Surgical instrument with enhanced battery performance

Contents of disclosure

0001[Related application] This application relates to the following simultaneous US patent applications that are incorporated herein by reference. 1. US Patent Application No. __ / _____ by J. Giordano et al. (Name: "SURGICAL INSTRUMENT WITH WIRELESS COMMUNICATION BETWEEN CONTROL UNIT" AND SENSOR TRANSPONDERS) ") (agent reference number: 060338 / END5923USNP) 2. US Patent Application No. __ / _____ by J. Giordano et al. (Name: "SURGICAL INSTRUMENT WITH WIRELESS COMMUNICATION BETWEEN CONTROL UNIT" AND REMOTE SENSOR) ") (agent reference number: 060339 / END5924USNP) 3. J. Jordano (J. US Patent Application No. __ / _____ by Giordano et al. (Name: "SURGICAL INSTRUMENT WITH ELEMENTS TO COMMUNICATE BETWEEN CONTROL UNIT AND END" EFFECTOR) ") (agent reference number: 060340 / END5925USNP) 4. US Patent Application No. __ / _____ by F. Shelton et al. (Name: "PREVENTION OF CARTRIDGE REUSE IN A SURGICAL INSTRUMENT") (Representative Reference number: 060341 / END5926USNP) 5. J. Sways (J. US Patent Application No. __ / _____ by Swayze et al. (Name: "POST-STERILIZATION PROGRAMMING OF SURGICAL INSTRUMENTS") (Agent reference number: 060342 / END5927USNP) 6. US Patent Application No. __ / _____ by F. Shelton et al. (Name: "INTERLOCK AND SURGICAL INSTRUMENT INCLUDING SAME") Number: 060343 / END5928USNP)

0002[Background of invention] Endoscopic surgical instruments are often preferred over traditional open surgical instruments because small incisions reduce postoperative recovery time and complications. Therefore, significant progress has been made in the development of various endoscopic surgical instruments suitable for accurately placing the distal end effector at the desired surgical site via the trocar cannula. Such distal end effectors engage tissue in a variety of ways to achieve diagnostic or therapeutic effects (eg, end cutters, grippers, cutters, staplers, clip appliers, access devices, drug / gene therapy). Delivery device and energy device using ultrasonic waves, RF, laser, etc.).

0003Known surgical staplers include end effectors that cut the tissue longitudinally and at the same time staple the staples on both sides of the incision. The end effector includes a pair of collaborative jaw members that can pass through the passage of the cannula when the instrument is used for an endoscope or arthroscope. One jaw member receives a staple cartridge having at least two rows of staples laterally spaced apart. The other jaw member defines an anvil with staple molding pockets aligned with the rows of staples in the cartridge. This device includes multiple reciprocating wedges. When driven distally, these wedges pass through the opening of the staple cartridge, engage the driver supporting the staple, and fire the staple towards the anvil.

0004An example of a surgical stapler suitable for endoscopic applications is described in US Pat. No. 5,465,895, which discloses an end cutter that performs the closing and firing movements separately. Physicians using this device can close the jaw member against the tissue to align the tissue prior to firing. Once the physician determines that the jaw member is properly gripping the tissue, the surgical stapler can be activated with a single firing stroke to cut and staple the tissue. Simultaneous cutting and stapling can prevent complications that can occur when cutting and stapling separately using separate surgical instruments.

0005One specific advantage that can be closed against the tissue before firing is that the doctor is in the desired position for cutting, including whether a sufficient amount of tissue is gripped between the opposing jaws. Whether or not it is arranged can be confirmed through an endoscope. Without this confirmation, the opposing jaws would be too close to each other and would be squeezed, especially at the distal end, and the amputated tissue could not be effectively stapled. On the contrary, if the amount of clamped tissue is excessive, it will clog and result in incomplete firing.

0006Endoscopic staplers / cutters are becoming more complex and functional with each generation. One reason for this is the need for a low level of firing power (FTF) that can be operated by all or the majority of surgeons. One known solution for lower FTF is CO₂Or the use of an electric motor. In another respect, such devices are not significantly superior to conventional manual devices. Surgeons usually end with staple molding to ensure that the cutting / staple cycle is complete with the upper limit force most surgeons can (usually about 15-30 lbs). I like to feel the force distribution proportional to the force the effector receives. Surgeons also usually want to maintain control of the staple attachment and be able to stop at any time if the force felt by the handle of the device is too great or for other clinical reasons.

0007To meet this demand, so-called "power-assisted" endoscopic surgical instruments have been developed in which an auxiliary power source assists in launching the instrument. For example, in some power assist devices, when the user pulls the firing trigger, the motor supplies auxiliary power to the input. Such a device can transmit load feedback and control to the operator to reduce the firing force that the operator needs to apply to complete the cutting operation. One such power assisting device incorporates the disclosures herein by reference, US Patent Application No. 11 / 343,573 by Shelton et al., Filed January 31, 2006 (name: "Load It is disclosed in "Motor-driven surgical cutting and clamping instrument with loading force feedback".

0008Another reason for increasing the complexity and function of endoscopic surgical instruments is the need to monitor the components of the instrument for tighter control of the components of the instrument. For example, sensors and control systems are being used to realize new features of surgical instruments, including electronic lockouts. For example, US Patent Application No. 11 / 343,439 (name: "Electronic Lockout" by Swayze et al., Filed January 31, 2006, which one such lockout device is incorporated herein by reference. And Electronic Lockouts And Surgical Instrument Including Same.

0009The challenge of using electronic components in all types of surgical instruments is to have a suitable power source. Most surgical instruments are stored in a sealed sterile package. For this reason, it is generally impractical to access the surgical instrument after it has been packaged to check the power status of the surgical instrument or to charge it if desired. Therefore, the shelf life of a surgical instrument is limited by how long the power source can reliably retain charge. However, for many types of surgical instruments, it is desirable to choose a power source with a high peak output. High peak power supplies are suitable for driving motors, sensors, and control systems used in surgical instruments. However, high peak power sources such as lithium ion batteries usually do not maintain sufficient charge for the desired long term. Therefore, the choice of power source must trade off long shelf life requirements and high peak output requirements.

