CN109907816A - A kind of low-temperature plasma incision knife surgical apparatus - Google Patents
A kind of low-temperature plasma incision knife surgical apparatus Download PDFInfo
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- CN109907816A CN109907816A CN201811261153.6A CN201811261153A CN109907816A CN 109907816 A CN109907816 A CN 109907816A CN 201811261153 A CN201811261153 A CN 201811261153A CN 109907816 A CN109907816 A CN 109907816A
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Abstract
The invention discloses a kind of low-temperature plasma incision knife surgical apparatus, the equipment includes: liquid input unit, in response to liquid input signal, to objective body at input liquid between emission electrode and loop electrode formed conducting medium thin layer；Bipolar electrode socket connector is connect, for receiving the first input voltage caused by radio-frequency generator with radio-frequency generator by high frequency connecting line；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 the conducting medium is promoted to be converted into plasmasphere, to generate plasma using electric energy excitation conducting medium, and cutting is vaporized to objective body based on the RF energy of plasma, loop electrode is imported by identical conduit with emission electrode and forms galvanic circle in objective body.
Description
Technical field
The present invention relates to radio frequency arts, and more particularly, to a kind of low-temperature plasma incision knife surgical apparatus.
Background technique
High frequency cutting electric knife is a kind of electrosurgical unit for replacing mechanical operation knife to carry out tissue cutting.High frequency cuts electric knife
Working principle be that the high-frequency high-voltage current generated by active electrode tip heats tissue when contacting with body, realize
Separation and solidification to body tissue, to play the purpose of cutting and hemostasis.High frequency cuts the peak value electricity of electric knife coagulation mode
Press it is big compared with cutting mode, when high-frequency current is by the tissue of high impedance, can heat in the tissue, cause tissue to gasify or solidification,
Good haemostatic effect is generated, but will also result in more obvious thermal damage simultaneously.High frequency cutting electric knife moment stabilization may be up to
150 DEG C or more, the heating effect of the high frequency cutting electric knife of tissue can be cut, is not as caused by heating electrode or cutter head.It
It is that the high-frequency current of high current density gathers together, directly destroys in the tissue being in contact with active electrode tip.When with
When active electrode is in contact or the temperature of adjoining tissue or cell rises to the protein denaturation in cell, cutting is just generated
And the effect of solidification.
The operating temperature of common high frequency cutting electric knife is usually 100~150 DEG C, this operating temperature counterpart tissue still belongs to
In high temperature, after histocyte is influenced by this temperature, the histone due to caused by cutting is denaturalized.Especially common high frequency cutting electricity
Knife continues working after a certain period of time, can cause thermal damage to tissue.And histiocytic degeneration necrosis is one and gradually develops
Process, common high frequency cutting electric knife will appear the reaction such as the swelling of art area, postoperative pain.
In the actual environment, high frequency cutting electric knife applies the nipple for carrying out duodenum lesion in Gastroenterology dept., hospital to cut hand
When art, it is easy to produce the complication of pancreatitis (death rate is high), this is because temperature has damage tissue.High frequency cutting electric knife has
Two electrodes, for an electrode paste with patient, another electrode is placed on cutter position, and electricity is arranged on handle and leads to
Road.High-frequency emission temperature is up to 400-500 degree, this temperature can accidentally injure the good tissue in periphery, so that bleeding problems
The probability of generation is high, is easily damaged pathological tissue.In this case, doctor can not carry out pathological analysis, and whole to being sliced
Reason causes trouble when effectively analyzing.
It is that duodenoscope is inserted to duodenum drop section through duodenoscope Retrograde cholangiopancreatography (ERCP),
The duodenofiberscope for appearing ductus pancreaticus, the bile duct wall opening on the inside of enteric cavity is inserted into angiography catheter through duodenoscope treatment duct,
Be open through nipple and insertion pancreatic duct Common openings or successively respectively enter ductus pancreaticus, bile duct, inject contrast agent, under x-ray to ductus pancreaticus,
The method that bile duct is checked.
It through Endoscopic Sphincterotomy of Duodenal Papilla Attached art (EST), is further developed on the basis of diagnosis ERCP technology
That gets up is cut duodenofiberscope sphincter and choledochus end section using dedicated high-frequency electrical incision knife under scope
A kind for the treatment of technology.
Duodenofiberscope includes main nipple and additional teat, and main nipple is usually also known as duodenofiberscope or watt nipple.
It is frequently located in descendant duodenum middle section back inner sidewall, and at stomach pylorus about 10cm, form is in nipple type mostly.The cream
Head otomy mainly all refers to the incision of main nipple.Under duodenum camera lens, the position of main nipple is usually all in center approximation
At 12 positions.Under the guidance of duodenoscope and the adjusting of front end lift pincers device, doctor operates the insertion of instrument high frequency incision knife
Into nipple, leads to high-frequency electrical, realize the cutting and solidification of tissue.High-frequency emission temperature is up to 400-500 degree, this temperature is to ten
The two good tissues in duodenum 12 nipple periphery can accidentally injure, and be easy to produce pancreatitis (death rate high), bleeding, the complication perforated etc.,
So that the probability of bleeding problems generation is high, is also easily damaged pathological tissue simultaneously.In this case, doctor can not carry out
Pathological analysis, and trouble is caused to when being sliced and arranging effectively analysis.
Summary of the invention
According to an aspect of the present invention, a kind of low-temperature plasma incision knife surgical apparatus is provided, the equipment includes:
Liquid input unit, in response to liquid input signal, to objective body at input liquid to emission electrode and return
The thin layer of conducting medium is formed between path electrode；
Bipolar electrode socket connector is connect by high frequency connecting line with radio-frequency generator, is occurred for receiving the high frequency
First input voltage caused by device；
Emission electrode receives the first input voltage caused by the radio-frequency generator via bipolar electrode socket connector,
Apply first voltage between emission electrode and loop electrode, so that the conducting medium reaches the first temperature and promotes described
Conducting medium is converted into plasmasphere, to generate plasma using electric energy excitation conducting medium, and is based on plasma
The RF energy of body is vaporized cutting to objective body,
Loop electrode is imported by identical conduit with the emission electrode and forms conductive return in the objective body
Road.
The bipolar electrode socket connector receives the second input voltage caused by the radio-frequency generator and will be described
Second input voltage is transferred to emission electrode, applies second voltage between emission electrode and loop electrode, so that objective body
Second temperature is remained, so that objective body be promoted to carry out ablation solidification.
The low-temperature plasma incision knife surgical apparatus further includes guidewire lumen, for inputting simultaneously seal wire along the guidewire lumen
And it is inserted to the head end of the low-temperature plasma incision knife surgical apparatus, to promote emission electrode and loop electrode to be placed in the mesh
At standard type.
The low-temperature plasma incision knife surgical apparatus further includes fluid-through chamber, inputs list to liquid based on liquid input instruction
Member inputs the liquid, wherein the current surplus of liquid described in the liquid input unit real-time measurement and will it is described it is current more than
Amount is sent to control unit, described control unit be based on the current surplus determine whether to generate the liquid input instruction and
Liquid input instruction is sent to liquid input unit after the liquid input instructs determining to generate.
The liquid input unit carries out liquid input: titration mode and continuous liquid supply mould by one of following mode
Formula, and the fluid-through chamber is the annular chamber except loop electrode.
A part cladding for the top far from the low-temperature plasma incision knife surgical apparatus of the emission electrode is exhausted
Edge layer, the insulating layer has been used to insulate and heat-insulated effect.
The infusion port of the liquid input unit is between the emission electrode and loop electrode.
