JP7697182B2 - Communication of smoke evacuation system parameters to a hub or cloud within a smoke evacuation module of an interactive surgical platform - 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. 62/691,257, filed June 28, 2018, entitled “COMMUNICATION OF SMOKE EVACUATION SYSTEM PARAMETERS TO HUB OR CLOUD IN SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM,” 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 also 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 also 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 disclosure 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.

The present disclosure provides a novel and innovative method and system for communication of smoke evacuation system parameters to a hub or cloud in a smoke evacuation module for an interactive surgical platform. An exemplary method includes a surgical evacuation system obtaining a value of the parameter and transmitting the value of the parameter to a cloud computing network or surgical hub. The cloud computing network or surgical hub may process the value of the parameter, determine an effect of the value of the parameter on the surgical evacuation system or modular device, and send instructions to the surgical evacuation system or modular device to adjust operation. The surgical evacuation system or modular device adjusts operation based on the instructions.

An exemplary system includes a surgical hub including a processor and memory, the surgical hub in communication with a smoke evacuation module. The smoke evacuation module is configured to obtain a value of a parameter and transmit the value of the parameter to a cloud computing network or the surgical hub. The cloud computing network or the surgical hub is configured to process the value of the parameter, determine an effect of the value of the parameter on the smoke evacuation module or modular device, and send instructions to the smoke evacuation module or modular device to adjust operation. The smoke evacuation module or modular device adjusts operation based on the instructions.

Further features and advantages of the disclosed methods and systems are described in, and will be apparent from, the following detailed description and drawings.

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 illustrates a perspective view of an ejector housing for 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 for a surgical ejection system, in accordance with at least one aspect of the present disclosure. FIG. 1 is a schematic diagram of an electrosurgical system including a smoke evacuator, in accordance with 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 for an evacuation 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. 15 is an elevational cross-sectional view of the fluid trap of FIG. 14 with parts removed for clarity, showing liquid trapped within the fluid trap and smoke flowing through the fluid trap, in accordance with at least one aspect 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. 1 illustrates a smoke evacuation system in communication with various other modules and devices in accordance with at least one aspect of the present disclosure. 1 illustrates an example flow diagram of interconnectivity between a surgical hub, cloud, smoke evacuation module, and/or various other modules A, B, and C, in accordance with at least one aspect of the present disclosure. 1 illustrates a smoke evacuation system in communication with various other modules and devices in accordance with at least one aspect of the present disclosure. 1 illustrates one aspect of a segmented control circuit in accordance with at least one aspect of the present disclosure. In accordance with at least one aspect of the present disclosure, a method of operating a control circuit portion of a smoke evacuation module to progressively energize a segmented control circuit is disclosed. 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. 1 is a surgical hub paired with a visualization system, a robotic system, and an intelligent instrument according to at least one aspect of the present disclosure. FIG. 1 illustrates a partial perspective view of a surgical hub enclosure and a combination generator module slidably receivable within a drawer of the surgical hub enclosure, 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 healthcare 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 operate the surgical tools 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, inductive regulation in accordance with at least one aspect of the present disclosure. 45 illustrates an example of a generator, which may be a form of the generator of FIG. 44, 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. ______ entitled "CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS," Attorney Docket No. END8542USNP/170755;
U.S. Patent Application Serial No. ______, entitled "CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS," Attorney Docket No. END8543USNP/170760;
U.S. Patent Application Serial No. ______, entitled "SYSTEMS FOR ADJUSTING END EFFECTOR PARAMETERS BASED ON PERIOPERATIVE INFORMATION," Attorney Docket No. END8543USNP1/170760-1;
U.S. Patent Application Serial No. ______, entitled "SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING," Attorney Docket No. END8543USNP2/170760-2;
U.S. Patent Application Serial No. ______, entitled "SAFETY SYSTEMS FOR SMART POWERED SURGICAL STAPLING," Attorney Docket No. END8543USNP3/170760-3;
U.S. Patent Application Serial No. ______, entitled "SURGICAL SYSTEMS FOR DETECTING END EFFECTOR TISSUE DISTRIBUTION IRREGULARITIES," Attorney Docket No. END8543USNP4/170760-4;
U.S. Patent Application Serial No. ______, entitled "SYSTEMS FOR DETECTING PROXIMITY OF SURGICAL END EFFECTOR TO CANCEROUS TISSUE," Attorney Docket No. END8543USNP5/170760-5;
U.S. Patent Application Serial No. ______, entitled "SURGICAL INSTRUMENT CARTRIDGE SENSOR ASSEMBLIES," Attorney Docket No. END8543USNP6/170760-6;
U.S. Patent Application Serial No. ______, entitled "VARIABLE OUTPUT CARTRIDGE SENSOR ASSEMBLY," Attorney Docket No. END8543USNP7/170760-7;
U.S. Patent Application Serial No. ______, entitled "SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE," Attorney Docket No. END8544USNP/170761;
U.S. Patent Application Serial No. ______, entitled "SURGICAL INSTRUMENT HAVING A FLEXIBLE CIRCUIT," Attorney Docket No. END8544USNP1/170761-1;
U.S. Patent Application Serial No. ______, entitled "SURGICAL INSTRUMENT WITH A TISSUE MARKING ASSEMBLY," Attorney Docket No. END8544USNP2/170761-2;
U.S. Patent Application Serial No. ______, entitled "SURGICAL SYSTEMS WITH PRIORITIZED DATA TRANSMISSION CAPABILITIES," Attorney Docket No. END8544USNP3/170761-3;
U.S. patent application Ser. No. ______, entitled "SURGICAL EVACUATION SENSING AND MOTOR CONTROL," Attorney Docket No. END8545USNP/170762;
U.S. Patent Application Serial No. ______, entitled "SURGICAL EVACUATION SENSOR ARRANGEMENTS," Attorney Docket No. END8545USNP1/170762-1;
U.S. Patent Application Serial No. ______ entitled "SURGICAL EVACUATION FLOW PATHS," Attorney Docket No. END8545USNP2/170762-2;
U.S. Patent Application Serial No. ______ entitled "SURGICAL EVACUATION SENSING AND GENERATOR CONTROL," Attorney Docket No. END8545USNP3/170762-3;
U.S. Patent Application Serial No. ______ entitled "SURGICAL EVACUATION SENSING AND DISPLAY," Attorney Docket No. END8545USNP4/170762-4;
U.S. patent application Ser. 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. ____, entitled "SURGICAL EVACUATION SYSTEM WITH A COMMUNICATION CIRCUIT FOR COMMUNICATION BETWEEN A FILTER AND A SMOKE EVACUATION DEVICE", Attorney Docket No. END8547USNP/170764, and U.S. patent application Ser. No. ____, entitled "DUAL IN-SERIES LARGE AND SMALL DROPLET FILTERS", Attorney Docket No. END8548USNP/170765.

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. 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."

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 Ser. 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".

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, the 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. In electrosurgical devices, the generator is configured to generate an oscillating current to energize the electrode. In the case of ultrasonic devices, the generator is configured to generate ultrasonic vibrations that 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 generates mechanical vibrations and is powered by a generator. Vibrating at high frequencies (e.g., 55,500 times per second), the ultrasonic blade generates friction and heat between the blade and the tissue, i.e., at the blade-tissue interface, which denatures proteins in the tissue to form a sticky coagulant. The pressure exerted by the blade surface on the tissue collapses blood vessels, allowing the coagulant to form a hemostatic seal. The precision of cutting and coagulation can be controlled, for example, by the clinician's technique and adjustments of 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. Such ultrasonic surgical instruments can be configured, for example, for open surgery, including robotic-assisted surgery, laparoscopic use, or endoscopic surgery.

Electrical energy may also be utilized for coagulation and/or cutting. Electrosurgical devices may 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 may 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 high frequency current with high current density to produce the surgical effect of coagulating and/or cutting tissue by cauterization. The return electrode carries the same RF 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 through 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 tissue and the 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 contracts when exposed to heat. Other electrosurgical instruments include, but are not limited to, irreversible and/or reversible electroporation and/or microwave techniques, among others. Thus, 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 may 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 discharge and treat the tissue (a form of coagulation where current arcs over the tissue producing tissue charring), desiccation (direct energy application that pushes cellular water out), and/or ablation (indirect energy application that vaporizes cellular fluids causing 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 the current application. In certain instances, as described further 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 that can result 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 may be configured to digitally generate and provide output waveforms to a surgical device such that the surgical device can 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 may provide energy to a monopolar device, a bipolar device, an ultrasonic device, or a combination electrosurgical/ultrasonic device. The generator may facilitate tissue-specific effects through waveform shaping and/or may push 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 a variety of surgical instruments that can be used together, including ultrasonic surgical instruments, RF electrosurgical instruments, and combination ultrasonic/RF electrosurgical instruments. The generator can be configurable for use with a variety of surgical instruments, as further described in U.S. Patent Application No. 15/265,279, filed September 14, 2016, entitled "TECHNIQUES FOR OPERATING GENERATOR FOR DIGITALLY GENERATING ELECTRICAL SIGNAL WAVEFORMS AND SURGICAL INSTRUMENTS" (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 the patient's tissue through an electrode operated by a clinician. The electrode delivers an electrical discharge to the cellular material of the patient's body adjacent to the electrode. This electrical discharge heats the cellular material, 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 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 the intended incision site. A generally uniform distribution of the RF energy discharge increases the likelihood of extraneous charge loss into the surrounding tissue, which can increase the likelihood of undesired tissue damage in the surrounding tissue.

A typical electrosurgical generator generates various operating frequencies of RF electrical energy 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, wave generators used in electrosurgery are adapted to generate RF waves having output powers ranging from 1 to 300 W in cutting mode and 1 to 120 W in coagulation mode, and frequencies ranging from 300 to 600 kHz. A typical wave 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, may allow the clinician to cut the patient's tissue, and 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 discharges 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 provided merely to illustrate one example of a technology area in which some aspects described herein may be practiced.

As provided herein, energy devices deliver 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 in and/or near the target tissue). Cutting, cauterizing, and/or coagulating tissue may release fluids and/or particulates into the air. Such fluids and/or particulates released during a surgical procedure may include, for example, smoke, which may include 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 surgical procedures generate some degree of smoke. Smoke may be unpleasant to the olfactory senses of the clinician(s), assistant(s), and/or patient(s), may obstruct the clinician(s)'s view of the surgical site, and may be unhealthy to inhale in certain instances. For example, smoke generated during electrosurgical procedures contains 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 materials identified in surgical smoke have been identified as known carcinogens. It has been estimated that one gram of tissue cauterized during electrosurgical procedures may be equivalent to the toxins and carcinogens contained in six unfiltered cigarettes. Additionally, 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 materials in surgical smoke, the size of the particulate matter in surgical smoke can be harmful to the respiratory system of the clinician(s), assistant(s), and/or patient(s). In certain instances, the particulates can be very small. Repeated inhalation of very small particulate matter can, in certain instances, lead to acute and chronic respiratory illness.

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

Exhaust systems often include 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 through the exhaust conduit to the conduit opening 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 positioned within the exhaust housing 50018. The smoke drawn into the exhaust housing 50018 travels to the filter via the suction conduit 50036, and harmful toxins and unpleasant odors are filtered from the smoke as it travels through the filter. The suction conduit can also be referred to as, for example, a vacuum and/or an exhaust conduit and/or tube. The filtered air may 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 includes 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. With further reference to FIG. 2, smoke S is drawn into the suction conduit 50036.

In certain examples, the exhaust 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 exhaust conduit and opening can be snapped onto the electrosurgical tool as shown in FIG. 3. For example, a portion of the suction conduit 51036 can be positioned 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 with 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, and the smoke or air can proceed through the flow path 50504 and be forced out 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 of the pump 50506. The second zone 50516 is downstream of 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 further described 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 exit 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 can comprise 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 can also comprise 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 may enter the filter 50502 at the inlet port 50522 and may be pumped through the flow path 50504 by the pump 50506 such that the smoke 50508 is drawn into the filter 50502. The filtered smoke 50510 may then be pumped through the exhaust mechanism 50520 and out the outlet port 50524 of the exhaust system 50500. The filtered smoke 50510 exiting the exhaust system 50500 at the outlet port 50524 is exhaust and may be comprised of filtered gasses 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 to be performed, the type of tissue being operated on, or the body cavity being treated. Contextual information related to a surgical procedure may enable a surgical system to improve how it controls, for example, modular devices (e.g., smoke evacuation systems) to which it is connected to provide contextual information or suggestions to the 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 based on, for example, 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 step-down 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 may be programmed to adjust various aspects, functions, and parameters of the electrosurgical system 50300. For example, the processor 50308 may 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 direct 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 to an analog signal (current, voltage, or charge) that governs the voltage step-down performed by the power converter 50306. Once the power converter 50306 steps down the 360V to a level that the processor 50308 determines provides the desired output power level, the stepped-down voltage is directed to the electrode tip 50334 to achieve electrosurgical treatment of the patient's tissue and then to the return or ground electrode 50335. 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 so that the processor 50308 can determine whether to adjust the output power level. As described herein, a typical wave generator is adapted to maintain selected settings throughout an electrosurgical procedure. In other examples, the operating parameters of the generator can be optimized during a surgical procedure based on one or more inputs to the processor 5308, such as 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 physically wired 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) and Galaxy Tab (registered trademark), etc.), an ultraportable computer, an ultramobile computer, a netbook computer, and/or a subnotebook computer, etc. In at least one aspect of the present disclosure, one of the devices may be a coordinator node.

