RU2008830C1 - Electrosurgical apparatus - Google Patents
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Изобретение относится к медицинской технике и может быть использовано для деструкции мягких тканей при проведении хирургических операций. The invention relates to medical equipment and can be used for the destruction of soft tissues during surgical operations.
Известный электрохирургический аппарат содержит последовательно соединенные между собой первую схему управления, источник питания, генератор, два электрода, подсоединенные через датчики тока к выходам генератора, вычислитель, подсоединенный своими соответствующими входами к выходам датчиков тока, вторую схему управления, подсоединенную своим первым выходом к второму входу генератора и вторым выходом к третьему входу вычислителя, схему сравнения, подсоединенную своим первым входом к выходу вычислителя и выходом к первой схеме управления, и задатчик входного сигнала, подсоединенный своим выходом к второму входу схемы сравнения. The known electrosurgical apparatus contains a first control circuit connected in series, a power source, a generator, two electrodes connected through current sensors to the outputs of the generator, a computer connected by its respective inputs to the outputs of the current sensors, a second control circuit connected by its first output to the second input generator and a second output to the third input of the calculator, a comparison circuit connected by its first input to the output of the calculator and the output to the first control circuit ny, and the input signal generator connected by its output to the second input of the comparison circuit.
Общими признаками предлагаемого электрохирургического аппарата и аналога является последовательно соединенная схема управления, источник питания, генератор, электроды, один из которых подсоединен через датчик тока к выходу генератора, источник сигнала задания и вычислитель, подсоединенный своим входом к датчику тока. Common features of the proposed electrosurgical apparatus and analogue are a series-connected control circuit, a power source, a generator, electrodes, one of which is connected through a current sensor to the output of the generator, a reference signal source and a computer connected by its input to the current sensor.
Недостатком аналога является отсутствие возможности оптимизации процесса деструкции мягких тканей, а также высокая сложность за счет наличия второй схемы управления и необходимость формирования измерительного импульса, по результатам изменения которого, после прохождения через мягкие ткани, производится корректировка уровня выходной мощности с целью предотвращения превышения предельного уровня. The disadvantage of the analogue is the inability to optimize the process of destruction of soft tissues, as well as the high complexity due to the presence of the second control circuit and the need to form a measuring pulse, according to the results of which, after passing through the soft tissues, the output power level is adjusted to prevent exceeding the limit level.
Известен также электрохирургический аппарат (см. заявку Великобритании N 2164473), взятый в качестве прототипа. Этот электрохирургический аппарат содержит последовательно соединенные между собой схему управления, источник питания, генератор, электроды, один из которых непосредственно, а другой - через датчик тока, подсоединены к выходам генератора, датчик напряжения, подсоединенный своими входами к электродам, вычислитель, подсоединенный своими соответствующими входами к выходам датчика тока и датчика напряжения, схема сравнения, подсоединенная своим первым входом к выходу вычислителя и выходом к схеме управления, и источник сигнала задания, подсоединенный своим выходом к второму входу схемы управления. An electrosurgical apparatus is also known (see UK application N 2164473), taken as a prototype. This electrosurgical apparatus contains a control circuit connected in series, a power source, a generator, electrodes, one of which is directly and the other through a current sensor, connected to the outputs of the generator, a voltage sensor connected to its inputs to the electrodes, a computer connected to its respective inputs to the outputs of the current sensor and the voltage sensor, a comparison circuit connected by its first input to the output of the calculator and the output to the control circuit, and the source of the reference signal, connected by its output to the second input of the control circuit.
Эти же признаки являются общими за исключением схемы сравнения с присущими ей связями. The same signs are common except for the comparison scheme with its inherent relationships.
Недостатком прототипа является невозможность оптимизации процесса деструкции мягких тканей во всем диапазоне изменений импеданса ткани, так как поддержание постоянной выходной мощности позволяет оптимизировать процесс деструкции лишь на ограниченном интервале изменений импеданса ткани. The disadvantage of the prototype is the inability to optimize the destruction of soft tissues in the entire range of changes in tissue impedance, since maintaining a constant output power allows you to optimize the destruction process only on a limited range of changes in tissue impedance.
