Patent Description:
<NUM>-Aminolevulinic Acid (<NUM>-ALA) is often given to patients a couple hours before surgery. <NUM>-ALA is a compound that occurs naturally in the hemoglobin synthesis pathway. In cancer cells, the hemoglobin synthesis is disrupted and the pathway stalls at an intermediate compound called Protoporphyrin IX (PPIX). During surgery, the healthcare professional may illuminate an area of brain tissue with excitation light (i.e., blue light) from a surgical microscope. The surgery may be carried out in a darkened or dimmed operating room environment. High-grade tumor cells containing PPIX absorb the excitation light and emit red fluorescent light having specific optical characteristics. The fluorescent light may be observed by the healthcare professional from the surgical microscope.

Once the target tissue has been identified, the healthcare professional switches the surgical microscope back to standard white light illumination and continues to resect the target tissue. The healthcare professional switches back and forth between illuminating the tissue with white light and the excitation light throughout the surgical procedure to ensure the appropriate target tissue is being resected until the tumor resection is complete. Each time the target area is illuminated with the excitation light from the surgical microscope, the PPIX present at the tumor site may degrade due to photo-bleaching from being illuminated by the strong excitation light.

Fluorescence guided surgery increases the chances of GTR in high-grade tumors such as with glioblastoma tumors. At present, GTR of lower grade tumors is comparatively low because <NUM>-ALA cannot be used to improve the outcome of lower-grade tumor resection as the tumor cells only emit a low level of fluorescence and the human eye is not sensitive enough to detect such low levels of fluorescence even with the use of the surgical microscope. A need exists for an improved system for fluorescence guided surgery that improves the chances of achieving GTR.

The background description provided here is for the purpose of generally presenting the context of the disclosure.

An apparatus for the uniform irradiation of the inner wall of a hollow organ is described in <CIT>. A catheter has a translucent balloon on its end. An optical sensing fiber is affixed to or within the balloon wall material. The apparatus is employed according to the following steps: inserting the catheter into the interior of the organ; inflating the balloon until it forms a predetermined configuration and distends the inner wall of the organ to be irradiated into a contiguous and congruent configuration; inserting a light transmission fiber having an isotropic light diffuser tip into the catheter so that the tip is positioned at the center of the balloon and, hence, automatically positioned at the center of the wall to be irradiated; transmitting light through the fiber out the tip, whereby light of uniform intensity irradiates the wall; and monitoring with the sensing fiber on the wall of the cavity the light to which the sensing fiber and, hence, the cavity wall are exposed.

<CIT> discloses an optical spectroscopy probe for providing optical spectroscopy guidance of a mechanical biopsy procedure, and a tissue biopsy device including an optical spectroscopy probe. The optical spectroscopy probe is positionable in a lumen of a mechanical biopsy device. The probe may enable optical spectroscopy guidance in biopsy procedures, including brain biopsy procedures.

An optical sensor system for detecting a tissue type in a surgical procedure is defined in claim <NUM>. Optional features are defined in the dependent claims.

In a feature, an optical sensor system for detecting a tissue type in a surgical procedure is exemplarily described. The optical sensor system includes an excitation source, a probe, an optical detection module, and a controller. The excitation source is configured to selectively emit excitation light. The probe includes at least one fiber that is coupled to the excitation source and that is configured to illuminate target tissue with excitation light and collect light from target tissue. The probe also includes a compliance member that is coupled to the at least one fiber, the compliance member being at least partially translucent and configured to deform in response to engagement by a surgical tool. A portion of the at least one fiber is disposed inside of the compliance member. The probe also includes an indicator element that is disposed at least partially within the compliance member and configured to emit light in response to receiving an indicator signal. The optical detection module is coupled to the at least one fiber and configured to generate a signal based on the collected light. The controller is operatively connected to the optical detection module and configured to determine a tissue characteristic based on the signal and generate the indicator signal based on the determined tissue characteristic.

In a feature, an optical sensor system for detecting a tissue type in a surgical procedure is exemplarily described. The optical sensor system includes an excitation source, a probe, an optical detection module, and a controller. The excitation source is configured to selectively emit excitation light. The probe includes at least one fiber coupled to the excitation source and configured to illuminate target tissue with excitation light and collect light from target tissue. The probe also includes a sensor body that is coupled to a distal end of the at least one fiber. The probe also includes a tab that is configured to be maneuvered by a surgical tool. The tab being coupled to the at least one fiber proximal to the sensor body. The probe also includes an indicator configured to provide an indication in response to receiving an indicator signal. The optical detection module is coupled to the at least one fiber and configured to generate a signal based on the collected light. The controller is operatively connected to the optical detection module and configured to determine a tissue characteristic based on the signal and generate the indicator signal based on the determined tissue characteristic.

In a feature, an attachment for an optical probe is exemplarily described. The optical probe includes at least one fiber, an indicator element, and a sensor. The at least one fiber is configured to illuminate target tissue with excitation light and collect fluorescent light from the target tissue. The indicator element is configured to emit an indication light. The sensor body comprising a compliant material that is at least partially translucent in order to allow for at least one of the excitation light, the fluorescent light, and the indication light to pass through. The compliant material being formed of material that is electrically and thermally insulating and configured to deform in response to engagement by a surgical tool.

In a feature, a method for detecting light emitted from brain tissue using an optical sensor system is exemplarily described. The optical sensor system includes an excitation source, a probe, and an optical detection module. The probe includes at least one fiber that is coupled to the excitation source. The probe further also includes a compliance member that is coupled to the at least one fiber and is deformable. The compliance member is at least partially translucent. The probe further includes an indicator element that is disposed at least partially within the compliance member. The optical detection module is coupled to the at least one fiber and a controller that is operatively connected to the optical detection module. The method includes positioning a suction tool such that the projection is near a lumen of the suction tool. The method further includes applying suction with the suction tool so that the projection becomes disposed within the lumen of the suction tool. The method further includes moving the compliance member with the suction tool to a desired position. The method further includes altering suction of the suction tool such that the suction releases the compliance member. The method further includes emitting, with the excitation source, excitation light. The method further includes illuminating, with the at least one fiber, the brain tissue with the excitation light. The method further includes collecting, with the at least one fiber, fluorescent light from the brain tissue. The method further includes generating, with the optical detection module, a signal based on the collected fluorescent light. The method further includes determining, with the controller, a tissue characteristic based on the signal. The method further includes generating, with the controller, an indicator signal based on the determined tissue characteristic. The method further includes emitting light, with the indicator element, in response to receiving the indicator signal.

In a feature, a method for detecting light emitted from brain tissue using an optical sensor system is exemplarily described. The optical sensor system includes an excitation source, a probe, and an optical detection module. The probe includes at least one fiber that is coupled to the excitation source. The probe further also includes a compliance member that is coupled to the at least one fiber and is deformable. The compliance member is at least partially translucent. The probe further includes an indicator element that is disposed at least partially within the compliance member. The optical detection module is coupled to the at least one fiber and a controller that is operatively connected to the optical detection module. The method includes engaging the compliance member with a surgical tool such that at least a portion of the compliance member is deformed. The method also includes moving the compliance member with the surgical tool to a desired position. The method also includes emitting, with the excitation source, excitation light. The method also includes illuminating, with the at least one fiber, the brain tissue with the excitation light. The method also includes collecting, with the at least one fiber, fluorescent light from the brain tissue. The method also includes generating, with the optical detection module, a signal based on the collected fluorescent light. The method also includes determining, with the controller, a tissue characteristic based on the signal. The method also includes generating, with the controller, an indicator signal based on the determined tissue characteristic. The method also includes emitting light, with the indicator element, in response to receiving the indicator signal.

