CN106137387B - 使用微波能量的脉管封闭 - Google Patents
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Abstract
本公开涉及一种使用微波能量的脉管封闭,具体提供一种用于微波钳的端部操作装置组件。端部操作装置组件包括一对相对钳口部件,这对相对钳口部件从相对于彼此处于间隔开关系的第一位置到至少一个随后位置是可运动的,在该至少一个随后位置中,钳口部件合作以在其间抓握组织。钳口部件的每一个包括微波天线组件和屏蔽部件,该屏蔽部件包括接地的金属板、和介电材料。端部操作装置组件还包括分裂器,该分裂器配置成从微波能量源接收有源信号,并且将有源信号分裂成第一信号和第二信号,该第一信号传输到钳口部件之一中的微波天线组件,该第二信号在另一个钳口部件中的微波天线组件中传输。
Description
本申请是申请日为2012年12月06日、申请号为201210519407.6,发明名称为“使用微波能量的脉管封闭”的发明专利申请的分案申请。
技术领域
本公开涉及用来封闭各种类型组织的钳。更具体地说,本公开涉及利用微波能量来封闭组织的敞开、腹腔镜或内窥镜钳。
背景技术
在多种外科过程中,身体脉管,例如血管、导管、粘连、输卵管、等等,被封闭,以使脉管失去机能或将其关闭。在传统上,卡钉、夹片或缝合已经用来关闭身体脉管。然而,这些传统过程常常将异物材料留在病人体内。在努力减少留在病人体内的异物材料并更有效地封闭身体脉管的过程中,已经采用通过加热过程封闭的能量技术。
钳对于封闭组织和脉管特别有用,因为钳利用机械作用以收缩、抓紧、解剖及/或夹持组织。当前脉管封闭过程利用热处理并且有时利用压力来加热和干燥组织,引起身体脉管的关闭和封闭。另外,钳允许控制对组织施加的压力。加热和施加压力的组合提供均匀、可控制封闭,具有对于身体组织的最小伴随损伤。
发明内容
如在图中表示和贯穿如下说明书描述的那样,如传统那样,当提到在外科器械上的相对定位时,术语“近侧”是指设备的、较靠近用户的端部,并且术语“远侧”是指设备的、离用户较远的端部。术语“临床医师”是指进行医疗过程的任何医务人员(例如,医生、外科医师、护士等),该医疗过程涉及这里描述的实施例的使用。
在本公开的一个方面,提供一种用于微波钳的端部操作装置组件。端部操作装置组件包括一对相对钳口部件,这对相对钳口部件从相对于彼此处于间隔开关系的第一位置到至少一个随后位置是可运动的,在该至少一个随后位置中,钳口部件合作以在其间抓握组织。钳口部件的每一个包括微波天线组件和屏蔽部件,该屏蔽部件包括接地的金属板、和介电材料。端部操作装置组件还包括分裂器,该分裂器配置成从微波能量源接收有源信号(active signal),并且将有源信号分裂成第一信号和第二信号,该第一信号传输到钳口部件之一中的微波天线组件,该第二信号在另一个钳口部件中的微波天线组件中传输。
第一信号的相位相对于第二信号的相位偏移,例如偏移180°。天线组件的远侧端部的末端可以是开口,或者可以分路到地。如果天线组件的末端是开口,则天线组件的长度是半波长的倍数。如果天线组件分路到地,则天线组件的长度是四分之一波长的奇数倍。
在本公开的另一个方面,提供一种用于微波钳的端部操作装置组件。端部操作装置组件包括分裂器,该分裂器配置成从微波能量源接收有源信号,并且将有源信号分裂成第一信号和第二信号。端部操作装置组件还包括一对相对钳口部件,这对相对钳口部件从相对于彼此处于间隔开关系的第一位置到至少一个随后位置是可运动的,在该至少一个随后位置中,钳口部件合作以在其间抓握组织。钳口部件的每一个包括:微波天线阵列,具有第一天线和多根第二天线;屏蔽部件,包括接地的金属板、和介电材料;及多路复用器,配置成从分裂器接收第一信号或第二信号,其中,多路复用器将第一信号或第二信号提供给微波天线阵列中的第一天线或第一天线和多根第二天线的至少一根。
第一信号的相位相对于第二信号的相位偏移,例如偏移180°。第一天线和多根第二天线的每一根的末端可以是开口,或者可以分路到地。如果第一天线和多根第二天线的每一根的末端是开口,则第一天线和多根第二天线的每一根的长度是半波长的倍数。如果第一天线和多根第二天线的每一根分路到地,则第一天线的长度是四分之一波长的奇数倍,并且多根第二天线的每一根的长度是半波长的倍数。
附图说明
