JP5015147B2 - 電気外科の電力制御 - Google Patents
電気外科の電力制御 Download PDFInfo
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Description
115 ディスプレイ
120 制御ボタン
130 状態表示器
140 レセプタクル
160 ケーブルプラグ
145 レセプタクル
155 ケーブル
162 ケーブルプラグ
200 電気外科的なプローブ
201 ハンドル
202 シャフトの遠心端
204 シャフト
206 電極
300 細胞組織
500 電力プロファイル
510 切除アルゴリズムに対応する部分
515 ライン
520 非切除アルゴリズムに対応する部分
525 ライン
530 切除アルゴリズムに対応する部分
Claims (50)
- その上に格納される命令を有する1つ以上のコンピュータ読み取り可能な記録媒体を備える装置であって、
前記命令が、少なくとも、
特定のプローブ構造を有する電気外科的なプローブの動作に関連付けられたパラメータの値を、前記プローブが所望の処置方法において細胞組織を処理しているときに判定する処理と、
特定のプローブ構造に関して前記プローブが所望の処置方法において細胞組織を処理していることを示すためにあらかじめ定められた値の範囲内に前記パラメータの値が存在するか否かを判定する処理と、
前記パラメータの値が値の範囲外に存在するという判定に基づくアルゴリズムに従い前記プローブに電力を供給する処理とを実行するように構成され、
前記アルゴリズムが、低電位側電力部分と高電位側電力部分を含むパルス化されたプロファイルを有すると共に、前記プロファイルの前記高電位側電力部分において前記パラメータを判定し、前記あらかじめ定められた値の範囲内に前記パラメータの値が存在する場合には、前記プローブが所望の処置方法において細胞組織を処理していると判断する
ことを特徴とする装置。 - 前記パラメータが、インピーダンスを含むと共に、
前記細胞組織の所望の処置方法が、切除を含む
ことを特徴とする請求項1に記載の装置。 - 前記インピーダンスの範囲が、約50オームと約4000オームとの間である
ことを特徴とする請求項2に記載の装置。 - その上に格納されると共に、少なくとも、前記パルス化されたプロファイルにおける低電位側電力を、切除を開始する際に実質的に顕著な遅延を引き起こさない継続時間に制限する処理を実行するように構成される命令を更に備える
ことを特徴とする請求項2または請求項3のいずれか一項に記載の装置。 - 前記パルス化された低電位側電力の継続時間が、約50ミリセカンドと約500ミリセカンドとの間にある
ことを特徴とする請求項2から請求項4のいずれか一項に記載の装置。 - 前記パルス化されたプロファイルにおける低電位側電力が、約0ワットと約50ワットとの間の電力設定値を含む
ことを特徴とする請求項2から請求項5のいずれか一項に記載の装置。 - その上に格納されると共に、少なくとも、切除を開始するのに十分な最小長に実質的に等しい継続時間を有する、前記パルス化されたプロファイルにおける高電位側電力を提供する処理を実行するように構成される命令を更に備える
ことを特徴とする請求項2から請求項6のいずれか一項に記載の装置。 - 前記高電位側電力が、約40ワットと約300ワットとの間の電力設定値を含む
ことを特徴とする請求項2から請求項6のいずれか一項に記載の装置。 - 前記パラメータが、温度を含むと共に、
前記細胞組織の所望の処置方法が、収縮を含む
ことを特徴とする請求項1に記載の装置。 - 前記温度の範囲が、約65℃と約90℃との間である
ことを特徴とする請求項9に記載の装置。 - 前記温度の範囲が、約75℃と約90℃との間である
ことを特徴とする請求項9または請求項10のいずれか一項に記載の装置。 - その上に格納されると共に、少なくとも、前記パルス化されたプロファイルにおける低電位側電力を、収縮を開始する際に遅延を制限する継続時間に制限する処理を実行するように構成される命令を更に備える
ことを特徴とする請求項9から請求項11のいずれか一項に記載の装置。 - 前記パルス化されたプロファイルにおける低電位側電力が、約0ワットと約20ワットとの間の電力設定値を含む
