EP3046493A1 - Procédé et dispositif de commande d'un appareil électrochirurgical hf, et appareil hf - Google Patents

Procédé et dispositif de commande d'un appareil électrochirurgical hf, et appareil hf

Info

Publication number
EP3046493A1
EP3046493A1 EP14766147.4A EP14766147A EP3046493A1 EP 3046493 A1 EP3046493 A1 EP 3046493A1 EP 14766147 A EP14766147 A EP 14766147A EP 3046493 A1 EP3046493 A1 EP 3046493A1
Authority
EP
European Patent Office
Prior art keywords
generator
user
application
instrument
activation
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.)
Ceased
Application number
EP14766147.4A
Other languages
German (de)
English (en)
Inventor
Thomas MASER
Heiko Reichle
Anton Keller
Stefan EICK
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Aesculap AG
Original Assignee
Aesculap AG
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Aesculap AG filed Critical Aesculap AG
Publication of EP3046493A1 publication Critical patent/EP3046493A1/fr
Ceased legal-status Critical Current

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
    • 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
    • A61B18/1206—Generators therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/90—Identification means for patients or instruments, e.g. tags
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00132—Setting operation time of a device
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00477—Coupling
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00477—Coupling
    • A61B2017/00482—Coupling with a code
    • 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
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00601—Cutting
    • 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
    • A61B2018/00642—Sensing and controlling the application of energy with feedback, i.e. closed loop control
    • 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
    • A61B2018/00696—Controlled or regulated parameters
    • A61B2018/00702—Power or energy
    • A61B2018/00708—Power or energy switching the power on or off
    • 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
    • A61B2018/00898—Alarms or notifications created in response to an abnormal condition
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/25—User interfaces for surgical systems
    • A61B2034/256—User interfaces for surgical systems having a database of accessory information, e.g. including context sensitive help or scientific articles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2560/00—Constructional details of operational features of apparatus; Accessories for medical measuring apparatus
    • A61B2560/04—Constructional details of apparatus
    • A61B2560/0487—Special user inputs or interfaces
    • A61B2560/0493—Special user inputs or interfaces controlled by voice

