KR102028411B1 - A Resonant Type of a Surgical Device Having a Structure of Variable Power for Performing a Coagulation and a Cutting Process - Google Patents

Abstract

The present invention relates to a resonant surgical device having a variable output structure for the automatic execution of the coagulation and ablation process, specifically, a plurality of electrodes are arranged to apply a current of different frequency band in the coagulation and ablation process to coagulation and ablation process The present invention relates to a resonant type surgical device having a variable output structure for automatically performing coagulation and ablation processes. A resonant surgical device having a variable output structure for automatically performing coagulation and ablation processes includes a grip module 13 having a structure capable of fixing tissues of the human body; separated from each other by the grip module 13 so as to be in contact with tissues of the human body. A plurality of working electrodes 141 to 14N installed; A detection unit 15 for detecting electrical characteristics of the plurality of working electrodes 141 to 14N in an operating state; And a switching setting unit 12 for setting an electrical connection to each of the plurality of working electrodes 141 to 14N; And a control module 11 for controlling the overall operation, wherein the plurality of operation electrodes 141 to 14N are independently controlled in operation, and the progression from solidification to ablation is based on detection information of the detection unit 15. Is automatically made by the switching setting unit 12.

Description

A resonant type of a surgical device having a structure of variable power for performing a coagulation and a cutting process

The present invention relates to a resonant surgical device having a variable output structure for the automatic execution of the coagulation and ablation process, specifically, a plurality of electrodes are arranged to apply a current of different frequency band in the coagulation and ablation process to coagulation and ablation process The present invention relates to a resonant type surgical device having a variable output structure for automatically performing coagulation and ablation processes.

In the surgical procedure for treating diseases inside the human body, a portion of a tissue such as a blood vessel should be incised or resected, and various types of surgical tools for this purpose are known in the art. For example, a bloodless resection surgical apparatus that coagulates for resection of blood vessels using high frequency or ultrasonic energy has been applied. The known high frequency surgical device has a structure in which a blood vessel is gripped to apply a high frequency to coagulate, and then a knife is protruded to remove the coagulated tissue. In contrast, the ultrasound surgical device allows coagulation and cutting to be performed in a single process, but has a disadvantage in that the procedure takes longer and it is difficult to avoid tissue damage due to fever. Therefore, there is a need to develop a technology that allows the ablation process to proceed efficiently as a high frequency method is applied.

Patent Registration No. 10-1764386 improves the knife used in the endoscope submucosal remedy treatment to facilitate the pre-cutting of the affected area, and to the high-frequency knife formed integrally with the drug injection needle swelling the mucosal tissue It is started. Patent Publication No. 10-2016-0141684 also incorporates IT knives, needle knives, and water jets to reduce the number of machine changes, saving time and enabling more efficient and safer surgery for endoscopes. It starts with.

The coagulation and ablation process proceeds at different temperatures, and since the parts applied to the human body are different, it is advantageous to be able to control the temperature while appropriately restricting the applied areas. However, the prior art or the known art does not disclose such an ablation apparatus.

The present invention is to solve the problems of the prior art has the following object.

Prior Art 1: Patent Registration No. 10-1764386 (Upex Med, Inc., Aug. 03, 2017) High-frequency knife for endoscopic submucosal dissection Prior Art 2: Patent Publication No. 10-2016-0141684 (Anlay Medical (Hangzhou) Company Limited, released December 09, 2016) Multifunctional high frequency cutting tool for endoscope

An object of the present invention is to adjust the frequency band applied to each electrode while placing a plurality of electrodes, the resonance of the variable output structure for the automatic performing of the coagulation and ablation process so that the tissue is ablated efficiently in the surgical procedure It is to provide a type surgical device.

According to a preferred embodiment of the present invention, the resonant surgical device of the variable output structure for the automatic performance of the coagulation and ablation process, the grip module having a structure capable of fixing the tissue of the human body; A plurality of operation electrodes installed on the grip module to be separated from each other and to be in contact with tissue of the human body; A detection unit for detecting electrical characteristics of the plurality of working electrodes in an operational state; And a switching setting unit for setting an electrical connection to each of the plurality of working electrodes; And a control module for controlling the overall operation, wherein the plurality of operation electrodes are independently controlled for operation, and the progression from solidification to ablation is automatically made by the switching setting unit based on the detection information of the detection unit.

