver white light or a different light depending on the surgical procedure.

During a surgical procedure, it may be inefficient to remove a surgical device from the surgical field and replace it with another surgical device that includes a different camera or a different light source. Temporary loss of view of the surgical field may result in undesirable results. The modular imaging device of the present disclosure is configured to allow replacement of a light source module or a camera module midstream during a surgical procedure without the need to remove the imaging device from the surgical field.

In one aspect, the imaging device comprises a tubular housing including a plurality of channels. A first channel is configured to slidably receive a camera module that may be configured for snap-fit engagement with the first channel. A second channel is configured to slidably receive a light source module that may be configured for snap-fit engagement with the second channel. In another embodiment, the camera module and/or the light source module may be rotated into a final position within their corresponding channels. A threaded engagement may be employed in place of the snap-fit engagement.

In various embodiments, multiple imaging devices are positioned at various locations within the surgical field to provide multiple fields of view. The imaging module 138 can be configured to switch between the imaging devices to provide an optimal field of view. In various aspects, the imaging module 138 can be configured to integrate images from the different imaging devices.

Various image processors and imaging devices suitable for use with the present disclosure are described in U.S. Patent No. 7,995,045, issued Aug. 9, 2011, entitled "COMBINED SBI AND CONVENTIONAL IMAGE PROCESSOR," which is incorporated herein by reference in its entirety. Additionally, U.S. Patent No. 7,982,776, issued Jul. 19, 2011, entitled "SBI MOTION ARTIFACT REMOVEAL APPARATUS AND METHOD," which is incorporated herein by reference in its entirety, describes various systems for removing motion artifacts from image data. Such systems may be integrated with the imaging module 138. Additionally, U.S. Patent Application Publication No. 2011/0306840, published December 15, 2011, entitled "CONTROLLABLE MAGNETIC SOURCE TO FIXTURE INTRACORPOREAL APPARATUS," and U.S. Patent Application Publication No. 2014/0243597, published August 28, 2014, entitled "SYSTEM FOR PERFORMING A MINIMALLY INVASIVE SURGICAL PROCEDURE," are each incorporated herein by reference in their entirety.

FIG. 46 illustrates a surgical data network 201 comprising a modular communication hub 203 configured to connect modular devices located in one or more operating rooms of a medical facility, or any room in a medical facility with specialized equipment for surgical procedures, to a cloud-based system (e.g., cloud 204, which may include a remote server 213 coupled to storage device 205). In one aspect, the modular communication hub 203 comprises a network hub 207 and/or a network switch 209 in communication with a network router. The modular communication hub 203 can further be coupled to a local computer system 210 to provide local computer processing and data manipulation. The surgical data network 201 may be configured as passive, intelligent, or switched. A passive surgical data network acts as a conduit for data, allowing data to go from one device (or segment) to another device (or segment) and to cloud computing resources. An intelligent surgical data network includes additional mechanisms that allow traffic to pass through the monitored surgical data network and configure each port in the network hub 207 or network switch 209. An intelligent surgical data network may be referred to as a manageable hub or switch. A switching hub reads the destination address of each packet and then forwards the packet to the correct port.

Modular devices 1a-1n located in the operating room may be coupled to the modular communication hub 203. The network hub 207 and/or the network switch 209 may be coupled to the network router 211 to connect the devices 1a-1n to the cloud 204 or the local computer system 210. Data associated with the devices 1a-1n may be transferred to a cloud-based computer via the router for remote data processing and manipulation. Data associated with the devices 1a-1n may also be transferred to the local computer system 210 for local data processing and manipulation. Modular devices 2a-2m located in the same operating room may also be coupled to the network switch 209. The network switch 209 may be coupled to the network hub 207 and/or the network router 211 to connect the devices 2a-2m to the cloud 204. Data associated with the devices 2a-2n may be transferred to the cloud 204 via the network router 211 for data processing and manipulation. Data associated with the devices 2a-2m may also be transferred to the local computer system 210 for local data processing and manipulation.

It will be appreciated that the surgical data network 201 may be expanded by interconnecting multiple network hubs 207 and/or multiple network switches 209 with multiple network routers 211. The modular communications hub 203 may be housed in a modular control tower configured to receive multiple devices 1a-1n/2a-2m. The local computer system 210 may also be housed in the modular control tower. The modular communications hub 203 is connected to a display 212 to display images acquired by some of the devices 1a-1n/2a-2m, for example, during a surgical procedure. In various aspects, devices 1a-1n/2a-2m may include various modules such as an imaging module 138 coupled to an endoscope, a generator module 140 coupled to an energy-based surgical device, a smoke evacuation module 126, an aspiration/irrigation module 128, a communications module 130, a processor module 132, a storage array 134, a surgical device coupled to a display, and/or a non-contact sensor module, among other modular devices that may be connected to a modular communications hub 203 of a surgical data network 201.

In one aspect, the surgical data network 201 may include a combination of network hub(s), network switch(es), and network router(s) that connect the devices 1a-1n/2a-2m to the cloud. Any one or all of the devices 1a-1n/2a-2m coupled to the network hub or network switch can collect data in real time and transfer the data to a cloud computer for data processing and manipulation. It will be understood that cloud computing relies on shared computing resources rather than having local servers or personal devices to handle software applications. Although the term "cloud" may be used as a metaphor for the "internet," the term is not so limited. Thus, the term "cloud computing" may be used herein to refer to "a type of internet-based computing" where various services such as servers, storage, and applications are delivered to the modular communications hub 203 and/or computer system 210 located in the operating room (e.g., a fixed, mobile, temporary, or on-site operating room or space) and to devices connected to the modular communications hub 203 and/or computer system 210 via the internet. The cloud infrastructure may be maintained by a cloud service provider. In this context, the cloud service provider may be an entity that coordinates the use and control of the devices 1a-1n/2a-2m located in one or more operating rooms. The cloud computing services may perform numerous calculations based on data collected by smart surgical instruments, robots, and other computerized devices located in the operating room. The hub hardware allows multiple devices or connections to connect to a computer that communicates with cloud computing resources and storage.

By applying cloud computer data processing techniques to data collected by the devices 1a-1n/2a-2m, the surgical data network provides improved surgical outcomes, reduced costs, and improved patient satisfaction. At least some of the devices 1a-1n/2a-2m can be used to observe tissue status and evaluate leakage or perfusion of the sealed tissue after tissue sealing and cutting procedures. At least some of the devices 1a-1n/2a-2m can be used to diagnostically inspect data including images of samples of body tissue to identify pathologies such as disease effects using cloud-based computing. This includes tissue and phenotype localization and margin confirmation. At least some of the devices 1a-1n/2a-2m can be used to identify anatomical structures of the body using techniques such as various sensors integrated with the imaging devices and overlaying images captured by multiple imaging devices. Data collected by the devices 1a-1n/2a-2m, including image data, may be transferred to the cloud 204 or a local computer system 210, or both, for data processing and manipulation, including image processing and manipulation. The data can be analyzed to improve the outcome of the surgical procedure by determining whether further treatments can be pursued, such as endoscopic interventions, emerging technologies, targeted radiation, targeted interventions, and application of precision robotics to tissue-specific sites and conditions. Such data analysis may further employ prognostic analysis processes, and using a standardized approach can provide useful feedback to either confirm or suggest modifications to surgical treatments and surgeon performance.

In one implementation, the operating room devices 1a-1n may be connected to the modular communication hub 203 via wired or wireless channels depending on the configuration of the devices 1a-1n relative to the network hub. The network hub 207 may be implemented in one aspect as a local network broadcast device that operates on the physical layer of the Open Systems Interconnection (OSI) model. The network hub provides connectivity to the devices 1a-1n located in the same operating room network. The network hub 207 collects data in the form of packets and sends them to the router in half-duplex mode. The network hub 207 does not store any media access control/internet protocol (MAC/IP) for forwarding the device data. Only one of the devices 1a-1n can send data at a time through the network hub 207. The network hub 207 does not have a routing table or intelligence regarding where to send the information and broadcasts all network data across each connection and to the remote server 213 (FIG. 47) on the cloud 204. Although the network hub 207 can detect basic network errors such as collisions, broadcasting all information to multiple ports can pose a security risk and cause bottlenecks.

In another implementation, the operating room devices 2a-2m may be connected to the network switch 209 via wired or wireless channels. The network switch 209 functions within the data link layer of the OSI model. The network switch 209 is a multicast device for connecting the devices 2a-2m located in the same operating room to the network. The network switch 209 transmits data in the form of frames to the network router 211 and functions in full duplex mode. Multiple devices 2a-2m can transmit data simultaneously through the network switch 209. The network switch 209 stores and uses the MAC addresses of the devices 2a-2m to forward data.

The network hub 207 and/or the network switch 209 are coupled to a network router 211 to connect to the cloud 204. The network router 211 functions within the network layer of the OSI model. The network router 211 creates a path for sending data packets received from the network hub 207 and/or the network switch 211 to cloud-based computer resources for further processing and manipulation of data collected by any one or all of the devices 1a-1n/2a-2m. The network router 211 may be used to connect two or more different networks located in different locations, such as, for example, different networks located in different operating rooms in the same medical facility, or different operating rooms in different medical facilities. The network router 211 transmits data in the form of packets to the cloud 204 and functions in full-duplex mode. Multiple devices can transmit data simultaneously. The network router 211 uses IP addresses to forward data.

In one embodiment, the network hub 207 may be implemented as a USB hub that allows multiple USB devices to be connected to a host computer. The USB hub may expand a single USB port into several tiers so that more ports are available for connecting devices to the host system computer. The network hub 207 may include wired or wireless capabilities for receiving information over a wired or wireless channel. In one aspect, a wireless USB short-range, high-bandwidth wireless communication protocol may be used for communication between the devices 1a-1n and 2a-2m located in the operating room.

In other embodiments, the operating room devices 1a-1n/2a-2m can communicate with the modular communications hub 203 via the Bluetooth wireless technology standard to exchange data over short distances from fixed and mobile devices (using short wavelength UHF radio waves in the ISM band of 2.4-2.485 GHz) and to create a personal area network (PAN). In other aspects, the operating room devices 1a-1n/2a-2m can communicate with the modular communications hub 203 via a number of wireless or wired communications standards or protocols, including, but not limited to, Wi-Fi (IEEE 802.11 family), WiMAX (IEEE 802.16 family), IEEE 802.20, Long Term Evolution (LTE), and Ev-DO, HSPA+, HSDPA+, HSUPA+, EDGE, GSM, GPRS, CDMA, TDMA, DECT, and Ethernet derivatives thereof, as well as any other wireless and wired protocols designated 3G, 4G, 5G, and beyond. The computing module may include multiple communications modules. For example, the first communication module may be dedicated to short-range wireless communication such as Wi-Fi and Bluetooth, and the second communication module may be dedicated to long-range wireless communication such as GPS, EDGE, GPRS, CDMA, WiMAX, LTE, and Ev-DO.

The modular communications hub 203 can act as a central connection for one or all of the operating room devices 1a-1n/2a-2m and handles data types known as frames. Frames carry data generated by the devices 1a-1n/2a-2m. Once the frames are received by the modular communications hub 203, they are amplified and transmitted to the network router 211, which forwards this data to cloud computing resources by using any number of wireless or wired communications standards or protocols described herein.

The modular communication hub 203 may be used as a stand-alone device or may be connected to compatible network hubs and network switches to form a larger network. The modular communication hub 203 is generally easy to install, configure, and maintain, making the modular communication hub 203 a good choice for networking the operating room devices 1a-1n/2a-2m.

FIG. 47 illustrates a computer-implemented interactive surgical system 200. The computer-implemented interactive surgical system 200 is similar in many respects to the computer-implemented interactive surgical system 100. For example, the computer-implemented interactive surgical system 200 includes one or more surgical systems 202 that are similar in many respects to the surgical system 102. Each surgical system 202 includes at least one surgical hub 206 that communicates with a cloud 204 that may include a remote server 213. In one aspect, the computer-implemented interactive surgical system 200 includes a modular control tower 236 connected to a plurality of operating room devices, such as, for example, intelligent surgical instruments, robots, and other computerized devices located in the operating room. As shown in FIG. 48, the modular control tower 236 includes a modular communication hub 203 coupled to a computer system 210. As illustrated in the embodiment of FIG. 47, the modular control tower 236 is coupled to an imaging module 238 coupled to an endoscope 239, a generator module 240 coupled to an energy device 241, a smoke evacuator module 226, a suction/irrigation module 228, a communication module 230, a processor module 232, a storage array 234, a smart device/instrument 235 optionally coupled to a display 237, and a non-contact sensor module 242. The operating room devices are coupled to cloud computing resources and data storage via the modular control tower 236. The robotic hub 222 may also be connected to the modular control tower 236 and cloud computing resources. The devices/instruments 235, visualization system 208, among others, may be coupled to the modular control tower 236 via wired or wireless communication standards or protocols described herein. The modular control tower 236 may be coupled to a hub display 215 (e.g., monitor, screen) for displaying and overlaying images received from the imaging module, device/instrument display, and/or other visualization system 208. The hub display may also display data received from devices connected to the modular control tower along with images and overlay images.

FIG. 48 illustrates a surgical hub 206 comprising a plurality of modules coupled to a modular control tower 236. The modular control tower 236 comprises a modular communications hub 203, e.g., a network-connected device, and a computer system 210, e.g., for providing local processing, visualization, and imaging. As shown in FIG. 48, the modular communications hubs 203 can be connected in a hierarchical configuration to expand the number of modules (e.g., devices) that can be connected to the modular communications hub 203 to transfer data associated with the modules to the computer system 210, cloud computing resources, or both. As shown in FIG. 48, each of the network hubs/switches in the modular communications hub 203 includes three downstream ports and one upstream port. The upstream network hub/switch is connected to a processor to provide a communications connection to the cloud computing resources and a local display 217. Communications to the cloud 204 can be via either wired or wireless communication channels.

The surgical hub 206 uses a non-contact sensor module 242 to measure the dimensions of the operating room and generate a map of the operating room using either an ultrasound or laser-based non-contact measurement device. As described in U.S. Provisional Patent Application No. 62/611,341, filed December 28, 2017, entitled "INTERACTIVE SURGICAL PLATFORM," section "Surgical Hub Spatial Awareness Within an Operating Room," the entire disclosure of which is incorporated herein by reference, the ultrasound-based non-contact sensor module is configured to scan the operating room by transmitting bursts of ultrasound and receiving echoes as the bursts of ultrasound reflect off the exterior walls of the operating room, where the sensor module determines the size of the operating room and adjusts the distance limit for Bluetooth pairing. The laser-based non-contact sensor module scans the operating room, for example, by transmitting laser light pulses, receiving laser light pulses that reflect off the exterior walls of the operating room, and comparing the phase of the transmitted pulses to the received pulses to determine the size of the operating room and adjust the Bluetooth pairing distance limits.

The computer system 210 includes a processor 244 and a network interface 245. The processor 244 is coupled to a communication module 247, a storage 248, a memory 249, a non-volatile memory 250, and an input/output interface 251 via a system bus. The system bus may be any of several types of bus structures (singular or multiple), including a memory bus or memory controller, a peripheral bus or external bus, and/or a local bus, using any of a variety of bus architectures, including, but not limited to, a 9-bit bus, an Industry Standard Architecture (ISA), a MicroChannel Architecture (MSA), an Enhanced ISA (EISA), an Intelligent Drive Electronics (IDE), a VESA Local Bus (VLB), a Peripheral Component Interconnect (PCI), a USB, an Advanced Graphics Port (AGP), a Personal Computer Memory Card International Association bus (PCMCIA), a Small Computer System Interface (SCSI), or any other proprietary bus.

Processor 244 may be any single-core or multi-core processor, such as those known under the trade name ARM Cortex manufactured by Texas Instruments. In one aspect, the processor may be, for example, an LM4F230H5QR ARM Cortex-M4F processor core available from Texas Instruments, including on-chip memory of 256 KB of single-cycle flash memory or other non-volatile memory up to 40 MHz, a pre-fetch buffer to improve performance beyond 40 MHz, 32 KB of single-cycle serial random access memory (SRAM), internal read-only memory (ROM) loaded with StellarisWare® software, 2 KB of electrically erasable programmable read-only memory (EEPROM), and/or one or more pulse width modulation (PWM) modules, one or more quadrature encoder input (QEI) analogs, one or more 12-bit analog-to-digital converters (ADCs) with 12 analog input channels, the details of which are available in the product data sheet.

In one aspect, the processor 244 may include a safety controller, including two controller families such as TMS570 and RM4x, also known under the trade name Hercules ARM Cortex R4, manufactured by Texas Instruments. The safety controller may be specifically configured for IEC 61508 and ISO 26262 safety limit applications, among others, to provide advanced integrated safety mechanisms while offering scalable performance, connectivity, and memory options.

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

The computer system 210 also includes removable/non-removable, volatile/non-volatile computer storage media, such as disk storage. Disk storage includes, but is not limited to, devices such as magnetic disk drives, floppy disk drives, tape drives, Jaz drives, Zip drives, LS-60 drives, flash memory cards, or memory sticks. In addition, disk storage can include storage media either independently or in combination with other storage media, including, but not limited to, optical disk drives, such as compact disk ROM drives (CD-ROM), compact disk recordable drives (CD-R drives), compact disk rewriteable drives (CD-RW drives), or digital versatile disk ROM drives (DVD-ROM). Removable or non-removable interfaces may be used to facilitate connection of disk storage devices to the system bus.

It should be appreciated that computer system 210 includes software that acts as an intermediary between users and basic computer resources as described in the preferred operating environment. Such software includes an operating system. The operating system, which may be stored on disk storage, functions to control and allocate resources of the computer system. System applications leverage resource management by the operating system through program modules and program data stored either in system memory or on disk storage. It should be appreciated that the various components described herein may be implemented with various operating systems or combinations of operating systems.

