Controlling a surgical instrument according to sensed closure parameters

• US 10,695,081 B2
• Filed: 06/29/2018
• Issued: 06/30/2020
• Est. Priority Date: 12/28/2017
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon, LLC (Johnson & Johnson)
• Inventors: Shelton, IV, Frederick E., Harris, Jason L., Eckert, Chad E., Wong, Jordan B., Yates, David C.
• Primary Examiner(s): Paul, Antony M
• Application Number:
  US16/024,057
• Publication Number:
  US 20190201018A1
• Time in Patent Office: 732 Days
• Field of Search: 901 8, 901 9, 901 10, 901 14, 901 15, 901 16, 901 19, 901 23, 901 24, 901 27, 901 28, 901 30, 901 31, 901 32, 901 39, 901 46, 600568, 606207, 31856811, 31856812, 31856816, 31856821, 31856822, 3185682, 318628, 318632, 31840001, 318700, 318701, 318727, 318721, 318799, 601 38
• CPC Class Codes: A61B 17/00 Surgical instruments, devices or methods, e.g. tourniquets A61B18/00 takes precedence; contraceptive devices, pessaries, or applicators therefor A61F6/00; eye surgery A61F9/007; ear surgery A61F11/00
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 17/07292 Reinforcements for staple line, e.g. pledgets
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/320092 with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
• CPC Class Codes: A61B 18/1442 Probes having pivoting end effectors, e.g. forceps
• CPC Class Codes: A61B 18/1445 at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
• CPC Class Codes: A61B 18/16 Indifferent or passive electrodes for grounding
• CPC Class Codes: A61B 2017/00017 Electrical control of surgical instruments
• CPC Class Codes: A61B 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/0003 of parts of the instruments
• CPC Class Codes: A61B 2017/00061 spectrum
• CPC Class Codes: A61B 2017/00119 alarm; indicating an abnormal situation
• CPC Class Codes: A61B 2017/00132 Setting operation time of a device A61B2017/00123 takes precedence
• CPC Class Codes: A61B 2017/00199 with a console, e.g. a control panel with a display
• CPC Class Codes: A61B 2017/00221 with wireless transmission of data, e.g. by infrared radiation or radiowaves
• CPC Class Codes: A61B 2017/00398 using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2017/0046 with a releasable handle; with handle and operating part separable for prosthetic joint-implanting tools A61F2/4603
• CPC Class Codes: A61B 2017/00734 battery operated
• CPC Class Codes: A61B 2017/07214 : Stapler heads
• CPC Class Codes: A61B 2017/07221 : curved
• CPC Class Codes: A61B 2017/07257 : characterised by its anvil
• CPC Class Codes: A61B 2017/07271 : characterised by its cartridge
• CPC Class Codes: A61B 2017/07285 : characterised by its cutter
• CPC Class Codes: A61B 2017/2926 : Details of heads or jaws
• CPC Class Codes: A61B 2017/2927 : the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2933 : camming or guiding means
• CPC Class Codes: A61B 2018/00589 : Coagulation
• CPC Class Codes: A61B 2018/00601 : Cutting
• CPC Class Codes: A61B 2018/00607 : Coagulation and cutting with the same instrument
• CPC Class Codes: A61B 2018/0063 : Sealing
• CPC Class Codes: A61B 2018/00994 : combining two or more different kinds of non-mechanical energy or combining one or more non-mechanical energies with ultrasound
• CPC Class Codes: A61B 2018/1253 : monopolar
• CPC Class Codes: A61B 2018/126 : bipolar
• CPC Class Codes: A61B 2034/2048 : using an accelerometer or inertia sensor
• CPC Class Codes: A61B 2034/2055 : Optical tracking systems
• CPC Class Codes: A61B 2034/2059 : Mechanical position encoders
• CPC Class Codes: A61B 2034/302 : specifically adapted for manipulations within body cavities, e.g. within abdominal or thoracic cavities
• CPC Class Codes: A61B 2090/061 : for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/064 : for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/065 : for measuring contact or contact pressure
• CPC Class Codes: A61B 2090/066 : for measuring torque
• CPC Class Codes: A61B 2090/0807 : Indication means
• CPC Class Codes: A61B 2090/0811 : for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
• CPC Class Codes: A61B 2217/005 : with suction drainage system
• CPC Class Codes: A61B 2217/007 : with irrigation system
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61B 2218/008 : for smoke evacuation
• CPC Class Codes: A61B 34/30 : Surgical robots
• CPC Class Codes: A61B 34/37 : Master-slave robots A61B34/35 takes precedence
• CPC Class Codes: A61B 34/74 : Manipulators with manual electric input means
• CPC Class Codes: A61B 34/76 : Manipulators having means for providing feel, e.g. force or tactile feedback
• CPC Class Codes: A61B 90/30 : Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
• CPC Class Codes: A61B 90/361 : Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61B 90/37 : Surgical systems with images on a monitor during operation
• CPC Class Codes: A61B 90/92 : coded with colour
• CPC Class Codes: A61B 90/98 : using electromagnetic means, e.g. transponders
• CPC Class Codes: G16H 10/60 : for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 20/00 : ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
• CPC Class Codes: G16H 20/40 : relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 40/20 : for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
• CPC Class Codes: G16H 40/60 : for the operation of medical equipment or devices
• CPC Class Codes: G16H 40/63 : for local operation
• CPC Class Codes: G16H 40/67 : for remote operation

