JP7091292B2 - 電気外科的システム - Google Patents
電気外科的システム Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- 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
- A61B18/1206—Generators therefor
- A61B18/1233—Generators therefor with circuits for assuring patient safety
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- 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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- 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
- A61B90/03—Automatic limiting or abutting means, e.g. for safety
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00059—Material properties
- A61B2018/00071—Electrical conductivity
- A61B2018/00077—Electrical conductivity high, i.e. electrically conducting
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- 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
- A61B2018/00607—Coagulation and cutting with the same instrument
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- 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
- A61B2018/00619—Welding
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- 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
- A61B2018/00642—Sensing and controlling the application of energy with feedback, i.e. closed loop control
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- 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
- A61B2018/00696—Controlled or regulated parameters
- A61B2018/00702—Power or energy
- A61B2018/00708—Power or energy switching the power on or off
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- 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
- A61B2018/00696—Controlled or regulated parameters
- A61B2018/00738—Depth, e.g. depth of ablation
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- A—HUMAN NECESSITIES
- 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
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- A61B2018/00696—Controlled or regulated parameters
- A61B2018/00767—Voltage
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- 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
- A61B2018/00773—Sensed parameters
- A61B2018/00869—Phase
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- 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
- A61B2018/00773—Sensed parameters
- A61B2018/00892—Voltage
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- 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
- A61B18/1206—Generators therefor
- A61B2018/1246—Generators therefor characterised by the output polarity
- A61B2018/126—Generators therefor characterised by the output polarity bipolar
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- 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
- A61B2018/1452—Probes having pivoting end effectors, e.g. forceps including means for cutting
- A61B2018/1455—Probes having pivoting end effectors, e.g. forceps including means for cutting having a moving blade for cutting tissue grasped by the jaws
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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
- A61B90/03—Automatic limiting or abutting means, e.g. for safety
- A61B2090/033—Abutting means, stops, e.g. abutting on tissue or skin
- A61B2090/034—Abutting means, stops, e.g. abutting on tissue or skin abutting on parts of the device itself
Description
本願は、2014年5月16日に出願された米国特許仮出願第61/994,192号、2014年5月16日に出願された米国特許仮出願第61/994,185号、2014年5月16日に出願された米国特許仮出願第61/994,415号、及び2014年5月16日に出願された米国特許仮出願第61/994,215号の権益主張出願であり、これらの米国特許仮出願を参照により引用し、これらの開示内容全体を本明細書の一部とする。
上式において、Tは、基本周期として定められ、Aは、基本振幅であり、pは、基本位相である。3次高調波周波数を次のように定めることができる。
