# US 12,181,579 B2 · Controlling an emitter assembly pulse sequence

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- Number: US 12,181,579 B2
- Document ID: US12181579B2
- Status: Granted
- Kind: B2
- Application number: 16/128,180
- Filed: 2018-09-11
- Published: 2020-01-16
- Granted: 2024-12-31
- Earliest claimed: 2018-07-16
- Assignees: Cilag GmbH Intemational
- Applicants: Cilag GmbH International
- Inventors: Charles J. Scheib; Joshua D. Talbert; Jeffrey S. Swayze
- Web page: https://patentgrep.com/patent/US12181579B2

## CPC

- G01S 17/36: with phase comparison between the received signal and the contemporaneously transmitted signal
- A61B 1/00006: {of control signals}
- A61B 1/000094: {extracting biological structures}
- A61B 1/00013: {using optical means}
- A61B 1/00043: {provided with output arrangements}
- A61B 1/00045: {Display arrangement}
- A61B 1/0005: {combining images e.g. side-by-side, superimposed or tiled}
- A61B 1/00087: {Tools (A61B17/00234 takes precedence)}
- A61B 1/00096: {Optical elements}
- A61B 1/00126: {optical, e.g. for light supply cables}
- A61B 1/00149: {using articulated arms}
- A61B 1/00154: {using guiding arrangements for insertion}
- A61B 1/0016: {using motor drive units}
- A61B 1/00194: {adapted for three-dimensional imaging}
- A61B 1/009: {with bending or curvature detection of the insertion part}
- A61B 1/018: for receiving instruments
- A61B 1/04: combined with photographic or television appliances
- A61B 1/043: {for fluorescence imaging}
- A61B 1/045: Control thereof
- A61B 1/046: {for infrared imaging}
- A61B 1/05: characterised by the image sensor, e.g. camera, being in the distal end portion
- A61B 1/051: {Details of CCD assembly}
- A61B 1/053: {being detachable}
- A61B 1/06: with illuminating arrangements
- A61B 1/0605: {for spatially modulated illumination}
- A61B 1/0607: {for annular illumination}
- A61B 1/063: {for monochromatic or narrow-band illumination}
- A61B 1/0638: {providing two or more wavelengths}
- A61B 1/0661: {Endoscope light sources}
- A61B 1/07: using light-conductive means, e.g. optical fibres
- A61B 1/3132: {for laparoscopy}
- A61B 5/0036: {including treatment, e.g., using an implantable medical device, ablating, ventilating}
- A61B 5/0064: {Body surface scanning}
- A61B 5/0075: {by spectroscopy, i.e. measuring spectra, e.g. Raman spectroscopy, infrared absorption spectroscopy (A61B5/0071 takes precedence)}
- A61B 5/0077: {Devices for viewing the surface of the body, e.g. camera, magnifying lens}
- A61B 5/0084: {for introduction into the body, e.g. by catheters (A61B5/1459 takes precedence)}
- A61B 5/0086: {using infrared radiation}
- A61B 5/0095: {by applying light and detecting acoustic waves, i.e. photoacoustic measurements}
- A61B 5/1072: {measuring distances on the body, e.g. measuring length, height or thickness (A61B5/1076 takes precedence)}
- A61B 5/1076: {for measuring dimensions inside body cavities, e.g. using catheters (A61B3/1005 takes precedence)}
- A61B 5/1079: {using optical or photographic means}
- A61B 5/6844: {Monitoring or controlling distance between sensor and tissue}
- A61B 5/6886: {Monitoring or controlling distance between sensor and tissue}
- A61B 17/00234: {for minimally invasive surgery (A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)}
- A61B 17/0218: {for minimally invasive surgery (A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)}
- A61B 17/0469: {Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery}
- A61B 17/0482: {Needle or suture guides (guides for drills, pins or wire A61B17/17; guides for puncturing needles A61B17/3403)}
- A61B 17/0483: {Hand-held instruments for holding sutures (A61B17/0469 takes precedence; other holders for needles or sutures A61B17/06061; surgical forceps A61B17/28; surgical pincettes A61B17/30)}