In a feature, an optical sensor system for detecting a tissue type in a surgical procedure is exemplarily described. The optical sensor system includes an excitation source, a probe, an optical detection module, and a controller. The excitation source is configured to selectively emit excitation light. The probe includes at least one fiber that is coupled to the excitation source and that is configured to illuminate target tissue with excitation light and collect light from target tissue. The probe also includes a compliance member that is coupled to the at least one fiber and being at least partially translucent. The compliance member is configured to deform in response to engagement by a surgical tool. A portion of the at least one fiber is disposed inside of the compliance member. The probe also includes an indicator that is configured to provide an indication in response to receiving an indicator signal. The optical detection module is coupled to the at least one fiber and is configured to generate a signal based on the collected light. The controller is operatively connected to the optical detection module and is configured to determine a tissue characteristic based on the signal and generate the indicator signal based on the determined tissue characteristic.

Further areas of applicability of the present disclosure will become apparent from the detailed description, the claims, and the drawings. The detailed description and specific examples are intended for purposes of illustration only and are not intended to limit the scope of the disclosure.

The present disclosure will become more fully understood from the detailed description and the accompanying drawings.

The present inventors realized that there exists a need for a neurosurgical tumor resection system and/or method that is capable of detecting low levels of fluorescence in white light operating conditions (i.e., not requiring a darkened or dimmed operating room) while in the process of resecting the tumor. There also exists a need for a system that can reduce the amount of time that the target area is illuminated with excitation light to reduce the effects of photo-bleaching. Additionally, there exists a need for a system that can illuminate excitation light in deep cavities as surgical microscope fail to adequately illuminate excitation light in deep cavities. There also exists a need for a system that assists in intraoperative detection of the anaplastic focus of the tumor which is of importance because finding the anaplastic focus is imperative for precise histopathological diagnosis and optimal patient treatment.

While the disclosure specifically discusses a surgical procedure related to resection of target tissue of a brain tumor with the administration of <NUM>-ALA to visualize fluorescence of PPIX, the teachings of the present disclosure may be extended to other types of surgical procedures, to detect other types of tissue, and to detect other types of fluorophores (Hypericin, Hexvix, Idocyanine Green, etc.). For example, ICG may be administered to help a healthcare professional visualize blood vessels during the surgical procedure. ICG may bond to plasma protein found in blood. ICG is excited by near infrared light and emits near infrared light having a slightly longer wavelength than the near infrared light that excited the ICG.

With reference to <FIG>, the neurosurgical system <NUM> is provided that solves the shortcomings of the prior art. The neurosurgical system <NUM> may include a surgical navigation system <NUM>, a surgical microscope <NUM>, and a surgical cart <NUM>. The surgical navigation system <NUM> includes a cart assembly <NUM> that houses a navigation computer <NUM>. The navigation computer <NUM> may also be referred to as the navigation controller. A navigation interface is in operative communication with the navigation computer <NUM>. The navigation interface may include one or more input devices may be used to input information into the navigation computer <NUM> or otherwise to select/control certain aspects of the navigation computer <NUM>. The navigation interface includes one or more displays <NUM>. Such input devices may include interactive touchscreen displays/menus, a keyboard, a mouse, a microphone (voice-activation), gesture control devices, or the like.

The navigation computer <NUM> may be configured to store one or more pre-operative or intra-operative images of the brain. Any suitable imaging device may be used to provide the pre-operative or intra-operative images of the brain. For example, any 2D, 3D or 4D imaging device, such as isocentric fluoroscopy, bi-plane fluoroscopy, ultrasound, computed tomography (CT), multi-slice computed tomography (MSCT), magnetic resonance imaging (MRI), positron emission tomography (PET), optical coherence tomography (OCT). The images may also be obtained and displayed in two, three or four dimensions. In more advanced forms, four-dimensional surface rendering regions of the body may also be achieved by incorporating patient data or other data from an atlas or anatomical model map or from pre-operative image data captured by MRI, CT, or echocardiography modalities.

The navigation computer <NUM> may generate the one or more images of the brain on a display <NUM>. The navigation computer <NUM> may also be connected with the surgical microscope <NUM>. For example, the display <NUM> may show an image corresponding to the field of view of the surgical microscope <NUM>. When the navigation computer <NUM> may include more than one display, with one such display showing the field of view of the surgical microscope <NUM> while the other such display may show a pre-operative or intra-operative image of the brain.

The tracking system <NUM> is coupled to the navigation computer <NUM> and is configured to sense the position of one or more tracking elements attached to a surgical tool or the patient. The tracking system <NUM> may be configured to track active or passive infrared tracking elements attached to the surgical tool or the patient. An example of a surgical navigation system <NUM> that may be used is Nav3i™ that is commercially available from Stryker. A surgical navigation system <NUM> may have various functions and features as described in <CIT> and <CIT>.

The surgical microscope <NUM> includes one or more objectives configured to provide magnification in a range (e.g., from about <NUM> times to about <NUM> times). The surgical microscope <NUM> can have a field of view having an area of a predetermined range. The surgical microscope <NUM> is configured for fluorescence microscopy, for example, to detect PPIX. The surgical microscope <NUM> may include one or more excitation sources (e.g., an excitation source configured to emit light in the visible light spectrum or an excitation source configured to emit light in the infrared spectrum) for illuminating the brain tissue <NUM> with excitation light to cause the PPIX to fluorescence. The surgical microscope <NUM> may also include a camera capable of detecting radiation at the fluorescent wavelengths of PPIX or ICG.

The surgical cart <NUM> may include a surgical system <NUM>, a tissue detection system <NUM>, and an ultrasonic surgical system <NUM>. A display <NUM> may be coupled to the surgical cart and operatively connected to the surgical system <NUM>, the tissue detection system <NUM>, and the ultrasonic surgical system <NUM> to display information related with each respective system <NUM>, <NUM>, and <NUM>. A healthcare professional may use the ultrasonic surgical system <NUM> and/or the surgical system <NUM> to ablate target tissue of the brain of the patient. The ultrasonic surgical system <NUM> may include an ultrasonic control console <NUM> and an ultrasonic handpiece assembly <NUM>.

The surgical system <NUM> may include a surgical tool and a surgical control console <NUM> to control various aspects of the surgical tool. The healthcare professional may also use the surgical tool to perform any surgical operation on the tissue. For example, to ablate the tissue, to suction fluid or debris from the tissue, to cauterize the tissue, or combinations thereof. In an example, the surgical system <NUM> may correspond to a suction system in which the surgical tool corresponds to a suction tool <NUM> for removing fluid and/or debris from the surgical site. The suction system may have various features, as described in <CIT>.

