RU2789638C2 - Device for powering cryosurgical instrument and method for monitoring of instrument - Google Patents

Abstract

FIELD: medical equipment.

SUBSTANCE: group of inventions relates to medical equipment, to a device for powering a cryosurgical instrument and a method for monitoring of a cryosurgical instrument, and allows for control of a physical state in an instrument and in a fluid supply line. The fluid line contains both a supply line and a return line with the possibility of supply to a cryo-tip of an electrical control signal passing from the device to the cryosurgical instrument and its cryo-tip and back, along the fluid line, to the device. Accordingly, the device contains a control signal transmitter, an echo signal receiver made with the possibility of reception of an echo signal, and an analyzing device made with the possibility of recording, based on the echo signal, of changes in a physical state in the instrument or near it, and/or in the fluid line or near it. The monitoring method includes, respectively, above-mentioned supply of electrical control signals, reception of echo signals generated by one or several electrical control signals, analysis of echo signals, and recording of change in a physical state in the instrument or near it, and/or in the fluid line or near it.

EFFECT: obtainment of a device for powering a cryosurgical instrument.

11 cl, 8 dwg

Description

The invention relates to a device for supplying a medical instrument connected via a line to the device with signal or operating power and/or a working medium, as well as to a method for monitoring a medical instrument powered from the device via a line.

From EP 2520241 B1 a device is known, consisting of a medical instrument for therapy of a patient and a device for supplying the instrument with an electric therapy current. The device measures the electrical current flowing through the patient's tissue during therapy, as well as the electrical voltage applied to the instrument, and uses the obtained current and voltage values to control the device.

Using a slightly different control algorithm, the device according to EP 2 520 240 B1 also uses the current conducted through the biological tissue from the instrument, as well as the voltage applied to the tissue or the instrument, to control the device.

From EP 1 064 532 B1 a method is known for measuring the clotting time of blood from a patient's blood sample, wherein the blood in the examination chamber is subjected to control signals from a voltage generator by means of electrical contacts in such a way that a current flows through the blood, which changes according to the clotting of the blood.

These devices and methods are made, respectively, specifically for specific measurements on biological tissues.

The aim of the invention is to provide a solution for the electrical monitoring of medical instruments as well as their respective components as well as their operation.

This goal is achieved in a device for supplying a cryosurgical instrument 30 connected to the device via a fluid line with a fluid used as a working medium for influencing biological tissue using a cryo-tip, and the fluid line contains both a supply line and a return line, and at least

at least one of these two lines is electrically conductive or provided with an electrical conductor capable of supplying to the cryo-tip, which serves for direct contact with biological tissue, an electrical control signal passing from the device along the fluid line to the cryosurgical instrument and its cryo-tip and back from the cryo-tip along fluid lines to the instrument.

The supply device according to the invention has:

- a transmitter of control signals, configured to issue control signals to the fluid line,

- an echo receiver configured to receive an echo generated by the pilot signal, and

- an analyzing device configured to detect, based on the echo signal, changes in the physical state in or near the tool and/or in or near the fluid line.

Preferably, the pilot signal is DC free and may have a voltage peak of several volts to several thousand volts depending on the application.

The line may be a fluid line, primarily a metal capillary or fluid hose, which contains one or more electrical conductors or is, as such, an electrical conductor. In this case, the pilot signal applied to the line by the transmitter of the pilot signal propagates along or in the line to the instrument, and then, in whole or in part, is absorbed and/or in whole or in part is reflected. The reflected echo arrives, decelerating according to its delay time, at the echo receiver and transmitted by it to the analyzing device. Now the analyzing device has the ability, based on the delay time, as well as distortion (violation) of the waveform or other properties of the echo signal, such as, for example, phase position, amplitude, modulation envelope, and other similar parameters, to detect the state of the line (for example, its length or integrity ), a physical state in or on the instrument, such as actuation of an activation switch, contact with biological tissue, or its condition, after which the instrument can be provided with appropriate control. For example, the instrument may be a cryosurgical instrument in which the control signal propagates up to the cryo-tip and is reflected back to the instrument. At the beginning of freezing on the Cricacon, the characteristic parameters of the echosignal undergo changes, for example, regarding their phase position in such a way that it is possible to recognize freezing and calculating freezing from the beginning of freezing. Ice formation in or on the line can also have an effect on the echo. For example, a repeated echo can be formed, the presence of which can be used as a criterion to create a signal that displays the corresponding event. Other uses are also possible. For example, using a solution according to the invention for both cryo -instruments and electrical tools, it is possible to detect automatic launch, that is, independent starting, therapy depending on the given states on the tool. Also, sparking, plasma monitoring, detection of ionization or measurement of ionization can be performed for electrical tools.

