U.S. patent application number 16/885838 was filed with the patent office on 2021-07-01 for electrosurgical instrument with asynchronous energizing electrodes.
The applicant listed for this patent is Ethicon LLC. Invention is credited to Kevin M. Fiebig, Jeffrey D. Messerly, Frederick E. Shelton, IV.
Application Number | 20210196357 16/885838 |
Document ID | / |
Family ID | 1000004902535 |
Filed Date | 2021-07-01 |
United States Patent
Application |
20210196357 |
Kind Code |
A1 |
Shelton, IV; Frederick E. ;
et al. |
July 1, 2021 |
ELECTROSURGICAL INSTRUMENT WITH ASYNCHRONOUS ENERGIZING
ELECTRODES
Abstract
A surgical instrument comprising an end effector including a
proximal end, a distal end, a first jaw, and a second jaw is
disclosed. The first jaw comprises a first electrode. The second
jaw comprises a second electrode and a monopolar electrode
centrally disposed down a length of the end effector. The first
electrode and the second electrode cooperate to deliver bipolar
energy to the tissue in a bipolar cycle. The monopolar electrode
comprises a wedge shape that graduates in width along the length of
the end effector. The monopolar electrode is electrically isolated
from the first and second electrodes. The monopolar electrode is
configured to employ monopolar energy to cut the tissue in a
monopolar cycle.
Inventors: |
Shelton, IV; Frederick E.;
(Hillsboro, OH) ; Messerly; Jeffrey D.;
(Cincinnati, OH) ; Fiebig; Kevin M.; (Cincinnati,
OH) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Ethicon LLC |
Guaynabo |
PR |
US |
|
|
Family ID: |
1000004902535 |
Appl. No.: |
16/885838 |
Filed: |
May 28, 2020 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
62955299 |
Dec 30, 2019 |
|
|
|
Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 2018/147 20130101;
A61B 2018/00077 20130101; A61B 2018/00083 20130101; A61B 18/1206
20130101; A61B 18/1445 20130101; A61B 2018/142 20130101; A61B
2018/1253 20130101; A61B 2018/126 20130101 |
International
Class: |
A61B 18/14 20060101
A61B018/14; A61B 18/12 20060101 A61B018/12 |
Claims
1. A surgical instrument, comprising: an end effector, comprising:
a proximal end; a distal end; a first jaw comprising a first
electrode; and a second jaw, wherein one of the first jaw and the
second jaw is movable relative to the other of the first jaw and
the second jaw from an open position to a closed position to grasp
tissue between the first jaw and the second jaw, and wherein the
second jaw comprises: a second electrode, wherein the first
electrode and the second electrode cooperate to deliver bipolar
energy to the tissue in a bipolar cycle; and a monopolar electrode
centrally disposed down a length of the end effector, wherein the
monopolar electrode comprises a wedge shape, wherein the wedge
shape graduates in width along the length of the end effector,
wherein the monopolar electrode is electrically isolated from the
first electrode and the second electrode, and wherein the monopolar
electrode is configured to employ monopolar energy to cut the
tissue in a monopolar cycle.
2. The surgical instrument of claim 1, wherein the first jaw and
the second jaw are laterally curved.
3. The surgical instrument of claim 1, wherein the monopolar cycle
is performed after the bipolar cycle.
4. The surgical instrument of claim 1, wherein the monopolar cycle
is performed independent of the bipolar cycle.
5. The surgical instrument of claim 1, wherein the monopolar cycle
and the bipolar cycle are asynchronously activated in a tissue
treatment cycle.
6. The surgical instrument of claim 1, wherein the monopolar cycle
is initiated after initiation of the bipolar cycle and before
termination of the bipolar cycle in a tissue treatment cycle.
7. A surgical instrument, comprising: an end effector, comprising:
a proximal end; a distal end; a first jaw comprising a first
electrode; and a second jaw, wherein one of the first jaw and the
second jaw is movable relative to the other of the first jaw and
the second jaw from an open position to a closed position to grasp
tissue between the first jaw and the second jaw, and wherein the
second jaw comprises: a second electrode, wherein the first
electrode and the second electrode cooperate to deliver bipolar
energy to the tissue in a bipolar cycle; and a monopolar electrode
electrically isolated from the first electrode and the second
electrode, the monopolar electrode comprising: a compliant
flex-circuit substrate centrally disposed down a length of the end
effector; and an electrically conductive member disposed onto the
compliant flex-circuit substrate, wherein the monopolar electrode
is configured to employ monopolar energy to cut the tissue in a
monopolar cycle.
8. The surgical instrument of claim 7, wherein the first jaw and
the second jaw are laterally curved.
9. The surgical instrument of claim 7, wherein the monopolar cycle
is performed after the bipolar cycle.
10. The surgical instrument of claim 7, wherein the monopolar cycle
is performed independent of the bipolar cycle.
11. The surgical instrument of claim 7, wherein the monopolar cycle
and the bipolar cycle are asynchronously activated.
12. The surgical instrument of claim 7, wherein the monopolar cycle
is initiated after initiation of the bipolar cycle and before
termination of the bipolar cycle in a tissue treatment cycle.
13. A surgical instrument, comprising: an end effector, comprising:
a proximal end; a distal end; a first jaw comprising a first
electrode; and a second jaw, wherein one of the first jaw and the
second jaw is movable relative to the other of the first jaw and
the second jaw from an open position to a closed position to grasp
tissue between the first jaw and the second jaw, and wherein the
second jaw comprises: a second electrode, wherein the first
electrode and the second electrode cooperate to deliver bipolar
energy to the tissue in a bipolar cycle; and a monopolar electrode
centrally disposed down a length of the end effector, wherein the
monopolar electrode comprises an electrically conductive wire
electrically isolated from the first electrode and the second
electrode, and wherein the monopolar electrode is configured to
employ monopolar energy to cut the tissue in a monopolar cycle.
14. The surgical instrument of claim 13, wherein the monopolar
cycle is performed after the bipolar cycle.
15. The surgical instrument of claim 13, wherein the monopolar
cycle is performed independent of the bipolar cycle.
16. The surgical instrument of claim 13, wherein the electrically
conductive wire comprises a flexible central portion.
17. The surgical instrument of claim 13, further comprising a
compliant member, wherein the electrically conductive wire is
electrically isolated from the second jaw by the compliant
member.
18. The surgical instrument of claim 17, wherein the compliant
member comprises a deformable dielectric material.
19. The surgical instrument of claim 17, wherein the compliant
member is compressible.
20. The surgical instrument of claim 17, wherein the compliant
member comprises a first compliant member, wherein the first jaw
comprises a second compliant member, and wherein the first
compliant member and the second compliant member electrically
isolate the electrically conductive wire from the first jaw and the
second jaw.
Description
CROSS REFERENCE TO RELATED APPLICATION
[0001] This non-provisional application claims the benefit under 35
U.S.C. .sctn. 119(e) of U.S. Provisional Patent Application Ser.
No. 62/955,299, entitled DEVICES AND SYSTEMS FOR ELECTROSURGERY,
filed Dec. 30, 2019, the disclosure of which is incorporated by
reference herein in its entirety.
BACKGROUND
[0002] The present invention relates to surgical instruments
designed to treat tissue, including but not limited to surgical
instruments that are configured to cut and fasten tissue. The
surgical instruments may include electrosurgical instruments
powered by generators to effect tissue dissecting, cutting, and/or
coagulation during surgical procedures. The surgical instruments
may include instruments that are configured to cut and staple
tissue using surgical staples and/or fasteners. The surgical
instruments may be configured for use in open surgical procedures,
but have applications in other types of surgery, such as
laparoscopic, endoscopic, and robotic-assisted procedures and may
include end effectors that are articulatable relative to a shaft
portion of the instrument to facilitate precise positioning within
a patient.
SUMMARY
[0003] In various embodiments, a surgical instrument comprising an
end effector is disclosed. The end effector comprises a proximal
end, a distal end, a first jaw, and a second jaw. The first jaw
comprises a first electrode. One of the first jaw and the second
jaw is movable relative to the other of the first jaw and the
second jaw from an open position to a closed position to grasp
tissue between the first jaw and the second jaw. The second jaw
comprises a second electrode and a monopolar electrode centrally
disposed down a length of the end effector. The first electrode and
the second electrode cooperate to deliver bipolar energy to the
tissue in a bipolar cycle. The monopolar electrode comprises a
wedge shape. The wedge shape graduates in width along the length of
the end effector. The monopolar electrode is electrically isolated
from the first electrode and the second electrode. The monopolar
electrode is configured to employ monopolar energy to cut the
tissue in a monopolar cycle.
[0004] In various embodiments, a surgical instrument comprising an
end effector is disclosed. The end effector comprises a proximal
end, a distal end, a first jaw, and a second jaw. The first jaw
comprises a first electrode. One of the first jaw and the second
jaw is movable relative to the other of the first jaw and the
second jaw from an open position to a closed position to grasp
tissue between the first jaw and the second jaw. The second jaw
comprises a second electrode and a monopolar electrode electrically
isolated from the first electrode and the second electrode. The
first electrode and the second electrode cooperate to deliver
bipolar energy to the tissue in a bipolar cycle. The monopolar
electrode comprises a compliant flex-circuit substrate centrally
disposed down a length of the end effector and an electrically
conductive member disposed onto the compliant flex-circuit
substrate. The monopolar electrode is configured to employ
monopolar energy to cut the tissue in a monopolar cycle.
[0005] In various embodiments, a surgical instrument comprising an
end effector is disclosed. The end effector comprises a proximal
end, a distal end, a first jaw, and a second jaw. The first jaw
comprises a first electrode. One of the first jaw and the second
jaw is movable relative to the other of the first jaw and the
second jaw from an open position to a closed position to grasp
tissue between the first jaw and the second jaw. The second jaw
comprises a second electrode and a monopolar electrode centrally
disposed down a length of the end effector. The first electrode and
the second electrode cooperate to deliver bipolar energy to the
tissue in a bipolar cycle. The monopolar electrode comprises an
electrically conductive wire electrically isolated from the first
electrode and the second electrode. The monopolar electrode is
configured to employ monopolar energy to cut the tissue in a
monopolar cycle.
BRIEF DESCRIPTION OF THE DRAWINGS
[0006] The novel features of the various aspects are set forth with
particularity in the appended claims. The described aspects,
however, both as to organization and methods of operation, may be
best understood by reference to the following description, taken in
conjunction with the accompanying drawings in which:
[0007] FIG. 1 illustrates an example of a generator for use with a
surgical system, in accordance with at least one aspect of the
present disclosure;
[0008] FIG. 2 illustrates one form of a surgical system comprising
a generator and an electrosurgical instrument usable therewith, in
accordance with at least one aspect of the present disclosure;
[0009] FIG. 3 illustrates a schematic diagram of a surgical
instrument or tool, in accordance with at least one aspect of the
present disclosure;
[0010] FIG. 4 is a side elevational view of an end effector for use
with an electrosurgical instrument in accordance with at least one
aspect of the present disclosure;
[0011] FIG. 5 is a side elevational view of the end effector of
FIG. 4 in a closed configuration;
[0012] FIG. 6 is a plan view of one of the jaws of the end effector
of FIG. 4;
[0013] FIG. 7 is a side elevational view of another one of the jaws
of the end effector of FIG. 4;
[0014] FIG. 8 is a side elevational view of an end effector for use
with an electrosurgical instrument in accordance with at least one
aspect of the present disclosure;
[0015] FIG. 9 is an end view of the end effector of FIG. 8;
[0016] FIG. 10 is an exploded perspective view of one of the jaws
of the end effector of FIG. 8;
[0017] FIG. 11 is a cross-sectional end view of an end effector for
use with an electrosurgical instrument in accordance with at least
one aspect of the present disclosure;
[0018] FIG. 12 is a cross-sectional end view of an end effector for
use with an electrosurgical instrument in accordance with at least
one aspect of the present disclosure;
[0019] FIG. 13 is a cross-sectional end view of an end effector for
use with an electrosurgical instrument in accordance with at least
one aspect of the present disclosure;
[0020] FIG. 14 is a cross-sectional end view of an end effector for
use with an electrosurgical instrument in accordance with at least
one aspect of the present disclosure;
[0021] FIG. 15 is a cross-sectional end view of an end effector for
use with an electrosurgical instrument in accordance with at least
one aspect of the present disclosure;
[0022] FIG. 16 is a cross sectional end view of an end effector for
use with an electrosurgical instrument in accordance with at least
one aspect of the present disclosure;
[0023] FIG. 17 is a cross-sectional end view of an end effector for
use with an electrosurgical instrument in accordance with at least
one aspect of the present disclosure;
[0024] FIG. 18 is a cross-sectional end view of an end effector for
use with an electrosurgical instrument in accordance with at least
one aspect of the present disclosure;
[0025] FIG. 19 is a graph illustrating a power scheme for
coagulating and cutting a tissue treatment region in a treatment
cycle applied by an end effector, in accordance with at least one
aspect of the present disclosure;
[0026] FIG. 20 is a perspective view of a surgical instrument
comprising a flexible wiring assembly in accordance with at least
one aspect of the present disclosure;
[0027] FIG. 21 is a partial side elevational of the flexible wiring
assembly of FIG. 20 in a relaxed configuration;
[0028] FIG. 22 is a partial side elevational view of the flexible
wiring assembly of FIG. 20 in a stretched configuration;
[0029] FIG. 23 is a perspective view of a wiring harness and an
inductive sensor for use with a surgical instrument in accordance
with at least one aspect of the present disclosure;
[0030] FIG. 24 is a perspective view of a flexible wiring harness
and an inductive sensor for use with a surgical instrument in
accordance with at least one aspect of the present disclosure;
[0031] FIG. 25 is an enlarged view of portion of the flexible
wiring harness of FIG. 24;
[0032] FIG. 26 is a perspective view of a surgical instrument
comprising a manual toggle member in accordance with at least one
aspect of the present disclosure;
[0033] FIG. 27 is an end cross-sectional view of the manual toggle
of FIG. 26 illustrating the manual toggle member in a rotated
position;
[0034] FIG. 28 is an end cross-sectional view of the manual toggle
member of FIG. 27 in a centered position;
[0035] FIG. 29 is a schematic diagram of the surgical instrument of
FIG. 26;
[0036] FIG. 30 is a perspective exploded view of the surgical
instrument of FIG. 26 illustrating the manual toggle member and an
elongate shaft;
[0037] FIG. 31 is a plan view of the elongate shaft of FIG. 30
illustrating the position of the elongate shaft when the manual
rocker member is in a centered position;
[0038] FIG. 32 is a plan view of the elongate shaft of FIG. 30
illustrating the position of the elongate shaft when the manual
toggle member is rotated counter clockwise;
[0039] FIG. 33 is a plan view of the elongate shaft of FIG. 30
illustrating the position of the elongate shaft when the manual
toggle member is rotated clockwise;
[0040] FIG. 34 is a schematic diagram of a surgical system in
accordance with at least one aspect of the present disclosure;
[0041] FIG. 35 is a graph of the battery recharge rate, battery
charge percentage, power draw, and motor velocity of the surgical
system of FIG. 34 over time;
[0042] FIG. 36 is a side view of a surgical system including a
surgical instrument, a monopolar power generator, and a bipolar
power generator in accordance with at least one aspect of the
present disclosure; and
[0043] FIG. 37 is a schematic of the battery charge percentage and
motor torque of multiple surgical instrument systems over time in
accordance with at least one aspect of the present disclosure.
DESCRIPTION
[0044] Applicant of the present application owns the following U.S.
patent applications that were filed on even date herewith and which
are each herein incorporated by reference in their respective
entireties: [0045] Attorney Docket No. END9234USNP1/190717-1M,
entitled METHOD FOR AN ELECTROSURGICAL PROCEDURE; [0046] Attorney
Docket No. END9234USNP2/190717-2, entitled ARTICULATABLE SURGICAL
INSTRUMENT; [0047] Attorney Docket No. END9234USNP3/190717-3,
entitled SURGICAL INSTRUMENT WITH JAW ALIGNMENT FEATURES; [0048]
Attorney Docket No. END9234USNP4/190717-4, entitled SURGICAL
INSTRUMENT WITH ROTATABLE AND ARTICULATABLE SURGICAL END EFFECTOR;
[0049] Attorney Docket No. END9234USNP6/190717-6, entitled
ELECTROSURGICAL INSTRUMENT WITH ELECTRODES BIASING SUPPORT; [0050]
Attorney Docket No. END9234USNP7/190717-7, entitled ELECTROSURGICAL
INSTRUMENT WITH FLEXIBLE WIRING ASSEMBLIES; [0051] Attorney Docket
No. END9234USNP8/190717-8, entitled ELECTROSURGICAL INSTRUMENT WITH
VARIABLE CONTROL MECHANISMS; [0052] Attorney Docket No.
END9234USNP9/190717-9, entitled ELECTROSURGICAL SYSTEMS WITH
INTEGRATED AND EXTERNAL POWER SOURCES; [0053] Attorney Docket No.
END9234USNP10/190717-10, entitled ELECTROSURGICAL INSTRUMENTS WITH
ELECTRODES HAVING ENERGY FOCUSING FEATURES; [0054] Attorney Docket
No. END9234USNP11/190717-11, entitled ELECTROSURGICAL INSTRUMENTS
WITH ELECTRODES HAVING VARIABLE ENERGY DENSITIES; [0055] Attorney
Docket No. END9234USNP12/190717-12, entitled ELECTROSURGICAL
INSTRUMENT WITH MONOPOLAR AND BIPOLAR ENERGY CAPABILITIES; [0056]
Attorney Docket No. END9234USNP13/190717-13, entitled
ELECTROSURGICAL END EFFECTORS WITH THERMALLY INSULATIVE AND
THERMALLY CONDUCTIVE PORTIONS; [0057] Attorney Docket No.
END9234USNP14/190717-14, entitled ELECTROSURGICAL INSTRUMENT WITH
ELECTRODES OPERABLE IN BIPOLAR AND MONOPOLAR MODES; [0058] Attorney
Docket No. END9234USNP15/190717-15, entitled ELECTROSURGICAL
INSTRUMENT FOR DELIVERING BLENDED ENERGY MODALITIES TO TISSUE;
[0059] Attorney Docket No. END9234USNP16/190717-16, entitled
CONTROL PROGRAM ADAPTATION BASED ON DEVICE STATUS AND USER INPUT;
[0060] Attorney Docket No. END9234USNP17/190717-17, entitled
CONTROL PROGRAM FOR MODULAR COMBINATION ENERGY DEVICE; and [0061]
Attorney Docket No. END9234USNP18/190717-18, entitled SURGICAL
SYSTEM COMMUNICATION PATHWAYS.
[0062] Applicant of the present application owns the following U.S.
Provisional patent applications that were filed on Dec. 30, 2019,
the disclosure of each of which is herein incorporated by reference
in its entirety: [0063] U.S. Provisional Patent Application Ser.
No. 62/955,294, entitled USER INTERFACE FOR SURGICAL INSTRUMENT
WITH COMBINATION ENERGY MODALITY END-EFFECTOR; [0064] U.S.
Provisional Patent Application Ser. No. 62/955,292, entitled
COMBINATION ENERGY MODALITY END-EFFECTOR; and [0065] U.S.
Provisional Patent Application Ser. No. 62/955,306, entitled
SURGICAL INSTRUMENT SYSTEMS.
