JP6608477B2 - 合成されたrf/マイクロ波伝送のための電気外科装置 - Google Patents
合成されたrf/マイクロ波伝送のための電気外科装置 Download PDFInfo
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Description
本発明は、高周波エネルギおよびマイクロ波周波数エネルギを用いて生物組織に対する処置を行なう電気外科手術装置に関する。特に、本発明は、組織を切断するために高周波(RF)エネルギを、止血(すなわち破れた血管を血液の凝固を促すことによって封止)するためにマイクロ波周波数エネルギを生成することが可能な外科手術装置に関する。
外科的切除は、人間または動物の体内から器官の一部を除去する1つの手段である。そのような器官には血管が多い場合がある。組織を切断(分割または横に切開)すると、小動脈と呼ばれる小さな血管が破損または破裂する。最初に出血が生じ、続いて、出血点を塞ごうとして血液が塊になる凝固カスケードが生じる。手術中に患者から失われる血液はできる限り少ないことが望ましいため、血を伴わない切断を提供しようとしてさまざまな装置が開発されている。内視鏡手術については、出血が生じること、および可能な限り迅速に、もしくは好都合に対処されないことも望ましくない。なぜなら、操作者の視界が血流で見えにくくなることがあり、手術を終了させることが必要となり、代わりに別の方法、すなわち開腹術を用いることになり得るからである。
方向信号の一部を逆に第3のポートからの信号に(注入カプラ432を介して)注入する。搬送波相殺回路は、位相調整器434を含むことにより、この注入される部分と、第1のポートから第3のポートに、その間を突破して入る信号との位相差が確実に180°になるようにして、この信号を相殺する。搬送波相殺回路はまた、信号減衰器436を含むことにより、注入される部分の大きさが確実に突破した信号と同一になるようにする。
び電流を示す電圧出力)は直接、対応するバッファ増幅器470、472および電圧クランプツェナーダイオード474、476、478、480による調節を経て、コントローラ406に接続される(図14に信号BおよびCとして示される)。
本発明は、英国特許第2486343号に開示されている電気外科装置に対する改良を提供する。当該改良は、装置に電力を供給するために用いられる電源エネルギからプローブを分離するために用いられる構成要素に関連する。
EM放射およびマイクロ波EM放射をプローブに送るための供給構造とを備える。供給構造は、プローブをRF信号生成器に接続するためのRFチャネルと、プローブをマイクロ波信号生成器に接続するためのマイクロ波チャネルとを含む。RFチャネルおよびマイクロ波チャネルは、RF信号生成器およびマイクロ波信号生成器からの物理的に別個の信号経路をそれぞれ含む。供給構造は、RFチャネル上の別個の信号経路に接続された第1の入力と、マイクロ波チャネル上の別個の信号経路に接続された第2の入力と、RF EM放射およびマイクロ波EM放射を単一のチャネルに沿って別々にまたは同時にプローブに伝えるための共通信号経路に接続された出力とを有する合成回路を含む。マイクロ波チャネルは、マイクロ波チャネル上の別個の信号経路をRF EM放射から分離するように接続された導波管アイソレータを含む。
に必要に応じて厚くなるように選択され得る。これらの2つの要件は矛盾しており、双方とも満たすことはできない場合がある。実際のところ、スリーブはしたがって、(i)マイクロ波漏れ要件を満たすが、キャパシタンスを減少させるためには外部導体と直列の付加的な容量性ブレークを必要とする薄い絶縁層(たとえば下記に述べる同軸アイソレータ)か、または(ii)RF REMエネルギ分離要件を満たすが、必要とされる低いマイクロ波漏れを実現するためには付加的なマイクロ波成分を必要とする厚い絶縁層(たとえば上で述べたマイクロ波チョーク)のいずれかを含んでもよい。
成回路と一体化されてもよい。たとえば一実施の形態では、合成回路は、一体的に形成されてマイクロ波EM放射が第1の入力から漏出することを防止するローパス、バンドパス、バンドストップ、またはノッチフィルタを有するT字形オープンマイクロストリップ双方向ダイプレクサ回路を含んでもよい。バンドストップフィルタは、ダイプレクサ回路の第1の入力とT接合部との間のマイクロストリップライン上に形成された複数のスタブ(たとえば2個、3個、または4個のスタブ)を含んでもよい。
マイクロ波チャネルからの測定された位相および/または大きさに関する情報に基づいて自動的に、プローブに伝送されてもよい。このシステムを用いて組織の焼灼および切断を実施してもよい。マイクロ波エネルギおよびRFエネルギが同時に伝送される場合、それぞれの生成器に戻されるRFエネルギおよびマイクロ波エネルギのうちいずれかまたは双方を、ハイパワーまたはローパワーで用いることにより、エネルギ伝送プロファイルを制御してもよい。この場合、エネルギ伝送フォーマットがパルス状のときはオフ時間中に測定することが望ましいであろう。
る。
以下、本発明の実施例について添付の図面を参照しながら詳細に説明する。