According to another suitable embodiment of the present invention, currents of different frequency bands are applied to at least one working electrode of the plurality of working electrodes during the solidification and ablation process.

According to another suitable embodiment of the present invention, it further comprises an operation initiation unit for initiation of operation of each operation electrode operated independently.

According to another suitable embodiment of the present invention, the detection unit periodically detects a change in the impedance of the tissue when the operation of the plurality of working electrodes is initiated.

According to another suitable embodiment of the invention, the current in the different frequency bands consists of a low frequency band and a high frequency band, and the electrical signals of the low frequency band are applied in a manner that limits the temperature of the tissue while being discontinuously applied.

Surgical apparatus according to the present invention is to efficiently perform ablation in the surgical process by appropriately adjusting the frequency band of the current applied to each electrode while placing a plurality of electrodes on the site for the gripping of tissues such as blood vessels . The surgical device according to the present invention allows the procedure time to be reduced while limiting the site of human injury due to the cutting process by selectively determining the coagulation site and the electrode and frequency band applied to the cutting site.

Figure 1 shows an embodiment of the structure of the surgical device according to the present invention.
2 shows an application example of the surgical device according to the present invention.
Figure 3 illustrates an embodiment of the electrode arrangement structure in the surgical device according to the present invention.
Figure 4 illustrates an embodiment of the process of coagulation and ablation by different electrodes by the surgical device according to the present invention.
5 illustrates an embodiment of a method of operating a surgical device according to the present invention.

Hereinafter, the present invention will be described in detail with reference to the embodiments set forth in the accompanying drawings, but the embodiments are provided for clarity of understanding and the present invention is not limited thereto. In the following description, components having the same reference numerals in different drawings have similar functions, and thus are not repeatedly described unless necessary for understanding of the invention, and well-known components are briefly described or omitted. It should not be understood to be excluded from the embodiment of.

Figure 1 shows an embodiment of the structure of the surgical device according to the present invention.

Referring to FIG. 1, a resonant surgical device having a variable output structure includes a grip module 13 having a structure capable of fixing tissues of a human body; A plurality of operation electrodes 141 to 14N which are separated from each other and installed to be in contact with tissues of the human body in the grip module 13; A detection unit 15 for detecting electrical characteristics of the plurality of working electrodes 141 to 14N in an operating state; And a switching setting unit 12 for setting an electrical connection to each of the plurality of working electrodes 141 to 14N; And a control module 11 for controlling the overall operation, wherein the plurality of operation electrodes 141 to 14N are independently controlled in operation, and the progression from solidification to ablation is based on detection information of the detection unit 15. Is automatically made by the switching setting unit 12.

The surgical device may be a device having various structures that cut or ablate by applying heat to a blood vessel or tissue by applying a high frequency or low frequency current during a surgical procedure. The surgical device may be inserted into the human body via a troika or similar induction device, for example, in a laparoscopy or endoscopic procedure. Then, by holding the ablation portion inside the human body to apply a current for hemostasis to generate heat to coagulate, after which the coagulated portion can be excised. The medical device may also be applied to exposed areas of the human body, for example for skin amelioration, scar removal or similar surgery. As such, the medical device may be made of various structures and applied to various surgical procedures. For example, the surgical device may be made of a handpiece structure or the like.

The grip module 13 may fix human tissue such as blood vessels, and the grip module 13 may be a vessel or the like, such as a pair of jaw units, a pair of interlocking pads or interlocking pad clamps arranged to face each other. It can have a variety of structures that can be fixed to the tissue. The surgical device may be inserted into the human body, or may be operated outside the human body, and may have a structure suitable for the surgical device. In addition, a plurality of working electrodes may be disposed on the grip module 13.

The plurality of working electrodes 141 to 14N may be disposed to be separated from each other and contact at least a part of the tissue that is gripped. The plurality of working electrodes 141 to 14N may be operated independently, for example, each of the plurality of working electrodes 141 to 14N may be connected to different power sources to operate, or each of the different working electrodes 141 to 14N may operate. 14N) can be operated regardless of the operation. In addition, each of the plurality of working electrodes 141 to 14N may apply a current having a different frequency band to the tissue or a portion thereof. Different working electrodes 141 to 14N may have the same or different structures, for example, the plurality of working electrodes 141 to 14N may be linear, rod or plate shape, but is not limited thereto.

