CN1839768A - 用于控制超声夹钳和切割器械的系统 - Google Patents

用于控制超声夹钳和切割器械的系统 Download PDF

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CN1839768A
CN1839768A CNA2006100733582A CN200610073358A CN1839768A CN 1839768 A CN1839768 A CN 1839768A CN A2006100733582 A CNA2006100733582 A CN A2006100733582A CN 200610073358 A CN200610073358 A CN 200610073358A CN 1839768 A CN1839768 A CN 1839768A
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艾坦·T·威纳
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Abstract

一种用于与超声外科器械一起使用的控制系统包括向超声外科器械供应电能的发生器，由该发生器供应的电能受到如此的控制，即，一旦达到预定的压力阈值，就将由器械施加的功率保持恒定。该控制系统如此操作，即：分配超声器械操作时的额定功率并调节施加给超声外科器械的电流和电压，以便将由超声外科器械施加的功率保持基本上处于额定功率。

Description

用于控制超声夹钳和切割器械的系统
技术领域
本发明涉及超声手术夹钳和切割器械。更具体地说，本发明涉及一种用于超声手术夹钳和切割器械的改进的功率限制机构。
背景技术
超声器械用于很多医疗情况的安全和有效的处理。超声器械是有利的，因为它们通过使用以机械振动的形式以超声频率传递到手术端部执行器的功率而被用来切割和凝固器官组织。
超生波振动当以适当的功率水平传递到器官组织上并使用适当的端部执行器时，可被用来切割和/或解剖组织。利用实芯(solid core)技术的超声器械是特别有利的，因为超声能量可从超声换能器通过波导传递到手术端部执行器。这种器械特别适于在微创手术中使用，例如内窥镜或腹腔镜手术，其中端部执行器穿过套管针以接近手术部位。
在手术端部执行器中，例如通过电激励的换能器来诱发超声振动，所述换能器可在器械手持件中由一个或多个压电或者磁阻元件构成。由换能器产生的振动通过从换能器部分延伸到手术端部执行器的超声导传递到手术端部执行器上。
现有技术中已知很多这种超声外科器械。但是，它们对由外科医生施加的压力高度敏感。具体地说，当外科医生施加更大的压力时，改变了超声器械的振动特性。实际上，在其中外科医生施加超出预定的压力水平的情况下，传递到组织上的能量可能太高。这可能导致不希望的组织效应，例如所作用的脉管的止血不良。另外，外科器械可能不能满足用于在高压力水平下产生的振动水平的材料压力要求，从而导致不理想的器械操作。已经试图例如通过在致动组件内加入弹簧来试图机械地控制所施加的压力，从而弥补与施加不同的压力相关联的问题。但是，这些试图仅获得了有限的成功。
这样，需要一种装置，其中能实现恒定的功率分布，与由外科医生施加的作用力的个人喜好无关。本发明提供了这种装置。
发明内容
因此本发明的一个目的是提供一种与超声外科器械联用的控制系统。该控制系统包括向超声外科器械供应电能的发生器，以如下方式控制由发生器供应的电能，即，一旦达到预定的压力阈值，将由器械施加的功率保持恒定。
本发明的另一个目的在于提供一种超声外科系统。该超声外科系统包括一器械和用于向器械供应所需信号的与器械相连的超声信号发生器。该器械包括超声换能器、壳体和端部执行器。该超声信号发生器包括一控制系统。该控制系统包括给器械供应电能的发生器，以如下方式控制由发生器供应的电能，即，一旦达到预定的压力阈值，将由器械施加的功率保持恒定。
