ADAPTIVE TISSUE COMPRESSION TECHNIQUES TO ADJUST CLOSURE RATES FOR MULTIPLE TISSUE TYPES

• US 20160256154A1
• Filed: 03/06/2015
• Published: 09/08/2016
• Est. Priority Date: 03/06/2015
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery LLC (Johnson & Johnson)
• Inventors: Shelton, Frederick E. IV, Yates, David C., Harris, Jason L.
• Granted Patent: US 10,687,806 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 17/105 Wound clamp magazines for packaging sharps A61B50/3001
• CPC Class Codes: A61B 17/295 combined with cutting implements
• 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 2017/00039 Electric or electromagnetic phenomena other than conductivity, e.g. capacity, inductivity, Hall effect
• CPC Class Codes: A61B 2017/00075 Motion
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/00119 alarm; indicating an abnormal situation
• CPC Class Codes: A61B 2017/00123 and automatic shutdown
• CPC Class Codes: A61B 2017/00128 related to intensity or progress of surgical action
• 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 2017/00464 for use with different instruments with hole for different instruments A61B2017/22072
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/00734 : battery operated
• CPC Class Codes: A61B 2090/065 : for measuring contact or contact pressure
• CPC Class Codes: A61B 2090/0803 : Counting the number of times an instrument is used
• CPC Class Codes: A61B 2560/0214 : of power generation or supply
• CPC Class Codes: A61B 2560/0475 : Special features of memory means, e.g. removable memory cards
• CPC Class Codes: A61B 90/03 : Automatic limiting or abutting means, e.g. for safety
• CPC Class Codes: A61B 90/90 : Identification means for patients or instruments, e.g. tags

Abstract

A mechanism is disclosed for adapting operations of a surgical instrument based on data from actual, expected or predicted properties of tissue, data from measuring operation of the surgical instrument itself, and data based on clinician conduct. The adaptive measures can be based on predetermined control measures such as algorithms stored in operative communication with the surgical instrument, based on dynamically generated control measures, or a combination of both. Utilizing such mechanisms can help to adjust closure and firing algorithms based on tissue properties, improve battery usage, and learn from user operations, enhancing functioning of the instrument within an operational envelope.

Claims

1. A surgical cutting and stapling instrument comprising at least one processor and operatively associated memory, the instrument configured to:

store a parameter;

store an acceptable value for the parameter;

store a first control measure associated with the parameter; and

determine, in response to determining that a measured value of the parameter has exceeded the acceptable value, that a second control measure be identified.

2. The instrument of claim 1, wherein the first control measure is associated with a property of a cartridge operatively engaged with the instrument.

3. The instrument of claim 1, wherein the first control measure is associated with an expected value for a property of a tissue.

4. The instrument of claim 3, wherein the expected value for the property of the tissue is based on at least one tissue compression value.

5. The instrument of claim 1, wherein the first control measure is associated with a voltage related to at least one motor of the instrument.

6. The instrument of claim 1, wherein the first control measure is associated with a current related to at least one motor of the instrument.

7. The instrument of claim 1, wherein the first control measure is associated with a usage metric related to at least one battery of the instrument.

8. The instrument of claim 1, wherein the first control measure is associated with a distance between a first jaw and a second jaw of the instrument.

9. The instrument of claim 1, wherein the first control measure is associated with a measured behavior of a clinician using the instrument during a surgical procedure.

10. The instrument of claim 1, wherein the second control measure is associated with a closure rate of a first jaw and a second jaw of the instrument.

11. The instrument of claim 1, wherein the second control measure is associated with a firing rate.

12. The instrument of claim 1, wherein a clinician is alerted during the course of a surgical procedure performed by the instrument that the measured value of the parameter has exceeded the acceptable value.

13. A surgical cutting and stapling instrument comprising at least one processor and operatively associated memory, the instrument configured to:

store a parameter;

store an acceptable value for the parameter;

store a first control measure associated with the parameter;

predict, during a surgical procedure by the instrument, that a measured value of the parameter will exceed the acceptable value; and

determine, based on the prediction, that a second control measure be identified.

14. The instrument of claim 13, wherein the first control measure is associated with an expected value for a property of a tissue.

15. The instrument of claim 13, wherein a prediction is made that a rate of change of a measurement of a tissue property during the closure of a first jaw and second jaw on a tissue portion will exceed an acceptable value, and wherein the second control measure is associated with adapting the closure rate.

16. The instrument of claim 13, wherein a prediction is made that a rate of change of a measurement of a tissue property during the firing of a firing member of the instrument will exceed an acceptable value, and wherein the second control measure is associated with adapting the firing rate associated with the firing member.

17. The instrument of claim 16, wherein the instrument determines whether the rate of change of the measurement of the tissue property graphically forms a convex shape or a concave shape.

18. The instrument of claim 13, wherein the first parameter is associated with a measurement of a voltage associated with at least one motor of the instrument.

19. The instrument of claim 13, wherein the first control measure is associated with a usage metric of at least one battery of the instrument.

20. The instrument of claim 13, wherein a clinician is alerted during the course of a surgical procedure performed by the instrument that the measured value of the parameter is predicted to exceed the acceptable value.