accessing data stored in a surgical instrument memory

专利摘要:
accessing data stored in a surgical instrument memory. The present invention relates to a surgical instrument for cutting and fixing (10) having an end actuator (12) including a housing (34) for holding the staples and a sliding support (33) having a cam surface for ejecting the clips. Bobby pins. the instrument has a main drive rod assembly (48, 50, 52) for pushing the slide holder through the housing to eject the clamps. also included is a motor (55) operatively coupled to the drive rod (48). the motor includes a drive assembly (20). the motor further includes a sensor (110) in the drive assembly to measure an actuation load. the instrument further includes a master (268) for measuring a motor power output. the instrument further includes a console (6) for remote control of the engine, said console comprising manually manipulated controls (18, 20). the instrument further includes means (268, 2400) for providing feedback provided from the sensors to the manually manipulated controls.
公开号:BR112013022171A2
申请号:R112013022171-2
申请日:2012-02-28
公开日:2020-11-10
发明作者:Jerome R. Morgan；Frederick E. Shelton Iv
申请人:Ethicon Endo-Surgery Inc；
IPC主号:

专利说明:

. 1/58 Invention Patent Descriptive Report for "ACCESS TO
DATA STORED IN A MEMORY OF A SURGICAL INSTRUMENT." Capabilities", by Shelton et al., filed January 31, 2006, which is hereby fully incorporated by reference.
REFERENCE TO RELATED APPLICATIONS The present application is related to the following US patent applications, which were filed concurrently with US Patent Application Serial No. 11/343,803, mentioned in the preceding paragraph, which are incorporated herein by way of reference, in its entirety: : 15 (1) MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING ' INSTRUMENT WITH USER FEEDBACK SYSTEM, by Frederick E. Shelton, - IV, John Ouwerkerk and Jerome R. Morgan, serial no. 11/ 343,498; (2) MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH LOADING FORCE FEEDBACK, by Frederick E. Shelton, IV, John N.Ouwerkerk, Jerome, R. Morgan and Jeffrey S. Swayze, serial no. 11/343,573; G) MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK, by Frederick E. Shelton, IV, John N.Ouwerkerk, Jerome, R. Morgan and Jeffrey S. Swayze, serial no. 11/344.035; (4) MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH ADAPTIVE USER FEEDBACK, by Frederick E. Shelton, IV, John N. Ouwerkerk and Jerome R. Morgan, serial no. 11/343,447; (5) MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING —INSTRUMENT WITH ARTICULATABLE END EFFECTOR, by Frederick E. Shelton, IV and Christoph L Gillum, Serial No. 11/343,562; (6) MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING
INSTRUMENT WITH MECHANICAL CLOSURE SYSTEM, by Frederick E. Shelton, IV and Christoph L Gillum, serial no. 11/344,024; (7) SURGICAL CUTTING AND FASTENING INSTRUMENT WI-VU TH CLOSURE TRIGGER LOCKING MECHANISM, by Frederick E. Shelton, IVekKevinR Doll, Serial No. 11/343,321; V (8) GEARING SELECTOR FOR A POWERED SURGICAL CUTTING AND FASTENING STAPLING INSTRUMENT, by Frederick E. Shelton, IV, Jeffrey S. Swayze, Eugene L. Timperman, Serial No. 11/343,563; (9) SURGICAL INSTRUMENT HAVING A REMOVABLE BATTERY, by Frederick E. Shelton, IV, Kevin R Doll, Jeffrey S. Swayze and Eugene Timperman, Serial No. 11/344,020; ' (10) ELECTRONIC LOCKOUTS AND SURGICAL INSTRUMENT - INCLUDING SAME, by Jeffrey S. Swayze, Frederick E. Shelton, IV, Kevin R Doll, Serial No. 11/343439; (11) ENDOSCOPIC SURGICAL INSTRUMENT WITH A HAN- o. DLE THAT CAN ARTICULATE WITH RESPECT TO THE SHAFT, by Frederick E. Shelton, IV, Jeffrey S. Swayze, Mark S. Ortiz, and Leslie M. Fugikawa, Serial No. 11/343,547; (12) ELECTRO-MECHANICAL SURGICAL CUTTING AND —FASTENING INSTRUMENT HAVING A ROTARY FIRING AND CLOSURE SYSTEM WITH PARALLEL CLOSURE AND ANVIL ALIGNMENT COMPONENTS, by Frederick E. Shelton, IV, Stephen J. Balek and Eugene L. Timperman, no. serial 11/344,021; (13) DISPOSABLE STAPLE CARTRIDGE HAVING AN ANVIL
WITH TISSUE LOCATOR FOR USE WITH A SURGICAL CUTTING AND | FASTENING INSTRUMENT AND MODULAR END EFFECTOR SYSTEM THEREFORE, by Frederick E. Shelton, IV, Michael S. Cropper, Joshua M. Broehl, Ryan S. Crisp, Jamison J. Float, Eugene L. Timperman, Serial No. 11/343,546; and (14) SURGICAL INSTRUMENT HAVING A FEEDBACK SYSTEM, by Frederick E. Shelton, IV, Jerome R. Morgan, Kevin R. Doll, Jeffrey S. Swayze and Eugene Timperman, serial no. 11/343,545.
. 3/58 BACKGROUND | The present invention relates generally to surgical instruments and more particularly to minimally invasive surgical instruments capable of recording various instrument conditions.
Endoscopic surgical instruments are often preferential to devices for traditional open surgery, as a smaller incision tends to reduce recovery time and complications in the postoperative period.
Consequently, significant development has been applied to a variety of endoscopic surgical instruments that are suitable for the precise positioning of a distal-end actuator at a desired surgical site via a trocar cannula.
These distal end actuators engage tissue in a variety of ways to achieve a diagnostic or therapeutic effect (e.g. an endoscopic surgical instrument, a forceps, a cutter, : 15 staplers, loop applicator, access device, - r application of pharmacological/genetic therapy, and energy device using ultrasound, RF, laser, etc.). ' Known surgical staplers include an end actuator that simultaneously makes a longitudinal incision in the tissue and applies rows of staples on opposite sides of the incision.
The end actuator includes a pair of cooperating gripping elements which, if the instrument is intended for endoscopic or laparoscopic applications, is capable of passing through a cannula.
One of the gripping elements receives a staple cartridge that has at least two laterally spaced rows of staples.
The other gripper element defines an anvil having staple forming pockets aligned with the rows of staples within the cartridge.
The instrument includes a plurality of reciprocating wedges which, when driven distally, pass through openings in the staple cartridge and engage with drivers supporting the staples to drive the staples toward the anvil.
An example of a surgical stapler suitable for endoscopic applications is described in US Patent No. 5,465,895 entitled "SUR-Po o
: 4/58 : GICAL STAPLER INSTRUMENT" for Knodel et al. who presents an endoscopic surgical instrument with distinct closing and triggering actions. A clinician using this device is able to close the U-clamp elements of the stapler over the tissues, to position said tissues before firing the staples. Once the clinician has determined that the CU gripping elements are properly gripping the tissues, the clinician can then fire the surgical stapler with a single firing stroke, or with multiple strokes. triggering, depending on the device. Triggering the surgical stapler causes sectioning and stapling of tissue. The use of simultaneous sectioning and stapling avoids complications that may arise when performing these actions sequentially with different surgical instruments that, respectively, only section and - staple the fabric.
A specific advantage of the ability to close over the fabric. 15 before shooting is that the clinician can verify, through an endoscope, that the desired location for the cut has been reached, including a sufficient amount of tissue that has been captured between opposing jaws. Otherwise, the opposing claws can be pulled too close together, specifically pinching the distal ends of the claws, and thus not effectively forming closed clamps in the separated tissue. At the other extreme, an excessive amount of trapped tissue can cause binding and incomplete firing. When endoscopic surgical instruments fail, they are often returned to the manufacturer or other entity for failure analysis. If the failure resulted in a critical class of device defect, it is necessary for the manufacturer to determine the cause of the failure and determine whether a design change is necessary. In this case, the manufacturer can spend hundreds of man-hours analyzing a failed instrument and trying to reconstruct the conditions under which it failed based solely on damage to the instrument. It can be expensive and challenging to analyze instrument failures in this way. Furthermore, many of these analyzes simply conclude that the failure was due to misuse of the instrument.
. 5/58
SUMMARY i In a general aspect, the present invention relates to a process and a system for downloading sensor data, stored on a positive CG memory disk of a surgical cutting and fixation instrument, to a . 5 external device or a remote computer. According to various modalities, the process involves storing data from one or more sensors of a surgical cutting and clamping instrument in a memory device of a surgical and cutting instrument control unit and fixation during a surgical procedure involving the surgical and cutting instrument. Then, after the surgical procedure, a data link between the control unit and the remote computer device | is established. Then the sensor data can be downloaded from the control unit to the remote computer device. Sensors can include, for example: The trigger closure sensor that detects . 15 an actuation of the reactive closing; an anvil closure sensor' for anvil closure detection; a closing load sensor. an anvil that detects a load on the staple cartridge exerted by the anvil when it is closed; a reactive trigger sensor to detect reactive trigger actuation; a knife position sensor for detecting the position of knives in the end actuator; a cartridge presence sensor to detect if the cartridge is present in the end actuator; a cartridge condition sensor for detecting a cartridge condition; and a linkage sensor for sensing the linkage of the end actuator.
DRAWINGS Various embodiments of the present invention are described herein by way of example in conjunction with the following figures, wherein: The Figures | and 2 are perspective views of a surgical instrument for cutting and fixing, in accordance with various embodiments of the present invention; Figures 3 to 5 are exploded views of an end actuator and an instrument stem in accordance with various embodiments of paragraph 6/58: In the present invention; Figure 6 is a side view of the end actuator in accordance with various embodiments of the present invention; o Figure 7 is an exploded view of the a- instrument cable. 5 in accordance with various embodiments of the present invention; Figures 8 and 9 are partial perspective views of the cable in accordance with various embodiments of the present invention; Figure 10 is a side view of the handle in accordance with various embodiments of the present invention; Figures 10A and 10B illustrate a sensor that may be used in accordance with various embodiments of the present invention; Figure 11 is a schematic diagram of another circuit - used in the instrument in accordance with various embodiments of the present invention; . Figures 12 and 13 are side views of the cable in accordance with other embodiments of the present invention; - Figures 14 to 22 illustrate different mechanisms for locking the closing trigger according to various embodiments of the present invention; Figures 23A-B show a universal joint ("u-joint") that may be employed at the pivot point of the instrument in accordance with various embodiments of the present invention; Figures 24A-B show a torsion cable that can be employed at the pivot point of the instrument according to various modes.
ities of the present invention; Figures 25 to 31 illustrate a "effort assisted" cutting and fixation surgical instrument in accordance with another embodiment of the present invention; Figures 32 to 36 illustrate a "effort assisted" cutting and fixation surgical instrument in accordance with yet another embodiment of the present invention; Figures 37 to 40 illustrate a surgical instrument for cutting
| : 7/58 |
: and tactile feedback attachment for embodiments of the present invention;
Figure 41 illustrates an exploded view of an end actuator.
middle and an instrument stem, in accordance with various embodiments of the present invention; . Figure 42 illustrates an exploded side view of the handle of a mechanical instrument in accordance with various embodiments of the present invention;
Figure 43 illustrates an exploded view of the handle of the mechanically actuated instrument of Figure 42; Figure 44 illustrates a block diagram of a recording system for recording various instrument conditions in accordance with various embodiments of the present invention; - Figures 45 and 46 illustrate cropped side views of an instrument cable showing various sensors according to various modes. 15 of the present invention; Figure 47 illustrates the end actuator of the instrument - showing various sensors in accordance with various embodiments of the present invention; Figure 48 illustrates a trigger bar of the instrument, including a sensor in accordance with various embodiments of the present invention; Figure 49 illustrates a side view of the cable, end actuator. middle, and apparatus trigger bar showing a sensor in accordance with various embodiments of the present invention;
Figure 50 illustrates an exploded view of the staple channel and portions of an instrument staple cartridge showing various sensors in accordance with various embodiments of the present invention;
Figure 51 illustrates a top-down view of the instrument's clamp channel showing various sensors in accordance with various embodiments of the present invention;
Figures 52A and 52B illustrate a flowchart showing a method for operating the instrument according to various embodiments;
Figure 53 illustrates a memory graph showing the conditions
. 8/58: illustrative tions recorded in the instrument according to various embodiments of the present invention; | Figure 54 illustrates a block diagram of a Cv recording system for recording various instrument conditions according to . 5 various embodiments of the present invention; Figure 55 is a diagram illustrating the surgical instrument in communication with a remote computer device; and Figure 56 is a flowchart depicting the process in accordance with various embodiments of the present invention.
DETAILED DESCRIPTION Figures 1 and 2 depict a surgical cutting and clamping instrument 10 in accordance with various embodiments of the present invention. The illustrated embodiment is an endoscopic surgical instrument 10 and, in general, the instrument 10 embodiments described herein are endoscopic cutting and fixation surgical instruments BR 15. It should be noted, however, that in accordance with other embodiments of the present invention, the instrument 10 may be a non-endoscopic surgical cutting instrument, such as a laparoscopic instrument. The surgical instrument 10 shown in Figures 1 and 2 comprises a handle 6, a rod 8, and a swivel end actuator 12 pivotally connected to the shank 8 at a pivot pivot 14. A pivot control 16 may be provided. adjacent to handle 6 to rotate end actuator 12 about pivot pivot
14. It will be understood that various embodiments may include a non-pivoting end actuator and, consequently, may not have a pivot pivot 14 or pivot control 16. Furthermore, in the illustrated embodiment, the end actuator 12 is configured to actuate as an endoscopic surgical instrument for clamping, sectioning and stapling tissue, | although, in other modalities, different types of end actuators | can be used, as end actuators for other types | of surgical devices such as tweezers, cutters, staplers, clip applicators, access devices, pharmacological therapy devices | the Na | | . 9/58 : AC/genetics, ultrasound, RF or laser devices, etc.
The handle 6 of the instrument 10 may include a closing trigger 18 and a triggering trigger 20 to actuate the VÚ end actuator 12. It will be recognized that instruments which have end actuators . 5 for different surgical tasks may have different numbers or types of triggers or other controls suitable for operating the end actuator 12. The end actuator 12 is shown separately from the handle 6 by a rod 8, preferably elongated.
In one embodiment, a clinician or instrument operator 10 can pivot end actuator 12 relative to stem 8 using pivot control 16, as described in more detail in pending publication US Patent Application No. 11/ 329,020, filed January 10, 2006, titled - "Surgical Instrument Having An Articulating End Effector", by Geoffrey C.
Hueil et al., which is hereby fully incorporated by reference. - 15 The end actuator 12 in this example includes, among other things, a groove of clamps 22 and a pivotally translatable gripping member, such as an anvil 24, which are kept in a spacing that ensures the effective stapling or severing of tissue trapped in end actuator 12. Handle 6 includes a pistol grip 26 toward which a closing trigger 18 is pivotally pulled by the clinician to cause the anvil 24 to be pinched or closed toward to the clamp channel 22 of the end actuator 12 to thereby secure the tissue positioned between the anvil jaw 24 and the channel 22. The firing trigger 20 is situated further out with respect to the closing trigger 18. the closing trigger 18 is locked in the closed position, as described below in more detail, the firing trigger 20 can rotate slightly towards the pistol grip 26 so that it can be reached ned by the operator with the use of one hand.
Then the operator can pull the trigger trigger 20 hingedly toward the pistol grip 26 to cause stapling and severing of tissue trapped in the end actuator 12. In other embodiments, different types of gripping members
. 10/58 | i are in addition to the anvil 24 can be used, such as an opposing claw, etc. It will be appreciated that the terms "proximal" and "distal" are used herein with reference to the act of tightening the handle 6 of an instrument 10 by the clinician. Therefore, the end actuator 12 is distal to the most proximal CV handle 6. It should be further recognized that, for the sake of convenience and clarity, spatial terms such as "vertical" and "horizontal" are used in the present invention. in relation to the drawings. However, surgical instruments can be used in many orientations and positions, and these terms are not intended to be limiting and absolute.
Closing trigger 18 can be triggered first. When - the Clinician is satisfied with the placement of the end actuator 12, he can retract the close trigger 18 to the fully closed and locked position adjacent to the pistol grip 26. stop 20 can then be actuated. Trigger trigger 20 returns to the open position (shown in Figures 1 and 2) when the clinician removes pressure, as described more fully below. A release button present on the handle 6 can, when pressed, release the latch of the closing trigger 18. The release button can be implemented in various forms, for example the release button 30 shown in the Figures 42 through 43, slide release button 160 shown in Figure 14, and/or button 172 shown in Figure 16. Figures 3 through 6 show embodiments of a rotationally driven end actuator 12 and stem 8 according to various modalities. Figure 3 is an exploded view of end actuator 12 according to various embodiments. As shown in the illustrated embodiment, the end actuator 12 may include, in addition to the previously mentioned groove 22 and anvil 24, a cutting tool 32, a sliding support 33, a staple cartridge 34 which is removable in groove 22, and a helical screw rod! 36. The cutting instrument 32 can be, for example, a knife. Anvil 24 can be opened and |