0010[Outline of Invention] In one aspect, the invention relates to an assembly that includes components of a surgical instrument such as an endoscopic instrument or an arthroscopic instrument. The assembly can include a package, components of surgical instruments within this package, and a power source within the package. The power supply can be arranged to communicate electrically with the components of the surgical instrument. The assembly can also include auxiliary power supplies and circuit elements within the package. This circuit element communicates electrically with the power supply and auxiliary power supply.

0011In another aspect, the invention relates to an end effector cartridge for use in surgical instruments. This end effector cartridge can include electrical elements, power supplies, and circuit elements. The circuit element can be configured to electrically connect the power source and the electrical element when the end effector cartridge is mounted within the surgical instrument.

0012In yet another aspect, the invention relates to a package and an assembly that includes an end effector cartridge within the package. The end effector cartridge can include electrical elements. The assembly can also include a power supply in the package and circuit elements in the package. The circuit element can be configured to electrically connect the power source and the electrical element when the end effector cartridge is mounted within the surgical instrument. Also disclosed are methods of regenerating surgical instruments and their components.

0013[Detailed explanation] Various embodiments of the present invention will be described as examples with reference to the accompanying drawings.

0014Various embodiments of the present invention relate to surgical instruments and / or components thereof having a power source capable of adding or maintaining an electric charge while the surgical instrument and / or its components remain in a sterile package. The present invention can be used for all types of surgical instruments, including at least one power source, such as endoscopic or arthroscopic surgical instruments. Before explaining the features of the system, a type of surgical instrument that can use embodiments of the present invention, namely an endoscopic staple / cutting instrument (end cutter), will first be described as an example.

00151 and 2 show an endoscopic surgical instrument 10 including a handle 6, a shaft 8, and a joint motion end effector 12 swivelably connected to the shaft 8 by a joint motion pivot 14. The exact placement and orientation of the end effector 12 is as follows: (1) Rotating knob to rotate the end effector 12 by rotating the closure tube (see FIGS. 4 and 5 for details) at the free rotation joint 29 of the shaft 8. 28, and (2) The joint movement control unit 16 for jointly moving the end effector 12 around the joint movement pivot 14, can be easily performed by the control unit provided on the handle 6. In the illustrated embodiment, the end effector 12 is configured to act as an end cutter for clamping, cutting, and stapling tissue, whereas in other embodiments, the end effector 12 is a gripper, cutter, stapler. Various types of end effectors can be used, such as clip appliers, access devices, drug / gene therapy devices, and end effectors for other types of surgical instruments such as ultrasonic, RF, or laser devices.

0016The handle 6 of the appliance 10 can include a closing trigger 18 and a firing trigger 20 for activating the end effector 12. It should be understood that surgical instruments with end effectors used in various surgical procedures can have different numbers or types of triggers or other suitable controls to activate the end effector 12. The end effector 12 is preferably separated from the handle 6 by an elongated shaft 8 as shown. In one embodiment, the doctor or operator of the surgical instrument 10 can use the joint movement control unit 16 to jointly move the end effector 12 with respect to the shaft 8. US Patent Application No. 11 / pending by Geoffrey C. Hueil et al., Filed in a January 10, 2006 application, which details are incorporated herein by reference. 329,020 (name: "Surgical Instrument Having An Articulating End Effector").

0017In this example, the end effector 12 specifically includes a staple grooved member 22 and a swivel clamp member such as an anvil 24. The staple grooved member 22 and the anvil 24 are maintained at regular intervals to ensure that the tissue clamped within the end effector 12 is stapled and cut. Handle 6 includes a pistol grip 26. The physician pulled the closure trigger 18 towards the pistol grip 26 and clamped or closed the anvil 24 towards the staple grooved member 22 of the end effector 12 and placed it between the anvil 24 and the grooved member 22. Tissue can be clamped. The firing trigger 20 is located outside the closing trigger 18. When the closing trigger 18 is locked in the closed position, the firing trigger 20 rotates slightly towards the pistol grip 26 and can be operated by the operator with one hand. The operator can then pull the firing trigger 20 towards the pistol grip 26 to staple and cut the tissue clamped within the end effector 12. U.S. Patent Application No. 11 / 343,573 describes various structures for locking and unlocking the closure trigger 18. In other embodiments, different types of clamp members other than the anvil 24, such as opposed jaws, can be used.

0018It should be understood that the terms "proximal" and "distal" as used herein are relative to the physician holding the handle 6 of the instrument 10. Therefore, the end effector 12 is distal to the proximal handle 6. In addition, it should be understood that spatial terms such as "vertical" and "horizontal" are used for drawings for clarity. However, surgical instruments can be used in a variety of orientations and positions, and such terms are not intended to be limiting or absolute.

0019First, the closure trigger 18 can be activated. When the physician is satisfied with the placement of the end effector 12, the physician can pull the closure trigger 18 to a fully closed lock position close to the pistol grip 26. Next, the firing trigger 20 can be activated. When the doctor releases the pressure, the firing trigger 20 returns to the open position (see FIGS. 1 and 2). In this example, pressing the release button 30 of the handle 6 provided on the pistol grip 26 of the handle 6 can release the locked closure trigger 18.

