SURGICAL DEVICES, SYSTEMS, AND METHODS INCLUDING ADAPTIVE CONTROL

A surgical system having adaptive control includes a surgical cutting device, at least one sensor, and a controller. The surgical cutting device includes a cutting tool and a motor configured to drive movement of the cutting tool. The at least one sensor is configured to produce sensor data indicative of at least one property of the surgical cutting device during use. The controller is configured to receive the sensor data and determine a performance condition of the surgical cutting device based at least on the sensor data. The controller is further configured, where the determined performance condition is an adverse performance condition, to at least one of: adjust settings of the surgical cutting device or recommend a change relating to use of the surgical cutting device.

FIELD

The present disclosure relates to surgical devices, systems, and methods and, more particularly, to surgical devices, systems, and methods including adaptive control.

BACKGROUND

Powered surgical cutting devices and systems are utilized in a wide variety of surgical procedures to perform various different surgical cutting functions including, for example, drilling, tapping, resection, dissection, debridement, shaving, sawing, pulverizing, and/or shaping of anatomical tissue including bone.

Many of such powered surgical cutting devices and systems are precisely designed to ensure the device functions safely and effectively. However, regardless of the precision of design, situations may be encountered during use that result in erratic performance, loss of stability, reduced efficiency or effectiveness, and/or other adverse conditions.

SUMMARY

As used herein, the term “distal” refers to the portion that is being described which is farther from an operator (whether a human surgeon or a surgical robot), while the term “proximal” refers to the portion that is being described which is closer to the operator. Terms including “generally,” “about,” “substantially,” and the like, as utilized herein, are meant to encompass variations, e.g., manufacturing tolerances, material tolerances, use and environmental tolerances, measurement variations, design variations, and/or other variations, up to and including plus or minus 10 percent (or greater, depending upon industry standards). To the extent consistent, any of the aspects described herein may be used in conjunction with any or all of the other aspects described herein.

Provided in accordance with aspects of the present disclosure is a surgical system having adaptive control. The surgical system includes a surgical cutting device, at least one sensor, and a controller. The surgical cutting device includes a cutting tool and a motor configured to drive movement of the cutting tool. The at least one sensor is configured to produce sensor data indicative of at least one property of the surgical cutting device during use. The controller is configured to receive the sensor data and determine a performance condition of the surgical cutting device based at least on the sensor data. The controller is further configured, where the determined performance condition is an adverse performance condition, to at least one of: adjust settings of the surgical cutting device or recommend a change relating to use of the surgical cutting device.

In an aspect of the present disclosure, the controller is further configured to receive other data and to determine the performance condition based at least on the sensor data and the other data. The other data may include, in aspects, identifying data, patient data, and/or procedure data.

In another aspect of the present disclosure, the determined performance condition includes at least one of a stability condition or an efficiency condition. Additionally or alternatively, the determined performance condition may be a binary determination or a scaled determination.

In still another aspect of the present disclosure, the controller is configured, where the determined performance condition is an adverse performance condition, to adjust settings of the surgical cutting device by adjusting at least one of: a speed of the motor; a torque of the motor; an operating mode; or a performance impacting component such as a dampening component (e.g., a position, property, etc. of the dampening component or other performance impacting component) of the surgical cutting device.

In yet another aspect of the present disclosure, the controller is configured, where the determined performance condition is an adverse performance condition, to recommend a change relating to use of the surgical cutting device by recommending: a change in ergonomic position, a change in technique, a manual change to a performance impacting component such as a dampening component (e.g., a position, property, etc. of the dampening component or other performance impacting component) of the surgical cutting device; or changing to a different surgical cutting device or portion thereof.

In still yet another aspect of the present disclosure, the at least one sensor includes at least one of: a vibration sensor, a position sensor, an acceleration sensor, an optical sensor, an audio sensor, a force sensor, a temperature sensor, and/or a motor electrical property sensor.