An instrument can also be understood to mean an electrosurgical bipolar or monopolar instrument which is connected via an electrical line to a power supply device. To power the instrument, a voltage-producing generator may be provided, such as a high frequency generator, which typically supplies a voltage of about 100 V or more, or also much higher. Typically, the therapy current may be provided in a pulsed manner, for example as a pulse width modulated signal, the pilot signal transmitter preferably emitting at least one pilot signal in each case during pauses of the pulsed therapy current. The pauses between the therapy electric current impulses preferably exceed the delay time between the emission of the control signal and the arrival of the echo signal. Preferably, the pauses are many times longer than the delay time of the control signal.

The echo signal may depend on physical conditions on the instrument, such as, for example, the condition and/or temperature of the electrode, the capacitance of the electrode with respect to the patient or the counter electrode, the electrical resistance between the electrode and the counter electrode, the electrical inductance of the signal path, the electrical impedance, the conductivity of the existing on the electrode of a fluid medium, primarily a gas, the contact of a line through another body or object, and the like.

Physical states can affect the properties of the echo signal. Such properties can be represented by, for example, time lag, number of echoes, echo amplitude, disruption of the pilot signal (i.e., its waveform) or phase position of the echo relative to the pilot, and the presence or absence of an echo.

The device may have a control device that responds to at least one or more of these recorded physical conditions with an action, such as, for example, turning the generator on and off, increasing or decreasing the generator power, peak voltage, therapy current, increasing or decreasing the pulse duration. electric current therapy or pauses between individual impulses of electric current therapy, and the like. Actions triggered in response to a characteristic change in the echo may also include the activation or deactivation of the instrument and/or the power supply. Activation or deactivation of the supply device means the supply or blocking of the supply of operating power or operating medium.

Preferably, the pilot signal transmitter is configured to generate DC-free voltage and/or DC-free pilot signals. Such pilot signals are, for example, high frequency modulated signals, such as modulated high frequency signals with a bell-shaped modulation envelope, such pilot signal being preferably a few nanoseconds long. Such a bell-shaped modulation envelope signal can be represented by a high-frequency signal burst, which is considered as a single pulse of the pilot signal. However, it is also possible to use other modulated high-frequency or pulse signals as pilot signals, for example, in particular DC-free pulse signals in the form of single pulses, triangular pulses, sawtooth pulses, rectangular pulses, cardinal sine pulses. or impulses similar to the specified impulses. By cardinal sine pulses is meant pulses of the form (sin x)/x or pulses that are formed from one or more such pulses.

By supplying test pulses to the line and outputting the echo signal, preferably by means of an inductive and/or capacitive connection to the line of the measuring current circuit, for example by means of a directional coupler, it is possible to galvanically separate the control electronics from the patient's electrical circuit.

The method according to the invention serves to monitor a medical instrument powered by a line from the device, wherein at least one control signal is applied to the line connecting the device to the instrument, a returning echo signal is received via the same line, and then subjected to analysis, and the change in the physical state in or on the tool, and, if necessary, also in or on the line supplying the tool. By evaluating the characteristics of the echo signal arriving with a delay relative to the moment the control signal was sent, it is possible to observe both the function and the state of the line and the instrument and, moreover, the biological tissue affected by the instrument.