Definitions

  • the present invention relates to a method and a device for
  • a high-frequency current (HF current) is passed through tissue to be treated via an electrosurgical instrument, which changes as a result.
  • HF current high-frequency current
  • the RF delivery is not automatically controlled, metered and terminated by the surgeon, but by an RF generator to which the instrument is electrically connected.
  • US Pat. No. 5,035,695 discloses a method and an instrument for electrocautery with blocking functions which enable safe operation of the instrument under manual control.
  • An electrode of the instrument is slidable by means of a manually operable slide from a retracted into the instrument rest position in a protruding from the instrument cauterization.
  • a blocking switch automatically disconnects the electrode from an RF power source / HF generator when it is in the rest position.
  • the slider mechanically disables activation switches for manual activation of the electrode, while the activation switches in the cauterizing position are released by the slider and manually operated.
  • the blocking or release of the instrument is done manually by the user without consideration of a generator setting.
  • European patent application EP 2 168 517 A1 discloses a system and method for manually locking manual switches of a hand-operated one
  • electrosurgical clamp known for coagulation and tissue cutting.
  • the clamp has two mutually movable jaws, which are to be acted upon for the coagulation of tissue with electricity.
  • a manual switch is to be manually operated by the user of the terminal to activate it.
  • a lock switch is also manually by the user of the terminal from a first position in which an operation of the manual switch is possible, movable to a second position in which an actuation of the manual switch and an activation of the terminal is not possible.
  • both the hand and the hand is to be manually operated by the user of the terminal to activate it.
  • a lock switch is also manually by the user of the terminal from a first position in which an operation of the manual switch is possible, movable to a second position in which an actuation of the manual switch and an activation of the terminal is not possible.
  • Lock switch must be electrically closed to allow activation of the terminal. Unfortunately, the blocking or release of the instrument is done manually by the user also without feedback to the generator.
  • WO2009 / 149799 A1 discloses a surgical device for coagulating and / or cutting biological tissue. It has a bipolar clamp with two jaws for application of RF power, an activation circuit and an RF generator.
  • the activation switch can be used to control the supply of HF current to the terminal.
  • the device has a safety device that interrupts the power supply to the terminal when its jaw parts take a position that is not suitable for coagulation. This is merely to prevent inadvertent activation of the terminal.
  • electrosurgical scalpel with a hand control for selective cutting or coagulation known, with specific modes of operation can be selectively prevented.
  • the scalpel has a slide switch, which can be positioned in three different positions on the user side, and via which an activation switch can be locked or released. In a first position is the
  • Activation switch locked. In a second position, it is to be operated in such a way that either a coagulation current is applied to the blade of the scalpel or no current flows. In a third position, the activation switch is released, so that either a coagulation current or a cutting current can be supplied to the blade of the scalpel or no current flows.
  • the hand control thus ensures that only after appropriate approval by the surgeon coagulation or
  • RF instruments or devices are operated with fixed process parameters and / or processes.
  • process parameters e.g. The amount and course of the RF energy, however, vary and must or should be adjusted accordingly in order to successfully carry out the desired operation on the one hand and to avoid further damage to the tissue on the other hand.
  • the object of the invention is to provide a method and a device for controlling an electrosurgical HF device and such an HF device, wherein it is ensured that before activation of the HF device each required device setting is correct.
  • This object is achieved on the procedural side by a method for controlling an electrosurgical HF device, which RF device is an electrosurgical instrument and an HF generator / electric power source for
  • the RF generator is in a locked state in which the HF generator is not user-activated
  • step b) starting from step a) on the user side an application to be carried out with the electrosurgical instrument is manually set (manually),
  • step b) the HF generator automatically goes into an unlocked state after carrying out step b), in which unlocked state the HF generator can be activated on the user side or is activated,
  • the HF generator and / or the electrosurgical instrument connected thereto for activating the desired application is activated on the user side or can be activated, and
  • step d) the HF generator after the user-side activation in step d) automatically merges into the locked state compulsory.
  • the object is further achieved by the device side by an electronic
  • Control unit of a for a) surgical RF device (comprising an electrical power source / RF generator and an electrosurgical instrument), which
