WO2018210792A1 - Commande pour un générateur chirurgical hf - Google Patents

Commande pour un générateur chirurgical hf Download PDF

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Publication number
WO2018210792A1
WO2018210792A1 PCT/EP2018/062461 EP2018062461W WO2018210792A1 WO 2018210792 A1 WO2018210792 A1 WO 2018210792A1 EP 2018062461 W EP2018062461 W EP 2018062461W WO 2018210792 A1 WO2018210792 A1 WO 2018210792A1
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WO
WIPO (PCT)
Prior art keywords
output
generator
switching means
profile
output profile
Prior art date
Application number
PCT/EP2018/062461
Other languages
German (de)
English (en)
Inventor
Ilja Assmus
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 WO2018210792A1 publication Critical patent/WO2018210792A1/fr

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/1206Generators therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577Ablation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00589Coagulation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00696Controlled or regulated parameters
    • A61B2018/00726Duty cycle
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00988Means for storing information, e.g. calibration constants, or for preventing excessive use, e.g. usage, service life counter

Definitions

  • the invention relates to a method for controlling a surgical RF generator according to claim 1 and to a surgical RF generator according to claim 11.
  • HF high-frequency
  • a surgical device comprising an HF (high-frequency) generator which supplies high-frequency electrical current, with the aid of which a surgeon, such as a surgeon, can selectively damage or cut body tissue.
  • a surgeon such as a surgeon
  • the surgical device may control other associated devices, such as an aspirator or a purge.
  • EP 1337194 B1 describes a method for operating an instrument for HF surgery, wherein operating data of the device, for. B. an RF generator, detected at least during a first use of the device connected to the device, sent to a memory device connected to the instrument and stored. Upon reuse or inspection of the instrument, this operational data is sent to a data acquisition device and the device is set in accordance with the operational data collected during the first use such that the instrument is operable as in the first use.
  • WO 2015/063444 A1 describes a method for controlling an electrosurgical HF device and a correspondingly controlled HF device with an associated electrosurgical instrument.
  • the RF generator is initially in a locked state in which its activation is not possible.
  • the HF generator is unlocked; this is how it should be ensured that before the activation of the RF device the respectively required device setting is made correctly.
  • operating data can record device uptime, operating date or set voltage, "current waveform", and auxiliary device usage, but no intraoperative activation data is collected, which can be saved for later use, such as:
  • the activation profile of the RF generator may be activated by an activation switch (usually a footswitch) during a particular operation, but activation in the interval of the activation switch may place a high physical strain on the foot and leg muscles of the operating unit, depending on the operation being performed rateurs.
  • the object of the present invention was to provide a method for controlling a surgical HF generator for the delivery of high-frequency current to at least one output thereof, which does not have the disadvantages of the prior art.
  • the invention in a first aspect, relates to a method of controlling a surgical RF generator for delivering high frequency current to at least one output of the RF generator. It comprises the following steps: reading the activation of an interval detection, followed by the detection of an interval operation of a switching means. Thereafter, a retrievable output profile from the detected interval operation is created and the retrievability of the created output profile for output to the at least one output of the RF generator signaled. It follows the reading of an operation of the switching means for triggering the output of the created output profile, and the output of the generated output profile to the at least one output of the HF generator.
  • a switching means is understood to be a component which allows the activation of the surgical HF generator for the delivery of high-frequency current at at least one output thereof.
  • the switching means is a mechanically actuated, electrical component, for.
  • an evaluation means is understood to mean a device which is designed in particular for processing data on the time sequence of switching signals. The beginning or the end, so the period of detection of the interval operation of the switching means can be defined in a variety of ways, eg.
  • the beginning and end of the detection of the interval operation of the switching means can be defined in a simple manner.
  • the activation or deactivation of the interval detection can take place on the control module of the HF generator.
  • the detection period can be e.g. also be preset on the device.
  • the detection of the end of the interval operation of the switching means can also be done by the evaluation. This may e.g. determine the time distance to the last switching signal: upon reaching a predetermined limit value (for example, a rest period of 20 seconds), the detection of the interval operation is ended.
  • the evaluation means may for example also determine the deviation of the hypothetical time difference between the last given and the yet to be given switching signal from the mean of the preceding intervals; upon reaching a predetermined threshold (e.g., 30% longer interval), the detection of the interval operation is terminated.
  • a predetermined threshold e.g. 30% longer interval
  • a control module is a control circuit formed as a module, wherein in the module all control-technically relevant functions, as well as the operating and display elements including their mechanical and optical functional elements are integrated.
  • the control module After signaling the retrievability of the created output profile for output to the at least one output of the RF generator by signaling means, the control module causes the Output of the output profile when the switching means is pressed again.
