CN107736931A - A kind of low-temperature plasma snare knife surgical apparatus - Google Patents

A kind of low-temperature plasma snare knife surgical apparatus Download PDF

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Publication number
CN107736931A
CN107736931A CN201711018975.7A CN201711018975A CN107736931A CN 107736931 A CN107736931 A CN 107736931A CN 201711018975 A CN201711018975 A CN 201711018975A CN 107736931 A CN107736931 A CN 107736931A
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electrode
mode
snare
low
instruction
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CN201711018975.7A
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Chinese (zh)
Inventor
严航
郑忠伟
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Shanghai Andaxin Medical Devices Co
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Shanghai Andaxin Medical Devices Co
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Priority to CN201711018975.7A priority Critical patent/CN107736931A/en
Publication of CN107736931A publication Critical patent/CN107736931A/en
Priority to CN201810976750.0A priority patent/CN109009415A/en
Priority to CN201821749099.5U priority patent/CN210301193U/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/042—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating using additional gas becoming plasma
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/1206—Generators therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00107—Coatings on the energy applicator
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00172—Connectors and adapters therefor
    • A61B2018/00178—Electrical connectors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00482—Digestive system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577—Ablation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577—Ablation
    • A61B2018/00583—Coblation, i.e. ablation using a cold plasma
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00595—Cauterization
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00601—Cutting
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00607—Coagulation and cutting with the same instrument
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00696—Controlled or regulated parameters
    • A61B2018/00732—Frequency
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00898—Alarms or notifications created in response to an abnormal condition
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/1206—Generators therefor
    • A61B2018/1246—Generators therefor characterised by the output polarity
    • A61B2018/126—Generators therefor characterised by the output polarity bipolar
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1412—Blade

Abstract

The invention discloses a kind of low-temperature plasma snare knife surgical apparatus, the equipment includes：Liquid input block, in response to liquid input signal, to objective body at infusion fluid so as to forming the thin layer of conducting medium between emission electrode and loop electrode；Bipolar electrode socket connector, it is connected by high frequency connecting line with radio-frequency generator, for receiving the first input voltage caused by radio-frequency generator；Emission electrode, the first input voltage caused by radio-frequency generator is received via bipolar electrode socket connector, apply first voltage between emission electrode and loop electrode, so that conducting medium reaches the first temperature and promotes the conducting medium to be converted into plasmasphere, so as to excite conducting medium to produce plasma using electric energy, and snare cutting is vaporized to objective body based on the RF energy of plasma, loop electrode, imported with emission electrode by identical conduit and form galvanic circle in objective body.

Description

A kind of low-temperature plasma snare knife surgical apparatus
Technical field
The present invention relates to radio frequency arts, and more particularly, to a kind of low-temperature plasma snare knife surgical apparatus.
Background technology
With the continuous development of digestive endoscopy technology, the Endoscopic Treatment of disease of digestive tract also increasingly popularizes electric circle set knife Supported the use with endoscope, for removing polyp or other excess tissues use in alimentary canal inscribe using high frequency electric.Biography can be exempted System operative treatment risk, have the characteristics that small wound, good effect, surgical technic require high.
High frequency snare cutting electric knife is a kind of electrosurgical unit for substituting mechanical operation knife to carry out tissue snare cutting.High frequency The operation principle of snare cutting electric knife is to tissue when being contacted by high-frequency high-voltage current caused by active electrode tip with body Heated, realize separation and solidification to body tissue, so as to play the purpose of snare cutting and hemostasis.High frequency snare is cut The crest voltage of electric knife coagulation pattern is big compared with TURP pattern, when high frequency electric is by the tissue of high impedance, can heat in the tissue, Cause tissue to gasify or solidify, produce good haemostatic effect, but will also result in more obvious fire damage simultaneously.High frequency snare Cut stable up to more than 150 DEG C of electric knife moment, the heating effect of the high frequency snare cutting electric knife of energy snare cutting tissue, and It is not as caused by heating electrode or cutter head.It is that the high frequency electric of high current density gathers together, directly destroy be in The tissue that active electrode tip is in contact.When being in contact with active electrode or the temperature of adjoining tissue or cell rises to carefully During protein denaturation in born of the same parents, the effect of snare cutting and solidification is just produced.
The operating temperature of common high frequency snare cutting electric knife is typically 100~150 DEG C, this operating temperature counterpart tissue High temperature is still fallen within, after histocyte is influenceed by this temperature, histone is denatured caused by snare is cut.It is especially common high After frequency snare cutting electric knife continuous firing certain time, fire damage can be caused to tissue.And histiocytic degeneration necrosis is one The individual process gradually developed, common high frequency snare cutting electric knife occur that the swelling of art area, postoperative pain etc. react.
In actual environment, high frequency snare cutting electric knife is applied carries out such as polyp or prominent inside alimentary canal in hospital Complication is easily produced in the snare stereotomy of tumor locus out, because temperature has damage to tissue.High frequency snare Cutting electric knife has two electrodes, and for an electrode paste with patient, another electrode is placed on snare knife position, and in handle Upper setting electric pathway.High-frequency emission temperature is up to 400-500 degree, and this temperature tissue good to periphery can accidentally injure, and then make Obtain probability height caused by bleeding problems, be easily damaged pathological tissue.In this case, doctor can not carry out pathological analysis, and And cause trouble when effectively analysis is arranged to section.
Such as Application No. CN201180055284.9 patent of invention discloses a kind of bipolar snare, the bipolar snare Device includes：Elongate tubular electric insulation sheath, a pair of elongated, flexible conductor wires being arranged in sheath, and online distal end is set The electric insulation connector at place, the electric insulation connector mechanically connect the distal end of this pair of lines and formed from the remote of sheath The lasso that distal process goes out.Line is provided with electrical insulator, the electrical insulator covering line in every line in addition to selected part All parts.Bipolar snare device also includes guiding elements, and the guiding elements is positioned in sheath, and is formed for conduction The compartment of every conductor wire in line, guiding elements can be in sheath internal rotations.Guiding elements is also moved rearwards from the distal end of sheath Extremely the whole lasso including at least a portion of connector is enabled to be received within the degree in sheath.However, this pair Pole snare can not also avoid accidentally injuring problem caused by temperature is too high.
The content of the invention
According to an aspect of the present invention, there is provided a kind of low-temperature plasma snare knife surgical apparatus, the equipment include：
Liquid input block, in response to liquid input signal, to objective body at infusion fluid so as in emission electrode and returning The thin layer of conducting medium is formed between path electrode；
Bipolar electrode socket connector, it is connected with radio-frequency generator by high frequency connecting line, is occurred for receiving the high frequency First input voltage caused by device；
Emission electrode, the first input voltage caused by the radio-frequency generator is received via bipolar electrode socket connector, Apply first voltage between emission electrode and loop electrode so that the conducting medium reaches the first temperature and promoted described Conducting medium is converted into plasmasphere, so as to excite conducting medium to produce plasma using electric energy, and is based on plasma The RF energy of body is vaporized snare cutting to objective body,
Loop electrode, imported with the emission electrode by identical conduit and form conductive return in the objective body Road.
The bipolar electrode socket connector receives the second input voltage caused by the radio-frequency generator and by described in Second input voltage is transferred to emission electrode, applies second voltage between emission electrode and loop electrode, to cause objective body Second temperature is remained, so as to promote objective body to carry out ablation solidification.