Поэтому задача создания несложных электрохирургических аппаратов, имеющих возможность оптимизации процесса деструкции во всем диапазоне изменений структуры мягких тканей, является актуальной на сегодняшний день. Therefore, the task of creating simple electrosurgical devices that can optimize the destruction process in the entire range of changes in the structure of soft tissues is relevant today.
Целью изобретения является оптимизация процесса деструкции ткани во всем диапазоне изменений импеданса. The aim of the invention is to optimize the process of tissue destruction in the entire range of impedance changes.
Поставленная цель достигается тем, что в электрохирургический аппарат, содержащий последовательно соединенные между собой схему управления, источник питания и генератор, первый электрод, соединенный с выходом генератора, второй электрод, соединенный с генератором через датчик тока, датчик напряжения параллельно подключенный входами к электродам, вычислитель, соединенный входами с выходом датчика тока и с выходом датчика напряжения, и источник сигнала задания, соединенный выходом с основным входом схемы управления, введены соединенные между собой аналого-цифровой преобразователь, регистр, постоянное запоминающее устройство, цифроаналоговый преобразователь и усилитель, вход которого соединен с дополнительным входом схемы управления, а также инвертор, выход которого соединен с вторым входом регистра, и мультивибратор, выходы которого подключены к входу инвертора и входу аналого-цифрового преобразователя, второй вход которого соединен с выходом вычислителя. This goal is achieved by the fact that in an electrosurgical apparatus containing a control circuit connected in series, a power source and a generator, a first electrode connected to the generator output, a second electrode connected to the generator through a current sensor, a voltage sensor connected in parallel with the inputs to the electrodes, a calculator connected by inputs to the output of the current sensor and the output of the voltage sensor, and a reference signal source connected by the output to the main input of the control circuit, connected there is an analog-to-digital converter, a register, read-only memory, a digital-to-analog converter and an amplifier, the input of which is connected to an additional input of the control circuit, as well as an inverter, the output of which is connected to the second input of the register, and a multivibrator, the outputs of which are connected to the inverter input and input analog-to-digital Converter, the second input of which is connected to the output of the computer.
Введение соединенных между собой аналого-цифрового преобразователя, регистра, постоянного запоминающего устройства, цифроаналогового преобразователя и усилителя, вход которого соединен с дополнительным входом схемы управления, а также инвертора, выход которого соединен с вторым входом регистра, и мультивибратора, выходы которого подключены к входу инвертора и входу аналого-цифрового преобразователя, второй вход которого соединен с выходом вычислителя, позволяет, используя выходной сигнал вычислителя, равный отношению амплитуд выходных сигналов датчика напряжения к датчику тока, а следовательно пропорциональный импедансу ткани, находящейся между электродами, преобразованный в адрес ячейки постоянного запоминающего устройства в которую ранее помещена информация, являющаяся фрагментом дискретной апроксимации функциональной зависимости, отражающей изменение оптимального уровня выходной мощности, приложенной к электродам от импеданса участка ткани между ними во всем диапазоне его изменений, что позволяет в свою очередь сформировать сигнал, амплитуда которого, с учетом коэффициента пропорциональности, вводимого источником сигнала задания, определяет величину напряжения вырабатываемого источником питания и однозначно определяет уровень выходной мощности, выдаваемой с генератора на электроды, и, следовательно, обеспечить уровень выходной мощности, соответствующий оптимальному процессу деструкции ткани во всем диапазоне изменений импеданса. Introduction of interconnected analog-to-digital converter, register, read-only memory, digital-to-analog converter and amplifier, the input of which is connected to an additional input of the control circuit, as well as an inverter, the output of which is connected to the second input of the register, and a multivibrator, the outputs of which are connected to the input of the inverter and the input of the analog-to-digital converter, the second input of which is connected to the output of the calculator, allows using the output signal of the calculator equal to the ratio of the amplitudes of the output signals of the voltage sensor to the current sensor, and therefore proportional to the impedance of the tissue located between the electrodes, converted to the address of the memory cell in which information was previously placed, which is a fragment of a discrete approximation of the functional dependence, reflecting the change in the optimal level of output power applied to the electrodes from the impedance of tissue between them in the entire range of its changes, which in turn allows you to generate a signal whose amplitude, with taking into account the proportionality coefficient introduced by the source of the reference signal, it determines the value of the voltage generated by the power source and uniquely determines the level of output power supplied from the generator to the electrodes, and, therefore, ensures the level of output power corresponding to the optimal process of tissue destruction in the entire range of impedance changes.
