Cilag Patente

An apparatus includes a first jaw (16) and a second jaw (618, 718, 900) that cooperate to clamp and staple tissue (90). The second jaw includes a jaw body (620, 720, 902) and a distal tip (619, 719, 906) pivotable relative to the jaw body between a first discrete and a second discrete position. First and second openings (663, 784, 785, 932, 934) are both defined by one of the distal tip or a structure (621, 920) located proximal to the distal tip. A projection (637, 781, 918) is defined by the other of the distal tip or the structure. The projection is positionable within the first opening (663, 785, 932) to releasably retain the distal tip in the first discrete position, and within the second opening (663, 784, 934) to releasably retain the distal tip in the second discrete position.

A surgical instrument and associated method includes an end effector having an ultrasonic blade, a metallic jaw clamp, and a partially conductive tissue pad coupled to the jaw clamp. The tissue pad comprises a polymeric substrate with a conductive trace formed on the surface of the polymeric substrate. The polymeric substate may be formed from polytetrafluoroethylene (PTFE), and the surface of the PTFE substrate may be treated to improve adhesion of the conductive trace. The tissue pad is erodible during activation of the ultrasonic blade. The conductive trace may be a multilayer laminate. A method for constructing the surgical instrument includes forming the conductive trace on the surface of the polymeric substrate and securing the polymeric substrate to the metallic jaw clamp.

A system includes an energy-based surgical instrument with a mode selector capable of selecting a latch mode and an automatic or non-latch mode. The surgical instrument may send a message signal indicative of the state of the mode selector to a surgical generator, which outputs an audio tone indicative of the state of the mode selector. The surgical instrument may generate feedback, such as haptic feedback, when energy delivery is nearly activated, and generate different feedback when the energy delivery is activated. The surgical instrument may measure tension applied at an end effector of the surgical instrument and generate haptic feedback based on the measured tension. Other embodiments are described and claimed.

A system includes an energy-based surgical instrument with an end effector having two electrodes. One of the electrodes has multiple electrode portions. A generator coupled to the surgical instrument supplies radio-frequency (RF) energy to an electrode portion for a tissue coagulation process and further supplies RF energy at a higher voltage or current to another electrode portion for a tissue transection process. A control element may monitor tissue impedance or tissue temperature. Other embodiments are described and claimed.

A control method for an energy-based surgical instrument includes activating an energy control signal at a subtherapeutic level, measuring a system response at the subtherapeutic level, adjusting one or more parameters based on the system response, and then activating an energy control signal at a therapeutic level according to the determined parameters. The subtherapeutic and therapeutic signals may be ultrasound or radio frequency (RF) energy and/or a combination of ultrasound and RF energy. Controlled parameters may include mode, cycle time, power (e.g., ultrasound tip displacement), or crest factor. Other embodiments are described and claimed.

Technologies for securing a tissue pad to a jaw clamp of an energy-based surgical instrument includes a surgical instrument having an end effector. The end effector includes an ultrasonic blade and a jaw clamp. The jaw clamp includes a metallic frame and a tissue pad attached to the metallic frame. The tissue pad of the jaw clamp has a minimum width that is greater than width of the ultrasonic blade. Additionally, the sidewalls of the tissue pad and the metallic frame may be beveled so as to retain the tissue pad in the metallic frame.

A surgical instrument and associated method for controlling clamping force of a surgical instrument includes an end effector having a jaw assembly movable between an open state and a closed state, a trigger assembly operable to move the jaw assembly of the end effector between the open state and the closed state, and a clamping force augmentation system controllable to increase a clamping force of the jaw assembly of the end effector. A controller of the surgical instrument is configured to activate the clamping force augmentation system to increase the clamping force of the jaw assembly of the end effector in response to an RF mode of the surgical instrument being activated and (ii) the position sensor indicating that the present state of the jaw assembly is in the closed state.

A system includes an energy-based surgical instrument with an end effector having one or more jaw clamps. The end effector may include a segmented electrode with a distal portion and a proximal portion coupled to one jaw clamp and a return electrode coupled to the other jaw clamp. The distal and proximal portions may be separately or cooperatively energized with radio frequency (RF) energy. A pressure varying mechanism may selectively limit or increase pressure at the distal portion of the electrode. The end effector may include a jaw clamp with a tissue pad positioned within a channel. The end effector may include a conformal or erodible electrode that extends to the distal tip of the jaw assembly. Other embodiments are described and claimed.

