DE9490466U1 - Automatische Steuerung für einen elektrochirurgischen Generator - Google Patents
Automatische Steuerung für einen elektrochirurgischen GeneratorInfo
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- DE9490466U1 DE9490466U1 DE9490466U DE9490466U DE9490466U1 DE 9490466 U1 DE9490466 U1 DE 9490466U1 DE 9490466 U DE9490466 U DE 9490466U DE 9490466 U DE9490466 U DE 9490466U DE 9490466 U1 DE9490466 U1 DE 9490466U1
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/1206—Generators therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/1206—Generators therefor
- A61B18/1233—Generators therefor with circuits for assuring patient safety
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1402—Probes for open surgery
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- A—HUMAN NECESSITIES
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- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
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- 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
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Description
(für die Eintragung des Gbm vorgefehene» Unterlagen j«
29. März 1996
PC8576ALP
VALLEYLAB, INC.
5920 Longbow Drive
Boulder, Colorade 80301
USA
5920 Longbow Drive
Boulder, Colorade 80301
USA
GENERATOR
1. Gebiet der Erfindung
Eine automatische Steuerung für einen elektrochirurgischen
Generator spricht auf den Pegel der Gewebeimpedanz zwischen der aktiven und der Rückelektrode an. Mehrere aktive
Elektrodenkontakte können jeweils getrennt und unabhängig voneinander Hochfrequenzleistung dem Gewebe von der aktiven
Leitung des elektrochirurgischen Generators zuführen. Mehrere Temperaturfühler, die jeweils der aktiven Elektrodenkontakte
zugeordnet sind, übertragen ein Signal, das die Temperatur am aktiven Elektrodenkontakt angibt.
2. Hintergrund der Erfindung
Als Ergebnis der bei der manuellen Betätigung auftretenden Schwierigkeiten hat man mehrere Wege patentiert, einen
automatischen Generatorbetrieb zu erzielen, wenn chirurgische Klemmen oder Zangen mit dem Patientengewebe in
Kontakt sind. Das US-Patent 2 827 056, das deutsche Patent 1 099 658 und das deutsche Patent 28 23 291 beschreiben
Schaltungen, die ein Gleichspannungspotential an die chirurgischen Zangen anlegen. Beim Kontakt der chirurgischen
Zangen mit dem Patientengewebe fließt ein kleiner Gleichstrom hindurch. Der Gleichstrom verursacht die Aktivierung
einer Relaisschaltung, wodurch die leistungsstärkere Hochfrequenzenergie freigegeben wird und für
chirurgische Effekte durch das Patientengewebe fließen kann. Die Wahl fester Widerstandswerte innerhalb der
Schaltungen bestimmt den Impedanzpegel des Gewebes
♦· ·· ♦* it* ·
unterhalb dem die Aktivierung der Hochfrequenzenergie stattfindet.
Das deutsche Patent DE 25 40 968 beschreibt eine Schaltung, die einen niederfrequenten Meßstrom zur Ermittlung der
relativen Impedanz des Patientengewebes verwendet; der niederfrequente Strom innerhalb eines spezifischen Amplitudenbereichs
schaltet die Hochfrequenzleistung des Generators für die elektrochirurgische Behandlung ein. Diese
Schaltung enthält auch ein zeitverzögerndes Relais zur Steuerung der Zeit zwischen dem Anlegen der Zangen an das
Patientengewebe und dem darauf folgenden Betrieb des Generators.
Nachfolgende Patente befaßten sich mit der Fähigkeit, die Leistung automatisch während bipolarer Trocknungsprozeduren
abzuschalten. Das deutsche Patent DE 31 20 102 Al beschreibt eine Schaltung, die den Differentialquotienten
(die zeitliche Ableitung) der Impedanz des Patientengewebes überwacht, um zu ermitteln, wann die Zufuhr der Hochfrequenzleistung
abgeschaltet wird; ein Nullpunkt der zeitlichen Ableitung wird zum Abschalten der Leistungszufuhr
gewählt. Das deutsche Patent DE 29 46 728 Al beschreibt eine Schaltung, die die Hochfrequenz leistung nach einer
einstellbaren, jedoch festen Zeitverzögerung ausschaltet. Das deutsche Patent DE 35 10 586 beschreibt eine Schaltung,
die einen niederfrequenten Steuerstrom oder eine Hochfrequenzgeneratorquelle geringen Pegels und einen Stromstärkefühler
verwendet, um die Generatorhochfrequenzleistung für elektrochirurgische Effekte einzuschalten. Die
Schaltung überwacht auch die Ausgangsspannung des Generators
daraufhin, ob die dritte Oberschwingung enthalten ist, um die Hochfrequenzleistung des Generators abzuschalten,
wenn die Trocknung beendet ist und bei Funkenbildung die Erzeugung von Oberschwingungen beginnt. Dies ist ein Gerät,
das den Strom durch das Gewebe mißt und ein digitales Signal der Stromstärke bildet. Das Signal und die manuelle
Betätigung werden zur Bedienung des Geräts kombiniert.
Das US-Patent 4 860 745 diskutiert die Schwierigkeiten, die
auftreten, wenn die Hochfrequenzenergie nach der Messung der zeitlichen Ableitung der Impedanz des Patientengewebes
abgeschaltet wird und schlägt statt dessen eine Schaltung vor, die die Hochfrequenzleistung des Generators basierend
auf festgelegten Veränderungen von Bruchteilen in der Stärke des während der Trocknung dem Patientengewebe zugeleiteten
Hochfrequenzstroms oder auf der Grundlage der Funkenbildung und der Erzeugung von Oberschwingungen des
Generators ausschaltet. Eine Spitzenwertdetektorschaltung untersucht die Stromspitzen an den Zangen und eine zweite
Schaltung überwacht den sich abschwächenden Strom während der Koagulation. Die gemessenen Stromstärken werden in den
Schaltungen in Spannungen umgewandelt. Die so gemessenen Spannungen steuern den elektrochirurgischen Generator, der
ausgeschaltet wird, wenn ein Bruchteil des Spitzenwerts des Stroms größer als der gemessene Strom ist, der während der
Koagulation durch das Gewebe fließt. Wenn der durch das Gewebe fließende Strom größer als dieser Bruchteil ist,
liefert der elektrochirurgische Generator weiterhin Ausgangsleistung, bis der Wert kleiner ist.