: 11/58 : closed on pivot pins 25 connected to the proximal end of the channel
22. The anvil 24 may also include, at its proximal end, a tab 27 which is inserted into a component of the mechanical closing system to open and close the anvil 24. When the closing trigger 18 is actuated , i.e. pulled by a user of instrument 10, anvil 24 can "pivot around pivot pins 25 forming a closed or locked position. If the end actuator grip 12 is satisfactory, the operator can triggering the trigger 20 which, as explained in more detail above, causes the knife 32 and the slide support 33 to run longitudinally along the channel 22, thereby cutting the tissue attached to the end actuator 12 Movement of the slider 33 along the channel 22 causes the staples (not shown) of the staple cartridge 34 to be driven through the separate tissue and with respect to the closed anvil 24, which turns the staples to secure the tissue separated. In : 15 different modalities, su slider 33 may be an integral component of cartridge 34. US Patent No. 6,978,921 entitled "SURGICAL STA-PLING INSTRUMENT INCORPORATING AN E-BEAM FIRING MECHA- : NISM", granted to Shelton, IV et al. ., which is fully incorporated here by reference, provides more detail on these two-stroke cutting and fastening instruments. The slide support 33 can be part of the cartridge 34, so that when the knife 32 retracts after the cutting operation, the slide support 33 does not retract. It should be noted that while the embodiments of the instrument 10 described herein employ an end actuator 12 that staples the sectioned tissue, other technical embodiments other than the different technical embodiments for clamping or sealing the sectioned tissue may be used. For example, end actuators that use RF (radio frequency) energy or adhesives to secure the sectioned tissue can also be used. US Patent No. 5,709,680 titled "ELECTROSURGICAL HEMOSTATIC DEVICE" by Yatesetal and US Patent No. 5,688,270 titled "ELECTROSURGICAL HEMOSTATIC DEVICE WITH RECESSED AND/OR OFFSET ELECTRODES" by Yates et al., which are here incorporated by way of reference,
: 12/58 : feature an endoscopic cutting instrument that uses RF energy to seal the separated tissue. US Patent Application Serial No. 11/267,811 to Jerome R. Morgan, et al, and US Patent Application Serial No. 11/267,383 to Frederick E. Shelton, IV, et. al, which are also incorporated herein, by way of reference in their entirety, feature cutting instruments that use adhesives to grip separate tissue.
Thus, while the description of the present invention pertains to cutting/stapling operations and the like, it should be recognized that this is an exemplary embodiment, and is not intended to be limiting. Other tissue gripping techniques can also be used.
Figures 4 and 5 are exploded views and Figure 6 is a side view of end actuator 12 and stem 8 according to various embodiments. As shown in the illustrated embodiment, the stem 8 may include an adjacent closure tube 40 and a distal closure tube 42:15 pivotally connected by a pivot connection 44. The distal closure tube 42 includes an opening 45 into which the tab 27 existing on the anvil - 24 is inserted, in order to open and close the anvil 24, as described below in more detail. Disposed within the closure tubes 40 and 42 may be a proximal structuring tube 46. Disposed within the protruding structuring tube. 46 may be a pivoting (or proximal) main drive rod 48 that communicates with a secondary drive rod 50! (or distal) by means of a set of bevel gears 52. The shaft of | secondary drive 50 is connected to a drive gear | 54 which engages an adjacent drive gear 56 of the stop rod | helical screw 36. Vertical bevel gear 52b can seat and pivot in an opening 57 in the distal end of the adjacent structuring tube. 46. A distal structuring tube 58 may be used to close off the secondary drive rod 50 and the drive gears 54, 56. Collectively, the main drive rod 48, the secondary drive rod 50, and the pivot assembly (eg, bevel gear assembly 52a to ac) are sometimes referred to in the present invention as "main drive rod assembly".
. 13/58: A bearing 38, positioned at a distal end of the staple groove 22, receives the helical screw 36, allowing the helical screw 36 to rotate freely with respect to the groove 22. The helical screw shank 36 can interlock an opening (not shown) of the knife 32 so that rotation of the shank 36 causes the knife 32" to rotate in a distal position or in a proximal direction (depending on the direction of rotation) through the clamp groove 22. rotation of the main drive rod 48 through actuation of the trigger 20 (as explained in greater detail below), the bevel gear assembly 52a-c causes the secondary drive rod 50 to rotate, which, in turn, in turn, due to the engagement of the drive gears 54, 56, it causes the helical screw rod 36 to rotate, which causes the knife drive member 32 to move longitudinally along the shaft. channel 22 p To cut any tissue : 15 trapped inside the end actuator 12. Slide support 33 can . be made, for example, of plastic, and may have an inclined distal surface. - As the sliding support 33 traverses the channel 22, the sloping front surface can push up or drive the staples in the staple cartridge through the clamped fabric and against the anvil 24. The anvil 24 turns the staples, thereby stapling the cut fabric. When the knife 32 is retracted, the knife 32 and the slide support 33 can become disengaged, thus exiting the slide support 33 at the distal end of the groove 22.
As described above, due to the lack of user feedback for the cutting/stapling operation, there is a lack of general acceptance among clinicians using motor-driven endoscopic surgical instruments where the cutting/stapling operation is actuated by a simple pressure of a button. In contrast, embodiments of the present invention provide a motor-driven endoscopic surgical instrument with feedback to the user about the positioning, force, and/or position of the cutting instrument 32 on the end actuator 12. Figures 7 through 10 illustrate a exemplary modality of a motor-driven endoscopic surgical instrument and, in particular, the | EN or
. 14/58
: cable of the same, which provides feedback to the user related to the positioning and loading force of the cutting instrument 32 on the end actuator 12. In addition, the modality can use the CV energy supplied by the user in the retraction trigger 20 to power the device (a mode called "assisted effort"). The embodiment can be used with the above-described embodiments of the rotationally driven end actuator 12 and stem 8. As shown in the illustrated embodiment, the handle 6 includes outer lower side pieces 59 and 60, and outer top sides 61 and 62, which join together to form, generally speaking, the outside of the handle 6. A battery 64, such as a lithium-ion battery pack 4, may be provided in the pistol grip portion 26. of the handle 6. The battery 64 powers an electric motor 65 disposed in an upper portion - of the pistol grip portion 26 of the handle 6. According to various embodiments, the motor 65 can be a current drive motor. 15 continuous brush, which has a maximum rotation of approximately "25,000 RPM.
Other suitable types of electric motors can also be used.
The motor 65 can drive a 90° bevel gear set 66 comprising a first bevel gear 68 and a second bevel gear 70. The bevel gear set 66 can drive a planetary gear set 72. along with planetary gears 72 may include a pinion gear 74 connected to a drive rod 76. The pinion gear 74 may drive a mating annular gear 78 which drives a helical gear drum 80 by means of a drive rod 82. A ring 84 may be threaded onto the helical gear drum 80. Therefore, when the motor 65 rotates, the ring 84 is forced to move along the helical gear drum 80, through the bevel gear set 66, the planetary gear set
72 and the annular gear 78, interposed therein.
Cable 6 may also include a motor run sensor 110 (see Figure 10) in communication with trigger trigger 20 to detect when trigger trigger 20 has been withdrawn (or "closed") in
. 15/58 : towards the pistol grip portion 26 of the handle 6 by the operator to thereby actuate the cutting/stapling operation by the end actuator 12. Sensor 110 may be a proportional sensor such as CV a rheostat or a variable resistor. When trigger trigger 20 is pulled, sensor 110 detects movement, and sends an electrical signal indicative of the voltage (or power) to be supplied to motor 65. When sensor 110 is a variable resistor or similar, rotation of the motor 65 can be generally proportional to the amount of movement of trigger 20. That is, if the operator only pulls or closes trigger trigger 20 only a little, the rotation of motor 65 is relatively low. When the trigger trigger 20 is fully pulled (or placed in the fully closed position), the rotation of motor 65 is at its maximum. In other words, the more force the user applies when pulling trigger trigger 20, the more voltage is applied to motor 65, causing higher rotational speeds. : 15 Handle 6 may include a handle midpiece 104 adjacent to the upper portion of the trigger 20. Handle 6 may also - comprise a return spring 112 connected between posts on the handle midpiece 104 and trigger trigger 20. Return spring 112 can force trigger trigger 20 to its fully open position. — Thereby, when the operator releases the trigger trigger 20, the return spring 112 pulls the trigger trigger 20 to its open position, thus removing the triggering of the sensor 110, and stopping the rotation of the motor
65. Furthermore, due to the return spring 112, whenever a user closes the trigger 20, the user will experience resistance to the closing operation, thus receiving feedback as to the amount of rotation exerted by the motor 65. Additionally, the operator could stop retracting the trigger trigger 20 to thereby remove force from the sensor 100 so as to stop the motor 65. In this way, the user could stop the positioning of the end actuator 12, the which gives the operator some control of the cutting/clamping operation.
The distal end of the 80 in- | includes a distal drive rod 120 that drives a gear
. 16/58 : ring 122, which corresponds to a pinion gear 124. The pinion gear 124 is connected to the main drive rod 48 of the main drive rod assembly. Thus, rotation of motor 65 causes the main drive rod assembly to rotate, which causes R 5 to drive end actuator 12, as described above.
The ring 84 threaded onto the helical gear drum 80 may include a column 86 which is disposed within a slot 88 of a slotted arm 90. The slotted arm 90 has, at its opposite end 94, an opening 92 which receives a pivot pin 96 which is connected between the outer side pieces 59 and 60 of the cable. The pivot pin 96 is also arranged through an opening 100 in the trigger and an opening 102 in the middle piece 104 of the handle. - In addition, cable 6 may include an engine reversing sensor (or end of stroke sensor) 130 and an engine stop sensor (or 15 start of stroke) 142. In various embodiments, the engine stop sensor (or. reversing motor 130 may be a limit switch located at the distal end of worm gear drum 80 so that ring 84 threaded onto worm gear drum 80 contacts, and actuates, the motor reversing sensor 130, when the ring 84 reaches the distal end 20 of the helical gear drum 80. The motor reversing sensor 130, when activated, sends a signal to the motor 65 to reverse its direction of rotation. , thus removing the knife 32 from the end actuator 12 after the cutting operation.
Motor stop sensor 142 can be, for example, a normally closed limit switch. In various embodiments, it may be located at the proximal end of the worm gear drum 80, so that the ring 84 actuates the key 142 upon reaching the proximal end of the worm gear drum 80. In operation, when a instrument operator 10 pulls back trigger trigger 20, sensor 110 detects the positioning of trigger trigger 20 and sends a signal to motor 65 to induce forward rotation of motor 65, for example, at a rate proportional to intensity
. 17/58 . whereupon the operator pulls back the trigger 20. The forward rotation of the motor 65, in turn, rotates the annular gear 78 present at the distal end of the planetary gear set 72, thus causing the gear drum to rotate. helical gear 80, and causing the threaded ring 84 on the worm gear drum 80 to move distally along said worm gear drum 80. Rotation of the worm gear drum 80 also directs the helical gear assembly 80. main drive rod as described above which, in turn, leads to the positioning of the knife 32 on the end actuator 12. That is, the knife 32 and the slide support 33 are brought to cross the groove 22 longitudinally, thus cutting , the tissue trapped in the end actuator 12. In addition, the stapling operation of the end actuator 12 is performed in embodiments in which a stapler type end actuator 12 is used. . 15 When the cutting/stapling operation by the end actuator 12 is complete, the ring 84 on the helical-gear drum 80 will have reached the distal end of the same, thus resulting in the activation of the motor reversal sensor. 130, which sends a signal to motor 65 to cause it to reverse rotation.
In its turn, . 20 this causes the knife 32 to retract and also causes the ring 84 on the helical gear drum 80 to move backwards to the adjacent end of the worm gear drum 80. The handle midpiece 104 includes a shoulder on the back 106 that couples to the split arm 90, as best shown in Figures 8 and 9. The cable midpiece 104 also has a forward movement lock 107 which engages the firing trigger 20. The movement of the slotted arm 90 is controlled, as explained above, by the rotation of the motor 65. When the slotted arm 90 rotates counterclockwise as the ring 84 travels from the adjacent end of the helical gear drum 80 to the distal end, the middle cable piece 104 will be free to rotate clockwise. anticlockwise.
That way, as the user pulls out the trigger
. 18/58: 20, the trigger trigger 20 will engage the forward movement stop 107 of the middle cable piece 104, causing the middle cable piece 104 to rotate counterclockwise.
Due to the rear CG shield 106 which engages the slotted arm 90, however, the middle handle piece 104 will only be able to rotate counterclockwise as far as the slotted arm 90 will allow.
Thus, if the motor 65 stops rotating for any reason, the slotted arm 90 will stop rotating, and the user will not be able to withdraw the trigger 20 further, due to the fact that the middle cable piece 104 is not free to rotate counterclockwise due to slotted arms 90. | Figures 10A and 10B illustrate two variable sensor states that can be used as the engine run sensor 110 in accordance with various embodiments of the present invention.
Sensor 110 may include a face portion 280, a first electrode (A) 282, a second electrode (B) 284, and a compressible dielectric material 286 between the electrodes of 282 and 284, such as, for example, an electroactive polymer (EAP). The sensor. 110 can be positioned so that the face portion 280 contacts the trigger 20 when retracted.
Consequently, when the trigger 20 is retracted, the dielectric material 286 is compressed, α-20 as shown in Figure 10B, so that the electrodes 282 and 284 are closer together.
Since the distance "b" between electrodes 282, 284 is directly related to the impedance between electrodes 282, 284, the greater the distance, the greater the impedance, and the smaller the distance, the lower the impedance.
In this way, the amount of compression of dielectric material 286 caused by retraction of trigger trigger 20 (denoted as force "F" in Figure 42) is proportional to the impedance between electrodes 282, 284, which can be used to proportionally control the motor 65. The components of an exemplary closing system for closing (or securing) the anvil 24 of the end actuator 12 by retracting the closing trigger 18 are also shown in Figures 7 to 10. In the illustrated embodiment, the closing system includes a yoke 250 connected to the closing trigger 18 by a pivot pin 251 inserted through the
. 19/58 +
: via openings aligned in both the closing trigger 18 and the yoke 250. A pivot pin 252, around which the closing trigger 18 pivots, is inserted through another opening in the closing trigger 18 , which is offset from the point at which the pin 251 - 5 is inserted through the closing trigger 18. In this way, retraction of the closing trigger 18 causes the upper part of the closing trigger 18, at the which yoke 250 is secured via pin 251, turn counterclockwise.
The distal end of the yoke 250 is connected, via a pin 254, to a first locking bracket 256. The first locking bracket 256 connects to a second locking bracket 258. Collectively, the locking brackets 256 and 258 define an opening in which the proximal end of the proximal closure tube 40 (see Figure 4) is supported and held so that the longitudinal movement of the closure clamps 256 and 258 causes a longitudinal movement of the closure clamps 256 and 258. proximal closure tube 40. The instrument 10 also includes a closure rod 260 disposed within the proximal closure tube 40. The closure rod 260 may include a window 261 within which a column 263 exists on one of the pieces. of the handle, such as the lower outer side piece 59 in the illustrated embodiment, 20 is arranged to securely connect the closing rod 260 to the handle 6. In this way, the closing tube proximately 40 is capable of moving longitudinally with respect to closure stem 260. Closure stem 260 may also include a distal collar 267 that fits within a cavity 269 in adjacent structuring tube 46 and is held therein. by a cover 271 (see Figure 4). In operation, when the yoke 250 rotates due to retraction of the closing trigger 18, the closing clamps 256, 258 cause the adjacent closing tube 40 to move distally (i.e., away from the end of instrument handle 10), which causes the distal closure tube 42 to move distally, which causes the anvil 24 to rotate around the pivot pins 25 to the closed or locked position.
When closing trigger 18 is unlocked from the locked position,