The low-temperature plasma incision knife surgical apparatus further includes pull rod, for making operator by providing branch pull rod
Support force, and the low-temperature plasma incision knife surgical apparatus further includes outer tube, for providing external sheath function.
In the initial state, the emission electrode and loop electrode are bonded each other, when the emission electrode and loop electrode
After reaching at the objective body, the emission electrode is pulled by the way that sliding block is mobile, so that the emission electrode and loop electrode
Form tortuous bow shape.
The range of the first voltage be 100Vrms to 300Vrms, and the range of the second voltage be 60Vrms extremely
80Vrms。
Preferably, the range of the first voltage is 100Vrms to 300Vrms, and the range of the second voltage is
60Vrms to 80Vrms.
Preferably, the range of first temperature is 35 DEG C -40 DEG C, and the range of the second temperature is 40 DEG C -70 DEG C.
The low-temperature plasma incision knife surgical apparatus, which detects, sends alarm signal, institute to alarm unit after operation troubles
Alarm unit is stated when receiving alarm signal, is shown and is alarmed by auditory tone cues, text prompt and/or indicator light；
The low-temperature plasma incision knife surgical apparatus is connect with foot-operated input equipment, and wherein user passes through to the foot
The formula input equipment of stepping on is operable to generate the control instruction for controlling low-temperature plasma incision knife surgical apparatus output power,
Wherein the control instruction be binary group<mode, power>.
The low-temperature plasma incision knife surgical apparatus is connect with display unit, and the display unit is used for real-time display institute
State the operating status of low-temperature plasma incision knife surgical apparatus.
Detailed description of the invention
By reference to the following drawings, exemplary 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 schematic diagram according to the plasma therapeutic apparatus of the preferred embodiment for the present invention；
Fig. 3 is the structural schematic diagram according to the low-temperature plasma incision knife surgery systems of the preferred embodiment for the present invention；
Fig. 4 is the flow chart according to the low-temperature plasma incision knife operation method of the preferred embodiment for the present invention；
Fig. 5 is the structural schematic diagram according to the low-temperature plasma incision knife surgical apparatus of the preferred embodiment for the present invention；With
And
Fig. 6-8 is the partial enlargement according to the low-temperature plasma incision knife surgical apparatus of the preferred embodiment for the present invention or cuts
Face schematic diagram；
Fig. 9 is the side view of the incision knife according to the present invention with helical structure；
Figure 10 is the longitudinal sectional view in the circle A in Fig. 9 of the incision knife according to the present invention with helical structure；
Figure 11 is the partial enlarged view near helical structure；
Figure 12 is the sectional view along the line I-I interception in Fig. 9.
Specific embodiment
Exemplary embodiments of the present invention are introduced referring now to the drawings, however, the present invention can use many different shapes
Formula is implemented, and is not limited to the embodiment described herein, and to provide these embodiments be at large and fully disclose
The present invention, and the scope of the present invention is sufficiently conveyed 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 use identical attached
Icon note.
Unless otherwise indicated, term (including scientific and technical terminology) used herein has person of ordinary skill in the field
It is common to understand meaning.Further it will be understood that with the term that usually used dictionary limits, should be understood as and its
The context of related fields has consistent meaning, and is not construed as Utopian or too 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
100 can be used in cutting, ablation and the solidification and hemostasis of duodenofiberscope.In addition, plasma therapeutic apparatus 100 can also be enough
Cutting, ablation, solidification and the hemostasis of soft tissue in the surgical operations such as joint, backbone, skin, ear nose larynx.The application it is equal from
Sub- therapeutic equipment 100 is to belong to brought into temporary contact within 24 hours, according to time of contact classification, according to contact human body property using the time
Classification belongs to external access instrument (with tissue/bone/dentine) and belongs to active doctor according to the classification of medical instrument structure feature
Treat instrument.Attachment bipolar operation electrode (incision knife) head of plasma therapeutic apparatus 100 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 cutting, ablation, solidification and hemostasis of the plasma technology realization to soft tissue in the operation such as ear nose larynx.When work, plasma is controlled
Instrument 100 is treated by physiological saline as conduction liquid, forms a thin layer when activating between emission electrode and loop electrode.When it is equal from
When sub- therapeutic equipment 100 gives enough energy (voltage), physiological saline translates into the gas being made of charged particle of energizing
Body layer (plasmasphere).That is, plasma therapeutic apparatus 100 using energy excitation conducting medium (for example, physiological saline) generate etc. from
Daughter, and tissue element key is interrupted by the energy of plasma.The energy of plasma is by protein and other
Direct Pyrolysis is at O2, CO2, N2Equal gases, so that the vaporization completed to tissue is cut.When the work knife to plasma therapeutic apparatus 100
For head when giving low-voltage, electric field requires lower than the thresholding for generating plasmasphere and generates tissue resistance heat, thus by tissue into
Row ablation solidification and hemostasis.
As shown in Figure 1, the functional architecture of plasma therapeutic apparatus 100 includes: primary control program, alarm unit, interface list
Member, output control unit, bipolar operation electrode (incision knife) interface, bipolar operation electrode (incision 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, are 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
The function introduction for treating the section components of instrument 100 is as shown in table 1,
The function introduction of 1 section components of table
Preferably, floor push can control the operating mode of plasma therapeutic apparatus 100.The work of plasma therapeutic apparatus 100
Operation mode is divided into cut mode and coagulation mode.The waterproofing grade of floor push is waterproofing grade standard IPX8, and rides and open
Close is that electric pedal switchs.
Preferably, the yellow pedal of floor push corresponds to cut mode, and the gear range of cut mode is 1 to 9
Shelves.That is, plasma therapeutic apparatus 100 enters cut mode when trampling the yellow pedal of floor push.The gear tune of cut mode
Section mode are as follows: (or manually adjusted on host panel yellow in the state of being adjusted to cut mode by dark buttons on floor push
Color button) it is adjusted.Cutting gear can choose any one shelves in from 1 to 9 grade.Wherein, gear is higher, and output voltage is got over
Greatly.In cut mode, 1 to 9 grade of output voltage is as shown in table 2:
Output gear in 2 cut mode of table
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, plasma therapeutic apparatus 100 enters coagulation mode when trampling the blue pedal of floor push.The gear tune of coagulation mode
Section mode are as follows: (cut mode and coagulation mode can be switched by mode key) by blue pedal in the state of being adjusted to coagulation mode
Upper dark buttons (or manually adjusting host panel blue buttons up and down) are adjusted.When foot-operated dark buttons, blood coagulation gear can
To select any one shelves in from 1 to 5 grade, middle gear more high output voltage is bigger.When needing to carry out blood coagulation in clinical use
When, it depresses blue pedal and carries out blood coagulation.In coagulation mode, 1 to 5 grade of output voltage is as shown in table 3:
Output gear in 3 coagulation mode of table
Preferably, foot control interface is used to receive the control instruction of floor push, and the control instruction is transmitted to master
Control program.Wherein, control instruction be binary group<mode, power>.Mode includes: cut mode and coagulation mode.In blanking punch
In formula, power includes 9 gears, and in coagulation mode, and power includes 5 gears.