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

The computer system 210 can operate in a networked environment using logical connections to one or more remote or local computers, such as a cloud computer(s). The remote cloud computer(s) can be a personal computer, a server, a router, a network PC, a workstation, a microprocessor-based device, a peer device, or other general network node, and typically includes many or all of the elements described with respect to a computer system. For simplicity, only memory storage devices are shown with the remote computer(s). The remote computer(s) are logically connected to the computer system through a network interface, which is then physically connected through a communication connection. The network interface encompasses communication networks such as local area networks (LANs) and wide area networks (WANs). LAN technologies include Fiber Distributed Data Interface (FDDI), Copper Distributed Data Interface (CDDI), Ethernet/IEEE 802.3, Token Ring/IEEE 802.5, and the like. WAN technologies include, but are not limited to, point-to-point links, circuit-switched networks such as Integrated Services Digital Networks (ISDN) and variations thereon, packet-switched networks, and Digital Subscriber Lines (DSL).

In various aspects, the computer system 210 of FIG. 48, the imaging module 238 of FIG. 48 and/or the visualization system 208, and/or the processor module 232 of FIGS. 47 and 48 may include an image processor, an image processing engine, a media processor, or any dedicated digital signal processor (DSP) used to process digital images. The image processor may use parallel computing using single instruction multiple data (SIMD) or multiple instruction multiple data (MIMD) techniques to increase speed and efficiency. The digital image processing engine may perform a variety of tasks. The image processor may be a system on a chip with a multi-core processor architecture.

The communications connection(s) refers to the hardware/software used to connect the network interface to the bus. Although the communications connections are shown internal to the computer system for clarity of illustration, the communications connections may be external to computer system 210. By way of example only, the hardware/software required to connect to the network interface may include internal and external technologies such as modems, including regular telephone grade modems, cable modems, and DSL modems, ISDN adapters, and Ethernet cards.

Figure 49 illustrates a functional block diagram of one embodiment of a USB network hub 300 device according to one aspect of the present disclosure. In the illustrated embodiment, the USB network hub device 300 employs a Texas Instruments TUSB2036 integrated circuit hub. The USB network hub 300 is a CMOS device that provides an upstream USB transmit/receive port 302 and up to three downstream USB transmit/receive ports 304, 306, 308 that conform to the USB 2.0 standard. The upstream USB transmit/receive port 302 is a differential rooted data port that includes a differential data minus (DM0) input paired with a differential data plus (DP0) input. The three downstream USB transmit/receive ports 304, 306, 308 are differential data ports, each including a differential data plus (DP1-DP3) output paired with a differential data minus (DM1-DM3) output.

The USB network hub 300 device is implemented with a digital state machine instead of a microcontroller and does not require firmware programming. A fully compliant USB transceiver is integrated into the circuitry of the upstream USB transmit/receive port 302 and all downstream USB transmit/receive ports 304, 306, 308. The downstream USB transmit/receive ports 304, 306, 308 support both full speed and low speed devices by automatically setting the slew rate depending on the speed of the device attached to the port. The USB network hub 300 device may be configured in either bus-powered or self-powered mode and includes hub power logic 312 to manage power.

The USB network hub 300 device includes a serial interface engine 310 (SIE). The SIE 310 is the front end of the USB network hub 300 hardware and handles most of the protocol described in Chapter 8 of the USB specification. The SIE 310 typically understands signaling down to the transaction level. Functions it handles may include packet recognition, transaction reordering, detection/generation of SOP, EOP, RESET, and RESUME signals, clock/data separation, non-return to zero inverted (NRZI) data encoding/decoding and bit stuffing, CRC generation and checking (token and data), Packet ID (PID) generation and checking/decoding, and/or serial-to-parallel/parallel-to-serial conversion. 310 receives a clock input 314 and is coupled to a suspend/resume logic and frame timer 316 circuit and a hub repeater circuit 318 to control communication between the upstream USB transmit/receive port 302 and the downstream USB transmit/receive ports 304, 306, 308 via port logic circuits 320, 322, 324. The SIE 310 is coupled to a command decoder 326 via interface logic for controlling commands from a serial EEPROM via a serial EEPROM interface 330.

In various aspects, the USB network hub 300 can connect up to 127 functions organized in up to six logical layers to a single computer. Additionally, the USB network hub 300 can connect to all peripherals using a standardized four-wire cable that provides both communication and power distribution. The power configurations are bus-powered and self-powered. The USB network hub 300 may be configured to support four modes of power management: bus-powered hub with either individual or ganged port power management, and self-powered hub with either individual or ganged port power management. In one aspect, using a USB cable, the USB network hub 300, the upstream USB transmit/receive port 302 is plugged into a USB host controller, and the downstream USB transmit/receive ports 304, 306, 308 are exposed for connecting USB compatible devices, and so on.

Surgical Instrument Hardware FIG. 50 shows a logic diagram of a surgical instrument or tool control system 470 according to one or more aspects of the present disclosure. The system 470 comprises a control circuit. The control circuit includes a microcontroller 461 with a processor 462 and a memory 468. For example, one or more of the sensors 472, 474, 476 provide real-time feedback to the processor 462. A motor 482 driven by a motor driver 492 operably couples the longitudinally movable displacement member to drive the I-beam knife element. A tracking system 480 is configured to determine the position of the longitudinally movable displacement member. The position information is provided to the processor 462, which can be programmed or configured to determine the position of the longitudinally movable drive member, as well as the firing member, firing bar, and I-beam knife element. Additional motors may be provided to the tool driver interface to control the firing of the I-beam, the movement of the closure tube, the rotation of the shaft, and the articulation. A display 473 displays various operating conditions of the instrument and may include touch screen functionality for data entry. Information displayed on the display 473 can be overlaid with images acquired via the endoscopic imaging module.

In one aspect, the microcontroller 461 may be any single-core or multi-core processor, such as those known under the trade name ARM Cortex manufactured by Texas Instruments. In one aspect, the main microcontroller 461 may be, for example, an LM4F230H5QR ARM Cortex-M4F processor core available from Texas Instruments, including on-chip memory of 256 KB of single-cycle flash memory or other non-volatile memory up to 40 MHz, a pre-fetch buffer to improve performance beyond 40 MHz, 32 KB of single-cycle SRAM, internal ROM loaded with StellarisWare® software, 2 KB of EEPROM, one or more PWM modules, one or more QEI analogs, and/or one or more 12-bit ADCs with 12 analog input channels, details of which are available in the product data sheet.

In one aspect, the microcontroller 461 may include a safety controller, including two controller families such as TMS570 and RM4x, also known under the trade name Hercules ARM Cortex R4, manufactured by Texas Instruments. The safety controller may be specifically configured for IEC 61508 and ISO 26262 safety limit applications, among others, to provide advanced integrated safety mechanisms while offering scalable performance, connectivity, and memory options.

The microcontroller 461 may be programmed to perform a variety of functions, such as precise control over the speed and position of the knife and articulation system. In one aspect, the microcontroller 461 includes a processor 462 and a memory 468. The electric motor 482 may be a brushed direct current (DC) motor with a gearbox and mechanical linkage to the articulation or knife system. In one aspect, the motor driver 492 may be an A3941 available from Allegro Microsystems, Inc. Other motor drivers may be easily substituted for use with the tracking system 480 with an absolute positioning system. A detailed description of the absolute positioning system is provided in U.S. Patent Application Publication No. 2017/0296213, published October 19, 2017, entitled "SYSTEMS AND METHODS FOR CONTROLLING A SURGICAL STAPLING AND CUTTING INSTRUMENT," which is incorporated herein by reference in its entirety.

The microcontroller 461 may be programmed to provide precise control over the speed and position of the displacement members and articulation system. The microcontroller 461 may be configured to calculate a response within the microcontroller 461 software. The calculated response is compared to the measured response of the actual system to obtain an "observed" response, which is used to determine the actual feedback. The observed response is a suitably adjusted value that balances the smooth, continuous nature of the simulated response with the measured response, which can detect external influences on the system.

In one aspect, the motor 482 may be controlled by a motor driver 492 and may be used by the surgical instrument or tool firing system. In various configurations, the motor 482 may be a brushed DC drive motor having a maximum rotational speed of, for example, about 25,000 RPM. In another configuration, the motor 482 may include a brushless motor, a cordless motor, a synchronous motor, a stepper motor, or any other suitable electric motor. The motor driver 492 may include, for example, an H-bridge driver including field effect transistors (FETs). The motor 482 may be powered by a power supply assembly releasably attached to the handle assembly or tool housing to provide control power to the surgical instrument or tool. The power supply assembly may include a battery that may include multiple battery cells connected in series that may be used as a power source to power the surgical instrument or tool. Under certain circumstances, the battery cells of the power supply assembly may be replaceable and/or rechargeable. In at least one embodiment, the battery cells may be lithium ion batteries that may be connectable to and separable from the power supply assembly.

The motor driver 492 may be an A3941 available from Allegro Microsystems, Inc. The A3941 492 is a full-bridge controller for use with external N-channel power metal-oxide-semiconductor field-effect transistors (MOSFETs) specifically designed for inductive loads such as brushed DC motors. The driver 492 has an intrinsic charge pump regulator that provides full (>10V) gate drive for battery voltages up to 7V, allowing the A3941 to operate with reduced gate drive down to 5.5V. A bootstrap capacitor may be used to provide the required above battery supply voltage for the N-channel MOSFETs. An internal charge pump for the high-side drive allows DC (100% duty cycle) operation. The full-bridge may be driven in fast or slow decay mode with diode or synchronous rectification. In slow decay mode, current recirculation is possible through either the high-side or low-side FETs. The power FETs are protected from shoot-through by resistor adjustable dead time. Integrated diagnostics indicate undervoltage, overtemperature, and power bridge faults and can be configured to protect the power MOSFETs under most short circuit conditions. Other motor drivers can be easily substituted for use in tracking system 480 with an absolute positioning system.

The tracking system 480 includes a controlled motor drive circuitry including a position sensor 472 according to one aspect of the present disclosure. The position sensor 472 for the absolute positioning system provides a unique position signal corresponding to the position of the displacement member. In one aspect, the displacement member represents a longitudinally movable drive member including a rack of drive teeth for meshing engagement with a corresponding drive gear of a gear reducer assembly. In another aspect, the displacement member represents a firing member that may be adapted and configured to include a rack of drive teeth. In yet another aspect, the displacement member represents a firing bar or an I-beam, each of which may be adapted and configured to include a rack of drive teeth. Thus, as used herein, the term displacement member is used generally to refer to any movable member of a surgical instrument or tool, such as a drive member, firing member, firing bar, I-beam, or any element that may be displaced. In one aspect, the longitudinally movable drive member is coupled to the firing member, firing bar, and I-beam. Thus, the absolute positioning system can actually track the linear displacement of the I-beam by tracking the linear displacement of the longitudinally movable drive member. In various other aspects, the displacement member may be coupled to any suitable position sensor 472 for measuring linear displacement. Thus, the longitudinally movable drive member, firing member, firing bar, or I-beam, or combinations thereof, may be coupled to any suitable linear displacement sensor. The linear displacement sensor may include contact or non-contact displacement sensors. The linear displacement sensor may include linear variable differential transformers (LVDTs), differential variable reluctance transducers (DVRTs), slide potentiometers, magnetic sensing systems with movable magnets and Hall effect sensors arranged in a series of linear positions, magnetic sensing systems with fixed magnets and Hall effect sensors arranged in a series of movable linear positions, optical sensing systems with movable light sources and photodiodes or photodetectors arranged in a series of linear positions, optical sensing systems with fixed light sources and photodiodes or photodetectors arranged in a series of movable linear positions, or any combination thereof.

The electric motor 482 may include a rotatable shaft operably interfaced with a gear assembly mounted in meshing engagement with a set or rack of drive teeth on the displacement member. The sensor element may be operably coupled to the gear assembly such that one revolution of the position sensor 472 element corresponds to some linear longitudinal translation of the displacement member. The gearing and sensor mechanism may be connected to a linear actuator by a rack and pinion mechanism or to a rotary actuator by a spur gear or other connection. The power source provides power to the absolute positioning system, and the output indicator may display the output of the absolute positioning system. The displacement member represents a longitudinally movable drive member with a rack of drive teeth formed thereon for meshing engagement with a corresponding drive gear of a gear reducer assembly. The displacement member represents a longitudinally movable firing member, firing bar, I-beam, or combinations thereof.

One revolution of the sensor element associated with the position sensor 472 corresponds to a linear longitudinal displacement d1 of the displacement member, where d1 is the linear longitudinal distance that the displacement member travels from point "a" to point "b" after one revolution of the sensor element coupled to the displacement member. The sensor mechanism may be connected via a gear reduction that results in the position sensor 472 completing one or more revolutions for a full stroke of the displacement member. The position sensor 472 may complete multiple revolutions for a full stroke of the displacement member.

A series of switches (where n is an integer greater than 1) may be used alone or in combination with gear reduction to provide a unique position signal for two or more revolutions of the position sensor 472. The state of the switches is fed back to the microcontroller 461, which applies logic to determine a unique position signal corresponding to the longitudinal linear displacement d1+d2+...dn of the displacement member. The output of the position sensor 472 is provided to the microcontroller 461. The position sensor 472 of the sensor mechanism may comprise a magnetic sensor, an analog rotation sensor such as a potentiometer, or an array of analog Hall effect elements that output a unique combination of position signals or values.

The position sensor 472 may comprise any number of magnetic sensing elements, such as magnetic sensors classified based on whether they measure the total magnetic field or vector components of a magnetic field. The technologies used to produce both types of magnetic sensors involve many aspects of physics and electronics. Technologies used to sense magnetic fields include search coils, fluxgates, optical pumping, nuclear precession, SQUIDs, Hall effect, anisotropic magnetoresistance, giant magnetoresistance, magnetic tunnel junctions, giant magnetoimpedance, magnetostrictive/piezoelectric composites, magnetodiodes, magnetotransistors, optical fiber, magneto-optical, and microelectromechanical systems based magnetic sensors, among others.

In one aspect, the position sensor 472 of the tracking system 480 with absolute positioning system comprises a magnetic rotation absolute positioning system. The position sensor 472 may be implemented as an AS5055EQFT single chip magnetic rotation position sensor available from Austria Microsystems, AG. The position sensor 472 works with the microcontroller 461 to provide the absolute positioning system. The position sensor 472 is a low voltage, low power component and includes four Hall effect elements in the area of the position sensor 472 located above the magnet. Additionally, a high resolution ADC and a smart power management controller are provided on the chip. A Coordinate Rotation Digital Computer (CORDIC) processor, also known as the digit-by-digit method and Volder's algorithm, is provided to implement simple and efficient algorithms for calculating hyperbolic and trigonometric functions, requiring only addition, subtraction, bit shifting, and table lookup operations. The angular position, alarm bits, and magnetic field information are transmitted to the microcontroller 461 via a standard serial communication interface, such as a Serial Peripheral Interface (SPI) interface. The position sensor 472 provides 12-bit or 14-bit resolution. The position sensor 472 may be an AS5055 chip provided in a small QFN 16-pin 4x4x0.85mm package.

The tracking system 480 with absolute positioning system may include and/or be programmed to implement a feedback controller, such as PID, state feedback, and adaptive controllers. A power supply converts the signal from the feedback controller into a physical input to the system, in this case voltage. Other examples include PWM of voltage, current, and force. In addition to the position measured by the position sensor 472, other sensor(s) may be provided to measure physical parameters of the physical system. In some aspects, the other sensor(s) may include any of the sensors described in U.S. Pat. No. 9,345,481, issued May 24, 2016, entitled "STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM," which is incorporated herein by reference in its entirety; U.S. Patent Application Publication No. 2014/0263552, published September 18, 2014, entitled "STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM," which is incorporated herein by reference in its entirety; and U.S. Patent Application Publication No. 2014/0263552, published September 18, 2014, entitled "TECHNIQUES FOR ADAPTIVE CONTROL OF MOTOR VELOCITY OF A SURGICAL Examples of sensor mechanisms include those described in U.S. Patent Application No. 15/628,175, filed June 20, 2017, entitled "STAPLING AND CUTTING INSTRUMENT." In a digital signal processing system, the absolute positioning system is coupled to a digital data acquisition system, where the output of the absolute positioning system has a finite resolution and sampling frequency. The absolute positioning system may include comparison and combination circuitry to combine the calculated response with the measured response using algorithms such as weighted averages and theoretical control loops that drive the calculated response towards the measured response. The calculated response of the physical system takes into account properties such as mass, inertia, viscous friction, and induced resistance in order to predict what the state and output of the physical system will be given knowledge of the input.

The absolute positioning system provides an absolute position of the displacement member upon powering up of the instrument without forcing the displacement member to retract or advance to a reset (zero or home) position, as may be required with conventional rotary encoders that simply count the number of steps taken by the motor 482 forward or backward to estimate the position of the device actuator, drive bar, knife, etc.

A sensor 474, such as a strain gauge or microstrain gauge, is configured to measure one or more parameters of the end effector, such as the amplitude of strain exerted on the anvil during the clamping operation, which can be indicative of the closure force applied to the anvil. The measured strain is converted to a digital signal and provided to the processor 462. Instead of or in addition to the sensor 474, a sensor 476, such as a load sensor, can measure the closure force applied to the anvil by the closure drive system. For example, the sensor 476, such as a load sensor, can measure the firing force applied to the I-beam during the firing stroke of the surgical instrument or tool. The I-beam is configured to engage a wedge-shaped sled that is configured to cam the staple driver upward to push the staples into deforming contact with the anvil. The I-beam also includes a sharp cutting edge that can be used to cut tissue as the I-beam is advanced distally by the firing bar. Alternatively, a current sensor 478 can be used to measure the current drawn by the motor 482. The force required to advance the firing member can correspond, for example, to the current drawn by the electric motor 482. The measured force is converted to a digital signal and provided to the processor 462.