. 20/58 . The adjacent closure tube 40 is caused to slide adjacently, which causes the distal closure tube 42 to slide adjacently, which, by virtue of the tab 27 which is inserted into the window 45 of the closure VC tube 42, causes the anvil 24 to pivot around the pins: 5 pivots 25 to the open or unclamped position. Thus, by retracting and locking the closing trigger 18, an operator can clamp the tissues between the anvil 24 and the channel 22, and can release the tissues following the cutting/stapling operation, by unlocking the closing trigger 20. from its locked position. Figure 11 is a schematic diagram of an electrical circuit of instrument 10 in accordance with various embodiments of the present invention. When an operator initially pulls the trigger trigger 20, after locking the closing trigger 18, the sensor 110 is activated, allowing a current to flow therethrough. If sensor normally open switch 130 . 15 motor reversing switch is open (meaning the end-of-travel of the end actuator has not been reached), current will flow to a pole relay. single and double drive 132. As motor reversing sensor switch 130 is not closed, inductor 134 of relay 132 will not be energized, so relay 132 will be in its de-energized state. Circuit 20 also includes a cartridge lock sensor 136. If end actuator 12 includes a staple cartridge 34, sensor 136 will be in the closed state, allowing current to flow. Otherwise, if the end actuator 12 does not include a staple cartridge 34, sensor 136 will be open, thus preventing battery 64 from powering motor 65. When staple cartridge 34 is present, sensor 136 is closed, which energizes a single-pole, single-acting relay
138. When relay 138 is energized, current flows through relay 136, through variable resistor sensor 110, and to motor 65 via a dual-pole, dual-drive relay 140, thus powering motor 65 and allowing that it rotates in the forward direction. When end actuator 12 reaches the end of its stroke, motor reversing sensor 130 will activate, thus closing the switch.
The %Õel =i!)2!T1ã AC. and is . AU iIA O MN | . 21/58 : 130 and energizing relay 134. This causes relay 134 to assume its energized state (not shown in Figure 13) which causes current to bypass cartridge latch sensor 136 and resistor variable 110, and at CV instead causes current to flow to the dual pole relay and drive 142 and back to motor 65, but through relay 140, which causes the motor to 65 reverses its rotational direction.
Since engine stop sensor switch 142 is normally closed, current will flow back to relay 134 to keep it closed until switch 142 opens.
When knife 32 is fully retracted, engine stop sensor switch 142 is activated, causing the knife to . ve 142 opens, thereby removing power from motor 65. In other embodiments, instead of a proportional type sensor 110, an on-off type sensor could be used.
In these modes, the rotation rate of the engine 65 would not be proportional to the force applied ' 15 by the operator.
Instead, motor 65 would generally rotate at a constant speed.
The operator, however, would still experience a retro-in. force formation, as the trigger 20 is engaged with the gear drive train.
Figure 12 is a side view of handle 6 of an "assisted effort" powered endoscopic surgical instrument according to another embodiment.
The embodiment of Figure 12 is similar to that of Figures 7 to 10 except that in the embodiment of Figure 12, there is no slotted arm connected to the ring 84 threaded into the helical gear drum 80. Instead, in the embodiment of Figure 12, ring 84 includes a sensing portion 114 that moves with ring 84 as ring 84 advances down (and back) into worm gear drum 80. Sensing portion 114 includes a notch 116. Motor reversal sensor 130 may be located at the distal end of notch 116 and motor stop sensor 142 may be located at the adjacent end of notch 116. — As ring 84 moves down helical gear drum 80 (and back), the sensing portion 114 moves with it.
Additionally, as shown in Figure 12, the intermediate piece 104 may have a
. 22/58 . arm 118 extending into notch 12.
In operation, as an operator of instrument 10 retracts trigger 20 towards pistol grip 26, motor run sensor 110 detects motion and sends a signal to 5 to energize motor 65, which, among other things, causes the 80° helical gear drum to rotate. As the helical gear drum 80 rotates, the ring 84 threaded on the helical gear drum 80 advances (or retracts, depending on the rotation). Furthermore, due to the pull of the trigger 20, the middle piece 104 is caused to rotate counterclockwise with the trigger 20 due to the stop of , forward movement 107 which engages the trigger 20. counterclockwise of midpiece 104 causes arm 118 to rotate counterclockwise with sensor portion 114 of ring 84 so that arm 118 is disposed in notch 116. When ring 84 reaches the end ' 15 —distal midway of the helical gear drum 80, the arm 118 will contact and thus activate the motor reversal sensor 130. Similarly, when the ring 84 reaches the adjacent end of the drum with helical gear 80, the arm will contact and thus trigger the motor stop sensor 142. Such actions can reverse and stop the motor 65, respectively as described above.
Figure 13 is a side view of handle 6 of an "assisted effort" powered endoscopic surgical instrument according to another embodiment. The embodiment of Figure 13 is similar to the embodiment of Figures 7 to 10 with the exception that in the embodiment of Figure 13, there is no slot in the arm 90. Instead, the ring 84 threaded on the helical gear drum 80 includes a vertical channel 126. Instead of a slot, arm 90 includes a column 128 which is disposed in channel 126. As helical gear drum 80 rotates, ring 84 threaded into helical gear drum 80 advances (or retracts, depending on rotation). Arm 90 rotates counterclockwise as ring 84 advances due to post 128 which is arranged in groove 126, as shown in Figure 13.
As mentioned above, while using an instrument
. 23/58 . motorized two-stroke, the operator first pulls back and locks the closing trigger 18. Figures 14 and 15 show one embodiment of a way to lock the closing trigger 18 to the GV pistol grip portion 26 of the handle 6 In the illustrated embodiment, the pistol grip portion 26 includes a hook 150 which is oriented to rotate counterclockwise around a pivot point 151 by a torsion spring 152. In addition, the closing trigger 18 includes a locking bar 154. As the operator withdraws the locking trigger 18, the locking bar 154 engages an inclined portion 156 of the hook 150, thereby rotating the hook 150 upwards (or clockwise in Figures 14 to 15). 15) until there; lock bar 154 completely passes the angled portion 156 into a recessed notch 158 of the hook 150, which locks the lock trigger 18 in place.
The operator can release the closing trigger 18 by pressing a slide release button 160 on the rear side or opposite the entire pistol grip portion 26. Pushing down the slide release button 160 rotates the hook 150 clockwise so that the locking bar 154 is released from the recessed notch: 158. Figure 16 shows another mechanism for locking the trigger 20 for locking according to various embodiments.
In the embodiment of Figure 16, the closing trigger 18 includes a wedge 160 provided with an arrowhead portion 161. The arrowhead portion 161 is oriented downward (or clockwise) by a spring bundle. 162. Wedge 160 and leaf spring 162 may be produced from, for example, molded plastic.
When the locking trigger 18 is retracted, the arrowhead portion 161 is inserted through an opening 164 in the pistol grip portion 26 of the handle 6. A lower beveled surface 166 of the arrowhead portion 161 engages. to a lower side wall 168 of opening 164, forcing arrowhead portion 161 to rotate counterclockwise.
Eventually, the lower beveled surface 166 completely passes the lower side wall 168, removing the counterclockwise force on the arrowhead portion 161, causing
. 24/58: Lower sidewall 168 slides into a locked position in a slot 170 behind arrowhead portion 161.
To unlock the closing trigger 18, a user presses down a button 172 on the opposite side of the closing trigger 18, the 5 causing the arrowhead portion 161 to rotate counterclockwise and allowing the arrowhead portion 161 slides out of opening 164. Figures 17 to 22 show a locking trigger locking mechanism according to another embodiment. As shown in this embodiment, the locking trigger 18 includes a flexible longitudinal arm 176 that includes a side pin 178 extending therefrom. The arm 176 and the pin 178 can be produced from plastic - molded, for example. The pistol grip portion 26 of the handle 6 includes an opening 180 with a laterally extending wedge 182 | . 15 arranged therein. When the lock trigger 18 is retracted, the pin 178 engages the wedge 182, and the pin 178 is forced downward (i.e., the arm 176 is rotated clockwise) by the lower surface 184 of the wedge. , as shown in Figures 17 and 18. When the pin 178 passes completely through the bottom surface 184, the clockwise force on the arm 176 is removed, and the pin 178 is rotated counterclockwise so that the pin 178 comes to rest in a notch 186 behind the wedge 182, as shown in Figure 19, thus locking the closing trigger.
18. The pin 178 is further held in place in the locked position by a flexible stop 188 extending from the wedge 184.
25 To unlock the closing trigger 18, the operator can still pull the closing trigger 18, causing the pin 178 to engage an inclined rear wall 190 of the opening 180, forcing the pin 178 upwards after the flexible stop 188, as shown in Figures and 21. The pin 178 is then free to go out of an upper channel 192 in the opening 180 so that the closing trigger 18 is no longer attached to the pistol grip portion 26, as shown in Figure
22.
. 25/58 . Figures 23A and B show a universal joint ("u-joint")
195. The second part 195-2 of the u-joint 195 rotates in a horizontal plane on which the first part 195-1 rests. Figure 23A shows the CV 195 U-joint in a linear orientation (180º) and Figure 23B shows the U-joint 195 or 5 in an approximately 150º orientation. U-joint 195 can be used instead of bevel gears 52a-c (see Figure 4, for example) at pivot point 14 of main drive rod assembly to pivot end actuator 12. Figures 24A-B show a torque cable 197 that can be used in place of the bevel gears 52a-c and the u-joint 195 to link the end actuator 12. Figures 25 to 31 illustrate another embodiment of an instrument. - two-stroke cutting and fixation motorized surgical 10 with "assisted effort", according to another embodiment of the present invention. The fashion- . The arrangement of Figures 25 to 31 is similar to the embodiment of Figures 6 to 10 with the exception that instead of the helical gear drum 80, the mode. The utility of Figures 23 to 28 includes an alternate gear drive assembly. The embodiment of Figures 25 to 31 includes a gearbox assembly 200 including several gears arranged in a frame 201, wherein the gears are connected between the planetary gear 72 and the pinion gear 124 at the adjacent end of the drive rod. 48. As explained further below, the gearbox assembly 200 provides feedback to the user via the trigger 20 regarding positioning and loading force 25. end actuator 12. In addition, the user can supply power to the system through the gear box assembly 200 to assist in positioning the end actuator 12. In this regard, like the embodiments described above, the embodiment of Figures 23 to 32 is another motorized instrument with "assisted effort" 10 that provides the user with information regarding the loading force experienced by the instrument. In the illustrated embodiment, the trigger 20 includes two
. 26/58 . parts: a main body portion 202 and a stiffening portion
204. The main body portion 202 can be made of plastic, for example, and the stiffener portion 204 can be made of a more rigid material, such as metal. In the illustrated embodiment, the stiffening portion 204 or 5 is adjacent to the main body portion 202, but in accordance with other embodiments, the stiffening portion 204 may be disposed within the main body portion 202. A pivot pin 207 may be inserted through openings in trigger parts 202 and 204 and may be the point around which trigger trigger 20 rotates. In addition, a spring 222 can direct the trigger 20 to rotate in a counterclockwise direction; time. Spring 222 may have a distal end connected to a pin 224 which is connected to parts 202, 204 of trigger 20. The adjacent end of spring 222 may be connected to one of the lower outer side pieces of handle 59, 60.
In the illustrated embodiment, both the main body portion 202' and the stiffening portion 204 include gear portions 206, at 208 (respectively) in their upper end portions. Gear portions 206, 208 engage a gear in the gearbox assembly 200, as explained below, to direct the main drive rod assembly and provide feedback to the user regarding the positioning of the shift actuator. end 12.
Gear box assembly 200 may include, as shown in the illustrated embodiment, six (6) gears. A first gear 210 of the gearbox assembly 200 engages the gear portions 206, 208 of the trigger 20. Further, the first gear 210 engages a second minor gear 212, the second minor gear 212 being coaxial with a third larger gear 214. The third gear 214 engages a fourth smaller gear 216, the fourth smaller gear being coaxial with a fifth gear 218. The fifth gear 218 is a 90° bevel gear that engages a 90° bevel gear. 220 (best shown in Figure 31) which is connected to pinion gear 124
. 27/58 . which drives the main drive rod 48. In operation, when the user retracts the trigger 20, an engine run sensor (not shown) is activated, which CÚ can provide a signal to the engine 65 to rotate at a rate proportional to the extent or force with which the operator is retracting the trigger
20. This causes the motor 65 to rotate at a speed proportional to the sensor signal. The sensor is not shown for this mode, but it may be similar to the 110 engine run sensor described above. The sensor can be located on the handle 6 so that it is lowered when the trigger 20 is retracted. Also, instead of a proportional s-type sensor, an on/off type sensor can be used. The rotation of the motor 65 causes the gear to bevel. 68, 70 rotate, which causes planetary gear 72 to rotate, which causes, through drive rod 76, ring gear 122 - 15 to rotate Ring gear 122 meshes with pinion gear ' 124, which is connected to the main drive rod 48. In this way, the rotation of the pinion gear 124 directs the main drive rod 48, which drives the cutting/stapling operation of the end actuator 12.
. 20 The forward rotation of the pinion gear 124, in turn, causes the bevel gear 220 to rotate, which causes the first gear 210 to rotate through the rest of the gears in the gearbox assembly 200. First gear 210 engages gear portions 206 and 208 of trigger trigger 20, thereby causing trigger trigger 20 to rotate counterclockwise when motor 65 provides forward drive to end actuator 12 ( and to rotate counterclockwise when motor 65 rotates in reverse to retract end actuator 12). In this way, the user receives feedback regarding the loading force and the positioning of the au- ! 30-. 12 through the user's grip over the trigger 20. In this way, when the user retracts the trigger 20, the operator will feel a resistance related to the load force felt
. 28/58 . by the end actuator 12. Similarly, when the operator releases the trigger trigger 20 after the cutting/stapling operation so that it can return to its original position, the user will experience a clockwise rotation force at from firing trigger 20 that 5 is generally proportional to the reverse speed of motor 65.
It should also be noted that in this mode the user can apply force (either instead of or in addition to the force of the motor 65) to drive the main drive rod assembly (and consequently the cutting/stapling operation of the end actuator). 12) by retracting the trigger 20. That is, retraction of the trigger 20 causes the gear portions 206 and 208 to rotate counterclockwise, which causes the gears in the gear case 200 rotate, thereby causing the pinion gear 124 to rotate, which causes the main drive rod 48 to rotate.
. 15 Although not shown in Figures 25 to 31, the instrument ' 10 may also include motor reversal and monotor stop sensors. As described above, engine reversing and stall sensors. can detect, respectively, the end of the cutting stroke (complete positioning of knife 32) and the end of the retraction operation (complete retraction - 20 of knife 32). A circuit similar to that described above with respect to Figure 11 can be used to properly energize motor 65.
Figures 32 to 36 illustrate a motorized surgical instrument for cutting and fixing two strokes 10 with "assisted effort" according to another embodiment. The embodiment of Figures 32 to 36 is similar to the embodiment of Figures 25 to 31 with the exception that in the embodiment of Figures 32 to 36, the trigger 20 includes a lower portion 228 and an upper portion 230. Both portions 228, 230 are connected. ae pivot about a pivot pin 207 which is disposed in each portion 228, 230. The upper portion 230 includes a gear portion 232 that engages the first gear 210 of the gear box assembly 200. The spring 222 is connected to the top 230 so that the top portion is oriented in a clockwise direction. The upper portion 230 may also include
. 29/58: a lower arm 234 that contacts a lower surface of the lower portion 228 of the trigger 20 so that when the upper portion 230 is caused to rotate clockwise, the lower portion 228 CÚ also rotates clockwise. clockwise, and when the lower portion 228 rotates counterclockwise, the upper portion 230 also rotates counterclockwise. Similarly, the lower portion 228 includes a rotational stop 238 that engages a shield of the upper portion 230. Thus, when the upper portion 230 is caused to rotate counterclockwise, the portion | lower portion 228 also rotates counterclockwise, and when lower portion 228 rotates clockwise, upper portion 230 also rotates clockwise. The illustrated embodiment also includes the engine run sensor 110 which communicates a signal to the engine 65 which, in various embodiments, can cause the engine 65 to rotate at a speed proportional to the force. applied by the operator when retracting the trigger trigger 20. The sensor 110 can be, for example, a rheostat or some other variable resistance sensor, as explained above. In addition, the instrument 10: may include a motor reversing sensor 130 that is obstructed or switched when contacted by a front face 242 of the upper portion 230 of the trigger trigger 20. When activated, the motor reversing sensor 130 sends a signal to motor 65 to reverse direction. In addition, the instrument 10 may include an engine stop sensor 142 that activates or activates when it comes into contact with the lower portion 228 of the trigger 20. When activated, the engine stop sensor 142 sends a signal to stop the reverse rotation of motor 65. In operation, when an operator retracts the close trigger 18 to the locked position, the trigger trigger 20 is slightly | retracted (through mechanisms known in the art, including US Patent No. 6,978,921 to Frederick Shelton, IV et al and US Patent No.