The grip module 13 may be composed of a pair of submodules facing each other, and a plurality of working electrodes 141 to 14N may be disposed on inner surfaces of the pair of submodules facing each other. Each of the working electrodes 141 to 14N may be operated or inactivated by the switching setting unit 12 according to the contact state with the tissue. The switching setting unit 12 may have, for example, a switch function for electrically connecting or disconnecting the power supply and the respective working electrodes 141 to 14N. In addition, the switching setting unit 12 may have a function of establishing a connection between different working electrodes 141 to 14N, or switching a frequency band of each of the working electrodes 141 to 14N. For example, the low frequency sub-electrode and the high frequency sub-electrode may be arranged in one working electrode 141 to 14N, and the sub-electrode operated by the switching setting unit 12 may be switched.

The plurality of working electrodes 141 to 14N may apply currents of different frequency bands during the solidification and ablation processes. Coagulation and cutting of the tissue may be performed using an exothermic phenomenon due to polarization of water molecules that form a moisture of the tissue by applying a high frequency current to the tissue. It is advantageous to apply a high voltage and a low current to the tissue for coagulation of the tissue, whereby water present in the tissue can be easily removed. It is also advantageous for the low frequency current to be applied discontinuously for the progress of the coagulation process, for example in the form of a pulse. Specifically, for the coagulation of the tissue held in the grip module 13, the current in the low frequency band of the frequency band of 300 to 500 kHz, preferably 350 to 450 kHz, most preferably 370 to 400 kHz is discontinuous and periodically pulsed. Can be applied as Once the coagulation process is complete, the ablation process can proceed.

It is advantageous to apply power having a low voltage and a large current density to the solidification site for ablation or cutting, and to be continuously applied in a narrow area in a short time. For example, a high frequency current of 1 MHz or more, preferably 1 to 5 MHz, most preferably 2 to 4 MHz may be applied to the region for ablation. The coagulation and ablation process may be adjusted according to the temperature generated in the process of applying the low frequency current and the high frequency current to the tissue. For example, coagulation can be carried out at a temperature below 100 ° C., and ablation can proceed at a temperature above 100 ° C.

According to one embodiment of the present invention, the cutting process from the solidification process is automatically progressed, the process switching can be made by the switching setting unit 12 based on the information detected by the detection unit 15. Specifically, the detection unit 15 may detect a change in temperature of the coagulation site, a change in moisture, or a similar state of tissue when the coagulation is started, and preferably detect a change in impedance of the coagulation site. The gripped part may have impedance changes as the solidification progresses, and a certain level of impedance may be maintained when the solidification is completed. Alternatively, the temperature change according to the application of the low frequency current may be large. The detection unit 15 may detect a state change of the tissue according to the progress of the coagulation process and transmit the detected state to the frequency setting unit 16. The frequency setting unit 16 may set the frequency band of the working electrodes 141 to 14N based on the information transmitted to the detection unit 15, for example, one or more working electrodes (from the low frequency band to the high frequency band). 141 to 14N) can be switched. Alternatively, one or more working electrodes 141 to 14N may set a high frequency current. And the setting value can be transmitted to the control module 11, the control module 11 controls the operation of the switching setting unit 12 to the frequency setting unit 16 to the at least one operating electrode (141 to 14N). It is possible to apply an alternating current having a frequency of the band set by.

The frequency setting unit 16 may thus have a function of switching the operation modes of the working electrodes 141 to 14N, and the operating frequency set in the frequency setting unit 16 is controlled by the ablation data unit 111. Can be compared to data. The ablation data unit 111 may generate data about an operating frequency required for ablation of tissue having different structures or blood vessels having different diameters. The ablation data unit 111 may have reference data for time, frequency band or temperature required for coagulation and ablation for different tissues, and may have data for impedance according to different states of different tissues. . The frequency setting unit 16 may set a frequency for ablation according to the current operating frequency and the impedance change of each of the working electrodes 141 to 14N according to the information transmitted from the detection unit 15. The control module 11 may determine an optimum frequency according to each operating state of each of the operating electrodes 141 to 14N by comparing the ablation data and the setting data. The determined optimum frequency may be transmitted to the switching setting unit 12 so that each of the working electrodes 141 to 14N may be set to operate at the optimum frequency during the surgical procedure.