Das deutsche Patent 2 455 174 befaßt sich mit einem Schalter und einem Relais, so daß der Arzt, wenn er den
normalerweise geschlossenen Schalter betätigt, eine ESTJ-Steuerung freigibt. Die öffnung des Schalters aktiviert ein
Relais, das den elektrochirurgischen Generator betreibt, wenn der Impedanzwert zwischen den Zangen innerhalb eines
vorgegebenen Bereichs liegt. Diese Ansprüche sind vermieden, da wir keinen Schalter und kein Relais haben. Außerdem
wird ein manuell betätigter Schalter zur Betätigung des Relais benötigt. Der Schalter sitzt am Handgriff der Zange.
Das US-Patent 4 658 819 beschreibt eine Schaltung, in der die der Elektrode zugeführte Leistung eine Funktion der
durch Fühler für die Lastspannung und den Strom gemessenen Spannung einer Gleichspannungsversorgung und der Last ist.
Eine Mikroprozessorsteuereinheit digitalisiert die Fühlersignale und berechnet die Lastimpedanz und die zugeführte
Istleistung. Die Mikroprozessorsteuereinheit wiederholt demgemäß die Messung, Berechnung und den Korrekturprozeß
annähernd so lang, wie der Generator arbeitet. Das US-Patent 4 372 315 beschreibt eine Schaltung, die Impedanzen
nach der Zufuhr einer bestimmten Anzahl von Hochfrequenzimpulsen in einem Impulsbündel auf Impulsbündelbasis mißt.
Das US-Patent 4 321 926 hat ein Rückkoppelsystem, um die Dosierung zu regeln, aber die Impedanzerfassung erfolgt
nicht in Echtzeit. Die US-Patente 3 964 487, 3 980 085, 4 188 927 und 4 092 986 haben Schaltungen, die den ausgegebenen
Strom in Übereinstimmung mit wachsender Lastimpedanz verringern. In diesem Patent wird die Ausgangsspannung
konstant gehalten, während der Strom bei sich erhöhender Lastimpedanz verringert wird. Das US-Patent 4 094 320 hat
eine Schaltung, die auf Impedanzwechsel reagiert, die durch einen erfaßten Strom in der aktiven und der Rückführungsleitung
gemessen werden. Die erfaßten Ströme werden voneinander subtrahiert, und wenn diese Differenz einen variablen
Schwellenwert überschreitet, wird der Generator ausgeschaltet. Der variable Schwellenwert ist eine Funktion des
Leistungsniveaus und des Leckstroms durch die Streukapazität.
Beim französischen Patent 2 573 301 werden ein oder zwei Thermopaare als Elektroden eines einpoligen oder bipolaren
Hochfrequenzwerkzeugs zur Überwachung der Elektrodentemperatur verwendet und um zu verhindern, daß Gewebe an der
Elektrode haften bleibt. Das US-Patent 4 492 231 behandelt die Temperatur, die Schneidenleitfähigkeit und das Ankleben
getrockneten Bluts an einer bipolaren Zange.
Die US-Patente 4 232 676 und 4 314 559, die an Corning Glass Works erteilt wurden, beschreiben Klingen mit
Bereichen für die Elektrochirurgie und anderen Bereichen, die keine hochfrequente Leistung leiten. Das US-Patent
4 232 676 hat bipolare Elektroden auf der selben Klinge, so
daß die dazwischen fließende Leistung eine Kauterisierung von Blutungen bewirkt. Das US-Patent 4 314 559 hat eine
erste leitende Lage für die Beschichtung der elektrochirurgischen Klinge und eine zweite Teflonlage, die eine Oberfläche
mit erschwerter Haftung erzielt. Die leitende Lage ist so, daß Teile davon frei liegen und eine Verbindung
zwischen einer chirurgischen Klinge und der Oberfläche so herstellen, daß das Teflon nur Lücken, Inklusionen und
dergleichen an der Oberfläche füllt und somit eine haftungsarme Oberfläche des Schneide- oder Koagulationsinstruments
erzielt.
Bislang ist keine Schaltung bekannt, die die zugeführte Leistung abhängig von der Impedanz einer oder mehrerer
Gewebeflächen, die mit aktiven Elektrodenkontakten an der aktiven Gewebeelektrode in Kontakt steht, automatisch
steuert oder regelt und die Temperatur an den aktiven Elektrodekontakten erfaßt. Es ist erwünscht, konsistente
Trocknungspegel bei sich weitgehend ändernden Gewebetypen zu erzielen, auch wenn diese nahe benachbart sind.
Eine automatische Steuerung oder Regelung für einen elektrochirurgischen Generator spricht bevorzugt auf den
Pegel der Gewebeimpedanz zwischen einer aktiven und einer Rückelektrode des elektrochirurgischen Generators während
der Gewebeaustrocknung an, und der elektrochirurgische Generator kann mit einer aktiven und einer Rückleitung zur
Einspeisung hochfrequenter elektrochirurgischer Leistung versehen sein. Ein Paar aktiver Elektrodengewebekontaktglxeder
können am Gewebe anbringbar sein. Die aktiven Elektrodengewebekontaktglxeder sind mit der aktiven Leitung
verbunden. Jedem aktiven Elektrodengewebekontaktglied können ein oder mehrere aktive Elektrodenkontakte
zugeordnet sein. Jeder aktive Elektrodenkontakt kann bevorzugt separat und unabhängig von den anderen Kontakten Hochfrequenzleistung
zur Verfügung stellen, die vom jeweiligen
aktiven Elektrodengewebekontaktglied eingespeist wird, um
das Gewebe elektrochirurgisch zu behandeln.
Eine Rückelektrode verbindet die Rückleitung des elektrochirurgischen
Generators, und ein Impedanzmonitor kann zwischen jedem aktiven Elektrodenkontakt und der Rückelektrode
enthalten sein und Signale über die momentanen Impedanzen dazwischen liefern. Ein Regler kann angeschlossen
sein, der Signale vom Impedanzmonitor empfängt, um eine unabhängige Zufuhr der vom elektrochirurgischen Generator
zu jedem aktiven Elektrodenkontakt gespeisten Leistung gestatten. Der Regler kann funktionell dem Ausgang des
elektrochirurgischen Generators zugeordnet sein, um separat und unabhängig die zwischen jedem aktiven Elektrodenkontakt
fließende Leistung in Übereinstimmung mit den Signalen bezüglich der überwachten Impedanzen zu regeln, indem er
den Pegel der zwischen dem elektrochirurgischen Generator und dem zugeordneten aktiven Elektrodenkontakt übertragenen
Hochfrequenzleistung ändert, um die von jedem aktiven Elektrodenkontakt zur Rückelektrode fließende Leistung
unabhängig zu regeln.