  • Control unit is adapted to be connected to an RF generator / electric power source as a control object with
  • an input device or a connection for the input device by means of which a desired application (specific usage of the HF device) can be activated (presettable) on the user side / is activated (preset),
  • control terminal through which the control unit outputs an enable signal to the RF generator / electrical power source, only if each time before the start with an application (treatment cycle) the desired application has been reactivated on the user side.
  • the object is further achieved on the device side by an electrosurgical HF device, the electrosurgical instrument and an RF generator / electrical Current source for generating / providing an RF current, wherein the RF generator is electrically connected to the electrosurgical instrument to supply the RF current to the instrument due to a user-side activation, and wherein the RF generator is set up,
  • the RF device according to the invention is in particular for performing the
  • the instrument can be both bi-monopoly and monopolar.
  • the advantage achieved by the invention is that many different applications can be performed with an HF device, whereby the respectively correct setting of process parameters for the respective application is always ensured. Examples of such applications are bowel discontinuation, resection or anastomosis.
  • the invention further enables a
  • tissue types small intestine, large intestine, rectum, stomach, esophagus
  • tissue types small intestine, large intestine, rectum, stomach, esophagus
  • the HF dosage is no longer controlled manually by the surgeon, but automatically controlled by the RF generator and possibly stopped according to the invention.
  • the surgeon or user merely makes a presetting, preferably on the HF generator, which then automatically based on this default setting for the respective application
  • Adjustment of the device or a selection of an application was made again (each time before an application-specific treatment cycle). It can also be prevented with advantage that the setting of the device or a selection of an application is forgotten and thus worked with the wrong device settings.
  • An application within the meaning of the present application is understood to mean a specific type of surgical application with which the method or HF device according to the invention is or will be used. Connected to the respective
  • Process parameters such as Current, Voltage, Frequency, Amplitude, Amplitude Shape, Duration of Current Flow, Intensity and their History, Shutdown Point / Termination Criteria, etc. These process parameters must be properly set and applied for the particular application to ensure satisfactory results and prevent patient damage can.
  • Each application is the corresponding process parameters e.g. assigned in a database. This database can be stored in the device or in a storage element in the
  • Treatment cycle e.g., deactivating the electrosurgical instrument
  • the HF generator automatically returns to the locked state due to the user-side or due to the user-side activation in method step d). According to another embodiment of the invention, it is provided that the HF generator automatically returns to the locked state when a predetermined time after setting an application no activation took place.
  • the automatic locking So the return of the RF generator in the locked state (step e)) after a predetermined period of time after completion of the last RF application done. Also, the generator may return to the locked state if a certain number (eg, two) of successive activation requests are detected with the same parameter settings.
  • the presently described safety device with which an activation of the RF generator and thus a supply of an RF current to the electrosurgical instrument only after a user-side input of an application is possible and the RF generator is otherwise locked, can be according to advantageous embodiments of the invention realize in the form of different designs.
  • the setting or selection of the respective application can be made on the HF device, e.g.
  • a screen of the RF device e.g., with and without a touchscreen device menu
  • voice command e.g., a dial
  • a dial e.g., a neutral position which must be selected between activations
  • electrosurgical instrument itself, e.g. by means of a rotary knob (for example, with neutral position, which must be selected between the activations) or by means of buttons on the instrument.
  • the rotary wheel for selecting the application can be additionally pressed in one embodiment, whereby the selected RF process can be started or the selected application can be confirmed.
  • user-side activation of the RF generator is possible only if the selection of the application and the activation, e.g. by pressing an activation key, done simultaneously.
  • the selected application is announced by the device. This may be useful if the device setting is not performed by the surgeon himself, but by the surgical staff, and provides the surgeon with advantage a way to make sure before the activation of the RF generator on the correctness of the selected application. After another suggestion can for certain
  • the safety mode can be overcome by deliberate decision of the user, for example by long-term actuation of the Activation device or by fast double or multiple actuation of the activation device.