The emission electrode of the low-temperature plasma snare knife surgical apparatus is connected to bipolar electrode by emission electrode wire and inserted Mouth joint, emission electrode conducting wire cladding insulating barrier, insulating barrier has been used to insulate and heat-insulated effect.
The low-temperature plasma snare knife surgical apparatus also includes fluid-through chamber, and list is inputted to liquid based on liquid input instruction Member inputs the liquid, wherein the liquid input block measures the current surplus of the liquid and will be described current remaining in real time Amount is sent to control unit, described control unit be based on the current surplus determine whether to generate the liquid input instruction and It is determined that the liquid input instruction is sent into liquid input block after generating the liquid input instruction.
The liquid input block passes through a kind of progress liquid input in following pattern：Titration mode and continuous liquid supply mould Formula, and the fluid-through chamber is to be located at the annular chamber outside loop electrode.
For the snare cutter head of the emission electrode of the remote low-temperature plasma snare knife surgical apparatus of the emission electrode Oval, hexagon or semilune.
The infusion port of the liquid input block is between the emission electrode and loop electrode.
The low-temperature plasma snare knife surgical apparatus also includes pull bar, for making operator by providing branch pull bar Support force, and the low-temperature plasma snare knife surgical apparatus also includes outer tube, for providing external sheath function.
The emission electrode of described low-temperature plasma snare knife surgical apparatus is telescopically set by sliding block.
The scope of the first voltage is 100Vrms to 300Vrms, and the scope of the second voltage be 60Vrms extremely 80Vrms。
Preferably, the scope of the first voltage is 100Vrms to 300Vrms, and the scope of the second voltage is 60Vrms to 80Vrms.
40-70 degree is only had according to the temperature of the work of the low-temperature plasma snare knife surgical apparatus of the application, so as to solve Accidental injury problem to periphery good organization, bleeding problems and reduce complication.In addition, the low-temperature plasma snare of the application Bipolar fashion is used in knife surgical apparatus structure, loop is directly formed on conduit.
Brief description of the drawings
By reference to the following drawings, the illustrative embodiments of the present invention can be more fully understood by：
Fig. 1 is the major part schematic diagram according to the plasma therapeutic apparatus of the preferred embodiment for the present invention；
Fig. 2 is the structural representation according to the plasma therapeutic apparatus of the preferred embodiment for the present invention；
Fig. 3 is the structural representation according to the low-temperature plasma snare knife surgery systems of the preferred embodiment for the present invention；
Fig. 4 is the flow chart according to the low-temperature plasma snare knife operation method of the preferred embodiment for the present invention；
Fig. 5 is the structural representation according to the low-temperature plasma snare knife surgical apparatus of the preferred embodiment for the present invention；With And
Fig. 6-8 is according to the partial enlargement of the low-temperature plasma snare knife surgical apparatus of the preferred embodiment for the present invention or cut Face schematic diagram.
Embodiment
Embodiments of the present invention are illustrated by particular specific embodiment below, those skilled in the art can be by this specification Disclosed content understands other advantages and effect of the present invention easily.
The illustrative embodiments of the present invention are introduced with reference now to accompanying drawing, however, the present invention can use many different shapes Formula is implemented, and is not limited to embodiment described herein, there is provided these embodiments are to disclose at large and fully The present invention, and fully pass on the scope of the present invention to person of ordinary skill in the field.Show for what is be illustrated in the accompanying drawings Term in example property embodiment is not limitation of the invention.In the accompanying drawings, identical cells/elements are attached using identical Icon is remembered.
Unless otherwise indicated, term (including scientific and technical terminology) used herein has to person of ordinary skill in the field It is common to understand implication.Further it will be understood that the term limited with usually used dictionary, be appreciated that and its The linguistic context of association area has consistent implication, and is not construed as Utopian or overly formal meaning.
Fig. 1 is the functional schematic according to the plasma therapeutic apparatus 100 of the preferred embodiment for the present invention.Plasma therapeutic apparatus The cutting of the snare of the 100 such as polyps that can be used in inside alimentary canal or outstanding tumor locus, ablation and solidification are with stopping Blood.In addition, plasma therapeutic apparatus 100 can also be used to the circle of soft tissue in the surgical operations such as joint, backbone, skin, ear nose larynx Set cutting, ablation, solidification and hemostasis.The usage time of plasma therapeutic apparatus 100 of the application be 24 hours within, according to contact when Between classification belong to brought into temporary contact, belong to outside access apparatus (with tissue/bone/dentine) according to contact human body qualitative classification and Belong to active medical apparatus according to the classification of medicine equipment architectural feature.Annex bipolar operation electrode (the circle of plasma therapeutic apparatus 100 Set knife) head belongs to disposable sterilized product.
Plasma therapeutic apparatus 100 uses bipolar scheme, and its working frequency is 110kHz.Plasma therapeutic apparatus 100 is logical Cross snare cutting, ablation, solidification and the hemostasis of soft tissue during plasma technology realization is performed the operation to ear nose larynx etc..During work, wait from Sub- therapeutic equipment 100 is used as conduction liquid by physiological saline, and a thin layer is formed when activating between emission electrode and loop electrode.When When plasma therapeutic apparatus 100 gives enough energy (voltage), physiological saline translates into one and is made up of charged particle of energizing Gas blanket (plasmasphere).That is, plasma therapeutic apparatus 100 is produced using energy excitation conducting medium (for example, physiological saline) Plasma, and interrupt tissue element key by the energy of plasma.The energy of plasma is big by the biology such as protein Molecule Direct Pyrolysis is into O2, CO2, N2Deng gas, so as to complete the vaporization snare cutting to tissue.When article on plasma therapeutic equipment 100 Work cutter head when giving low-voltage, electric field is less than the thresholding requirement for producing plasmasphere and produces tissue resistance heat, so as to Tissue is subjected to ablation solidification and hemostasis.
As shown in figure 1, the functional architecture of plasma therapeutic apparatus 100 includes：Primary control program, alarm unit, interface are single Member, output control unit, bipolar operation electrode (snare knife) interface, bipolar operation electrode (snare knife), floor push, foot control connect Mouth, dropping liquid control valve and dropping liquid control valve interface.Wherein, primary control program, alarm unit, boundary element, output control, bipolar Procedures electrode interface, foot control interface and dropping liquid control valve interface belong to the software section of plasma therapeutic apparatus 100.Plasma is controlled It is as shown in table 1 to treat the function introduction of the section components of instrument 100,
The function introduction of the section components of table 1
Preferably, floor push can control the mode of operation of plasma therapeutic apparatus 100.The work of plasma therapeutic apparatus 100 Operation mode is divided into snare cut mode and coagulation mode.The classification of waterproof of floor push is classification of waterproof standard IPX8, and pin Switch is stepped on to switch for electric pedal.