Other details of advantageous embodiments of the invention are the subject of the drawing, description or claims. The drawing illustrates embodiments of the invention. Shown on:

Fig. 1 - a device for cryosurgical therapy of a patient using a cryosurgical instrument and a device for powering it, in a schematic representation,

Fig. 2 - a cryosurgical instrument and the biological tissue exposed to it, in a schematic representation,

Fig. 3 - directional coupler for diverting an echo signal from the line feeding the instrument, in a schematic representation,

Fig. 4-6 show various control signals and their echoes, respectively, in the form of a schematic diagram,

Fig. 7 - a device for electrosurgical therapy of biological tissue with a bipolar instrument and with a device that feeds it, in a schematic representation, and

Fig. 8 - directional coupler for diverting the echo signal from the line feeding the tool.

In FIG. 1 shows a cryosurgical device 10 which serves to act on a patient 11. The patient is positioned in FIG. 1, purely by way of example, lying on a couch 12 by means of which the patient 11 is connected at least capacitively to earth potential 13.

The patient 11 is treated with a cryoprobe 14, which is connected via a line 15 to a supply device 16. Typically, line 15 is represented by a fluid line, such as a capillary tube, a hose or the like. Through line 15, the working fluid from instrument 16 is supplied to instrument 14. Line 15 may comprise, as shown in FIG. 2, both the supply line 17 and the return line 18. Preferably, at least one of the two lines 17, 18 is electrically conductive or provided with an electrical conductor in such a way that the cryo-tip 19, which serves for direct contact with the biological tissue 20, can be sent an electrical control signal, which, starting from the device 16, propagates through the line 15 to the instrument 14, first of all to the cryo-tip 19, and from it through the line 15 back to the device 16. Preferably, the control signal is shorter than the delay time signal such that the pilot signal and echo are present at the beginning of the line with a time offset. The cryoprobe 19 can be connected to the electrical line contained in the line 15 in a galvanic or also only capacitive manner.

The tool 10 includes a power supply 21 by means of which the tool 14 is supplied with a working medium and/or working power. In the embodiment according to FIG. 1, working medium is understood to mean a fluid, such as carbon dioxide or laughing gas (N ₂ O), nitrogen, for example as a gas, as a liquid, preferably in the vicinity of the liquid line, or as a two-phase mixture. The power supply 21 contains or is connected to an appropriate supply of fluid. For manual control, in particular for starting a therapy procedure, i.e. for signaling the start of therapy, a control input can be provided in the device 16, which is not illustrated in more detail. Alternatively or additionally, the supply device may have a control input 22, by means of which it is able to receive an on or off signal, or also another control signal. In addition, the power supply 21 may have an output 23 through which it can send a read command to the slaves. The read command may serve to initiate a measurement cycle that serves to detect a physical state in or on line 15 as well as in or on tool 14. In the embodiment of FIG. 1, a pilot signal transmitter 24 is connected to output 23, which, by means of a connector 25, supplies a pilot signal to line 15. This pilot signal in this and all other embodiments described hereinafter has a signal duration that does not exceed the propagation delay time control signal via line 15 to tool 14 and, as an echo, back to connector 25.

In addition to the signal input 26, the connection device 25 has a signal output 27 which provides an echo output via the line 15 and transmits it to the echo receiver 28 . The latter is part of the analyzing device 29 or is connected to one that analyzes the echo signal and supplies the control signal corresponding to the test result to the control input 22.

Fig. 3 schematically and by way of example illustrates a connection device 25. The connection device 25 is understood to mean a directional coupler for inputting and outputting electrical signals in an electrically conductive and fluid line 15. To this end, a conductive section 30 is located on a suitable holder, which , along its entire length, or at least at its ends, provides a capacitive connection with the line 15, while it has a self-inductance other than zero. At its both ends, respectively, oscillations of an electrical signal can be taken, for example, propagating in the forward and reverse directions along the line 15 of the control signal 31. For example, the control signal 31 created by the transmitter 24 of the control signals can be fed to the signal input 26, as is schematically illustrated in fig. 3. Preferably, the time duration of this signal is less significant than the time it takes for the pilot signal 31 to propagate along the line 15 to the tool 14 and, as an echo signal 32, back to the connector 25. Typically, the pilot signal 31 has a duration of several nanoseconds.

