JP5883844B2 - 電気手術のための電力伝達のインピーダンス媒介制御 - Google Patents
電気手術のための電力伝達のインピーダンス媒介制御 Download PDFInfo
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Description
Claims (33)
- 事前設定された傾斜比率で事前設定されたRF最終値まで増加する事前設定されたRF開始値を含むプロフィールを有する最初のパルスから開始される一連のパルスを含む縫合サイクルで、電気手術装置を通して対象組織でエネルギーを伝達するように構成されるRF発生器と、
RF設定点に対する第一インピーダンス閾値、累積時間に対する第二インピーダンス閾値及びエネルギー削減に対する第三インピーダンス閾値を含む三つの事前設定されたインピーダンス閾値のそれぞれと対象組織の被検出インピーダンス値とを比較するように構成される比較器と、を含み、
前記RF発生器は、さらに、前記被検出インピーダンス値と三つの前記インピーダンス閾値との比較に応じて縫合サイクルの間のエネルギー伝達を制御するように構成され、
前記第二インピーダンス閾値は前記第一インピーダンス閾値より高く、前記第三インピーダンス閾値は前記第二インピーダンス閾値より高く、
前記第二インピーダンス閾値より高いインピーダンス値を示す組織の累積時間が事前設定された縫合サイクル持続期間の限度に到逹したとき、縫合サイクルを中断させるように構成され、
先行パルスの終了時点の前記被検出インピーダンス値が前記RF設定点に対する前記第一インピーダンス閾値より小さいとき、後続パルスが前記最初のパルスと同一のパルスプロフィールを有するように当該後続パルスに対するエネルギー伝達を制御するように構成され、
パルス途中の任意の時点の前記被検出インピーダンスが前記第三インピーダンス閾値を超える場合、前記RF発生器におけるエネルギー伝達を削減する制御を実行する電気手術システム。 - 先行パルスの終了時点の前記被検出インピーダンス値が前記RF設定点に対する前記第一インピーダンス閾値を超えるとき、後続パルスが上昇型プロフィールを有するように当該後続パルスに対するエネルギー伝達を制御するようにさらに構成されている、請求項1に記載の電気手術システム。
- 前記後続パルスの上昇型プロフィールは、パルスの開始時点に前記RF開始値から直接前記RF最終値まで階段式で増加するプロフィールを含む、請求項2に記載の電気手術システム。
- 前記後続パルスの上昇型プロフィールは、先行パルスの前記RF開始値、前記RF最終値、及び前記RF開始値から前記RF最終値までの傾斜比率とそれぞれ比較して、増加された前記RF開始値、増加された前記RF最終値、及び増加された前記傾斜比率のうち何れか一つ以上を含む、請求項2に記載の電気手術システム。
- 前記エネルギー伝達を削減する制御は、先行パルスの前記RF開始値、前記RF最終値、及び前記RF開始値から前記RF最終値までの傾斜比率とそれぞれ比較して、前記RF開始値の低減、前記RF最終値の低減、及び前記傾斜比率の低減のうち何れかを含む、請求項1に記載の電気手術システム。
- 前記エネルギー伝達を削減する制御は、前記被検出インピーダンスが前記第三インピーダンス閾値を超える時点に伝達されるエネルギーの一部の量だけを低減させるように、伝達されるエネルギーの量を低減させることを含む、請求項1に記載の電気手術システム。
- 事前設定された傾斜比率で事前設定されたRF最終値まで増加する事前設定されたRF開始値を含むプロフィールを有する最初のパルスから開始される一連のパルスを含む縫合サイクルで電気手術装置から対象組織にエネルギーを伝達するステップと、
RF設定点に対する第一インピーダンス閾値、累積時間に対する第二インピーダンス閾値及びエネルギー削減に対する第三インピーダンス閾値を含む三つの事前設定されたインピーダンス閾値のそれぞれと対象組織の被検出インピーダンス値とを比較するステップと、
前記被検出インピーダンス値と三つの前記インピーダンス閾値との間の比較に応じて縫合サイクルの間のエネルギー伝達を制御するステップと、
を含み、
前記第二インピーダンス閾値は前記第一インピーダンス閾値より高く設定され、前記第三インピーダンス閾値は前記第二インピーダンス閾値より高く設定され、
前記被検出インピーダンス値と三つの前記インピーダンス閾値との間の比較に応じて縫合サイクルの間のエネルギー伝達を制御するステップは、
前記第二インピーダンス閾値より高いインピーダンス値を示す組織の累積時間が事前設定された縫合サイクル持続期間の限度に到逹したとき、縫合サイクルを中断させるステップと、
先行パルスの終了時点の前記被検出インピーダンス値が前記第一インピーダンス閾値より小さいとき、後続パルスが前記最初のパルスと同一のパルスプロフィールを有するように当該後続パルスに対するエネルギーの伝達を制御するステップと、
パルス途中の任意の時点の前記被検出インピーダンスが前記第三インピーダンス閾値を超えるとき、エネルギー伝達を削減するステップを含む、人間以外の生物を対象とする電気手術方法。 - 前記被検出インピーダンス値が前記第二インピーダンス閾値を超える間、進行中の縫合サイクル内の累積時間を記録するステップをさらに含む、請求項7に記載の電気手術方法。
