Abstract: A surgical instrument, has an end effector that includes an ultrasonic blade, and a clamp arm that moves relative to the ultrasonic blade from an opened position toward an intermediate position and a closed position. The clamp arm is offset from the ultrasonic blade to define a predetermined gap in the intermediate position between the opened position and the closed position. A clamp arm actuator connects to the clamp arm and moves from an opened configuration to a closed configuration to direct the clamp arm from the opened position toward the intermediate position and the closed position. A spacer connects with the clamp arm to inhibit movement of the clamp arm from the intermediate position toward the closed position for maintaining the predetermined gap between the clamp arm and the ultrasonic blade.

Abstract: A method of distributing data among members of a surgical team may include receiving imaging data, by a modular control tower, from a plurality of imaging devices, receiving device-dependent data, by the modular control tower, from each of a plurality of intelligent surgical instruments, associating, by the modular control tower, a display device with a member of the surgical team, defining, by the modular control tower, a functional role for the member of the surgical team, and displaying, by the modular control tower, a augmented reality display by the display device. The augmented reality display on the display device may include virtual objects based on the imaging data, the device-dependent data, the functional role of the member of the surgical team, and a surgical activity by the member of the surgical team. An interactive surgical system may implement this method.

Abstract: Disclosed is a surgical instrument with an end-effector adapted and configured to deliver a plurality of energy modalities to tissue at a distal end thereof. The energy modalities may be applied simultaneously, independently, or sequentially. A generator is electrically coupled to the surgical instrument and is configured to supply a plurality of energy modalities to the end-effector. In one aspect, the generator is configured to supply electrosurgical energy (e.g., monopolar or bipolar radio frequency (RF) energy) and ultrasonic energy to the end-effector to allow the end-effector to interact with the tissue. The energy modalities may be supplied to the end-effector by a single generator or multiple generators.

Abstract: One or more data streams may be used for controlling multi-system interaction. For example, a data stream may be received, and a surgical option associated with a surgical instrument may be selected based on the data stream. A control signal associated with the surgical instrument may be generated based on the selected surgical option. A surgical device may receive an external data stream from a source external to the surgical system. The device may derive, based at least on the external data stream, decision contextual information. The device may select a surgical option associated with a surgical instrument based on the decision context information. The device may generate a visual indication of the decision context information associated with selecting the surgical option. The device may generate a control signal associated with the surgical instrument based on the selected surgical option.

Abstract: A surgical system may include a processor configured to make a determination that a data stream is invalid. The processor may be further configured to obtain a data stream associated with a measurement from a surgical device. The processor may be further configured to generate a first control signal associated with the surgical device based on the data stream. The processor may be further configured to detect that the data stream is invalid. Upon detecting that the data stream is invalid, the processor may be further configured to determine an approximation factor associated with the data stream. The processor may be further configured to generate a second control signal associated with the surgical device based on the determined approximation factor.

Abstract: Device and methods for visualization of automated surgical system decisions. An example device may select a candidate action to perform based on steps of a surgical procedure and the effects of the candidate action. The effects may include whether the candidate action will impair the ability of a surgical instrument to perform a later step in the procedure. The candidate action may involve initial device placement, device movements, port placement, and/or the like.

Abstract: Devices and method for visualizing effects of device movements in an operating room. The device may identify candidate motions of a first robotic arm configured to place a first end effector in a target end effector position internal to a patient. The device may determine, for a first candidate motion, a first number of associated interactions in which the first robotic arm and a second robotic arm will co-occupy space external to the patient. The device may determine, for a second candidate motion, a second number of associated interactions in which the first robotic arm and the second robotic arm will co-occupy space external to the patient. The device may select the first candidate motion or the second candidate motion based on the first and second number of interactions. The device may generate a control signal based on the selected candidate motion of the first robotic arm.

Abstract: A surgical system may include a processor configured to obtain an input control data stream associated with a measurement. The input control data stream may be associated with a control loop of the surgical system. The processor may be further configured to determine an importance factor of a condition associated with a patient. The processor may be further configured to generate a response reaction based on the input control data stream and the importance factor of the condition associated with the patient. The processor may be further configured to determine a reaction time between an instant of the input control data stream causes a response reaction to be generated. The processor may be further configured to modify the response reaction based on the generated response reaction.

Abstract: A surgical system may include a processor configured to make a determination between two seemingly accurate but conflicting data streams. The processor may be further configured to obtain a first data stream and a second data stream associated with a same measurement. The processor may be further configured to determine a first control parameter based at least in part on the first data stream. The processor may be further configured to determine a second control parameter based at least in part on a second data stream. The processor may be further configured to compare the first control parameter and the second parameter. The processor may be further configured to select a data stream between the first data stream and the second data stream based on the comparing. The processor may be further configured to generate a control signal based on the selected data stream.

Abstract: Systems, methods, and/or instrumentalities disclosed herein may determine a problem-solving level based on the balance of unknowns and data streams. The device may receive a first dataflow from a first surgical element. The device may determine that a physiological parameter of the patient exceeds a patient safety threshold. The device may determine a second dataflow associated with a second surgical element. The determination may be based on an indication of a relational link. The device may transmit a configuration message including an indication that the physiological parameter of the patient exceeded the patient safety threshold. The device may transmit, to the second surgical element, a control message including an indication of the control data associated with the first surgical element. The device may cause the output characteristic associated with the second surgical element to be adjusted based on the control data associated with the first surgical element.

