DE19717411A1 - Monitoring of thermal loading of patient tissue in contact region of neutral electrode of HF treatment unit - Google Patents

Monitoring of thermal loading of patient tissue in contact region of neutral electrode of HF treatment unit

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Publication number
DE19717411A1
DE19717411A1 DE1997117411 DE19717411A DE19717411A1 DE 19717411 A1 DE19717411 A1 DE 19717411A1 DE 1997117411 DE1997117411 DE 1997117411 DE 19717411 A DE19717411 A DE 19717411A DE 19717411 A1 DE19717411 A1 DE 19717411A1
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Prior art keywords
hf
current
electrode
neutral
treatment
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Ceased
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DE1997117411
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German (de)
Inventor
Roland Dipl Ing Haeberlen
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Aesculap AG
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Aesculap AG
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/05Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radiowaves
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/1206Generators therefor
    • A61B18/1233Generators therefor with circuits for assuring patient safety
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/72Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7235Details of waveform analysis
    • A61B5/7242Details of waveform analysis using integration
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • A61B18/16Indifferent or passive electrodes for grounding

Abstract

The method involves measuring the HF current flowing across the neutral electrode. A signal is produced corresponding to the square of this current. This signal during the entire treatment duration is led to an integrator for integration. The integration signal is used as a measure for the thermal loading of the tissue. The HF current flowing across the neutral electrode may be determined by a direct current measurement in the line leading from the HF treatment unit to the neutral electrode. The HF current flowing across the neutral electrode may be measured indirectly by measuring the primary side current measurement in the HF treatment unit.

Description

Die Erfindung betrifft ein Verfahren zur Überwachung der thermischen Belastung des Gewebes eines Patienten im Anlagebereich einer Neutralelektrode einer Hochfre quenzbehandlungseinrichtung sowie eine Vorrichtung zur Durchführung dieses Verfahrens. The invention relates to a method for monitoring the thermal load on the tissue of a patient in the contact area a neutral electrode of a Hochfre quenzbehandlungseinrichtung and an apparatus for performing this method.

In der Chirurgie werden Hochfrequenzbehandlungseinrich tungen verwendet, um bestimmte Bereiche des Körpers stark zu erwärmen. In surgery Hochfrequenzbehandlungseinrich obligations are used to heat certain areas of the body strong. Hochfrequenzstrom wird dabei über eine Arbeitselektrode einem bestimmten Körperbereich zugeführt, an dem die Behandlung stattfinden soll, über eine Neutralelektrode wird der Hochfrequenzstrom vom Körper wieder der Hochfrequenzeinrichtung zugeführt. High-frequency current is supplied via a working electrode a specific body region at which the treatment is to take place, via a neutral electrode of the high-frequency current is fed back to the high frequency device by the body. Während im Bereich der Arbeitselektrode der Hochfre quenzstrom eine lokale Erwärmung hervorrufen soll, ist dies im Bereich der Neutralelektrode unerwünscht. While in the area of ​​the working electrode of Hochfre local heating to cause quenzstrom, this is undesirable in the area of ​​the neutral electrode. Auf grund des Übergangswiderstandes im Anlagebereich der Neutralelektrode am Körper des Patienten ist eine Er wärmung jedoch nicht zu vermeiden und kann unter Um ständen zu unerwünschten Gewebeschädigungen führen. On the basis of the contact resistance in the contact area of ​​the neutral electrode on the patient's body is a He-heating can not be avoided and can were under order to result in undesirable tissue damage.

Um diese Erwärmung möglichst gering zu halten, ist es bereits bekannt, die Neutralelektroden großflächig aus zubilden und dadurch die Stromdichte im Anlagebereich herabzusetzen. In order to keep this heating as low as possible, it is already known to reduce the neutral electrodes over a large area from zubilden and thus the current density in the investment field.

Es ist weiterhin bekannt, die Leistung eines Hochfre quenzgerätes während der Behandlungsdauer dadurch zu bestimmen, daß die Spannung zwischen den mit dem Körper verbundenen Elektroden einerseits und der über diese Elektroden fließende Strom andererseits bestimmt wer den, so daß abhängig von dem Widerstand des in den Stromkreis eingeschalteten Gewebes die jeweils abge gebene Leistung gemessen und zur Regelung der Abgabe leistung der Hochfrequenzeinrichtung verwendet werden kann (WO95/09577). It is also known to determine the performance of a Hochfre quenzgerätes during the treatment period characterized in that the voltage between the connected to the body electrode on the one hand and the current flowing through this electrode current on the other hand determines who to, so that, depending on the resistance of the circuit switched-on fabric can be measured each abge added performance and the discharge performance of the high-frequency device control uses (WO95 / 09577). Durch dieses Verfahren ist es mög lich, Gewebeänderungen im Behandlungsbereich, bei spielsweise durch Verdampfen von Flüssigkeit, zu be rücksichtigen, die zu einer Veränderung des Ohm'schen Widerstandes des Gewebes und damit auch zu einer Verän derung der im Operationsbereich abgegebenen Leistung führen. By this method it is possible, please include, tissue changes in the treatment area, in example by evaporation of liquid to be taken into account that alteration to a change in the ohmic resistance of the tissue and thus also a modifier result of the votes in the operation area performance. Die Wärmeentwicklung im Bereich der Neutral elektrode kann dadurch in keiner Weise bestimmt oder beeinflußt werden. The heat development in the area of ​​the neutral electrode can be determined in any way or affected.

