Patent Description:
Various features of the embodiments described herein, together with advantages thereof, may be understood in accordance with the following description taken in conjunction with the accompanying drawings as follows:.

Corresponding reference characters indicate corresponding parts throughout the several views. The exemplifications set out herein illustrate certain embodiments of the invention, in one form, and such exemplifications are not to be construed as limiting the scope of the invention in any manner.

Applicant of the present application also owns the following U. Patent Applications that were filed on even date herewith:.

Applicant of the present application owns the following U. Patent Applications, filed on December <NUM>, <NUM>:.

Numerous specific details are set forth to provide a thorough understanding of the overall structure, function, manufacture, and use of the embodiments as described in the specification and illustrated in the accompanying drawings. Well-known operations, components, and elements have not been described in detail so as not to obscure the embodiments described in the specification. The reader will understand that the embodiments described and illustrated herein are non-limiting examples, and thus it can be appreciated that the specific structural and functional details disclosed herein may be representative and illustrative. Variations and changes thereto may be made without departing from the scope of the claims.

Various exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, the reader will readily appreciate that the various methods and devices disclosed herein can be used in numerous surgical procedures and applications including, for example, in connection with open surgical procedures. As the present Detailed Description proceeds, the reader will further appreciate that the various instruments disclosed herein can be inserted into a body in any way, such as through a natural orifice, through an incision or puncture hole formed in tissue, etc. The working portions or end effector portions of the instruments can be inserted directly into a patient's body or can be inserted through an access device that has a working channel through which the end effector and elongate shaft of a surgical instrument can be advanced.

<FIG> illustrates a schematic diagram of a surgical instrument <NUM> configured to deliver a surgical treatment to a tissue to seal and/or cut the tissue. The surgical treatment includes at least two phases. In the first phase, a therapeutic electrical energy is employed to seal the tissue. In at least one example, the therapeutic electrical energy is an RF energy. In the second phase, staples are deployed into the tissue and, optionally, a cutting member <NUM> (<FIG>) cuts the tissue.

The surgical instrument <NUM> includes an end effector <NUM> with jaws <NUM>. At least one of the jaws <NUM> is movable relative to the other from an open configuration to a closed configuration to grasp tissue therebetween. As illustrated in <FIG>, the end effector <NUM> includes at least one electrode <NUM> configured to deliver the therapeutic electrical energy to the tissue in the first phase of the surgical treatment. The end effector <NUM> further includes an anvil <NUM> and a staple cartridge <NUM> configured to cooperate to form staples <NUM> (<FIG>) deployable from the staple cartridge <NUM> into the tissue in the second phase of the surgical treatment. The staples <NUM> are formed by anvil pockets 747a, 747b (<FIG>).

One of the jaws <NUM> of the end effector <NUM> includes a channel <NUM> configured to slidably receive the staple cartridge <NUM>. In the illustrated example, the staple cartridge <NUM> is inserted into the channel <NUM> through a distal opening <NUM>. The channel <NUM> and the staple cartridge <NUM> include corresponding locking features <NUM>, <NUM> that cooperate to reversibly lock the staple cartridge <NUM> and the channel in a locked configuration. In the illustrated example, the locking features <NUM>, <NUM> are in the form of a ramp and a corresponding groove. In other examples, the locking features <NUM>, <NUM> can be in the form of protrusions, nubs, bulges, dimples, or any suitable projections, and corresponding valleys, holes, or any suitable depressions. In certain instances, the projections can be in the form of biasing or spring members.

In the illustrated example, the staple cartridge <NUM> includes two staple cavity rows 757a, 757b on opposite sides of a longitudinal slot <NUM> configured to accommodate a sliding movement of a cutting member <NUM>. The cutting member <NUM> is slidably advanced through the longitudinal slot <NUM> to cut tissue grasped between the jaws <NUM>. In other examples, more or less than two rows of staple cavities can be longitudinally disposed alongside the longitudinal slot <NUM>.

Further to the above, the channel <NUM> includes a ceiling or cover <NUM> that includes a longitudinal opening <NUM> configured to at least partially accommodate the staple cavity rows 757a, 757b when the staple cartridge <NUM> is assembled with the channel <NUM>. In the illustrated example, the staple cartridge <NUM> includes a stepped deck <NUM> that raises the staple cavity rows 757a, 757b. Side walls 744a, 744b of the channel <NUM> include narrowed portions configured to snuggly receive the stepped deck <NUM> to ensure a proper alignment of the staple cavity rows 757a, 757b with the longitudinal opening <NUM> defined in the ceiling or cover <NUM>.

In the illustrated example, the at least one electrode <NUM> includes electrode segments 796a, 796b, 796c that define a partial perimeter around the longitudinal opening <NUM>. In the assembled configuration, as illustrated in <FIG>, the raised staple cavity rows 757a, 757b of the stepped deck <NUM> extend longitudinally in parallel, or substantially in parallel, with the electrode segments 796a, 796b, 796c cooperatively defining a tissue contacting surface. <FIG> illustrates a tissue T including a tissue portion T1 fastened by a staple <NUM> from the staple cavity row 757a, and a tissue portion T2 sealed by RF energy from the electrode segment 796b. The tissue T is cut, in the second phase, along a plane P (perpendicular to the page) by a cutting member <NUM> driven by an I-beam <NUM>, for example, through the longitudinal slot <NUM>, for example.

In the illustrated example, the electrode segments 796a, 796b, 796c are disposed onto, or are partially embedded, in corresponding insulative segments 797a, 797b, 797c of an insulative layer <NUM>. Furthermore, the anvil <NUM> includes electrodes <NUM>, <NUM>, which are disposed onto, or are partially embedded, in corresponding insulative segments <NUM>, <NUM>. RF energy may flow from the at least one electrode <NUM> to the electrodes <NUM>, <NUM> through tissue grasped between the jaws <NUM>.

To avoid unintentionally forming a short circuit, the electrodes <NUM>, <NUM> are offset from the electrode segments 797a, 797c, as illustrated in <FIG>. In other words, the electrodes <NUM>, <NUM> remain spaced apart from the electrode segments 797a, 797c, respectively, in a closed configuration of the end effector without tissue. In the illustrated example, the channel <NUM> is grounded, and the at least one electrode <NUM> is an integral part of the channel <NUM> with no moving parts. In at least one example, the at least one electrode <NUM> is hard-wired into channel <NUM> so electrical connections are not exposed to fluids that may cause a short. In the illustrated example, the electrodes <NUM>, <NUM> are separated from the anvil <NUM> by the insulative segments <NUM>, <NUM>, respectively. In other examples, the electrodes <NUM>, <NUM> are integral with the anvil <NUM>. In such examples, the anvil <NUM> is a part of the return path of the RF energy.

In the illustrated example, the RF energy is configured to flow from the at least one electrode <NUM> toward the electrodes <NUM>, <NUM>. In other examples, however, the end effector <NUM> can be configured to cause the RF energy to flow from the electrodes <NUM>, <NUM> toward the at least one electrode <NUM>.

