SURGICAL INSTRUMENTS AND SYSTEMS CONFIGURED TO DETECT, ANALYZE, AND/OR DISTINGUISH SMOKE AND STEAM DURING A SURGICAL PROCEDURE

A surgical system includes a surgical instrument configured for insertion into a surgical site, a sensor configured to sense at least one property of smoke at the surgical site, and a surgical generator including a controller and an energy output. The energy output is configured to supply energy to the surgical instrument for application to tissue at the surgical site to treat the tissue. The controller is configured to receive the at least one property, determine at least one parameter of smoke at the surgical site based upon the at least one property, and control the energy output based upon the at least one parameter and/or provide an output based upon the at least one parameter.

FIELD

The present disclosure relates to surgical instruments and systems, and, more particularly, to energy-based surgical instruments and systems configured to detect, analyze, and/or distinguish smoke and steam during the application of energy to tissue to facilitate tissue treatment.

BACKGROUND

Surgical instruments and methods for energy-based tissue treatment may utilize mechanical clamping action and application of energy, e.g., bipolar electrosurgical energy, to affect hemostasis by heating tissue to treat, e.g., coagulate, cauterize, and/or seal, tissue. Other surgical instruments include an energizable element, e.g., a monopolar electrosurgical element, a thermal element, etc., for energy-based tissue dissection.

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, and/or other variations, up to and including plus or minus 10 percent. Further, any or all of the aspects described herein, to the extent consistent, 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 including a surgical instrument configured for insertion into a surgical site, a sensor configured to sense at least one property of smoke at the surgical site, and a surgical generator including a controller and an energy output configured to supply energy to the surgical instrument for application to tissue at the surgical site to treat the tissue. The controller is configured to receive the at least one property and determine at least one parameter of smoke at the surgical site based upon the at least one property. The controller is further configured to control the energy output based upon the at least one parameter and/or provide an output based upon the at least one parameter.

In an aspect of the present disclosure, the sensor includes at least one of: an optical sensor, an electrical sensor, a smell-based sensor, or a chemical sensor.

In another aspect of the present disclosure, the at least one property includes: an optical property, a chemical property, an electrical property, or a smell-based property.

In yet another aspect of the present disclosure, the at least one parameter includes: presence of smoke, presence of a type of smoke particle, an amount of smoke particles, an amount of steam particles, or a ratio of smoke to steam. Additionally or alternatively, the at least one parameter includes: temperature of smoke, density of smoke, or color of smoke.

In still another aspect of the present disclosure, controlling the energy output includes at least one of: starting, modifying, continuing, or stopping the supply of energy to the surgical instrument.

In still yet another aspect of the present disclosure, the controller includes a storage device storing a machine learning algorithm configured to determine the at least one parameter based upon the at least one property.

In another aspect of the present disclosure, the controller is further configured to determine a type of the tissue being treated based upon the at least one parameter. The controller, in such aspects, may further be configured to control the energy output based upon the type of the tissue being treated and/or provide, via the output, an indication of the type of the tissue being treated.

In still another aspect of the present disclosure, the controller is further configured to determine a state of the tissue being treated based upon the at least one parameter. The controller, in such aspects, may further be configured to control the energy output based upon the state of the tissue being treated and/or provide, via the output, an indication of the state of the tissue being treated.

In yet another aspect of the present disclosure, the controller is further configured to determine a status of tissue treatment based upon the at least one parameter. The controller, in such aspects, may further be configured to control the energy output based upon the status of tissue treatment and/or provide, via the output, an indication of the status of the tissue treatment.

In an aspect of the present disclosure, the output includes at least one of: an audible output, a visual output, or a tactile output.

A method of surgery provided in accordance with the present disclosure includes inserting a surgical instrument into a surgical site, supplying energy from a surgical generator to tissue at the surgical site via the surgical instrument to treat the tissue, sensing at least one property of smoke at the surgical site, and determining at least one parameter of smoke at the surgical site based upon the at least one property. The method further includes controlling the supply of energy from the surgical generator based upon the at least one parameter and/or providing an output based upon the at least one parameter.

In an aspect of the present disclosure, sensing the at least one property includes sensing an optical property, a chemical property, an electrical property, or a smell-based property.

In another aspect of the present disclosure, determining the at least one parameter includes determining presence of smoke, presence of a type of smoke particle, an amount of smoke particles, or a ratio of smoke to steam. Additionally or alternatively, determining the at least one parameter includes determining temperature of smoke, density of smoke, or color of smoke.

In still another aspect of the present disclosure, the sensing is performed by a device separate from the surgical instrument, e.g., a surgical camera.

In yet another aspect of the present disclosure, controlling the supply of energy includes at least one of: starting, modifying, continuing, or stopping the supply of energy from the surgical generator to the surgical instrument.