In another aspect of the present disclosure, the surgical cutting device further includes a handle housing the motor therein and a shaft assembly coupled to the handle and including an outer sleeve. The cutting tool, in such aspects, extends through the outer sleeve of the shaft assembly. In these aspects, the at least one sensor may be disposed on or within at least one of: the handle, the outer sleeve, or the cutting tool.

In yet another aspect of the present disclosure, the controller is configured to operate in near real time, e.g., to determine the performance condition and, where the determined performance condition is an adverse performance condition, at least one of: adjust or recommend.

In still another aspect of the present disclosure, the surgical system includes a console configured to supply power and control signals to the surgical cutting device. In such aspects, the controller is disposed within the console.

In still yet another aspect of the present disclosure, the controller is configured to implement at least one machine learning algorithm to determine the performance condition.

A method of adaptive control of a surgical system provided in accordance with the present disclosure includes: driving a motor to move a cutting tool of a surgical cutting device to cut tissue; monitoring, during the cutting of the tissue, sensor data indicative of at least one property of the surgical cutting device; determining a performance condition of the surgical cutting device based at least on the sensor data; and where the determined performance condition is an adverse performance condition, at least one of: adjusting settings of the surgical cutting device or recommending a change relating to use of the surgical cutting device.

In an aspect of the present disclosure, the method further includes receiving other data including at least one of: identifying data, patient data, or procedure data. The performance condition, in such aspects, is determined based at least on the sensor data and the other data.

In another aspect of the present disclosure, the determined performance condition includes at least one of a stability condition or an efficiency condition.

In still another aspect of the present disclosure, where the determined performance condition is an adverse performance condition, the settings of the surgical cutting device are adjusted by adjusting at least one of: a speed of the motor; a torque of the motor; an operating mode; or a performance impacting component such as a dampening component (e.g., a position, property, etc. of the dampening component or other performance impacting component) of the surgical cutting device.

In yet another aspect of the present disclosure, where the determined performance condition is an adverse performance condition, a change relating to use of the surgical cutting device is recommended by recommending: a change in ergonomic position, a change in technique, a manual change to a performance impacting component such as a dampening component (e.g., a position, property, etc. of the dampening component or other performance impacting component) of the surgical cutting device; or changing to a different surgical cutting device or portion thereof.

In still yet another aspect of the present disclosure, the sensor data includes at least one of: vibration data, position data, acceleration data, optical data, audio data, force data, temperature data, and/or motor electrical property data.

DETAILED DESCRIPTION

Turning toFIG.1, a surgical system10provided in accordance with the present disclosure includes a console100and one or more surgical cutting devices300. Console100may include an outer housing110enclosing the internal operable components of console100, a touch screen graphical user interface (GUI)120to receive user input and display information to the user, a plurality of device ports130, one or more fluid pumps140, and/or other suitable features. One or more controllers600(seeFIG.6) including one or more processors and associated memory(s) are disposed within outer housing110and function to provide power and control signals to devices connected to console100; to process user inputs, feedback data, and other data received at console100; and to control the one or more fluid pumps140. Suitable hardware and drive mechanisms as part of or in addition to controller600(FIG.6) may be disposed within outer housing110to perform the various functions of console100and may include, for example, one or more central processing units (CPU's) and/or microcontroller units (MCU's), power generating and control hardware and corresponding firmware/software stored thereon, sensor circuitry, motors, pump drivers, pump controllers, etc.

The one or more surgical cutting devices300may define any suitable configurations for use in performing various different surgical tasks, for use in various different procedures, etc. One example of a suitable surgical cutting device, surgical cutting device300, generally includes a handle310, a shaft assembly320extending distally from handle310(releasably or integrally connected thereto), a cutting tool330extending distally from shaft assembly320310(releasably or integrally connected thereto), a motor340disposed within handle310and operably coupled to cutting tool330to drive rotation and/or reciprocation of cutting tool330relative to shaft assembly320to cut tissue, and a cord350to connect motor340to console100to enable console100to power and control motor340, thereby controlling cutting tool330. In aspects, shaft assembly320includes a rotation collar322that is rotatable relative to handle310to advance or retract (depending upon the direction of rotation of rotation collar322) an outer sleeve324of shaft assembly320relative to cutting tool330to expose more or less of cutting tool330at the distal end of outer sleeve324. Motor340may be an electric motor, pneumatic motor, ultrasonic transducer, or other suitable motor configured to drive cutting tool330to rotate and/or reciprocate for cutting tissue. Console100is configured to drive and control motor340such as, for example, a speed, torque, etc. output by motor340. In aspects, surgical cutting device300may include additional features such as, for example, hand control(s), navigation, articulation, etc.