Es ist Aufgabe der Erfindung, ein Verfahren anzugeben, mit dem die thermische Belastung des Gewebes eines Pa tienten im Anlagebereich einer Neutralelektrode einer Hochfrequenzbehandlungseinrichtung bestimmt werden kann. It is an object of the invention to provide a method by which the thermal load on the tissue of a Pa can be determined tienten in the contact area of ​​a neutral electrode of a high frequency treatment device.

Diese Aufgabe wird bei einem solchen Verfahren erfin dungsgemäß dadurch gelöst, daß man den über die Neu tralelektrode fließenden HF-Strom mißt, ein dem Quadrat dieses Stromes entsprechendes Signal erzeugt, dieses Signal während der gesamten Behandlungsdauer einem In tegrator zu führt und aufintegriert und das erzeugte In tegrationssignal als Maß für die thermische Belastung des Gewebes verwendet. This object is achieved in such a process OF INVENTION dung achieved according by measuring the through the New tralelektrode flowing RF current generates a corresponding to the square of this current signal, this signal to leads during the entire duration of treatment an in integrator and integrated and the generated used in tegrationssignal as a measure of the thermal load of the fabric.

Das Integrationssignal, das in dieser Weise gewonnen wird, ist ein Maß für die Energie, die während der Be handlungsdauer im Bereich der Neutralelektrode in Wärme umgesetzt wird, denn diese Energie ergibt sich aus ei nem Produkt aus der Einschaltzeit, dem Übergangswider stand Neutralelektrode/Körpergewebe und dem Quadrat des Momentanwertes des HF-Stromes in der Neutralelektrode. which is obtained in this way, the integration signal is a measure of the energy that is converted during the loading duration of treatment in the area of ​​the neutral electrode to heat, because this energy is derived from egg nem product of the switch, the contact resistance was neutral electrode / body tissues and the square of the instantaneous value of the RF current in the neutral electrode. Dieser Momentanwert des HF-Stromes ändert sich während der Behandlungsdauer abhängig von der jeweiligen Be handlungstätigkeit und den behandelten Gewebeteilen, so daß durch eine Integration der Quadrate des sich än dernden HF-Stromes insgesamt ein Maß zur Verfügung steht für die im Bereich der Neutralelektrode während der gesamten Behandlungsdauer erzeugte Wärme. This instantaneous value of the HF-current changes during the duration of treatment depends on the loading action activity and the treated fabric parts, so that an integration of the squares of the to Su-reducing HF current total of a measure is available for the in the area of ​​the neutral electrode during the treatment period generated heat.

Der über die Neutralelektrode fließende HF-Strom kann direkt durch eine Strommessung in der Leitung bestimmt werden, die von der Behandlungseinheit zur Neutralelek trode führt. The current flowing through the neutral electrode RF current can be determined directly by measuring the current in the line leading from the treatment unit for Neutralelek trode.

Es ist aber grundsätzlich auch möglich, die Größe des über die Neutralelektrode fließenden HF-Stromes indi rekt zu bestimmen, beispielsweise durch eine Messung des HF-Stromes auf der Primärseite des HF-Stromkreises, also in der Behandlungseinheit selbst, oder durch eine Messung des zur Behandlungseinheit fließenden Versor gungsstromes, es kann sich dabei auch um einen Gleich strom handeln. However, it is also possible in principle to determine the magnitude of current flowing through the neutral electrode RF current indi rectly, for example, by measuring the high frequency current on the primary side of the RF circuit, so in the treatment unit itself, or by a measurement of the treatment unit flowing versor supply current, it can involve current and a DC.

Es ist dabei besonders vorteilhaft, wenn man das Inte grationssignal über den gesamten Behandlungszeitraum kontinuierlich reduziert. It is particularly advantageous when grationssignal reduces the Inte over the entire treatment period continuously. Diese Reduzierung entspricht einer Abkühlung im Anlagebereich der Neutralelektrode, diese Abkühlung kann durch Wärmeabstrahlung in die Um gebung, durch Wärmeabfuhr durch Körperflüssigkeiten oder durch Wärmeleitung im Körpergewebe erfolgen, sie wird während der gesamten Behandlungsdauer stattfinden, so daß es sinnvoll ist, das in der oben beschriebenen Weise erzeugte Integrationssignal während der gesamten Behandlungsdauer kontinuierlich zu erniedrigen, um die ser Abkühlung Rechnung zu tragen. This reduction corresponds to a cooling in the contact area of ​​the neutral electrode, this cooling can be accomplished by radiation of heat to the surrounding region, through heat removal by body fluids or by heat conduction in the body tissue, it will take place throughout the treatment period so that it is useful to that described in the above- decrease as integration signal generated during the treatment period continuously to carry the ser cooling bill.