The transceivers 50320 may be configured to receive serial transmit data from the processor 50308 via the respective UARTs, modulate the serial transmit data onto an RF carrier to generate a transmit RF signal, and transmit the transmit RF signal via the respective antennas. The transceiver(s) are further configured to receive a receive RF signal including an RF carrier modulated with the serial receive data via the respective antennas, demodulate the receive RF signal to extract the serial receive data, and provide the serial receive data to the respective UARTs to provide 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 with which the transceiver(s) 50320 may comply. In other words, each transceiver 50320 may 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 control device 50324 that is coupled to the smoke evacuator 50326. The smoke evacuator 50326 can include one or more sensors 50327 and can also include a pump motor controlled by a pump and 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 control device 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 control device 50324 is configured to evaluate the fluids, particles, and gases extracted via the exhaust conduit 50336 to, for example, improve smoke extraction efficiency and/or reduce user smoke output, 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 of the electrosurgical system 50300, and/or one or more external sensors 50332 of the electrosurgical system 50300.

In certain examples, the processor can be located within an ejector housing of the surgical evacuation system. For example, with reference to FIG. 6, the processor 50408 and memory 50410 therefor are located within an 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 in connection with FIG. 5. The communication device 50418 can 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 may 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 the surgical evacuation system 50400 of FIG. 6 may be incorporated into the electrosurgical system 50300 of FIG. 5 in certain instances. The surgical evacuation system 50400 also includes a pump 50450 including its pump motor 50451, an evacuation conduit 50436, and an exhaust outlet 50452. The various pumps, exhaust conduits, and exhaust outlets are further described herein. The surgical evacuation system 50400 may also include a sensing and intelligent control device, which may be similar in many respects to the sensing and intelligent control device 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, the processor and sensor system, e.g., processors 50308 and 50408 and their respective sensor systems in communication therewith (FIGS. 5 and 6), are configured to sense airflow through the vacuum source to adjust parameters of the smoke evacuation system and/or external devices and/or systems used in series with the smoke evacuation system, e.g., electrosurgical systems, energy devices, and/or generators. In one aspect of the disclosure, the sensor system may include multiple sensors positioned along the air path of the surgical evacuation system. The sensors may measure a pressure difference in the evacuation system to detect a state or status of the system between the sensors. For example, the system between two sensors may be a filter, and the pressure difference may be used to increase the speed of a pump motor as the flow rate through the filter decreases to maintain flow rate through the system. As another example, the system may be a fluid trap in the evacuation system, and the pressure difference may be used to determine the airflow path through the evacuation system. In yet another example, the system may be an inlet and an outlet (or exhaust) of the evacuation system, and the pressure difference may 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, the processor and sensor system, e.g., processors 50308 and 50408 and respective 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 processor and sensor system, e.g., processors 50308 and 50408 and respective sensor systems in communication therewith (FIGS. 5 and 6), are configured to perform chemical analysis on particles expelled from within the abdominal cavity of the patient. For example, the sensing and intelligent control device 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 may communicate the detected characteristic(s) to the generator to adjust its output. For example, the smoke evacuation device 50326 and/or the sensing and intelligent control device 50324 therefor may be configured to adjust the exhaust flow rate and/or pump motor speed, and at a given particulate level, may operatively affect the generator output power or waveform to lower the smoke generated by the end effector.

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

In one aspect of the disclosure, a processor, e.g., processor 50308 or processor 50408 (FIGS. 5 and 6), is configured to compare sample velocity images acquired from the endoscope with the evacuation particle count from the sensing system (e.g., sensing and intelligent control device 50324), e.g., to determine a correlation and/or adjust the revolutions per minute (RPM) speed of the pump. In one example, activation of the generator can be communicated to the smoke evacuation system so that the expected required smoke evacuation rate can be implemented. Activation of the generator can be communicated to the surgical evacuation system, e.g., through a surgical hub, a cloud communication system, and/or a direct connection.

In one aspect of the disclosure, the smoke evacuation system sensor system and algorithms (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 to the smoke evacuation system inlet and/or from 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 can be enhanced based on the lack of smoke to the evacuation system and/or filtered particles from the smoke evacuation system. The automatic mode speed can provide automatic sensing and compensation for laparoscopic mode in certain examples.

In one aspect of the 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 processors, e.g., 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, for example. The segmented control circuit can also be configured to have an energized portion and a non-energized portion until the energized portion performs 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 can also include circuit elements for operating the motor in a first state in which the motor is activated by the user, and a circuit element for operating the motor in a second state in which the motor is not activated by the user but allows the pump to operate quieter and at a slower speed. The segmented control circuit can, for example, allow the smoke evacuator to be energized in a stepped manner.

The electrical and communication architecture of the evacuation system (see, e.g., Figures 5 and 6) can also provide for interconnection of the smoke evacuation system with other components in the surgical hub for interaction, as well as 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 can be operational or 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 include, for example, an enclosure and replaceable components, a control, and a display. Circuitry is provided for communicating security identifiers (IDs) between such replaceable components. For example, communication between the filter and the smoke evacuation electronics can be provided to verify component reliability, remaining life, update parameters within the components, log errors, and/or limit the number and/or types of components that can be identified by the system. In various examples, the communication circuitry can authenticate the ability to enable and/or disable configuration parameters. The communication circuitry can employ encryption and/or error handling schemes to manage security and unique relationships between the 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 features that are arranged in series with one another to extract large and small fluid droplets, respectively. In a particular example, the air flow path can contain a recirculation or secondary fluid channel that returns to the primary reservoir from downstream of the exhaust port of the primary fluid management chamber.

In one aspect of the present disclosure, an advancement pad can be coupled to the electrosurgical system. For example, the ground electrode 50335 of the electrosurgical system 50300 (FIG. 5) can include an advancement 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 the neural control signal and/or movement of a selected anatomical location 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 communicates electrical energy from the signal generator to the electrosurgical instrument. The utility conduit also includes a vacuum hose that conveys captured and/or 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 ejector housing 50618 of the ejection 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-conducting 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 the target tissue and/or cauterize blood vessels in/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 material 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 (depending on the type of return electrode) is applied to the patient or placed in close proximity to the patient to complete the circuit and provide a return electrical path to the generator 50640 for the energy entering the patient's body.

Heating of the patient's cellular material by the electrode tip, or cauterization of blood vessels to prevent bleeding, often results in the emission of smoke at the location where the cauterization is performed, as described further herein. In such instances, the exhaust system 50600 is configured to capture smoke emitted during the 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 vacuum hose 50636 toward the exhaust housing 50618 of the smoke evacuation 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 that is open to receive a filter and a second end 50623 that communicates with the flow path 50699 through the ejector housing 50618. The filter 50670 (FIGS. 10 and 11) may be removably positioned 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 connection nipple of the filter 50670.

Surgical exhaust systems 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 understand that the filter 50670 shown in Figures 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 configured to receive smoke directly from a suction hose 50636 (FIG. 7) or other smoke source, in certain instances. 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 transferring 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 a fluid trap exhaust port, such as port 50766 of the fluid trap 50760 (FIGS. 14-17), for transferring the partially treated smoke into 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 vent 50680 defined within a rear cap 50674 of the filter 50670. When the filter 50670 is associated with an exhaust system, suction generated within the exhaust housing 50618 of the exhaust system 50600 can be communicated to the filter 50670 through the filter vent 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: direct interception (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 interception (particles under 0.5 microns are trapped by the effect of Brownian random thermal motion, as the particles "seek out" the fibers and attach to them).

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

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 be comprised 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 exhaust.

The filter 50670 includes multiple dams between components of the filter body 50676. For example, a first dam 50690 is positioned intermediate the filter inlet 50678 (FIG. 10) and a first particulate filter, such as, for example, the coarse media filter 50684. A second dam 50692 is positioned intermediate the second particulate filter, such as, for example, the fine particulate filter 50686, and the carbon reservoir 50688. Additionally, a third dam 50694 is positioned 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 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 configured to remove at least 85% of particulate matter larger than 10 μm, at least 90% of particulate matter larger than 10 μm, at least 95% of specific matter larger than 10 μm, at least 99% of specific matter larger than 10 μm, at least 99.9% of specific matter larger than 10 μm, or at least 99.99% of specific 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, at least 90% of particulate matter larger than 1 μm, at least 95% of specific matter larger than 1 μm, at least 99% of specific matter larger than 1 μm, at least 99.9% of specific matter larger than 1 μm, or at least 99.99% of specific 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 capable of filtering a higher percentage of particles of the same size as the coarse media filter 50684, and/or a filter capable of filtering particles of a smaller size than the coarse media filter 50684. In some aspects of the present 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 present 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 bounded by porous partitions 50696 and 50698 disposed between intermediate and end dams 50692 and 50694, respectively. In some aspects of the disclosure, the porous partitions 50696 and 50698 are rigid and/or inflexible and define a constant spatial volume of the carbon reservoir 50688.

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

4, the exhaust system 50500 includes a pump 50506 in the exhaust housing 50518. Similarly, the exhaust system 50600 shown in FIG. 7 can include a pump located in the exhaust 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 create a pressure differential in the exhaust housing 50618 that causes the smoke to move into the filter 50670 and exit 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 can be arranged 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 can provide a sealed positive displacement flow path. In various examples, the pump can create a sealed positive displacement flow path by trapping (sealing) a first volume of gas as the gas moves through the pump and reducing that volume to a second, smaller volume. By reducing the volume of the trapped gas, the pressure of the gas increases. The second, pressurized volume of gas can be released from the pump at the pump outlet. For example, the pump can be a compressor. More specifically, the pump can include a hybrid regenerative blower, a claw pump, a lobe compressor, and/or a scroll compressor. A positive displacement compressor can provide improved compression ratios and operating pressures while limiting vibration and noise generated by the ejection system 50600. Additionally or alternatively, the ejection system 50600 can include a fan for moving fluid therethrough.

An example of a positive displacement compressor, e.g., a scroll compressor pump 50650, is shown in FIG. 12. 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 axis 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 arranged alternately 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 helical contours of the scrolls 50652 and 50654 toward the center of the scroll compressor pump 50650. The compression chamber 50656 defines a sealed space in which the gas resides. Also, as the moving scroll 50654 moves the trapped gas toward the center of the stator scroll 50652, the volume of the compression chamber 50656 decreases. This decrease in volume increases the pressure of the gas inside the compression chamber 50656. The gas in the sealed compression chamber 50656 is trapped while the volume is decreasing, thereby 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 through the filter end cap 50603 of FIG. 13. Rather, the suction hose 50636 is connected to the evacuation housing 50618 through a fluid trap 50760. A filter similar to the filter 50670 may be positioned 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 retains 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 surgical environment), as described herein. 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 extend the life of a filter associated with the exhaust system 50700, in certain instances.

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 liquid-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 examples, other mechanisms for connecting or joining the suction hose 50636 to the inlet port 50762 can be used, such as a latch-based compression fitting, an O-ring, a threaded connection to the inlet port 50762 of the suction hose 50636, and/or other connection mechanisms.

In various examples, the liquid-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 materials in the exhausted smoke at or near the junction of these components. In some examples, for example, the suction hose 50636 can be associated with the inlet port 50762 through an intermediate coupling device, such as an O-ring and/or an adapter, to further ensure an air-tight and/or liquid-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 examples, the exhaust port 50766 is sized and shaped to be in close association with a surgical exhaust system or a component thereof. For example, the exhaust port 50766 can be sized and shaped to be in association with and in communication with at least partially treated smoke from the fluid trap 50760 and a filter (FIG. 13) housed within the exhaust housing 50618. 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 function 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 pass freely through 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 positioned and dimensioned to assist a user in handling the fluid trap 50760 and/or connecting the fluid trap 50760 to the suction hose 50636 and/or the ejector housing 50618. The gripping area 50772 is shown to be an elongated recess. However, the reader will readily appreciate that the gripping area 50772 may include, for example, at least one recess, groove, protrusion, sag, 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 positioning 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 passes through the fluid trap 50760. In a particular example, the inlet port 50762 can include a notched cylindrical shape that can direct smoke and associated fluids in one direction, toward the fluid reservoir 50774 of the fluid trap 50760 or otherwise away from the exhaust port 50766. One example of such a fluid flow is 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 the smoke source to travel in a substantially opposite but parallel path toward the upper portion of the fluid trap 50760 and out of the exhaust port 50766 (indicated by arrows D and E).

The unidirectional flow of smoke through the fluid trap 50760 can ensure that liquid in the smoke is extracted and retained in a lower portion of the fluid trap 50760 (e.g., the fluid reservoir 50774). Furthermore, the relative positioning of the exhaust port 50766 vertically above the inlet port 50762 when the fluid trap 50760 is in an upright position is configured to inhibit liquid from being inadvertently carried through the exhaust port 50766 by the smoke flow while not substantially impeding the flow of fluid into or out of the fluid trap 50760. Furthermore, 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 spill-resistant.