本公开的以上和其它方面、特征、及优点,当联系附图进行时,鉴于如下详细描述将成为更显然的,在这些附图中:
图1是根据本公开一个实施例的组织封闭系统的立体图,该组织封闭系统包括钳和能量发生器;
图2是图1的钳的远侧端部的剖视图;
图3A-3C是根据本公开一个实施例的微波端部操作装置组件的视图;
图4A-4B是根据本公开另一个实施例的微波端部操作装置组件的视图;
图5A-5B是根据本公开另一个实施例的微波端部操作装置组件的视图;以及
图6是根据本公开另一个实施例的微波端部操作装置组件的视图。
具体实施方式
下面参照附图描述本公开的具体实施例;然而,公开的实施例仅仅是本公开的例子,并且可以按各种形式实施。为了避免在不必要细节中使本公开模糊,没有详细地描述熟知功能或结构。因此,这里公开的具体结构和功能细节不要解释成限制性的,而是仅仅作为用于权利要求书的基础、和作为用来向本领域的技术人员讲授在几乎任何适当详细结构中不同地采用本公开的代表性基础。类似附图标记贯穿图的描述可以指相似或相同部件。
本公开针对利用微波能量来封闭组织的敞开、腹腔镜或内窥镜钳。通过使用微波能量来封闭组织,组织可较快地干燥,由此减少封闭时间,同时减小热散布量。微波能量使用近场效应使在组织内的水分子相对于彼此振动,以产生组织融合所需要的热量。在下面描述的实施例中,电磁近场可以被包含和被定向成,在加热位于电磁近场内的组织的同时不加热任何周围健康结构。
现在参照图1,示出根据本公开的组织封闭系统2,该组织封闭系统2包括钳10,该钳10联接到发生器20上。钳10适于使用微波能量封闭组织。发生器20可以配置成,输出各种类型的微波能量(例如,从约300MHz至约10,000MHz)。
钳10经电缆11联接到发生器20上,该电缆11适于在钳10与发生器20之间传输能量和控制信号。下面更详细地讨论利用上述类型能量的钳10的各个实施例。可选择地,钳10可以是可携带手持装置,该可携带手持装置包括电刀功率源,该电刀功率源包括发生器、控制器及电池。
钳10配置成,支持端部操作装置组件100。钳10典型地包括相互合作的各种常规特征(例如,壳体60、手柄组件75、转动组件80、触发组件70、端部操作装置100),以抓握、封闭、及如果有理由则划分组织。手柄组件75包括可动手柄62、和与壳体60是整体的手柄72。手柄62相对于手柄72是可运动的,以致动端部操作装置组件100而抓握和处理组织。钳10也包括轴12,该轴12具有远侧端部14和近侧端部16,该远侧端部14机械地啮合端部操作装置组件100,该近侧端部16机械地啮合在转动组件80附近的壳体60,该转动组件80布置在壳体60的远侧端部处。转动组件80与轴12机械地相关联。转动组件80的运动将类似转动运动传给轴12,该轴12又转动端部操作装置组件100。
参照图2,端部操作装置组件100包括两个钳口部件110和120,这两个钳口部件110和120具有近侧端部111、121和远侧端部113、123。钳口部件110和120绕支柱160是可枢转的,并且从第一位置到第二位置是可运动的,在该第一位置中,钳口部件110和120相对于彼此间隔开,在该第二位置中,钳口部件110和120关闭,并且合作以在其间抓握组织。钳口部件110和120可以是单向的或双向的。如下面更详细讨论的那样,端部操作装置组件100可以适于与各种能量源一起使用。可选择地,钳口部件110和120之一可以保持静止,而另一个钳口部件相对于静止的钳口部件运动。
轴12容纳推杆101、或其它适当致动机构,该推杆101、或其它适当致动机构可操作地联接到可动手柄62上,从而当手柄62相对于手柄72运动时,推杆101在轴12内纵向地,或者向近侧或者向远侧运动。推杆101包括推针103,该推针103布置在轴12的远侧端部16处。钳口部件110和120的每一个分别包括布置在其近侧端部处的槽口105和107。槽口105和107与推针103机械合作,该推针103适于在槽口105和107内运动。推针103和槽口105和107作为凸轮-从动机械连杆操作。推杆101的运动使针103在相应槽口105和107内滑动。槽口105和107可以相对于钳口部件110和120的远侧端部倾斜,从而当推杆101分别在近侧或远侧方向上纵向运动时,部件110和120彼此相向地或远离地运动。