Einem oder mehreren der aktiven Elektrodenkontakte können ein oder mehrere Temperaturfühler zugeordnet sein, wobei
jeder derselben für die übertragung eines Temperaturwerts zum elektrochirurgischen Generator verbunden sein kann. Der
Temperaturwert gibt wenigstens die Temperatur am zugehörigen aktiven Elektrodenkontakt an. Der Regler ist bevorzugt
so verbunden, daß er die momentanen Temperaturwerte empfängt und Temperaturänderungen für eine unabhängige
Regelung der jedem aktiven Elektrodenkontakt vom elektrochirurgischen Generator übertragenen Leistung abschätzt, um
elektrochirurgisch das Gewebe individuell zwischen jedem aktiven Elektrodenkontakt und der Rückelektrode nach Maßgabe
des Temperaturwerts zu beeinflussen.
Ein isolierter Träger kann das Paar der Gewebekontaktglieder einschließlich eines oder mehrerer der aktiven
Elektrodenkontakte tragen. Die Rückelektrode kann in ihrer Stellung am isolierten Träger gehalten werden, um Gewebe
zwischen der Rückelektrode und einem oder mehreren der aktiven Gewebekontaktglieder aufzunehmen, die bevorzugt
einen oder mehrere aktive Elektrodenkontakte haben und dadurch einen einpoligen Kreis mit der Rückelektrode zu
bilden. Wenigstens zwei der aktiven Gewebekontaktglieder bilden bevorzugt eine Klemme, die eine oder mehrere aktive
Elektrodenkontakte trägt. Die Kontaktglieder, die aktiven Elektrodenkontakte oder die Rückelektrode können in ihrer
Position zu- und voneinander beweglich sein und Gewebe zwischen sich einschließen.
Die aktiven Elektrodengewebekontaktglieder können mit der Rückelektrode das bipolare Instrument bilden und bevorzugt
in Form einer Schere ausgelegt sein. Die Schneidekanten der Scheren können zwischen einem oder mehreren der aktiven
Elektrodenkontakte und der elektrisch davon isolierten, jedoch relativ dazu beweglichen Rückelektrode elektrochirurgische
Effekte erzielen. Bevorzugt ist ein erster Multiplexer mit einem oder mehreren der aktiven Elektrodenkontakte
verbunden, um hochfrequente elektrochirurgische Leistung für eine getrennte und unabhängige Speisung jedes
aktiven Elektrodenkontakts von der aktiven Leitung des elektrochxrurgischen Generators zur Verfügung zu stellen.
Ein zweiter Multiplexer ist bevorzugt mit einem oder mehreren der Temperaturfühler verbunden, um die Temperaturwerte
der ihnen zugeordneten aktiven Elektrodenkontakte dem elektrochxrurgischen Generator zuzuführen.
Ein länglicher isolierter Träger soll wenigstens einen der aktiven Elektrodenkontakte an seinem Platz halten und auf
diese Weise eine einpolige elektrochirurgische Elektrode für eine laparoskopische Prozedur bilden. Der isolierte
Träger hat bevorzugt einen kreisförmigen Querschnitt, um in Kooperation mit einem mittels einer Trokarhülse durch das
Gewebe gebildeten Durchgang als laparoskopisches Instrument zu wirken. Eine Benutzersteuerung ist bevorzugt am
elektrochirurgischen Generator vorgesehen, um das für die
Elektrochirurgie verwendete Leistungsniveau einzustellen.
Fig. 1 ist eine schematische Darstellung eines den Patienten einschließenden einpoligen elektrochirurgischen
Generatorkreises.
Fig. 2 ist eine schematische vergrößerte Darstellung der aktiven Elektrodenkontakte und/oder der Temperaturfühler,
wie sie im Kreis der Fig. 1 verwendet werden können.
Fig. 3 ist eine perspektivische Ansicht einer in einem einpoligen Kreis mit entfernt positionierter Rückelektrode,
wie in Fig. 1, als laparoskopisches Instrument verwendbaren Klemme mit einem aktiven Elektrodenpaar mit den aktiven
Elektrodenkontakten und/oder den nebeneinander liegenden Temperaturfühlern; die Rückelektrode ist in Fig. 3 nicht
gezeigt.
Fig. 4 ist eine perspektivische Ansicht einer bipolaren Klemme, die als laparoskopisches Instrument verwendbar
ist, mit einer aktiven Elektrode, die aktive Elektrodenkontakte und/oder Temperaturfühler hat, die für einen
selektiven Kontakt mit der Rückelektrode gegeneinander beweglich angeordnet sind.
Fig. 5 ist eine Seitenansicht einer zweipoligen Schere mit einer aktiven und einer Rückelektrode, wobei die aktive
Elektrode aktive Elektrodenkontakte und/oder Temperaturfühler hat.
Fig. 6 ist ein schematisches Schaltbild der Impedanzüberwachung und der Temperaturfühler, die ein Teil der
Regelung für die elektrochirurgische Einwirkung sind.
r>RTATT.T.TF,RTE BESCHREIBUNG DER ERFINDUNG
Eine automatische Steuerung oder Regelung 10 für einen elektrochirurgischen Generator 11, wie er in den Figuren 1
und 6 gezeigt ist, spricht auf den Impedanzpegel des Gewebes zwischen einer aktiven Elektrode 12 und einer Rückelektrode
13 zur Einspeisung von elektrochirurgischer Generatorleistung während der Gewebetrocknung an. Der elektrochirurgische
Generator 11 enthält eine automatische Steueroder Regelschaltung 10 mit einer aktiven Leitung 14 und
einer Rückleitung 15 zur Einspeisung elektrochirurgischer Hochfrequenzleistung. Die überwachung und Kontrolle der
Temperatur am elektrochirurgischen Situs 16 ist auch Teil dieser Beschreibung. Ein Paar aktiver Elektroden 17, die
ein Gewebekontaktglied bilden, sind, wie in Fig. 3 gezeigt, am Gewebe so anbringbar, daß sie zwischen sich während der
Trocknung Gewebe einklemmen. Das Glied 17 ist mit der aktiven Leitung 14 verbunden. Ein oder mehrere aktive Elektrodenkontakte
18, wie sie in vergrößerter Darstellung in Fig. 2 gezeigt sind, sind jedem Kontaktglied 17 der aktiven
Elektrode zugeordnet. Jeder aktive Elektrodenkontakt 18 kann separat und unabhängig vom jeweiligen Kontaktglied 17
Hochfrequenzleistung zuführen, um das damit in Berührung stehende Gewebe elektrochirurgisch zu beeinflussen.