0020FIG. 3 is an assembled exploded view of the end effector 12 according to various embodiments. As shown in the illustrated embodiment, the end effector 12 is removably arranged within the cutting instrument 32, the thread 33, and the grooved member 22 in addition to the grooved member 22 and the anvil 24 described above. A staple cartridge 34, and a spiral threaded shaft 36 can be included. The cutting tool 32 can be, for example, a knife. The anvil 24 can be opened and closed at a pivot point 25 connected to the proximal end of the grooved member 22. The anvil 24 may also be provided with a tab 27 at its proximal end that is inserted into a component of the mechanical closure system (details below) to open and close the anvil 24. When the closure trigger 18 is activated, i.e. pulled by the user of the instrument 10, the anvil 24 can rotate about the pivot point 25 to the clamp i.e. closed position. When satisfied with the clamp on the end effector 12, the operator activates the firing trigger 20 to move the knife 32 and thread 33 longitudinally along the grooved member 22, as described in more detail below. Tissue clamped in can be cut. The movement of the thread 33 along the grooved member 22 causes the staples of the staple cartridge 34 to travel through the cut tissue towards the closed anvil 24 and be bent by the anvil 24 to close the cut tissue. US Pat. No. 6,978,921 (Name:) which is incorporated herein by reference. Such a two-stroke cutting / fastening instrument is disclosed in detail in "Surgical stapleling instrument incorporating an E-beam firing mechanism". The thread 33 can be part of the cartridge 34 so that if the knife 32 is pulled back after the cutting operation, the thread 33 will not be pulled back. The grooved member 22 and the anvil 24 can be formed from a conductive material (such as metal) and, in various embodiments, can function as part of an antenna that communicates with a sensor in the end effector. The cartridge 34 can be made of a non-conductive material (such as plastic) and the sensor can be connected to or placed inside the cartridge 34 as described in detail below.

0021The surgical instrument 10 embodiment disclosed herein uses an end effector 12 that staples the cut tissue, while other embodiments use different techniques for fastening or sealing the cut tissue. Note that you can. For example, an end effector that uses RF energy or glue to close the cut tissue can be used. US Pat. No. 5,709,680 by Yates et al. (Name: "Electrosurgical Hemostatic Device") and US Pat. No. 5,688,270 by Yates et al. Electrosurgical Hemostatic Device With Recessed And / Or Offset Electrodes) ) discloses a cutting instrument that closes the cut tissue using RF energy. Close the tissue cut with an adhesive in U.S. Patent Application No. 11 / 267,811 by Morgan et al. And U.S. Patent Application No. 11 / 267,363 by Shelton et al., Which are incorporated herein by reference. Cutting instruments are disclosed. Therefore, although the present specification describes cutting / stapling operations and the like, it should be understood that this is an exemplary embodiment and is not intended to be limiting. Other tissue fastening techniques can also be used.

00224 and 5 are exploded views of the end effector 12 and shaft 8 according to various embodiments, and FIG. 6 is a side view. As shown in the illustrated embodiment, the shaft 8 can include a proximal closure tube 40 and a distal closure tube 42 that is rotatably connected by a pivot link 44. The distal closure tube 42 includes an opening 45 into which the tab 27 of the anvil 24 is inserted to open and close the anvil 24. Proximal spine tubes 46 can be placed within the closure tubes 40, 42. Within the proximal spine tube 46, a first rotary (or proximal) drive shaft 48 connected to a second (or distal) drive shaft 50 via a bevel assembly 52 can be located. The second drive shaft 50 is connected to a drive gear 54 that engages the proximal drive gear 56 of the spiral screw shaft 36. The vertical bevel gear 52b can be rotatably placed within the opening 57 at the distal end of the proximal spine tube 46. The distal spine tube 58 can be used to cover the second drive shaft 50 and drive gears 54, 56. The first drive shaft 48, the second drive shaft 50, and the articulated assembly (eg, bevel gear assembly 52a-52c) are collectively referred to herein as the "main drive shaft assembly". There is also.

0023The bearing 38 located at the distal end of the staple grooved member 22 receives the spiral drive screw 36 so that the spiral drive screw 36 can rotate freely with respect to the grooved member 22. The spiral threaded shaft 36 is coupled to the screw opening (not shown) of the knife 32 so that this rotation causes the knife 32 to move distally or proximally (determined by the direction of rotation) within the staple grooved member 22. Can be made to. Therefore, as will be described in detail later, when the first drive shaft 48 is rotated by the operation of the firing trigger 20, the bevel gear assembly 52a-52c rotates the second drive shaft 50, and the drive gears 54 and 56 The meshing causes the spiral screw shaft 36 to rotate, the knife 32 to move longitudinally along the grooved member 22, and all the tissue clamped in the end effector to be cut. The thread 33 can be made of, for example, plastic and can have an inclined distal surface. As the thread 33 traverses the grooved member 22, its sloping front surface allows the staples in the staple cartridge 34 to be pushed up towards the anvil 24 through the clamped tissue. Anvil 24 bends the staples and the cut tissue is stapled. When the knife 32 is pulled back, the knife 32 and the thread 33 are disengaged, leaving the thread 33 at the distal end of the grooved member 22.

0024According to various embodiments, the surgical instrument can include a battery 64 within the handle 6, as shown in FIGS. 7-10. The illustrated embodiment feeds back to the user about the placement of the cutting instrument within the end effector 12 and the force of the load. In addition, this embodiment can power the appliance 10 by utilizing the force of the user pulling the firing trigger 18 (so-called "power assist" mode). As shown in the illustrated embodiment, the handle 6 includes lower outer surface parts 59, 60 and upper outer surface parts 61, 62 that are joined together to form the outer surface of the handle 6. The handle parts 59-62 can be formed from a non-conductive material such as plastic. A battery 64, such as a lithium-ion battery, can be placed within the pistol grip portion 26 of the handle 6. The battery 64 powers the motor 65 located in the upper part of the pistol grip portion 26 of the handle 6. Battery 64 is, for example, LiCoO₂And LiNiO₂It can be manufactured according to any suitable structure or chemistry, including lithium ion chemistry or nickel hydrogen chemistry such as. According to various embodiments, the motor 65 can be a DC brush driven motor having a maximum rotational speed of about 5000 RPM to 100,000 RPM. The motor 64 can drive a 90 degree bevel assembly 66 including a first bevel 68 and a second bevel 70. The bevel gear assembly 66 can drive the planetary gear assembly 72. The planetary gear assembly 72 may include a pinion gear 74 connected to a drive shaft 76. The pinion gear 74 can drive the meshing ring gear 78 that drives the spiral gear drum 80 via the drive shaft 82. The ring 84 can be screwed onto the spiral gear drum 80. Thus, as the motor 65 rotates, the ring 84 is moved along the spiral gear drum 80 by the bevel gear assembly 66, the planetary gear assembly 72, and the ring gear 78 arranged in between.

