WO2018066740A1

WO2018066740A1 - Electric surgical device

Info

Publication number: WO2018066740A1
Application number: PCT/KR2016/011273
Authority: WO
Inventors: 이치영
Original assignee: (주) 헤파토
Priority date: 2016-10-04
Filing date: 2016-10-07
Publication date: 2018-04-12
Also published as: KR101780269B1

Abstract

An electric surgical device of the present invention may comprise: an image information reception unit for receiving image information of a body with respect to a region of a tumor; a monitor unit for displaying the image information; at least one or more first connection terminals to which a radiofrequency ablation (hereinafter referred to as RFA) probe is connected; at least one or more second connection terminal to which an irreversible electroporation (hereinafter referred to as IRE) probe is connected; a first drive unit for applying a radiofrequency alternating current to the RFA probe connected to the first connection terminal; a second drive unit for applying an electric pulse to the IRE probe connected to the second connection terminal; and a switch unit for selectively controlling the drive of the RFA probe or the IRE probe connected to the first connection terminal or the second connection terminal.

Description

Electrosurgical device

Embodiments of the present invention relate to an electrosurgical device.

Radiofrequency ablation (RFA) is a method of killing cells by releasing radiofrequency currents that induce frictional heat in electrode ceramics arranged in cell tissues, causing local tissue necrosis. Placing a specially designed probe on the site to be excised, through high-frequency alternating current (an alternating current between 350 and 500 KHz), causes the probe tip to heat up to 70 to 100 ° C. At this time, heat causes tissue necrosis in the cell. RFA does not require surgical methods such as thoracotomy or general anesthesia. This procedure is performed after confirming the mechanism and incidence of arrhythmia by electrophysiology test. Usually, 3 ~ 4 thin and elastic electrode ceramics are inserted into the vein under the thigh or collarbone, and then the help of X-ray fluoroscopy in real time. Take it and insert it into the affected part. In this state, the electrophysiological examination is performed to diagnose the electrical characteristics of the arrhythmia, the position of the regression circuit or the subcircuit, etc., first, and then perform treatment by administering high frequency energy to a specific site with an ablation probe. RFA does not affect nerve or heart function. It is possible to treat tumors of the liver, lungs, kidneys, bones and other organs that can be accessed through image guidance, and can remove both liver tumors and tumor metastases.

In general, the RFA device which is widely used forms an ablation zone of 2 to 5 cm in diameter, and thus an overlapping procedure is required to remove a larger ablation zone. In addition, RFA may cause a lethal temperature to occur in a portion adjacent to the probe within 3mm, there is a disadvantage in that dehydration and carbonization of the cell tissue. In addition, due to electromagnetic interference, only one RFA probe may be activated, and a ground pad may be attached to a portion where a skin burn may occur.

Thus, irreversible electroporation (IRE) has been proposed as a new resection. IRE is a method of killing cancer cells by applying electric pulses using DC current to the cells. It's a way of killing cancer cells by punching them through millions of electrical stimuli per second. IRE uses a high voltage of 2500V, which produces a stripping area of 3 cm or less.

The IRE has a short ablation time of less than 1 minute and has a detachment area of 3 cm or less, so that only cells of the treatment target can be accurately excised on a real-time ultrasound image. In addition, IRE is a method that punctures and kills cells through millions of electric stimulation per second, and it has the advantage that important tissues such as blood vessels, nerves, and vessels around the tumor cells of RFA, which heat and kill cells, are not likely to be damaged by heat. . In addition, IRE can perform treatment using multiple IRE probes simultaneously in multiple overlapping treatment regions, and due to electromagnetic interference, it is distinguished from RFA treatment that can use only one RFA probe.

Currently, in the treatment of tumors, only RFA or IRE treatment is selectively used, and there is no proposed device capable of combining RFA treatment and IRE treatment as needed.

In order to solve the problems of the prior art as described above, the present invention is to propose an electrosurgical apparatus that can be effectively combined with RFA treatment and IRE treatment.

Other objects of the present invention may be derived by those skilled in the art through the following examples.

