JP2010104813A - 電気外科用出力を制御するための動き検出器 - Google Patents
電気外科用出力を制御するための動き検出器 Download PDFInfo
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- 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
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
- A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
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- 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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- 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
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- 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
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- A—HUMAN NECESSITIES
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- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
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- A61B2018/00773—Sensed parameters
- A61B2018/00875—Resistance or impedance
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- 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
- A61B90/06—Measuring instruments not otherwise provided for
- A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
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Abstract
【解決手段】本開示の一態様では、本電気外科用機器は、細長いハウジングと、該ハウジング内に支持されかつ該ハウジングから遠位に延びる、電気外科用エネルギー源に接続可能な導電性要素と、該ハウジング内に配置されかつ電気外科用発電機に電気的に接続されたセンサとを含む。本センサは、導電性要素の動きを検出し、該導電性要素の動きに関連する信号を電気外科用発電機に伝達する。電気外科用エネルギー源は、センサからの信号に応答して電気外科用エネルギーを供給する。
【選択図】図1
Description
本出願は、それらの全内容が引用により本明細書に組み込まれる、2003年2月20日に提出された米国特許仮出願第60/448、520号、および2004年1月1日に提出された米国特許仮出願第60/533、695号の優先権の利益を主張する。
(技術分野)
本開示は、全体として電気外科用機器に関し、より詳細には、その電気外科的出力を制御するための動き検出器を有する電気外科用ペンシルに関する。
近年、電気外科用機器は、外科医によって広く用いられるようになってきた。その結果、取り扱いが容易で操作しやすく、かつ信頼性を有し安全な機器に対する必要性が生じてきている。概して、ほとんどの外科用機器は通常、種々のハンドヘルドペンシル、例えば電気外科用ペンシル、鉗子、鋏等、および電気外科用ペンシルを含んでおり、それらによってエネルギーが組織部位に移送される。電気外科用エネルギーは、最初に電気外科用発電機から活性電極へ伝達され、次いで、該活性電極が、電気外科用エネルギーを組織に伝達する。単極システムでは、帰還電極パッドが患者の下に配置され、電気外科用発電機への電気経路を完成する。双極システム構成では、より小さい帰還電極が、手術部位と身体的に接触して、または手術部位に直接隣接して配置される。
または丸みを帯びた遠位端を有する薄い平坦なブレードの形状とすることができる導電性要素である。一般に、この種の電極は、当技術界で「ブレード」型として知られている。代替的に、活性電極は、平坦な遠位端、丸みを帯びた遠位端、先のとがった遠位端、または傾斜した遠位端を有する中実の若しくは中空の細長く狭い円筒状の針を含むことができる。一般に、この種の電極は、当技術界で「ループ」型または「係蹄」型、或いは「針型」若しくは「ボール」型として知られている。
その電気外科的出力を制御するための動き感知装置を有する電気外科用機器を開示する。本開示の一態様では、電気外科用機器は、細長いハウジングと、該ハウジング内に支持されかつ該ハウジングから遠位に延びる、電気外科用エネルギー源に接続可能な導電性要素と、該ハウジング内に配置されかつ電気外科用発電機に電気的に接続されたセンサとを含む。本センサは、導電性要素の動きを検出し、該導電性要素の動きに関連する信号を電気外科用発電機に伝達する。電気外科用エネルギー源は、センサから伝達された信号に応答して電気外科用エネルギーを供給する。
本明細書に開示する電気外科用ペンシルの実施形態を、同じ参照数字は類似の要素または同一の要素を示す図面を参照し、ここで詳細に説明する。図面において、また後続の説明において、従来と同様に、用語「近位」は、電気外科用ペンシルの術者に最も近接する端部を指し、用語「遠位」は、電気外科用ペンシルの術者から最も遠い端部を指す。
Healthcare,LPの一部門であるValleylab,Inc.,によって製造された「FORCE FX」発電機、「FORCE 2」発電機または「FORCE
4」発電機のうちの任意の1つ、若しくはそれらと等価の物とすることができる。電気外科用発電機「G」のエネルギー出力は、組織切断に対して適切な電気外科用信号(例えば1ワット〜300ワット)を提供しかつ組織凝固に対して適切な電気外科用信号(例えば1ワット〜120ワット)を提供するために可変とすることができるのが好ましい。適した電気外科用発電機「G」の一例は、本発明の譲受人に譲渡された、Orszulakらに付与された米国特許第6、068、627号に開示されており、その全内容が引用により本明細書に組み込まれる。‘627号特許に開示された電気外科用発電機は、とりわけ、その中に識別回路およびスイッチを含む。一般に、識別回路は、発電機から受信した情報に応答し、発電機に検証信号を返信する。一方、スイッチは、識別回路に接続され、該識別回路から受信した信号伝達に応答する。
端部または傾斜した端部を有する中実の若しくは中空の細長く狭い円筒状の針とすることができる。
(項1)
電気外科用ペンシルであって、
細長いハウジングと、