Таким образом, введение узла памяти, хранящего ранее помещенную в него информацию, позволяет осуществить оптимизацию процесса деструкции ткани во всем диапазоне изменений импеданса ткани. Thus, the introduction of a memory node that stores information previously placed in it allows optimization of the process of tissue destruction in the entire range of changes in tissue impedance.
На чертеже представлена функциональная схема электрохирургического аппарата. The drawing shows a functional diagram of an electrosurgical apparatus.
Устройство электрохирургического аппарата содержит последовательно соединенные между собой схему управления 1, источник питания 2, генератор 3, электрод 4, подсоединенный к первому выходу генератора 3 непосредственно, а электрод 5 подсоединен к второму выходу генератора 3 через датчик тока 6, датчик напряжения 7, подсоединенный своими входами к электродам 4 и 5, вычислитель 8, подсоединенный своими соответствующими входами к выходам датчика тока 6 и датчика напряжения 7, аналого-цифровой преобразователь 9, подсоединенный своим входом к выходу вычислителя 8, регистр 10, подсоединенный входом к выходу аналого-цифрового преобразователя 9, постоянное запоминающее устройство 11, подсоединенное входом к выходу регистра 10, цифроаналоговый преобразователь 12, подсоединенный входом к выходу постоянного запоминающего устройства 11, усилитель 13, подсоединенный входом к выходу цифроаналогового преобразователя 12, а выходом - к дополнительному входу схемы управления 1, мультивибратор 14, подсоединенный своим выходом к управляющему входу аналого-цифрового преобразователя 9, инвертор 15, подсоединенный своим входом к выходу мультивибратора 14, а выходом - к управляющему входу регистра 10, источник сигнала задания 16, подсоединенный к основному входу управления 1. The device of the electrosurgical apparatus contains a
Электрохирургический аппарат работает следующим образом. С датчика тока 6 на соответствующий вход вычислителя 8 поступает сигнал постоянного тока, величина напряжения которого пропорциональна амплитуде переменного тока в цепи между выходом генератора 3 и электродом 5. С датчика напряжения 7 на соответствующий вход вычислителя 8 поступает сигнал постоянного тока, величина напряжения которого пропорциональна амплитуде переменного напряжения между электродами 4 и 5. Вычислитель 8 производит деление сигнала датчика напряжения 7 на сигнал датчика тока 6, определяя импеданс ткани находящейся между электродами 4 и 5 и выводит его в виде напряжения постоянного тока. Это напряжение преобразуется аналого-цифровым преобразователем 9 в двоичное число с периодичностью определяемой частотой мультивибратора 14. Затем это число поступает на вход регистра 10 и записывается в него управляющим сигналом с инвертора 15, для обеспечения непрерывности информации на адресном входе постоянного запоминающего устройства 11. В постоянном запоминающем устройстве 11 в виде двоичных чисел хранятся коэффициенты оптимизации процесса деструкции мягких тканей. В соответствии с кодом числа, поступающего на адресный вход постоянного запоминающего устройства 11, на его вход выводится соответствующий двоичный код коэффициента оптимизации, поступающий далее на вход цифроаналогового преобразователя 12 и затем через усилитель 13 в виде аналогового сигнала - на вход схемы управления 1. Схема управления 1 преобразует этот сигнал, с учетом коэффициента пропорциональности определяемого источником сигнала задания 16, в широтно модулированные импульсы и выводит их в качестве выходного сигнала. Electrosurgical apparatus operates as follows. From the