6,905,057 to Jeffery S. Swayze et. al, all of which are hereby incorporated by reference in their entirety) so that the user can hold the trigger 20 to initiate the cutting/stapling operation, con-
.: 30/58 | : as shown in Figures 32 and 33. At this time, as shown in Figure 33, the gear portion 232 of the upper portion 230 of the trigger 20 moves into engagement with the first gear 210 of the C6 gearbox assembly. 200. When the operator retracts the trigger of the trigger 20, in accordance with various modes, the trigger trigger 20 may rotate a little, such as five degrees, before activating the motor run sensor 110, as shown in Fig. Figure 34. Activation of sensor 110 causes motor 65 to rotate forward at a rate proportional to the retraction force applied by the operator. The forward rotation of the motor 65 causes, as described above, the main drive rod 48 to rotate, which causes the knife 32 in the end actuator 12 to be positioned (i.e., begin to cross the channel 22) . Rotation of pinion gear 124, which is connected to main drive rod 48, causes gears 210 to 220 in gearbox assembly 200 . 15 turn. Once the first gear 210 is in engagement with the gear portion 232 of the upper portion 230 of the trigger 20, the upper portion 232 is urged to rotate counterclockwise, which causes: lower portion 228 also rotate counterclockwise.
When the knife 32 is fully positioned (i.e., at the end of the cutting stroke), the front face 242 of the upper portion 230 activates the reversing sensor of the motor 130, which sends a signal to the motor 65 to reverse. the rotational direction. This causes the main drive rod assembly to reverse rotational direction to retract knife 32. Reverse rotation of the main drive rod assembly also causes gears 210 to 220 in the gearbox assembly to shift. in the reverse direction, which causes the upper portion 230 of the trigger 20 to rotate clockwise, which causes the lower portion 228 of the trigger 20 to rotate clockwise until the lower portion 228 run through or act on stop motor sensor 142 when knife 32 is fully retracted, which causes motor 65 to stop. In this way, the user perceives feedback regarding the positioning of the end actuator 12 through the user's grip on the trigger.
. 31/58 . trigger 20. In this way, when the user retracts trigger trigger 20, the operator will feel resistance related to the positioning of end actuator 12, and in particular the loading force felt U by knife 32. Similarly , when the operator releases the trigger trigger 5 20 after the cutting/stapling operation so that it can return to its original position, the user will experience a clockwise rotation force from trigger trigger 20 which is generally proportional to the reverse speed of motor 65. It should also be noted that in this mode the user can apply force (either in place of or in addition to the force of motor 65) to drive the . main drive rod assembly (and consequently the cutting/stapling operation of the end actuator 12) through retraction of the trigger trigger 20. That is, the retraction of the trigger trigger 20 causes the portion gear 232 of upper portion 230 rotates counterclockwise, which causes the gears of the gear box assembly 200 to rotate, thereby causing the pinion gear 124 to rotate, which causes the main drive rod assembly to rotate.
The modalities described above employed "effort-assisted" user feedback systems, with or without adaptive control (e.g. using a sensor 110, 130, and 142 outside the motor's closed-loop system). 65, gear drive train, and end actuator 12) for a two-stroke motorized cutting and clamping surgical instrument. That is, the force applied by the user on retraction of the trigger trigger 20 can be added to the force applied by the motor 65 because the trigger trigger 20 is meshed (directly or indirectly) with the gear drive train between the motor 65 and the main drive rod 48. In other embodiments of the present invention, tactile feedback regarding the position of the knife 32 in the end actuator can be provided to the user, but without having the trigger 20 engaged with the drive train. gear drive. Figures 37" to 40 illustrate a motorized surgical instrument for cutting and fixing with the
. 32/58 . referred to tactile position feedback system. . In the embodiment illustrated in Figures 37 to 40, the trigger 20 may have a lower portion 228 and an upper portion 230, similar to the instrument 10 shown in Figures 32 to 36. Figures 32 to 36, however, the upper portion 230 does not have a gear portion that matches a gear drive train portion. Instead, the instrument includes a second motor 265 with a threaded rod 266 threaded thereto. The threaded rod 266 moves longitudinally in and out of the motor 265 as the motor 265 rotates, depending on the direction of rotation. The ins- ! instrument 10 also includes an encoder 268 which responds to rotations of main drive rod 48 to translate internal angular motion. key drive rod 48 (or other component of the main drive assembly) in a corresponding series of signals. 15 fingerprints, for example. In the illustrated embodiment, the pinion gear 124 : includes a proximal drive rod 270 that connects to the encoder at 268. : The instrument 10 also includes a control circuit (not shown), which can be implemented using a microcontroller - 20 or some other type of integrated circuit, which receives the digital signals from the encoder 268. Based on the signals from the encoder 268, the control circuit can calculate the positioning stage of the knife 32 in the end actuator 12. That is, the control circuit can calculate whether knife 32 is fully positioned, fully retracted, or in an intermittent stage. Based on the calculation of the end actuator positioning stage 12, the control circuit can send a signal to the second motor 265 to control its rotation to thereby control the reciprocal movement of the threaded rod 266.
In operation, as shown in Figure 37, when the closing trigger 18 is not locked in the closed position, the . shot 20 is rotated away from the pistol grip portion 26 of the handle 6 so that the front face 242 of the upper portion 230 of the trigger
. 33/58 . trigger 20 does not contact the adjacent end of threaded rod 266. When the operator retracts the closing trigger 18 and locks it in the closed position, the trigger 20 rotates slightly in the U direction to the closing trigger 20 so that the trigger 20 operator can hold the trigger of the trigger 20, as shown in Figure 38. In this position, the front face 242 of the upper portion 230 contacts the adjacent end of the threaded rod 266. As the user then retracts the trigger of trigger 20, after an initial rotational amount (e.g. 5 degrees of rotation), the motor run sensor 110 can be activated so that, as explained above, the sensor 110 sends a signal to the motor 65 to cause it to rotate at a feedrate proportional to the amount of retraction force applied by the operator to the trigger 20. Forward rotation of motor 65 causes main drive rod 48 . 15 rotates through the gear drive train, which causes the knife ' 32 and slider 33 to descend through channel 22 and cut through the tissue trapped in the end actuator 12. The control circuit receives the output signals. ' output from encoder 268 related to the incremental rotations of the main drive rod assembly and sends a signal to the second motor 265 - 20 to cause the second motor 265 to rotate, which causes a threaded rod 266 to retract into the motor 265 This allows the upper portion 230 of the trigger 20 to rotate counterclockwise, which allows the lower portion 228 of the trigger trigger 20 to also rotate counterclockwise.
In this way, because the reciprocating movement of the threaded rod 266 is related to the rotations of the main actuation rod assembly, the operator of the instrument 10, through his grip on the triggering trigger 20, feels tactile feedback regarding the position of the actuator. 12. The retraction force applied by the operator, however, does not directly affect the steering of the main drive stem assembly because the trigger trigger 20 is not engaged with the gear drive train in this mode.
Due to tracking of incremental rotations of the set
. 34/58' of main drive rod via the output signals from encoder 268, the control circuit can calculate when knife 32 is fully positioned (ie, fully extended). At this point, the control CU circuit can send a signal to the motor 65 to reverse direction to the - | o 5 causes retraction of knife 32. Reverse direction of motor 65 causes rotation of main drive rod assembly to change direction, o | which is also detected by the encoder 268. Based on the reverse rotation detected by the encoder 268, the control circuit sends a signal to the | second motor 265 to cause it to change rotational direction so that screw 266 begins to extend longitudinally from motor 265. This movement forces upper portion 230 of trigger 20 to rotate clockwise, which causes causing the lower portion 228 - to rotate clockwise.
In this way, the operator can experience a clockwise force from the trigger 20, which provides re-. 15 information for the operator as for the retracted position of the 32 blades: on the end actuator 12. The control circuit can determine when the 32 blade is fully retracted.
At this point, the control circuit . can send a signal to motor 65 for rotation.
According to other embodiments, instead of the control circuit 20 determining the position of the knife 32, the motor reversal and motor stop sensors can be used, as described above.
Furthermore, instead of using a proportional sensor 110 to control the rotation of the engine 65, an on/off type switch or sensor can be used.
In this mode, the operator would not be able to control the engine's rotation rate65. Instead, it would spin at a pre-programmed rate.
Figures 41 to 43 illustrate an exemplary embodiment of a mechanically actuated endoscopic surgical instrument and in particular the handle 6, the stem 8 and the end actuator 12 thereof.
More details of a mechanically actuated endoscopic surgical instrument can be found in US Patent Application Serial No. 11/052, 632, entitled, "Surgical Stapling Instrument Incorporating A Multi-Stroke Firing Mechanism With Automatic End Of Firing Travel Retraction." ", which is here in-
. 35/58 | BR generally incorporated by reference. Referring to Figure 41, end actuator 12 responds to the closing movement of handle 6 (not shown in Figure 41) by first including a CU anvil face 1002 that connects to a proximal end of anvil 1004 that includes the 5 laterally projecting anvil pivot pins 25 that are proximal to a vertically projecting anvil flap 27. Anvil pivot pins 25 travel inside kidney-shaped openings 1006 in clamp channel 22 to opening and closing the anvil 24 with respect to the channel 22. The tab 27 engages a flexed tab 1007 that extends inwardly into the opening of the tab 45 at a distal end 1008 of the closing tube at 1005, the latter terminating distally in a distal edge 1008 that pushes against the anvil face 1002. In this way, when the closing tube 1005 moves proximally from its open position, the flexed tab 1007 of the closing tube 1005 pulls the anvil tab. - 15 27 proximally, and the anvil pivot pins 25 follow the openings : with kidney shape 1006 of the clamp channel 22 causing the anvil 24 to simultaneously travel proximally and lift to the .: open position . As the closing tube 1005 moves distally, the flexed tab 1007 at the opening of the tab 45 is released from the anvil tab 27 - 20 and the distal edge 1008 pushes the anvil face 1002, closing the anvil.
24.
With continued reference to Figure 41, the rod 8 and end actuator 12 also include components that respond to a firing motion of a firing stick 1010. In particular, the firing stick 1010 pivotally engages a recess member. 1012 which has a longitudinal recess 1014. The firing recess member 1012 moves longitudinally within the frame 1016 in direct response to the longitudinal movement of the firing stick 1010. A longitudinal slot 1018 in the closure tube 1005 becomes operably couples to the right and left outer side handle pieces 61 and 62 of handle 6 (not shown in Figure 41). The length of the longitudinal slot 1018 in the closure tube 1005 is long enough to allow movement
: 36/58 . relative longitudinal with the cable parts 61 and 62 to carry out the closing and firing movements respectively with the coupling of the cable parts 61 and 62 passing through a longitudinal slot 1020 in the VV frame 1016 to slidingly engage the longitudinal recess : 5 1014 frame recess member 1012.
The distal end of frame recess member 1012 is attached to a proximal end of an ignition bar 1022 that moves within frame 1016, specifically within a guide 1024 therein, to project knives 32 distally therein. the end actuator 12. The end actuator 12 includes a staple cartridge 34 which is actuated by knife 32. The staple cartridge 34 has a tray 1028 which contains a staple cartridge body 1030, an actuator wedge mount driver 33, clamp drivers 1034 and clamps 1036. It will be understood that the . 15 wedge 33 moves longitudinally within a firing recess (not shown) located between cartridge tray 1028 and cartridge body 1030. contact and lift the clamp drivers 1034 upwards, driving the clamps 1036. The cartridge body 20 of clamp 1030 further includes a proximally open vertical slot 1031 for passage of the knife 32. Specifically, a cutting surface 1027 is provided along a distal end of knife 32 for cutting tissue after being stapled. It should be understood that rod 8 is shown in Figure 4 as a non-hinged rod. However, applications may include instruments capable of articulation, for example , as shown above with reference to Figures 1 to 4 and described in the following US patents and patent applications, the disclosures of which are incorporated herein by reference. in their entirety: (1) "SURGICAL INSTRUMENT INCORPO-
RATING AN ARTICULATION MECHANISM HAVING ROTATION ABOUT THE LONGITUDINAL AXIS", US Patent Application Publication No. 2005/0006434, by Frederick E. Shelton IV, Brian J. Hemmeilgarn, Jeffrey S.
UN or NM
. 37/58' Swayze, Kenneth S. Wales, filed July 9, 2003; (2) "SURGICAL STAPLING INSTRUMENT INCORPORATING AN ARTICULATION JOINT FOR A FIRING BAR TRACK", US Patent No. 6,786,382 by Brian J.
" Hemmelgarn; (3) "A SURGICAL INSTRUMENT WITH A LATERAL-MOVING and 5 —ARTICULATION CONTROL", US Patent No. 6,981,628 to Jeffrey S. - —Swayze; (4) "SURGICAL STAPLING INSTRUMENT INCORPORATING A
TAPERED FIRING BAR FOR INCREASED FLEXIBILITY AROUND THE ARTICULATION JOINT", US Patent No. 6,964,363, to Frederick E. Shelton IV, Michael Setser, Bruce Weisenburgh II; and (5) "SURGICAL STAPLING
INSTRUMENT HAVING ARTICULATION JOINT SUPPORT PLATES FOR ) SUPPORTING A FIRING BAR", US Patent Application Publication No.
Figures 42 to 43 show an embodiment of the cable 6 which is . 15 configured for use in a mechanically actuated endoscopic surgical instrument in conjunction with the rod 8 and end actuator 12 modality as shown above in Figure 41. It will be understood that any suitable cable design can be used to mechanically close and trigger the end actuator 12. In Figures 42 to 43, the handle 6 of the surgical stapling and sectioning instrument 10 includes a 1060 linked transmission trigger mechanism that provides features such as increased force, size reduced cable, minimized connection, efc.
Closing of end actuator 12 (not shown in Figures 42 to 43) is caused by lowering closing trigger 18 towards pistol grip 26 of handle 6. Closing trigger 18 pivots around a pivot pin of lock 252 which is coupled to the lower right and left outer side pieces 59 and 60 of the handle 6, causing an upper portion 1094 of the lock trigger 18 to move forward. The closing tube 1005 receives this closing movement through the closing fork 250 which is pinned to a closing loop 1042 and to the upper portion 1094 of the closing trigger 18 respectively by a pin of the closing fork. I
. 38/58 . 1044 and a closing link pin 1046.
In the fully open position of Figure 42, the upper portion 1094 of the closing trigger 18 contacts and retains a C1-latching arm 1048 of the pivoting closing release button 30 in the position shown. When the locking trigger 18 reaches its fully lowered position, the locking trigger 18 releases the locking arm 1048 and an adjoining surface 1050 rotates to form the engagement with a right-facing distal notch 1052 of the locking locking arm 1050. 1048, retaining the closing trigger 18 in this closed or locked position. A proximal end of locking arm 1048 pivots around a lateral pivot connection 1054 with parts 59 and 60 to expose lock release button 30. An intermediate distal side 1056 of lock release button 30 is urged. proximally by a 1058 compression spring, which is compressed between a frame. 15 housing frame 1040 and the lock release button 30. The result is that the lock release button 30 forces the locking arm 1048 counterclockwise (when viewed from the left) forged. . I send the latching contact with the adjoining surface 1050 of the closing trigger 18, which prevents unlocking of the closing trigger 20 18 when the connected transmission trigger system 1040 is in a non-retracted condition.
With closing trigger 18 retracted and fully lowered, trigger trigger 20 is unlocked and can be lowered toward pistol grip 26 multiple times in this mode to trigger end actuator 12. As shown , the connected transmission firing mechanism 1060 is initially retracted, forced to remain in this position by a combination compression/tension spring 1062 which is constricted within the pistol grip 26 of the handle 6, with its non-movable end 1063 connected to parts 59 and 860 and a movable end 1064 connected to a proximal retracted and downwardly flexed end 1067 of a steel band 1066.
A distally disposed end 1068 of the steel band
. 39/58 . 1066 is attached to a link coupling 1070 for structural loading which, in turn, is attached to a front link 1072a of a plurality of links 1072a to 1072d that form a chained rack 1074. The chained rack 1074 it is flexible and still has distal links that form a linear rigid rack assembly that can transfer significant firing force through the firing stick 1010 onto rod 6, yet readily retracts into the pistol grip 26 to minimize the longitudinal length of the cable 6. It should be noted that the compression/tension spring in combination 1062 increases the amount of firing path available while essentially reducing the minimum length by + half over a single spring.
Firing trigger 20 pivots around a firing trigger pin 96 that is connected to handle parts 59 and 60. An upper portion 228 of firing trigger 20 moves distally around pin R 15 of the trigger. trigger 96 as trigger 20 is depressed towards pistol grip 26, stretching a proximally placed trigger tension spring 222 closely connected. between the upper portion 228 of the trigger 20 and the parts 59 and
