WO2022091224A1 - Ablation system - Google Patents

Abstract

Provided is an ablation system capable of improving the efficiency of cauterization during an ablation. This ablation system 5 comprises an electrode needle 1, and a power source device 3 having a control unit 33 and a power source unit 32 for supplying power Pout. During the ablation, the control unit 33 measures an impedance value Z between an electrode needle 1 and a counter electrode plate 4 while counting a brake number Nb, which is the number of times the impedance value Z has exceeded a threshold value Zth and a transition to a brake state has occurred. If the brake number Nb has reached the threshold value Nth, the control unit 33 stops automatically the supply of power Pout, thereby ending the ablation automatically. If the brake number Nb has not reached the threshold value Nth, the control unit 33 lowers or stops temporarily the supply of the power Pout by using as a criterion the power supply value Pout 1 at which the transition to the brake state occurs, and resumes the supply of the power Pout in a state wherein the supply value for the power Pout has been set to a power supply value Pout 2, which is obtained through a reduction by a value equivalent to a predetermined decrease value ΔP1 from the power supply value Pout 1.

Description

Ablation system

The present invention relates to an ablation system including an electrode needle that is percutaneously punctured into an affected area in the body and a power supply device that supplies electric power for ablation (causing).

As one of the medical devices for treating an affected area in a patient's body (for example, an affected area having a tumor such as cancer), an ablation system that ablate the affected area has been proposed (for example, Patent Document 1). reference). This ablation system includes an electrode needle that is percutaneously punctured into the affected area in the body, and a power supply device that supplies electric power to perform ablation on the affected area.

Japanese Unexamined Patent Publication No. 2019-41782

By the way, in such an ablation system, for example, it is required to improve the cauterization efficiency at the time of ablation. It is desirable to provide an ablation system that can improve the ablation efficiency during ablation.

The ablation system according to the embodiment of the present invention is a power source that supplies electric power for ablation between an electrode needle that is percutaneously punctured into an affected portion in the body and the electrode needle and the counter electrode plate. It is provided with a power supply device having a unit and a control unit for controlling the power supply operation in the power supply unit. The control unit measures the impedance value between the electrode needle and the counter electrode plate during ablation, and counts the number of breaks, which is the number of times the impedance value exceeds the first threshold and shifts to the break state. When the number of breaks reaches the second threshold, the ablation is automatically terminated by automatically stopping the power supply, while the number of breaks does not reach the second threshold. In, the power supply is temporarily reduced or stopped based on the first power supply value, which is the power supply value at the time of transition to the break state, and a predetermined decrease from the first power supply value. The power supply is restarted in the state of being set to the second power supply value lowered by the value.

In the ablation system according to the embodiment of the present invention, the number of breaks is counted in the control unit, and when the number of breaks reaches the second threshold value, the power supply from the power supply unit is automatically supplied. By stopping, the ablation ends automatically. This is compared to, for example, a case where the ablation is manually terminated after visually confirming the number of breaks, or a case where the ablation is automatically terminated after a predetermined waiting time has elapsed without confirming the number of breaks. Effective ablation will be facilitated. When the number of breaks does not reach the second threshold value, the power supply is temporarily reduced or stopped based on the first power supply value, and the power supply value becomes the first power supply value. The power supply is restarted in a state of being set to the second power supply value which is lowered by a predetermined decrease value from the one power supply value. As a result, for example, it becomes difficult to shift to the next break state in a short time (shift to the next break state) as compared with the case where the power supply is restarted at the power supply value of about the first power supply value. It is possible to secure a certain amount of time until it is done). Therefore, the ablation after the restart of the power supply is enabled, and the ablation target can be efficiently cauterized (it becomes easy to prevent the ablation efficiency from being lowered due to the transition to the break state).

In the ablation system according to the embodiment of the present invention, the control unit controls so that the power supply value is maintained after the restart of the power supply until the next break state is entered. May be good. In this case, it becomes easier to secure the time until the transition to the next break state, so that cauterization is performed more efficiently. As a result, the cauterization efficiency during ablation is further improved.

In this case, the target time from the start to the end of the ablation is set, and the control unit maintains the power supply value from the current time to the end of the target time. When the remaining time of the above is equal to or greater than the third threshold value and the increase value per unit time in the impedance value is equal to or greater than the fourth threshold value, the power supply value may be further reduced. In this case, when the remaining time until the above target time is secured to some extent, there is a sign that the state shifts to the next break state, so that the power supply value can be further reduced. , The short transition to the next break state is more likely to be avoided. Therefore, as a result of the cauterization being performed more efficiently, the cauterization efficiency at the time of ablation is further improved.

Further, in the state where the power supply value is maintained, the control unit has the remaining time less than the third threshold value, and the increase value of the impedance value per unit time is less than the fourth threshold value. In some cases, the power supply value may be increased. In this case, even if the remaining time until the above target time is short, there is no sign of transition to the next break state yet, so by increasing the power supply value, it is possible to increase the power supply value. It is possible to facilitate a forced transition to the next break state and promote the end of ablation within the above target time. Therefore, the cauterization efficiency during ablation is further improved while minimizing the burden on the patient's body due to long-term ablation.

Further, in the state where the power supply value is maintained, the control unit has the remaining time less than the third threshold value and the increase value of the impedance value per unit time is equal to or higher than the fourth threshold value. In some cases, the power supply value is maintained, and it is determined whether or not the elapsed time from the start of the ablation has reached the target time, and when the elapsed time reaches the target time. Automatically terminates the ablation by automatically stopping the power supply, while the impedance value exceeds the first threshold value when the elapsed time has not reached the target time. Then, it may be determined whether or not the transition to the next break state has occurred.

In addition, information indicating the measured temperature near the tip of the electrode needle is supplied from the electrode needle to the control unit, and the control unit is in the state before the transition to the break state. When the amount of decrease in the measured temperature after the restart of the power supply is equal to or greater than the fifth threshold value based on the measured temperature, the power supply value may be increased from the second power supply value. .. In this case, the ablation efficiency is avoided due to the significant decrease in the measured temperature after the restart of the power supply, and as a result, the ablation efficiency at the time of ablation is further improved.

Here, the control unit may adjust so that the predetermined decrease value increases as the remaining time increases. In this case, the longer the remaining time is, the larger the predetermined decrease value is adjusted, so that the transition to the next break state in a short time is more likely to be avoided. Therefore, as a result of more efficient cauterization, the cauterization efficiency at the time of ablation is further improved.

Further, the control unit may control the power supply value to increase during the period from the start of the ablation to the time when the first break state is entered.

Further, the control unit automatically performs the ablation when the number of breaks reaches two times as the second threshold value before the elapsed time from the start of the ablation reaches the target time. It may be controlled to end. In this case, since the ablation is completed while suppressing the number of breaks to the minimum, it is possible to improve the ablation efficiency while minimizing the burden on the patient's body during the ablation.

According to the ablation system according to the embodiment of the present invention, when the number of breaks does not reach the second threshold value, the power supply is temporarily reduced or the power supply is temporarily reduced with reference to the first power supply value. In addition to stopping the power supply, the power supply is restarted with the power supply value set to the second power supply value, which is a predetermined decrease from the first power supply value, so that the ablation can be performed efficiently in a short time. It can be carried out. Therefore, it is possible to improve the cauterization efficiency during ablation.