  • the display of the retrievability of the output profile can be carried out, for example, via an acoustic, optical or tactile signal.
  • the actuation of the switching means may be designed such that a certain sequence of switching signals (eg a double or triple actuation) triggers the step of outputting the output profile produced to the at least one output of the RF generator; At the same time, the output of the generated output profile can be terminated or interrupted accordingly via such a switching sequence.
  • a certain sequence of switching signals eg a double or triple actuation
  • high-frequency current is emitted in the interval at the at least one HF generator output, for example to one or more supply lines to a surgical instrument.
  • the method according to the invention makes it possible to detect an interval actuation of a switching means, for example a footswitch, caused by the surgeon.
  • a switching means for example a footswitch
  • the surgeon can retrieve by simply pressing the switching means, so that the surgical RF generator is activated at the desired interval.
  • This is particularly advantageous at high activation frequencies of the RF generator, as this significantly reduces the physical load on the foot and leg muscles and avoids false activations.
  • the period of detection of the interval actuation can be adjusted by means of a pushbutton, i.
  • the activation or deactivation of the interval detection can be carried out via an additional pushbutton, for example directly on the control module of the HF generator.
  • This key can be pressed at the beginning of the interval detection to activate the interval detection; accordingly, it can be pressed at the end of the interval operation to signal the end of the detection.
  • the so-formed activation or deactivation of the interval detection is particularly easy to use and technically easy to implement.
  • the interval operation may comprise 2 to 50 switching signals of the switching means, which are detected in step (b).
  • an evaluation means can determine the period of the detection of the interval operation.
  • a switching signal is a signal caused by the mechanical actuation of the switching means.
  • it is an electrical signal. It can be detected 2 to 50 switching signals of the switching means, especially preferably 5 to 30 switching signals of the switching means, particularly preferably 8 to 20 switching signals of the switching means.
  • the detection of switching signals to the extent mentioned allows the creation of a variety of different output profiles for use in a wide variety of operational areas.
  • the use of the automatic determination of the period of detection of the interval operation of the switching means by an evaluation means also allows an even more convenient application of the method according to the invention by the surgeon.
  • a continuous actuation of the switching means can be read when reading the operation of the switching means to trigger the output of the output profile created.
  • Reading a continuous operation of the switching means allows the output of the output profile produced to the at least one output of the RF generator to be triggered by the user, such as an operator, in a simple manner, so that the user does not have to remember more complicated triggering signals.
  • the continuous actuation mode for triggering the output of the created output profile at the RF generator can be preset.
  • the output of the actuation of the switching means for triggering the output of the created output profile, the output of high-frequency current from the at least one RF generator output can be terminated at the end of reading.
  • the surgeon can individually control when the delivery of high frequency current is terminated, for example, after the (pre-) determined period of output of the output profile described above, continuously continue the output of high-frequency current from the output of the RF generator for a self-selected period of time, should the operation procedure require it,
  • the output of the output profile can be interrupted during its execution by the operation of the switching means, such as a footswitch The output of high frequency current from the at least one output of the RF generator can thus be controlled in a simple and user-friendly manner.
  • the retrievable output profile can be stored in an additional step.
  • the storage allows a simple retrieval of the retrievable output profile, for example at the beginning of an operation, but also in the event that the repetition of an operation step is required during an operation and a stored output profile for this operation step is present.
  • the output profile can be stored after the output of the created output profile to the at least one output of the RF generator. In this way, it is possible, for example, to perform the detection of the interval operation and thus the creation of the output profile before the operation, and to save the created output profile only if it has proven to be advantageous during intraoperative use (after a single pass). If the retrievable output profile is not stored, upon renewed actuation of the switching means, the output of the last generated output profile to the at least one output of the RF generator by the control module.
  • the step of outputting the generated output profile to the at least one output of the HF generator can be repeated periodically, preferably 1 to 50 times, more preferably 3 to 30 times, even more preferably 5 to 10 times.
  • a periodic repetition of the output profile is understood to be a repetition of the complete profile at equal intervals.
  • the repetition of the step is particularly advantageous for output profiles comprising a small number of intervals (eg, 2-3) of only a small amount of time (eg, 1 -2 sec).
  • the surgeon can cause the repeated output of the output profile created to the at least one output of the RF generator by reading the operation of the switching means once.
  • a repeatability of the output profile on the device is set in advance, for example, limited to a certain number of repetitions.
