WO2017005665A1 - Générateur haute fréquence destiné à être raccordé à des instruments électrochirurgicaux - Google Patents

Générateur haute fréquence destiné à être raccordé à des instruments électrochirurgicaux Download PDF

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Publication number
WO2017005665A1
WO2017005665A1 PCT/EP2016/065615 EP2016065615W WO2017005665A1 WO 2017005665 A1 WO2017005665 A1 WO 2017005665A1 EP 2016065615 W EP2016065615 W EP 2016065615W WO 2017005665 A1 WO2017005665 A1 WO 2017005665A1
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WO
WIPO (PCT)
Prior art keywords
frequency
frequency generator
internal resistance
stimulation
generator according
Prior art date
Application number
PCT/EP2016/065615
Other languages
German (de)
English (en)
Inventor
Uwe Fischer
Lutz Kersten
Stefan Schiddel
Thomas FAEHSING
Original Assignee
Olympus Winter & Ibe 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 Olympus Winter & Ibe Gmbh filed Critical Olympus Winter & Ibe Gmbh
Publication of WO2017005665A1 publication Critical patent/WO2017005665A1/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
    • A61B18/1206—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
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00696—Controlled or regulated parameters
    • A61B2018/00732—Frequency
    • 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
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00696—Controlled or regulated parameters
    • A61B2018/00755—Resistance or impedance
    • 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
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A61B2018/00875—Resistance or impedance
    • 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
    • A61B2018/1246—Generators therefor characterised by the output polarity
    • A61B2018/126—Generators therefor characterised by the output polarity bipolar
    • 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
    • A61B2018/128—Generators therefor generating two or more frequencies