ことを特徴とする請求項9から請求項12のいずれか一項に記載の装置。 - その上に格納されると共に、少なくとも、前記プローブが細胞組織を収縮させている場合に温度が範囲の下限に達するのに必要とされる時間より大きく、かつ前記プローブが細胞組織を収縮させていない場合に温度が範囲の下限に達するのに必要とされる時間より小さい継続時間を有する、前記パルス化されたプロファイルにおける高電位側電力を提供する処理を実行するように構成される命令を更に備える
ことを特徴とする請求項9から請求項13のいずれか一項に記載の装置。 - 前記高電位側電力が、約10ワットと約300ワットとの間の電力設定値を含む
ことを特徴とする請求項9から請求項14のいずれか一項に記載の装置。 - その上に格納されると共に、少なくとも、前記値の範囲内に前記パラメータの値が存在するという判定に基づいて、前記所望の処置方法において細胞組織を処理するために、前記アルゴリズムと異なる第2のアルゴリズムに従い前記プローブに電力を供給する処理を実行するように構成される命令を更に備え、
前記第2のアルゴリズムが、前記プローブに細胞組織を切除するのに十分な電力を供給し続けながら前記パラメータを判定し、前記あらかじめ定められた値の範囲内に前記パラメータの値が存在する場合には、前記プローブが所望の処置方法において細胞組織を処理していると判断する
ことを特徴とする請求項1に記載の装置。 - その上に格納されると共に、少なくとも、前記パラメータの値が値の範囲の下限よりマージン分だけ大きいという判定に基づいて、前記アルゴリズムから前記第2のアルゴリズムに切り替わる処理を実行するように構成される命令を更に備える
ことを特徴とする請求項16に記載の装置。 - その上に格納されると共に、少なくとも、前記パラメータの値が値の範囲の下限よりマージン分だけ小さいという判定に基づいて、前記第2のアルゴリズムから前記アルゴリズムに切り替わる処理を実行するように構成される命令を更に備える
ことを特徴とする請求項16または請求項17のいずれか一項に記載の装置。 - その上に格納されると共に、少なくとも、前記パラメータの1つより多い特定数の値を判定する処理と、前記特定数の値の全てより小さいものについて、あらかじめ定められた値の範囲内に前記パラメータの値が存在するか否かを判定する処理とを実行するように構成される命令を更に備える
ことを特徴とする請求項1に記載の装置。 - 前記パラメータが、インピーダンスを含むと共に、
前記装置は、その上に格納されると共に、少なくとも、前記値の範囲内に前記パラメータの値が存在するか否かを判定する処理が、前記電気外科的なプローブにより感知されるインピーダンス値がしきい値より小さいという1つ以上の判定を下す処理を含み、前記アルゴリズムに従い前記プローブに電力を供給する処理が、前記インピーダンス値がしきい値より小さいという1つ以上の判定の内の少なくとも1つに応答して前記電気外科的なプローブに電力を供給することによって、細胞組織の壊死を200ミクロンより小さい範囲に制限する処理を含むように構成される命令を更に備える
ことを特徴とする請求項1に記載の装置。 - 前記細胞組織を処理する所望の処置方法が、切除を含み、
前記パラメータの値が値の範囲外であるという判定は、前記プローブが非切除モードであるという判定であり、
前記アルゴリズムの前記パルス化されたプロファイルにおける高電位側電力部分が、切除モードを開始するのに十分な継続時間の部分であり、
前記継続時間が、250ミリセカンドより小さいと共に、
前記装置は、その上に格納されると共に、少なくとも、前記値の範囲内に前記パラメータの値がある場合に、前記アルゴリズムと異なる第2のアルゴリズムに従って電力を供給する処理を実行するように構成される命令を更に備え、
前記値の範囲内に前記パラメータの値があるという判定は、前記プローブが切除モードであるという判定であると共に、
前記第2のアルゴリズムが、前記プローブに細胞組織を切除するのに十分な電力を供給し続けながら前記パラメータを判定し、前記あらかじめ定められた値の範囲内に前記パラメータの値が存在する場合には、前記プローブが所望の処置方法において細胞組織を処理していると判断する
ことを特徴とする請求項1に記載の装置。 - 前記パラメータが、温度の範囲に前記プローブの温度が接近する速度を含み、
前記細胞組織の所望の処置方法が、前記細胞組織の収縮を含み、
