# US 11,896,322 B2 · Sensing the patient position and contact utilizing the mono-polar return pad electrode to provide situational awareness to the hub

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- Number: US 11,896,322 B2
- Document ID: US11896322B2
- Status: Granted
- Kind: B2
- Application number: 16/182,267
- Filed: 2018-11-06
- Published: 2019-07-04
- Granted: 2024-02-13
- Earliest claimed: 2017-12-28
- Assignees: Cilag GmbH International
- Applicants: Cilag GmbH International
- Inventors: David C. Yates; Frederick E. Shelton, IV; Shane R. Adams; Jason L. Harris
- Web page: https://patentgrep.com/patent/US11896322B2

## CPC

- A61B 34/25: {User interfaces for surgical systems}
- A61B 1/015: Control of fluid supply or evacuation
- A61B 5/24: Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B 18/14: Probes or electrodes therefor
- A61B 18/1402: {Probes for open surgery}
- A61B 18/16: Indifferent or passive electrodes for grounding
- A61B 34/35: for telesurgery
- G16H 20/40: relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
- G16H 40/63: for local operation
- A61B 1/00011: {characterised by signal transmission}
- A61B 1/00121: {Connectors, fasteners and adapters, e.g. on the endoscope handle}
- A61B 5/4836: {Diagnosis combined with treatment in closed-loop systems or methods (A61B5/0036 takes precedence)}
- A61B 6/04: Positioning of patients; Tiltable beds or the like
- A61B 17/320068: {using mechanical vibrations, e.g. ultrasonic (A61B17/22012 takes precedence; dental tooth drilling devices operated by vibration A61C3/03; removing intra-ocular material using mechanical vibrations A61F9/00745)}
- A61B 18/1206: {Generators therefor}
- A61B 34/30: Surgical robots
- A61B 34/37: Leader-follower robots (A61B34/35 takes precedence)
- A61B 90/361: {Image-producing devices, e.g. surgical cameras}
- A61B 90/37: {Surgical systems with images on a monitor during operation}
- A61B 2017/00221: {with wireless transmission of data, e.g. by infrared radiation or radiowaves}
- A61B 2018/00601: {Cutting}
- A61B 2018/0063: {Sealing}
- A61B 2018/00642: {with feedback, i.e. closed loop control}
- A61B 2018/00702: {Power or energy}
- A61B 2018/00779: {Power or energy}
- A61B 2018/00994: {combining two or more different kinds of non-mechanical energy or combining one or more non-mechanical energies with ultrasound}
- A61B 2018/1253: {monopolar}
- A61B 2018/126: {bipolar}
- A61B 2018/167: {Passive electrodes capacitively coupled to the skin}
- A61B 2034/2057: {Details of tracking cameras}
- A61B 2034/252: {indicating steps of a surgical procedure}
- A61B 2034/302: {specifically adapted for manipulations within body cavities, e.g. within abdominal or thoracic cavities}
- A61B 2090/373: {using light, e.g. by using optical scanners}
- A61B 2218/002: Irrigation
- A61B 2218/006: for smoke evacuation
- A61B 2218/007: Aspiration
- A61B 2218/008: for smoke evacuation
- G16H 10/60: for patient-specific data, e.g. for electronic patient records
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA

## Abstract

A surgical system is disclosed. The surgical system includes a monopolar return pad and a surgical hub wirelessly coupled to the monopolar return pad. The surgical hub includes a control circuit configured to determined a presence and a position of a patient on the monopolar return pad according to data received from the monopolar return pad.

## Claims

### Claim 1

A surgical system comprising:
a monopolar return pad; and
a surgical hub communicatively coupled to the monopolar return pad, the surgical hub comprising a control circuit configured to determine a presence and a position of a patient on the monopolar return pad according to data received from the monopolar return pad.