Definitions

  • the invention relates to a high-frequency generator for connecting a high-frequency electrosurgical instrument.
  • the high-frequency generator can be operated in different operating modes.
  • High frequency generators for connecting electrosurgical instruments are known in various forms. Examples can be found e.g. in WO 2010/124785, DE 10 2013 222 800, WO 2010/102620 and WO 2010/142438.
  • a high-frequency generator and a high-frequency electro-surgical instrument connected thereto form a high-frequency surgical system whose characteristics such as output voltage, output current and thus also the output power depend both on the high-frequency generator and on the high-frequency electrosurgical instrument connected thereto. These characteristics may change if another high frequency electrosurgical instrument is connected to a particular radiofrequency generator.
  • the aim is to expand the scope of a high-frequency surgical system.
  • this object is achieved by a high-frequency generator which is to be operated in different operating modes and is characterized in that the High frequency generator has a controllable variable internal resistance and / or frequency response.
  • the invention includes the recognition that conventional high frequency generators in a particular configuration, i. Depending on the particular operating mode of the high-frequency generator and connected to the high-frequency generator high-frequency electrosurgical instrument, a specific frequency response, a certain internal resistance and thus a certain output impedance (the high-frequency generator) have. This has the consequence that the internal resistance of the high-frequency generator and thus also the output impedance of the high-frequency rurie system are fixed for a particular configuration and can not be changed.
  • the internal resistance of the high-frequency generator and / or its frequency response can be controlled by appropriately activating, setting, connecting and / or disconnecting electrical components and / or by setting the stimulation frequency such that predetermined output values, such as current, Voltage or power result.
  • the driving, adjusting, switching on and / or off electrical components by the high frequency generator itself takes place.
  • the high frequency generator has a bandpass at its output, which is variable, wherein the high frequency generator is formed, the bandpass during operation in an operating mode be changed so that for a respective selected operating mode predetermined output values such as current, voltage or power result.
  • the bandpass has an inductivity that is variable or its quality is variable, so that by changing the inductance or the quality of the inductance, an adjustment of the predetermined output values by the high-frequency generator during an operating mode can take place.
  • the high-frequency generator may have a transformer with a plurality of primary and / or secondary windings and be configured such that the high-frequency generator performs a switching between individual primary and / or secondary windings such that for a respective selected operating mode predetermined output values such as current, Voltage and / or power result.
  • the high-frequency generator additionally or alternatively be designed so that an internal resistance by adding a parallel or a serial load at the output of the high-frequency generator is adjustable such that the high-frequency generator predetermined by connecting or disconnecting the serial or parallel load for a respective selected operating mode Output values such as current, voltage or power can be set.
  • the internal resistance of the high-frequency generator can be controlled by setting the stimulation frequency such that predetermined output values such as current, voltage or power result for a respective selected operating mode.
  • the high-frequency generator can in particular be designed so that it adjusts the stimulation frequency, taking into account a frequency response (ie the frequency-dependent internal resistance) of the high-frequency generator and the selected operating mode, that results in a respectively predetermined target internal resistance.
  • the high-frequency generator can be designed to determine and adjust the control of the stimulation frequency as a function of the frequency response of the entire high-frequency surgical system including the high-frequency generator and the connected high-frequency electrosurgical instrument.
  • the high-frequency generator is designed to control the stimulation frequency as a function of a load impedance applied to its output so that the internal resistance of the high-frequency generator increases with decreasing load impedance.
  • a falling load impedance occurs, for example, when unwanted sparks or arcs occur during electrosurgical coagulation or cutting, which are to be avoided or erased.
  • the load impedance drops abruptly. If the high-frequency generator then changes the stimulation frequency so that the internal resistance of the high-frequency generator increases, thereby a resulting arc can be deleted.
  • the embodiment which is designed in accordance with the high-frequency generator to change the stimulation frequency in order to adjust the internal resistance of the high-frequency generator is based on the finding that the frequency response of a high-frequency generator in a respective operating frequency range is not constant and in particular is typically also not linear. Rather, a slight change in the stimulation frequency (output frequency of the high-frequency generator) can lead to a significant change in the internal resistance of the high-frequency generator.