0025The handle 6 and the firing trigger 20 are used to detect that the operator has pulled (or closed) the firing trigger 20 toward the pistol grip portion 26 of the handle 6 to perform a cutting / stapling operation on the end effector 12. A motor operation sensor 110 that communicates can also be included. The sensor 110 can be, for example, a proportional sensor such as a rheostat or variable resistor. When the firing trigger 20 is pulled, the sensor 110 detects this movement and sends an electrical signal indicating the voltage (power) supplied to the motor 65. When the sensor 110 is a variable resistor or the like, the rotation of the motor 65 can usually be proportional to the momentum of the firing trigger 20. That is, when the operator pulls the firing trigger 20 slightly, that is, closes it, the rotation speed of the motor 65 is relatively low. When the firing trigger 20 is fully pulled or completely closed, the rotational speed of the motor 65 is maximized. In other words, the harder the user pulls the firing trigger 20, the greater the voltage supplied to the motor 65 and the greater the rotational speed. In another embodiment, for example, a control unit (discussed in detail below) can output a PWM control signal to the motor 65 based on an input from the sensor 110 to control the motor 65.

0026The handle 6 may include an intermediate handle component 104 close to the top of the firing trigger 20. The handle 6 may include an urging spring 112 located between the post of the intermediate handle component 104 and the firing trigger 20. The urging spring 112 can urge the firing trigger 20 to a fully open position. In this method, when the operator releases the firing trigger 20, the urging spring 112 returns the firing trigger 20 to the open position, stops the operation of the sensor 110, and stops the rotation of the motor 65. Further, when the user closes the firing trigger 20, the urging spring 112 causes the user to feel resistance to the closing operation. This allows the user to receive feedback on the degree of rotation by the motor 65. Further, when the operator stops pulling the firing trigger 20, no force is applied to the sensor 110 and the motor 65 stops. Therefore, since the user can stop the arrangement of the end effector 12, a means for controlling the cutting / fastening operation can be obtained.

0027The distal end of the spiral gear drum 80 includes a distal drive shaft 120 that drives a ring gear 122 that meshes with a pinion gear 124. The pinion gear 124 is connected to the first drive shaft 48 of the main drive shaft assembly. In this method, the rotation of the motor 65 rotates the main drive shaft assembly, and the end effector 12 operates as described above.

0028The ring 84 screwed into the spiral gear drum 80 can include a post 86 that is received within slot 88 of the slot arm 90. The slot arm 90 has an opening 92 at its opposite end 94 that receives the pivot pin 96 coupled between the handle outer components 59 and 60. The pivot pin 96 is located within the opening 100 of the firing trigger 20 and the opening 102 of the intermediate handle component 104.

0029In addition, the handle 6 can include a motor reverse rotation (or stroke end) sensor 130 and a motor stop (or stroke start) sensor 142. In various embodiments, the motor reverse rotation sensor 130 operates when the ring 84 reaches the distal end of the spiral gear drum 80 and the ring 84 screwed into the spiral gear drum 80 contacts the motor reverse rotation sensor 130. It can be a limit switch located at the distal end of the spiral gear drum 80 so as to allow. When the motor reverse rotation sensor 130 operates, it sends a signal to the control unit, which sends a signal to reverse the rotation of the motor 65 to the motor 65, and the knife 32 of the end effector 12 is pulled back after the cutting operation. ..

0030The motor stop sensor 142 can be, for example, a normally closed limit switch. In various embodiments, the sensor 142 is located at the proximal end of the spiral gear drum 80 so that the ring 84 activates the switch 142 when the ring 84 reaches the proximal end of the spiral gear drum 80. Can be done.

0031When the operator of the appliance 10 pulls the firing trigger 20 during operation, the sensor 110 detects the movement of the firing trigger 20 and sends a signal to the control unit, which sends a signal to the motor 65. , The motor 65 rotates forward at a speed proportional to the force with which the operator pulls the firing trigger 20. The forward rotation of the motor 65 causes the ring gear 78 at the distal end of the planetary gear assembly 72 to rotate, which in turn causes the spiral gear drum 80 to rotate, and the ring 84 screwed into the spiral gear drum 80 is the spiral gear. Move distally over the drum 80. The rotation of the spiral gear drum 80 also drives the main drive shaft assembly described above, which causes the knife 32 to operate within the end effector 12. That is, the knife 32 and the thread 33 move longitudinally through the grooved member 22 to cut the tissue clamped in the end effector 12. Further, in the embodiment in which the staple-stopping type end effector is used, the staple-stopping operation of the end effector 12 is also performed.

0032When the cutting / stapling operation of the end effector 12 is completed, the ring 84 of the spiral gear drum 80 reaches the distal end of the spiral gear drum 80, and the motor reverse rotation sensor 130 operates to send a signal to the control unit. Then, this control unit sends a signal to the motor 65, and the motor 65 rotates in the reverse direction. This pulls back the knife 32 and returns the ring 84 of the spiral gear drum 80 to the proximal end of the spiral gear drum 80.

0033The intermediate handle component 104 includes a rear shoulder 106 that engages the slot arm 90, as best shown in FIGS. 8 and 9. The intermediate handle component 104 also has a forward motion stopper 107 that engages the firing trigger 20. The movement of the slot arm 90 is controlled by the rotation of the motor 65 as described above. As the slot arm 90 rotates counterclockwise as the ring 84 moves from the proximal end to the distal end of the spiral gear drum 80, the intermediate handle part 104 is free to rotate counterclockwise. To do. Therefore, when the user pulls the firing trigger 20, the firing trigger 20 engages with the forward movement stopper 107 of the intermediate handle component 104, and the intermediate handle component 104 rotates in the counterclockwise direction. However, the rear shoulder 106 engaged to the slot arm 90 allows the intermediate handle component 104 to rotate counterclockwise to the extent allowed by the slot arm 90. In this method, if the motor 65 must stop rotating for some reason, the slot arm 90 stops rotating, and the slot arm 90 cannot freely rotate the intermediate handle component 104 in the counterclockwise direction, so that the slot arm 90 fires. Trigger 20 cannot be pulled further.