Preferably, the yellow pedal of floor push corresponds to snare cut mode, and the gear level of snare cut mode Wei not be 1 to 9 grade.That is, when trampling the yellow pedal of floor push, plasma therapeutic apparatus 100 enters rise to bait cut mode.Snare The gear regulative mode of cut mode is：Adjust in the state of snare cut mode by dark buttons on floor push (or Yellow button on regulation host panel manually) it is adjusted.Snare cutting gear can be selected from any one shelves in 1 to 9 grade. Wherein, gear is higher, and output voltage is bigger.In snare cut mode, 1 to 9 grade of output voltage is as shown in table 2：
Output gear in the snare cut mode of table 2
Preferably, the blue pedal of floor push corresponds to coagulation mode, and the gear range of coagulation mode is 1 to 5 Shelves.That is, when trampling the blue pedal of floor push, plasma therapeutic apparatus 100 enters coagulation mode.The gear of coagulation mode is adjusted Section mode is：(by the changeable snare cut mode of mode key and coagulation mode) by blueness in the state of adjusting to coagulation mode Dark buttons (or blue buttons above and below regulation host panel manually) are adjusted on pedal.During foot-operated dark buttons, blood coagulation shelves Position can select bigger from any one shelves in 1 to 5 grade, its middle gear more high output voltage.When needing to carry out in Clinical practice During blood coagulation, depress blue pedal and carry out blood coagulation.In coagulation mode, 1 to 5 grade of output voltage is as shown in table 3：
Output gear in the coagulation mode of table 3
Preferably, foot control interface is used for the control instruction for receiving floor push, and the control instruction is transmitted into master Control program.Wherein, control instruction is two tuples<Pattern, power>.Pattern includes：Snare cut mode and coagulation mode.Enclosing Cover in cut mode, power includes 9 gears, and in coagulation mode, power includes 5 gears.
Preferably, primary control program is parsed to the control instruction and when the control instruction indicates first mode First mode instruction is generated, is calculated according to present impedance and the control instruction for the power output under first mode, by the One mode instruction and the first voltage associated with the power output under first mode instruction are sent to output control list Member.Wherein, initial present impedance is zero, i.e., when the start of plasma therapeutic apparatus 100 is operated, the present impedance of acquiescence is Zero.The primary control program is parsed to the control instruction and generates second when the control instruction indicates second mode Mode instruction, calculated according to present impedance and the control instruction for the power output under second mode, second mode is referred to Order and the second voltage associated with the power output under second mode instruction are sent to output control unit.Wherein institute Stating present impedance includes high impedance, middle impedance and Low ESR (0 impedance is Low ESR).Preferably, according to present impedance and described Control instruction calculates to be included for the power output under first mode：If present impedance is high impedance and the control instruction The 2nd grade under first mode is indicated, then the power output under first mode is arranged to the 4th grade；If present impedance is middle resistance The 2nd grade under anti-and described control instruction instruction first mode, then the power output under first mode is arranged to the 3rd grade； And if present impedance is the 2nd grade under Low ESR and control instruction instruction first mode, then by under first mode Power output be arranged to the 2nd grade.Preferably, calculated according to present impedance and the control instruction for defeated under second mode Going out power includes：If present impedance is the 2nd grade under high impedance and control instruction instruction second mode, by second Power output under pattern is arranged to the 4th grade；If present impedance is middle impedance and the control instruction indicates second mode Under the 2nd grade, then the power output under second mode is arranged to the 3rd grade；And if present impedance is Low ESR and institute The 2nd grade under control instruction instruction second mode is stated, then the power output under second mode is arranged to the 2nd grade.Preferably, when It is defeated using highest gear as reality when the power output being calculated exceedes the highest gear in first mode or second mode Go out power.
Preferably, output control unit is used to receive first mode instruction and first voltage instruction from the primary control program, And first mode instruction and first voltage instruction are transmitted to bipolar operation electrode interface, and from bipolar operation electrode The present impedance of interface target contact jaw and the present impedance is sent to the primary control program.And the output Control unit from the primary control program receive second mode instruction and second voltage instruction, and by the second mode instruction and Second voltage instruction is transmitted to bipolar operation electrode interface.
Preferably, bipolar operation electrode interface is used for the power instruction for receiving primary control program and indicates to send out by the power Bipolar operation electrode is given, and the real-time impedance of bipolar operation electrode is measured and passed through the real-time impedance defeated Go out control unit and pass to primary control program.
Preferably, bipolar operation electrode from the bipolar operation electrode interface first mode in response to instructing and first Voltage indicates, into first mode：Pass through emission electrode of the conducting medium at the target contact jaw of the bipolar operation electrode Circuit activation is carried out between loop electrode to form thin layer, applies first voltage between emission electrode and loop electrode, makes Obtain the conducting medium to reach the first temperature and be converted into plasmasphere, so as to excite conducting medium generation etc. using electric energy Gas ions, and snare cutting is vaporized to objective body based on the RF energy of plasma.In response to from the bipolar hand The second instruction and second voltage instruction, the bipolar operation electrode that art electrode interface receives enter second mode：Apply second Voltage by the target contact jaw of the bipolar operation electrode to remain second temperature, so as to which objective body is carried out into ablation solidification.
Preferably, alarm unit is used for when receiving alarm signal, passes through auditory tone cues, text prompt and/or instruction Lamp, which is shown, is alarmed.Alarm signal is sent to primary control program wherein after the bipolar operation electrode detects operation troubles, Alarm signal is sent to the alarm unit by the primary control program.
Preferably, boundary element, the running status for low-temperature plasma snare knife surgery systems described in real-time display.
Preferably, dropping liquid control valve is used for based on the conducting medium input instruction of the primary control program to bipolar operation electrode The conducting medium is inputted, wherein the bipolar operation electrode measures the current surplus of the conducting medium and by described in real time Current surplus is sent to primary control program, the primary control program be based on the current surplus determine whether to generate the conducting medium it is defeated Enter instruction and it is determined that the conducting medium input instruction is sent into dropping liquid control after generating the conducting medium input instruction Valve processed.Preferably, dropping liquid control valve interface is used to realize the two-way communication between dropping liquid control valve and primary control program.
Preferably, the emission electrode at bipolar operation electrode tip catheter, plasmasphere, loop electrode and target contact End forms loop.In snare cut mode, the operating temperature of bipolar operation electrode is 35 to 40 DEG C, and conventional electrosurgical knife Operating temperature is 350 to 700 DEG C.The thermal break-through distance of bipolar operation electrode than conventional electrosurgical knife thermal break-through apart from small, its The thermal break-through distance that the thermal break-through distance being trapped in cut mode is less than or equal in 150 microns and coagulation mode be less than or Equal to 200 microns, and the thermal break-through of conventional electrosurgical knife distance is more than 9000 microns.