In another example, the surgical system <NUM> may include bipolar forceps <NUM> as the surgical tool. The bipolar forceps <NUM> may have features, as described in <CIT>. While the disclosure discusses and illustrates that the surgical tool may include a suction tool <NUM> and bipolar forceps <NUM>, the surgical system <NUM> and surgical tool may include other tools. In another example, the surgical tool may include a neuro stimulator, a dissector, or an ablation device (e.g., an RF ablation device and/or a laser ablation device). Any number of surgical systems and any number of surgical tools may be employed by the healthcare professional in performing the surgical procedure.

The tissue detection system <NUM> may include a control console <NUM> and a sample probe <NUM>. The control console <NUM> may provide the healthcare professional with a real-time indication when brain tissue <NUM> corresponds to the target tissue. The tissue detection system <NUM> determines when the brain tissue <NUM> corresponds to target tissue based on fluorescent light emitted by the target tissue caused by the fluorophore. In an example, the fluorophore may correspond to PPIX. In another example, the fluorophore may correspond to ICG. Based on the intensity and the wavelengths of the fluorescent light emitted by PPIX, the tissue detection system <NUM> may determine that the target tissue is present.

With reference to <FIG>, a schematic of the neurosurgical system <NUM> is shown. The tissue detection system <NUM>, although capable of performing a similar function (i.e., allowing the healthcare professional to detect the presence of PPIX) to the surgical microscope <NUM>, may be used in conjunction with the surgical microscope <NUM> to improve the outcome of a tumor resection procedure and the chances of achieving GTR.

During the surgical procedure, the healthcare professional may initially view the brain tissue <NUM> of the patient with the surgical microscope <NUM> under excitation light (e.g., the blue light) to identify which portion of the brain tissue <NUM> corresponds to the target tissue evidenced by the red fluorescent light. The healthcare professional may switch the surgical microscope <NUM> back to standard white light illumination for better visibility in order to begin resection of the target tissue.

Prior to beginning the resection, the healthcare professional may place the sample probe <NUM>, specifically a compliance member <NUM> of the sample probe <NUM>, on the target tissue. The healthcare professional may perform the resection of the target tissue with the ultrasonic handpiece assembly <NUM> in one hand and bipolar forceps <NUM> in the other hand. During the resection procedure, the healthcare professional may move the compliance member <NUM> as he/she with either the bipolar forceps <NUM> or the ultrasonic handpiece assembly <NUM>. The sample probe <NUM> is designed to be easily engaged by a number of different surgical tools, including but not limited to bipolar forceps, <NUM>, the ultrasonic handpiece assembly <NUM>, and the suction tool <NUM>.

As the healthcare professional is resecting the target tissue, the control console <NUM> may function to provide the healthcare professional with a real-time indication of the target tissue in the brain tissue <NUM> via the sample probe <NUM>. The tissue detection system <NUM> according to the teachings of the present disclosure prevents the healthcare professional from having to switch back and forth between the various illumination settings of the surgical microscope <NUM> (i.e., illuminating the tissue with excitation light and white light) as the healthcare professional is performing resection of the target tissue. This becomes especially important as the healthcare professional approaches the margin of the target tissue because it is desirable for the healthcare professional to achieve GTR (resect all of the target tissue) but to leave as much healthy tissue intact as possible.

With reference to <FIG>, the ultrasonic handpiece assembly <NUM> may comprise an ultrasonic handpiece <NUM> comprising a proximal end and distal end. The ultrasonic handpiece assembly <NUM> may further comprise a sleeve <NUM> and an ultrasonic tip <NUM> that may be coupled to the distal end of the ultrasonic handpiece <NUM>. The sleeve <NUM> may be configured to provide irrigation to the ultrasonic tip <NUM> and/or the surgical site. It is further contemplated that the sleeve <NUM> may also be configured to provide aspiration to the ultrasonic tip <NUM>. The ultrasonic tip <NUM> may comprise a cutting feature that is configured to ablate, cut, shape, and/or remove biological tissue. The ultrasonic handpiece assembly <NUM> may have various features, as described in <CIT>; <CIT>; and <CIT> and <CIT>.

The ultrasonic handpiece assembly <NUM> may also comprise a cable <NUM> or other power cord comprising a power connector <NUM> or adapter configured to couple the ultrasonic handpiece assembly <NUM> to a power supply, such as the ultrasonic control console <NUM> configured to regulate the various aspects of the ultrasonic handpiece assembly <NUM>. The ultrasonic control console <NUM> may also be configured to regulate the irrigation and/or aspiration functions of the ultrasonic handpiece assembly <NUM> to optimize performance of the ultrasonic handpiece assembly <NUM>. An example of ultrasonic surgical systems that may be used are commercially available from Stryker including Sonopet IQ Ultrasonic Aspirator. The ultrasonic control console <NUM> may control various operation parameters based on signals received from the tissue detection system <NUM>.

With reference to <FIG> and <FIG>, the tissue detection system <NUM> includes a sample probe <NUM> and a control console <NUM>. The sample probe <NUM> is connected to the control console <NUM> via the connector <NUM>. The sample probe <NUM> includes an indicator fiber <NUM>, an excitation fiber <NUM>, a collection fiber <NUM>, and a compliance member <NUM>. The control console <NUM> may include a controller <NUM>, a user interface <NUM>, a power supply <NUM>, an optics module <NUM>, and a microcontroller <NUM>. The optics module <NUM> may include an optics block <NUM>, a spectrometer <NUM>, an excitation source <NUM>, and an optical connector <NUM>. The function of each component will be discussed in greater detail below.

The user interface <NUM> may include a display for displaying output from the controller <NUM> or microcontroller <NUM>, which may be integrated into a single device or communicate with one another. The user interface <NUM> may also include one or more inputs (e.g., a push button, a touch button, a switch, etc.) configured for engagement by the healthcare professional. The power supply <NUM> may supply power to various components of the control console <NUM>. The control console <NUM> may include a probe port <NUM> in which the connector <NUM> of the sample probe <NUM> is connected. The fibers <NUM>, <NUM>, <NUM> may then be connected to the optics block <NUM> via the optical connector <NUM>. The control console <NUM> may also include an electrical port <NUM> for establishing a communication link to the surgical system <NUM>, the ultrasonic surgical system <NUM>, or any other system.

The excitation source <NUM> may illuminate the target tissue with excitation light via the excitation fiber <NUM>. The excitation source <NUM> may be configured to emit the excitation light (e.g., blue light at about <NUM> or blue light in the range of <NUM> to <NUM>. The excitation source <NUM> may also be configured to emit excitation light corresponding to other wavelengths such as wavelengths associated with the rest of the visible light spectrum other than blue light (e.g., greater than <NUM> but less than <NUM>), wavelengths associated with ultraviolet light spectrum (less than <NUM>) and/or infrared light spectrum (greater than <NUM>). The excitation source <NUM> may include any number of light sources such as a light emitting diode (LED), a pulsed laser, a continuous wave laser, a modulated laser, a filtered white light source, etc..

The excitation source <NUM> is operable in different states, the different states including at least one of an on state, an off state, a first flashing state in which light is emitted at a first frequency, a second flashing state in which light is emitted at a second frequency different than the flashing state, a first intensity state in which light is emitted at a first intensity, a second intensity state in which light is emitted at a second intensity different than the first intensity, and different color states (i.e., different wavelengths) as described above.