Systems, methods, and/or instrumentalities disclosed herein may be related to adjusting automated cooperative operations based on situationally derived constraints. A system may be configured to receive a first dataflow and/or a second dataflow from a first surgical element and/or a second surgical element. The second dataflow may indicate a second output parameter associated with a complementary task. The system may determine a relationship between the first surgical element and a second surgical element based on the first dataflow and/or the second dataflow. The system may determine a boundary parameter associated with the second output parameter based on the first output parameter and/or the relationship. The system may send an indication of the boundary parameter to the second surgical element. The system may cause the second surgical element to perform the complementary task based on the boundary parameter.

A surgical system that may be associated with using smart devices for autonomous task performance. The system may include a processor configured to monitor the actions of a surgeon controlling a first smart device during surgery and to identify patterns in the actions. Based on identifying the patterns, the system may determine tasks that are suitable for autonomous performance by a second smart device.

A system may adaptively recognize the abilities of surgical elements to adjust an automation strategy during a procedure. The system may be configured to obtain operational data for a first surgical element and a second surgical element. The system may determine an automation assistance parameter. The system may detect an adaptive recognition event. The adaptive recognition event may be at least one of a relationship between the first surgical element and the second surgical element, or a determination that the physiological parameter of the patient satisfies a life-threatening threshold. The system may select a second automation assistance parameter for the first surgical element. The system may transmit an indication of the second automation assistance parameter to the first surgical element. The system may cause the first surgical element to perform the second set of automated tasks based on the second automation assistance parameter.

A surgical smart system may configure positioning and orientation of surgical instruments during surgical procedures by considering current and subsequent surgical steps. The system may include a processor configured to identify an active surgical step and a subsequent surgical step associated with a surgical instrument. The system may determine multiple possible positional configurations for the active step, assess the instrument's and patient's orientations, and calculate corresponding downstream configurations for the subsequent step. Based on the determination, the system may adjust the current configuration and select a suitable configuration for the active step.

A surgical system may include a processor configured to identify a surgical motion performed by a user. The surgical motion may be determined to be able to be automated by the surgical system. A plurality of assistance control options may be generated. An assistance control option may be applied from the plurality of assistance control options based on a selection made by the user. The surgical motion may be performed with the selected assistance control option. The surgical motion may be performed with the selected assistance control option after an indication from the user.

A surgical system may be associated with cutting and retraction of tissues. The system may include a processor that is configured to work with a surgical cutting instrument and a retraction instrument. The processor may identify a current surgical task, determine the proximity of nearby structures, and calculate a retraction force direction and an intensity. Based on retraction force direction and intensity, the system may generate a control signal that directs the retraction instrument to apply the calculated force, which may allow for the first tissue to be retracted and the second tissue to be cut by the surgical cutting instrument.

Surgical systems and related computer-implemented methods are provided, including during performance of a surgical procedure on a patient, receiving, at a first surgical system, a first dataflow from a second surgical system, the first dataflow including first data regarding a measured patient parameter that the first surgical system is configured to use in performing a function during the performance of the surgical procedure. The computer-implemented methods including determining that a trigger event occurred during the performance of the surgical procedure such that a sum of a first bandwidth of the first dataflow and a second bandwidth of a second dataflow exceeds an available bandwidth, and in response to determining that the trigger event occurred, and during the performance of the surgical procedure, adjusting at least one of the first and second dataflows such that the sum of the first and second bandwidths does not exceed the available bandwidth.

Device and methods for visualizing internal processes of an automated operation. An example device may receive an external data stream from a source external to the surgical system. The device may derive, based at least on the external data stream, decision contextual information. The device may select a surgical option associated with a surgical instrument based on the decision context information. The device may generate a visual indication of the decision context information associated with selecting the surgical option. The device may generate a control signal associated with the surgical instrument based on the selected surgical option.

A surgical system may include a processor configured to make a determination between two seemingly accurate but conflicting data streams. The processor may be further configured to obtain a first data stream and a second data stream associated with a same measurement. The processor may be further configured to determine a first control parameter based at least in part on the first data stream. The processor may be further configured to determine a second control parameter based at least in part on a second data stream. The processor may be further configured to compare the first control parameter and the second parameter. The processor may be further configured to select a data stream between the first data stream and the second data stream based on the comparing. The processor may be further configured to generate a control signal based on the selected data stream.