The operation principle of plasma therapeutic apparatus 100 is effect of plasma radiofrequency ablation at low temperature.Energy is produced using bipolar cutter head, by life Reason salt solution is converted into plasma thin layer, dissociates the molecular link that cell component is formed in target tissue, causes tissue coagulation downright bad, Form the effect of ablation or snare cutting.Due to working at relatively low temperature, cut than the high frequency snare that tradition uses Electric knife is minimized degree to the fire damage of perienchyma.It can reduce target volume in 35 DEG C or so operating temperatures, target group Capilary closing in knitting, cuts off lesion.Its low temperature and tissue volume reduction Ablation characteristic, more common Single-pole electric knife is with more shortening Post-operative recovery time, mitigate the advantages of postoperative pain and reduction expenses of surgical treatment.Wherein, plasma therapeutic apparatus and common high frequency The temperature of snare cutting electric knife is more as shown in table 4：
Table 4
Cutter head environment temperature (refers to isolated experiment research tissue fire damage report to plasma therapeutic apparatus less than 70 DEG C at work Accuse), operating temperature is lower compared with traditional common high frequency snare cutting electric knife (100~150 DEG C of high temperature), although low The treatment temperature counterpart tissue of warm plasma blade still falls within high temperature, and after histocyte is influenceed by this temperature, electricity equally occurs Cutter ring set cutting causes histone to be denatured, and especially after certain time, also can cause fire damage to tissue.And organize thin The degeneration necrosis of born of the same parents is a process gradually developed, therefore some patientss row low-temperature plasma Post operation, its art area swelling, postoperative The reaction such as pain cuts electric knife response light unlike high frequency snare.The damage of plasma therapeutic apparatus and common high frequency snare cutting electric knife Fire damage depth ratio is more as shown in table 5 below：
Table 5
Fire damage depth when snare is cut Fire damage depth during blood coagulation
Plasma therapeutic apparatus 150 microns of average value 200 microns of average value
High frequency snare cuts electric knife 1.23±0.24mm 1.37±0.26mm
Because each operating time is had differences so plasma therapeutic apparatus is in isolated experiment research tissue fire damage report In selected maximum operating time, by contrasting the plasma therapeutic apparatus of visible maximum operating time and the high frequency snare of normal use Cut electric knife heat waste depth.Therefore the heat waste depth of the plasma therapeutic apparatus of normal use should be less than high frequency snare cutting electric knife heat waste Depth.
Fig. 2 is the major part schematic diagram according to the plasma therapeutic apparatus 200 of the preferred embodiment for the present invention.Such as Fig. 2 institutes Show, the major part of plasma therapeutic apparatus 200 includes：Bipolar operation electrode interface 201, dropping liquid control valve interface 202, trample out Close interface 203, display screen 204, mainboard 205, loudspeaker 206, front panel 207, trouble lamp 208, lower mould 209, upper mould 210, Power module 211, dropping liquid control valve 212 and fan 213.
Preferably, trample switch interface 203 and be used to receiving the instruction of floor push, floor push and can control etc. from The mode of operation of sub- therapeutic equipment 200.The mode of operation of plasma therapeutic apparatus 200 is divided into snare cut mode and coagulation mode.Pin The classification of waterproof for stepping on switch is classification of waterproof standard IPX8, and floor push switchs for electric pedal.
Preferably, the yellow pedal of floor push corresponds to snare cut mode, and the gear level of snare cut mode Wei not be 1 to 9 grade.That is, when trampling the yellow pedal of floor push, plasma therapeutic apparatus 200 enters rise to bait cut mode.Snare The gear regulative mode of cut mode is：Adjust in the state of snare cut mode by dark buttons on floor push (or Yellow button on regulation host panel manually) it is adjusted.Snare cutting gear can be selected from any one shelves in 1 to 9 grade. Wherein, gear is higher, and output voltage is bigger.
Preferably, the blue pedal of floor push corresponds to coagulation mode, and the gear range of coagulation mode is 1 to 5 Shelves.That is, when trampling the blue pedal of floor push, plasma therapeutic apparatus 200 enters coagulation mode.The gear of coagulation mode is adjusted Section mode is：(by the changeable snare cut mode of mode key and coagulation mode) by blueness in the state of adjusting to coagulation mode Dark buttons (or blue buttons above and below regulation host panel manually) are adjusted on pedal.During foot-operated dark buttons, blood coagulation shelves Position can select bigger from any one shelves in 1 to 5 grade, its middle gear more high output voltage.When needing to carry out in Clinical practice During blood coagulation, depress blue pedal and carry out blood coagulation.
Preferably, the control instruction that switch interface 203 is used to receive floor push is trampled, and the control instruction is turned Issue primary control program.Wherein, control instruction is two tuples<Pattern, power>.Pattern includes：Snare cut mode and blood coagulation mould Formula.In snare cut mode, power includes 9 gears, and in coagulation mode, power includes 5 gears.
Preferably, mainboard 205 is used to accommodate firmware, and primary control program is stored in the firmware.Wherein, primary control program is to described Control instruction is parsed and first mode instruction is generated when the control instruction indicates first mode, according to present impedance Calculated with the control instruction for the power output under first mode, by first mode instruct and with the first mode The associated first voltage instruction of power output be sent to output control unit.Wherein, initial present impedance is zero, that is, is existed When the start of plasma therapeutic apparatus 200 is operated, the present impedance of acquiescence is zero.The primary control program enters to the control instruction Row parsing and the generation second mode instruction when the control instruction indicates second mode, according to present impedance and the control Instruction calculate be used for second mode under power output, by second mode instruct and with the power output under the second mode Associated second voltage instruction is sent to output control unit.Wherein described present impedance includes high impedance, middle impedance and low Impedance (0 impedance is Low ESR).Preferably, calculated according to present impedance and the control instruction for the output under first mode Power includes：If present impedance is the 2nd grade under high impedance and control instruction instruction first mode, by the first mould Power output under formula is arranged to the 4th grade；If present impedance is middle impedance and the control instruction is indicated under first mode The 2nd grade, then the power output under first mode is arranged to the 3rd grade；And if present impedance is Low ESR and described The 2nd grade under control instruction instruction first mode, then the power output under first mode is arranged to the 2nd grade.Preferably, according to Present impedance and the control instruction calculate to be included for the power output under second mode：If present impedance be high impedance simultaneously And the 2nd grade under the control instruction instruction second mode, then the power output under second mode is arranged to the 4th grade；If Present impedance is the 2nd grade under middle impedance and control instruction instruction second mode, then by the output work under second mode Rate is arranged to the 3rd grade；And if present impedance is the 2nd grade under Low ESR and control instruction instruction second mode, The power output under second mode is then arranged to the 2nd grade.Preferably, when the power output being calculated exceedes first mode Or during highest gear in second mode, real output is used as using highest gear.
Preferably, output control unit (not shown in Fig. 2) be used for from the primary control program receive first mode instruction and First voltage is indicated, and first mode instruction and first voltage instruction are transmitted into bipolar operation electrode interface 201, with And receive the present impedance of target contact jaw from bipolar operation electrode interface 201 and the present impedance is sent to the master Control program.And the output control unit receives second mode instruction and second voltage instruction from the primary control program, and Second mode instruction and second voltage instruction are transmitted to bipolar operation electrode interface 201.
Preferably, bipolar operation electrode interface 201 is used for the power instruction for receiving primary control program and refers to the power Show and be sent to bipolar operation electrode, and the real-time impedance of bipolar operation electrode is measured and leads to the real-time impedance Cross output control unit and pass to primary control program.
Preferably, bipolar operation electrode (not shown) from the bipolar operation electrode interface 201 in response to receiving the One mode instruction and first voltage instruction, into first mode：Connect by target of the conducting medium in the bipolar operation electrode Circuit activation is carried out between emission electrode and loop electrode at contravention to form thin layer, between emission electrode and loop electrode Apply first voltage so that the conducting medium reaches the first temperature and is converted into plasmasphere, so as to swash using electric energy Send out conducting medium and produce plasma, and be vaporized snare cutting to objective body based on the RF energy of plasma.Ring The second instruction and second voltage instruction, the bipolar operation electrode that bipolar operation electrode interface 201 described in Ying Yucong receives are entered Enter second mode：Apply second voltage so that the target contact jaw of the bipolar operation electrode is remained into second temperature, so that will Objective body carries out ablation solidification.