In various examples, the exhaust system can include a number of sensors and an intelligent control, for example as further described herein in connection with FIGs. 5 and 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 that travels through the surgical exhaust system and/or is 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 within an ejector housing. For example, the pressure sensor can be positioned upstream of a filter, between a filter and a pump, and/or downstream of a pump. In certain examples, the pressure sensor can be positioned to detect a pressure in an ambient environment outside the exhaust system. Similarly, the particle sensor can be positioned to detect particles within the exhaust system, such as within an ejector housing. The particle sensor can be positioned, for example, upstream of a filter, between a filter and a pump, and/or downstream of a pump. In various examples, the particle sensor can be positioned to detect particles in the surrounding environment, for example, to determine air quality in a surgical suite.

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 the ejector housings 50018 and/or 50618, for example, and/or may be incorporated into various ejection systems disclosed herein. The ejector housing 50818 includes a number of sensors, which are described further 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 sequentially aligned along the flow path 50804 through the ejector housing 50818 between the inlet 50822 and the outlet 50824.

The ejector housing can include modular and/or replaceable components, as further described herein. For example, the ejector housing can include a socket or receptacle 50871 sized to receive a modular fluid trap and/or a replaceable filter. In certain examples, the fluid trap and filter can be incorporated into a single interchangeable module 50859, as shown in FIG. 18. More specifically, the fluid trap 50860 and the filter 50870 form an interchangeable module 50859, which can be modular and/or replaceable, and can be removably installed in a receptacle 50871 in the ejector housing 50818. In other examples, the fluid trap 50860 and the filter 50870 can be separate and distinct modular components, which can 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 interchangeable 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 may be drawn into the inlet 50822 through the fluid trap 50860 and into the ejector housing 50818. The flow path 50804 through the ejector housing 50818 of FIG. 18 may include a sealed conduit or tube 50805 extending between the various in-line components. In various examples, the smoke may flow through the fluid detection sensor 50830 and the chemical sensor 50832 to a diversion valve 50834, further described herein. A fluid detection sensor, such as the sensor 50830, may detect fluid particles in the smoke. In one example, the fluid detection sensor 50830 may be a continuity sensor. For example, the fluid detection sensor 50830 may include two spaced apart electrodes and a sensor for detecting the degree of continuity between them. When no fluid is present, the continuity may be zero or substantially zero, for example. The chemical sensor 50832 may detect a chemical characteristic of the smoke.

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

With further reference to FIG. 18, the smoke may then be directed to flow into a filter 50870 of the interchangeable module 50859. At the inlet to the filter 50870, the smoke may flow through a particle sensor 50838 and a pressure sensor 50840. In one form, the particle sensor 50838 may include a laser particle counter, as further described herein. The smoke may 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 along a flow path 50804 in the ejector housing 50818 toward the pump 50806. Moving through the pump 50806, the filtered smoke can flow past a particle sensor 50848 and an outlet pressure sensor 50850 to the ejector housing 50818. In one form, the particle sensor 50848 can include a laser particle counter, as described further herein. The ejector 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. The air quality particle sensor, or external/ambient air particle sensor 50852, can include at least one form of 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 particle concentration 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 shape of the fluid trap 50860 can be selected to prevent trapped fluid from spilling and/or leaking. In certain examples, the fluid trap 50860 can include a baffle and/or splatter screen, such as 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 arrangements and shapes 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 following filter families: course media filters, fine media filters, and sorbent-based filters. The course media filters can be low air resistance filters that can be constructed of, for example, fiberglass, polyester, and/or pleated filters. The fine media filters can be high efficiency particulate air (HEPA) filters and/or ULPA filters. The sorbent-based filters can be, for example, activated carbon filters. The reader will readily appreciate that a variety of alternative filter arrangements and shapes 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 substituted 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 arrangements and shapes can be used to generate suction in the flow path 50804 to draw the 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, another ejector housing 50918 for 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 to the ejector housing 50918. Intermediate the inlet 50922 and the outlet 50924 are sequentially disposed 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 diversion valve 50934, the fluid may be directed into a condenser 50935 of the fluid trap 50960 and the smoke may proceed towards a filter 50970. In certain examples, the fluid trap 50960 may include a baffle 50964, such as a screen 50962, and/or a splatter screen 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 mechanism 50980 and a recirculation valve 50990. The recirculation valve 50990 can be selectively opened and closed to recirculate the fluid through the fluid trap 50960. For example, if the fluid detection sensor 50836 detects fluid, the recirculation valve 50990 can be opened such 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 such that the smoke is directed into the filter 50970. As the fluid is recirculated through the recirculation valve 50990, the fluid can be drawn through the recirculation conduit 50982. The centrifugal blower mechanism 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 first centrifugal blower, or tumbling basket 50984 to rotate, which can be transferred into a second centrifugal blower, or tumbling basket 50986, which draws the recirculating fluid 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.

Communication Of Smoke Evacuation System Parameters to Surgical Hub Or Cloud To Effect The Output Or Operation Of Other Attached Devices END8546USNP (M-1/164469)
Parameters such as particle type, particle concentration, and particle size in surgical smoke have not previously been monitored during the course of a surgical procedure in which electrosurgical instruments are being used. This lack of smoke monitoring during a surgical procedure suggests that smoke evacuation devices present at the surgical site could not adjust their operation to more carefully evacuate the smoke to compensate for changing parameters during the course of a surgical procedure (e.g., higher particle concentrations in the smoke being evacuated).

20-22 and 25-35, an exemplary smart smoke evacuation system 56100 as described herein can communicate detected or sensed parameters to the surgical hub 206 or cloud analytics computing environment 204 (hereafter cloud 204), which can affect the output and operation of other devices in communication with the surgical hub 206 or cloud 204. For example, if different particle concentrations are detected, the different parameters can be communicated to the surgical hub 206 or cloud 204, which can adjust the operation of another component in the smart smoke evacuation system 56100, such as the power level applied to the electrosurgical instrument, to compensate for the different parameters.

By automatically adjusting the operation of other devices due to parameters detected by the smart smoke evacuation system, smoke generated by the operation of the electrosurgical instrument is more effectively removed, reducing the danger to the surgeon and other personnel present during the surgical procedure.

FIG. 20 illustrates a smoke evacuation system 56100 in which various modules and devices are in communication with one another, according to at least one aspect of the present disclosure. Communication between the modules and devices identified in the smoke evacuation system 56100 may occur directly or indirectly via connections through the surgical hub 204 and/or cloud 204. The smoke evacuation system 56100 may be actively coupled to the surgical hub 206 and/or cloud 204, for example, as described in FIGS. 25-35. In this manner, parameters sensed or detected by the smoke evacuation module 226 may affect the function of other modules, devices, or components within the computer-implemented surgical system, such as those shown in FIGS. 32-24. FIG. 20 illustrates a computer-implemented smoke evacuation system 56100, for example, including the cloud 204, the surgical hub 206, the smoke evacuation module 226, module A 56108, module B 56106, and module C 56104. Modules A 56108, B 56106, and C 56104 may be any of the modules or devices that communicate with or are part of the surgical hub 206. For example, modules A 56108, B 56106, and C 56104 may be components of the visualization system 208, components of the robotic system 222, intelligent instruments 235, imaging module 238, generator module 240, suction/irrigation module 228, communications module 230, processor module 232, storage array 234, operating room mapping module 242, etc. Examples and descriptions of these various types of modules and components can be found, for example, in the descriptions of Figures 25-35.

The smoke evacuation module 226 includes at least one sensor. The sensor may be any type of sensor, including a sensor that detects an operating parameter, such as, for example, an ambient pressure sensor, an air quality particle sensor, etc. Additionally, the sensor may be an internal sensor, such as, for example, a pressure sensor, a fluid detection sensor, a chemical sensor, a laser particle counter, etc. Additionally, two or more pressure sensors may be included in the smoke evacuation module 226 to determine pressure differentials across various portions of the smoke evacuation module 226. Descriptions of sensors used in the context of the smoke evacuation system 56100 may be found, for example, in connection with FIGS. 4-6, 18, and 19.

In various aspects, the smoke evacuation module 226 and modules A 56108, B 56106, and C 56104 may communicate directly or indirectly with, for example, the surgical hub 206 and/or the cloud 204. Referring again to FIG. 20, the smoke evacuation module 206 and modules A 56108, B 56106, and C 56104 are shown engaged in bidirectional communication with the surgical hub 206. This bidirectional communication is indicated by two-way arrows, such as arrow 56112. This bidirectional communication may be accomplished, in one example, by connecting the modular housing of the smoke evacuation module 226 or modules A 56108, B 56106, and C 56104 to a modular backplane that includes an internal connector console. The modular backplane is configured to connect laterally or vertically to the modular housing of the smoke evacuation module 226 or modules A 56108, B 56106, and C 56104 with the surgical hub 206. One example of this is shown in Figures 27-31. In an alternative embodiment, bidirectional communication may be established by the housing of the smoke evacuation module 226 or modules A 56108, B 56106, and C 56104 being a stand-alone housing with a wired connection attachment on the back of the device that allows for interfacing with the surgical hub 206. Alternatively, in another embodiment, the smoke evacuation module 226 and modules A 56108, B 56106, and C 56104 may be directly connected to one another. In yet another embodiment, the smoke evacuation module 226 and modules A 56108, B 56106, and C 56104 may include wireless communication modules for communicating, directly or indirectly, with the surgical hub 206 and/or the cloud 204. In the embodiment illustrated in FIG. 20, the surgical hub 206 is shown in bidirectional communication with the cloud 204. Alternatively, in another embodiment, the smoke evacuation module 226, as indicated by dashed line 56110, and any one or all of modules A 56108, B 56106, and C 56104 may communicate directly with the cloud 204 to receive instructions or information directly from the cloud without going through the surgical hub 206.

21 illustrates a flow diagram 56200 of an exemplary method of interconnection between the surgical hub 206, cloud 204, smoke evacuation module 226, and/or various other modules A 56108, B 56106, and C 56104, in accordance with at least one aspect of the present disclosure. The exemplary method 56200 is described with reference to the flow diagram illustrated in FIG. 21, however, it will be understood that many other ways of implementing the operations associated with this method may also be used. For example, the order of some of the blocks may be changed, certain blocks may be combined with other blocks, and some of the described blocks are optional.

25-35, initially, a parameter is acquired by the smoke evacuation module 226 (56202). For example, a sensor component of the smoke evacuation module 226, such as an air quality particle sensor, will detect the parameter. The parameter may be any parameter related to the ambient environment of the operating room, such as, for example, the air quality of the operating room. In this example, there is only one sensed parameter, but the disclosure should not be so limited. In alternative examples, there may be many sensed parameters by any number of different sensors. How frequently the parameter is sensed and how frequently the smoke evacuation module 226 is activated depends on the amount of smoke being evacuated. For example, if little smoke is being evacuated, the smoke evacuation module 226 may operate more slowly and/or sense the parameter less frequently. Alternatively, if the smoke evacuation module 226 is actively acting to evacuate rapidly evolving smoke, it may be useful for the smoke evacuation module 226 to operate at a higher speed and/or sense the parameter more frequently to ensure that the equipment is functioning properly. This can provide a safe environment for all surgeons, personnel, and medical equipment present in the operating room. Other parameters that can be sensed include those sensed by internal sensors, such as particulate concentration, aerosol fraction, or chemical analysis. Alternatively, operational parameters sensed by sensors on the housing of the smoke evacuation module 226 can include, for example, airflow, pressure differential, or air quality. Descriptions of sensors used in the context of the smoke evacuation system 56100 can be found, for example, in Figures 4-6, 18, and 19.

The smoke evacuation module 226 then transmits the obtained parameter values to the surgical hub 206 or the cloud 204 (56204). For example, if a value for the air quality of the operating room is obtained, the value may be sent by the smoke evacuation module 226 to the surgical hub 206. The surgical hub 206 may process the parameters and/or communicate the received air quality parameters to the cloud 204. This may be accomplished via the network router 211, the network hub 207, the network switch 209, or any combination thereof. In alternative embodiments, the smoke evacuation module 226 may communicate the air quality parameters directly to the cloud 204 using wired or wireless communication techniques.

The parameter value is then processed (56206) to determine if the parameter value affects the way the surgical evacuation system 56100 or another modular device should operate (56208). This processing may occur in the surgical hub 206 in the cloud 204, or in a combination of the surgical hub 206 and the cloud 204. The processing performed on the sensed parameter includes using the sensed parameter value with various algorithms and learning software to determine if the operation of the smoke evacuation module 226 or any of modules A 56108, B 56106, and C 56104 should be automatically adjusted to compensate for the detected parameter value. The parameter value is a smoke evacuation variable. The algorithms and learning software may be stored in the cloud 204 (storage 105) or the surgical hub 206 (storage 248) prior to processing and may be updated remotely as needed.

For example, if the value of the sensed air quality parameter indicates a large amount of smoke particles in the air, the cloud 204 may include a software algorithm that uses the value of the air quality parameter to determine how the operation of the smoke evacuation module or modules A 56108, B 56106, and C 56104 may be modified to improve the air quality around the operating room. In this example, the cloud 204 may determine that the operation of the intelligent instrument 235 should be modified, which is optimally adjusted by adjusting the generator output to supply to the intelligent instrument 235. The generator module 240 converts electricity into a high frequency waveform consisting of an oscillating current that is delivered to the electrodes to affect the tissue. In an alternative example, the cloud 204 may determine that none of the modules A 56108, B 56106, and C 56104 should be adjusted, but the operation of the smoke evacuation module 226 should be adjusted. In this alternative example, the cloud 204 may determine that the value of the air quality parameter indicates that the smoke evacuation module 226 may provide a safer environment if the operation of the smoke evacuation module 226 is adjusted to more quickly evacuate the smoke from the operating room.

