WO2010121704A1

WO2010121704A1 - Electrosurgical device

Info

Publication number: WO2010121704A1
Application number: PCT/EP2010/002083
Authority: WO
Inventors: Jürgen BELLER
Original assignee: Erbe Elektromedizin Gmbh
Priority date: 2009-04-20
Filing date: 2010-03-31
Publication date: 2010-10-28
Also published as: DE102009018100A1

Abstract

The invention deals with the problems that arise when a plurality of HF instruments are driven by an HF generator. For the doctor treating the patient it is often difficult to determine which of the HF instruments is activated and thus available to apply an HF voltage. The invention solves said problems by providing an electrosurgical device comprising a plurality of electrosurgical instruments, an HF generator that is connected to the instruments in order to provide an HF voltage, a control unit for controlling the HF generator and a selection unit. The selection unit is connected to the control unit for selecting an instrument as an active instrument, at least one instrument among the plurality of instruments having a display device for displaying the activation state. The display device on the instrument indicates to the doctor treating the patient whether the corresponding instrument has been activated.

Description

Electrosurgical device

description

The invention relates to an electrosurgical device according to claim 1.

Electrosurgical instruments have been used for many years in high frequency surgery (RF surgery) to coagulate and / or cut biological tissue. In coagulation, a high-frequency current is passed through the tissue to be treated, so that this changes due to protein coagulation and dehydration. The tissue contracts in such a way that the vessels are closed and bleeding is stopped. After successful coagulation, the tissue is completely severable while avoiding heavy bleeding, both with the help of high-frequency current, as well as by mechanical means.

Electrosurgical procedures can be performed with monopolar and bipolar instruments. In the monopolar technique, the current path usually leads from the electrosurgical instrument via the tissue to be treated to a neutral electrode. Alternatively, bipolar instruments may be used, which are formed with two mutually electrically isolated sections. The current path in this case runs from a first section (first application electrode) of the electrosurgical instrument via the tissue to be treated to a second section (second application electrode) of the electrosurgical instrument.

For the successful execution of an operation by means of an electrosurgical instrument, a high degree of user-friendliness is important. The electrosurgical instrument should be intuitively operated and display relevant information quickly. Said relevant information includes, for example, status information provided by an RF generator. There are RF generators to which several electrosurgical instruments are connected simultaneously. The attending physician and the patient are at risk of serious injury if several of the connected instruments are activated simultaneously. There are known RF generators, in which a selection can be made, which is supplied to the connected instruments with an RF voltage. An assignment of the outputs of the RF generator to a specific instrument, be it a bipolar clamp or a monopolar hook electrode, is often difficult.

Various electrosurgical instruments are known from the prior art.

DE 36 27 221 A1 shows a handle for an electrosurgical instrument having a power control and an optical power indicator. This power indicator on the handle indicates information about the power delivered, such as the application of high or low voltage.

From DE 40 12 545 Al a handle for an electrosurgical instrument is known, which is characterized in that the electrode-side end of the handle, a light exit opening is provided, which is fed by a located in the RF generator cold light generator. The light source serves to illuminate the surgical field better.

DE 199 43 792 A1 discloses an electrosurgical instrument in which the handle disposed thereon comprises a display device which makes it possible to read operation-specific information, for example an operating mode of the electrosurgical instrument.

The instruments described above are very complex.

Based on this prior art, it is an object of the present invention to ensure safe operation of a variety of instruments that are connected to an RF generator. The object is achieved by an electrosurgical device according to claim 1.

In particular, the object is achieved by an electrosurgical device, the device comprising:

a plurality of electrosurgical instruments, an RF generator connected to the instruments for providing an RF voltage, a control unit for controlling the RF generator, selection means connected to the control unit for selecting one of the instruments as an active instrument in Connection, wherein at least one instrument of the plurality of instruments has a display device for displaying an activation state.