前記装置は、その上に格納されると共に、少なくとも、前記値の範囲内に前記パラメータの値が存在するか否かを判定する処理が、前記プローブから前記細胞組織までの距離が温度の範囲内の温度において前記細胞組織の収縮を可能にするのに十分に小さいことを示すためにあらかじめ定められた速度の範囲内に前記速度があるか否かを判定する処理を含むように構成される命令を更に備える
ことを特徴とする請求項1に記載の装置。 - 電力を細胞組織に供給するように構成される電気外科的なプローブと、
前記電気外科的なプローブの動作に関連付けられたパラメータの値を、前記プローブが所望の処置方法において細胞組織を処理しているときに判定し、特定のプローブ構造に関して前記プローブが所望の処置方法において細胞組織を処理していることを示すためにあらかじめ定められた値の範囲内に前記パラメータの値が存在するか否かを判定し、前記パラメータの値が値の範囲外に存在するという判定に基づくアルゴリズムに従い前記プローブに電力を供給する処理とを実行するように構成される制御モジュールとを備え、
前記アルゴリズムが、低電位側電力部分と高電位側電力部分を含むパルス化されたプロファイルを有すると共に、前記プロファイルの前記高電位側電力部分において前記パラメータを判定し、前記あらかじめ定められた値の範囲内に前記パラメータの値が存在する場合には、前記プローブが所望の処置方法において細胞組織を処理していると判断する
ことを特徴とする装置。 - 前記制御モジュールが、前記アルゴリズムに含まれる前記パルス化されたプロファイルの継続時間を、切除を開始する際に実質的に顕著な遅延を引き起こさない継続時間に制限するように更に構成される
ことを特徴とする請求項23に記載の装置。 - 前記制御モジュールが、切除を開始するのに十分な最小長に実質的に等しい継続時間を有する、前記パルス化されたプロファイルにおける高電位側電力を提供するように更に構成される
ことを特徴とする請求項23または請求項24のいずれか一項に記載の装置。 - 前記制御モジュールが、少なくとも、前記値の範囲内に前記パラメータの値が存在するという判定に基づいて、前記所望の処置方法において細胞組織を処理するために、前記アルゴリズムと異なる第2のアルゴリズムに従い前記プローブに電力を供給する処理を実行するように更に構成され、
前記第2のアルゴリズムが、前記プローブに細胞組織を切除するのに十分な電力を供給し続けながら前記パラメータを判定し、前記あらかじめ定められた値の範囲内に前記パラメータの値が存在する場合には、前記プローブが所望の処置方法において細胞組織を処理していると判断する
ことを特徴とする請求項23から請求項25のいずれか一項に記載の装置。 - 特定のプローブ構造を有する電気外科的なプローブの動作に関連付けられたパラメータの値を、前記プローブが所望の処置方法において細胞組織を処理しているときに判定する処理と、
特定のプローブ構造に関して前記プローブが所望の処置方法において細胞組織を処理していることを示すためにあらかじめ定められた値の範囲内に前記パラメータの値が存在するか否かを判定する処理と、
前記パラメータの値が値の範囲外に存在するという判定に基づくアルゴリズムに従い前記プローブに電力を供給する処理とを含み、
前記アルゴリズムが、低電位側電力部分と高電位側電力部分を含むパルス化されたプロファイルを有すると共に、前記プロファイルの前記高電位側電力部分において前記パラメータを判定し、前記あらかじめ定められた値の範囲内に前記パラメータの値が存在する場合には、前記プローブが所望の処置方法において細胞組織を処理していると判断する
ことを特徴とする方法。 - 前記パラメータが、インピーダンスを含む
ことを特徴とする請求項27に記載の方法。 - 前記インピーダンスの範囲が、約50オームと約4000オームとの間である
ことを特徴とする請求項28に記載の方法。 - 前記細胞組織の所望の処置方法が、切除を含む
ことを特徴とする請求項28または請求項29のいずれか一項に記載の方法。 - 前記パルス化されたプロファイルにおける低電位側電力を、切除を開始する際に実質的に顕著な遅延を引き起こさない継続時間に制限する処理を更に含む
ことを特徴とする請求項30に記載の方法。 - 前記パルス化された低電位側電力の継続時間が、約50ミリセカンドと約500ミリセカンドとの間にある
ことを特徴とする請求項27から請求項31のいずれか一項に記載の方法。 - 前記パルス化されたプロファイルにおける低電位側電力が、約0ワットと約50ワットとの間の電力設定値を含む