Device and methods for visualization of automated surgical system decisions. An example device may select a candidate action to perform based on steps of a surgical procedure and the effects of the candidate action. The effects may include whether the candidate action will impair the ability of a surgical instrument to perform a later step in the procedure. The candidate action may involve initial device placement, device movements, port placement, and/or the like.

A surgical system may include a processor configured to make a determination that a data stream is invalid. The processor may be further configured to obtain a data stream associated with a measurement from a surgical device. The processor may be further configured to generate a first control signal associated with the surgical device based on the data stream. The processor may be further configured to detect that the data stream is invalid. Upon detecting that the data stream is invalid, the processor may be further configured to determine an approximation factor associated with the data stream. The processor may be further configured to generate a second control signal associated with the surgical device based on the determined approximation factor.

Systems, methods, and/or instrumentalities disclosed herein may augment dataflows to rebalance the number of unknowns and dataflows. The device may be configured to receive a first dataflow from a first surgical element. The first dataflow may be associated with a physiological parameter of a patient. The device may determine that the first dataflow from the first surgical element is erroneous. The device may determine a second dataflow associated with a second surgical element. The determination of the second dataflow may be based on an indication of a relational link associated with the second dataflow of the second surgical element, control data for the first surgical element, and/or the physiological parameter of the patient. The device may generate control data for the first surgical element based on the second dataflow. The control data may indicate an adjustment to an output characteristic associated with the first surgical element.

Systems, methods, and/or instrumentalities disclosed herein may collect user choices and/or resulting outcomes from surgeries to provide weighted suggestions for future decisions. A system may be configured to receive an user input indicating a selection of a procedure and/or a tactical domain target. The system may be configured to determine a tactical domain data for the procedure. The tactical domain data may include one or more relationships associated with a primary surgical element, a secondary surgical element, the parameter of the patient, and/or the tactical domain target. The system may be configured to generate a recommendation based on the tactical domain data. The recommendation may include an indication of an optimized control loop for the primary surgical element. The system may be configured to send the recommendation to the primary surgical element to adjust an output characteristic associated with the primary surgical element to achieve the tactical domain target.

A surgical system may include a processor configured to obtain an input control data stream associated with a measurement. The input control data stream may be associated with a control loop of the surgical system. The processor may be further configured to determine an importance factor of a condition associated with a patient. The processor may be further configured to generate a response reaction based on the input control data stream and the importance factor of the condition associated with the patient. The processor may be further configured to determine a reaction time, the reaction time being a time period between an instant at which the input control data stream is obtained and an instant at which the response reaction is generated. The processor may be further configured to modify the response reaction based on the determined reaction time.

Systems, methods, and/or instrumentalities disclosed herein may determine a problem-solving level based on the balance of unknowns and data streams. The device may receive a first dataflow from a first surgical element. The device may determine that a physiological parameter of the patient exceeds a patient safety threshold. The device may determine a second dataflow associated with a second surgical element. The determination may be based on an indication of a relational link. The device may transmit a configuration message including an indication that the physiological parameter of the patient exceeded the patient safety threshold. The device may transmit, to the second surgical element, a control message including an indication of the control data associated with the first surgical element. The device may cause the output characteristic associated with the second surgical element to be adjusted based on the control data associated with the first surgical element.

A surgical system may include a processor configured to make a determination between two seemingly accurate but conflicting data streams. The processor may be further configured to obtain a first data stream associated with a measurement. The first data stream may be associated with a first control loop of the surgical system. The processor may be further configured to obtain a second data stream associated with the measurement. The second data stream may be associated with a second control loop of the surgical system. The processor may be further configured to determine that the first control loop and the second control loop are diverging. The processor may be further configured to generate a control signal based on the first and second data streams.

Devices and method for visualizing effects of device movements in an operating room. The device may identify candidate motions of a first robotic arm configured to place a first end effector in a target end effector position internal to a patient. The device may determine, for a first candidate motion, a first number of associated interactions in which the first robotic arm and a second robotic arm will co-occupy space external to the patient. The device may determine, for a second candidate motion, a second number of associated interactions in which the first robotic arm and the second robotic arm will co-occupy space external to the patient. The device may select the first candidate motion or the second candidate motion based on the first and second number of interactions. The device may generate a control signal based on the selected candidate motion of the first robotic arm.

Device and methods for displaying complex and conflicting interrelated data streams. An example device may receive a first biomarker value associated with a first biomarker in a first data stream and a second biomarker value associated with a second biomarker in a second data stream. The device may determine, based on the first biomarker value and the second biomarker value, that a close-loop control condition associated with a control parameter for the surgical device is failed. Based on determining that the close-loop control condition is failed, the device may identify an intraoperative metric associated with the first data stream and the second data stream. The device may generate a control signal configured to display a value associated with the intraoperative metric.