Источник питания 2, воспринимая широтно модулированные импульсы, устанавливает на своем выходе напряжение постоянного тока, величина которого находится в определенной зависимости от коэффициента оптимизации, поступающего с постоянного запоминающего устройства 11, и коэффициента пропорциональности, определяемого состоянием источника сигнала задания 16. Генератор 3 работает в ключевом режиме и его выходная мощность, поступающая на электроды 4 и 5, однозначно определяется величиной питающего напряжения, поступающего с источника питания 2. The
Таким образом, уровень выходной мощности на электродах 4 и 5 находится в соответствии с импедансом участка ткани, находящейся между электродами и коэффициентом пропорциональности, определяемом источником сигнала задания 16, а если в постоянном запоминающем устройстве 11 находится информация, содержащая дискретную аппроксимацию функциональной зависимости уровня выходной мощности от импеданса ткани, являющейся оптимальной с точки зрения степени деструкции, то процесс воздействия на ткань будет проходить с большой скоростью, минимальной кровопотерей и с оптимальной степенью деструкции. Thus, the output power level at the
(56) Заявка ФРГ N 3626698, кл. А 61 В 17/36, 1983. (56) Application of Germany N 3626698, CL A 61 B 17/36, 1983.
Патент Великобритании N 2164473, кл. А 61 В 17/36, 1975. UK patent N 2164473, CL A 61 B 17/36, 1975.
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US11737751B2 (en) | 2020-12-02 | 2023-08-29 | Cilag Gmbh International | Devices and methods of managing energy dissipated within sterile barriers of surgical instrument housings |
US11627960B2 (en) | 2020-12-02 | 2023-04-18 | Cilag Gmbh International | Powered surgical instruments with smart reload with separately attachable exteriorly mounted wiring connections |
US11849943B2 (en) | 2020-12-02 | 2023-12-26 | Cilag Gmbh International | Surgical instrument with cartridge release mechanisms |
US11751869B2 (en) | 2021-02-26 | 2023-09-12 | Cilag Gmbh International | Monitoring of multiple sensors over time to detect moving characteristics of tissue |
US11950779B2 (en) | 2021-02-26 | 2024-04-09 | Cilag Gmbh International | Method of powering and communicating with a staple cartridge |
US11793514B2 (en) | 2021-02-26 | 2023-10-24 | Cilag Gmbh International | Staple cartridge comprising sensor array which may be embedded in cartridge body |
US11723657B2 (en) | 2021-02-26 | 2023-08-15 | Cilag Gmbh International | Adjustable communication based on available bandwidth and power capacity |
US11950777B2 (en) | 2021-02-26 | 2024-04-09 | Cilag Gmbh International | Staple cartridge comprising an information access control system |
US11730473B2 (en) | 2021-02-26 | 2023-08-22 | Cilag Gmbh International | Monitoring of manufacturing life-cycle |
US11812964B2 (en) | 2021-02-26 | 2023-11-14 | Cilag Gmbh International | Staple cartridge comprising a power management circuit |
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US11696757B2 (en) | 2021-02-26 | 2023-07-11 | Cilag Gmbh International | Monitoring of internal systems to detect and track cartridge motion status |
US11701113B2 (en) | 2021-02-26 | 2023-07-18 | Cilag Gmbh International | Stapling instrument comprising a separate power antenna and a data transfer antenna |
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US11826042B2 (en) | 2021-03-22 | 2023-11-28 | Cilag Gmbh International | Surgical instrument comprising a firing drive including a selectable leverage mechanism |
US11806011B2 (en) | 2021-03-22 | 2023-11-07 | Cilag Gmbh International | Stapling instrument comprising tissue compression systems |
US11717291B2 (en) | 2021-03-22 | 2023-08-08 | Cilag Gmbh International | Staple cartridge comprising staples configured to apply different tissue compression |
US11826012B2 (en) | 2021-03-22 | 2023-11-28 | Cilag Gmbh International | Stapling instrument comprising a pulsed motor-driven firing rack |