In still yet another aspect of the present disclosure, the at least one parameter is determined using a machine learning algorithm.

In another aspect of the present disclosure, providing the output includes providing at least one of an audible output, a visual output, or a tactile output.

In yet another aspect of the present disclosure, the method further includes determining a type of the tissue being treated based upon the at least one parameter. In such aspects, the method may further include controlling the supply of energy based upon the type of the tissue being treated and/or indicating, via the output, the type of the tissue being treated.

In still another aspect of the present disclosure, the method further includes determining a state of the tissue being treated based upon the at least one parameter. In such aspects, the method may further include controlling the supply of energy based upon the state of the tissue being treated and/or indicating, via the output, the state of the tissue being treated.

In another aspect of the present disclosure, the method further includes determining a status of tissue treatment based upon the at least one parameter. In such aspects, the method may further include controlling the supply of energy based upon the status of tissue treatment and/or indicating, via the output, the status of tissue treatment.

An electrosurgical system provided in accordance with aspects of the present disclosure includes an end effector assembly and a sensor. The end effector assembly includes first and second jaw members each defining an electrically-conductive tissue-contacting surface. At least one of the first or second jaw members is movable relative to the other between a spaced-apart position and an approximated position for grasping tissue between the tissue-contacting surfaces thereof. The electrically-conductive tissue-contacting surfaces of the first and second jaw members are adapted to connect to a source of electrosurgical energy for conducting energy through tissue grasped therebetween to treat tissue. The sensor is configured to sense at least one property of smoke produced as a result of the conduction of energy through tissue grasped between the electrically-conductive tissue-contacting surfaces.

In an aspect of the present disclosure, the sensor is incorporated into the end effector assembly. The sensor, in such aspects, may be disposed on or within one of the first or second jaw members. Alternatively, the sensor may be incorporated into a device separate from the end effector assembly.

The sensor and/or the at least one property may be similar to any of the aspects detailed above or otherwise herein.

In another aspect of the present disclosure, the sensor is further configured to sense at least one property of steam produced as a result of the conduction of energy through tissue grasped between the electrically-conductive tissue-contacting surfaces.

In yet another aspect of the present disclosure, the electrosurgical system further includes a controller. In such aspects, the sensor is configured to communicate the at least one property to the controller. The controller may be configured to determine at least one parameter of smoke produced as a result of the conduction of energy through tissue grasped between the electrically-conductive tissue-contacting surfaces based upon the at least one property, e.g., any of the parameters detailed above or otherwise herein.

In still another aspect of the present disclosure, the controller is configured to determine a type of tissue being treated based upon the at least one property, a state of tissue being treated based upon the at least one parameter, and/or a status of tissue treatment based upon the at least one parameter.

In still yet another aspect of the present disclosure, a housing and a shaft extending distally from the housing are provided. The end effector assembly is disposed at a distal end portion of the shaft in such aspects. A manual actuator, e.g., handle, may be coupled to the housing and configured to move the at least one of the first or second jaw members between the spaced-apart position and the approximated position.

In another aspect of the present disclosure, first and second shaft members pivotably coupled to one another about a pivot are provided. In such aspects, the end effector assembly extends distally from the pivot and the first and second shaft members are movable relative to one another to move the at least one of the first or second jaw members between the spaced-apart position and the approximated position.

In yet another aspect of the present disclosure, a robotic arm is provided wherein the end effector assembly extends distally from the robotic arm.

In another aspect of the present disclosure, the sensor is an optical sensor including a transmitter and a receiver.

In still another aspect of the present disclosure, the sensor includes at least one needle configured to penetrate tissue grasped between the tissue-contacting surfaces of the first and second jaw members.

DETAILED DESCRIPTION

The present disclosure provides energy-based surgical instruments and systems configured to detect, analyze, and/or distinguish smoke and steam during the application of energy to tissue to facilitate tissue treatment. Various exemplary energy-based surgical instruments, systems, and sensor mechanisms are detailed below; however, the aspects and features of the present disclosure are not limited thereto as any other suitable energy-based surgical instruments, systems, and/or sensor mechanisms are also contemplated for use in accordance with the present disclosure.

Referring toFIG. 1A, a shaft-based electrosurgical forceps provided in accordance with the present disclosure is shown generally identified by reference numeral10. Aspects and features of forceps10not germane to the understanding of the present disclosure are omitted to avoid obscuring the aspects and features of the present disclosure in unnecessary detail.