When the staple cartridge <NUM> is assembled with the channel <NUM>, a nose portion <NUM> of the staple cartridge <NUM> extend beyond the distal opening <NUM>, while the remainder of the staple cartridge <NUM> is received within the channel <NUM>. Furthermore, the staple cartridge <NUM> comprises a cartridge release latch <NUM> configured to unlock the locking engagement of the locking features <NUM>, <NUM> to permit removal of the staple cartridge <NUM> from the channel <NUM>.

<FIG> illustrate an end effector <NUM> similar in many respects to the end effector <NUM>. The end effector <NUM> can be utilized with the surgical instrument <NUM> in lieu of the end effector <NUM>. Like the end effector <NUM>, the end effector <NUM> includes jaws configured to grasp tissue to deliver a surgical treatment to the tissue in first and second treatment phases.

Furthermore, the end effector <NUM> includes an anvil <NUM> and a channel <NUM> configured to releasably retain a staple cartridge <NUM>. An RF overlay <NUM> is pivotally coupled to the channel <NUM>. <FIG> illustrates a process and mechanisms for attaching and detaching the RF overlay <NUM> to the staple cartridge <NUM> while the staple cartridge <NUM> is retained in the channel <NUM>.

In certain examples, the staple cartridge <NUM>, similar to the staple cartridge <NUM>, includes a stepped deck <NUM> with raised staple cavity rows 857a, 857b and an insulative depressed region <NUM> configured to releasably retain the RF overlay <NUM>, as best illustrated in <FIG>. In an assembled configuration, as illustrated in <FIG>, the staple cavity rows 857a, 857b and at least one electrode <NUM> of the RF overlay <NUM> cooperatively define a tissue contacting surface.

Furthermore, the staple cavity rows 857a, 857b and electrode segments 896a, 896b of the at least one electrode <NUM> extend longitudinally in parallel, or at least substantially in parallel, on opposite sides of a longitudinal slot <NUM> cooperatively defined by the RF overlay <NUM> and the staple cartridge <NUM> while the staple cartridge <NUM> is retained in the channel <NUM>. In the illustrated example, the drive member <NUM> terminates in an I-beam <NUM> that includes a cutting member <NUM> movable through the longitudinal slot <NUM> to cut tissue grasped between the jaws of the end effector <NUM> in a similar manner described in connection with the end effector <NUM>.

In the illustrated example, the RF overlay <NUM> comprises a U-shape, and includes two body portions 897a, 897c extending longitudinally in parallel, or at least substantially in parallel. The body portions 897a, 897c are separated by a longitudinal opening <NUM> defined in the RF overlay <NUM>. A distal arcuate portion 897b connects the body portions 897a, 897c. The longitudinal opening <NUM> facilitates translation of the cutting member <NUM> relative to the RF overlay <NUM>. The at least one electrode <NUM> also comprises a U-shape, and is disposed onto, or is at least partially embedded into, the portions 897a, 897b, 897c. In certain instances, the at least one electrode <NUM> includes 896a, 896b, 896c that can be connected to the RF energy source <NUM>. Other electrode shapes and configurations for the RF overlay <NUM> are contemplated by the present disclosure.

In the illustrated examples, the overlay <NUM> includes pivots <NUM> extending laterally from a proximal portion of the RF overlay <NUM>. The pivots <NUM> are received in corresponding pivot holes <NUM> defined in sidewalls of the channel <NUM>. The overlay <NUM> is rotatable between an unlocked configuration (<FIG>) and a locked configuration (<FIG>) about an axis extending through the pivot holes <NUM>. In the illustrated example, the anvil <NUM> pivots the RF overlay <NUM> toward the staple cartridge <NUM>. The anvil <NUM> may cause the staple cartridge <NUM> to snap into the channel <NUM>, and the RF overlay <NUM> to snap into the staple cartridge <NUM>.

Furthermore, the staple cartridge <NUM> includes a latch mechanism <NUM> including a latch member <NUM> and a biasing member <NUM> configured to maintain the latch member <NUM> at a first position, as illustrated in <FIG>. In the illustrated example, the RF overlay includes a distal projection <NUM> configured to be caught by the latch member <NUM> in the locked configuration.

Further to the above, as illustrated in <FIG>, a sled <NUM> can be motivated by the drive member <NUM> to disengage the latch member <NUM> from the distal projection <NUM>. In the illustrated example, the sled <NUM>, toward the end of a sled-firing-stroke, pushes the latch member <NUM> distally, which compresses the biasing member <NUM>, and releases the distal projection <NUM> from the latch member <NUM>. The spent staple cartridge <NUM> can then be pulled out of the channel <NUM>, and replaced with an unspent staple cartridge <NUM>. The RF overlay <NUM> can then be motivated by the anvil <NUM> into a locking engagement with the unspent staple cartridge <NUM>.

Referring primarily to <FIG>, a control circuit <NUM> may be programmed to control one or more functions of the surgical instrument <NUM> such as, for example, closure of the end effector <NUM>, activation of the at least one electrode, and/or firing the staple cartridge. The control circuit <NUM>, in some examples, may comprise one or more microcontrollers, microprocessors, or other suitable processors for executing instructions that cause the processor or processors to control the one or more functions of the surgical instrument <NUM>. In one aspect, a timer/counter <NUM> provides an output signal, such as the elapsed time or a digital count, to the control circuit <NUM>. The timer/counter <NUM> may be configured to measure elapsed time, count external events, or time external events.

The control circuit <NUM> may generate a motor set point signal <NUM>. The motor set point signal <NUM> may be provided to a motor controller <NUM>. The motor controller <NUM> may comprise one or more circuits configured to provide a motor drive signal <NUM> to the motor <NUM> to drive the motor <NUM> as described herein. In some examples, the motor <NUM> may be a brushed DC electric motor. For example, the velocity of the motor <NUM> may be proportional to the motor drive signal <NUM>. In some examples, the motor <NUM> may be a brushless DC electric motor and the motor drive signal <NUM> may comprise a PWM signal provided to one or more stator windings of the motor <NUM>. Also, in some examples, the motor controller <NUM> may be omitted, and the control circuit <NUM> may generate the motor drive signal <NUM> directly.

The motor <NUM> may receive power from an energy source <NUM>. The energy source <NUM> may be or include a battery, a super capacitor, or any other suitable energy source. The motor <NUM> may be mechanically coupled to the drive member <NUM> via a transmission <NUM>. The transmission <NUM> may include one or more gears or other linkage components to couple the motor <NUM> to a drive member <NUM>.

Further to the above, an RF energy source <NUM> is coupled to an end effector (e.g., end effectors <NUM> (<FIG>), <NUM> (<FIG>)), and is applied to an RF electrode of the end effector (e.g., electrodes <NUM> (<FIG>), <NUM> (<FIG>)) or the RF electrode. In at least one example, the anvil <NUM> is at least partial made of electrically conductive metal and may be employed as the return path for electrosurgical RF current. The control circuit <NUM> controls the delivery of the RF energy to the RF electrode <NUM>, or the RF electrode <NUM>.