[0066] Applicant of the present application owns the following U.S.
patent applications, the disclosure of each of which is herein
incorporated by reference in its entirety: [0067] U.S. patent
application Ser. No. 16/209,395, titled METHOD OF HUB
COMMUNICATION, now U.S. Patent Application Publication No.
2019/0201136; [0068] U.S. patent application Ser. No. 16/209,403,
titled METHOD OF CLOUD BASED DATA ANALYTICS FOR USE WITH THE HUB,
now U.S. Patent Application Publication No. 2019/0206569; [0069]
U.S. patent application Ser. No. 16/209,407, titled METHOD OF
ROBOTIC HUB COMMUNICATION, DETECTION, AND CONTROL, now U.S. Patent
Application Publication No. 2019/0201137; [0070] U.S. patent
application Ser. No. 16/209,416, titled METHOD OF HUB
COMMUNICATION, PROCESSING, DISPLAY, AND CLOUD ANALYTICS, now U.S.
Patent Application Publication No. 2019/0206562; [0071] U.S. patent
application Ser. No. 16/209,423, titled METHOD OF COMPRESSING
TISSUE WITHIN A STAPLING DEVICE AND SIMULTANEOUSLY DISPLAYING THE
LOCATION OF THE TISSUE WITHIN THE JAWS, now U.S. Patent Application
Publication No. 2019/0200981; [0072] U.S. patent application Ser.
No. 16/209,427, titled METHOD OF USING REINFORCED FLEXIBLE CIRCUITS
WITH MULTIPLE SENSORS TO OPTIMIZE PERFORMANCE OF RADIO FREQUENCY
DEVICES, now U.S. Patent Application Publication No. 2019/0208641;
[0073] U.S. patent application Ser. No. 16/209,433, titled METHOD
OF SENSING PARTICULATE FROM SMOKE EVACUATED FROM A PATIENT,
ADJUSTING THE PUMP SPEED BASED ON THE SENSED INFORMATION, AND
COMMUNICATING THE FUNCTIONAL PARAMETERS OF THE SYSTEM TO THE HUB,
now U.S. Patent Application Publication No. 2019/0201594; [0074]
U.S. patent application Ser. No. 16/209,447, titled METHOD FOR
SMOKE EVACUATION FOR SURGICAL HUB, now U.S. Patent Application
Publication No. 2019/0201045; [0075] U.S. patent application Ser.
No. 16/209,453, titled METHOD FOR CONTROLLING SMART ENERGY DEVICES,
now U.S. Patent Application Publication No. 2019/0201046; [0076]
U.S. patent application Ser. No. 16/209,458, titled METHOD FOR
SMART ENERGY DEVICE INFRASTRUCTURE, now U.S. Patent Application
Publication No. 2019/0201047; [0077] U.S. patent application Ser.
No. 16/209,465, titled METHOD FOR ADAPTIVE CONTROL SCHEMES FOR
SURGICAL NETWORK CONTROL AND INTERACTION, now U.S. Patent
Application Publication No. 2019/0206563; [0078] U.S. patent
application Ser. No. 16/209,478, titled METHOD FOR SITUATIONAL
AWARENESS FOR SURGICAL NETWORK OR SURGICAL NETWORK CONNECTED DEVICE
CAPABLE OF ADJUSTING FUNCTION BASED ON A SENSED SITUATION OR USAGE,
now U.S. Patent Application Publication No. 2019/0104919; [0079]
U.S. patent application Ser. No. 16/209,490, titled METHOD FOR
FACILITY DATA COLLECTION AND INTERPRETATION, now U.S. Patent
Application Publication No. 2019/0206564; [0080] U.S. patent
application Ser. No. 16/209,491, titled METHOD FOR CIRCULAR STAPLER
CONTROL ALGORITHM ADJUSTMENT BASED ON SITUATIONAL AWARENESS, now
U.S. Patent Application Publication No. 2019/0200998; [0081] U.S.
patent application Ser. No. 16/562,123, titled METHOD FOR
CONSTRUCTING AND USING A MODULAR SURGICAL ENERGY SYSTEM WITH
MULTIPLE DEVICES; [0082] U.S. patent application Ser. No.
16/562,135, titled METHOD FOR CONTROLLING AN ENERGY MODULE OUTPUT;
[0083] U.S. patent application Ser. No. 16/562,144, titled METHOD
FOR CONTROLLING A MODULAR ENERGY SYSTEM USER INTERFACE; and [0084]
U.S. patent application Ser. No. 16/562,125, titled METHOD FOR
COMMUNICATING BETWEEN MODULES AND DEVICES IN A MODULAR SURGICAL
SYSTEM.
[0085] Before explaining various aspects of an electrosurgical
system in detail, it should be noted that the illustrative examples
are not limited in application or use to the details of
construction and arrangement of parts illustrated in the
accompanying drawings and description. The illustrative examples
may be implemented or incorporated in other aspects, variations,
and modifications, and may be practiced or carried out in various
ways. Further, unless otherwise indicated, the terms and
expressions employed herein have been chosen for the purpose of
describing the illustrative examples for the convenience of the
reader and are not for the purpose of limitation thereof. Also, it
will be appreciated that one or more of the following-described
aspects, expressions of aspects, and/or examples, can be combined
with any one or more of the other following-described aspects,
expressions of aspects, and/or examples.
[0086] Various aspects are directed to electrosurgical systems that
include electrosurgical instruments powered by generators to effect
tissue dissecting, cutting, and/or coagulation during surgical
procedures. The electrosurgical instruments may be configured for
use in open surgical procedures, but has applications in other
types of surgery, such as laparoscopic, endoscopic, and
robotic-assisted procedures.
[0087] As described below in greater detail, an electrosurgical
instrument generally includes a shaft having a distally-mounted end
effector (e.g., one or more electrodes). The end effector can be
positioned against the tissue such that electrical current is
introduced into the tissue. Electrosurgical instruments can be
configured for bipolar or monopolar operation. During bipolar
operation, current is introduced into and returned from the tissue
by active and return electrodes, respectively, of the end effector.
During monopolar operation, current is introduced into the tissue
by an active electrode of the end effector and returned through a
return electrode (e.g., a grounding pad) separately located on a
patient's body. Heat generated by the current flowing through the
tissue may form hemostatic seals within the tissue and/or between
tissues and thus may be particularly useful for sealing blood
vessels, for example.
[0088] FIG. 1 illustrates an example of a generator 900 configured
to deliver multiple energy modalities to a surgical instrument. The
generator 900 provides RF and/or ultrasonic signals for delivering
energy to a surgical instrument. The generator 900 comprises at
least one generator output that can deliver multiple energy
modalities (e.g., ultrasonic, bipolar or monopolar RF, irreversible
and/or reversible electroporation, and/or microwave energy, among
others) through a single port, and these signals can be delivered
separately or simultaneously to an end effector to treat tissue.
The generator 900 comprises a processor 902 coupled to a waveform
generator 904. The processor 902 and waveform generator 904 are
configured to generate a variety of signal waveforms based on
information stored in a memory coupled to the processor 902, not
shown for clarity of disclosure. The digital information associated
with a waveform is provided to the waveform generator 904 which
includes one or more DAC circuits to convert the digital input into
an analog output. The analog output is fed to an amplifier 906 for
signal conditioning and amplification. The conditioned and
amplified output of the amplifier 906 is coupled to a power
transformer 908. The signals are coupled across the power
transformer 908 to the secondary side, which is in the patient
isolation side. A first signal of a first energy modality is
provided to the surgical instrument between the terminals labeled
ENERGY.sub.1 and RETURN. A second signal of a second energy
modality is coupled across a capacitor 910 and is provided to the
surgical instrument between the terminals labeled ENERGY.sub.2 and
RETURN. It will be appreciated that more than two energy modalities
may be output and thus the subscript "n" may be used to designate
that up to n ENERGY.sub.n terminals may be provided, where n is a
positive integer greater than 1. It also will be appreciated that
up to "n" return paths RETURN.sub.n may be provided without
departing from the scope of the present disclosure.
[0089] A first voltage sensing circuit 912 is coupled across the
terminals labeled ENERGY.sub.1 and the RETURN path to measure the
output voltage therebetween. A second voltage sensing circuit 924
is coupled across the terminals labeled ENERGY.sub.2 and the RETURN
path to measure the output voltage therebetween. A current sensing
circuit 914 is disposed in series with the RETURN leg of the
secondary side of the power transformer 908 as shown to measure the
output current for either energy modality. If different return
paths are provided for each energy modality, then a separate
current sensing circuit should be provided in each return leg. The
outputs of the first and second voltage sensing circuits 912, 924
are provided to respective isolation transformers 928, 922 and the
output of the current sensing circuit 914 is provided to another
isolation transformer 916. The outputs of the isolation
transformers 916, 928, 922 on the primary side of the power
transformer 908 (non-patient isolated side) are provided to a one
or more ADC circuit 926. The digitized output of the ADC circuit
926 is provided to the processor 902 for further processing and
computation. The output voltages and output current feedback
information can be employed to adjust the output voltage and
current provided to the surgical instrument and to compute output
impedance, among other parameters. Input/output communications
between the processor 902 and patient isolated circuits is provided
through an interface circuit 920. Sensors also may be in electrical
communication with the processor 902 by way of the interface
circuit 920.
[0090] In one aspect, the impedance may be determined by the
processor 902 by dividing the output of either the first voltage
sensing circuit 912 coupled across the terminals labeled
ENERGY.sub.1/RETURN or the second voltage sensing circuit 924
coupled across the terminals labeled ENERGY.sub.2/RETURN by the
output of the current sensing circuit 914 disposed in series with
the RETURN leg of the secondary side of the power transformer 908.
The outputs of the first and second voltage sensing circuits 912,
924 are provided to separate isolations transformers 928, 922 and
the output of the current sensing circuit 914 is provided to
another isolation transformer 916. The digitized voltage and
current sensing measurements from the ADC circuit 926 are provided
the processor 902 for computing impedance. As an example, the first
energy modality ENERGY.sub.1 may be RF monopolar energy and the
second energy modality ENERGY.sub.2 may be RF bipolar energy.
Nevertheless, in addition to bipolar and monopolar RF energy
modalities, other energy modalities include ultrasonic energy,
irreversible and/or reversible electroporation and/or microwave
energy, among others. Also, although the example illustrated in
FIG. 1 shows a single return path RETURN may be provided for two or
more energy modalities, in other aspects, multiple return paths
RETURN.sub.n may be provided for each energy modality
ENERGY.sub.n.
[0091] As shown in FIG. 1, the generator 900 comprising at least
one output port can include a power transformer 908 with a single
output and with multiple taps to provide power in the form of one
or more energy modalities, such as ultrasonic, bipolar or monopolar
RF, irreversible and/or reversible electroporation, and/or
microwave energy, among others, for example, to the end effector
depending on the type of treatment of tissue being performed. For
example, the generator 900 can deliver energy with higher voltage
and lower current to drive an ultrasonic transducer, with lower
voltage and higher current to drive RF electrodes for sealing
tissue, or with a coagulation waveform for spot coagulation using
either monopolar or bipolar RF electrosurgical electrodes. The
output waveform from the generator 900 can be steered, switched, or
filtered to provide the frequency to the end effector of the
surgical instrument. In one example, a connection of RF bipolar
electrodes to the generator 900 output would be preferably located
between the output labeled ENERGY.sub.2 and RETURN. In the case of
monopolar output, the preferred connections would be active
electrode (e.g., pencil or other probe) to the ENERGY.sub.2 output
and a suitable return pad connected to the RETURN output.
[0092] Additional details are disclosed in U.S. Patent Application
Publication No. 2017/0086914, titled TECHNIQUES FOR OPERATING
GENERATOR FOR DIGITALLY GENERATING ELECTRICAL SIGNAL WAVEFORMS AND
SURGICAL INSTRUMENTS, which published on Mar. 30, 2017, which is
herein incorporated by reference in its entirety.
[0093] FIG. 2 illustrates one form of a surgical system 1000
comprising a generator 1100 and various surgical instruments 1104,
1106, 1108 usable therewith, where the surgical instrument 1104 is
an ultrasonic surgical instrument, the surgical instrument 1106 is
an RF electrosurgical instrument, and the multifunction surgical
instrument 1108 is a combination ultrasonic/RF electrosurgical
instrument. The generator 1100 is configurable for use with a
variety of surgical instruments. According to various forms, the
generator 1100 may be configurable for use with different surgical
instruments of different types including, for example, ultrasonic
surgical instruments 1104, RF electrosurgical instruments 1106, and
multifunction surgical instruments 1108 that integrate RF and
ultrasonic energies delivered simultaneously from the generator
1100. Although in the form of FIG. 2 the generator 1100 is shown
separate from the surgical instruments 1104, 1106, 1108 in one
form, the generator 1100 may be formed integrally with any of the
surgical instruments 1104, 1106, 1108 to form a unitary surgical
system. The generator 1100 comprises an input device 1110 located
on a front panel of the generator 1100 console. The input device
1110 may comprise any suitable device that generates signals
suitable for programming the operation of the generator 1100. The
generator 1100 may be configured for wired or wireless
communication.
[0094] The generator 1100 is configured to drive multiple surgical
instruments 1104, 1106, 1108. The first surgical instrument is an
ultrasonic surgical instrument 1104 and comprises a handpiece 1105
(HP), an ultrasonic transducer 1120, a shaft 1126, and an end
effector 1122. The end effector 1122 comprises an ultrasonic blade
1128 acoustically coupled to the ultrasonic transducer 1120 and a
clamp arm 1140. The handpiece 1105 comprises a trigger 1143 to
operate the clamp arm 1140 and a combination of the toggle buttons
1137, 1134b, 1134c to energize and drive the ultrasonic blade 1128
or other function. The toggle buttons 1137, 1134b, 1134c can be
configured to energize the ultrasonic transducer 1120 with the
generator 1100.
[0095] The generator 1100 also is configured to drive a second
surgical instrument 1106. The second surgical instrument 1106 is an
RF electrosurgical instrument and comprises a handpiece 1107 (HP),
a shaft 1127, and an end effector 1124. The end effector 1124
comprises electrodes in clamp arms 1145, 1142b and return through
an electrical conductor portion of the shaft 1127. The electrodes
are coupled to and energized by a bipolar energy source within the
generator 1100. The handpiece 1107 comprises a trigger 1145 to
operate the clamp arms 1145, 1142b and an energy button 1135 to
actuate an energy switch to energize the electrodes in the end
effector 1124. The second surgical instrument 1106 can also be used
with a return pad to deliver monopolar energy to tissue.
[0096] The generator 1100 also is configured to drive a
multifunction surgical instrument 1108. The multifunction surgical
instrument 1108 comprises a handpiece 1109 (HP), a shaft 1129, and
an end effector 1125. The end effector 1125 comprises an ultrasonic
blade 1149 and a clamp arm 1146. The ultrasonic blade 1149 is
acoustically coupled to the ultrasonic transducer 1120. The
handpiece 1109 comprises a trigger 1147 to operate the clamp arm
1146 and a combination of the toggle buttons 11310, 1137b, 1137c to
energize and drive the ultrasonic blade 1149 or other function. The
toggle buttons 11310, 1137b, 1137c can be configured to energize
the ultrasonic transducer 1120 with the generator 1100 and energize
the ultrasonic blade 1149 with a bipolar energy source also
contained within the generator 1100. Monopolar energy can be
delivered to the tissue in combination with, or separately from,
the bipolar energy.
[0097] The generator 1100 is configurable for use with a variety of
surgical instruments. According to various forms, the generator
1100 may be configurable for use with different surgical
instruments of different types including, for example, the
ultrasonic surgical instrument 1104, the RF electrosurgical
instrument 1106, and the multifunction surgical instrument 1108
that integrates RF and ultrasonic energies delivered simultaneously
from the generator 1100. Although in the form of FIG. 2, the
generator 1100 is shown separate from the surgical instruments
1104, 1106, 1108, in another form the generator 1100 may be formed
integrally with any one of the surgical instruments 1104, 1106,
1108 to form a unitary surgical system. As discussed above, the
generator 1100 comprises an input device 1110 located on a front
panel of the generator 1100 console. The input device 1110 may
comprise any suitable device that generates signals suitable for
programming the operation of the generator 1100. The generator 1100
also may comprise one or more output devices 1112. Further aspects
of generators for digitally generating electrical signal waveforms
and surgical instruments are described in US patent application
publication US-2017-0086914-A1, which is herein incorporated by
reference in its entirety.
[0098] FIG. 3 illustrates a schematic diagram of a surgical
instrument or tool 600 comprising a plurality of motor assemblies
that can be activated to perform various functions. In the
illustrated example, a closure motor assembly 610 is operable to
transition an end effector between an open configuration and a
closed configuration, and an articulation motor assembly 620 is
operable to articulate the end effector relative to a shaft
assembly. In certain instances, the plurality of motors assemblies
can be individually activated to cause firing, closure, and/or
articulation motions in the end effector. The firing, closure,
and/or articulation motions can be transmitted to the end effector
through a shaft assembly, for example.
[0099] In certain instances, the closure motor assembly 610
includes a closure motor. The closure 603 may be operably coupled
to a closure motor drive assembly 612 which can be configured to
transmit closure motions, generated by the motor to the end
effector, in particular to displace a closure member to close to
transition the end effector to the closed configuration. The
closure motions may cause the end effector to transition from an
open configuration to a closed configuration to capture tissue, for
example. The end effector may be transitioned to an open position
by reversing the direction of the motor.
[0100] In certain instances, the articulation motor assembly 620
includes an articulation motor that be operably coupled to an
articulation drive assembly 622 which can be configured to transmit
articulation motions, generated by the motor to the end effector.
In certain instances, the articulation motions may cause the end
effector to articulate relative to the shaft, for example.
[0101] One or more of the motors of the surgical instrument 600 may
comprise a torque sensor to measure the output torque on the shaft
of the motor. The force on an end effector may be sensed in any
conventional manner, such as by force sensors on the outer sides of
the jaws or by a torque sensor for the motor actuating the
jaws.
[0102] In various instances, the motor assemblies 610, 620 include
one or more motor drivers that may comprise one or more H-Bridge
FETs. The motor drivers may modulate the power transmitted from a
power source 630 to a motor based on input from a microcontroller
640 (the "controller"), for example, of a control circuit 601. In
certain instances, the microcontroller 640 can be employed to
determine the current drawn by the motor, for example.
[0103] In certain instances, the microcontroller 640 may include a
microprocessor 642 (the "processor") and one or more non-transitory
computer-readable mediums or memory units 644 (the "memory"). In
certain instances, the memory 644 may store various program
instructions, which when executed may cause the processor 642 to
perform a plurality of functions and/or calculations described
herein. In certain instances, one or more of the memory units 644
may be coupled to the processor 642, for example. In various
aspects, the microcontroller 640 may communicate over a wired or
wireless channel, or combinations thereof.
[0104] In certain instances, the power source 630 can be employed
to supply power to the microcontroller 640, for example. In certain
instances, the power source 630 may comprise a battery (or "battery
pack" or "power pack"), such as a lithium-ion battery, for example.
In certain instances, the battery pack may be configured to be
releasably mounted to a handle for supplying power to the surgical
instrument 600. A number of battery cells connected in series may
be used as the power source 630. In certain instances, the power
source 630 may be replaceable and/or rechargeable, for example.