Die Rückelektrode 13, wie sie in den verschiedenen Darstellungen der Figuren 1, 2, 4 und 5 gezeigt ist, ist mit der
Rückleitung 15 des elektrochirurgischen Generators 11 verbunden. Ein Impedanzmonitor 19 ist zwischen jedem der
aktiven Elektrodenkontakte 18 und der Rückelektrode 13 enthalten und liefert Signale über den momentanen Impedanzwert
zwischen ihnen. Es sind verschiedene Wege zur Überwachung der Impedanz beschrieben und typischerweise werden
Spannungs- und Stromsignale von den elektrochirurgischen Generatorleitungen 14 und 15 oder an den Elektroden 12 und
13 abgegriffen, so daß das Produkt dieser Signale zur Bestimmung der Last an den Elektroden 12 und 13 dienen
kann. Erteilte Patente, wie z.B. das US-Patent 4 922 210 und 4 969 885 befassen sich mit der überwachung der
Gewebeimpedanz; diese Beschreibung ist nicht auf eine spezielle Überwachung der Impedanz beschränkt, und die oben
angeführten Patente sind hier lediglich als Beispiele in Bezug genommen.
Ein Regler 20 ist so verbunden, daß er vom Impedanzmonitor 19 Signale 21 und 22 empfängt und so daß er die Zufuhr
elektrochirurgischer Leistung vom elektrochirurgischen
Generator 11 zum Gewebe über jeden aktiven Elektrodenkontakt 18 regeln kann. Der Regler 20 ist, wie beschrieben
werden wird, auch mit der Temperaturkontrolle am aktiven Elektrodenkontakt befaßt. Der Regler 20 ist funktionell dem
Ausgang des elektrochirurgischen Generators 11 für eine separate und unabhängige Regelung der vom elektrochirurgischen
Generator über jeden aktiven Elektrodenkontakt 18 übertragenen Hochfrequenzleistung in Übereinstimmung mit
den überwachten ImpedanzSignalen zugeordnet, wobei er den
Pegel der zwischen dem elektrochirurgischen Generator 11 und den zugehörigen aktiven Elektrodenkontakten übertragenen
Hochfrequenzleistung für eine unabhängige Regelung der Leistung, die zur Rückelektrode 13 von jedem aktiven
Elektrodenkontakt 18 fließt, ändert. Dieser Weg bezieht reale Veränderungen in der Gewebeimpedanz bei anliegenden
Gewebeabschnitten mit ein und versucht eine Anpassung an solche Veränderungen mit der automatischen Regelung 10, die
auf das Gewebe an jedem aktiven Elektrodenkontakt anspricht.
Ein oder mehrere Temperaturfühler 23 sind in einer Ausführung einem oder mehreren der Elektrodenkontakte zugeordnet,
so daß jeder Temperaturfühler 23 für die Übertragung eines
Temperaturwerts zum elektrochirurgischen Generator 11 verbunden ist. Es ist wichtig, die Temperatur am aktiven
Elektrodenkontakt 18 zu erfassen, weil das Trocknen des Gewebes bevorzugt erfolgt, während die Temperatur des
Trocknungsprozesses kontrolliert wird, um dadurch eine Überhitzung zu vermeiden, die, abgesehen von anderen
Schwierigkeiten, ein Festkleben der aktiven Elektrodenkontakte und der Rückelektrode 13 an dem getrockneten
Gewebe verursachen könnte. Ein solches Verkleben läßt die
Eiweißstoffe des koagulierten Gewebes reißen und zerstört dadurch das Bezweckte nach der Gerinselbildung. Der
Temperaturwert gibt zumindest die Temperatur am zugeordneten aktiven Elektrodenkontakt 18 an. Der von den Temperaturfühleren
23 erzeugte Temperaturwert in der Nähe der aktiven Elektrodenkontakte 18 wird durch einen zweiten
Multiplexer 24 übertragen.
Ein isolierter Träger 25 ist eine in den Figuren 3, 4 und 5 gezeigte Alternative und trägt das Paar der Gewebekontaktglieder
17 einschließlich eines oder mehrerer der aktiven Elektrodenkontakte 18. Die Rückelektrode 13 in den Figuren
4 und 5 ist gegenüberliegend am isolierten Träger 25 gehalten und ist beweglich, um Gewebe zwischen der
Rückelektrode 13 und einer oder mehreren der Gewebekontaktglieder 17 einzuklemmen, die bevorzugt einen oder
mehrere aktive Elektrodenkontakte haben und ein bipolares Instrument 26 bilden. Fig. 3 zeigt einzig, daß zwei
einander gegenüberliegende aktive Gewebekontaktglieder 17 vorhanden sind, die Gewebe zwischen sich einklemmen und das
Gewebe mittels der aktiven Elektrodenkontakte 13 durch einen geschlossenen Stromkreis über die davon abgesetzte
Rückelektrode 13 trocknen, wie in Fig. 1 gezeigt ist. Somit können wenigstens zwei der aktiven Gewebekontaktglieder 17
als bipolares Instrument fungieren und bilden bevorzugt eine Klemme, die einen oder mehrere aktive Elektrodenkontakte
18 trägt. Die Gewebekontaktglieder 17, die aktiven Elektrodenkontakte 18 und die Rückelektrode 13 können
hinsichtlich ihrer Position von- und zueinander bewegt werden, um zwischen sich Gewebe aufzunehmen.
Wenigstens zwei der Gewebekontaktglieder 17 der aktiven Elektrode oder eines zusammen mit der Rückelektrode 13, wie
es Fig. 4 zeigt, können das bipolare Instrument 26 bilden oder alternativ scherenförmig aneinandergelenkt sein, wie
Fig. 5 zeigt. Die Scheren haben Scherenkanten 27 mit einem oder mehreren aktiven Elektrodenkontakten 18, und die Rückelektrode
13 ist ihnen gegenüber elektrisch isoliert,
jedoch akkurat und beweglich daran angelenkt, um dazwischen eine elektrochirurgische und mechanische Schneidewirkung zu
erzielen.