Next, instructions are sent to the surgical exhaust system 56100 or modular device to adjust operation (56210). For example, the cloud 204 may determine that the operation of the intelligent instrument 235 should be adjusted based on the value of the sensed air quality parameter, which was previously determined by the cloud 204 to be most effective in this example by modifying the output of the generator module 240. Thus, in this example, at step 56210, the cloud 204 sends instructions to the generator module 240 (e.g., module A 56108). In an example, instructions are sent to the generator module 240 instructing it to modify the output of the generator module 240 to change the operation of the intelligent instrument 235.

Finally, the operation of the surgical drainage system 56100 or modular device is adjusted (56212) based on the instructions. For example, the generator module 240 changes the shape of the waveform output to the intelligent instrument 235 in accordance with the instructions received from the cloud 204. This adjustment causes the intelligent instrument 235 to affect the tissue in a desired manner. In one embodiment, the instructions for the various modules are pre-stored in the cloud 204 or surgical hub 206, but may be updated remotely as needed. Alternatively, these instructions are dynamically generated by the cloud 204 or surgical hub 206 as needed.

Figure 22 illustrates a smoke evacuation system 56300 in communication with various other modules and devices in accordance with at least one aspect of the present disclosure. The embodiment illustrated in Figure 22 discloses an alternative embodiment of the computer-implemented surgical system shown in Figure 20. With continued reference to Figures 25-35 and Figure 22, a cloud 204 and a surgical hub 206 are shown. Although the illustrated embodiment shows one cloud 204 and one surgical hub 206 in an alternative embodiment, there may be more than one cloud 204 and/or surgical hub 206 in the computer-implemented surgical system.

In FIG. 22, the surgical hub 206 may include various modules such as aspiration/irrigation module 228, smoke evacuation module 226, and generator module 240. The smoke evacuation module 226 may include a first sensor 56302 and a second sensor 56304 that detect different parameters. For example, the first sensor 56302 may be a chemical sensor that performs a chemical analysis on the smoke being exhausted from the operating room, and the second sensor 56304 may be a laser particle counter that determines the particle concentration of the smoke being exhausted from the operating room. In alternative embodiments, there may be more than one sensor in the smoke evacuation module 226.

In an embodiment, the first sensor 56302 senses a first parameter 56306, e.g., the pH of the smoke being exhausted from the operating room. The second sensor 56304 senses a second parameter 56308, e.g., the particulate count (parts per million) of the smoke being exhausted from the operating room. The smoke evacuation module 226 may be connected to or part of the surgical hub 206, such that the first parameter 56306 and the second parameter 56308 may be automatically provided to the surgical hub 206 after being sensed. In an alternative embodiment, the surgical hub 206 may periodically request any sensed parameters from the smoke evacuation module 226 or upon user request of the sensed parameter information, and the smoke evacuation module 226 will provide the values of the sensed parameters in response to the request. Alternatively, the smoke evacuation module 226 may periodically provide the sensed values to the surgical hub 206 without being requested.

In one embodiment, the surgical hub 206 can process, modify, or manipulate the first parameter 56306 and the second parameter 56308 to become the first processed parameter 56306' and the second processed parameter 56308'. In an alternative embodiment, the surgical hub 206 may not perform any processing of the first parameter 56306 and the second parameter 56308. The surgical hub 206 may send the first processed parameter 56306' and the second processed parameter 56308' to the cloud 204 for further processing to determine whether the operation of various modules should be adjusted based on the values of the sensed parameters. The cloud 204 can execute various algorithms to determine whether the values of the first processed parameter 56306' and the second processed parameter 56308' indicate whether any of the other modules and devices, including the smoke evacuation module 226, should be adjusted in operation to create a more ideal surgical environment in the operating room. The cloud 204, in this example, can determine whether the values of the first processed parameter 56306' and the second processed parameter 56308' are above or below acceptable thresholds, and therefore, that the operation of other modules should be adjusted to compensate for the sensed/detected values of the first processed parameter 56306' and the second processed parameter 56308'.

In the example shown in FIG. 22, cloud 204 may determine that the display of visualization system 208 should be adjusted to accurately depict the surgical site. In this case, cloud 204 may send instruction A 56312 to visualization system 208 to adjust the display of the surgical site. Visualization system 208 is communicatively coupled to surgical hub 206.

Furthermore, in an embodiment, the cloud 204 may determine, after executing various algorithms, that the operation of the aspirate/irrigation module 228 should also be adjusted based on the value of either the first processing parameter 56306' or the second processing parameter 56308'. In an embodiment, the command B 56310 may be sent from the cloud 204 to the surgical hub 206. The surgical hub 206 may transmit the command B 56310 to the aspirate/irrigation module 228. In an alternative embodiment, the surgical hub 206 may have a processor 244 located within the surgical hub 206 adjust the operation of the aspirate/irrigation module 228. In another alternative embodiment, the cloud 204 may send the command B 56310 directly to the aspirate/irrigation module 228 without first sending the command B 56310 through the surgical hub 206.

The cloud 204, after executing various algorithms, may determine that the generator module 240 may not benefit from an adjustment during operation or that the sensed parameters may not be effectively affected from an adjustment during operation of the generator module 240. Thus, in the embodiment illustrated in FIG. 22, the cloud 204 may not send instructions to the generator module 240. Alternatively, the cloud 204 may send an indication to the generator module 240 that no operational modification is required.

Smoke Evacuation System Containing a Segmented Control Circuit Where the Circuit is Energized in a Staged Method to Check for Errors, Shorts, and Safety Checks of the System END8546USNP1 (M-7/162220)
If a fault in the smoke evacuation system is not detected, the smoke evacuation system may be unknowingly operated in a surgical context when the smoke evacuation system is not functioning properly. This may result in an unsafe surgical environment where dangerous or carcinogenic smoke is not properly filtered from the operating room. Alternatively, parts of the smoke evacuation system may be functioning properly, but other parts may not be functioning properly. This may make the smoke evacuation system generally unsafe to energize and operate.

For example, the smoke evacuation system 56100, 56300 including a smoke evacuation module 226 coupled to the surgical hub 206 and/or cloud 204 as described with reference to FIGS. 20-22 may further include a segmented control circuit 57100 as described with reference to FIG. 23. The segmented control circuit 57100 may be energized in stages to check for faults, errors, shorts, and perform various safety checks while powering up the smoke evacuation module 226 to help determine that the smoke evacuation module 226 is safe to operate.

By initiating the smoke evacuation module 226 in a step-by-step manner, faults and errors can be identified before attempting to operate the smoke evacuation module 226. This can improve the overall safety of the surgical procedure since the smoke evacuation system may be repaired or, if necessary, replaced with a replacement smoke evacuation module.

In one aspect, the smoke evacuation module 226 described in FIGS. 20-22 includes a segmented control circuit, where the circuit may be energized in a staged manner to check for errors, shorts, and perform system safety checks. FIG. 23 illustrates one aspect of a segmented control circuit 57100 according to at least one aspect of the present disclosure. It should be noted that although certain features, modules, processors, motors, etc. are grouped into various segments shown in FIG. 23, the disclosure should not be limited to this example. In alternative embodiments, the segments may include more, fewer, or different components than those disclosed in FIG. 23. Additionally, in another alternative embodiment, the number of segments in the example segmented circuit may be more than three or less than three segments.

23, the segmented control circuit 57100 includes a first segment 57102, a second segment 57104, and a third segment 57106. In one embodiment, the first segment 57102 includes a main processor 57108 and a safety processor 57110. The main processor 57108 may be directly wired to a power button or switch 57120. Thus, in this embodiment, the first segment 57102, specifically the main processor 57108, activates the first segment 57102 and the components 57108.

The safety processor 57110 and/or the main processor 57108 may be configured to interact with one or more additional circuit segments and their components, such as the second segment 57104, which may include a sensing circuit 57112 and a display circuit 57114, and the third segment 57106, which may include a motor control circuit 57116 and a motor 57118. Each of the circuit segments and their components may be coupled to or in communication with the safety processor 57110 and/or the main processor 57108. The main processor 57108 and/or the safety processor 57110 may also be coupled to or include an internal memory. The main processor 57108 and/or the safety processor 57110 may also be coupled to or in wired or wireless communication with a communication device that would enable communication over a network, such as the surgical hub 206 and/or the cloud 204.

The main processor 57108 may have multiple inputs, for example coupled to one or more circuit segments, a battery, and/or multiple switches. The segmented control circuit 57100 may be implemented by any suitable circuit, such as, for example, a printed circuit board assembly (PCBA) in the smoke evacuation module 226. The term processor, as used herein, should be understood to include any microprocessor, processor, one or more controllers, or other basic computing device that incorporates the functionality of a computer's central processing unit (CPU) on one integrated circuit or up to a few integrated circuits. The main processor 57108 and the safety processor 57110 are general-purpose programmable devices that accept digital data as input, process the data according to instructions stored in their memory, and provide results as output. Since it has internal memory, it is an example of sequential digital logic. The safety processor 57110 may be specifically configured for safety-critical applications, among others, to provide highly integrated safety features while providing scalable performance, connectivity, and memory options.

In the embodiment shown in FIG. 23, the second segment 57104 may include a sensing circuit 57112 and a display circuit 57114, both coupled to or in signal communication with the main processor 57108. The sensing circuit 57112 of the smoke evacuation module 226 generally described herein includes various sensors, some internal to the smoke evacuation module 226 and some external, located on the housing of the smoke evacuation module 226. These sensors include various pressure sensors, fluid sensors, chemical sensors, laser particle counters or other laser sensors, and air quality sensors. Descriptions of sensors used in the context of the smoke evacuation system 56100 can be found, for example, in FIGS. 4-6, 18, and 19.

In an alternative embodiment, the sensing circuit 57112 may include a number of sensors located on the external housing of the smoke evacuation module 226 communicating and/or connecting with the sensing circuit 57112, the main processor 57108 and/or the safety processor 57102 via a communication device. The display circuit 57114 may include a screen or other display capable of displaying text, images, graphs, charts, etc. acquired by the smoke evacuation module 226 or another device communicating with the smoke evacuation module 226 or the surgical hub 206. For example, the display circuit 57114 may include a monitor or screen (e.g., display 210, 217 or monitor 135) capable of displaying and overlaying images or data received from the imaging module 238, the device/instrument 235, and/or other visualization system 208. This display or screen may present to the user the status of each segment in the segmented control circuit 57100, or the status of each component in each segment. The status of each segment, or the status of each component of each segment, may be identified by the segmented control circuit 57100 by identifying each component or segment, receiving or determining the status of each component or segment, and displaying the status of each component or segment to a user. A component or segment may be identified using, for example, a unique data packet format, authentication information, encryption, ID numbers, passwords, signaling, flags, etc. The status of a component or segment may be determined using flags, indications, values of sensed parameters, measurements, etc.

These functions (identification, determination, and indication) may be implemented using, for example, Wi-Fi, wired connection, signal communication, Thread, Bluetooth, RFID, or NFC. For example, the components of the segmented control circuit 57100 may include a communication device for communicating over a network, or may be coupled to an external communication device that enables communication over a network. The communication device may include a transceiver configured to communicate physically wired or wirelessly. The device 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 communication transceiver (NFC). The communication device may include or be configured to communicate with the main processor 57108, the safety processor 57110, the display circuitry 57114, the surgical hub 206, or the cloud 204, which may verify or receive the identity of the components and their associated status. The transceivers may be configured to receive serial transmit data from the processor via their respective UARTs, modulate the serial transmit data onto an RF carrier to generate a transmit RF signal, and transmit the RF signal via their respective antennas. Each transceiver may support a selected wireless communication standard and/or protocol, for example, an implementation of IEEE 802.11a/b/g/n for Wi-Fi and/or IEEE 802.15.4 for wireless mesh networking using Zigbee routing as described herein. In an alternative aspect, the display circuitry may include a small speaker that signals audio or a small light/indication to indicate the status of the smoke detector, on/off operation, remaining filter life, etc. Identification of each component and their status may be optionally provided by each component, which may send or transmit such information at regular or irregular time intervals. An example of an irregular time interval may be, for example, when a user indicates the information to be sent. In alternative embodiments, identification and status information of each component or segment may be requested at regular or irregular time intervals. For example, identification and status of the motor control circuit 57116 may be requested every 1 minute, 20 minutes, 40 minutes, 1 hour, 3 hours, 24 hours, etc.