When the excitation source <NUM> includes a plurality of excitation sources such as a first excitation source, a second excitation source, and a third excitation source, the first excitation source may be configured to emit a first excitation light at the predetermined wavelength of the visible light spectrum, the second excitation source may be configured to emit infrared light at a second wavelength range corresponding to the infrared light spectrum (e.g., <NUM> to <NUM>) and the third excitation source may be configured to emit a third excitation light at a predetermined wavelength of the visible light which is different than the first predetermined wavelength. Stated differently, the first excitation source may be configured to emit light which would excite a first fluorophore such as PPIX, the second excitation source may be configured to emit visible light at a second predetermined wavelength, the second predetermined wavelength representing, for example, green light and the third excitation source may be configured to emit infrared light which would excite a second fluorophore, such as ICG.

The controller <NUM> may control operation of the excitation source <NUM> such as to operate the excitation source <NUM> in one of the previous mentioned states. The controller <NUM> may control operation of the excitation source <NUM> by varying operating parameters of the excitation source <NUM>. The operating parameters may correspond to a time setting, a power setting, or another suitable setting. The time setting may include a pulse width. The pulse width may be based on the integration time of the spectrometer <NUM>. The integration time of the spectrometer <NUM> is discussed in greater detail below.

With reference to <FIG>, the optics block <NUM> is shown. The optical connector <NUM> may be coupled to the optics block <NUM>. The optics block <NUM> may include an outer casing <NUM> constructed of metal or another suitable material and may fully enclose components <NUM> of the optics block <NUM>. <FIG> shows the optics block <NUM> with the top of the casing removed such that the components <NUM> of the optics block <NUM> are visible. The optics block <NUM> may be L-shaped and include a first portion <NUM> and a second portion <NUM>. The excitation source <NUM> may be coupled to the first portion <NUM> of the optics block <NUM>. The spectrometer <NUM> may be coupled to the second portion <NUM> of the optics block <NUM>.

With additional reference to <FIG>, an exploded view of the components <NUM> of the optics module <NUM> is shown illustrating an optical path <NUM> for the excitation light and the optical path <NUM> for the collected light from the brain tissue <NUM>. The first portion <NUM> may include the optical path <NUM> for the excitation light to travel from the one or more excitation sources <NUM> to the brain tissue <NUM> via the excitation fiber(s) <NUM>. The optical path <NUM> may be defined by the components <NUM> in the first portion <NUM> of the optical block. The second portion <NUM> may include the optical path <NUM> for the collected light to travel from the brain tissue <NUM> via the collection fiber <NUM> to the spectrometer <NUM>. The optical path <NUM> may be defined by the components <NUM> in the second portion <NUM> of the optical block. The components <NUM> of the optical block may include any optical components such as a laser line filter and one or more long-pass filters. The optics block <NUM> may include other optical components such as one or more mirrors, lenses, optical connectors, optical fiber, and/or any other suitable optical components.

In <FIG>, the excitation source <NUM> emits the excitation light which travels through one or more components <NUM>, such as a laser line filter and/or long pass filter. The laser line filter or bandpass filter may be configured to reject unwanted noise (e.g., lower level transitions, plasma, and glows) generated by the excitation source <NUM>. Stated differently, the laser line filter may be configured to clean up the excitation light or make the excitation light more monochromatic. The long-pass filter may be configured to reflect the light down the excitation fiber <NUM> and to the brain tissue <NUM>. The excitation source <NUM> may be configured to deliver unfiltered excitation light (i.e., the filters may be omitted) via the excitation fiber <NUM> to the target tissue. The excitation fiber <NUM> may guide the excitation light to the brain tissue <NUM> via the sample probe <NUM>.

The collection fiber <NUM> may be configured to collect light (i.e., fluorescent light and ambient light) from the brain tissue <NUM> after the tissue has been excited. Due to the presence of ambient light and/or background light caused by various sources in the operating room such as the surgical microscope <NUM>, surgical lamps, or any other devices in the operating room, the light collected from the brain tissue <NUM> may include the ambient light and/or background light. With reference to <FIG>, the light collected by the collection fiber passes through the components <NUM>, such as the long pass filter, of the second portion <NUM> of the optics block <NUM>. After the light passes through the components <NUM>, the light may enter the spectrometer <NUM> which is coupled to the optics block <NUM>.

While the example is provided that the excitation fiber <NUM> and the collection fiber <NUM> are described as separate fibers, according to the present invention, a single fiber is provided and configured to perform the functions of the excitation fiber <NUM> and the collection fiber <NUM>. In this configuration one or more other optical components may be necessary. While the excitation fiber <NUM>, the collection fiber <NUM>, and the indicator fiber <NUM> are discussed as a single fiber for simplicity, it is understood that there may be more than one fiber. For example, the excitation fiber <NUM> may include a bundle of excitation fibers, the collection fiber <NUM> may include a bundle of collection fibers, and the indicator fiber <NUM> may include a bundle of indicator fibers all being connected in similar fashion to the single fiber connections discussed above. In another example, the excitation fiber <NUM> may include any number of fibers connected in series, the collection fiber <NUM> may include any number of fibers connected in series and the indicator fiber <NUM> may include any number of fibers connected in series.

The spectrometer <NUM> is configured to convert the filtered optical signals (i.e., filtered light) into spectral signals in the form of electrical signals. The microcontroller <NUM> is configured to control operation of the spectrometer <NUM>. Examples of spectrometer systems that may be used are commercially available from Hamamatsu including Mini-spectrometer micro series C12880MA. The spectrometer <NUM> may include an entrance slit, a collimating lens/mirror, transmission grating element, a focusing mirror, and an image sensor. The entrance slit may receive the collected light from the optics block <NUM> which then passes through the collimating lens/mirror. The collimating lens/mirror collimates the collected light passed through the entrance slit and guides it onto the grating element. The grating element separates the incident light from the collimating lens into different wavelengths and lets the light at each wavelength pass through or reflect away at a different diffraction angle. The focusing lens or mirror forms an image of the light dispersed into wavelengths by the grating element onto linearly arranged pixels of the image sensor according to wavelength.

Each wavelength is photoelectrically converted into an electrical signal (i.e., a spectral signal). The image sensor outputs the signal of light incident on each pixel at a certain time interval (i.e., the image sensor converts the optical signals into electrical signals and outputs them). The time interval may be referred to as the integration timing. The microcontroller <NUM> may be configured to control operation of the spectrometer <NUM>, for example, the integration timing based on instructions from the controller <NUM>. The microcontroller <NUM> forwards the spectral signals via a communication interface (e.g., serial peripheral interface (SPI)) to the controller <NUM>.

As described previously, since ambient light may be present in the optical signals collected at the target tissue and thus present in the spectral signals provided by spectrometer <NUM>, the controller <NUM> may be configured to perform one or more functions or methods of control to remove the ambient light or noise from the spectral signals (i.e., the wavelengths associated with the ambient light) to accurately detect when the brain tissue <NUM> corresponds to the target tissue as evidenced by the PPIX present in the target tissue. The spectral signals after ambient light has been removed may be referred to as modified spectral signals.