Cutting tool330may define any suitable configuration and may be integrated with surgical cutting device300or removable therefrom. More specifically, and with additional reference toFIG.2, various different rotational cutting tools332may be configured for releasable attachment with surgical cutting device300. In aspects, rotational cutting tools332are releasably engagable with shaft assembly320(which, in turn, may be releasably or integrally connected to handle310). Alternatively, rotational cutting tools332may be integral with corresponding shaft assemblies320that are, in turn, releasably engagable with handle310. In either configuration, surgical cutting device300is thus capable of being interchangeably customized with a particular rotational cutting tool332, depending upon a particular purpose. Reciprocating cutting tools and/or cutting tools configured for both rotation and reciprocation are also contemplated.

With reference toFIGS.3A-3C, in addition or as an alternative to rotational cutting tools332(FIG.2), handle310may releasably or integrally connect to a shaft assembly322a,322b,322cincluding a respective saw cutting tool334a,334b,334cconfigured for longitudinal reciprocating motion along a longitudinal axis of the shaft assembly322a, oscillating motion about an axis substantially parallel to a longitudinal axis of the shaft assembly322b, or oscillating motion about an axis substantially perpendicular to a longitudinal axis of the shaft assembly322c, respectively. Other suitable saw cutting tools are also contemplated.

Referring toFIGS.4and5, shaft assembly320of surgical cutting device300(FIG.1) is shown including cutting tool330extending distally therefrom. Although detailed with respect to shaft assembly320and cutting tool330, the aspects and features of the present disclosure detailed below are equally applicable for use with the other shaft assemblies and cutting tools detailed herein or any other suitable shaft assemblies and/or cutting tools.

Shaft assembly320includes, as noted above, rotation collar322and outer sleeve324, and further includes a proximal hub326configured to releasably (or, in other aspects, integrally) connect shaft assembly320to handle310(FIG.1) and a plurality of bearings328configured to movably support cutting tool330within outer sleeve324, thus permitting rotation and/or translation of cutting tool330relative to outer sleeve324to cut tissue. Rotation collar322operably engages outer sleeve324with proximal hub326(and, thus, handle310(FIG.1)) via a lead screw coupling323such that, as noted above, rotation of rotation collar322advances or retracts outer sleeve324about and relative to cutting tool330. Although this adjustment, e.g., advancement and retraction, of outer sleeve324relative to cutting tool330is shown and described as a manual adjustment, it is also contemplated that motor340(FIG.1) or a separate motor may be utilized to provide powered (and, in aspects, automatic) adjustment, e.g., advancement and retraction, of outer sleeve324relative to cutting tool330.

Cutting tool330extends through outer sleeve324and may be configured for direct or indirect coupling with motor340(FIG.1) to enable rotational, reciprocating, and/or other motional driving of cutting tool330. Cutting tool330further includes a distal working tip334that extends distally from outer sleeve324. Distal working tip334may define any suitable configuration such as, without limitation, those illustrated inFIG.2.