Preferably, primary control program carries out parsing 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 output power under first mode, by the
It is single that one mode instruction and first voltage associated with the output power under first mode instruction are sent to output control
Member.Wherein, initial present impedance is zero, i.e., when the booting of plasma therapeutic apparatus 100 is operated, the present impedance of default is
Zero.The primary control program carries out parsing to the control instruction and generates second when the control instruction indicates second mode
Mode instruction calculates for the output power under second mode according to present impedance and the control instruction, second mode is referred to
It enables and second voltage associated with the output power under second mode instruction is 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
If it is high impedance and the control instruction that control instruction calculating, which includes: present impedance for the output power under first mode,
It indicates the 2nd grade under first mode, then sets the 4th grade for the output power under first mode；If present impedance is middle resistance
The 2nd grade under the anti-and described control instruction instruction first mode, then the 3rd grade is set by the output power under first mode；
It, will be under first mode and if present impedance is Low ESR and the control instruction indicates the 2nd grade under first mode
Output power be set as the 2nd grade.Preferably, it is calculated according to present impedance and the control instruction under second mode
If it is that high impedance and the control instruction indicate the 2nd grade under second mode that output power, which includes: present impedance, by the
Output power under two modes is set as the 4th grade；If present impedance is middle impedance and the control instruction indicates the second mould
The 2nd grade under formula, then the 3rd grade is set by the output power under second mode；And if present impedance be Low ESR and
The 2nd grade under the control instruction instruction second mode, then the 2nd grade is set by the output power under second mode.Preferably,
When the output power being calculated is more than the highest gear in first mode or second mode, using highest gear as reality
Output 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 to receive the power indication of primary control program and sends out the power indication
Bipolar operation electrode is given, and the real-time impedance of bipolar operation electrode is measured and is passed through the real-time impedance defeated
Control unit passes to primary control program out.
Preferably, bipolar operation electrode from the bipolar operation electrode interface first mode in response to instructing and first
Voltage instruction, into first mode: passing 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, make
It obtains the conducting medium to reach the first temperature and be converted into plasmasphere, to utilize electric energy excitation conducting medium generation etc.
Gas ions, and cutting is vaporized to objective body based on the RF energy of plasma.In response to electric from the bipolar surgery
Second instruction of pole interface and second voltage instruction, the bipolar operation electrode enter second mode: applying second voltage
The target contact jaw of the bipolar operation electrode is remained second temperature, so that objective body is carried out 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, alarms.Alarm signal wherein is sent to primary control program 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 operating status for low-temperature plasma incision knife surgery systems described in real-time display.
Preferably, dropping liquid control valve is instructed for the conducting medium input based on the primary control program to bipolar operation electrode
The conducting medium is inputted, wherein the current surplus of conducting medium described in the bipolar operation electrode real-time measurement and will be described
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 conducting medium input instruction is sent to dropping liquid control after the conducting medium input instructs determining to generate
Valve processed.Preferably, dropping liquid control valve interface is for realizing 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 forming circuit.In cut mode, the operating temperature of bipolar operation electrode is 35 to 40 DEG C, and the work of conventional electrosurgical knife
Temperature is 350 to 700 DEG C.The thermal break-through distance of bipolar operation electrode than the thermal break-through of conventional electrosurgical knife apart from small, wherein cutting
It cuts the thermal break-through distance that the thermal break-through distance in mode is less than or equal in 150 microns and coagulation mode and is less than or equal to 200
Micron, and the thermal break-through of conventional electrosurgical knife distance is greater than 9000 microns.
100 working principle of plasma therapeutic apparatus is effect of plasma radiofrequency ablation at low temperature.Energy is generated using bipolar cutter head, will be given birth to
Reason salt water is converted into plasma thin layer, dissociates the molecular link that cell component is constituted in target tissue, causes tissue coagulation downright bad,
Form the effect of ablation or cutting.Due to working at relatively low temperature, electric knife is cut to week than the high frequency that tradition uses
The thermal damage of side texture is minimized degree.Target volume can be made to reduce in 35 DEG C or so operating temperatures, it is micro- in target tissue
Vessel closure 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 mitigates the advantages of postoperative pain and reduction expenses of surgical treatment.Wherein, plasma therapeutic apparatus and common high frequency cut electric knife
Temperature it is more as shown in table 4:
Table 4
Cutter head ambient temperature (is detailed in isolated experiment research tissue thermal damage to report plasma therapeutic apparatus lower than 70 DEG C at work
Accuse), operating temperature is lower compared with traditional common high frequency cutting electric knife (100~150 DEG C of high temperature), although low temperature etc.
The treatment temperature counterpart tissue of ion knife still falls within high temperature, after histocyte is influenced by this temperature, equally will appear electric knife and cuts
It cuts and histone is caused to be denaturalized, especially after certain time, can also cause thermal damage to tissue.And histiocytic denaturation
Necrosis is the process gradually developed, therefore after the operation of some patientss row low-temperature plasma, the swelling of art area, postoperative pain etc. are anti-
Electric knife response light should be cut unlike high frequency.Compared with damage thermal damage's depth of plasma therapeutic apparatus and common high frequency cutting electric knife as
Shown in the following table 5:
Table 5
| Thermal damage's depth when cutting | Thermal damage's depth when blood coagulation | |
| Plasma therapeutic apparatus | 150 microns of average value | 200 microns of average value |
| High frequency cuts electric knife | 1.23±0.24mm | 1.37±0.26mm |
Since each operating time has differences so plasma therapeutic apparatus is in isolated experiment research tissue thermal damage report
In selected maximum operating time, cut by the plasma therapeutic apparatus and the high frequency of normal use that compare visible maximum operating time
Electric knife heat waste depth.Therefore the heat waste depth of the plasma therapeutic apparatus of normal use should cut electric knife heat waste depth lower than high frequency.
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 institute
Show, the major part of plasma therapeutic apparatus 200 includes: bipolar operation electrode interface 201, dropping liquid control valve interface 202, tramples out
Close interface 203, display screen 204, mainboard 205, loudspeaker 206, front panel 207, trouble lamp 208, lower die 209, upper mold 210,
Power module 211, dropping liquid control valve 212 and fan 213.
Preferably, trample switch interface 203 is used to receive the instruction of floor push, floor push and can control etc. from
The operating mode of sub- therapeutic equipment 200.The operating mode of plasma therapeutic apparatus 200 is divided into cut mode and coagulation mode.It is foot-operated to open
The waterproofing grade of pass is waterproofing grade standard IPX8, and floor push is electric pedal switch.
Preferably, the yellow pedal of floor push corresponds to cut mode, and the gear range of cut mode is 1 to 9
Shelves.That is, plasma therapeutic apparatus 200 enters cut mode when trampling the yellow pedal of floor push.The gear tune of cut mode
Section mode are as follows: (or manually adjusted on host panel yellow in the state of being adjusted to cut mode by dark buttons on floor push
Color button) it is adjusted.Cutting gear can choose any one shelves in from 1 to 9 grade.Wherein, gear is higher, and output voltage is got over
Greatly.
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, plasma therapeutic apparatus 200 enters coagulation mode when trampling the blue pedal of floor push.The gear tune of coagulation mode
Section mode are as follows: (cut mode and coagulation mode can be switched by mode key) by blue pedal in the state of being adjusted to coagulation mode
Upper dark buttons (or manually adjusting host panel blue buttons up and down) are adjusted.When foot-operated dark buttons, blood coagulation gear can
To select any one shelves in from 1 to 5 grade, middle gear more high output voltage is bigger.When needing to carry out blood coagulation in clinical use
When, it depresses blue pedal and carries out blood coagulation.
Preferably, trample switch interface 203 is used to receive the control instruction of floor push, and the control instruction is turned
Issue primary control program.Wherein, control instruction be binary group<mode, power>.Mode includes: cut mode and coagulation mode.?
In cut mode, power includes 9 gears, and in coagulation mode, and power includes 5 gears.