It is a block diagram schematically showing the whole configuration example of the ablation system which concerns on one Embodiment of this invention. It is a schematic diagram which shows an example of the cauterization condition in the affected part by ablation. It is a timing diagram schematically showing an example of the break state and the number of breaks at the time of ablation. It is a schematic diagram which shows an example of the display mode in the display part at the time of ablation which concerns on embodiment. It is a flow chart which shows the processing example of ablation which concerns on embodiment. It is a flow chart which shows the processing example following FIG. 5A. It is a flow chart which shows the detailed processing example of a part of processing shown in FIG. 5A. It is a figure which shows an example of the operation mode at the time of resuming the power supply and changing the power supply value shown in FIG. 5A. It is a schematic diagram which shows the timing waveform example at the time of a part of the processing shown in FIG. It is a schematic diagram which shows the timing waveform example at the time of the other part of the processing shown in FIG. It is a schematic diagram which shows the timing waveform example at the time of the other part of the processing shown in FIG. It is a schematic diagram which shows the timing waveform example at the time of the other part of the processing shown in FIG. It is a figure which shows the timing waveform example at the time of ablation which concerns on a comparative example and an Example.

Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. The explanation will be given in the following order.
1. 1. Embodiment (example of a method of controlling the power supply value at the time of restart after the transition to the break state)
2. 2. Modification example

<1. Embodiment>
[Constitution]
FIG. 1 is a schematic block diagram showing an overall configuration example of an ablation system (ablation system 5) according to an embodiment of the present invention. This ablation system 5, for example, as shown in FIG. 1, is a system used when treating an affected portion 90 in the body of a patient 9, and a predetermined ablation is performed on such an affected portion 90. There is. Examples of the affected area 90 include an affected area having a tumor such as cancer (liver cancer, lung cancer, breast cancer, kidney cancer, thyroid cancer, etc.).

As shown in FIG. 1, the ablation system 5 includes an electrode needle 1, a liquid supply device 2, and a power supply device 3. Further, in the ablation using the ablation system 5, for example, the counter electrode plate 4 shown in FIG. 1 is also appropriately used.

(A. Electrode needle 1)
The electrode needle 1 is, for example, as shown by the arrow P1 in FIG. 1, a needle that is percutaneously punctured into the affected portion 90 in the body of the patient 9. The electrode needle 1 is used during the above-mentioned ablation, and has an electrode portion 11 and a covering portion 12 as shown in FIG. 1, for example. The liquid L supplied from the liquid supply device 2 described later circulates and flows inside the electrode needle 1 (see FIG. 1).

The electrode portion 11 is a region portion of the needle-shaped structure constituting the electrode needle 1 that is not covered with an insulating coating, and is a portion that functions as an electrode during ablation. The covering portion 12 is a region portion of the above-mentioned needle-shaped structure in which an insulating coating is made. As shown in FIG. 1, the electrode portion 11 is arranged near the tip of the electrode needle 1, and the covering portion 12 is arranged on the proximal end side of the electrode portion 11.

(Liquid supply device 2)
The liquid supply device 2 is a device that supplies the cooling liquid L to the electrode needle 1 described above, and has, for example, a liquid supply unit 21 as shown in FIG. Examples of the cooling liquid L include sterilized water and sterilized physiological saline.

The liquid supply unit 21 supplies the above-mentioned liquid L to the electrode needle 1 at any time according to the control by the control signal CTL2 described later. Specifically, for example, as shown in FIG. 1, the liquid supply unit 21 causes the liquid L to circulate between the inside of the liquid supply device 2 and the inside of the electrode needle 1 (in a predetermined flow path). Then, the liquid L is supplied. Further, although the details will be described later, such a liquid L supply operation is executed or stopped according to the control by the control signal CTL2 described above. The liquid supply unit 21 is configured to include, for example, a liquid pump or the like.

(Power supply device 3)
The power supply device 3 supplies a power Pout (for example, radio frequency (RF) power) for ablation between the electrode needle 1 and the counter electrode plate 4, and also supplies the liquid L in the liquid supply device 2 described above. It is a device that controls the supply operation. As shown in FIG. 1, the power supply device 3 has an input unit 31, a power supply unit 32, a control unit 33, and a display unit 34.

The input unit 31 is a part for inputting various set values and an instruction signal (operation signal Sm) for instructing a predetermined operation described later. Such an operation signal Sm is input from the input unit 31 in response to an operation by an operator (for example, an engineer or the like) of the power supply device 3. However, these various setting values are not input according to the operation by the operator, but may be set in advance in the power supply device 3 at the time of shipment of the product, for example. Further, the set value input by the input unit 31 is supplied to the control unit 33, which will be described later. It should be noted that such an input unit 31 is configured by using, for example, a predetermined dial, button, touch panel, or the like.

The power supply unit 32 is a portion that supplies the above-mentioned power Pout between the electrode needle 1 and the counter electrode plate 4 according to the control signal CTL1 described later. Such a power supply unit 32 is configured by using a predetermined power supply circuit (for example, a switching regulator or the like). When the power Pout is composed of high frequency power, the frequency is, for example, about 450 kHz to 550 kHz (for example, 500 kHz).

The control unit 33 is a part that controls the entire power supply device 3 and performs predetermined arithmetic processing, and is configured by using, for example, a microcomputer or the like. Specifically, the control unit 33 first has a function (power supply control function) of controlling the power supply operation of the power supply unit 32 by using the control signal CTL1. Further, the control unit 33 has a function (liquid supply control function) of controlling the supply operation of the liquid L in the liquid supply device 2 (liquid supply unit 21) by using the control signal CTL 2. Further, the control unit 33 has a function (display control function) for controlling the display operation in the display unit 34, which will be described later.

Such a control unit 33 also has temperature information indicating the temperature measured Tm near the tip of the electrode needle 1 (a temperature sensor such as a thermoelectric pair arranged inside the electrode unit 11), for example, as shown in FIG. It is designed to be supplied at any time. Further, for example, as shown in FIG. 1, the measured value of the impedance value Z (described later) is supplied to the control unit 33 from the power supply unit 32 described above at any time.

The details of the control operation and the like in the control unit 33 including the above-mentioned power supply control function and liquid supply control function will be described later.

The display unit 34 is a part (monitor) that displays various information and outputs it to the outside. The information to be displayed includes, for example, the various set values input from the input unit 31 and various parameters supplied from the control unit 33 (for example, the impedance value Z described later and the count value of the number of breaks Nb). , Temperature information It supplied from the electrode needle 1 (information on the measurement temperature Tm described above) and the like. However, the information to be displayed is not limited to these information, and other information may be displayed instead or by adding other information. Such a display unit 34 is configured by using a display by various methods (for example, a liquid crystal display, a CRT (Cathode Ray Tube) display, an organic EL (Electro Luminescence) display, or the like).

A detailed example of the information displayed on the display unit 34 will be described later (FIG. 4).