Dabei kann in einer ersten Ausführungsform vorgesehen sein, daß man das Integrationssignal pro Zeiteinheit um einen gleichbleibenden Betrag reduziert, dies ent spricht der angenäherten Annahme, daß die Wärmeabfuhr im Anlagebereich der Neutralelektrode über den Zeitraum konstant erfolgt. It can be provided in a first embodiment, that reduces the integration signal per unit time by a constant amount, This corresponds to the approximate assumption that the heat dissipation in the contact area of ​​the neutral electrode is carried out over the period constant. Es kann aber auch vorgesehen sein, daß man das Integrationssignal pro Zeiteinheit um einen Betrag reduziert, der dem Integrationssignal zu Beginn der Zeiteinheit proportional ist. but it can also be provided that reduces the integration signal per unit time by an amount that is proportional to the integration signal at the beginning of the time unit. Dies würde der Tatsa che Rechnung tragen, daß die Wärmeabfuhr im Anlagebe reich der Neutralelektrode tatsächlich der erreichten Temperatur in diesem Bereich proportional ist, also hö her ausfällt, wenn die Erwärmung in diesem Bereich größer ist, und dies wird durch das Integrationssignal repräsentiert. This would take care of Tatsa che account that the heat dissipation in Anlagebe the neutral electrode of the temperature reached in this area is rich indeed proportional so forth fails hö if the warming is greater in this area, and this is represented by the integration signal.

Es kann weiterhin vorgesehen sein, daß man die Größe des dem Quadrat des HF-Stromes entsprechenden Signals und/oder die Größe des Integrationssignals während des Behandlungszeitraumes einem Datenspeicher zuführt und in bestimmten Zeitabständen speichert. It can further be provided by supplying to the size of the corresponding to the square of the RF current signal and / or the size of the integration signal during the treatment period, a data memory and stores in specific time intervals. Auf diese Weise erhält man eine vollständige Dokumentation der pro Zeiteinheit im Anlagebereich der Neutralelektrode in Wärme umgesetzten Energiemenge bzw. der Erwärmung im Anlagebereich, so daß auch am Ende des Behandlungszeit raumes diese Vorgänge exakt überprüft und reproduziert werden können. In this way, a complete documentation of the per unit implemented in the contact area of ​​the neutral electrode in amount of heat energy or heating in the contact area, so that at the end of the treatment period, these operations can be accurately verified and reproduced, space.

Günstig ist es, wenn man das Integrationssignal mit ei nem Maximalwert vergleicht und bei dessen Überschreiten eine Anzeigeeinrichtung und/oder eine Abschalteinrich tung für den HF-Strom betätigt. It is favorable when compared with the integration signal ei nem maximum value and above which a display device and / or a Abschalteinrich operated processing for the RF current. Da das Integrations signal ein Maß für die Erwärmung des Anlagebereiches ist, läßt sich dadurch sicherstellen, daß beim Errei chen einer maximalen Erwärmung in diesem Bereich die Behandlungsperson gewarnt wird oder der HF-Strom voll ständig abgeschaltet wird, um eine weitere Erwärmung zu verhindern. Since the integration signal is a measure of the heating of the bearing region, it can be ensured in that during Errei chen a maximum heating in this area, the treatment is warned or the RF power is fully constantly switched off to prevent further heating.

Die angegebene Aufgabe läßt sich durch eine Überwa chungsschaltung zur Bestimmung der thermischen Bela stung des Gewebes eines Patienten im Anlagebereich ei ner neutralen Elektrode einer Hochfrequenzbehandlungs einrichtung lösen, die gekennzeichnet ist durch eine Meßeinrichtung zur Bestimmung des über die Neutralelek trode fließenden HF-Stromes, durch eine Quadriereinheit zur Erzeugung eines dem Quadrat dieses Stromes entspre chenden Signals und durch einen Speicher zur Integra tion dieses Signals über den gesamten Behandlungszeit raum zur Erzeugung eines Integrationssignales als Maß für die thermische Belastung des Gewebes. The stated object can be achieved by a surveil monitoring circuit for determining the thermal loading stung a patient's tissue in the contact area ei ner neutral electrode of a high-frequency treatment solve device which is characterized by a measuring device for determining the current flowing HF current trode on the Neutralelek, by a squaring unit for producing a entspre the square of this current sponding signal and a memory for Integra tion of this signal over the entire treatment period for generating an integration signal as a measure of the thermal load of the fabric.

Die Größe des über die Neutralelektrode fließenden HF- Stromes kann durch eine Strommeßeinrichtung in der von der Behandlungseinheit zur Neutralelektrode führenden Leitung bestimmt werden. The size of the current flowing through the neutral electrode RF current can be determined by a current measuring device in the leading of the treatment unit to the neutral electrode lead. Bei einer abgewandelten Aus führungsform ist vorgesehen, daß diese Bestimmung des über die Neutralelektrode fließenden HF-Stromes indi rekt erfolgt, und zwar durch eine Strommeßeinrichtung in der Primärseite des HF-Stromkreises oder aber durch eine Strommeßeinrichtung in der zur Behandlungseinheit führenden Versorgungsleitung. In an alternative imple mentation, it is provided that this determination of the current flowing through the neutral electrode RF current indi carried rectly, through a current measuring device in the primary side of the RF circuit or by a current measuring device in the leading to the treatment unit supply line.