Additional details are disclosed in <CIT>.

The control circuit <NUM> may be in communication with one or more sensors <NUM>. The sensors <NUM> may be positioned on the end effector <NUM> and adapted to operate with the surgical instrument <NUM> to measure the various derived parameters such as gap distance versus time, tissue compression versus time, and anvil strain versus time. The sensors <NUM> may comprise a magnetic sensor, a magnetic field sensor, a strain gauge, a pressure sensor, a force sensor, an inductive sensor such as an eddy current sensor, a resistive sensor, a capacitive sensor, an optical sensor, and/or any other suitable sensor for measuring one or more parameters of the end effector <NUM>.

In one aspect, sensors <NUM> may be implemented as a limit switch, electromechanical device, solid-state switches, Hall-effect devices, MR devices, GMR devices, magnetometers, among others. In other implementations, the sensors <NUM> may be solid-state switches that operate under the influence of light, such as optical sensors, IR sensors, ultraviolet sensors, among others. Still, the switches may be solid-state devices such as transistors (e.g., FET, junction FET, MOSFET, bipolar, and the like). In other implementations, the sensors <NUM> may include electrical conductorless switches, ultrasonic switches, accelerometers, and inertial sensors, among others. The sensors <NUM> may include one or more sensors.

The control circuit <NUM> can be configured to simulate the response of the actual system of the instrument in the software of a controller. The drive member <NUM> can move one or more elements in the end effector <NUM> at or near a target velocity. The surgical instrument <NUM> can include a feedback controller, which can be one of any feedback controllers, including, but not limited to a PID, a state feedback, LQR, and/or an adaptive controller, for example. The surgical instrument <NUM> can include a power source to convert the signal from the feedback controller into a physical input such as case voltage, PWM voltage, frequency modulated voltage, current, torque, and/or force, for example.

As described above in greater detail, various example aspects are directed to a surgical instrument <NUM> comprising an end effector <NUM>, or an end effector <NUM>, with motor-driven surgical sealing and cutting implements. In various examples, the surgical instrument <NUM> may comprise a control circuit <NUM> programmed to control the distal translation of the drive member <NUM> based on one or more tissue conditions. The control circuit <NUM> may be programmed to sense tissue conditions, such as thickness, either directly or indirectly, as described herein. The control circuit <NUM> may be programmed to select a control program based on tissue conditions. A control program may describe the distal motion of the drive member <NUM>. Different control programs may be selected to better treat different tissue conditions. For example, when thicker tissue is present, the control circuit <NUM> may be programmed to translate the drive member <NUM> at a lower velocity and/or with lower power. When thinner tissue is present, the control circuit <NUM> may be programmed to translate the drive member <NUM> at a higher velocity and/or with higher power.

<FIG> is a logic flow diagram of a process <NUM> depicting a control program or a logic configuration for effecting a surgical treatment of a tissue. In certain instances, the process <NUM> is implemented using the surgical instrument <NUM>, for example. In certain instances the process <NUM> is implemented, or at least partially implemented, using the control circuit <NUM>, for example. In the illustrated example, the process <NUM> includes applying <NUM> a first phase of a surgical treatment to the tissue grasped by the surgical instrument <NUM>. In certain instances, the process <NUM> includes switching <NUM> from the first phase of the surgical treatment to the second phase of the surgical treatment based on at least one of a predetermined threshold of the tissue property and a predetermined threshold time of the first phase.

In the illustrated example, if <NUM> a property of the tissue being treated becomes equal to or greater than a predetermined threshold, the process <NUM> switches <NUM> to a second phase of the surgical treatment. The process <NUM> also switches <NUM> to the second phase of the surgical treatment if <NUM> a threshold application time of the first phase is reached prior to the property of the tissue being treated reaching the predetermined threshold. Accordingly, the process <NUM> may switch from the first phase of the surgical treatment to the second phase of the surgical treatment if at least one of two conditions is met. The first condition is triggered by reaching or exceeding a predetermined threshold of the first tissue property, and the second condition is triggered by reaching or exceeding a predetermined threshold time of the first phase.

In certain instances, the tissue property determined in the first phase is a tissue impedance. Various mechanisms for monitoring tissue impedance are disclosed in <CIT>. In at least one example, the tissue impedance is determined based on a current passed through the tissue by the RF energy source <NUM>. A current sensor may measure the current passed through the tissue based on a preset voltage value. Alternatively, voltage sensor may measure the voltage between the electrode <NUM>, or alternatively the electrode <NUM>, and a return electrode based on a preset current values. Tissue impedance can be determined based on the current and voltage values.

Further to the above, the first phase and the second phase are different. In at least one example, the first phase comprises an electrical sealing of the tissue, while the second phase comprises a mechanical sealing of the tissue and, optionally, a mechanical cutting of the tissue. In at least one example, the first phase comprises applying a therapeutic RF energy to the tissue, while the second phase comprises stapling the tissue via staples from a staple cartridge. In certain instances, the second phase is applied after completion of the first phase. In other instances, the second phase is set to begin before completion of the first phase. In other instances, the second phase and the first phase are separated by a predetermined wait-time. In certain instances, the wait-time is based on a characteristic of the tissue determined during the first phase.

Further to the above, the process <NUM> includes setting <NUM> a parameter of the second phase based on at least one measurement of the tissue property determined in the first phase. In certain examples, the at least one measurement is taken at a beginning of the first phase of the surgical treatment or an end of the first phase of the surgical treatment. In other examples, the at least one measurement comprises multiple measurements of the first tissue property taken during the first phase of the surgical treatment. In one example, the parameter of the second phase is set based on an average of multiple measurements of the first tissue property taken during the first phase of the surgical treatment.

In various aspects, the parameter of the second phase is a drive velocity of the motor controller <NUM>, for example. In certain aspects, the parameter of the second phase is a velocity of the drive member <NUM>, for example. The drive velocity can be an initial drive velocity. In certain instances, the drive velocity is a velocity in a predetermined initial zone of a firing path of the I-beam <NUM>, for example.

The process <NUM> may further include monitoring <NUM> a second tissue property, different from the first tissue property, in the second phase of the surgical treatment. In certain instances, the second tissue property is a tissue compression. The sensors <NUM> may be configured to measure forces exerted on the jaws by a drive member <NUM> of a drive system <NUM> of the surgical instrument <NUM>. The forces exerted on the jaws can be representative of the tissue compression experienced by the tissue section grasped by the jaws. The one or more sensors <NUM> can be positioned at various interaction points along the drive system <NUM> to detect the closure and/or firing forces applied to the end effector (e.g., end effectors <NUM>, <NUM>) by the drive system <NUM> (<FIG>). The one or more sensors <NUM> may be sampled in real time during the surgical treatment involving a closure/firing operation by the control circuit <NUM>. The control circuit <NUM> receives real-time sample measurements to provide and analyze time-based information and assess, in real time, closure/firing forces applied to the end effector <NUM> in the surgical treatment.