本发明的再一个目的在于提供一种用于控制超声外科器械的功率施加的方法。通过分配额定功率实现该方法，超声器械在该额定功率下操作并且调节施加到超声外科器械上的电流和电压，以便将由超声器械施加的功率保持基本上处于额定功率。
(1)本发明涉及一种用于与超声外科器械一起使用的控制系统，包括：
向超声外科器械供应电能的发生器，由该发生器供应的电能受到如此的控制，即，一旦达到预定的压力阈值，就将由器械施加的功率保持恒定。
(2)如项目(1)所述的控制系统，其中，由器械施加的功率等于由发生器产生的电流和电压的乘积。
(3)如项目(2)所述的控制系统，还包括用于测量通过超声外科器械的阻抗并基于所测量到的阻抗控制功率水平的装置。
(4)如项目(3)所述的控制系统，其中，用于控制功率水平的装置包括根据所测得的阻抗通过超声外科器械的调整电流。
(5)如项目(1)所述的控制系统，其中，由所述发生器供应的电压随施加的力的连续增加而增大。
(6)如项目(1)所述的控制系统，还包括用于测量通过超声外科器械的阻抗并基于所测量到的阻抗控制功率水平的装置。
(7)如项目(6)所述的控制系统，其中，用于控制功率水平的装置包括根据所测得的阻抗通过超声外科器械的调整电流。
(8)如项目(1)所述的控制系统，还包括用由超声外科器械施加的压力平衡该超声外科器械的震动水平的装置。
(9)本发明还涉及一种超声外科系统，包括：
一器械和与该器械连接、用于给该器械提供所需信号的超声信号发生器，所述器械包括超声换能器，壳体和端部执行器；
所述超声信号发生器包括控制系统，该控制系统包括向所述器械供应电能的发生器，由该发生器供应的电能受到如此的控制，即，一旦达到预定的压力阈值，就将由器械施加的功率保持恒定。
(10)如项目(9)所述的超声外科系统，其中，由所述器械施加的功率等于由发生器产生的电流和电压的乘积。
(11)如项目(10)所述的超声外科系统，还包括用于测量通过所述器械的阻抗并基于所测量到的阻抗控制功率水平的装置。
(12)如项目(11)所述的超声外科系统，其中，用于控制功率水平的装置包括根据所测得的阻抗通过所述器械的调整电流。
(13)如项目(9)所述的超声外科系统，其中，由所述发生器供应的电压随施加的力的连续增加而增大。
(14)如项目(9)所述的超声外科系统，还包括用于测量通过所述器械的阻抗并基于所测量到的阻抗控制功率水平的装置。
(15)如项目(14)所述的超声外科系统，其中，用于控制功率水平的装置包括根据所测得的阻抗通过所述器械的调整电流。
(16)如项目(9)所述的超声外科系统，还包括用由所述器械施加的压力平衡该器械的震动水平的装置。
(17)本发明进一步涉及一种用于控制由超声外科器械施加的功率的方法，包括以下步骤：
分配超声器械操作时的额定功率；
调节施加给超声外科器械的电流和电压，以便将由超声外科器械施加的功率保持基本上处于额定功率。
(18)如项目(17)所述的方法，其中，调节步骤包括测量通过所述超声外科器械的阻抗并基于所测量到的阻抗控制功率水平。
(19)如项目(18)所述的方法，其中，控制功率水平包括根据所测得的阻抗通过所述超声外科器械的调整电流。
(20)如项目(17)所述的方法，其中，由所述发生器供应的电压随施加的力的连续增加而增大。
(21)如项目(17)所述的方法，其中，调节步骤包括用由所述超声外科器械施加的压力平衡该超声外科器械的震动水平。
可通过下面的详细说明并结合附图清楚地了解本发明的其它目的和优点，下面的说明中描述了本发明的几个实施例。
附图说明
图1是根据本发明的系统的视图。
图2是示出了根据本发明的电流、电压和功率分布的曲线图。