In one form, a strain gauge sensor 474 can be used to measure the force applied by the end effector to the tissue. A strain gauge can be coupled to the end effector to measure the force applied by the end effector to the tissue being treated. A system for measuring the force applied to the tissue gripped by the end effector includes a strain gauge sensor 474, such as a micro strain gauge, configured to measure one or more parameters of the end effector. In one aspect, the strain gauge sensor 474 can measure the amplitude or magnitude of the strain exerted on the jaw members of the end effector during the gripping operation, which can indicate compression of the tissue. The measured strain is converted to a digital signal and provided to the processor 462 of the microcontroller 461. The load sensor 476 can measure the force used to manipulate the knife element, for example, to cut the tissue captured between the anvil and the staple cartridge. A magnetic field sensor can be used to measure the thickness of the captured tissue. The magnetic field sensor measurements can also be converted to a digital signal and provided to the processor 462.

Measurements of tissue compression, tissue thickness, and/or force required to close the end effector on the tissue, measured by sensors 474, 476, respectively, can be used by microcontroller 461 to characterize a selected position of the firing member and/or a corresponding value of the velocity of the firing member. In one example, memory 468 can store techniques, equations, and/or look-up tables that can be used by microcontroller 461 in the evaluation.

The surgical instrument or tool control system 470 may also include wired or wireless communication circuitry for communicating with the modular communication hub as shown in FIG. 50.

FIG. 51 illustrates a control circuit 500 configured to control aspects of a surgical instrument or tool according to one aspect of the present disclosure. The control circuit 500 can be configured to implement various processes described herein. The control circuit 500 can include a microcontroller that includes one or more processors 502 (e.g., microprocessors, microcontrollers) coupled to at least one memory circuit 504. The memory circuit 504 stores machine executable instructions that, when executed by the processor 502, cause the processor 502 to execute machine instructions to implement various processes described herein. The processor 502 can be any one of a number of single or multi-core processors known in the art. The memory circuit 504 can include volatile and non-volatile storage media. The processor 502 can include an instruction processing unit 506 and an arithmetic unit 508. The instruction processing unit can be configured to receive instructions from the memory circuit 504 of the present disclosure.

52 illustrates a combinational logic circuit 510 configured to control aspects of a surgical instrument or tool, according to one aspect of the present disclosure. The combinational logic circuit 510 can be configured to implement various processes described herein. The combinational logic circuit 510 can include a finite state machine including combinational logic 512 configured to receive data associated with the surgical instrument or tool at an input 514, process the data through the combinational logic 512, and provide an output 516.

FIG. 53 illustrates a sequential logic circuit 520 configured to control aspects of a surgical instrument or tool, according to one aspect of the disclosure. The sequential logic circuit 520 or combinatorial logic 522 can be configured to implement various processes described herein. The sequential logic circuit 520 may include a finite state machine. The sequential logic circuit 520 may include, for example, combinatorial logic 522, at least one memory circuit 524, and a clock 529. The at least one memory circuit 524 can store a current state of the finite state machine. In certain examples, the sequential logic circuit 520 may be synchronous or asynchronous. The combinatorial logic 522 is configured to receive data associated with the surgical instrument or tool from an input 526, process the data by the combinatorial logic 522, and provide an output 528. In other aspects, the circuit may include a combination of a processor (e.g., processor 502 of FIG. 51) and a finite state machine that implements various processes herein. In other aspects, the finite state machine can include a combination of combinational logic (e.g., combinational logic 510 of FIG. 52) and sequential logic 520.

54 illustrates a surgical instrument or tool with multiple motors that can be activated to perform various functions. In a particular example, a first motor can be activated to perform a first function, a second motor can be activated to perform a second function, a third motor can be activated to perform a third function, a fourth motor can be activated to perform a fourth function, and so on. In a particular example, the multiple motors of the robotic surgical instrument 600 can be individually activated to produce a firing, closing, and/or articulation motion in the end effector. The firing, closing, and/or articulation motion can be transmitted to the end effector via a shaft assembly, for example.

In certain examples, the surgical instrument system or tool may include a firing motor 602. The firing motor 602 may be operably coupled to a firing motor drive assembly 604, which may be configured to transmit a firing motion generated by the motor 602 to an end effector, specifically to displace an I-beam element. In certain examples, the firing motion generated by the motor 602 may, for example, deploy staples from a staple cartridge into tissue captured by the end effector and/or advance a cutting blade of the I-beam element to cut the captured tissue. The I-beam element may be retracted by reversing the direction of the motor 602.

In certain examples, the surgical instrument or tool may include a closure motor 603. The closure motor 603 may be operatively coupled to a closure motor drive assembly 605, which may be configured to transmit the closure motion generated by the motor 603 to the end effector, specifically to displace a closure tube to close the anvil and compress tissue between the anvil and the staple cartridge. The closure motion may, for example, transition the end effector from an open configuration to an approximated configuration to capture tissue. The end effector may be transitioned to the open position by reversing the direction of the motor 603.

In certain examples, a surgical instrument or tool may include, for example, one or more articulation motors 606a, 606b. The motors 606a, 606b may be operatively coupled to corresponding articulation motor drive assemblies 608a, 608b that may be configured to transmit articulation motion generated by the motors 606a, 606b to an end effector. In certain examples, the articulation motion may, for example, cause the end effector to articulate relative to the shaft.

As discussed above, a surgical instrument or tool may include multiple motors that may be configured to perform various independent functions. In certain examples, multiple motors of a surgical instrument or tool may be independently or separately activated to perform one or more functions while other motors remain stopped. For example, articulation motors 606a, 606b may be activated to articulate an end effector while firing motor 602 remains stopped. Alternatively, firing motor 602 may be activated to fire multiple staples and/or advance a cutting edge while articulation motor 606 is stopped. Additionally, closure motor 603 may be activated simultaneously with firing motor 602 to distally advance a closure tube and an I-beam element, as described in more detail herein below.

In certain examples, a surgical instrument or tool may include a common control module 610 that can be used with multiple motors of the surgical instrument or tool. In certain examples, the common control module 610 can accommodate one of the multiple motors at a time. For example, the common control module 610 may be capable of individually coupling and decoupling multiple motors of a robotic surgical instrument. In certain examples, multiple motors of a surgical instrument or tool may share one or more common control modules, such as the common control module 610. In certain examples, multiple motors of a surgical instrument or tool can be independently and selectively engaged with the common control module 610. In certain examples, the common control module 610 can be selectively switched from coupling with one of the multiple motors of the surgical instrument or tool to coupling with another of the multiple motors of the surgical instrument or tool.

In at least one embodiment, the common control module 610 can be selectively switched between operative engagement with the articulation motors 606a, 606b and operative engagement with either the firing motor 602 or the closing motor 603. In at least one embodiment, as shown in FIG. 54, the switch 614 can be moved or transitioned between a number of positions and/or states. For example, in a first position 616, the switch 614 can electrically couple the common control module 610 to the firing motor 602, in a second position 617, the switch 614 can electrically couple the common control module 610 to the closing motor 603, in a third position 618a, the switch 614 can electrically couple the common control module 610 to the first articulation motor 606a, and in a fourth position 618b, the switch 614 can electrically couple the common control module 610 to the second articulation motor 606b. In certain examples, a separate common control module 610 may be electrically coupled to the firing motor 602, the closing motor 603, and the articulation motors 606a, 606b at the same time. In certain examples, the switch 614 may be a mechanical switch, an electromechanical switch, a solid-state switch, or any suitable switching mechanism.

Each of the motors 602, 603, 606a, 606b may be equipped with a torque sensor to measure the output torque on the shaft of the motor. The force on the end effector may be sensed in any conventional manner, such as by a force sensor outside the jaws or by a torque sensor on the motor that actuates the jaws.

In various examples, as shown in FIG. 54, the common control module 610 may include a motor driver 626, which may include one or more H-bridge FETs. The motor driver 626 may modulate the power transferred from a power source 628 to a motor coupled to the common control module 610, for example, based on input from a microcontroller 620 ("controller"). In certain examples, the microcontroller 620 may be used to determine, for example, the current drawn by a motor while the motor is coupled to the common control module 610, as described above.

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

In certain examples, the power source 628 may be used to provide power to, for example, the microcontroller 620. In certain examples, the power source 628 may include a battery (or "battery pack" or "power pack"), such as, for example, a lithium ion battery. In certain examples, the battery pack may be configured to be releasably attached to the handle to provide power to the surgical instrument 600. Multiple battery cells connected in series may be used as the power source 628. In certain examples, the power source 628 may be, for example, replaceable and/or rechargeable.

In various examples, the processor 622 can control the motor driver 626 to control the position, direction, and/or speed of the motors coupled to the common control module 610. In certain examples, the processor 622 can signal the motor driver 626 to stop and/or disable the motors coupled to the common control module 610. The term "processor" as used herein should be understood to include any suitable microprocessor, microcontroller, or other basic computing device that integrates the functionality of a computer's central processing unit (CPU) on one integrated circuit or up to a few integrated circuits. A processor is a multipurpose programmable device that accepts digital data as input, processes the data according to instructions stored in memory, and provides the results as output. It is an example of sequential digital logic because it has internal memory. The processor operates on numbers and symbols represented in the binary system.

In one example, the processor 622 may be any single-core or multi-core processor, such as those known under the trade name ARM Cortex manufactured by Texas Instruments. In a particular example, the microcontroller 620 may be, for example, an LM 4F230H5QR available from Texas Instruments. In at least one embodiment, the Texas Instruments LM4F230H5QR is an ARM Cortex-M4F processor core that includes, among other characteristics readily available in the product data sheet, on-chip memory of 256 KB of single-cycle flash memory or other non-volatile memory up to 40 MHz, a pre-fetch buffer to improve performance beyond 40 MHz, 32 KB of single-cycle SRAM, internal ROM loaded with StellarisWare® software, 2 KB of EEPROM, one or more PWM modules, one or more QEI analog, one or more 12-bit ADCs with 12 analog input channels. Other microcontrollers may be readily substituted for use with module 4410. Thus, the present disclosure should not be limited in this context.

In certain examples, the memory 624 may include program instructions for controlling each of the motors of the surgical instrument 600 that may be coupled to a common control module 610. For example, the memory 624 may include program instructions for controlling the firing motor 602, the closing motor 603, and the articulation motors 606a, 606b. Such program instructions may cause the processor 622 to control the firing, closing, and articulation functions according to inputs from an algorithm or control program of the surgical instrument or tool.

In certain examples, one or more mechanisms and/or sensors, such as, for example, sensor 630, can be used to alert processor 622 to program instructions to be used in a particular setting. For example, sensor 630 can alert processor 622 to use program instructions associated with firing, closing, and articulating the end effector. In certain examples, sensor 630 can include a position sensor that can be used to sense the position of switch 614, for example. Thus, processor 622 can use program instructions associated with firing the I-beam of the end effector when it detects, for example, via sensor 630 that switch 614 is in the first position 616, processor 622 can use program instructions associated with closing the anvil when it detects, for example, that switch 614 is in the second position 617 via sensor 630, and processor 622 can use program instructions associated with articulating the end effector when it detects, for example, that switch 614 is in the third position 618a or the fourth position 618b via sensor 630.

55 is a schematic diagram of a robotic surgical instrument 700 configured to manipulate a surgical tool described herein, according to one aspect of the present disclosure. The robotic surgical instrument 700 may be programmed or configured to control the distal/proximal translation of the displacement member, the distal/proximal displacement of the closure tube, the shaft rotation, and the articulation, using either a single or multiple articulation drive couplings. In one aspect, the surgical instrument 700 can be programmed or configured to individually control the firing member, the closure member, the shaft member, or one or more articulation members. The surgical instrument 700 includes a control circuit 710 configured to control a motorized firing member, a closure member, a shaft member, or one or more articulation members.

In one aspect, the robotic surgical instrument 700 includes a control circuit 710 configured to control the anvil 716 and I-beam 714 (including sharp cutting blade) portions of the end effector 702, the removable staple cartridge 718, the shaft 740, and one or more articulating members 742a, 742b via a plurality of motors 704a-704e. The position sensor 734 can be configured to provide position feedback of the I-beam 714 to the control circuit 710. Other sensors 738 may be configured to provide feedback to the control circuit 710. A timer/counter 731 provides timing and counting information to the control circuit 710. An energy source 712 may be provided to operate the motors 704a-704e, and a current sensor 736 provides motor current feedback to the control circuit 710. The motors 704a-704e can be individually operated by the control circuit 710 in open-loop or closed-loop feedback control.

In one aspect, the control circuitry 710 may comprise one or more microcontrollers, microprocessors, or other suitable processors for executing instructions that cause a processor or processors to perform one or more tasks. In one aspect, the timer/counter 731 provides an output signal, such as an elapsed time or digital count, to the control circuitry 710 to correlate the position of the I-beam 714 determined by the position sensor 734 with the output of the timer/counter 731, such that the control circuitry 710 can determine the position of the I-beam 714 at a particular time (t) relative to a starting position or time (t) when the I-beam 714 is at a particular position relative to the starting position. The timer/counter 731 may be configured to measure elapsed time, count external events, or measure the time of an external event.

In one aspect, the control circuitry 710 may be programmed to control the function of the end effector 702 based on one or more tissue conditions. The control circuitry 710 may be programmed to sense tissue conditions, such as thickness, either directly or indirectly, as described herein. The control circuitry 710 may be programmed to select a firing control program or a closing control program based on the tissue condition. The firing control program may describe the distal motion of the displacement member. Different firing control programs may be selected to better handle different tissue conditions. For example, when thicker tissue is present, the control circuitry 710 may be programmed to translate the displacement member at a slower speed and/or with less power. When thinner tissue is present, the control circuitry 710 may be programmed to translate the displacement member at a higher speed and/or with more power. The closing control program may control the closing force applied to the tissue by the anvil 716. Other control programs control the rotation of the shaft 740 and the articulating members 742a, 742b.

In one aspect, the control circuitry 710 can generate motor set point signals. The motor set point signals may be provided to various motor controllers 708a-708e. The motor controllers 708a-708e may include one or more circuits configured to provide motor drive signals to the motors 704a-704e to drive the motors 704a-704e as described herein. In some examples, the motors 704a-704e may be brushed DC electric motors. For example, the speed of the motors 704a-704e may be proportional to the respective motor drive signals. In some examples, the motors 704a-704e may be brushless DC electric motors, and the respective motor drive signals may include PWM signals provided to one or more stator windings of the motors 704a-704e. Also, in some examples, the motor controllers 708a-708e may be omitted, and the control circuitry 710 may directly generate the motor drive signals.

In one aspect, the control circuit 710 may initially operate each of the motors 704a-704e in an open-loop configuration for a first open-loop portion of the stroke of the displacement member. Based on the response of the robotic surgical instrument 700 during the open-loop portion of the stroke, the control circuit 710 may select a firing control program for a closed-loop configuration. The instrument response may include the translation distance of the displacement member during the open-loop portion, the time elapsed during the open-loop portion, the energy provided to one of the motors 704a-704e during the open-loop portion, the sum of the pulse widths of the motor drive signals, etc. After the open-loop portion, the control circuit 710 may implement the selected firing control program for a second portion of the displacement member stroke. For example, during the closed-loop portion of the stroke, the control circuit 710 may modulate one of the motors 704a-704e in a closed-loop manner based on translation data describing the position of the displacement member to translate the displacement member at a constant velocity.

In one aspect, the motors 704a-704e can receive power from an energy source 712. The energy source 712 may be a DC power source driven by a mains AC power source, a battery, a supercapacitor, or any other suitable energy source. The motors 704a-704e may be mechanically coupled to individual moving mechanical elements, such as the I-beam 714, the anvil 716, the shaft 740, the articulation 742a, and the articulation 742b, via respective transmission mechanisms 706a-706e. The transmission mechanisms 706a-706e may include one or more gears or other coupling components for coupling the motors 704a-704e to the moving mechanical elements. The position sensor 734 can sense the position of the I-beam 714. The position sensor 734 may be or include any type of sensor capable of generating position data indicative of the position of the I-beam 714. In some embodiments, the position sensor 734 may include an encoder configured to provide a series of pulses to the control circuitry 710 as the I-beam 714 translates distally and proximally. The control circuitry 710 may track the pulses to determine the position of the I-beam 714. Other suitable position sensors may be used, including, for example, a proximity sensor. Other types of position sensors may provide other signals indicative of the movement of the I-beam 714. Also, in some embodiments, the position sensor 734 may be omitted. If any of the motors 704a-704e are step motors, the control circuitry 710 may track the position of the I-beam 714 by summing up the number and direction of steps the motor 704 is commanded to perform. The position sensor 734 may be located in the end effector 702 or in any other part of the instrument. The output of each of the motors 704a-704e includes a torque sensor 744a-744e for sensing force and has an encoder for sensing rotation of the drive shaft.

In one aspect, the control circuit 710 is configured to drive a firing member, such as the I-beam 714 portion of the end effector 702. The control circuit 710 provides motor settings to the motor controller 708a, which provides a drive signal to the motor 704a. The output shaft of the motor 704a is coupled to a torque sensor 744a. The torque sensor 744a is coupled to a transmission mechanism 706a, which is coupled to the I-beam 714. The transmission mechanism 706a includes a movable mechanical element, such as a rotating element and a firing member, for controlling the movement of the I-beam 714 in the distal and proximal directions along the longitudinal axis of the end effector 702. In one aspect, the motor 704a may be coupled to a knife gear assembly including a knife gear reduction set including a first knife drive gear and a second knife drive gear. The torque sensor 744a provides a firing force feedback signal to the control circuit 710. The firing force signal represents the force required to fire or displace the I-beam 714. The position sensor 734 can be configured to provide the position of the I-beam 714 or the firing member along the firing stroke as a feedback signal to the control circuit 710. The end effector 702 may include additional sensors 738 configured to provide feedback signals to the control circuit 710. When ready for use, the control circuit 710 can provide a firing signal to the motor control 708a. In response to the firing signal, the motor 704a can drive the firing member distally along the longitudinal axis of the end effector 702 from a proximal start-of-stroke position to an end-of-stroke position distal to the start-of-stroke position. As the firing member translates distally, the I-beam 714 with a cutting element disposed at its distal end advances distally to cut tissue located between the staple cartridge 718 and the anvil 716.