[0105] In various instances, the processor 642 may control a motor
driver to control the position, direction of rotation, and/or
velocity of a motor of the assemblies 610, 620. In certain
instances, the processor 642 can signal the motor driver to stop
and/or disable the motor. It should be understood that the term
"processor" as used herein includes any suitable microprocessor,
microcontroller, or other basic computing device that incorporates
the functions of a computer's central processing unit (CPU) on an
integrated circuit or, at most, a few integrated circuits. The
processor 642 is a multipurpose, programmable device that accepts
digital data as input, processes it according to instructions
stored in its memory, and provides results as output. It is an
example of sequential digital logic, as it has internal memory.
Processors operate on numbers and symbols represented in the binary
numeral system.
[0106] In one instance, the processor 642 may be any single-core or
multicore processor such as those known under the trade name ARM
Cortex by Texas Instruments. In certain instances, the
microcontroller 620 may be an LM 4F230H5QR, available from Texas
Instruments, for example. In at least one example, the Texas
Instruments LM4F230H5QR is an ARM Cortex-M4F Processor Core
comprising an on-chip memory of 256 KB single-cycle flash memory,
or other non-volatile memory, up to 40 MHz, a prefetch buffer to
improve performance above 40 MHz, a 32 KB single-cycle SRAM, an
internal ROM loaded with StellarisWare.RTM. software, a 2 KB
EEPROM, one or more PWM modules, one or more QEI analogs, one or
more 12-bit ADCs with 12 analog input channels, among other
features that are readily available for the product datasheet.
Other microcontrollers may be readily substituted for use with the
surgical instrument 600. Accordingly, the present disclosure should
not be limited in this context.
[0107] In certain instances, the memory 644 may include program
instructions for controlling each of the motors of the surgical
instrument 600. For example, the memory 644 may include program
instructions for controlling the closure motor and the articulation
motor. Such program instructions may cause the processor 642 to
control the closure and articulation functions in accordance with
inputs from algorithms or control programs of the surgical
instrument 600.
[0108] In certain instances, one or more mechanisms and/or sensors
such as, for example, sensors 645 can be employed to alert the
processor 642 to the program instructions that should be used in a
particular setting. For example, the sensors 645 may alert the
processor 642 to use the program instructions associated with
closing and articulating the end effector. In certain instances,
the sensors 645 may comprise position sensors which can be employed
to sense the position of a closure actuator, for example.
Accordingly, the processor 642 may use the program instructions
associated with closing the end effector to activate the motor of
the closure drive assembly 620 if the processor 642 receives a
signal from the sensors 630 indicative of actuation of the closure
actuator.
[0109] In some examples, the motors may be brushless DC electric
motors, and the respective motor drive signals may comprise a PWM
signal provided to one or more stator windings of the motors. Also,
in some examples, the motor drivers may be omitted and the control
circuit 601 may generate the motor drive signals directly.
[0110] It is common practice during various laparoscopic surgical
procedures to insert a surgical end effector portion of a surgical
instrument through a trocar that has been installed in the
abdominal wall of a patient to access a surgical site located
inside the patient's abdomen. In its simplest form, a trocar is a
pen-shaped instrument with a sharp triangular point at one end that
is typically used inside a hollow tube, known as a cannula or
sleeve, to create an opening into the body through which surgical
end effectors may be introduced. Such arrangement forms an access
port into the body cavity through which surgical end effectors may
be inserted. The inner diameter of the trocar's cannula necessarily
limits the size of the end effector and drive-supporting shaft of
the surgical instrument that may be inserted through the
trocar.
[0111] Regardless of the specific type of surgical procedure being
performed, once the surgical end effector has been inserted into
the patient through the trocar cannula, it is often necessary to
move the surgical end effector relative to the shaft assembly that
is positioned within the trocar cannula in order to properly
position the surgical end effector relative to the tissue or organ
to be treated. This movement or positioning of the surgical end
effector relative to the portion of the shaft that remains within
the trocar cannula is often referred to as "articulation" of the
surgical end effector. A variety of articulation joints have been
developed to attach a surgical end effector to an associated shaft
in order to facilitate such articulation of the surgical end
effector. As one might expect, in many surgical procedures, it is
desirable to employ a surgical end effector that has as large a
range of articulation as possible.
[0112] Due to the size constraints imposed by the size of the
trocar cannula, the articulation joint components must be sized so
as to be freely insertable through the trocar cannula. These size
constraints also limit the size and composition of various drive
members and components that operably interface with the motors
and/or other control systems that are supported in a housing that
may be handheld or comprise a portion of a larger automated system.
In many instances, these drive members must operably pass through
the articulation joint to be operably coupled to or operably
interface with the surgical end effector. For example, one such
drive member is commonly employed to apply articulation control
motions to the surgical end effector. During use, the articulation
drive member may be unactuated to position the surgical end
effector in an unarticulated position to facilitate insertion of
the surgical end effector through the trocar and then be actuated
to articulate the surgical end effector to a desired position once
the surgical end effector has entered the patient.
[0113] Thus, the aforementioned size constraints form many
challenges to developing an articulation system that can effectuate
a desired range of articulation, yet accommodate a variety of
different drive systems that are necessary to operate various
features of the surgical end effector. Further, once the surgical
end effector has been positioned in a desired articulated position,
the articulation system and articulation joint must be able to
retain the surgical end effector in that position during the
actuation of the end effector and completion of the surgical
procedure. Such articulation joint arrangements must also be able
to withstand external forces that are experienced by the end
effector during use.
[0114] FIGS. 4-7 depict an electrosurgical instrument 30100
comprising a first jaw 30110, a second jaw 30120, and a monopolar
wedge electrode 30130. The first jaw 30110 and the second jaw 30120
are movable between an open position and a closed position and are
configured to grasp tissue T therebetween. Each of the first jaw
30110 and the second jaw 30120 comprises an electrode that is
electrically coupled to a power generator. Example suitable power
generators 900, 1100 are described above in connection with FIGS. 1
and 2. The power generator is configured to supply power to cause
the electrodes of the first and second jaws 30110, 30120 to
cooperatively deliver bipolar energy to the grasped tissue to seal,
coagulate, and/or cauterize the tissue in a bipolar
tissue-treatment cycle.
[0115] In use, the first jaw 30110 and the second jaw 30120 may
deflect away from each other at their distal ends when the tissue T
is grasped therebetween. When the tissue T is grasped, the tissue T
exerts a force on the first jaw 30110 and the second jaw 30120
causing the jaws to deflect away from each other. More
specifically, the gap B between the first jaw 30110 and the second
jaw 30120 toward the distal end of the jaws may be greater than the
gap A between the first jaw 30110 and the second jaw 30120 toward
the proximal end of the jaws when tissue T is grasped between the
first jaw 30110 and the second jaw 30120.
[0116] Further to the above, the end effector 30100 of the
electrosurgical instrument 30100 further includes monopolar wedge
electrode 30130 is electrically connected to the power generator
(e.g. power generators 900, 1100) and configured to cut the tissue
T positioned between the first jaw 30110 and the second jaw 30120
when energized by the power generator. In the illustrated
embodiment, the monopolar wedge electrode 30130 is affixed to the
second jaw 30120; however, other embodiments are envisioned where
the monopolar wedge electrode 30130 is affixed to the first jaw
30110. The monopolar wedge electrode 30130 is thinner at its
proximal end and thicker at its distal end (see FIG. 7) to
compensate for the variable gap defined between the first jaw 30110
and the second jaw 30120. In other words, the monopolar wedge
electrode 30130 comprises a wedge shape. As previously discussed,
the variable gap defined between the jaws 30110, 30120 is due, at
least in part, to the deflection of the jaws 30110, 30120 when
tissue is grasped therebetween. In at least one embodiment, the
monopolar wedge electrode 30130 comprises a compliant flex circuit
substrate 30132. The compliant flex circuit substrate 30132 is
configured to bend and/or flex longitudinally to compensate for the
deflection of the first jaw 30110 and the second jaw 30120 when
tissue is grasped between the first and second jaws 30110,
30120.
[0117] In various examples, the monopolar wedge electrode 30130
includes an electrically conductive member 30134 disposed centrally
along a length of the compliant flex circuit substrate 30132. In
the illustrated example, the electrically conductive member 30134
is disposed onto the compliant flex circuit substrate 30132 where
at least a portion thereof is exposed through a top surface of the
compliant flex circuit substrate 30132. In certain examples,
portions of the electrically conductive member 30134 are exposed
while other portions are covered by the compliant flex circuit
substrate 30132.
[0118] In examples where the jaws 30110, 30120 comprise a curved
shape, the monopolar wedge electrode 30130 extends longitudinally
in a similar curved profile. Furthermore, the monopolar wedge
electrode 30130 graduates from a larger width to a smaller width as
it extends longitudinally. Accordingly, a first width of the
monopolar wedge electrode 30130 near a proximal end thereof is
greater than a second width near a distal end thereof, as
illustrated in FIG. 6. In other examples, a first width of a
monopolar wedge electrode near a proximal end thereof can be
smaller than a second width near a distal end thereof.
[0119] In the illustrated example, the distal end of the
electrically conductive member 30134 is proximal to the distal end
of the compliant flex circuit substrate 30132, and the distal end
of the compliant flex circuit substrate 30132 is proximal to the
distal end of the jaw 30130. In other examples, however, the distal
ends of the jaw 30130, the electrically conductive member 30134 and
the compliant flex circuit substrate 30132 are united at one
position.
[0120] FIGS. 8-10 depict an electrosurgical instrument 30200
comprising a first jaw 30210, a second jaw 30220, and a monopolar
electrode 30230. The first jaw 30210 and the second jaw 30220 are
movable between an open position and a closed position, wherein
tissue is configured to be positioned therebetween. The first jaw
30210 and the second jaw 30220 are comprised of metal and can be
coated with a dielectric material. In at least one embodiment, the
first jaw 30210 and the second jaw 30220 are comprised of stainless
steel and are coated with a shrink tube. In various aspects, the
jaws 30210, 30220 define bipolar electrodes that are electrically
isolated from the monopolar electrode 30230.
[0121] The first jaw 30210 comprises a first compliant member 30240
positioned around the first jaw 30210 and the second jaw 30220
comprises a second compliant member 30250 positioned around the
second jaw 30220. The compliant members 30240, 30250 comprise a
deformable dielectric material that is compressible to enhance
contact with tissue when tissue is positioned between the first jaw
30210 and the second jaw 30220. In at least one embodiment, the
compliant members 30240, 30250 comprise silicone and/or rubber.
[0122] Further to the above, the monopolar electrode 30230 is
utilized to cut tissue positioned between the first jaw 30210 and
the second jaw 30220 when the monopolar electrode 30230 is
energized by a power generator (e.g. generators 1100, 900). The
monopolar electrode 30230 comprises a wire that extends along the
first jaw 30210 and into the first compliant member 30240. The
monopolar electrode 30230 exits the first compliant member 20140
through a proximal opening 30242 in the first compliant member
30240, extends along the exterior of the first compliant member
30240, and then re-enters the first compliant member 20140 through
a distal opening 30244 in the first compliant member 30240. This
arrangement permits a central portion 30232 of the monopolar
electrode 30230 to bend and/or flex when tissue is grasped between
the first jaw 30210 and the second jaw 30220. Further, the central
portion 30232 of the monopolar electrode 30230 is reinforced by the
first compliant member 30240 along its length. Stated another way,
the first compliant member 30240 applies a biasing force to the
central portion 30232 of the monopolar electrode 30230 toward the
second jaw 30220. The first compliant member 30240 increases the
pressure exerted by the monopolar electrode 30230 on the tissue to
improve the cutting ability of the monopolar electrode 30230 when
the first jaw 30210 and the second jaw 30220 grasp tissue
therebetween.
[0123] In various aspects, the monopolar electrode 30230 can be
comprised of a metal such as, for example, stainless steel,
titanium, or any other suitable metal. The exposed surface of the
monopolar electrode 30230 can have a bare metal finish, or can be
coated with a thin dielectric material such as, for example, PTFE.
In various aspects, the coating can be skived to reveal a thin
metal strip defining an electrically conductive surface.
[0124] FIG. 11 depicts a surgical instrument 30300 comprising a
first jaw 30310, a second jaw 30320, and a monopolar electrode
30330. The first jaw 30310 and the second jaw 30320 are movable
between an open position and a closed position to grasp tissue T
therebetween. The first jaw 30310 comprises a first bipolar
electrode and the second jaw 30320 comprises a second bipolar
electrode. The first and second bipolar electrodes cooperate to
delivery bipolar energy to cauterize and/or seal tissue grasped
between the first and second jaws 30310, 30320 in a bipolar
tissue-treatment cycle.
[0125] Further to the above, the first jaw 30310 comprises a first
tissue contacting surface 30314 and the second jaw 30320 comprises
a second tissue contacting surface 30324. The first jaw 30310
comprises a first recess 30312 configured to receive a first
compliant or biasing member 30340 therein. The first biasing member
30340 is configured to bias the tissue T toward the second jaw
30320 when the tissue T is grasped between the first jaw 30310 and
the second jaw 30320. The second jaw comprises a second recess
30322 configured to receive a second compliant or biasing member
30350 and the monopolar electrode 30330 therein. The second biasing
member 30350 is configured to bias the monopolar electrode 30330
and the tissue T toward the first jaw 30310 when the tissue T is
grasped between the first jaw 30310 and the second jaw 30320.
[0126] Further to the above, the first recess 30312 and the second
recess 30322 are sized and shaped to receive the first biasing
member 30340, the second biasing member 30350, and the monopolar
electrode 30330 to ensure the first jaw 30310 and the second jaw
30320 can be fully closed. In other words, when the first jaw 30310
and the second jaw 30320 are in the closed position, the first
tissue-contacting surface 30314 and the second tissue-contacting
surface 30324 contact one another when no tissue T is positioned
therebetween. However, other embodiments are envisioned where a gap
is defined between the first tissue-contacting surface 30314 and
the second tissue-contacting surface 30324 when the first jaw 30310
and the second jaw 30320 are in the closed position when tissue T
is positioned therebetween and/or when tissue T is not positioned
therebetween. In any event, the first recess 30312 and the second
recess 30322 are sized and/or shaped such that the monopolar
electrode 30330 extends above the second tissue-contacting surface
30324 and into the first recess 30312 of the first jaw 30310 to
increase the ability of the first jaw 30310 and the second jaw
30320 to fully close. The first and second recesses 30312, 30322
comprise an electrically isolative material to electrically isolate
the monopolar electrode 30330 from the first and second jaws 30310,
30320. However, other embodiments are envisioned where the first
and second recesses 30312, 30322 do not electrically isolate the
monopolar electrode 30330 from the first and second jaws 30310,
30320. The monopolar electrode 30330 comprises an independent
wiring connection to the control housing of the surgical instrument
30300. The independent wiring connection allows the monopolar
electrode 30330 to be energized independent of the first and second
electrodes of the first and second jaws 30310, 30320 to permit
cutting and/or sealing operations to be performed independent of
one another. In at least one embodiment, the control housing of the
surgical instrument 30300 prevents the monopolar electrode 30330
from being energized until the first and second electrodes of the
first and second jaws 30310, 30320 have been energized to prevent
cutting of tissue T that has not been cauterized and/or sealed.
[0127] FIG. 12 illustrates a surgical end effector 30400 for use
with an electrosurgical instrument. The end effector 30400
comprises a first jaw including a first bipolar electrode 30410, a
second jaw including a second bipolar electrode 30420, and a
monopolar electrode 30430. The first bipolar electrode 30410 and
the second bipolar electrode 30420 are at least partially
surrounded by a compliant member and/or a compliant insulator
30440. The compliant insulator 30440 can comprise rubber, silicone,
Polytetrafluoroethylene (PTFE) tubing, and/or combinations thereof.
The monopolar electrode 30430 is affixed to the compliant insulator
30440 of the first bipolar electrode 30410. Thus, the monopolar
electrode 30430 is electrically insulated from the first bipolar
electrode 30410. In at least one embodiment, the compliant
insulator 30440 surrounding the first electrode 30410 comprises a
rigid, or at least substantially rigid, PTFE tubing and the second
compliant insulator 30440 surrounding the second electrode 30420
comprises a silicone and/or rubber material. Other embodiments are
envisioned with different combinations of PTFE tubing, rubber,
and/or silicone, positioned at least partially around the first
bipolar electrode 30410 and the second bipolar electrode 30420, for
example.
[0128] FIG. 13 illustrates a surgical end effector 30500 for use
with an electrosurgical instrument. The surgical end effector
comprises a first jaw 30510 and a second jaw 30520 movable between
open and closed positions to grasp tissue therebetween. The first
jaw 30510 is at least partially surrounded by a first compliant
member 30514 and the second jaw 30520 is at least partially
surrounded by a second compliant member 30524. The first compliant
member 30514 is almost completely surrounded by a first bipolar
electrode 30512 and the second compliant member 30524 is almost
completely surrounded by a second bipolar electrode 30522. More
specifically, the first bipolar electrode 30512 surrounds the first
compliant member 30514 except for a gap portion 30516 where a
monopolar electrode 30530 is affixed to the first compliant member
30514. Further, the second bipolar electrode 30522 surrounds the
second compliant member 30524 except for a gap portion 30526 facing
the first jaw 30510. The gap portion 30526 in the second jaw 30520
permits the monopolar electrode 30530 extending from the first
complaint member 30514 to experience biasing forces from both the
first and second compliant members 30514, 30524 when the first jaw
30510 and the second jaw 30520 grasp tissue in the closed position.
The first complaint member 30514 and the second compliant member
30524 comprise an electrically insulative material to electrically
isolate the monopolar electrode 30530 from the first bipolar
electrode 30512 and the second bipolar electrode 30522. The first
and second complaint members 30514, 30524 can comprise rubber,
silicone, PTFE tubing, and/or combinations thereof.
[0129] FIG. 14 illustrates a surgical end effector 30600 for use
with an electrosurgical instrument. The surgical end effector 30600
comprises a first jaw 30610 and a second jaw 30620 movable between
open and closed positions to grasp tissue therebetween. The first
jaw 30610 is at least partially surrounded by a first compliant
member 30614 and the second jaw 30620 is at least partially
surrounded by a second compliant member 30624. The first compliant
member 30614 is almost completely surrounded by a first bipolar
electrode 30612 and the second compliant member 30624 is almost
completely surrounded by a second bipolar electrode 30622. In other
words, the first bipolar electrode 30612 surrounds the first
compliant member 30614 except for a gap portion 30616 where a
monopolar electrode 30630 is affixed to the first compliant member
30614. Further, the second bipolar electrode 30622 surrounds the
second compliant member 30624 except for a gap portion 30626.
[0130] Further to the above, the gap portions 30616, 30626 in the
first and second bipolar electrodes 30612, 30622 permit the
monopolar electrode 30630 extending from the first complaint member
30614 to contact the second compliant member 30624 when the first
jaw 30610 and the second jaw 30620 are in the closed position.
Further, the gap portions 30616, 30626 are offset to permit the
first bipolar electrode 30612 to contact the second compliant
member 30624 and the second bipolar electrode 30622 to contact the
first compliant member 30614 when the jaws 30610, 30620 are closed
with no tissue positioned therebetween. Unlike the electrodes
30512, 30533, the electrodes 30612, 30622 are not mirror images of
each other. Instead, the electrode 30612 is offset with the
electrode 30622 causing the gap portions 30616, 30610 to also be
offset with one another. This arrangement prevents circuit
shorting.