图3是根据本发明的用于控制施加到超声器械上的功率水平的优选方案的流程图。
具体实施方式
下面将披露本发明的详细实施例。但是应当理解，所披露的实施例仅是本发明的例证，本发明可以各种形式实现。因此，此处披露的细节不应解释为限制，而是仅作为权利要求的基础以及作为用于告知本领域技术人员如何制造和/或使用本发明的基础。
参照图1，披露了与超声手术夹钳和切割器械12联用的超声系统10。根据本发明的一个优选实施例，超声系统10包括超声信号发生器15，该信号发生器15适于施加足以在手术期间将功率保持基本上恒定的电流和电压。
根据本发明的一个优选实施例，该系统适于与超声器械12联用，该超声器械12与在名称为“Force limiting mechanism for an ultrasonicsurgical instrument”的美国专利No.6,458,142中披露的器械类似，将该美国专利在此引入作为参考，但是鉴于本发明使用电流和电压来控制由器械施加的功率，本发明不需要该器械的这种力限制机构。尽管根据本发明披露了一种优选的器械，但是本领域技术人员清楚地了解，本发明提供了适于与广泛的各种装置联用的系统。
为了披露本发明，器械12包括夹层型超声换能器82、手持件壳体20和夹钳凝固器120。该夹钳凝固器120用于开放手术或者腹腔镜手术。称为“兰杰文堆”的超声换能器82通常包括转换部分90、第一谐振器或端部钟形件形件(endbell)92、第二谐振器或者前部钟形件(forebell)94以及辅助部件。升学组件80包括超声换能器82、支座36、速度变换器64和表面95。
端部钟形件形件92的远端连接到转换部分90的近端上，并且前部钟形件94的近端连接到转换部分90的远端上。前部钟形件94和端部钟形件92具有由多种因素确定的长度，这些因素包括转换部分90的厚度、用于制造端部钟形件92和前部钟形件94的材料的密度和弹性模量以及超声换能器82的谐振频率。前部钟形件94可以从其近端到其远端向内变细，以随着速度变换器(未示出)增大超声振幅，或者没有振幅增大。
压电元件100优选由适当的材料制成，例如锆钛酸铅、偏铌酸铅或者其它压电晶体材料。正电极96、负电极98和压电元件每个都具有穿过其中心延伸的孔。正、负电极96、98分别电连接到第一和第二导线102、104上。第一和第二导线102、104装入电缆25中并可电连接到超声系统10的超声信号发生器上。
实际上，声学组件80的超声换能器82将来自超声信号发生器的电信号转换成机械能，该机械能导致超声换能器82和端部执行器180以超声频率基本上沿纵向振动。当给声学组件供电时，通过声学组件80产生振动驻波。在沿着声学组件80的任何位置的振动振幅取决于沿着声学组件80的振动被测量的位置。
第一和第二导线102、104将电信号从超声信号发生器15传递到正电极96和负电极98上。可获得适合的发生器，如辛辛那提的伊西康内外科公司的型号GEN01的发生器。压电元件100由来自超声信号发生器的响应于脚踏开关118的电信号供电，以在声学组件80中产生声学驻波。电信号在压电元件100中形成干扰，其形式为在材料中导致大压力的重复位移。该重复的小位移使得压电元件100以连续的方式沿着压力梯度扩张和收缩，从而产生超声能量的纵波。超声能量通过声学组件80传递到端部执行器180上。
为了使声学组件80将能量传递到端部执行器180上，声学组件80的所有部件必须声学地连接到夹钳凝固器120的超声活性部分上。超声换能器82的远端可在第一表面通过螺纹连接件(例如短柱50)声学地连接到超声波导的近端上。声学组件80的部件优选可声学地调谐，从而任何组件的长度是半波长的整数倍，其中波长拉姆达是预选的或者声学组件80的操作纵向振动驱动频率的波长，其中N是任意正整数。在不背离本发明的精神的情况下，也可以设想声学组件80可以采用声学元件的任何合适的布置。