The RF generator of the electrosurgical device according to the invention is therefore designed to supply a plurality of electrosurgical instruments with a corresponding RF voltage. The selector makes it possible to select at least one of these plurality of instruments that is activated (ie the selected instrument is in an activated state). For the purposes of this application, "activated" may mean that the corresponding instrument is ready for operation so that an HF current is applied via at least one application electrode arranged on the instrument by actuating an actuating element or due to another input, eg a control signal from the control unit Thus, the application of an HF current can also take place automatically with an activated instrument A central idea of the present invention is to display the activation state of a specific instrument by means of a display arranged on it Display device, so that the control unit can output by means of the display device corresponding signals that can be perceived by the person using the instrument. Preferably, the control unit is thus in particular come with the display device unicative link to indicate if the at least one instrument is the active instrument. In one embodiment, the control unit may be equipped with at least one contact detection unit which is designed to detect a tissue contact of the at least one instrument, wherein the control unit is designed such that it applies an RF voltage to the at least one instrument, in particular to at least one application electrode. applies when the contact detection unit detects a tissue contact. That is, the contact detection unit is used to detect a contact closure between the at least one application electrode and the tissue to be treated and to output corresponding signals to the control unit. Upon receipt of these signals, the control unit controls the RF generator such that an RF voltage is applied to the at least one application electrode of the instrument concerned. This preferably assumes that the instrument has been activated in advance by means of the selection device. In one embodiment, the contact detection unit and / or control unit is designed such that a contact detection takes place only at the at least one activated instrument. This means that the instruments that are not activated at the current time can not be decisive for the automatic application of an HF voltage. Thus, an unwanted application of an HF current can be avoided. The automatic application process described can be implemented for both bipolar and monopolar instruments.

The contact detection unit may comprise a resistance detection unit, which is in electrical connection with a first application electrode of the at least one instrument and is designed to measure an electrical resistance between at least the first application electrode and a second application electrode or a neutral electrode or at least a portion thereof, to a tissue contact to capture. A measurement can thus take place between an application electrode and a neutral electrode or between two application electrodes (bipolar instrument) or between sections of the neutral electrode and the application electrode or between sections of two application electrodes. Furthermore, it is possible to measure the resistance between individual sections of a single application electrode in both bipolar and monopolar instruments. For this purpose, the application electrode must comprise a plurality of electrically isolated sections. The resistance measurement makes it very easy and efficient to detect contact of the at least one application electrode with the tissue. Due to the Contact detection unit, the doctor must not manually control the application of the RF current.

The control unit may be configured to apply an RF voltage to the at least one instrument when the measured resistance is less than a predetermined threshold.

The control unit can be in communicative connection with the display device in order to display by means of this additional information, in particular information relating to an operating mode. The display device on the at least one instrument can thus not only be used to output information regarding an activation state, but can also provide further information for the user. For example, by means of these a set operating mode, e.g. a mode of coagulation or cutting. Thus, the user not only detects from the display device whether the corresponding instrument is active, but also receives further information about the manner in which a corresponding HF current is applied. This is particularly advantageous if the electrosurgical device has the contact detection unit described above, since the pre-set HF current is automatically applied during the contacting of tissue. Since essential information is provided directly at the instrument, the physician does not have to turn away from the patient during surgery to record data on a display on the RF generator.

The electrosurgical device may comprise a data transmission line and / or an optical signal transmission line, in particular a glass fiber line, for connecting the display device to the control device. Thus, corresponding signals from the control unit can be efficiently passed to the display device. If one decides for the optical signal transmission line, it is often possible to dispense with an additional circuit on the instrument. Thus, eliminates a costly hedging this circuit relative to the RF circuit. Furthermore, no additional processing means within the electrosurgical instrument need to be provided, which may be more robust and simple in construction. An optical signal transmission line can transmit a plurality of different optical signals. The thus connected display device can output a plurality of different signals, in particular light signals, in order to to signal a variety of different information. These signals can provide information about the operating mode, for example.

The electrosurgical device may include at least one footswitch as a selector. The display device according to the invention on the at least one instrument is particularly advantageous if the selection of the active instrument is effected by means of a footswitch. In practice, it has been shown that with the use of foot switches for selecting the instrument to be activated and / or for the application of an HF current, a malfunction occurs more frequently than with other operating elements. Thus, the invention is particularly suitable for avoiding errors in this constellation.

The display device can be designed to emit colored light signals.

The display device may comprise at least one LED. For example, two LEDs (yellow and blue) may be attached to the at least one instrument, the yellow being illuminated when the instrument is cutting on tissue contact, and the blue being illuminated when the instrument coagulates upon tissue contact.

The display device can be coupled into a supply voltage of the at least one instrument. The display device can therefore be designed to detect the activation state independently based on the presence of a supply voltage. Furthermore, the display device can branch off a possibly necessary supply voltage directly from the supply voltage of the HF instrument. It can therefore be dispensed with additional lines.