  • This intrinsically undesirable property is in the Hochfre- Frequency generator is used to make specific changes in the Stirn ulationsfrequenz in order to specifically change the internal resistance of the high-frequency generator so that there are desired output values such as current, voltage and / or power.
  • the high-frequency generator has at least two operating modes, namely at least one cutting mode for cutting body tissue by means of a high-frequency current and a coagulation mode for coagulating body tissue by means of a high-frequency current.
  • the high-frequency generator can be designed to determine a respective load impedance (load applied to the high-frequency electrosurgical instrument) and to set the internal resistance as a function of this load impedance.
  • load applied to the high-frequency electrosurgical instrument load applied to the high-frequency electrosurgical instrument
  • the high-frequency generator is designed to effect a change in the internal resistance and / or the frequency response by connecting and disconnecting at least one of the electrical components and preferably from at least one of the additional frequency components resulting therefrom in the frequency spectrum of a stimulation frequency. Sidebands) to determine a load impedance.
  • a load impedance determination has hitherto been carried out exclusively with invariable internal resistance and / or fixed frequency response and thus significant tissue changes such as tissue type or coagulation result based on a few insufficient measurements.
  • additional frequency components are introduced into the stimulation frequency as the basis for determining the load impedance.
  • the load impedance determination excludes an evaluation of a step response caused by switching on and off of at least one of the electrical components.
  • the change of the internal resistance and / or the frequency response is provided by switching on and off of the at least one of the electrical components exclusively for the determination of the load impedance and / or independently of any provided load matching circuit for adapting the load of the high frequency generator to a high frequency electrosurgical instrument.
  • the high frequency generator is free from a load adaptation circuit for adapting the load of the high frequency generator to a high frequency electrosurgical instrument.
  • the high-frequency generator is preferably designed to generate a stimulation voltage having a stimulation frequency between 200 kHz and 2 MHz and to generate sidebands of preferably +/- 10 kHz by connecting and disconnecting at least one of the electrical components in the frequency spectrum of the stimulation frequency.
  • the stimulation frequency remains unchanged by the switching on and off of at least one of the electrical components.
  • sidebands occur in the frequency spectrum of the stimulation frequency.
  • load impedance determination includes measuring the time history of the output values of current and voltage.
  • the measurement of the time profile of the output values current and voltage is performed by a measuring module of the high-frequency generator.
  • the measuring module is preferably connected downstream of the at least one of the electrical components.
  • the change in the internal resistance and / or the frequency response by switching on and off a serial load at the output of the high-frequency generator takes place for the load impedance determination.
  • the measuring module can be connected downstream of the serial load.
  • the high-frequency generator is designed such that the connection and disconnection of the at least one of the electrical components takes place in a clocked manner, wherein the switched-on state corresponds to a pulse duration and the switched-off state corresponds to a pause duration.
  • the pulse-pause ratio is preferably 1: 1. Other pulse-pause ratios are possible.
  • the pulse-pause ratio may be predetermined by a preferably variable pulse width modulation signal, by a maximum length sequence signal (MLS) or a pulse signal.
  • the high-frequency generator can be configured to determine a respective load impedance both in the switched-on state and in the switched-off state.
  • the high-frequency generator is preferably designed to connect a bipolar high-frequency electrosurgical instrument.
  • bipolar radiofrequency electrosurgical instruments both electrodes are located on the instrument for electrosurgical therapy (anode and cathode).
  • monopolar instruments have only one electrode pole (anode or cathode) while the counter electrode is typically a large-area neutral electrode.
  • the high-frequency generator is preferably designed to output a high-frequency output voltage having a stimulation frequency within a frequency range from 200 kHz to 2 MHz.
  • the high-frequency generator is designed to vary the stimulation frequency within a mode of operation by a maximum of +/- 10 kHz or even +/- 50 kHz in order to set a predetermined internal resistance in this manner.
  • Figure 1 a high-frequency surgery system in a schematic representation
  • FIG. 2 shows components of a high-frequency generator for the controllable influencing of its internal resistance and / or frequency response
  • Figure 3 an example of a frequency response of a high-frequency generator for
  • Figure 4 Components of a high-frequency generator for controllable influence on its internal resistance and / or frequency response and for load impedance determination.