Ein erster Multiplexer 28 ist vorzugsweise mit einem oder mehreren der aktiven Elektrodenkontakte 18 verbunden und
führt hochfrequente elektrochirurgische Leistung separat und unabhängig von der aktiven Leitung 14 des elektrochirurgischen
Generators 11 an jeden aktiven Elektrodenkontakt 18. In Fig. 6 sind der erste und zweite Multiplexer
28 und 24 gezeigt. Insbesondere aktiviert der erste Multiplexer 28 die Aktive 29 (Act 0) und speist dann Energie vom
elektrochirurgischen Generator zum dortigen Gewebe. Ein Rückkoppelalgoritmus regelt die dem Gewebe zugeführten
Leistung als Funktion des Impedanzsignals und des Temperaturwerts
bei 29 (Act 0). Die Trocknung wird vervollständigt durch Einspeisen von Leistung in Übereinstimmung mit einer
vorgegebenen Kurve für den gelieferten Leistungswert in Verbindung mit den spezifischen Impedanzsignalen und den
Temperaturwerten. Die Gewebeimpedanz legt den Endpunkt für die Einspeisung der Leistung fest, da die Veränderung des
Impedanzsignals sehr abrupt ist, wenn die Feuchtigkeit des Gewebes verschwunden ist.
Der Regler 20 enthält eine thermische Kurve für die Ableitung des Temperaturwerts nach der Zeit, die gewünschte
Temperatur, bei der das Gewebe verbleiben soll, und die Zeit, während der die Temperatur konstant bleiben soll. Als
Alternative zu letzterem reagiert der Regler 20 auf das Gewebeimpedanz signal und gibt den Endpunkt an, sobald eine
Ableitung des Gewebeimpedanzsignals die momentane Bedingung
für die Beendigung gibt. Das sich schließlich nach vollständiger Trocknung einstellende Gewebeimpedanzsignal kann
vom anfänglichen Gewebeimpedanzsignal vor der Zufuhr von Leistung abhängen, d.h., daß die Gewebeart für die thermische
Kurve maßgeblich sein kann. Ein synchroner Detektor 30 in Fig. 6 sucht und findet den Temperaturwert in dem im
Gewebe vom elektrochirurgischen Generator 11 erzeugten
Hochfrequenzfeld auf. Die momentanen Temperaturwerte werden
abgeschätzt, und irgendwelche Temperaturänderungen an irgendeinem aktiven Elektrodenkontakt 18 werden durch die
vom elektrochirurgischen Generator 11 zu jedem aktiven Elektrodenkontakt 18 gelieferte Leistung unabhängig dadurch
geregelt, daß Gewebe zwischen dem jeweiligen aktiven Elektrodenkopf 18 und der Rückelektrode 13 in Reaktion auf
den Temperaturwert individuell elektrochirurgisch beeinflußt wird. Eine thermische Rückkopplung 31 zu den
überwachenden Temperaturfühlern 23 und spezifisch zur Überwachung des Temperaturwerts ermöglicht eine exakten
Regelung der vom elektrochirurgischen Generator 11 dem Gewebe zugeführten Leistung. Eine Signalformungsschaltung
32 sorgt für die Verstärkung und Skalierung des Temperaturwerts, so daß das Ergebnis eine identifizierbare Volt-pro-Skalenteil-Beziehung
hat.
Ein Ausgangssignal der Signalformungsschaltung 32 wird mit der Temperaturkurve verglichen, z.B. als Potentiometereinstellung
in Fig. 6. Eine Differenz 34 zwischen dem Temperaturwert und dem durch Kurve angegebenen Wert wird
mit der Hochspannungssteuerung 35 des Hochfrequenztreibers
des elektrochirurgischen Generators 11 kombiniert, um diese als Funktion der Temperatur zu verändern. Nach ausgeführter
Austrocknung bei 29 (Act 0) wird die Prozedur für (Act I,
2, 3 u.s.w.) wiederholt.
Der zweite Multiplexer 24 ist vorzugsweise mit einem oder mehreren der Temperaturfühler 23 verbunden und liefert an
den elektrochirurgischen Generator 11 die Temperaturwerte, die die Temperatur um den zugehörigen aktiven Elektrodenkontakt
18 herum angeben.
Der längliche isolierte Träger 25 in den Figuren 3, 4 und 5 hält wenigstens einen aktiven Elektrodenkontakt 18 an
seiner Position und bildet, wie erläutert, eine einpolige oder bipolare elektrochirurgische Einrichtung. Wenn der
isolierte Träger 25 lang genug ist, daß er in einer
laparoskopischer Prozedur eingesetzt werden kann, können die aktiven Elektrodenkontakte 18 dementsprechend verwendet
werden. Der isolierte Träger 25 hat bevorzugt einen kreisförmigen Querschnitt, um gemeinsam in einem Durchgang durch
das Gewebe, der durch ein (nicht gezeigtes) Trokar festgelegt ist, als laparoskopisches Instrument zu fungieren. Da
die Laparoskopie nicht der Hauptzweck dieser Erfindung ist, und die praktizierenden Personen das Prinzip einer Trokarpassage
bestens kennen, sind hier keine Einzelheiten aufgeführt. Eine in Fig. 1 gezeigte Benutz er Steuerung ist am
elektrochirurgischen Generator 11 vorgesehen, um das für die Elektrochirurgie geforderte Leistungsniveau einzustellen,
wobei es viele Wege gibt, um das gewünschte Leistungsniveau zu erhalten. Ein solcher Weg ist die Steuerung am
elektrochirurgischen Generator 11, der unter der Bezeichnung "Force 40" von Valleylab, Boulder, Colorado, gehandelt
wird.