In one aspect, the control circuit 710 is configured to drive a closure member, such as the anvil 716 portion of the end effector 702. The control circuit 710 provides a motor set point to a motor control 708b, which provides a drive signal to the motor 704b. The output shaft of the motor 704b is coupled to a torque sensor 744b. The torque sensor 744b is coupled to a transmission mechanism 706b, which is coupled to the anvil 716. The transmission mechanism 706b includes a movable mechanical element, such as a rotating element and a closure member, for controlling the movement of the anvil 716 from the open and closed positions. In one aspect, the motor 704b is coupled to a closure gear assembly including a closure reduction gear set supported in meshing engagement with a closure spur gear. The torque sensor 744b provides a closure force feedback signal to the control circuit 710. The closure force feedback signal is representative of the closure force applied to the anvil 716. The position sensor 734 may be configured to provide the position of the closure member as a feedback signal to the control circuit 710. An additional sensor 738 in the end effector 702 can provide a closure force feedback signal to the control circuit 710. The pivotable anvil 716 is disposed opposite the staple cartridge 718. When ready for use, the control circuit 710 can provide a closure signal to the motor control 708b. In response to the closure signal, the motor 704b advances the closure member to grasp tissue between the anvil 716 and the staple cartridge 718.

In one aspect, the control circuit 710 is configured to rotate a shaft member, such as the shaft 740, to rotate the end effector 702. The control circuit 710 provides a motor set point to a motor controller 708c, which provides a drive signal to the motor 704c. The output shaft of the motor 704c is coupled to a torque sensor 744c. The torque sensor 744c is coupled to a transmission mechanism 706c, which is coupled to the shaft 740. The transmission mechanism 706c includes a movable mechanical element, such as a rotating element, to control the clockwise or counterclockwise rotation of the shaft 740 up to and beyond 360 degrees. In one aspect, the motor 704c is coupled to a rotational transmission mechanism assembly including a tubular gear segment formed on (or attached to) the proximal end of the proximal closure tube to be operably engaged by a rotational gear assembly operably supported on the tool mounting plate. The torque sensor 744c provides a rotational force feedback signal to the control circuit 710. The rotational force feedback signal is indicative of the rotational force applied to the shaft 740. The position sensor 734 may be configured to provide the position of the closure member as a feedback signal to the control circuit 710. An additional sensor 738, such as a shaft encoder, may provide the rotational position of the shaft 740 to the control circuit 710.

In one aspect, the control circuit 710 is configured to articulate the end effector 702. The control circuit 710 provides a motor set point to a motor controller 708d, which provides a drive signal to the motor 704d. The output shaft of the motor 704d is coupled to a torque sensor 744d. The torque sensor 744d is coupled to a transmission mechanism 706d, which is coupled to the articulation member 742a. The transmission mechanism 706d includes a movable mechanical element, such as an articulation element, for controlling the ±65° articulation of the end effector 702. In one aspect, the motor 704d is coupled to an articulation nut, which is rotatably journaled on a proximal end portion of the distal spine portion and rotatably driven by an articulation gear assembly on the proximal end portion of the distal spine portion. The torque sensor 744d provides an articulation force feedback signal to the control circuit 710. The articulation force feedback signal is indicative of the articulation force applied to the end effector 702. A sensor 738, such as an articulation encoder, may provide the articulation position of the end effector 702 to the control circuit 710.

In another aspect, the articulation function of the robotic surgical system 700 may include two articulation members, or linkages 742a, 742b. These articulation members 742a, 742b are driven by separate disks on a robot interface (rack) driven by two motors 708d, 708e. When a separate firing motor 704a is provided, each of the articulation linkages 742a, 742b may be driven antagonistically relative to the other linkage to provide resistive holding motion and loading to the head when the head is not moving, and to provide articulation motion when the head is articulating. The articulation members 742a, 742b are attached to the head at a fixed radius as the head rotates. Thus, as the head rotates, the mechanical efficiency of the push-pull linkage changes. This change in mechanical efficiency may be more pronounced with other articulation linkage drive systems.

In one aspect, one or more of the motors 704a-704e may comprise brushed DC motors with gearboxes and mechanical connections to the firing members, closure members, or articulation members. Another example includes electric motors 704a-704e operating moving mechanical elements such as displacement members, articulation connections, closure tubes, and shafts. External influences are the unmeasured and unpredictable influences of things such as tissue, surroundings, and friction on a physical system. Such external influences may be referred to as drags that act against one of the electric motors 704a-704e. External influences such as drags may cause the operation of a physical system to deviate from the desired operation of the physical system.

In one aspect, the position sensor 734 may be implemented as an absolute positioning system. In one aspect, the position sensor 734 may comprise a magnetic rotary absolute positioning system implemented as an AS5055EQFT single chip magnetic rotary position sensor available from Austria Microsystems, AG. The position sensor 734 may provide an absolute positioning system in conjunction with the control circuit 710. The position may include multiple Hall effect elements located above a magnet and coupled to a CORDIC processor, also known as the digit-by-digit and Boulder algorithms, which are provided to implement simple and efficient algorithms for calculating hyperbolic and trigonometric functions, requiring only addition, subtraction, bit shifting, and table lookup operations.

In one aspect, the control circuitry 710 may be in communication with one or more sensors 738. The sensors 738 may be disposed on the end effector 702 and adapted to operate with the robotic surgical instrument 700 to measure various derived parameters, such as gap distance versus time, tissue compression versus time, and anvil strain versus time. The sensors 738 may comprise magnetic sensors, magnetic field sensors, strain gauges, load cells, pressure sensors, force sensors, torque sensors, inductive sensors such as eddy current sensors, resistive sensors, capacitive sensors, optical sensors, and/or any other suitable sensors for measuring one or more parameters of the end effector 702. The sensors 738 may include one or more sensors. The sensors 738 may be disposed on the deck of the staple cartridge 718 to determine the position of the tissue using a split electrode. The torque sensors 744a-744e may be configured to sense forces, such as firing forces, closure forces, and/or articulation forces, among others. Thus, the control circuit 710 can sense (1) the closure load experienced by the distal closure tube and its position, (2) the firing member in the rack and its position, (3) which portion of the staple cartridge 718 has tissue thereon, and (4) the load and position on both articulation rods.

In one aspect, the one or more sensors 738 may comprise a strain gauge, such as a micro strain gauge, configured to measure the magnitude of strain in the anvil 716 during the clamping state. The strain gauge provides an electrical signal that varies in amplitude with the magnitude of strain. The sensor 738 may comprise a pressure sensor configured to detect pressure generated by the presence of compressed tissue between the anvil 716 and the staple cartridge 718. The sensor 738 may be configured to detect the impedance of a tissue portion located between the anvil 716 and the staple cartridge 718, which impedance is indicative of the thickness and/or fullness of the tissue located therebetween.

In one aspect, the sensor 738 may be implemented as one or more limit switches, electromechanical devices, solid-state switches, Hall effect devices, magnetoresistive (MR) devices, giant magnetoresistive (GMR) devices, magnetometers, among others. In other implementations, the sensor 738 may be implemented as a solid-state switch that operates under the influence of light, such as a light sensor, an IR sensor, an ultraviolet sensor, among others. Additionally, the switch may be a solid-state device such as a transistor (e.g., FET, junction FET, MOSFET, bipolar, etc.). In other implementations, the sensor 738 may include a non-conductor-containing switch, an ultrasonic switch, an accelerometer, and an inertial sensor, among others.

In one aspect, the sensor 738 can be configured to measure the force exerted by the closure drive system on the anvil 716. For example, one or more sensors 738 may be located at an interaction point between the closure tube and the anvil 716 to detect the closure force exerted by the closure tube on the anvil 716. The force exerted on the anvil 716 can be representative of tissue compression experienced by tissue portions captured between the anvil 716 and the staple cartridge 718. One or more sensors 738 can be positioned at various interaction points along the closure drive system to detect the closure force exerted by the closure drive system on the anvil 716. The one or more sensors 738 may be sampled in real time during the clamping operation by a processor of the control circuit 710. The control circuit 710 receives the real time sample measurements to provide and analyze time-based information to assess the closure force exerted on the anvil 716 in real time.

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

56 illustrates a block diagram of a surgical instrument 750 programmed to control the distal translation of a displacement member, according to one aspect of the present disclosure. In one aspect, the surgical instrument 750 is programmed to control the distal translation of a displacement member, such as an I-beam 764. The surgical instrument 750 includes an anvil 766, an I-beam 764 (including a sharp cutting blade), and an end effector 752 that can include a removable staple cartridge 768.

The position, movement, displacement, and/or translation of a linear displacement member, such as the I-beam 764, can be measured by an absolute positioning system, a sensor mechanism, and a position sensor 784. Because the I-beam 764 is coupled to a longitudinally movable drive member, the position of the I-beam 764 can be determined by measuring the position of the longitudinally movable drive member using the position sensor 784. Thus, in the following description, the position, displacement, and/or translation of the I-beam 764 can be achieved by the position sensor 784 described herein. The control circuitry 760 may be programmed to control the translation of a displacement member, such as the I-beam 764. In some embodiments, the control circuitry 760 may comprise one or more microcontrollers, microprocessors, or other suitable processors for executing instructions that cause a processor or processors to control a displacement member, such as the I-beam 764, in the manner described. In one aspect, the timer/counter 781 provides an output signal, such as an elapsed time or a digital count, to the control circuit 760 to correlate the position of the I-beam 764 determined by the position sensor 784 with the output of the timer/counter 781 so that the control circuit 760 can determine the position of the I-beam 764 at a particular time (t) relative to a starting position. The timer/counter 781 may be configured to measure elapsed time, count external events, or measure the time of an external event.

The control circuitry 760 may generate a motor set point signal 772. The motor set point signal 772 may be provided to the motor controller 758. The motor controller 758 may include one or more circuits configured to provide a motor drive signal 774 to the motor 754 to drive the motor 754, as described herein. In some examples, the motor 754 may be a brushed DC electric motor. For example, the speed of the motor 754 may be proportional to the motor drive signal 774. In some examples, the motor 754 may be a brushless DC electric motor, and the motor drive signal 774 may include a PWM signal provided to one or more stator windings of the motor 754. Also, in some examples, the motor controller 758 may be omitted, and the control circuitry 760 may directly generate the motor drive signal 774.

The motor 754 can receive power from an energy source 762. The energy source 762 can be or include a battery, a supercapacitor, or any other suitable energy source. The motor 754 can be mechanically coupled to the I-beam 764 via a transmission mechanism 756. The transmission mechanism 756 can include one or more gears or other coupling components for coupling the motor 754 to the I-beam 764. The position sensor 784 can sense the position of the I-beam 764. The position sensor 784 can be or include any type of sensor capable of generating position data indicative of the position of the I-beam 764. In some embodiments, the position sensor 784 can include an encoder configured to provide a series of pulses to the control circuitry 760 as the I-beam 764 translates distally and proximally. The control circuitry 760 can track the pulses to determine the position of the I-beam 764. Other suitable position sensors can be used, including, for example, a proximity sensor. Other types of position sensors can provide other signals indicative of the movement of the I-beam 764. Also, in some embodiments, the position sensor 784 may be omitted. If the motor 754 is a stepper motor, the control circuit 760 can track the position of the I-beam 764 by summing the number and direction of steps the motor 754 is commanded to perform. The position sensor 784 can be located in the end effector 752 or in any other part of the instrument.

The control circuitry 760 can be in communication with one or more sensors 788. The sensors 788 may be disposed on the end effector 752 and adapted to operate with the surgical instrument 750 to measure various derived parameters, such as gap distance versus time, tissue compression versus time, and anvil strain versus time. The sensors 788 may comprise magnetic sensors, magnetic field sensors, strain gauges, pressure sensors, force sensors, inductive sensors such as eddy current sensors, resistive sensors, capacitive sensors, optical sensors, and/or any other suitable sensors for measuring one or more parameters of the end effector 752. The sensors 788 can include one or more sensors.

The one or more sensors 788 may comprise a strain gauge, such as a micro strain gauge, configured to measure the magnitude of strain in the anvil 766 during the clamping condition. The strain gauge provides an electrical signal that varies in amplitude with the magnitude of strain. The sensor 788 may comprise a pressure sensor configured to detect pressure generated by the presence of compressed tissue between the anvil 766 and the staple cartridge 768. The sensor 788 may be configured to detect the impedance of a tissue portion located between the anvil 766 and the staple cartridge 768, which impedance is indicative of the thickness and/or fullness of the tissue located therebetween.

The sensor 788 can be configured to measure the force exerted by the closure drive system on the anvil 766. For example, one or more sensors 788 may be located at an interaction point between the closure tube and the anvil 766 to detect the closure force exerted by the closure tube on the anvil 766. The force exerted on the anvil 766 can be representative of tissue compression experienced by tissue portions captured between the anvil 766 and the staple cartridge 768. One or more sensors 788 can be positioned at various interaction points along the closure drive system to detect the closure force exerted by the closure drive system on the anvil 766. The one or more sensors 788 may be sampled in real time during the clamping operation by a processor of the control circuit 760. The control circuit 760 receives the real time sample measurements to provide and analyze time-based information to assess the closure force exerted on the anvil 766 in real time.

A current sensor 786 can be used to measure the current drawn by the motor 754. The force required to advance the I-beam 764 corresponds to the current drawn by the motor 754. The force is converted to a digital signal and provided to the control circuit 760.

The control circuitry 760 can be configured to simulate the response of the actual system of the instrument in the controller software. The displacement member can be actuated to move the I-beam 764 in the end effector 752 at or near a target velocity. The surgical instrument 750 can include a feedback controller, which can be any one of any feedback controllers, including, but not limited to, a PID, state feedback, LQR, and/or adaptive controller. The surgical instrument 750 can include a power supply to convert the signal from the feedback controller into a physical input, such as, for example, a case voltage, a PWM voltage, a frequency modulated voltage, a current, a torque, and/or a force.

The actual drive system of the surgical tool 750 is configured to drive the displacement member, cutting member, or I-beam 764 by a brushed DC motor with a gearbox and mechanical linkage to the articulation and/or knife system. Another example is an electric motor 754 that operates, for example, the displacement member and the articulation driver of an interchangeable shaft assembly. External influences are the unmeasured and unpredictable influences of things like tissue, surroundings, and friction on the physical system. Such external influences may be referred to as impediments that act against the electric motor 754. External influences such as impediments may cause the operation of the physical system to deviate from the desired operation of the physical system.

Various exemplary aspects are directed to a surgical instrument 750 comprising an end effector 752 having a motor-driven surgical stapling and cutting means. For example, a motor 754 may drive a displacement member in a distal and proximal direction along a longitudinal axis of the end effector 752. The end effector 752 may comprise a pivotable anvil 766 and, if configured for use, a staple cartridge 768 disposed opposite the anvil 766. A clinician may grasp tissue between the anvil 766 and the staple cartridge 768 as described herein. When the instrument 750 is ready to be used, the clinician may provide a firing signal, for example, by pressing a trigger of the instrument 750. In response to the firing signal, the motor 754 may drive the displacement member in a distal direction along a longitudinal axis of the end effector 752 from a proximal start-of-stroke position to an end-of-stroke position distal to the start-of-stroke position. As the displacement member translates distally, the I-beam 764 having a cutting element disposed at its distal end can cut tissue between the staple cartridge 768 and the anvil 766.

In various embodiments, the surgical instrument 750 may include a control circuit 760 programmed to control the distal translation of a displacement member, such as, for example, an I-beam 764, based on one or more tissue conditions. The control circuit 760 may be programmed to sense tissue conditions, such as thickness, either directly or indirectly, as described herein. The control circuit 760 may be programmed to select a firing control program based on the tissue condition. The firing control program may describe the distal motion of the displacement member. Different firing control programs may be selected to better handle different tissue conditions. For example, when thicker tissue is present, the control circuit 760 may be programmed to translate the displacement member at a slower speed and/or with less power. When thinner tissue is present, the control circuit 760 may be programmed to translate the displacement member at a higher speed and/or with more power.

In some embodiments, the control circuit 760 may initially operate the motor 754 in an open loop configuration for a first open loop portion of the stroke of the displacement member. Based on the response of the instrument 750 during the open loop portion of the stroke, the control circuit 760 may select a firing control program. The response of the instrument may include the translation distance of the displacement member during the open loop portion, the time elapsed during the open loop portion, the energy provided to the motor 754 during the open loop portion, the total pulse width of the motor drive signal, etc. After the open loop portion, the control circuit 760 may implement the selected firing control program for a second portion of the displacement member stroke. For example, during the closed loop portion of the stroke, the control circuit 760 may modulate the motor 754 in a closed loop manner based on translation data describing the position of the displacement member to translate the displacement member at a constant velocity. Further details are disclosed in U.S. Patent Application No. 15/720,852, entitled "SYSTEM AND METHODS FOR CONTROLLING A DISPLAY OF A SURGICAL INSTRUMENT," filed September 29, 2017, which is incorporated herein by reference in its entirety.

57 is a schematic diagram of a surgical instrument 790 configured to control various functions, according to one aspect of the present disclosure. In one aspect, the surgical instrument 790 is programmed to control the distal translation of a displacement member, such as an I-beam 764. The surgical instrument 790 includes an end effector 792 that can include an anvil 766, an I-beam 764, and a removable staple cartridge 768 that can be replaced with an RF cartridge 796 (shown in dashed lines).