Forceps10includes a housing20, a handle assembly30, a trigger assembly60, a rotating assembly70, an activation switch80, and an end effector assembly100. Forceps10further includes a shaft12having a distal end portion14configured to (directly or indirectly) engage end effector assembly100and a proximal end portion16that (directly or indirectly) engages housing20. Forceps10also includes cable90that connects forceps10to an electrosurgical generator400. Cable90includes a wire (or wires) (not shown) extending therethrough that has sufficient length to extend through shaft12in order to provide energy to one or both tissue-contacting surfaces114,124of jaw members110,120, respectively, of end effector assembly100(seeFIGS. 1B and 1C). Activation switch80is coupled to tissue-contacting surfaces114,124(FIGS. 1B and 1C) and electrosurgical generator400for enabling the selective activation of the supply of energy to jaw members110,120for treating, e.g., sealing, tissue.

Handle assembly30of forceps10includes a fixed handle50and a movable handle40(although both handles40,50may move, in embodiments). Fixed handle50is integrally associated with housing20and handle40is movable relative to fixed handle50. Movable handle40of handle assembly30is operably coupled to a drive assembly (not shown) that, together, mechanically cooperate to impart movement of one or both of jaw members110,120of end effector assembly100about a pivot103between a spaced-apart position (FIG. 1B) and an approximated position (FIG. 1C) to grasp tissue between jaw members110,120. As shown inFIG. 1A, movable handle40is initially spaced-apart from fixed handle50and, correspondingly, jaw members110,120of end effector assembly100are disposed in the spaced-apart position. Movable handle40is depressible from this initial position to a depressed position corresponding to the approximated position of jaw members110,120(FIG. 1C).

Trigger assembly60includes a trigger62coupled to housing20and movable relative thereto between an un-actuated position and an actuated position. Trigger62is operably coupled to a knife64(FIG. 1B), so as to actuate knife64(FIG. 1B) to cut tissue grasped between jaw members110,120of end effector assembly100upon actuation of trigger62. As an alternative to knife64, other suitable mechanical, electrical, or electromechanical cutting mechanisms (stationary or movable) are also contemplated.

With additional reference toFIGS. 1B and 1C, end effector assembly100, as noted above, includes first and second jaw members110,120. Each jaw member110,120includes a proximal flange portion111,121, an outer insulative jaw housing112,122disposed about the distal portion (not explicitly shown) of each jaw member110,120, and a tissue-contacting surface114,124, respectively. Proximal flange portions111,121are pivotably coupled to one another about pivot103for moving jaw members110,120between the spaced-apart and approximated positions, although other suitable mechanisms for pivoting jaw members110,120relative to one another are also contemplated. The distal portions (not explicitly shown) of the jaw members110,120are configured to support jaw housings112,122, and tissue-contacting surfaces114,124, respectively, thereon.

Outer insulative jaw housings112,122of jaw members110,120support and retain tissue-contacting surfaces114,124on respective jaw members110,120in opposed relation relative to one another. Tissue-contacting surfaces114,124are at least partially formed from an electrically conductive material, e.g., for conducting electrical energy therebetween for treating tissue, although tissue-contacting surfaces114,124may alternatively be configured to conduct any suitable energy, e.g., thermal, microwave, light, ultrasonic, etc., through tissue grasped therebetween for energy-based tissue treatment. As mentioned above, tissue-contacting surfaces114,124are coupled to activation switch80and electrosurgical generator400, e.g., via the wires (not shown) extending from cable90through forceps10, such that energy may be selectively supplied to tissue-contacting surface114and/or tissue-contacting surface124and conducted therebetween and through tissue disposed between jaw members110,120to treat tissue.

Continuing with reference toFIGS. 1B and 1C, end effector assembly100further includes a sensor mechanism150including components disposed within, on, or otherwise associated with one or both of jaw members110,120. Sensor mechanism150is configured to sense one or more properties of smoke and/or steam between jaw members110,120and/or in the surrounding environment and to provide sensor feedback to generator400(FIG. 1) to detect, analyze, and/or distinguish smoke during the application of energy to tissue, after the application of energy to tissue, and/or intermittently between energy application, e.g., to determine one or more parameters thereof. Various configurations of sensor mechanism150are detailed below.

With reference toFIGS. 2A-2D, a multi-function surgical instrument provided in accordance with the present disclosure is shown generally identified by reference numeral210. Instrument210includes similar features as forceps10(FIGS. 1A-1C) except that instrument210further includes a second activation assembly270, a deployable assembly280, and a deployment and retraction mechanism290and, thus, only these additional features are detailed below.