In another aspect, the segmented control circuit 57100 allows for energization of a status circuit that allows the smoke evacuation module 226 to query or poll all attached components. The status circuit may be located in any of the segments, but in this example may be located in the first segment 57102. This status circuit may be capable of querying/polling all components, including the first segment 57102, the second segment 57104, the third segment 57106, and any other additional components, such as those depicted in Figures 25-35. The polling/querying of the attached components may be done to verify compatibility, i.e., that the component or segment may be compatible with the smoke evacuation system or hub, reliability, i.e., that the component or segment may be the correct component and is reliable, the status of any segments or components that have a lifespan based on use, such as filters, and correct insertion of the segment or component, such as correctly inserting the filter before energizing the motor and pump connected to the motor. In one embodiment, an intelligent instrument such as intelligent instrument 235 may be further queried/polled to ensure that an appropriate instrument is being used and that the smoke evacuation system can or knows how to function with the polled/queried intelligent instrument. For example, the intelligent instrument 235 being polled or queried may be a Zip Pen®. Knowing that a Zip Pen® is being used may help determine how the smoke evacuation system functions. If an unidentified intelligent instrument is being used, the smoke evacuation system may determine that the motor energization is improper or unsafe and an error may be displayed by the display circuit 57114. This may be done for any component of the smart surgical environment, not just the intelligent instrument 235. Alternatively, if an unidentified intelligent instrument is being used, the smoke evacuation system may determine that the device may be used in a universally safe mode of operation.

As described above, energizing the status circuitry that allows the smoke evacuation module 226 to query/poll other components can also provide unique identification, authentication, and status text strings for the queried/polled components. This allows for controlled identification of the smoke evacuation module 226 and its subcomponents to prevent mimicking devices from spoofing security devices. For example, an exemplary attempt to spoof a security device is by building a "skimmer" to make a unique connection. To prevent the system from being spoofed, operations can be performed to authenticate each component. Each component installed in the smoke evacuation system may be authenticated based on stored data, security encryption, authentication, parameters, or some combination of these. The stored data may include an identification number or another identifier, product name and type, a unique device identifier, company trademark, serial number, and/or other manufacturing data, configuration parameters, usage information, enabled or disabled features, or algorithms/instructions on how to use the installed component.

In the example shown in FIG. 23, the third segment 57106 may include a motor control circuit 57116 and a motor 57118. The motor control circuit 57116 and/or the motor 57118 may be coupled to or in signal communication with the main processor 57108 and/or the safety processor 57110. The main processor 57108 may instruct the motor control circuit 57116 to decrease or increase the speed of the motor 57118. In an alternative embodiment, the motor control circuit 57116 and the motor 57118 may be coupled to or in signal communication with the safety processor 57110. The motor 57118 may be coupled to a pump in the smoke evacuation module 226 (see FIGS. 4 and 6-19), and operation of the motor 57118 may cause the pump to function. Specifically, in one embodiment, the motor 57118 may operate in two different states. The first state may be when the motor 57118 is activated by a user. In this first state, the motor 57118 may operate at a higher speed than in the second state. In the second state, the motor 57118, the motor control circuitry 57116, the main processor 57108, or the safety processor 57110 may sense a lack of user activity or may receive a command from the main processor 57108, the safety processor 57110, the surgical hub 204, the cloud 206, or another module located within the surgical hub 206 (e.g., the processor module 232) to slow down the operating speed of the motor 57118.

The number of different states in which the motor 57118 may operate is not limited to two. The motor 57118 may change or select its operating state based on various measurements of parameters. In another aspect, the motor 57118 may determine or set its operating state based on a user activity level that falls within, exceeds, or falls below a particular threshold. Additionally, these thresholds may be related to or correlated with thresholds of other modules or components of the smoke evacuation module 226.

In an alternative embodiment, the motor 57118 may have a mode, optionally referred to as a sleep mode. In this example, the sleep mode may be activated or the motor 57118 may be shut down into a sleep mode (a significant mode, or a low power mode) when not used for a predetermined amount of time. The threshold amount of activity before entering the sleep mode may vary depending on a number of factors, including the type of surgical procedure, the particular surgeon performing the procedure, or other factors. Thus, the predetermined amount of time may be preset, but may be easily adjusted. For example, an exemplary threshold from switching from an active state to a sleep mode may be 10 minutes. In this example, if the intelligent instrument 235 is not used by the surgeon for more than 10 minutes, the motor control circuitry 5716 or the motor 5718 may receive a command to enter the sleep mode. In an alternative embodiment, if the intelligent instrument 235 is not used by the surgeon for more than 10 minutes, the intelligent instrument 235 may automatically activate the sleep mode by slowing the motor 57118 to a sleep mode state. Additionally, when the smoke evacuation module 226 or intelligent appliance 235 is used again or user interaction is sensed, the smoke evacuation module 226 may undergo a wake-up sequence to re-energize the segmented circuit 57100. This wake-up sequence may be the same as the start-up sequence used to energize the segmented circuit 57100 while checking for errors or faults. Alternatively, the wake-up sequence may be an abbreviated version of the start-up sequence to quickly re-energize the segmented circuit 57100 when user interaction is sensed.

24 discloses a method 57200 of operating a control circuit portion of a smoke evacuation module 226 to energize a segmented control circuit 57100 in a stepwise manner, in accordance with at least one aspect of the present disclosure. In this manner, various portions of the control circuit can perform safety checks before energizing subsequent segments, providing a safe electrical start-up circuit method. Although the exemplary method 57200 is described with reference to the flow diagram shown in FIG. 24, it will be understood that many other ways of implementing the operations associated with this method may also be used. For example, the order of some of the blocks may be changed, certain blocks may be combined with other blocks, and some of the described blocks are optional.

According to method 57200, control circuit 57100 first activates first segment 57102 (57202). For example, as previously described in FIG. 23, first segment 57102 may include main processor 57108 and safety processor 57110. In alternative embodiments, other components may also be included in first segment 57102, or first segment 57102 may not include main processor 57108 and/or safety processor 57110.

Next, the first segment 57102 performs a first function 57204. This first function may relate to, for example, verifying the safety of the control circuit 57100 and/or the smoke evacuation module 226. For example, the main processor 57108 or safety processor 57110 may check each segment or component of the segment for shorts and other errors before engaging the high power portion of the segmented control circuit 57100. The main processor 57108 and/or safety processor 57110 may perform a safety check on each component or each segment to determine that they are functioning properly. Furthermore, in another embodiment, the main processor 57108 or safety processor 57110 may perform a verification function to ensure that the components in the smoke evacuation module 226 are the correct components. For example, the main processor 57108 or the safety processor 57110 may include a Trusted Platform Module (TPM), or the TPM may be a separate component in the segmented control circuit 57100 to ensure that the components of the smoke evacuation system 56100, 56300 are the correct components. This verification can be done in a variety of ways. For example, one exemplary method is to store a key for each component or segment in the TPM. The connected components are compared, and if the key for each component or segment is not found in the TPM, the smoke evacuation module 226 may not enable or power those modules. In a further example, the described keys may incorporate encryption or alternatively require authentication by components of the smoke evacuation module 226, such as the main processor 57108 or the safety processor 57110.

Further, for example, the main processor 57108 and/or the safety processor 57110 may include switching logic stored in memory to prevent the segmented control circuit 57100 from activating a portion of the circuit if certain safety conditions are not met. For example, there may be various conditions stored in the safety processor 57118 associated with a logic switch or multiple logic switches. For example, if the protective enclosure is not fully closed, the filter module is not fully or properly inserted, the fluid reservoir is not fully or properly inserted, the hose is not properly or completely inserted, and the fluid reservoir is not fully filled, a logic switch may be triggered and the segmented control circuit 57100 or the associated portion of the smoke evacuation module 226 may not be activated.

In an alternative embodiment, there may be a separate enclosure circuit to verify that the enclosure is completely and properly closed before allowing the smoke evacuation module 226 or one of the various segments to be activated or operated. For example, if the enclosure is not completely closed, the circuit may not be complete. Thus, the remaining segments or components of the segmented control circuit 57100 may not be activated. This enclosure circuit concept may be used in a tamper circuit to prevent unauthorized maintenance. For example, the tamper circuit may include a verification circuit. If an enclosure that should not be opened is opened, the verification circuit may be permanently destroyed, either electrically or mechanically. This destructible verification circuit may have an internal connection strip that can bridge two rigidly fixed electrical connection blocks, one block may be located on the shell of the enclosure and the other block may be located on the base frame of the enclosure. The internal connection has a rigid insertable electrical connector that can be latched to the respective connection block, the electrical connector having a latching mechanism on each of the shell and the base frame. When destroyed, it may become apparent that the enclosure has been opened or tampered with. Once broken, the electrical connectors can be easily released and replaced when the housing is opened for replacement. In an alternative aspect, the blocking and latching mechanisms may be located in different portions and each segment may include a separate blocking and latching mechanism. For example, the first segment 57102, the second segment 57104, and the third segment 57106 may each have a separate verification circuit. If the first segment 57102 is tampered with or opened, the verification circuit may be identified as having been tampered with by breaking the rigid interconnect strips and/or the verification circuit may be replaced. By having separate verification circuits, it may be easily detectable whether any of the various segments or components of the segmented control circuit 57100 have been tampered with.

Alternatively, the enclosure circuit may be used as a segmented security device. For example, if a portion of the system requires maintenance, the enclosure circuit may allow the portion of the system to be opened and maintained, but may prevent use of the segmented control circuit 57100 or the smoke evacuation module 226 after an unauthorized separate portion of the segmented control circuit 57100 has been opened, dismantled, or modified. For example, if the segmented control circuit 57100 of the smoke evacuation system 226 is to be maintained, but only the display circuit 57114 needs to be provided with maintenance, there may be no reason for a maintenance technician or other personnel to maintain the third segment 57106 or the first segment 57102. Thus, the third segment 57106 and the first segment 57102 may include separate enclosure circuits that include single use fuses or other mechanical/electromechanical devices, or digital versions of the like. If the third segment 57106 and the first segment 57102 are opened, modified, or dismantled, the fuse may blow to prevent power from reaching the third segment 57106 and the first segment 57102.

If an error, short circuit, fault, or other problem is detected, the segmented control circuit 57100 may operate at least one segment of the segmented control circuit 57100 while not operating the other segments. To ensure the safety of the segmented control circuit 57100, the portions of the segmented control circuit 57100 and the connections between them may be physically switches, fuses, or circuit breakers that can trip and prevent current flow when an unsafe condition exists. The switches may be implemented using any suitable mechanical, electromechanical, or solid-state switches. For example, there may be a single-use fuse, a resettable fuse, or a solid-state switching device present between the main processor 57108 and the motor control circuit 57116. In general, a fuse is an electrical safety device that operates to provide overcurrent protection for an electrical circuit. A fuse may include a metal wire or strip that melts when too much current flows through it, thereby interrupting the current. Generally, a resettable fuse is a polymeric positive temperature coefficient (PPTC) device that is a passive electronic component used to protect against overcurrent faults in electronic circuits. The device may also be known as a polyfuse or polyswitch. In general, the solid-state switch may be a solid-state switch that operates under the influence of a magnetic field, such as a Hall effect device, a magnetoresistive (MR) device, a giant magnetoresistive (GMR) device, a magnetometer, among others. In other implementations, the switch may be a solid-state switch that operates under the influence of light, such as a light sensor, an infrared sensor, and an ultraviolet sensor, among others. Additionally, the switch may be a solid-state device, such as a transistor (e.g., FET, junction FET, metal oxide semiconductor FET (MOSFET), bipolar, etc.). Other switches may include wireless switches, ultrasonic switches, accelerometers, and inertial sensors, among others.

Next, the second segment may be activated (57206). For example, the second segment 57104, including the sense circuit 57112 and the display circuit 57114, may be energized. Next, the third segment may be activated (57208). For example, the third segment 57106, including the motor control circuit 57116 and the motor 57118, may be energized. Although this exemplary embodiment discloses activating the first segment 57102 before the second segment 57102 and activating the second segment 57104 before the third segment 57106, the order of segment activation may be modified as deemed appropriate. Additionally, in alternative embodiments, various error checks, validations, etc. may be performed during energization of the second segment 57104 and the third segment 57106.

The reader will readily appreciate that the various surgical evacuation systems and components described herein may be incorporated into a computer-implemented interactive surgical system, a surgical hub, and/or a robotic system. For example, the surgical evacuation system may 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. 25, a computer-implemented interactive surgical system 100 includes one or more surgical systems 102 and a cloud-based system (e.g., a cloud 104 that may include a remote server 113 coupled to a storage device 105). Each surgical system 102 includes at least one surgical hub 106 in communication with the cloud 104 that may include a remote server 113. In one example, as shown in FIG. 25, the surgical system 102 includes 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.

27 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, filed December 28, 2017, entitled "ROBOT ASSISTED SURGICAL PLATFORM," 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 imaging device 124 includes at least one image sensor and one or more optical components. Suitable image sensors include, but are not limited to, charge-coupled device (CCD) sensors and complementary metal-oxide semiconductor (CMOS) sensors.

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 luminous 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 structures. 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 procedure 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 to be 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. 26, 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. The 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. 26, 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 use the displays 107, 109, and 119 to coordinate information flow to operators inside and outside the sterile field. 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.

26, 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.

27, 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. 27, 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 various generators and facilitate bidirectional communication therebetween. 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.

3-7, aspects of the disclosure are presented regarding the hub's 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's modular housing 136 further facilitates bidirectional communication between the modules 140, 126, 128. As shown in FIG. 29, the generator module 140 may be a generator module with integrated monopolar, bipolar, and ultrasonic components supported in a single housing unit 139 that is slidably insertable into the hub's modular housing 136. As shown in FIG. 29, 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 comprise a series of monopolar, bipolar, and/or ultrasonic generator modules that interact via the hub's 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. 28 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 within 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 with a single housing unit 139, as shown in FIG. 29.