Preferably, mainboard 205 stores primary control program in the firmware for accommodating firmware.Wherein, primary control program is to described
Control instruction carries out parsing and generates first mode instruction when the control instruction indicates first mode, according to present impedance
Calculate with the control instruction for the output power under first mode, by first mode instruct and under the first mode
Output power associated first voltage instruction be sent to output control unit.Wherein, initial present impedance is zero, that is, is existed
When the booting of plasma therapeutic apparatus 200 is operated, the present impedance of default is zero.The primary control program to the control instruction into
Row parsing and the generation second mode instruction when the control instruction indicates second mode, according to present impedance and the control
Instruction is calculated for the output power under second mode, by second mode instruct and with the output power under the second mode
Associated second voltage instruction is sent to output control unit.Wherein the present impedance includes high impedance, middle impedance and low
Impedance (0 impedance is Low ESR).Preferably, it is calculated according to present impedance and the control instruction for the output under first mode
If power includes: present impedance for high impedance and the control instruction indicates the 2nd grade under first mode, by the first mould
Output power under formula is set as the 4th grade；If present impedance is middle impedance and the control instruction indicates under first mode
The 2nd grade, then set the 3rd grade for the output power under first mode；And if present impedance is Low ESR and described
Control instruction indicates the 2nd grade under first mode, then sets the 2nd grade for the output power under first mode.Preferably, according to
If present impedance and the control instruction calculate for the output power under second mode include: present impedance be high impedance simultaneously
And the 2nd grade under the control instruction instruction second mode, then the 4th grade is set by the output power under second mode；If
Present impedance is middle impedance and the control instruction indicates the 2nd grade under second mode, then by the output work under second mode
Rate is set as the 3rd grade；And if present impedance is Low ESR and the control instruction indicates the 2nd grade under second mode,
Then the 2nd grade is set by the output power under second mode.Preferably, when the output power being calculated is more than first mode
Or when highest gear in second mode, using highest gear as real output.
Preferably, output control unit (being not shown in Fig. 2) be used for from the primary control program receive first mode instruction and
First voltage instruction, and first mode instruction and first voltage instruction are transmitted to bipolar operation electrode interface 201, with
And the present impedance of target contact jaw is received 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 to receive the power indication of 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
It crosses output control unit and passes to primary control program.
Preferably, bipolar operation electrode (not shown) is in response to receiving the from the bipolar operation electrode interface 201
One mode instruction and first voltage instruction, connect into first mode: the target by 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, to swash using electric energy
It sends out conducting medium and generates plasma, and cutting is vaporized to objective body based on the RF energy of plasma.In response to
From the bipolar operation electrode interface 201 received second instruction and second voltage instruction, the bipolar operation electrode enters the
Two modes: apply second voltage the target contact jaw of the bipolar operation electrode is remained second temperature, thus by target
Body carries out ablation solidification.
Preferably, trouble lamp 208 is used for when receiving alarm signal, is shown and is alarmed by indicator light.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, operating status of the display screen 204 for low-temperature plasma incision knife surgery systems described in real-time display.
Preferably, dropping liquid control valve 212 is instructed for the conducting medium input based on the primary control program to bipolar surgery
Electrode inputs the conducting medium, wherein the current surplus of conducting medium described in the bipolar operation electrode real-time measurement and general
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, which instructs and the conducting medium is inputted instruction after determining the generation conducting medium input instruction, is sent to drop
Hydraulic control valve 212.Preferably, dropping liquid control valve interface 202 is for realizing two-way between dropping liquid control valve 212 and primary control program
Communication.
Preferably, the application uses double mode liquid outlet: 1, titration mode, i.e., a drop as the mode of infusion
The supply of one drop；And 2, continuous supply model, i.e., the mode of liquid flow without interruption.Bipolar operation electrode interface (incision knife
Interface) it is connect by patch with the bipolar electrode socket connector (incision knife connector) of Fig. 5 as described below, dropping liquid control valve connects
Mouth is connected by the fluid-through chamber of connecting tube and Fig. 5.Floor push mouth is connect by connecting line with external foot pedal, for controlling
The supply and disconnection of energy and dropping liquid.When foot pedal is stepped on, energy and dropping liquid supply；When foot pedal unclamps, energy and drop
Liquid disconnects.
Preferably, the emission electrode at bipolar operation electrode tip catheter, plasmasphere, loop electrode and target contact
End forming circuit.In cut mode, the operating temperature of bipolar operation electrode is 35 to 40 DEG C, and the work of conventional electrosurgical knife
Temperature is 350 to 700 DEG C.The thermal break-through distance of bipolar operation electrode than the thermal break-through of conventional electrosurgical knife apart from small, wherein cutting
It cuts the thermal break-through distance that the thermal break-through distance in mode is less than or equal in 150 microns and coagulation mode and is less than or equal to 200
Micron, and the thermal break-through of conventional electrosurgical knife distance is greater than 9000 microns.
Preferably, upper mold 210 and lower die 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 for displaying data and operating control.
Fig. 3 is the structural schematic diagram according to the low-temperature plasma incision knife surgery systems 300 of the preferred embodiment for the present invention.
Low-temperature plasma incision knife surgery systems 300 can be used in cutting, ablation and the solidification and hemostasis of duodenofiberscope.In addition,
Low-temperature plasma incision knife surgery systems 300 can also be used to soft tissue in the surgical operations such as joint, backbone, skin, ear nose larynx
Cutting, ablation, solidification and hemostasis.The low-temperature plasma incision knife surgery systems 300 of the application using the time be 24 hours with
It is interior, belong to brought into temporary contact according to time of contact classification, belong to according to contact human body qualitative classification external access instrument (with tissue/
Bone/dentine) and according to medical instrument structure feature classification belong to active medical instrument.
Low-temperature plasma incision knife surgery systems 300 use bipolar scheme, and its working frequency is 110kHz.Low temperature etc.
Ion incision knife surgery systems 300 realize cutting, ablation, the solidification to soft tissue in the operation such as ear nose larynx by plasma technology
With hemostasis.When work, low-temperature plasma incision knife surgery systems 300, as conduction liquid, activate emission electrode by physiological saline
A thin layer is formed when between loop electrode.When low-temperature plasma incision knife surgery systems 300 give enough energy (electricity
Pressure) when, physiological saline translates into the gas blanket being made of charged particle of energizing (plasmasphere).That is, low-temperature plasma
Incision knife surgery systems 300 using energy excitation conducting medium (for example, physiological saline) generate plasma, and by etc. from
The energy of daughter interrupts tissue element key.The energy of plasma is by protein and other Direct Pyrolysis at O2, CO2, N2
Equal gases, so that the vaporization completed to tissue is cut.When the work cutter head to plasma therapeutic apparatus 100 gives low-voltage, electricity
Field requires lower than the thresholding for generating plasmasphere and generates tissue resistance heat, so that tissue be carried out to melt solidification and hemostasis.
As shown in figure 3, low-temperature plasma incision knife surgery systems 300 include: input unit 301, control unit 302, connect
Mouth unit 303, plasma cell 304, alarm unit 305, dropping liquid input unit 306 and display unit 307.Preferably, defeated
Entering unit 301 is, for example, floor push, and floor push can control 300 Working mould of low-temperature plasma incision knife surgery systems
Formula.The operating mode of low-temperature plasma incision knife surgery systems 300 is divided into cut mode and coagulation mode.The waterproof of floor push
Grade is waterproofing grade standard IPX8, and floor push is electric pedal switch.