Deployable assembly280includes a sheath282and an energizable member284. Sheath282, in embodiments, is insulative, although other configurations are also contemplated. Sheath282is movable relative to end effector assembly100′ between a retracted position, wherein sheath282is disposed proximally of end effector assembly100′, and an extended position, wherein sheath282is substantially disposed about end effector assembly100′. Energizable member284is coupled to generator400(FIG. 1A) and second activation assembly270via one or more wires (not shown) and may function as the active electrode of a monopolar circuit or may be energizable with any other suitable form of energy, e.g., thermal, microwave, etc. Energizable member284is movable together with sheath282and relative to end effector assembly100′ between a retracted position, wherein distal tissue-treating portion286of energizable member284is positioned more-proximally, and an extended position, wherein distal tissue-treating portion286of energizable member284extends distally from end effector assembly100′ to facilitate treating tissue therewith. Energizable member284, more specifically, is engaged with sleeve282such that energizable member284and sleeve282move together between their respective retracted and extended positions (collectively the retracted and extended positions of deployable assembly280). In the extended position, in embodiments where sheath282is insulative, sheath282serves to electrically insulate end effector assembly100′ from distal tissue-treating portion286of energizable member284, while distal tissue-treating portion286extends distally from end effector assembly100′. In the extended position, energy may be supplied to distal tissue-treating portion286of energizable member284, e.g., via activation of either of the activation switches272of second activation assembly270, for treating, e.g., dissecting, tissue.

Deployment and retraction mechanism290is configured for selectively transitioning deployable assembly280between its retracted position and its extended position. Deployment and retraction mechanism290generally includes a gear assembly (not shown) disposed within housing220, a pair of input shafts292operably coupled to the gear assembly and extending transversely from either side of housing220, a pair of deployment paddles294operably coupled to the input shafts292(only one side of housing220and, thus, one paddle294is illustrated), and a slider (not shown) disposed within housing220and operably coupling an output of the gear assembly with energizable member284of deployable assembly280(which, in turn, is engaged with sheath282) such that deployment and retraction mechanism290is configured to enable both deployment and retraction of deployable assembly280in a push-push manner, e.g., wherein deployable assembly280is both deployed and retracted by pushing either of paddles294in the same direction. Other configurations are also contemplated. Further, as opposed to a multi-function instrument, an instrument including just an energizable member284of any suitable configuration and/or energy (monopolar, bipolar, thermal, etc.) is also contemplated.

Referring toFIG. 3, a hemostat-style electrosurgical forceps provided in accordance with the present disclosure is shown generally identified by reference numeral310. Aspects and features of forceps310not germane to the understanding of the present disclosure are omitted to avoid obscuring the aspects and features of the present disclosure in unnecessary detail.

Forceps310includes two elongated shaft members312a,312b, each having a proximal end portion316a,316b, and a distal end portion314a,314b, respectively. Forceps310is configured for use with an end effector assembly100″ similar to end effector assembly100(FIGS. 1B and 1C). More specifically, end effector assembly100″ includes first and second jaw members110″,120″ attached to respective distal end portions314a,314bof shaft members312a,312b. Jaw members110″,120″ are pivotably connected about a pivot103″. Each shaft member312a,312bincludes a handle317a,317bdisposed at the proximal end portion316a,316bthereof. Each handle317a,317bdefines a finger hole318a,318btherethrough for receiving a finger of the user. As can be appreciated, finger holes318a,318bfacilitate movement of the shaft members312a,312brelative to one another to, in turn, pivot jaw members110″,120″ from the spaced-apart position, wherein jaw members110″,120″ are disposed in spaced relation relative to one another, to the approximated position, wherein jaw members110″,120″ cooperate to grasp tissue therebetween.

One of the shaft members312a,312bof forceps310, e.g., shaft member312b, includes a proximal shaft connector319configured to connect forceps310to electrosurgical generator400(FIG. 1A). Proximal shaft connector319secures a cable390to forceps310such that the user may selectively supply energy to jaw members110″,120″ for treating tissue. More specifically, an activation switch380is provided for supplying energy to jaw members110″,120″ to treat tissue upon sufficient approximation of shaft members312a,312b, e.g., upon activation of activation switch380via shaft member312a.

Forceps310further includes a trigger assembly360including a trigger362coupled to one of the shaft members, e.g., shaft member312a, and movable relative thereto between an un-actuated position and an actuated position. Trigger362is operably coupled to a knife (not shown; similar to knife64(FIG. 1B) of forceps10(FIG. 1A)) so as to actuate the knife to cut tissue grasped between jaw members110″,120″ of end effector assembly100″ upon movement of trigger362to the actuated position. Similarly as noted above with respect to forceps10(FIG. 1A), other suitable cutting mechanisms are also contemplated.

Referring toFIG. 4, a robotic surgical instrument provided in accordance with the present disclosure is shown generally identified by reference numeral1000. Aspects and features of robotic surgical instrument1000not germane to the understanding of the present disclosure are omitted to avoid obscuring the aspects and features of the present disclosure in unnecessary detail.