(Counter electrode plate 4)
As shown in FIG. 1, for example, the counter electrode plate 4 is used in a state of being attached to the body surface of the patient 9 at the time of ablation. Although the details will be described later, at the time of ablation, high frequency energization (power Pout is supplied) is performed between the above-mentioned electrode needle 1 (electrode portion 11) and the counter electrode plate 4. Further, as will be described in detail later, at the time of such ablation, as shown in FIG. 1, the impedance value Z between the electrode needle 1 (electrode portion 11) and the counter electrode plate 4 is measured and measured at any time. The impedance value Z is supplied from the power supply unit 32 to the control unit 33 in the power supply device 3.

[Operation and action / effect]
(A. Basic operation)
In this ablation system 5, when treating an affected part 90 having a tumor such as cancer, a predetermined ablation is performed on such an affected part 90 (see FIG. 1). In such ablation, first, as shown by an arrow P1 in FIG. 1, the electrode needle 1 is percutaneously punctured from the tip side (electrode portion 11 side) into the affected portion 90 in the body of the patient 9. To. Then, power Pout (for example, high frequency power) is supplied from the power supply device 3 (power supply unit 32) between the electrode needle 1 and the counter electrode plate 4, so that the affected area 90 is ablated by Joule heat generation. Will be.

Further, at the time of such ablation, the liquid supply device 2 (so that the cooling liquid L circulates between the inside of the liquid supply device 2 and the inside of the electrode needle 1 (in a predetermined flow path)). The liquid L is supplied from the liquid supply unit 21) to the electrode needle 1 (see FIG. 1). As a result, during ablation, a cooling operation (cooling) is performed on the electrode needle 1. After the ablation is completed, such a cooling operation is also stopped, and then the tissue temperature of the affected area 90 rises sufficiently based on the temperature information It indicating the measured temperature Tm near the tip of the electrode needle 1. The condition of cauterization of the affected area is confirmed, such as whether it is present.

FIG. 2 schematically shows an example of the cauterization condition in the affected area 90 due to such ablation. As shown in FIG. 2, when the above-mentioned ablation is performed using the electrode needle 1 punctured in the affected portion 90, for example, the initial rugby ball-shaped (elliptical spherical) thermal coagulation region Ah1 gradually expands. By doing so, a substantially spherical thermal coagulation region Ah2 is obtained (see the broken line arrow in FIG. 2). As a result, isotropic ablation of the entire affected area 90 is performed, and as a result, effective treatment of the affected area 90 is performed.

(B. Break status and number of breaks)
Here, in addition to FIGS. 1 and 2, the details of the above-mentioned ablation (break state and number of breaks described later) will be described with reference to FIG. FIG. 3 schematically shows an example of the break state and the number of breaks at the time of ablation in a timing diagram. Specifically, in FIG. 3, an example of a measured waveform of the impedance value Z between the electrode needle 1 (electrode portion 11) and the counter electrode plate 4 is shown along the time axis.

As shown in the example shown in FIG. 3, in general, when ablation using the electrode needle 1, the impedance value Z rapidly rises due to the evaporation of water in the tissue in the affected area 90. Such a rapid increase in the impedance value Z (impedance rise) is an index of thermal coagulation of the tissue in the affected area 90, and thus serves as a guideline for the stop timing during ablation. Specifically, a state in which the impedance value Z exceeds a predetermined threshold value Zth (Z> Zth) is called a “break state” (see FIG. 3). Further, when the state shifts to such a break state, ablation (supply of electric power Pout) is temporarily stopped, and then ablation is restarted. When the ablation is temporarily stopped, water is supplied from the surrounding tissue into the tissue in the affected area 90, and as a result, the impedance value Z is lowered again (see FIG. 3). Then, by repeating such intermittent ablation a plurality of times, the affected portion 90 is treated. The temporary stop time of ablation (waiting time until restart of ablation) is, for example, a preset predetermined time (for example, about 10 seconds to 15 seconds) or before the impedance value Z rises. The time it takes to return to the value of.

Specifically, in the example shown in FIG. 3, with the passage of time, the ablation shifts to the break state three times at the timings t1, t2, and t3, and the ablation is temporarily stopped. The number of transitions to the break state (number of transitions) in the case where the transition to the break state is repeated a plurality of times is hereinafter referred to as "break count Nb". That is, in the example of FIG. 3, the transition to the first break state at the timing t1 (Nb = 1), the transition to the second break state at the timing t2 (Nb = 2), and the third break state at the timing t3. It has shifted to the break state of (Nb = 3).

Incidentally, in the treatment of the affected area 90 by ablation using the electrode needle 1, the number of breaks Nb is generally about 2 to 3 times (Nb = 2 or Nb = 3) as a guide. That is, the thermal coagulation regions Ah1 and Ah2 shown in FIG. 2 described above correspond to the case of Nb = 1 and Nb = 3, respectively, as an example.

Various information such as the count value of the number of breaks Nb is displayed at any time on the display unit 34 of the power supply device 3, as shown schematically in FIG. 4, for example. Specifically, in the display unit 34, first, as schematically shown in FIG. 3 described above, the measured waveform of the impedance value Z is displayed along the time axis (reference numeral in FIG. 4). See page 20). Further, in the example of the display unit 34, the current value of the impedance value Z (Impedance: refer to the reference numeral P21), the temperature information It (Temperature: refer to the reference numeral P22) indicating the measurement temperature Tm described above, and the supply value of the power Pout. (Power: see reference numeral P23) and information (Ablation Time: see reference numeral P24) of the ablation time (described later, the elapsed time Δtsn from the start of ablation) are displayed. Further, in the example of the display unit 34, as shown in FIG. 4, the current value of the impedance value Z (see reference numeral P21) and the count value of the break count Nb described above are also displayed. In addition, in the example of the display unit 34, as shown by reference numeral P25 in FIG. 4, the elapsed time from the start of ablation to the first break state (time to the timing t1 described above) and the electric power. The energy amount ΔE (integrated value (energy integrated value, joule amount) of the power Pout supply value from the start of ablation) due to the Pout supply operation is displayed respectively.

(C. Ablation of the present embodiment)
Subsequently, in addition to FIGS. 1 to 4, the ablation in the ablation system 5 of the present embodiment will be described in detail with reference to FIGS. 5A to 11.

Here, FIGS. 5A and 5B are flow charts showing an example of ablation processing according to the present embodiment. Further, FIG. 6 is a flow chart showing a detailed processing example of a part of the processing shown in FIG. 5A (processing of step S17 described later: processing of changing the supply value of the power Pout as necessary). .. Further, FIG. 7 shows an example of the operation mode when the power Pout supply is restarted (step S16 in FIG. 5A), which will be described later, and the power Pout supply value is changed (step S17 in FIG. 5A), which will be described later. Is. Further, FIGS. 8 to 11 schematically show examples of timing waveforms during the process shown in FIG. 6 (process in step S17 described above). In each of FIGS. 8 to 11, the horizontal axis indicates time, and the vertical axis indicates the supply value and impedance value Z of the power Pout.