As an exemplary pilot signal in FIG. 4 illustrates a needle-like positive voltage pulse followed by a negative triangular pulse. The surface areas covered by the positive and negative portions of the pilot signal are preferably the same in size, so that the pilot signal 31 is generally DC-free.

The echo signal 32 has a modified form, which is symbolically illustrated in FIG. 4. For example, high-frequency components may be absent, while spikes may occur, and the echo signal may also be stretched or compressed in time, and also changed in its amplitude, primarily reduced.

Preferably, the echo receiver 28 is configured to sample the echoes 32 originating from the successive control signals 31, however with a time offset. These sampling times are indicated in FIG. 4 by vertical lines a, b, c, d, e, f, g. Received at different times from a to g discrete values receiver 28 echo signals reconstructs the echo signal. The number of discrete values is set for reasons of expediency. In this respect, FIG. 4 is just an example.

The apparatus 10 described so far operates in the manner described below.

After the main activation of the device 16 and placement of the tool 14 in or on the tissue 20 of the patient 11, for example, as shown in FIG. 2, feeder 21 is unlocked so that it supplies fluid via line 15 to cryo-tip 19. Initially, cryo-tip 19 is surrounded by still wet, living tissue. Earlier or at the same time, the pilot signal transmitter 24 is activated, which now delivers the pilot signals 31, for example according to FIG. 4 to connector 25 and through it to line 15. Each pilot signal 31 now propagates along line 15 to tip 19 where it encounters at least a capacitively grounded fabric 20. Thus, the electrically conductive fabric 20 is capacitive and resistive. thus closes the electric line consisting of line 15 and cryo-tip 19. Accordingly, the control signal 31 is attenuated and, depending on the electrical resistance present at the cryo-tip, is reflected with the same or inverted phase. At the same time, depending on the capacitance per unit length and inductance per unit length, as well as due to the influence of the tissue 20, it undergoes distortion, as a result of which the shape of the echo signal 32 curve differs from that of the control signal 31. After several, for example, the following each after another with an interval of several microseconds of measurement cycles, which consist respectively of sending the control signals 21 by the transmitter 24 of the control signals and of receiving echo signals by the echo receiver 28, the shape of the echo signal 32 can be recorded and evaluated by the analyzing device 29. By continuous cooling of the cryo-tip 19 in tissue 20 may be formed frozen area 33, which characteristically changes the physical properties in the immediate vicinity of the tip 19 of the probe. For example, the electrical conductivity decreases. Due to this, the shape of the echo signal 32 also changes significantly. For example, the formation of ice that begins at the cryo-tip 19 can lead to the fact that the end of the cryo-tip 19 considered as a waveguide looks “open” electrically, while before the formation of ice, it was subject to consideration electrically as a "short-circuited". Accordingly, the echo signal 32 changes its phase as ice begins to form. This change in phase can be registered by the analyzing device 29, and a corresponding signal can be applied to the control input 22. The signal can be used to control the operation of the power supply 21. In the event that the power supply 21 provides for the use of a predetermined time for the formation of ice on the cryo-tip 19, now, starting from the arrival of a signal at the control input 22, a pre-assigned freezing time can be started. .

The embodiment described above serves to illustrate the principal aspects of operation. However, the analyzing device 29 can also be configured to perform a much finer analysis. For example, one or more of these or other physical conditions can be recorded by means of the echo signal shape 32, for example, the temperature of the cryoprobe 19 and/or tissue 20, the size of the frozen tissue 33, the type of cryo-tip 19 attached to the instrument 14, the length of the line 15, and the like.

