IP Library › Granted Patent US 12,376,910
Granted Patent B2
US 12,376,910 · App. 17/450,020 · Granted Aug 5, 2025

Methods for controlling cooperative surgical instruments

Inventors: Frederick E. Shelton, IV (Hillsboro, OH); Charles J. Scheib (Loveland, OH); Jason L. Harris (Lebanon, OH)
Assignee: Cilag GmbH International
A61B34/20A61B1/00006A61B1/000095A61B1/005A61B1/044A61B1/3132A61B5/0075A61B5/0084A61B5/065A61B5/6835A61B17/1114G16H20/40G16H40/63A61B2017/00876A61B2017/1139A61B17/115A61B2034/2051A61B2034/2055A61B2034/2057A61B2034/2065A61B2034/302
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Quick Facts
Patent No.
US 12,376,910
App. No.
17/450,020
Granted
Aug 5, 2025
Kind
B2
Abstract

Systems, devices, and methods for controlling cooperative surgical instruments are provided. Various aspects of the present disclosure provide for coordinated operation of surgical instruments accessing a common body cavity of a patient from different approaches to achieve a common surgical purpose. For example, various methods, devices, and systems disclosed herein can enable the coordinated treatment of surgical tissue by disparate minimally invasive surgical systems that approach the tissue from varying anatomical spaces and operate in concert with one another to effect a desired surgical treatment.

Claims (71)

1. A method, performed by a controller, comprising:

determining a location of a first surgical instrument within a first portion of a body cavity of a patient, wherein the first surgical instrument has a first portion of a surgical implant releasably engaged thereon, the location of the first surgical instrument is based on image data gathered by a first image sensor coupled to a distal end of a first endoscope, and the image data gathered by the first image sensor characterizes the first portion of the body cavity;

determining a location of a second surgical instrument within a second portion of the body cavity relative to the first surgical instrument, wherein the second surgical instrument has a second portion of the surgical implant releasably engaged thereon, the location of the second surgical instrument is based on image data gathered by a second image sensor coupled to a distal end of a second endoscope, and the image data gathered by the second image sensor characterizes the second portion of the body cavity;

determining at least one of a thickness of a tissue wall between the location of the first surgical instrument an the location of the second surgical instrument, a stiffness of the tissue wall between the location of the first surgical instrument an the location of the second surgical instrument, or a tissue composition of the tissue wall between the location of the first surgical instrument an the location of the second surgical instrument; and

determining a placement location of the first portion of the surgical implant in the tissue wall and a placement location of the second portion of the surgical implant in the tissue wall based on at least one of the thickness of the tissue wall between the location of the first surgical instrument and the location of the second surgical instrument, the stiffness of the tissue wall between the location of the first surgical instrument and the location of the second surgical instrument, or the tissue composition of the tissue wall between the location of the first surgical instrument and the location of the second surgical instrument; wherein:

the first surgical instrument is outside of a field of view of the second image sensor,

the second surgical instrument is outside of a field of view of the first image sensor, and

the second portion of the body cavity is different than the first portion of the body cavity.

2. The method of claim 1 , wherein the at least one of the thickness of the tissue wall between the location of the first surgical instrument and the location of the second surgical instrument, the stiffness of the tissue wall between the location of the first surgical instrument and the location of the second surgical instrument, or the tissue composition of the tissue wall between the location of the first surgical instrument and the location of the second surgical instrument are determined based on at least one of tissue impedance or non-visual light spectrum imaging.

3. The method of claim 1 , wherein the location of the first surgical instrument and the location of the second surgical instrument are determined with tissue obstructing the second surgical instrument from the field of view of the first image sensor and with tissue obstructing the first surgical instrument from the field of view of the second image sensor.

4. The method of claim 1 , wherein the placement location of the first portion of the surgical implant in the tissue wall and the placement location of the second portion of the surgical implant in the tissue wall are determined further based on electromagnetic tracker data transmitted to the controller from the first and second portions of the surgical implant.

5. The method of claim 1 , wherein the surgical implant comprises a two-part magnetic anastomosis device in which the first and second portions of the surgical implant are magnetic.

6. The method of claim 5 , further comprising:

causing the first and second portions of the surgical implant to be positioned at the determined placement locations such that the first and second portions are magnetically attracted together and form an anastomosis at the location of the first surgical instrument and the location of the second surgical instrument.