According to a preferred embodiment of the present invention to achieve the above object, the image information receiving unit for receiving the image information of the body for the tumor site; A monitor unit displaying the image information; A first connection terminal to which a radio frequency ablation (hereinafter referred to as RFA) pro part is connected and provided with at least one; A second connecting terminal to which an irreversible electroporation (IRE) probe is connected and provided with at least one; A first driver applying high frequency alternating current to the RFA probe connected to the first connection terminal; A second driver for applying an electric pulse to the IRE probe connected to the second connection terminal; And a switch unit for selectively controlling the driving of the RFA probe or the IRE pro unit connected to the first connection terminal or the second connection terminal.

Analyzing the image information, extracting a tumor region, generating an RFA treatment region through the RFA probe and an IRE treatment region through the IRE probe among the tumor regions, and displaying the generated treatment region through the monitor unit. The control unit may further include.

The apparatus may further include an input unit configured to receive an external input, wherein the controller monitors the received region information when receiving a tumor region, the RFA treatment region, and the IRE treatment region selected by the user through the input unit among the image information. Can be displayed via the negative.

Markers for identifying respective probes are formed in the RFA probe and the IRE probe, and the controller may recognize the RFA probe and the IRE probe by using a marker in the image information.

The controller may control the first driver or the second driver to operate only when the RFA probe is recognized in the RFA treatment region or when the IRE probe is recognized in the IRE treatment region.

The controller may generate a tumor region around the vessel region as the IRE region when the image information includes at least one major tissue region among blood vessels, nerves, and vessels.

According to the present invention, during electrosurgery to remove tumors, RFA therapy and IRE therapy can be efficiently performed in parallel.

In addition, the present invention is to protect the patient by controlling the probe operation only when the probe corresponding to the treatment region is recognized by each of the RFA probe and the IRE probe recognized by the marker using a marker. Can be.

1 is a view showing a perspective view of an electrosurgical apparatus according to an embodiment of the present invention.

Figure 2 is a block diagram showing an electrosurgical apparatus according to an embodiment of the present invention.

3 is a view showing an example in which an electrosurgical probe is connected to an electrosurgical apparatus according to an embodiment of the present invention.

4 is a view showing an embodiment of the treatment using the electrosurgical apparatus according to an embodiment of the present invention.

5 and 6 illustrate examples of image information displayed on a monitor unit according to an exemplary embodiment of the present invention.

Specific details of other embodiments are included in the detailed description and the drawings.

Advantages and features of the present invention and methods for achieving them will be apparent with reference to the embodiments described below in detail with the accompanying drawings. However, the present invention is not limited to the embodiments disclosed below, but may be implemented in various forms. In the following description, when a part is connected to another part, it is only directly connected. It also includes a case in which another device is electrically connected in the middle. In the drawings, parts irrelevant to the present invention are omitted for clarity, and like reference numerals designate like parts throughout the specification.

Hereinafter, the present invention will be described with reference to the accompanying drawings.

1 is a view showing a perspective view of an electrosurgical apparatus according to an embodiment of the present invention, Figure 2 is a block diagram showing an electrosurgical apparatus according to an embodiment of the present invention. 3 is a view showing an example in which an electrosurgical probe is connected to an electrosurgical apparatus according to an embodiment of the present invention.

1 to 3, the electrosurgical apparatus of the present invention includes an image information receiving unit 101, a monitor unit 130, an input unit 105, a first connection module 107, a second connection module 109, The RFA probe 111, the IRE probe 113, the first driver 115, the second driver 117, the switch unit 119, and the controller 121 may be included.

The image information receiver 101 receives image information about the treatment area of the patient's body. The image information about the treatment area inside the patient's body may be image information received from various devices capable of acquiring image information in the body, such as an X-ray apparatus, an ultrasound apparatus, a CT, and an MRI.

The monitor 103 displays the image information received by the image information receiver 101.

The input unit 105 may be configured to receive information related to treatment from a therapist, and may include a keyboard and a mouse.

The first connection terminal 107 is a terminal to which the radio frequency ablation (hereinafter referred to as RFA) pro part 111 is connected, and may be provided with at least one.

The second connection terminal 109 is a terminal to which the irreversible electroporation (IRE) probe 113 is connected, and may be provided with at least one.