In the ablation of this embodiment, first, various parameters including the above-mentioned threshold value Zth (threshold value of impedance value Z) and the later-described threshold value Nth (threshold value of the number of breaks Nb) are set (FIG. 5A). Step S10). Such various parameters include, in addition to the above-mentioned threshold values Zth and Nth, the threshold value ΔZth (threshold value of the impedance increase value ΔZ described later), the threshold value ΔTmth (threshold value of the decrease amount ΔTm of the measured temperature Tm described later), and the ablation described later. Examples thereof include a target time Δtse and a threshold value Δth (threshold value of the remaining time Δtr described later). Further, the set values of these various parameters (threshold value Zth, ΔZth, Nth, ΔTmth, Δtrth, target time Δtse, etc.) are input from the input unit 31 according to the operation by the operator of the power supply device 3, respectively, and are input from the input unit 33. It is supposed to be supplied to.

The above-mentioned threshold value Zth of the impedance value Z corresponds to a specific example of the "first threshold value" in the present invention, and the above-mentioned threshold value Nth of the number of breaks Nb is a specific example of the "second threshold value" in the present invention. It corresponds to. Further, the above-mentioned threshold value Δth of the remaining time Δtr corresponds to a specific example of the “third threshold value” in the present invention, and the above-mentioned threshold value ΔZth of the impedance increase value ΔZ is a specific example of the “fourth threshold value” in the present invention. Corresponding to an example, the threshold value ΔTmth of the amount of decrease ΔTm of the measured temperature Tm described above corresponds to a specific example of the “fifth threshold value” in the present invention.

Here, as the threshold value Nth, as described above with respect to the number of breaks Nb, for example, 2 times (Nth = 2) (or 3 times (Nth = 3)) can be mentioned. As the threshold value Zth, a method specified by an absolute value (for example, about Zth = 120 [Ω]) and a method specified by a relative value (a method specified by what Ω or what percentage is increased: for example, about 30 Ω). Or it is roughly divided into (such as an increase of about 30%). Further, as the method of defining by this relative value, there are a method of defining the impedance value Z at the start of ablation as a reference and a method of defining the minimum value of the impedance value Z after the start of ablation as a reference. As described above, the setting values of such various parameters are not input according to the operation by the operator, but are set in advance in the power supply device 3, for example, at the time of shipment of the product. You may do so.

Next, ablation with respect to the affected portion 90 is started by supplying a power Pout from the power supply device 3 (power supply unit 32) between the electrode needle 1 and the counter electrode plate 4 (step S11). Specifically, the start of this ablation is executed by inputting the operation signal Sm from the input unit 31 and supplying it to the control unit 33 in response to the operation by the operator of the power supply device 3. That is, in this example, the ablation is manually initiated.

Here, for example, as shown by the broken line arrow in FIGS. 8 to 11, from the start ts of such ablation to the time point (timing t1) of transitioning to the first (first) break state described later. During the period of, the control unit 33 controls, for example, so that the supply value of the electric power Pout increases. Specifically, in the examples of FIGS. 8 to 11, the control unit 33 controls so that the supply value of the electric power Pout during this period gradually (linearly) increases. However, the control unit 33 may control, for example, so that the supply value of the electric power Pout during this period rises stepwise. The increase in the power supply value of the power Pout during this period is not automatically controlled by the control unit 33, but is manually controlled according to the operation (operation signal Sm) by the operator of the power supply device 3. You may do so.

Subsequently, when such ablation is started, the power supply unit 32 first measures the impedance value Z between the electrode needle 1 and the counter electrode plate 4, and also measures near the tip of the electrode needle 1 described above. The measurement for the temperature Tm is performed by the electrode needle 1 (step S12). In other words, the control unit 33 acquires the measurement information of the impedance value Z and the temperature information It indicating the measurement temperature Tm at this time point (see FIG. 1).

Then, when these impedance values Z and the measured temperature Tm are supplied to the control unit 33 from the power supply unit 32 and the electrode needle 1, respectively, the control unit 33 makes the following determinations. That is, whether or not the impedance value Z is larger than the threshold value Zth set in step S10 (whether or not Z> Zth is satisfied), that is, whether or not the control unit 33 has shifted to the break state described above. Is determined (step S13). Here, when it is determined that the impedance value Z is equal to or less than the threshold value Zth (Z> Zth is not satisfied) (step S13: N), the process returns to step S12 described above, and the measurement of the impedance value Z or the like is performed. It will be done again.

On the other hand, when it is determined that the impedance value Z is larger than the threshold value Zth (Satisfying Z> Zth) (step S13: Y), it means that the state has shifted to the above-mentioned break state (here, the first break state). means. Therefore, in this case, the control unit 33 then automatically counts the number of break states (break count Nb: here, Nb = 1) (step S14). The count value of the number of breaks Nb is stored in various storage media in the control unit 33 at any time.

Further, in this step S14, the control unit 33 stores various parameters at the time of transitioning to such a first break state (at the time of the first break). Specifically, the control unit 33 first stores the elapsed time Δtsn (see FIG. 8) from the start time ts of ablation to the present time (here, timing t1). Further, the control unit 33 supplies a power Pout value (power supply value) at the time of transitioning to the first break state (for example, at the time of transitioning to the break state, at the time when the impedance value Z stabilizes, etc.). Pout1: (see FIGS. 8 to 11) is stored. Further, the control unit 33 stores the above-mentioned measurement temperature Tm (for example, the average temperature within a predetermined period before the transition) before the transition to the first break state.

Subsequently, the control unit 33 uses the control signal CTL1 described above to temporarily reduce or stop the supply of the power Pout from the power supply unit 32 with reference to the power supply value Pout1 described above to perform ablation. Temporarily stop (step S15: see the dashed arrow in the power Pout in FIGS. 8-11). As a result, as described above, the impedance value Z drops again, and the break state is exited (see FIGS. 8 to 11).

Next, the control unit 33 reduces the power supply value of the power Pout by a predetermined decrease value ΔP1 (for example, about 20 [W]) from the power supply value Pout1 described above, and the power supply value Pout2 (= Pout1-). With the setting set to ΔP1), the supply (ablation) of the power Pout is restarted (step S16: see the broken line arrow in the power Pout in FIGS. 8 to 11). This power supply value Pout2 is set to, for example, a power supply value just before the transition to the break state (for example, a power supply value of about 80% of the power supply value Pout1). Further, after the restart of the power supply Pout, the control unit 33 basically (when the power supply value change process in step S17 described later is performed) until the next break state is entered. (Except for), control is performed so that the supply value of the power Pout is maintained (see the broken line arrow in the power Pout in FIGS. 8 to 11).

Incidentally, the control unit 33 may adjust the magnitude of the above-mentioned decrease value ΔP1 as shown by the solid arrow A1 in FIG. 8, for example. That is, the magnitude of this decrease value ΔP1 may be adjusted at any time during ablation instead of a preset fixed value. Specifically, as shown in FIG. 8, the control unit 33 is the balance from the current time (here, timing t1) to the end time te of the target time Δtse from the start time ts to the end time te of the ablation. As the time Δtr (= target time Δtse-elapsed time Δtsn) becomes longer, the decrease value ΔP1 may be adjusted to increase. The target time Δtse at the time of this ablation is, for example, about 6 to 12 minutes, and one example is about 8 minutes.