上式において、kAは、3次高調波周波数の振幅として定められ、kは、3次高調波振幅と基本振幅の比であり、qは、3次高調波周波数の位相である。同期検出器の実数(Re)及び虚数(Im)出力電圧は、以下の通りである。
3次高調波の振幅がゼロに等しくない場合、複素振幅は、これとは異なる結果を有することができる。
その理由として、
すると、
且つ
この場合、複素振幅は次の通りである。
びSynchDetIm)のところでの例示の信号波形を示している。図6~図10は、著しく損なわれているが、4次高調波よりも高い高調波を含んでいない例示の入力信号を提供すると共に同様に図6‐11及び図6‐12に示されているようにかかる入力信号のための低域通過フィルタ93による濾波に先立ってそれぞれの出力(SynchDetRe及びSynchDetIm)のところでの例示の信号波形を提供している。したがって、図示のように、同期検出器は、種々の実施形態に従って、かかる入力信号の基本振幅及び位相を正確に回復させることができ、かくして、位相の検出及び測定又は計算及び/又は位相の変化率に関して実数(Re)及び虚数(Im)出力電圧を正確に提供することができる。
Claims (15)
- 電気外科的システムであって、
組織を把持して高周波(RF)エネルギーを用いて該組織を溶融させるよう構成された電気外科的器械を有し、この電気外科的器械が、
第1の電極を備えた第1のジョーと、
前記第1のジョーに結合されると共に前記第1の電極に向いた第2の電極を備える第2のジョーであって、前記第1の電極及び第2の電極は、前記第1の電極と前記第2の電極との間で高周波(RF)エネルギーを伝えるよう配置され、前記第1及び前記第2の電極は、同一の導電性材料で作られている前記第2のジョーと、
近位端部、遠位端部及び前記近位端部から前記遠位端部まで延びる長手方向軸線を備えた細長いシャフトであって、前記第1及び前記第2のジョーは、前記細長いシャフトの前記遠位端部に回動可能に結合されている前記細長いシャフトと、
前記第2のジョー中に組み込まれると共に前記第2のジョーから前記第1のジョーに向かって延びる導電性ポストであって、前記導電性ポストは、静止しており且つ前記第1及前記第2の電極と同一の導電性材料で作られ、様々な高さを有する複数の導電性ポストを含み、前記複数の導電性ポストは、最も近位側の導電性ポストの高さよりも高い高さを有する最も遠位側の導電性ポストを含んでいる前記導電性ポストと、を有し、
前記電気外科的システムが、更に、
前記電気外科的器械に接続可能であると共に前記電気外科的器械を介して前記RFエネルギーを供給するように構成された電気外科的発生器を有し、この電気外科的発生器が、
前記電気外科的器械を介してRFエネルギーを供給するRF増幅器と、
前記供給されたRFエネルギーから供給RF波形を受け取るよう構成されたRFセンスと、を有し、
前記RFセンスは、前記供給RF波形の電圧及び電流の実数成分及び虚数成分を計算するよう構成された同期検波器と、を有している、
ことを特徴とする電気外科的システム。 - 前記RFセンスは、前記計算された電圧及び電流の実数成分及び虚数成分から前記供給RFエネルギーの位相角を決定するように構成され、さらに、制御装置を有し、この制御装置は、決定された位相角が既定の位相値よりも小さいとき、RF増幅器に信号を送ってRRエネルギーの供給を停止するように構成されている、
請求項1に記載の電気外科的システム。 - 前記既定の位相値は、負の値である、請求項2に記載の電気外科的システム。
- 前記既定の位相値は、ゼロ度未満である、
請求項2記載の電気外科的システム。 - 前記RFセンスが、前記RF増幅器からの供給RFエネルギーの電圧および電流を測定し、測定された電圧および電流の電圧、電流、電力および位相を示すDC信号を生成し、
更に、前記RFセンスからの生成DC信号からノイズを除くと共に前記供給RFエネルギーの電圧、電流、電力および位相を表す平滑な変調DC信号を前記生成DC信号から外挿するRFスムーザを有する、
請求項1又は4に記載の電気外科的システム。 - 前記複数の導電性ポストの少なくとも1本は、前記第2のジョーの上面から延びる上側部分及び前記第2のジョー内に設けられた絶縁材料内に封入された下側部分を備え、前記絶縁材料は、前記複数の導電性ポストの少なくとも1本を前記第2のジョー内の導電性材料から隔てている、
請求項1又は4に記載の電気外科的システム。 - 前記電気外科的器機は、更に、近位位置から遠位位置まで長手方向軸線に沿って動くことができ、そして前記近位位置まで戻ることができるブレードを有し、前記ブレードは、前記第2のジョーの外周内に配置され、前記第2のジョーはそこを通って移動するチャネルを備えている、
請求項1に記載の電気外科的システム。 - 前記複数の導電性ポストの少なくとも1本は、前記第2のジョーのチャネルに隣接して配置されている、
請求項7に記載の電気外科的システム。 - 前記電気外科的器機は、更に、前記細長いシャフトの前記近位端部に設けられたアクチュエータを有し、前記アクチュエータは、前記アクチュエータの操作により前記第1及び前記第2のジョーが動かされ、前記RFエネルギーの供給又はブレードの並進運動が開始された場合、ユーザにより接近可能であるよう配置されている、
請求項8に記載の電気外科的システム。 - 前記電気外科的発生器は、高周波エネルギーを前記複数の導電性ポスト及び前記ブレードにではなく、前記第1および第2の電極にのみ供給するよう構成されている、
請求項8又は9に記載の電気外科的システム。 - 前記電気外科的器械は、更に、前記電気外科的発生器によりRFエネルギーを供給させるスイッチを有する、
請求項1に記載の電気外科的システム。 - 前記電気外科的発生器の制御装置は、前記電気外科的器械及び電気外科的発生器の両者の使用をログ記録する、
請求項11に記載の電気外科的システム。 - 前記複数の導電性ポストの少なくとも1本が、熱可塑性樹脂オーバーモールディングによって前記第2のジョーに固定されている、
請求項1に記載の電気外科的システム。 - 前記同期検波器が、同調信号を利用して前記供給RF波形の電圧及び電流の実数成分及び虚数成分を計算するよう構成されている、
請求項1に記載の電気外科的システム。 - 前記RFセンスが、計算された電圧及び電流の実数成分及び虚数成分を使用して、二乗平均(RMS)電圧、RMS電流、見かけの電力及び位相を計算する、
請求項14に記載の電気外科的システム。
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US201461994192P | 2014-05-16 | 2014-05-16 | |
US201461994415P | 2014-05-16 | 2014-05-16 | |
US201461994215P | 2014-05-16 | 2014-05-16 | |
US201461994185P | 2014-05-16 | 2014-05-16 | |
US61/994,415 | 2014-05-16 | ||
US61/994,215 | 2014-05-16 | ||
US61/994,185 | 2014-05-16 | ||
US61/994,192 | 2014-05-16 |
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EP (2) | EP3142583B1 (ja) |
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KR (3) | KR102413537B1 (ja) |
AU (3) | AU2015258819B2 (ja) |
CA (1) | CA2948855A1 (ja) |
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KR102413537B1 (ko) | 2022-06-27 |
EP3142583B1 (en) | 2023-04-12 |
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JP2020000886A (ja) | 2020-01-09 |
JP2022137050A (ja) | 2022-09-21 |
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