Es ist dabei vorteilhaft, wenn dem Speicher eine Spei cherabflußsteuerung zugeordnet ist, die das Intregra tionssignal über den gesamten Behandlungszeitraum kon tinuierlich reduziert. It is advantageous if the memory is a SpeI cherabflußsteuerung assigned, which reduces the Intregra tion signal over the entire treatment period kon continuously.

Gemäß einer bevorzugten Ausführungsform kann die Spei cherabflußsteuerung dabei das Intregrationssignal pro Zeiteinheit um einen gleichbleibenden Betrag reduzieren oder aber bevorzugt um einen Betrag, der dem Integrati onssignal zu Beginn der Zeiteinheit proportional ist. According to a preferred embodiment, the SpeI can cherabflußsteuerung thereby reduce the Intregrationssignal per unit time by a constant amount, or preferably by an amount which is the Integrati onssignal proportional to the beginning of the time unit.

Die Überwachungsschaltung kann gemäß einer bevorzugten Ausführungsform durch einen Datenspeicher gekennzeich net sein, der der Quadriereinheit und/oder dem Speicher zugeordnet ist und der die Größe des dem Quadrat des HF-Stromes entsprechenden Signals und/oder die Größe des Integrationssignales während des Behandlungszeit raumes in bestimmten Zeitabständen speichert. The monitoring circuit may be net gekennzeich according to a preferred embodiment, by a data store associated with the squarer and / or the memory and the space, the size of the corresponding to the square of the RF current signal and / or the size of the integration signal during the time of treatment in certain intervals stores.

Weiterhin kann eine Vergleichseinheit vorgesehen sein, die das Integrationssignal mit einem Maximalwert ver gleicht und bei dessen Überschreiten eine Anzeigeein richtung und/oder eine Abschalteinrichtung für den HF- Strom betätigt. Furthermore, a comparison unit can be provided which is similar to ver the integration signal with a maximum value and when it is exceeded a Anzeigeein direction and / or a switch-off device for the RF power actuated.

Die nachfolgende Beschreibung einer bevorzugten Ausfüh rungsform der Erfindung dient im Zusammenhang mit der Zeichnung der näheren Erläuterung. The following description of a preferred exporting approximately of the invention serves in conjunction with the drawings for a more detailed explanation. Die Zeichnung zeigt schematisch eine Überwachungsschaltung zur Bestimmung der thermischen Belastung des Gewebes eines Patienten im Anlagebereich einer Neutralelektrode. The drawing shows schematically a monitoring circuit for determining the thermal load on the tissue of a patient in the contact area of ​​a neutral electrode.

Eine Hochfrequenz-Behandlungseinheit 1 weist zwei An schlüsse 2 , 3 auf. A high-frequency treatment unit 1 has two connections to 2, 3. An den ersten Anschluß 2 ist über einen Antifaradisationskondensator 4 ein HF-Behand lungsgerät 5 angeschlossen, beispielsweise eine Haken elektrode, der zweite Anschluß 3 steht mit einer Neu tralelektrode 6 in Verbindung, die großflächig ausge bildet ist und an den Körper eines Patienten 7 flächig angelegt ist, es kann sich dabei um bekannte folienför mige Elektroden handeln. To the first terminal 2, an RF treatmen is a Antifaradisationskondensator 4 lung machine is connected 5, such as electrode a hook, the second terminal 3 is connected, which forms a large area out with a New tralelektrode 6 and applied flat against the body of a patient 7 , it can involve known to folienför-shaped electrodes.

Bei der Behandlung eines Patienten wird das Behand lungsgerät 5 mit seinem Elektrodenbereich an das zu be handelnde Gewebe des Patienten herangeführt, so daß der Patient 7 in den Hochfrequenzstromkreis eingeschaltet wird, Hochfrequenzstrom fließt dann von der Behand lungseinheit 1 über das Behandlungsgerät 5 , die behan delten Gewebebereiche und andere Gewebebereiche des Patienten zu der Neutralelektrode 6 zurück zur Behand lungseinheit 1 . In the treatment of a patient, the treatmen is development device 5 with its electrode portion to the to be acting tissue of the patient introduced, so that the patient is switched to the high-frequency circuit 7, high-frequency current then flows from the treatmen averaging unit 1 via the treatment device 5, the behan punched areas of tissue and other tissue regions of the patient to the return electrode 6 back to treatmen averaging unit. 1 Im Behandlungsbereich sollen hohe Stromdichten erreicht werden, da durch Wärmeentwicklung das Gewebe behandelt wird, im Bereich der Neutralelek trode 6 hingegen, in der eine solche Erwärmung vermie den werden soll, wird durch großflächige Ausbildung der Elektroden versucht, die Stromdichte niedrig zu halten. In the treatment area high current densities to be achieved, since the fabric is treated by heat, trode in the Neutralelek 6, however, in such heating vermie to be, an attempt by large-scale formation of the electrodes to keep the current density low.