[0131] In any event, when the first jaw 30610 and the second jaw
30620 are closed, the monopolar electrode 30630 is positioned
between the first compliant member 30614 and the second compliant
member 30624 to provide a spring bias or biasing force to the
monopolar electrode 30630 when tissue is grasped between the jaws
30610, 30620. In other words, the monopolar electrode 30630
experiences biasing forces from both the first compliant member
30614 and the second compliant member 30624 when the first jaw
30610 and the second jaw 30620 are closed around tissue. The
biasing forces from the compliant members 30614, 30624 facilitate
cutting of tissue when the monopolar electrode 30630 is
energized.
[0132] Further to the above, in at least one embodiment, the first
complaint member 30614 and the second compliant member 30624
comprise electrically insulative material to electrically isolate
the monopolar electrode 30630 from the first bipolar electrode
30612 and the second bipolar electrode 30622. In at least one
embodiment, the first and second complaint members 30614, 30624 can
comprise rubber, silicon, PTFE tubing, and/or combinations
thereof.
[0133] FIG. 15 illustrates a surgical end effector 30700 for use
with an electrosurgical instrument. The end effector 30700
comprises a first jaw 30710 and a second jaw 30720 movable between
open and closed positions to grasp tissue therebetween. The first
jaw 30710 defines a first bipolar electrode and the second jaw
30720 defines a second bipolar electrode that are configured to
cooperate to delivery bipolar energy to cauterize and/or seal
tissue grasped between the first and second jaws 30710, 30720.
Further, the first jaw 30710 comprises a first longitudinal recess
30712 comprising a first compliant member 30714 affixed therein.
The second jaw 30720 comprises a second longitudinal recess 30722
comprising a second compliant member 30724 affixed therein. The
surgical end effector 30700 further comprises a monopolar electrode
30730 affixed to the first compliant member 30714. The first
compliant member 30714 and the second compliant member 30724 permit
the monopolar electrode 30730 extending from the first complaint
member 30714 to experience biasing forces from both the first and
second compliant members 30714, 30724 when the first jaw 30710 and
the second jaw 30720 grasp tissue in the closed position. The first
complaint member 30714 and the second compliant member 30724
comprise electrically insulative material to electrically isolate
the monopolar electrode 30730 from the first electrode of the first
jaw 30710 and the second electrode of the second jaw 30720. The
first and second complaint members 30714, 30724 can comprises
rubber, silicone, PTFE tubing, and/or combinations thereof.
[0134] FIG. 16 illustrates a surgical end effector for use with an
electrosurgical instrument. The end effector 30800 comprises a
first jaw 30810 and a second jaw 30820 movable between an open
position and a closed position to grasp tissue therebetween. The
first jaw 30810 defines a first bipolar electrode and the second
jaw 30820 defines a second bipolar electrode. As discussed above,
the first and second bipolar electrodes are configured to cooperate
to delivery bipolar energy to cauterize and/or seal tissue
positioned between the first and second jaws 30810, 30820. Further,
the first jaw 30810 comprises a longitudinal recess 30812
comprising a compliant member 30814 affixed therein. In at least
one embodiment, the second jaw 30820 comprises stainless steel
coated with PTFE shrink tube. The surgical end effector 30800
further comprises a monopolar electrode 30830 affixed to the
compliant member 30814 of the first jaw 30810. The compliant member
30814 provides a biasing force to the monopolar electrode 30830
when the first jaw 30810 and the second jaw 30820 grasp tissue
therebetween. The biasing force of the compliant member 30814
enhances contact between the monopolar electrode 30830 and the
tissue during cutting operations. The complaint member 30814
comprises an electrically insulative material to electrically
isolate the monopolar electrode 30830 from the first electrode of
the first jaw 30810. The complaint member 30814 can comprise
rubber, silicone, PTFE tubing, and/or combinations thereof.
[0135] FIG. 17 illustrates an alternative surgical end effector
30800' to the surgical end effector 30800. The end effector 30800'
is similar to the end effector 30800; however, the monopolar
electrode 30830 is affixed to the second jaw 30820. When tissue is
positioned between the first jaw 30810 and the second jaw 30820,
the compliant member 30814 applies a biasing force through the
tissue to the monopolar electrode 30830 affixed to the second jaw
30820.
[0136] FIG. 18 illustrates a surgical end effector 30900 for use
with an electrosurgical instrument. The surgical end effector 30900
defines an end effector axis EA extending longitudinally along the
length of the end effector 30900. The surgical end effector 30900
comprises a first jaw 30910 and a second jaw 30920 movable between
an open position and a closed position to grasp tissue
therebetween. The first jaw 30910 comprises a first honeycomb
lattice structure 30912 surrounded by a first diamond-like coating
30914. The second jaw 30920 comprises a second honeycomb lattice
structure 30922 surrounded by a second diamond-like coating 30924.
The diamond-like coatings 30914, 30924 may be any of the
diamond-like coatings described herein, for example. The first
honeycomb lattice structure 30912 and the second honeycomb lattice
structure 30922 comprise the same geometric array and material.
However, other embodiments are envisioned where the first honeycomb
lattice structure 30912 and the second honeycomb lattice structure
30922 comprise different geometric arrays and materials which
comprise more or less air pockets, as described herein. The first
diamond-like coating 30914 and the second diamond-like coating
30924 comprise the same material. However, other embodiments are
envisioned where the first diamond-like coating 30914 and the
second diamond-like coating 30924 comprise different materials.
[0137] Further to the above, the end effector 30900 further
comprises a first bipolar electrode 30940 affixed to the first
diamond-like coating 30914 of the first jaw 30910 on a first
lateral side of the end effector axis EA. The first bipolar
electrode 30940 extends longitudinally along a length of the end
effector 30900. The second jaw 30920 comprises a compliant member
30960 affixed within a cutout portion 30926 defined in the second
jaw 30920. The end effector 30900 further comprises a second
bipolar electrode 30950 affixed to the compliant member 30960 on a
second lateral side of the end effector axis EA. The second bipolar
electrode 30950 extends longitudinally along a length of the end
effector 30900. The electrodes 30940, 30950 cooperate to deliver a
bipolar energy to tissue grasped between the jaws 30910, 30920.
Further, the electrodes 30940, 30950 are offset from one another to
prevent incidental contact between them in the closed position,
which can form a short circuit.
[0138] Further, the end effector 30900 comprises a monopolar
electrode 30930 affixed to the compliant member 30960 and
positioned intermediate the first bipolar electrode 30940 and the
second bipolar electrode 30950. The monopolar electrode 30930
extends longitudinally along a length of the end effector 30900
and, in at least one embodiment, is aligned with the end effector
axis EA.
[0139] As discussed herein, the first bipolar electrode 30940 and
the second bipolar electrode 30950 are configured to cauterize
and/or seal tissue when tissue is positioned between the first and
second jaws 30910, 30920 by delivering bipolar energy to the tissue
in a bipolar energy cycle. Further, the monopolar electrode 30930
is configured to cut the tissue by delivering monopolar energy to
the tissue in a monopolar energy cycle.
[0140] Further to the above, the compliant member 30960 is
compressible and exerts pressure on tissue positioned between the
first jaw 30910 and the second jaw 30920. More specifically, the
pressure exerted by the jaws 30910, 30920 on the tissue in the
region directly above the compliant member 30960 is greater than
the pressure exerted on the tissue in the regions adjacent to the
compliant member 30960 (i.e., the regions where the compliant
member 30960 is not present). In at least one embodiment, the
compliant member 30960 comprises an elastomeric and/or plastic
honeycomb structure that insulates the second bipolar electrode
30950 and the monopolar electrode 30930 from the second
diamond-like coating 30924 and honeycomb lattice structure 30922 of
the second jaw 30920. The compliant member 30960 holds the second
bipolar electrode 30950 and the monopolar electrode 30930 in place
and provides a biasing force to the monopolar electrode 30930 and
the second bipolar electrode 30950 toward the first jaw 30910 when
tissue is grasped between the first and second jaws 30910,
30920.
[0141] Further to the above, the first and second diamond-like
coatings 30914, 30924 are electrically conductive and thermally
insulative. However, other embodiments are envisioned where the
first and second diamond-like coatings 30914, 30924 are
electrically insulative and/or thermally insulative. The first and
second honeycomb lattice structures 30912, 30922 comprise air
pockets which provide thermal insulation for the first and second
jaws 30910, 30920. The first and second honeycomb lattice
structures 30912, 30922 provide an additional spring bias to the
tissue when the tissue is positioned between the first and second
jaws 30910, 30920. In at least one embodiment, the first and second
honeycomb lattice structures 30912, 30922 allow the first and
second jaws 30910, 30920 to flex and/or bend when tissue is grasped
therebetween. In any event, the spring forces of the first and
second honeycomb lattice structures 30912, 30922 and the compliant
member 30960 provide consistent pressure to the tissue when the
tissue is grasped between the first and second jaws 30910,
30920.
[0142] In various aspects, one or more of the Diamond-Like coatings
(DLC) 30914, 30924 are comprised of an amorphous carbon-hydrogen
network with graphite and diamond bondings between the carbon
atoms. The DLC coatings 30914, 30924 can form films with low
friction and high hardness characteristics around the first and
second honeycomb lattice structures 30912, 30922. The DLC coatings
30914, 30924 can be doped or undoped, and are generally in the form
of amorphous carbon (a-C) or hydrogenated amorphous carbon (a-C:H)
containing a large fraction of sp3 bonds. Various surface coating
technologies can be utilized to form the DLC coatings 30914, 30924
such as the surface coating technologies developed by Oerlikon
Balzers. In at least one example, the DLC coatings 30914, 30924 are
generated using Plasma-assisted Chemical Vapor Deposition
(PACVD).
[0143] In various aspects, one or both of the DLC coatings can be
substituted with a coating comprising Titanium Nitride, Chromium
Nitride, Graphit iC.TM., or any other suitable coating.
[0144] Still referring to FIG. 18, the electrodes 30940, 30950 are
offset such that a plane extending along the axis EA and
transecting the monopolar electrode 30930 extends between the
electrodes 30940, 30950. Further, in the illustrated examples, the
electrodes 30930, 30940, 30950 protrude from the outer surface of
the jaws 30910, 30920. In other examples, however, one or more of
the electrodes 30930, 30940, 30950 can be embedded into the jaws
30910, 30920 such that their outer surfaces are flush with the
outer surface of the jaws 30910, 30920.
[0145] A number of the end effectors described in connection with
FIGS. 4-18 are configured to coagulate, cauterize, seal, and/or cut
tissue grasped by the end effector in a tissue treatment cycle that
includes delivery of bipolar energy and/or monopolar energy to the
tissue. The bipolar energy and the monopolar energy can be
delivered separately, or in combination, to the tissue. In one
example, the monopolar energy is delivered to the tissue after
bipolar energy delivery to the tissue is terminated.
[0146] FIG. 19 is a graph depicting an alternative example of a
tissue treatment cycle 31000 that delivers bipolar energy, in a
bipolar energy cycle, and monopolar energy, in a monopolar energy
cycle, to the tissue. The tissue treatment cycle 31000 includes a
bipolar-only phase 31002, a blended energy phase 31004, and a
monopolar-only phase 31006. The tissue treatment cycle 31000 can be
implemented by an electrosurgical system including a generator
(e.g. generators 1100, 900) coupled to an electrosurgical
instrument that includes an end effector (e.g. end effectors of
FIGS. 4-18), for example.
[0147] The graph of FIG. 19 depicts power (W) on the y-axis and
time on the x-axis. The power values provided in the graph and in
the following description are thereof are non-limiting examples of
the power levels that can be utilized with the tissue treatment
cycle 31000. Other suitable power levels are contemplated by the
present disclosure. The graph depicts a bipolar power curve 31010
and a monopolar power curve 31014. Further, a blended power curve
31012 represents simultaneous application of the monopolar and
bipolar energies to the tissue.
[0148] Referring still to FIG. 19, an initial tissue contacting
stage is depicted between t.sub.0 and t.sub.1, which takes place
prior to application of any energy to the tissue. The jaws of the
end effector are positioned on opposite sides of the tissue to be
treated. Bipolar energy is then applied to the tissue throughout a
tissue coagulation stage starting at t.sub.1 and terminating at
t.sub.4. During a feathering segment (t.sub.1-t.sub.2), bipolar
energy application is increased to a predetermined power value
(e.g. 100 W) and is maintained at the predetermined power value
through the remainder of the feathering segment (t.sub.1-t.sub.2)
and a tissue-warming segment (t.sub.2-t.sub.3). During a sealing
segment (t.sub.3-t.sub.4), the bipolar energy application is
gradually reduced. Bipolar energy application is terminated at the
end of the sealing segment (t.sub.3-t.sub.4), and prior to the
beginning of the cutting/transecting stage.
[0149] Further to the above, monopolar energy application to the
tissue is activated during the tissue coagulation stage. In the
example illustrated in FIG. 19, activation of the monopolar energy
commences at the end of the feathering segment and the beginning of
the tissue-warming segment, at time t.sub.2. Like bipolar energy,
the monopolar energy application to the tissue is gradually
increased to a predetermined power level (e.g. 75 W) that is
maintained for the remainder of the tissue-warming segment and an
initial portion of the sealing segment.
[0150] During the sealing segment (t.sub.3-t.sub.4) of the tissue
coagulation stage, the monopolar energy application to the tissue
gradually increases in power as bipolar energy application to the
tissue gradually decreases in power. In the illustrated example,
the bipolar energy application to the tissue is stopped at the end
of the tissue coagulation cycle (t.sub.4). The beginning of the
tissue transecting stage is ushered by an inflection point in the
monopolar power curve 31014 at t.sub.4 where the previous gradual
increase in monopolar energy, experienced during the sealing
segment (t.sub.3-t.sub.4), is followed by a step up to a
predetermined maximum threshold power level (e.g. 150 W) sufficient
to transect the coagulated tissue. The maximum power threshold is
maintained for a predetermined time period that ends with the
return of the monopolar power level to zero.
[0151] Accordingly, the tissue treatment cycle 31000 is configured
to deliver three different energy modalities to a tissue treatment
region at three consecutive time periods. The first energy
modality, which includes bipolar energy but not monopolar energy,
is applied to the tissue treatment region from t.sub.1 to t.sub.2,
during the feathering segment. The second energy modality, which is
a blended energy modality that includes a combination of monopolar
energy and bipolar energy, is applied to the tissue treatment
region from t.sub.2 to t.sub.4, during the tissue-warming segment
and tissue-sealing segment. Lastly, the third energy modality,
which includes monopolar energy but not bipolar energy, is applied
to the tissue from t.sub.4 to t.sub.5, during the cutting segment.
Furthermore, the second energy modality comprises a power level
that is the sum of the power levels of monopolar energy and bipolar
energy. In at least one example, the power level of the second
energy modality includes a maximum threshold (e.g. 120 W). In
various aspects, the monopolar energy and the bipolar energy can be
delivered to an end effector from two different electrical
generators.
[0152] The blended power curve 31012, applied during the blended
energy phase 31004, represents a combination of bipolar energy and
monopolar energy application to the tissue. During the tissue
warming segment (t.sub.2-t.sub.3), the blended power curve 31012
rises as monopolar power is activated, at t.sub.2, and increased,
while the bipolar power is maintained at a constant, or at least
substantially constant, level through the remainder of the tissue
warming segment (t.sub.2, t.sub.3) and the beginning of the tissue
sealing segment (t.sub.3-t.sub.4). During the sealing segment
(t.sub.3-t.sub.4), the blended power curve 31012 is maintained at a
constant, or at least substantially constant, level by gradually
decreasing the bipolar power level as the monopolar power level is
increased.
[0153] In various aspects, the bipolar and/or monopolar power
levels of the tissue treatment cycle 31000 can be adjusted based on
one or more measured parameters including tissue impedance, jaw
motor velocity, jaw motor force, jaws aperture of an end effector
and/or current draw of the motor effecting end effector
closure.
[0154] In accordance with at least one embodiment, a monopolar
electrode for cutting patient tissue comprises a monopolar camming
lobe electrode and a wire attached thereto. The monopolar camming
lobe electrode is initially located at a distal end of an end
effector of an electrosurgical instrument. When the clinician
desires to cut patient tissue, the monopolar camming lobe electrode
is energized (i.e., via a power generator, as discussed herein) and
pulled on by the wire attached thereto. The wire first induces the
camming lobe electrode to rotate upward into the tissue gap along
the centerline of the end effector and is then pulled from the
distal end to the proximal end to cut the patient tissue. In other
words, the camming lobe electrode acts like a pivoting cutting
blade of a surgical instrument if the pivoting cutting blade was
located at the distal end and then pulled proximally. Further, in
at least one embodiment, the wire attached to the camming lobe
electrode is offset from the rotational center of the camming lobe
electrode such that when the wire is pulled proximally, the camming
lobe electrode is initially rotated into an upright position. The
camming lobe electrode exerts a force vertically against the
opposite side of the end effector jaw from where the camming lobe
electrode is positioned. In such an arrangement, the camming lobe
electrode may be initially concealed from the tissue gap between
the jaws of the end effector until the wire initially pulls on the
camming lobe electrode to rotate the camming lobe electrode into
its upright position. Since the camming lobe electrode is initially
concealed, the load the camming lobe is exerting against the other
jaw of the end effector is independent of the tissue gap. In other
words, the camming lobe electrode will either stand substantially
upright prior to beginning distal to proximal motion or the camming
lobe electrode will stand partially up prior to beginning distal to
proximal motion. The amount the camming lobe electrode is rotated
toward its upright position is dependent upon the amount of tissue
positioned between the jaws of the end effector and the stiffness
of the tissue. For example, stiffer tissue resists the camming lobe
electrode from rotating into its upright position more than softer
tissue before the camming lobe electrode begins to move from the
distal end toward the proximal end.
[0155] FIG. 20 depicts an electrosurgical instrument 40100
comprising a housing, a shaft 40110 extending from the housing, and
an end effector 40120 extending from the shaft 40110. An
articulation joint 40130 rotatably connects the shaft 40110 and the
end effector 40120 to facilitate articulation of the end effector
40120 relative to the shaft 40110. A circuit board 40140 is located
in the housing of the instrument 40100. However, other embodiments
are envisioned with the circuit board 40140 positioned in any
suitable location. In at least one example, the circuit board 40140
is a printed circuit board. The printed circuit board 40140
includes a connection plug 40142 for connecting the printed circuit
board 40140 to a wiring assembly 40150. The wiring assembly 40150
extends from the printed circuit board 40140 through the shaft
40110 and into the end effector 40120. The wiring assembly 40150 is
configured to monitor at least one function of the end effector
40120 and relay monitored information to the printed circuit board
40140. The wiring assembly 40150 can monitor functions of the end
effector including the compression rate of the jaws of the end
effector 40120 and/or the heat cycle of the end effector 40120, for
example. In the illustrated example, the wiring assembly 40150
comprises a sensor 40122 positioned in the end effector 40120. The
sensor 40122 monitors at least one function of the end effector
40120.
[0156] In various aspects, the sensor 40122 may comprise any
suitable sensor, such as, for example, a magnetic sensor, such as a
Hall effect sensor, a strain gauge, a pressure sensor, an inductive
sensor, such as an eddy current sensor, a resistive sensor, a
capacitive sensor, an optical sensor, and/or any other suitable
sensor. In various aspects, the circuit board 40140 comprises a
control circuit that includes a microcontroller with a processor
and a memory unit. The memory unit may store one or more algorithms
and/or look-up tables to recognize certain parameters of the end
effector 40120 and/or tissue grasped by the end effector 40120
based on measurements provided by the sensor 40122.