Preferably, trouble lamp 208 is used for when receiving alarm signal, is shown and is alarmed by indicator lamp.Its In after the bipolar operation electrode detects operation troubles to primary control program send alarm signal, the primary control program will alarm Signal is sent to the trouble lamp 208.Loudspeaker 206 are used for when receiving alarm signal, are alarmed by sound.Its In after the bipolar operation electrode detects operation troubles to primary control program send alarm signal, the primary control program will alarm Signal is sent to the loudspeaker 206.
Preferably, display screen 204 is used for the running status of low-temperature plasma snare knife surgery systems described in real-time display.
Preferably, dropping liquid control valve 212 is used for based on the conducting medium input instruction of the primary control program to bipolar surgery Electrode inputs the conducting medium, wherein the bipolar operation electrode measures the current surplus of the conducting medium and will in real time The current surplus is sent to primary control program, and the primary control program is based on the current surplus and determines whether to generate conductive Jie Matter input instruction and it is determined that the conducting medium input instruction is sent into drop after generating the conducting medium input instruction Hydraulic control valve 212.Preferably, dropping liquid control valve interface 202 is two-way between dropping liquid control valve 212 and primary control program for realizing Communication.
Preferably, the application uses double mode liquid outlet：1st, titration mode, i.e., a drop as the mode of infusion The supply of one drop；And 2, continuous supply model, i.e., the pattern of liquid flow without interruption.Bipolar operation electrode interface (snare knife Interface) it is connected by patch with Fig. 5 as described below bipolar electrode socket connector (snare knife joint), dropping liquid control valve connects Mouth passes through connecting tube and Fig. 5 fluid-through chamber and connected.Floor push mouth is connected by connecting line with external pedal, for controlling The supply and disconnection of energy and dropping liquid.When pedal is stepped on, energy and dropping liquid supply；When pedal unclamps, energy and drop Liquid disconnects.
Preferably, the emission electrode at bipolar operation electrode tip catheter, plasmasphere, loop electrode and target contact End forms loop.In snare cut mode, the operating temperature of bipolar operation electrode is 35 to 40 DEG C, and conventional electrosurgical knife Operating temperature is 350 to 700 DEG C.The thermal break-through distance of bipolar operation electrode than conventional electrosurgical knife thermal break-through apart from small, its The thermal break-through distance that the thermal break-through distance being trapped in cut mode is less than or equal in 150 microns and coagulation mode be less than or Equal to 200 microns, and the thermal break-through of conventional electrosurgical knife distance is more than 9000 microns.
Preferably, upper mould 210 and lower mould 209 protect mainboard by way of combination.Fan 213 is used to radiate, and Power module 211 is used to provide electric power for plasma therapeutic apparatus 200.Front panel 207 is used to carrying out data showing and operational control.
Fig. 3 is the structural representation according to the low-temperature plasma snare knife surgery systems 300 of the preferred embodiment for the present invention. Such as polyp that low-temperature plasma snare knife surgery systems 300 can be used in inside alimentary canal or outstanding tumor locus Snare cutting, ablation and solidification and hemostasis.In addition, low-temperature plasma snare knife surgery systems 300 can also be used to joint, ridge Snare cutting, ablation, solidification and the hemostasis of soft tissue in the surgical operations such as post, skin, ear nose larynx.The low-temperature plasma of the application The usage time of snare knife surgery systems 300 is to belong to brought into temporary contact, according to contact people within 24 hours, according to time of contact classification Volume property classification belongs to outside access apparatus (with tissue/bone/dentine) and belonged to according to the classification of medicine equipment architectural feature Active medical apparatus.
Low-temperature plasma snare knife surgery systems 300 use bipolar scheme, and its working frequency is 110kHz.Low temperature etc. Ion snare knife surgery systems 300 by plasma technology realize to ear nose larynx etc. perform the operation in soft tissue snare cut, ablation, Solidification and hemostasis.During work, low-temperature plasma snare knife surgery systems 300 are used as conduction liquid, activation transmitting by physiological saline A thin layer is formed when between electrode and loop electrode.When low-temperature plasma snare knife surgery systems 300 give enough energy When (voltage), physiological saline translates into a gas blanket being made up of charged particle of energizing (plasmasphere).That is, low temperature etc. from Subloop set knife surgery systems 300 produce plasma using energy excitation conducting medium (for example, physiological saline), and rely on etc. The energy of gas ions interrupts tissue element key.The energy of plasma is by protein and other Direct Pyrolysis into O2, CO2, N2Deng gas, so as to complete the vaporization snare cutting to tissue.When the work cutter head of article on plasma therapeutic equipment 100 gives low-voltage When, electric field less than produce plasmasphere thresholding requirement and produce tissue resistance heat, so as to by tissue carry out ablation solidification with Hemostasis.
As shown in figure 3, low-temperature plasma snare knife surgery systems 300 include：Input block 301, control unit 302, connect Mouth unit 303, plasma cell 304, alarm unit 305, dropping liquid input block 306 and display unit 307.Preferably, it is defeated It is, for example, floor push to enter unit 301, and floor push can control the Working mould of low-temperature plasma snare knife surgery systems 300 Formula.The mode of operation of low-temperature plasma snare knife surgery systems 300 is divided into snare cut mode and coagulation mode.Floor push Classification of waterproof is classification of waterproof standard IPX8, and floor push switchs for electric pedal.
Preferably, the yellow pedal of floor push corresponds to snare cut mode, and the gear level of snare cut mode Wei not be 1 to 9 grade.That is, when trampling the yellow pedal of floor push, low-temperature plasma snare knife surgery systems 300 enter rise to bait Cut mode.The gear regulative mode of snare cut mode is：By floor push in the state of adjusting to snare cut mode Upper dark buttons (or yellow button on regulation host panel manually) are adjusted.Snare cutting gear can be selected from 1 to 9 grade In any one shelves.Wherein, gear is higher, and output voltage is bigger.
Preferably, the blue pedal of floor push corresponds to coagulation mode, and the gear range of coagulation mode is 1 to 5 Shelves.That is, when trampling the blue pedal of floor push, low-temperature plasma snare knife surgery systems 300 enter coagulation mode.Blood coagulation The gear regulative mode of pattern is：(by the changeable snare cut mode of mode key and coagulated in the state of adjusting to coagulation mode Blood pattern) it is adjusted by dark buttons on blue pedal (or blue buttons above and below regulation host panel manually).Foot-operated black During button, blood coagulation gear can select bigger from any one shelves in 1 to 5 grade, its middle gear more high output voltage.When clinic makes When needing to carry out blood coagulation in, depress blue pedal and carry out blood coagulation.
Preferably, foot control interface is used for the control instruction for receiving floor push, and the control instruction is transmitted into master Control program.Wherein, control instruction is two tuples<Pattern, power>.Pattern includes：Snare cut mode and coagulation mode.Enclosing Cover in cut mode, power includes 9 gears, and in coagulation mode, power includes 5 gears.