0034The components of an exemplary closure system for pulling the closure trigger 18 to close or clamp the anvil 24 of the end effector 12 are shown in FIGS. 7-10. In the illustrated embodiment, the closure system comprises a yoke 250 connected to the closure trigger 18 by a pin 251 inserted into the matched opening of both the closure trigger 18 and the yoke 250. The pivot pin 252, which is the center of rotation of the closing trigger 18, is inserted into another opening of the closing trigger 18 that is offset from the position where the pin 251 is inserted into the closing trigger 18. Therefore, when the closure trigger 18 is pulled, the top of the closure trigger 18 to which the yoke 250 is attached with the pin 251 rotates counterclockwise. The distal end of the yoke 250 is connected to the first closure bracket 256 by a pin 254. The first closing bracket 256 is coupled to the second closing bracket 258. The closure brackets 256 and 258 collectively receive the proximal end of the proximal closure tube 40 (see Figure 4) so that these longitudinal movements move the proximal closure tube 40 longitudinally. It defines the opening to be made. Instrument 10 also includes a closure rod 260 located within the proximal closure tube 40. The closing rod 260 may include a window 261 in which one post 263 of the handle outer surface component, such as the lower outer surface component 59, is arranged in the illustrated embodiment to secure the closing rod 260 to the handle 6. .. In this scheme, the proximal closure tube 40 can move longitudinally with respect to the closure rod 260. The closure rod 260 can also include a distal collar 267 that fits within the cavity 269 of the proximal spine tube 46 and is held within it by a cap 271 (see Figure 4).

0035During operation, as the closure trigger 18 is pulled and the yoke 250 rotates, the closure brackets 256, 258 move the proximal closure tube 40 to the distal side (ie, away from the handle end of instrument 10). This causes the distal closure tube 42 to move distally and the anvil 24 to rotate about the pivot point 25 to the clamp or closed position. When the closure trigger 18 is released from the locked position, the proximal closure tube 40 slides proximally, which causes the distal closure tube 42 to slide proximally into the window 45 of the distal closure tube 42. The inserted tab 27 causes the anvil 24 to rotate around pivot point 25 to an unclamped open position. In this method, by pulling and locking the closure trigger 18, the operator can clamp the tissue between the anvil 24 and the grooved member 22, and after the cutting / stapling action, the closure trigger 18 is It can be released from the locked position to release the tissue clamp.

0036The control unit, which will be described in detail later, can receive outputs from the stroke end sensor 130, the stroke start sensor 142, and the motor operation sensor 110, and can control the motor 65 based on these inputs. For example, when the operator first pulls the firing trigger 20 after locking the closing trigger 18, the motor operation sensor 110 is activated. When the staple cartridge 34 is present in the end effector 12, the cartridge lockout sensor (not shown) closes, the control unit outputs a control signal to the motor 65, and the motor 65 rotates in the forward direction. When the end effector 12 reaches the end of the stroke, the motor reverse rotation sensor 130 is activated. The control unit can receive this output from the motor reverse rotation sensor 130 and reversely rotate the motor 65. When the knife 32 is completely pulled back, the motor stop sensor switch 142 is activated and the control unit stops the motor 65.

0037In other embodiments, an on / off sensor can be used instead of the proportional sensor 110. In such an embodiment, the rotational speed of the motor 65 is not proportional to the force applied by the operator. Rather, the motor 65 rotates at a constant speed. However, since the firing trigger 20 is engaged with the gear drive train, the operator can receive force feedback.

0038Instrument 10 includes the condition of the staple cartridge 34 (or another type of cartridge depending on the type of surgical instrument), user input load, stapler progression during closure and launch, surgical instrument or instrument compatible with cartridge 34, etc. A large number of sensors for detecting various states related to the end effector 12 such as a sensor for determining the end effector 12 can be included in the end effector 12. The sensor may be passively powered by an inductive signal, or may be powered by a remote power source, such as a battery in the end effector 12. Sensors can include, for example, magnetic resistance sensors, optical sensors, electromechanical sensors, wireless IC (RFID) sensors, microelectromechanical system (MEMS) sensors, motion sensors, or pressure sensors. These sensors can communicate with a control unit 300 that can be located within the handle 6 of the appliance 10, for example, as shown in FIG. The sensor can be connected to the control unit 300 by any suitable wired or wireless method.

0039As shown in FIG. 12, according to various embodiments, the control unit 300 can include a processor 306 and one or more memory units 308. By performing instructional actions stored in memory 308, processor 306 is based on various end effector sensors and other sensors such as motor drive sensor 110, stroke end sensor 130, and stroke start sensor 142. Various components of the appliance 10 such as the motor 65 or the user display (not shown) can be controlled. The control unit 300 can be powered by the battery 64 during the surgical use of the instrument 10. In embodiments where the control unit 300 does not have a direct wired connection to each sensor and / or motor, the control unit 300 guides to send and receive radio signals to various sensors / motors and the like. It can include element 302 (eg, coil or antenna). The input signal received by the inductive element 302 that functions as a receiving antenna can be demodulated by the demodulator 310 and decoded by the decoder 312. The output signal can be transmitted via the encoder 316, the modulator 318, and the inductive element 302. Various embodiments can include a receiving guiding element and a transmitting guiding element separately (not shown).