In one aspect, the sensor 788 may be implemented as a limit switch, an electromechanical device, a solid-state switch, a Hall effect device, an MR device, a GMR device, a magnetometer, among others. In other implementations, the sensor 638 may be a solid-state switch that operates under the influence of light, such as a light sensor, an IR sensor, an ultraviolet sensor, among others. Additionally, the switch may be a solid-state device such as a transistor (e.g., FET, junction FET, MOSFET, bipolar, etc.). In other implementations, the sensor 788 may include a non-conductor-containing switch, an ultrasonic switch, an accelerometer, and an inertial sensor, among others.

In one aspect, the position sensor 784 may be implemented as an absolute positioning system with a magnetic rotary absolute positioning system implemented as an AS5055EQFT single chip magnetic rotary position sensor available from Austria Microsystems, AG. The position sensor 784 may provide an absolute positioning system in conjunction with the control circuit 760. The position may include multiple Hall effect elements located above a magnet and coupled to a CORDIC processor, also known as the digit-by-digit and Boulder algorithms, which are provided to implement simple and efficient algorithms for calculating hyperbolic and trigonometric functions, requiring only addition, subtraction, bit shifting, and table lookup operations.

In one aspect, the I-beam 764 may be implemented as a knife member comprising a knife body operatively supporting a tissue-cutting blade thereon, and may further include anvil engagement tabs or features and channel engagement features or feet. In one aspect, the staple cartridge 768 may be implemented as a standard (mechanical) surgical fastener cartridge. In one aspect, the RF cartridge 796 may be implemented as an RF cartridge. These and other sensor mechanisms are described in commonly-assigned U.S. Patent Application No. 15/628,175, filed June 20, 2017, entitled "TECHNIQUES FOR ADAPTIVE CONTROL OF MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT," which is incorporated by reference herein in its entirety.

The position, movement, displacement, and/or translation of a linear displacement member, such as the I-beam 764, can be measured by an absolute positioning system, a sensor mechanism, and a position sensor, represented as position sensor 784. Because the I-beam 764 is coupled to a longitudinally movable drive member, the position of the I-beam 764 can be determined by measuring the position of the longitudinally movable drive member using the position sensor 784. Thus, in the following description, the position, displacement, and/or translation of the I-beam 764 can be achieved by the position sensor 784 described herein. The control circuitry 760 may be programmed to control the translation of a displacement member, such as the I-beam 764, as described herein. In some embodiments, the control circuitry 760 may comprise one or more microcontrollers, microprocessors, or other suitable processors for executing instructions that cause a processor or processors to control a displacement member, such as the I-beam 764, in the manner described. In one aspect, the timer/counter 781 provides an output signal, such as an elapsed time or a digital count, to the control circuit 760 to correlate the position of the I-beam 764 determined by the position sensor 784 with the output of the timer/counter 781 so that the control circuit 760 can determine the position of the I-beam 764 at a particular time (t) relative to a starting position. The timer/counter 781 may be configured to measure elapsed time, count external events, or measure the time of an external event.

The control circuitry 760 may generate a motor set point signal 772. The motor set point signal 772 may be provided to the motor controller 758. The motor controller 758 may include one or more circuits configured to provide a motor drive signal 774 to the motor 754 to drive the motor 754, as described herein. In some examples, the motor 754 may be a brushed DC electric motor. For example, the speed of the motor 754 may be proportional to the motor drive signal 774. In some examples, the motor 754 may be a brushless DC electric motor, and the motor drive signal 774 may include a PWM signal provided to one or more stator windings of the motor 754. Also, in some examples, the motor controller 758 may be omitted, and the control circuitry 760 may directly generate the motor drive signal 774.

The motor 754 can receive power from an energy source 762. The energy source 762 can be or include a battery, a supercapacitor, or any other suitable energy source. The motor 754 can be mechanically coupled to the I-beam 764 via a transmission mechanism 756. The transmission mechanism 756 can include one or more gears or other coupling components for coupling the motor 754 to the I-beam 764. The position sensor 784 can sense the position of the I-beam 764. The position sensor 784 can be or include any type of sensor capable of generating position data indicative of the position of the I-beam 764. In some embodiments, the position sensor 784 can include an encoder configured to provide a series of pulses to the control circuitry 760 as the I-beam 764 translates distally and proximally. The control circuitry 760 can track the pulses to determine the position of the I-beam 764. Other suitable position sensors can be used, including, for example, a proximity sensor. Other types of position sensors can provide other signals indicative of the movement of the I-beam 764. Also, in some embodiments, the position sensor 784 may be omitted. If the motor 754 is a stepper motor, the control circuit 760 can track the position of the I-beam 764 by summing the number and direction of steps the motor is commanded to perform. The position sensor 784 can be located in the end effector 792 or in any other part of the instrument.

The control circuitry 760 can be in communication with one or more sensors 788. The sensors 788 may be disposed on the end effector 792 and adapted to operate with the surgical instrument 790 to measure various derived parameters, such as gap distance versus time, tissue compression versus time, and anvil strain versus time. The sensors 788 may comprise magnetic sensors, magnetic field sensors, strain gauges, pressure sensors, force sensors, inductive sensors such as eddy current sensors, resistive sensors, capacitive sensors, optical sensors, and/or any other suitable sensors for measuring one or more parameters of the end effector 792. The sensors 788 can include one or more sensors.

The one or more sensors 788 may comprise a strain gauge, such as a micro strain gauge, configured to measure the magnitude of strain in the anvil 766 during the clamping condition. The strain gauge provides an electrical signal that varies in amplitude with the magnitude of strain. The sensor 788 may comprise a pressure sensor configured to detect pressure generated by the presence of compressed tissue between the anvil 766 and the staple cartridge 768. The sensor 788 may be configured to detect the impedance of a tissue portion located between the anvil 766 and the staple cartridge 768, which impedance is indicative of the thickness and/or fullness of the tissue located therebetween.

The sensor 788 can be configured to measure the force exerted by the closure drive system on the anvil 766. For example, one or more sensors 788 may be located at an interaction point between the closure tube and the anvil 766 to detect the closure force exerted by the closure tube on the anvil 766. The force exerted on the anvil 766 may be representative of tissue compression experienced by tissue portions captured between the anvil 766 and the staple cartridge 768. One or more sensors 788 can be positioned at various interaction points along the closure drive system to detect the closure force exerted by the closure drive system on the anvil 766. The one or more sensors 788 may be sampled in real time during the clamping operation by the processor portion of the control circuitry 760. The control circuitry 760 receives the real time sample measurements to provide and analyze time-based information to assess the closure force exerted on the anvil 766 in real time.

A current sensor 786 can be used to measure the current drawn by the motor 754. The force required to advance the I-beam 764 corresponds to the current drawn by the motor 754. The force is converted to a digital signal and provided to the control circuit 760.

The RF energy source 794 is coupled to the end effector 792 and is applied to the RF cartridge 796 when the RF cartridge 796 is loaded into the end effector 792 in place of the staple cartridge 768. The control circuitry 760 controls the delivery of RF energy to the RF cartridge 796.

Further details are disclosed in U.S. Patent Application No. 15/636,096, entitled "SURGICAL SYSTEM COUPLABLE WITH STAPLE CARTRIDGE AND RADIO FREQUENCY CARTRIDGE, AND METHOD OF USING SAME," filed June 28, 2017, which is incorporated herein by reference in its entirety.

Generator Hardware Figure 58 is a simplified block diagram of a generator 800 configured to provide, among other advantages, inductorless tuning. Additional details of the generator 800 are described in U.S. Patent No. 9,060,775, entitled "SURGICAL GENERATOR FOR ULTRASONIC AND ELECTROSURGICAL DEVICES," filed June 23, 2015, which is incorporated herein by reference in its entirety. The generator 800 may include a patient-isolated stage 802 in communication with a non-isolated stage 804 via a power transformer 806. A secondary winding 808 of the power transformer 806 is housed within the isolation stage 802 and can include a tap configuration (e.g., center tapped or non-center tapped configuration) to define drive signal outputs 810a, 810b, 810c for delivering drive signals to various surgical instruments, such as ultrasonic surgical instruments, RF electrosurgical instruments, and multifunction surgical instruments including ultrasonic and RF energy modes that can be delivered alone or simultaneously. Specifically, drive signal outputs 810a, 810c may output an ultrasonic drive signal (e.g., a 420V root-mean-square (RMS) drive signal) to an ultrasonic surgical instrument, and drive signal outputs 810b, 810c may output an RF electrosurgical drive signal (e.g., a 100V RMS drive signal) to an RF electrosurgical instrument, with drive signal output 810b corresponding to the center tap of the power transformer 806.

In certain configurations, ultrasonic and electrosurgical drive signals may be provided simultaneously to separate surgical instruments and/or to a single surgical instrument, such as a multifunction surgical instrument capable of delivering both ultrasonic and electrosurgical energy to tissue. It will be understood that the electrosurgical signals provided to either the dedicated electrosurgical instrument and/or the combined multifunction ultrasonic/electrosurgical instrument may be either therapeutic or sub-therapeutic level signals, and the sub-therapeutic signals may be used, for example, to monitor tissue or instrument status and provide feedback to the generator. For example, ultrasonic and RF signals may be delivered separately or simultaneously from a generator having a single output port to provide a desired output signal to the surgical instrument, as discussed in more detail below. Thus, the generator may combine ultrasonic and electrosurgical RF energy to deliver a combined energy to the multifunction ultrasonic/electrosurgical instrument. Bipolar electrodes may be positioned on one or both jaws of the end effector. One jaw may be driven by ultrasonic energy in addition to electrosurgical RF energy, working simultaneously. Ultrasonic energy may be used to cut tissue, while electrosurgical RF energy may be used to seal blood vessels.

The non-isolated stage 804 may include a power amplifier 812 having an output connected to a primary winding 814 of a power transformer 806. In certain configurations, the power amplifier 812 may include a push-pull amplifier. For example, the non-isolated stage 804 may further include a logic device 816 for providing a digital output to a digital-to-analog converter (DAC) circuit 818 that subsequently provides a corresponding analog signal to the input of the power amplifier 812. In certain configurations, the logic device 816 may include, for example, a programmable gate array (PGA), an FPGA, a programmable logic device (PLD), among other logic circuits. Thus, the logic device 816 may control any of a number of parameters (e.g., frequency, waveform, waveform amplitude) of the drive signal appearing at the drive signal output 810a, 810b, 810c by controlling the input of the power amplifier 812 via the DAC circuit 818. In certain embodiments, and as described below, the logic device 816, in conjunction with a processor (e.g., a DSP, described below), can implement a number of DSP-based and/or other control algorithms to control parameters of the drive signal output by the generator 800.

Power may be provided to the power rails of the power amplifier 812 by a switch mode regulator 820, e.g., a power converter. In a particular embodiment, the switch mode regulator 820 may include, for example, an adjustable buck regulator. The non-isolated stage 804 may further include a first processor 822, which in one embodiment may include, for example, a DSP processor, such as an Analog Devices ADSP-21469 SHARC DSP available from Analog Devices (Norwood, MA), although in various embodiments any suitable processor may be used. In a particular embodiment, the DSP processor 822 may control the operation of the switch mode regulator 820 in response to voltage feedback data that the DSP processor 822 receives from the power amplifier 812 via the ADC circuit 824. In one form, for example, the DSP processor 822 may receive as an input via the ADC circuitry 824 the waveform envelope of the signal (e.g., an RF signal) amplified by the power amplifier 812. The DSP processor 822 may then control the switch mode regulator 820 (e.g., via a PWM output) so that the rail voltages supplied to the power amplifier 812 track the waveform envelope of the amplified signal. By dynamically modulating the rail voltages of the power amplifier 812 based on the waveform envelope, the efficiency of the power amplifier 812 can be significantly improved over a fixed rail voltage amplifier scheme.

In certain forms, the logic device 816, together with the DSP processor 822, may implement a digital synthesis circuit, such as a direct digital synthesizer control scheme, to control the waveform shape, frequency, and/or amplitude of the drive signal output by the generator 800. In one form, for example, the logic device 816 may implement a DDS control algorithm by calling up waveform samples stored in a dynamically updated lookup table (LUT), such as a RAM LUT that may be embedded in an FPGA. This control algorithm is particularly useful in ultrasonic applications, where an ultrasonic transducer, such as an ultrasonic transducer, can be driven by a well-defined sinusoidal current at its resonant frequency. Minimizing or reducing the total distortion of the operating branch current can correspondingly minimize or reduce undesirable resonant effects, since other frequencies may excite parasitic resonances. Because the waveform shape of the drive signal output by the generator 800 is affected by various sources of distortion present in the output drive circuit (e.g., power transformer 806, power amplifier 812), feedback data of voltage and current based on the drive signal can be input to an algorithm, such as an error control algorithm implemented by the DSP processor 822, to dynamically and continuously (e.g., in real time) compensate for the distortion by suitably pre-distorting or modifying the waveform samples stored in the LUT. In one form, the amount or degree of pre-distortion applied to the LUT samples may be based on the error between the calculated motion branch current and the desired current waveform, the error being determined on a sample-by-sample basis. In this manner, the pre-distorted LUT samples, when processed by the drive circuit, may result in a motion branch drive signal having a desired waveform shape (e.g., sinusoidal) to optimally drive the ultrasonic transducer. In such a form, the LUT waveform samples thus do not represent the desired waveform of the drive signal, but rather represent the waveform required to ultimately generate the desired waveform of the motion branch drive signal when considering distortion effects.

The non-isolated stage 804 may further include a first ADC circuit 826 and a second ADC circuit 828 coupled to the output of the power transformer 806 via respective isolation transformers 830, 832 to sample the voltage and current, respectively, of the drive signal output by the generator 800. In a particular embodiment, the ADC circuits 826, 828 may be configured to sample at a high speed (e.g., 80 mega samples per second (MSPS)) to allow oversampling of the drive signal. In one embodiment, for example, the sampling rate of the ADC circuits 826, 828 may allow for approximately 200x (depending on frequency) oversampling of the drive signal. In a particular embodiment, the sampling operation of the ADC circuits 826, 828 may be performed by a single ADC circuit that receives the input voltage and current signals via a bidirectional multiplexer. The use of high speed sampling in the form of generator 800 can, among other things, allow for the calculation of complex currents flowing through the motional branches (which may be used in certain forms to implement the DDS-based waveform shape control described above), accurate digital filtering of the sampled signals, and calculation of real power consumption with high precision. The voltage and current feedback data output by ADC circuits 826, 828 can be received and processed by logic device 816 (e.g., first-in-first-out (FIFO) buffers, multiplexers) and stored in a data memory, for example, for subsequent retrieval by DSP processor 822. As noted above, the voltage and current feedback data can be used as input to an algorithm to pre-distort or modify the LUT waveform samples on a dynamic and ongoing basis. In certain forms, this may require that each stored voltage and current feedback data pair be indexed based on or otherwise associated with the corresponding LUT sample output by logic device 816 when the voltage and current feedback data pair is obtained. Synchronizing the LUT samples with the voltage and current feedback data in this manner contributes to precise timing and stability of the predistortion algorithm.

In certain configurations, the voltage and current feedback data may be used to control the frequency and/or amplitude (e.g., current amplitude) of the drive signal. For example, in one configuration, the voltage and current feedback data may be used to determine the impedance phase. The frequency of the drive signal may then be controlled to minimize or reduce the difference between the determined impedance phase and the impedance phase set point (e.g., 0°), thus minimizing or reducing the effects of harmonic distortion and correspondingly improving impedance phase measurement accuracy. The determination of the phase impedance and frequency control signal may be implemented, for example, in the DSP processor 822, and the frequency control signal is provided as an input to a DDS control algorithm implemented by the logic device 816.

In another embodiment, for example, current feedback data may be monitored to maintain the current amplitude of the drive signal at a current amplitude set point. The current amplitude set point may be directly specified or indirectly determined based on specified voltage amplitude and power set points. In a particular embodiment, control of the current amplitude may be performed by a control algorithm, such as, for example, a proportional-integral-derivative (PID) control algorithm in the DSP processor 822. To suitably control the current amplitude of the drive signal, variables controlled by the control algorithm may include, for example, the scaling of the LUT waveform samples stored in the logic device 816 and/or the full-scale output voltage of the DAC circuit 818 (which provides an input to the power amplifier 812) via the DAC circuit 834.

The non-isolated stage 804 may further include a second processor 836 to provide, among other things, user interface (UI) functions. In one form, the UI processor 836 may include, for example, an Atmel AT91SAM9263 processor with an ARM 926EJ-S core, available from Atmel Corporation, San Jose, California. Examples of UI functions supported by the UI processor 836 may include audible and visual user feedback, communication with peripheral devices (e.g., via a USB interface), communication with a foot switch, communication with an input device (e.g., a touch screen display), and communication with an output device (e.g., a speaker). The UI processor 836 may communicate with the DSP processor 822 and the logic device 816 (e.g., via an SPI bus). The UI processor 836 may primarily support UI functions, but in certain configurations may also perform hazard mitigation in coordination with the DSP processor 822. For example, the UI processor 836 may be programmed to monitor various aspects of user input and/or other input (e.g., touch screen input, foot switch input, temperature sensor input) and may disable the drive output of the generator 800 if an erroneous condition is detected.

In certain configurations, both the DSP processor 822 and the UI processor 836 may, for example, determine and monitor the operating state of the generator 800. With respect to the DSP processor 822, the operating state of the generator 800 may represent, for example, which control and/or diagnostic processes are implemented by the DSP processor 822. With respect to the UI processor 836, the operating state of the generator 800 may represent, for example, which elements of the UI (e.g., display screen, sound) are presented to the user. The DSP processor 822 and the UI processor 836 may each separately maintain the current operating state of the generator 800 and recognize and evaluate possible transitions from the current operating state. The DSP processor 822 may act as a master in this relationship and determine when transitions between operating states occur. The UI processor 836 may recognize valid transitions between operating states and may verify that a particular transition is appropriate. For example, when the DSP processor 822 commands the UI processor 836 to transition to a particular state, the UI processor 836 may verify that the requested transition is valid. If the requested transition between states is determined by the UI processor 836 to be invalid, the UI processor 836 may place the generator 800 in a failure mode.