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 line may be in the form of a flexible tube that terminates at the smoke evacuation module 126. The utility conduit and fluid line 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. 28, 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, to prevent inserting a module into a drawer with incompatible contacts, the contacts of a particular module may be keyed to engage with the contacts of a particular drawer.

28, the docking port 150 of one drawer 151 can be coupled to the docking port 150 of another drawer 151 via a communication link 157 to facilitate bidirectional communication between modules housed within the hub's modular housing 136. The docking port 150 of the hub's modular housing 136 can alternatively or additionally facilitate wireless bidirectional 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.

30 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. 30, 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.

31 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 through the docking ports of the vertical modular housing 164. In the embodiment of FIG. 31, 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 consequences. 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 to 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. 32 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 can 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 the modular communications hub 203 of the 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 appreciated 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 at the surgical site (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 devices 1a-1n/2a-2m, the surgical data network provides improved surgical outcomes, reduced costs, and improved patient satisfaction. At least some of devices 1a-1n/2a-2m can be used to observe tissue status and evaluate leakage or perfusion of sealed tissue after tissue sealing and cutting procedures. At least some of devices 1a-1n/2a-2m can be used to diagnostically inspect data including images of body tissue samples to identify pathologies such as disease effects using cloud-based computing. This includes tissue and phenotype localization and margin confirmation. At least some of devices 1a-1n/2a-2m can be used to identify anatomical structures of the body using techniques such as various sensors integrated with imaging devices and overlaying images captured by multiple imaging devices. Data collected by devices 1a-1n/2a-2m, including image data, may be transferred to cloud 204 or 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 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 on where to send the information and broadcasts all network data across each connection and to the remote server 213 (FIG. 33) 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 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. 33 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. 34, the modular control tower 236 includes a modular communication hub 203 coupled to a computer system 210. As shown in the embodiment of FIG. 33, 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. Among other things, the devices/instruments 235, visualization system 208 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 displays, and/or other visualization systems 208. The hub display may also display data received from devices connected to the modular control tower along with images and overlay images.

34 illustrates a surgical hub 206 comprising a number 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. 34, the modular communications hub 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. 34, 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 site using either an ultrasound or laser-based non-contact measurement device. As described in the section entitled "Surgical Hub Spatial Awareness Within an Operating Room" of 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, 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 structure(s), 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 Device 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) analog, 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 devices (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 into the computer system 210 through input device(s) coupled to the I/O interface 251. Input devices include, but are not limited to, pointing devices such as a mouse, trackball, stylus, touchpad, keyboard, microphone, joystick, gamepad, satellite dish, scanner, TV tuner card, digital camera, digital video camera, webcam, and the like. These and other input devices connect to the processor through the system bus via interface port(s). Interface port(s) include, for example, serial port, parallel port, game port, and USB. 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 also 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 computers, such as cloud computer(s), or local computers. The remote cloud computer(s) can be a personal computer, a server, a router, a network PC, a workstation, a microprocessor-based appliance, 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. 34, the imaging module 238 of FIGS. 9-10, and/or the visualization system 208, and/or the processor module 232 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.

35 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. 36 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 may be programmed or configured to determine the position of the longitudinally movable drive member, as well as the position of 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. The display 473 displays various operating conditions of the instrument and may include touch screen capabilities for data entry. Information displayed on the display 473 can be overlaid with images acquired via the endoscopic imaging module.

In one aspect, 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 analog, 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 various 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 suitable 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 example, 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. Accordingly, as used herein, the term displacement member is used to collectively 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 rotation 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. A power source provides power to the absolute positioning system, and an 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 combination 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 traveled by the displacement member 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 STAPLING," which is incorporated herein by reference in its entirety. Examples of sensor mechanisms include those described in U.S. Patent Application No. 15/628,175, filed June 20, 2017, entitled "A CUTTING INSTRUMENT AND A 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 forward or backward strokes taken by the motor 482 to estimate the position of the device actuator, drive bar, knife, etc.

The sensor 474, e.g., a strain gauge or microstrain gauge, is configured to measure one or more parameters of the end effector, e.g., 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, e.g., a load sensor, can measure the closure force applied to the anvil by the closure drive system. For example, the sensor 476, e.g., 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 drive 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 draw by the motor 482. The force required to advance the firing member may correspond, for example, to the current drawn by the 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 clamping 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 Figures 8-11.

37 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.

38 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. 39 illustrates a sequential logic circuit 520 configured to control aspects of a surgical instrument or tool according to one aspect of the present 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. 37) 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. 38) and sequential logic 520.

FIG. 40 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, the multiple motors of a surgical instrument or tool may be independently or separately activated to perform one or more functions while the other motors remain stopped. For example, the articulation motors 606a, 606b may be activated to articulate the end effector while the firing motor 602 remains stopped. Alternatively, the firing motor 602 may be activated to fire multiple staples and/or advance the cutting edge while the articulation motor 606 is stopped. Additionally, the closure motor 603 may be activated simultaneously with the firing motor 602 to distally advance the closure tube and 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 example, 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 example, as shown in FIG. 40, the switch 614 can be moved or transitioned between a plurality 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. 40, 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 multiple 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, for example, power 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 power 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 device (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 LM4F230H5QR from Texas Instruments 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.

41 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 may 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 motor-driven 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. A position sensor 734 may be configured to provide position feedback of the I-beam 714 to the control circuit 710. Another sensor 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 may 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 the 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, so 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 can be provided to various motor controllers 708a-708e. The motor controllers 708a-708e can 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 embodiments, the motors 704a-704e can be brushed DC electric motors. For example, the speed of the motors 704a-704e can be proportional to the respective motor drive signals. In some embodiments, the motors 704a-704e can be brushless DC electric motors, and the respective motor drive signals can include PWM signals provided to one or more stator windings of the motors 704a-704e. Also, in some embodiments, the motor controllers 708a-708e can be omitted, and the control circuitry 710 can generate the motor drive signals directly.

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 respective movable mechanical elements, such as the I-beam 714, the anvil 716, the shaft 740, the articulation 742a, and the articulation 742b, via respective transmissions 706a-706e. The transmissions 706a-706e may include one or more gears or other coupling components for coupling the motors 704a-704e to the movable mechanical elements. The position sensor 734 may 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 stepper 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 instructed 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 control 708a, which provides a drive signal to the motor 704a. The output shaft of the motor 704a is coupled to a torque sensor 744a. The torque sensor 744a is coupled to a transmission 706a, which is coupled to the I-beam 714. The transmission 706a includes a movable mechanical element, such as a rotating element and a firing member, for controlling the movement of the I-beam 714 distally and proximally 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 may 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 may provide a firing signal to the motor control 708a. In response to the firing signal, the motor 704a may 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 positioned 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 706b, which is coupled to the anvil 716. The transmission 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 indicative 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 positioned 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 706c, which is coupled to the shaft 740. The transmission 706c comprises 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 assembly that includes 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 706d, which is coupled to the articulation member 742a. The transmission 706d comprises 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 positioned 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 located on the deck of the staple cartridge 718 to determine the position of the tissue using segmented electrodes. 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, magnetoresistance (MR) devices, giant magnetoresistance (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 may be configured to measure the force applied to the anvil 716 by the closure drive system. 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 applied to the anvil 716 by the closure tube. The force applied to the anvil 716 may be representative of tissue compression experienced by tissue portions captured between the anvil 716 and the staple cartridge 718. One or more sensors 738 may be positioned at various interaction points along the closure drive system to detect the closure force applied to the anvil 716 by the closure drive system. The one or more sensors 738 may be sampled in real time during the clamping operation by a processor of the control circuitry 710. The control circuitry 710 receives the real time sample measurements to provide and analyze time-based information to evaluate the closure force applied to 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 movable 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 source 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.

FIG. 42 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 edge), and an end effector 752 that may 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 circuit 760 may be programmed to control the translation of a displacement member, such as the I-beam 764. In some embodiments, the control circuit 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 a 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 756. The transmission 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 examples, 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 circuitry 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 can be positioned on the end effector 752 and adapted to operate with the surgical instrument 750 to measure various derived parameters, such as gap distance versus time, tissue compression versus time, and anvil strain versus time. The sensors 788 can include 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 the 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 may be configured to measure the force exerted on the anvil 766 by the closure drive system. 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 applied by the closure tube to the anvil 766. The force exerted against 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 may be positioned at various interaction points along the closure drive system to detect the closure force applied to the anvil 766 by the closure drive system. 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 evaluate the closure force applied to 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 may be configured to simulate the response of the actual system of the instrument in the controller software. The displacement member may be actuated to move the I-beam 764 in the end effector 752 at or near a target velocity. The surgical instrument 750 may include a feedback controller, which may 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 may 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 instrument 750 is configured to drive the displacement member, cutting member, or I-beam 764 by a brushed DC motor with a gear box and mechanical link 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 such as 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 that includes an end effector 752 having a motorized surgical stapling and cutting instrument. For example, a motor 754 may drive a displacement member distally and proximally along a longitudinal axis of the end effector 752. The end effector 752 may include a pivotable anvil 766 and, if configured for use, a staple cartridge 768 positioned 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 distally 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 positioned 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 lower power. When thinner tissue is present, the control circuit 760 may be programmed to translate the displacement member at a higher speed and/or with higher 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 displacement member stroke. 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.

43 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 may include an anvil 766, an I-beam 764, and a removable staple cartridge 768 that may 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 co-pending U.S. patent application Ser. No. 15/628,175, filed Jun. 20, 2017, entitled "TECHNIQUES FOR ADAPTIVE CONTROL OF MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT," which is incorporated herein by reference 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 closure member 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 a 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 756. The transmission 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 examples, 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 can be positioned on the end effector 792 and adapted to operate with the surgical instrument 790 to measure various derived parameters, such as gap distance versus time, tissue compression versus time, and anvil strain versus time. The sensors 788 can include 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 the 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 may be configured to measure the force exerted on the anvil 766 by the closure drive system. 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 applied to the anvil 766 by the closure tube. The force exerted against 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 may be positioned at various interaction points along the closure drive system to detect the closure force applied to the anvil 766 by the closure drive system. 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 applied to the clamp arm 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 44 is a simplified block diagram of a generator 800 configured to provide, among other advantages, inductor tuning. Additional details of the generator 800 are described in U.S. Patent No. 9,060,775, filed June 23, 2015, entitled "SURGICAL GENERATOR FOR ULTRASONIC AND ELECTROSURGICAL DEVICES," the disclosure of 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 may 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 different 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 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, with the sub-therapeutic signals being used, for example, to monitor tissue or instrument conditions 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 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 configurations, 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 one particular embodiment, the switch-mode regulator 820 may comprise, for example, an adjustable buck regulator. The non-isolated stage 804 may further comprise a first processor 822, which in one embodiment may comprise, for example, a DSP processor, such as an Analog Devices ADSP-21469 SHARC DSP available from Analog Devices, Norwood, Mass., 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 an ADC circuit 824. In one form, for example, the DSP processor 822 may receive as an input via the ADC circuit 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., a PWM output) so that the rail voltage supplied to the power amplifier 812 tracks the waveform envelope of the amplified signal. By dynamically modulating the rail voltage of the power amplifier 812 based on the waveform envelope, the efficiency of the power amplifier 812 may 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 waveform samples stored in a dynamically updated look-up 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, may 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 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), voltage and current feedback data based on the drive signal can be input to an algorithm, such as an error control algorithm executed by the DSP processor 822, which compensates for the distortion by suitably pre-distorting or modifying the waveform samples stored in the LUT on a dynamic, on-the-fly basis (e.g., real-time). 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 the waveform required to ultimately generate the desired waveform of the motion branch drive signal when considering the 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 megasamples 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 may allow, among other things, 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 may be received and processed by logic device 816 (e.g., first-in, first-out (FIFO) buffers, multiplexers, etc.) and stored in a data memory for subsequent retrieval, for example, by DSP processor 822. As noted above, the voltage and current feedback data may 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 setpoint (e.g., 0°), thereby minimizing or reducing the effects of harmonic distortion and correspondingly improving the measurement accuracy of the impedance phase. The determination of the phase impedance and frequency control signal may be implemented, for example, in the DSP processor 822, with the frequency control signal being 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, 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) functionality. 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 functionality supported by the 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., an SPI bus). The UI processor 836 may primarily support UI functionality, but in certain configurations, the UI processor 836 may also cooperate with the DSP processor 822 to provide hazard mitigation. 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 can disable the drive output of the generator 800 when 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 provided 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 to be invalid by the UI processor 836, 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 the 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, when the generator 800 is in the power on state, if activation of the "on/off" input device is detected, the controller 838 may initiate a sequence to transition the generator 800 to the power off state. For example, in a particular embodiment, the controller 838 may report the activation of an "on/off" input device to the UI processor 836, which in turn performs the process sequence necessary for transitioning the generator 800 to a powered off state. In this embodiment, 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 stages 802 and 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 device 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, for example, using a bipolar current source fed by a differential amplifier. The interrogation signal may be communicated to a surgical instrument control circuit (e.g., using a conductive pair in a cable connecting the generator 800 to the surgical instrument) and monitored to determine the 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. For example, in one form, the signal conditioning circuitry 844 may include an ADC circuit to generate samples of the voltage signal appearing across the 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) may 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 in or otherwise associated with the surgical instrument. In certain forms, for example, the first data circuit may be disposed in a cable or adapter integrally attached to the surgical instrument handpiece for interfacing with a particular surgical instrument type or model with 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 forms, 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 the surgical instrument was used in, 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 forwarded 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 function or operation 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 the surgical instrument was used in and/or the date and/or time of its use.