Continuing with reference toFIGS.4and5, and with additional reference toFIG.1, surgical cutting device300may include one or more sensors350disposed at various different locations on or within one or more of the components or assemblies of surgical cutting device300. The one or more sensors350may include: vibration or inertial sensors such as piezoelectric sensors, accelerometers, gyroscopes, magnetometers, or combinations thereof (e.g., to monitor vibration/motion of cutting tool330and/or outer sleeve324); position or displacement sensors such as optical and/or laser sensors for obtaining displacement, position, and/or vibration data; force sensors (e.g., to monitor force, torque, and/or strain on cutting tool330and/or outer sleeve324); audio sensors (e.g., to monitor noise produced by surgical cutting device300and/or components thereof, at the interface between cutting tool330and tissue, etc.); electrical property sensors (e.g., sensors configured to monitor current (such as motor current), impedance, voltage, power, chances thereof, etc.); and/or temperature sensors (e.g., to monitor the temperature of surgical cutting device300and/or components thereof, at the interface between cutting tool330and tissue, etc.). Other suitable sensors are also contemplated. In aspects, a single sensor350is provided. In other aspects, a plurality of sensors350of the same type are provided at various locations on or within surgical cutting device300. In still other aspects, one or more sensors350of a first type and one or more sensors350of a second, different type are provided at the same and/or different locations on or within surgical cutting device300.

With respect to the location(s) of sensor(s)350on or within surgical cutting device300, a sensor350may be disposed, for example and as shown inFIGS.4and5: on or within rotation collar322; on or within outer sleeve324(towards the proximal end, distal end, and/or at an intermediate location of outer sleeve324); between outer sleeve324and cutting tool330; on or within proximal hub326; coupled to or incorporated within a bearing328; on or within cutting tool330(within outer sleeve324and/or on or within exposed portion of cutting tool330; towards the proximal end, distal end, and/or at an intermediate location of cutting tool330); on or within a drive rotor342of motor340(FIG.1) that is driven by motor340(FIG.1) to, in turn, drive movement of cutting tool330; and/or associated with motor340(FIG.1) and/or the electrical inputs thereto (whether disposed on or within motor340(FIG.1) or remote therefrom such as, for example, within console100(FIG.1)). A sensor350may be provided at any other suitable location. In particular, a sensor350may be provided at a location that experiences detectable changes in the property to be sensed depending upon the performance condition of surgical cutting device300. For example, temperature sensors, vibration sensors, and/or force sensors may be disposed at respective locations that tend to heat up, vibrate more, and/or experience increased forces when surgical cutting device300is operating in an unstable condition as compared to a normal condition.

Suitable electrical wires, electrically conductive structures, electrical traces, contacts, wireless connection interfaces, combinations thereof, etc. (not explicitly shown) are provide on or within surgical cutting device300(and/or the components thereof) to electrically couple the one or more sensors350with console100.

Regardless of the particular type and/or location of the one or more sensors350, the one or more sensors350are configured to provide data indicative of one or more properties of surgical cutting device300that, alone or in combination with feedback from additional sensors350, other sensors associated with or separate from surgical cutting device300, data input by a user, input read/received from components of surgical cutting device300or other devices, and/or other data, enables determination of a performance condition of surgical cutting device300. The performance condition of surgical cutting device300may include, for example, stability and/or efficiency. With respect to stability, the sensor data and, in aspects, additional data, may be utilized to determine a stability of surgical cutting device300during use (and, in aspects, in real time). The stability may be a binary output, e.g., whether the surgical cutting device300is operating in a stable manner or an unstable manner. Alternatively, the stability may be provided as a level of stability, for example, on a numerical scale (e.g., stability on a scale of 1-10 or 1-100) or on a symbolic scale (e.g., stability indicated as green, yellow, or red). Sensor data indicative of stability of surgical cutting device300that may be utilized to determine the stability performance condition includes, for example and without limitation: vibration or motion data; force, torque, and/or strain data; audio data; and/or temperature data.

With respect to efficiency, the sensor data and, in aspects, additional data, may be utilized to determine an efficiency of surgical cutting device300during use (and, in aspects, in real time). The efficiency may be a binary output, e.g., whether the surgical cutting device300is operating in an efficient manner or an inefficient manner. Alternatively, the stability may be provided as a level of efficiency, for example, on a numerical scale (e.g., efficiency on a scale of 1-10 or 1-100) or on a symbolic scale (e.g., efficiency indicated as green, yellow, or red). Sensor data indicative of efficiency of surgical cutting device300that may be utilized to determine the efficiency performance condition includes, for example and without limitation: vibration or motion data; force, torque, and/or strain data; and/or electrical properties.