Here, as shown in FIG. 7, as the operation modes at the time of restarting the supply of the power Pout (step S16), for example, "full auto mode (first operation mode)" and "semi-auto mode" are used. (Second operation mode) ”, two types of operation modes can be mentioned. Regarding these two types of operation modes, the same operation modes can be obtained even when the supply value of the power Pout described later is changed (step S17 in FIG. 5A: for example, steps S172, S177, S178 in FIG. 6). Can be mentioned.

First, in the full ode mode, the control unit 33 automatically restarts the power Pout supply (ablation) or automatically changes the power Pout supply value. Specifically, the control unit 33 automatically restarts the supply of the power Pout from the power supply unit 32 or automatically changes the supply value of the power Pout by using the control signal CTL1 described above. .. That is, in this fully automatic mode, the supply of the electric power Pout is restarted and the supply value of the electric power Pout is changed automatically.

On the other hand, in the semi-ode mode, the control unit 33 restarts the supply of the power Pout or changes the supply value of the power Pout based on the operation signal Sm input in response to the operation by the operator of the power supply device 3. Or something. That is, in this semi-auto mode, the supply of the electric power Pout is restarted and the supply value of the electric power Pout is changed manually. At the time of manually restarting the supply of the power Pout or changing the supply value of the power Pout, for example, a predetermined notification to the outside of the power supply device 3 (a predetermined message on the display unit 34). , Etc.) may be performed to urge the operator of the power supply device 3 to perform the above operation.

Further, in the present embodiment, for example, in the power supply device 3, such two types of operation modes (“full auto mode” and “semi-auto mode”) may be switchable (shown in FIG. 7). See the dashed arrow P3). That is, for example, these two types of operation modes may be switched at any time based on the operation signal Sm input in response to the operation by the operator of the power supply device 3.

Subsequently, the control unit 33 performs a process of changing the supply value of the power Pout as needed (step S17). Each specific process in the process of changing the supply value of the electric power Pout as needed will be described in detail below with reference to FIG.

In each of the specific processes, first, the control unit 33 makes the following determination based on the measured temperature Tm (measured temperature Tm stored in step S14 described above) before the transition to the first break state. .. That is, the control unit 33 uses the measured temperature Tm as a reference, and the decrease amount ΔTm of the measured temperature Tm after restarting the supply of the power Pout (step S16) is equal to or greater than the threshold value ΔTmth set in step S10. It is determined whether or not (ΔTm ≧ ΔTmth) is satisfied (step S170 in FIG. 6). Examples of such a threshold value ΔTmth include a value of about 5 [° C.] to 20 [° C.] (preferably, a value of about 10 [° C.] to 20 [° C.]).

Here, when it is determined that the above-mentioned decrease amount ΔTm is less than the threshold value ΔTmth (ΔTm ≧ ΔTmth is not satisfied) (step S170: N), the control unit 33 causes the control unit 33 to maintain the supply value of the power Pout. (Step S171). After that, the process proceeds to step S173, which will be described later.

On the other hand, when it is determined that the above-mentioned decrease amount ΔTm is equal to or greater than the threshold value ΔTmth (satisfying ΔTm ≧ ΔTmth) (step S170: Y), the control unit 33 sets the supply value of the power Pout to a predetermined increase value. It is increased by the amount of ΔP2 (for example, about 5 [W] to 10 [W]) (step S172). Specifically, for example, as shown in FIG. 9, the control unit 33 increases the power supply value Pout2 at this time point (timing t12) by the amount of the increase value ΔP2 (= Pout2 + ΔP2). The power supply value of Pout is set so as to be. After increasing the supply value of the electric power Pout in this way, for example, the control unit 33 may check whether or not the measurement temperature Tm described above has actually increased.

Next, the control unit 33 determines whether or not the above-mentioned remaining time Δtr (= Δtse−Δtsn) is equal to or greater than the threshold value Δtrth set in step S10 while maintaining the supply value of the electric power Pout (= Δtse−Δtsn). It is determined whether or not Δtr ≧ Δtrth) is satisfied (step S173). As the threshold value Δtrth, for example, a value of about 30 [sec] to 120 [sec] (preferably, a value of about 30 [sec] to 60 [sec]) can be mentioned.

Here, when it is determined that the remaining time Δtr described above is equal to or greater than the threshold value Δtrth (satisfying Δtr ≧ Δtrth) (step S173: Y), the control unit 33 then controls the control unit 33 per unit time at the impedance value Z. The rise value (impedance rise value ΔZ) is calculated (step S174a). This impedance rise value ΔZ is a parameter indicating the degree of sign of transition to the next break state. Such an impedance rise value ΔZ corresponds to the minimum value of the impedance value Z in the period from the current value (Zn) in the impedance value Z to the period before the above-mentioned unit time (for example, about 60 [sec]). It is calculated by subtracting the past value (Zp) to be calculated (ΔZ = Zn—Zp).

Next, the control unit 33 determines whether or not the impedance increase value ΔZ calculated in this way is equal to or greater than the threshold value ΔZth set in step S10 (whether or not ΔZ ≧ ΔZth is satisfied). (Step S175a). As such a threshold value ΔZth, for example, a value of about 10 [Ω] to 20 [Ω] can be mentioned.

Here, when it is determined that the impedance increase value ΔZ is less than the threshold value ΔZth (ΔZ ≧ ΔZth is not satisfied) (step S175a: N), there is no sign of transition to the next break state. become. Therefore, in this case, the control unit 33 maintains the supply value of the power Pout (step S176a) and returns to the above-mentioned step S173.

On the other hand, when it is determined that the impedance increase value ΔZ is equal to or higher than the threshold value ΔZth (satisfying ΔZ ≧ ΔZth) (step S175a: Y), there is a sign that the state shifts to the next break state. (For example, see FIG. 10). Therefore, in this case, the control unit 33 further lowers the supply value of the power Pout by a predetermined decrease value ΔP3 (for example, about 5 [W] to 10 [W]) (step S177). Specifically, for example, as shown in FIG. 10, the control unit 33 reduces the power supply value Pout2 at this time point (timing t13) by the decrease value ΔP3 (= Pout2-). The supply value of the power Pout is set so as to be ΔP3). As a result, as shown by the broken line arrow in FIG. 10, the impedance value Z subsequently decreases, and the sign of transition to the next break state is suppressed. After that, the process returns to step S173 described above.

Here, if it is determined in step S173 described above that the remaining time Δtr is less than the threshold value Δtrth (Δtr ≧ Δtrth is not satisfied) (step S173: N), then the control unit 33 controls the above-mentioned step. The impedance rise value ΔZ) is calculated in the same manner as in S174a (step S174b). Then, the control unit 33 determines whether or not the calculated impedance increase value ΔZ is equal to or greater than the threshold value ΔZth (whether or not ΔZ ≧ ΔZth is satisfied) in the same manner as in step S175a described above (step). S175b).