In die Leitung 8 zwischen Neutralelektrode 6 und An schluß 3 ist eine Meßeinrichtung 9 zur Messung des Ef fektiv-HF-Stromes in der Leitung 8 eingeschaltet. In the conduit 8 between the neutral electrode 6 and at 3 a measuring circuit 9 is turned on to measure the ef fectively RF current in the line. 8 Diese erzeugt ein dem Effektivstrom proportionales elektri sches Signal, das über eine Leitung 10 einer Quadrier einheit 11 zugeführt wird. This produces a proportional to the rms current electrical signals are available, which is supplied via a line 10 to a squaring device. 11 Diese erzeugt ein dem Qua drat des gemessenen effektiven HF-Stromes entsprechen des elektrisches Signal und führt dies über eine Lei tung 12 einer Speicherzuflußsteuerung 13 zu. This produces a hydrate of the Qua measured effective high frequency current corresponding to the electric signal, and this leads to a Lei tung 12 of a Speicherzuflußsteuerung. 13 Diese wird von einem Zeitgeber 14 über eine Leitung 15 angesteuert und diese bestimmt für einen bestimmten kurzen Zeitraum Δt, der beispielsweise 100 ms betragen kann, einen für diesen kurzen Zeitraum Δt repräsentativen Wert des von der Quadriereinheit 11 gelieferten Signals. This is activated and by a timer 14 via a line 15, this is determined for a given short period of time At, which may be, for example, 100 ms, a representative for this short period .DELTA.t value supplied from the squaring unit 11 signal.

Da sich der Wert des HF-Effektivstroms während der Be handlung stark ändern kann, ist es notwendig, für klei ne Zeiteinheiten einen solchen repräsentativen Wert zu bestimmen, dies kann beispielsweise dadurch geschehen, daß im Zeitraum Δt über alle anfallenden Werte des qua drierten HF-Effektivstromes integriert wird, so daß die Speicherzuflußsteuerung ein Signal erzeugt, welches ein Maß für die Energie ist, die im Zeitraum Δt im Bereich der Neutralelektrode in Wärme umgesetzt wird. Since the value of the RF-effective current can change substantially during the loading action, it is necessary to determine such a value representative of klei ne units of time, this can for example be done by the period .DELTA.t any applicable values ​​of the qua drierten RF effective current is integrated, so that the Speicherzuflußsteuerung generates a signal which is a measure of the energy that is implemented in the period .DELTA.t in the area of ​​the neutral electrode to heat.

Diese Einzelsignale werden über eine Leitung 16 einem integrierenden Speicher 17 zugeführt, der diese pro Zeiteinheit Δt umgesetzten Wärmemengen über den gesam ten Behandlungszeitraum auf integriert und somit ein In tegrationssignal erzeugt, welches ein Maß für die durch den HF-Strom im Bereich der Neutralelektrode in Wärme umgesetzte Energie bildet. These individual signals are fed via a line 16 to an integrating memory 17 of this per unit of time .DELTA.t unreacted amounts of heat over the GESAM th processing period to be integrated and thus generates a In tegrationssignal, which is a measure for by the RF current in the range of the neutral electrode in heat is converted energy.

Der integrierende Speicher 17 ist über eine Leitung 18 mit einer Speicherabflußsteuerung 19 verbunden, die ih rerseits über eine Leitung 20 mit dem Zeitgeber 14 in Verbindung steht. The integrating memory 17 is connected via a line 18 to a storage discharge control 19, which ih hand, is connected via a line 20 to the timer fourteenth Der Zeitgeber 14 steuert die Spei cherabflußsteuerung 19 derart, daß diese pro Zeitein heit das Integrationssignal des integrierenden Spei chers 17 um einen bestimmten Betrag erniedrigt, dies kann ein für jede Zeiteinheit gleicher Betrag sein, dieser Betrag kann aber auch der jeweiligen Größe des Integrationssignales proportional sein. The timer 14 controls the SpeI cherabflußsteuerung 19 so that these per SET TIME standardize the integration signal of the integrating SpeI Chers 17 by a certain amount is lowered, this can be a same for each unit time amount, but this amount may be proportional also the respective size of the integration signal , Diese Reduzie rung des Integrationssignales ist ein Maß dafür, wie im Bereich der Neutralelektrode erzeugte Verlustwärme in die Umgebung abgegeben wird, sei es durch Abstrahlung, durch Wärmeleitung über das Körpergewebe oder durch Konvektion in der umgebenden Luft. This Reduzie tion of the integration signal is a measure of heat loss generated as in the area of ​​the neutral electrode is discharged into the environment, either by radiation, by heat conduction through the body tissue or by convection in the surrounding air.