0040According to various embodiments, the control unit 300 is a microcontroller, system on chip (S)._OIt can also be embodied as C) or system in a package (SIP). Alternatively, the control unit 300 can be embodied as two or more separate components. As shown in FIG. 11, the control unit 300 can be included in the handle 6 of the appliance 10 and one or more sensors 368 of the appliance 10 can be placed in the end effector 12. In an embodiment in which the control unit 300 and the sensor 358 communicate wirelessly, the inductive element 302 of the control unit 300 is connected to one or more wires (eg, wire 322) and / or a second inductive element (eg, coil 320 or 324). It can be inductively coupled to the transponder via. The second guiding elements 320, 324 can be arranged so that the wires passing through the joint motion joints such as the rotary joint 29 and the pivot 14 do not need to be provided.

0041FIG. 13 is a diagram of the end effector 12 including the transponder 368 held or embedded in the cartridge 34 at the distal end of the grooved member 22. The sensor 368 can be coupled to the cartridge 34 with a suitable adhesive material such as epoxy. In this embodiment, the sensor 368 includes a magnetoresistive sensor. Anvil 24 also includes a permanent magnet 369 facing the transponder 368 at its distal end. The cartridge 34 also includes a permanent magnet 370 coupled to a thread 33 in the embodiment of this example. This causes the sensor 368 to both open and close the end effector 12 (because the permanent magnets 369 move away from or closer to the transponder as the anvil 24 opens and closes) and completes the stapling / cutting operation (cutting operation). As the thread 33 moves through the grooved member 22, the permanent magnet 370 moves towards the sensor 368) as part of the detection. Various other sensors and / or sensor types can be included within the end effector 12 and / or cartridge 34, for example, including the illustrated radio frequency identification (RFID) sensor 371.

0042FIG. 13 also shows the staple 380 and staple driver 382 of the staple cartridge 34. As described above, according to various embodiments, when the thread 33 traverses the grooved member 22, the thread 33 drives the staple driver 382, whereby the staple 380 is held in the end effector 12 and cut. Entering the tissue, staple 380 is molded by anvil 24. As mentioned above, such a surgical cutting / fastening instrument is one type of surgical instrument that can take advantage of the present invention. Various embodiments of the present invention can be used for any type of surgical instrument having one or more sensors.

0043In the embodiments described above, the battery 64 or other suitable power source powers the appliance 10 at least partially for the firing operation. Therefore, this device can be called a so-called "power assisted" device. Further details and other embodiments of such power assist devices are disclosed in US Patent Application No. 11 / 343,573, which is incorporated herein by reference. However, it should be understood that the appliance 10 does not necessarily have to be a power assisting device, but is merely an example of one type of apparatus that can take advantage of the features of the present invention. For example, the appliance 10 can include a user display (such as an LCD or LED display) powered by a battery 64 and controlled by a control unit 300. Data from the sensor sensor 368 in the end effector 12 can be displayed on such a display.

0044Generally, surgical instruments such as instrument 10 are cleaned and sterilized before use. In one sterilization technique, instrument 10 is placed in a sealed package 280 such as a plastic and / or TYVEK container or bag, as shown in FIGS. 14 and 15. The package 280 and instrument are then placed in a field of radiation that can penetrate the package, such as gamma rays, x-rays, or high energy electrons. This radiation kills bacteria on instrument 10 and in package 280. The sterilized instrument 10 can then be stored in the sterilization package 280. The sealed sterilization package 280 maintains the sterilization of instrument 10 until it is opened in a medical facility or other environment of use. Instead of radiation, other sterilization means of instrument 10 such as ethylene oxide and steam can be used. Instrument 10 can be supplied to consumers in a sterile or non-sterile state. If the instrument 10 is supplied unsterilized, the consumer can sterilize the instrument 10 in the hospital or send it to an external contractor.

0045FIG. 16 shows side views of the package 280 with the appliance 10 and the auxiliary power supply 402 in various embodiments. The auxiliary power supply 402 can telecommunications with the appliance 10 (eg, battery 64) via a connection 404 and a circuit element (not shown). Auxiliary power supply 402 can be powered to charge and / or recharge the power supply of the appliance. The auxiliary power supply 402 can be any type of battery or other suitable power source. For example, rechargeable batteries such as lithium-ion batteries or nickel-metal hydride batteries, or zinc / carbon, Zn / alkali / MnO₂, Li / MnO₂, Zn / Ag₂O, Li / FeS₂Can include non-rechargeable batteries such as.

0046The circuit element can adjust the power supplied to the appliance 10 from the auxiliary power supply 402 so that the battery 64 or other power source of the appliance 10 has an appropriate charge when using the appliance 10. Physically, the circuit element can be placed as a single element at any suitable location, including, for example, in the package 280, in the auxiliary power supply 402, or in the appliance. The connection 404 can be any suitable type of connection, including, for example, a direct wired connection, an inductive coupling, and the like. In inductive coupling, the connections 404 can include inductive elements in close proximity to each other. The current of the first inductive element can induce the current corresponding to the second inductive element and transmit power via the connection 404.

0047FIG. 17 shows an exemplary schematic diagram of an auxiliary power supply 402 connected to an instrument power supply 406 (eg, battery 64) via circuit element 410. The auxiliary power supply 402 can charge the power supply 406 of the appliance according to any suitable method or charging profile. For example, circuit element 410 may include a direct connection (eg, induction or wiring) between power supplies 402 and 406. The auxiliary power supply 402 can supply a charging current to charge the power supply 406, for example, if the charge of the power supply 406 of the device drops while the device 10 is stored. Further, for example, the auxiliary power supply 402 can supply a charging current based on the current state of the power supply of the appliance. As shown in FIG. 18, the circuit element 410 monitors the charge of the power supply 406 of the appliance and, when the charge of the power supply 406 reaches a predetermined threshold, 1 to supply current from the auxiliary power supply 402. Alternatively, it can include multiple switches 402 or resistors (not shown). The current supplied by the auxiliary power supply 402 can be regulated by various other means, including, for example, the microprocessor 414 and the switch network 416, as shown in FIG. The function of processor 444 can be accomplished by processor 306 described above or by any other control system of appliance 10.