钳10也包括触发组件70,该触发组件70使刀200(选择性的)前进,该刀200布置在端部操作装置组件100内。一旦形成组织封闭,用户就致动触发组件70,以使组织沿组织封闭分离。刀200包括锋利刀刃205,用来切割在组织封闭部位处在钳口部件110和120之间保持的组织。
每个钳口部件110和120分别包括位于其面向内的表面上的封闭表面112和122。封闭表面112和122合作,以在施加微波之后,通过将封闭压力施加到组织上而封闭保持在其间的组织。钳10基于位于钳口部件110和120之间的组织的各种性质,确定在组织上的封闭压力,上述各种性质包括:组织阻抗、组织类型、组织清晰度、组织顺应性、组织或钳口部件的温度、组织中的水含量、钳口打开角度、组织中的水活性、能量输送、钳口关闭压力等等。基于这样的性质,可以在至少一个钳口部件的电气致动之前、期间或之后在电气致动期间实时地确定封闭压力。压力控制器(未示出)可以可操作地联接到钳10的轴12上。压力控制器可以是任何类型的电气、或机电机构,该电气、或机电机构提供在驱动组件(未示出)上的另外力,以增大或减小钳口部件110和120的封闭压力,该封闭压力又增大或减小位于钳口部件110和120之间的组织上的封闭压力。例如,伺服马达、齿轮组件、液压机构、蜗杆驱动器等等可以联接到轴12上,并且可操作地联接到驱动组件(未示出)上,以按照信息将另外的力提供给驱动组件(未示出)。
图3A-3C表明根据本公开一个实施例的微波端部操作装置组件300。微波端部操作装置组件300联接到同轴电缆210上,该同轴电缆210容纳在轴12和电缆11内。电缆210包括内部导体212,该内部导体212由内部绝缘体214包围,该内部绝缘体214又由外部导体216(例如,圆柱形导电护套)包围。内部导体212和外部导体216可以由铜、金、不锈钢、或具有类似导电率值的其它导电金属构成。金属可以镀有其它材料,例如其它导电材料,以改进其性能,例如改进导电率或减小能量损失、等等。
端部操作装置组件300包括微波天线组件302,该微波天线组件302具有分别与封闭表面312和322相关联的一根或多根微波天线302a、302b、302c及302d。微波天线302a-302d电气联接到发生器20上,该发生器20适于通过电缆210将微波能量供给到钳10。同轴电缆210将微波天线302a、302b和302c、302d的一根或多根通过内部导体212连接到发生器20的有源元件上。当钳口部件110和120在关闭位置中时,发生器20才将有源信号供给到天线302a-302d。
如图3A所示,来自内部导体212的有源信号馈送到分裂器222。分裂器222接收有源信号,并且将有源信号的相位分裂成两个相等信号,这两个相等信号具有彼此偏移180°的相位分量。分裂器222可以使用平衡-不平衡变换器、线延迟、集总元件或任何其它适当电气元件分裂信号,这些其它适当电气元件可以用来将有源信号分裂成具有相位偏移180°的两个信号。分裂器222可以经传输线218电气联接到发生器20上。传输线218可以提供成分离导线,或者可以集成到电缆210中。发生器20可以控制分裂器222,以改变在两个分裂信号之间的相位偏移,并且/或者控制分裂的方法。
图3B表示微波天线302a-302d的俯视图,这些微波天线302a-302d配置成纵向带条,这些纵向带条延伸封闭表面312和322的长度。微波天线302a-302d可以由任何类型的导电、非活性金属制成,如由不锈钢制成。
当组织由组件300封闭时,天线302a-302d可以提供封闭过程的自动终止。随着封闭进行,分离天线302a、302b和302c、302d的组织收缩,由此减小在天线302a、302b和302c、302d之间的分离。随着天线302a、302b和302c、302d通过压缩力朝向彼此运动,通过其传输的微波能量通过其反射回,并且辐射由于微波天线组件302的天线(例如,天线302a、302b和302c、302d)的接近而自动地停止。
如图3A所示,天线组件302的远侧端部的末端是开口。在这种情形下,天线302a-302d的长度l1(图3B)是半波长的倍数(即,λ/2、λ、1.5λ、2λ、等等),以在两个有源体之间帮助引导能量。例如,当如图3A所示两个天线组件的末端都是开口,并且波长是λ/2时,反射回源的阻抗看着像开口(在天线与地之间没有能量传输)。当在钳口部件310和320中的两个天线组件302被正确地定距离时,距离是介电距离“d”、和在钳口部件310和320之间的组织的宽度的函数,在钳口部件310和320中的天线组件302之间的阻抗接近源阻抗,并且在两个天线组件302之间可传输最大功率。