Durch die Speicherabflußsteuerung wird also das Inte grationssignal korrigiert, so daß es tatsächlich dem Erwärmungsverhalten im Bereich der Neutralelektrode 6 entspricht, so daß ein niedriges Integrationssignal auf eine geringe resultierende Erwärmung hindeutet, ein großes Integrationssignal dagegen auf eine große resul tierende Erwärmung. By the memory discharge control so the Inte is corrected grationssignal so that it actually corresponds to the heating behavior in the area of the neutral electrode 6 so that a low integration signal, however indicating little resulting warming, a large integration signal to a great resul animal-border warming.

Das in dieser Weise erzeugte und gegebenenfalls durch die Speicherabflußsteuerung korrigierte Integrations signal wird über eine Leitung 21 einer Anzeigeeinrich tung 22 zugeführt, in der das Integrationssignal mit einem fest vorgegebenen Maximalsignal verglichen wird. The produced in this manner and possibly corrected by the memory discharge control integration signal is supplied to 22 in which the integration signal is compared to a fixed predetermined maximum signal processing via a line 21 a Anzeigeeinrich. Wenn das Integrationssignal diesen Maximalwert über steigt, wird die Anzeigeeinrichtung 22 aktiviert, die dann Warnsignale abgibt oder die Behandlungseinheit 1 abschaltet oder in der abgegebenen Leistung reduziert. When the integration signal rises above this maximum value, the indicator device 22 is activated, which then emits warning signals or switches off the treatment unit 1 or reduction in the power output.

Mit dem Ausgang der Speicherzuflußsteuerung 13 und mit dem integrierenden Speicher 17 ist ein Dokumentations speicher 23 verbunden, der die von der Speicherzufluß steuerung dem integrierenden Speicher 17 zugeführten Signale in Abhängigkeit von der Behandlungszeit spei chert und der außerdem die jeweilige Größe des im inte grierenden Speicher 17 erzeugten Integrationssignales während der Behandlungszeit speichert. To the output of Speicherzuflußsteuerung 13 and to the integrated memory 17 a documentation memory 23 is connected to the control from the Speicherzufluß the integrating memory chert 17 supplied signals as a function of the treatment time SpeI and also the respective size of the grier forming the inte memory 17 integration signal generated during the treatment time stores. Im Dokumenten speicher ist somit der gesamte Behandlungsablauf nach prüfbar, und zwar einerseits durch die einzelnen pro Zeiteinheit Δt über die Neutralelektrode fließenden Energiepakete und zum anderen hinsichtlich der durch das Integrationssignal repräsentierten Gesamterwärmung. Thus, in the document store the entire treatment process to be tested, on the one hand by the individual per unit of time .DELTA.t current flowing through the neutral electrode packets of energy and on the other with respect to the total represented by the integration signal warming. Es ist dadurch überprüfbar, ob beispielsweise eine Schädigung des Gewebes im Anlagebereich der Neutral elektrode 6 auf eine zu hohe Erwärmung zurückzuführen ist oder auf andere Effekte, beispielsweise auf eine Drucknekrose oder auf eine chemische Verätzung. It is therefore to check whether, for example, tissue damage in the contact area of the neutral electrode is due 6 to excessive heating or other effects, for example to a pressure necrosis or chemical burn hazard.

Die beschriebene Überwachungsschaltung kann auch wäh rend der Behandlungspausen weiterbetrieben werden. The monitoring circuit described can also currency rend continue to operate the treatment breaks. In dieser Zeit ist der gemessene HF-Strom Null, es werden also über die Speicherzuflußsteuerung keine Signale dem integrierenden Speicher 17 zugeführt, die das Integra tionssignal erhöhen könnten jedoch wird über die Spei cherabflußsteuerung weiterhin das Integrationssignal entsprechend der Abkühlung des Anlagebereichs der Neu tralelektrode reduziert, so daß damit die wirklichen Verhältnisse im Anlagebereich reproduziert werden. In this time, the measured RF current is zero, so there is no signals are supplied to the integrating memory 17 via the Speicherzuflußsteuerung, which could increase the Integra tion signal, however, is tralelektrode reduced over the SpeI further cherabflußsteuerung the integration signal corresponding to the cooling of the system area of the New, so that so that the actual conditions are reproduced in the investment field. Wenn nach einer längeren Behandlungspause erneut behandelt wird, ist der Anlagebereich abgekühlt, und dies spie gelt sich darin wider, daß das Integrationssignal im integrierenden Speicher 17 einen Minimalwert erreicht hat, der von der Speicherabflußsteuerung nicht weiter erniedrigt werden kann. When treated again after a long interval, the plant area is cooled, and this spat gelt in it contradicts that the integration signal reaches a minimum value in the integrated memory 17, which can not be further lowered from the memory discharge control.