Abstract: Systems, methods, and/or instrumentalities disclosed herein may augment dataflows to rebalance the number of unknowns and dataflows. The device may be configured to receive a first dataflow from a first surgical element. The first dataflow may be associated with a physiological parameter of a patient. The device may determine that the first dataflow from the first surgical element is erroneous. The device may determine a second dataflow associated with a second surgical element. The determination of the second dataflow may be based on an indication of a relational link associated with the second dataflow of the second surgical element, control data for the first surgical element, and/or the physiological parameter of the patient. The device may generate control data for the first surgical element based on the second dataflow. The control data may indicate an adjustment to an output characteristic associated with the first surgical element.

Abstract: A surgical system may include a processor configured to make a determination between two seemingly accurate but conflicting data streams. The processor may be further configured to obtain a first data stream associated with a measurement. The first data stream may be associated with a first control loop of the surgical system. The processor may be further configured to obtain a second data stream associated with the measurement. The second data stream may be associated with a second control loop of the surgical system. The processor may be further configured to determine that the first control loop and the second control loop are diverging. The processor may be further configured to generate a control signal based on the first and second data streams.

Abstract: Devices and methods for visualizing effects of device placement in an operating room. An example device may determine a fixed position of a first base attached to a first robotic arm. The device may determine based on the fixed position of the first base, that a first candidate position of a second base is associated with a first number of interactions in which the first robotic arm and a second robotic arm attached to the second base will co-occupy space. The device may determine, based on the fixed position of the first base, that a second candidate position of the second base is associated with a second number of interactions in which the first robotic arm and the second robotic arm will co-occupy space. The device may select the first candidate position or the second candidate position based on the first number of interactions and the second number of interactions.

Abstract: Device and methods for visualizing internal processes of an automated operation. An example device may receive an external data stream from a source external to the surgical system. The device may derive, based at least on the external data stream, decision contextual information. The device may select a surgical option associated with a surgical instrument based on the decision context information. The device may generate a visual indication of the decision context information associated with selecting the surgical option. The device may generate a control signal associated with the surgical instrument based on the selected surgical option.

Abstract: Device and methods for displaying complex and conflicting interrelated data streams. An example device may receive a first biomarker value associated with a first biomarker in a first data stream and a second biomarker value associated with a second biomarker in a second data stream. The device may determine, based on the first biomarker value and the second biomarker value, that a close-loop control condition associated with a control parameter for the surgical device is failed. Based on determining that the close-loop control condition is failed, the device may identify an intraoperative metric associated with the first data stream and the second data stream. The device may generate a control signal configured to display a value associated with the intraoperative metric.

Abstract: Various aspects of a generator, ultrasonic device, and method for estimating a state of an end effector of an ultrasonic device are disclosed. The ultrasonic device includes an electromechanical ultrasonic system defined by a predetermined resonant frequency, including an ultrasonic transducer coupled to an ultrasonic blade. A control circuit measures a complex impedance of an ultrasonic transducer, wherein the complex impedance is defined as Zg(t)=Vg(t)/Ig(t). The control circuit receives a complex impedance measurement data point and compares the complex impedance measurement data point to a data point in a reference complex impedance characteristic pattern. The control circuit then classifies the complex impedance measurement data point based on a result of the comparison analysis and assigns a state or condition of the end effector based on the result of the comparison analysis.

Abstract: A surgical instrument, has an end effector that includes an ultrasonic blade, and a clamp arm that moves relative to the ultrasonic blade from an opened position toward an intermediate position and a closed position. The clamp arm is offset from the ultrasonic blade to define a predetermined gap in the intermediate position between the opened position and the closed position. A clamp arm actuator connects to the clamp arm and moves from an opened configuration to a closed configuration to direct the clamp arm from the opened position toward the intermediate position and the closed position. A spacer connects with the clamp arm to inhibit movement of the clamp arm from the intermediate position toward the closed position for maintaining the predetermined gap between the clamp arm and the ultrasonic blade.

Abstract: An end-effector is disclosed. The end-effector includes a clamp arm and an ultrasonic blade configured to acoustically couple to an ultrasonic transducer and electrically couple to a pole of an electrical generator. The clamp arm includes a clamp jaw and an electrode configured to electrically couple to an opposite pole of the electrical generator. In one configuration, the electrode is segmented. In another configuration, the ultrasonic blade includes electrically insulative material deposited on selected areas to prevent electrical shorting in the event of the ultrasonic blade contacts the electrode. In another configuration, the clamp arm, the ultrasonic blade, or both include selectively coated components.

Abstract: Various aspects of a generator, ultrasonic device, and method for estimating a state of an end effector of an ultrasonic device are disclosed. The ultrasonic device includes an electromechanical ultrasonic system defined by a predetermined resonant frequency, including an ultrasonic transducer coupled to an ultrasonic blade. A control circuit measures a complex impedance of an ultrasonic transducer, wherein the complex impedance is defined as Z g ( t ) = V g ( t ) I g ( t ) . The control circuit receives a complex impedance measurement data point and compares the complex impedance measurement data point to a data point in a reference complex impedance characteristic pattern. The control circuit then classifies the complex impedance measurement data point based on a result of the comparison analysis and assigns a state or condition of the end effector based on the result of the comparison analysis.

Abstract: A modular surgical instrument system that comprises modular components and a control circuit electrically couplable to the modular components. The modular components comprise a shaft and a handle assembly. The handle assembly comprises a disposable outer housing. The disposable outer housing is movable between an open configuration and a closed configuration. The handle assembly further comprises a control inner core receivable inside the disposable outer housing in the open configuration. The disposable outer housing is configured to isolate the control inner core in the closed configuration. The modular components further comprise a loading unit releasably couplable to the shaft and a staple cartridge releasably couplable to an end effector. The loading unit comprises the end effector.