ことを特徴とする請求項27から請求項32のいずれか一項に記載の方法。 - 切除を開始するのに十分な最小長に実質的に等しい継続時間を有する、前記パルス化されたプロファイルにおける高電位側電力を提供する処理を更に含む
ことを特徴とする請求項27から請求項33のいずれか一項に記載の方法。 - 前記高電位側電力が、約40ワットと約300ワットとの間の電力設定値を含む
ことを特徴とする請求項27から請求項33のいずれか一項に記載の方法。 - 前記パラメータが、温度を含む
ことを特徴とする請求項27に記載の方法。 - 前記温度の範囲が、約65℃と約90℃との間である
ことを特徴とする請求項36に記載の方法。 - 前記温度の範囲が、約75℃と約90℃との間である
ことを特徴とする請求項36または請求項37のいずれか一項に記載の方法。 - 前記細胞組織の所望の処置方法が、収縮を含む
ことを特徴とする請求項36から請求項38のいずれか一項に記載の方法。 - 前記パルス化されたプロファイルにおける低電位側電力を、収縮を開始する際に遅延を制限する継続時間に制限する処理を更に含む
ことを特徴とする請求項36から請求項39のいずれか一項に記載の方法。 - 前記パルス化されたプロファイルにおける低電位側電力が、約0ワットと約20ワットとの間の電力設定値を含む
ことを特徴とする請求項36から請求項40のいずれか一項に記載の方法。 - 前記プローブが細胞組織を収縮させている場合に温度が範囲の下限に達するのに必要とされる時間より大きく、かつ前記プローブが細胞組織を収縮させていない場合に温度が範囲の下限に達するのに必要とされる時間より小さい継続時間を有する、前記パルス化されたプロファイルにおける高電位側電力を提供する処理を更に含む
ことを特徴とする請求項36から請求項41のいずれか一項に記載の方法。 - 前記高電位側電力が、約10ワットと約300ワットとの間の電力設定値を含む
ことを特徴とする請求項36から請求項42のいずれか一項に記載の方法。 - 前記値の範囲内に前記パラメータの値が存在するという判定に基づいて、前記所望の処置方法において細胞組織を処理するために、前記アルゴリズムと異なる第2のアルゴリズムに従い前記プローブに電力を供給する処理を更に含み、
前記第2のアルゴリズムが、前記プローブに細胞組織を切除するのに十分な電力を供給し続けながら前記パラメータを判定し、前記あらかじめ定められた値の範囲内に前記パラメータの値が存在する場合には、前記プローブが所望の処置方法において細胞組織を処理していると判断する
ことを特徴とする請求項27に記載の方法。 - 前記パラメータの値が値の範囲の下限よりマージン分だけ大きいという判定に基づいて、前記アルゴリズムから前記第2のアルゴリズムに切り替わる処理を更に含む
ことを特徴とする請求項44に記載の方法。 - 前記パラメータの値が値の範囲の下限よりマージン分だけ小さいという判定に基づいて、前記第2のアルゴリズムから前記アルゴリズムに切り替わる処理を更に含む
ことを特徴とする請求項44または請求項45のいずれか一項に記載の方法。 - 前記パラメータの1つより多い特定数の値を判定する処理と、
前記特定数の値の全てより小さいものについて、あらかじめ定められた値の範囲内に前記パラメータの値が存在するか否かを判定する処理と
を更に含むことを特徴とする請求項27に記載の方法。 - 前記パラメータが、インピーダンスを含むと共に、
前記値の範囲内に前記パラメータの値が存在するか否かを判定する処理が、前記電気外科的なプローブにより感知されるインピーダンス値がしきい値より小さいという1つ以上の判定を下す処理を含み、
前記アルゴリズムに従い前記プローブに電力を供給する処理が、前記インピーダンス値がしきい値より小さいという1つ以上の判定の内の少なくとも1つに応答して前記電気外科的なプローブに電力を供給することによって、細胞組織の壊死を200ミクロンより小さい範囲に制限する処理を含む
ことを特徴とする請求項27に記載の方法。 - 前記細胞組織の所望の処置方法が、切除を含み、
前記パラメータの値が値の範囲外であるという判定は、前記プローブが非切除モードであるという判定であり、
前記アルゴリズムの前記パルス化されたプロファイルにおける高電位側電力部分が、切除モードを開始するのに十分な継続時間の部分であり、
前記継続時間が、250ミリセカンドより小さいと共に、