  • FIG. 1 shows a schematic illustration of a high-frequency surgical system 10 having a high-frequency generator 12 and a bipolar high-frequency electrosurgical instrument 14 connected thereto.
  • the high frequency generator 12 comprises a high voltage supply unit 16 and a high frequency high voltage output stage 18, which is formed by a resonant circuit 20 having at least one inductor 22 and a capacitor 24, and an output transformer 26.
  • the output transformer 26 has a primary winding 28 and a secondary winding 30.
  • the primary winding 28 may also act as the sole inductance of the resonant circuit 20, so that the inductance 22 may be omitted under certain circumstances.
  • a drive unit 32 feeds a DC voltage supplied by the high-voltage supply unit 16 clocked into the resonant circuit 20.
  • the clock frequency corresponds to the desired stimulation frequency.
  • the output transformer 26 effects a galvanic isolation of the high-frequency resonant circuit from the connections for the high-frequency electrosurgical instrument 14.
  • FIG. 2 shows some of the components of the high-frequency generator from FIG. 1 as well as possible additional components of the high-frequency generator with which the internal resistance and / or the frequency response of the generator can change during operation in an operating mode and thus can be controlled.
  • the resonance unit 34 includes the resonance circuit 20 and the output transformer 26.
  • variable band-pass 36 is shown as well as a switchable resistor network 38.
  • Both the variable band-pass 36 and the switchable resistor network 38 are optional components that are connected downstream of the secondary winding 30 'of the output transformer but are components of the high frequency generator 12' and of This can be controlled or switched.
  • variable bandpass 36 and the switchable resistor network 38 are each exemplary.
  • the switchable resistor network 38 may also contain only a single resistor 40.1 or 40.2 and also only a single switch 42.1 or 41.2 associated with the resistor.
  • the internal resistance of the high-frequency generator 12 ' can be changed in each case.
  • this can be done, for example, by changing an inductance 36.1 of the band-pass 36 in a controlled manner or by changing the quality of the inductance 36.1 goodness.
  • FIG. 2 Not shown in FIG. 2 is the high-frequency electrosurgical instrument. Instead, an equivalent circuit 44 is shown, which schematically represents the electrical properties of the high-frequency electrosurgical instrument in connection with the respective body tissue.
  • the secondary winding 30' of the output transformer can have several taps, so that the effective inductance of the secondary winding 30 'of the output transformer can be influenced in this way in turn, the resistance and frequency response of the high frequency generator 12 'are controllably variable.
  • a particularly preferred variant for adjusting the internal resistance of the high-frequency generator 12 ' is to specifically change the stimulation frequency of the high-frequency generator for setting a desired internal resistance.
  • the pacing frequency is understood here to mean the frequency with which the resonance circuit 20 is excited by the high-voltage supply unit 16 with voltage pulses, that is, stimulated.
  • FIG. Fig. 3 shows a possible frequency response of a high-frequency generator.
  • the frequency response of the high frequency generator is neither linear nor constant. This opens up the possibility of operating the high-frequency generator at a target stimulation frequency f z between 200 kHz and 2 MHz, for example, and changing this target stimulation frequency f z by a maximum of +/- Af, eg +/- 10 kHz.
  • the output impedance Z of the high-frequency generator can be adjusted in the region ⁇ by varying the stimulation frequency alone. be presented.
  • FIG. 4 shows a high-frequency generator 12 'which corresponds to the high-frequency generator described with reference to FIG.
  • the high-frequency generator 12 ' is followed by a resistor 40.1, which forms a serial load.
  • the resistor 40.1 can be switched on and off.
  • the desired sidebands are generated by connecting and disconnecting the resistor 40. 1 as an electrical component.
  • other electrical components or other electrical components may be used, such as inductors, capacitors, nonlinear components (diodes), etc.
  • the switching on and off is done automatically by the high frequency generator 12 'by means of the clock signal T. , which has a pulse-pause ratio of 1: 1 by way of example.
  • the high-frequency generator 12 ' is designed to generate a stimulation voltage with a target stimulation frequency f z between 200 kHz and 2 MHz and to change this target stimulation frequency f z by a maximum of 10 kHz by switching the resistance 40.1 on and off.
  • a measuring module 50 which serves to measure the time profile of the output values current and voltage and, as a result, the determination of the load impedance (equivalent circuit 44), is connected downstream of the resistor 40.1.
  • a frequency spectrum S (0) of a stimulation frequency fz Indicated on the left of the resistor 40.1 is a frequency spectrum S (0) of a stimulation frequency fz, as would occur without the connection and disconnection of the resistor 40.1. The only significant peak occurs at the pacing rate fz. Indicated on the right of the resistor 40.1 is a frequency spectrum S (+) of a stimulation frequency fz, as occurs with the connection and disconnection of the resistor 40.1. In addition to the significant peak occurring at the pacing rate fz, two smaller peaks occur at the pacing rate fz and fz +, which also serve to determine the load impedance. LIST OF REFERENCE NUMBERS