As previously mentioned, surgical instruments may be removable from the handpiece to facilitate instrument interchangeability and/or disposability (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 enable communication with an instrument-based data circuit. For example, the generator 800 may be configured to communicate with a second data circuit housed within the instrument (e.g., a multifunction surgical instrument). In some configurations, the second data circuit is 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 enables 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 may be configured such that communication between the logic circuit 842 and the second data circuit may be effected without the need to provide additional conductors for this purpose (e.g., a dedicated conductor in the cable connecting the handpiece to the generator 800). In one form, information may 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 may 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 DC 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, for example, current leakage from a point between the blocking capacitors 850-1 and 850-2 is monitored by an ADC circuit 852 to sample a 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 embodiments, the non-isolated stage 804 may include a power supply 854 for delivering DC power at a suitable voltage and current. The power supply may include, for example, a 400 W power supply for delivering a 48 VDC system voltage. The power supply 854 may 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 may receive input from the controller 838 to enable operation or activation of the DC/DC voltage converters 856 when activation of an "on/off" input device by a user is detected by the controller 838.

FIG. 45 shows an example of a generator 900, which is a form of generator 800 (FIG. 44). 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 waveform 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 1. 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 the RETURN path and measures the output voltage therebetween. A second voltage sense circuit 924 is coupled across the terminals labeled ENERGY2 and the RETURN path 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 through 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 a first voltage sense circuit 912 coupled across the terminals labeled ENERGY1/RETURN or a second voltage sense circuit 924 coupled across the terminals labeled ENERGY2/RETURN by the output of a current sense circuit 914 disposed 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. 45 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. 45, 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 of the ultrasonic transducer to the output of the generator 900 would preferably be located between the outputs labeled ENERGY1 and RETURN shown in FIG. 45. 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 peripheral devices 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 that are made up of various 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) analog, 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 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. 3 and 9 ) 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 injection 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 an instrument. The information may include the type of procedure to be 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 the surgical system to improve how it controls, for example, modular devices (e.g., robotic arms and/or robotic surgical tools) to which it is connected to provide contextual information or suggestions to the surgeon during the course of a surgical procedure.

Referring now to FIG. 46, 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., contextual information) regarding the ongoing procedure as new data is received, such as which steps of the procedure are 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 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 equipment. The auxiliary equipment utilized may vary according to the type of surgical procedure and the technology used by the surgeon, but in this exemplary case, these include smoke evacuators, aspirators, and medical imaging devices. Once activated, the auxiliary equipment, 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 devices that connect 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, the surgical hub 106, 206 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 monitoring devices) 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 footage 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. 26) may be utilized 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 the visualization of the patient's anatomy, by monitoring the number or medical imaging devices being utilized (i.e., activated and paired with the surgical hub 106, 206), and by monitoring the type of visualization device being utilized. 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 the 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, it 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 can 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 described in the following numbered examples.

Example 1. A method comprising: obtaining, by a surgical evacuation system, a value of a parameter; transmitting, by at least one of a cloud computing network and a surgical hub, the value of the parameter; processing, by at least one of the cloud computing network and the surgical hub, the value of the parameter; determining, by at least one of the cloud computing network and the surgical hub, an effect of the value of the parameter on at least one of the surgical evacuation system and the modular device; sending, from at least one of the cloud computing network and the surgical hub, an instruction to adjust operation to at least one of the surgical evacuation system and the modular device; and adjusting operation by at least one of the surgical evacuation system and the modular device based on the instruction.

Example 2. The method of example 1, wherein the parameter is sensed by an internal sensor within the surgical drainage system.

Example 3. The method of example 2, wherein the parameter is at least one of particulate concentration, aerosol fraction, or chemical analysis, and any combination thereof.

Example 4. The method of any one of Examples 1-3, wherein the internal sensor in the surgical drainage system is at least one of a fluid sensor, a chemical sensor, a laser particle counter, or a pressure sensor, and any combination thereof.

Example 5. The method of any one of Examples 1 to 4, wherein the parameter is an operational parameter.

Example 6. The method of example 5, wherein the operating parameter is at least one of air flow, pressure differential, or air quality, and any combination thereof.

Example 7. The method of any one of Examples 1 to 6, wherein the operating parameter is sensed by at least one of an air quality particle sensor or an ambient pressure sensor, and any combination thereof.

Example 8. The method of any one of Examples 1 to 7, further comprising transmitting the value of the parameter from the surgical hub to a cloud computing network.

Example 9. The method of example 8, wherein the value of the parameter is manipulated by the surgical hub before transmitting the value of the parameter to the cloud computing network.

Example 10. The method of any one of Examples 1 to 9, wherein the value of the parameter is transmitted from the surgical hub to a cloud computing network via a network router.

Example 11. The method of any one of Examples 1 to 10, further comprising sending instructions to adjust the operation from the cloud computing network to the surgical hub.

Example 12. The method of example 11, wherein the surgical hub sends instructions to at least one of the surgical evacuation system and the modular device to regulate operation.

Example 13. The method of any one of Examples 1 to 12, wherein the surgical ejection system obtains values for at least two parameters.

Example 14. The method of any one of Examples 1 to 13, wherein the modular device is at least one of a visualization circuit, a robotic circuit, an intelligent communication circuit, an imaging circuit, a generator, an aspiration/irrigation circuit, a communication device, a processor, a storage array, and an operating room mapping circuit.

Example 15. The method of any one of Examples 1-14, wherein at least one of the cloud computing network and the surgical hub is in bidirectional communication with at least one of the surgical evacuation system and the modular device.

Example 16. The method of any one of Examples 1 to 15, wherein the cloud computing network is in bidirectional communication with the surgical hub.

Example 17. The method of any one of Examples 1-16, wherein at least one of the cloud computing network and the surgical hub includes an algorithm contained in memory for determining the effect of the parameter value on at least one of the surgical evacuation system and the modular device.

Example 18. The method of any one of Examples 1-17, wherein at least one of the cloud computing network and the surgical hub includes learning software contained in memory to determine the effect of parameter values on at least one of the surgical evacuation system and the modular device.

Example 19. A computer-implemented surgical system comprising: a surgical hub, the surgical hub including a processor and a memory; and a smoke evacuation module in communication with the surgical hub, the smoke evacuation module configured to obtain a value of a parameter and transmit the value of the parameter to at least one of a cloud computing network and the surgical hub, the at least one of the cloud computing network and the surgical hub configured to process the value of the parameter, determine an effect of the value of the parameter on at least one of the smoke evacuation module and the modular device, and send instructions to at least one of the smoke evacuation module and the modular device to adjust operation, the at least one of the smoke evacuation module and the modular device configured to adjust operation based on the instructions.

Example 20. A non-transitory computer readable medium storing computer readable instructions that, when executed, cause a machine to obtain a value of a parameter by a surgical evacuation system; transmit the value of the parameter to at least one of a cloud computing network and a surgical hub; process the value of the parameter by at least one of the cloud computing network and the surgical hub; determine an effect of the value of the parameter on at least one of the surgical evacuation system and the modular device by at least one of the cloud computing network and the surgical hub; send instructions from at least one of the cloud computing network and the surgical hub to at least one of the surgical evacuation system and the modular device to adjust operation; and adjust operation by at least one of the surgical evacuation system and the modular device based on the instructions.

Example 21. A method comprising: obtaining, by a surgical evacuation system, a value of a parameter; transmitting, by the cloud computing network, the value of the parameter; processing, by the cloud computing network, the value of the parameter; determining, by the cloud computing network, an effect of the value of the parameter on at least one of the surgical evacuation system and the modular device; sending, via the network router, from the cloud computing network to at least one of the surgical evacuation system and the modular device, an instruction to adjust operation; and adjusting, by at least one of the surgical evacuation system and the modular device, based on the instruction.

Example 22. The method of example 21, wherein the parameter is sensed by an internal sensor within the surgical drainage system.

Example 23. The method of example 21 or 22, wherein the parameter is at least one of particulate concentration, aerosol fraction, or chemical analysis, and any combination thereof.

Example 24. The method of any one of Examples 21-23, wherein the internal sensor in the surgical drainage system is at least one of a fluid sensor, a chemical sensor, a laser particle counter, or a pressure sensor, and any combination thereof.

Example 25. The method of any one of Examples 21 to 24, wherein the parameter is an operational parameter.

Example 26. The method of example 25, wherein the operating parameter is at least one of air flow, pressure differential, or air quality, and any combination thereof.

Example 27. The method of any one of Examples 25 or 26, wherein the operating parameter is sensed by at least one of an air quality particle sensor or an ambient pressure sensor, and any combination thereof.

Example 28. A method comprising: obtaining, by a surgical evacuation system, a value of a parameter; transmitting, by a surgical hub, the value of the parameter; transmitting, by the cloud computing network, the value of the parameter; determining, by the cloud computing network, an effect of the value of the parameter on at least one of the surgical evacuation system and the modular device; sending, by the cloud computing network, via the network router, an instruction to adjust operation from the cloud computing network to at least one of the surgical evacuation system and the modular device; and adjusting operation by at least one of the surgical evacuation system and the modular device based on the instruction.

Example 29. The method of example 28, wherein the parameter is sensed by an internal sensor within the surgical drainage system.

Example 30. The method of example 29, wherein the internal sensor in the surgical drainage system is at least one of a fluid sensor, a chemical sensor, a laser particle counter, or a pressure sensor, and any combination thereof.

Example 31. The method of any one of Examples 28-30, wherein the parameter is at least one of particulate concentration, aerosol fraction, or chemical analysis, and any combination thereof.

Example 32. The method of any one of Examples 28 to 31, wherein the parameter is an operational parameter.

Example 33. The method of example 32, wherein the operating parameter is at least one of air flow, pressure differential, or air quality, and any combination thereof.

Example 34. The method of any one of Examples 32 or 33, wherein the operating parameter is sensed by at least one of an air quality particle sensor or an ambient pressure sensor, and any combination thereof.

Example 35. A method comprising: obtaining, by a surgical evacuation system, a value of a parameter; transmitting, by the surgical hub, the value of the parameter; processing, by the surgical hub, the value of the parameter; determining, by the surgical hub, an effect of the value of the parameter on at least one of the surgical evacuation system and the modular device; sending, from the surgical hub, instructions to adjust operation, by at least one of the surgical evacuation system and the modular device; and adjusting operation, by at least one of the surgical evacuation system and the modular device, based on the instructions.

Example 36. The method of example 35, wherein the parameter is sensed by an internal sensor within the surgical drainage system.

Example 37. The method of example 35 or 36, wherein the parameter is at least one of particulate concentration, aerosol fraction, or chemical analysis, and any combination thereof.

Example 38. The method of any one of Examples 35-37, wherein the internal sensor in the surgical drainage system is at least one of a fluid sensor, a chemical sensor, a laser particle counter, or a pressure sensor, and any combination thereof.

Example 39. The method of any one of Examples 35 to 38, wherein the parameter is an operational parameter.

Example 40. The method of any one of Examples 35 to 39, wherein the operating parameter is at least one of air flow, pressure differential, or air quality, and any combination thereof.

Example 41. The method of any one of Examples 35-40, wherein the operating parameter is sensed by at least one of an air quality particle sensor and an ambient pressure sensor.

Example 42. A computer-implemented surgical system comprising a surgical hub and a smoke evacuation module located within the surgical hub, the smoke evacuation module configured to sense a parameter by a sensor and transmit the parameter to the surgical hub, and the surgical hub configured to analyze the parameter and modify the operation of at least one of the smoke evacuation module and a second module in communication with the surgical hub based on the analysis of the parameter.

Example 43. A surgical hub comprising a processor and a memory coupled to the processor, the memory storing instructions executable by the processor to perform the method of any one of Examples 21 to 31.

Example 44. A non-transitory computer-readable medium storing computer-readable instructions that, when executed, cause a machine to perform the method of any one of Examples 21 to 31.

Example 45. A method comprising: obtaining, by a surgical evacuation system, a value of a parameter; transmitting, by at least one of a cloud computing network and a surgical hub, the value of the parameter; processing, by at least one of the cloud computing network and the surgical hub, the value of the parameter; determining, by at least one of the cloud computing network and the surgical hub, an effect of the value of the parameter on at least one of the surgical evacuation system and the modular device; sending, from at least one of the cloud computing network and the surgical hub, an instruction to adjust operation to at least one of the surgical evacuation system and the modular device; and adjusting operation by at least one of the surgical evacuation system and the modular device based on the instruction.

Example 46. The method of example 45, wherein the parameter is sensed by an internal sensor within the surgical drainage system.

Example 47. The method of example 45 or 46, wherein the parameter is at least one of particulate concentration, aerosol fraction, or chemical analysis, and any combination thereof.