Preferably, the yellow pedal of floor push corresponds to cut mode, and the gear range of cut mode is 1 to 9
Shelves.That is, low-temperature plasma incision knife surgery systems 300 enter cut mode when trampling the yellow pedal of floor push.Cutting
The gear regulative mode of mode are as follows: (or manually adjusted in the state of being adjusted to cut mode by dark buttons on floor push
Yellow button on host panel) it is adjusted.Cutting gear can choose any one shelves in from 1 to 9 grade.Wherein, gear is got over
Height, output voltage are 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, low-temperature plasma incision knife surgery systems 300 enter coagulation mode when trampling the blue pedal of floor push.Blood coagulation
The gear regulative mode of mode are as follows: (cut mode and blood coagulation mould can be switched by mode key in the state of being adjusted to coagulation mode
Formula) it is adjusted by dark buttons on blue pedal (or manually adjusting host panel blue buttons up and down).Foot-operated dark buttons
When, blood coagulation gear can choose any one shelves in from 1 to 5 grade, and middle gear more high output voltage is bigger.When in clinical use
When needing to carry out blood coagulation, depresses blue pedal and carry out blood coagulation.
Preferably, foot control interface is used to receive the control instruction of floor push, and the control instruction is transmitted to master
Control program.Wherein, control instruction be binary group<mode, power>.Mode includes: cut mode and coagulation mode.In blanking punch
In formula, power includes 9 gears, and in coagulation mode, and power includes 5 gears.
Preferably, control unit 302 parse and when the control instruction indicates the first mould to the control instruction
First mode instruction is generated when formula, is calculated according to present impedance and the control instruction for the output power under first mode,
First mode instruction and first voltage associated with the output power under first mode instruction are sent to interface list
Member 303.Wherein, initial present impedance is zero, i.e., when the booting of low-temperature plasma incision knife surgery systems 300 is operated,
The present impedance of default is zero.Described control unit 302 parse and when the control instruction refers to the control instruction
Second mode instruction is generated when showing second mode, is calculated according to present impedance and the control instruction for defeated under second mode
Second mode instruction and second voltage associated with the output power under second mode instruction are sent to by power out
Interface unit 303.Wherein the present impedance includes high impedance, middle impedance and Low ESR (0 impedance is Low ESR).Preferably,
If including: present impedance for the output power under first mode according to present impedance and control instruction calculating is high resistant
The 2nd grade under the anti-and described control instruction instruction first mode, then the 4th grade is set by the output power under first mode；
If present impedance is middle impedance and the control instruction indicates the 2nd grade under first mode, will be defeated under first mode
Power setting is the 3rd grade out；And if present impedance is Low ESR and the control instruction indicates the 2nd under first mode
Shelves, then set the 2nd grade for the output power under first mode.Preferably, it is calculated according to present impedance and the control instruction
If including: present impedance for the output power under second mode is high impedance and control instruction instruction second mode
Under the 2nd grade, then set the 4th grade for the output power under second mode；If present impedance is middle impedance and the control
The 2nd grade under system instruction instruction second mode, then the 3rd grade is set by the output power under second mode；And it is if current
Impedance is Low ESR and the control instruction indicates the 2nd grade under second mode, then sets the output power under second mode
It is set to the 2nd grade.Preferably, when the output power being calculated is more than the highest gear in first mode or second mode,
Using highest gear as real output.
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 to described control unit 302.And it described connects
Mouthful unit 303 receives second mode instruction and second voltage instruction from described control unit 302, and by the second mode
Instruction and second voltage instruction are transmitted to plasma cell 304.
Preferably, interface unit 303 is used for the power indication of reception control unit 302 and sends the power indication
To plasma cell 304, and the real-time impedance of plasma cell 304 is measured and by the real-time impedance by connecing
Mouth unit 303 passes to control unit 302.
Preferably, plasma cell 304 is in response to receiving first mode instruction and the first electricity from the plasma cell 304
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, thus using electric energy excitation conducting medium generate etc. from
Daughter, and cutting is vaporized to objective body based on the RF energy of plasma.In response to from the plasma cell 304
Received second instruction and second voltage instruction, the plasma cell 304 enter second mode: applying second voltage with by institute
The target contact jaw for stating plasma cell 304 remains second temperature, so that objective body is carried out ablation solidification.
Preferably, alarm unit 305 is used for when receiving alarm signal, by auditory tone cues, text prompt and/or is referred to
Show that lamp is shown to alarm.It wherein sends and alarms to control unit 302 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 unit 306 for the conducting medium input instruction based on described control unit 302 to it is equal from
Subelement 304 inputs the conducting medium, wherein the current surplus of conducting medium described in 304 real-time measurement of the plasma cell
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
Instruction is inputted at the conducting medium and inputs the conducting medium after the conducting medium inputs instruction determining to generate
Instruction is sent to dropping liquid input unit 306.
Preferably, emission electrode, plasmasphere, loop electrode and the target at 304 tip catheter of plasma cell connect
Contravention forming circuit.In cut mode, the operating temperature of plasma cell 304 is 35 to 40 DEG C, and conventional electrosurgical knife
Operating temperature is 350 to 700 DEG C.The thermal break-through distance of plasma cell 304 than the thermal break-through of conventional electrosurgical knife apart from small,
The thermal break-through distance that thermal break-through distance in middle cut mode is less than or equal in 150 microns and coagulation mode is less than or equal to
200 microns, and the thermal break-through of conventional electrosurgical knife distance is greater than 9000 microns.
Preferably, display unit 307, the operation shape for low-temperature plasma incision knife surgery systems described in real-time display
State.300 working principle of low-temperature plasma incision knife surgery systems is effect of plasma radiofrequency ablation at low temperature.Energy is generated using bipolar cutter head
Physiological saline is converted into plasma thin layer by amount, is dissociated the molecular link for constituting cell component in target tissue, is caused tissue coagulation
Property necrosis, formed ablation or cutting effect.It is more electric than the high frequency cutting that tradition uses due to working at relatively low temperature
Knife is minimized degree to the thermal damage of perienchyma.Target volume can be made to reduce in 35 DEG C or so operating temperatures, target tissue
In capilary closing, cut off lesion.Its low temperature and tissue volume reduction Ablation characteristic, more common Single-pole electric knife have more desmopyknosis
Afterwards the advantages of recovery time, mitigation postoperative pain and reduction expenses of surgical treatment.Low-temperature plasma incision knife surgery systems 300 exist
Lower than 70 DEG C of cutter head ambient temperature (are detailed in isolated experiment research tissue thermal damage report) when work, and it is traditional common
High frequency cutting electric knife (100~150 DEG C of high temperature) is lower compared to operating temperature, although the treatment temperature of low temperature-controlled plasma radio-frequency ablation is opposite
People's tissue still falls within high temperature, after histocyte is influenced by this temperature, equally will appear electric knife cutting and histone is caused to be denaturalized, especially
After it is certain time, can also thermal damage be caused to tissue.And histiocytic degeneration necrosis is one and gradually develops
Process, therefore after the operation of some patientss row low-temperature plasma, the reaction such as the swelling of art area, postoperative pain is anti-unlike high frequency cutting electric knife
It should be light.Since each operating time has differences so plasma therapeutic apparatus selects in isolated experiment research tissue thermal damage report
With maximum operating time, electric knife is cut by the plasma therapeutic apparatus of the visible maximum operating time of comparison and the high frequency of normal use
Heat waste depth.Therefore the heat waste depth of the plasma therapeutic apparatus of normal use should cut electric knife heat waste depth lower than high frequency.
Fig. 4 is the flow chart according to the low-temperature plasma incision 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 of user's input is received.
In step 402, parsing and the generation when the control instruction indicates first mode are carried out to the control instruction
First mode instruction, calculates according to present impedance and the control instruction for the output power under first mode.
In step 403, first voltage instruction associated with the output power under the first mode is determined.