In one form, the one or more sensors <NUM> include a strain gauge sensor that can be used to measure the force applied to the tissue by the end effector, for example. A strain gauge can be coupled to the end effector to measure the force on the tissue being treated by the end effector. In at least one example, the strain gauge sensor is a micro-strain gauge configured to measure one or more parameters of the end effector. In one aspect, the strain gauge sensor can measure the amplitude or magnitude of the strain exerted on a jaw member of an end effector during a surgical treatment, which can be indicative of the tissue compression. The measured strain is converted to a digital signal and provided to the control circuit <NUM>. In certain instances, sensors <NUM> may comprise a load sensor configured to detect a load generated by the presence of compressed tissue between the jaws of the end effector.

In certain instances, a current sensor <NUM> can be employed to measure the current drawn by the motor <NUM>. The force required to advance the drive member <NUM> corresponds to the current drawn by the motor <NUM>. The force is converted to a digital signal and provided to the control circuit <NUM>. The current drawn by the motor <NUM> can represent tissue compression.

<FIG> is a graph <NUM> representing an example implementation of the surgical treatment of the process <NUM> to two tissues with different tissue compressibility. A less-compressible tissue is represented by dashed lines, while a more-compressible tissue is represented by solid lines. Graph <NUM> tracks tissue impedance (Z), I-beam force (F), and I-beam travel distance (δ) against time (t). As RF energy is applied to the tissues, in the first phase of the surgical treatment, the tissue impedance (Z) generally decreases to a minimum value (Z<NUM> at t<NUM>, Z<NUM>' at t<NUM>'), which depends, in part, on the compressibility of the tissue. With further application of the RF energy, the minimum tissue impedance is maintained. At t<NUM>', t<NUM>, the tissue impedance begins to rise toward a predetermined maximum threshold of the tissue impedance (Zmax).

The rise of the tissue impedance is faster in the more-compressible tissue than the less-compressible tissue. In the illustrated example, the end of the first phase is determined by reaching, at t<NUM>', a predetermined maximum threshold of the tissue impedance (Zmax) in the case of the more-compressible tissue. However, in the less-compressible tissue, the end of the first phase is determined by reaching, at time t<NUM>, a maximum time threshold (Δt'max) of the first phase. Accordingly, the switch <NUM> from the first phase to the second phase occurs earlier for the more-compressible tissue, at t<NUM>', than the less-compressible tissue, at t<NUM>.

In the illustrated example, reaching the end of the first phase triggers activation of the motor <NUM>, which begins the second phase of the surgical treatment. The second phase of the surgical treatment involves activating the motor <NUM> to effect firing a staple cartridge (e.g., staple cartridges <NUM>, <NUM>) by deploying staples from the staple cavity rows into the tissue. The staples are formed against anvil pockets of the anvil (e.g., anvil <NUM>, <NUM>). In the instance of the more-compressible tissue, activation of the motor <NUM> is triggered by reaching the predetermined maximum threshold of the tissue impedance (Zmax) in the first phase. However, in the instance of the less-compressible tissue, activation of the motor <NUM> is triggered by reaching the maximum time threshold (Δt'max) of the first phase at time t<NUM>.

Further to the above, different initial I-beam or motor drive velocities V0', V0 (slopes of lines <NUM>, <NUM>) are selected for the second phase based on the tissue impedance readings determined at the ends (t<NUM>', t<NUM>) of the first phase, as determined by reaching the predetermined maximum threshold of the tissue impedance (Zmax), or by reaching the maximum time threshold (Δt'max). In other examples, the initial I-beam or motor drive velocities V0', V0 (slopes of lines <NUM>, <NUM>) of the second phase can be determined based on tissue impedance readings at the beginnings (Z1', Z1) of the first phase. In yet other examples, the initial I-beam or motor drive velocities V0', V0 (slopes of lines <NUM>, <NUM>) of the second phase can be determined based on multiple tissue impedance readings at various points of the first phase. For example, and average of multiple tissue impedance readings at various points of the first phase can be used to determine an initial I-beam or motor drive velocity of the second phase.

In various instances, the control circuit <NUM> includes a microcontroller with a storage medium and a processor. The storage medium may be in the form of a memory unit storing a database, an equation, or a lookup table that can be utilized by the processor to determine an initial I-beam or motor drive velocity for the second phase based on tissue impedance readings of the first phase. In certain instances, the initial I-beam or motor drive velocity is an initial steady state velocity after an initial ramping segment to reach the initial steady state velocity. In certain instances, the initial I-beam or motor drive velocity is a target initial velocity set by the processor based on the tissue impedance readings of the first phase.

Referring still to <FIG>, as described above in greater detail, the process <NUM> may include monitoring <NUM> tissue compression during the second phase, and making adjustments to the I-beam or motor drive velocity based on the detected tissue compression. In the illustrated example, the control circuit <NUM> is configured to maintain the I-beam force within a predetermined force threshold range (Fmin-Fmax). The I-beam force in the instance of the less-compressible tissue reaches <NUM> the predetermined maximum I-beam force (Fmax) at t<NUM>, which triggers the control circuit <NUM> to adjust the drive velocity of the I-beam or motor. In the illustrated example, the control circuit <NUM> adjusts the drive velocity from the initial drive velocity V<NUM> (slope of the line <NUM>) to a drive velocity V<NUM> (slope of the line <NUM>) less than the initial drive velocity V<NUM>. The reduction in drive velocity at t<NUM> causes the I-beam force to decrease to a level below the predetermined maximum I-beam force (Fmax).

Conversely, at t<NUM>, the I-beam force in the instance of the less-compressible tissue, reaches <NUM> the predetermined minimum I-beam force (Fmin), which triggers the control circuit <NUM> to adjust the drive velocity of the I-beam or motor. In the illustrated example, the control circuit <NUM> adjusts the drive velocity from the drive velocity V<NUM> (slope of the line <NUM>) to a drive velocity V<NUM> (slope of the line <NUM>) greater than the drive velocity V<NUM>. The increase in drive velocity at t<NUM> causes the I-beam force to increase to a level above the predetermined minimum I-beam force (Fmin), and remain within the predetermined force threshold range (Fmin-Fmax).

In addition to making adjustments to the drive velocity based on the I-beam force, the control circuit <NUM> may also make adjustments to the drive velocity based on the tissue impedance readings determined within the second phase. In certain instances, the tissue impedance is monitored in the second phase by driving a non-therapeutic, or therapeutic, current through the tissue, and measuring the tissue impedance based on the non-therapeutic, or therapeutic, current. In certain instances, the adjustments to the drive velocity based on the tissue impedance readings within the second phase are performed while the I-beam force is maintained within the predetermined force threshold range (Fmin-Fmax). Accordingly, in such instances, the control circuit <NUM> is configured to make first adjustments to the drive velocity based on the tissue compression, and second adjustments to the drive velocity based on the tissue impedance.