0048According to various embodiments, the auxiliary power supply 402 can charge the device power supply 406 relatively quickly when using the device 10. For example, referring to FIG. 18, switch 412 can be left in the open position with instrument 10 and package 280 stored. Therefore, the charge of the power supply 406 of the appliance can be reduced. When using the appliance 10, switch 412 is closed, the auxiliary power supply 402 supplies the charging current to the power supply 406, and the power supply 406 is charged before use. For example, switch 412 can be configured to automatically close when package 280 is opened. In various embodiments, the switch can include tab 405 as shown in FIG. Tab 405 can be configured to be coupled to a portion of package 280 so that switch 412 is closed when this package 280 is opened. Also, for example, a doctor can pull the tab 450 to close the switch 412 and charge the power supply 406 when or before using the instrument 10.

0049As mentioned above, certain end effector cartridges 34 can have sensors or other electrical elements that require power. For example, FIG. 3 shows a cartridge 34 with a power supply 456. The power supply 456 can use any power supply suitable for operating the electronic components in the cartridge and / or end effector 12. For example, the power supply 456 can include a capacitor, a battery, and the like. The power supply 456 can be placed at any suitable location within the cartridge 34, including, for example, the distal end, as shown in FIG. 20 and of the thread 33 as shown in FIG. Can be part.

0050The end effector cartridge 34 can be stored and sterilized according to the method described above. For example, FIG. 20 shows a cartridge 34 sealed in package 450 for sterilization. As shown, package 450 also includes an auxiliary power supply 452. This auxiliary power supply can power the cartridge power supply 456. Like the power supply 402, the power supply 452 can charge or recharge the power supply 456 of the cartridge 34 to extend the storage life of the cartridge 34. The auxiliary power supply 452 can be connected to the cartridge 34 via a connection portion 454 and a circuit element similar to the circuit element described above (not shown). Auxiliary power supplies 452, circuit elements, and cartridge power supplies are connected to power supply 456 according to any suitable wired or wireless (eg, inductive) method, including, for example, the methods described with reference to FIGS. 17-19. 456 can be charged.

0051According to various embodiments, the cartridge power supply 456 can have a small capacitance. Therefore, it would be desirable not to use this charge unnecessarily. For example, the cartridge power supply 456 can be electrically isolated from the load until the cartridge 34 is ready for use. The cartridge 34 may include a cutoff switch or other circuit element that closes when the cartridge 34 is mounted within the end effector 12. When the cutoff switch is closed, the power supply 456 can be connected to its load (eg, any sensor or other powered electronic component provided on the cartridge 34).

0052The cutoff switch can be embodied in any suitable way. For example, as shown in FIG. 3, the cartridge 34 may include a corresponding recess 401 that, when secured within the grooved member 22, receives a protrusion (not shown) of the grooved member. .. The switch element can be arranged in such a recess 401. When the cartridge 34 is mounted in the grooved member 22, the protrusion is received in the recess 401, the cutoff switch closes, and the power supply 456 is connected to the load. FIG. 21 shows another embodiment of the cutoff switch. As shown, the cutoff switch can include a pair of electrical contacts 462 located on the side wall of the cartridge 34. When the cartridge 34 is mounted within the grooved member 22 (see FIG. 3), the contacts 462 are shorted by the conductive side wall of the grooved member 22, the switch closes, and the power supply 456 is connected to the load.

0053Although various embodiments of the present invention have been described using cutting surgical instruments, in other embodiments, the surgical instruments of the invention disclosed herein do not have to be cutting surgical instruments, but rather remote sensors. It should be understood that it can be used with all types of surgical instruments, including transponders. For example, the surgical instrument of the present invention is an uncut endoscopic instrument, a grasper, a stapler, a clip applier, an access device, a drug / gene therapy delivery device, and an energy device using ultrasonic waves, RF, laser, or the like. be able to. In addition, the present invention can be used, for example, in arthroscopic instruments.

0054The devices disclosed herein can be designed to be discarded in a single use or designed to be used multiple times. However, in either case, the device can be regenerated for reuse after at least one use. This regeneration can include any combination of disassembly steps of the device, subsequent cleaning or replacement steps of specific parts, and reassembly steps. Specifically, the device can be disassembled and then selectively replaced or removed in any combination of any number of specific parts of the device. Upon cleaning and / or replacement of certain parts, the device may be reassembled in refurbishment equipment immediately prior to surgery or by the surgical team for subsequent use. Those skilled in the art will appreciate that the regeneration of equipment can use a variety of techniques for disassembly, cleaning / replacement, and reassembly. The use of such techniques and the resulting remanufactured equipment is within the scope of this specification.

0055Although the present invention has been described using specific embodiments, various improvements and modifications can be made to these embodiments. For example, various types of end effectors can be used. In addition, although the materials of specific components have been disclosed, other materials can also be used. The above description and the appended claims shall include all such improvements and changes.

0056All or part of all patent documents, publications, or other disclosure materials that are referred to and incorporated herein by reference are the definitions, statements, or other disclosure materials that the material to be incorporated discloses in this specification. It shall be incorporated to the extent that it does not contradict. Accordingly, to the extent necessary, the disclosures expressly set forth herein are superseded by all contradictory material which is incorporated herein by reference. Although stated to be incorporated herein by reference, all or part of any material contrary to the definitions, statements, or other disclosures disclosed herein may cause conflict between the material to be incorporated and this Disclosure Material. It shall be incorporated to the extent that it does not exist.

0057[Implementation mode] (1) In the assembly Package and With the surgical instrument components in the package A power source in the package that is configured to be arranged to electrically communicate with the surgical instrument component. With the auxiliary power supply in the package Circuit elements that electrically communicate with the power supply and the auxiliary power supply, Including the assembly. (2) In the assembly according to embodiment (1), The package is sterilized, an assembly. (3) In the assembly according to embodiment (1). The power source is a battery, an assembly. (4) In the assembly according to embodiment (1), The battery is an assembly comprising at least one battery selected from the group consisting of lithium ion batteries and nickel metal hydride batteries. (5) In the assembly according to embodiment (1). The power source is a capacitor, an assembly.