[0157] Further to the above, the wiring assembly 40150 may comprise
several flexible, rigid, and/or stretchable portions as part of a
flexible circuit to allow the wiring assembly 40150 to flex, bend,
and/or stretch across various part boundaries and/or joints of the
surgical instrument 40100. For example, as the wiring assembly
40150 crosses a part boundary or joint an inextensible flexible
plastic substrate (i.e., polyimide, peek, transparent conductive
polyester film) transitions to a flexible silicone, or elastomeric
substrate, and then back to the inextensible flexible substrate on
the other side of the joint. The metallic conductor within the
wiring assembly 40150 remains continuous but stretchable over the
part boundary and/or joint. This arrangement enables the entire
circuit to be flexible with local portions being flexible in at
least two planes. Thus, the portions of the wiring assembly 40150
that span across part boundaries and/or joints allow local relative
motions without tearing the wiring assembly 40150, or a loss in its
continuity. The wiring assembly 40150 is fixed around the local
movement zones to protect the wiring assembly 40150 from excessive
strain and/or distortion.
[0158] Further to the above, in the present embodiment, the wiring
assembly 40150 comprises a first elastic portion 40152, a proximal
rigid portion 40154, a second elastic portion 40156, and a distal
rigid portion 40158. The proximal rigid portion 40154 is positioned
in the elongate shaft 40110 and the distal rigid portion 40158 is
positioned in the end effector 40120. The first elastic portion
40152 is positioned between the printed circuit board 40140 and the
proximal rigid portion 40154. The second elastic portion 40156 is
positioned between the proximal rigid portion 40154 and the distal
rigid portion 40158. Other embodiments are envisioned where the
wiring assembly 40150 comprises more or less than two elastic
portions. The rigid portions 40154, 40158 may be fixed to the shaft
40110 and end effector 40120, respectively, with an adhesive 40105,
for example. However, any suitable attachment means may be
utilized. The elastic portions 40152, 40156 further comprise a
resilient portion (i.e., for bending and/or flexing) and a
stretchable portion (i.e. for stretching). In at least one
embodiment, the resilient portion comprise a first substrate, or
layer, and the stretchable portions comprise a second substrate, or
layer. The first and second substrates comprise different
materials. However, other embodiments are envisioned where the
first and second substrates comprise the same material in different
configurations.
[0159] Further to the above, the wiring assembly 40150 further
comprises an electrical trace, or conductor 40160, spanning the
entire length of the wiring assembly 40150 and configured to carry
electrical energy between the printed circuit board 40140 and the
end effector 40120. Referring primarily to FIGS. 21 and 22, the
conductor 40160 comprises a stretchable portion 40162 spanning the
elastic portions 40152, 40156. The stretchable portion 40162
comprises a snaking, oscillating, and/or zig-zag pattern which
allows the stretchable portion 40162 to stretch when the elastic
portions 40152, 40156 are extended as illustrated in FIG. 22. When
the elastic portions 40152, 40156 are returned to their relaxed
and/or natural state, the stretchable portion 40162 is returned to
its snaking, oscillating, and/or zig-zag pattern as illustrated in
FIG. 21.
[0160] Further to the above, in at least one embodiment, the
conductor 40160 may be used in high current applications such as RF
treatment energy where the conductor 40160 comprises a copper
conductor that is printed into the wiring assembly 40150 in a
snaking, oscillating, and/or zig-zag pattern. Other embodiments are
envisioned where the stretchable portions 40162 of the conductor
40160 spanning the elastic portions 40152, 40156 comprise
conductive links that interlock to allow the stretchable portion
40162 to stretch across the joint.
[0161] FIG. 23 illustrates an electrosurgical instrument 40200
comprising a shaft 40210, a translating member 40220, and a flex
circuit and/or wiring harness 40230. The wiring harness 40230 may
be similar to the wiring assembly 40150. The translating member
40220 may be a knife drive rod for incising patient tissue, an
articulation cable, and/or a rigid articulation member of the
instrument 40200, for example. However, the translating member
40220 may be any translating member as described herein. In any
event, the translating member 40220 is configured to translate
relative to the shaft 40210 and comprises a ferrous element 40222
that translates with the translating member 40220. The ferrous
element 40222 may be attached to or housed within the translating
member 40220, for example. The wiring harness 40230 is fixed within
the shaft 40210 and comprises a linear inductive sensor 40232
configured to detect the linear position of the ferrous element
40222 and thus the linear position of the translating member 40220.
More specifically, the linear inductive sensor 40232 is configured
to generate an electrical field which the ferrous element 40222
disrupts. The linear inductive sensor 40232 is integrated into the
wiring harness 40230 to provide robust protection from external
elements and fluids.
[0162] In various aspects, the sensor 40232 can be a magnetic
sensor, such as a Hall effect sensor, a strain gauge, a pressure
sensor, an inductive sensor, such as an eddy current sensor, a
resistive sensor, a capacitive sensor, an optical sensor, and/or
any other suitable sensor. In various aspects, a control circuit a
includes a microcontroller with a processor and a memory unit that
stores one or more algorithms and/or look-up tables to recognize
certain parameters of the surgical instrument 40200 and/or tissue
treated by the surgical instrument 40200 based on measurements
provided by the sensor 40232.
[0163] FIGS. 24 and 25 illustrate an electrosurgical instrument
40300 comprising a shaft 40310, a translating member 40320, and a
flex circuit or wiring harness 40330. The translating member 40320
is configured to translate relative to the shaft 40310 to perform
an end effector function. The translating member 40320 may be a
knife drive rod for incising patient tissue, an articulation cable,
and/or a rigid articulation member of the instrument 40300, for
example. However, the translating member may be any translating
member described herein, for example. In any event, the wiring
harness 40330 comprises a conductor 40331, a body portion 40332,
and an elastic portion 40334 which extends from the body portion
40332. The body portion 40332 is fixed to the shaft 40310 and
comprises a first sensor 40340 configured to measure a function of
an end effector of the surgical instrument 40300. The elastic
portion 40334 is attached to the translating member 40320 and
comprises a second sensor 40350. The second sensor 40350 is
positioned at the end of the elastic portion 40334 where the
elastic portion 40334 attaches to the translating member 40320.
Thus, the second sensor 40350 translates with the translating
member 40320. The second sensor 40350 is configured to measure the
stress and/or strain within the translating member 40320. However,
other embodiments are envisioned where the second sensor is
configured to measure the position, velocity, and/or acceleration
of the translating member 40320.
[0164] In various aspects, a control circuit a includes a
microcontroller with a processor and a memory unit that stores one
or more algorithms and/or look-up tables to recognize certain
parameters of the surgical instrument 40300 and/or tissue treated
by the surgical instrument 40300 based on measurements provided by
the sensors 40340, 40350.
[0165] Further to the above, the elastic portion 40334 is similar
to the elastic portions 40152, 40156 discussed herein with respect
to FIGS. 20-22. More specifically, the elastic portion 40334
comprises resilient and/or stretchable portions which allow the
elastic portion 40334 to bend, flex, and/or stretch relative to the
body portion 40332 of the wiring harness 40330. Such an arrangement
allows the second sensor 40350 to be integral to the wiring harness
40330 without the detected measurements of the second sensor 40350
being impacted by the movement of the translating member 40320
relative to the wiring harness 40330.
[0166] FIGS. 26-33 depict an electrosurgical instrument 40400
comprising a handle 40410, a shaft 40420 extending from the handle
40410, and a distal head or end effector 40430 extending from the
shaft 40420. The handle 40410 comprises a trigger 40412 an electric
motor assembly 40411 including a motor 40411a driven by a motor
driver/controller 40422b configured to drive the motor 40411a per
input from a control circuit 40413, and in response to actuation
motions of the trigger 40412. In various aspects, the control
circuit 40413 includes a microcontroller 40414 that has a processor
40415 and a memory unit 40417. A power source 40418 is coupled to
the motor controller 40411b for powering the motor and to the
microcontroller 40414.
[0167] The shaft 40420 defines a shaft axis SA and comprises an end
effector drive member, such as the end effector drive member 40419.
The end effector drive member 40419 is operably responsive to the
electric motor 40411a in the handle 40410 and is configured to
perform at least two end effector functions. The end effector 40430
is configured to be selectively locked and unlocked from the shaft
40420, as discussed herein. More specifically, when the end
effector 40430 is locked to the shaft 40420, the end effector 40430
cannot be rotated and/or articulated relative to the shaft 40420,
and the end effector drive member 40419 is configured to open and
close jaws of the end effector 40430. Further, when the end
effector 40430 is unlocked from the shaft 40420, the end effector
can be rotated and/or articulated relative to the shaft 40420 and
the end effector drive member 40419 rotates the end effector 40430
about the shaft axis SA when the end effector drive member 40419 is
actuated by the electric motor.
[0168] The instrument 40400 further comprises a manual toggle
member or rocker member 40440, an elongate shaft 40450, and a pull
cable 40460. The elongate shaft 40450 is crimped to the pull cable
40460 such that the elongate shaft 40450 and pull cable 40460 move
together along the shaft axis SA. The rocker member 40440 comprises
a slot 40442 defined therein which is configured to receive the
elongate shaft 40450. The rocker member 40440 and elongate shaft
40450 are mounted within the handle 40410 and portions of the
rocker member 40440 extending laterally beyond each side of the
handle 40410 to allow the rocker member 40440 to be manually
actuated by a clinician. The rocker member 40440 further comprises
a pin 40444 extending into the slot 40442. The pin 40444 extends
into a V-shaped groove 40452 defined in the outer diameter of the
elongate shaft 40450. The elongate shaft 40450 is biased, such as
by a spring, away from the rocker member 40440 (i.e., biased
distally).
[0169] In use, when the rocker member 40440 is rotated in a
clockwise direction CW the pin 40444 slides within a first side of
the V-shaped groove 40452 and retracts the elongate shaft 40450
toward the rocker member 40440 (i.e., proximally). When the rocker
member 40440 is rotated in a counter-clockwise direction CCW the
pin 40444 slides within a second side of the V-shaped groove 40452,
opposite from the first side, and retracts the elongate shaft 40450
toward the rocker member 40440 (i.e., proximally). Referring to
FIG. 31, when the rocker member 40440 is centered, the elongate
shaft 40450 is in its distal most position (i.e., farthest away
from the rocker member 40440). Referring to FIGS. 32 and 33, when
the rocker member 40440 is rotated in either the clockwise
direction CW or the counter-clockwise direction CCW, the elongate
shaft 40450 is retracted toward the rocker member 40440 (i.e.,
proximally).
[0170] As discussed above, the elongate shaft 40450 is crimped to
the pull cable 40460. Thus, the pull cable 40460 is retracted when
the rocker member 40440 is rotated in either the clockwise
direction CW or the counter-clockwise direction CCW. The pull cable
40460 may be similar to the unlocking cable 11342 illustrated in
FIG. 54 of U.S. patent application Attorney Docket No.
END9234USNP2/190717-2. More specifically, the pull cable 40460,
when retracted, (i.e., moved proximally) unlocks the end effector
40430 to permit the end effector 40430 to be rotated and/or
articulated relative to the shaft 40420. Thus, when the rocker
member 40440 is rotated in either the clockwise direction CW or the
counter-clockwise direction CCW, the end effector 40430 is unlocked
to allow for rotation and/or articulation of the end effector
40430.
[0171] Further to the above, the rocker member 40440 further
comprises a downwardly extending post 40446 configured to engage a
first switch 40447 and a second switch 40448 positioned on either
side of the downwardly extending post 40446. The first switch 40447
and the second switch 40448 are configured to activate an
articulation motor positioned within the handle 40410. More
specifically, when the rocker member 40440 is rotated in the
clockwise direction CW, the pull cable 40460 is retracted to unlock
the end effector 40430 and the post 40446 engages the first switch
40447 resulting in rotation of the motor 40411a in a first
direction which causes an articulation drive assembly 40417 to
articulate the end effector 40430 to the right, for example. When
the rocker member 40440 is rotated in the counter-clockwise
direction CCW, the pull cable 40460 is retracted to unlock the end
effector 40430. The post 40446 engages the second switch 40448
which results in the rotation of the motor 40411a in a second
direction, opposite the first direction, thereby causing the
articulation drive assembly 40417 to articulate the end effector
40430 to the left.
[0172] Further to the above, when the rocker member 40440 is
centered, as illustrated in FIG. 28, neither the first switch 40447
nor the second switch 40448 are activated. The pull cable 40460 is
in its distal most position corresponding to the end effector 40430
being locked, as discussed above. In various aspect, any suitable
shifter or clutch mechanism can be configured to shift the drive
member 40419 between an operable engagement with the articulation
drive assembly 40417 and an operable engagement with a
closure/firing assembly 40421. The shifter mechanism can be
motivated by the rocker member 40440 such that the drive member
40419 is operably coupled to the closure/firing drive assembly
40421 when the rocker member 40440 is centered, and is operably
coupled to the articulation drive assembly 40417 when the rocker
member 40440 is rotated either the clockwise direction CW or the
counter-clockwise direction CCW from the centered position.
[0173] When the end effector 40430 is locked, rotation of the
electric motor in the handle 40410 results in rotation of the end
effector drive member 40419 to cause the closure/firing drive
assembly 40421 to move the pair of jaws of the end effector 40430
between the open and closed positions. However, other embodiments
are envisioned where rotation of the end effector drive member
40419 translates a firing member through the end effector 40430
when the end effector 40430 is locked. In any event, when the
rocker member 40440 is rotated in either the clockwise direction CW
or the counter-clockwise direction CCW, the end effector 40430 is
unlocked which allows for rotation of the end effector 40430 about
the shaft axis SA. More specifically, when the end effector 40430
is unlocked, and the end effector drive member 40419 is actuated by
the electric motor 40411a in the handle 40410, the end effector
40430 is rotated about the shaft axis SA relative to the shaft
40420.
[0174] Further to the above, other embodiments are envisioned with
more than one articulation motor where the articulation motors are
operably responsive to the first switch 40447 and the second switch
40448. Such an arrangement facilitates articulation of the end
effector 40430 about multiple axes if a double articulation joint
is employed between the end effector 40430 and the shaft 40420, for
example. Other embodiments are also envisioned with separate motors
dedicated to closure, firing, and/or articulation.
[0175] In various aspects, the motor driver 40411b is configured to
operate the electric motor 40411a in a plurality of operating
states based on input from the processor 40416. For example, when
the end effector drive member 40419 is opening and closing the jaws
of the end effector 40430 (i.e., the distal head or end effector
40430 is locked), the electric motor is in a first operating mode.
When the electric motor 40411a is in the first operating mode, the
end effector drive member 40419 is operated at a first speed, at a
first rate, with a first amount of torque, and/or with a first
amount of acceleration to open and close the jaws of the end
effector 40430. When the end effector drive member 40419 is
rotating the end effector 40430 about the shaft axis SA (i.e., the
distal head or end effector 40430 is unlocked) the electric motor
40411a is in a second operating mode. When the electric motor
40411a is in the second operating mode, the end effector drive
member 40419 is operated at a second speed, at a second rate, with
a second amount of torque, and/or with a second amount of
acceleration to rotate the end effector 40430.
[0176] In at least one embodiment, the first operating mode and the
second operating mode are different and comprise different
combinations of control parameters to drive the end effector drive
member 40419 at different speeds, torques, and/or accelerations,
for example. In at least one embodiment, the second operating mode
(i.e., distal head rotation) comprises a lower max torque limit, a
graduated acceleration to allow precise adjustments, and/or a lower
max torque velocity than the first operating mode, for example. In
contrast, the end effector drive member 40419 comprises a higher
torque limit, comprises no, or limited, graduation of acceleration,
and/or rotates at a faster speed in the first operating mode, for
example.
[0177] In various aspects, the memory 40415 stores program
instructions that, when executed by the processor 40416, cause the
processor 40416 to select one of the first operating mode or the
second operating mode. Various combinations of control parameters
to drive the end effector drive member 40419 at different speeds,
torques, and/or accelerations, for example, can be selected by the
processor 40416 from a lookup table, algorithm, and/or equation
stored in the memory 40415.
[0178] Further to the above, referring to FIG. 29, the control
circuit 40413 controls the speed, torque, and/or accelerations of
the articulation motor. The articulation motor is activated by the
first switch 40447 and the second switch 40448 to articulate the
end effector 40430 relative to the shaft axis SA, as discussed
above. In at least one embodiment, the first switch 40447 and the
second switch 40448 are adaptively controlled. The microcontroller
40414 can be in signal communication with the first switch 40447
and the second switch 40448 to provide proportional speed control
of the motor 40411a to articulate the end effector 40430 based on
the manual movements of the rocker member 40440. More specifically,
the distance and/or or force by which the first switch 40447 or the
second switch 40448 is depressed is directly proportional to the
speed, torque, and/or acceleration with which the end effector
40430 is articulated. Alternatively, in certain examples, the
switches 40447 and 40448 are directly in communication with the
motor driver 40411b.
[0179] As illustrated in FIG. 29, various embodiments are
envisioned wherein the surgical instrument 40400 comprises a
transmission, a shiftable motor drive, and/or a shifter 40427 to
lock two drive mechanisms together, such as the end effector drive
shaft 40419 and the articulation drive assembly 40417 which drives
articulation of the end effector 40430, for example, or lock the
end effector drive shaft 40419 and the closure/firing drive
assembly 40421. In such an arrangement, the surgical instrument
40400 comprises a single electric motor 40411a to drive
articulation of the end effector 40430, rotate the end effector
40430 about the shaft axis SA, and open and close the jaws of the
end effector 40430. More specifically, the shifter 40427 switches
the single electric motor between engagement with the articulation
drive assembly 40417 and the closure/firing drive assembly
40421.
[0180] In accordance with at least one embodiment, handle user
controls of the motors and/or end-effector motions of a surgical
instrument are in signal communication with a control system of the
surgical instrument. The control system is housed within the handle
and couples user trigger feedback to the motor driven feedback of
the end-effector to provide proportionate, but not direct, control
of the end-effector. In at least one embodiment, the control system
provides indirect open loop control of the end-effector with an
alternative means for providing clamp level feedback to the user.
The surgical instrument comprises tactile feedback and a trigger
sweep correlation. Further, the surgical instrument comprises
feedback systems to the control system for monitoring alternative
compression or pressure in the jaws to compensate for the removal
of tactile feedback. In such an arrangement, the manual user inputs
drive the jaws independent of the stroke of the trigger. In at
least one embodiment, a smaller trigger that is finger sized with
spring returns is utilized to improve the maneuverability of the
manual controls and the handle. Further, in at least one
embodiment, modular attachment of an electrical backbone to the
surgical instrument is employed when a new single use shaft is
introduced.
[0181] FIG. 35 illustrates a graph 40500 of a power schematic of a
surgical system 40550 (FIG. 34) comprising an electrosurgical
instrument 40551 and a power source (e.g. a power generator) 40552
configured to supply power to the electrosurgical instrument 40551.