60. The upper portion 228 of the trigger 20 engages the chained rack 1074 during each depression of the trigger by a pull mechanism 1078 which also disengages when the trigger 20 is released. The trigger tension spring 222 forces the trigger trigger 20 distally when released and disengages the pull mechanism 1078.
As the linked transmission trigger mechanism 1040 operates, an idler gear 1080 is rotated clockwise (as viewed from the left side) through engagement with a toothed lower surface 1082 of the chained rack 1074. This rotation is coupled to an indicator gear 1084, which thus rotates counterclockwise in response to idler gear 1080. Both idler gear 1080 and indicator gear 1084 are pivotally connected to parts 59 and 60 of cable 6. A relation of
| . 40/58 | - gear between chained rack 1074, intermediate gear 1080 and indicator gear 1084 can be advantageously selected so that the lower toothed surface 1082 has tooth CV dimensions that are suitably strong and that the indicator gear 1084 and 5 do not make more than one revolution during the entire firing path of the 1060 on transmission firing mechanism.
As described in more detail below, the 1084 indicator gear performs at least four functions. First, when chained rack 1074 is fully retracted and both triggers 18 and 20 are open as shown in Figure 42, an opening 1086 at i and a circular ridge 1088 on the left side of indicator gear 1084 is presented to a lower surface 1090 of the locking arm 1048. The . Locking arm 1048 is oriented into opening 1086 through contact with closing trigger 18 which in turn is urged into the open position by a closing tension spring 1092. lock trigger tension 1092 is proximally connected to upper portion 1094 of lock trigger 18 and parts. of handle 59 and 60 and thus has stored energy during the closing of the closing trigger 18 which urges the closing trigger 18 - 20 distally to its unclosed position.
A second function of the indicator gear 1084 is that it is connected to the indicator retract button 1096 externally disposed on the handle 6. In this way, the indicator gear 1084 communicates the relative position of the trigger mechanism 1060 to the indication retraction button 1096 so that the surgeon has a visual indication of how many strokes of the firing trigger 20 are required to complete the firing.
A third function of the indicator gear 1084 is to move longitudinally and angularly an anti-return release lever 1098 of an anti-return mechanism (one-way clamping mechanism) 1097 | as the surgical sectioning and stapling instrument 10 is operated. During firing strokes, proximal movement of the lever
- 41/58 - anti-return release 1098 through indicator gear 1084 activates the anti-return mechanism 1097 that allows distal movement of the ignition bar 1010 and prevents proximal movement of the ignition bar 1010. This movement also extends the anti-return release button. 1100 of the 5th end of the proximal end of the handle parts 59 and 60 for the operator to actuate, a need may arise for the connected transmission trigger mechanism 1060 to be retracted during the trigger strokes. Upon completion of the firing strokes, the indicator gear 1084 reverses the direction of rotation as the firing mechanism 1060 retracts. Reverse rotation disables the anti-return mechanism 1097, extracts the anti-return release button 1100 on handle 6, and turns the anti-return release lever 1098 laterally to the right to allow continuous reverse rotation . of the 1084 indicator gear.
A fourth function of the indicator gear 1084 is to receive a manual rotation of the indicator retract button 1096 (clockwise in the presentation of Figure 42) to retract the trigger mechanism 1060 with the anti-return mechanism 1097 unlocked, overcoming . thus any linkage in the trigger mechanism 1060 that is not readily overcome by the compression/tension spring in combination 1062. - 20 This manual retraction aid can be employed after a partial triggering of the trigger mechanism 1060 which would, in otherwise, prevented by the backstop mechanism 1097 which extracts the backstop release button 1100 so that the latter cannot laterally move the backstop release lever 1098. Continuing with Figures 42 to 43, the backstop mechanism 1097 consists of the backstop lever 1098. Operator accessible non-return release 1098 operably coupled at the proximal end to the 1100 non-return release button and at the distal end to a non-return yoke
1102. In particular, a distal end 1099 of the R 30 anti-return release lever 1098 is engaged with the anti-return yoke 1102 by a non-return clevis pin 1104. The non-return yoke 1102 moves longitudinally to impart rotation to a slit tube of non-return cam
. 42/58' 1106 which is longitudinally constrained by cable parts 59 and 90 and which spans the firing stick 1010 distally with respect to the firing baton connection 1010 to the linkage coupling 1070 of the chained rack CÚ 1074. The non-return yoke 1102 communicates longitudinal movement of the anti-return release lever 1098 through a cam slot tube pin 1108 to the anti-return cam slot tube
1106. That is, the longitudinal movement of the cam slotted tube pin | 1108 in an angled slot in non-return cam slot tube 1106 rotates anti-return slotted tube 1106. Trapped between a proximal end of frame 1016; and anti-return cam slot tube 1106 respectively are an anti-return compression spring 1110, an anti-return plate 1112, and a - anti-return cam tube 1114. As shown, the proximal movement of the firing stick 1010 causes the anti-return plate 1112 hinges - 15 from the top to the rear, featuring increased frictional contact for the firing stick 1010 which additionally resists proximal movement in the firing stick 1010. . This anti-return plate 1112 pivots in a manner similar to that of a screen door latch that holds a screen door open - 20 when the anti-return cam slot tube 1106 is spaced closely spaced apart from the anti-return cam tube. 1114. Specifically, the anti-return compression spring 1110 is capable of acting on a top surface of the plate 1112 to tilt the anti-return plate 1112 to its locked position. Rotation of the anti-return cam slot tube 1106 causes a distal cam movement of the anti-return cam tube 1114 thus forcing the top of the anti-return plate 1112 distally, overcoming the force of the anti-return compression spring 1110, thereby positioning the 1112 anti-return plate in a non-tilted (perpendicular) unlocked position that allows for proximal retraction of the firing baton
1010. With particular reference to Figure 43, the pulling mechanism 1078 is shown to be composed of a pawl 1116 having a
. 43/58 . distally projecting narrow tip 1118 and a rightwardly projecting side pin 1120 at its proximal end which is rotationally inserted through a hole 1076 in the upper portion 230 of the firing trigger 20. On the side right of the trigger 20, the side pin 1120 and 5 receive a guide member, shown as the guide wheel 1122. As the trigger 20 moves back and forth, the wheel | guide 1122 traverses an arc adjacent to the right half part | 59 of the handle 6, in its distal course portion encroaching on a guide ramp 1124 integrally formed in the right half piece 59. The guide wheel 1122 can advantageously be formed from a ma-. resilient frictional material that induces a counterclockwise rotation (when viewed from the left) in the lateral pin 1120 of the pawl 1116, - thereby orienting with traction the narrow protruding tip 1118 distally downwards on a central rail at link rise 1075 - 15 closer 1072a ad to engage chained rack 1074. | ' As the trigger 20 is released, the steering wheel 1122 tractionally orients, thereby, the pawl 1116 in direction . opposite, raising the narrow end 1118 of the rising center rail 1075 of the chained rack 1074. To ensure disengagement of the end 1118 - 20 under high load conditions and in the nearly complete distal travel of the pawl 1116, the right side of pawl 1116 rises over an upwardly and proximally chamfered surface 1126 on the right side of the closing fork 250 to disengage the narrow end 1118 of the ascending center rail 1075. If the trigger trigger 20 is released at any point other than the complete travel, the wheel The guide wheel 1122 is used to lift the narrow end 1118 of the rising center rail 1075. While a guide wheel 1122 is shown, it should be noted that the shape of the guide wheel member 1122 is illustrative and may be varied. - Designed to accommodate a variety of shapes that use friction or traction to engage or disengage end actuator triggering 12. Various surgical instrument modalities co 10 have the ability to record instrument conditions one or more times during the
. 44/58
THERE . use. Figure 44 shows a block diagram of a system 2000 for recording conditions of instrument 10. It will be understood that system 2000 may be implemented in embodiments of instrument 10 that have motor-assisted or motorized CV triggering, for example, as described above and 5 with reference to Figures 1 to 40, as well as embodiments of the instrument 10 that have mechanically actuated triggering, for example as described above with reference to Figures 41 to 43.
The 2000 system can include multiple 2002, 2004, 2006, 2008, 2010, and 2012 sensors to capture instrument conditions. The sensors can be positioned, for example, on or inside the instrument 10. ' In various embodiments, the sensors can be dedicated sensors that provide output only to the 2000 system, or they can be dual-use sensors that perform other functions on the instrument 10. For example, the sensors 110, 130 and 142 described above can be configured to also provide output to the 2000 system. ' . Directly or indirectly, each sensor supplies a signal to the memory device 2001, which records the signals as described in . detail below. The 2001 memory device can be any type of device capable of storing or recording sensor signals. For example, the 2001 memory device may include a microprocessor, an EE-PROM (Electrically Erasable Programmable Read-Only Memory), or any other suitable storage device. The memory device 2001 can record the signals provided by the sensors in any suitable way. For example, in one embodiment, memory device 2001 may record the signal from a particular sensor when that signal changes states. In another embodiment, memory device 2001 may record a state of system 2000, for example, signals from all sensors included in system 2000, when the signal from any sensor changes states. This can provide a sudden change of state of the instrument 10. In various embodiments, the memory device 2001 and/or sensors can be implemented to include 1-WIRE bus distributed products.
. 45/58 ' available with the DALLAS SEMICONDUCTOR such as 1-WIRE EEPROM.
In various embodiments, memory device 2001 is externally accessible, allowing an external device, such as a computer, to access instrument conditions recorded by memory device 2001. For example, memory device 2001 can include a data port 2020. Data port 2020 can provide stored instrument conditions according to any wired or wireless communication protocol in, for example, serial or parallel format.
Memory device 2001 may also include removable medium 2021 in addition to or instead of output port 2020. Removable medium 2021 may be any type of suitable data storage device that may be removed from instrument 10. For example, removable medium 2021 may include any suitable type of fast memory, co-. 15 mounm personal computer memory card international association card (PCMCIA), a COMPACTFLASH card, a MUL-no TIMEDIA card, a FLASHMEDIA card, etc.
Removable means 2021 can also. It may also include any suitable type of disk-based storage including, for example, a portable hard disk, a compact disk (CD), a digital video disk (DVD), etc.
The close trigger sensor 2002 senses a condition of the close trigger 18. Figures 45 and 46 show an exemplifying embodiment of the close trigger sensor 2002. In Figures 45 and 46, the close trigger sensor 2002 is positioned between the closing trigger 18 and the closing pivot pin 252. It will be understood that pulling the closing trigger 18 towards the pistol grip 26 causes the closing trigger 18 to exert a force on the closing pivot pin 252. Sensor 2002 may be sensitive to this force, and generate a signal in response thereto, for example, as described above with respect to sensor 110 and Figures 10A and 10B.
In various embodiments, the closing trigger sensor 2002 can be a digital sensor that only indicates whether the closing trigger 18 is actuated or not actuated.
In others
- 46/58 , various modes, the closing trigger sensor 2002 can be an analog sensor that indicates the force exerted on the closing trigger 18 and/or the position of the closing trigger 18. If the CÚ closing trigger sensor 2002 is an analog sensor, an ADC (Analog-to-Digital Con- o 5 verter (analog to digital converter)) can be logically positioned between the 2002 sensor and the 2001 memory device. 2002 Closing Trigger Sensor can take any suitable shape and be placed in any suitable location that allows for capturing the condition of the Closing Trigger. | The 2004 anvil close sensor can pick up if the bi- . 24 is closed. Figure 47 shows an exemplary anvil closure sensor 2004. Sensor 2004 is positioned near or within the kidney-shaped openings 1006 of clamp channel 22 as shown. As the anvil 24 is closed, the anvil pivot pins 15 25 slide through the kidney-shaped openings 1006 and make contact with sensor 2004, causing sensor 2004 to generate a signal that does not indicate that the anvil 24 is closed. The 2004 sensor can be any suitable R-type analog or digital sensor including a proximity sensor, etc. It will be understood that when the anvil close sensor - 20 2004 is an analog sensor, an analog to digital converter may logically be included between the 2004 sensor and the memory device
2001. The anvil closing load sensor 2006 is shown placed on an interior bottom surface of the clamp channel 22. In use, the sensor 2006 may be in contact with a bottom side of the clamp cartridge 34 (not shown in Figure 46). As the anvil 24 is closed, it exerts a force on the staple cartridge 34 which is transferred to sensor 2006. In response, sensor 2006 generates a signal. The signal can be an analog signal proportional to the force exerted on the sensor 2006 by the staple cartridge 34 and due to the closing of the anvil 24. Referring to Figure 44, the analog signal can be supplied to an analog to digital converter. 2014, which converts the analog signal to an oo - 47/58 . digital signal before providing it to memory device 2001. It will be understood that embodiments where sensor 2006 is a digital or binary sensor which may not include analog to digital converter 2014. CU Trigger trigger sensor 110 captures the position and/or state o 5 of the trigger trigger 20. In motor-assisted or motorized modes of the instrument, the trigger trigger sensor may double as the motor run sensor 110 described above.
In addition, the trigger sensor 110 can take any of the forms described above, and can be analog or digital.
Figures 45 and 46 show an additional embodiment of trigger sensor 110. In Figures 45 and . 46, the trigger trigger sensor is mounted between the trigger trigger 20 and the trigger trigger pivot pin 96. When the trigger trigger 20 is pulled, this will exert a force on the trigger trigger pivot pin 96. trigger 96 that is picked up by sensor 110. Referring to Figure 44, in embodiments where the output of trigger sensor 110 is analog, the analog to digital converter 2016 is logically included between the trigger sensor trigger 110 and memory device 2001. ' Knife position sensor 2008 captures the position of knife 32 or cutting surface 1027 within clamp groove 22. Figures 47 and - 20 48 show embodiments of a position sensor 2008 knife blades that are suitable for use with the mechanically actuated rod 8 and end actuator 12 shown in Figure 41. The sensor 2008 includes a magnet 2009 coupled to the ignition bar 1022 of the instrument 10. A coil 2011 is positioned around a a 1022 trigger bar, and can be in snapped; for example, along the longitudinal recess 1014 of the trigger recess element 1012 (see Figure 41). As knife 32 and cutting surface 1027 are alternated through clamp groove 22, ignition bar 1022 and magnet 2009 can move back and forth through coil 2011. This movement relative to coil induces a voltage on the spool proportional to the position of the trigger stick within the spool and the cutting edge 1027 within the clamp groove 22. This voltage can be supplied to the memory device 2001, for example, via the con-
. 48/58 - analog to digital converter 2018.
In various embodiments, the 2008 knife position sensor can instead be implemented as a series of digital sensors (not CO shown) placed at various positions on or inside the rod 8. The digital sensors 5 can pick up a feature of the ignition bar 1022 such as magnet 2009, as the resource cycles through rod 8. The position of the ignition bar 1022 within the rod 8, and by extension, the position of the knife 32 within the groove of clamp 22, can be approximated as the position of the last digital sensor traveled. It will be understood that knife position may also be captured in embodiments of instrument 10 with a rotationally driven end actuator 12 and stem 8, for example, as described above in . reference to Figures 3 through 6. An encoder, such as the 268 encoder, can be configured to generate a signal proportional to the rotations of the pa- rod. 15 helical screw 36, or any drive shaft or gear. Due to the fact that the rotation of the rod 36 and other rods and drive gears is proportional to the movement of the knife 32 through the groove. 22, the signal generated by the encoder 268 is also proportional to the movement of the knife 32. In this way, the output of the encoder 268 can be supplied to the memory device 2001.
The 2010 Cartridge Presence Sensor can sense the presence of the 34 staple cartridge within the 22 staple groove. On motor-assisted or motorized instruments, the 2010 Cartridge Presence Sensor can double as the 136 Cartridge Lock Sensor. described above with reference to Figure 11. Figures 50 and 51 show an embodiment of the 2010 cartridge presence sensor. In the embodiment shown, the 2010 cartridge presence sensor includes two contacts, 2011 and 2013. When no cartridge 34 is present , contacts 2011 and 2013 form an open circuit. When a cartridge 34 is present, the cartridge tray 1028 of the staple cartridge 34 contacts contacts 2011, 2013, a closed loop is formed. When the circuit is open, the 2010 sensor may output a logic zero. When the circuit is closed
The zan=ssza wing eea"Ps ig: MMS 1 ! . 49/58 . do, the 2010 sensor can emit a logic one. The 2010 sensor output is fed to the 2001 memory device, as shown in Figure