Claims (18)

  1. 1. Verfahren zur Überwachung der thermischen Bela stung des Gewebes eines Patienten im Anlagebe reich einer Neutralelektrode einer Hochfrequenz behandlungseinrichtung, dadurch gekennzeichnet , daß man den über die Neutralelektrode fließenden HF-Strom mißt, ein dem Quadrat dieses Stromes entsprechendes Signal erzeugt, dieses Signal wäh rend der gesamten Behandlungsdauer einem Integra tor zu führt und aufintegriert und das erzeugte Integrationssignal als Maß für die thermische Be lastung des Gewebes verwendet. 1. A method of monitoring the thermal loading stung of the tissue of a patient in Anlagebe reaching a neutral electrode of a high-frequency treatment device, characterized in that one measures the current flowing through the neutral electrode RF power, generates a corresponding to the square of this current signal, this signal currency rend the entire treatment period Integra goal and to an integrated and the integration signal generated as a measure of the thermal load on the loading fabric.
  2. 2. Verfahren nach Anspruch 1, dadurch gekennzeich net, daß man den über die Neutralelektrode flie ßenden HF-Strom durch eine direkte Strommessung in der von der Hochfrequenzbehandlungseinrichtung zur Neutralelektrode führenden Leitung bestimmt. 2. The method according to claim 1, characterized in that one determines the sequent RF current flowing through the neutral electrode through a direct current measurement in the leading of the high-frequency treatment device to the neutral electrode lead.
  3. 3. Verfahren nach Anspruch 1, dadurch gekennzeich net, daß man den über die Neutralelektrode flie ßenden HF-Strom auf indirekte Weise durch eine primärseitige Strommessung in der Hochfrequenzbe handlungseinrichtung bestimmt. 3. The method according to claim 1, characterized in that one determines the sequent RF current flowing through the neutral electrode in an indirect way by a primary-side current measurement in the Hochfrequenzbe treatment device.
  4. 4. Verfahren nach Anspruch 1, dadurch gekennzeich net, daß man den über die Neutralelektrode flie ßenden HF-Strom indirekt durch eine Messung des zur Hochfrequenzbehandlungseinrichtung fließenden Versorgungsstromes bestimmt. 4. The method according to claim 1, characterized in that it indirectly determines the sequent RF current flowing through the neutral electrode, by measuring the current flowing to the high-frequency treatment device supply current.
  5. 5. Verfahren nach einem der voranstehenden Ansprü che, dadurch gekennzeichnet, daß man das Integra tionssignal über den gesamten Behandlungszeitraum kontinuierlich reduziert. 5. The method according to any one of the preceding Ansprü surface, characterized in that signal tion reduces the Integra over the entire treatment period continuously.
  6. 6. Verfahren nach Anspruch 5, dadurch gekennzeich net, daß man das Integrationssignal über den ge samten Behandlungszeitraum pro Zeiteinheit um ei nen gleichbleibenden Betrag reduziert. 6. The method according to claim 5, characterized in that one reduces the integration signal via the ge entire treatment period per unit time to ei NEN constant amount.
  7. 7. Verfahren nach Anspruch 5, dadurch gekennzeich net, daß man das Integrationssignal über den ge samten Behandlungszeitraum pro Zeiteinheit um ei nen Betrag reduziert, der dem Integrationssignal zu Beginn der Zeiteinheit proportional ist. 7. The method according to claim 5, characterized in that one reduces the integration signal via the ge entire treatment period per unit time to ei NEN amount that is proportional to the integration signal at the beginning of the time unit.
  8. 8. Verfahren nach einem der voranstehenden Ansprü che, dadurch gekennzeichnet, daß man die Größe des dem Quadrat des HF-Stromes entsprechenden Si gnals und/oder die Größe des Integrationssignals während des Behandlungszeitraumes einem Daten speicher zuführt und in bestimmten Zeitabständen speichert. 8. The method according to any one of the preceding Ansprü surface, characterized by supplying to the size of the corresponding to the square of the HF current Si gnals and / or the size of the integration signal during the treatment period, a data memory and stores in specific time intervals.
  9. 9. Verfahren nach einem der voranstehenden Ansprü che, dadurch gekennzeichnet, daß man das Integra tionssignal mit einem Maximalwert vergleicht und bei dessen Überschreiten eine Anzeigeeinrichtung und/oder eine Abschalteinrichtung für den HF- Strom betätigt. 9. The method according to any one of the preceding Ansprü che, characterized in that one compares the Integra tion signal with a maximum value and above which a display device and / or a switch-off device for the RF power actuated.