Abstract

L'invention concerne un générateur haute fréquence (12, 12') destiné à être raccordé à un instrument d'électrochirurgie à haute fréquence (14) qui est prévu pour fonctionner selon différents modes de fonctionnement. Le générateur haute fréquence (12, 12') présente une résistance interne et/ou une réponse en fréquence variables de manière réglable.
PCT/EP2016/065615 2015-07-03 2016-07-01 Générateur haute fréquence destiné à être raccordé à des instruments électrochirurgicaux WO2017005665A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102015212546.7 2015-07-03
DE102015212546.7A DE102015212546A1 (de) 2015-07-03 2015-07-03 Hochfrequenzgenerator zum Anschluss elektrochirurgischer Instrumente

Publications (1)

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WO2017005665A1 true WO2017005665A1 (fr) 2017-01-12

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PCT/EP2016/065615 WO2017005665A1 (fr) 2015-07-03 2016-07-01 Générateur haute fréquence destiné à être raccordé à des instruments électrochirurgicaux

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WO (1) WO2017005665A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2019112549A1 (fr) * 2017-12-04 2019-06-13 Aerojet Rocketdyne, Inc. Testeur d'impédance de charge et procédé de mesure

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US5628745A (en) * 1995-06-06 1997-05-13 Bek; Robin B. Exit spark control for an electrosurgical generator
US5743900A (en) * 1995-06-06 1998-04-28 Sun Star Technology, Inc. Hot tip catheter and method for using the same
US20030181898A1 (en) * 1999-05-28 2003-09-25 Bowers William J. RF filter for an electrosurgical generator
US20040138654A1 (en) * 2003-01-09 2004-07-15 Gyrus Medical Limited Electrosurgical generator
US20110071514A1 (en) * 2009-09-23 2011-03-24 Taewoong Medical Co., Ltd Method and system for controlling radio frequency output according to change in impedance of biological cells
EP2329782A1 (fr) * 2008-10-03 2011-06-08 Olympus Medical Systems Corp. Dispositif électrochirurgical, procédé de commande du dispositif électrochirurgical, dispositif de traitement haute fréquence, et procédé de traitement haute fréquence
US20120041435A1 (en) * 2009-03-11 2012-02-16 Heiko Schall High frequency surgical generator comprising an additional transformer
US20130023867A1 (en) * 2011-07-19 2013-01-24 Tyco Healthcare Group Lp System and method of matching impedances of an electrosurgical generator and/or a microwave generator
US20130345689A1 (en) * 2010-05-21 2013-12-26 David Ian Ruddenklau Medical device
US20140074084A1 (en) * 2011-05-04 2014-03-13 The University Of Akron Variable-frequency stimulator for electrosurgery
US20150105766A1 (en) * 2013-10-16 2015-04-16 Covidien Lp Radiofrequency amplifier impedance optimization

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US8777941B2 (en) * 2007-05-10 2014-07-15 Covidien Lp Adjustable impedance electrosurgical electrodes
DE102009012431A1 (de) 2009-03-10 2010-09-23 Farin, Günter, Dipl.-Ing. Verfahren und Einrichtung zum Betreiben einer HF-chirurgischen Anordnung
WO2010124785A1 (fr) 2009-04-29 2010-11-04 Erbe Elektromedizin Gmbh Générateur chirurgical hf, et procédé permettant de faire fonctionner un générateur chirurgical hf
DE102009024612A1 (de) 2009-06-10 2010-12-16 Erbe Elektromedizin Gmbh Versorgungseinrichtung zur Bereitstellung einer HF-Ausgangsspannung, HF-Chirurgiegerät mit entsprechender Versorgungseinrichtung und Verfahren zum Betreiben einer HF-Generatoreinheit
GB201220151D0 (en) 2012-11-08 2012-12-26 Gyrus Medical Ltd Electrosurgical generator

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5628745A (en) * 1995-06-06 1997-05-13 Bek; Robin B. Exit spark control for an electrosurgical generator
US5743900A (en) * 1995-06-06 1998-04-28 Sun Star Technology, Inc. Hot tip catheter and method for using the same
US20030181898A1 (en) * 1999-05-28 2003-09-25 Bowers William J. RF filter for an electrosurgical generator
US20040138654A1 (en) * 2003-01-09 2004-07-15 Gyrus Medical Limited Electrosurgical generator
EP2329782A1 (fr) * 2008-10-03 2011-06-08 Olympus Medical Systems Corp. Dispositif électrochirurgical, procédé de commande du dispositif électrochirurgical, dispositif de traitement haute fréquence, et procédé de traitement haute fréquence
US20120041435A1 (en) * 2009-03-11 2012-02-16 Heiko Schall High frequency surgical generator comprising an additional transformer
US20110071514A1 (en) * 2009-09-23 2011-03-24 Taewoong Medical Co., Ltd Method and system for controlling radio frequency output according to change in impedance of biological cells
US20130345689A1 (en) * 2010-05-21 2013-12-26 David Ian Ruddenklau Medical device
US20140074084A1 (en) * 2011-05-04 2014-03-13 The University Of Akron Variable-frequency stimulator for electrosurgery
US20130023867A1 (en) * 2011-07-19 2013-01-24 Tyco Healthcare Group Lp System and method of matching impedances of an electrosurgical generator and/or a microwave generator
US20150105766A1 (en) * 2013-10-16 2015-04-16 Covidien Lp Radiofrequency amplifier impedance optimization

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2019112549A1 (fr) * 2017-12-04 2019-06-13 Aerojet Rocketdyne, Inc. Testeur d'impédance de charge et procédé de mesure
CN111417859A (zh) * 2017-12-04 2020-07-14 航天喷气发动机洛克达因股份有限公司 负载阻抗测试器及测量方法
US11162988B2 (en) 2017-12-04 2021-11-02 Aerojet Rocketdyne, Inc. Load impedance tester and measurement method

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