Abstract

A surgical instrument includes an end effector, a motor for opening and closing the jaws, a sensor configured to detect a tissue compression parameter associated with a tissue between the jaws, and a control circuit. The control circuit is configured to determine a value of the tissue compression parameter via the sensor as the jaws transition from the open configuration to the closed configuration, cause the motor to increase a time to transition the jaws to the closed configuration according to whether the value of the tissue compression parameter is above a first threshold, and provide feedback according to whether the value of the tissue compression parameter is below a second threshold.

Claims

1. A surgical instrument comprising:

an end effector comprising jaws transitionable between an open configuration and a closed configuration;

a motor operably coupled to the jaws, the motor configured to transition the jaws between the open configuration and the closed configuration;

a sensor configured to transmit at least one signal indicative of a tissue compression parameter associated with a tissue between the jaws; and

a control circuit coupled to the sensor and the motor, the control circuit configured to;

receive the at least one signal;

determine a value of the tissue compression parameter based on the at least one signal as the jaws transition from the open configuration to the closed configuration;

cause the motor to increase a time to transition the jaws to the closed configuration according to whether the value of the tissue compression parameter is above a first threshold; and

provide feedback according to whether the value of the tissue compression parameter is below a second threshold.

2. The surgical instrument of claim 1, wherein the tissue compression parameter comprises a force exerted by the motor to transition the jaws to the closed configuration.

3. The surgical instrument of claim 1, wherein the tissue compression parameter comprises a time rate of change of a force exerted by the motor to transition the jaws to the closed configuration.

4. The surgical instrument of claim 1, wherein the feedback comprises a suggestion for adjunct reinforcement.

5. The surgical instrument of claim 1, wherein the control circuit is configured to increase the time to transition the jaws to the closed configuration by decreasing a rate at which the motor transitions the jaws to the closed configuration.

6. The surgical instrument of claim 1, wherein the control circuit is configured to increase the time to transition the jaws to the closed configuration by increasing a length of time that the motor is paused when transitioning the jaws to the closed configuration.

7. The surgical instrument of claim 1, wherein the control circuit is configured to increase the time to transition the jaws to the closed configuration by lowering a stabilization threshold to stop the motor in transitioning the jaws to the closed configuration.

8. A surgical instrument comprising:

an end effector comprising;

jaws transitionable between an open configuration and a closed configuration; and

one or more sensors disposed along a tissue contacting surface of each of the jaws, the one or more sensors configured to detect contact with a tissue;

a motor operably coupled to the jaws, the motor configured to transition the jaws between the open configuration and the closed configuration; and

a control circuit coupled to the one or more sensors and the motor, the control circuit configured to;

determine an initial contact point at which the tissue contacts the tissue contacting surfaces of the jaws;

determine a separation between the jaws at the initial contact point;

determine a degree of contact between the tissue contacting surfaces and the tissue;

cause the motor to transition the jaws to the closed configuration at a rate corresponding to the separation between the jaws and the degree of contact between the tissue contacting surfaces and the tissue at the initial contact point; and

cause the motor to adjust the rate at which the jaws are transitioned to the closed configuration according to whether a force exerted by the motor to transition the jaws to the closed configuration exceeds a threshold;

wherein the threshold corresponds to the separation between the jaws and the degree of contact between the tissue contacting surfaces and the tissue at the initial contact point.

