Classifications

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Definitions

• Figure 12 is a graph depicting illustrative hyperspectral identifying signatures to differentiate a ureter from obscurants
• a surgical visualization system is configured to leverage “digital surgery” to obtain additional information about a patient’s anatomy and/or a surgical procedure.
• the surgical visualization system is further configured to convey data to one or more medical practitioners in a helpful manner.
• Various aspects of the present disclosure provide improved visualization of the patient’s anatomy and/or the surgical procedure, and/or use visualization to provide improved control of a surgical tool (also referred to herein as a “surgical device” or a “surgical instrument”).
• the tissue identification subsystem can be achieved with a spectral imaging system.
• the spectral imaging system can rely on imaging such as hyperspectral imaging, multispectral imaging, or selective spectral imaging.
• Embodiments of hyperspectral imaging of tissue are further described in U.S. Pat. No. 9,274,047 entitled “System And Method For Gross Anatomic Pathology Using Hyperspectral Imaging” issued March 1, 2016, which is hereby incorporated by reference in its entirety.
• the surgical visualization system 100 includes a control system configured to control various aspects of the surgical visualization system 100.
• Figure 4 illustrates one embodiment of a control system 133 that can be utilized as the control system of the surgical visualization system 100 (or other surgical visualization system described herein).
• the control system 133 includes a control circuit 132 configured to be in signal communication with a memory 134.
• the memory 134 is configured to store instructions executable by the control circuit 132, such as instructions to determine and/or recognize critical structures (e.g., the critical structure 101 of Figure 1), instructions to determine and/or compute one or more distances and/or three- dimensional digital representations, and instructions to communicate information to a medical practitioner.
• the image sensor 135 is a solid-state electronic device containing up to millions of discrete photodetector sites called pixels.
• the image sensor 135 technology falls into one of two categories: Charge-Coupled Device (CCD) and Complementary Metal Oxide Semiconductor (CMOS) imagers and more recently, short-wave infrared (SWIR) is an emerging technology in imaging.
• CCD Charge-Coupled Device
• CMOS Complementary Metal Oxide Semiconductor
• SWIR short-wave infrared
• Another type of the image sensor 135 employs a hybrid CCD/CMOS architecture (sold under the name “sCMOS”) and consists of CMOS readout integrated circuits (ROICs) that are bump bonded to a CCD imaging substrate.
• sCMOS hybrid CCD/CMOS architecture
• ROICs CMOS readout integrated circuits
• Figure 10 shows a graph 300 depicting how the absorption coefficient of various biological materials varies across the EMR wavelength spectrum.
• the vertical axis 302 represents absorption coefficient of the biological material in cm' 1
• the horizontal axis 304 represents EMR wavelength in pm.
• a first line 306 in the graph 300 represents the absorption coefficient of water at various EMR wavelengths
• a second line 308 represents the absorption coefficient of protein at various EMR wavelengths
• a third line 310 represents the absorption coefficient of melanin at various EMR wavelengths
• a fourth line 312 represents the absorption coefficient of deoxygenated hemoglobin at various EMR wavelengths
• a fifth line 314 represents the absorption coefficient of oxygenated hemoglobin at various EMR wavelengths
• a sixth line 316 represents the absorption coefficient of collagen at various EMR wavelengths.
• Different tissue types have different combinations of constituent materials and, therefore, the tissue type(s) being visualized by a surgical visualization system can be identified and differentiated between according to the particular combination of detected constituent materials.
• Tissues and/or structures can also be imaged or characterized according to their reflective characteristics, in addition to or in lieu of their absorptive characteristics described above with respect to Figure 10 and Figure 11, across the EMR wavelength spectrum.
• Figure 12, Figure 13, and Figure 14 illustrate various graphs of reflectance of different types of tissues or structures across different EMR wavelengths.
• Figure 12 is a graphical representation 340 of an illustrative ureter signature versus obscurants.
• Figure 13 is a graphical representation 342 of an illustrative artery signature versus obscurants.
• Figure 14 is a graphical representation 344 of an illustrative nerve signature versus obscurants.
• Figure 17 illustrates another embodiment of a time-of-flight sensor system 504 utilizing waves 524a, 524b, 524c, 525a, 525b, 525c is shown.
• the surgical system 702 can include an M number of hubs 706, an N number of visualization systems 708, an O number of robotic systems 710, and a P number of intelligent surgical instruments 712, where M, N, O, and P are integers greater than or equal to one that may or may not be equal to any one or more of each other.