The non-isolated stage 804 may further include a controller 838 for monitoring input devices (e.g., capacitive touch sensors used to turn the generator 800 on and off, capacitive touch screen). In certain forms, the controller 838 may include at least one processor and/or other controller device in communication with the UI processor 836. In one form, for example, the controller 838 may include a processor (e.g., a Meg168 8-bit controller available from Atmel) configured to monitor user input provided via one or more capacitive touch sensors. In one form, the controller 838 may include a touch screen controller (e.g., a QT5480 touch screen controller available from Atmel) for controlling and managing acquisition of touch data from the capacitive touch screen.

In certain forms, when the generator 800 is in the "power off" state, the controller 838 may continue to receive operating power (e.g., via a line from a power source of the generator 800, such as the power source 854 described below). In this manner, the controller 838 may continue to monitor an input device (e.g., a capacitive touch sensor located on the front panel of the generator 800) for turning the generator 800 on and off. When the generator 800 is in the power off state, the controller 838 may activate a power source (e.g., enable operation of one or more DC/DC voltage converters 856 of the power source 854) if activation of the "on/off" input device by a user is detected. As a result, the controller 838 may initiate a sequence to transition the generator 800 to the "power on" state. Conversely, if activation of the "on/off" input device is detected when the generator 800 is in the power on state, the controller 838 may initiate a sequence to transition the generator 800 to the power off state. In certain configurations, for example, the controller 838 may report activation of an "on/off" input device to the UI processor 836, which then performs the process sequence necessary to transition the generator 800 to a powered off state. In such configurations, the controller 838 may not have a separate capability to remove power from the generator 800 after the generator 800's powered on state has been established.

In certain forms, the controller 838 may cause the generator 800 to provide audible or other sensory feedback to alert the user that a power on or power off sequence has begun. Such an alert may be provided at the start of the power on or power off sequence and prior to the start of other processes associated with the sequence.

In certain forms, the isolated stage 802 may include an instrument interface circuit 840 to provide a communication interface between, for example, the surgical instrument's control circuitry (e.g., control circuitry including handpiece switches) and components of the non-isolated stage 804, such as, for example, the logic device 816, the DSP processor 822, and/or the UI processor 836. The instrument interface circuit 840 may exchange information with components of the non-isolated stage 804 via a communication link that maintains a suitable degree of electrical isolation between the isolated stage 802 and the non-isolated stage 804, such as, for example, an IR-based communication link. For example, the instrument interface circuit 840 may be powered using a low dropout voltage regulator powered by an isolation transformer driven from the non-isolated stage 804.

In one form, the instrument interface circuit 840 may include a logic circuit 842 (e.g., logic circuit, programmable logic circuit, PGA, FPGA, PLD) in communication with a signal conditioning circuit 844. The signal conditioning circuit 844 may be configured to receive a periodic signal (e.g., a 2 kHz square wave) from the logic circuit 842 to generate a bipolar interrogation signal having the same frequency. The interrogation signal may be generated using, for example, a bipolar current source fed by a differential amplifier. The interrogation signal may be communicated to a surgical instrument control circuit (e.g., by using a conductive pair in a cable connecting the generator 800 to the surgical instrument) and monitored to determine a state or configuration of the control circuit. The control circuit may include a number of switches, resistors, and/or diodes and may modify one or more characteristics (e.g., amplitude, rectification) of the interrogation signal such that the state or configuration of the control circuit is individually identifiable based on the one or more characteristics. In one form, for example, the signal conditioning circuitry 844 can include an ADC circuit to generate samples of a voltage signal appearing across an input of the control circuit resulting from the path traversed by the interrogation signal. The logic circuitry 842 (or components of the non-isolated stage 804) can then determine the state or configuration of the control circuit based on the ADC circuit samples.

In one form, the instrument interface circuit 840 may include a first data circuit interface 846 to enable the exchange of information between the logic circuit 842 (or other elements of the instrument interface circuit 840) and a first data circuit disposed within or otherwise associated with the surgical instrument. In certain forms, for example, the first data circuit may be disposed within a cable or adapter integrally attached to the surgical instrument handpiece for interfacing with a particular surgical instrument type or model having the generator 800. The first data circuit may be implemented in any suitable manner and may communicate with the generator according to any suitable protocol, including, for example, those described herein with respect to the first data circuit. In certain forms, the first data circuit may include a non-volatile storage device, such as an EEPROM device. In certain forms, the first data circuit interface 846 may be implemented separately from the logic circuit 842 and may include suitable circuitry (e.g., a separate logic device, processor) to enable communication between the logic circuit 842 and the first data circuit. In other embodiments, the first data circuit interface 846 may be integral with the logic circuit 842.

In certain configurations, the first data circuit may store information regarding the particular surgical instrument with which the first data circuit is associated. Such information may include, for example, a model number, a serial number, the number of operations in which the surgical instrument was used, and/or any other type of information. This information may be read by the instrument interface circuit 840 (e.g., by logic circuit 842) and communicated to components of the non-isolated stage 804 (e.g., logic device 816, DSP processor 822, and/or UI processor 836) for presentation to a user via an output device and/or for control of the functions or operations of the generator 800. Additionally, any type of information may be communicated (e.g., using logic circuit 842) to the first data circuit for internal storage via the first data circuit interface 846. Such information may include, for example, the most recent number of operations in which the surgical instrument was used and/or the date and/or time of its use.

As noted above, surgical instruments may be removable from the handpiece to facilitate interchangeability and/or disposability of the instruments (e.g., multi-function surgical instruments may be removable from the handpiece). In such cases, conventional generators may be limited in their ability to recognize the particular instrument configuration being used and correspondingly optimize their control and diagnostic processes. However, adding readable data circuitry to the surgical instrument to address this issue is problematic from a compatibility standpoint. For example, designing a surgical instrument to be backward compatible with a generator lacking the necessary data read functionality may not be practical due to, for example, different signaling schemes, design complexity, and expense. The instrument configurations discussed herein address these concerns by economically using data circuitry that may be implemented in existing surgical instruments and minimizing design changes to maintain compatibility of the surgical instrument with modern generator platforms.

Additionally, configurations of the generator 800 may allow for communication with an instrument-based data circuit. For example, the generator 800 may be configured to communicate with a second data circuit housed within an instrument (e.g., a multifunction surgical instrument). In some configurations, the second data circuit may be implemented in many similar ways to that of the first data circuit described herein. The instrument interface circuit 840 may include a second data circuit interface 848 that allows for this communication. In one configuration, the second data circuit interface 848 may include a tri-state digital interface, although other interfaces may also be used. In certain configurations, the second data circuit may generally be any circuit for transmitting and/or receiving data. In one configuration, for example, the second data circuit may store information regarding the particular surgical instrument with which the second data circuit is associated. Such information may include, for example, a model number, a serial number, the number of operations the surgical instrument has been used in, and/or any other type of information.

In some forms, the second data circuit may store information regarding electrical and/or ultrasonic characteristics of the associated ultrasonic transducer, end effector, or ultrasonic drive system. For example, the first data circuit may indicate a burn-in frequency slope, as described herein. Additionally or alternatively, any type of information may be communicated (e.g., using logic circuit 842) to the second data circuit for internal storage via second data circuit interface 848. Such information may include, for example, the most recent number of operations the instrument was used for, and/or the date and/or time of its use. In certain forms, the second data circuit may transmit data acquired by one or more sensors (e.g., instrument-based temperature sensors). In certain forms, the second data circuit may receive data from the generator 800 and provide an indication (e.g., a light emitting diode indication or other visual indication) to the user based on the received data.

In certain forms, the second data circuit and the second data circuit interface 848 can be configured to provide communication between the logic circuit 842 and the second data circuit without the need to provide additional conductors for this purpose (e.g., dedicated conductors in the cable connecting the handpiece to the generator 800). In one form, information can be communicated to and from the second data circuit using a one-wire bus communication scheme implemented on existing cable wiring, for example, where one of the conductors used transmits an interrogation signal from the signal conditioning circuit 844 to the control circuitry in the handpiece. In this way, design changes or modifications to the surgical instrument that may otherwise be required are minimized or reduced. Furthermore, because different types of communications carried out on a common physical channel can be frequency band separated, the presence of the second data circuit is "invisible" to generators that do not have the necessary data reading capabilities, thus enabling backward compatibility of the surgical instrument.

In certain configurations, the isolation stage 802 may include at least one blocking capacitor 850-1 connected to the drive signal output 810b to prevent direct current from passing through the patient. A single blocking capacitor may be required, for example, to comply with medical regulations or standards. Although failure in a single capacitor design is relatively rare, such failure may nevertheless have negative consequences. In one configuration, a second blocking capacitor 850-2 may be provided in series with the blocking capacitor 850-1, and current leakage from a point between the blocking capacitors 850-1 and 850-2 is monitored, for example, by an ADC circuit 852 to sample the voltage induced by the leakage current. The samples may be received, for example, by the logic circuit 842. Based on the change in leakage current (as indicated by the voltage sample), the generator 800 may determine when at least one of the blocking capacitors 850-1, 850-2 has failed, thus providing an advantage over a single capacitor design having a single point of failure.

In certain forms, the non-isolated stage 804 can include a power supply 854 for delivering DC power at a suitable voltage and current. The power supply can include, for example, a 400 W power supply for delivering a 48 VDC system voltage. The power supply 854 can further include one or more DC/DC voltage converters 856 for receiving the output of the power supply and generating a DC output at the voltage and current required by the various components of the generator 800. As described above in connection with the controller 838, one or more of the DC/DC voltage converters 856 can receive input from the controller 838 to enable or activate the operation of the DC/DC voltage converters 856 when activation of an "on/off" input device by a user is detected by the controller 838.

59 shows an example of a generator 900, which is a form of generator 800 (FIG. 58). The generator 900 is configured to deliver multiple energy modalities to a surgical instrument. The generator 900 provides RF and ultrasonic signals, either alone or simultaneously, for delivering energy to the surgical instrument. The RF and ultrasonic signals may be provided alone or in combination, and may be provided simultaneously. As described above, at least one generator output can deliver multiple energy modalities (e.g., ultrasonic, bipolar or monopolar RF, irreversible and/or reversible electroporation, and/or microwave energy, among others) through a single port, which signals can be delivered individually or simultaneously to an end effector to treat tissue.

The generator 900 comprises a processor 902 coupled to a waveform generator 904. The processor 902 and waveform generator 904 are configured to generate various signal waveforms based on information stored in a memory (not shown for clarity of disclosure) coupled to the processor 902. Digital information related to the waveforms is provided to the waveform generator 904, which includes one or more DAC circuits to convert the digital input to an analog output. The analog output is provided to an amplifier 1106 for signal conditioning and amplification. The conditioned and amplified output of the amplifier 906 is coupled to a power transformer 908. The signal is coupled across the power transformer 908 to a secondary on the patient-isolated side. A first signal of a first energy modality is provided to the surgical instrument between terminals labeled ENERGY1 and RETURN. A second signal of the second energy modality is coupled across capacitor 910 and provided to the surgical instrument between terminals labeled ENERGY2 and RETURN. It will be appreciated that more than two energy modalities may be output, and thus the subscript "n" may be used to indicate that up to n ENERGYn terminals may be provided, where n is a positive integer greater than or equal to 2. It will also be appreciated that up to "n" return paths (RETURNn) may be provided without departing from the scope of this disclosure.

A first voltage sense circuit 912 is coupled across the terminals labeled ENERGY1 and RETURN paths and measures the output voltage therebetween. A second voltage sense circuit 924 is coupled across the terminals labeled ENERGY2 and RETURN paths and measures the output voltage therebetween. A current sense circuit 914 is disposed in series with the RETURN section of the secondary side of the illustrated power transformer 908 to measure the output current of either energy modality. If a different return path is provided for each energy modality, a separate current sense circuit must be provided in each return section. The outputs of the first voltage sense circuit 912 and the second voltage sense circuit 924 are provided to corresponding isolation transformers 916, 922, and the output of the current sense circuit 914 is provided to another isolation transformer 918. The outputs of the isolation transformers 916, 928, 922 on the primary side (non-patient isolated side) of the power transformer 908 are provided to one or more ADC circuits 926. The digitized output of the ADC circuit 926 is provided to the processor 902 for further processing and calculations. Feedback information of the output voltage and output current can be used to adjust the output voltage and current provided to the surgical instrument and to calculate the output impedance, among other parameters. Input/output communication between the processor 902 and the patient isolation circuitry is provided via an interface circuit 920. Sensors may also be in electrical communication with the processor 902 via the interface circuit 920.

In one aspect, the impedance may be determined by the processor 902 by dividing the output of either the first voltage sense circuit 912 coupled across the terminals labeled ENERGY1/RETURN or the second voltage sense circuit 924 coupled across the terminals labeled ENERGY2/RETURN by the output of a current sense circuit 914 placed in series with the RETURN section of the secondary side of the power transformer 908. The outputs of the first voltage sense circuit 912 and the second voltage sense circuit 924 are provided to separate isolation transformers 916, 922, and the output of the current sense circuit 914 is provided to another isolation transformer 916. Digitized voltage and current sense measurements from the ADC circuit 926 are provided to the processor 902 to calculate the impedance. As an example, the first energy modality ENERGY1 may be ultrasonic energy and the second energy modality ENERGY2 may be RF energy. Yet, in addition to ultrasound energy modalities and bipolar or monopolar RF energy modalities, other energy modalities include irreversible and/or reversible electroporation and/or microwave energy, among others. Also, while the example illustrated in FIG. 59 shows that a single return path RETURN may be provided to two or more energy modalities, in other aspects, multiple return paths RETURNn may be provided to each energy modality ENERGYn. Thus, as described herein, the impedance of the ultrasound transducer may be measured by dividing the output of the first voltage sensing circuit 912 by the current sensing circuit 914, and the impedance of the tissue may be measured by dividing the output of the second voltage sensing circuit 924 by the current sensing circuit 914.

As shown in FIG. 59, a generator 900 including at least one output port may include a power transformer 908 having a single output and multiple taps to provide power to an end effector in the form of one or more energy modalities, such as, for example, ultrasonic, bipolar or monopolar RF, irreversible and/or reversible electroporation, and/or microwave energy, among others, depending on the type of tissue treatment being performed. For example, the generator 900 may deliver energy with either monopolar or bipolar RF electrosurgical electrodes, at high voltage and low current to drive an ultrasonic transducer, at low voltage and high current to drive an RF electrode for tissue sealing, or in a coagulation waveform for spot coagulation. The output waveform from the generator 900 may be directed, switched, or filtered to provide the frequency to the end effector of the surgical instrument. The connection to the output of the generator 900 of the ultrasonic transducer would preferably be located between the outputs labeled ENERGY1 and RETURN shown in FIG. 59. In one embodiment, the RF bipolar electrode connection to the generator 900 output would preferably be located between the output labeled ENERGY2 and the output labeled RETURN. In the case of a unipolar output, the preferred connection would be an active electrode (e.g., a pencil or other probe) to a suitable return pad connected to the ENERGY2 and RETURN outputs.

Further details are disclosed in U.S. Patent Application Publication No. 2017/0086914, published March 30, 2017, entitled "TECHNIQUES FOR OPERATING GENERATOR FOR DIGITALLY GENERATING ELECTRICAL SIGNAL WAVEFORMS AND SURGICAL INSTRUMENTS," which is incorporated herein by reference in its entirety.

As used throughout this description, the term "wireless" and its derivatives may be used to describe circuits, devices, systems, methods, techniques, communication channels, etc. that may communicate data through the use of modulated electromagnetic radiation over a non-solid medium. This term does not imply that the associated devices do not include any wires, although in some aspects they may not be present. The communication module may implement any of a number of wireless or wired communication standards or protocols, including, but not limited to, Wi-Fi (IEEE 802.11 family), WiMAX (IEEE 802.16 family), IEEE 802.20, Long Term Evolution (LTE), Ev-DO, HSPA+, HSDPA+, HSUPA+, EDGE, GSM, GPRS, CDMA, TDMA, DECT, Bluetooth, Ethernet derivatives thereof, as well as any other wireless and wired protocols designated 3G, 4G, 5G, and beyond. The computing module may include multiple communication modules. For example, a first communication module may be dedicated to short-range wireless communication such as Wi-Fi and Bluetooth, and a second communication module may be dedicated to long-range wireless communication such as GPS, EDGE, GPRS, CDMA, WiMAX, LTE, Ev-DO, etc.

As used herein, a processor or processing unit is an electronic circuit that performs operations on some external data source, usually a memory or some other data stream. The term is used herein to refer to a system that combines many dedicated "processors" or the central processor (central processing unit) in a computer system, especially a system-on-chip (SoC).

As used herein, a system on a chip or system on a chip (SoC or SOC) is an integrated circuit (also known as an "IC" or "chip") that integrates all the components of a computer or other electronic system. It can include digital, analog, mixed-signal, and often high-frequency functions, all on a single substrate. SoCs integrate a microcontroller (or microprocessor) with modern peripherals such as a graphics processing unit (GPU), Wi-Fi module, or co-processor. SoCs may or may not include built-in memory.

As used herein, a microcontroller or controller is a system that integrates a microprocessor with peripheral circuits and memory. A microcontroller (or MCU for Microcontroller Unit) may be implemented as a small computer on a single integrated circuit. This may be similar to a SoC, which may include a microcontroller as one of its components. A microcontroller may house one or more core processing units (CPUs) along with memory and programmable input/output peripherals. Program memory in the form of ferroelectric RAM, NOR flash, or OTP ROM, and a small amount of RAM are often also included on the chip. Microcontrollers may be employed for embedded applications, as opposed to microprocessors used in personal computers or other general purpose applications, which are made up of a variety of separate chips.