Further advantageous embodiments will become apparent from the dependent claims.

The invention will be described with reference to some embodiments, which are explained in more detail by means of illustrations. Hereby show:

- Fig. 1 is a schematic representation of a bipolar electrosurgical

Instruments; FIG. 2 shows essential components of an electrosurgical device comprising two electrosurgical instruments according to FIG. 1, an HF generator, a control unit and two foot switches; FIG.

Fig. 3 integral display devices on instruments, wherein the

Display devices are connected via an optical signal line to the control unit; and

- Fig. 4 integral display devices on instruments, the

Display devices are operated via supply lines;

FIG. 5 shows a circuit diagram of a display device from FIG. 4; FIG. and

FIG. 6 shows an alternative embodiment of a display device. FIG.

In the following description, the same reference numerals are used for the same and like parts.

Fig. 1 shows an electrosurgical instrument 10, which is composed of a handle 12 and a bipolar instrument head 14. The handle 12 has an elongated shape, wherein the distal end of the bipolar instrument head 14 attaches to perform a surgical procedure. The instrument head 14 has a first electrode 16 and a second electrode 16 'to which an RF voltage (a high frequency alternating current) can be applied for coagulation or tissue cutting. The electrosurgical instrument 10 of Fig. 1 further comprises at the distal end of the handle 12 a display device 50 adapted to emit a signal.

An electrosurgical device 1 according to the invention preferably comprises the following components (see FIG.

A control unit 40; An RF generator 20;

- At least one foot switch 30, 30 ';

At least two electrosurgical instruments 10, 10 ', wherein the electrosurgical instruments 10, 10' each have at least one display device 50, 50 'respectively. In order to supply the electrosurgical instruments 10, 10 'with a voltage and / or a suitable frequency pattern suitable for the respective operation, the electrosurgical device 1 has a control unit 40, which acts on the HF generator 20 in such a way that it outputs a corresponding output provides. The electrosurgical instruments 10, 10 'are connected by a cable to the RF generator 20 to provide a corresponding RF voltage to the electrodes 16, 16'. In order to be able to act on the behavior of the control unit 40, the device 1 has input devices, in particular the foot switches 30, 30 '. There may be other input devices, such as hand switches or buttons on the RF generator 20 or the instruments 10, 10 'may be provided to affect the operation of the electrosurgical device 1. The control unit 40 is configured such that after switching on the electrosurgical device 1, an instrument 10, 10 'is always activated. That is, one of the instruments 10, 10 'is in a standby condition such that upon a contact closure between the bipolar instrument head 14 and the tissue, an RF voltage is applied to the electrodes 16, 16' to coagulate or cut the tissue. By means of the foot switches 30, 30 ', the activation can be switched from a first instrument 10 to a second instrument 10'. For the automatic delivery of an HF current by means of the electrodes 16, 16 ', the control unit 40 further comprises a resistance detection device 42. This is in electrical connection with the electrodes 16, 16' and measures a resistance between these two electrodes 16, 16 '. As soon as the electrodes 16, 16 'contact tissue, the measured resistance decreases so much that this can be detected easily by means of the resistance detection device 42. The

Resistance detection device 42 outputs corresponding signals to the control unit 40, which activates the RF generator 20. According to the invention, the display device 50 or 50 'integrated in the first and second instrument 10, 10' indicates which of the two instruments 10, 10 'is activated. The attending physician is thus always able to determine whether the instrument 10, 10 'which he currently holds in his hands is activated.

3 and 4 show two different ways in which corresponding display devices 50, 50 'can be connected to the control unit 40. In Fig. 3, the electrosurgical instruments 10, 10 'are connected via an optical signal line, while in Fig. 4 supply lines 43a, 43b, 43a', 43b 'are used to operate the display devices 50, 50'. alternative a data bus may be provided which communicates with a corresponding control device within the instruments 10, 10 '.

In detail, FIG. 3 schematically shows a part of the control unit 40, which communicates via a first optical fiber line 45 with a first instrument 10 and via a second optical fiber line 45 'with the second instrument 10'. For this purpose, the control unit 40 comprises a first light-emitting diode 54 and a second light-emitting diode 54 '. When the first instrument 10 is activated, the first light-emitting diode 54 lights up. The emitted light waves are transported via the first optical fiber line 45 to the first display device 50 and output there. Upon activation of the second instrument 10 ', the control unit 40 activates the second light-emitting diode 54' in such a way that the emitted light waves are conducted via the second glass fiber line 45 'to the second display device 50'. A supply of the electrodes 16, 16 'via the supply lines 43a, 43b. Further supply lines 43a 'and 43b' may be provided to operate bipolar instruments 10, 10 '.