7. The method of claim 1 , wherein:

the first surgical instrument is advanced distally into the first portion of the body cavity, with the first portion of the surgical implant releasably engaged on the first surgical instrument, along an exterior of the first endoscope, and

the second surgical instrument is advanced distally into the second portion of the body cavity, with the second portion of the surgical implant releasably engaged on the second surgical instrument, along an exterior of the second endoscope.

8. The method of claim 1 , further comprising:

determining

an orientation of the first surgical instrument within the first portion of the body cavity and an orientation of the second surgical instrument within the second portion of the body cavity.

9. The method of claim 1 , wherein:

the first portion of the surgical implant is releasably engaged on the first surgical instrument at a distal end of the first surgical instrument, and

the second portion of the surgical implant is releasably engaged on the second surgical instrument at a distal end of the second surgical instrument.

10. The method of claim 9 , wherein:

the first surgical instrument is advanced distally into the first portion of the body cavity, with the first portion of the surgical implant releasably engaged on the distal end of the first surgical instrument, through a working channel of the first endoscope, and

the second surgical instrument is advanced distally into the second portion of the body cavity, with the second portion of the surgical implant releasably engaged on the distal end of the second surgical instrument, through a working channel of the second endoscope.

11. The method of claim 10 , wherein:

the first surgical instrument is inserted through the working channel of the first endoscope until the distal end of the first surgical instrument is positioned distally beyond the first endoscope at the location of the first surgical instrument, and

the second surgical instrument is inserted through the working channel of the second endoscope until the distal end of the second surgical instrument is positioned distally beyond the second endoscope at the location of the second surgical instrument.

12. The method of claim 1 , further comprising:

determining

a location of the first endoscope within the first portion of the body cavity and a location of the second endoscope within the second portion of the body cavity;

wherein the thickness of the tissue wall is determined using the determined first and second locations of the first and second endoscope.

13. The method of claim 1 , wherein the location of the first surgical instrument is a first location of the surgical instrument, the location of the second surgical instrument is a first location of the surgical instrument, the image gathered by the first image sensor is a first image gathered by the first image sensor, and the image gathered by the second image sensor is a first image gathered by the second image sensor, further comprising:

determining a second location of the first surgical instrument within the first portion of the body cavity, the second location of the first surgical instrument is based on second image data gathered by the first image sensor, and the second image data gathered by the first image sensor characterizes the first portion of the body cavity;

determining a second location of the second surgical instrument within the second portion of the body cavity, the second location of the second surgical instrument is based on second image data gathered by the second image sensor, and the second image data gathered by the second image sensor characterizes the second portion of the body cavity;

determining least one of a thickness of the tissue wall between the second location of the first surgical instrument and the second location of the second surgical instrument, a stiffness of the tissue wall between the second location of the first surgical instrument and the second location of the second surgical instrument, or a tissue composition of the tissue wall between the second location of the first surgical instrument and the second location of the second surgical instrument; and

comparing at least one of the thickness of the tissue wall between the first location of the first surgical instrument and the first location of the second surgical instrument with the thickness of the tissue wall between the second location of the first surgical instrument and the second location of the second surgical instrument, the stiffness of the tissue wall between the first location of the first surgical instrument and the first location of the second surgical instrument with the stiffness of the tissue wall between the second location of the first surgical instrument and the second location of the second surgical instrument, or the tissue composition of the tissue wall between the first location of the first surgical instrument and the first location of the second surgical instrument with the tissue composition of the tissue wall between the second location of the first surgical instrument and the second location of the second surgical instrument;

wherein determining the placement locations of the first and second portions of the surgical implant is further based on the comparison.

14. The method of claim 13 , wherein:

the body cavity comprises a jejunum;

the surgical implant comprises an anastomosis device;

the first and second locations of the first surgical instrument are determined during advancement of the first surgical instrument distally within the jejunum; and

the first and second locations of the second surgical instrument are determined during advancement of the second surgical instrument distally within the jejunum.

15. A surgical system, comprising:

a first surgical instrument;

a second surgical instrument; and

a controller, wherein the controller is configured to:

determine a location of the first surgical instrument within a first portion of a body cavity of a patient, wherein the first surgical instrument has a first portion of a surgical implant releasably engaged thereon, the location of the first surgical instrument is based on image data gathered by a first image sensor coupled to a distal end of a first endoscope, and the image data gathered by the first image sensor characterizes the first portion of the body cavity;

determine a location of the second surgical instrument within a second portion of the body cavity relative to the first surgical instrument, wherein the second surgical instrument has a second portion of the surgical implant releasably engaged thereon, the location of the second surgical instrument is based on image data gathered by a second image sensor coupled to a distal end of a second endoscope, and the image data gathered by the second image sensor characterizes the second portion of the body cavity;