• M, N, O, and P are integers greater than or equal to one that may or may not be equal to any one or more of each other.
• the surgical hub can be configured to cause visualization of the received data to be provided in the surgical setting on a display so that a medical practitioner in the surgical setting can view the data and thereby receive an understanding of the operation of the imaging device(s) in use in the surgical setting.
• information provided via visualization can include text and/or images.
• the algorithm is stored in the form of one or more sets of pluralities of data points defining and/or representing instructions, notifications, signals, etc. to control functions of the intelligent surgical device.
• data gathered by the intelligent surgical device can be used by the intelligent surgical device, e.g., by a processor of the intelligent surgical device, to change at least one variable parameter of the algorithm.
• a surgical hub can be in communication with an intelligent surgical device, so data gathered by the intelligent surgical device can be communicated to the surgical hub and/or data gathered by another device in communication with the surgical hub can be communicated to the surgical hub, and data can be communicated from the surgical hub to the intelligent surgical device.
• the surgical instrument 900 also includes a communications interface 908, e.g., a wireless transceiver or other wired or wireless communications interface, configured to communicate with another device, such as a surgical hub 910.
• the communications interface 908 can be configured to allow one-way communication, such as providing data to a remote server (e.g., a cloud server or other server) and/or to a local, surgical hub server, and/or receiving instructions or commands from a remote server and/or a local, surgical hub server, or two-way communication, such as providing information, messages, data, etc. regarding the surgical instrument 900 and/or data stored thereon and receiving instructions, such as from a doctor; a remote server regarding updates to software; a local, surgical hub server regarding updates to software; etc.
• a remote server e.g., a cloud server or other server
• two-way communication such as providing information, messages, data, etc. regarding the surgical instrument 900 and/or data stored thereon and receiving instructions, such as from a doctor; a remote server regarding
• Another benefit includes proactively and automatically controlling modular devices according to the particular step of the surgical procedure that is being performed to reduce the number of times that medical practitioners are required to interact with or control the surgical system during the course of a surgical procedure, such as by a situationally aware surgical hub proactively activating a generator to which an RF electrosurgical instrument is connected if it determines that a subsequent step of the procedure requires the use of the instrument. Proactively activating the energy source allows the instrument to be ready for use a soon as the preceding step of the procedure is completed.
• the laparoscope 10414 includes the second optical sensor 10458.
• the second optical sensor 10458 is configured to transmit image data of a second scene within a field of view of the laparoscope 10414 to the controller 10470.
• the surgical instrument 10462 is arranged within the field of view of the laparoscope 10414.
• the controller 10470 based on the transmitted image data, can determine the relative distance between the surgical instrument 10462 and the surgical instrument 10432.
• Figure 26a illustrates an exemplary embodiment of a merged image.
• the first scope device 10512 is further inserted through a lumen of a sealing port 10540, with the sealing port 10540 being arranged within a wall 10506 of the colon 10502, and into a colon cavity 10507 (e.g., intraluminal anatomical space).
• the first scope device 10512 can be inserted into and through the first trocar 10536 and sealing port 10540 such that a first portion 10512a of the first scope device 10512 is present in the abdominal cavity 10505 (e.g., an extraluminal anatomical space), and a second portion 10512b of the first scope device 10512 that is distal to the first portion 10512a is positioned in the colon cavity 10507 (e.g., an intraluminal anatomical space).
• the first and second imaging systems 10528, 10558 are connected to one or more displays that provide a snapshot and/or a live video feed of the surgical site(s).
• the snapshot and/or live video feed on the displays can permit a medical practitioner to observe a surgical site from multiple angles and approaches, for example.
• the first and second imaging systems 10528, 10558 can provide information to the medical practitioner that can be used in determining effective working volume spaces for the first and second instruments for a particular surgical task or step or throughout the entire surgical procedure and what, if any, adjustments need to be made to the first insufflated space, the second insufflated space, or both.

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• 2022
  • 2022-09-26 EP EP22786489.9A patent/EP4262574A1/de active Pending
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