Example 48. The method of any one of Examples 45-47, wherein the internal sensor in the surgical drainage system is at least one of a fluid sensor, a chemical sensor, a laser particle counter, or a pressure sensor, and any combination thereof.

Example 49. The method of any one of Examples 45 to 48, wherein the parameter is an operating parameter.

Example 50. The method of any one of Examples 45 to 49, wherein the operating parameter is at least one of air flow, pressure differential, or air quality, and any combination thereof.

Example 51. The method of any one of Examples 45-50, wherein the operating parameter is sensed by at least one of an air quality particle sensor or an ambient pressure sensor, and any combination thereof.

Example 52. The method of any one of Examples 45 to 51, further comprising transmitting the value of the parameter from the surgical hub to a cloud computing network.

Example 53. The method of any one of Examples 45 to 52, wherein the value of the parameter is manipulated by the surgical hub before transmitting the value of the parameter to the cloud computing network.

Example 54. The method of any one of Examples 45 to 53, wherein the value of the parameter is transmitted from the surgical hub to a cloud computing network via a network router.

Example 55. The method of any one of Examples 45-54, further comprising sending instructions from the cloud computing network to the surgical hub to adjust the operation.

Example 56. The method of any one of Examples 45-55, wherein the surgical hub sends instructions to at least one of the surgical evacuation system and the modular device to regulate operation.

Example 57. The method of any one of Examples 45 to 56, wherein the surgical ejection system obtains values for at least two parameters.

Example 58. The method of any one of Examples 45 to 57, wherein the modular device is at least one of a visualization circuit, a robotic circuit, an intelligent communication circuit, an imaging circuit, a generator, an aspiration/irrigation circuit, a communication device, a processor, a storage array, and an operating room mapping circuit.

Example 59. The method of any one of Examples 45-58, wherein at least one of the cloud computing network and the surgical hub is in bidirectional communication with at least one of the surgical evacuation system and the modular device.

Example 60. The method of any one of Examples 45 to 59, wherein the cloud computing network is in bidirectional communication with the surgical hub.

Example 61. The method of any one of Examples 45-60, wherein at least one of the cloud computing network and the surgical hub includes an algorithm contained in memory for determining the effect of the parameter value on at least one of the surgical evacuation system and the modular device.

Example 62. The method of any one of Examples 45-61, wherein at least one of the cloud computing network and the surgical hub includes learning software included in the memory to determine the effect of parameter values on at least one of the surgical evacuation system and the modular device.

Example 63. A computer-implemented surgical system comprising: a surgical hub, the surgical hub including a processor and a memory; and a smoke evacuation module in communication with the surgical hub, the smoke evacuation module configured to obtain a value of a parameter and transmit the value of the parameter to at least one of a cloud computing network and the surgical hub, the at least one of the cloud computing network and the surgical hub configured to process the value of the parameter, determine an effect of the value of the parameter on at least one of the smoke evacuation module and the modular device, and send instructions to at least one of the smoke evacuation module and the modular device to adjust operation, the at least one of the smoke evacuation module and the modular device configured to adjust operation based on the instructions.

Example 64. A non-transitory computer readable medium storing computer readable instructions that, when executed, cause a machine to obtain a value of a parameter by a surgical evacuation system; transmit the value of the parameter to at least one of a cloud computing network and a surgical hub; process the value of the parameter by at least one of the cloud computing network and the surgical hub; determine an effect of the value of the parameter on at least one of the surgical evacuation system and the modular device by at least one of the cloud computing network and the surgical hub; send instructions from at least one of the cloud computing network and the surgical hub to at least one of the surgical evacuation system and the modular device to adjust operation; and adjust operation by at least one of the surgical evacuation system and the modular device based on the instructions.

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 that 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 devices 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 all or a portion of some aspects of the embodiments disclosed herein 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 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) including 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 that at least partially executes the processes and/or devices described herein, or a microprocessor configured by a computer program that at least partially executes 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 opto-electronic device). Those skilled in the art will recognize that the subject matter described herein may be implemented in analog or digital form, or some combination thereof.

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 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 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," "upper," and "lower" 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 any disjunctive word and/or phrase that typically represents 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 possibility 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 sequence(s), 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 forms 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 method comprising the steps of:
obtaining a value of a parameter by the surgical drainage system;
transmitting the values of the parameters to at least one of a cloud computing network and a surgical hub;
processing the values of the parameters by at least one of the cloud computing network and the surgical hub;
determining, by at least one of the cloud computing network and the surgical hub, an effect of the value of the parameter on at least one of the surgical drainage system and a modular device;
sending instructions from at least one of the cloud computing network and the surgical hub to at least one of the surgical drainage system and the modular device to coordinate operation;
and coordinating operation by at least one of the surgical drainage system and the modular device based on the instructions.
2. The method of claim 1, wherein the parameter is sensed by an internal sensor within the surgical drainage system.
3. The method of claim 2, wherein the parameter is at least one of particulate concentration, aerosol fraction, or chemical analysis, and any combination thereof.
4. The method of claim 2, wherein the internal sensor within the surgical drainage system is at least one of a fluid sensor, a chemical sensor, a laser particle counter, or a pressure sensor, and any combination thereof.
5. The method of claim 1, wherein the parameter is an operational parameter.

6. The method of claim 5, wherein the operating parameter is at least one of air flow, pressure differential, or air quality, and any combination thereof.
7. The method of claim 5, wherein the operating parameter is sensed by at least one of an air quality particle sensor or an ambient pressure sensor, and any combination thereof.
8. The method of claim 1, further comprising transmitting the value of the parameter from the surgical hub to the cloud computing network.
9. The method of claim 8, wherein the value of the parameter is manipulated by the surgical hub prior to transmitting the value of the parameter to the cloud computing network.
10. The method of claim 8, wherein the value of the parameter is transmitted from the surgical hub to the cloud computing network via a network router.

11. The method of claim 1, further comprising sending the instructions to adjust an operation from the cloud computing network to the surgical hub.
12. The method of claim 11, wherein the surgical hub sends the instructions to at least one of the surgical evacuation system and the modular device to regulate operation.
13. The method of claim 1, wherein the surgical drainage system obtains values for at least two parameters.
14. The method of claim 1, wherein the modular device is at least one of a visualization circuit, a robotic circuit, an intelligent communication circuit, an imaging circuit, a generator, an aspiration/irrigation circuit, a communication device, a processor, a storage array, and an operating room mapping circuit.
15. The method of claim 1, wherein at least one of the cloud computing network and the surgical hub are in bidirectional communication with at least one of the surgical drainage system and the modular device.

16. The method of claim 1, wherein the cloud computing network is in bidirectional communication with the surgical hub.
17. The method of claim 1, wherein at least one of the cloud computing network and the surgical hub comprises an algorithm contained in a memory for determining an effect of the value of the parameter on at least one of the surgical drainage system and the modular device.
18. The method of claim 1, wherein at least one of the cloud computing network and the surgical hub comprises learning software contained in a memory for determining an effect of the values of the parameters on at least one of the surgical drainage system and the modular device.
(19) A computer-implemented surgical system, comprising:
a surgical hub, the surgical hub including a processor and a memory;
a smoke evacuation module in communication with the surgical hub, the smoke evacuation module comprising:
Obtaining the value of the parameter;
and transmitting the value of the parameter to at least one of a cloud computing network and the surgical hub;
At least one of the cloud computing network and the surgical hub:
processing the values of the parameters;
determining an effect of the value of the parameter on at least one of the gas evacuation module and a modular device;
and sending instructions to at least one of the smoke evacuation module and the modular device to adjust operation;
At least one of the gas evacuation module and the modular device is
A computer-implemented surgical system configured to adjust an action based on the instructions.
(20) A non-transitory computer-readable medium storing computer-readable instructions that, when executed, cause a machine to:
obtaining a value of a parameter by a surgical drainage system;
transmitting the values of the parameters to at least one of a cloud computing network and a surgical hub;
processing the values of the parameters by at least one of the cloud computing network and the surgical hub;
determining, by at least one of the cloud computing network and the surgical hub, an effect of the value of the parameter on at least one of the surgical drainage system and a modular device;
sending instructions from at least one of the cloud computing network and the surgical hub to at least one of the surgical drainage system and the modular device to coordinate operation;
and coordinating operation by at least one of the surgical drainage system and the modular device based on the instructions.

Claims (20)

1. A method of operating a computer implemented surgical system, comprising:
The computer implemented surgical system includes a surgical hub, a cloud computing network, a surgical exhaust system, and modular devices, the surgical exhaust system and the modular devices being in signal communication with the surgical hub, the surgical hub being a central connection for networking a plurality of the modular devices installed in an operating room, at least one of the plurality of modular devices including a generator;
The method comprises:
obtaining, by the surgical exhaust system, a value of a parameter related to an environment within the operating room;
transmitting the value of the parameter to the surgical hub;
processing, by the surgical hub, the value of the parameter;
determining, by the surgical hub, an effect of the value of the parameter on at least one of the surgical drainage system and the generator;
sending commands from the surgical hub to at least one of the surgical drainage system and the generator to adjust operation based on the effect;
and adjusting operation of at least one of the surgical drainage system and the generator based on the instructions. The method of claim 1, wherein the parameter is sensed by an internal sensor within the surgical drainage system. The method of claim 2, wherein the parameter is at least one of particulate concentration, aerosol fraction, or chemical analysis, and any combination thereof. The method of claim 2, wherein the internal sensor within the surgical drainage system is at least one of a fluid sensor, a chemical sensor, a laser particle counter, or a pressure sensor, and any combination thereof. The method of claim 1, wherein the parameter is an operational parameter. The method of claim 5, wherein the operating parameter is at least one of airflow, pressure differential between inside and outside the operating room, or air quality, and any combination thereof. The method of claim 5, wherein the operating parameter is sensed by at least one of an air quality particle sensor or an ambient pressure sensor, and any combination thereof. The method of claim 1, further comprising transmitting the value of the parameter from the surgical hub to the cloud computing network. The method of claim 8, wherein the value of the parameter is processed by the surgical hub prior to transmitting the value of the parameter to the cloud computing network. The method of claim 8, wherein the values of the parameters are transmitted from the surgical hub to the cloud computing network via a network router. The method of claim 1, wherein the surgical ejection system obtains values for at least two of the parameters. The method of claim 1, wherein the modular device including the generator is a first modular device, and the computer-implemented surgical system includes a second modular device, the second modular device being at least one of a visualization circuit, a robotic circuit, an intelligent communication circuit, an imaging circuit, a second generator, an aspiration/irrigation circuit, a communication device, a processor, a storage array, and a circuit for generating a map of the operating room. The method of claim 1, wherein at least one of the cloud computing network and the surgical hub are in bidirectional communication with at least one of the surgical exhaust system and the generator. The method of claim 1, wherein the cloud computing network is in bidirectional communication with the surgical hub. The method of claim 1, wherein at least one of the cloud computing network and the surgical hub includes an algorithm contained in memory for determining an effect of the value of the parameter on at least one of the surgical drainage system and the generator. The method of claim 1, wherein at least one of the cloud computing network and the surgical hub includes learning software contained in memory to determine an effect of the values of the parameters on at least one of the surgical drainage system and the generator. the surgical evacuation system includes a smoke evacuation module;
Adjusting the operation includes:
operating the smoke evacuation module more slowly and/or sensing the parameter less frequently, or
10. The method of claim 1, comprising operating the smoke evacuation module at a higher speed and/or sensing the parameter more frequently. The method of claim 1, wherein the surgical exhaust system is for exhausting smoke generated during a surgical procedure utilizing one or more energy devices, the energy devices being configured to be energized by the generator. 1. A computer implemented surgical system comprising:
a surgical hub, the surgical hub including a processor and a memory;
Cloud computing networks;
a modular device in signal communication with the surgical hub ;
a smoke evacuation module in signal communication with the surgical hub;
the surgical hub is a central connection in an operating room for networking a plurality of the modular devices, at least one of the modular devices including a generator;
The gas evacuation module comprises:
Obtaining values of parameters related to the environment in the operating room ;
transmitting the value of the parameter to the surgical hub;
the surgical hub comprising:
processing the values of the parameters;
determining an effect of the value of the parameter on at least one of the smoke evacuation module and the generator;
and sending instructions to at least one of the smoke evacuation module and the generator to adjust operation based on the effect;
At least one of the smoke evacuation module and the generator,
A computer-implemented surgical system configured to adjust an action based on the instructions. A non-transitory computer readable medium storing computer readable instructions that, when executed, provide a method for controlling a computer implemented surgical system, the computer implemented surgical system including a surgical hub, a cloud computing network, a surgical exhaust system , and modular devices , the surgical exhaust system and the modular devices being in signal communication with the surgical hub, the surgical hub being a central connection for networking a plurality of the modular devices located in an operating room, at least one of the plurality of modular devices including a generator;
obtaining, by the surgical exhaust system , a value of a parameter related to an environment within the operating room ;
transmitting the value of the parameter to the surgical hub;
processing, by the surgical hub, the value of the parameter;
determining, by the surgical hub, an effect of the value of the parameter on at least one of the surgical drainage system and the generator;
sending commands from the surgical hub to at least one of the surgical drainage system and the generator to adjust operation based on the effect;
and adjusting operation of at least one of the surgical drainage system and the generator based on the instructions.

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