The first driver 115 applies high frequency alternating current to the RFA probe 111 connected to the first connection terminal 107. More specifically, the first driver 115 applies an alternating current between 350 and 550 KHz to the RFA probe 111 to heat the end of the RFA probe 111, and the heat generated in this way causes tissue necrosis in the cell. . Since the RFA probe 111 forms an ablation region having a diameter of 2 to 5 cm, overlapping procedures are required for the removal of a larger ablation region, and lethal temperature may occur at a portion adjacent to the RFA probe 111, thereby There are side effects of dehydration and dehydration. In addition, there is a disadvantage that only one RFA probe 111 can be activated due to electromagnetic interference. Since the driving principle of the first driver 115 is already known, a detailed description thereof will be omitted.

The second driver 117 applies an electric pulse to the IRE probe 113 connected to the second connection terminal 109. In more detail, the second driver 117 applies the electric pulse using the DC current to the IRE probe 113. IRE probes puncture the hair by inducing millions of electrical stimuli per second to induce tissue necrosis. The IRE probe 113 generates a stripping area of 3 cm or less, and the DC current applied to the IRE probe 113 may be generated using a high voltage of 2500V. Cell ablation using the IRE probe 113 has a measurable time of less than 1 minute ultrashort f, and has a detachment area of less than 3 cm, there is an advantage that can be accurately excised only the cells of the treatment on a real-time image . In addition, IRE is a method that punctures and kills cells through millions of electric stimulation per second, and it has the advantage that important tissues such as blood vessels, nerves, and vessels around the tumor cells of RFA, which heat and kill cells, are not likely to be damaged by heat. . In addition, since IRE does not generate electromagnetic interference, multiple overlapping treatment areas can be treated using multiple IRE probes at the same time. Therefore, due to electromagnetic interference, it is different from RFA therapy that can use only one RFA probe. Has characteristics. Since a more detailed driving principle of the second driver 117 is already known, a detailed description thereof will be omitted.

The switch unit 119 selectively controls the driving of the RFA probe 111 or the IRE probe 113 connected to the first connection terminal 107 or the second connection terminal 109.

Referring to FIG. 3, since the IRE probes 113-1 and 113-2 may be driven at the same time, a plurality of IRE probes 113-1 and 113-2 may be connected to the second connection terminals 109-1 and 109-2 of the electrosurgical apparatus. Since the 111 may not be driven simultaneously, only one first connection terminal 107 may be connected. However, this is an example for description of the invention, and a plurality of RFA probes 111 may be connected.

The controller 121 analyzes the image information, extracts a tumor region, generates an RFA treatment region through the RFA probe 111 and an IRE treatment region through the IRE probe 113 among the extracted tumor regions, and generates the generated treatment. The area can be displayed via the monitor. In more detail, when the image information includes at least one of blood vessels, nerves, and vessels in the image information, the controller 121 may generate a tumor region around the vessel region as an IRE region, and the other region may be an RFA treatment region. Can be created with Alternatively, the controller 121 may generate an RFA treatment region so that the exfoliation region of the RFA probe 111 does not overlap at least one region of the blood vessel, nerve, or vessel, and IRE treatment of the other region adjacent to the vessel, nerve, or vessel. Can be created as an area.

That is, the present invention prevents damage to blood vessels, nerves, and vessels by performing the treatment around the blood vessels, nerves, and vasculature through the IRE probe 113, and other areas are separated more broadly than the IRE probe 113. The treatment is performed through the RFA probe 111 having the region, thereby enabling efficient treatment.

According to another embodiment of the present invention, the control unit 121 displays the received area information through the monitor unit when receiving the tumor area, RFA treatment area, IRE treatment area selected by the user through the input unit 105 of the image information You could do it.

According to an embodiment of the present invention, the RFA probe 111 and the IRE probe 113 may be formed with markers for identifying respective probes, and the controller 121 may use the RFA probe using markers in the image information. 111 and the IRE pro 113 can be recognized.

In this case, when the IRE probe 113 is recognized in the RFA treatment region or the RFA probe 111 is recognized in the IRE treatment region, the controller 121 may correspond to the first driver 115 or the corresponding probe. Driving of the second driver 117 may be limited.

Referring to FIG. 4, the user may simultaneously insert the RFA probe 111 and the IRE probe 113 into the tumor C to perform treatment. In the case of the conventional RFA probe 111, because only one RFA probe could be used due to electromagnetic interference, overlapping procedures were inevitable in order to remove a large area of tumor (C). In addition, there was a problem that the major tissues such as blood vessels, nerves, vasculature can be damaged by heat.