In step 404, first mode instruction and first voltage instruction are transmitted to plasma apparatus, and from described
The present impedance of plasma apparatus reception target contact jaw.
In step 405, indicated in response to receiving first mode instruction and first voltage, promote the plasma apparatus into
Enter first mode: by conducting medium between the emission electrode and loop electrode of the target contact jaw of the plasma cell into
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 it is converted into plasmasphere, to generate plasma using electric energy excitation conducting medium, and is based on
The RF energy of plasma is vaporized cutting to objective body；
The wherein emission electrode, plasmasphere, loop electrode and target contact jaw forming circuit.
It further include carrying out parsing to the control instruction and generating second when the control instruction indicates second mode
Mode instruction is calculated according to present impedance and the control instruction for the output power under second mode, and determining and institute
State the associated second voltage instruction of output power under second mode.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
Apply second voltage the target contact jaw of the plasma apparatus is remained second temperature, so that objective body be carried out likes:
Ablation solidification.
It further include being shown and being reported by auditory tone cues, text prompt and/or indicator light when receiving alarm signal
It is alert；Alarm signal is wherein generated after detecting operation troubles.
Wherein user generates the control instruction by being operable to foot-operated input equipment, wherein the control refers to
Enabling is binary group<mode, power>.
It further include that the conducting medium is inputted to the plasma apparatus based on conducting medium input instruction, wherein described etc.
The current surplus of conducting medium described in ion device real-time measurement and based on the current surplus determine whether generate described in lead
Dielectric input instruction.The operating status of plasma apparatus described in 400 real-time display of method.
Fig. 5 is the structural schematic diagram according to the low-temperature plasma incision knife surgical apparatus of the preferred embodiment for the present invention.Such as
Shown in Fig. 5, low-temperature plasma incision knife surgical apparatus includes: emission electrode (cutting silk) 501, loop electrode (circle set) 502, pipe
Sheath 503, guidewire lumen interface 504, injecting cavity interface 505, rod cap 506, cushion block 507, sliding block (band socket aperture) 508, socket Pin
509 and pull rod 510.Preferably, emission electrode (cutting silk) 501 and loop electrode (circle set) 502 are imported by identical conduit
And galvanic circle is formed in objective body.Emission electrode (cutting silk) 501, receives the high frequency via socket Pin 509 and occurs
First input voltage caused by device applies first between emission electrode (cutting silk) 501 and loop electrode (circle set) 502
Voltage, so that the conducting medium reaches the first temperature and the conducting medium is promoted to be converted into plasmasphere, thus sharp
Plasma is generated with electric energy excitation conducting medium, and the RF energy based on plasma is vaporized objective body and cuts
It cuts.In the initial state, emission electrode 501 and loop electrode 502 be depend on substantially it is linear, before facilitating pipe sheath 503
End enters human body.After reaching designated position, sliding block 508 is moved backward, and pulls emission electrode 501, is made emission electrode 501 and is returned
Path electrode 502 forms tortuous bow shape.Insulating layer (being not shown in Fig. 5) coats emission electrode (cutting silk) 501 conducting wires, and described
Insulating layer has been used to insulate and heat-insulated effect.Pipe sheath, for providing external sheath function.Injecting cavity interface 505 is based on liquid
Input instruction inputs the liquid to liquid input unit, wherein liquid described in the liquid input unit real-time measurement is current
Surplus and the current surplus is sent to control unit, described control unit is based on the current surplus and determines whether to generate
The liquid input, which instructs and the liquid is inputted instruction after determining the generation liquid input instruction, is sent to dropping liquid
Input unit.Injecting cavity interface 505 is the annular chamber outside loop electrode conducting wire.
Guidewire lumen interface 504 by seal wire along the guidewire lumen for inputting and being inserted to the low-temperature plasma incision knife hand
The head end of art equipment, to promote emission electrode 501 and loop electrode 502 to be placed at the objective body.Pull rod 510 is for making to grasp
Author is by providing support force pull rod 510.Socket Pin 509 is connect by high frequency connecting line with radio-frequency generator, is used for
Receive the first input voltage caused by the radio-frequency generator.Socket Pin 509 is received caused by the radio-frequency generator
Second input voltage and second input voltage is transferred to emission electrode, emission electrode 501 and loop electrode 502 it
Between apply second voltage so that objective body remains second temperature, so that objective body be promoted to carry out ablation solidification.Liquid input
Unit (is not shown) in Fig. 5, in response to liquid input signal, to objective body at input liquid in emission electrode and circuit
The thin layer of conducting medium is formed between electrode.Liquid input unit carries out liquid input by one of following mode: titration
Mode and continuous liquid supply mode.
Wherein, the material of emission electrode (cut silk) 501 be stainless steel 304, loop electrode (circle set) 502 material be not
Rust steel 304, pipe sheath 503 material be polytetrafluoroethylene PTFE, guidewire lumen interface 504 material be acrylonitrile-butadiene-benzene second
Alkene copolymer ABS, injecting cavity interface 505 material be ABS, rod cap 506 material be ABS, cushion block 507 material be ABS,
The material of sliding block (with socket aperture) be ABS, socket Pin material be the material of stainless steel 304 and pull rod 510 be ABS.
As shown in figure 5, the length of loop electrode 502 can be any reasonable numerical value, such as 4 to 5 millimeters.Wherein, it returns
It can be and appoint at a distance from the one end and the junction of emission electrode 501 and pipe sheath 503 at 503 top of close pipe sheath of path electrode 502
It anticipates reasonable numerical value, such as 2 to 3 millimeters.Wherein, the close low temperature of loop electrode is arranged in water outlet (or referred to as infusion port)
Between the side of the uncoated insulating layer of the side and emission electrode on the top of plasma incision knife surgical apparatus, i.e. water outlet quilt
It is arranged in the range of shown in Fig. 52 to 3 millimeters.
In the initial state, emission electrode 501 and loop electrode 502 be depend on substantially it is linear, to facilitate pipe sheath 503
Front end enter human body.After reaching designated position, sliding block 508 is moved backward, and is pulled emission electrode 501, is made emission electrode 501
Tortuous bow shape is formed with loop electrode 502.Sliding block 508 is at socket aperture, and socket Pin 509 is arranged in socket aperture.
Fig. 6-8 is the partial enlargement according to the low-temperature plasma incision knife surgical apparatus of the preferred embodiment for the present invention or cuts
Face schematic diagram.Fig. 6 shows the partial enlargement diagram of bipolar electrode socket connector (incision knife connector) 600, including: it returns
Path electrode conducting wire 601 and emission electrode conducting wire (cutting silk conducting wire) 602.Low-temperature plasma incision knife surgical apparatus can be used in ten
Cutting, ablation and the solidification and hemostasis of two duodenum 12 nipples.In addition, low-temperature plasma incision knife surgical apparatus can also be used to close
Cutting, ablation, solidification and the hemostasis of soft tissue in the surgical operations such as section, backbone, skin, ear nose larynx.Low temperature of the application etc. from
Sub- incision knife surgical apparatus is to belong to brought into temporary contact, according to contact people within 24 hours, according to time of contact classification using the time
Volume property classification belongs to external access instrument (with tissue/bone/dentine) and belongs to according to the classification of medical instrument structure feature
Active medical instrument.The attachment bipolar operation electrode of low-temperature plasma incision knife surgical apparatus belongs to disposable sterilized product.
