DE2540968C2 - Einrichtung zum Einschalten des Koagulationsstroms einer bipolaren Koagulationspinzette - Google Patents
Einrichtung zum Einschalten des Koagulationsstroms einer bipolaren KoagulationspinzetteInfo
- Publication number
- DE2540968C2 DE2540968C2 DE19752540968 DE2540968A DE2540968C2 DE 2540968 C2 DE2540968 C2 DE 2540968C2 DE 19752540968 DE19752540968 DE 19752540968 DE 2540968 A DE2540968 A DE 2540968A DE 2540968 C2 DE2540968 C2 DE 2540968C2
- Authority
- DE
- Germany
- Prior art keywords
- coagulation
- current
- forceps
- relay
- switching
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/1206—Generators therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/0066—Sensing and controlling the application of energy without feedback, i.e. open loop control
Landscapes
- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
- Life Sciences & Earth Sciences (AREA)
- Biomedical Technology (AREA)
- Otolaryngology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Plasma & Fusion (AREA)
- Physics & Mathematics (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Description
Die Erfindung betrifft eine Einrichtung zum Einschalten des Koagulationsstroms einer bipolaren Koagulationspinzette
mit elektrisch gegeneinander isolierten Armen, sowie mit einem elektronischen Relais zum
selbsttätigen Einschalten eines Hochfrequenzgenerators bei Berührung des Patienten zur Erzeugung des
Koagulationsstroms.
Legt man an die beiden Arme einer derartigen bipolaren Koagulationspinzette eine geeignete elektrische
Spannung an, so fließt ein Strom durch das zwischen den Pinzettenspitzen eingeklemmte, zu koagulierende
biologische Gewebe. In der chirurgischen Praxis können damit dünne Blutgefäße und kleine Gewebeteile beispielsweise
unter einem Operationsmikroskop koaguliert werden. Als Spannungsquelle für die Erzeugung
des Koagulationsstroms werden vorzugsweise Hochfrequenzgeneratoren verwandt, um Reizungen nervöser
Zellen zu vermeiden.
Zum Einschalten beziehungsweise Ausschalten des hochfrequenten Koagulationsstroms durch den Chirurgen
wird üblicherweise ein Fußschalter vorgesehen. Dadurch ist die Möglichkeit gegeben, daß vor dem Einschalten
des Fußschalters der Chirurg das zu koagulierende Gewebe mit der Koagulatiorispinzette präparieren
kann. Dabei wird jedoch als nachteilig angesehen, daß insbesondere bei einer Koagulation im Bereich der
Mik/ochirurgie unter dem Operationsmikroskop für den Chirurgen die Schwierigkeit besteht, den Fußschalter
unter dem Operationstisch mit dem Fuß suchen zu müssen. Um diesen Nachteil zu vermeiden, ist es bereits
bekannt (DE-OS 20 19 891), zwischen den beiden elektrisch isolierten Armen der bipolaren Koagulationspinzette
einen manuell schließbaren Schalter vorzusehen, um über einen niederfrequenten Schaltstromkreis den
Hochfrequenzgenerator zur Erzeugung des Koagulationsstroms einschalten zu können. Dabei wird als nachteilig
angesehen, daß bei nicht beabsichtigten, kurzzeitigen Berührungen der Pinzettenspitzen oder bei Berührungen
eines Leiters mit den Spitzen ein Kurzschlußstrom auftreten kann, durch den die empfindlichen Spit-
s zen beschädigt werden können, und daß die erforderliche Betätigung des Fingerschalters bei Durchführung
einer Koagulation störend sein kann. Insbesondere ist es bei einer bipolaren Koagulationspinzette mit einem
derartigen Schalter nur durch eine manuelle Zwei-Stufen-Betätigung möglich, die Pinzette vor der Koagulation
zum Präparieren des zu koagulierenden Gewebes zu verwenden.