Robotic surgical instrument1000includes a plurality of robot arms1002,1003; a control device1004; and an operating console1005coupled with control device1004. Operating console1005may include a display device1006, which may be set up in particular to display three-dimensional images; and manual input devices1007,1008, by means of which a surgeon may be able to telemanipulate robot arms1002,1003in a first operating mode. Robotic surgical instrument1000may be configured for use on a patient1013lying on a patient table1012to be treated in a minimally invasive manner. Robotic surgical instrument1000may further include a database1014, in particular coupled to control device1004, in which are stored, for example, pre-operative data from patient1013and/or anatomical atlases.

Each of the robot arms1002,1003may include a plurality of members, which are connected through joints, and an attaching device1009,1011, to which may be attached, for example, an end effector assembly1100,1200, respectively. End effector assembly1100is similar to end effector assembly100(FIGS. 1B and 1C), although other suitable end effector assemblies for coupling to attaching device1009are also contemplated. End effector assembly1100is connected to electrosurgical generator400(FIG. 1A), which may be integrated into or separate from robotic surgical instrument1000. End effector assembly1200may be any end effector assembly, e.g., an endoscopic camera, other surgical tool, etc. Robot arms1002,1003and end effector assemblies1100,1200may be driven by electric drives, e.g., motors, that are connected to control device1004. Control device1004(e.g., a computer) may be configured to activate the motors, in particular by means of a computer program, in such a way that robot arms1002,1003, their attaching devices1009,1011, and end effector assemblies1100,1200execute a desired movement and/or function according to a corresponding input from manual input devices1007,1008, respectively. Control device1004may also be configured in such a way that it regulates the movement of robot arms1002,1003and/or of the motors.

Referring toFIG. 5, electrosurgical generator400is shown as a schematic block diagram. Generator400may be utilized as a stand-alone generator (as shown inFIG. 1A), may be incorporated into a surgical instrument10,210,1000(FIGS. 1, 3, and 4, respectively), or may be provided in any other suitable manner. Generator400includes sensor circuitry422, a controller424, a high voltage DC power supply (“HVPS”)426and an RF output stage428. Sensor circuitry422is configured to receive sensor feedback from sensor mechanism150(FIGS. 1B and 1C) and to relay the same to controller424. Controller424is configured to control the output of energy from HVPS426to RF output stage428and, thus, the application of energy from tissue-contacting surfaces114,124of jaw members110,120to tissue grasped therebetween (FIGS. 1B and 1C). More specifically, controller424is configured to receive the sensor feedback from sensor circuitry422; detect, analyze, and/or distinguish smoke and steam in real time during the application of energy to tissue (FIGS. 1B and 1C); and, based thereon, start, continue, modify, stop, etc., the output of energy from HVPS426to RF output stage428. Alternatively or additionally, controller424may provide a suitable output, e.g., an audible, visual, and/or tactile indicator, to the user based upon the smoke and steam detected, analyzed, and/or distinguished. Controller424is detailed below.

HVPS426, under the direction of controller424, provides high voltage DC power to RF output stage428which converts the high voltage DC power into RF energy for delivery to tissue-contacting114,124of jaw members110,120, respectively, of end effector assembly100(seeFIGS. 1B and 1C). In particular, RF output stage428generates sinusoidal waveforms of high frequency RF energy. RF output stage428may be configured to generate waveforms having various duty cycles, peak voltages, crest factors, and other properties. Other suitable configurations are also contemplated such as for example, pulsed energy output, other waveforms, etc.

With additional reference toFIG. 6, controller424is configured to receive the sensor feedback from sensor circuitry422(as sensed by sensor mechanism150(FIGS. 1B and 1C)) and, based thereon, detect, analyze, and/or distinguish smoke and steam in real-time (allowing computer processing time within a suitable real-time constraint), before, during, after, and/or intermittently between the application of energy to the tissue. The detection, analysis, and/or distinction of smoke and steam may include determining one or more parameters of smoke and/or steam, for example: determining the presence, relative amount, constituency, density, spread, etc. of smoke; and/or determining the presence, relative amount, temperature, density, spread, etc. of steam. This detection, analysis, and/or distinction may be accomplished using, for example, a look-up table correlating the sensor feedback with the one or more parameters of smoke and/or steam. Alternatively, a fixed algorithm determining the one or more parameters of smoke and/or steam based upon the sensor feedback may be utilized. As another alternative, the one or more parameters of smoke and/or steam may be determined using a machine learning algorithm. This detection, analysis, and/or distinction may additionally or alternatively be utilized for minimizing smoke and/or steam generation.