The operating frequency of the working electrodes 141 to 14N in the solidification or ablation process can be set in various ways and is not limited to the embodiments shown.

2 shows an application example of the surgical device according to the present invention.

2, the grip module of the surgical device may be composed of a pair of jaw units (21, 22) facing each other, the tissue is gripped and fixed between the pair of jaw units (21, 22), A plurality of working electrodes 23a and 23b may be arranged on the pair of electrode modules 23a and 23b formed on the inner surfaces of the respective jaw units 21 and 22.

Specifically, the medical device may be made of a hand piece structure, and the connector 25 is installed on one side of the induction rod 26 extending in the shape of a hollow cylinder, and the operation bracket 24 coupled to the connector 25 may be provided. It may have a structure in which a pair of sub-join units (21, 22) arranged to face each other. The other end of the induction rod 26 may be connected with an actuating body (not shown) in which a trigger for actuation of the sub jaw units 21, 22 or an actuation module for actuation of the electrode modules 23a, 23b is arranged. . The two sub jaw units 22 can be rotated with one end fixed with respect to the one sub jaw unit 211, and tissue such as blood vessels can be gripped between the one and two sub jaw units 21 and 22. Can be.

The electrode modules 23a and 23 may be disposed inside each of the sub jaw units 21 and 22, and may be disposed inside the sub jaw units 21 and 22 to be in contact with the gripped blood vessel. Each electrode module 23a, 23b may comprise a plurality of working electrodes described above, each working electrode being operated by a power cable 27 extending along the interior of the induction rod 26. Can be connected to a power source.

A plurality of working electrodes to which a low frequency or high frequency current is applied may be disposed in the one or two electrode modules 23a and 23b, and the plurality of working electrodes may be arranged in a structure suitable for solidification or ablation.

Figure 3 illustrates an embodiment of the electrode arrangement structure in the surgical device according to the present invention.

Referring to FIG. 3, a plurality of working electrodes 141 to 14N having a plurality of linear structures may be arranged side by side, and a surface where each of the working electrodes 141 to 14N is in contact with the tissue may be planar or knife. It can be shaped. For example, the working electrode for cutting (for example 143 or 144) placed in the center part is knife-shaped at the lower part, and the working electrode (for example 141 or 14N) disposed at both edges is low frequency for solidification. It may be an electrode to which a current is applied. Each working electrode 141 to 14N may be connected to each working power source 321 to 32N via the switch module 31. The control module 11 can adjust the operation of each of the working electrodes 141 to 14N based on the information transmitted from the detection unit described above. The control module 11 may transmit the operation information of each of the operation electrodes 141 to 145 through the operation start unit 33. For example, the operation information may include information about low frequency current, high frequency current, or connection disconnection, and may also include information about operation start time. When such operation information is transmitted to the operation start unit 33, the operation start unit 33 can transmit an operation start signal to each of the power sources 321 to 32N. The operation of each power source can be started by the operation start signal, and the connection of the switch module 31 can be established. And based on that, each working electrode (141-14N) can be operated.

Figure 4 illustrates an embodiment of the process of coagulation and ablation by different electrodes by the surgical device according to the present invention.

Referring to FIG. 4, a plurality of working electrodes 141 to 14N may be linearly arranged side by side on the inner surface of the grip pad 41 for fixing tissues such as blood vessels. And the blood vessel may be fixed by the grip pad 41 to extend in a direction perpendicular to the extending direction of each of the working electrodes (141 to 14N), the grip pad 41 is a pair of sub-grips facing each other It may be made of a pad. The same or different low frequency bands may be applied discontinuously to the respective working electrodes 141 to 14N for coagulation of tissue. The frequency bands of the currents applied to the respective working electrodes 141 to 14N may be different from each other, and the frequency is lowered in the low frequency band selected outwardly based on, for example, an intermediate working electrode (for example, 143). In this manner, a low frequency current may be applied to each of the working electrodes 141 to 14N. In operation, the impedance of the tissue grasped and solidified by the impedance detection unit 42 may be detected. The detected impedance information may be transmitted to the mode switching unit 43. The mode switching unit 43 may analyze the transmitted impedance information to determine whether the coagulation of the tissue is at a predetermined level and determine the coagulation level of the tissue and transmit the same to the control module 11 and the switch module 31. When it is determined that the coagulation is completed, the information about the coagulation may be transmitted to the control module 11 and the switch module 31 to generate a mode change signal.