該ハウジング内で支持されかつ該ハウジングから遠位に延びる導電性要素であって、電気外科用エネルギー源に接続可能な導電性要素と、
該ハウジング内に配置されかつ該電気外科用エネルギー源に電気的に接続されたセンサとを備え、該センサは、該導電性要素の動きを検出しかつ該導電性要素の該動きに関連する信号を該電気外科用エネルギー源に伝達し、該電気外科用エネルギー源は、該センサから伝達された該信号に応答して電気外科用エネルギーを供給する、
電気外科用ペンシル。
(項2)
前記導電性要素の動きを検出するための前記センサは、加速度計、光学位置決定システム、高周波位置決定システム、および超音波位置決定システムのうちの少なくとも1つである、上記項1に記載の電気外科用機器。
(項3)
前記導電性要素は、該要素を貫通するように規定される長手軸を含み、前記センサは、該長手軸に沿った該導電性要素の軸方向運動、該導電性要素の前記長手軸を横断する横運動、および該導電性要素の該長手軸を中心とした回転運動のうちの少なくとも1つを検出する、上記項1に記載の電気外科用機器。
(項4)
前記電気外科用エネルギー源は、前記長手軸に沿った前記導電性要素の軸方向運動の前記検出に応答して切開用RFエネルギー出力を伝達する、上記項3に記載の電気外科用機器。
(項5)
前記電気外科用エネルギー源は、前記長手軸を横断する前記導電性要素の横運動の前記検出に応答して止血用RFエネルギー出力を伝達する、上記項3に記載の電気外科用機器。
(項6)
前記センサは、差動平行板加速度計、平衡相互嵌合櫛歯状加速度計、オフセット相互嵌合櫛歯状加速度計、および薄膜型加速度計のうちの少なくとも1つである、上記項1に記載の電気外科用機器。
(項7)
前記センサは、
前記長手軸に沿った軸方向の前記導電性要素の動きを検出するための第1の加速度計と、
前記長手軸を横断する横方向の前記導電性要素の動きを検出するための第2の加速度計とを含む、上記項6に記載の電気外科用機器。
(項8)
前記第1の加速度計は、前記導電性要素の前記軸方向運動に対応する出力信号を前記電気外科用エネルギー源に伝達するように構成および適合されており、前記第2の加速度計は、該導電性要素の前記横運動に対応する出力信号を該電気外科用エネルギー源に伝達するように構成および適合されている、上記項7に記載の電気外科用機器。
(項9)
前記第1および第2の加速度計の各々は、差動平行板加速度計、平衡相互嵌合櫛歯状加速度計、オフセット相互嵌合櫛歯状加速度計、および薄膜型加速度計のうちの少なくとも1つである、上記項7に記載の電気外科用機器。
(項10)
前記第1および第2の加速度計の各々は、少なくとも1つの圧電フィルム動き検出器を含む、上記項7に記載の電気外科用機器。
(項11)
前記電気外科用エネルギー源は、
所定時間における前記電気外科用ペンシルの動き、および
動きの所定閾値レベルを上回る前記電気外科用ペンシルの動き、
のうちの少なくとも1つを前記センサが検出しないときに電気外科用エネルギーの供給を実質的に減少させる、上記項1に記載の電気外科用機器。
(項12)
前記電気外科用エネルギー源は、
前記所定時間後の前記電気外科用ペンシルの動き、および
前記動きの所定閾値レベルを上回る前記電気外科用ペンシルの動き、
のうちの少なくとも1つを前記センサが検出したときに電気外科用エネルギーの供給を実質的に増加させる、上記項11に記載の電気外科用機器。
(項13)
前記電気外科用エネルギー源は、
所定時間における前記電気外科用ペンシルの動き、および
動きの所定閾値レベルを上回る前記電気外科用ペンシルの動き、
のうちの少なくとも1つを前記センサが検出しないときに電気外科用エネルギーの供給を実質的に減少させる、上記項3に記載の電気外科用機器。
(項14)
前記電気外科用エネルギー源は、
前記所定時間後の前記電気外科用ペンシルの動き、および
前記動きの所定閾値レベルを上回る前記電気外科用ペンシルの動き、
のうちの少なくとも1つを前記センサが検出したときに電気外科用エネルギーの供給を実質的に増加させる、上記項13に記載の電気外科用機器。
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JP2010005344A Withdrawn JP2010104813A (ja) | 2003-02-20 | 2010-01-13 | 電気外科用出力を制御するための動き検出器 |
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EP (2) | EP1596743B1 (ja) |
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CA (1) | CA2516451A1 (ja) |
DE (1) | DE602004012972T2 (ja) |
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CN108141161A (zh) * | 2015-09-23 | 2018-06-08 | 伊西康有限责任公司 | 具有基于驱动系统部件的马达控件的外科缝合器 |
JP2018531769A (ja) * | 2015-09-23 | 2018-11-01 | エシコン エルエルシーEthicon LLC | 駆動システム構成要素に基づいたモータ制御を有する外科用ステープラ |
CN108141161B (zh) * | 2015-09-23 | 2022-04-19 | 伊西康有限责任公司 | 具有基于驱动系统部件的马达控件的外科缝合器 |
Also Published As
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US20070142832A1 (en) | 2007-06-21 |
US20040230262A1 (en) | 2004-11-18 |
EP1596743A4 (en) | 2007-01-24 |
EP1596743B1 (en) | 2008-04-09 |
JP2006518262A (ja) | 2006-08-10 |
US7955327B2 (en) | 2011-06-07 |
DE602004012972T2 (de) | 2009-06-10 |
DE602004012972D1 (de) | 2008-05-21 |
EP1596743A2 (en) | 2005-11-23 |
ES2300746T3 (es) | 2008-06-16 |
WO2004073753A3 (en) | 2004-10-07 |
JP4469843B2 (ja) | 2010-06-02 |
WO2004073753A2 (en) | 2004-09-02 |
US7235072B2 (en) | 2007-06-26 |
AU2004212990A1 (en) | 2004-09-02 |
AU2004212990B2 (en) | 2009-12-10 |
EP1949867A1 (en) | 2008-07-30 |
EP1949867B1 (en) | 2013-07-31 |
CA2516451A1 (en) | 2004-09-02 |
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