FR2502935A1 - Diathermic knife for coagulating tissues - has monitoring current added to HF coagulating current in order to control end of operation as function or resistance of coagulating tissues - Google Patents

Diathermic knife for coagulating tissues - has monitoring current added to HF coagulating current in order to control end of operation as function or resistance of coagulating tissues Download PDF

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Publication number
FR2502935A1
FR2502935A1 FR8106454A FR8106454A FR2502935A1 FR 2502935 A1 FR2502935 A1 FR 2502935A1 FR 8106454 A FR8106454 A FR 8106454A FR 8106454 A FR8106454 A FR 8106454A FR 2502935 A1 FR2502935 A1 FR 2502935A1
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France
Prior art keywords
current
coagulation
tissues
intensity
control
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Granted
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FR8106454A
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French (fr)
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FR2502935B1 (en
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Dolley Roger
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Priority to FR8106454A priority Critical patent/FR2502935B1/en
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Publication of FR2502935B1 publication Critical patent/FR2502935B1/en
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Classifications

    • 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
    • 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
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00773Sensed parameters
    • A61B2018/00875Resistance or impedance

Abstract

<P> METHOD AND DEVICE FOR CONTROLLING TISSUE COAGULATION USING HIGH FREQUENCY CURRENT. </ P> <P> A LOW INTENSITY CONTROLLED CURRENT I, WHICH IS CLEARLY IDENTIFIABLE, IS SUPERIMPOSED TO THE COAGULATION CURRENT A HIGH FREQUENCY I PROVIDED BY A GENERATOR 1 AND APPLIED BY THE ELECTRODE 3 TO THE TISSUE OF A PATIENT 12. THE VARIATION IN THE INTENSITY OF THE CONTROL CURRENT I DURING COAGULATION IS MEASURED AND THE MEASURING DEVICE 18 TURNS OFF STOPPING THE COAGULATION (RELAY 22, CONTACT 23) WHEN THE CURRENT INTENSITY I WHICH IS FUNCTION OF THE TISSUE RESISTANCE REACHES A PREDETERMINED LOWER LIMIT. </ P> <P> APPLICATION TO ELECTROCOAGULATION IN SURGERY < / P>

Description

Method and device for controlling tissue coagulation using a high frequency current

 The present invention relates to a method of controlling tissue coagulation using a high frequency current.

 The operation of the electrical lancets is based on the principle that if a high frequency current is applied to the body of a patient, a rise in temperature occurs at each of the current application electrodes; the rise in temperature is all the more important as the contact area of the electrode is small. A high frequency current is used to avoid any faradic excitation that would occur if the frequency was low enough to be felt by the patient.

 If one of the electrodes used is very fine while the other is large, the temperature rise will be considerable at the thin electrode and virtually nonexistent at the large surface electrode. Thus, at the level of the fine electrode, a cutting effect or a coagulation effect of the tissues is obtained, depending on the power applied.

 It is also possible to obtain an electrocoagulation effect by connecting the two poles of a high frequency current generator with two thin electrodes applied against the tissue to be coagulated in the operating zone. In general, these two electrodes are constituted by the two isolated branches of a clamp, the coagulation being limited to the part of the tissues which are between the two jaws of the clamp.

 The power required for this so-called "bipolar" coagulation process is significantly lower than that required for so-called "monopolar" coagulation, using a large-area electrode called an indifferent electrode and a thin electrode called an active electrode.

 Two factors determine the quality of the coagulation, namely the intensity of the current, on the one hand, and the time of passage of the current, on the other hand. Until now, the operator performs the dosing of the power and the coagulation time.

In particular, variations in coagulation time lead to irregular coagulation, some being too strong and others too weak.

 The subject of the present invention is a method of controlling both monopolar and bipolar coagulation by means of high frequency currents so that, independently of the action of the operator, all coagulation occurs. be of equal and optimal quality.

 The invention also relates to a device for implementing this method.