Here, when it is determined that the impedance increase value ΔZ is equal to or greater than the threshold value ΔZth (satisfying ΔZ ≧ ΔZth) (step S175b: Y), there is already a sign of transition to the next break state. become. Therefore, in this case, the control unit 33 maintains the supply value of the power Pout (step S176b), and proceeds to step S18 in FIG. 5A, which will be described later.

On the other hand, when it is determined that the impedance increase value ΔZ is less than the threshold value ΔZth (ΔZ ≧ ΔZth is not satisfied) (step S175b: N), there is still a sign of transition to the next break state. There will be no (see, for example, FIG. 11). Therefore, in this case, the control unit 33 raises the supply value of the power Pout by a predetermined rise value ΔP4 (for example, about 10 [W] to 20 [W]) (step S178). Specifically, for example, as shown in FIG. 11, the control unit 33 increases the power supply value Pout2 at this time point (timing t14) by the amount of the increase value ΔP4 (= Pout2 + ΔP4). The power supply value of Pout is set so as to be. As a result, as shown by the broken line arrow in FIG. 11, the impedance value Z subsequently rises, and the transition to the next break state is promoted. After that, the process returns to step S174b described above.

Here, in step S18 in FIG. 5A described above, the control unit 33 determines whether or not the elapsed time Δtsn from the start time ts of ablation has reached the target time Δtsse described above (step S18). .. When such an elapsed time Δtsn reaches the target time Δtse (step S18: Y), the process proceeds to step S23 described later. That is, although the details will be described later, the control unit 33 automatically ends the ablation by automatically stopping (completely stopping) the supply of the power Pout from the power supply unit 32. As a result, the ablation for the affected area 90 is automatically terminated by the control unit 33.

On the other hand, when the elapsed time Δtsn has not reached the target time Δtse (step S18: N), the control unit 33 receives the measurement information of the impedance value Z at this time and the measurement information of the impedance value Z at this time in the same manner as in step S12 described above. The temperature information It indicating the measured temperature Tm is acquired (step S19 in FIG. 5B). Then, the control unit 33 makes the following determination in the same manner as in step S13 described above. That is, the control unit 33 determines whether or not the impedance value Z is larger than the threshold value Zth (whether or not Z> Zth is satisfied), that is, whether or not the next (second or later) break state is entered. , Make a determination (step S20). Here, if it is determined that the impedance value Z is equal to or less than the threshold value Zth (Z> Zth is not satisfied) (step S20: N), the process returns to step S18 described above, and the elapsed time Δtsn described above is the target time. The determination as to whether or not the Δtse has been reached is performed again.

On the other hand, when it is determined that the impedance value Z is larger than the threshold value Zth (satisfying Z> Zth) (step S20: Y), it means that the state has moved to the next break state. Therefore, in this case, the control unit 33 then automatically counts the number of break states (break count Nb: here, Nb ≧ 2) in the same manner as in step S14 described above (step S21).

Further, also in this step S21, similarly to the above-mentioned step S14, the control unit 33 stores various parameters at the time of transitioning to such a second and subsequent break states (at the time of the second and subsequent breaks). .. Specifically, as in step S14, the control unit 33 has an elapsed time Δtsn, a supply value of the power Pout at the time of transition to the second and subsequent break states, and before the transition to the second and subsequent break states. The measured temperature Tm (for example, the average temperature within a predetermined period before the transition) is stored.

Subsequently, the control unit 33 determines whether or not the number of breaks Nb counted in step S21 is equal to or greater than the threshold value Nth set in step S10 (whether or not Nb ≧ Nth is satisfied). (Step S22). Here, if it is determined that the number of breaks Nb is less than the threshold value Nth (Nb ≧ Nth is not satisfied) (step S22: N), the process returns to step S15 described above. That is, the supply of the power Pout is temporarily reduced or stopped again, and the ablation is temporarily stopped again.

On the other hand, when it is determined that the break count Nb described above is equal to or greater than the threshold value Nth (Satisfying Nb ≧ Nth) (step S22: Y), the control unit 33 then performs the following control. That is, in this case, the control unit 33 automatically ends the ablation by automatically stopping (completely stopping) the supply of the power Pout from the power supply unit 32 (step S23: in FIGS. 8 to 11). See the dashed arrow in the power Pout of. Specifically, the control unit 33 automatically stops the supply of the power Pout by using the control signal CTL1 described above. As a result, the ablation for the affected area 90 is automatically terminated by the control unit 33.

Here, for example, as shown in FIGS. 8 to 11, in the present embodiment, the control unit 33 controls the number of breaks Nb at the time of automatic termination of such ablation, for example, as follows. Is desirable. That is, the control unit 33 automatically ends the ablation when the number of breaks Nb reaches twice as the threshold value Nth before the elapsed time Δtsn from the start time ts of the ablation reaches the target time Δtsse. It is desirable to control it so that it does.

Subsequently, the control unit 33 automatically ends the ablation in this way (step S23), and then automatically stops the supply of the cooling liquid L from the liquid supply device 2 (step S24). .. Specifically, the control unit 33 automatically stops the supply of the liquid L from the liquid supply unit 21 by using the control signal CTL2 described above. As a result, the circulation of the liquid L between the inside of the liquid supply device 2 and the inside of the electrode needle 1 is stopped (see FIG. 1), and the cooling operation (cooling) for the electrode needle 1 is stopped.

This completes the series of processes shown in FIGS. 5A, 5B, and 6 (examples of ablation processing according to this embodiment).

(D. Action / Effect)
In this way, in the ablation system 5 of the present embodiment, the control unit 33 performs the following control at the time of ablation. That is, first, the control unit 33 measures the impedance value Z between the electrode needle 1 and the counter electrode plate 4, and the number of breaks, which is the number of times the impedance value Z exceeds the threshold value Zth and shifts to the break state. Count Nb. Then, when the break number Nb reaches the threshold value Nth, the control unit 33 automatically stops the supply of the power Pout to automatically end the ablation. As a result, for example, there is a case where the ablation is manually terminated after visually confirming the number of breaks Nb, or a case where the ablation is automatically terminated after a predetermined waiting time has elapsed without confirming the number of breaks Nb. In comparison, effective ablation can be easily performed.

On the other hand, when the number of breaks Nb has not reached the threshold value Nth, the control unit 33 supplies the power Pout with reference to the power Pout supply value (power supply value Pout1) at the time of transition to the break state. Temporarily lowers or stops. Then, the control unit 33 restarts the supply of the electric power Pout in a state where the supply value of the electric power Pout is set to the electric power supply value Pout2 which is lowered by a predetermined decrease value ΔP1 from the electric power supply value Pout1 described above. This makes it difficult to shift to the next break state in a short time, for example, as compared with the case where the power supply is restarted at the above-mentioned power supply value Pout1 (corresponding to the comparative example described later). It is possible to secure a certain amount of time until the state shifts to the break state). Therefore, the ablation after the restart of the power supply is enabled, and the ablation target (affected portion 90) can be efficiently cauterized. Specifically, for example, during the break time of the power supply Pout supply (the above-mentioned temporary decrease or stop period: about 15 seconds), energy cannot be injected into the ablation target or a break state occurs. By repeating the transition, it becomes easy to prevent a decrease in ablation efficiency due to a transition to a break state, such as deterioration of heat conduction due to scorching. Therefore, although the details will be described later in Examples, it is easy to perform isotropic ablation to the entire affected area 90 as in the heat coagulation region Ah2 (almost spherical region) in FIG. 2 described above. Will be able to. As a result, in the present embodiment, it is possible to improve the cauterization efficiency at the time of ablation.