Other applications of the solution according to the invention are also possible. For example, the cryo-tip 19 can be electrically isolated from the fluid inlet line 17 and thus also from the line 15. The same can be valid for the fluid outlet line 18. In this case, the principle according to the invention can be applied to register called on the instrument 14 manual changes. For example, an electrically conductive control element 34 can be provided for this, which can be brought into contact and removed from it with respect to the fluid inlet line 17 or the fluid outlet line 18 (or both) in such a way that it locally affects the container per unit line length 15 or cryo-tip. In addition, the control element 34 can be made electrically conductive and thus can be in galvanic connection with the operator immediately after he comes into contact with him. It can be connected to or disconnected from line 15 depending on how the operator activates control element 34. If the control element 34 is electrically disconnected from the line 15, the echo signal 32 has a different shape than when connected to the line 15. The corresponding signal change can be used by the analyzer 29 to switch the power supply 21 on and off.

The last described embodiment with control element 34 can also be combined with the previously described embodiment in which cryo-tip 19 is electrically connected to line 15. element 34.

It is also possible to place other elements between the control element 34 and the line 15, such as, for example, an inductor 35 or, as shown in FIG. 2, a parallel oscillation circuit, a series oscillation circuit, or the like. Accordingly, the elements or oscillating circuits are able to act on the pilot signal in a characteristic manner and produce a corresponding characteristic echo.

By placing on the tool 14 for this purpose several such oscillating circuits or other electrical elements, as well as several control elements, various changes in the echo signal 32 thus achieved make it possible to transmit various commands to the power supply.

For all the previously and in the following described embodiments, the possibility of actuation with the control signal 31 according to FIG. 4, and alternatively also with other control signals, as illustrated purely by way of example in FIG. 5 and 6. The preferred pilot signal is a Gaussian amplitude modulated high frequency signal as illustrated in FIG. 5. It is free of DC voltage.

Instead of an amplitude modulated high frequency signal, a cardinal sine signal can also be used, which is provided as a single pulse or as a sequence of two or more cardinal sine pulses with different polarities.

Echo signal 32 according to FIG. 4 typically has a modified modulation envelope that is characteristic of various physical states on the instrument 14. In this case, the physical states may refer to both the biological tissue 20 being exposed, and other states, such as, for example, contact with the control element 34 (or with other controls) or actuating it. In addition to the modulation envelope, the phase position of the modulated RF modulation envelope can also be evaluated. All of these embodiments are possible implementations of the echo receiver 28 and the analyzer 29.

Fig. 6 illustrates another possible pilot signal, for example in the form of a positive followed, with a pause or directly, by a negative square wave. The corresponding echo signal 32 may have reduced side slope, overshoot, phase rotation, and the like other changes relative to the pilot signal 31. Each change in the echo signal 32 compared to the pilot signal 31 can be considered as a characteristic occurring on the line 15 and/or on the tool 14 changes in physical conditions and can be evaluated by the analyzing device 29 accordingly.

Instead of the rectangular pulses according to FIG. 6, triangular or trapezoidal pulses can also serve as pilot signal 31. Other waveforms are also possible.

Essentially, the principle according to the invention is suitable for all devices 10 in which the device 16 supplies the monopolar or bipolar instrument 14 with a fluid or also with operating power, for example with electric current or electric voltage. For illustration, in FIG. 7 shows a bipolar instrument 14 whose power supply 21 is a high frequency generator. The tool 14 is symbolically illustrated with caustic tongs, and any design form of the bipolar electrical tool 14 can be provided. Line 15 comprises an electrical supply line 17' and an electrical return line 18', which together form a waveguide. For example, lines 17', 18' are attached to both jaws of the caustic tongs. Additionally, a control element 34 can be provided, for example in the form of an electrical switch, with which the lines 17', 18' are interconnected through another element, which can locally change the waveguide properties of the line 15. This other element can be represented, for example, an inductance 35 or, as shown, an oscillatory circuit. An oscillatory circuit can be represented by a parallel oscillatory circuit, a series oscillatory circuit, or a structural element that combines both capacitive and inductive properties. Alternatively, a resistive element may be provided, such as a resistance, which corresponds to the characteristic impedance of the line 15. In this case, closing the switch 34 causes the control signal 31 to be absorbed so that the echo signal 32 does not occur.

