Sealing and Cutting Surgical Instrument With Advanced Feedback Loop

Abstract

Surgical instruments and assemblies for sealing and cutting tissue monitor jaw angle and/or jaw clamping force to provide feedback to an operator of the surgical instrument indicative of whether the tissue is suitable clamped for sealing and/or cutting. A surgical instrument or assembly includes a jaw operable to clamp tissue, a sealing mechanism, a cutting mechanism, an actuation monitoring assembly, and a feedback assembly. The actuation monitoring assembly monitors jaw angle and/or clamping force. The feedback assembly outputs feedback to the operator, based on the jaw angle and/or clamping force, as to whether the current clamping angle and/or jaw angle is suitable for sealing and/or clamping tissue.

What is claimed is: 
     
         1 . A surgical instrument for sealing and cutting tissue, the surgical instrument comprising:
 an end effector comprising a jaw and a knife, wherein the end effector is configured to receive a sealing energy to seal tissue clamped by the jaw;   a sealing energy generator operable to output the sealing energy to the end effector;   a proximal assembly configured to be held and manipulated by an operator of the surgical instrument, wherein the proximal assembly comprises an actuation input operable by the operator to incrementally close the jaw to clamp a tissue, wherein the proximal assembly comprises one or more output elements, and wherein each of the one or more output elements is operable to output, to the operator of the surgical instrument, a feedback regarding operation of the actuation input by the operator;   an actuation monitoring assembly that generates at least one of a jaw-angle output indicative of a current clamping angle of the jaw and a clamping-force output indicative of a current clamping force of the jaw; and   a feedback assembly that controls operation of the one or more output elements to output, in response to at least one of the jaw-angle output and the clamping-force output, one or more indications comprising at least one of:   an indication that the current clamping angle is greater than a maximum recommended clamping angle for sealing tissue clamped by the jaw;   an indication that the current clamping angle is equal to or less than the maximum recommended clamping angle for sealing tissue clamped by the jaw;   an indication that the current clamping angle is greater than a maximum recommended clamping angle for cutting tissue clamped by the jaw;   an indication that the current clamping angle is equal to or less than the maximum recommended clamping angle for cutting tissue clamped by the jaw;   an indication that the current clamping force of the jaw is less than a minimum recommended clamping force of the jaw for sealing tissue clamped by the jaw; and   an indication that the current clamping force of the jaw is equal to or greater than the minimum recommended clamping force of the jaw for sealing tissue clamped by the jaw.   
     
     
         2 . The surgical instrument of  claim 1 , wherein:
 the actuation monitoring assembly generates the jaw-angle output; and   the feedback assembly controls operation of the one or more output elements to output at least one of:   the indication that the current clamping angle is greater than the maximum recommended clamping angle for cutting tissue clamped by the jaw; and   the indication that the current clamping angle is equal to or less than the maximum recommended clamping angle for cutting tissue clamped by the jaw.   
     
     
         3 . The surgical instrument of  claim 1 , wherein:
 the actuation monitoring assembly generates the jaw-angle output; and   the feedback assembly controls operation of the one or more output elements to output at least one of:   the indication that the current clamping angle is greater than the maximum recommended clamping angle for sealing tissue clamped by the jaw; and   the indication that the current clamping angle is equal to or less than the maximum recommended clamping angle for sealing tissue clamped by the jaw.   
     
     
         4 . The surgical instrument of  claim 1 , wherein:
 the actuation monitoring assembly generates the clamping-force output; and   the feedback assembly controls operation of the one or more output elements to output at least one of:   the indication that the current clamping force of the jaw is less than the minimum recommended clamping force of the jaw for sealing tissue clamped by the jaw; and   the indication that the current clamping force of the jaw is equal to or greater than the minimum recommended clamping force of the jaw for sealing tissue clamped by the jaw.   
     
     
         5 . The surgical instrument of  claim 1 , wherein:
 the actuation monitoring assembly generates the jaw-angle output and the clamping-force output; and   the feedback assembly controls operation of the one or more output elements to output at least one of:   the indication that the current clamping angle is greater than the maximum recommended clamping angle for sealing tissue clamped by the jaw; and   the indication that the current clamping angle is equal to or less than the maximum recommended clamping angle for sealing tissue clamped by the jaw; and   the feedback assembly comprises a control unit that:   monitors the jaw-angle output and the clamping-force output to identify an initial contact jaw angle corresponding to initial contact between the jaw and tissue clamped by the jaw; and   selects the maximum recommended clamping angle for sealing tissue clamped by the jaw based on the initial contact jaw angle.   
     
     
         6 . The surgical instrument of  claim 5 , wherein the control unit:
 processes the jaw-angle output and the clamping-force output to determine a tissue stiffness of the tissue clamped by the jaw; and   selects the maximum recommended clamping angle for sealing tissue clamped by the jaw based on the tissue stiffness.   
     
     
         7 . The surgical instrument of  claim 1 , wherein the one or more output elements comprise at least one of:
 one or more indicator lights;   an output display; and   an aural output device.   
     
     
         8 . The surgical instrument of  claim 1 , comprising a sealing enablement output that outputs a sealing enablement signal for controlling enablement of supply of a sealing energy to the surgical instrument for sealing tissue clamped by the jaw, the sealing enablement signal being indicative of at least one of:
 the current clamping angle is greater than the maximum recommended clamping angle for sealing tissue clamped by the jaw;   the current clamping angle is equal to or less than the maximum recommended clamping angle for sealing tissue clamped by the jaw;   the current clamping force of the jaw is less than the minimum recommended clamping force of the jaw for sealing tissue clamped by the jaw; and   the current clamping force of the jaw is equal to or greater than the minimum recommended clamping force of the jaw for sealing tissue clamped by the jaw.   
     