Low-temperature plasma incision knife surgical apparatus uses bipolar scheme, and its working frequency is 110kHz.Plasma is controlled
Treat cutting, ablation, solidification and hemostasis of the instrument 100 by plasma technology realization to soft tissue in the operation such as ear nose larynx.When work,
Low-temperature plasma incision knife surgical apparatus, as conduction liquid, activates shape when between emission electrode and loop electrode by physiological saline
At a thin layer.When plasma therapeutic apparatus gives enough energy (voltage), physiological saline translates into one by band of energizing
The molecular gas blanket of electrochondria (plasmasphere).That is, low-temperature plasma incision knife surgical apparatus utilizes energy excitation conducting medium
(for example, physiological saline) generates plasma, and interrupts tissue element key by the energy of plasma.The energy of plasma
Amount is by protein and other Direct Pyrolysis at O2, CO2, N2Equal gases, so that the vaporization completed to tissue is cut.When right
When the work cutter head of low-temperature plasma incision knife surgical apparatus gives low-voltage, electric field is lower than the thresholding requirement for generating plasmasphere
And tissue resistance heat is generated, so that tissue is carried out ablation solidification and hemostasis.
Fig. 7 shows the schematic cross-section along B-B, including: loop electrode conducting wire 701, emission electrode conducting wire (are cut
Silk conducting wire) 702, guidewire lumen 703, fluid-through chamber 704 and emission electrode chamber 705.In more detail, Fig. 7 shows loop electrode and leads
The sectional view 706 of line 701, including insulating layer 707 and wire 708.Loop electrode conducting wire needs insulating layer, acts as insulation
With heat-insulated effect, emission electrode conducting wire (cutting silk conducting wire) can be not provided with insulating layer.
In addition, those skilled in the art is as needed, emission electrode chamber 705 can also be regard as fluid-through chamber, emitted
When electrode cavity 705 is as fluid-through chamber, insulating layer need to be arranged in emission electrode conducting wire (cutting silk conducting wire).
Fig. 8 shows the schematic cross-section along C-C, (cuts including loop electrode conducting wire 801 and emission electrode conducting wire
Silk conducting wire) 802.
Fig. 9 is the side view of the incision knife (low-temperature plasma incision knife) of seal assembly according to the present invention.In the present invention
Incision knife can be used in the cutting of duodenofiberscope, ablation and solidification and hemostasis.In addition, the incision knife can also be used to close
Cutting, ablation, solidification and the hemostasis of soft tissue in the surgical operations such as section, backbone, skin, ear nose larynx.The incision knife uses the time
It is to belong to brought into temporary contact within 24 hours, according to time of contact classification, belong to external access device according to contact human body qualitative classification
Tool (with tissue/bone/dentine) and according to medical instrument structure feature classification belong to active medical instrument.Incision knife is using double
Pole scheme, and its working frequency is 105kHz.Optionally, the working frequency of the incision knife can be in the range of 100-110.
Incision knife realizes cutting, ablation, solidification and the hemostasis to soft tissue in the operation such as ear nose larynx by plasma technology.When work,
Incision knife, as conduction liquid, forms a thin layer by physiological saline when activating between emission electrode and loop electrode.Work as incision
When knife gives enough energy (voltage), physiological saline translate into the gas blanket being made of charged particle of energizing (wait from
Sublayer).That is, incision knife generates plasma using energy excitation conducting medium (for example, physiological saline), and rely on plasma
The energy of body interrupts tissue element key.The energy of plasma is by protein and other Direct Pyrolysis at O2, CO2, N2Deng
Gas, so that the vaporization completed to tissue is cut.When the work cutter head to incision knife gives low-voltage, electric field is lower than generation etc.
The thresholding of sheath requires and generates tissue resistance heat, so that tissue is carried out ablation solidification and hemostasis.
The operation part of incision knife includes that handle 1, pull rod 2, socket Pin 3, sliding block 4, cushion block 5, front bar 6 (are also referred to as drawn
Pole cap), pipe sheath 7, injecting cavity interface 8, push rod 9 (the first push rod) and push rod 10 (the second push rod) etc..Pull rod 2 is by operator's handle
It holds to facilitate and operates the incision knife.Pipe sheath 7 is the elongated tubular longitudinally extended from front bar 16, pipe sheath 7 to be inserted into objective body (human body
Lesion).
As shown in Figure 10, fluid-through chamber 18 is arranged in pipe sheath 7, which leads to from the chamber being formed in front bar 6
The top of pipe sheath 7.Fluid-through chamber 18 surrounds emission electrode conducting wire 16 (referring to Figure 12).Liquid (for example, conducting medium, ejected wash water etc.)
Fluid-through chamber 18 is entered by the chamber in front bar 6 via the fluid entry port 8a in injecting cavity interface 8.
Pipe sheath 7 is for providing external sheath function.Injecting cavity interface 8 is inputted based on the liquid from controller (not shown)
Instruction input liquid (such as conducting medium), wherein the current surplus of the liquid is by real-time measurement and the current surplus quilt
It is transmitted to controller, controller determines whether to generate the liquid input instruction and generate determining based on the current surplus
After the liquid input instruction control liquid from the fluid entry port 8a in injecting cavity interface 8 via the chamber in front bar 6 to
Fluid-through chamber 18 and finally to the input of objective body.
In addition, as shown in figure 9, the operation part of incision knife further includes that 21 He of emission electrode on the top of pipe sheath 7 is arranged in
Loop electrode 22.Emission electrode 21 is formed as cutting silk.
Emission electrode 21 (cutting silk) and loop electrode 22 (circle set) pass through pipe sheath 7 and are imported into objective body and in objective body
Form galvanic circle.Emission electrode 21 is via the socket Pin 3 being connect by high frequency connecting line with radio-frequency generator (not shown)
The first input voltage caused by the radio-frequency generator is received, to apply first between emission electrode 21 and loop electrode 22
Voltage, so that the conducting medium reaches the first temperature and the conducting medium is promoted to be converted into plasmasphere, thus sharp
Plasma is generated with electric energy excitation conducting medium, and the RF energy based on plasma is vaporized objective body and cuts
It cuts.
In the initial state, emission electrode 21 and loop electrode 22 be depend on substantially it is linear, before facilitating pipe sheath 7
End enters human body, as shown by the broken line in fig. 9.After reaching designated position, sliding block 4 is moved backward, via emission electrode conducting wire
16 pull emission electrode 21, so that emission electrode 21 and loop electrode 22 is formed tortuous bow shape, as shown by the solid line in FIG 9.
As shown in figure 9, incision knife includes guidewire lumen, for seal wire to be inputted to along guidewire lumen and is inserted to the top of pipe sheath 7,
To promote emission electrode 21 and loop electrode 22 to be placed at objective body.Pass through seal wire, emission electrode 21 and loop electrode as a result,
22 can swimmingly reach at objective body.
Seal wire for being inputted along the guidewire lumen and being inserted to the head end of incision knife by guidewire lumen interface 23, to promote to emit
Electrode 21 and loop electrode 22 are placed at the objective body.Pull rod 2 is for making operator by providing support pull rod 2
Power.Socket Pin 3 is connect by high frequency connecting line with radio-frequency generator, for receiving first caused by the radio-frequency generator
Input voltage.Socket Pin 3 receives the second input voltage caused by the radio-frequency generator and inputs electricity for described second
Pressure is transferred to emission electrode 21, applies second voltage between emission electrode 21 and loop electrode 22, so that objective body is kept
For second temperature, so that objective body be promoted to carry out ablation solidification.
For example, the range of first temperature is 35 DEG C -40 DEG C, the range of the second temperature is 40 DEG C -70 DEG C.It is described
The range of first voltage is 100Vrms to 300Vrms, and the range of the second voltage is 60Vrms to 80Vrms.