 According to the invention, a very small calibrated control flow which is clearly identifiable with respect to the coagulation stream is superimposed on the high-frequency coagulation stream. This control current therefore circulates, like the high-frequency coagulation current, either between a thin electrode called an active electrode, applied against the tissue to be coagulated in the operating zone of a patient, and a large surface electrode-the so-called indifferent electrode. contact with the patient outside the operating zone, or between two so-called active electrodes applied against the tissue to be coagulated in the operating zone of a patient. The variation of the intensity of this control current is measured to trigger the automatic cessation of coagulation as the intensity of the control current, which is a function of the resistance of the tissues during coagulation, reaches a predetermined lower limit value.

 Indeed, the resistance of the tissues to be coagulated is low at the moment when the coagulation begins and this resistance increases progressively as the tissues dry out under the effect of the heating of A at the passage of the coagulation stream. Consequently, the intensity of the control current superimposed on the high-frequency coagulation current is a function of the resistance of the coagulating tissues, which triggers the automatic cessation of coagulation when the tissue resistance reaches a value. The role of the operator is thus limited to triggering the start of coagulation, after having placed the active electrode or the active electrodes at the desired location, the coagulation stopping automatically as soon as it reaches a predetermined optimum value. .

 The device for carrying out the control method according to the invention comprises a control current generator connected in parallel with the high frequency coagulation current generator, a device for measuring the intensity of the control current. , connected in series with said control current generator, a filtering device between the high frequency circuit and the DC or low frequency circuit, and a device for stopping the high frequency current generator controlled by said device measured when the intensity of the control current reaches a predetermined lower limit value.

 With reference to the appended drawing, an illustrative and nonlimiting embodiment of a control device according to the invention in its application to the control of monopolar coagulation will be described below, using an active electrode. and an indifferent electrode.

 In the diagram of the single figure of the drawing, a high-frequency current generator 1 is connected, via a transformer 2, to an electrode 3 whose feed conductor 4 comprises a plug 5 connected in such a way removable on a socket 6 connected to 8 a secondary terminal of the transformer 2, the other terminal is grounded. An electrode 7 of large surface placed on an operating table 8 is connected by a conductor 9 terminating in a plug 10, in a removable manner to another socket 11 which is fitted to the mass. A patient 12 on which a intervention involving electrical surgery (cutting of tissues by electrocautery) and / or electrocoagulation is based on the table 8 so as to be in good contact with the electrode 7.

 The control of the high frequency generator 1 is effected, depending on whether it is a question of cutting or coagulating, by means of a lancet control pedal 13 or a coagulation control paddle 14 connected by two conductors respectively 15 and 16 to the generator 1.

 The device according to the invention for controlling the electrocoagulation comprises a control current generator 17 connected in parallel with the secondary of the transformer 2, so that the current ic of very low intensity, calibrated and easily identifiable, of the generator 17 is superimposed on the IHF current of the generator 1. A device 18 for measuring the intensity of the current ic of the generator 17 is connected in series with the latter. A filtering device 19 represented as comprising an impedance 20 and a capacitor 21 ensures the separation of the two currents IHF and ic to allow accurate measurement of the current ic and to avoid the destruction of the measuring device 18 by the high frequency current.

 The measuring device 18 is connected to a relay 22 actuating a contact 23 which controls the opening and closing of the conductor 16 connecting the coagulation control pedal 14 to the high-frequency current generator 1.

A manual switch 24 is mounted in parallel with the contact 23 to be able to shunt the latter.

 When the high frequency current generator 1 is set to the scalpel position (bist.) And is controlled by the scalpel control pedal 13, the control device according to the invention comprising the control current generator 17, the measuring device 18, the relay 22 and the contact 23 is not in action. On the other hand, the control device is automatically activated when the generator 1 is set to the coagulation position (coag.) And when the switch 24 is opened.

 To perform a coagulation, the operator applies the electrode 3 at the place where he wants to achieve coagulation and depresses the pedal 14. The IHF current which is superimposed on the ic current of the generator 17 thus produces a heating of the tissue at the level of the end of the electrode 3, warming up which coagulates the tissues.