The connecting device 25 may be, according to FIG. 8 is represented by a directional coupler, which is, for example, in the form of a coaxial design or also in the form of a conductive strip on a circuit board. For example, the therapy current guide line 15 may be located on one side of the circuit board, while the conductive section 30 is located on the opposite side of the circuit board. In this way, a high dielectric strength is achieved in a simple manner and thus a reliable separation between the electric generator of the power supply 21 and the electrical circuit leading to the tool 14 on the one hand, and the control signal circuit leading from the control signal transmitter 24 to the control signal receiver 28 with the other side.

In turn, it is possible to implement several embodiments with the device 10. For example, the analyzing device 29, by appropriate evaluation of the data of the echo signal 32, has the ability to detect the beginning or end of the cauterization, or also the successful separation of the tissue, as well as actuating the possibly present control element 34.

The principle is also applicable to monopolar instruments, in which only the supply line 17' leads from the device 16 to the instrument 14, while the return line 18' leads from the neutral electrode attached to the patient to the device 16. Also in this case, the control signal 31 propagates through the supply line 17' from the tool 16 to the tool 14, and the echo signal 32 propagates back along the same supply line 17' from the tool 14 to the generator 16. conditions on the supply line 17' and on the instrument 14 so that the corresponding changes in the echo can be used to initiate actions such as turning the power supply on and off, increasing or decreasing the voltage, power or current supplied by it, and/or changing the waveform supplied by the power supply device 21 voltage.

In all devices 10 in which the power supply 21 is designed to transmit the therapy electric current, the control signals 31 upon receipt of the echoes 32 are preferably performed during short pauses during which the power supply 21 does not supply a power signal to the line 15. To do this the operation of the power generator 21 preferably takes place with repeated short interruptions. For example, the oscillator is a high frequency oscillator that oscillates at a fundamental frequency of several hundred kHz (eg, 350 or 400 kHz), the oscillation being pulse-width modulated at a frequency of several tens of kHz (eg, 46 kHz). As a result, the high-frequency signal supplied by the high-frequency generator is, for example, square-wave modulated, that is, it is a succession of high-frequency burst signals. Each high frequency burst signal consists of at least one, optionally also several or many high frequency oscillations. Preferably, the sending of the control signal 21 and the reception of the echo signal 32 take place in the intervals between two successive high frequency bursts.

With the presented solution, not only the properties of the tool 14 and the properties of the tissue 20 can be detected, but also the properties of the fluids surrounding the electrode of the tool, primarily gases or plasmas. For example, the state of ionization of the gas present at the electrode for a spark-discharge tool can be detected by pilot pulses in the pauses between two high-frequency bursts, and then used to drive the power supply 21. The pilot pulses can have a voltage amplitude of more than 1000 V. For example , in a monopolar or bipolar coagulation instrument, the pause between two successive high frequency bursts can be shortened if excessive development of plasma recombination is detected in the pause between two successive high frequency bursts. Also, the temperature of the electrodes can have an effect on the shape of the echo signal 32 and thus can be detected by evaluating the echo data.

On the other hand, when a new ignition is desired for each high frequency burst, the interval between individual bursts can also be increased until sufficient plasma recombination is detected.