The length L1 of loop electrode 22 can be any reasonable numerical value, such as 4 to 5 millimeters.Wherein, loop electrode 22
The one end at close 7 top of pipe sheath can be any reasonable numerical value, such as 2 to 3 millimeters with the top end face distance L2 of pipe sheath 7.
Wherein, the top of pipe sheath 7 is arranged in water outlet (or referred to as infusion port, not shown), enters from the liquid in injecting cavity interface 8
The liquid that port 8a enters enters objective body from water outlet.
Wherein, for example, the material of emission electrode 21 is stainless steel 304, the material of loop electrode 22 is stainless steel 304, pipe
The material of sheath 7 is polytetrafluoroethylene PTFE, and the material of injecting cavity interface 8 is acrylonitrile-butadiene-styrene copolymer ABS,
The material of front bar 6 is ABS, and the material of cushion block 5 is ABS, and the material of sliding block 4 is ABS, and the material of socket Pin 3 is stainless steel
304 and the material of handle 1 be ABS.
In addition, as shown in figure 12, illustrating emission electrode conducting wire (cutting silk conducting wire) 16, loop electrode conducting wire 17, logical liquid
Chamber 18, loop electrode chamber 19 and guidewire lumen B.In more detail, the enlarged view in Figure 12 shows emission electrode conducting wire 16
Sectional view, including insulating layer 16a and wire 16b.Emission electrode conducting wire 16 needs insulating layer, act as insulation and it is heat-insulated
Effect, loop electrode conducting wire 17 can be not provided with insulating layer.
Incidentally, loop electrode chamber 19 and fluid-through chamber 18 are formed in pipe sheath 7 in parallel to each other and through pipe sheaths 7.
Push rod 9 and push rod 10 are inserted into fluid-through chamber 18 and loop electrode chamber 19 respectively, and emission electrode 21 and loop electrode 22 are distinguished
(do not schemed by being connected to radio-frequency generator through the emission electrode conducting wire 16 and loop electrode conducting wire 17 of push rod 9 and push rod 10
Show).
As shown in figure 11, a part of loop electrode conducting wire 17 being located in the second push rod 10 is formed as spiral-shaped.It should
The diameter of a part of 17a is slightly smaller than the diameter of the second push rod 10.
Utilize above-mentioned construction, when the second push rod 10 is pushed, spiral-shaped a part of 17a of loop electrode conducting wire 17
Allow the mutual sliding between loop electrode conducting wire 17 and the second push rod 10, and passes through spiral-shaped a part of 17a and the
The loop current between loop electrode conducting wire 17 and the second push rod 10 is connected in contact between the inner surface of two push rods 10.This
Outside, it is contacted due to loop electrode conducting wire 17 with the inner surface of the second push rod 10, loop electrode conducting wire 17 is in second push rod
It will not be moved radially in 10.Further, since a part of 17a is located in the second push rod 10, therefore even if the second push rod 10 is pushed away
It is dynamic, it also can guarantee that a part of 17a is always positioned in pipe sheath 7 (PTFE tube), without being pushed out.
The present invention is described by reference to a small amount of embodiment.However, it is known in those skilled in the art, as
Defined by subsidiary Patent right requirement, in addition to the present invention other embodiments disclosed above equally fall in it is of the invention
In range.
Normally, all terms used in the claims are all solved according to them in the common meaning of technical field
It releases, unless in addition clearly being defined 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 accurate sequence, unless explicitly stated otherwise.
Claims (10)
1. a kind of low-temperature plasma incision knife surgical apparatus, which is characterized in that the equipment includes:
Liquid input unit, in response to liquid input signal, to objective body at input liquid to emission electrode and circuit electricity
The thin layer of conducting medium is formed between pole；
Bipolar electrode socket connector is connect by high frequency connecting line with radio-frequency generator, for receiving the radio-frequency generator institute
The first input voltage generated；
Emission electrode receives the first input voltage caused by the radio-frequency generator via bipolar electrode socket connector, is 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, to generate plasma using electric energy excitation conducting medium, and based on plasma
RF energy is vaporized cutting to objective body,
Loop electrode is imported by identical conduit with the emission electrode and forms galvanic circle in the objective body.
2. low-temperature plasma incision knife surgical apparatus according to claim 1, which is characterized in that the bipolar electrode socket
Connector receives the second input voltage caused by the radio-frequency generator and second input voltage is transferred to transmitting electricity
Pole applies second voltage between emission electrode and loop electrode, so that objective body remains second temperature, to promote mesh
Standard type carries out ablation solidification.
3. low-temperature plasma incision knife surgical apparatus according to claim 1, which is characterized in that further include guidewire lumen, use
In the head end that seal wire is inputted to along the guidewire lumen and is inserted to the low-temperature plasma incision knife surgical apparatus, to promote to emit
Electrode and loop electrode are placed at the objective body.
4. low-temperature plasma incision knife surgical apparatus according to claim 1, which is characterized in that further include fluid-through chamber, base
The liquid is inputted to liquid input unit in liquid input instruction, wherein liquid described in the liquid input unit real-time measurement
Current surplus and the current surplus is sent to control unit, described control unit is based on the current surplus determination
It is no to generate the liquid input instruction and the liquid is inputted into instruction transmission after determining the generation liquid input instruction
Give liquid input unit.
5. low-temperature plasma incision knife surgical apparatus according to claim 4, which is characterized in that the liquid input unit
Liquid input: titration mode and continuous liquid supply mode is carried out by one of following mode, and the fluid-through chamber is to be located at
Annular chamber except loop electrode.
6. low-temperature plasma incision knife surgical apparatus according to claim 3, which is characterized in that the emission electrode it is remote
A part cladding insulating layer on top from the low-temperature plasma incision knife surgical apparatus, the insulating layer be used for insulation with
Heat-insulated effect.
7. low-temperature plasma incision knife surgical apparatus according to claim 6, which is characterized in that the liquid input unit
Infusion port between the emission electrode and loop electrode.
8. low-temperature plasma incision knife surgical apparatus according to claim 1, which is characterized in that the low-temperature plasma is cut
Open surgery equipment further includes pull rod, for making operator by pull rod being provided support force, and the low-temperature plasma
Incision knife surgical apparatus further includes outer tube, for providing external sheath function.
9. low-temperature plasma incision knife surgical apparatus according to claim 1, which is characterized in that in the initial state, institute
It states emission electrode and loop electrode is bonded each other, after at the emission electrode and the loop electrode arrival objective body, pass through
Sliding block is mobile to pull the emission electrode, so that the emission electrode and loop electrode form tortuous bow shape.
10. low-temperature plasma incision knife surgical apparatus according to claim 1, which is characterized in that the first voltage
Range is 100Vrms to 300Vrms, and the range of the second voltage is 60Vrms to 80Vrms.
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| Application Number | Priority Date | Filing Date | Title |
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| CN201811261153.6A CN109907816A (en) | 2018-10-27 | 2018-10-27 | A kind of low-temperature plasma incision knife surgical apparatus |
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| Application Number | Priority Date | Filing Date | Title |
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| CN201811261153.6A CN109907816A (en) | 2018-10-27 | 2018-10-27 | A kind of low-temperature plasma incision knife surgical apparatus |
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| CN109907816A true CN109907816A (en) | 2019-06-21 |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
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| CN112220555A (en) * | 2020-10-01 | 2021-01-15 | 成都美创医疗科技股份有限公司 | Micro low-temperature plasma electrode and operation system thereof |
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| CN107693111A (en) * | 2017-10-27 | 2018-02-16 | 上海诺英医疗器械有限公司 | A kind of low-temperature plasma incision knife surgical apparatus |
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