The controller <NUM> may generate an indication signal based on the modified spectral signals. For example, the controller <NUM> may compare the PPIX intensity to a predetermined intensity threshold and in response to the PPIX intensity exceeding the threshold, the controller <NUM> may generate an indication signal. The excitation sources <NUM> may emit light which travels down the indicator fiber <NUM> and illuminates a portion of the sample probe <NUM> in response to receiving the indication signal. For example, the controller <NUM> may control the excitation source <NUM> to emit green light (e.g., wavelengths of about <NUM>-<NUM>) when PPIX above a threshold is detected or yellow light (e.g., wavelengths <NUM>-<NUM>) when ICG is detected. Alternatively, as described above, the controller <NUM> may control an indicator other than one coupled to an indicator fiber, such as controlling a light source, i.e., turning on a light source on the probe in response to receiving the indication signal.

The controller <NUM> may communicate with the ultrasonic control console <NUM> via a communication link established through the electrical port <NUM>. For example, a cord may be plugged into the electrical port and also plugged into the ultrasonic control console <NUM> to establish the communication link. The communication link may also be established wirelessly. The controller <NUM> may inform the ultrasonic control console <NUM> based on a type of tissue detected. The controller <NUM> may inform the ultrasonic control console <NUM> when target tissue is present or absent.

Based on the information provided from the controller <NUM>, the ultrasonic control console <NUM> may adjust one or more operating parameters. For example, when target tissue is present, the resection rate may not be limited; however, when target tissue is not present, the resection rate may be limited such that the ultrasonic handpiece assembly <NUM> is prevented from cutting the healthy tissue. In such an example, the ultrasonic control console <NUM> may control the drive signal, such as the voltage, current, or both supplied to the ultrasonic handpiece assembly <NUM> based on the whether the target tissue is detected. While the example is provided that the controller <NUM> may communicate with the ultrasonic control console <NUM>, the controller <NUM> may communicate with other surgical devices such as the surgical control console <NUM> to control the various surgical tools (e.g., bipolar forceps <NUM>, neuro stimulators, dissectors, ablation devices, etc.) based on the absence or presence of target tissue.

With general reference to <FIG>, a detailed description of the sample probe <NUM> will follow. The sample probe <NUM> may include the fiber(s) <NUM>, <NUM>, <NUM>, a compliance member <NUM>, a connector <NUM>, and optionally, a jacket <NUM>. The fiber(s) <NUM>, <NUM>, <NUM> may be coupled between the connector <NUM> and a distal end <NUM> of sample probe <NUM>. The distal end <NUM> of the sample probe <NUM> may include a lens or other optical component to allow for the collection and passage of light to and from the target tissue. The jacket <NUM> may enclose the fibers <NUM>, <NUM>, <NUM> in order to provide protection and shield the fiber(s) <NUM>, <NUM>, <NUM> from the environment. The jacket <NUM> may be formed with any suitable material including Polyethylene, Polyvinyl Chloride, Polyvinyl Difluoride, etc. The outer surface of the jacket <NUM> may be hydrophilic. A portion of the outer surface of the jacket <NUM> may also have small serrations such as to increase grip between the jacket <NUM> and whatever surface it comes into contact with. In some examples, a portion of the optical fiber may be coupled to one of the electrical cable(s) or suction lines of the surgical tools (i.e., the bipolar forceps <NUM>, the ultrasonic handpiece assembly <NUM>, or the suction tool <NUM>), and a second portion of the fiber may be decoupled from the surgical tool. This allows the probe to rest in position while the user moves the surgical tool to perform surgery, such as resect tissue.

With reference to <FIG>, a carrier may be coupled to at least a portion of the jacket <NUM>. The carrier may be configured to assume different shapes which in turns controls the shape of the portion of the jacket <NUM> in which the carrier is coupled to. The carrier may be a wire <NUM> or other malleable component including a first attachment portion <NUM> configured to attach to a first portion of the jacket <NUM> and a second attachment portion <NUM> configured to attached to a second portion of the jacket <NUM>. The wire <NUM> may be attached between the first attachment portion <NUM> and the second attachment portion <NUM>. The healthcare professional may bend the wire <NUM> or malleable member as desired in order to fix the shape of the relevant portion of the jacket <NUM>.

In another example, the carrier may include a tension adjustment mechanism. The tension adjustment mechanism may be configured to adjust an amount of tension applied to the jacket <NUM>. The tension adjustment member includes a first adjustment member, a second adjustment member and a flexible cable. The first adjustment member may be coupled to the compliance member and a first portion of the jacket <NUM>. The second adjustment member coupled to a second portion of the jacket <NUM>. The flexible cable may be connected between the first adjustment member and the second adjustment member. The second adjustment member may be configured to slidably move along the jacket <NUM> and in order adjust an amount of tension applied to the jacket <NUM>. When the second adjustment member is at a first position, the second adjustment member is closer to the compliance member <NUM> than it is in a second position. In the first position, the flexible cable may be in a non-stiff state and the sample probe <NUM> may move freely as if there were no tension adjustment mechanism constraining movement. When the second adjustment member is in the second position, the flexible cable may be in a stiff state and the tension in the flexible cable constrains the movement of the portion of the jacket <NUM> coupled between the first and the second adjustment members.

With reference to <FIG>, a gripping element <NUM> may be removably coupled to the jacket <NUM> proximal to the compliance member <NUM>. Thus, the gripping element <NUM> may be located proximal to the compliance member. The gripping element <NUM> may be implemented as a fastener configured to attach to a portion of the patient in order to prevent movement of the sample probe <NUM> from a desired position. The gripping element <NUM> may include a jacket attachment portion <NUM> and a patient engagement portion <NUM>. The jacket attachment portion <NUM> may include a tubular like sleeve having a snug fit and configured to slide along the jacket <NUM> with application of force by a healthcare professional. The patient engagement portion <NUM> may be mounted or otherwise attached to the jacket attachment portion <NUM>. The patient engagement portion <NUM> may include a clip or a clamp configured to be attached to the patient or inanimate component near the patient.

With reference to <FIG>, the gripping element <NUM>' may also be implemented as a tab <NUM> configured for engagement by the surgical tool. As an alternative to the tab, the compliance member may define a tubular like structure including a hole, aperture, or cavity slightly larger in diameter than the lumen of the suction tool <NUM> such that the suction tool <NUM> may be inserted through. The suction tool <NUM> may engage the tab <NUM> such as to guide the compliance member <NUM> into a hard to reach portion of the brain such as a deep narrow cavity of the brain.

Alternative, the compliance member may be free of any tab or gripping element, but may include a magnetic or ferrous material such that the compliance member can be maneuvered by use of a surgical tool that includes a ferrous metal or a magnetic material, respectively.

With reference to <FIG>, an anchor <NUM> may be coupled to the jacket <NUM> or fiber(s) and slidable along the length of the jacket <NUM>. The healthcare professional may place the anchor <NUM> at any position along the length of the jacket <NUM> in order to anchor the sample probe <NUM> to a point of interest. The point of interest may correspond to a point of transition between the sterile field and non-sterile field, such as out of the patient or contacting skin or bone, as opposed to brain tissue. The anchor <NUM> may be cylindrical shaped. As such, the anchor <NUM> may include two-base ends <NUM>, <NUM> connected by a curved surface <NUM>. The curved surface <NUM> may be formed with a through bore <NUM> in which the sample probe <NUM> is inserted through. The anchor <NUM> may be formed of metal or another suitable dense material capable of countering the weight of the sample probe <NUM> and anchoring the sample probe <NUM> to a particular point of interest.