为了适应由不同外科医生采用的不同的力分布，本发明控制由超声外科发生器15施加到器械12上的功率。如此控制所施加的额定功率，即防止被夹钳和/或切割的组织产生不希望的效果。通过根据本发明控制功率，消除了在现有技术的超声器械中对机械控制系统的需要，并且向用户提供了改善的反馈。最后，通过超声器械12施加的功率受到在组织和端部执行器180之间产生的摩擦、端部执行器的速度和由端部执行器180施加的法向力的影响。实际上，在组织和端部执行器180之间的摩擦通常非常恒定不变，仅由于组织的干燥度而具有微小的变化。因此在功率施加中的变量是端部执行器的速度和所施加的法向力。
如将在下面详细描述的一样，本发明通过基于所测量的通过换能器的阻抗来控制超声外科器械12的电压和电流，从而将输入功率保持基本上恒定，所述阻抗与所需的恒定功率水平有关。具体地说，参照图2所示的功率分布图，在达到预定的压力水平之后由超声外科器械12施加的功率保持恒定。通过连续地监控与由操作者施加的作用力有关的通过换能器82的阻抗，并且通过调节与端部执行器180的速度有关的通过其中的电流，将额定功率保持在所需的水平，本发明能够对组织提供一致的功率施加，而与操作者施加的作用力无关。
由超声外科器械12所产生的功率是超声外科器械所采用的由超声外科发生器15提供的电压和电流的乘积。如图2所示，在由外科医生施加的作用力水平低于400g时，超声外科发生器15设计用于通过将输入电流保持给换能器而在超声器械12的端部执行器180处保持某个固定的振动速度。同样，由超声外科器械12的超声外科发生器15施加的电压随着由外科医生施加的作用力继续增加而成比例地增加，从而保持固定的电流。因此，直到图2中400g的点，功率连续增加。超过400g的点时，超声外科发生器15被设计用于转换到这样一种模式，其中它将某一固定的功率保持到手术刀上，并由此保持到目标组织上，与操作者施加的作用力无关。在这种模式中，当由外科医生施加的作用力增加时，电压以使电流减小的这样一种比例增加，但是功率保持同样的水平。
由于电压增加的比例的变化所产生的电流减小导致流过超声外科器械12的换能器82的电流减小，并由此导致超声器械12的端部执行器180的振动速度减小。相比于现有技术的装置，电压不是以将电流并因此将振动保持在恒定的水平的方式增加。而电压相对于电流以这样的方式增加，即将通过超声外科器械12的超声换能器82提供的功率保持在恒定水平。通过考虑所施加的作用力控制电压和电流，来实现用于保持恒定功率的机构，以便保持恒定的额定功率。通过将功率保持在恒定水平，不管所施加的作用力，通过控制通过超声外科械12的电压和电流，本发明的超声外科器械12将施加恒定的功率，而与外科医生所施加的压力无关。
同样，如上面描述的一样，根据本发明恒定功率的施加用由端布执行器180所施加的法向压力平衡端部执行器180的振动(或速度)水平。例如，当外科医生通过端部执行器180施加更大的法向作用力时，振动水平减小，并且所施加的功率水平保持恒定。如本领域技术人员将理解的那样，参照图2中的曲线，一段倾斜上升对于利用与超声外科器械12联用的本发明是必须的。如图2所示，当压力从零增加到400克力时倾斜上升发生。在这段时间，当由外科医生施加的作用力增加时，电流保持恒定，而电压增加，以补偿振动和电流减小的趋势。
一旦达到400g的作用力，调节电压和电流，以将功率保持在恒定水平。如本领域技术人员将理解的那样，功率保持恒定，在根据本发明使用的作用力特性范围内。施加的作用力超过预定的极限将导致装置故障，将警告外科医生已经到达了不可接受的作用力水平。