4 shows the electrosurgical instruments 10, 10 ', which are connected via supply lines 43a, 43b, 43a', 43b 'to the control unit 40 and thus to the HF generator 20. The first and second supply lines 43a, 43a 'of the first instrument 10 are connected via a first plug connection, the first and second supply lines 43b, 43b' of the second instrument 10 'via a second plug connection. The first display device 50 has a first light-emitting diode 54, which are coupled into the supply lines 43a, 43a '. The second display device 50 'has two light emitting diodes 54', 54 "coupled into the supply lines 43b, 43b '. A display device 50, 50' may theoretically include a plurality of light emitting diodes 54, 54 ', 54" to select a plurality of LEDs States, including an activation state and / or an operating state display. For example, the light emitting diode 54 'may illuminate when the second instrument 10' is activated and a coagulation mode is set. The light emitting diode 54 "may illuminate in addition to or in place of the light emitting diode 54 'when the second instrument 10' is activated and a cutting mode is set in. Similarly, the control unit 40 of Figure 3 may include a plurality of different light emitting diodes 54, 54 ', 54" to provide a plurality of signals to the display devices 50, 50 'of the instruments 10, 10' by means of the fiber optic lines 54, 54 '. FIGS. 5 and 6 show circuits which make it possible to operate the display devices 50, 50 'directly on the supply lines 43a, 43b, 43a', 43b 'of the instruments 10, 10'. These very simple embodiments make it possible to configure the display devices 50, 50 'in such a way that separate control of these by the control unit 40 is unnecessary. The display devices 50, 50 'can detect and output a voltage applied to the instruments 10, 10' via the supply lines 43a, 43b, 43a ', 43b'. Thus, the control unit 40 only has to ensure that an HF voltage is applied to one of the instruments 10, 10 '. The activation of the associated display device 50, 50 'then takes place automatically. Alternatively, the circuits of FIGS. 5 and 6 can be operated on separate circuits, which are selectively controlled by the control unit 40.

As shown in FIG. 5, the second display device 50 'of FIG. 4 may include two light emitting diodes 54', 54 "disposed parallel to one another, each of the light emitting diodes 54 ', 54" being in electrical communication with the supply lines 43b, 43b'. The supply lines 43b, 43b 'therefore not only supply the instrument 10' with an RF voltage but also operate the display device 50 '. The light-emitting diodes 54 ', 54 "are each protective diodes 53, 53' connected upstream, so that the AC voltage does not damage the LEDs 54 ', 54" leads. Correspondingly arranged resistors 52, 52 'regulate the voltage which drops across the light-emitting diodes 54', 54 ". For a first and a second light-emitting diode string, this results in a series circuit comprising a resistor 52 or 52 ', a light-emitting diode 54, 54, respectively The protective diodes 53, 53 'are arranged and configured in such a way that they carry an electric current in a first flow direction in the first light-emitting diode string and an electric current in a second of the first opposite flow direction in the second light-emitting diode string Other components may be provided to indicate different modes of operation by means of the light emitting diodes 54 ', 54 ".

In another embodiment, after activation of the second instrument 10 'with the circuit of FIG. 5, the control unit 40 may apply a first DC voltage to the supply lines 43b, 43b' in a first mode of operation. This DC voltage can be such that the light-emitting diode 54 'is supplied with an electric current. The first DC voltage also serves to determine whether a tissue contact on the electrodes 16, 16 ' is present. Once a corresponding contact is detected, an RF voltage is applied to the supply lines 43b, 43b '. In order to operate the light-emitting diode 54 "before an application of an HF current upon activation of the second instrument 10 ', a second DC voltage is applied to the supply lines 43b, 43b' in a second operating mode, which has a reversed potential gradient with respect to the first DC voltage. This second DC voltage can also be used to detect a contacting of the tissue in order to automatically apply a corresponding HF current, ie in the described embodiment it would be sufficient to provide two supply lines 43b, 43b 'on the instrument 10' by two different ones To indicate operating conditions as well as the activation state and to measure the contacting of the tissue The supply lines 43b, 43b 'can also be used to apply an HF current.