前記方法が、前記値の範囲内に前記パラメータの値がある場合に、前記アルゴリズムと異なる第2のアルゴリズムに従って電力を供給する処理を更に含み、
前記値の範囲内に前記パラメータの値があるという判定は、前記プローブが切除モードであるという判定であると共に、
前記第2のアルゴリズムが、前記プローブに細胞組織を切除するのに十分な電力を供給し続けながら前記パラメータを判定し、前記あらかじめ定められた値の範囲内に前記パラメータの値が存在する場合には、前記プローブが所望の処置方法において細胞組織を処理していると判断する
ことを特徴とする請求項27に記載の方法。 - 前記パラメータが、温度の範囲に前記プローブの温度が接近する速度を含み、
前記細胞組織の所望の処置方法が、前記細胞組織の収縮を含み、
前記値の範囲内に前記パラメータの値が存在するか否かを判定する処理が、前記プローブから前記細胞組織までの距離が温度の範囲内の温度において前記細胞組織の収縮を可能にするのに十分に小さいことを示すためにあらかじめ定められた速度の範囲内に前記速度があるか否かを判定する処理を含む
ことを特徴とする請求項27に記載の方法。
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Cited By (5)
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KR20150126609A (ko) * | 2013-03-07 | 2015-11-12 | 아서로케어 코포레이션 | 전기 수술 시스템 및 방법 |
KR102061384B1 (ko) | 2013-03-07 | 2020-02-11 | 아서로케어 코포레이션 | 전기 수술 시스템 및 방법 |
JP2018510010A (ja) * | 2015-03-31 | 2018-04-12 | セント・ジュード・メディカル,カーディオロジー・ディヴィジョン,インコーポレイテッド | カテーテル・アブレーション中にパルスrfエネルギーを送達するための方法およびデバイス |
US11350986B2 (en) | 2015-03-31 | 2022-06-07 | St. Jude Medical, Cardiology Division, Inc. | High-thermal-sensitivity ablation catheters and catheter tips |
US11419674B2 (en) | 2015-03-31 | 2022-08-23 | St. Jude Medical, Cardiology Division, Inc. | Methods and devices for delivering pulsed RF energy during catheter ablation |
Also Published As
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WO2007002262A2 (en) | 2007-01-04 |
US8052675B2 (en) | 2011-11-08 |
AU2006262180B2 (en) | 2012-12-06 |
JP2008543505A (ja) | 2008-12-04 |
EP1895922B1 (en) | 2018-06-13 |
US20130096556A1 (en) | 2013-04-18 |
US20120010613A1 (en) | 2012-01-12 |
US8348934B2 (en) | 2013-01-08 |
US20100121317A1 (en) | 2010-05-13 |
US20140088589A1 (en) | 2014-03-27 |
US8956347B2 (en) | 2015-02-17 |
WO2007002262A3 (en) | 2007-05-31 |
AU2006262180A1 (en) | 2007-01-04 |
EP1895922A2 (en) | 2008-03-12 |
US8603082B2 (en) | 2013-12-10 |
US7655003B2 (en) | 2010-02-02 |
US20060293649A1 (en) | 2006-12-28 |
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