With additional reference to <FIG>, the compliance member <NUM> may be removably coupled to the jacket <NUM> and/or fibers at the distal end of the sample probe <NUM>. In some implementations, the compliance member <NUM> is removable from the sample probe <NUM> so that a healthcare professional may reach a deep narrow cavity of the brain in which the sample probe <NUM> would not otherwise be able to reach with the compliance member <NUM> attached.

The compliance member <NUM> may be at least partially translucent to visible light and in some implementations, configured to deform in response to engagement by a surgical tool, such as the bipolar forceps <NUM>, the suction tool <NUM>, or the ultrasonic handpiece assembly <NUM>. The compliance member <NUM> may be formed with any suitable material that is deformable, electrically insulating, and thermally insulating.

The material of the compliance member <NUM> may be selected to be refractive index-matching. Stated differently, the material of the compliance member <NUM> may be selected such that a refractive index of the compliance member <NUM> is within a predetermined threshold of a refractive index of the tissue and/or a refraction index of the fibers <NUM>, <NUM> so that the refraction of light passing between the fiber(s) <NUM>, <NUM> and the tissue is minimized. The collection fiber <NUM> may have a refraction index with a range of approximately <NUM> to <NUM>, the compliance member <NUM> may have a refraction index of approximately <NUM>, and the tissue may have a refractive index varying approximately between <NUM> to <NUM>.

The material of the compliance member <NUM> may be selected based on other desired optical properties for the compliance member <NUM> such as the ability to disperse light from the excitation fiber <NUM> and/or indication fiber <NUM> broadly to the surrounding environment. The compliance member may be formed of a polymer. In certain embodiments, the compliance member may be a foam. The compliance member may comprise a bioresorbable material, such as a polyurerthane. Bioresorbable refers to the ability of being completely metabolized by the human or animal body. The compliance member may be formed from a material selected from silicone, polyvinylchloride, a hydrogel, a polyurethane, a polysaccharide, cellulose, polylactic acid, and combinations thereof. The compliance member may have has a Rockwell Shore Hardness <NUM> of <NUM>-<NUM>, <NUM>-<NUM>, or <NUM>-<NUM> or a Rockwell Shore Hardness A of <NUM>-<NUM>, or <NUM>-<NUM>.

The compliance member <NUM> may be sphere shaped. Optionally, with the sphere-shaped configuration, the compliance member <NUM> may include an aperture that may expose a portion of the distal end of the sample probe <NUM> to the environment. The compliance member <NUM> may have a smooth surface or may include one or more features on the outer surface that make it easier for a surgical tool, such as the bipolar forceps <NUM> or the suction tool <NUM>, to engage the compliance member <NUM>. For example, with reference to <FIG>, the one or more features may include a plurality of ridges including a first ridge <NUM> and a second ridge <NUM> extending along an outer surface. The bipolar forceps <NUM> may engage the compliance member <NUM> at either of the first ridge <NUM> or the second ridge <NUM> using the tines so that the compliance member <NUM> does not slip out from the grip of the bipolar forceps <NUM> or any other surgical tool.

While the compliance member is described as being compliant in several aspects of this disclosure, in some implementations, the compliance member may be not be compliant or deformable, and in this instances, the compliance member may be referred to as a locating member, where the locating member may include any of the features described above with respect to the compliance member, but for the ability to deform in response to engagement by the surgical tool.

With reference to <FIG>, the one or more features may include a projection <NUM>. The projection <NUM> may extend along an axis transverse (or at any angle) relative to an axis of at least one of the collection fiber <NUM> and/or the excitation fiber <NUM>. The projection <NUM> may be sized to be disposed at least partially within a lumen of the suction tool <NUM> or the ultrasonic handpiece assembly <NUM>. Thus, suction may be applied with the suction tool <NUM> when the projection <NUM> is disposed within the lumen and the healthcare professional may move the compliance member <NUM> to a desired location. The projection is optional, and need not be included in all configurations of the probe. The projection may extend from an outer surface of the compliance member, and may optionally be integral with the compliance member. The projection may be included with the locating member implementation.

A shown in previous FIGS. , the compliance member <NUM> is shown to have the shape of a sphere but it is understood that the compliance member <NUM> may take on any shape. As shown in <FIG>, the compliance member <NUM> may be tubular shaped as shown in <FIG>, cone shaped as shown in <FIG>, rectangular or cubeshaped as shown in <FIG>, or as shown in <FIG>, an invertible C-shape that allows for a distal portion of the compliance member <NUM> to be moved relative to a distal end of the sample probe <NUM> such that the sample probe <NUM> is able to illuminate the target area in a diffused mode or a focused mode, as discussed in greater detail in the preceding paragraph.

As shown in <FIG>, the compliance member <NUM> may include a first portion <NUM>, a center portion <NUM>, and a second portion <NUM>. The center portion <NUM> may include an aperture in which the distal end <NUM> of the sample probe <NUM> is inserted therethrough. In a diffused position, the first portion <NUM> and the second portion <NUM> may extend forward from the distal end <NUM> of the sample probe <NUM> such that the sample probe <NUM> delivers diffused excitation light (i.e., light hat spreads in all directions) to the target area. In a diffused position, at least a portion of the first portion <NUM> and at least a portion of the second portion <NUM> may be in contact with each other. In a focused position, the first portion <NUM> and the second portion <NUM> may be folded or peeled back by the health care professional such that the center portion <NUM> of the compliance member <NUM> is disposed forward the first portion <NUM> and the second portion <NUM> and closer to the distal end <NUM> of the sample probe <NUM>. In the focused position, the distal end <NUM> of the sample probe <NUM> is exposed and configured to deliver focused excitation light (i.e., light that is directed straight out of the sample probe <NUM> and that may enter small target area) to the target area. It should be understood that in the diffused position, the excitation light is more diffused than in the focused position. Similarly, in the focused position, the excitation light is more focused than when in the diffused position.

With reference to <FIG>, a cross section of one implementation of the sample probe <NUM> is shown. As described previously, the jacket <NUM> of the sample probe <NUM> may enclose the fibers <NUM>, <NUM>, <NUM> in order to provide protection and shield the fibers <NUM>, <NUM>, <NUM> from the environment. In some examples, the excitation fiber <NUM> and the collection fiber <NUM> may be disposed closer to the distal portion of the compliance member <NUM> or locating member than the indicator fiber <NUM>. As discussed previously, the compliance member <NUM> may include an aperture at the distal portion which exposes the excitation fiber <NUM> and the collection fiber <NUM> to the environment such that the excitation fiber <NUM> is able to illuminate the target area with excitation light and the collection fiber <NUM> is able to collect light from the target area without the light traveling directly through the material that forms the compliance member/locating member. The compliance member <NUM> may include a first and second hemisphere with the excitation fiber <NUM> and collection fiber <NUM> being disposed in the first hemisphere and the indicator fiber <NUM> being disposed in the second hemisphere.

