WO2010121704A1 - Appareil électrochirurgical - Google Patents

Appareil électrochirurgical Download PDF

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Publication number
WO2010121704A1
WO2010121704A1 PCT/EP2010/002083 EP2010002083W WO2010121704A1 WO 2010121704 A1 WO2010121704 A1 WO 2010121704A1 EP 2010002083 W EP2010002083 W EP 2010002083W WO 2010121704 A1 WO2010121704 A1 WO 2010121704A1
Authority
WO
WIPO (PCT)
Prior art keywords
instrument
control unit
instruments
electrosurgical
display device
Prior art date
Application number
PCT/EP2010/002083
Other languages
German (de)
English (en)
Inventor
Jürgen BELLER
Original Assignee
Erbe Elektromedizin Gmbh
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Erbe Elektromedizin Gmbh filed Critical Erbe Elektromedizin Gmbh
Publication of WO2010121704A1 publication Critical patent/WO2010121704A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1402—Probes for open surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/1206—Generators therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/0091—Handpieces of the surgical instrument or device
    • A61B2018/00916—Handpieces of the surgical instrument or device with means for switching or controlling the main function of the instrument or device
    • A61B2018/00928—Handpieces of the surgical instrument or device with means for switching or controlling the main function of the instrument or device by sending a signal to an external energy source

Definitions

  • 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.
  • RF surgery high frequency surgery
  • 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.
  • 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.
  • the current path usually leads from the electrosurgical instrument via the tissue to be treated to a neutral electrode.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • a handle for an electrosurgical instrument 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.
  • an electrosurgical 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).
  • 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
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • a set operating mode e.g. a mode of coagulation or cutting.
  • 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.
  • 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.
  • 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.
  • 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.
  • two LEDs 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.
  • 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.
  • Fig. 1 is a schematic representation of a bipolar electrosurgical
  • 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;
  • Display devices are connected via an optical signal line to the control unit;
  • 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. 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 preferably comprises the following components (see FIG.
  • At least two electrosurgical instruments 10, 10 ' wherein the electrosurgical instruments 10, 10' each have at least one display device 50, 50 'respectively.
  • 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'.
  • the device 1 has input devices, in particular the foot switches 30, 30 '.
  • 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'.
  • 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.
  • Resistance detection device 42 outputs corresponding signals to the control unit 40, which activates the RF generator 20.
  • 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.
  • FIG. 3 and 4 show two different ways in which corresponding display devices 50, 50 'can be connected to the control unit 40.
  • the electrosurgical instruments 10, 10 ' are connected via an optical signal line
  • Fig. 4 supply lines 43a, 43b, 43a', 43b 'are used to operate the display devices 50, 50'.
  • a data bus may be provided which communicates with a corresponding control device within the instruments 10, 10 '.
  • 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'.
  • the control unit 40 comprises a first light-emitting diode 54 and a second light-emitting diode 54 '.
  • 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.
  • the control unit 40 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'.
  • the 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.
  • 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.
  • 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'.
  • 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.
  • the circuits of FIGS. 5 and 6 can be operated on separate circuits, which are selectively controlled by the control unit 40.
  • 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 '.
  • Correspondingly arranged resistors 52, 52 ' regulate the voltage which drops across the light-emitting diodes 54', 54 ".
  • first and a second light-emitting diode string 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 ".
  • 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 '.
  • 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 ".
  • 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.
  • 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.
  • 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.
  • 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" ,