  • the invention relates to a method for controlling an HF generator by means of a stored, retrievable output profile, which was created according to the inventive method described above. It includes the steps of calling the stored retrievable output profile, reading in a Actuating the switching means to trigger the output of the created output profile, and outputting the stored output profile to at least one RF generator output.
  • a preferred output profile to be used for a particular operational method can be called up and output in a simple manner.
  • a continuous actuation of the switching means can be read in order to trigger the output of the created output profile;
  • the delivery of high frequency current from the at least one RF generator output can be terminated.
  • the output of a stored output profile can thus easily be terminated by the user, such as a surgeon, and ended individually, for example, according to the operational requirements.
  • the continuous output of high-frequency current may be required (output until the completion of the operation of the switching means).
  • the output of the output profile can also be interrupted by simply releasing the switching means.
  • this method may additionally include the step of storing the retrieved output profile.
  • the sequence of applications of the called output profile can be detected.
  • the output of the stored output profile can be repeated periodically at at least one HF generator output, preferably 1 to 50 times, more preferably 3 to 30 times, even more preferably 5 to 10 times.
  • the repetition of the step is, as stated above, particularly advantageous in output profiles comprising a small number of intervals of only a short period of time, since the operator repeats the output profile generated to the at least one output of the RF generator by reading in once the actuation of the switching means can cause.
  • the at least one output of the HF generator can be connected to at least one surgical instrument.
  • the surgical instrument can be, for example, an electrode, such. B. a sliding electrode for the vaporization and / or coagulation of tissue, a cutting tool, a gripping tool, a sewing tool act.
  • the invention in another aspect, relates to a surgical RF generator by means of which the method described above can be carried out.
  • the HF Generator includes a control module, signaling means, at least one output of the RF generator for the delivery of high-frequency current and at least one switching means.
  • the control module comprises an activatable interval detection, wherein the interval detection is designed as an evaluation means, which is adapted to detect an interval operation of the switching means.
  • the control module is in turn adapted to create a retrievable output profile from the detected interval operation. The retrievability of the generated output profile for output at the at least one output of the HF generator is signaled by means of the signaling means configured for this purpose.
  • the control module is further adapted to control the output of the created output profile to the at least one output of the RF generator upon signaling the retrievability of the output profile by the signaling means and upon actuation of the switching means to trigger the output of the created output profile.
  • a control module is understood as a control circuit designed as a module, wherein all the control-relevant functions and all operating and display elements, including their mechanical and optical functional elements, are integrated in the module
  • the interval detection on the control module can be switched, i. be activated or deactivated, for example via a switch.
  • the RF generator constructed in this way allows the execution of the method according to the invention by means of conventional components.
  • a switching means is understood to mean a component which allows the activation of the surgical HF generator for the delivery of high-frequency current to at least one output thereof.
  • a signaling means according to the invention signals the retrievability of the created output profile by means of an acoustic and / or optical signal.
  • the HF generator additionally comprises a user interface adapted for displaying the interval actuation and / or the retrievable output profile.
  • the user interface can be embodied, for example, in the form of an interactive display, by means of which advantageously the selection of already stored output profiles or the specific storage of created output profiles (for example, after surgical procedure and / or after operator) can be carried out.
  • the switching means can be designed as a footswitch.
  • a switching means formed a variety of interval operations in a simple manner be carried out without obstructing or interfering with the operator in his activity in the surgical field.
  • a hand switch may be formed on the at least one surgical instrument connected to the at least one output of the HF generator.
  • FIG. 1 shows a flow chart of the method according to the invention in general form.
  • Figure 2 shows a flow chart of the method according to the invention, wherein the actuation of the switching means for triggering the output of the created output profile is carried out continuously.
  • FIG. 3 shows an overview of the individual components included in the HF generator and the switching means for carrying out the method according to the invention.
  • FIG. 1 shows a flow chart of the method according to the invention in general form.
  • the interval detection can be activated, followed by the detection of an interval operation of a switching means (if reading: activation of the interval detection: "yes")
  • a corresponding evaluation means must be able to detect at least one interval, ie, at least two actuations of the switching means are required
  • Interval actuation of the switching means by the evaluation means takes place in a defined period of time, the start or the end of this period being indexed by the user, for example, but can also be predetermined by the user can be specified by pressing a pushbutton.
  • An output profile is generated from the actuation intervals.
  • This output profile is the time profile of the high-frequency current to be output at at least one output of the HF generator.