As shown in <FIG>, when a tip of the indicator fiber <NUM> is disposed with the compliance member <NUM>, the light from the indicator fiber <NUM> may light up the compliance member <NUM> to indicate the presence of the target tissue. However, in some examples, such as shown in <FIG> and <FIG>, the indicator fiber <NUM> is not disposed within the compliance member <NUM> at all and instead the indicator fiber <NUM> may illuminate another portion of the sample probe <NUM>, and may terminate at a distal end 260T, which is outside of the compliance member.

In such an example, with reference to <FIG>, the sample probe <NUM> may be a co-axial fiber <NUM> with a central core <NUM> and an outer channel <NUM>. At least a portion of the sidewall of the outer channel <NUM> may be transparent. The excitation fiber <NUM> and the collection fiber <NUM> may be disposed within the central core <NUM> while the indicator fiber <NUM> is disposed within the outer channel <NUM>. A distal portion of the central core <NUM> may be disposed within the compliance member <NUM>. The indicator fiber <NUM> may emit light through the sidewalls of the outer channel <NUM>. The sample probe <NUM> may have an exposed portion <NUM> in which the jacket <NUM> does not cover the entire length of the co-axial fiber <NUM> such that the light emitted through the side walls is visible to the healthcare professional via the exposed portion <NUM>. The exposed portion <NUM> may be situated proximal to the compliance member <NUM> to ensure that the healthcare professional is able to view the indicator light emitted as the healthcare professional is resecting tissue. Optionally, the exposed portion <NUM> may be covered with a clear or transparent piece of plastic or another suitable material. As such, the side wall of the outer channel may be transparent and configured to allow the indicator element, such as an LED, to diffuse light to an ambient area.

In another example, as described above, the indicator fiber <NUM> may be omitted entirely. Instead, the sample probe <NUM> may include a light emitting diode (LED) that is activated in response to receiving the activation signal. The LED may be disposed proximal to the compliance member <NUM> and coupled to an outer surface of the jacket <NUM> or at another suitable location along the sample probe <NUM>. In another example, others forms of indication may be provided such as an audible indication generated by a speaker associated with the control console <NUM> or a haptic indication generated by a haptic device attached to the sample probe <NUM>. In other words, indicator form may take the form of a indicator element, such as a light source, and the indicator element need not take the form of a fiber, and the indicator element need not necessarily be disposed within or partially within the compliance member or locating member, but rather the indicator element could be positioned proximally or distally the compliance member, and alternatively, the indicator element may appear as an icon or display element on the console.

With reference to <FIG>, various surgical tools are shown engaging the sample probe <NUM>. In <FIG> and <FIG>, either the ultrasonic handpiece assembly <NUM> or the suction tool <NUM> is directly engaging the compliance member <NUM>; however, as previously described, the compliance member <NUM> may include the projection <NUM> (hidden from view as disposed in the lumen) which may fit into a lumen of the ultrasonic handpiece assembly <NUM> or the suction tool <NUM>. Once the ultrasonic handpiece assembly <NUM> or the suction tool <NUM> is coupled to the compliance member <NUM>, suction may be applied by the healthcare professional in order to move the compliance member <NUM> to a desired location. In <FIG>, the compliance member <NUM> is engaged by the bipolar forceps <NUM>, having tines <NUM>, <NUM>. As illustrated, the compliance member <NUM> includes the previously described plurality of ridges <NUM>, <NUM>. The compliance member <NUM> may be gripped by the bipolar forceps <NUM> at one or both of the plurality of ridges <NUM>, <NUM>.

A tracking system may be used and coupled to the navigation computer. The tracking system is configured to sense the pose (i.e., position and orientation) of one or more tracking elements attached to probe and provide the pose to the navigation computer. The tracking elements may be active or passive infrared tracking elements. An example of a surgical navigation system <NUM> which includes a tracking system is Nav3i™ that is commercially available from Stryker. A surgical navigation system <NUM> may have various functions and features as described in <CIT> and <CIT>.

Referring now to <FIG>, the member <NUM>', such as the compliance member, defines a lumen <NUM>. This may allow the user to position surgical tools therethrough. In this configuration, the compliance member <NUM>' may be coupled to the optical fibers as described throughout. The compliance member <NUM>' may assume the shape of a doughnut or a cylindrical shape. The indicator may be disposed within the compliance member <NUM>' as described above, such as an LED or the distal end of the indicator fiber may be disposed within the compliance member <NUM>'. The lumen may be sized to allow a portion of the surgical tool to be placed therethrough. The lumen may range in size, but is at least <NUM> in diameter, or ranging from <NUM> to <NUM> in diameter.

Referring to <FIG>, the locating member <NUM>"includes one or more electrodes <NUM> positioned on the surface of the member <NUM>". The locating member may be the compliance member described throughout but may optionally omit the optical fibers for optical detection. The electrodes <NUM> may be spaced apart from one another such that they can be in contact with tissue that abuts the circumference or outer surface of the member <NUM>". The electrodes <NUM> may be coupled to a detection module that processes the electrical signals received by the electrode(s) to determine a tissue type, such as whether the tissue contacted by the electrode is a critical structure. For example, the electrodes may facilitate functional mapping, bioimpedance analysis, or other electrical analysis of the brain tissue. The detection module may be coupled to an indicator <NUM>, such as an LED or an optical fiber. In instances where the indicator is an LED or other light source, the member <NUM>" may include a conductor <NUM>. The indicator <NUM> may illuminate when a target tissue is detected, such as lighting red when a critical tissue type has been detected, and lighting green when a non-critical tissue type has been detected. Exemplary processing techniques and electrode constructions can be found in <CIT> and <CIT> and <CIT>. Exemplary techniques include functional brain mapping, electroencephalography, magnetoencephalography, electrocorticography, or combinations thereof. The probe may be placed such that the electrode is placed on a particular region of the brain and/or on, through or inside of intracranial or extracranial blood vessels or other tissues at a second position not in contact with said particular region of the brain but electrically coupled to the brain, and monitoring the brain activity from said particular region through signals received by the electrode.

Referring to <FIG>, the probe <NUM>' may include a connector <NUM> that allows the compliance member <NUM>‴ to be detached from the fiber and/or conductor and remain at the surgical site. In such an implementation, the compliance member <NUM>‴ may include radiopaque material. During use of the probe, the compliance member <NUM>‴ may be detached from the probe and the surgical site may be imaged using an imager, such as an MRI scanner or CT scanner. The incorporation of radio-opaque material into the compliance member <NUM>‴ allows the compliance member to be visualized relative to other critical structures. It is contemplated that the radiopaque material be gadolinium, but other radiopaque materials are also contemplated. It is also contemplated that only a portion of the compliance member be removed from the probe, and this removed portion contain the radiopaque material and be visualized with the imager. The radiopaque material may be dispersed in the compliance member, or may be received in a pocket.

International Application No. <CIT>and aspects may be used in conjunction with the probe described herein.