Preferably, control unit 302 is parsed to the control instruction and when the control instruction indicates the first mould First mode instruction is generated during formula, is calculated according to present impedance and the control instruction for the power output under first mode, First mode instruction and the first voltage associated with the power output under first mode instruction are sent to interface list Member 303.Wherein, initial present impedance is zero, i.e., when the start of low-temperature plasma snare knife surgery systems 300 is operated, The present impedance of acquiescence is zero.Described control unit 302 is parsed to the control instruction and when the control instruction refers to Second mode instruction is generated when showing second mode, is calculated according to present impedance and the control instruction for defeated under second mode Go out power, second mode instruction and the second voltage associated with the power output under second mode instruction are sent to Interface unit 303.Wherein described present impedance includes high impedance, middle impedance and Low ESR (0 impedance is Low ESR).Preferably, Calculated according to present impedance and the control instruction includes for the power output under first mode：If present impedance is high resistant The 2nd grade under anti-and described control instruction instruction first mode, then the power output under first mode is arranged to the 4th grade； If present impedance is the 2nd grade under middle impedance and control instruction instruction first mode, will be defeated under first mode Go out power setting for the 3rd grade；And if present impedance is the 2 under Low ESR and control instruction instruction first mode Shelves, then be arranged to the 2nd grade by the power output under first mode.Preferably, calculated according to present impedance and the control instruction Include for the power output under second mode：If present impedance is high impedance and the control instruction indicates second mode Under the 2nd grade, then the power output under second mode is arranged to the 4th grade；If present impedance is middle impedance and the control The 2nd grade under system instruction instruction second mode, then the power output under second mode is arranged to the 3rd grade；It is and if current Impedance is the 2nd grade under Low ESR and control instruction instruction second mode, then sets the power output under second mode It is set to the 2nd grade.Preferably, when the power output being calculated exceedes the highest gear in first mode or second mode, Real output is used as using highest gear.
Preferably, interface unit 303 is used to receive first mode instruction from described control unit 302 and first voltage refers to Show, and first mode instruction and first voltage instruction are transmitted to plasma cell 304, and from plasma cell 304 receive the present impedance of target contact jaws and the present impedance are sent into described control unit 302.And described connect Mouth unit 303 receives second mode instruction and second voltage instruction from described control unit 302, and the second mode is referred to Order and second voltage instruction are transmitted to plasma cell 304.
Preferably, interface unit 303 is used for the power instruction of reception control unit 302 and indicates to send by the power Real-time impedance to plasma cell 304, and article on plasma unit 304 measures and by the real-time impedance by connecing Mouth unit 303 passes to control unit 302.
Preferably, plasma cell 304 from the plasma cell 304 in response to receiving first mode instruction and the first electricity Pressure instruction, into first mode：By emission electrode of the conducting medium at the target contact jaw of the plasma cell 304 and Circuit activation is carried out between loop electrode to form thin layer, applies first voltage between emission electrode and loop electrode so that The conducting medium reaches the first temperature and is converted into plasmasphere, so as to using electric energy excite conducting medium produce etc. from Daughter, and snare cutting is vaporized to objective body based on the RF energy of plasma.In response to from the plasma list The second instruction and second voltage instruction, the plasma cell 304 that member 304 receives enter second mode：Apply second voltage So that the target contact jaw of the plasma cell 304 is remained into second temperature, so as to which objective body is carried out into ablation solidification.
Preferably, alarm unit 305 is used for when receiving alarm signal, by auditory tone cues, text prompt and/or refers to Show that lamp is shown to be alarmed.Send and alarm to control unit 302 wherein after the plasma cell 304 detects operation troubles Alarm signal is sent to the alarm unit 305 by signal, described control unit 302.
Preferably, dropping liquid input block 306 be used for based on the conducting medium input instruction of described control unit 302 to wait from Subelement 304 inputs the conducting medium, wherein the plasma cell 304 measures the current surplus of the conducting medium in real time And the current surplus is sent to control unit 302, described control unit 302 is based on the current surplus and determines whether to give birth to Into the conducting medium input instruction and it is determined that the conducting medium is inputted after generating the conducting medium input instruction Instruction is sent to dropping liquid input block 306.
Preferably, emission electrode, plasmasphere, loop electrode and the target at the tip catheter of plasma cell 304 connect Contravention forms loop.In snare cut mode, the operating temperature of plasma cell 304 is 35 to 40 DEG C, and conventional electrosurgical The operating temperature of knife is 350 to 700 DEG C.Thermal break-through distance of the thermal break-through distance of plasma cell 304 than conventional electrosurgical knife Thermal break-through distance small, that its thermal break-through distance being trapped in cut mode is less than or equal in 150 microns and coagulation mode Less than or equal to 200 microns, and the thermal break-through of conventional electrosurgical knife distance is more than 9000 microns.
Preferably, display unit 307, the operation shape for low-temperature plasma snare knife surgery systems described in real-time display State.The operation principle of low-temperature plasma snare knife surgery systems 300 is effect of plasma radiofrequency ablation at low temperature.Energy is produced using bipolar cutter head Amount, physiological saline is converted into plasma thin layer, dissociates the molecular link that cell component is formed in target tissue, cause tissue coagulation Property necrosis, formed ablation or snare cutting effect.Due to working at relatively low temperature, than traditional high-frequency ring used Set cutting electric knife is minimized degree to the fire damage of perienchyma.Target volume can be made to contract in 35 DEG C or so operating temperatures It is small, the capilary closing in target tissue, cut off lesion.Its low temperature and tissue volume reduction Ablation characteristic, more common Single-pole electric knife is more The advantages of with shortening post-operative recovery time, mitigating postoperative pain and reduce expenses of surgical treatment.Low-temperature plasma snare knife hand Cutter head environment temperature is less than 70 DEG C (referring to the report of isolated experiment research tissue fire damage) to art system 300 at work, with tradition Common high frequency snare cutting electric knife (100~150 DEG C of high temperature) in meaning is lower compared to operating temperature, although low temperature-controlled plasma radio-frequency ablation Treatment temperature counterpart tissue still fall within high temperature, after histocyte is influenceed by this temperature, equally occur electric knife snare cut Cause histone to be denatured, especially after certain time, can also cause fire damage to tissue.And it is histiocytic denaturation it is bad Extremely it is a process gradually developed, therefore some patientss row low-temperature plasma Post operation, its swelling of art area, postoperative pain etc. react Electric knife response light is cut unlike high frequency snare.Because each operating time is had differences so plasma therapeutic apparatus is in isolated experiment Selected maximum operating time in research tissue fire damage report, by contrast visible maximum operating time plasma therapeutic apparatus and The high frequency snare cutting electric knife heat waste depth of normal use.Therefore the heat waste depth of the plasma therapeutic apparatus of normal use should be less than height Frequency snare cuts electric knife heat waste depth.
Fig. 4 is the flow chart according to the low-temperature plasma snare knife operation method 400 of the preferred embodiment for the present invention.Such as figure Shown in 4, method 400 is since step 401 place.In step 401, the control instruction that user inputs is received.
In step 402, the control instruction is parsed and generated when the control instruction indicates first mode First mode instructs, and is calculated according to present impedance and the control instruction for the power output under first mode.
In step 403, it is determined that the first voltage instruction associated with the power output under the first mode.
In step 404, first mode instruction and first voltage instruction are transmitted to plasma apparatus, and from described Plasma apparatus receives the present impedance of target contact jaw.