Claims (12)
1. Automatische Steuerung oder Regelung (10) für einen elektrochirurgischen Generator (11) in separater und
unabhängiger Reaktion auf den Pegel der Impedanz des Gewebes zwischen einer aktiven Elektrode und einer Rückelektrode
(13) des elektrochirurgischen Generators (11) während der Trocknung des Gewebes, wobei die Steuerung oder
Regelung (10) aufweist:
einen elektrochirurgischen Generator (11), der eine aktive Elektrode (12) und eine Rückelektrode (13) in einem
Stromkreis mit dem Gewebe hat, die über eine aktive Leitung und eine Rückleitung jeweils mit dem elektrochirurgischen
Generator verbunden sind, um dem zwischen der aktiven Elektrode und der Rückelektrode befindlichen Gewebe hochfrequente
elektrochirurgische Leistung zuzuführen;
mehrere aktive Elektrodenkontakte (18), die mit der
aktiven Elektrode (12) verbunden und ihr zugeordnet sind und auf der aktiven Elektrode liegen und Kontakt mit dem
Gewebe herstellen, um jeweils separat und unabhängig voneinander vom elektrochirurgischen Generator durch die
aktive Elektrode (12) und durch die daran angebrachten aktiven Elektrodenkontakte eingespeiste Hochfrequenzleistung
zur elektrochirurgischen Behandlung des dazwischenliegenden Gewebes zur Verfügung stellen können;
eine überwachungseinrichtung, die in einem Stromkreis
mit jedem aktiven Elektrodenkontakt (18) und der Rückelektrode (13) verbunden ist, und separat und unabhängig auf
die Spannung an den aktiven Elektrodenkontakten, den Strom durch die aktiven Elektrodenkontakte, das Gewebe und die
Rückelektrode anspricht, um, davon abgeleitet, Signale über die momentanen Impedanzen dazwischen zu erzeugen, und
einen Regler (20), der einem Betriebsausgang des elektrochirurgischen Generators (11) zugeordnet ist und in
einem Stromkreis mit ihm liegt, um den elektrochirurgischen Generator ansprechend auf die Gewebeimpedanz zwischen jedem
aktiven Elektrodenkontakt (18) und der Rückelektrode (13) in Übereinstimmung mit den überwachten ImpedanzSignalen
separat und unabhängig zu regeln, indem er einen Pegel, der zwischen dem elektrochirurgischen Generator (11) und dem
zugehörigen aktiven Elektrodenkontakt (18) übertragenen Hochfrequenzleistung verändert, um separat und unabhängig
die von jedem aktiven Elektrodenkontakt (18) zur Rückelektrode (13) strömende Leistung zu regeln.
2. Automatische Steuerung oder Regelung (10) für einen elektrochirurgischen Generator (11), in separater und
unabhängiger Reaktion auf den Pegel der Impedanz des Gewebes zwischen jedem aktiven Elektrodenkontakt (18) und
der Rückelektrode (13) gemäß Anspruch 1, bei der ein oder mehrere Temperaturfühler (23) vorgesehen sind, jeweils
zugeordnet einem oder mehreren der aktiven Elektrodenkontakte (18), wobei jeder Temperaturfühler (23) so verbunden
ist, daß er an den elektrochirurgischen Generator (11) seinen Temperaturwert überträgt, der wenigstens die Temperatur
an einem zugehörigen aktiven Elektrodenkontakt (18) angibt, und
bei dem die überwachungseinrichtung so verbunden ist, daß sie momentane Temperaturwerte unverzüglich empfängt,
Änderungen dieser Temperaturwerte abschätzt, um die Leistung des elektrochirurgischen Generators (11) für jeden
aktiven Elektrodenkontakt (18) separat und unabhängig zu regeln und um damit individuell elektrochirurgisch das
Gewebe zwischen jedem aktiven Elektrodenkontakt (18) und der Rückelektrode (13) in Übereinstimmung mit dem
betreffenden Temperaturwert zu behandeln.
3. Automatische Steuerung oder Regelung (10) für einen elektrochirurgischen Generator (11), in separater und unabhängiger
Reaktion auf den Pegel der Impedanz des Gewebes
zwischen jedem aktiven Elektrodenkontakt (18) und der Rückelektrode (13) gemäß Anspruch 2, wobei ein isolierter
Träger (25) ein Paar Glieder (17) trägt, die ein oder mehrere aktive Elektrodenkontakte (18) auf einem der beiden
Glieder (17) enthalten, und die Rückelektrode (13) an dem anderen der Glieder (17) liegt/ wobei das Gliederpaar in
seiner Stellung am isolierten Träger (25) so gehalten wird, daß es Gewebe zwischen der Rückelektrode (13) und einem
oder mehreren der aktiven Elektroden (12) des mit dem Gewebe in Berührung stehenden Glieds (17) aufnehmen kann
und so ein bipolares Instrument (26) bildet.
4. Automatische Steuerung oder Regelung (10) für einen elektrochirurgischen Generator (11), in separater und
unabhängiger Reaktion auf den Pegel der Impedanz des Gewebes zwischen jedem aktiven Elektrodenkontakt (12) und
der Rückelektrode (13) gemäß Anspruch 3, wobei das Paar der ein bipolares Instrument (26) bildenden Glieder (17) eine
Zange bildet, die ein oder mehrere aktive Elektrodenkontakte (12) und die Rückelektrode (13) in einer Stellung
hält, in der sie unter Aufnahme von Gewebe dazwischen zu- und voneinander weg beweglich sind.
5. Automatische Steuerung oder Regelung (10) für einen elektrochirurgischen Generator (11), in separater und
unabhängiger Reaktion auf den Pegel der Impedanz des Gewebes zwischen jedem aktiven Elektrodenkontakt (12) und
der Rückelektrode (13) gemäß Anspruch 3, wobei die das bipolare Instrument (26) bildenden Glieder (17) scherenförmig
aneinandergelenkt sind, und die Glieder (17) Scherkanten (27) mit einem oder mehreren aktiven Elektrodenkontakten
und der elektrisch isolierten Rückelektrode (13) haben, um dazwischen eine elekrochirurgische Wirkung auszuüben.
6. Automatische Steuerung oder Regelung (10) für einen elektrochirurgischen Generator (11), in separater und
unabhängiger Reaktion auf den Pegel der Impedanz des
Gewebes zwischen jedem aktiven Elektrodenkontakt (12) und der Rückelektrode (13) gemäß Anspruch 2, wobei ein erster
Multiplexer (28) elektrisch mit einem oder mehreren der aktiven Elektrodenkontakten (12) verbunden ist und hochfrequente
Leistung vom elektrochirurgischen Generator (11) jedem aktiven Elektrodenkontakt (12) separat und unabhängig
zuführt.
7. Automatische Steuerung oder Regelung (10) für einen elektrochirurgischen Generator (11), in separater und
unabhängiger Reaktion auf den Pegel der Impedanz des Gewebes zwischen jedem aktiven Elektrodenkontakt (12) und
der Rückelektrode (13) gemäß Anspruch 2, wobei ein zweiter Multiplexer (24) elektrisch mit einem oder mehreren der
Temperaturfühler (23) verbunden ist und Signale über die erfassten Temperaturwerte dem elektrochirurgischen Generator
(11) zuführt/ die die Temperatur an einem zugehörigen aktiven Elektrodenkontakt (12) angeben.