Referring particularly toFIG. 6, controller424includes a processor520connected to a computer-readable storage medium or a memory530which may be a volatile type memory, e.g., RAM, or a non-volatile type memory, e.g., flash media, disk media, etc. In embodiments, processor520may 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 embodiments, memory530can be random access memory, read-only memory, magnetic disk memory, solid state memory, optical disc memory, and/or another type of memory. In embodiments, memory530can be separate from controller424and can communicate with processor520through communication buses of a circuit board and/or through communication cables such as serial ATA cables or other types of cables. Memory530includes computer-readable instructions that are executable by processor520to operate controller424. In embodiments, controller424includes a network interface540to communicate with other computers or a server. In embodiments, a storage device510may be used for storing data. In embodiments, controller424may include one or more FPGAs550. FPGA550may be used for executing various algorithms, e.g., fixed algorithms, machine learning algorithms, etc.

Memory530stores suitable instructions, to be executed by processor520, for receiving the sensed data, e.g., sensed data from sensor circuitry422(FIG. 5), accessing storage device510of controller424, and determining the one or more parameters of smoke and/or steam based upon the sensed data and information stored in storage device510. Memory530further stores suitable instructions, to be executed by processor520, to provide feedback based upon the one or more parameters of smoke and/or steam. Although illustrated as part of generator400, it is also contemplated that controller424be remote from generator400, e.g., on a remote server, and accessible by generator400via a wired or wireless connection. In embodiments where controller424is remote, it is contemplated that controller424may be accessible by and connected to multiple generators400.

With reference toFIGS. 6 and 7, in embodiments where one or more machine learning machine learning algorithms608are used, storage device510of controller424stores the one or more machine learning algorithms608. The machine learning algorithm(s)608may be trained on and learn from stored settings604, e.g., experimental data and/or data from previous procedures initially input into the one or more machine learning applications, and/or the sensed data602from sensor circuitry422(FIG. 5) in order to enable the machine learning application(s) to determine the one or more parameters of smoke and/or steam610. In embodiments, training the machine learning algorithm may be performed by a computing device outside of generator400and the resulting algorithm may be communicated to controller424of generator400.

In embodiments, controller424receives the determined one or more parameters of smoke and/or steam610that was output from the machine learning algorithm608and communicates the same to a computing device, e.g., of controller424, for use in controlling the output of energy from HVPS426to RF output stage428. This controlling may include starting, continuing, modifying, or stopping the output of energy. More specifically, a tissue treating algorithm stored in storage device510of controller424may be implemented, modified, stopped, switched to another tissue treating algorithm, etc.; the waveform output may modified, stopped, switched to another tissue treating waveform; a setting may be changed, e.g., power may be increased or decreased; and/or an energy output time may be increased or decreased. That is, the energy output is adapted, if necessary, in accordance with the one or more parameters of smoke and/or steam determined. In this manner, smoke and/or steam may be monitored during tissue treatment, e.g., tissue sealing, to ensure that the desired tissue treatment is achieved, e.g., sealing the tissue, and, after, to check that a sufficient tissue effect, e.g., a tissue seal, indeed resulted.

For example, the parameter(s): the presence of smoke; the presence of a particular type of smoke particle or particles; the amount of smoke particles or relative ratio of different smoke particles; a ratio of smoke (or particles thereof) to steam (measured in particles, volume, etc.) exceeding a threshold; the temperature, density, color (or other optical parameter) of smoke; and/or the extent of smoke spread may indicate, during the application of energy to tissue to treat, e.g., seal, tissue, a status of the tissue sealing process, e.g., whether collagen has denatured, liquefied, and crosslinked, whether the tissue is being burned, whether collateral tissue is being burned, etc., since smoke and/or steam generated may vary during the various stages of tissue sealing and/or as a result of different effects on tissue. The energy applied may then be varied, if appropriate, in accordance with the status of the tissue sealing process in order to facilitate tissue sealing and/or reduce collateral damage.

As another example, the above parameters may indicate a type of tissue, e.g., vascular, muscle, organ, etc., and/or a state of tissue, e.g., healthy, diseased, etc., during the application of energy to tissue to treat, e.g., seal, tissue, as smoke and/or steam may be generated differently based upon the type and/or state of tissue to which the energy is applied. The energy-delivery algorithm may then be varied, if appropriate, in order to facilitate treatment of the particular tissue type and/or state determined.

As noted above, controller424may alternatively or additionally receive the determined one or more parameters of smoke and/or steam610that was output from the machine learning algorithm608and communicate the same to a computing device, e.g., of controller424, for use in providing a suitable output, e.g., an audible, visual, and/or tactile indicator, to the user based upon the one or more parameters of smoke and/or steam610.