44. CU The 2012 cartridge condition sensor can indicate if a car- o 5 tucho34 installed inside the clamp groove 22 has been fired or worn. As the knife 32 is moved through the end actuator 12, this pushes on the slider 33, which fires the staple cartridge. Then the knife 32 is moved back to its original position, leaving the slider 33 at the distal end of the cartridge. Without the sliding support 33 to guide it, the knife 32 may fall into the lock pocket 2022. The sensor ' 2012 can pick up whether the knife 32 is present in the lock pocket 2022, which indirectly indicates whether the cartridge 34 has been spent. It will be understood that in - various embodiments, the sensor 2012 may directly sense the presence of the slider at the adjacent end of the cartridge 34, eliminating . 15 thus the need for the knife 32 to fall into the locking pocket 2022. ' Figures 52A and 52B show a process flow 2200 o for operating modalities of the surgical instrument 10 configured as an : endoscopic surgical instrument and with the ability to record conditions instrument according to various modalities. In case 2202, the -20 anvil 24 of instrument 10 may be closed. This causes the close trigger sensor 2002 and/or the close anvil sensor 2006 to change state. In response, memory device 2001 can record the state of all sensors in system 2000 in box 2203. In box 2204, instrument 10 can be inserted into a patient. When the instrument is inserted, the anvil 24 can be opened or closed in the housing 2206, for example, to manipulate tissue at the surgical site. Each opening and closing of the anvil 24 causes the close trigger sensor 2002 and/or the close anvil sensor 2004 to change state. In response, memory device 2001 records the state of system 2000 in box 2205. In box 2208, the fabric is clamped for cutting and stapling. If anvil 24 is not closed in decision block 2210, the grip continues.
- 50/58 Ú . anything is needed. If anvil 24 is closed, then sensors 2002, 2004, and/or 2006 may change state by requesting memory device 2001 to record the system state in box 2213. This record may include a closing pressure received from sensor 2006. In box 2212, clipping and stapling can occur. The trigger trigger sensor 110 can change state as the trigger trigger 20 is pulled towards the pistol grip 26. 32 moves through the clamp channel 22, the knife position sensor 2008 will change state. In response, the memory device 2001 can record the state of system 2000 in the box 2013. : When cutting and stapling operations are complete, knife 32 may return to a pre-firing position. Due to: the fact that cartridge 34 has now been fired, knife 32 may fall into locking pocket 2022, changing the state of the condition sensor of car- . 15 tappet 2012 and triggering memory device 2001 to record the status of system 2000 in box 2015. Anvil 24 can then be opened to clear the tissue. This can cause one or more of the sen- . 2002 close trigger sensor, 2004 anvil close sensor, and 2006 anvil close load sensor change state, resulting in a 2000 system state record in the 2017 box. After the fabric is made clear, the anvil 24 can be closed back in the box
2220. This causes another state change for at least sensors 2002 and 2004, which in turn causes memory device 2001 to record the system state in box 2019. Then, instrument 10 can be removed from the patient in the box 2222.
If instrument 10 is to be used again during the same procedure, the anvil can be opened at canister 2224, triggering another system state register in canister 2223. Spent cartridge 34 can be removed from end actuator 12 in canister 2226. This causes the cartridge presence sensor 2010 to change state and causes a recording of the system status in box 2225. Another cartridge 34 can be inserted in box 2228. This causes a state change in the presence sensor.
. 51/58 . cartridge 2010 and a system status record in box 2227. If the other cartridge 34 is a new cartridge, indicated in decision block 2230, . its insertion can also cause a state change for the cartridge condition sensor 2012. In this case, the system state can be registered in box 2231.
Fig. 53 shows an exemplary memory map 2300 of memory device 2001 according to various embodiments. Memory map 2300 includes a series of columns 2302, 2304, 2306, 2308, 2310, 2312, 2314, and 2316 and (unidentified) rows. Column 2302 shows an event number for each of the rows. The other columns represent . tam the output of a 2000 system sensor. All sensor readings logged in a given time can be logged in the same row | - under the same event number. Therefore, each row represents an instance where one or more of the signals from the sensors of the system 2000 - 15 are registered.
Column 2304 lists the closing load recorded for each event. This may reflect the output of the bi-closing load sensor. gorna 2006. Column 2306 lists the firing course position. This can be derived from the knife position sensor 2008. For example, the total travel - 20 of knife32 can be partitioned. The number mentioned in column 2306 may represent the partition where knife 32 is currently present. Trigger load is mentioned in column 2308. This can be derived from trigger trigger sensor 110. Knife position is mentioned in column 2310. Knife position can be derived from knife position sensor 2008 similarly to stroke stroke. shot. The possibility that the anvil 24 is open or closed can be mentioned in column 2312. This value can be derived from the output of the anvil close sensor 2004 and/or the anvil close load sensor 2006. 33 is present, or whether the cartridge 34 is worn can be indicated in column 2314. This value can be derived from the cartridge condition sensor 2012. Finally, the possibility that cartridge 34 is present can be indicated in column 2316. This value can be derived
. 52/58 ' | cartridge presence sensor 2010. It will be understood that various other values may be stored in the memory device 2001 including: including, for example, the end and beginning of firing strokes, for example, as measured by sensors 130 and 142.
o 5 Figures 54 and 55 show another embodiment of the system
2000. The illustrated modality of Figure 54 is similar to that of Figure 44, except that in Figure 54 the sensors 2002 to 2010 are in communication with a control unit 2400, preferably located on cable 6 of the instrument, and more preferably in the pistol grip portion 26 of the handle6. The control unit 2400 may comprise a processor 2402 and the memory device 2001. The memory device 2001 may comprise a read-only memory unit 2404, and a read-write memory unit 2406. The control unit 2400 may also comprise analog-to-digital converters (ADC) and digital-to-analog converters (DAC) (not shown) for communicating with sensors ' 2002 to 2010. Read-only memory unit 2404 may comprise EPROM memory units and/or Instant EEPROM. The read and write memory unit 2406 may comprise a volatile memory unit such as a random access memory (RAM) unit. - 20 The various components of the 2400 control unit can be discrete or can be integrated into one or a few components. For example, in one embodiment, the processor 2402, ROM 2404, RAM 2406, DACs, and ADCs may be part of a microcontroller or computer on a single integrated circuit (chip).
The 2400 control unit can be powered by a 2408 power source, such as a battery. For instruments 10 that have a DC motor to power the end actuator, the 2408 power supply that powers the 2400 control unit can be the same power supply that powers the motor, or different power supplies can be used. for control unit 2400 and motor 65.
Output data from multiple sensors can be stored in digital format on one or both of the 2404 and 2406 memory units. The :
. 53/58 - US Published Patent Application No. 2007/0175964 A1, which is hereby fully incorporated by reference, describes an endoscopic surgical instrument having a memory device for storing and recording sensor data.
Output data from some of the sensors mentioned above may be in analog format.
For these types of sensors, ADCs can be used to convert analog sensor signals to digital format for storage in the 2404 and 2406 memory units. wired and/or wireless communication.
For example, sensors and control unit 2400 can communicate via . a 1-WIRE or IPC bus.
For embodiments where the sensors communicate with the 2400 control unit in wireless mode, the sensors may comprise a transponder (transponder) that communicates with a transceiver (not shown) on the control unit. 2400. . 15 Although not shown in Figure 44, the instrument 10 may also comprise one or more sensors that detect the state of articulation of the end actuator.
For example, the articulation sensors can be located at or near the articulation pivot and detect the relative articulation between the end actuator 12 and the stem 8. The articulation sensors 20 can also be in communication with the 2400 control unit and data from the articulation sensors can be stored in the 2400 control unit memory device 2001. US Patent Application Serial No. 12/124,655 entitled "Surgical Instrument With Automatically Reconfigurable Articulating End Effector", filed 721 May 2008, which is hereby incorporated by reference, in its entirety, provides further details on such articulation sensors.
Additionally, the sensors can include various engine related sensors that detect 65 engine conditions such as RPM, etc.
In accordance with various embodiments, data stored in memory device 2001 may be encrypted.
For example, one of the memory units 2404, 2406, such as ROM 2404, can store encoding or encryption software that, when executed by the process,
- 54/58 o | - sador 2402 causes the processor 2402 to encrypt the data received from the sensor from the sensors and stored in the memory device 2001.
: 'The control unit 2400 can also have an output 2020 of the .-. 5 port that is externally accessible by a remote computer device 2420 through a communication link 2422 connected to output port 2020. Communication link 2422 may be a wired or wireless communication link. For example, the 2020 output port may comprise a serial data port, such as a USB port (including type A, type B, Mini-A, or Mini-B USB ports), an IEEE 1394 - interface port (including IEEE 1394a, 1394b, or 1394C), an RS-232 port, an RS-423 port, an RS-485 port, an optical port such as a SONET or SDH port, : or any other serial data port suitable for a data link. 2422 wired serial data communication. In addition, the . 15 cation 2422 can be a parallel data communication link, such as ISA, ATA, SCSI, or PCI. Output port 2020 can be a corresponding data parallel or output port in such circumstances. Also, the 2422 communication link can be a wireless data link, such as a link that uses one of the IEEE 802.11 standards.
“= 20 The remote computing device 2420 can be any device with a processor and a memory, and capable of communicating with the control unit 2400 and downloading sensor data stored in the memory device 2001. For example, the device remote computing device 2420 can be a personal computer, a portable computer, a server, a workstation, a handheld computer, a mini-computer, a wearable computer, and so on. That remote computing device 2420 may be located outside the instrument 10 (i.e., not part of the instrument 10) and may be located relatively close to the instrument 10 when data is transferred to the computing device 2420, or the Computing 2420 may be located further away from instrument 10, such as in an adjacent room or even further away.
Figure 56 is a flowchart illustrating a process according to
. 55/58 . with various embodiments of the present invention. The process starts at step 2500, where the doctor performs a surgical procedure, using instrument 10. At step 2502, the various sensors of the instruments capture the data and transmit them to the control unit 2400 In step ..5 2504, the data can be encrypted by the control unit 2400 and, in step 2506, the encrypted data is stored in the memory unit 2001. In other embodiments, the data need not be encrypted or only a portion of the detected data is encrypted. Then, in step 2508, a data link is established between remote computing device 2420 and control unit 2400, such as through the 2020's output ports. Then, in step 2510, some or all of the data stored in the memory unit 2001 from the sensors is downloaded to the remote computing device 2420. For modalities, where the stored data is encrypted, the remote computing device 2420 can decrypt. 15 modifying the data before or after being loaded to a memory device on the remote computing device 2420. In step 2512, the data, now stored on the remote computing device 2420, can be manipulated. For example, calculations or analysis can be performed on the data, or it can be downloaded or transferred to another storage medium.
The devices disclosed in the present invention may be designed to be discarded after a single procedure (which may comprise multiple triggers), or they may be designed to be used in multiple procedures. However, in each case, the device can be reconditioned for reuse after at least one procedure. Overhaul may include any combination of the steps of disassembling the device, followed by cleaning or replacing particular parts, and subsequent reassembly. In particular, the device can be dismantled, and any number of parts or particular parts of the device can be selectively exchanged or removed, in any combination. After cleaning and/or replacing particular parts, the device can be reassembled for subsequent use in a refurbishment facility.
. 56/58 : | | - surgery or by a surgical team immediately before a surgical procedure. Those skilled in the art will appreciate that you refurbish it. Installation of a device can use a variety of techniques for disassembly, cleaning or replacement, and reassembly. The use of such techniques, and the provision -. 5 resulting refurbished device are all within the scope of this application. Preferably, the various embodiments of the invention described herein will be processed prior to surgery. First, a new or used instrument is obtained and, if necessary, cleaned. The instrument can then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a thermoformed plastic housing covered with a sheet of TYVEK. The vessel and instrument are then co-. located in the field of radiation that can penetrate the container, such as gamma radiation, X-rays, or high-energy electrons. The radiation kills the 15 bacteria on the instrument and container. The sterilized instrument can then be stored in a sterile container. The sterile container keeps the instrument sterile until it is opened in the medical facility. - It is preferable that the device is sterilized. This can be done by various techniques known to those skilled in the art, including gamma or beta radiation, ethylene oxide, water vapor and other methods. The invention described above also has applicability to surgical robotic systems. Such systems are well known in the art and include those available from Intuitive Surgical, Inc., Sunnyvale, CA, USA. Examples are also described in US patents 6,783,524,
7,524,320 and 7,824,401. All of which are incorporated herein by reference. In general, surgical robotic systems have a remotely controllable user interface and a remotely controllable arm that are configured for the interface to operate surgical instruments and systems. The arms are controllable with an electronic control system that is typically adapted to a console located to interface with the user. The instruments can be supplied locally by the surgical system or by isolated supply systems from the control.
. 57/58 - general robotics. The surgical robotic system includes an actuation set, a . monitor, a robot, and at least one loading unit securely attached to the robot arm that has at least one surgical instrument.. 5 for performing at least one surgical task and configured to be detachably attached to the distal end of the arm.
In yet another embodiment of the robotic surgical system includes a processor, at least one encoder for determining the location of at least one drive motor assembly, a receiver for receiving electrical signals transmitted from the stapling unit, and controlling its movement. An exemplary disposable charging unit for . use with a robot is described in US Patent No. 6,231,565 to Tovey et al. An exemplary surgical robot with control proportional to the surgeon is - 15 —described in US patent No. 5,624,398 of Smith et al. In another aspect of the present invention, the robotic system has a frame, a robotic arm that is movable with respect to the frame and has a clamp assembly with an elongated tube connecting the clamp assembly to the robotic arm. Both the elongated tube with the stapling assembly 20 and the stapling assembly itself are releasably secured and operatively coupled to the robotic arm. One configuration of the stapling set can be removed and a different configuration fixed and operated.
Referring to Figures 4 and 5, the robotic system includes a coupling element that is releasably connected to the proximal end of the cap tube 40 and radially couples to the proximal end of the rotating drive rod 48. The joint is further configured. - able to lock inside the proximal end of the retaining channel 46 housed between the interior of the cap 271, which also interacts with the retaining channel 46.
Although the present invention has been illustrated by the description - of various embodiments and although the illustrative embodiments have been
. 58/58 - described in considerable detail, it is not the intention of the applicants to restrict or in any way limit the scope of the claims appended to . such details. Additional advantages and modifications may be readily available to those skilled in the art. The various embodiments of the present invention represent vast improvements over previous staple methods, which require the use of different staple sizes in a single cartridge to make the staples have different final heights.
Accordingly, the present invention has been discussed in terms of endoscopic procedures and apparatus. However, terms such as "endoscope" should not be interpreted to limit the present invention to a surgical stapling and sectioning instrument for use only in conjunction with an endoscopic tube (i.e., a cannula or trocar). ). Rather, it is believed that the present invention may find use in any procedure where access is limited, including, but not limited to, laparoscopic procedures as well as open procedures. Furthermore, the unique and innovative aspects of the various staple cartridge embodiments of the present invention may find utility when used in conjunction with other forms of stapling apparatus without departing from the spirit and scope of the present invention.
Any patent, application, or other information, in whole or in part, which is cited as incorporated herein by reference, is incorporated only to the extent that the incorporated material does not conflict with existing definitions and statements, or with any other descriptive material presented in this description. Accordingly, the description as explicitly set forth herein supersedes any conflicting material incorporated herein by reference.