  • the retrievability of the generated output profile is signaled by signaling means; For example, they can emit an optical or acoustic signal.
  • a control module triggers the output of the output profile to the at least one output of the HF generator.
  • the switching means can be actuated in any way; For example, the output of the output profile can be triggered by simple, double or triple actuation. After outputting the output profile, the output of high-frequency current is terminated at the at least one output of the HF generator. The user, for.
  • the procedure is ended. If, however, the switching means is actuated a second time (reading: actuation of the switching means: "yes"), the output profile produced last is reissued. The end of the period of output of the output profile terminates the emission of high-frequency current, which is preferably at least operable a surgical instrument connected to the at least one output of the RF generator, for example a bipolar electrode or a surgical vaporisation electrode.
  • the output of the output profile can also be repeated. This is particularly advantageous for short output profiles, which include only a few intervals.
  • an output profile is retrieved. This can advantageously be selected depending on the surgical procedure and / or on the surgeon. After the operation of the switching means has been read in, the respectively selected output profile is output and, after the end of the output, the emission of high-frequency current is terminated, as described above.
  • the output of the output profile can also be repeated periodically in this process, preferably in the range of 1 to 50 times, more preferably 3 to 30 times, even more preferably 5 to 10 times. Again, the output profile can be saved after this step; This may be advantageous, for example, if an output profile is to be used in another operative method and / or for another operator.
  • the method of controlling an RF generator described above in a general form enables the simple recording, storage and output of activation protocols, so that the delivery of high-frequency current through an HF generator is possible.
  • Generator can be adapted to a variety of surgical procedures. The surgeon can conveniently select those output profiles that have proven to be beneficial prior to surgery and retrieve them intraoperatively. The physical loads of the surgeon associated with the activation of the switching means in the interval, in particular at high interval frequencies, and unwanted false activations are avoided with the method according to the invention.
  • FIG. 2 shows a flow diagram of the method according to the invention, in which the actuation of the switching means for triggering the output of the output profile produced takes place continuously.
  • the first steps of the method which include the activation of the interval detection, the detection of the interval operation of the switching means, the creation of the output profile and the signaling of the retrievability of the output profile, are identical to the flowchart shown in FIG. After signaling the retrievability of the output of the output profile to the at least one output of the RF generator is triggered by a continuous actuation of the switching means.
  • the delivery of high-frequency current is possible in this configuration, even after the output of the created output profile output to the at least one output of the RF generator; This may be advantageous, for example, in a vaporization electrode connected as a surgical instrument, in which, after passing through a defined output profile for igniting the electrode, the ignited plasma must be permanently maintained for coagulation and vaporization.
  • the cessation of high frequency current delivery is triggered by the setting of the actuation of the switching means, ie, for example, by simply "releasing" a switching means, such as by stopping actuation of the footswitch and the delivery of high-frequency current to the at least one output of the HF generator can be ended. If the switching means is operated continuously again (read-in: actuation of the switching means: "yes”), the output profile can be output again.
  • FIG. 3 shows an overview of the individual components comprised by the HF generator (1) and the switching means (2) for carrying out the method according to the invention.
  • the switching means (2) preferably a mechanically actuated foot switch, is connected directly to the control module of the HF generator (1), which also comprises the evaluation means for detecting the interval operation of the switching means.
  • the production of the output profile from the detected interval operation takes place in the control module, which enables the output of high-frequency current in accordance with the generated output profile at the RF output of the HF generator (1).
  • a user interface for example an interactive display.
  • the user interface can be used to retrieve stored output profiles or to save created output profiles and to integrate them with the operating procedure data and / or user / operator information.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Otolaryngology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Plasma & Fusion (AREA)
  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un procédé pour la commande d'un générateur chirurgical HF pour distribuer un courant haute fréquence à au moins une sortie du générateur HF ainsi qu'un générateur chirurgical HF. Le procédé comporte la lecture de l'activation d'une détection d'intervalle, la détection d'un actionnement d'intervalle d'un moyen de commutation, l'établissement d'un profil de distribution pouvant être consulté à partir de l'actionnement d'intervalle détecté, la signalisation de la possibilité de consultation du profil de distribution établi et la distribution du profil de distribution établi à au moins une sortie du générateur HF après la lecture d'un actionnement du moyen de commutation pour déclencher la distribution.
PCT/EP2018/062461 2017-05-18 2018-05-15 Commande pour un générateur chirurgical hf WO2018210792A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102017004765.0A DE102017004765A1 (de) 2017-05-18 2017-05-18 Verfahren zur Steuerung eines chirurgischen HF-Generators
DE102017004765.0 2017-05-18