  • the described safety device can only be used for certain types of instruments.
  • the instruments can be detected automatically, for example, when connecting to the RF device.
  • the safety device is only switched on if this is stored in the parameters of an instrument memory of the HF device.
  • data on possible applications can also be stored in the instrument memory.
  • FIG. 2 is a schematic representation of a program flowchart for an RF activation according to the preferred embodiment of the invention
  • Fig. 3 is a schematic representation of a state diagram of an RF activation
  • Fig. 4 shows schematically an RF device to which the invention can be applied.
  • the RF device has a possibly interchangeable electrosurgical instrument 1 of known type, for example a bipolar force with two relatively movable scissors and a handle with operation buttons for selectively acting on the scissor branches or electrodes arranged thereon with an HF current.
  • a possibly interchangeable electrosurgical instrument 1 of known type, for example a bipolar force with two relatively movable scissors and a handle with operation buttons for selectively acting on the scissor branches or electrodes arranged thereon with an HF current.
  • Such an instrument 1 is connected via an electrical conductor cable (bundle) to an electrical power source, e.g. an RF generator or an RF power amplifier 2
  • an electrical power source e.g. an RF generator or an RF power amplifier 2
  • an input device 5 is e.g. a keyboard and an output device, e.g. one
  • Display / monitor 4 provided. It would also be possible to use the monitor as
  • a control unit 3 has or is connected to the current source / generator 2, which activates the current source / generator 2 in accordance with certain conditions for the provision of a specific, application-specific HF current and then optionally controls it.
  • the input and output device 4, 5 are connected. It is also conceivable, the input and
  • components 2, 3, 4 and 5 are installed in one device, the generator.
  • control unit 3 can be set to one of a plurality of previously stored selectable applications (with corresponding operating parameters), as will be described below with reference to FIGS. 1 to 3.
  • the selected application is then displayed in the output device 4.
  • the control unit 3 then operates the RF generator 2 in response to parameters associated with the selected application according to a particular process flow in accordance with the present invention.
  • FIG. 1 schematically shows the sequence of such a process activation.
  • user-defined selection variables are entered. This input can be that, for example, a specific application is selected or determined from a plurality of possible applications
  • the automatic blocking of the RF generator 2 is canceled, so that this user-side is activated or is activated.
  • the HF process (treatment cycle) is started by a user-side instruction, that is to say the surgical instrument is put into operation and if necessary the HF generator 2 is activated.
  • the RF process (treatment cycle) is executed, ie the application selected by the user is executed, wherein the corresponding HF current (corresponding to the selected application
  • the enable signal is canceled by the control unit 3 and the RF generator 2 thus automatically returns to the locked state in which its user-side activation is not possible without an application selected again and thus again Release signal is generated.
  • FIG. 2 shows, by way of example, a program flow chart for the activation of the HF.
  • the value of a Boolean variable "Parameter input” is set to the value "false”.
  • the RF generator 2 is disabled and can not be unlocked or activated on the user side (for example, by operation of the instrument 1).
  • this decision it is checked whether a selection-size input, ie a selection of an application by the user, has been made via the input device. If this decision is negated (false), ie if no user has selected an application, an error message is output and the routine returns to the initial state in which the variable "parameter input” or “selection input” is set to the value "false”. If the decision is in the affirmative (true), the HF Generator 2 unlocked, the operating parameters corresponding to the selected
  • Application set and the routine can after user activation
  • FIG. 3 schematically shows a state diagram of
  • the HF device After the device has started, the status "locked” or “locked” is automatically present, meaning that the RF generator 2 is in the locked state in which its user-side activation is not possible , eg by pressing a corresponding activation key, the HF device automatically issues an error message, activation is not carried out.
  • the system automatically switches to the unlocked or unlocked state.
  • the user can then perform the activation (once), e.g. by pressing an activation key, and the activation is carried out, i. the HF generator 2 is active and leads the
  • the present invention essentially relates to
  • Method and device for controlling an electrosurgical HF device in particular an HF device with an electrosurgical instrument 1 and an HF generator 2 for generating an HF current, wherein the HF generator 2 is in a locked state in which its Activation is not possible, and before a user-side activation of the RF generator 2 compulsory to select an application to be selected, whereby the RF generator 2 is unlocked.