- A61B 17/06066: {Needles, e.g. needle tip configurations}
- A61B 17/062: Needle manipulators
- A61B 17/064: Surgical staples, {i.e. penetrating the tissue}
- A61B 17/1114: {of the digestive tract, e.g. bowels or oesophagus}
- A61B 17/1155: {Circular staplers comprising a plurality of staples}
- A61B 17/3423: {Access ports, e.g. toroid shape introducers for instruments or hands (access sites for liquids A61M39/0247)}
- A61B 34/20: Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B 34/30: Surgical robots
- A61B 34/32: operating autonomously
- A61B 34/73: {Manipulators for magnetic surgery}
- A61B 90/03: {Automatic limiting or abutting means, e.g. for safety}
- A61B 90/13: guided by light, e.g. laser pointers
- A61B 90/30: Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
- A61B 90/35: Supports therefor
- A61B 90/36: {Image-producing devices or illumination devices not otherwise provided for}
- A61B 90/361: {Image-producing devices, e.g. surgical cameras}
- A61B 90/37: {Surgical systems with images on a monitor during operation}
- G01B 11/25: by projecting a pattern, e.g. {one or more lines,} moiré fringes on the object (G01B11/255 takes precedence {; image analysis for depth or shape recovery G06T7/50})
- G01B 11/2513: {with several lines being projected in more than one direction, e.g. grids, patterns}
- G01J 3/0229: {using masks, aperture plates, spatial light modulators or spatial filters, e.g. reflective filters}
- G01J 3/027: {Control of working procedures of a spectrometer; Failure detection; Bandwidth calculation}
- G01J 3/0278: {Control or determination of height or angle information for sensors or receivers}
- G01J 3/10: Arrangements of light sources specially adapted for spectrometry or colorimetry
- G01J 3/2803: {using photoelectric array detector}
- G01J 3/2823: {Imaging spectrometer}
- G01N 21/4795: {spatially resolved investigating of object in scattering medium (in vivo A61B)}
- G01S 7/4865: Time delay measurement, e.g. time-of-flight measurement, time of arrival measurement or determining the exact position of a peak (peak detection in noise, signal conditioning G01S7/487)
- G01S 17/10: using transmission of interrupted, pulse-modulated waves (determination of distance by phase measurements G01S17/32)
- G01S 17/48: Active triangulation systems, i.e. using the transmission and reflection of electromagnetic waves other than radio waves
- G02F 1/1326: {Liquid crystal optical waveguides or liquid crystal cells specially adapted for gating or modulating between optical waveguides}
- G06T 1/0007: {Image acquisition}
- 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 1/00009: {of image signals during a use of endoscope}
- A61B 1/0676: {at distal tip of an endoscope}
- A61B 5/0071: {by measuring fluorescence emission}
- A61B 5/7267: {involving training the classification device}
- A61B 5/7425: {Displaying combinations of multiple images regardless of image source, e.g. displaying a reference anatomical image with a live image}
- A61B 34/25: {User interfaces for surgical systems}
- A61B 2017/00017: {Electrical control of surgical instruments}
- A61B 2017/00057: {Light}
- A61B 2017/00061: {spectrum}
- A61B 2017/00119: {alarm; indicating an abnormal situation}
- A61B 2017/00154: {pulsed}
- A61B 2017/00367: {Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like}
- A61B 2017/00477: {Coupling (A61B2017/0046 takes precedence)}
- A61B 2017/00809: {Lung operations}
- A61B 2017/00818: {Treatment of the gastro-intestinal system}
- A61B 2017/00876: {magnetic}
- A61B 2017/2927: {the angular position of the head being adjustable with respect to the shaft}
- A61B 2034/105: {Modelling of the patient, e.g. for ligaments or bones}