8. Automatische Steuerung oder Regelung (10) für einen elektrochirurgischen Generator (11)&lgr; in separater und
unabhängiger Reaktion auf den Pegel der Impedanz des Gewebes zwischen jedem aktiven Elektrodenkontakt (12) und
der Rückelektrode (13) gemäß Anspruch 2, bei der ein erster Multiplexer (28) elektrisch mit einem oder mehreren der
aktiven Elektrodenkontakte verbunden ist, wobei der erste Multiplexer (28) separat und unabhängig jedem aktiven
Elektrodenkontakt vom elektrochirurgischen Generator (11) hochfrequente elektrochirurgische Leistung einspeist und
ein zweiter Multiplexer (24) elektrisch mit einem oder mehreren Temperaturfühlern (23) verbunden ist und dem
elektrochirurgischen Generator (11) Signale über die erfassten Temperaturwerte zuführt, die jeweils die Temperatur
an einem zugehörigen aktiven Elektrodenkontakt (12) angeben.
9. Automatische Steuerung oder Regelung (10) für einen
elektrochirurgischen Generator (11), in separater und
Rückelektrode 13 gemäß Anspruch 2, bei der ein länglicher isolierter Träger 25 wenigstens einen der aktiven Elektrodenkontakte
12 in seiner Position hält und eine einpolige elektrochirurgische Elektrode für die Verwendung in
laparoskopischen Prozeduren bildet.
10. Automatische Steuerung oder Regelung 10 für einen elektrochirurgischen Generator 11, in separater und
unabhängiger Reaktion auf den Pegel der Impedanz des Gewebes zwischen jedem aktiven Elektrodenkontakt 12 und der
Rückelektrode 13 gemäß Anspruch 2, wobei der isolierte Träger 25 einen kreisförmigen Querschnitt hat, um gemeinsam
mit einer mit einem Trokar durch das Gewebe führenden Passage als laparoskopisches Instrument zu fungieren.
11. Automatische Steuerung oder Regelung 10 für einen elektrochirurgischen Generator 11, in separater und
unabhängiger Reaktion auf den Pegel der Impedanz des Gewebes zwischen jedem aktiven Elektrodenkontakt 12 und der
Rückelektrode 13 gemäß Anspruch 2, bei der eine Benutzersteuerung 36 am elektrochirurgischen Generator 11
liegt und mit ihm elektrisch zur Einstellung des für die elektrochirurgische Prozedur gewünschten Leistungspegels
verbunden ist.
12. Automatische Steuerung oder Regelung 10 für einen elektrochirurgischen Generator 11, in separater und
unabhängiger Reaktion auf den Pegel der Impedanz des Gewebes zwischen jedem aktiven Elektrodenkontakt 12 und der
Rückelektrode 13 des elektrochirurgischen Generators 11 während der Gewebetrocknung, wobei die Steuerung oder
Regelung 10 aufweist:
einen elektrochirurgischen Generator 11, mit dem eine aktive Leitung 14 und eine Rückleitung 15 zur Einspeisung
hochfrequenter elektrochirurgischer Leistung verbunden sind;
ein Paar Gewebekontaktglieder 17 der aktiven Elektrode 12, die am Gewebe anlegbar sind, wobei die Gewebekontakt-
Einspeisung hochfrequenter elektrochirurgischer Leistung verbunden sind;
ein Paar Gewebekontaktglieder (17) der aktiven Elektrode (12), die am Gewebe anlegbar sind, wobei die
Gewebekontaktglieder (17) der aktiven Elektrode (12) mit
der aktiven Leitung (14) verbunden sind;
mehrere aktive Elektrodenkontakte (12), die jedem Paar der Gewebekontaktglieder (17) zugeordnet sind, wobei jeder
aktive Elektrodenkontakt (12) in einem Stromkreis mit dem Gewebe die dem jeweiligen Gewebekontaktglied (17) eingespeiste
Hochfrequenzleistung separat und unabhängig einspeisen kann, um das mit dem jeweiligen aktiven Elektrodenkontakt
in Kontakt stehende Gewebe elektrochirurgisch zu behandeln;
eine Rückelektrode (13), die mit der Rückleitung (15)
des elektrochirurgischen Generators (11) verbunden ist und mit dem Gewebe in Kontakt steht,
eine überwachungseinrichtung, die in einem Stromkreis
zwischen den aktiven Elektrodenkontakten und der Rückelektrode (13) verbunden ist und separat und unabhängig auf die
Spannung an den aktiven Elektrodenkontakten, den Strom durch die aktiven Elektrodenkontakte, das Gewebe und die
Rückelektrode reagiert, um, davon abgeleitet, Signale über die momentanen Impedanzen dazwischen zu erzeugen;
einen oder mehrere Temperaturfühler (23), die jeweils einem oder mehreren der aktiven Elektrodenkontakte zugeordnet
sind und die für die übertragung eines wenigstens die Temperatur am zugehörigen aktiven Elektrodenkontakt angebenden
Temperaturwerts zum elektrochirurgischen Generator verbunden sind, wobei
die überwachungseinrichtung so verbunden ist, daß sie
momentane Temperaturwerte unverzüglich empfängt und Temperaturänderungen zu einer separaten und unabhängigen
Regelung der den jeweiligen aktiven Elektrodenkontakten vom elektrochirurgischen Generator (11) zugeführten Leistung
abschätzt, um damit das Gewebe zwischen jedem aktiven Elektrodenkontakt (12) und der Rückelektrode (13) in
Reaktion auf den erfassten Temperaturwert individuell elektrochirurgisch zu behandeln;
einen mit einem Leistungsausgang des elektrochirurgischen Generators (11) elektrisch verbundenen und diesem
zugeordneten Regler (20), der den elektrochirurgischen Generator (11) als Funktion der signalisierten Impedanz
(19) zwischen den jeweiligen aktiven Elektrodenkontakten und des erfaßten Temperaturwerts separat und unabhängig
regelt, und der in einem Stromkreis mit dem elektrochirurgischen Generator liegt, um einen Pegel der zwischen dem
elektrochirurgischen Generator und dem zugeordneten aktiven Elektrodenkontakt übertragenen Hochfrequenzleistung für
eine unabhängige Regelung der zwischen der Rückelektrode (13) und jedem aktiven Elektrodenkontakt (12) fließenden
Leistung zu ändern;
einen ersten Multiplexer (28), der elektrisch mit den aktiven Elektrodenkontakten (12) verbunden ist und elektrochirurgische
Hochfrequenzleistung den jeweiligen aktiven Elektrodenkontakten (12) von der aktiven Leitung des