- 後続パルスに先行するパルス又は最終パルスであるそれぞれのパルスの間中、プロセッサに前記被検出インピーダンス値を伝送するステップをさらに含む、請求項7に記載の電気手術方法。
- 先行パルスの終了時点の前記被検出インピーダンス値が前記RF設定点に対するインピーダンス閾値を超えるとき、後続パルスが上昇型プロフィールを有するように前記後続パルスに対するエネルギーの伝達を制御するステップをさらに含む、請求項7に記載の電気手術方法。
- 前記後続パルスの上昇型プロフィールは、パルスの開始時点に前記RF開始値から直接前記RF最終値まで階段式で増加するプロフィールを含む、請求項10に記載の電気手術方法。
- 前記後続パルスの上昇型プロフィールは、先行パルスの前記RF開始値、前記RF最終値、及び前記RF開始値から前記RF最終値までの傾斜比率とそれぞれ比較して、増加された前記RF開始値、増加された前記RF最終値、及び増加された前記傾斜比率のうち一つ以上を含む、請求項10に記載の電気手術方法。
- 前記エネルギー伝達を削減するステップは、エネルギー伝達を即時に削減するステップを含む、請求項7に記載の電気手術方法。
- 前記エネルギー伝達を削減するステップは、エネルギー伝達の削減に先立って、前記被検出インピーダンス値が前記第三インピーダンス閾値を超える事前設定された累積経過時間の間待機するステップを含む、請求項7に記載の電気手術方法。
- 前記エネルギー伝達を削減するステップは、先行パルスの前記RF開始値、前記RF最終値、及び前記RF開始値から前記RF最終値までの傾斜比率とそれぞれ比較して、前記RF開始値を低減するステップ、前記RF最終値を低減するステップ、及び前記傾斜比率を低減するステップのうち一つ以上のステップを含む、請求項7に記載の電気手術方法。
- 前記エネルギー伝達を削減するステップは、伝達するエネルギーの一部の量だけエネルギー伝達を減少させるステップを含む、請求項7に記載の電気手術方法。
- 前記伝達するエネルギーの一部の量だけエネルギー伝達を減少させるステップは、前記被検出インピーダンスが前記第三インピーダンス閾値を超える分量に対応する分量だけエネルギー伝達を減少させるステップを含む、請求項16に記載の電気手術方法。
- 前記伝達するエネルギーの量を一部の量だけエネルギー伝達を減少させるステップは、継続してリアルタイム方式でエネルギーの量を減少させるステップを含む、請求項16に記載の電気手術方法。
- 前記パルスは、それぞれ0.5秒〜10秒の範囲の一定の持続期間を有する、請求項7に記載の電気手術方法。
- 累積縫合終了点持続期間は0.1秒と5秒との間である、請求項7に記載の電気手術方法。
- 前記RF開始値は25ワット〜150ワットの範囲である、請求項7に記載の電気手術方法。
- 前記RF最終値は50ワット〜150ワットの範囲である、請求項7に記載の電気手術方法。
- 前記第一インピーダンス閾値は5オーム〜250オームの範囲である、請求項7に記載の電気手術方法。
- 前記第三インピーダンス閾値は100オーム〜900オームの範囲である、請求項7に記載の電気手術方法。
- 前記第二インピーダンス閾値は100オーム〜750オームの範囲である、請求項7に記載の電気手術方法。
- 前記エネルギーを伝達するステップは、伝達されるエネルギーのレベルをパルス中に前記RF開始値から前記RF最終値まで増加させるステップを含む、請求項7に記載の電気手術方法。
- それぞれ事前設定されたパルス持続期間を有するパルスからなり、パルス中に事前設定されたRF最終値まで増加する事前設定されたRF開始値を含む最初のパルスプロフィールを有する最初のパルスから開始する一連のパルスを含む縫合サイクルで、電気手術装置から対象組織にエネルギーを伝達するステップと、
後続パルスに先行するパルス又は最終パルスであるそれぞれのパルス中に組織のインピーダンス値を検出するステップと、
a.第1のパルス中に組織に示されるインピーダンス値とRF設定点に対する事前設定された第一インピーダンス閾値との比較により、先行パルスのプロフィールと関連した後続パルスのプロフィールが同一のプロフィール及びより高いエネルギープロフィールのうち任意のプロフィールを有するようにし、
b.被検出インピーダンス値がエネルギー削減に対する事前設定された第三インピーダンス閾値を超えるときは、エネルギーがパルス中に削減されるようにし、
c.前記被検出インピーダンスが累積時間に対する事前設定された第二インピーダンス閾値を超えた時間の累計値が事前設定された縫合サイクル持続期間の限度まで累積されたときは、エネルギーの伝達が中断されるようにして、
縫合サイクルの間のエネルギー伝達を制御するステップと、
を含み、
前記第二インピーダンス閾値は前記第一インピーダンス閾値より高く設定され、前記第三インピーダンス閾値は前記第二インピーダンス閾値より高く設定されている、人間以外の生物を対象とする電気手術方法。 - 前記被検出インピーダンスが前記第一インピーダンス閾値を超えるときは、後続パルスのエネルギープロフィールが先行パルスのエネルギープロフィールを超え、
前記被検出インピーダンスが前記第一インピーダンス閾値より小さいときは、後続パルスのエネルギープロフィールが先行パルスのエネルギープロフィールと同一である、請求項27に記載の電気手術方法。 - パルスのエネルギープロフィールは、前記RF開始値、前記RF最終値、及び前記RF開始値と前記RF最終値との間の移行期間を含む、請求項27に記載の電気手術方法。