Further, in the present embodiment, after the supply of the electric power Pout is restarted, the power Pout supply value is controlled so as to be maintained until the next break state is entered, so that the result is as follows. That is, since it becomes easier to secure the time until the transition to the next break state, cauterization is performed more efficiently. As a result, the cauterization efficiency during ablation can be further improved.

Further, in the present embodiment, in the state where the supply value of the electric power Pout is maintained, the remaining time Δtr from the present time to the end time te of the above-mentioned target time Δtse is equal to or more than the threshold value Δtrth, and is described above. When the impedance rise value ΔZ is equal to or higher than the threshold value ΔZth, the supply value of the power Pout is further lowered, so that the result is as follows. That is, in a situation where the remaining time Δtr until the target time Δtse is secured to some extent, there is a sign that the state shifts to the next break state. Therefore, by further reducing the supply value of the power Pout, the next It is easier to avoid the transition to the break state in a short time. Therefore, as a result of the cauterization being performed more efficiently, it is possible to further improve the cauterization efficiency at the time of ablation.

In addition, in the present embodiment, when the remaining time Δtr described above is less than the threshold value Δtrth and the impedance increase value ΔZ described above is less than the threshold value ΔZth in a state where the supply value of the power Pout is maintained. Since the supply value of the power Pout is increased, the result is as follows. That is, even in a situation where the remaining time Δtr until the target time Δtse is small, there is no sign of transition to the next break state yet, so by increasing the supply value of the power Pout, the next It is possible to facilitate the forced transition to the break state and promote the end of ablation within the target time Δtse. Therefore, it is possible to further improve the ablation efficiency during ablation while minimizing the burden on the body of the patient 9 due to long-term ablation (details will be described later).

Further, in the present embodiment, the amount of decrease ΔTm of the measured temperature Tm after restarting the supply of the power Pout is based on the measured temperature Tm (measured temperature near the tip of the electrode needle 1) before the transition to the break state. When the threshold value is ΔTmth or more, the supply value of the power Pout is increased from the power supply value Pout2, so that the result is as follows. That is, as a result of avoiding a decrease in ablation efficiency due to a significant decrease in the measured temperature Tm after restarting the power supply, it is possible to further improve the ablation efficiency during ablation.

Further, in the present embodiment, as the remaining time Δtr described above becomes longer, the decrease value ΔP1 described above is adjusted to increase, so that the result is as follows. That is, as the remaining time Δtr is adjusted so that the decrease value ΔP1 becomes larger, it becomes easier to avoid the transition to the next break state in a short time. Therefore, as a result of more efficient cauterization, it is possible to further improve the ablation efficiency.

In addition, in the present embodiment, the number of breaks Nb reaches 2 times as the threshold value Nth before the elapsed time Δtsn from the start time ts of the ablation reaches the target time Δtsse described above, and the ablation occurs. Since it is controlled to end automatically, it becomes as follows. That is, since the ablation is completed while suppressing the number of breaks to the minimum (Nb = 2), it is possible to improve the ablation efficiency while minimizing the burden on the body of the patient 9 at the time of ablation. Become.

Specifically, when the number of breaks Nb increases more than necessary within the ablation time (for example, 3 times or more or 4 times or more), the affected area 90 becomes more than necessary during treatment by ablation. A break state will be given. As a result, the pain felt by the patient 9 becomes large, and the burden on the body of the patient 9 may become large.

Here, this pain means the pain felt by the patient 9 during treatment, and it is said that, for example, the right shoulder and the like often hurt as referred pain via the spinal nerve. Since the impedance value Z rises sharply in the break state, the output voltage also rises sharply when the power Pout is output as a constant power, for example. In addition, the temperature at the affected area 90 tends to rise before the transition to the break state. Therefore, it is said that this pain has both electrical and thermal causes.

[Example]
Subsequently, an embodiment of the present embodiment will be described while comparing with a comparative example.

FIG. 12 shows an example of a timing waveform (actual measurement waveform example) at the time of ablation according to a comparative example and an example. Specifically, FIG. 12A shows an example of a timing waveform at the time of ablation according to a comparative example, and FIG. 12B shows an example of a timing waveform at the time of ablation according to an embodiment. Specifically, in FIGS. 12A and 12B, the impedance value Z [Ω], the measured temperature Tm [° C.] near the tip of the electrode needle 1, and the power Pout [W] are the times, respectively. It is shown in common units along the axis.

First, each condition and each measurement result in the comparative example shown in FIG. 12A are as follows.
-Ablation target (specimen): Pig-extracted liver-Length of electrode portion 11 near the tip of electrode needle 1 (tip portion length): 3 [cm]
-Power Pout supply value at the start of ablation (output at the start): 40 [W]
・ Power Pout increase method until the first break (t = 1): 10 [W / min], linear increase ・ Break count Nb: 2
-Decrease value of power Pout when power supply is restarted after the first break ΔP1:10 [W]
(Power Pout after restart: Setting to increase linearly (see the broken line arrow in FIG. 12 (A)))
・ T1 = 4 minutes 52 seconds ・ t2 = 5 minutes 58 seconds (duration from t1 to t2: 1 minute 06 seconds)
-Vertical length in the thermal coagulation region to be ablated: 40.8 [mm]
-Horizontal length in the thermal coagulation region to be ablated: 28.2 [mm]

On the other hand, each condition and each measurement result in the example shown in FIG. 12B are as follows.
-Ablation target (specimen): Pig-extracted liver-Length of electrode portion 11 near the tip of electrode needle 1 (tip portion length): 3 [cm]
-Power Pout supply value at the start of ablation (output at the start): 40 [W]
・ Power Pout increase method until the first break (t = 1): 10 [W / min], linear increase ・ Break count Nb: 2
-Decrease value of power Pout when power supply is restarted after the first break ΔP1:30 [W]
(Power Pout after restart: Set to the maintained state (see the broken line arrow in FIG. 12B))
・ T1 = 4 minutes 54 seconds ・ t2 = 11 minutes 07 seconds (duration from t1 to t2: 6 minutes 13 seconds)
-Vertical length in the thermal coagulation region to be ablated: 38.1 [mm]
-Horizontal length in the thermal coagulation region to be ablated: 36.2 [mm]

In this way, the basic conditions are the same between the comparative example and the embodiment. However, while the decrease value ΔP1 of the power Pout at the time of restarting the power supply after the first break is relatively small in the comparative example (the power supply is restarted at the same level as the power supply value at the first break stage). , In the examples, it is larger. Further, in the comparative example, the power Pout after resumption is set to increase linearly, while in the embodiment, the power Pout after resumption is set to be maintained.