更具体地说，参照附图3，披露了表示一个优选操作过程的流程图。根据本发明，超声外科器械12和超声外科发生器15启动。超声外科发生器15通过其操作处理器从置于超声器械12中的存储装置读取额定驱动设定值。具体地说，读取下列设定值：无负载时的驱动电流(即，额定电流Inom)和调节成承受负载的额定功率(Pnom)(即，该器械设计用于根据本发明操作的预定功率)。
之后，由操作者确定是否要求器械激活。如果答案是NO，器械12返回到等待激活要求的激活要求状态。如果操作者要求激活器械，进行扫频，以定位器械12的谐振频率和试图以额定电流(Inom)驱动器械。超声外科发生器15然后确定是否定位谐振频率，以及器械是否能够在额定电流(Inom)下驱动。如果超声外科发生器15不能定位谐振频率或者在额定电流(Inom)下驱动手术刀，显示错误并且超声外科发生器15关闭。如果定位谐振频率并且器械在额定电流(Inom)下操作，计算出谐振频率时的手术刀阻抗(Zr)，这是通过如下公式实现的：
Zr＝V÷I
其中，I＝驱动电流(初始为Inom)，以及
V＝实现驱动电流所需的驱动电压。
该系统然后确定计算为I2×Zr的功率是否大于调节承受负载的额定功率(Pnom)。如果确定调节承受负载的额定功率(Pnom)小于I2×Zr，认为器械施加的功率过高，并且通过将驱动电流减小成I＝SQRT(Pnom/Zr)而将器械的功率减小程额定功率(Pnom)。如本领域技术人员理解的那样，通过改变驱动电压调节驱动电流。
之后，超生外科发生器15确定是否能够将锁定保持在谐振频率，并且在所需的电流下驱动。如果回答是NO，显示错误并且程序中止。如果超声外科发生器能将锁定保持在谐振频率并且在所需的电流下驱动，超生外科发生器15检查看看是否检测到停用要求，如果没有检测到停用要求，超声外科发生器15回到在谐振频率下计算手术刀阻抗(Zr)的步骤。
如果额定功率(Pnom)大于I2×Zr，保持额定驱动电流(Inom)，并且系统确定是否能够将锁定保持在谐振频率，并且在所需的电流下驱动。如果回答是NO，显示错误并且程序中止。如果回答是YES，超生外科发生器15确定是否检测到停用要求，如果没有检测到，超声外科发生器15回到在谐振频率下计算手术刀阻抗(Zr)的步骤。
在外科手术期间连续重复该过程，以保持额定所需功率水平，并且操作根据本发明的系统。通过连续地监控与操作者施加的作用力有关的通过换能器82的阻抗，将额定功率保持在所需的水平，本发明能够提供一致的功率施加，而与操作者施加的作用力无关。
尽管已经示出和描述了优选的实施例，应当理解，并不意图通过这些实施例来限制本发明，而是旨在覆盖落入本发明的精神和范围内的所有变型和可选择的结构。

Claims (8)

1.一种用于与超声外科器械一起使用的控制系统，包括：
向超声外科器械供应电能的发生器，由该发生器供应的电能受到如此的控制，即，一旦达到预定的压力阈值，就将由器械施加的功率保持恒定。
2.如权利要求1所述的控制系统，其特征为，由器械施加的功率等于由发生器产生的电流和电压的乘积。
3.如权利要求2所述的控制系统，还包括用于测量通过超声外科器械的阻抗并基于所测量到的阻抗控制功率水平的装置。
4.如权利要求3所述的控制系统，其特征为，用于控制功率水平的装置包括根据所测得的阻抗通过超声外科器械的调整电流。
5.如权利要求1所述的控制系统，其特征为，由所述发生器供应的电压随施加的力的连续增加而增大。
6.如权利要求1所述的控制系统，还包括用于测量通过超声外科器械的阻抗并基于所测量到的阻抗控制功率水平的装置。
7.如权利要求6所述的控制系统，其特征为，用于控制功率水平的装置包括根据所测得的阻抗通过超声外科器械的调整电流。
8.如权利要求1所述的控制系统，还包括用由超声外科器械施加的压力平衡该超声外科器械的震动水平的装置。
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