elektrochirurgischen Generators (11) separat und unabhängig zu Verfügung stellt, und
einen zweiten Multiplexer (24), der elektrisch mit einem oder mehreren der Temperaturfühler (23) verbunden ist
und die die Temperatur am zugeordneten aktiven Elektrodenkontakt (12) angebenden Temperaturwerte dem elektrochirurgischen
Generator (11) zuführt.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US08/133,235 US5496312A (en) | 1993-10-07 | 1993-10-07 | Impedance and temperature generator control |
PCT/IB1994/000269 WO1995009576A1 (en) | 1993-10-07 | 1994-09-09 | Automatic control for electrosurgical generator |
Publications (1)
Publication Number | Publication Date |
---|---|
DE9490466U1 true DE9490466U1 (de) | 1996-06-13 |
Family
ID=22457622
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE69415037T Expired - Lifetime DE69415037D1 (de) | 1993-10-07 | 1994-09-09 | Automatische kontrolle für elektrochirurgischen generator |
DE9490466U Expired - Lifetime DE9490466U1 (de) | 1993-10-07 | 1994-09-09 | Automatische Steuerung für einen elektrochirurgischen Generator |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE69415037T Expired - Lifetime DE69415037D1 (de) | 1993-10-07 | 1994-09-09 | Automatische kontrolle für elektrochirurgischen generator |
Country Status (8)
Country | Link |
---|---|
US (1) | US5496312A (de) |
EP (1) | EP0722296B1 (de) |
JP (1) | JP2677456B2 (de) |
AU (1) | AU7507094A (de) |
CA (1) | CA2171758A1 (de) |
DE (2) | DE69415037D1 (de) |
FI (1) | FI961529A (de) |
WO (1) | WO1995009576A1 (de) |
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US4321926A (en) * | 1979-04-16 | 1982-03-30 | Roge Ralph R | Insertion detecting probe and electrolysis system |
DE2946728A1 (de) * | 1979-11-20 | 1981-05-27 | Erbe Elektromedizin GmbH & Co KG, 7400 Tübingen | Hochfrequenz-chirurgiegeraet |
US4314559A (en) * | 1979-12-12 | 1982-02-09 | Corning Glass Works | Nonstick conductive coating |
US4372315A (en) * | 1980-07-03 | 1983-02-08 | Hair Free Centers | Impedance sensing epilator |
DE3120102A1 (de) * | 1981-05-20 | 1982-12-09 | F.L. Fischer GmbH & Co, 7800 Freiburg | Anordnung zur hochfrequenzkoagulation von eiweiss fuer chirurgische zwecke |
DE3228136C2 (de) * | 1982-07-28 | 1985-05-30 | Erbe Elektromedizin GmbH, 7400 Tübingen | Hochfrequenz-Chirurgiegerät |
US4492231A (en) * | 1982-09-17 | 1985-01-08 | Auth David C | Non-sticking electrocautery system and forceps |
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FR2573301B3 (fr) * | 1984-11-16 | 1987-04-30 | Lamidey Gilles | Pince chirurgicale et son appareillage de commande et de controle |
DE3510586A1 (de) * | 1985-03-23 | 1986-10-02 | Erbe Elektromedizin GmbH, 7400 Tübingen | Kontrolleinrichtung fuer ein hochfrequenz-chirurgiegeraet |
EP0253012B1 (de) * | 1986-07-17 | 1992-01-22 | Erbe Elektromedizin GmbH. | Hochfrequenz-Chirurgiegerät für die thermische Koagulation biologischer Gewebe |
US4907589A (en) * | 1988-04-29 | 1990-03-13 | Cosman Eric R | Automatic over-temperature control apparatus for a therapeutic heating device |
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US5122137A (en) * | 1990-04-27 | 1992-06-16 | Boston Scientific Corporation | Temperature controlled rf coagulation |
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US5383917A (en) * | 1991-07-05 | 1995-01-24 | Jawahar M. Desai | Device and method for multi-phase radio-frequency ablation |
JPH07500757A (ja) * | 1991-11-08 | 1995-01-26 | イーピー テクノロジーズ,インコーポレイテッド | 組織のインピーダンスをモニタしながら組織を切除するシステム及び方法 |
DE4205213A1 (de) * | 1992-02-20 | 1993-08-26 | Delma Elektro Med App | Hochfrequenzchirurgiegeraet |
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US5573533A (en) * | 1992-04-10 | 1996-11-12 | Medtronic Cardiorhythm | Method and system for radiofrequency ablation of cardiac tissue |
-
1993
- 1993-10-07 US US08/133,235 patent/US5496312A/en not_active Expired - Lifetime
-
1994
- 1994-09-09 CA CA002171758A patent/CA2171758A1/en not_active Abandoned
- 1994-09-09 DE DE69415037T patent/DE69415037D1/de not_active Expired - Lifetime
- 1994-09-09 WO PCT/IB1994/000269 patent/WO1995009576A1/en active IP Right Grant
- 1994-09-09 DE DE9490466U patent/DE9490466U1/de not_active Expired - Lifetime
- 1994-09-09 EP EP94924973A patent/EP0722296B1/de not_active Expired - Lifetime
- 1994-09-09 JP JP7504783A patent/JP2677456B2/ja not_active Expired - Fee Related
- 1994-09-09 AU AU75070/94A patent/AU7507094A/en not_active Abandoned
-
1996
- 1996-04-04 FI FI961529A patent/FI961529A/fi not_active Application Discontinuation
Cited By (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8003709B2 (en) | 1996-07-09 | 2011-08-23 | Orthopaedic Hospital | Crosslinking of polyethylene for low wear using radiation and thermal treatments |
US8801705B2 (en) | 2003-10-20 | 2014-08-12 | Arthrocare Corporation | Electrosurgical method and apparatus for removing tissue within a bone body |
US8979838B2 (en) | 2010-05-24 | 2015-03-17 | Arthrocare Corporation | Symmetric switching electrode method and related system |
DE102011102369B4 (de) * | 2010-05-24 | 2015-09-03 | Arthrocare Corporation | Symmetrisches Elektroden-Umschaltverfahren und zugehöriges System |
Also Published As
Publication number | Publication date |
---|---|
FI961529A0 (fi) | 1996-04-04 |
CA2171758A1 (en) | 1995-04-13 |
US5496312A (en) | 1996-03-05 |
EP0722296B1 (de) | 1998-12-02 |
JP2677456B2 (ja) | 1997-11-17 |
JPH09501577A (ja) | 1997-02-18 |
AU7507094A (en) | 1995-05-01 |
FI961529A (fi) | 1996-04-04 |
DE69415037D1 (de) | 1999-01-14 |
EP0722296A1 (de) | 1996-07-24 |
WO1995009576A1 (en) | 1995-04-13 |
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