In addition, with the above-described pulse echo measurements, it is possible to detect subtle dynamic changes in conditions on the electrode during the therapy process, and use them to control the power supply 21. For example, in contact coagulation, the electrodes of the instrument may first be brought into contact with wet tissue. In this state, the echo signal 32 has a characteristic shape. As soon as the drying of the electrode is registered as a result of the constant supply of energy to the involved electrode and vaporization on the tissue, the echo signal 32 changes its shape in a characteristic way. Now the power supply 21 has the possibility of changing its power output, for example, reducing the voltage, which ensures the prevention of, for example, threatening sparking. Can be changed, for example reduced, the peak voltage and/or duty cycle or other factors of influence. Because the echo waveform responds to conditions at the highly receptive electrode, it is possible to drive each desired mode of operation, such as contact coagulation, with continuous control action while maximizing energy input without the risk of sparking. On the other hand, in therapy regimens in which sparking is desirable, by constantly checking the echo waveform, it is possible to achieve the desired operating mode, such as sparking, as well as plasma confinement with a high frequency pulse-width modulated signal under various conditions, such as minimum power or maximum cutting action or the like.

In the device according to the invention and in the context of the method according to the invention, control signals 31 are sent by the device 16 to the instrument 14, and the resulting arriving echoes 32 are examined to record the desired properties and change the properties on the line 15, the instrument 14, the tissue 20 or also on those present on electrode tool 14 fluid bodies, such as plasma, as well as to control the operation of the power supply device 21 in an appropriate way.

LIST OF REFERENCES

10 Device

11 Patient

12 Daybed

13 Ground potential

14 Instrument/cryoprobe

15 Line

16 Appliance

17 Fluid supply line

18 Fluid outlet line

19 Cryo-tip

20 Fabric

21 Power supply

22 Control input

23 Exit

24 Control signal transmitter

25 Connecting device

26 Signal input

27 Signal output

28 Echo receiver

29 Analyzing device

30 Conductive section

31 Tell-tale

32 Echo

33 Frozen Cloth

34 Control element

35 Inductance

Claims (17)

1. A device for supplying a cryosurgical instrument connected to the device via a fluid line with a fluid used as a working medium for influencing biological tissue using a cryo-tip, the fluid line containing both a supply line and a return line, and at least at least one of these two lines is electrically conductive or provided with an electrical conductor capable of supplying to the cryo-tip, which serves for direct contact with biological tissue, an electrical control signal passing from the device along the fluid line to the cryosurgical instrument and its cryo-tip and back from the cryo-tip along the line fluid to the instrument, having: - a transmitter of control signals, configured to issue control signals to the fluid line, - an echo receiver configured to receive an echo generated by the pilot signal, and - an analyzing device configured to detect, on the basis of the echo signal, changes in the physical state in the tool or near it and/or in the fluid line or near it. 2. The device according to claim. 1, characterized in that the analyzing device is configured to initiate an action as a response to a characteristic change in the echo signal. 3. The device according to claim. 2, characterized in that the action includes the activation or deactivation of the tool. 4. The device according to paragraphs 2 or 3, characterized in that the action includes the production of a signal that characterizes the attached tool. 5. The device according to one of the previous points, characterized in that the transmitter of the control signals is made with the possibility of developing free from the constant component of the voltage and/or free from the constant component of the current of the control signals. 6. The device according to one of the previous points, characterized in that the transmitter of the control signals is made with the possibility of issuing a modulated high frequency signal. 7. The device according to one of the previous points, characterized in that the transmitter of the control signals is made with the possibility of issuing a pulsed signal from a constant component of voltage. 8. A method of monitoring a cryosurgical tool feeds through a turnover line from the device along one of the previous points, characterized by the fact that: - in the line by means of which the tool is supplied with a fluid using the working environment, electrical control signals are supplied, - take at least one echosignal generated by one or more electrical control signals, - Echosil is analyzed, and according to the results of the analysis, they record a change in the physical condition in the tool either near it and/or in the fluid line, or near it. 9. The method according to paragraph 8, characterized by the fact that as control signals, are used free from the constant component of the voltage and/or free from the constant component of the current pulse. 10. The method according to paragraphs 8 or 9, characterized by the fact that the analysis is carried out during the use of the tool on the body of a person or animal. 11. The method according to one of paragraphs. 8-10, characterized by the fact that a characteristic change in echosignal is used to control the device and/or tool.

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