A61B2018/0088

SAFETY MECHANISM FOR ROBOTIC BONE CUTTING

Methods and systems for providing a safety mechanism for a robotically controlled surgical tool. Embodiments of the methods use sensors to detect parameters that vary by the tissue traversed by a surgical tool. The sensors detect signals arising from the interaction of the surgical tool with the tissue and provide this information to a robotic controller. For example, during drilling, the sensors may measure power, vibration, sound frequency, mechanical load, electrical impedance, and distance traversed according to preoperative measurements on a three-dimensional image set used for planning the tool trajectory. By comparing the detected output with that expected for the tool position based on the planned trajectory, identified discrepancies in output would indicate that the tool has veered from the planned trajectory. The robotic controller may then alter the tool trajectory, change the speed of the tool, or discontinue power to the tool, thereby preventing damage to underlying tissue.

SURGICAL LASER SYSTEMS AND LASER LITHOTRIPSY TECHNIQUES

A surgical laser system (100) includes a first laser source (140A), a second laser source (140B), a beam combiner (142) and a laser probe (108). The first laser source is configured to output a first laser pulse train (144, 104A) comprising first laser pulses (146). The second laser source is configured to output a second laser pulse train (148, 104B) comprising second laser pulses (150). The beam combiner is configured to combine the first and second laser pulse trains and output a combined laser pulse train (152, 104) comprising the first and second laser pulses. The laser probe is optically coupled to an output of the beam combiner and is configured to discharge the combined laser pulse train.

In some embodiments, a surgical laser system includes a laser generator (102), a laser probe (108), a stone analyzer (170), and a controller (122). The laser generator is configured to generate laser energy (104) based on laser energy settings (126). The laser probe is configured to discharge the laser energy. The stone analyzer has an output relating to a characteristic of a targeted stone (120). The controller comprises at least one processor configured to determine the laser energy settings based on the output.

In some embodiments of a method of fragmenting a targeted kidney or bladder stone, a first laser pulse train (144) comprising first laser pulses (146) is generated using a first laser source (140A). A second laser pulse train (148) comprising second laser pulses (150) is generated using a second laser source (140B). The first and second laser pulse trains are combined into a combined laser pulse train (152) comprising the first and second laser pulses. The stone is exposed to the combined laser pulse train using a laser probe (108). The stone is fragmented in response to exposing the stone to the combined laser pulse train.

In some embodiments of a method of fragmenting a targeted kidney or bladder stone, an output relating to a characteristic of the targeted stone (120) is generated using a stone analyzer (170). Embodiments of the characteristic include an estimated size of the stone, an estimated length of the stone, an estimated composition of the stone, and a vibration frequency measurement of the stone. Laser energy settings (126) are generated based on the output. Laser energy (104) is generated using a laser generator in accordance with the laser energy settings. The stone is exposed to the laser energy using a laser probe (108

Combination ultrasonic and electrosurgical instrument with adjustable energy modalities and method for sealing tissue and inhibiting tissue resection

An ultrasonic surgical instrument and method of sealing tissue includes interrogating the tissue with an electrical signal and adjusting an electrical parameter of at least one of the ultrasonic energy or the RF energy in response to the tissue feedback to inhibit transecting the tissue. The ultrasonic surgical instrument has an end effector, a shaft assembly, a body, and a power controller. The power controller is operatively connected to the ultrasonic blade and the RF electrode and configured to direct activation of the ultrasonic blade or the RF electrode. The power controller is further configured to interrogate the tissue with the electrical signal via the ultrasonic blade or the RF electrode to provide a tissue feedback and adjust an electrical parameter of the ultrasonic energy or the RF energy in response to the tissue feedback to inhibit transecting the tissue.

Systems and methods for locating blood vessels in the treatment of rhinitis

Apparatus and methods for treating and monitoring conditions such as rhinitis are disclosed herein. The technology utilizes ultrasound scans to identify target treatment sites, and monitor the treatment of a patient undergoing a treatment. The treatment may be an ablation treatment of a nasal nerve, for example the PNN for the treatment of nasal conditions, such as rhinitis. The ultrasound scans are performed within the nasal cavity with an ultrasound probe or a combined ultrasound and ablation probe and may use Doppler, A-mode, B-mode, M-mode or other ultrasound and non-ultrasound modalities to detect and monitor the target treatment sites.