权利要求:
Claims (1)
[1]
o - 11 : CLAIM
1. Surgical instrument for cutting and fixation comprising: a. an end actuator comprising a housing for holding the clamps, and a sliding bracket having a cam surface for securing the clamps; B. a main drive rod assembly for pushing the slider through the housing to eject the clamps; ç. a motor operatively coupled to the drive rod, said motor comprising a drive assembly; d. a sensor in the drive assembly to measure an actuation load; and. a sensor to measure a motor power output f. a console for remote engine control, said console | understanding manually manipulated controls; and - 15 g. a means for providing proportionate feedback from sensors to manually manipulated controls.
] - : the FA |
2) O, : is FIG. 1
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IS COMPLETE
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à — 2 SE " i NE = . e xo 2 3 8 or Ss. 3 - Eu 3. ú a ês ZQ oP - Wo =: +. FENANIR 2 A É és o : SE 3 2d sale 3Eo EE Sos . SKE , gs “5. - ' NpPp 232 ds 2 is E > õ = PA So ê : : . õ = : : - E - : BE ) [8
EO " Zuão i E olus 2 OP o 2/25 - : NR) IF as - E : ; ; “ ; ; Or 8 ê Ss no 8 : <Z 2 3 8 8| IF ê ê Í : > 8 2 = See Ê E É o O &1); “ O o SE : u Sã 3 co ua S| zu Ss ãe 2< So no Ss z25 8 s =.SE $ des z is à Eé mn or Su oo oo ND | 52/53 2020 JS [5] AMSN =) 10x o YA — , (RS Ni 2420 > NM : Ss) Es ooo 20 Cc ae FIG 2 ; 2 '
| | 53/53 EXECUTING PROCEDURE | 2500
SURGICAL DETECT DATA AND 2502 TRANSMIT THEM TO THE UNIT
CONTROL i 2504 DATA ENCRYPTION
SENSOR - STORING DATA IN THE 2506
MEMORY UNIT . ESTABLISH 2508 LINK : DATA WITH DEVICE : REMOTE COMPUTING . DOWNLOAD DATA FOR THE 2510 ; DEVICE OF
REMOTE COMPUTING MANIPULATE DATA 2512
DOWNLOADED : a