Fig. 6 shows a further embodiment in which an incandescent lamp 56 is operated on the supply lines 43a, 43a '. This circuit can be used, for example, to operate a display device 50, 50 'with a single signal generator. To protect the bulb 56, it is connected in series with a corresponding resistor 52 ".

In the foregoing, exemplary embodiments have been described in which one or two luminescent means are assigned to a specific display device 50, 50 'in order to indicate an activation state and further operating states. It will be understood that a display device 50, 50 'may be associated with a plurality of illuminants to signal a plurality of states. The lighting means can be designed to output signals in different hues. Alternatively, the display devices 50, 50 'may be designed such that they output repetitive activation patterns which make it possible to draw conclusions about the activation state or other states. For example, a blinking light emitting diode 54, 54 ', 54 "may indicate that the corresponding instrument 10, 10' is deactivated, while the activation of the corresponding instrument 10, 10 'is symbolized by a continuous illumination of the light emitting diode 54, 54', 54" ,

In the foregoing, embodiments have been described in which optical fiber lines 54, 54 'or supply lines 43a, 43b, 43a', 43b 'are used to drive the display devices 50, 50'. Alternatively, a data bus with the Display device 50, 50 'be connected to allow communication between the control unit 40 and the display devices 50, 50'.

LIST OF REFERENCES

1 electrosurgical instrument

10, 10 'electrosurgical instrument

12 handle

14 bipolar instrument head

16, 16 'electrodes

20 HF generator

30, 30 'footswitch

40 control unit

42 resistance detection unit

43a, 43b, 43a ', 43b' supply lines

45, 45 'fiber optic cables

50, 50 'display device

52, 52 ', 52 "resistance

53, 53 'protection diode

54, 54 ', 54 "LED

56 light bulb

Claims

claims

An electrosurgical device comprising:

a plurality of electrosurgical instruments (10, 10 '),

an RF generator (20) connected to the instruments (10, 10 ') for providing an RF voltage,

a control unit (40) for controlling the HF generator, selection means (30, 30 ') communicating with the control unit (40) for selecting one of the instruments as an active instrument (10, 10'), dad u rch I note that at least one instrument (10, 10 ') of the multiplicity of instruments (10,

10 ') a display device (50, 50') for displaying a

Has activation state.

2. Electrosurgical device according to claim 1, characterized in that the control unit (40) comprises at least one contact detection unit for detecting a tissue contact of the at least one instrument (10, 10 '), wherein the control unit (40) is designed in this way in that it applies an HF voltage to the at least one instrument (10, 10 '), in particular to at least one application electrode (16, 16'), when the contact detection unit detects a tissue contact and the at least one instrument (10, 10 ') is selected as an active instrument (10, 10 ').

3. Electrosurgical device according to claim 1 or 2, in particular according to claim 2, characterized in that the contact detection unit comprises a resistance detection unit (42) connected to a first application electrode (16) of the at least one instrument (10, 10 ') is in electrical connection and is designed to measure an electrical resistance at least between the first application electrode (16) and a second application electrode (16') of a neutral electrode in order to detect a tissue contact.

4. Electrosurgical device according to one of the preceding claims, in particular according to claim 3, For this purpose, the control unit (40) is designed to apply an HF voltage to the at least one instrument (10, 10 ') if the measured resistance is less than a predefined threshold value.

5. Electrosurgical device according to one of the preceding claims, characterized in that the control unit (40) is in communicative connection with the display device (50, 50 ') in order to display by means of this additional information, in particular information relating to an operating mode ,

6. Electrosurgical device according to one of the preceding claims, geke n nzeich net du rch a data transmission line and / or an optical signal transmission line, in particular a glass fiber line (45, 45 '), for the communicative connection of the display device (50, 50') with the control unit ( 40).

7. An electrosurgical device according to one of the preceding claims, characterized in that the selection device (30, 30 ') comprises a footswitch.

8. Electrosurgical device according to one of the preceding claims, characterized in that the display device (50, 50 ') is designed to deliver colored light signals.

9. Electrosurgical device according to one of the preceding claims, characterized in that the display device (50, 50 ') comprises at least one LED (54, 54', 54 ").

10. An electrosurgical device according to one of the preceding claims, characterized in that the display device (50, 50 ') is coupled into a supply voltage of the at least one instrument (10, 10').