Abstract

La présente invention s'attaque aux problèmes qui surviennent lorsqu'une pluralité d'instruments HF fonctionne sur un générateur HF. Pour le médecin traitant, il est souvent difficile d'établir lequel des instruments HF est actionné et donc prêt à appliquer une tension HF. La présente invention résout ce problème en offrant un appareil électrochirurgical ayant une pluralité d'instruments électrochirurgicaux, un générateur HF raccordé aux instruments pour délivrer une tension HF, une unité de commande pour commander le générateur HF et un sélecteur. Le sélecteur est raccordé à l'unité de commande afin de sélectionner un instrument en tant qu'instrument actif, au moins un instrument parmi la pluralité d'instruments présentant un dispositif d'affichage destiné à afficher l'état d'actionnement. Le dispositif d'affichage sur l'instrument signale au médecin traitant si l'instrument correspondant est actionné.
PCT/EP2010/002083 2009-04-20 2010-03-31 Appareil électrochirurgical WO2010121704A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102009018100.8 2009-04-20
DE102009018100A DE102009018100A1 (de) 2009-04-20 2009-04-20 Elektrochirurgisches Gerät

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WO2010121704A1 true WO2010121704A1 (fr) 2010-10-28

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PCT/EP2010/002083 WO2010121704A1 (fr) 2009-04-20 2010-03-31 Appareil électrochirurgical

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WO (1) WO2010121704A1 (fr)

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102018106737A1 (de) * 2018-03-21 2019-09-26 Olympus Winter & Ibe Gmbh Elektrochirurgiesystem

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE3627221A1 (de) 1986-01-15 1988-02-18 Siemens Ag Hf-chirurgiegeraet mit leistungssteuerung vom chirurgie-handgriff aus
DE4012545A1 (de) 1990-04-19 1991-10-24 Siemens Ag Chirurgie-handgriff mit einer aufnahme fuer eine aktive elektrode
DE19943792A1 (de) 1999-09-13 2001-04-12 Erbe Elektromedizin Hochfrequenz-Chirurgiergerät und Hochfrequenzchirurgie-Anordnung
US20050043828A1 (en) * 2003-08-19 2005-02-24 Olympus Corporation Control device for a medical system and control method for medical system
EP1803410A1 (fr) * 2005-12-30 2007-07-04 Biosense Webster, Inc. Système et méthode permettant d'alimenter de manière sélective des électrodes positionnées sur un cathéter.
EP1932487A2 (fr) * 2004-10-08 2008-06-18 Covidien AG Système électrochirurgical utilisant plusieurs électrodes
WO2008098085A2 (fr) * 2007-02-06 2008-08-14 The Uab Research Foundation Système de commande d'une fonction chirurgicale universelle
US20090012516A1 (en) * 2007-06-19 2009-01-08 Gyrus Medical Limited Electrosurgical system

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19740976A1 (de) * 1997-04-01 1998-10-08 Axel Muntermann Verfahren und Vorrichtung zur Erfassung des Katheter-Gewebekontaktes bei der HF-chirurgischen Katheterablation
DE102007053336A1 (de) * 2007-11-08 2009-05-20 Erbe Elektromedizin Gmbh Signaleinrichtung für elektrochirurgische Instrumente, Adapter zum Anschluss eines elektrochirurgischen Instruments

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE3627221A1 (de) 1986-01-15 1988-02-18 Siemens Ag Hf-chirurgiegeraet mit leistungssteuerung vom chirurgie-handgriff aus
DE4012545A1 (de) 1990-04-19 1991-10-24 Siemens Ag Chirurgie-handgriff mit einer aufnahme fuer eine aktive elektrode
DE19943792A1 (de) 1999-09-13 2001-04-12 Erbe Elektromedizin Hochfrequenz-Chirurgiergerät und Hochfrequenzchirurgie-Anordnung
US20050043828A1 (en) * 2003-08-19 2005-02-24 Olympus Corporation Control device for a medical system and control method for medical system
EP1932487A2 (fr) * 2004-10-08 2008-06-18 Covidien AG Système électrochirurgical utilisant plusieurs électrodes
EP1803410A1 (fr) * 2005-12-30 2007-07-04 Biosense Webster, Inc. Système et méthode permettant d'alimenter de manière sélective des électrodes positionnées sur un cathéter.
WO2008098085A2 (fr) * 2007-02-06 2008-08-14 The Uab Research Foundation Système de commande d'une fonction chirurgicale universelle
US20090012516A1 (en) * 2007-06-19 2009-01-08 Gyrus Medical Limited Electrosurgical system

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