In certain instances, the adjustments to the drive velocity during the second phase can be based on the rate of change of the tissue impedance. As the I-beam is advanced distally, the tissue compression causes changes in tissue impedance over time. In the illustrated example, the control circuit <NUM> determines the rate of change of tissue impedance (ΔZ<NUM>/Δt<NUM>), e.g., slope of the line <NUM>, by monitoring changes in tissue impedance over time, e.g., time period t<NUM>'-t<NUM>'.

If the control circuit <NUM> determines that the rate of change of the tissue impedance is beyond a predetermined threshold range, the control circuit <NUM> may adjust the drive velocity to return the rate of change of the tissue impedance to a value within the predetermined threshold range. For example, the drive velocity may be adjusted from the initial drive velocity V0', slope of the line <NUM>, to a drive velocity V1', slope of the line <NUM>, which causes the rate of change of the tissue impedance to be adjusted from (ΔZ<NUM>/Δt<NUM>), slope of the line <NUM>, to (ΔZ<NUM>/Δt<NUM>), slope of the line <NUM>.

In certain instances, the rate of change of the tissue impedance in the second phase is utilized as a feedback indicator for drive velocity adjustments. The adjustments in the drive velocity can yield changes in the rate of change of the tissue impedance. In the illustrated examples, slopes of the lines <NUM>, <NUM>, <NUM> correspond to the slopes of the lines <NUM>, <NUM>, <NUM>, for example. Accordingly, a control circuit <NUM> can be configured to confirm changes made to the drive velocity settings by monitoring the rate of change of the tissue impedance, for example.

Further to the above, still referring to <FIG>, the second phase of the surgical treatment involves firing a staple cartridge (e.g., staple cartridges <NUM>, <NUM>) by deploying staples from the staple cavity rows into the tissue. The staples are formed against anvil pockets of the anvil (e.g., anvil <NUM>, <NUM>). As the staples are gradually deployed and formed, the I-beam force fluctuates within the predetermined force threshold range (Fmin-Fmax). As described above, the control circuit <NUM> is configured to maintain the I-beam force within the predetermined force threshold range (Fmin-Fmax) by making adjustments to the drive velocity. Toward the end of the second phase, after the staple deployment and forming is completed, the I-beam force rapidly decreases to a minimum value, which coincides with a rapid increase in the tissue impedance curve (e.g., at t<NUM>, t<NUM>'), which can be detected by the control circuit <NUM> based on tissue impedance readings. In response, the control circuit <NUM> further adjusts the drive velocity (e.g., slopes of lines <NUM>, <NUM>) to terminate the second phase.

Referring now to <FIG>, a top view of a cartridge deck <NUM> is represented. The cartridge deck <NUM> is similar in many respects to other cartridge decks disclosed elsewhere herein such as, for example, the cartridge decks <NUM>, <NUM>. For example, the cartridge deck <NUM> includes two staple cavity rows 657a, 657b on opposite sides of a longitudinal slot <NUM>. Furthermore, the cartridge deck <NUM> also includes electrode segments 696a, 696c, 696e and electrode segments 696b, 696d, 696f on opposite sides of the longitudinal slot <NUM>.

In the illustrated example, the staple cavity rows 657a, 657b are closer to the longitudinal slot <NUM> than the electrode segments 696a-696f. In other arrangements, however, the staple cavity rows 657a, 657b can be further away from the longitudinal slot <NUM> than the electrode segments 696a-696f. In various instances, a cartridge deck <NUM> may include more, or less, than two staple cavity rows and/or more, or less, than six electrode segments.

In certain instances, the cartridge deck <NUM> can be implemented using an end effector similar in many respects to the end effector <NUM> (<FIG>). In such instances, the electrode segments 696a-696f can be integrated with a channel <NUM> (<FIG>), for example. The cartridge deck <NUM> can be formed by insertion of a staple cartridge including the staple cavity rows 657a, 657b into a distal end of the channel <NUM>.

In other instances, the cartridge deck <NUM> can be implemented using an end effector similar in many respects to the end effector <NUM> (<FIG>). In such instances, the electrode segments 696a-696f can be integrated into an RF overlay, similar in many respects to the RF overlay <NUM>. Further, the cartridge deck <NUM> can be formed by insertion of a staple cartridge including the staple cavity rows 657a, 657b into a channel <NUM>, and pivoting the RF overlay that includes the electrode segments 696a-696f toward the channel <NUM>, and into a locking engagement with the staple cartridge, as detailed by the assembly process described in connection with <FIG>.

Further to the above, the cartridge deck <NUM> may form a tissue contacting surface <NUM> for grasping tissue in cooperation with an anvil <NUM>, for example, and in response to drive motions generated by the motor <NUM> of the surgical instrument <NUM>, for example. Furthermore, the electrode segments 696a-696f can be electrically coupled to the RF energy source <NUM>, which can selectively transmit RF energy to the tissue grasped between the tissue contacting surface <NUM> of the cartridge deck <NUM> and the anvil <NUM>. The control circuit <NUM> may cause the RF energy source <NUM> to selectively energize and de-energize, or activate and deactivate, the electrode segments 696a-696f in a predetermined sequence to deliver a therapeutic RF energy to the grasped tissue.

In the illustrated example, the electrode segments 696a-696f are arranged in two rows on opposite sides of the longitudinal slot <NUM>. The electrode segments in each row are separately residing in consecutive treatment zones: a proximal zone (Zone <NUM>), an intermediate zone (Zone <NUM>), and a distal zone (Zone <NUM>), for example. In other examples, more or less than three consecutive treatment zones are contemplated such as, for example, two, four, five, and/or size treatment zones.

In the illustrated example, the electrode segments 696a-696f are arranged are arranged in pairs in each of the consecutive treatment zones. The electrode segments of a pair (e.g., electrode segments 695a, 696b) are positioned on opposite sides of the longitudinal slot <NUM>. In other examples, electrode segments in the consecutive treatment zones can be arranged on one side of the longitudinal slot <NUM>. In other examples, electrode segments in the consecutive treatment zones could alternate where a first electrode segment resides in a first treatment zone on one side of the longitudinal slot <NUM>, while a second electrode segment resides in a second treatment zone, distal, or proximal, to the first treatment zone, on the other side of the longitudinal slot <NUM>.

In the illustrated example, the electrode segments 696a-696f are different in size. Specifically, the electrode segments 696c, 696d of the intermediate zone are smaller in size than the electrode segments 696a, 696b, 696e, 696f in the proximal and distal zones. In other examples, electrode segments with different, or the same, sizes are contemplated. In one example, electrode segments arranged in a row may comprise sizes increasing gradually in a proximal direction or a distal direction.

In the illustrated example, the electrode segments of different treatment zones are spaced apart and can be separately activated, or deactivated, in a predetermined sequence. In at least one example, each electrode segment, or pair of electrode segments, in a treatment zone is separately coupled to the RF energy source thereby allowing the RF energy source <NUM> to selectively energize and de-energize, or activate and deactivate, the electrode segments 696a-696f in a predetermined sequence to selectively deliver a therapeutic RF energy to the grasped tissue in a predetermined zone-treatment order, as discussed in greater detail below.