Bei fclektrochirurgischen Geräten zur Elektrokoagu-1
ation, bei denen eine an eine Klemme des Hochfrequenzgenerators angeschlossene aktive Elektrode und
eine an die andere Klemme angeschlossene inaktive Elektrode vorgesehen sind, ist es ferner bekannt, den
Koagulationsstrom durch Betätigung einer Kippschaltung erst dann einzuschalten, wenn sich die aktive Elek-
trode in vollständigem Kontakt mit dem Körper des Patienten befindet und der Widerstand zwischen der monopolaren
Elektrode und dem Patienten kleiner als ein vorher eingestellter Grenzwert eines Widerstands ist
(DE-AS 11 46 989). Ein derartiges Chirurgiegerät ist je-
doch nicht ohne weiteres in Verbindung mit einer bipolaren Koagulationspinzette geeignet, weil dann wie im
oben genannten Fall bei einer Berührung der Pinzettenspitzen ein Kurzschlußstrom auftreten würde. Insbesondere
köruite damit nicht präpariert werden, weil beim
Präparieren in vielen Fällen das Gewebe verhältnismäßig stark zwischen den Pinzettenspitzen eingeklemmt
wird, so daß eine unerwünschte Auslösung des Koagulationsstroms während des Präparierens verursacht werden
könnte. Auch andere bekannte Einschaltvorrichtungen für monopolare Elektrodenanordnungen (GB-PS
8 97 961 und US-PS 28 27 056) sind nicht ohne weiteres dazu geeignet, Einschaltprobleme der genannten Art zu
vermeiden. Es ist deshalb Aufgabe der Erfindung, eine Einrichtung der eingangs genannten Art zum Einschal-
ten des Koagulationsstroms einer bipolaren Koagulationspinzette unter möglichst weitgehender Vermeidung
der genannten Nachteile und Schwierigkeiten derart zu verbessern, daß es möglich ist, vor dem selbsttätigen
Einschalten des Koagulationsstroms Präparierar-
beiten durchzuführen, ohne daß die Gefahr besteht, daß durch einen Kurzschlußstrom Personen verletzt oder
Gegenstände beschädigt werden.
Diese Aufgabe wird bei einer Einrichtung der eingangs genannten Art zum Einschalten des Koagula-
tionsstroms einer bipolaren Koagulationspinzette dadurch
gelöst, daß das Einschalten durch das Relais mit einer vorherbestimmten Verzögerungszeit erfolgt. Vorzugsweise
sind an dem Relais unterschiedliche Verzögerungszeiten einstellbar, wodurch sich der Vorteil ergibt,
daß eine individuellen Bedürfnissen entsprechende Verzögerungszeit
eingestellt werden kann. In vorteilhafter Weiterbildung der Erfindung schaltet das Relais den
Koagulationsstrom nur dann ein, wenn der elektrische Widerstand zwischen den beiden Armen der Koagulationspinzette
beim Berühren des zu koagulierenden Gewebes in einem vorherbestimmten Widerstandsbereich
liegt.
Da in weiterer Ausgestaltung der Erfindung das Relais nach jeder Unterbrechung der Berührung des Ge-
webes mit den Spitzen der bipolaren Koagulationspinzette die Verzögerungszeit neu beginnen kann, ergibt
sich weiterhin der Vorteil, daß der Chirurg gewünschtenfalls beliebig lange präparieren kann, weil die Koa-
gulation erst beginnt, wenn das zu koaguherende Gewebe
ununterbrochen während der eingestellten Verzögerungszeit zwischen den Spitzen der Pinzette gehalten
wird. Gegenüber der Verwendung eines manuell betätigbaren
Schalters an der Pinzette ergibt sich ferner der Vorteil, daß eine derartige Pinzette einfacher hergestellt
und gereinigt werden kann. ....
Anhand der Zeichnung soll die Erfindung beispielsweise näher erläutert werden. Es zeigen
F i g. 1 eine schematische Darstellung einer schaltung
für eine Koagulationspinzette; und
F i g. 2 eine graphische Darstellung zur Erläuterung der Wirkungsweise des Verzögerungsrelais.
Bei dem in Fig. 1 dargestellten Ausführungsbeispiel ist zwischen den Spitzen einer Pinzette 1 Gewebe 2 eingeklemmt
Die beiden Arme der Pinzette sind in an sich
bekannter Weise durch ein nicht dargestelltes Isolierstück elektrisch gegeneinander isoliert An die Arme ist
über ein zweiadriges Kabel sowohl ein Verzögerungsrelais 4 über ein Tiefpaßfilter, als auch ein Hochfrequenzgenerator
5 über ein Hochpaßfilter angeschlossen. Durch das Hochpaßfilter und das Tiefpaßfilter sind der
hochfrequente Koagulationsstrom und der niederfrequente Strom des elektrischen Verzögerungsrelais gegeneinander
entkoppelt
Im folgenden soll die Arbeitsweise einer derartigen Koagulationspinzette in Verbindung mit Fig.2 näher
erläutert werden.