The electrosurgical instrument 40551 comprises an integrated, or
self-contained, power source that works in concert with the
separate power generator 40552 to power motors and other components
of the electrosurgical instrument 40551. The integrated power
source comprises a charge accumulator device such as a
rechargeable, non-removable battery 40553, for example. The battery
40553 is configured to begin recharging as soon as the battery
40553 is attached to the power output from the generator 40552. The
integrated power source can begin recharging during use within the
procedure, for example. The integrated power source, or
rechargeable battery, draws a constant power level from the power
output generator 40552 regardless of the power being expended by
the motors, controllers, and/or sensors until the rechargeable
battery 40553 is charged to a maximum predetermined level. The
battery 40553 can be simultaneously discharging to operate the
controls or motors of the electrosurgical instrument 40551 and
charging via the power output generator 40552. The battery 40553
continues to charge until it reaches a predetermined level in
between user requested operations during generator initialization
or in wait state in-between uses. If the battery 40553 drains to a
minimum predetermined level, the user is notified that they have to
wait an amount of time until the battery 40553 is charged above a
minimum threshold level before the electrosurgical instrument 40551
can be used again.
[0182] Further to the above, the graph 40500 of FIG. 35 includes
graphs 40502, 40504, 40506, 40508 including Y-axes representing
various parameters of the surgical system 40550 plotted against
time t on the X-axis. Graph 40502 depicts on the Y-axis power in
Watts (W) supplied by a generator 40552 to a power source (e.g.
internal charge accumulator such as a rechargeable battery 40553)
of the electrosurgical instrument. Graph 40504 depicts on the
Y-axis the charge level of the battery 40553 as a percentage of a
maximum charge level threshold. Graph 40506 depicts on the Y-axis
power in Watts (W) drawn from the battery 40553 by components of
the surgical instrument 40551 such as, for example, a motor 40554.
Graph 40508 depicts on the Y-axis motor velocity limits set as a
percentage of a maximum motor-velocity threshold.
[0183] In the illustrated example, the electrosurgical instrument
40551 is connected to the generator 40552 at a time to. The
generator 40552 charges the rechargeable battery 40553 at a
constant recharge rate (S1) until the charge level of the battery
40553 reaches a maximum threshold at 100%, which is achieved at
t.sub.1. The power supply by the generator 40552 is automatically
started upon connecting the surgical instrument 40551 to the
generator 40552, and is automatically stopped once the charge level
reaches the maximum threshold. In various examples, the surgical
system 40550 includes a control circuit 40555 that comprises a
charge meter 40556 for detecting the charge level of the battery
40553, and a switching mechanism for deactivating the power supply
to the surgical instrument 40551 when the charge level reaches the
maximum threshold. In at least one example, the battery can be
charged at a constant rate of 15 W. The generator will
automatically stop charging the battery 40553 when the battery
charge level has reached 100%.
[0184] Further, at time t.sub.2, the motor 40554 is activated to
cause an end effector 40557 of the surgical instrument 40551 to
perform one or more functions. The motor 40554 draws power from the
battery 40553 causing the battery 40553 to discharge at a rate
S.sub.2. The battery 40553 continues to charge while discharging
power to the motor 40554. Accordingly, the rate of discharge
S.sub.2 is derived from a combination of the rate of discharge of
the battery 40553 caused by the motor draw of power from the
battery and the rate of charge of the battery 40553 by power
supplied to the battery 40553 by the generator 40552, which occur
concurrently, or simultaneously, until the motor 40554 is
deactivated. Once the power draw by the motor 40554 is stopped, the
battery 40553 returns to recharging at the constant rate S1.
[0185] In the illustrated example, the motor 40553 is activated at
first and second instances 40501, 40503, as depicted in Graph
40506, to open and close the jaws of the end effector 40557 to
grasp tissue, for example. A clinician may open and close the jaws
a number of times to achieve a good grasp of the tissue. At the end
of the second instance 40503 of the motor activation, the battery
40553 returns to recharging at the constant rate S1 up to the 100%
charge level achieved at t.sub.3, at which point the power supplied
by the generator 40552 to the battery 40553 is stopped. Further, a
third instance 40505 of the motor activation, to articulate the end
effector 40557, causes the battery 40553 to discharge at a rate
S.sub.3 from time t.sub.4 to time t.sub.5. The end effector
closure/opening and articulation can be driven by the same or
different motors that draw power from the battery 40553.
[0186] Further, as depicted in graphs 40504, 40506, fourth, fifth,
sixth, and seventh instances 40507, 40509, 40511, 40513 of motor
activations cause the charge level of the battery 40553 to reach
and cross a first predetermined minimum threshold (e.g. 40%) and a
second predetermined minimum threshold (e.g. 20%). A motor
driver/controller 40558 of the electrosurgical instrument 40551,
which is in signal communication with the generator 40552 and the
battery 40553, maintains the motor velocity limit at 100% until the
battery charge level is reduced to the first predetermined
threshold level. When the charge level of the battery 40553 is
reduced to a first predetermined level, for example 40% at time
t.sub.6, the motor controller 40558 reduces the motor velocity
limit (e.g. to 50%) to conserve battery power. Accordingly, when
the battery charge level is at 40% and the jaws of the end effector
40557 are actuated, the instrument will close the jaws of the end
effector 40557 at first a reduced speed, which causes the time
period t.sub.b of the motor activation instance 40509 to greater
than the time period t.sub.0 of the motor activation instance
40507. Further, when the charge level is reduced to a second
predetermined level, for example 20% at time t.sub.7, the motor
controller 40558 reduces the velocity limit of the motor to 25% to
further conserve the battery power. When the battery charge level
is at 20% and the jaws of the end effector 40557 are actuated, the
instrument clamps the jaws of the end effector 40557 at a second
reduced speed that is less than the first reduced speed, which
causes the time period t.sub.c of the motor activation instance
40513 to greater than the time period t.sub.b of the motor
activation instance 40509. Accordingly, the motor controller 40558
causes the motor to perform similar functions at different speeds
based on corresponding charge levels of the battery 40553 supplying
power to the motor 40554.
[0187] Further, when the charge level of the battery 40553 is
reduced to a predetermined minimum level, for example 10% at time
t.sub.8, the motor velocity limit is reduced to zero and the
surgical instrument alerts the clinician to wait until the battery
40553 is charged above a predetermined minimum level, for example
40% at time t.sub.9. When the battery 40553 has been re-charged
from 10% to 40% and the jaws of the end effector 40557 are actuated
at a motor activation instance 40515, the surgical instrument 40551
will move the jaws of the end effector 40557 at the first reduced
speed for a time period t.sub.d that is less than the time period
ta. Upon completion of the activation instance 40515, at the end of
the time period t.sub.d, the battery 40553 commences recharging at
the constant recharging rate S.sub.1 until it reaches the maximum
charge level at t.sub.10 at which point the power supply from the
generator 40552 to the battery 40553 is stopped.
[0188] FIG. 34 is a simplified schematic diagram of the surgical
system 40550 that includes a control circuit 40550 that has a
microcontroller 40560 including a processor 40561 and a memory
40562 that stores program instructions. When the program
instructions are executed, the program instructions cause the
processor 40561 to detect a charge level of the battery 40553. In
at least one example, the processor 40561 is in communication with
a charge meter 40556 configured to measure the charge level of the
battery 40553. Further, detecting that the charge level of the
battery 40553 is equal to or less than a first minimum charge level
threshold (e.g. 40%) while the motor 40554 is in operation causes
the processor to reduce a maximum velocity limit of the motor 40554
to a first maximum threshold. In at least one example, the
processor 4056 is in communication with a motor driver 40558
configured to control the velocity of the motor 40554. In such
example, the processor 40561 signals the motor driver 40558 to
reduce the motor velocity limit of the motor 40554 to first maximum
threshold. Alternatively, in other examples, the processor 40561
may directly control the maximum motor velocity limit.
[0189] Further, detecting that the charge level of the battery
40561 is equal to or less than a second minimum charge level
threshold (e.g. 20%) while the motor 40554 is in operation causes
the processor to reduce the maximum velocity limit of the motor
40554 to a second maximum threshold less than the first maximum
threshold. In addition, detecting that the charge level of the
battery 40553 is equal to or less than a third minimum charge level
threshold (e.g. 10%) while the motor 40554 is in operation causes
the processor to reduce the maximum velocity limit of the motor
40554 to zero or stop the motor 40554. The processor 40561 may
prevent the restart of the motor 40554 until the minimum charge
level is equal to or greater than a predetermined threshold such
as, for example, the second minimum charge level threshold (e.g.
20%).
[0190] In certain examples, the processor 40561 may further employ
one or more feedback systems 40563 to issue an alert to a
clinician. In certain instances, the feedback systems 40563 may
comprise one or more visual feedback systems such as display
screens, backlights, and/or LEDs, for example. In certain
instances, the feedback systems 40563 may comprise one or more
audio feedback systems such as speakers and/or buzzers, for
example. In certain instances, the feedback systems 40563 may
comprise one or more haptic feedback systems, for example. In
certain instances, the feedback systems 40563 may comprise
combinations of visual, audio, and/or haptic feedback systems, for
example.
[0191] Further to the above, in at least one embodiment, the
internal battery is charged in-between surgical procedures and/or
during surgical procedures by an external charge accumulation
device, or by an external battery attached to the surgical
instrument. In at least one embodiment, the external battery
comprises disposable batteries which are introduced into the
sterile field in sterile packaging and attached to the surgical
instrument to supplement the internal battery and/or to replace the
internal battery, for example. In at least one embodiment, the
external battery is the sole operational power source for
controlling the mechanical operating systems while radio frequency
(RF) power for the therapeutic treatment of tissue is supplied by
the power generator, for example. In such an arrangement, the
external battery is connected to the surgical instrument when the
internal battery is insufficient to power the device. More
specifically, the external battery is used cooperatively with the
internal battery rather than in place of it. Further, in at least
one embodiment, the external battery comprises disposable batteries
which are connected to the internal battery of the surgical
instrument when the surgical instrument is not performing a
surgical procedure to charge the internal battery. The external
battery is then disconnected from the surgical instrument for later
use by the clinician if supplemental power is required.
[0192] FIG. 36 illustrates a surgical system 40600 comprising a
surgical instrument 40610, a monopolar power generator 40620, and a
bipolar power generator 40630. In the illustrated embodiment, the
monopolar power generator 40620 is electrically coupled directly to
a motor 40650 of the surgical instrument 40610 and the bipolar
power generator 40630 is electrically coupled directly to the
battery 40640. The bipolar power generator 40630 is configured to
charge the battery 40640 which in turn supplies power to the motor
40650. The monopolar power generator 40620 is configured to supply
power directly to the motor 40650 and charge the battery 40640.
More specifically, an additional electrical connection 40660 is
supplied between the monopolar power generator 40620 and the
battery to allow the monopolar power generator 40620 to supply
power to the motor 40650 while also supplying power to the battery
40640 to charge the battery 40640. The monopolar power generator
40620 and the bipolar power generator 40630 are configured to
output DC power to the battery 40640 and the motor 40650.
[0193] In various aspects, the surgical instrument 40610 includes
an end effector 40611. The motor 40650 is operably coupled to the
end effector 40611, and can be activated to cause the end effector
40611 to perform a plurality of functions such as, for example,
causing at least one of the jaws of 40613, 40614 of the end
effector 40611 to move to transition the end effector 40611 between
an open configuration, as illustrated in FIG. 36, and a closed
configuration to grasp tissue therebetween. Further, the end
effector 40611 extends distally from a shaft 40615, and is
articulatable relative to the shaft 40611 about a longitudinal axis
extending centrally through the shaft 40615 by actuation motions
generated by the motor 40650.
[0194] In addition, the surgical instrument 40610 further includes
a power supply assembly 40616 that routes power from the generators
40620 and 40630 to the motor 40650 and/or the battery 40640. In at
least one example, the power supply assembly 40616 separately
receives a first power from the generator 40620 and a second power
from the generator 40630. The power supply assembly 40616 is
configured to route the second power to the battery 40640 to charge
the battery at a constant rate (S1) up to a maximum predetermined
charge level. The power supply assembly 40616 is further configured
to route the first power to the electric motor 40650 and the
battery 40650. In the illustrated example, the motor 40650 is
concurrently, or simultaneously, powered by the battery 40640 and
the generator 40620.
[0195] FIG. 37 illustrates a graph 40700 of the battery charge
percentage and the motor torque of the surgical system 40600. Line
40710 represents the battery charge percentage of the battery 40640
if only the bipolar power generator 40630 is utilized with the
surgical instrument 40610. Line 40720 represents the combined
battery charge percentage when both the monopolar power generator
40620 and the bipolar power generator 40630 are utilized with the
surgical instrument 40610. When both the monopolar power generator
40620 and the bipolar power generator 40630 are used to charge the
battery 40640, the battery 40640 is charged faster than if only one
of the monopolar power generator 40620 and the bipolar power
generator 40630 were used to charge the battery 40640. Further,
line 40730 represents the motor torque of the motor 40650 if only
the bipolar power generator 40630 is utilized with the surgical
instrument 40610. Line 40740 represents the motor torque of the
motor 40650 when both the monopolar power generator 40620 and the
bipolar power generator 40630 are utilized with the surgical
instrument 40610. When both the monopolar power generator 40620 and
the bipolar power generator 40630 are used to power the motor
40650, the motor 40650 can produce more torque as compared to if
only one of the monopolar power generator 40620 and the bipolar
power generator 40630 were used to power the motor 40650.
[0196] Further to the above, other embodiments are envisioned where
the monopolar power generator 40620 is configured to supply power
only to the motor 40650 and the bipolar power generator 40630 is
configured to charge the battery 40640 which in turn supplies
additional power to the motor 40650 (i.e., the monopolar power
generator 40620 does not charge the battery 40640). Further, other
embodiments are envisioned where both the monopolar power generator
40620 and the bipolar power generator 40630 are used solely to
charge the battery 40640 which in turn supplies power to the motor
40650, for example. In such an arrangement, both the monopolar
power generator 40620 and the bipolar power generator 40630 could
be synchronized to charge the battery 40640 in unison which is in
turn used to operate the motor 40650. In at least one embodiment,
more than one motor may be utilized to drive the end effector 40611
of the surgical instrument 40610. In such an arrangement, the
monopolar power generator 40620 can supply power to one of the
motors and the bipolar power generator 40630 can supply power to
another of the motors. Further, both the monopolar power generator
40620 and the bipolar power generator 40630 are used to charge the
battery 40640 which in turn can be used to power the motors.
However, other embodiments are envisioned where only one of the
monopolar power generator 40620 and the bipolar power generator
40630 are used to charge the battery 40640.
[0197] Various aspects of the subject matter described herein are
set out in the following example sets.
Example Set 1
[0198] Example 1--A surgical instrument comprising an end effector.
The end effector comprises a proximal end, a distal end, a first
jaw, and a second jaw. The first jaw comprises a first electrode.
One of the first jaw and the second jaw is movable relative to the
other of the first jaw and the second jaw from an open position to
a closed position to grasp tissue between the first jaw and the
second jaw. The second jaw comprises a second electrode and a
monopolar electrode centrally disposed down a length of the end
effector. The first electrode and the second electrode cooperate to
deliver bipolar energy to the tissue in a bipolar cycle. The
monopolar electrode comprises a wedge shape. The wedge shape
graduates in width along the length of the end effector. The
monopolar electrode is electrically isolated from the first
electrode and the second electrode. The monopolar electrode is
configured to employ monopolar energy to cut the tissue in a
monopolar cycle.
[0199] Example 2--The surgical instrument of Example 1, wherein the
first jaw and the second jaw are laterally curved.
[0200] Example 3--The surgical instrument of Examples 1 or 2,
wherein the monopolar cycle is performed after the bipolar
cycle.
[0201] Example 4--The surgical instrument of Examples 1, 2, or 3,
wherein the monopolar cycle is performed independent of the bipolar
cycle.
[0202] Example 5--The surgical instrument of Examples 1 or 2,
wherein the monopolar cycle and the bipolar cycle are
asynchronously activated in a tissue treatment cycle.
[0203] Example 6--The surgical instrument of Examples 1, 2, 3, or
4, wherein the monopolar cycle is initiated after initiation of the
bipolar cycle and before termination of the bipolar cycle in a
tissue treatment cycle.
[0204] Example 7--A surgical instrument comprising and end
effector. The end effector comprises a proximal end, a distal end,
a first jaw, and a second jaw. The first jaw comprises a first
electrode. One of the first jaw and the second jaw is movable
relative to the other of the first jaw and the second jaw from an
open position to a closed position to grasp tissue between the
first jaw and the second jaw. The second jaw comprises a second
electrode and a monopolar electrode electrically isolated from the
first electrode and the second electrode. The first electrode and
the second electrode cooperate to deliver bipolar energy to the
tissue in a bipolar cycle. The monopolar electrode comprises a
compliant flex-circuit substrate centrally disposed down a length
of the end effector and an electrically conductive member disposed
onto the compliant flex-circuit substrate. The monopolar electrode
is configured to employ monopolar energy to cut the tissue in a
monopolar cycle.
[0205] Example 8--The surgical instrument of Example 7, wherein the
first jaw and the second jaw are laterally curved.
[0206] Example 9--The surgical instrument of Examples 7 or 8,
wherein the monopolar cycle is performed after the bipolar
cycle.
[0207] Example 10--The surgical instrument of Examples 7, 8, or 9,
wherein the monopolar cycle is performed independent of the bipolar
cycle.
[0208] Example 11--The surgical instrument of Examples 7 or 8,
wherein the monopolar cycle and the bipolar cycle are
asynchronously activated.
[0209] Example 12--The surgical instrument of Examples 7, 8, 9, or
10, wherein the monopolar cycle is initiated after initiation of
the bipolar cycle and before termination of the bipolar cycle in a
tissue treatment cycle.
[0210] Example 13--A surgical instrument comprising an end
effector. The end effector comprises a proximal end, a distal end,
a first jaw, and a second jaw. The first jaw comprises a first
electrode. One of the first jaw and the second jaw is movable
relative to the other of the first jaw and the second jaw from an
open position to a closed position to grasp tissue between the
first jaw and the second jaw. The second jaw comprises a second
electrode and a monopolar electrode centrally disposed down a
length of the end effector. The first electrode and the second
electrode cooperate to deliver bipolar energy to the tissue in a
bipolar cycle. The monopolar electrode comprises an electrically
conductive wire electrically isolated from the first electrode and
the second electrode. The monopolar electrode is configured to
employ monopolar energy to cut the tissue in a monopolar cycle.
[0211] Example 14--The surgical instrument of Example 13, wherein
the monopolar cycle is performed after the bipolar cycle.
[0212] Example 15--The surgical instrument of Examples 13 or 14,
wherein the monopolar cycle is performed independent of the bipolar
cycle.
[0213] Example 16--The surgical instrument of Examples 13, 14, or
15, wherein the electrically conductive wire comprises a flexible
central portion.
[0214] Example 17--The surgical instrument of Examples 13, 14, 15,
or 16, further comprising a compliant member, wherein the
electrically conductive wire is electrically isolated from the
second jaw by the compliant member.
[0215] Example 18--The surgical instrument of Example 17, wherein
the compliant member comprises a deformable dielectric
material.
[0216] Example 19--The surgical instrument of Examples 17 or 18,
wherein the compliant member is compressible.
[0217] Example 20--The surgical instrument of Examples 17, 18, or
19, wherein the compliant member comprises a first compliant
member, wherein the first jaw comprises a second compliant member,
and wherein the first compliant member and the second compliant
member electrically isolate the electrically conductive wire from
the first jaw and the second jaw.