钳口部件310和320也包括位于其中的屏蔽部件304和306,这些屏蔽部件304和306包括相应封闭表面312和322。屏蔽部件304和306的每一个可以包括介电部分307和311、以及金属板309和313,该金属板309和313分别布置在介电部分307和311上。金属板309和313联接到外部导体216上,并且配置成,起接地屏蔽的作用。如图3C所示,接地屏蔽可构造成,包围由天线302a-302d产生的整个电磁场。这样,接地屏蔽减小杂散场发射到钳口外罩外侧,并且保证只有在天线组件302之间的中间区域暴露于微波能量。天线组件302也可以定位成,使得屏蔽部件304和306创建抛物面反射器,以将微波能量集中在距离D1或组织处。
介电部分307和311可以由介电材料形成,并且起在天线302a、302b和302c、302d之间的缓冲器的作用,该介电材料控制天线组件302的阻抗。介电部分307和311可以由陶瓷(例如,氮化铝(AlN)或氧化铝(Al2O3))、聚四氟乙烯、泡沫聚苯乙烯、聚酯泡沫、玻璃、塑料、等等制成。缓冲可减小当组织加热或干燥时变化的组织介电特性的影响。
在天线组件302与金属板309和313之间的距离“D”可以变化,以在钳口之间抓握的组织中产生不同影响。比如,如果距离“D”减小,从而天线组件302布置得较靠近金属板309和313,则在组织中有较高干燥,导致切割效果。
屏蔽部件304和306,通过介电性能的本质和金属板309和313的存在,将微波能量从天线302a-302d向抓握在封闭表面312和322之间的组织反射。这种布置允许任何数量的天线302(例如,单根天线)的使用,因为将微波能量限制到在钳口部件310和320之间抓握的组织体积。
端部操作装置组件300也包括纵向定向通道311,该纵向定向通道311限定在封闭表面312中,从近侧端部延伸到其远侧端部。通道315促进刀200沿特定切割平面的纵向往复运动,以有效和准确地沿形成的组织封闭分离组织。通道315也可以限定在封闭表面322中,或者单独地布置在仅一个封闭表面中,例如在封闭表面312中。
图4A和4B表明根据本公开另一个实施例的微波端部操作装置组件400。端部操作装置组件400包括钳口部件410和420。钳口部件410和420包括天线组件402,该天线组件402分别包括天线402a、402b和402c、402d。如图4A所示,天线组件402经分路器404而分路到金属板309和313。分路器404可以由诸如铜、铝、不锈钢之类的金属构成,并且可以形成为金属带条或箔。可选择地,天线402可以延伸到金属板309和313。当天线组件402分路到接地屏蔽时,天线402a-402d和分路器404的长度l2是四分之一波长的奇数倍(即,λ/4、3λ/4、5λ/4、等等)。
当长度l2是四分之一波长的奇数倍时,波正确地终止,并且在屏蔽部件304和306处没有误匹配、或电压电位。最大电压电位可能在钳口的中部中。如果长度l2不是四分之一波长的奇数倍,则将有反射波。这可用来通过改变频率将波峰电压沿钳口部件410和420运动。
在天线组件(例如,图3C,天线组件302)之间的Z距离不如天线组件的长度关键。Z距离将在两个钳口部件之间创建某种幅值差,但它不会影响波长。这种误匹配可以由分裂器222补偿。
图5A和5B表明根据本公开另一个实施例的微波端部操作装置组件500。端部操作装置组件500包括在钳口部件510和520中的天线阵列,该天线阵列包括天线502。多路复用器510联接在分裂器222与在每个钳口部件510和520中的天线502之间。两个多路复用器510都经传输线518可操作地联接到发生器20上。多路复用器510用来选择天线502的一根或多根,以改变天线阵列的有效长度。每根天线502具有是半波长的倍数(即,λ/2、λ、1.5λ、2λ、等等)的长度。
图6表明根据本公开另一个实施例的微波端部操作装置组件600。组件600包括天线组件602,其中,近侧天线621和每根天线622经分路器604分路到接地屏蔽。近侧天线621的长度是四分之一波长的奇数倍(即,λ/4、3λ/4、5λ/4、等等),而每根天线622具有是半波长的倍数(即,λ/2、λ、1.5λ、2λ、等等)的长度。多路复用器510用来选择天线621和/或622的一根或多根。