図2は、本発明の実施形態である電気外科装置のための分離回路200の概略図である。分離回路200は、RF信号生成器218からのRF EM放射およびマイクロ波信号生成器220からのマイクロ波放射をプローブに送るための供給構造の一部を形成する。この実施の形態では、プローブ(図示せず)は筐体226に設けられた出力ポート228に接続可能である。供給構造は、RF EM放射を送るためのRF信号経路212および214を有するRFチャネルと、マイクロ波EM放射を送るためのマイクロ波信号経路210を有するマイクロ波チャネルとを含む。RF EM放射およびマイクロ波放射のための信号経路は、互いに物理的に別々である。RF信号生成器は、電圧変圧器216を介して、RF信号経路212および214に接続される。変圧器216の二次コイル(つまり配置のプローブ側)は浮動しており、したがって、患者とRF信号生成器218との間に直流電流経路はない。これは、RF信号経路212および214の信号導体212および接地導体214が双方とも浮動していることを意味する。
224の形態でT字形マイクロストリップ接合部上に設けられる。接合部に最も近いスタブは、マイクロストリップによって伝送されたマイクロ波EM放射の4分の1波長の奇数倍だけ接合部から離間される。これに続くスタブは、波長の半分だけ互いから分離される。2つ以上のスタブを用いることにより、マイクロ波EM放射がRF経路212,214に流出するのを防ぐ際のフィルタの有効性が高まる。
mであることを必要とし得る。導波管の幾何学的配列の他の局面は以下のように決定される。
することが可能である。IEC60601によれば、150WのRFパワー生成器は、RF出力と接地との間に最低限に好都合に接続された200Ωの抵抗器における最大伝送パワーの1%(つまり1.5Wrms)を可能にし得る。図3に示される比較例では、分離された接地(出力側と生成器側と)の間、および分離されたRF出力(出力側)と分離された接地(生成器側)との間に200Ωの抵抗器を接続した。これらの抵抗器で消費されるパワーをオシロスコープを用いて測定した。RF出力と分離さた接地(生成器側)との間に接続された200Ωの抵抗器で消費されるパワーは4.7Wrmsであった。これは、規定されているIEC 60601の最小値より大きい。
ソレータ内において、内側導電性ロッド616は内部導体618の端部から離間された点において、同軸出力プローブ(出力ポート232)の内部導体618と接触する。また、内側導電性ロッドの位置は、いずれかの著しいマイクロ波パワーを結合しないように、導波管アイソレータ内のマイクロ波エネルギの等電位と実質的に平行となるように選択される。この位置は、既知のシミュレーション技術によって決定することができ、挿入点の径方向位置の調節を許可して、または好適な同調ねじによって、細かく調整され得る。
Claims (4)
- 生物組織の切除のための電気外科手術装置のための分離回路であって、前記分離回路は、
第1の周波数を有する高周波(RF)電磁(EM)放射をRFチャネルから受けるように接続可能な第1の入力と、第1の周波数より高い第2の周波数を有するマイクロ波EM放射をマイクロ波チャネルから受けるように接続可能な第2の入力と、前記RF EM放射および前記マイクロ波EM放射を共通信号経路に送るために前記第1および第2の入力と通信する出力とを有する合成回路を備え、
前記合成回路は、導波管アイソレータと一体化され、前記導波管アイソレータは、前記マイクロ波チャネル上の信号経路を前記RF EM放射から分離するように前記第2の入力と前記出力との間に接続され、
前記導波管アイソレータは、導電性入力セクションと、導電性出力セクションとを含み、前記導電性出力セクションは、前記入力セクションと噛合い、前記入力および出力セクションによって包囲された体積内に導波管のキャビティを規定し、前記導波管アイソレータはさらに、前記入力および出力セクションの間に配置されたDC分離バリアを含み、
前記合成回路からの出力は、信号導体および接地導体を含み、
前記分離回路は、前記合成回路からの出力の前記接地導体と、前記導波管アイソレータの導電性入力セクションとの間に容量性構造体を含み、前記容量性構造体は、前記RF EMエネルギの結合および前記マイクロ波EMエネルギの漏れを阻止するように配置される、分離回路。 - 前記容量性構造体は、前記DC分離バリアと、前記導波管アイソレータの前記入力セクション上に形成されたマイクロ波チョークとによって設けられる、請求項1に記載の分離回路。
- 前記導波管アイソレータの内側セクションおよび外側セクションは円筒状体を規定し、前記マイクロ波チョークは、前記導波管アイソレータの前記内側セクションの前記遠位端から軸方向に延在する環状チャネルを含む、請求項2に記載の分離回路。
- 前記DC分離バリアは、前記導波管アイソレータの内側セクションと外側セクションとの間に載置された剛性絶縁スペーサ要素を含む、請求項1〜3のいずれか1項に記載の分離回路。
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