9. The surgical instrument of claim 8, wherein the one or more sensors comprise pressure sensors.

10. The surgical instrument of claim 8, wherein the one or more sensors comprise impedance sensors.

11. The surgical instrument of claim 8, wherein the separation between the jaws comprises an angle between the jaws.

12. The surgical instrument of claim 8, wherein the separation between the jaws comprises a gap between the jaws.

13. A surgical instrument comprising:

an end effector comprising;

jaws configured to transition between an open configuration and a closed configuration to grasp a tissue; and

a contact sensor assembly configured to sense the tissue thereagainst;

a position sensor configured to sense a configuration of the jaws;

a motor coupled to the jaws, the motor configured to transition the jaws between the open configuration and the closed configuration;

a control circuit coupled to the contact sensor assembly, the position sensor, and the motor, the control circuit configured to;

determine an initial contact point at which the tissue contacts the jaws;

determine the configuration of the jaws via the position sensor at the initial contact point;

determine an amount of tissue contact between the tissue and the jaws via the contact sensor assembly at the initial contact point;

set a closure rate at which the motor transitions the jaws to the closed configuration according to the configuration of the jaws and the amount of tissue contact at the initial contact point;

set a closure threshold according to the configuration of the jaws and the amount of tissue contact at the initial contact point; and

control the motor according to a force exerted by the motor to transition the jaws to the closed configuration relative to a threshold.

14. The surgical instrument of claim 13, wherein the contact sensor assembly comprises a pressure sensor.

15. The surgical instrument of claim 13, wherein the contact sensor assembly comprises an impedance sensor.

16. The surgical instrument of claim 13, wherein the configuration of the jaws corresponds to an angle between the jaws.

17. The surgical instrument of claim 13, wherein the configuration of the jaws corresponds to a gap between the jaws.

18. A surgical instrument, comprising:

an end effector comprising jaws transitionable between an open configuration and a closed configuration;

a motor operably coupled to the jaws, the motor configured to transition the jaws between the open configuration and the closed configuration;

a sensor configured to detect a tissue compression parameter associated with a tissue between the jaws; and

a control circuit coupled to the sensor and the motor, the control circuit configured to;

receive a signal from the sensor indicative of a value of the tissue compression parameter;

cause the motor to change a rate at which the jaws transition towards the closed configuration based on a comparison of the value of the tissue compression parameter to a first threshold; and

provide feedback based on a comparison of the value of the tissue compression parameter to a second threshold.

19. A surgical instrument, comprising:

an end effector, comprising;

jaws transitionable between an open configuration and a closed configuration; and

one or more sensors disposed along a tissue contacting surface of each of the jaws, the one or more sensors configured to detect contact with a tissue;

a motor operably coupled to the jaws, the motor configured to transition the jaws between the open configuration and the closed configuration; and

a control circuit coupled to the one or more sensors and the motor, the control circuit configured to;

determine an initial contact point at which the tissue contacts the tissue contacting surfaces of the jaws;

determine a separation between the jaws at the initial contact point;

determine a degree of contact between the tissue contacting surfaces and the tissue;

cause the motor to transition the jaws towards the closed configuration at a rate corresponding to the separation between the jaws and the degree of contact between the tissue contacting surfaces and the tissue at the initial contact point; and

cause the motor to adjust the rate at which the jaws are transitioned towards the closed configuration based on a comparison of a force exerted by the motor to transition the jaws towards the closed configuration to a threshold;

wherein the threshold corresponds to the separation between the jaws and the degree of contact between the tissue contacting surfaces and the tissue at the initial contact point.

20. A surgical instrument, comprising:

an end effector, comprising;

jaws configured to transition between an open configuration and a closed configuration to grasp a tissue; and

a contact sensor assembly configured to sense the tissue thereagainst;

a position sensor configured to sense a configuration of the jaws;

a motor coupled to the jaws, the motor configured to transition the jaws between the open configuration and the closed configuration;

a control circuit coupled to the contact sensor assembly, the position sensor, and the motor, the control circuit configured to;

determine an initial contact point at which the tissue contacts the jaws;

determine the configuration of the jaws via the position sensor at the initial contact point;

determine an amount of tissue contact between the tissue and the jaws via the contact sensor assembly at the initial contact point;

set a closure rate at which the motor transitions the jaws towards the closed configuration according to the configuration of the jaws and the amount of tissue contact at the initial contact point;

set a closure threshold according to the configuration of the jaws and the amount of tissue contact at the initial contact point; and

control the motor based on a comparison of a force exerted by the motor to transition the jaws towards the closed configuration to a threshold.