As used herein, the term controller or microcontroller may be a standalone IC or chip device that interfaces with a peripheral device. It may also be the link between two parts of a computer or controller on an external device that manages the operation of (and connections to) that device.

Any of the processors or microcontrollers described herein may be any single-core or multi-core processor, such as those known under the trade name ARM Cortex manufactured by Texas Instruments. In one aspect, the processor may be, for example, an LM4F230H5QR ARM Cortex-M4F processor core available from Texas Instruments, including on-chip memory of 256 KB of single-cycle flash memory or other non-volatile memory up to 40 MHz, a pre-fetch buffer to improve performance beyond 40 MHz, 32 KB of single-cycle serial random access memory (SRAM), internal read-only memory (ROM) loaded with StellarisWare® software, 2 KB of electrically erasable programmable read-only memory (EEPROM), one or more pulse width modulation (PWM) modules, one or more quadrature encoder input (QEI) analogs, one or more 12-bit analog-to-digital converters (ADCs) with 12 analog input channels, details of which are available in the product data sheet.

In one aspect, the processor may include a safety controller, including two controller families such as TMS570 and RM4x, also known under the trade name Hercules ARM Cortex R4, manufactured by Texas Instruments. The safety controller may be specifically configured for IEC 61508 and ISO 26262 safety limit applications, among others, to provide advanced integrated safety mechanisms while offering scalable performance, connectivity, and memory options.

Modular devices include modules that can be received in a surgical hub (e.g., as described in connection with FIGS. 41 and 48) and surgical devices or instruments that can be connected to various modules to connect or pair with corresponding surgical hubs. Modular devices include, for example, intelligent surgical instruments, medical imaging devices, suction/irrigation devices, smoke evacuators, energy generators, ventilators, aspirators, and displays. The modular devices described herein can be controlled by a control algorithm. The control algorithm can be executed on the modular device itself, on the surgical hub to which the particular modular device is paired, or on both the modular device and the surgical hub (e.g., via a distributed computing architecture). In some examples, the control algorithm of the modular device controls the device based on data sensed by the modular device itself (i.e., by sensors in, on, or connected to the modular device). This data can relate to the patient during surgery (e.g., tissue characteristics or insufflation pressure) or the modular device itself (e.g., advancing knife speed, motor current, or energy level). For example, a control algorithm for a surgical stapling and severing instrument can control the speed at which the instrument's motor drives the knife through tissue based on the resistance the knife encounters as it advances.

Situational Awareness Situational awareness is the ability of some aspects of a surgical system to determine or infer information relevant to a surgical procedure from data received from a database and/or instruments. The information may include the type of procedure being performed, the type of tissue being operated on, or the body cavity that is the subject of the procedure. Contextual information related to a surgical procedure may enable a surgical system to improve how it controls modular devices (e.g., robotic arms and/or robotic surgical tools) that are connected to it and provide contextualized information or suggestions to the surgeon during the course of the surgical procedure.

Referring now to FIG. 60, there is shown a timeline 5200 illustrating the situational awareness of a hub, such as surgical hub 106 or 206. The timeline 5200 illustrates an exemplary surgical procedure and the contextual information that the surgical hub 106, 206 can derive from data received from data sources at each step of the surgical procedure. The timeline 5200 illustrates typical steps that may be taken by nurses, surgeons, and other medical personnel during the course of a lung segmentectomy surgery, beginning with setting up the operating room and ending with transporting the patient to a post-op recovery room.

The situation-aware surgical hub 106, 206 receives data from data sources throughout the course of a surgical procedure, including data generated each time medical personnel use a modular device paired with the surgical hub 106, 206. The surgical hub 106, 206 receives this data from the paired modular devices and other data sources to continually derive inferences (i.e., context information) regarding the ongoing procedure as new data is received, such as which step of the procedure is being performed at any given time. The situation-aware system of the surgical hub 106, 206 can, for example, record data regarding the procedure to generate a report, verify steps being taken by medical personnel, provide data or prompts (e.g., via a display screen) that may be relevant to a particular procedure step, adjust the modular device based on the context (e.g., activate a monitor, adjust the field of view (FOV) of a medical imaging device, or change the energy level of an ultrasonic surgical instrument or an RF electrosurgical instrument), and any other such actions described above.

As a first step 5202 in this example procedure, hospital personnel retrieve the patient's Electronic Medical Record (EMR) from the hospital's EMR database. Based on selected patient data in the EMR, the surgical hub 106, 206 determines that the procedure to be performed is a thoracic procedure.

In a second step 5204, the personnel scans the incoming medical supplies for the procedure. The surgical hub 106, 206 cross-references the scanned supplies with a list of supplies utilized in various types of procedures to verify that the mix of supplies is compatible with the thoracic procedure. Additionally, the surgical hub 106, 206 may also determine that the procedure is not a wedge procedure (either because the incoming supplies do not include certain supplies required for a thoracic wedge procedure or are not otherwise compatible with a thoracic wedge procedure).

In a third step 5206, medical personnel scans the patient's band via a scanner communicatively connected to the surgical hub 106, 206. The surgical hub 106, 206 can then verify the patient's identity based on the scanned data.

In a fourth step 5208, the medical staff turns on the auxiliary devices. The auxiliary devices utilized may vary according to the type of surgical procedure and the technology used by the surgeon, but in this exemplary case, they include smoke evacuators, aspirators, and medical imaging devices. Once activated, the auxiliary device, which is a modular device, may automatically pair with the surgical hub 106, 206 located within a certain proximity of the modular device as part of its initialization process. The surgical hub 106, 206 may then derive contextual information regarding the surgical procedure by detecting the type of modular device that is paired with it during this pre-operative or initialization phase. In this particular example, the surgical hub 106, 206 determines that the surgical procedure is a VATS procedure based on this particular combination of paired modular devices. Based on a combination of data from the patient's EMR, a list of medical supplies used in the procedure, and the type of modular device that connects to the hub, the surgical hub 106, 206 may roughly estimate the particular procedure that the surgical team will perform. Once the surgical hub 106, 206 knows what particular procedure is being performed, it can then retrieve the steps of that procedure from memory or from the cloud and then cross-reference data subsequently received from connected data sources (e.g., modular devices and patient monitors) to extrapolate which steps of the surgical procedure the surgical team is performing.

In a fifth step 5210, personnel attach EKG electrodes and other patient monitoring devices to the patient. The EKG electrodes and other patient monitoring devices may be paired with the surgical hub 106, 206. Once the surgical hub 106, 206 begins receiving data from the patient monitoring devices, the surgical hub 106, 206 confirms that the patient is in the operating room.

In a sixth step 5212, medical personnel induce anesthesia in the patient. The surgical hub 106, 206 can estimate that the patient is under anesthesia based on data from the modular devices and/or patient monitoring devices, including, for example, EKG data, blood pressure data, ventilator data, or a combination thereof. Once the sixth step 5212 is completed, the pre-operative portion of the lung segmentectomy surgery is complete and the operative portion begins.

In a seventh step 5214, the patient's lung being operated on is collapsed (while ventilation is switched to the contralateral lung). The surgical hub 106, 206 can, for example, infer from ventilator data that the patient's lung has been collapsed. Because the surgical hub 106, 206 can compare the detection of the patient's lung being collapsed to the expected steps of the procedure (which may be accessed or read in advance), it can infer that the surgical portion of the procedure has begun, thereby determining that collapsing the lung is the first surgical step in this particular procedure.

In an eighth step 5216, a medical imaging device (e.g., a scope) is inserted and video feed from the medical imaging device is initiated. The surgical hub 106, 206 receives the medical imaging device data (i.e., video or image data) through a connection to the medical imaging device. Upon receiving the medical imaging device data, the surgical hub 106, 206 may determine that the laparoscopic portion of the surgical procedure has begun. Additionally, the surgical hub 106, 206 may determine that the particular procedure being performed is a segmentectomy as opposed to a lobectomy (note that the wedge procedure has already been discounted by the surgical hub 106, 206 based on the data received in the second step 5204 of the procedure). Data from the medical imaging device 124 (FIG. 40) may be used to determine contextual information regarding the type of procedure being performed among many different methods, including by determining the angle at which the medical imaging device is oriented with respect to visualization of the patient's anatomy, by monitoring the number or medical imaging devices being used (i.e., activated and paired with the surgical hub 106, 206), and by monitoring the type of visualization device being used. For example, one technique for performing a VATS lobectomy places the camera above the diaphragm in the anterior inferior corner of the patient's thoracic cavity, while one technique for performing a VATS segmentectomy places the camera in an anterior intercostal position relative to the segmental fissure. For example, using pattern recognition or machine learning techniques, a situational awareness system may be trained to recognize the location of the medical imaging device based on visualization of the patient's anatomy. As another example, one technique for performing a VATS lobectomy utilizes a single medical imaging device, while another technique for performing a VATS segmentectomy utilizes multiple cameras. As yet another example, one technique for performing a VATS segmentectomy uses an infrared light source (which may be communicatively coupled to the surgical hub as part of a visualization system) to visualize the segmental fissure, which is not used in a VATS lobectomy. By tracking any or all of this data from the medical imaging device, the surgical hub 106, 206 can determine the particular type of surgical procedure being performed and/or the technique being used for the particular type of surgical procedure.

At a ninth step 5218, the surgical team begins the dissection step of the procedure. Because the surgical hub 106, 206 receives data from the RF or ultrasonic generator indicating that an energy instrument is being fired, it can infer that the surgeon is in the process of dissecting and separating the patient's lungs. The surgical hub 106, 206 can cross-reference the received data with the retrieved steps of the surgical procedure to determine that the energy instrument being fired at this point in the process (i.e., after the steps of the procedure described above have been completed) corresponds to the dissection step. In a particular example, the energy instrument can be an energy tool attached to a robotic arm of a robotic surgical system.

At a tenth step 5220, the surgical team proceeds to the ligation step of the procedure. Because the surgical hub 106, 206 receives data from the surgical stapling and severing instrument indicating that the instrument is being fired, the surgical hub 106, 206 can infer that the surgeon is ligating the artery and vein. As with the previous step, the surgical hub 106, 206 can derive this inference by cross-referencing the receipt of data from the surgical stapling and severing instrument with the steps in the retrieved process. In a particular example, the surgical instrument may be a surgical tool attached to a robotic arm of a robotic surgical system.

In an eleventh step 5222, the segmental resection portion of the procedure is performed. The surgical hub 106, 206 can infer that the surgeon is transecting parenchymal tissue based on data from the surgical stapling and cutting instrument, including data from its cartridge. The cartridge data can correspond to, for example, the size or type of staples fired by the instrument. Because different types of staples are utilized on different types of tissue, the cartridge data can indicate the type of tissue being stapled and/or transected. In this case, the type of staples fired is utilized on parenchymal tissue (or other similar tissue type), which allows the surgical hub 106, 206 to infer that the segmental resection portion of the procedure is being performed.

Then, in a twelfth step 5224, a node dissection step is performed. The surgical hub 106, 206 can infer that the surgical team is dissecting the node and performing a leak test based on the data received from the generator indicating that an RF or ultrasonic instrument is being fired. For this particular procedure, the RF or ultrasonic instrument used after the parenchymal tissue is transected corresponds to the node dissection step, which allows the surgical hub 106, 206 to make this inference. It should be noted that the surgeon will periodically alternate between the surgical stapling/cutting instrument and the surgical energy (i.e., RF or ultrasonic) instrument depending on the particular step during the procedure, as different instruments are better suited for certain tasks. Thus, the particular sequence in which the stapling/cutting instrument and the surgical energy instrument are used can indicate which step of the procedure the surgeon is performing. Additionally, in certain instances, a robotic tool can be used for one or more steps during the surgical procedure, and/or a handheld surgical instrument can be used for one or more steps during the surgical procedure. The surgeon(s) can, for example, alternate between the robotic tool and the handheld surgical instrument and/or can use the devices simultaneously, for example. Once the twelfth step 5224 is completed, the incision is closed and the post-operative portion of the procedure begins.

In a thirteenth step 5226, the patient's anesthesia is reversed. The surgical hub 106, 206 can estimate that the patient is emerging from anesthesia, for example, based on ventilator data (i.e., the patient's breathing rate begins to increase).

Finally, the fourteenth step 5228 is for the medical personnel to remove the various patient monitoring devices from the patient. Thus, the surgical hub 106, 206 can presume that the patient is being transferred to a recovery room when the hub loses EKG, BP, and other data from the patient monitoring devices. As can be seen from this exemplary procedure description, based on data received from various data sources communicatively coupled to the surgical hub 106, 206, the surgical hub 106, 206 can determine or presume when each step of a given surgical procedure is occurring.

Situational awareness is further described in U.S. Provisional Patent Application No. 62/611,341, filed December 28, 2017, entitled "INTERACTIVE SURGICAL PLATFORM," the entire disclosure of which is incorporated herein by reference. In certain examples, the operation of a robotic surgical system, including, for example, the various robotic surgical systems disclosed herein, may be controlled by the hub 106, 206 based on its situational awareness and/or feedback from its components and/or based on information from the cloud 104.

Various aspects of the subject matter described herein are illustrated in the following numbered examples.

Example 1 - A surgical drainage system comprising a pump, a motor operably coupled to the pump, a flow path fluidly coupled to the pump, and a sensor system. The sensor system includes a first pressure sensor and a second pressure sensor. The first pressure sensor is disposed along the flow path. The second pressure sensor is disposed along the flow path upstream of the first pressure sensor. The surgical drainage system further comprises a control circuit configured to determine a pressure differential between the first pressure sensor and the second pressure sensor. The control circuit is further configured to adjust an operating parameter of the motor based on the pressure differential.

Example 2 - The surgical drainage system of Example 1, further comprising a receptacle and a filter disposed within the receptacle. The first pressure sensor is disposed downstream of the filter and the second pressure sensor is disposed upstream of the filter.

Example 3 - A surgical drainage system as described in Example 1 or 2, wherein the control circuit is configured to increase the speed of the motor when the pressure differential increases above a threshold amount.

Example 4 - The surgical drainage system of Examples 1, 2, or 3, further comprising a fluid trap, the first pressure sensor being disposed downstream of the fluid trap, and the second pressure sensor being disposed upstream of the fluid trap.

Example 5 - A surgical drainage system as described in Example 4, where the pressure differential indicates a flow path to the fluid trap.

Example 6 - The surgical drainage system of Examples 1, 2, 3, 4, or 5, further comprising a housing including an inlet and an outlet, the flow path extending between the inlet and the outlet, the first pressure sensor disposed adjacent the outlet, and the second pressure sensor disposed adjacent the inlet.

Example 7 - A surgical drainage system as described in Examples 1, 2, 3, 4, 5, or 6, wherein the control circuit is configured to maintain the suction load on the pump below a maximum suction load.

Example 8 - The surgical drainage system of any one of Examples 1, 2, 3, 4, 5, 6, or 7, wherein the control circuitry includes a processor communicatively coupled to the sensor system. The control circuitry further includes a memory communicatively coupled to the processor, the memory storing instructions executable by the processor.

Example 9 - A surgical drainage system comprising a pump including a motor, a flow path fluidly coupled to the pump, and a sensor system. The sensor system includes a first pressure sensor and a second pressure sensor. The first pressure sensor is disposed along the flow path to detect a first pressure. The second pressure sensor is disposed along the flow path upstream of the first pressure sensor to detect a second pressure. The surgical drainage system further comprises a control circuit configured to determine a ratio of the second pressure to the first pressure and determine an operating state of the surgical drainage system based on the ratio.

Example 10 - The surgical evacuation system of Example 9, wherein the control circuit is further configured to adjust operating parameters of the motor based on an operating state of the surgical evacuation system.

Example 11 - The surgical drainage system of Examples 9 or 10, further comprising a receptacle and a filter disposed within the receptacle. The first pressure sensor is disposed downstream of the filter. The second pressure sensor is disposed upstream of the filter.

Example 12 - The surgical drainage system of Examples 9, 10, or 11, wherein the control circuit is further configured to increase the speed of the motor in proportion to the ratio of the second pressure to the first pressure.

Example 13 - The surgical drainage system of Examples 9, 10, 11, or 12, further comprising a fluid trap, the first pressure sensor being disposed downstream of the fluid trap, and the second pressure sensor being disposed upstream of the fluid trap, and the operating state corresponding to the flow path relative to the fluid trap.

Example 14 - The surgical drainage system of Example 9, 10, 11, 12, or 13, further comprising a housing including an inlet and an outlet, the flow path extending between the inlet and the outlet, the first pressure sensor disposed adjacent the outlet, and the second pressure sensor disposed adjacent the inlet, and the control circuitry further configured to maintain a suction load on the pump below a maximum suction load.

Example 15 - The surgical drainage system of Examples 9, 10, 11, 12, 13, or 14, wherein the control circuitry includes a processor communicatively coupled to the sensor system. The control circuitry further includes a memory communicatively coupled to the processor, the memory storing instructions executable by the processor.

Example 16 - A non-transitory computer readable medium storing computer readable instructions that, when executed, cause a machine to receive a first signal from a first sensor disposed along a flow path through the surgical drainage system, receive a second signal from a second sensor disposed along the flow path through the surgical drainage system, determine an operating condition of the surgical drainage system based on the first signal and the second signal, and adjust an operating parameter of the surgical drainage system based on the operating condition.

Example 17 - The non-transitory computer-readable medium of Example 16, wherein the first sensor includes a first pressure sensor and the second sensor includes a second pressure sensor.

Example 18 - The non-transitory computer-readable medium of Examples 16 or 17, wherein the operating state corresponds to a state of a filtration system of a surgical drainage system.

Example 19 - The non-transitory computer readable medium of Example 18, the computer readable instructions, when executed, cause a machine to increase the speed of a pump motor of a surgical drainage system when the condition of the filtration system has a partially occluded condition.