Other sensors associated with or separate from surgical cutting device300that may provide data suitable for use in determining the performance condition of surgical cutting device300include, for example and without limitation, an image sensor to enable real time imaging, e.g., video imaging, thermal imaging, ultrasound imaging, etc., of a field of view including at least cutting tool330and/or tissue being cut with cutting tool330; an electrical impedance and/or other electrical characteristic sensor, e.g., to measure tissue electrical conductivity (and/or other electrical properties) of tissue being cut; a force/pressure sensor, e.g., to measure force or pressure applied to tissue being cut); and/or other suitable sensors. Such sensors may enable, for example, determination of properties of the tissue being cut and/or to enable determination of the type of tissue being cut. Determination of properties of tissue being cut include tissue category (soft tissue or hard tissue), tissue thickness, tissue density, tissue condition (healthy or diseased), transitions between tissues (e.g., tissue layers, between types of tissue, etc. entry or exit to/from anatomical cavities), etc. Determination of the type of tissue being cut includes determination of whether the tissue is, for example, bone, cartilage, muscle, organ, etc.

Referring still toFIGS.1,4, and5, data regarding properties of the tissue being cut and/or the type of tissue being cut may be utilized together with the data from the one or more sensors350to determine the performance condition of surgical cutting device300during use. More specifically, because surgical cutting device300may exhibit different properties when cutting tissue having different properties and/or tissues of different type (such as, for example, where surgical cutting device300generates more heat and vibration when cutting bone or harder tissue as compared to cartilage or softer tissue, or where a spike in motor current occurs in response to transitioning from cutting soft tissue to cutting hard tissue), data regarding the properties and/or types of tissue being cut can be utilized to contextualize the data provided by sensors350. For example, temperatures, amplitudes of vibration, and/or motor currents, or changes thereof, may be typical for cutting one type of tissue or tissue with certain properties; however, the same temperatures, amplitudes of vibration, and/or motor currents, or changes thereof, may indicate instability and/or inefficiency when exhibited during cutting of another type of tissue or tissue with other properties.

Other data which may be utilized to facilitate determination of the performance condition of surgical cutting device300during use may include data input by a user, input read/received from components or devices, and/or other data. This data may include data relating to surgical cutting device300and/or components thereof (e.g., the attached shaft assembly320and/or cutting tool330) including, for example and without limitation: device/component ID; device/component type; device/component lot number; device/component manufacture date; surgeon and/or hospital data; patient data; procedure data; etc. Because surgical cutting device300may exhibit different properties when cutting tissue depending upon the type, age, and/or configuration of surgical cutting device300(and/or the components thereof), the technique utilized, the approach taken, the experience of the surgeon, the type of procedure being performed, and/or the condition and/or anatomy of the patient, such data can be utilized to contextualize the data provided by sensors350.

For example, forces, strains, and/or torques, or changes thereof, encountered during use of surgical cutting device300may be typical for one procedure or technique; however, the same forces, strains, and/or torques, or changes thereof, may indicate instability and/or inefficiency when exhibited during cutting of tissue in another procedure or using another technique. As another example, temperatures, amplitudes of vibration, and/or motor currents, or changes thereof, may be typical when one type and/or age of cutting tool330, shaft assembly320, and/or handle310is utilized; however, the same temperatures, amplitudes of vibration, and/or motor currents, or changes thereof, may indicate instability and/or inefficiency when exhibited during use of another type and/or age of cutting tool330, shaft assembly320, and/or handle310.