  10. 10. Überwachungsschaltung zur Bestimmung der thermi schen Belastung des Gewebes eines Patienten im Anlagebereich einer Neutralelektrode einer Hoch frequenzbehandlungseinrichtung, gekennzeichnet durch eine Meßeinrichtung ( 9 ) zur Bestimmung des über die Neutralelektrode ( 6 ) fließenden HF-Stro mes, durch eine Quadriereinheit ( 11 ) zur Erzeu gung eines dem Quadrat dieses Stromes entspre chenden Signals, durch einen Speicher ( 17 ) zur Integration dieses Signals über den gesamten Be handlungszeitraum zur Erzeugung eines Integrati onssignals als Maß für die thermische Belastung des Gewebes. 10. Monitoring circuit for determining the thermi's load on the tissue of a patient in the contact area of a neutral electrode of a high-frequency treatment device, characterized by measuring means (9) for determining on the neutral electrode (6) flowing RF Stro mes, by a squaring unit (11) for Erzeu supply of the square of this current signal entspre sponding, by a memory (17) for the integration of that signal throughout the entire treatment period Be for generating a onssignals Integrati as a measure of thermal loading of the tissue.
  11. 11. Überwachungsschaltung nach Anspruch 10, dadurch gekennzeichnet, daß die Meßeinrichtung ( 9 ) eine Strommeßeinrichtung ist, die in die Leitung ( 8 ) zwischen Neutralelektrode ( 6 ) und Behandlungsein heit ( 1 ) eingeschaltet ist. 11. Monitoring circuit according to claim 10, characterized in that the measuring device (9) is a current measuring device which in the line (8) between the neutral electrode (6) and Behandlungsein unit (1) is turned on.
  12. 12. Schaltung nach Anspruch 10, dadurch gekennzeich net, daß die Meßeinrichtung zur Bestimmung des über die Neutralelektrode ( 6 ) fließenden HF-Stro mes eine direkte Meßeinrichtung ist, die den pri märseitig in der Hochfrequenz-Behandlungseinheit ( 1 ) fließenden Strom bestimmt. 12. The circuit according to claim 10, characterized in that the measuring device for determining on the neutral electrode (6) flowing RF biasing current is a direct measuring device, which determines the pri märseitig in the high-frequency treatment unit (1) flowing stream.
  13. 13. Schaltung nach Anspruch 10, dadurch gekennzeich net, daß die Meßeinrichtung zur Bestimmung des über die Neutralelektrode ( 6 ) fließenden HF-Stro mes durch eine indirekte Strommeßeinrichtung ge bildet wird, die in die Stromversorgungsleitung der Hochfrequenz-Behandlungseinheit ( 1 ) einge schaltet ist. 13. The circuit according to claim 10, characterized in that the measuring current flowing to determine via the neutral electrode (6) RF Stro forms mes ge by an indirect current measuring device is, the switches in the power supply line of the high-frequency treatment unit (1) inserted is ,
  14. 14. Schaltung nach einem der Ansprüche 10 bis 13, da durch gekennzeichnet, daß dem Speicher ( 17 ) eine Speicherabflußsteuerung ( 19 ) zugeordnet ist, die das Intregrationssignal über den gesamten Behand lungszeitraum kontinuierlich reduziert. 14. The circuit according to one of claims 10 to 13, as by in that the memory (17) a memory discharge control (19) is associated, which continuously reduces the Intregrationssignal over the entire treatmen averaging period.
  15. 15. Schaltung nach einem der Ansprüche 12 bis 14, da durch gekennzeichnet, daß die Speicherabflußsteu erung ( 19 ) das Intregrationssignal pro Zeitein heit um einen gleichbleibenden Betrag reduziert. 15. A circuit according to any one of claims 12 to 14, as characterized by, that the augmentation Speicherabflußsteu (19) reduces the Intregrationssignal per SET TIME standardized to a constant amount.
  16. 16. Schaltung nach einem der Ansprüche 12 bis 14, da durch gekennzeichnet, daß die Speicherabflußsteu erung ( 19 ) das Intregrationssignal pro Zeitein heit um einen Betrag reduziert, der dem Integra tionssignal zu Beginn der Zeiteinheit proportio nal ist. 16. A circuit according to any one of claims 12 to 14, as characterized by, that the augmentation Speicherabflußsteu (19) reduces the Intregrationssignal per SET TIME integrated by an amount which is the Integra tion signal at the beginning of the time unit proportio nal.
  17. 17. Schaltung nach einem der Ansprüche 12 bis 16, ge kennzeichnet durch einen Datenspeicher ( 23 ), der der Quadriereinheit ( 11 ) und/oder dem Speicher ( 17 ) zugeordnet ist und der die Größe des dem Quadrat des HF-Stromes entsprechenden Signals und/oder die Größe des Integrationssignals wäh rend des Behandlungszeitraumes in bestimmten Zeitabständen speichert. 17. A circuit according to any one of claims 12 to 16, characterized by at a data memory (23) associated with the squarer (11) and / or the memory (17) and the size of the corresponding to the square of the RF current signal and the treatment period stores / or the size of the integration signal currency rend at certain time intervals.
  18. 18. Schaltung nach einem der Ansprüche 12 bis 17, ge kennzeichnet durch eine Vergleichseinheit ( 22 ), die das Integrationssignal mit einem Maximalwert vergleicht und bei dessen Überschreiten eine An zeigeeinrichtung und/oder eine Abschalteinrich tung für den HF-Strom betätigt. 18. A circuit according to any one of claims 12 to 17, characterized by at a comparison unit (22) which compares the integration signal with a maximum value and when it is exceeded pointing device an on and / or a Abschalteinrich operated processing for the RF current.
DE1997117411 1997-04-25 1997-04-25 Monitoring of thermal loading of patient tissue in contact region of neutral electrode of HF treatment unit Ceased DE19717411A1 (en)

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