- A61B 2034/107: {Visualisation of planned trajectories or target regions}
- A61B 2034/2051: {Electromagnetic tracking systems}
- A61B 2034/2055: {Optical tracking systems}
- A61B 2034/2057: {Details of tracking cameras}
- A61B 2034/2063: {Acoustic tracking systems, e.g. using ultrasound}
- A61B 2034/2065: {Tracking using image or pattern recognition}
- A61B 2034/256: {having a database of accessory information, e.g. including context sensitive help or scientific articles}
- A61B 2034/301: {for introducing or steering flexible instruments inserted into the body, e.g. catheters or endoscopes}
- A61B 2034/302: {specifically adapted for manipulations within body cavities, e.g. within abdominal or thoracic cavities}
- A61B 2090/061: {for measuring dimensions, e.g. length}
- A61B 2090/064: {for measuring force, pressure or mechanical tension}
- A61B 2090/066: {for measuring torque}
- A61B 2090/08021: {of the patient or his organs}
- A61B 2090/0807: {Indication means}
- A61B 2090/0811: {for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument}
- A61B 2090/304: {using chemi-luminescent materials}
- A61B 2090/306: {using optical fibres}
- A61B 2090/364: {Correlation of different images or relation of image positions in respect to the body}
- A61B 2090/365: {augmented reality, i.e. correlating a live optical image with another image}
- A61B 2090/367: {creating a 3D dataset from 2D images using position information}
- A61B 2090/371: {with simultaneous use of two cameras}
- A61B 2090/373: {using light, e.g. by using optical scanners}
- A61B 2090/374: {NMR or MRI}
- A61B 2090/3762: {using computed tomography systems [CT]}
- A61B 2090/378: {using ultrasound}
- A61B 2090/3937: {Visible markers}
- A61B 2505/05: Surgical care
- A61B 2560/0462: Apparatus with built-in sensors
- A61B 2576/00: Medical imaging apparatus involving image processing or analysis (A61B1/00009, A61B6/52 and A61B8/52 take precedence)
- G01J 2003/104: {Monochromatic plural sources}
- G01J 2003/106: {the two sources being alternating or selectable, e.g. in two ranges or line:continuum}
- G01J 2003/2813: {2D-array}
- G01N 2021/3129: {Determining multicomponents by multiwavelength light}
- G01N 2021/4797: {time resolved, e.g. analysis of ballistic photons}
- G01S 17/894: Three-dimensional [3D] imaging with simultaneous measurement of time-of-flight at a two-dimensional [2D] array of receiver pixels, e.g. time-of-flight cameras or flash lidar
- G01S: RADIO DIRECTION-FINDING; RADIO NAVIGATION; DETERMINING DISTANCE OR VELOCITY BY USE OF RADIO WAVES; LOCATING OR PRESENCE-DETECTING BY USE OF THE REFLECTION OR RERADIATION OF RADIO WAVES; ANALOGOUS ARRANGEMENTS USING OTHER WAVES
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- G01B: MEASURING LENGTH, THICKNESS OR SIMILAR LINEAR DIMENSIONS; MEASURING ANGLES; MEASURING AREAS; MEASURING IRREGULARITIES OF SURFACES OR CONTOURS
- G01J: MEASUREMENT OF INTENSITY, VELOCITY, SPECTRAL CONTENT, POLARISATION, PHASE OR PULSE CHARACTERISTICS OF INFRARED, VISIBLE OR ULTRAVIOLET LIGHT; COLORIMETRY; RADIATION PYROMETRY (light sources F21, H01J, H01K, H05B; investigating properties of materials by optical means G01N)
- G01N: INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES (measuring or testing apparatus or processes other than immunoassay, involving enzymes or microorganisms C12M, C12Q)
- G02F: OPTICAL DEVICES OR ARRANGEMENTS FOR THE CONTROL OF LIGHT BY MODIFICATION OF THE OPTICAL PROPERTIES OF THE MEDIA OF THE ELEMENTS INVOLVED THEREIN; NON-LINEAR OPTICS; FREQUENCY-CHANGING OF LIGHT; OPTICAL LOGIC ELEMENTS; OPTICAL ANALOGUE/DIGITAL CONVERTERS
- G06T: IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
- G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA