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同族专利:

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公开号 | 公开日

---

WO2012118841A1|2012-09-07|

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AU2012223477A1|2013-08-22|

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RU2623305C2|2017-06-23|

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JP2014517707A|2014-07-24|

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CN103379866B|2016-09-07|

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RU2013143955A|2015-04-10|

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EP2680762A1|2014-01-08|

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US20110155784A1|2011-06-30|

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CN103379866A|2013-10-30|

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WO2012118841A8|2013-09-06|

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CA2828474C|2019-04-23|

---

US8763879B2|2014-07-01|

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CA2828474A1|2012-09-07|

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US11246593B2|2020-03-06|2022-02-15|Covidien Lp|Staple cartridge|

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法律状态:
2020-11-17| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|

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2021-06-29| B07A| Application suspended after technical examination (opinion) [chapter 7.1 patent gazette]|

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2021-10-13| B09B| Patent application refused [chapter 9.2 patent gazette]|

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2021-12-07| B350| Update of information on the portal [chapter 15.35 patent gazette]|

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2022-01-04| B09B| Patent application refused [chapter 9.2 patent gazette]|Free format text: MANTIDO O INDEFERIMENTO UMA VEZ QUE NAO FOI APRESENTADO RECURSO DENTRO DO PRAZO LEGAL |

优先权:

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申请号 | 申请日 | 专利标题

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US13/037,566|US8763879B2|2006-01-31|2011-03-01|Accessing data stored in a memory of surgical instrument|

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US13/037,566|2011-03-01|

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PCT/US2012/026993|WO2012118841A1|2011-03-01|2012-02-28|Accessing data stored in a memory of a surgical instrument|

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