- 先行パルスに比べて、低下した後続パルスのパルスエネルギープロフィールは、低下した前記RF開始値、低下した前記RF最終値、及び前記RF開始値から前記RF最終値までの低下した転移比率のうち任意の値を含む、請求項27に記載の電気手術方法。
- 先行パルスに比べて、増加した後続パルスのパルスエネルギープロフィールは、より高い前記RF開始値、より高い前記RF最終値、及び前記RF開始値から前記RF最終値までのより高い転移比率のうち任意の値を含む、請求項27に記載の電気手術方法。
- 前記RF開始値から前記RF最終値までの転移は、傾斜式転移又は階段式転移のうち任意の転移を含む、請求項27に記載の電気手術方法。
- それぞれ事前設定された持続期間を有するパルスからなり、事前設定された傾斜比率で事前設定されたRF最終値まで増加する事前設定されたRF開始値を含むプロフィールを有する最初のパルスから開始する一連のパルスを含む縫合サイクルで、電気手術装置から対象組織にエネルギーを伝達するステップと、
後続パルスに先行するパルス又は最終パルスであるそれぞれのパルスの間中に、組織のインピーダンス値を検出するステップと、
RF設定点に対する第一インピーダンス閾値、累積時間に対する第二インピーダンス閾値及びエネルギー削減に対する第三インピーダンス閾値を含む三つの事前設定されたインピーダンス閾値のそれぞれと被検出インピーダンス値とを比較するステップと、
前記被検出インピーダンス値と三つの前記インピーダンス閾値との間の比較に応じて、前記第二インピーダンス閾値を超えるインピーダンス値が組織に示される累積時間が事前設定された縫合サイクル持続期間の限度に到逹するときに縫合サイクルが中断されるように、縫合サイクルの間のエネルギー伝達を制御するステップと、
を含み、
前記縫合サイクルの間のエネルギー伝達を制御するステップは、
先行パルスの終了時点の前記被検出インピーダンス値が前記第一インピーダンス閾値より小さいとき、後続パルスが前記最初のパルスと同一のパルスプロフィールを有するように当該後続パルスに対するエネルギーの伝達を制御するステップと、
パルス途中の任意の時点の前記被検出インピーダンスが前記第三インピーダンス閾値を超えるとき、エネルギー伝達を削減するステップと、
を含み、
前記第二インピーダンス閾値は前記第一インピーダンス閾値より高く設定され、前記第三インピーダンス閾値は前記第二インピーダンス閾値より高く設定されている、人間以外の生物を対象とする電気手術方法。
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US12/907,646 US8827992B2 (en) | 2010-03-26 | 2010-10-19 | Impedance mediated control of power delivery for electrosurgery |
US12/907,646 | 2010-10-19 | ||
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US20100280508A1 (en) | 2009-05-01 | 2010-11-04 | Joseph Charles Eder | Method and Apparatus for RF Anastomosis |
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EP2552335A4 (en) | 2013-11-27 |
CN102834069A (zh) | 2012-12-19 |
CA2793961A1 (en) | 2011-09-29 |
JP2013523219A (ja) | 2013-06-17 |
EP2552335A2 (en) | 2013-02-06 |
EP2552335B1 (en) | 2016-01-13 |
WO2011119933A2 (en) | 2011-09-29 |
AU2011230632A1 (en) | 2012-08-16 |
KR20130052534A (ko) | 2013-05-22 |
US8827992B2 (en) | 2014-09-09 |
BR112012021212B1 (pt) | 2021-07-13 |
RU2012145668A (ru) | 2014-05-10 |
WO2011119933A3 (en) | 2012-03-01 |
BR112012021212A2 (pt) | 2016-05-17 |
ES2562269T3 (es) | 2016-03-03 |
US20150025529A1 (en) | 2015-01-22 |
US20110238056A1 (en) | 2011-09-29 |
CN102834069B (zh) | 2015-11-25 |
US10130411B2 (en) | 2018-11-20 |
KR101818784B1 (ko) | 2018-01-16 |
MX2012008814A (es) | 2012-09-28 |
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