In aspects, in order to read/write at least some of the other data noted above, some or all components of surgical cutting device300, e.g., handle310, shaft assembly320, and/or cutting tool330, include RFID or other suitable communication chips (not explicitly shown) having memories storing data. For example, handle310, shaft assembly320, and/or cutting tool330may include memories, e.g., read-only memories, storing identifying data that can be read by console100(e.g., unique ID, device/component type, lot number, manufacture date, configuration data, features, components, and/or settings). Handle310, shaft assembly320, and/or cutting tool330may additionally or alternatively include memories, e.g., read/write memories, that can be read and/or written to by console100storing, for example, a use count, a sterilization count, usage data, an event/error log, use and/or operational flags, etc. Data transmitted to/from surgical cutting device300(and/or components thereof) may be transmitted via a wired or wireless network or in any other suitable manner for storage in a remote server (including cloud servers) to enable managing and tracking such information. Further, rather than on-board memories, surgical cutting device300(and/or components thereof) may include barcodes or other identifiers to enable association of data thereof with the surgical cutting device300(and/or components thereof), thereby enabling management and tracking at the remote server. In addition, additional data may include data from a robotic surgical system, navigation system, and/or other system(s) associated with use of surgical cutting device300.

Turning toFIG.6, a controller600of console100(FIG.1) is detailed. Although controller600is detailed as part of console100(FIG.1), controller600may alternatively be incorporated into surgical cutting device300(FIG.1), distributed across console100and surgical cutting device300, or distributed across multiple devices including cloud server(s) and/or remote device(s) connected via a network or other communication link. Controller600includes a processor610connected to a computer-readable storage medium or a memory620which may be a volatile type memory, e.g., RAM, or a non-volatile type memory, e.g., flash media, disk media, etc. In aspects, processor610may be, without limitation, a digital signal processor, a microprocessor, an ASIC, a graphics processing unit (GPU), field-programmable gate array (FPGA), or a central processing unit (CPU). In aspects, memory620can be random access memory, read-only memory, magnetic disk memory, solid state memory, optical disc memory, and/or another type of memory. In aspects, memory620can be separate from controller600and can communicate with processor610through communication buses of a circuit board and/or through communication cables such as serial ATA cables or other types of cables. Memory620includes computer-readable instructions that are executable by processor610to operate controller600. In aspects, controller600includes a network interface630to communicate with other computers or a server. In aspects, a storage device640may be used for storing data. In embodiments, controller600may include one or more FPGAs650. FPGA650may be used for performing computations and/or executing algorithms including machine learning algorithms.

Memory620stores suitable instructions, to be executed by processor610, for receiving the sensed data, e.g., sensed data from sensors350(FIGS.4and5), and any other data; accessing storage device640of controller600; determining the performance condition of surgical cutting device300(FIG.1); and, based upon the determined performance condition, adjusting operational settings (thus providing automatic adaptive control) and/or recommending changes (thus enabling manual adaptive control).

Determining the performance condition of surgical cutting device300(FIG.1) may initially include processing the received data, e.g., data from sensors350(FIGS.4and5). This processing may include, for example, evaluating the sensor data over time, computing statistics (averages, maximums, minimums, etc.), determining rates of change (direction and amplitude), identifying steady-state conditions and deviations from the steady-state conditions, etc.

With additional reference toFIG.7, the sensed data710(whether processed data or the original data, in aspects where initial processing is not performed), together with other data720, is input into one or more algorithms730, e.g., including one or more thresholds stored in one or more look-up tables of storage device640, to determine the performance condition(s)740. The algorithm(s)730and, more specifically, the applicable thresholds thereof, may vary depending upon time data, different processed data from the same sensor(s)350, data from different sensors350, and/or other data720. For example, an adverse performance condition (e.g., instability and/or inefficiency) may be determined where sensed data exceeds a first threshold for a first amount of time or where the sensed data does not exceed the first threshold but exceeds a second, lower threshold for a second, longer amount of time. As another example, an adverse performance condition (e.g., instability and/or inefficiency) may be determined where first sensed data exceeds a first threshold without consideration of other sensed data or where the first sensed data does not exceed the first threshold but exceeds a second, lower threshold and second sensed data also exceeds a threshold. As still another example, thresholds need not be universal but may be adjusted depending upon, for example, the other data obtained that may help contextualize the sensor data, as detailed above.