尽管附图描绘了相对于彼此可枢转的钳口部件,但微波天线组件可以集成到一对钳口部件中,这对钳口部件相对于彼此平行地或者单向地或者双向地运动。
以上描述仅示例说明本公开。由本领域的技术人员可想到各种变更和修改,而不脱离本公开。相应地,本公开打算包容全部这样的可选择例、修改及变化。呈现参照附图描述的实施例,以仅表明本公开的某些例子。与以上和/或在附属权利要求书中描述的那些不是实质不同的其它元素、步骤、方法及技术,也打算在本公开的范围内。
Claims (10)
1.一种用于微波钳的端部操作装置组件,包括:
第一钳口部件和第二钳口部件,第一钳口部件或第二钳口部件中的至少一个钳口部件从相对于另一个钳口部件处于间隔开关系的第一位置到至少一个随后位置是可运动的,在该至少一个随后位置中,第一钳口部件和第二钳口部件合作以在其间抓握组织,第一钳口部件包括第一微波天线、包括耦接到地的金属板和介电材料的第一屏蔽部件和用于通过第一屏蔽部件的金属板将第一微波天线接地的第一分路器,第二钳口部件包括第二微波天线、包括耦接到地的金属板和介电材料的第二屏蔽部件和用于通过第二屏蔽部件的金属板将第二微波天线接地的第二分路器,其中每个钳口部件包括封闭表面,以及每个钳口部件的微波天线与对应的封闭表面间隔开;和
分裂器,配置成从微波能量源接收有源信号,并且将有源信号分裂成第一信号和第二信号,该第一信号被配置成传输到第一微波天线,该第二信号被配置成传输到第二微波天线。
2.根据权利要求1所述的端部操作装置组件,其中,第一信号的相位相对于第二信号的相位偏移。
3.根据权利要求1所述的端部操作装置组件,其中,第一信号的相位相对于第二信号的相位偏移180°。
4.根据权利要求1所述的端部操作装置组件,其中,第一微波天线和第二微波天线的远侧端部分路到地。
5.根据权利要求1所述的端部操作装置组件,其中,第一微波天线和第二微波天线的长度是四分之一波长的奇数倍。
6.一种用于微波钳的端部操作装置组件,包括:
分裂器,配置成从微波能量源接收有源信号,并且将有源信号分裂成第一信号和第二信号;
第一钳口部件和第二钳口部件,第一钳口部件或第二钳口部件中的至少一个钳口部件从相对于另一个钳口部件处于间隔开关系的第一位置到至少一个随后位置是可运动的,在该至少一个随后位置中,钳口部件合作以在其间抓握组织,其中:
第一钳口部件包括第一微波天线组件、包括耦接到地的金属板和介电材料的第一屏蔽部件、用于通过第一屏蔽部件的金属板将第一微波天线组件接地的第一分路器以及第一多路复用器,第一微波天线组件包括近侧天线和其他天线,第一多路复用器被配置为选择第一微波天线组件的近侧天线和其他天线中的一个或多个;以及
第二钳口部件包括第二微波天线组件、包括耦接到地的金属板和介电材料的第二屏蔽部件、用于通过第二屏蔽部件的金属板将第二微波天线组件接地的第二分路器以及第二多路复用器,第二微波天线组件包括近侧天线和其他天线,第二多路复用器被配置为选择第二微波天线组件的近侧天线和其他天线中的一个或多个,其中每个钳口部件包括封闭表面,以及每个钳口部件的微波天线与对应的封闭表面间隔开。
7.根据权利要求6所述的端部操作装置组件,其中,第一信号的相位相对于第二信号的相位偏移。
8.根据权利要求6所述的端部操作装置组件,其中,第一信号的相位相对于第二信号的相位偏移180°。
9.根据权利要求6所述的端部操作装置组件,其中,第一微波天线组件和第二微波天线组件的远侧端部分路到地。
10.根据权利要求6所述的端部操作装置组件,其中,第一微波天线组件和第二微波天线组件的近侧天线的长度是四分之一波长的奇数倍,第一微波天线组件和第二微波天线组件的其他天线的长度是半波长的倍数。
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US20130144284A1 (en) | 2013-06-06 |
CN106137387A (zh) | 2016-11-23 |
US9259268B2 (en) | 2016-02-16 |
EP2601904A1 (en) | 2013-06-12 |
CN103142306B (zh) | 2016-08-24 |
CN103142306A (zh) | 2013-06-12 |
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