Detection of coagulation completion can be accomplished in a variety of ways and is not limited to the presented embodiments.

5 illustrates an embodiment of a method of operating a surgical device according to the present invention.

Referring to FIG. 5, a method of operating a surgical device may include preparing a multi-linear array electrode capable of applying low frequency or high frequency current (P51); Holding a tissue part of the human body by a grip module in which multiple linear array electrodes are disposed (P52); Detecting an initial impedance of the gripped tissue (P53); A step (P54) in which each linear electrode is operated independently and low frequency currents of the same or different frequency bands are applied to the at least one linear electrode according to the contact state of the tissue; Measuring the impedance of the tissue to be solidified by generating heat according to the application of the low frequency electrode (P55); Determining whether the solidification of the gripped tissue is completed according to the measured impedance information (P56); If the coagulation is not completed (NO), the measurement of the coagulation impedance is continued, and if it is determined that the coagulation is completed (YES), the ablation electrode is selected to be ablation (P57).

As described above, multiple linear array electrodes can apply different frequency bands of current to the held tissue during coagulation and ablation. In addition, a plurality of linearly arranged working electrodes can be selectively operated during solidification and ablation. For example, a low frequency electrode may be applied discontinuously to a working electrode disposed at both portions with respect to the central portion during the solidification process. When the coagulation is completed, the ablation electrode may be selected, and the ablation electrode may be, for example, a working electrode disposed at the center portion (P57). In addition, a high frequency band current is continuously applied to the electrode selected for ablation for a short time so that ablation of the coagulation site may proceed (P57).

The surgical device according to the present invention can be operated in various ways and is not limited to the presented embodiments.

Although the present invention has been described in detail above with reference to the presented embodiments, those skilled in the art may make various modifications and modifications without departing from the technical spirit of the present invention with reference to the presented embodiments. . The invention is not limited by the invention as such variations and modifications but only by the claims appended hereto.

11: control module 12: switching setting unit
13: grip module 15: detection unit
16: Frequency setting unit 21, 22: 1, 2 sub-joint unit
23a, 23b: electrode module 24: operating bracket
25: connector 26: induction rod
27: power cable 31: switch module
33: operation start unit 41: grip pad
42: impedance detection unit 43: mode switching unit
111: ablation data unit 141 to 14N: working electrode
321 to 32N: working power supply

Claims (5)

A grip module 13 having a structure capable of fixing tissues of a human body;
A plurality of operation electrodes 141 to 14N which are separated from each other and installed to be in contact with tissues of the human body in the grip module 13;
A detection unit 15 for detecting electrical characteristics of the plurality of working electrodes 141 to 14N in an operating state; And
A switching setting unit 12 for setting an electrical connection to each of the plurality of working electrodes 141 to 14N; And
A control module 11 for controlling overall operation,
The plurality of working electrodes 141 to 14N are disposed on the pair of electrode modules 23a and 23b formed on the inner surfaces of the pair of jaw units 21 and 22 of the grip module 13 so that operation is independently controlled. The process from solidification to ablation is automatically made by the switching setting unit 12 based on the detection information of the detection unit 15,
At least one working electrode 141 to 14N of the plurality of working electrodes 141 to 14N is applied with a current having a different frequency band during the solidification and ablation process,
And an actuation initiation unit (33) for initiation of actuation of each actuation electrode (141 to 14N) acting independently. delete delete The resonant surgical device according to claim 1, wherein the detection unit (15) periodically detects a change in the impedance of the tissue when the operation of the plurality of working electrodes (141 to 14N) is started. The variable output structure of claim 1, wherein currents of different frequency bands are formed of a low frequency band and a high frequency band, and electrical signals of the low frequency band are applied in a manner of restricting the temperature of tissue while being discontinuously applied. Resonant surgical device.

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