For example, the parameter(s): the presence of smoke; the presence of a particular type of smoke particle or particles; the amount of smoke particles or relative ratio of different smoke particles; a ratio of smoke (or particles thereof) to steam (measured in particles, volume, etc.) exceeding a threshold; the temperature, density, color (or other optical parameter) of smoke; and/or the extent of smoke spread may indicate, during the application of energy to tissue to treat, e.g., seal, tissue, a state of tissue, e.g., healthy, diseased (cancerous), etc. Accordingly, with respect to a diseased tissue removal procedure, a suitable output may be provided to the user to indicate to the user that the tissue being treated is diseased. This may allow the user, for example, to further remove tissue until the margins are not diseased (and no such output is given). Thus, the output facilitates the full removal of diseased tissue by helping to identify the margins of the diseased tissue.

As another example, the above parameters may indicate a type of tissue, e.g., vascular, muscle, organ, etc., and/or the presence of a foreign object or a critical tissue, e.g., nerve, organ, duct, etc. during the application of energy to tissue to treat, e.g., seal, tissue, as smoke and/or steam may be generated differently based upon the type of tissue to which the energy is applied and/or based upon surrounding objects, critical tissue, etc. Accordingly, a suitable output may be provided to the user to indicate to the user a type of tissue and/or the presence of a foreign object or a critical tissue that the user may be unaware of, thus helping to prevent inadvertent treatment. The application of energy to tissue may also be automatically stopped or paused based upon the detection of a particular type of tissue, a foreign object, or a critical tissue (together with the output or separate therefrom), providing a further safety feature against inadvertent treatment.

Turning toFIGS. 8-10B, detailed below are various embodiments of sensor mechanisms150incorporated into or associated with jaw member110and/or jaw member120of end effector assembly100(or any other end effector assembly detailed herein or suitable for use in accordance with the present disclosure). As noted above, sensor mechanisms150are configured to communicate sensor feedback to sensor circuitry422of generator400(seeFIG. 5) which, in turn, is configured to communicate with controller424(seeFIG. 6) to enable the detection, analysis, and/or distinction of smoke and steam in real-time during the application of energy to tissue.

Referring initially toFIG. 8, in embodiments, sensor mechanism150may include one or more sensor assemblies730positioned within knife channels116,126defined within the first and second jaw members110,120. The one or more sensor assemblies730may include one or more transmitters, e.g., a transmitter732disposed within knife channel116of jaw member110, one or more receivers, e.g., a receiver734disposed within knife channel126of jaw member120, and/or one or more transceivers (not shown) configured to cooperate to sense one or more properties of smoke and/or steam within tissue “T” and/or the surrounding environment, e.g., disposed within knife channels116,126, and to provide the same to sensor circuitry422(FIG. 5) for determination of the one or more parameters of smoke and/or steam.

In embodiments, sensor assembly730is an optical sensor assembly utilizing fluorescence spectroscopy, infrared imaging, video imaging, or other suitable optical technique to sense one or more optical properties of smoke and/or steam within tissue “T” and/or the surrounding environment. In other embodiments, sensor assembly730is a smoke and/or other particle detector, e.g., an ionization detector or a photoelectric detector, and is configured to detect smoke and/or other particles within the surrounding environment. In still other embodiments, the sensor assembly730is an electronic nose configured to electronically sense one or more smell-based properties of smoke and/or steam within tissue “T” and/or the surrounding environment. In yet another embodiment, the sensor assembly730is a chemical sensor, e.g., a molecular sensor, gas chromatograph, etc., configured to sense one or more chemical properties of smoke and/or steam within tissue “T” and/or the surrounding environment. Other suitable sensors including but not limited to, for example, moisture sensors, pressure sensors, density sensors, temperature sensors, ultrasonic sensors, audio sensors, etc., are also contemplated. Further, combinations of sensors, e.g., two or more of the above-noted or other suitable sensors, may be utilized.

Regardless of the particular sensor configuration utilized, the sensed properties, as noted above, are used to determine one or more parameters such as, for example, the presence of smoke; the presence of a particular type of smoke particle or particles; the amount of smoke particles or relative ratio of different smoke particles; a ratio of smoke (or particles thereof) to steam (measured in particles, volume, etc.) exceeding a threshold; the temperature, density, color (or other optical parameter) of smoke; and/or the extent of smoke spread.

As an alternative to positioning sensor assembly730, e.g., transmitters732, receivers734, and/or transceivers (not shown), within one or both of knife channels116,126of first and second jaw members110,120, respectively, the components732,734of sensor assembly730may be disposed at any other suitable position on or within jaw member110and/or jaw member120. For example, sensor mechanism150may alternatively or additionally include one or more tissue-surface sensors (not shown) configured to contact a surface of tissue “T” grasped between jaw members110,120.