US11723658B2 (en) | 2021-03-22 | 2023-08-15 | Cilag Gmbh International | Staple cartridge comprising a firing lockout |
US11759202B2 (en) | 2021-03-22 | 2023-09-19 | Cilag Gmbh International | Staple cartridge comprising an implantable layer |
US11849945B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Rotary-driven surgical stapling assembly comprising eccentrically driven firing member |
US11903582B2 (en) | 2021-03-24 | 2024-02-20 | Cilag Gmbh International | Leveraging surfaces for cartridge installation |
US11896218B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Method of using a powered stapling device |
US11896219B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Mating features between drivers and underside of a cartridge deck |
US11857183B2 (en) | 2021-03-24 | 2024-01-02 | Cilag Gmbh International | Stapling assembly components having metal substrates and plastic bodies |
US11849944B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Drivers for fastener cartridge assemblies having rotary drive screws |
US11793516B2 (en) | 2021-03-24 | 2023-10-24 | Cilag Gmbh International | Surgical staple cartridge comprising longitudinal support beam |
US11832816B2 (en) | 2021-03-24 | 2023-12-05 | Cilag Gmbh International | Surgical stapling assembly comprising nonplanar staples and planar staples |
US11944336B2 (en) | 2021-03-24 | 2024-04-02 | Cilag Gmbh International | Joint arrangements for multi-planar alignment and support of operational drive shafts in articulatable surgical instruments |
US11786243B2 (en) | 2021-03-24 | 2023-10-17 | Cilag Gmbh International | Firing members having flexible portions for adapting to a load during a surgical firing stroke |
US11786239B2 (en) | 2021-03-24 | 2023-10-17 | Cilag Gmbh International | Surgical instrument articulation joint arrangements comprising multiple moving linkage features |
US11744603B2 (en) | 2021-03-24 | 2023-09-05 | Cilag Gmbh International | Multi-axis pivot joints for surgical instruments and methods for manufacturing same |
US11723662B2 (en) | 2021-05-28 | 2023-08-15 | Cilag Gmbh International | Stapling instrument comprising an articulation control display |
US11918217B2 (en) | 2021-05-28 | 2024-03-05 | Cilag Gmbh International | Stapling instrument comprising a staple cartridge insertion stop |
US11826047B2 (en) | 2021-05-28 | 2023-11-28 | Cilag Gmbh International | Stapling instrument comprising jaw mounts |
US11957344B2 (en) | 2021-09-27 | 2024-04-16 | Cilag Gmbh International | Surgical stapler having rows of obliquely oriented staples |
US11877745B2 (en) | 2021-10-18 | 2024-01-23 | Cilag Gmbh International | Surgical stapling assembly having longitudinally-repeating staple leg clusters |
US11957337B2 (en) | 2021-10-18 | 2024-04-16 | Cilag Gmbh International | Surgical stapling assembly with offset ramped drive surfaces |
US11937816B2 (en) | 2021-10-28 | 2024-03-26 | Cilag Gmbh International | Electrical lead arrangements for surgical instruments |
US11957339B2 (en) | 2021-11-09 | 2024-04-16 | Cilag Gmbh International | Method for fabricating surgical stapler anvils |
US11957795B2 (en) | 2021-12-13 | 2024-04-16 | Cilag Gmbh International | Tissue thickness compensator configured to redistribute compressive forces |
US11963682B2 (en) | 2022-05-17 | 2024-04-23 | Cilag Gmbh International | Surgical staples comprising hardness variations for improved fastening of tissue |
US11963680B2 (en) | 2022-10-19 | 2024-04-23 | Cilag Gmbh International | Cartridge body design with force reduction based on firing completion |
US11957345B2 (en) | 2022-12-19 | 2024-04-16 | Cilag Gmbh International | Articulatable surgical instruments with conductive pathways for signal communication |
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