In step 405, indicated in response to receiving first mode instruction and first voltage, promote the plasma apparatus to enter Enter first mode：Entered by conducting medium between the emission electrode and loop electrode of the target contact jaw of the plasma cell Row Circuit activation applies first voltage to form thin layer between emission electrode and loop electrode so that the conducting medium reaches To the first temperature and plasmasphere is converted into, so as to excite conducting medium to produce plasma using electric energy, and is based on The RF energy of plasma is vaporized snare cutting to objective body；
Wherein described emission electrode, plasmasphere, loop electrode and target contact jaw form loop.
Also include parsing the control instruction and generate second when the control instruction indicates second mode Mode instruction, calculated according to present impedance and the control instruction for the power output under second mode, and determination and institute The associated second voltage of the power output under second mode is stated to indicate.Second mode instruction and second voltage instruction are turned Issue plasma apparatus.In response to from the second instruction and second voltage instruction is received, the plasma apparatus enters the second mould Formula：Apply second voltage so that the target contact jaw of the plasma apparatus is remained into second temperature, so as to which objective body be carried out Ablation solidification.
It is additionally included in when receiving alarm signal, is shown and reported by auditory tone cues, text prompt and/or indicator lamp It is alert；Alarm signal is wherein generated after operation troubles is detected.
Wherein user generates the control instruction by being operable to foot-operated input equipment, wherein the control refers to Make as two tuples<Pattern, power>.
Also include inputting the conducting medium to the plasma apparatus based on conducting medium input instruction, wherein described etc. Ion device measures the current surplus of the conducting medium and determines whether to lead described in generation based on the current surplus in real time Dielectric input instruction.The running status of plasma apparatus described in the real-time display of method 400.
Fig. 5 is the structural representation according to the low-temperature plasma snare knife surgical apparatus of the preferred embodiment for the present invention.Such as Shown in Fig. 5, low-temperature plasma snare knife surgical apparatus includes：Emission electrode (snare cutter head) 501, loop electrode (circle set) 502, Pipe sheath 503, injecting cavity interface 505, rod cap 506, cushion block 507, sliding block (band socket aperture) 508, socket Pin 509 and pull bar 510.Preferably, emission electrode (snare cutter head) 501 and loop electrode (circle set) 502 are imported by identical conduit and in mesh Standard type forms galvanic circle.Emission electrode (snare cutter head) 501, receive the radio-frequency generator via socket Pin 509 and produced The first raw input voltage, apply first voltage between emission electrode (snare cutter head) 501 and loop electrode (circle set) 502, So that the conducting medium reaches the first temperature and promotes the conducting medium to be converted into plasmasphere, so as to utilize electric energy Excite conducting medium to produce plasma, and be vaporized snare cutting to objective body based on the RF energy of plasma. Pipe sheath 503, for providing external sheath function.Injecting cavity interface 505 is based on liquid input instruction and inputted to liquid input block The liquid, wherein the liquid input block measures the current surplus of the liquid and sends the current surplus in real time To control unit, described control unit be based on the current surplus determine whether to generate the liquid input instruction and it is determined that Generate and the liquid input instruction is sent to dropping liquid input block after the liquid input instruction.Injecting cavity interface 505 is position In the annular chamber of emission electrode wire described later (snare cutter head wire) outside.
Pull bar 510 is used to make operator by providing support force pull bar 510.Socket Pin 509 is connected by high frequency Line is connected with radio-frequency generator, for receiving the first input voltage caused by the radio-frequency generator.Socket Pin 509 is received Second input voltage caused by the radio-frequency generator and second input voltage is transferred to emission electrode, launched Apply second voltage between electrode 501 and loop electrode 502, to cause objective body to remain second temperature, so as to promote target Body carries out ablation solidification.Liquid input block (not shown in Fig. 5), in response to liquid input signal, to objective body at input liquid Body is so as to the thin layer of the formation conducting medium between emission electrode and loop electrode.Liquid input block passes through in following pattern One kind carries out liquid input：Titration mode and continuous liquid supply pattern.
Wherein, the material of emission electrode (snare cutter head) 501 is that stainless steel 304, the material of loop electrode (circle set) 502 are Stainless steel 304, the material of pipe sheath 503 are that polytetrafluoroethylene PTFE, the material of injecting cavity interface 505 are acrylonitrile-butadiene-benzene Ethylene copolymer ABS, the material of rod cap 506 are that ABS, the material of cushion block 507 are that ABS, the material of sliding block (with socket aperture) are ABS, socket Pin material are that the material of stainless steel 304 and pull bar 510 is ABS.
As shown in figure 5, the snare cutter head that emission electrode 2 forms closing around objective body is ellipse, can also be six Side shape or semilune, snare cutting is carried out to adapt to different target shapes.Further, the head of lasso can have It is easy to the tip shunk, sophisticated both sides seal wire is bonded to each other, and can play guiding function when lasso shrinks into sheath, just Contraction and opening in lasso.
The length of loop electrode 502 can be arbitrarily rational numerical value, such as 4 to 5 millimeters.Wherein, loop electrode 502 Distance close to the one end at the top of pipe sheath 503 and the top end face of pipe sheath 503 can be arbitrarily rational numerical value, such as 2 to 3 millis Rice.Wherein, delivery port 511 (or being referred to as infusion port) sets the top end face of tube-placing sheath 503.
Emission electrode 501 is telescopically set by sliding block 508.In an initial condition, the retraction of emission electrode 501 causes pipe sheath In 503, to facilitate the front end of pipe sheath 503 to enter human body.After specified location is reached, sliding block 508 moves forward, by emission electrode 501 release the top end face of pipe sheath 503.Sliding block 508 is at socket aperture, and socket Pin 509 is arranged in socket aperture.
Fig. 6-8 is according to the partial enlargement of the low-temperature plasma snare knife surgical apparatus of the preferred embodiment for the present invention or cut Face schematic diagram.Fig. 6 shows the close-up schematic view of bipolar electrode socket connector (snare knife joint) 600, including：Hair Radio polar conductor (snare cutter head wire) 601 and loop electrode wire 602.Low-temperature plasma snare knife surgical apparatus can be used in Snare cutting, ablation and the solidification and hemostasis of such as polyp or outstanding tumor locus inside alimentary canal.In addition, low temperature The snare that plasma snare knife surgical apparatus can also be used to soft tissue in the surgical operations such as joint, backbone, skin, ear nose larynx is cut Cut, melt, solidifying and hemostasis.The low-temperature plasma snare knife surgical apparatus usage time of the application be 24 hours within, according to Time of contact classification belongs to brought into temporary contact, belongs to outside access apparatus according to contact human body qualitative classification (with tissue/bone/tooth sheet Matter) and according to medicine equipment architectural feature classification belong to active medical apparatus.Low-temperature plasma snare knife surgical apparatus it is attached Part bipolar operation electrode belongs to disposable sterilized product.