In addition to the RF energy, staples from the staple cavity rows 657a, 657b are deployed into the tissue. The staples are formed against anvil pockets of the anvil (e.g., anvil <NUM>, <NUM>). The staples are sequentially deployed by a sled driven by the I-beam <NUM> and advanced from a proximal end <NUM> toward a distal end <NUM> of the cartridge deck <NUM>. The sled advancement by the I-beam <NUM> is motivated by drive motions generated by the motor <NUM> and transmitted to the I-beam <NUM> by the drive member <NUM>, for example.

<FIG> and <FIG> are logic flow diagrams of processes <NUM>, <NUM> depicting control programs or logic configurations for effecting surgical treatments of tissue. In one form, the processes <NUM>, <NUM> are implemented by the surgical instrument <NUM> while equipped with an end effector including the cartridge deck <NUM> (<FIG>), for example. The tissue is grasped between the tissue contacting surface <NUM> of the cartridge deck <NUM> of a staple cartridge <NUM> and an anvil <NUM> (<FIG>), for example.

The processes <NUM>, <NUM> include simultaneously delivering <NUM> a therapeutic energy to the tissue in all the consecutive treatment zones. The processes <NUM>, <NUM> further include causing <NUM> the motor <NUM> to drive staple deployment from the staple cartridge <NUM> sequentially in the consecutive treatment zones residing between the proximal end <NUM> and the distal end <NUM> of the cartridge deck <NUM>.

The process <NUM> includes detecting <NUM> a parameter indicative of progress of the staple deployment from the staple cartridge in the consecutive treatment zones, and sequentially deactivating electrode segments 696a-696f to sequentially seize <NUM> the delivery of the therapeutic energy to the tissue in the consecutive treatment zones based on the progress of the staple deployment from the staple cartridge.

In at least one example, as illustrated in <FIG>, and as illustrated in a graph <NUM> of <FIG>, the process <NUM> continues to deliver the therapeutic RF energy to Zone1, Zone2, and Zone <NUM> until certain conditions are met. If <NUM> it is detected that the staple deployment in Zone <NUM> is completed, the process <NUM> stops <NUM> delivery of the therapeutic RF energy to Zone <NUM>, while continuing to deliver the therapeutic RF energy to Zone <NUM> and Zone <NUM>. Then, if <NUM> it is detected that the staple deployment in Zone <NUM> is completed, the process <NUM> stops <NUM> delivery of the therapeutic RF energy to Zone <NUM>, while continuing to deliver the therapeutic RF energy to Zone <NUM>. Finally, if <NUM> it is detected that the staple deployment in Zone <NUM> is completed, the process <NUM> stops <NUM> delivery of the therapeutic RF energy to Zone <NUM>.

In certain instances, the parameter indicative of the progress of the staple deployment is a distance-based parameter or a position-based parameter. In such instances, the control circuit <NUM> is configured to implement a predetermined deactivation sequence of the electrode segments 696a-696f based on the progress of the staple deployment, as detected based on distance and/or position readings received from one or more sensors <NUM>.

The distance can be a distance travelled by the drive member <NUM> or the I-beam <NUM> to advance a sled, for example, through the consecutive treatment zones. Likewise, the position can be a position of the I-beam <NUM>, or a sled driven by the I-beam <NUM>, with respect to the consecutive treatment zones. In certain instances, detecting that the I-beam <NUM> has transitioned from a proximal zone to a distal zone triggers the control circuit <NUM> to seize the delivery of the therapeutic RF energy to the proximal zone.

In various aspects, the one or more sensors <NUM> may include a position sensor configured to sense a position of the drive member <NUM> and/or I-beam <NUM>, for example. The position sensor may be or include any type of sensor that is capable of generating position data that indicate a position of the drive member <NUM> and/or I-beam <NUM>. In some examples, the position sensor may include an encoder configured to provide a series of pulses to the control circuit <NUM> as the drive member <NUM> and/or I-beam <NUM> translates distally and proximally. The control circuit <NUM> may track the pulses to determine the position of the drive member <NUM> and/or I-beam <NUM>. Other suitable position sensors may be used, including, for example, a proximity sensor. Other types of position sensors may provide other signals indicating motion of the drive member <NUM> and/or I-beam <NUM>.

In certain instances, where the motor <NUM> is a stepper motor, the control circuit <NUM> may track the position of the drive member <NUM> by aggregating the number and direction of steps that the motor <NUM> has been instructed to execute. Accordingly, in such instances, the parameter indicative of the progress of the staple deployment can be based on the number and direction of steps that the motor <NUM> has been instructed to execute.

The position sensor may be located in the end effector <NUM> or at any other portion of the instrument. Further, a detailed description of an absolute positioning system, for use with the surgical instrument <NUM>, is described in <CIT>.

In certain instances, the parameter indicative of the progress of the staple deployment is a time-based parameter. The control circuit <NUM> may employ the timer/counter <NUM> to assess the staple deployment progress, for example. The control circuit <NUM> may start the timer/counter <NUM> and activate the motor <NUM> (<FIG>) simultaneously. The control circuit <NUM> utilizes the time spent after activation of the motor <NUM>, as detected by the timer/counter <NUM>, to assess the staple deployment progress based on a technique, an equation, a formula, a database, and/or a lookup table stored in a memory unit, for example.

In certain instances, the parameter indicative of the progress of the staple deployment is a tissue impedance-based parameter or a force-based parameter. In certain instances, the parameter indicative of the progress of the staple deployment is based on tissue thickness, for example.

Measurements of the tissue compression, the tissue impedance, the tissue thickness, and/or the force required to close the end effector on the tissue, as measured by the sensors <NUM>, can be used by a microcontroller of the control circuit <NUM> to assess the staple deployment progress, for example. In one instance, the microcontroller may include a memory that stores a technique, an equation, a formula, a database, and/or a lookup table, which can be employed by the microcontroller to assess the staple deployment progress based on readings from the sensors <NUM>.

The surgical instrument systems described herein are motivated by an electric motor; however, the surgical instrument systems described herein can be motivated in any suitable manner. In certain instances, the motors disclosed herein may comprise a portion or portions of a robotically controlled system. <CIT>, entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, now <CIT>, for example, discloses several examples of a robotic surgical instrument system in greater detail. The disclosures of International Patent Publication No. <CIT>, International Patent Publication No. <CIT>, International Patent Publication No. <CIT>, <CIT>, entitled STAPLER WITH CABLE-DRIVEN ADVANCEABLE CLAMPING ELEMENT AND DUAL DISTAL PULLEYS, <CIT>, entitled STAPLER WITH CABLE-DRIVEN ADVANCEABLE CLAMPING ELEMENT AND DISTAL PULLEY, and <CIT>.