With reference toFIG. 9, sensor mechanism150, in embodiments, may be associated with a device740external to and, in embodiments, independent of, end effector assembly100. Device740may be, for example, an endoscopic camera including a sensor assembly742including one or more optical sensors744such as those detailed above. Alternatively, device740may be a surgical probe or other suitable device carrying one or more other sensors, e.g., any of the sensors detailed above. The sensor assembly, e.g., sensor assembly742, is configured to sense one or more properties of smoke and/or steam within tissue “T” and/or the surrounding environment, e.g., the volume surrounding end effector assembly100, and to provide the same to sensor circuitry422(FIG. 5). In embodiments, device740may include a visible light and/or infrared camera to enable sensing of thermal spread, tissue expansion, tissue color, tissue temperature, etc., additionally or alternatively with the sensing of smoke and/or steam. Such sensed properties from device740may also be utilized to determine tissue type.

Referring toFIGS. 10A and 10B, sensor mechanism150may alternatively or additionally include one or more tissue-penetrating needles750operably coupled to a sensor assembly752. Needles750protrude from jaw member110and/or jaw member120towards the other and are configured to penetrate tissue “T” grasped between jaw members110,120. Tissue-penetrating needles750may include or be associated with sensor assembly752including any suitable sensor(s) such as those detailed above. The sensor(s) of sensor assembly752are configured to sense one or more properties of the smoke and/or steam within the penetrated tissue “T” or the interior thereof. In embodiments, needles750may be configured to sense the smoke and/or steam within tissue “T” and/or to extract fluid, tissue, etc., from the penetrated tissue “T” to enable isolated sensing of smoke and/or steam therein. Regardless of the particular configuration of needles750, needles750and sensor assembly752sense one or more properties to determination of one or more parameters such as, for example, the presence of smoke; the presence of a particular type of smoke particle or particles; the amount of smoke particles or relative ratio of different smoke particles; a ratio of smoke (or particles thereof) to steam (measured in particles, volume, etc.) exceeding a threshold; the temperature, density, color (or other optical parameter) of smoke; and/or the extent of smoke spread.

Turning toFIGS. 11-13, various embodiments of sensor mechanisms150′ incorporated into or associated within deployable assembly280of surgical instrument210, although sensor mechanisms150′ may alternatively by incorporated into any other suitable surgical instrument, e.g., an electrosurgical probe or other energy-based device, an access device, a tissue manipulation device, a visualization device, a dedicated sensing device, etc. Referring toFIG. 11, sensor mechanism150′ may include a sensor assembly760disposed on energizable member284. Sensor assembly760may include any suitable sensor, e.g., any of the sensors detailed above, and is configured to sense one or more properties of smoke and/or steam within tissue adjacent deployable assembly280and/or the surrounding environment, e.g., the volume surrounding deployable assembly280, and to provide the same to sensor circuitry422(FIG. 5) for determination of the one or more parameters of smoke and/or steam.

As shown inFIG. 12, sensor mechanism150′ may include a sensor assembly762disposed within sheath282of deployable assembly280. Sensor assembly762may include any suitable sensor, e.g., any of the sensors detailed above, and is configured to sense one or more properties of smoke and/or steam within sheath282, and to provide the same to sensor circuitry422(FIG. 5) for determination of the one or more parameters of smoke and/or steam.

FIG. 13illustrates a configuration wherein sensor mechanism150′ is associated with a device764external to and, in embodiments, independent of, deployable assembly280. Device764includes one or more sensors766, may be similar to any of the embodiments of device740(FIG. 9) detailed above, and is configured to sense one or more properties of smoke and/or steam within tissue adjacent deployable assembly280and/or the surrounding environment, and to provide the same to sensor circuitry422(FIG. 5) for determination of the one or more parameters of smoke and/or steam.

In any of the above-detailed embodiments of sensor mechanism150and/or sensor mechanism150′, suction may be incorporated into the instrument via one or more suction channels, apertures, etc. connected to a suction source (not shown) to direct, e.g., draw, fluid to the sensor assemblies to facilitate determination of the one or more parameters of smoke and/or steam. In such embodiments, the sensor mechanisms150,150′ may be more-proximally disposed such as within the shaft or housing, whereby the fluid travels through a suction conduit to the sensor mechanism150,150′ for determination of the one or more parameters of smoke and/or steam.

It should be understood that various aspects disclosed herein may be combined in different combinations than the combinations specifically presented hereinabove and in the accompanying drawings. In addition, while certain aspects of the present disclosure are described as being performed by a single module or unit for purposes of clarity, it should be understood that the techniques of this disclosure may be performed by a combination of units or modules associated with, for example, a surgical system.