## Abstract

A system and method for controlling an emitter assembly for visualizing a surgical site is disclosed. The emitter assembly is configured to emit a pulse pattern of electromagnetic radiation at the surgical site. The electromagnetic radiation pattern can include infrared radiation, visible light, or combinations thereof in either structured or non-structured formats. Further, a receiver assembly is configured to receive the electromagnetic radiation reflected from the surgical site. The control circuit can be configured to control the sequence or pattern in which the electromagnetic radiation is pulsed according to a preset sequence or according to feedback from the surgical site.

## Claims

### Claim 1

A surgical instrument for visualizing a surgical site, the surgical instrument comprising:
an emitter assembly configured to emit electromagnetic radiation at the surgical site, the electromagnetic radiation comprising infrared radiation and visible light;
a receiver assembly configured to receive electromagnetic radiation reflected from the surgical site, wherein the reflected electromagnetic radiation corresponds to the emitted electromagnetic radiation; and
a control circuit coupled to the emitter assembly and the receiver assembly, the control circuit configured to:
cause the emitter assembly to pulse the electromagnetic radiation in a predetermined sequence comprising the infrared radiation and the visible light, wherein the predetermined sequence corresponds to a preselected tissue type;
detect reflected electromagnetic radiation corresponding to the emitted electromagnetic radiation via the receiver assembly;
determine tissue information according to the reflected electromagnetic radiation; and
modify the predetermined sequence in which the infrared radiation and the visible light are emitted by the emitter assembly according to the tissue information;
wherein causing the emitter assembly to pulse the electromagnetic radiation in a predetermined sequence comprising the infrared radiation and the visible light comprises emitting the infrared radiation for a first predetermined length of time, emitting the visible light for a second predetermined length of time, and emitting the infrared radiation and the visible light in a predetermined order;
wherein emitting the infrared radiation and the visible light in the predetermined order comprises emitting the infrared radiation before emitting the visible light, wherein modifying the predetermined sequence comprises modifying the predetermined sequence to a second sequence in which the visible light is emitted before the infrared radiation, and wherein the control circuit is further configured to cause the emitter assembly to pulse the electromagnetic radiation in the second sequence based on the modification.

### Claim 2 (depends on 1)

The surgical instrument of claim 1, wherein the control circuit is configured to control the emitter assembly to sweep the emitted electromagnetic radiation over a range of wavelengths.

### Claim 3 (depends on 2)

The surgical instrument of claim 2, wherein the control circuit is configured to modify the predetermined sequence in which the infrared radiation and the visible light are emitted by the emitter assembly according to the tissue information, wherein the tissue information is determined according to one or more wavelengths within the range of wavelengths.

### Claim 4 (depends on 1)

The surgical instrument of claim 1, wherein the tissue information comprises at least one of a distance to a tissue, a shape of the tissue, or an anatomical type of the tissue and combinations thereof.

### Claim 5 (depends on 1)

The surgical instrument of claim 1, wherein the surgical instrument comprises an end effector comprising a first jaw and a second jaw, and wherein the end effector comprises the emitter assembly and the receiver assembly.

### Claim 6 (depends on 1)

The surgical instrument of claim 1, wherein the control circuit is configured to visualize a tissue on a display coupled to the control circuit according to the determined tissue information.

### Claim 7 (depends on 6)

The surgical instrument of claim 6, wherein the control circuit is configured to track movement of tissue structures on the display according to the determined tissue information.

### Claim 8 (depends on 6)

The surgical instrument of claim 6, wherein the control circuit is configured to distinguish the preselected tissue type from other tissue on the display.

### Claim 9 (depends on 1)

The surgical instrument of claim 1, wherein the preselected tissue type comprises one of a plurality of tissue types stored in a memory.

### Claim 10 (depends on 1)

The surgical instrument of claim 1, wherein modifying the predetermined sequence comprises modifying the first predetermined length of time, the second predetermined length of time, and the predetermined order of the infrared radiation and the visible light.

### Claim 11 (depends on 1)

The surgical instrument of claim 1, wherein the determined tissue information comprises a tissue type, and wherein modifying the predetermined sequence comprises modifying the predetermined order of the infrared radiation and the visible light according to the tissue type.

### Claim 12

A surgical visualization system for visualizing a surgical site, the surgical visualization system comprising a control circuit configured to:
cause electromagnetic radiation to be pulsed in a predetermined sequence comprising infrared radiation and visible light, wherein the predetermined sequence corresponds to a preselected tissue type;
extract tissue information from reflected electromagnetic radiation corresponding to the emitted electromagnetic radiation; and
modify the predetermined sequence in which the infrared radiation and the visible light are emitted according to the tissue information;
wherein causing electromagnetic radiation to be pulsed in a predetermined sequence comprising infrared radiation and visible light comprises emitting the infrared radiation for a first predetermined length of time, emitting the visible light for a second predetermined length of time, and emitting the infrared radiation and the visible light in a predetermined order;
wherein emitting the infrared radiation and the visible light in the predetermined order comprises emitting the visible light before the infrared radiation, wherein modifying the predetermined sequence comprises modifying the predetermined sequence to a second sequence in which the infrared radiation is emitted before the visible light, and wherein the control circuit is further configured to cause the electromagnetic radiation to be pulsed in the second sequence based on the modification.

### Claim 13 (depends on 12)

The surgical visualization system of claim 12, comprising an emitter assembly, wherein the control circuit is configured to control the emitter assembly to sweep the emitted electromagnetic radiation over a range of wavelengths.