As a result, in the comparative example, the period from the first break time to the second break time (the period from t1 to t2) is very short (1 minute 06 seconds), and the second break state is shortened. It can be seen that the time has shifted (see FIG. 12 (A)). On the other hand, in the example, the period from the first break to the second break (the period from t1 to t2) is about 6 times longer than that of the comparative example (6 minutes 13 seconds). It can be seen that the time required to shift to the second break state is secured to some extent (see FIG. 12 (B)).

As a result, in the comparative example, the difference (12.6 [mm]) between the vertical length and the horizontal length in the thermal coagulation region of the ablation target is large, and the ablation is anisotropic with respect to the ablation target. You can see that it has become. On the other hand, in the examples, the difference (1.9 [mm]) between the vertical length and the horizontal length in the thermal coagulation region to be ablated is very small ((1/6) or less in the case of the comparative example). ), It can be seen that the above-mentioned isotropic ablation is performed on the ablation target.

From the above, it can be said that it was actually confirmed that the cauterization efficiency during ablation was improved in the examples as compared with the comparative examples.

<2. Modification example>
Although the present invention has been described above with reference to embodiments and examples, the present invention is not limited to these embodiments and the like, and various modifications are possible.

For example, the material and the like of each member described in the above-described embodiment and the like are not limited, and may be other materials. Further, in the above-described embodiment and the like, the configuration of the electrode needle 1 has been specifically described, but it is not always necessary to include all the members, and other members may be further provided. Further, the values, ranges, magnitude relations, etc. of various parameters described in the above-described embodiments are not limited to those described in the above-described embodiments, and may be other values, ranges, magnitude relations, etc. good.

Further, in the above-described embodiment and the like, the block configurations of the liquid supply device 2 and the power supply device 3 have been specifically described, but it is not always necessary to include all the blocks described in the above-described embodiment and the like. Other blocks may be further provided. Further, the ablation system 5 as a whole may be further provided with other devices in addition to the devices described in the above-described embodiment and the like.

Further, in the above-described embodiment and the like, the control operation (ablation method) in the control unit 33 including the power supply control function and the liquid supply control function has been specifically described. However, the control method (ablation method) in these power supply control functions, liquid supply control functions, and the like is not limited to the methods mentioned in the above-described embodiments.

Specifically, for example, in the ablation processing example shown in FIGS. 5A, 5B, and 6, in some cases, for example, the target time Δtse described above is reached before shifting to the first break state. Before shifting to the second break state, the target time Δtse is reached without the impedance rise value ΔZ described above exceeding the threshold value ΔZth (without any sign of the second break state). There may be cases of relaxation. However, even in such a case, for example, even if the target time Δtse is exceeded, the transition to the first break state is indispensable, or even if the target time Δtse is exceeded, the occurrence of the second break state sign is indispensable. You may try to do it.

Further, for example, in the ablation processing example shown in FIGS. 5A, 5B, and 6, the case of performing control using the measured temperature Tm (temperature information It) (processing of changing the supply value of the power Pout, etc.) has been described. , Not limited to this case. That is, for example, in some cases, control using such a measured temperature Tm may not be performed.

Further, for example, in the ablation processing example shown in FIGS. 5A, 5B, and 6, instead of the target time Δtse at the time of ablation (or in addition to the target time Δtse), for example, the above-mentioned energy amount ΔE (ablation). Control (processing of changing the supply value of the power Pout, etc.) may be performed by using the integrated value of the supply value of the power Pout from ts at the start of.

In addition, the series of processes described in the above-described embodiment or the like may be performed by hardware (circuit) or software (program). When it is done by software, the software is composed of a group of programs for executing each function by a computer. Each program may be used by being preliminarily incorporated in the computer, for example, or may be installed and used in the computer from a network or a recording medium.

Further, the various examples described so far may be applied in any combination.

Claims (9)

1. An electrode needle that is percutaneously punctured into the affected area in the body,
   It is provided with a power supply device having a power supply unit for supplying electric power for ablation between the electrode needle and the counter electrode needle, and a control unit for controlling the power supply operation in the power supply unit.
   The control unit
   At the time of the ablation, the impedance value between the electrode needle and the counter electrode plate is measured, and the number of breaks, which is the number of times the impedance value exceeds the first threshold value and shifts to the break state, is counted.
   When the number of breaks reaches the second threshold value, the ablation is automatically terminated by automatically stopping the supply of the electric power, while the ablation is automatically terminated.
   If the number of breaks has not reached the second threshold,
   With reference to the first power supply value, which is the power supply value at the time of transition to the break state, the power supply is temporarily reduced or stopped, and the power supply is temporarily reduced or stopped.
   An ablation system that restarts the supply of electric power in a state where the electric power supply value is set to a second electric power supply value that is lowered by a predetermined decrease value from the first electric power supply value.
2. The control unit
   After resuming the power supply, until the next break state is entered.
   The ablation system according to claim 1, wherein the power supply value is controlled to be maintained.
3. The target time from the start to the end of the ablation is set and
   The control unit
   While maintaining the power supply value,
   Of the target time, the remaining time from the present time to the end time is equal to or more than the third threshold value, and
   When the rising value per unit time in the impedance value is equal to or higher than the fourth threshold value,
   The ablation system according to claim 2, further reducing the power supply value.
4. The target time from the start to the end of the ablation is set and
   The control unit
   While maintaining the power supply value,
   Of the target time, the remaining time from the present time to the end time is less than the third threshold value, and
   When the increase value per unit time in the impedance value is less than the fourth threshold value,
   The ablation system according to claim 2 or 3, wherein the power supply value is increased.
5. The target time from the start to the end of the ablation is set and
   The control unit
   While maintaining the power supply value,
   Of the target time, the remaining time from the present time to the end time is less than the third threshold value, and
   When the rising value per unit time in the impedance value is equal to or higher than the fourth threshold value,
   While maintaining the power supply value, it is determined whether or not the elapsed time from the start of the ablation has reached the target time.
   When the elapsed time reaches the target time, the ablation is automatically terminated by automatically stopping the supply of the electric power, while the ablation is automatically terminated.
   Claims 2 to 4 for determining whether or not the impedance value exceeds the first threshold value and shifts to the next break state when the elapsed time has not reached the target time. The ablation system according to any one of the above.
6. Information indicating the measured temperature near the tip of the electrode needle is supplied from the electrode needle to the control unit, and at the same time.
   The control unit
   When the amount of decrease in the measured temperature after the restart of the power supply is equal to or greater than the fifth threshold value, based on the measured temperature before the transition to the break state.
   The ablation system according to any one of claims 2 to 5, wherein the power supply value is increased from the second power supply value.
7. The target time from the start to the end of the ablation is set and
   The control unit
   The item according to any one of claims 1 to 6, wherein the predetermined decrease value is adjusted so that the remaining time from the present time to the end of the target time becomes longer. Ablation system.
8. The control unit
   In the period from the start of the ablation to the point of transition to the first break state,
   The ablation system according to any one of claims 1 to 7, wherein the power supply value is controlled to increase.
9. The target time from the start to the end of the ablation is set and
   The control unit
   Before the elapsed time from the start of the ablation reaches the target time,
   The ablation system according to any one of claims 1 to 8, wherein the number of breaks reaches 2 times as the second threshold value, and the ablation is automatically terminated.

Images