Example Set 2
[0218] Example 1--A surgical end effector for use with an
electrosurgical instrument. The end effector comprises a proximal
end, a distal end, a first jaw, and a second jaw. A central plane
of the surgical end effector extends through the proximal end and
the distal end. The first jaw is longitudinally bisected by the
central plane. The first jaw comprises a first electrode extending
along a portion of the first jaw. The first electrode is positioned
on a first side of the central plane. The second jaw is
longitudinally bisected by the central plane. At least one of the
first jaw and the second jaw is movable to transition the end
effector from an open configuration to a closed configuration to
grasp tissue between the first jaw and the second jaw. The second
jaw comprises a second electrode and a compliant substrate. The
second electrode extends along a portion of the second jaw. The
second electrode is positioned on a second side of the central
plane. The first electrode and the second electrode are configured
to cooperate to deliver a bipolar energy to the tissue. The
compliant substrate extends along the length of the second jaw. The
compliant substrate comprises a first compliant portion on the
first side of the central plane, a second compliant portion on the
second side of the central plane, and a monopolar electrode
extending along the central plane. The second electrode is mounted
onto the second compliant portion. The monopolar electrode is
mounted onto the compliant substrate. The monopolar electrode is
configured to deliver a monopolar energy to the tissue. The
compliant substrate is configured to apply a biasing force to the
second electrode and the monopolar electrode toward the first jaw
in the closed configuration.
[0219] Example 2--The surgical end effector of Example 1, wherein
the first compliant portion is smaller than the second compliant
portion.
[0220] Example 3--The surgical end effector of Examples 1 or 2,
wherein the second jaw comprises a dielectric coating.
[0221] Example 4--The surgical end effector of Example 3, wherein
the compliant substrate and the dielectric coating define a flush
tissue-contacting surface.
[0222] Example 5--The surgical end effector of Examples 3 or 4,
wherein the compliant substrate separates the dielectric coating
from the monopolar electrode and the second electrode.
[0223] Example 6--The surgical end effector of Examples 1, 2, 3, 4,
or 5, wherein the compliant substrate comprises a porous
structure.
[0224] Example 7--The surgical end effector of Examples 1, 2, 3, 4,
5, or 6, wherein the compliant substrate comprises an elastic
honeycomb structure.
[0225] Example 8--The surgical end effector of Examples 1, 2, 3, 4,
5, 6, or 7, wherein the first jaw further comprises a first porous
skeleton and a first diamond-like coating at least partially
covering the first porous skeleton, wherein the first electrode is
disposed on the first diamond-like coating.
[0226] Example 9--The surgical end effector of Examples 1, 2, 3, 4,
5, 6, 7, or 8, wherein the second jaw further comprises a second
porous skeleton and a second diamond-like coating at least
partially covering the second porous skeleton, wherein the
compliant substrate is disposed on the second diamond-like
coating.
[0227] Example 10--A surgical instrument comprising a shaft and an
end effector extending from the shaft. The end effector comprises a
proximal end, a distal end, a first jaw, and a second jaw. A
central plane of the end effector extends through the proximal end
and the distal end. The first jaw is longitudinally bisected by the
central plane. The first jaw comprises a first electrode extending
along a portion of the first jaw. The first electrode is positioned
on a first side of the central plane. The second jaw is
longitudinally bisected by the central plane. At least one of the
first jaw and the second jaw is movable to transition the end
effector from an open configuration to a closed configuration to
grasp tissue between the first jaw and the second jaw. The second
jaw comprises a second electrode and a compressible support. The
second electrode extends along a portion of the second jaw. The
second electrode is positioned on a second side of the central
plane. The first electrode and the second electrode are configured
to cooperate to deliver a bipolar energy to the tissue. The
compressible support extends along the length of the second jaw.
The compressible support comprises a first compressible portion on
the first side of the central plane, a second compressible portion
on the second side of the central plane, and a monopolar electrode
extending along the central plane. The second electrode is mounted
onto the second compressible portion. The monopolar electrode is
mounted onto the compressible support. The monopolar electrode is
configured to deliver a monopolar energy to the tissue. The
compressible support is configured to apply a spring bias to the
second electrode and the monopolar electrode against the first jaw
in the closed configuration.
[0228] Example 11--The surgical instrument of Example 10, wherein
the first compressible portion is smaller than the second
compressible portion.
[0229] Example 12--The surgical instrument of Examples 10 or 11,
wherein the second jaw comprises a dielectric coating.
[0230] Example 13--The surgical instrument of Example 12, wherein
the compressible support and the dielectric coating define a flush
tissue-contacting surface.
[0231] Example 14--The surgical instrument of Examples 12 or 13,
wherein the compressible support separates the dielectric coating
from the monopolar electrode and the second electrode.
[0232] Example 15--The surgical instrument of Examples 10, 11, 12,
13, or 14, wherein the compressible support comprises a porous
structure.
[0233] Example 16--The surgical instrument of Examples 10, 11, 12,
13, 14, or 15, wherein the compressible support comprises an
elastic honeycomb structure.
[0234] Example 17--The surgical instrument of Examples 10, 11, 12,
13, 14, 15, or 16, wherein the first jaw further comprises a first
porous skeleton and a first diamond-like coating at least partially
covering the first porous skeleton, wherein the first electrode is
disposed on the first diamond-like coating.
[0235] Example 18--The surgical instrument of Examples 10, 11, 12,
13, 14, 15, 16, or 17, wherein the second jaw further comprises a
second porous skeleton and a second diamond-like coating at least
partially covering the second porous skeleton, wherein the
compressible support is disposed on the second diamond-like
coating.
[0236] Example 19--A surgical end effector for use with an
electrosurgical instrument. The end effector comprises a proximal
end, a distal end, a first jaw, and a second jaw. The first jaw
extends longitudinally between the proximal end to the distal end.
The first jaw comprises a first electrode extending longitudinally
along a portion of the first jaw. The second jaw extends
longitudinally between the proximal end and the distal end. At
least one of the first jaw and the second jaw is movable to
transition the end effector from an open configuration to a closed
configuration to grasp tissue between the first jaw and the second
jaw. The second jaw comprises a second electrode, a monopolar
electrode, and a compliant substrate. The second electrode extends
longitudinally along a portion of the second jaw. The second
electrode is laterally offset from the first electrode. The first
electrode and the second electrode are configured to cooperate to
deliver a bipolar energy to the tissue. The monopolar electrode
extends longitudinally alongside the second electrode. The
monopolar electrode is configured to deliver a monopolar energy to
the tissue. The monopolar electrode and the second electrode are
fixedly attached onto the compliant substrate in a spaced apart
arrangement. The compliant substrate is configured to apply a
biasing force to the second electrode and the monopolar electrode
toward the first jaw in the closed configuration.
[0237] Example 20--The surgical end effector of Example 19, wherein
at least one of the first jaw and the second jaw comprises a
dielectric coating.
Example Set 3
[0238] Example 1--An electrosurgical instrument comprising a
housing, a shaft extending from the housing, an end effector
extending from the shaft, an articulation joint rotatably
connecting the end effector to the shaft, and a wiring circuit. The
housing comprises a printed control board. The wiring circuit
extends from the printed control board through the shaft and into
the end effector. The wiring circuit is configured to monitor a
function of the end effector and communicate the monitored function
to the printed control board. The wiring circuit comprises a
proximal rigid portion fixed to the shaft, a distal rigid portion
fixed to the end effector, and an intermediate portion extending
from the proximal rigid portion to the distal rigid portion. The
intermediate portion comprises a resilient portion and a
stretchable portion.
[0239] Example 2--The electrosurgical instrument of Example 1,
wherein the resilient portion comprises a first substrate and the
stretchable portion comprises a second substrate, and wherein the
first substrate and the second substrate are different.
[0240] Example 3--The electrosurgical instrument of Examples 1 or
2, wherein the stretchable portion comprises a conductor in a
zig-zag configuration, and wherein the conductor is made of a
non-stretchable metallic material.
[0241] Example 4--The electrosurgical instrument of Examples 1, 2,
or 3, wherein the stretchable portion comprises a conductor in an
accordion shape, and wherein the conductor is made of a
non-stretchable metallic material.
[0242] Example 5--The electrosurgical instrument of Examples 1, 2,
3, or 4, wherein the resilient portion comprises a laminate portion
comprising a substrate.
[0243] Example 6--An electrosurgical instrument comprising a
housing, a shaft extending from the housing, an end effector
extending from the shaft, an articulation joint rotatably
connecting the end effector to the shaft, and a wiring circuit. The
housing comprises a printed control board. The wiring circuit
extends from the printed control board through the shaft and into
the end effector. The wiring circuit is configured to monitor a
function of the end effector and communicate the monitored function
to the printed control board. The wiring circuit comprises a rigid
portion, a resilient portion transitionable between a relaxed
configuration and an unrelaxed configuration, and a conductive wire
extending through the resilient portion. The conductive wire
comprises a stretchable portion. The conductive wire is configured
to elongate when the resilient portion is transitioned from the
relaxed configuration to the unrelaxed configuration.
[0244] Example 7--The electrosurgical instrument of Example 6,
wherein the stretchable portion comprises a zig-zag pattern.
[0245] Example 8--The electrosurgical instrument of Examples 6 or
7, wherein the stretchable portion comprises an oscillating
patter.
[0246] Example 9--The electrosurgical instrument of Examples 6, 7,
or 8, wherein the stretchable portion comprises an accordion
shape.
[0247] Example 10--The electrosurgical instrument of Examples 6, 7,
8, or 9, wherein the resilient portion comprises a laminate portion
comprising a substrate.
[0248] Example 11--An electrosurgical instrument comprising a
housing, a shaft extending from the housing, an end effector
extending from the shaft, a translating member configured to
translate relative to the shaft to perform an end effector
function, and a wiring harness. The housing comprises a printed
control board. The wiring harness extends from the printed control
board into the shaft. The wiring harness comprises a rigid body
portion fixed to the shaft, a resilient portion extending from the
rigid body portion, and a conductive wire extending through the
rigid body portion and the resilient portion. An end of the
resilient portion is attached to the translating member. The end of
the resilient portion attached to the translating member comprises
a sensor configured to measure an attribute of the translating
member.
[0249] Example 12--The electrosurgical instrument of Example 11,
wherein the attribute of the translating member comprises the
stress within the translating member.
[0250] Example 13--The electrosurgical instrument of Example 11,
wherein the attribute of the translating member comprises the
strain within the translating member.
[0251] Example 14--The electrosurgical instrument of Example 11,
wherein the attribute of the translating member comprises the
stress and strain within the translating member.
[0252] Example 15--The electrosurgical instrument of Examples 11,
12, 13, or 14, wherein the attribute of the translating member
comprises one of the group consisting of the position of the
translating member, the velocity of the translating member, and the
acceleration of the translating member.
[0253] Example 16--The electrosurgical instrument of Examples 11,
12, 13, 14, or 15, wherein a portion of the conductive wire
positioned within the resilient portion of the wiring harness
comprises a stretchable portion.
[0254] Example 17--The electrosurgical instrument of Example 16,
wherein the stretchable portion comprises a zig-zag pattern.
[0255] Example 18--The electrosurgical instrument of Examples 16 or
17, wherein the stretchable portion comprises an oscillating
pattern.
[0256] Example 19--The electrosurgical instrument of Examples 16,
17, or 18, wherein the stretchable portion comprises an accordion
shape.
[0257] Example 20--The electrosurgical instrument of Examples 11,
12, 13, 14, 15, 16, 17, 18, or 19, wherein the wiring harness
extends into the end effector and comprises a second sensor
configured to measure an end effector function.
Example Set 4
[0258] Example 1--A surgical instrument comprising a motor
assembly, a shaft defining a shaft axis, a distal head extending
from the shaft, a rotary drive member, and a distal head lock
member. The distal head is rotatable about the shaft axis. The
motor assembly comprises a motor and a motor controller. The motor
controller is configured to operate the motor in a first operating
mode and a second operating mode. The distal head comprises an end
effector movable between an open configuration and a closed
configuration. The rotary drive member is operably responsive to
the motor. The rotary drive member is operably engaged with the
distal head. The distal head lock member is manually movable
between a first position where the distal head is unlocked from the
shaft and a second position where the distal head is locked to the
shaft. The distal head is rotated about the shaft axis relative to
the shaft when the distal head lock member is in the first position
and the rotary drive member is actuated. The end effector is moved
from the open configuration toward the closed configuration when
the distal head lock member is in the second position and the
rotary drive member is actuated.
[0259] Example 2--The surgical instrument of Example 1, wherein the
motor assembly is configured to operate in the first operating mode
when the distal head lock member is in the first position, and
wherein the motor is configured to operate in the second operating
mode when the distal head lock member is in the second
position.
[0260] Example 3--The surgical instrument of Examples 1 or 2,
wherein the motor is configured to rotate the rotary drive member
at a first speed when the motor is in the first operating mode,
wherein the motor is configured to rotate the rotary drive member
at a second speed when the motor is in the second operating mode,
and wherein the first speed and the second speed are different.
[0261] Example 4--The surgical instrument of Examples 1, 2, or 3,
wherein the motor is configured to produce a first amount of torque
when the motor is in the first operating mode, wherein the motor is
configured to produce a second amount of torque when the motor is
in the second operating mode, and wherein the first amount of
torque and the second amount of torque are different.
[0262] Example 5--The surgical instrument of Examples 1, 2, 3, or
4, wherein the rotary drive member accelerates at a first rate when
the motor is in the first operating mode, wherein the rotary drive
member accelerates at a second rate when the motor is in the second
operating mode, and wherein the first rate and the second rate are
different.
[0263] Example 6--The surgical instrument of Examples 1, 2, 3, 4,
or 5, further comprising a pull cable operably engaged with the
distal head lock member, wherein the pull cable is operably engaged
with the distal head to transition the distal head between a first
configuration where the distal head is unlocked from the shaft and
a second configuration where the distal head is locked to the
shaft.
[0264] Example 7--A surgical instrument comprising a motor
assembly, a shaft defining a shaft axis, an end effector extending
from the shaft, a rotary drive member, and a mode selector member.
The motor assembly comprises a motor and a motor controller. The
motor controller is configured to operate the motor in a first
operating mode and a second operating mode. The end effector is
configured to perform a first end effector function and a second
end effector function that is different than the first end effector
function. The rotary drive member is operably responsive to the
motor. The rotary drive member is operably engaged with the end
effector and configured to selectively perform the first end
effector function and the second end effector function. The mode
selector member is operably engaged with the end effector and the
rotary drive member. The mode selector member is manually movable
between a first position where the end effector performs the first
end effector function when the rotary drive member is actuated by
the motor and a second position where the end effector performs the
second end effector function when the rotary drive member is
actuated by the motor. The motor is configured to operate in the
first operating mode when the mode selector member is in the first
position. The motor is configured to operate in the second
operating mode when the mode selector member is in the second
position.
[0265] Example 8--The surgical instrument of Example 7, wherein the
motor is configured to rotate the rotary drive member at a first
speed when the motor is in the first operating mode, wherein the
motor is configured to rotate the rotary drive member at a second
speed when the motor is in the second operating mode, and wherein
the first speed and the second speed are different.
[0266] Example 9--The surgical instrument of Examples 7 or 8,
wherein the motor is configured to produce a first amount of torque
when the motor is in the first operating mode, wherein the motor is
configured to produce a second amount of torque when the motor is
in the second operating mode, and wherein the first amount of
torque and the second amount of torque are different.
[0267] Example 10--The surgical instrument of Examples 7, 8, or 9,
wherein the rotary drive member accelerates at a first rate when
the motor is in the first operating mode, wherein the rotary drive
member accelerates at a second rate when the motor is in the second
operating mode, and wherein the first rate and the second rate are
different.
[0268] Example 11--A surgical instrument comprising a motor, a
shaft defining a shaft axis, an end effector extending from the
shaft, a rotary drive member operably responsive to the motor, a
lock member operably engaged with the rotary drive member, and a
toggle member operably engaged with the lock member. The rotary
drive member is operably engaged with the end effector and
configured to selectively perform a first end effector function and
a second end effector function that is different than the first end
effector function. The lock member is movable between a first
position where the end effector is locked to the shaft and a second
position where the end effector is unlocked from the shaft. The
toggle member is rotatable about the shaft axis to move the lock
member between the first position and the second position. The
rotary drive member is configured to perform the first end effector
function when the lock member is in the first position. The rotary
drive member is configured to perform the second end effector
function when the lock member is in the second position.
[0269] Example 12--The surgical instrument of Example 11, wherein
the first end effector function comprises a rotation of the end
effector about the shaft axis, and wherein the second end effector
function comprises actuating a pair of jaws of the end
effector.
[0270] Example 13--The surgical instrument of Example 11, wherein
the first end effector function comprises translating a firing
member through the end effector, and wherein the second end
effector function comprises actuating a pair of jaws of the end
effector.
[0271] Example 14--The surgical instrument of Example 11, further
comprising an articulation joint, wherein the second end effector
function comprises articulation of the end effector relative to the
shaft about an articulation axis.
[0272] Example 15--The surgical instrument of Examples 11, 12, 13,
or 14, further comprising a motor controller configured to operate
the motor in a first operating mode and a second operating mode
that is different than the first operating mode.
[0273] Example 16--The surgical instrument of Example 15, wherein
the motor controller is configured to operate the motor in the
first operating mode when the lock member is in the first position
and operate the motor in the second operating mode when the lock
member is in the second position.
[0274] Example 17--The surgical instrument of Example 16, wherein
the motor is configured to rotate the rotary drive member at a
first speed when the motor is in the first operating mode, wherein
the motor is configured to rotate the rotary drive member at a
second speed when the motor is in the second operating mode, and
wherein the first speed and the second speed are different.
[0275] Example 18--The surgical instrument of Examples 16 or 17,
wherein the motor is configured to produce a first amount of torque
when the motor is in the first operating mode, wherein the motor is
configured to produce a second amount of torque when the motor is
in the second operating mode, and wherein the first amount of
torque and the second amount of torque are different.
[0276] Example 19--The surgical instrument of Examples 16, 17, or
18, wherein the rotary drive member accelerates at a first rate
when the motor is in the first operating mode, wherein the rotary
drive member accelerates at a second rate when the motor is in the
second operating mode, and wherein the first rate and the second
rate are different.
[0277] Example 20--The surgical instrument of Examples 11, 12, 13,
14, 15, 16, 17, 18, or 19, further comprising a pull cable operably
engaged with the lock member and the end effector, wherein the pull
cable is configured to transition the end effector between a first
configuration where the end effector is unlocked from the shaft and
a second configuration where the end effector is locked to the
shaft.
Example Set 5
[0278] Example 1--A surgical system comprising a generator and a
surgical instrument configured to receive power from the generator.
The surgical instrument comprises a housing, a shaft extending form
the housing, an end effector extending from the shaft, and an
internal charge accumulator in electrical communication with the
generator. The housing comprises an electric motor. The shaft
defines a longitudinal shaft axis. The end effector is operably
responsive to actuations from the electric motor. The end effector
is transitionable between an open configuration and a closed
configuration. The end effector is rotatable relative to the
longitudinal shaft axis about an articulation axis that is
transverse to the longitudinal shaft axis. The generator is
incapable of supplying a sufficient power directly to the electric
motor to cause the electric motor to perform the actuations. The
internal charge accumulator is configured to supply power to the
electric motor. The internal charge accumulator is chargeable by
the generator to a threshold value at a charge rate dependent on a
charge level of the internal charge accumulator. The charge rate is
independent of a charge expenditure by the surgical instrument.
[0279] Example 2--The surgical system of Example 1, wherein the
generator is configured to charge the internal charge accumulator
during the charge expenditure.