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WO2018210792A1 true WO2018210792A1 (fr) 2018-11-22

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP3871627A1 (fr) 2020-02-27 2021-09-01 Erbe Elektromedizin GmbH Dispositif chirurgical et son procédé de commande

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE2946728A1 (de) * 1979-11-20 1981-05-27 Erbe Elektromedizin GmbH & Co KG, 7400 Tübingen Hochfrequenz-chirurgiegeraet
DE3228136A1 (de) * 1982-07-28 1984-02-09 Erbe Elektromedizin GmbH, 7400 Tübingen Hochfrequenz-chirurgiegeraet
US20040030328A1 (en) * 2001-07-12 2004-02-12 Eggers Philip E. Electrosurgical generator
EP1337194B1 (fr) 2000-11-21 2008-12-03 Erbe Elektromedizin GmbH Procede servant a faire fonctionner un instrument de chirurgie hf et dispositif electrochirurgical
WO2015063444A1 (fr) 2013-10-29 2015-05-07 Imperial Innovations Limited Procédé et appareil d'inversion de forme d'onde totale

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE2946728A1 (de) * 1979-11-20 1981-05-27 Erbe Elektromedizin GmbH & Co KG, 7400 Tübingen Hochfrequenz-chirurgiegeraet
DE3228136A1 (de) * 1982-07-28 1984-02-09 Erbe Elektromedizin GmbH, 7400 Tübingen Hochfrequenz-chirurgiegeraet
EP1337194B1 (fr) 2000-11-21 2008-12-03 Erbe Elektromedizin GmbH Procede servant a faire fonctionner un instrument de chirurgie hf et dispositif electrochirurgical
US20040030328A1 (en) * 2001-07-12 2004-02-12 Eggers Philip E. Electrosurgical generator
WO2015063444A1 (fr) 2013-10-29 2015-05-07 Imperial Innovations Limited Procédé et appareil d'inversion de forme d'onde totale

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP3871627A1 (fr) 2020-02-27 2021-09-01 Erbe Elektromedizin GmbH Dispositif chirurgical et son procédé de commande

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