Low-temperature plasma snare knife surgical apparatus uses bipolar scheme, and its working frequency is 110kHz.Plasma is controlled Treat snare cutting, ablation, solidification and the hemostasis of soft tissue during instrument 100 is performed the operation by plasma technology realization to ear nose larynx etc..Work When making, low-temperature plasma snare knife surgical apparatus is used as conduction liquid by physiological saline, activate emission electrode and loop electrode it Between when formed a thin layer.When plasma therapeutic apparatus gives enough energy (voltage), physiological saline translate into one by The gas blanket (plasmasphere) of charged particle of energizing composition.That is, low-temperature plasma snare knife surgical apparatus is led using energy excitation Dielectric (for example, physiological saline) produces plasma, and interrupts tissue element key by the energy of plasma.Plasma The energy of body is by protein and other Direct Pyrolysis into O2, CO2, N2Deng gas, so as to complete the vaporization snare to tissue Cutting.When the work cutter head to low-temperature plasma snare knife surgical apparatus gives low-voltage, electric field is less than generation plasmasphere Thresholding requirement and produce tissue resistance heat, so as to by tissue carry out ablation solidification and hemostasis.
Fig. 7 shows the schematic cross-section along B-B, including：Emission electrode wire (snare cutter head wire) 701, return Path electrode wire 702, fluid-through chamber 704 and emission electrode chamber 705.In more detail, Fig. 7 shows emission electrode wire (snare Cutter head wire) 701 profile 706, including insulating barrier 707 and wire 708.Emission electrode wire (lead by snare cutter head Line) insulating barrier is needed, insulation and heat-insulated effect are acted as, loop electrode wire 702 can be not provided with insulating barrier.
In addition, those skilled in the art is as needed, can also be using loop electrode chamber 705 as fluid-through chamber, in loop When electrode cavity 705 is as fluid-through chamber, loop electrode wire 702 need to set insulating barrier.
Fig. 8 shows the schematic cross-section along C-C, including emission electrode wire (snare cutter head wire) 801 and returns Path electrode wire 802.
The present invention is described by reference to a small amount of embodiment.However, it is known in those skilled in the art, as What subsidiary Patent right requirement was limited, except the present invention other embodiments disclosed above equally fall the present invention's In the range of.
Normally, all terms used in the claims are all solved according to them in the usual implication of technical field Release, unless clearly being defined in addition wherein.All references " one/described/be somebody's turn to do [device, component etc.] " are all opened ground At least one example being construed in described device, component etc., unless otherwise expressly specified.Any method disclosed herein Step need not all be run with disclosed accurately order, unless explicitly stated otherwise.

Claims (10)

1. a kind of low-temperature plasma snare knife surgical apparatus, it is characterised in that the equipment includes：
Liquid input block, in response to liquid input signal, to objective body at infusion fluid so as in emission electrode and loop electricity The thin layer of conducting medium is formed between pole；
Bipolar electrode socket connector, it is connected by high frequency connecting line with radio-frequency generator, for receiving the radio-frequency generator institute Caused first input voltage；
Emission electrode, via the first input voltage caused by the bipolar electrode socket connector reception radio-frequency generator, sending out Apply first voltage between radio pole and loop electrode so that the conducting medium reaches the first temperature and promotes the conduction Medium is converted into plasmasphere, so as to excite conducting medium to produce plasma using electric energy, and based on plasma RF energy is vaporized snare cutting to objective body,
Loop electrode, imported with the emission electrode by identical conduit and form galvanic circle in the objective body.
2. low-temperature plasma snare knife surgical apparatus according to claim 1, it is characterised in that the bipolar electrode socket Joint receives the second input voltage caused by the radio-frequency generator and second input voltage is transferred into transmitting electricity Pole, apply second voltage between emission electrode and loop electrode, to cause objective body to remain second temperature, so as to promote mesh Standard type carries out ablation solidification.
3. low-temperature plasma snare knife surgical apparatus according to claim 1, it is characterised in that the emission electrode passes through Emission electrode wire is connected to the bipolar electrode socket connector, the emission electrode conducting wire cladding insulating barrier, and the insulating barrier is used Insulation and heat-insulated effect in.
4. low-temperature plasma snare knife surgical apparatus according to claim 1, it is characterised in that also including fluid-through chamber, base The liquid is inputted to liquid input block in liquid input instruction, wherein the liquid input block measures the liquid in real time Current surplus and the current surplus is sent to control unit, described control unit be based on the current surplus and determine is It is no to generate the liquid input instruction and it is determined that sending the liquid input instruction after generating the liquid input instruction Liquid input block.
5. low-temperature plasma snare knife surgical apparatus according to claim 4, it is characterised in that the liquid input block Pass through a kind of progress liquid input in following pattern：Titration mode and continuous liquid supply pattern, and the fluid-through chamber is to be located at Annular chamber outside loop electrode.
6. low-temperature plasma snare knife surgical apparatus according to claim 1, it is characterised in that the circle of the emission electrode Cover oval cutter head, hexagon or semilune.
7. low-temperature plasma snare knife surgical apparatus according to claim 6, it is characterised in that the liquid input block Infusion port between the emission electrode and loop electrode.
8. low-temperature plasma snare knife surgical apparatus according to claim 1, it is characterised in that also including pull bar, be used for Make operator by providing support force pull bar, and the low-temperature plasma snare knife surgical apparatus also includes outer tube, uses In offer external sheath function.
9. low-temperature plasma snare knife surgical apparatus according to claim 1, it is characterised in that the emission electrode passes through Sliding block is telescopically set.
10. low-temperature plasma snare knife surgical apparatus according to claim 1, it is characterised in that the first voltage Scope is 100Vrms to 300Vrms, and the scope of the second voltage is 60Vrms to 80Vrms.
CN201711018975.7A 2017-10-27 2017-10-27 A kind of low-temperature plasma snare knife surgical apparatus Pending CN107736931A (en)

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WO2019080078A1 (en) * 2017-10-27 2019-05-02 上海诺英医疗器械有限公司 Low temperature plasma snare knife surgical device, system and method
CN110013301A (en) * 2019-05-28 2019-07-16 张家港市第一人民医院 Pen electrocoagulator
CN110464445A (en) * 2018-05-13 2019-11-19 上海诺英医疗器械有限公司 A kind of seal assembly for snare
CN110507383A (en) * 2019-07-23 2019-11-29 江苏黛希芬生物科技有限公司 A kind of Novel medical plasma end effector mechanism

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CN112168333A (en) * 2020-09-21 2021-01-05 扬州发特利医疗器械科技有限公司 Bipolar electric snare
CN114431948B (en) * 2021-08-25 2023-10-13 深圳高性能医疗器械国家研究院有限公司 Plasma surgical knife and operation method thereof

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CN105792764B (en) * 2014-04-11 2018-11-02 奥林巴斯株式会社 Plasma disposal system
WO2016036927A1 (en) * 2014-09-05 2016-03-10 Bovie Medical Corporation Electrosurgical snare device
CN107007345B (en) * 2017-05-23 2023-12-22 北京安德思考普科技有限公司 Novel bipolar radio frequency plasma knife

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2019080078A1 (en) * 2017-10-27 2019-05-02 上海诺英医疗器械有限公司 Low temperature plasma snare knife surgical device, system and method
CN110464445A (en) * 2018-05-13 2019-11-19 上海诺英医疗器械有限公司 A kind of seal assembly for snare
CN110013301A (en) * 2019-05-28 2019-07-16 张家港市第一人民医院 Pen electrocoagulator
CN110507383A (en) * 2019-07-23 2019-11-29 江苏黛希芬生物科技有限公司 A kind of Novel medical plasma end effector mechanism

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Application publication date: 20180227