As noted above, the determination of a performance condition740, e.g., stability and/or efficiency, may be a binary output or a scaled (numerical or symbolic) output. In configurations where a scaled output is provided, different thresholds may be utilized to determine the performance condition740on the corresponding scale. Regardless of the form of the determination, once the determination is made, controller600provides instructions and/or an output based upon the determined performance condition740, as detailed below.

Referring toFIGS.6and8, in aspects, one or more machine learning algorithms810are utilized by controller600to determine the performance condition. The machine learning algorithm(s)810may be trained on and learn from base data820, e.g., experimental data and/or data from previous procedures initially input into one or more machine learning algorithms810; the sensed data830, e.g., sensed data from sensor(s)350(FIGS.4and5); and/or other data840in order to enable the machine learning algorithm(s)810to determine the performance condition850. In aspects, training the machine learning algorithm(s)810may be performed by a computing device outside of console100(FIG.1) and the resulting algorithm may be communicated to controller600. Further, training may be initially performed and the machine learning algorithm(s)810thereafter locked, or machine learning algorithm(s)810may be trained and updated based on data obtained during use, e.g., continuously or discretely in accordance with scheduled updates.

The determination of a performance condition850, e.g., stability and/or efficiency, as noted above, may be a binary output or a scaled (numerical or symbolic) output. The output, e.g., binary or scaled, may dictate the type of machine learning algorithm(s)810utilized. For example, classification machine learning techniques may be utilized where a binary output or scaled output of a relatively few selections is utilized. On the other hand, regression machine learning techniques may be utilized where a scaled output of a relatively large number of selections is utilized (e.g., 1-100). The machine learning algorithm(s)810may implement one or more of: supervised learning, semi-supervised learning, unsupervised learning, reinforcement learning, association rule learning, decision tree learning, anomaly detection, feature learning, computer vision, etc., and may be modeled as one or more of a neural network, Bayesian network, support vector machine, genetic algorithm, etc. Once the determination is made, controller600provides instructions and/or an output based upon the determined performance condition850, as detailed below.

Turning toFIG.9, a method900in accordance with the present disclosure is shown. As noted above, during use, sensor feedback and/or other data is received, as indicated at910. Based upon this sensor feedback and/or other data, as indicated at920, one or more performance conditions are determined. The determination of the one or more performance conditions may be made continuously, periodically, or in any other suitable manner. With respect to a binary output of the determination of the one or more performance conditions, for example, if it is determined that an adverse performance condition exists, e.g., instability and/or inefficiency, the method proceeds to930and/or940. At930, a recommended change is output, e.g., controller600(FIG.6) provides instructions to output a recommended change in the form of, for example, a visual output, e.g., graphics and/or text on GUI120of console100(seeFIG.1), and/or an audible output, e.g., from a speaker associated with console100(FIG.1). The recommended change may direct a user to take one or more corrective actions to remedy the adverse performance condition(s), e.g., instability and/or inefficiency. The recommended corrective actions may include, for example, recommending: changing technique, changing ergonomic position to better balance and/or support the surgical cutting device300(FIG.1), use of a lower speed, reducing pressure/force, choking up on the surgical cutting device300(FIG.1), reducing exposure of the cutting tool330(FIG.1; e.g., via rotating rotation collar322to advance or retract outer sleeve324of shaft assembly320relative to cutting tool330), changing tool type and/or size, etc. With respect to a scaled output, the number and/or type of corrective actions recommended may vary depending upon the scaled output.

At940, alternatively or additionally, if it is determined that an adverse performance condition exists, e.g., instability and/or inefficiency, controller600(FIG.6) provides instructions to automatically adjust settings of console100and/or surgical cutting device300(seeFIG.1) based on the determined adverse performance condition. For example, controller600(FIG.6) may provide instructions to control motor340of surgical cutting device300(seeFIG.1) to automatically reduce motor speed, reduce motor torque, advance or retract outer sleeve324of shaft assembly320relative to cutting tool330(in aspects where such adjustment is automated), etc. With respect to a scaled output, the severity and/or type of corrective actions taken may vary depending upon the scaled output.