Abstract

La présente invention concerne un procédé de commande d'un appareil électrochirurgical HF ainsi qu'un appareil HF équipé d'un instrument électrochirurgical et d'un générateur HF servant à produire un courant HF. Le générateur HF se trouve dans un état verrouillé dans lequel il n'est pas possible de l'activer et, avant une activation du générateur HF par un utilisateur, celui-ci doit sélectionner l'application à exécuter afin de déverrouiller le générateur HF.
EP14766147.4A 2013-09-16 2014-09-10 Procédé et dispositif de commande d'un appareil électrochirurgical hf, et appareil hf Ceased EP3046493A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE201310110172 DE102013110172A1 (de) 2013-09-16 2013-09-16 Verfahren und Vorrichtung zur Steuerung eines elektrochirurgischen HF-Geräts sowie HF-Gerät
PCT/EP2014/069315 WO2015036444A1 (fr) 2013-09-16 2014-09-10 Procédé et dispositif de commande d'un appareil électrochirurgical hf, et appareil hf

Publications (1)

Publication Number Publication Date
EP3046493A1 true EP3046493A1 (fr) 2016-07-27

Family

ID=51541071

Family Applications (1)

Application Number Title Priority Date Filing Date
EP14766147.4A Ceased EP3046493A1 (fr) 2013-09-16 2014-09-10 Procédé et dispositif de commande d'un appareil électrochirurgical hf, et appareil hf

Country Status (7)

Country Link
US (1) US10687885B2 (fr)
EP (1) EP3046493A1 (fr)
JP (2) JP2016530036A (fr)
CN (1) CN105555216B (fr)
BR (1) BR112016005672B1 (fr)
DE (1) DE102013110172A1 (fr)
WO (1) WO2015036444A1 (fr)

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102020103280A1 (de) * 2020-02-10 2021-08-12 Olympus Winter & Ibe Gmbh Elektrochirurgisches System, elektrochirurgisches Instrument, Verfahren zum Auslesen von Konfigurationsdaten, und elektrochirurgisches Versorgungsgerät

Citations (1)

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US4860745A (en) * 1986-07-17 1989-08-29 Erbe Elektromedizin Gmbh High frequency electrosurgical apparatus for thermal coagulation of biologic tissues

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DE1146989B (de) * 1958-07-11 1963-04-11 Alexandre Fuks Elektrochirurgisches Geraet fuer elektrische Schnitte und zur Elektrokoagulation
US4655215A (en) 1985-03-15 1987-04-07 Harold Pike Hand control for electrosurgical electrodes
US5035695A (en) 1987-11-30 1991-07-30 Jaroy Weber, Jr. Extendable electrocautery surgery apparatus and method
AU701320B2 (en) 1994-12-22 1999-01-28 Ethicon Endo-Surgery, Inc. Impedance feedback monitor with query electrode for electrosurgical instrument
US7137980B2 (en) * 1998-10-23 2006-11-21 Sherwood Services Ag Method and system for controlling output of RF medical generator
US6948503B2 (en) * 2002-11-19 2005-09-27 Conmed Corporation Electrosurgical generator and method for cross-checking output power
US8147485B2 (en) * 2006-01-24 2012-04-03 Covidien Ag System and method for tissue sealing
US20080033428A1 (en) 2006-08-04 2008-02-07 Sherwood Services Ag System and method for disabling handswitching on an electrosurgical instrument
US9757142B2 (en) * 2006-08-09 2017-09-12 Olympus Corporation Relay device and ultrasonic-surgical and electrosurgical system
JP4914736B2 (ja) 2007-02-14 2012-04-11 オリンパスメディカルシステムズ株式会社 内視鏡システム
DE102007061483A1 (de) 2007-12-20 2009-07-02 Erbe Elektromedizin Gmbh Chirurgiegerätesteckersystem
US8348947B2 (en) * 2008-04-25 2013-01-08 Olympus Medical Systems Corp. Treatment system, and treatment method for living tissue using energy
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EP2713922B1 (fr) * 2011-05-31 2021-08-11 Intuitive Surgical Operations, Inc. Commande positive d'un effecteur terminal d'instrument chirurgical robotique

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US4860745A (en) * 1986-07-17 1989-08-29 Erbe Elektromedizin Gmbh High frequency electrosurgical apparatus for thermal coagulation of biologic tissues

Also Published As

Publication number Publication date
CN105555216B (zh) 2019-11-22
JP2019162502A (ja) 2019-09-26
US10687885B2 (en) 2020-06-23
JP6816217B2 (ja) 2021-01-20
BR112016005672A2 (fr) 2017-08-01
WO2015036444A1 (fr) 2015-03-19
BR112016005672B1 (pt) 2022-04-12
CN105555216A (zh) 2016-05-04
JP2016530036A (ja) 2016-09-29
DE102013110172A1 (de) 2015-03-19
US20160220299A1 (en) 2016-08-04

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