determine at least one of a thickness of a tissue wall between the location of the first surgical instrument an the location of the second surgical instrument, a stiffness of the tissue wall between the location of the first surgical instrument an the location of the second surgical instrument, or a tissue composition of the tissue wall between the location of the first surgical instrument an the location of the second surgical instrument; and

determine a placement location of the first portion of the surgical implant in the tissue wall and a placement location of the second portion of the surgical implant in the tissue wall based on at least one of the thickness of the tissue wall between the location of the first surgical instrument and the location of the second surgical instrument, the stiffness of the tissue wall between the location of the first surgical instrument and the location of the second surgical instrument, or the tissue composition of the tissue wall between the location of the first surgical instrument and the location of the second surgical instrument; wherein:

the first surgical instrument is outside of a field of view of the second image sensor,

the second surgical instrument is outside of a field of view of the first image sensor, and

the second portion of the body cavity is different than the first portion of the body cavity.

16. The surgical system of claim 15 , wherein the at least one of the thickness of the tissue wall between the location of the first surgical instrument and the location of the second surgical instrument, the stiffness of the tissue wall between the location of the first surgical instrument and the location of the second surgical instrument, or the tissue composition of the tissue wall between the location of the first surgical instrument and the location of the second surgical instrument is determined based on at least one of tissue impedance or non-visual light spectrum imaging.

17. The surgical system of claim 15 , wherein the placement location of the first portion of the surgical implant in the tissue wall and the placement location of the second portion of the surgical implant in the tissue wall are determined further based on electromagnetic tracker data transmitted to the controller from the first and second portions of the surgical implant.

18. The surgical system of claim 15 , further comprising:

determine a location of the first endoscope within the first portion of the body cavity and a location of the second endoscope within the second portion of the body cavity;

wherein the thickness of the tissue wall is determined using the determined first and second locations of the first and second endoscope.

19. The surgical system of claim 15 , wherein the location of the first surgical instrument is a first location of the surgical instrument, the location of the second surgical instrument is a first location of the surgical instrument, the image gathered by the first image sensor is a first image gathered by the first image sensor, and the image gathered by the second image sensor is a first image gathered by the second image sensor, further comprising:

determine a second location of the first surgical instrument within the first portion of the body cavity, the second location of the first surgical instrument is based on second image data gathered by the first image sensor, and the second image data gathered by the first image sensor characterizes the first portion of the body cavity;

determine a second location of the second surgical instrument within the second portion of the body cavity, the second location of the second surgical instrument is based on second image data gathered by the second image sensor, and the second image data gathered by the second image sensor characterizes the second portion of the body cavity;

determine at least one of a thickness of the tissue wall between the second location of the first surgical instrument and the second location of the second surgical instrument, a stiffness of the tissue wall between the second location of the first surgical instrument and the second location of the second surgical instrument, or a tissue composition of the tissue wall between the second location of the first surgical instrument and the second location of the second surgical instrument; and

compare at least one of the thickness of the tissue wall between the first location of the first surgical instrument and the first location of the second surgical instrument with the thickness of the tissue wall between the second location of the first surgical instrument and the second location of the second surgical instrument, the stiffness of the tissue wall between the first location of the first surgical instrument and the first location of the second surgical instrument with the stiffness of the tissue wall between the second location of the first surgical instrument and the second location of the second surgical instrument, or the tissue composition of the tissue wall between the first location of the first surgical instrument and the first location of the second surgical instrument with the tissue composition of the tissue wall between the second location of the first surgical instrument and the second location of the second surgical instrument;

wherein the placement locations of the first and second portions of the surgical implant are determined further based on the comparison.

20. The surgical system of claim 19 , wherein:

the body cavity comprises a jejunum;

the surgical implant comprises an anastomosis device;

the first and second locations of the first surgical instrument are determined during advancement of the first surgical instrument distally within the jejunum; and

the first and second locations of the second surgical instrument are determined during advancement of the second surgical instrument distally within the jejunum.

Assignments (1)
ASSIGNMENT OF ASSIGNOR'S INTEREST Recorded Nov 8, 2021
From: SHELTON, FREDERICK E., IV; SCHEIB, CHARLES J.; HARRIS, JASON L.
To: CILAG GMBH INTERNATIONAL
Reel/Frame 058050/0798 →
Continuity (2)
Provisional Application 63249870 · Sep 29, 2021
Related Publication 20230100698A1 · Mar 30, 2023
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