[0280] Example 3--The surgical system of Examples 1 or 2, wherein
the generator supplies power to the internal charge accumulator at
a constant rate when the charge level of the internal charge
accumulator is below the threshold value while the electric motor
is drawing power from the internal charge accumulator.
[0281] Example 4--The surgical system of Examples 1, 2, or 3,
wherein the speed of the electric motor is permitted to reach a
maximum speed when the charge level of the internal charge
accumulator is above a predetermined minimum level.
[0282] Example 5--The surgical system of Example 4, wherein the
speed of the electric motor is limited to a reduced speed when the
charge level of the internal charge accumulator is below the
predetermined minimum level.
[0283] Example 6--The surgical instrument of Examples 1, 2, 3, 4,
or 5, wherein the end effector comprises a first jaw comprising an
electrode and a second jaw, and wherein the generator is configured
to supply a first power to the surgical instrument to cause the
electrode to cauterize tissue captured between the first jaw and
the second jaw while supplying a second power to the surgical
instrument to charge the internal charge accumulator.
[0284] Example 7--The surgical instrument of Examples 1, 2, 3, 4,
5, or 6, wherein the internal charge accumulator comprises a
rechargeable battery.
[0285] Example 8--The surgical instrument of Example 7, wherein the
rechargeable battery is integrated with the housing.
[0286] Example 9--A surgical system comprising a power source and a
surgical instrument configured to receive power from the power
source. The surgical instrument comprises a housing, a shaft
extending from the housing, an end effector extending from the
shaft, and an internal charge accumulator. The housing comprises an
electric motor. The end effector is operably coupled to the
electric motor. The electric motor is configured to drive the end
effector to perform end effector functions. The internal charge
accumulator is in electric communication with the power source. The
internal charge accumulator is configured to supply power to the
electric motor. The internal charge accumulator is chargeable by
the power source to a threshold value at a charge rate dependent on
a charge level of the internal charge accumulator. The internal
charge accumulator is chargeable by the power source while the
electric motor is driving the end effector to perform the end
effector functions.
[0287] Example 10--The surgical system of Example 9, further
comprising a control circuit configured to detect the charge level
of the internal charge accumulator, wherein detecting a reduction
of the charge level to or below a first minimum charge-level causes
the control circuit to reduce a maximum velocity limit of the
electric motor to a first minimum velocity-limit threshold.
[0288] Example 11--The surgical system of Example 10, wherein
detecting a reduction of the charge level to or below a second
minimum charge-level below the first minimum charge-level causes
the control circuit to reduce a maximum velocity limit of the
electric motor to a second minimum velocity-limit threshold less
than the first minimum velocity-limit threshold.
[0289] Example 12--The surgical system of Example 11, wherein
detecting a reduction of the charge level to or below a third
minimum charge-level below the second minimum charge-level causes
the control circuit to stop the electric motor.
[0290] Example 13--The surgical system of Example 12, wherein the
control circuit is configured to prevent reactivation of the
electric motor until the charge level of the internal charge
accumulator is at or above the third minimum charge-level.
[0291] Example 14--The surgical system of Examples 9, 10, 11, 12,
or 13, wherein the power source supplies power to the internal
charge accumulator at a constant rate when the charge level of the
internal charge accumulator is below the threshold value while the
electric motor is drawing power from the internal charge
accumulator.
[0292] Example 15--The surgical instrument of Examples 9, 10, 11,
12, 13, or 14, wherein the end effector comprises a first jaw
comprising an electrode and a second jaw, and wherein the power
source is configured to supply a first power to the surgical
instrument to cause the electrode to cauterize tissue captured
between the first jaw and the second jaw while supplying a second
power to the surgical instrument to charge the internal charge
accumulator.
[0293] Example 16--The surgical instrument of Examples 9, 10, 11,
12, 13, 14, or 15, wherein the internal charge accumulator
comprises a rechargeable battery.
[0294] Example 17--The surgical instrument of Examples 9, 10, 11,
12, 13, 14, 15, or 16, wherein the power source is a disposable
battery.
[0295] Example 18--A surgical instrument comprising a housing, a
shaft extending from the housing, an end effector extending from
the shaft, and a power supply. The housing comprises an electric
motor and an internal charge accumulator connected to the electric
motor. The electric motor is configured to cause the end effector
to perform end effector functions. The power supply assembly is
connectable to two separate power sources. The power supply
assembly is configured to separately receive a first power and a
second power from the power sources. The power supply assembly is
configured to route the second power to the internal charge
accumulator. The power supply assembly is configured to route the
first power to the electric motor and to the internal charge
accumulator. The power supply assembly is configured to cause the
electric motor to be simultaneously powered by the internal charge
accumulator and the first power.
[0296] Example 19--The surgical instrument of Example 18, wherein
the internal charge accumulator and the first power are configured
to cause the electric motor to produce a first motor torque greater
than a second motor torque caused by either one of the internal
charge accumulator and the first power alone.
[0297] Example 20--The surgical instrument of Examples 18 or 19,
wherein the internal charge accumulator comprises a rechargeable
battery.
[0298] While several forms have been illustrated and described, it
is not the intention of Applicant to restrict or limit the scope of
the appended claims to such detail. Numerous modifications,
variations, changes, substitutions, combinations, and equivalents
to those forms may be implemented and will occur to those skilled
in the art without departing from the scope of the present
disclosure. Moreover, the structure of each element associated with
the described forms can be alternatively described as a means for
providing the function performed by the element. Also, where
materials are disclosed for certain components, other materials may
be used. It is therefore to be understood that the foregoing
description and the appended claims are intended to cover all such
modifications, combinations, and variations as falling within the
scope of the disclosed forms. The appended claims are intended to
cover all such modifications, variations, changes, substitutions,
modifications, and equivalents.
[0299] The foregoing detailed description has set forth various
forms of the devices and/or processes via the use of block
diagrams, flowcharts, and/or examples. Insofar as such block
diagrams, flowcharts, and/or examples contain one or more functions
and/or operations, it will be understood by those within the art
that each function and/or operation within such block diagrams,
flowcharts, and/or examples can be implemented, individually and/or
collectively, by a wide range of hardware, software, firmware, or
virtually any combination thereof. Those skilled in the art will
recognize that some aspects of the forms disclosed herein, in whole
or in part, can be equivalently implemented in integrated circuits,
as one or more computer programs running on one or more computers
(e.g., as one or more programs running on one or more computer
systems), as one or more programs running on one or more processors
(e.g., as one or more programs running on one or more
microprocessors), as firmware, or as virtually any combination
thereof, and that designing the circuitry and/or writing the code
for the software and or firmware would be well within the skill of
one of skill in the art in light of this disclosure. In addition,
those skilled in the art will appreciate that the mechanisms of the
subject matter described herein are capable of being distributed as
one or more program products in a variety of forms, and that an
illustrative form of the subject matter described herein applies
regardless of the particular type of signal bearing medium used to
actually carry out the distribution.
[0300] Instructions used to program logic to perform various
disclosed aspects can be stored within a memory in the system, such
as dynamic random access memory (DRAM), cache, flash memory, or
other storage. Furthermore, the instructions can be distributed via
a network or by way of other computer readable media. Thus a
machine-readable medium may include any mechanism for storing or
transmitting information in a form readable by a machine (e.g., a
computer), but is not limited to, floppy diskettes, optical disks,
compact disc, read-only memory (CD-ROMs), and magneto-optical
disks, read-only memory (ROMs), random access memory (RAM),
erasable programmable read-only memory (EPROM), electrically
erasable programmable read-only memory (EEPROM), magnetic or
optical cards, flash memory, or a tangible, machine-readable
storage used in the transmission of information over the Internet
via electrical, optical, acoustical or other forms of propagated
signals (e.g., carrier waves, infrared signals, digital signals,
etc.). Accordingly, the non-transitory computer-readable medium
includes any type of tangible machine-readable medium suitable for
storing or transmitting electronic instructions or information in a
form readable by a machine (e.g., a computer).
[0301] As used in any aspect herein, the term "control circuit" may
refer to, for example, hardwired circuitry, programmable circuitry
(e.g., a computer processor including one or more individual
instruction processing cores, processing unit, processor,
microcontroller, microcontroller unit, controller, digital signal
processor (DSP), programmable logic device (PLD), programmable
logic array (PLA), or field programmable gate array (FPGA)), state
machine circuitry, firmware that stores instructions executed by
programmable circuitry, and any combination thereof. The control
circuit may, collectively or individually, be embodied as circuitry
that forms part of a larger system, for example, an integrated
circuit (IC), an application-specific integrated circuit (ASIC), a
system on-chip (SoC), desktop computers, laptop computers, tablet
computers, servers, smart phones, etc. Accordingly, as used herein
"control circuit" includes, but is not limited to, electrical
circuitry having at least one discrete electrical circuit,
electrical circuitry having at least one integrated circuit,
electrical circuitry having at least one application specific
integrated circuit, electrical circuitry forming a general purpose
computing device configured by a computer program (e.g., a general
purpose computer configured by a computer program which at least
partially carries out processes and/or devices described herein, or
a microprocessor configured by a computer program which at least
partially carries out processes and/or devices described herein),
electrical circuitry forming a memory device (e.g., forms of random
access memory), and/or electrical circuitry forming a
communications device (e.g., a modem, communications switch, or
optical-electrical equipment). Those having skill in the art will
recognize that the subject matter described herein may be
implemented in an analog or digital fashion or some combination
thereof.
[0302] As used in any aspect herein, the term "logic" may refer to
an app, software, firmware and/or circuitry configured to perform
any of the aforementioned operations. Software may be embodied as a
software package, code, instructions, instruction sets and/or data
recorded on non-transitory computer readable storage medium.
Firmware may be embodied as code, instructions or instruction sets
and/or data that are hard-coded (e.g., nonvolatile) in memory
devices.
[0303] As used in any aspect herein, the terms "component,"
"system," "module" and the like can refer to a computer-related
entity, either hardware, a combination of hardware and software,
software, or software in execution.
[0304] As used in any aspect herein, an "algorithm" refers to a
self-consistent sequence of steps leading to a desired result,
where a "step" refers to a manipulation of physical quantities
and/or logic states which may, though need not necessarily, take
the form of electrical or magnetic signals capable of being stored,
transferred, combined, compared, and otherwise manipulated. It is
common usage to refer to these signals as bits, values, elements,
symbols, characters, terms, numbers, or the like. These and similar
terms may be associated with the appropriate physical quantities
and are merely convenient labels applied to these quantities and/or
states.
[0305] A network may include a packet switched network. The
communication devices may be capable of communicating with each
other using a selected packet switched network communications
protocol. One example communications protocol may include an
Ethernet communications protocol which may be capable permitting
communication using a Transmission Control Protocol/Internet
Protocol (TCP/IP). The Ethernet protocol may comply or be
compatible with the Ethernet standard published by the Institute of
Electrical and Electronics Engineers (IEEE) titled "IEEE 802.3
Standard", published in December, 2008 and/or later versions of
this standard. Alternatively or additionally, the communication
devices may be capable of communicating with each other using an
X.25 communications protocol. The X.25 communications protocol may
comply or be compatible with a standard promulgated by the
International Telecommunication Union-Telecommunication
Standardization Sector (ITU-T). Alternatively or additionally, the
communication devices may be capable of communicating with each
other using a frame relay communications protocol. The frame relay
communications protocol may comply or be compatible with a standard
promulgated by Consultative Committee for International Telegraph
and Telephone (CCITT) and/or the American National Standards
Institute (ANSI). Alternatively or additionally, the transceivers
may be capable of communicating with each other using an
Asynchronous Transfer Mode (ATM) communications protocol. The ATM
communications protocol may comply or be compatible with an ATM
standard published by the ATM Forum titled "ATM-MPLS Network
Interworking 2.0" published August 2001, and/or later versions of
this standard. Of course, different and/or after-developed
connection-oriented network communication protocols are equally
contemplated herein.
[0306] Unless specifically stated otherwise as apparent from the
foregoing disclosure, it is appreciated that, throughout the
foregoing disclosure, discussions using terms such as "processing,"
"computing," "calculating," "determining," "displaying," or the
like, refer to the action and processes of a computer system, or
similar electronic computing device, that manipulates and
transforms data represented as physical (electronic) quantities
within the computer system's registers and memories into other data
similarly represented as physical quantities within the computer
system memories or registers or other such information storage,
transmission or display devices.
[0307] One or more components may be referred to herein as
"configured to," "configurable to," "operable/operative to,"
"adapted/adaptable," "able to," "conformable/conformed to," etc.
Those skilled in the art will recognize that "configured to" can
generally encompass active-state components and/or inactive-state
components and/or standby-state components, unless context requires
otherwise.
[0308] The terms "proximal" and "distal" are used herein with
reference to a clinician manipulating the handle portion of the
surgical instrument. The term "proximal" refers to the portion
closest to the clinician and the term "distal" refers to the
portion located away from the clinician. It will be further
appreciated that, for convenience and clarity, spatial terms such
as "vertical", "horizontal", "up", and "down" may be used herein
with respect to the drawings. However, surgical instruments are
used in many orientations and positions, and these terms are not
intended to be limiting and/or absolute.
[0309] Those skilled in the art will recognize that, in general,
terms used herein, and especially in the appended claims (e.g.,
bodies of the appended claims) are generally intended as "open"
terms (e.g., the term "including" should be interpreted as
"including but not limited to," the term "having" should be
interpreted as "having at least," the term "includes" should be
interpreted as "includes but is not limited to," etc.). It will be
further understood by those within the art that if a specific
number of an introduced claim recitation is intended, such an
intent will be explicitly recited in the claim, and in the absence
of such recitation no such intent is present. For example, as an
aid to understanding, the following appended claims may contain
usage of the introductory phrases "at least one" and "one or more"
to introduce claim recitations. However, the use of such phrases
should not be construed to imply that the introduction of a claim
recitation by the indefinite articles "a" or "an" limits any
particular claim containing such introduced claim recitation to
claims containing only one such recitation, even when the same
claim includes the introductory phrases "one or more" or "at least
one" and indefinite articles such as "a" or "an" (e.g., "a" and/or
"an" should typically be interpreted to mean "at least one" or "one
or more"); the same holds true for the use of definite articles
used to introduce claim recitations.
[0310] In addition, even if a specific number of an introduced
claim recitation is explicitly recited, those skilled in the art
will recognize that such recitation should typically be interpreted
to mean at least the recited number (e.g., the bare recitation of
"two recitations," without other modifiers, typically means at
least two recitations, or two or more recitations). Furthermore, in
those instances where a convention analogous to "at least one of A,
B, and C, etc." is used, in general such a construction is intended
in the sense one having skill in the art would understand the
convention (e.g., "a system having at least one of A, B, and C"
would include but not be limited to systems that have A alone, B
alone, C alone, A and B together, A and C together, B and C
together, and/or A, B, and C together, etc.). In those instances
where a convention analogous to "at least one of A, B, or C, etc."
is used, in general such a construction is intended in the sense
one having skill in the art would understand the convention (e.g.,
"a system having at least one of A, B, or C" would include but not
be limited to systems that have A alone, B alone, C alone, A and B
together, A and C together, B and C together, and/or A, B, and C
together, etc.). It will be further understood by those within the
art that typically a disjunctive word and/or phrase presenting two
or more alternative terms, whether in the description, claims, or
drawings, should be understood to contemplate the possibilities of
including one of the terms, either of the terms, or both terms
unless context dictates otherwise. For example, the phrase "A or B"
will be typically understood to include the possibilities of "A" or
"B" or "A and B."
[0311] With respect to the appended claims, those skilled in the
art will appreciate that recited operations therein may generally
be performed in any order. Also, although various operational flow
diagrams are presented in a sequence(s), it should be understood
that the various operations may be performed in other orders than
those which are illustrated, or may be performed concurrently.
Examples of such alternate orderings may include overlapping,
interleaved, interrupted, reordered, incremental, preparatory,
supplemental, simultaneous, reverse, or other variant orderings,
unless context dictates otherwise. Furthermore, terms like
"responsive to," "related to," or other past-tense adjectives are
generally not intended to exclude such variants, unless context
dictates otherwise.
[0312] It is worthy to note that any reference to "one aspect," "an
aspect," "an exemplification," "one exemplification," and the like
means that a particular feature, structure, or characteristic
described in connection with the aspect is included in at least one
aspect. Thus, appearances of the phrases "in one aspect," "in an
aspect," "in an exemplification," and "in one exemplification" in
various places throughout the specification are not necessarily all
referring to the same aspect. Furthermore, the particular features,
structures or characteristics may be combined in any suitable
manner in one or more aspects.
[0313] In this specification, unless otherwise indicated, terms
"about" or "approximately" as used in the present disclosure,
unless otherwise specified, means an acceptable error for a
particular value as determined by one of ordinary skill in the art,
which depends in part on how the value is measured or determined.
In certain embodiments, the term "about" or "approximately" means
within 1, 2, 3, or 4 standard deviations. In certain embodiments,
the term "about" or "approximately" means within 50%, 20%, 15%,
10%, 9%, 8%, 7%, 6%, 5%, 4%, 3%, 2%, 1%, 0.5%, or 0.05% of a given
value or range.
[0314] In this specification, unless otherwise indicated, all
numerical parameters are to be understood as being prefaced and
modified in all instances by the term "about," in which the
numerical parameters possess the inherent variability
characteristic of the underlying measurement techniques used to
determine the numerical value of the parameter. At the very least,
and not as an attempt to limit the application of the doctrine of
equivalents to the scope of the claims, each numerical parameter
described herein should at least be construed in light of the
number of reported significant digits and by applying ordinary
rounding techniques.
[0315] Any numerical range recited herein includes all sub-ranges
subsumed within the recited range. For example, a range of "1 to
10" includes all sub-ranges between (and including) the recited
minimum value of 1 and the recited maximum value of 10, that is,
having a minimum value equal to or greater than 1 and a maximum
value equal to or less than 10. Also, all ranges recited herein are
inclusive of the end points of the recited ranges. For example, a
range of "1 to 10" includes the end points 1 and 10. Any maximum
numerical limitation recited in this specification is intended to
include all lower numerical limitations subsumed therein, and any
minimum numerical limitation recited in this specification is
intended to include all higher numerical limitations subsumed
therein. Accordingly, Applicant reserves the right to amend this
specification, including the claims, to expressly recite any
sub-range subsumed within the ranges expressly recited. All such
ranges are inherently described in this specification.
[0316] Any patent application, patent, non-patent publication, or
other disclosure material referred to in this specification and/or
listed in any Application Data Sheet is incorporated by reference
herein, to the extent that the incorporated materials is not
inconsistent herewith. As such, and to the extent necessary, the
disclosure as explicitly set forth herein supersedes any
conflicting material incorporated herein by reference. Any
material, or portion thereof, that is said to be incorporated by
reference herein, but which conflicts with existing definitions,
statements, or other disclosure material set forth herein will only
be incorporated to the extent that no conflict arises between that
incorporated material and the existing disclosure material.
[0317] In summary, numerous benefits have been described which
result from employing the concepts described herein. The foregoing
description of the one or more forms has been presented for
purposes of illustration and description. It is not intended to be
exhaustive or limiting to the precise form disclosed. Modifications
or variations are possible in light of the above teachings. The one
or more forms were chosen and described in order to illustrate
principles and practical application to thereby enable one of
ordinary skill in the art to utilize the various forms and with
various modifications as are suited to the particular use
contemplated. It is intended that the claims submitted herewith
define the overall scope.
* * * * *