     
         9 . The surgical instrument of  claim 1 , wherein the proximal assembly further comprises a detent ratchet mechanism configured to accommodate multiple actuations of the actuation input to incrementally close the jaw on the tissue. 
     
     
         10 . The surgical instrument of  claim 1 , wherein the proximal assembly further comprises a sensor configured to monitor a clamping force of the jaw applied via the jaw to the tissue. 
     
     
         11 . A method of generating feedback to an operator of a surgical instrument that seals and cuts tissue, the method comprising:
 actuating a jaw of an end effector included in the surgical instrument from an open configuration towards a closed configuration to clamp tissue, wherein the jaw of the end effector is drivingly coupled with an actuation input of a proximal assembly configured to be held and manipulated by an operator of the surgical instrument, wherein an incremental actuation of the actuation input produces an incremental actuation of the jaw from the open configuration towards the closed configuration;   generating, with an actuation monitoring assembly included in the surgical instrument, at least one of a jaw-angle output indicative of a clamping angle of the jaw or a clamping-force output indicative of a clamping force of the jaw;   controlling, via a feedback assembly included in the surgical instrument, one or more output elements of the feedback assembly to output, in response to at least one of the jaw-angle output or the clamping-force output, one or more indications comprising at least one of:   an indication to the operator that the clamping angle is greater than a maximum recommended clamping angle for sealing tissue clamped by the jaw;   an indication to the operator that the clamping angle is equal to or less than the maximum recommended clamping angle for sealing tissue clamped by the jaw;   an indication to the operator that the clamping angle is greater than a maximum recommended clamping angle for cutting tissue clamped by the jaw;   an indication to the operator that the clamping angle is equal to or less than the maximum recommended clamping angle for cutting tissue clamped by the jaw;   an indication to the operator that the clamping force of the jaw is less than a minimum recommended clamping force of the jaw for sealing tissue clamped by the jaw; and   an indication to the operator that the clamping force of the jaw is equal to or greater than the minimum recommended clamping force of the jaw for sealing tissue clamped by the jaw.   
     
     
         12 . The method of  claim 11 , comprising generating, with the actuation monitoring assembly, the jaw-angle output, and wherein the one or more indications comprise at least one of:
 the indication to the operator that the clamping angle is greater than the maximum recommended clamping angle for cutting tissue clamped by the jaw; and   the indication to the operator that the clamping angle is equal to or less than the maximum recommended clamping angle for cutting tissue clamped by the jaw.   
     
     
         13 . The method of  claim 11 , comprising generating, with the actuation monitoring assembly, the jaw-angle output, and wherein the one or more indications comprise at least one of:
 the indication to the operator that the clamping angle is greater than the maximum recommended clamping angle for sealing tissue clamped by the jaw; and   the indication to the operator that the clamping angle is equal to or less than the maximum recommended clamping angle for sealing tissue clamped by the jaw.   
     
     
         14 . The method of  claim 11 , comprising generating, with the actuation monitoring assembly, the clamping-force output, and wherein the one or more indications comprise at least one of:
 the indication to the operator that the clamping force of the jaw is less than the minimum recommended clamping force of the jaw for sealing tissue clamped by the jaw; and   the indication to the operator that the clamping force of the jaw is equal to or greater than the minimum recommended clamping force of the jaw for sealing tissue clamped by the jaw.   
     
     
         15 . The method of  claim 11 , comprising:
 generating, with the actuation monitoring assembly, the jaw-angle output and the clamping-force output;   processing, with a control unit, the jaw-angle output and the clamping-force output to identify an initial contact jaw angle corresponding to initial contact between the jaw and tissue clamped by the jaw;   selecting, by the control unit, the maximum recommended clamping angle for sealing tissue clamped by the jaw based on the initial contact jaw angle; and   controlling, via the feedback assembly, operation of the one or more output elements to output at least one of:   the indication to the operator that the clamping angle is greater than a maximum recommended clamping angle for sealing tissue clamped by the jaw; and   the indication to the operator that the clamping angle is equal to or less than the maximum recommended clamping angle for sealing tissue clamped by the jaw.   
     
     
         16 . The method of  claim 15 , comprising:
 processing, by the control unit, the jaw-angle output and the clamping-force output to determine a tissue stiffness of the tissue clamped by the jaw; and   selecting, by the control unit, the maximum recommended clamping angle for sealing tissue clamped by the jaw based on the tissue stiffness.   
     
     
         17 . The method of  claim 11 , wherein the one or more output elements comprise at least one of:
 one or more indicator lights;   an output display; and   an aural output device.   
     
     
         18 . The method of  claim 11 , wherein the surgical instrument comprises a spring assembly comprising an output link drivingly coupled with the jaw, an input link drivingly coupled with the actuation input, and a spring coupled with the input link and the output link to transfer an articulation force from the input link to the output link to induce a grip force of the jaw, the spring being preloaded to inhibit relative movement between the input link and the output link while the articulation force is below a predetermined level and so as to allow relative movement between the input link and the output link when the articulation force is above the predetermined level. 
     
     
         19 . The method of  claim 11 , further comprising:
 generating, by the actuation monitoring assembly, a sealing enablement signal indicative of at least one of:   the clamping angle is greater than the maximum recommended clamping angle for sealing tissue clamped by the jaw;   the clamping angle is equal to or less than the maximum recommended clamping angle for sealing tissue clamped by the jaw;   the clamping force of the jaw is less than the minimum recommended clamping force of the jaw for sealing tissue clamped by the jaw; and   the clamping force of the jaw is equal to or greater than the minimum recommended clamping force of the jaw for sealing tissue clamped by the jaw; and   controlling, based on the sealing enablement signal, enablement of supply of a sealing energy to the surgical instrument for sealing tissue clamped by the jaw.