Cryoprotective Compositions and Methods for Protection of a Surgical Site During Cryosurgery

A cryoprotective composition configured to be applied during cryotreatment of a patient includes at least one biodegradable and/or bioerodible fluid agent and at least one non-toxic cryoprotectant agent. A therapeutically effective amount of the cryoprotective composition deposited in a body space of the patient in proximity to the cryotreatment remains within at least a portion of the body space for a duration of the cryotreatment. At least a portion of a body tissue proximate to the body space is viable after the cryotreatment. A method of protecting a surgical site during prostate cryosurgery is also provided. The method includes injecting a therapeutically effective amount of the cryoprotective composition into the body space, wherein the body space is a periprostatic space of a patient.

Combination ultrasonic and electrosurgical instrument with a production clamp force based ultrasonic seal process and related methods
11266455 · 2022-03-08 · ·

An ultrasonic surgical instrument and method of sealing a tissue based on a production clamp force includes determining an ultrasonic seal process with the controller based on the production clamp force between an upper jaw and a lower jaw of an end effector and activating the ultrasonic energy or RF energy according to the determined ultrasonic seal process. The ultrasonic surgical instrument further includes an end effector having an ultrasonic blade, a jaw, an RF electrode, and a controller. The jaw is movably positioned relative to the ultrasonic blade and configured to move between an open position and a closed position and clamp together with a production clamp force in the closed position. The controller operatively connects to the ultrasonic blade and the RF electrode and includes the ultrasonic seal process based on the production clamp force stored thereon for driving the ultrasonic blade or the RF electrode.

Combination ultrasonic and electrosurgical instrument with clamp arm position input and method for identifying tissue state
11229473 · 2022-01-25 · ·

An ultrasonic surgical instrument and method for identifying tissue state and energizing the surgical instrument includes an end effector having an ultrasonic blade and an RF electrode, a shaft assembly, a body, and a power controller. A first ultrasonic energy input is configured to be actuated from a first unactuated energy input state to a first actuated energy input state. A trigger input is configured to be actuated from an unactuated trigger input state to an actuated trigger input state. The power controller is operatively connected to the ultrasonic blade, the RF electrode, the first ultrasonic energy input, and the trigger input and configured to direct at least one of the ultrasonic blade or the RF electrode to be selectively driven according to a predetermined drive function based on the tissue impedance, the state of the first energy input, and the state of the trigger input.

Combination ultrasonic and electrosurgical instrument with adjustable energy modalities and method for limiting blade temperature

An ultrasonic surgical instrument and method of limiting an ultrasonic blade temperature includes adjusting at least one power parameter of the ultrasonic energy in response to reaching a predetermined frequency parameter change threshold in the ultrasonic blade limiting the temperature of the ultrasonic blade to an upper temperature limit. The ultrasonic surgical instrument further includes an end effector having an ultrasonic blade, a jaw, and a controller. The jaw is movably positioned relative to the ultrasonic blade and configured to move between an open position and a closed position. The controller operatively connects to the ultrasonic blade and is configured to measure an ultrasonic frequency of the ultrasonic blade. The controller has a memory including a plurality of predetermined data correlations that correlate changes in measured ultrasonic frequency of the ultrasonic blade to a blade temperature of the ultrasonic blade.

Device and method for in vivo detection of clots within circulatory vessels

A device and method of using the device to detect the presence and composition of clots and other target objects in a circulatory vessel of a living subject is described. In particular, devices and methods of detecting the presence and composition of clots and other target objects in a circulatory vessel of a living subject using in vivo photoacoustic flow cytometry techniques is described.

Apparatus and method to control operation of surgical instrument based on audible feedback

An apparatus includes a body, a shaft assembly, an end effector, a first acoustic sensor, and a processor. The shaft assembly extends distally from the body. The end effector is located at the distal end of the shaft assembly. The end effector is operable to apply energy to tissue and thereby change a state of the tissue. The first acoustic sensor is configured to pick up sound emitted by tissue. The processor is in communication with the first acoustic sensor. The processor is configured to provide an automated response in response to a signal from the first acoustic sensor indicating a change in the state of the tissue.