Example 20 - The non-transitory computer readable medium of Examples 16, 17, 18, or 19, wherein the computer readable instructions, when executed, cause the machine to redirect a flow path through the surgical drainage system.

While several embodiments have been illustrated and described, it is not the applicant's intention to restrict or limit the appended "claims" to such details. Numerous modifications, variations, changes, substitutions, combinations, and equivalents of these embodiments can be implemented and will occur to those skilled in the art without departing from the scope of the present disclosure. Moreover, the structure of each element associated with the described embodiments can alternatively be described as a means for providing the function performed by the element. Also, although materials are disclosed with respect to specific components, other materials may be used. It is therefore to be understood that the above description and the appended claims are intended to cover all such modifications, combinations, and variations as falling within the scope of the disclosed embodiments. The appended claims are intended to cover all such modifications, variations, changes, substitutions, modifications, and equivalents.

The above detailed description has described various aspects of the apparatus and/or processes using block diagrams, flow charts, and/or examples. To the extent that such block diagrams, flow charts, and/or examples include one or more functions and/or operations, it should be understood by one of ordinary skill in the art that each function and/or operation included in such block diagrams, flow charts, and/or examples can be implemented individually and/or collectively by a variety of hardware, software, firmware, or virtually any combination thereof. It will be understood by one of ordinary skill in the art that some aspects of the embodiments disclosed herein, in whole or in part, can be equivalently implemented on an integrated circuit as one or more computer programs running on one or more computers (e.g., as one or more programs running on one or more computer systems), as one or more programs running on one or more processors (e.g., as one or more programs running on one or more microprocessors), as firmware, or as virtually any combination thereof, and that designing circuits and/or writing software and/or firmware code is within the skill of one of ordinary skill in the art in view of the present disclosure. Moreover, those skilled in the art will appreciate that the subject matter described herein may be distributed as one or more program products in a variety of formats, and that the specific form of the subject matter described herein may be used regardless of the particular type of signal-bearing medium used to actually effect the distribution.

The instructions used to program the logic to perform the various disclosed aspects may be stored in a system memory such as dynamic random access memory (DRAM), cache, flash memory, or other storage. Additionally, the instructions may be distributed over a network or by other computer-readable media. Thus, a machine-readable medium may include any mechanism for storing or transmitting information in a form readable by a machine (e.g., a computer), but is not limited to floppy diskettes, optical disks, compact disks, read-only memories (CD-ROMs), as well as magneto-optical disks, read-only memories (ROMs), random access memories (RAMs), erasable programmable read-only memories (EPROMs), electrically erasable programmable read-only memories (EEPROMs), magnetic or optical cards, flash memories, or tangible machine-readable storage used to transmit information over the Internet via electrical, optical, acoustic, or other forms of propagated signals (e.g., carrier waves, infrared signals, digital signals, etc.). Thus, non-transitory computer-readable media includes any type of tangible machine-readable medium suitable for storing or transmitting electronic instructions or information in a form readable by a machine (e.g., a computer).

As used in any aspect of this specification, the term "control circuitry" may refer to, for example, hardwired circuitry, programmable circuitry (e.g., a computer processor, processing unit, processor, microcontroller, microcontroller unit, controller, digital signal processor (DSP), programmable logic device (PLD), programmable logic array (PLA), or field programmable gate array (FPGA) that includes one or more individual instruction processing cores), state machine circuitry, firmware that stores instructions executed by the programmable circuitry, and any combination thereof. The control circuitry may be embodied, collectively or individually, as circuits that form part of a larger system, such as, for example, an integrated circuit (IC), an application specific integrated circuit (ASIC), a system on a chip (SoC), a desktop computer, a laptop computer, a tablet computer, a server, a smartphone, etc. Thus, as used herein, a "control circuit" includes, but is not limited to, an electrical circuit having at least one discrete electrical circuit, an electrical circuit having at least one integrated circuit, an electrical circuit having at least one application specific integrated circuit, an electrical circuit forming a general purpose computing device configured by a computer program (e.g., a general purpose computer configured by a computer program to at least partially execute the processes and/or devices described herein, or a microprocessor configured by a computer program to at least partially execute the processes and/or devices described herein), an electrical circuit forming a memory device (e.g., a form of random access memory), and/or an electrical circuit forming a communication device (e.g., a modem, a communication switch, or an optical-electrical facility). Those skilled in the art will recognize that the subject matter described herein may be implemented in analog or digital form, or some combination thereof.

As used in any aspect of this specification, the term "logic" may refer to an application, software, firmware, and/or circuitry configured to perform any of the operations described above. Software may be embodied as a software package, code, instructions, instruction sets, and/or data recorded on a non-transitory computer-readable storage medium. Firmware may be embodied as code, instructions, or instruction sets, and/or hard-coded (e.g., non-volatile) data in a memory device.

When used in any aspect of this specification, the terms "component," "system," "module," etc. may refer to a computer-related entity that is either hardware, a combination of hardware and software, software, or software in execution.

As used in any aspect of this specification, an "algorithm" refers to a self-consistent sequence of steps leading to a desired result, and the "steps" refer to the manipulation of physical quantities and/or logical states, which may, but need not, take the form of electrical or magnetic signals capable of being stored, transferred, combined, compared, and otherwise manipulated. It is common practice to refer to these signals as bits, values, elements, symbols, characters, terms, numbers, or the like. These and similar terms may be associated with the appropriate physical quantities or are merely convenient labels applied to these quantities and/or states.

The network may include a packet-switched network. The communication devices may communicate with each other using a selected packet-switched network communication protocol. One exemplary communication protocol may include an Ethernet communication protocol that may enable communication using Transmission Control Protocol/Internet Protocol (TCP/IP). The Ethernet protocol may conform to or be compatible with the Ethernet standard entitled "IEEE 802.3 Standard" issued in December 2008 by the Institute of Electrical and Electronics Engineers (IEEE), and/or later versions of this standard. Alternatively or additionally, the communication devices may communicate with each other using the X.25 communication protocol. The T.25 communication protocol may conform to or be compatible with standards promulgated by the International Telecommunications Union-Telecommunications Standardization Sector (ITU-T). Alternatively or additionally, the communication devices may communicate with each other using a frame relay communication protocol. The frame relay communication protocol may conform to or be compatible with standards promulgated by the Consultative Committee for International Telegraph and Telephone (CCITT) and/or the American National Standards Institute (ANSI). Alternatively or additionally, the transceivers may be capable of communicating with each other using an asynchronous transfer mode (ATM) communication protocol. The ATM communications protocol may conform to or be compatible with the ATM standard published by the ATM Forum in August 2001, entitled "ATM-MPLS Network Interworking 2.0," and/or any later version of this standard. Of course, different and/or later developed connection-oriented network communications protocols are equally contemplated herein.

Unless expressly specified otherwise, as will be apparent from the foregoing disclosure, discussions throughout the foregoing disclosure using terms such as "processing," "calculating," "computing," "determining," and "displaying" will be understood to refer to the operations and processing of a computer system or similar electronic computing device that manipulates and converts data represented as physical (electronic) quantities in the registers and memory of the computer system into other data similarly represented as physical quantities in the memory or registers of the computer system or other such information storage, transmission, or display device.

One or more components may be referred to herein as being "configured to," "configurable to," "operable/operative to," "adapted/adaptable," "able to," "conformable/conformed to," and the like. Those skilled in the art will understand that "configured to" may generally encompass active and/or inactive and/or standby components, unless the context requires otherwise.

The terms "proximal" and "distal" are used herein with reference to a clinician manipulating a handle portion of a surgical instrument. The term "proximal" refers to the portion closest to the clinician and the term "distal" refers to the portion located away from the clinician. It will be further understood 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.

Those skilled in the art will understand that the terms used herein generally, and in the appended claims in particular (e.g., the body 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.). Furthermore, those skilled in the art will understand that where a specific number is intended in an introduced claim recitation, such intent is clearly set forth in the claim, and in the absence of such a recitation, no such intent exists. For example, as an aid to understanding, the appended claims may include the introductory phrases "at least one" and "one or more" to introduce the claim recitation. However, the use of such phrases should not be construed as implying that when a claim recitation is introduced by the indefinite article "a" or "an," any particular claim containing such an introduced claim recitation is limited to claims containing only one such recitation, even if the same claim contains an introductory phrase such as "one or more" or "at least one" and the indefinite article "a" or "an" (e.g., "a" and/or "an" should generally be construed to mean "at least one" or "one or more"). The same applies when a definite article is used to introduce a claim recitation.

Furthermore, even when a specific number is specified in an introduced claim description, those skilled in the art will recognize that such a description should typically be interpreted to mean at least the number recited (e.g., a description of "two items" without other qualifiers generally means at least two items, or more than two items). Furthermore, when a notation similar to "at least one of A, B, and C, etc." is used, such syntax is generally intended in the sense that a person skilled in the art would understand the notation (e.g., "a system having at least one of A, B, and C" includes, but is not limited to, systems having only A, only B, only C, both A and B, both A and C, both B and C, and/or all of A, B, and C, etc.). When a notation similar to "at least one of A, B, or C, etc." is used, such syntax is generally intended in the sense that one of ordinary skill in the art would understand the notation (e.g., "a system having at least one of A, B, or C" includes, but is not limited to, systems having only A, only B, only C, both A and B, both A and C, both B and C, and/or all of A, B, and C, etc.). Furthermore, one of ordinary skill in the art will understand that typically, any disjunctive word and/or phrase expressing two or more alternative terms should be understood to contemplate the possibility of including one of those terms, either of those terms, or both of those terms, unless the context requires otherwise, whether in the specification, claims, or drawings. For example, the phrase "A or B" will typically be understood to include the possibilities of "A" or "B" or "A and B."

With respect to the appended claims, one of ordinary skill in the art will appreciate that the recited operations herein may generally be performed in any order. Also, while flow diagrams of various operations are shown in a sequence or sequences, it should be understood that the various operations may be performed in orders other than those illustrated, or may be performed simultaneously. Examples of such alternative orderings may include overlapping, interleaving, interrupting, reordering, incremental, preliminary, additional, simultaneous, reverse, or other different orderings, unless the context requires otherwise. Moreover, terms such as "responsive to," "related to," or other past tense adjectives are generally not intended to exclude such variations, unless the context requires otherwise.

It is worth noting that any reference to "one embodiment," "an embodiment," "an example," "an example," or the like means that a particular feature, structure, or characteristic described in connection with that embodiment is included in at least one embodiment. Thus, the appearances of the phrases "in one embodiment," "in an embodiment," "in an example," and "in one example" in various places throughout this specification do not necessarily all refer to the same embodiment. Furthermore, particular features, structures, or characteristics may be combined in any suitable manner in one or more embodiments.

Any patent application, patent, non-patent publication, or other disclosure material referenced herein and/or listed in any Application Data Sheet is incorporated herein by reference to the extent that the incorporated material is not inconsistent with this specification. As such, and to the extent necessary, the disclosure material explicitly set forth in this specification shall take precedence over any conflicting statements incorporated herein by reference. Any content, or portions thereof, that conflicts with current definitions, opinions, or other disclosure material set forth herein shall be incorporated herein by reference, but only to the extent that no conflict arises between the reference material and the current disclosure material.

In summary, many benefits have been described that result from using the concepts described herein. The foregoing description of one or more embodiments has been presented for purposes of illustration and description. It is not intended to be exhaustive or to be limited to the precise form disclosed. Modifications or variations are possible in light of the above teachings. The one or more embodiments have been selected and described in order to illustrate the principles and practical applications, thereby enabling those skilled in the art to utilize various embodiments, with various modifications, as suitable for the particular use contemplated. It is intended that the claims presented herewith define the overall scope.

[Embodiment]
(1) a pump;
a motor operably connected to the pump;
a flow path fluidly connected to the pump;
1. A sensor system comprising:
a first pressure sensor disposed along the flow path;
a second pressure sensor disposed along the flow path upstream of the first pressure sensor;
A sensor system including:
A control circuit comprising:
determining a pressure differential between the first pressure sensor and the second pressure sensor;
adjusting an operating parameter of the motor based on the pressure differential;
A control circuit configured as follows:
A surgical drainage system comprising:
(2) a receptacle;
a filter disposed within the receptacle;
wherein the first pressure sensor is disposed downstream of the filter and the second pressure sensor is disposed upstream of the filter.
2. The surgical drainage system of claim 1.
3. The surgical drainage system of claim 2, wherein the control circuit is configured to increase a speed of the motor when the pressure differential increases above a threshold amount.
4. The surgical drainage system of claim 1, further comprising a fluid trap, the first pressure sensor being positioned downstream of the fluid trap and the second pressure sensor being positioned upstream of the fluid trap.
5. The surgical drainage system of claim 4, wherein the pressure differential is indicative of the flow path relative to the fluid trap.

6. The surgical drainage system of claim 1, further comprising a housing including an inlet and an outlet, the flow path extending between the inlet and the outlet, the first pressure sensor disposed adjacent to the outlet, and the second pressure sensor disposed adjacent to the inlet.
7. The surgical drainage system of claim 6, wherein the control circuit is configured to maintain a suction load on the pump below a maximum suction load.
(8) The control circuit
a processor communicatively coupled to the sensor system;
a memory communicatively coupled to the processor;
wherein the memory stores instructions executable by the processor.
2. The surgical drainage system of claim 1.
(9) A surgical drainage system comprising:
a pump including a motor;
a flow path fluidly connected to the pump;
1. A sensor system comprising:
a first pressure sensor disposed along the flow path for detecting a first pressure;
a second pressure sensor disposed along the flow path upstream of the first pressure sensor for detecting a second pressure;
A sensor system including:
A control circuit comprising:
determining a ratio of the second pressure to the first pressure;
determining an operational status of the surgical drainage system based on the ratio;
A control circuit configured as above.
A surgical drainage system comprising:
10. The surgical drainage system of claim 9, wherein the control circuitry is further configured to adjust operating parameters of the motor based on the operating condition of the surgical drainage system.

(11) a receptacle;
a filter disposed within the receptacle;
wherein the first pressure sensor is disposed downstream of the filter and the second pressure sensor is disposed upstream of the filter.
11. The surgical drainage system of claim 10.
12. The surgical drainage system of claim 11, wherein the control circuit is further configured to increase a speed of the motor in proportion to the ratio.
13. The surgical drainage system of claim 9, further comprising a fluid trap, the first pressure sensor being disposed downstream of the fluid trap and the second pressure sensor being disposed upstream of the fluid trap, and the operating state corresponding to the flow path relative to the fluid trap.
14. The surgical drainage system of claim 9, further comprising a housing including an inlet and an outlet, the flow path extending between the inlet and the outlet, the first pressure sensor disposed adjacent the outlet, and the second pressure sensor disposed adjacent the inlet, and the control circuitry further configured to maintain a suction load on the pump below a maximum suction load.
(15) The control circuit
a processor communicatively coupled to the sensor system;
a memory communicatively coupled to the processor;
wherein the memory stores instructions executable by the processor.
10. The surgical evacuation system of claim 9.

(16) A non-transitory computer-readable medium storing computer-readable instructions, the computer-readable instructions, when executed, causing a machine to:
receiving a first signal from a first sensor disposed along a flow path through the surgical drainage system;
receiving a second signal from a second sensor disposed along the flow path through the surgical drainage system;
determining an operational status of the surgical drainage system based on the first signal and the second signal;
adjusting an operating parameter of the surgical drainage system based on the operating condition.
Non-transitory computer-readable medium.
17. The non-transitory computer-readable medium of claim 16, wherein the first sensor includes a first pressure sensor and the second sensor includes a second pressure sensor.
18. The non-transitory computer-readable medium of claim 16, wherein the operational state corresponds to a state of a filtration system of the surgical drainage system.
19. The non-transitory computer readable medium of claim 18, wherein the computer readable instructions, when executed, cause the machine to increase a speed of a pump motor of the surgical drainage system when the condition of the filtration system has a partially occluded condition.
20. The non-transitory computer readable medium of claim 16, wherein the computer readable instructions, when executed, cause the machine to redirect the flow path through the surgical drainage system.

Claims (5)

A pump,
a motor operably connected to the pump;
a flow path fluidly connected to the pump;
1. A sensor system comprising:
A third pressure sensor; and
a first pressure sensor disposed along the flow path upstream of the third pressure sensor;
a second pressure sensor disposed in the flow path between the third pressure sensor and the first pressure sensor;
A sensor system including:
A control circuit comprising:
determining a first pressure differential between the third pressure sensor and the second pressure sensor;
determining a second pressure differential between the first pressure sensor and the second pressure sensor;
adjusting an operating parameter of the motor based on the first pressure differential and the second pressure differential.
A control circuit configured as follows:
1. A surgical drainage system comprising:
The surgical drainage system comprises:
A receptacle;
a filter disposed within the receptacle;
the third pressure sensor and the second pressure sensor are disposed downstream of the filter, and the first pressure sensor is disposed upstream of the filter;
The surgical drainage system further comprises a housing including an inlet and an outlet, the flow path extending between the inlet and the outlet, the third pressure sensor being disposed adjacent the outlet and downstream of the pump, the first pressure sensor being disposed adjacent the inlet and the second pressure sensor being disposed upstream of the pump;
The pump is disposed downstream of the filter and upstream of the outlet. The surgical drainage system of claim 1 , wherein the control circuit is configured to increase a speed of the motor when the second pressure differential increases above a threshold amount. The surgical drainage system of claim 1 , further comprising a fluid trap , the first pressure sensor being disposed downstream of the fluid trap. The surgical drainage system of claim 1, wherein the control circuit is configured to maintain a suction load on the pump below a maximum suction load. The control circuit includes:
a processor communicatively coupled to the sensor system;
a memory communicatively coupled to the processor;
wherein the memory stores instructions executable by the processor.
10. The surgical drainage system of claim 1.

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