0058(6) In the assembly according to embodiment (1), The circuit element is an assembly that includes a direct electrical connection between the power supply and the auxiliary power supply. (7) In the assembly according to embodiment (6), The assembly, wherein the direct electrical connection involves inductive coupling. (8) In the assembly according to embodiment (1), The circuit element is an assembly comprising a control circuit configured to control telecommunications between the power source and the auxiliary power source. (9) In the assembly according to embodiment (8), The control circuit is an assembly that includes a switch between the auxiliary power supply and the power supply. (10) In the assembly according to embodiment (9), The switch is an assembly configured to close when the package is opened.

0059(11) In the assembly according to embodiment (9), The switch is an assembly that includes removable tabs. (12) In the assembly according to embodiment (8). The control circuit is an assembly that includes a microprocessor. (13) In the assembly according to embodiment (12). An assembly in which the microprocessor is configured to control at least one component of the surgical instrument during use of the surgical instrument. (14) In the assembly according to embodiment (1). The surgical instrument component is an assembly that includes an end cutter. (15) In the assembly according to embodiment (1). The surgical instrument component is an assembly that includes an end cutter cartridge for the surgical instrument.

0060(16) In the assembly according to embodiment (1). An assembly in which the power source does not electrically communicate with the surgical instrument component. (17) In the assembly according to embodiment (1). The auxiliary power source is a zinc battery, Zn / alkaline / MnO.₂Battery, Li / MnO₂Battery, Zn / Ag₂O battery, Li / FeS₂An assembly that includes at least one battery selected from the group consisting of batteries. (18) In end effector cartridges for use in surgical instruments With electrical elements Power supply and When the end effector cartridge is mounted in a surgical instrument, a circuit element configured to electrically connect the power source and the electrical element. End effector cartridge, including. (19) In the end effector cartridge according to embodiment (18), The electrical element is an end effector cartridge comprising at least one sensor selected from the group consisting of passive sensors and active sensors. (20) In the end effector cartridge according to embodiment (18), The electrical element is an end effector cartridge that includes a radio frequency identification (RFID) element.

0061(21) In the end effector cartridge according to embodiment (18), The electrical element is configured to indicate the condition of the end effector cartridge, the type of end effector cartridge, and at least one of the group consisting of surgical instruments adapted to the end effector cartridge. (22) In the end effector cartridge according to embodiment (18), The circuit element comprises an end effector cartridge comprising a switch configured to close the electrical connection between the electrical element and the power source when the end effector cartridge is mounted within the surgical instrument. (23) In the end effector cartridge according to embodiment (18). An end effector cartridge comprising at least two electrodes, wherein the electrodes are electrically connected when the cartridge is mounted in a surgical instrument. (24) In the end effector cartridge according to embodiment (18). The circuit element comprises an end effector cartridge comprising a contact switch configured to operate when the end effector cartridge is mounted within the surgical instrument. (25) In the assembly Package and An end effector cartridge in the package that includes an electrical element. With the power supply in the package A circuit element within the package that is configured to electrically connect the power source and the electrical element when the end effector cartridge is mounted in a surgical instrument. Including the assembly.

0062(26) In the assembly according to embodiment (25). The package is sterilized, an assembly. (27) In the assembly according to embodiment (25). The circuit element comprises a switch configured to close the electrical connection between the electrical element and the power source when the end effector cartridge is mounted within the surgical instrument. (28) In the method of processing the end effector cartridge, The step of preparing the end effector cartridge according to the embodiment (18), and The step of sterilizing the end effector cartridge and The step of storing the end effector cartridge in a sterilization package and Including methods.

0063<figref num="1">FIG. 3 is a perspective view of a surgical instrument according to various embodiments of the present invention.</figref><figref num="2">FIG. 3 is a perspective view of a surgical instrument according to various embodiments of the present invention.</figref><figref num="3">It is an assembly exploded view of the end effector of the surgical instrument according to various embodiments of this invention.</figref><figref num="4">It is an assembly exploded view of the shaft of the surgical instrument according to various embodiments of this invention.</figref><figref num="5">It is an assembly exploded view of the end effector and the shaft of the surgical instrument according to various embodiments of this invention.</figref><figref num="6">It is a side view of the end effector according to various embodiments of this invention.</figref><figref num="7">It is an assembly exploded view of the handle of the surgical instrument according to various embodiments of this invention.</figref><figref num="8">FIG. 3 is a perspective view of a portion of a handle according to various embodiments of the present invention.</figref><figref num="9">FIG. 3 is a perspective view of a portion of a handle according to various embodiments of the present invention.</figref><figref num="10">It is a side view of the handle according to various embodiments of this invention.</figref><figref num="11">FIG. 3 is a perspective view of a surgical instrument according to various embodiments of the present invention.</figref><figref num="12">FIG. 3 is a block diagram of a control unit used in a surgical instrument according to various embodiments of the present invention.</figref><figref num="13">FIG. 5 is a side view of an end effector used in a surgical instrument according to various embodiments of the present invention.</figref><figref num="14">It is a figure which shows the surgical instrument in a sterilized container according to various embodiments of this invention.</figref><figref num="15">It is sectional drawing seen along line 15-15 of FIG.</figref><figref num="16">It is a figure which shows the surgical instrument in a sterilized container according to various embodiments of this invention.</figref><figref num="17">FIG. 6 is a schematic diagram of a circuit used in a surgical instrument according to various embodiments of the present invention.</figref><figref num="18">FIG. 6 is a schematic diagram of another circuit used in a surgical instrument according to various embodiments of the present invention.</figref><figref num="19">FIG. 6 is a schematic diagram of another circuit used in a surgical instrument according to various embodiments of the present invention.</figref><figref num="20">It is a figure which shows the component of the surgical instrument in a sterile package according to various embodiments of this invention.</figref><figref num="21">It is a figure which shows the component of the surgical instrument according to various embodiments of this invention.</figref>