### Claim 14 (depends on 13)

The surgical visualization system of claim 13, wherein the control circuit is configured to modify the predetermined sequence in which the infrared radiation and the visible light are emitted by the emitter assembly according to the tissue information, wherein the tissue information is determined according to one or more wavelengths within the range of wavelengths.

### Claim 15 (depends on 12)

The surgical visualization system of claim 12, wherein the tissue information comprises at least one of a distance to a tissue, a shape of the tissue, or an anatomical type of the tissue and combinations thereof.

### Claim 16 (depends on 12)

The surgical visualization system of claim 12, comprising a waveform sensor assembly positioned on a surgical instrument comprising an end effector.

### Claim 17 (depends on 12)

The surgical visualization system of claim 12, wherein the control circuit is configured to visualize a tissue on a display coupled to the control circuit according to the determined tissue information.

### Claim 18 (depends on 17)

The surgical visualization system of claim 17, wherein the control circuit is configured to track movement of tissue structures on the display according to the determined tissue information.

### Claim 19 (depends on 12)

The surgical visualization system of claim 12, wherein the preselected tissue type comprises one of a plurality of tissue types stored in a memory.

### Claim 20

A surgical instrument for visualizing a surgical site, the surgical instrument comprising:
an emitter assembly configured to emit electromagnetic radiation at the surgical site, the electromagnetic radiation comprising more than one wavelength, the more than one wavelength comprising a first wavelength and a second wavelength;
a receiver assembly configured to receive electromagnetic radiation reflected from the surgical site, wherein the reflected electromagnetic radiation corresponds to the emitted electromagnetic radiation; and
a control circuit coupled to the emitter assembly and the receiver assembly, the control circuit configured to:
receive a tissue type selection;
cause the emitter assembly to pulse the electromagnetic radiation in a preselected sequence corresponding to the tissue type selection, the preselected sequence comprising the more than one wavelength;
detect reflected electromagnetic radiation corresponding to the emitted electromagnetic radiation via the receiver assembly;
determine tissue information according to the reflected electromagnetic radiation; and
cause the emitter assembly to emit the second wavelength before the first wavelength based on the determined tissue information;
wherein causing the emitter assembly to pulse the electromagnetic radiation in a preselected sequence corresponding to the tissue type selection comprises emitting each wavelength of the more than one wavelength a predetermined length of time and in a predetermined order, and wherein emitting each wavelength of the more than one wavelength in a predetermined order comprises emitting the first wavelength before the second wavelength.

### Claim 21 (depends on 20)

The surgical instrument of claim 20, wherein the preselected sequence corresponding to the tissue type selection is configured for visualizing the tissue type selection.

### Claim 22 (depends on 20)

The surgical instrument of claim 20, wherein the tissue information comprises at least one of a distance to a tissue, a shape of the tissue, or an anatomical type of the tissue and combinations thereof.

### Claim 23 (depends on 20)

The surgical instrument of claim 20, wherein the surgical instrument comprises an end effector.

### Claim 24 (depends on 20)

The surgical instrument of claim 20, wherein the control circuit is configured to visualize a tissue on a display coupled to the control circuit according to the determined tissue information.

### Claim 25 (depends on 24)

The surgical instrument of claim 24, wherein the control circuit is configured to track movement of tissue structures on the display according to the determined tissue information.

### Claim 26 (depends on 20)

The surgical instrument of claim 20, wherein the tissue type selection comprises one of a plurality of tissue types stored in a memory.

### Claim 27

A surgical system, comprising:
an emitter assembly configured to emit electromagnetic radiation at a surgical site, the electromagnetic radiation comprising a first wavelength, a second wavelength, and a third wavelength;
a receiver assembly configured to receive electromagnetic radiation reflected from the surgical site, wherein the reflected electromagnetic radiation corresponds to the emitted electromagnetic radiation; and
a control circuit coupled to the emitter assembly and the receiver assembly, the control circuit configured to:
cause the emitter assembly to pulse the first wavelength, the second wavelength, and the third wavelength in a first order;
detect reflected electromagnetic radiation corresponding to the emitted electromagnetic radiation via the receiver assembly;
determine tissue information according to the reflected electromagnetic radiation; and
cause the emitter assembly to pulse the first wavelength, the second wavelength, and the third wavelength in a second order different than the first order based on the tissue information.