The foregoing description is merely illustrative in nature and is in no way intended to limit the disclosure, its application, or uses. The broad teachings of the disclosure can be implemented in a variety of forms. Therefore, while this disclosure includes particular examples, the true scope of the disclosure should not be so limited since other modifications will become apparent upon a study of the drawings, the specification, and the following claims. It should be understood that one or more steps within a method may be executed in different order (or concurrently) without altering the principles of the present disclosure. Further, although each of the examples is described above as having certain features, any one or more of those features described with respect to any example of the disclosure can be implemented in and/or combined with features of any of the other examples, even if that combination is not explicitly described. In other words, the described examples are not mutually exclusive, and permutations of one or more examples with one another remain within the scope of this disclosure.

Spatial and functional relationships between elements (for example, between controllers, circuit elements, semiconductor layers, etc.) are described using various terms, including "connected," "engaged," "coupled," "adjacent," "next to," "on top of," "above," "below," and "disposed. " Unless explicitly described as being "direct," when a relationship between first and second elements is described in the above disclosure, that relationship can be a direct relationship where no other intervening elements are present between the first and second elements, but can also be an indirect relationship where one or more intervening elements are present (either spatially or functionally) between the first and second elements.

As used herein, the phrase at least one of A, B, and C should be construed to mean a logical (A OR B OR C), using a non-exclusive logical OR, and should not be construed to mean "at least one of A, at least one of B, and at least one of C. " The term subset does not necessarily require a proper subset. In other words, a first subset of a first set may be coextensive with (equal to) the first set.

In the figures, the direction of an arrow, as indicated by the arrowhead, generally demonstrates the flow of information (such as data or instructions) that is of interest to the illustration. For example, when element A and element B exchange a variety of information but information transmitted from element A to element B is relevant to the illustration, the arrow may point from element A to element B. This unidirectional arrow does not imply that no other information is transmitted from element B to element A. Further, for information sent from element A to element B, element B may send requests for, or receipt acknowledgements of, the information to element A.

In this application, including the definitions below, the term "controller" or "module" may be replaced with the term "circuit. " The term "controller" may refer to, be part of, or include: an Application Specific Integrated Circuit (ASIC); a programmable system on a chip (PSoC); a digital, analog, or mixed analog/digital discrete circuit; a digital, analog, or mixed analog/digital integrated circuit; a combinational logic circuit; a field programmable gate array (FPGA); a processor circuit (shared, dedicated, or group) that executes code; a memory circuit (shared, dedicated, or group) that stores code executed by the processor circuit; other suitable hardware components that provide the described functionality; or a combination of some or all of the above, such as in a system-on-chip.

The controller may include one or more interface circuits with one or more transceivers. In some examples, the interface circuit(s) may implement wired or wireless interfaces that connect to a local area network (LAN) or a wireless personal area network (WPAN). Examples of a LAN are Institute of Electrical and Electronics Engineers (IEEE) Standard <NUM>-<NUM> (also known as the WIFI wireless networking standard) and IEEE Standard <NUM>-<NUM> (also known as the ETHERNET wired networking standard). Examples of a WPAN are the BLUETOOTH wireless networking standard from the Bluetooth Special Interest Group and IEEE Standard <NUM>.

The controller may communicate with other controllers using the interface circuit(s). Although the controller may be depicted in the present disclosure as logically communicating directly with other controllers, in various implementations the controller may actually communicate via a communications system. The communications system may include physical and/or virtual networking equipment such as hubs, switches, routers, gateways and transceivers. In some implementations, the communications system connects to or traverses a wide area network (WAN) such as the Internet. For example, the communications system may include multiple LANs connected to each other over the Internet or point-to-point leased lines using technologies including Multiprotocol Label Switching (MPLS) and virtual private networks (VPNs).

In various implementations, the functionality of the controller may be distributed among multiple controllers that are connected via the communications system. For example, multiple controllers may implement the same functionality distributed by a load balancing system. In a further example, the functionality of the controller may be split between a server (also known as remote, or cloud) controller and a client (or, user) controller.

Some or all hardware features of a controller may be defined using a language for hardware description, such as IEEE Standard <NUM>-<NUM> (commonly called "Verilog") and IEEE Standard <NUM>-<NUM> (commonly called "VHDL"). The hardware description language may be used to manufacture and/or program a hardware circuit. In some implementations, some or all features of a controller may be defined by a language, such as IEEE <NUM>-<NUM> (commonly called "SystemC"), that encompasses both code, as described below, and hardware description.

The term shared processor circuit encompasses a single processor circuit that executes some or all code from multiple controllers. The term group processor circuit encompasses a processor circuit that, in combination with additional processor circuits, executes some or all code from one or more controllers. The term shared memory circuit encompasses a single memory circuit that stores some or all code from multiple controllers. The term group memory circuit encompasses a memory circuit that, in combination with additional memories, stores some or all code from one or more controllers.

The term memory circuit is a subset of the term computer-readable medium. The term computer-readable medium, as used herein, does not encompass transitory electrical or electromagnetic signals propagating through a medium (such as on a carrier wave); the term computer-readable medium may therefore be considered tangible and non-transitory. Non-limiting examples of a non-transitory computer-readable medium are nonvolatile memory circuits (such as a flash memory circuit, an erasable programmable read-only memory circuit, or a mask read-only memory circuit), volatile memory circuits (such as a static random access memory circuit or a dynamic random access memory circuit), magnetic storage media (such as an analog or digital magnetic tape or a hard disk drive), and optical storage media (such as a CD, a DVD, or a Blu-ray Disc).

The apparatuses and methods described in this application may be partially or fully implemented by a special purpose computer created by configuring a general purpose computer to execute one or more particular functions embodied in computer programs. The functional blocks and flowchart elements described above may serve as software specifications, which can be translated into the computer programs by the routine work of a skilled technician or programmer. The computer programs include processor-executable instructions that are stored on at least one non-transitory computer-readable medium. The computer programs may also include or rely on stored data. The computer programs may encompass a basic input/output system (BIOS) that interacts with hardware of the special purpose computer, device drivers that interact with particular devices of the special purpose computer, one or more operating systems, user applications, background services, background applications, etc..

Claim 1:
An optical sensor system (<NUM>) for detecting a tissue type in a surgical procedure, the optical sensor system (<NUM>) comprising:
an excitation source (<NUM>) configured to selectively emit excitation light;
a probe (<NUM>) comprising:
a fiber (<NUM>, <NUM>) coupled to the excitation source (<NUM>); and
a compliance member (<NUM>) coupled to the fiber (<NUM>, <NUM>), the compliance member (<NUM>) being at least partially translucent and configured to deform in response to engagement by a surgical tool, wherein a portion of the fiber (<NUM>, <NUM>) is disposed inside of the compliance member (<NUM>);
an optical detection module (<NUM>) coupled to the fiber (<NUM>, <NUM>) and configured to generate a signal based on the collected light from the target tissue; and
a controller (<NUM>) operatively connected to the optical detection module (<NUM>) and the probe (<NUM>) and configured to determine a tissue characteristic based on the signal and generate an indicator signal based on the determined tissue characteristic;
characterized in that
the fiber (<NUM>, <NUM>) is configured to illuminate target tissue with the excitation light and collect light from target tissue; and
the probe (<NUM>) further comprises an indicator element (<NUM>) configured to emit light in response to receiving the indicator signal.