However, in the case of using the electrosurgical apparatus of the present invention, at the same time as the procedure using the RFA probe 111, the tumor (C) around the main tissue (B), such as blood vessels, nerves, vasculature, etc. Since it is possible to perform the procedure, there is an advantage that can prevent important tissue from being damaged by heat.

Referring to FIG. 5, the RFA treatment region R and the IRE treatment region I generated by the controller 121 may be displayed on the image information displayed through the monitor 103. When the image information includes at least one major tissue region B of blood vessels, nerves, or vasculatures, the control unit 121 replaces the tumor region C around the major tissue region B with the IRE treatment region I. ), And other areas may be generated as RFA treatment areas (R).

According to an embodiment of the present invention, a marker M1 for identifying the RFA probe 111 is formed on the RFA probe 111, and a marker M2 for grafting the IRE probe 113 on the IRE probe 113. ) May be formed. The controller 121 identifies the probe as the RFA probe 111 when the marker M1 in the image is recognized, and identifies the probe as the IRE probe 113 when the marker M2 is recognized.

In this case, the controller 121 controls the first driver 115 to operate only when the RFA probe 111 is recognized in the RFA treatment region R, and the IRE probe 113 in the IRE treatment region I. The second driver 117 can be controlled to operate only when () is recognized.

As in the present invention, when the RFA probe 111 and the IRE probe 113 are provided to provide a different treatment method in the electrosurgical apparatus, as shown in Figure 6, the user accidentally RFA probe 111 and the IRE pro part It may happen that the 113 is inserted into the treatment area. As such, when the RFA probe 111 is inserted into the IRE treatment region I and the IRE pro portion 113 is inserted into the RFA treatment region R, the treatment may be fatal to the patient.

Therefore, according to the present invention, the controller 121 controls the first driver 115 to operate only when the RFA probe 111 is recognized in the RFA treatment region R as shown in FIG. 5. By controlling the second driver 117 to operate only when the IRE probe 113 is recognized in the IRE treatment region I, it is possible to block a problem that may be caused by incorrect insertion of the probe.

In the present invention as described above has been described by the specific embodiments, such as specific components and limited embodiments and drawings, but this is provided to help a more general understanding of the present invention, the present invention is not limited to the above embodiments. For those skilled in the art, various modifications and variations are possible from these descriptions. Therefore, the spirit of the present invention should not be limited to the described embodiments, and all the things that are equivalent to or equivalent to the claims as well as the following claims will belong to the scope of the present invention. .

Claims

An image information receiver configured to receive image information of a body of a tumor site;

A monitor unit displaying the image information;

A first connection terminal to which a radio frequency ablation (hereinafter referred to as RFA) pro part is connected and provided with at least one;

A second connecting terminal to which an irreversible electroporation (IRE) probe is connected and provided with at least one;

A first driver applying high frequency alternating current to the RFA probe connected to the first connection terminal;

A second driver for applying an electric pulse to the IRE probe connected to the second connection terminal; And

And a switch unit configured to selectively control the driving of the RFA probe or the IRE pro unit connected to the first connection terminal or the second connection terminal.
The method of claim 1,

Analyzing the image information, extracting a tumor region, generating an RFA treatment region through the RFA probe and an IRE treatment region through the IRE probe among the tumor regions, and displaying the generated treatment region through the monitor unit. Electrosurgical apparatus further comprising a control unit.
The method of claim 2,

Further comprising an input unit for receiving an external input,

The controller may display the received region information through the monitor unit when receiving the tumor region, the RFA treatment region, and the IRE treatment region selected by the user through the input unit among the image information. .
The method of claim 3,

Markers for identifying each probe are formed on the RFA probe and the IRE probe,

And the controller recognizes the RFA probe and the IRE probe by using a marker in the image information.
The method of claim 4, wherein

And the controller controls the first driver or the second driver to operate only when the RFA probe is recognized in the RFA treatment region or when the IRE probe is recognized in the IRE treatment region.
The method of claim 2,

And the controller generates the tumor region around the vessel region as the IRE region when the image information includes at least one major tissue region among blood vessels, nerves, and vessels.