Devices and methods for visualizing effects of device placement in an operating room. An example device may determine a fixed position of a first base attached to a first robotic arm. The device may determine based on the fixed position of the first base, that a first candidate position of a second base is associated with a first number of interactions in which the first robotic arm and a second robotic arm attached to the second base will co-occupy space. The device may determine, based on the fixed position of the first base, that a second candidate position of the second base is associated with a second number of interactions in which the first robotic arm and the second robotic arm will co-occupy space. The device may select the first candidate position or the second candidate position based on the first number of interactions and the second number of interactions.

A surgical instrument system comprising a drive train and a control circuit is disclosed. The drive train comprises a motor and a shaft actuatable by the motor to actuate a function of an end effector. The control circuit is coupled to the motor, wherein the control circuit is configured to determine a relative excess capacity of the drive train, compare the relative excess capacity to a predetermined shifting threshold, and increase the speed of the motor based on the relative excess capacity exceeding the predetermined shifting threshold.

Surgical systems and related computer-implemented methods are provided, including during performance of a surgical procedure on a patient, receiving, at a first surgical system, a first dataflow from a second surgical system, the first dataflow including first data regarding a measured patient parameter that the first surgical system is configured to use in performing a function during the performance of the surgical procedure. The computer-implemented methods including determining that a trigger event occurred during the performance of the surgical procedure such that a sum of a first bandwidth of the first dataflow and a second bandwidth of a second dataflow exceeds an available bandwidth, and in response to determining that the trigger event occurred, and during the performance of the surgical procedure, adjusting at least one of the first and second dataflows such that the sum of the first and second bandwidths does not exceed the available bandwidth.

A surgical system is disclosed including an evacuation module and a controller. The evacuation module comprises a motor and a pump drivable by the motor to draw smoke from a patient. The controller is operable to receive a first input indicative of a type of a surgical instrument, receive a second input indicative of a power level of the surgical instrument, and set a motor speed of the motor based on the first and second inputs.

A surgical system is disclosed including a power source operable to provide a source amount of power, a first surgical module electrically coupled to the power source, a second surgical module electrically coupled to the power source, and a controller operable to determine a free amount of power available to the second surgical module from the power source. The first surgical module is transitionable between an idle state, in which the first surgical module draws a first amount of power from the power source, and an active state, in which the first surgical module draws a second amount of power greater than the first amount of power from the power source. The free amount of power corresponds to a difference between the source amount of power and an amount of power being drawn by the first surgical module.

A system is disclosed including an evacuator module and a controller. The evacuator module provides a housing that defines an inlet port and an outlet port, a flow path extending between the inlet and outlet ports, a pump drivable by a motor to draw smoke into the inlet port and along the flow path, and an air quality sensor positioned at a location along the flow path to measure a parameter. The controller is in operable communication with the air quality sensor and the motor. The controller is operable to control the motor based on the parameter measured by the air quality sensor.

An apparatus includes a jaw body, an anvil surface defined by the jaw hod, and an elongate s'ot extending through the anvil surface and along a ongitudinai axis of the jaw body. The apparatus further includes a first longitudinal row of staple forming pockets disposed on the anvil surface and configured to form a pharality of first staples such that first legs of each formed first staple are laterally aligned with each other. The apparatus also includes a second longitudinal row of staple forming pockets disposed on the anvil surface haterali outwardly of the first longitudinal row of staple forming pockets relative to the longitudinal axis, and configured to form a plurality of second stapes such that second legs of each formed second staple skew ateraUv away from a second crown of the respective formed second staple.

An apparatus includes a cartridge body, a deck, an elongate slot, a plurality of pockets, and a plurality of engagement protrusions. The plurality of engagement protrusions extend from the deck and are configured to grip tissue or an adjunct material. The plurality of engagement protrusions include a first engagement protrusion associated with the first pocket. The first engagement protrusion includes a first inwardly facing projection and a first planar surface. The first inwardly facing projection extends inwardly between a first longitudinal end and a first lateral side of the first pocket. The first planar surface extends substantially parallel to the deck. The first planar surface is defined by the first inwardly facing projection. The first planar surface defines a maximum height of the engagement protrusion relative to the deck. The first planar surface has a non-uniform area defined at least in part by the first inwardly facing projection.

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