The initial weak resistance of the tissues in contact with the electrode 3 increases progressively as the tissues coagulate, i.e., dry out. As the tissue strength increases, the intensity of the current iC decreases. The measuring device 18 is set to an intensity threshold corresponding to an optimum degree of coagulation defined by a determined resistance of the tissues. As soon as this threshold is reached, the measuring device 18 excites the relay 22 which opens the contact 23, thus interrupting the control of the generator 1, which stops the coagulation.

 By closing the switch 24, the control device can be put out of service, which allows the operator to self-dose the coagulations if he so desires.

The measuring device 18 is set up so as to allow the operation and cause the high-frequency current generator 1 to stop, during coagulation, according to three thresholds corresponding to three resistors.
R1 (R2 <R3 and the resistance value R presented by the patient's tissues.

 If R> R3 (electrode 3 not applied to the tissues of the patient), the measuring device 18 prohibits the operation of the generator 1, even if the coagulation control pedal 14 is depressed.

 If R <R1 (electrode 3 in contact with the tissues), the generator 1 operates when the pedal 14 is actuated. Coagulation begins and R gradually increases.

 As soon as R = R2 (R2 being the threshold for triggering the cessation of coagulation), the measuring device 18 stops the generator 1 without the operator having to release the pedal 14.

 To reset the control device, the operator returns the electrode 3 but can hold down the pedal 14; this also has the advantage for the operator to be able to perform several coagulation series without releasing the pedal, simply by moving the electrode 3.

 On the other hand, the operator remains at all times master of the coagulation which he can stop immediately, if it deems necessary, by releasing the pedal 14.

 To apply the control device as represented and described to bipolar coagulation which consists of using a pair of insulated tweezers each of which is connected to a pole of a high-frequency current generator, it is sufficient to connect the two branches of the the clamp by two conductors, directly or indirectly, to the two sockets 6 and 11.

 Only the general characteristics of the control device according to the invention have been described above and shown in the attached schematic drawing. Multiple variants within the reach of those skilled in the art are conceivable as regards, for example, the production of the filter 19, the measuring device 18 and the stop device 22, 23, in particular according to the nature of the control current used. This current may be, for example a direct current as in the example shown, or alternatively a low-frequency alternating current, an alternating current having a frequency much higher than that of the coagulation current, or also a complex current, for example encoded pulses. It is sufficient for this current to be of very low intensity, calibrated and easily identifiable with respect to the coagulation current.

Claims (2)

 1. A method for controlling the coagulation of tissues of a patient using a high frequency current supplied by a generator of which either a pole is connected to a thin electrode called active electrode applied against the tissues to be coagulated in the operating area of the patient and the other to a large surface electrode called indifferent electrode, in contact with the patient outside the operating area, or the two blades are connected to two thin electrodes applied against the tissues to be coagulated in the operating area of the patient, characterized in that a control current of very low intensity, calibrated, clearly identifiable with respect to the coagulation current is superimposed on the high-frequency coagulation current, and that the variation in the intensity of the coagulation is measured. this control current to trigger the cessation of coagulation as soon as the intensity of the control current, which is a function of the resistance of the tissues in the course of oagulation, reaches a predetermined lower limit value.
 2. Device for implementing the method according to claim 1, characterized in that it comprises a control current generator connected in parallel with the high frequency coagulation current generator, a device for measuring the intensity of the control current, connected in series with said control current generator, a filtering device separating the coagulation current from the control current, and an automatic shutdown device of the coagulation current generator, controlled by the control device. measurement of the control current when the intensity of this current reaches a predetermined lower limit value.
FR8106454A 1981-03-31 1981-03-31 Method and tissue coagulation control device using a current to high frequency Expired FR2502935B1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
FR8106454A FR2502935B1 (en) 1981-03-31 1981-03-31 Method and tissue coagulation control device using a current to high frequency

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
FR8106454A FR2502935B1 (en) 1981-03-31 1981-03-31 Method and tissue coagulation control device using a current to high frequency

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FR2502935A1 true FR2502935A1 (en) 1982-10-08
FR2502935B1 FR2502935B1 (en) 1985-10-04

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