The surgical instrument systems described herein have been described in connection with the deployment and deformation of staples; however, the embodiments described herein are not so limited. Various embodiments are envisioned which deploy fasteners other than staples, such as clamps or tacks, for example. Moreover, various embodiments are envisioned which utilize any suitable means for sealing tissue. For instance, an end effector in accordance with various embodiments can comprise electrodes configured to heat and seal the tissue. Also, for instance, an end effector in accordance with certain embodiments can apply vibrational energy to seal the tissue.

The foregoing detailed description has set forth various forms of the devices and/or processes via the use of block diagrams, flowcharts, and/or examples. Insofar as such block diagrams, flowcharts, and/or examples contain one or more functions and/or operations, it will be understood by those within the art that each function and/or operation within such block diagrams, flowcharts, and/or examples can be implemented, individually and/or collectively, by a wide range of hardware, software, firmware, or virtually any combination thereof. Those skilled in the art will recognize that some aspects of the forms disclosed herein, in whole or in part, can be equivalently implemented in integrated circuits, as one or more computer programs running on one or more computers (e.g., as one or more programs running on one or more computer systems), as one or more programs running on one or more processors (e.g., as one or more programs running on one or more microprocessors), as firmware, or as virtually any combination thereof, and that designing the circuitry and/or writing the code for the software and or firmware would be well within the skill of one of skill in the art in light of this disclosure. In addition, those skilled in the art will appreciate that the mechanisms of the subject matter described herein are capable of being distributed as one or more program products in a variety of forms, and that an illustrative form of the subject matter described herein applies regardless of the particular type of signal bearing medium used to actually carry out the distribution.

Instructions used to program logic to perform various disclosed aspects can be stored within a memory in the system, such as dynamic random access memory (DRAM), cache, flash memory, or other storage. Furthermore, the instructions can be distributed via a network or by way of other computer readable media. Thus a machine-readable medium may include any mechanism for storing or transmitting information in a form readable by a machine (e.g., a computer), but is not limited to, floppy diskettes, optical disks, compact disc, read-only memory (CD-ROMs), and magneto-optical disks, read-only memory (ROMs), random access memory (RAM), erasable programmable read-only memory (EPROM), electrically erasable programmable read-only memory (EEPROM), magnetic or optical cards, flash memory, or a tangible, machine-readable storage used in the transmission of information over the Internet via electrical, optical, acoustical or other forms of propagated signals (e.g., carrier waves, infrared signals, digital signals, etc.). Accordingly, the non-transitory computer-readable medium includes any type of tangible machine-readable medium suitable for storing or transmitting electronic instructions or information in a form readable by a machine (e.g., a computer).

As used in any aspect herein, the term "control circuit" may refer to, for example, hardwired circuitry, programmable circuitry (e.g., a computer processor including one or more individual instruction processing cores, processing unit, processor, microcontroller, microcontroller unit, controller, digital signal processor (DSP), programmable logic device (PLD), programmable logic array (PLA), or field programmable gate array (FPGA)), state machine circuitry, firmware that stores instructions executed by programmable circuitry, and any combination thereof. The control circuit may, collectively or individually, be embodied as circuitry that forms part of a larger system, for example, an integrated circuit (IC), an application-specific integrated circuit (ASIC), a system on-chip (SoC), desktop computers, laptop computers, tablet computers, servers, smart phones, etc. Accordingly, as used herein "control circuit" includes, but is not limited to, electrical circuitry having at least one discrete electrical circuit, electrical circuitry having at least one integrated circuit, electrical circuitry having at least one application specific integrated circuit, electrical circuitry forming a general purpose computing device configured by a computer program (e.g., a general purpose computer configured by a computer program which at least partially carries out processes and/or devices described herein, or a microprocessor configured by a computer program which at least partially carries out processes and/or devices described herein), electrical circuitry forming a memory device (e.g., forms of random access memory), and/or electrical circuitry forming a communications device (e.g., a modem, communications switch, or optical-electrical equipment). Those having skill in the art will recognize that the subject matter described herein may be implemented in an analog or digital fashion or some combination thereof.

As used in any aspect herein, the term "logic" may refer to an app, software, firmware and/or circuitry configured to perform any of the aforementioned operations. Software may be embodied as a software package, code, instructions, instruction sets and/or data recorded on non-transitory computer readable storage medium. Firmware may be embodied as code, instructions or instruction sets and/or data that are hard-coded (e.g., nonvolatile) in memory devices.

As used in any aspect herein, the terms "component," "system," "module" and the like can refer to a computer-related entity, either hardware, a combination of hardware and software, software, or software in execution.

As used in any aspect herein, an "algorithm" refers to a self-consistent sequence of steps leading to a desired result, where a "step" refers to a manipulation of physical quantities and/or logic states which may, though need not necessarily, take the form of electrical or magnetic signals capable of being stored, transferred, combined, compared, and otherwise manipulated. It is common usage to refer to these signals as bits, values, elements, symbols, characters, terms, numbers, or the like. These and similar terms may be associated with the appropriate physical quantities and are merely convenient labels applied to these quantities and/or states.

A network may include a packet switched network. The communication devices may be capable of communicating with each other using a selected packet switched network communications protocol. One example communications protocol may include an Ethernet communications protocol which may be capable permitting communication using a Transmission Control Protocol/Internet Protocol (TCP/IP). The Ethernet protocol may comply or be compatible with the Ethernet standard published by the Institute of Electrical and Electronics Engineers (IEEE) titled "IEEE <NUM> Standard", published in December, <NUM> and/or later versions of this standard. Alternatively or additionally, the communication devices may be capable of communicating with each other using an X. <NUM> communications protocol. <NUM> communications protocol may comply or be compatible with a standard promulgated by the International Telecommunication Union-Telecommunication Standardization Sector (ITU-T). Alternatively or additionally, the communication devices may be capable of communicating with each other using a frame relay communications protocol. The frame relay communications protocol may comply or be compatible with a standard promulgated by Consultative Committee for International Telegraph and Telephone (CCITT) and/or the American National Standards Institute (ANSI). Alternatively or additionally, the transceivers may be capable of communicating with each other using an Asynchronous Transfer Mode (ATM) communications protocol. The ATM communications protocol may comply or be compatible with an ATM standard published by the ATM Forum titled "ATM-MPLS Network Interworking <NUM>" published August <NUM>, and/or later versions of this standard. Of course, different and/or after-developed connection-oriented network communication protocols are equally contemplated herein.

Unless specifically stated otherwise as apparent from the foregoing disclosure, it is appreciated that, throughout the foregoing disclosure, discussions using terms such as "processing," "computing," "calculating," "determining," "displaying," or the like, refer to the action and processes of a computer system, or similar electronic computing device, that manipulates and transforms data represented as physical (electronic) quantities within the computer system's registers and memories into other data similarly represented as physical quantities within the computer system memories or registers or other such information storage, transmission or display devices.

One or more components may be referred to herein as "configured to," "configurable to," "operable/operative to," "adapted/adaptable," "able to," "conformable/conformed to," etc. Those skilled in the art will recognize that "configured to" can generally encompass active-state components and/or inactive-state components and/or standby-state components, unless context requires otherwise.