### Claim 2 (depends on 1)

The surgical system of claim 1, wherein the control circuit is configured to control a visualization means according to at least one of the determined presence or the determined position of the patient on the monopolar return pad, or a combination thereof.

### Claim 3 (depends on 1)

The surgical system of claim 1, wherein the control circuit is further configured to:
control an electrosurgical generator to provide a varying range of electrosurgical frequencies to the patient; and
monitor a response to the varying range of electrosurgical frequencies by the monopolar return pad to determine the position of the patient.

### Claim 4 (depends on 1)

The surgical system of claim 1, wherein the control circuit is further configured to:
determine a maximum power of a generator according to capacitive coupling variations of the monopolar return pad; and
adjust a power of the generator based on the determination.

### Claim 5 (depends on 1)

The surgical system of claim 1, wherein the control circuit is further configured to monitor radiative resistance of the monopolar return pad to determine at least one of the presence or the position of the patient on the monopolar return pad.

### Claim 6 (depends on 5)

The surgical system of claim 5, wherein the control circuit is further configured to utilize situational awareness in combination with the monitored radiative resistance of the monopolar return pad to determine the at least one of the presence or the position of the patient, by comparing the monitored radiative resistance to previous radiative resistance data obtained in similarly situated events of other patients on similarly situated monopolar return pads.

### Claim 7 (depends on 1)

The surgical system of claim 1, wherein the control circuit is further configured to monitor parasitic loading of the monopolar return pad to determine at least one of the presence or the position of the patient on the monopolar return pad.

### Claim 8 (depends on 7)

The surgical system of claim 7, wherein the control circuit is further configured to utilize situational awareness in combination with the monitored parasitic loading of the monopolar return pad to determine the at least one of the presence or the position of the patient, by comparing the monitored parasitic loading to previous parasitic loading data obtained in similarly situated events of other patients on similarly situated monopolar return pads.

### Claim 9 (depends on 1)

The surgical system of claim 1, further comprising a monopolar surgical device configured to stimulate a nerve using RF energy at a surgical site of the patient, wherein the control circuit is further configured to monitor patient movement based on the nerve stimulation to determine at least one of the presence or the position of the patient on the monopolar return pad.

### Claim 10

A surgical system comprising:
a monopolar return pad;
a surgical hub communicatively coupled to the monopolar return pad; and
a monopolar surgical instrument communicatively coupled to the surgical hub and configured to supply energy to a patient on the monopolar return pad;
the surgical hub comprising a compensation circuit configured to adjust power to the monopolar surgical instrument to maintain a peak applied power at the monopolar surgical instrument while the patient is on the monopolar return pad.

### Claim 11 (depends on 10)

The surgical system of claim 10, wherein the compensation circuit comprises a plurality of binary compensation relays.

### Claim 12 (depends on 11)

The surgical system of claim 11, wherein adjusting power to the monopolar surgical instrument comprises:
measuring a power level of the monopolar surgical instrument;
incrementing the power supplied to the monopolar surgical instrument using the plurality of binary compensation relays by one power unit;
measuring the power level of the monopolar surgical instrument after the power is incremented; and
comparing the power level before the power was incremented to the power level after the power was incremented.

### Claim 13 (depends on 12)

The surgical system of claim 12, wherein adjusting power to the monopolar surgical instrument further comprises:
determining that the power level before the power was incremented is higher than the power level after the power was incremented; and
maintaining the power level based on the determination.

### Claim 14 (depends on 10)

The surgical system of claim 10, wherein the surgical hub is further configured to:
determine a presence and a position of a patient on the monopolar return pad according to data received from the monopolar return pad; and
automatically halt power supplied to the monopolar surgical instrument after determining at least one of:
the patient is out of position, or
the patient is off the monopolar return pad.

### Claim 15 (depends on 14)

The surgical system of claim 14, wherein the surgical hub is further configured to utilize situational awareness to determine at least one of:
the patient is out of position, or
the patient is off the monopolar return pad.