In aspects, in response to detection of an adverse performance condition (or adverse performance condition above a threshold), the automatic adjustment may include a safety shutdown preventing operation or a safety pause preventing operation for a determined amount of time and/or until the adverse performance condition ceases. In robotic implementations, this may additionally or alternatively include moving the instrument out of the surgical site or to a safe location within the surgical site.

Further, in aspects where the adverse performance condition is an overheating or thermal condition (as sensed by a temperature sensor or thermal camera, for example), the automatic adjustment may include increasing irrigation flow (where such is provided for use with surgical cutting device300(FIG.1)) to increase cooling of the surgical cutting device300(FIG.1) and recovery from the adverse performance condition.

After a change is recommended at930and/or settings are adjusted at940, or where it is determined that an adverse performance condition does not exist (that is, where normal performance conditions are detected), the method reverts to910to evaluate new data and again determine, as detailed above, whether an adverse performance condition exists and, if so, what action to take in response thereto.

With reference toFIGS.10A and10B, a distal portion of surgical cutting device300is shown in use cutting tissue “T” with outer sleeve324of shaft assembly320disposed in retracted and extended positions, respectively, relative to cutting tool330to expose more or less of cutting tool330at the distal end of outer sleeve324. In the retracted position (FIG.10A), wherein more of cutting tool330is exposed at the distal end of outer sleeve324, cutting tool330is less constrained and, thus, movement of cutting tool330is less dampened and/or the cutting tool330is relatively less stiff. This may enable increased cutting performance during use in a normal performance condition. However, in this retracted position (FIG.10A), surgical cutting device300may be more prone to instability and/or inefficiency when operating in an adverse performance condition. Thus, depending upon the performance condition(s) determined, outer sleeve324may be automatically moved or a recommendation to move outer sleeve324may be provided to move outer sleeve324from the retracted position (FIG.10A) to the extended position (FIG.10B). In the extended position (FIG.10B), less of cutting tool330is exposed at the distal end of outer sleeve324such that cutting tool330is more constrained and, thus, movement of cutting tool330is dampened and vibrations of cutting tool330are reduced. Additionally or alternatively, a stiffness of cutting tool330is increased to thereby constrain motion of cutting tool330. Thus, greater stability and/or efficiency are achieved. In configuration where the performance condition is determined according to a scale, the extended position, e.g., the extent to which outer sleeve324is moved distally about cutting tool330, may be determined based upon the scaled performance condition, e.g., where outer sleeve324is advanced further distally about cutting tool330when more severe instability is detected as compared to less severe instability. Regardless of the particular implementation, the present disclosure enables live tuning (or recommendation of the same) of surgical cutting device300based on system feedback which, in some situations, may depart from the direction and/or conventional wisdom of the operator, thus providing adaptive control above and beyond that which may be provided manually.

Referring toFIGS.11A and11B, console100is shown wherein GUI120is displaying initial operating settings during use for speed (RPM's)1110and torque (% of a pre-determined torque reference value)1120and adjusted operating settings during use for speed1110and torque1120, respectively. Depending upon the performance condition(s) determined, controller600(FIG.6) may automatically adjust the speed1110and/or torque1120settings of motor340(FIG.1) in order to improve stability and/or efficiency and enable safe continued use in response to detection of an adverse performance condition. More specifically, reducing speed and/or torque may reduce vibrations, temperature hot spots, excess forces, etc., thus increasing stability and/or efficiency. The amount of speed and/or torque adjustment (e.g., decrease) may depend upon, for example the level of instability and/or inefficiency detected (e.g., where a scaled performance condition is determined).

While several aspects of the present disclosure have been shown in the drawings, it is not intended that the present disclosure be limited thereto, as it is intended that the present disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular aspects. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.