Berühren im Zeitpunkt ίο die beiden Spitzen der Pinzette
das elektrisch leitende Gewebe 2, so kann ab dem Zeitpunkt ίο ein niederfrequenter elektrischer Strom
aus dem elektronischen Relais 4 über das Gewebe 2 ßie-
ßen. Bleiben die Spitzen der Pinzette ί mit dem Gewebe
2 in elektrisch leitendem Kontakt, so erzeugt das elektronische Verzögerungsrelais 4 nach Ablauf einer
Verzögerungszeit f ι ein Signal, das den Hochfrequenzgenerator
5 im Zeitpunkt t \ einschaltet und so lange eingeschaltet hält, bis die Pinzettenspitzen vom Gewebe 2
entfernt werden und der Stromfluß aus dem Verzögerungsrelais 4 zum Zeitpunkt t^ unterbrochen wird Die
Verzögerungszeit 11 wird nach jedem erneuten Berühren
des Gewebes mit den Spitzen der Pinzette 1 in vol-.ler
Dauer abgemessen, so daß auch nach mehrmaligem kurzem Berühren des Gewebes 2 mit der Spitze der Pinzette
der Hochfrequenzgenerator nur dann eingeschaltet wird, wenn diese Berührung ohne Unterbrechung
mindestens so lange wie die eingestellte Verzögerungszeit andauert
Durch Verwendung eines Tiefpaßfilters und eines Hochpaßfilters kann erreicht werden, daß der Koagulationsstrom
nach Ablauf der Verzögerungszeit nur dann eingeschaltet wird, wenn ein Widerstandswert zwischen
den Spitzen der Arme der Pinzette innerhalb eines vorherbestimmten Bereichs vorhanden ist, der
durch in der Praxis zu erwartende "Widerstandswerte des koagulierenden Gewebes bestimmt werden kann.
Als Verzögerungsrelais können ferner an sich bekannte Relais Verwendung finden, deren Verzögeningszeit verstellbar
ist, so daß eine für den speziellen Verwendungszweck bevorzugte Verzögerungszeit eingestellt werden
kann. Ferner kann an dem Hochfrequenzgenerator eine Anzeigeeinrichtung vorgesehen sein, welche das
Fließen eines Koagulationsstroms anzeigt
Hierzu 1 Blatt Zeichnungen
Claims (4)
1. Einrichtung zum Einschalten des Koagulationsstroms
einer bipolaren Koagulationspinzette mit elektrisch gegeneinander isolierten Armen, sowie
mit einem elektronischen Relais zum selbsttätigen Einschalten eines Hochfrequenzgenerators bei Berührung
des Patienten zur Erzeugung des Koagulationsstroms, dadurch gekennzeichnet, daß das Einschalten durch das Relais (4) mit einer
vorherbestimmten Verzögerungszeit (f i) erfolgt.
2. Einrichtung nach Anspruch 1, dadurch gekennzeichnet,
daß an dem Relais unterschiedliche Verzögerungszeiten einstellbar sind.
3. Einrichtung nach Anspruch 1 oder 2, dadurch gekennzeichnet, daß das Relais den Koagulationsstrom nur dann einschaltet, wenn der elektrische
Widerstand zwischen den beiden Armen der Koagulationspinzette beim Berühren des zu koagulierenden
Gewebes in einem vorherbestimmten Widerstandsbereich liegt
4. Einrichtung nach einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, daß das Relais
nach jeder Unterbrechung der Berührung des Gewebes mit den Spitzen der bipolaren Koagulationspinzette die Verzögerungszeit neu beginnt
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE19752540968 DE2540968C2 (de) | 1975-09-13 | 1975-09-13 | Einrichtung zum Einschalten des Koagulationsstroms einer bipolaren Koagulationspinzette |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE19752540968 DE2540968C2 (de) | 1975-09-13 | 1975-09-13 | Einrichtung zum Einschalten des Koagulationsstroms einer bipolaren Koagulationspinzette |
Publications (2)
Publication Number | Publication Date |
---|---|
DE2540968A1 DE2540968A1 (de) | 1977-03-17 |
DE2540968C2 true DE2540968C2 (de) | 1982-12-30 |
Family
ID=5956445
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE19752540968 Expired DE2540968C2 (de) | 1975-09-13 | 1975-09-13 | Einrichtung zum Einschalten des Koagulationsstroms einer bipolaren Koagulationspinzette |
Country Status (1)
Country | Link |
---|---|
DE (1) | DE2540968C2 (de) |
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