The terms "proximal" and "distal" are used herein with reference to a clinician manipulating the handle portion of the surgical instrument. The term "proximal" refers to the portion closest to the clinician and the term "distal" refers to the portion located away from the clinician. It will be further appreciated that, for convenience and clarity, spatial terms such as "vertical", "horizontal", "up", and "down" may be used herein with respect to the drawings. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and/or absolute.

Those skilled in the art will recognize that, in general, terms used herein, and especially in the appended claims (e.g., bodies of the appended claims) are generally intended as "open" terms (e.g., the term "including" should be interpreted as "including but not limited to," the term "having" should be interpreted as "having at least," the term "includes" should be interpreted as "includes but is not limited to," etc.). It will be further understood by those within the art that if a specific number of an introduced claim recitation is intended, such an intent will be explicitly recited in the claim, and in the absence of such recitation no such intent is present. However, the use of such phrases should not be construed to imply that the introduction of a claim recitation by the indefinite articles "a" or "an" limits any particular claim containing such introduced claim recitation to claims containing only one such recitation, even when the same claim includes the introductory phrases "one or more" or "at least one" and indefinite articles such as "a" or "an" (e.g., "a" and/or "an" should typically be interpreted to mean "at least one" or "one or more"); the same holds true for the use of definite articles used to introduce claim recitations.

In addition, even if a specific number of an introduced claim recitation is explicitly recited, those skilled in the art will recognize that such recitation should typically be interpreted to mean at least the recited number (e.g., the bare recitation of "two recitations," without other modifiers, typically means at least two recitations, or two or more recitations). Furthermore, in those instances where a convention analogous to "at least one of A, B, and C, etc." is used, in general such a construction is intended in the sense one having skill in the art would understand the convention (e.g., "a system having at least one of A, B, and C" would include but not be limited to systems that have A alone, B alone, C alone, A and B together, A and C together, B and C together, and/or A, B, and C together, etc.). In those instances where a convention analogous to "at least one of A, B, or C, etc." is used, in general such a construction is intended in the sense one having skill in the art would understand the convention (e.g., "a system having at least one of A, B, or C" would include but not be limited to systems that have A alone, B alone, C alone, A and B together, A and C together, B and C together, and/or A, B, and C together, etc.). It will be further understood by those within the art that typically a disjunctive word and/or phrase presenting two or more alternative terms, whether in the description, claims, or drawings, should be understood to contemplate the possibilities of including one of the terms, either of the terms, or both terms unless context dictates otherwise. For example, the phrase "A or B" will be typically understood to include the possibilities of "A" or "B" or "A and B.

With respect to the appended claims, those skilled in the art will appreciate that recited operations therein may generally be performed in any order. Also, although various operational flow diagrams are presented in a sequence(s), it should be understood that the various operations may be performed in other orders than those which are illustrated, or may be performed concurrently. Examples of such alternate orderings may include overlapping, interleaved, interrupted, reordered, incremental, preparatory, supplemental, simultaneous, reverse, or other variant orderings, unless context dictates otherwise. Furthermore, terms like "responsive to," "related to," or other past-tense adjectives are generally not intended to exclude such variants, unless context dictates otherwise.

It is worthy to note that any reference to "one aspect," "an aspect," "an exemplification," "one exemplification," and the like means that a particular feature, structure, or characteristic described in connection with the aspect is included in at least one aspect. Thus, appearances of the phrases "in one aspect," "in an aspect," "in an exemplification," and "in one exemplification" in various places throughout the specification are not necessarily all referring to the same aspect. Furthermore, the particular features, structures or characteristics may be combined in any suitable manner in one or more aspects.

In this specification, unless otherwise indicated, terms "about" or "approximately" as used in the present disclosure, unless otherwise specified, means an acceptable error for a particular value as determined by one of ordinary skill in the art, which depends in part on how the value is measured or determined. In certain embodiments, the term "about" or "approximately" means within <NUM>, <NUM>, <NUM>, or <NUM> standard deviations. In certain embodiments, the term "about" or "approximately" means within <NUM>%, <NUM>%, <NUM>%, <NUM>%, <NUM>%, <NUM>%, <NUM>%, <NUM>%, <NUM>%, <NUM>%, <NUM>%, <NUM>%, <NUM>%, <NUM>%, or <NUM>% of a given value or range.

In this specification, unless otherwise indicated, all numerical parameters are to be understood as being prefaced and modified in all instances by the term "about," in which the numerical parameters possess the inherent variability characteristic of the underlying measurement techniques used to determine the numerical value of the parameter. At the very least, and not as an attempt to limit the application of the doctrine of equivalents to the scope of the claims, each numerical parameter described herein should at least be construed in light of the number of reported significant digits and by applying ordinary rounding techniques.

Any numerical range recited herein includes all sub-ranges subsumed within the recited range. For example, a range of "<NUM> to <NUM>" includes all sub-ranges between (and including) the recited minimum value of <NUM> and the recited maximum value of <NUM>, that is, having a minimum value equal to or greater than <NUM> and a maximum value equal to or less than <NUM>. Also, all ranges recited herein are inclusive of the end points of the recited ranges. For example, a range of "<NUM> to <NUM>" includes the end points <NUM> and <NUM>. Any maximum numerical limitation recited in this specification is intended to include all lower numerical limitations subsumed therein, and any minimum numerical limitation recited in this specification is intended to include all higher numerical limitations subsumed therein. Accordingly, Applicant reserves the right to amend this specification, including the claims, to expressly recite any sub-range subsumed within the ranges expressly recited. All such ranges are inherently described in this specification.

Claim 1:
A surgical instrument (<NUM>), comprising:
an end effector (<NUM>, <NUM>), comprising:
a first jaw (<NUM>);
a second jaw (<NUM>) movable relative to the first jaw between an open configuration and a closed configuration to grasp tissue;
a staple cartridge (<NUM>, <NUM>); and
at least one electrode (<NUM>, <NUM>);
a drive member (<NUM>);
a motor assembly (<NUM>) configured to generate drive motions to move the drive member; and
a control circuit (<NUM>) configured to:
cause the at least one electrode to deliver (<NUM>) a therapeutic energy to the tissue in a first phase of a surgical treatment;
cause the motor assembly to move (<NUM>) the drive member to deploy staples (<NUM>) from the staple cartridge into the tissue in a second phase of the surgical treatment;
monitor a first tissue property in the first phase of the surgical treatment;
switch from the first phase of the surgical treatment to the second phase of the surgical treatment if at least one of two conditions is met, wherein a first of the two conditions is triggered by reaching or exceeding (<NUM>) a predetermined threshold of the first tissue property, and wherein a second of the two conditions is triggered by reaching or exceeding (<NUM>) a predetermined threshold time of the first phase;
set (<NUM>) a parameter of the second phase of the surgical treatment based on at least one measurement of the tissue property determined in the first phase of the surgical treatment; and
monitor (<NUM>) a second tissue property, different from the first tissue property, in the second phase of the surgical treatment.