The invention relates to a high-frequency surgical appliance for cutting and/or coagulating biological tissue with a high-frequency generator which is designed to generate a high-frequency alternating current during operation.
The invention also relates to a method for operating a high-frequency surgical appliance in which a high-frequency alternating current is generated by means of a high-frequency generator for cutting and/or coagulating biological tissue.
The term high-frequency surgery is understood as meaning essentially the cutting and/or coagulating (sclerozing) of biological tissue by using high-frequency alternating current (preferably about 0.2 MHz or 0.3 MHz to 3 MHz, in some cases up to 5 MHz). For this purpose, high-frequency surgical systems with a high-frequency surgical appliance and an electrosurgical instrument connected thereto are preferably used.
In the case of coagulation, high-frequency alternating current is used in particular for stopping bleeding or for the ablation of tissue. This involves heating tissue surrounding an electrode of an electrosurgical instrument to the extent that denaturation and shrinkage of the tissue and the blood vessels occurs, and consequently ultimately the stopping of any bleeding. Also in the case of ablation, a region of tissue is denatured in this way. The region of tissue thus treated scars and is eliminated by the body's own processes, without having to be surgically removed.
In the cutting operation, the cutting effect in the biological tissue is based on the forming of an arc between an active electrode, known as the cutting electrode, of an electrosurgical instrument and the tissue. Electrically conductive tissue can in this case be severed almost without any mechanical pressure.
In the case of the monopolar technique, an active coagulating or cutting electrode of an electrosurgical instrument and a neutral electrode applied over a large surface area are used. The high-frequency current in this case flows from the active electrode via the tissue to be treated to the neutral electrode. An active electrode of a small area in comparison with a neutral electrode of a large area is decisive for the thermal effect of the current at the application site. As a result, a high current density, and consequently a strong heating of the tissue, are achieved at the operating site, and at the same time unwanted instances of tissue damage on the neutral electrode are avoided.
In the case of bipolar applications, two electrodes are used, combined in an electrosurgical instrument or formed on different electrosurgical appliances. The high-frequency current in this case flows from the one electrode via the tissue to be treated to the other electrode of the electrosurgical instrument.
High-frequency surgical appliances of the type mentioned at the beginning are known from the prior art and serve the purpose of supplying electrosurgical instruments with high-frequency current. They are used in surgery for various procedures and treatments. For the different application areas, and for example on account of the tissue-dependent significantly different impedances of the tissue, high-frequency surgical appliances can be operated with a differing output power. At the same time, in the case of many high-frequency surgical appliances, the spark intensity is limited and kept constant by means of what is known as spark control. The aim is to carry out treatments safely and efficiently for the patient and the user and in particular to achieve reproducible cutting and/or coagulating effects. One requirement for high-frequency surgical appliances is therefore to ensure reproducible cutting and/or coagulating properties, largely independently of external conditions, such as for example the cutting speed or electrode size. When electrosurgical systems are used, however, it may happen in practice that electrodes stick to the tissue or the cutting and/or coagulating quality is insufficient. This may lead to undesired interruptions in the treatment and/or prolong the treatment time.
Therefore, an object of the present invention is to provide a high-frequency surgical appliance and a method for operating such a high-frequency surgical appliance that improve existing high-frequency surgical appliances and associated operating methods. In particular, an object of the present invention is to provide a high-frequency surgical appliance and a corresponding operating method that can reduce the number and/or duration of interruptions in the treatment, and consequently preferably also reduce the treatment time.
This object is achieved according to the invention by a high-frequency surgical appliance for cutting and/or coagulating biological tissue with a high-frequency generator which is designed to generate a high-frequency alternating current during operation. The high-frequency surgical appliance also has a power setting device, which is arranged and designed to set or limit an output power of the high-frequency surgical appliance to a power value selected by a user. Also provided is a spark control device, which is arranged and designed to set or limit a spark voltage to a setpoint spark value, the spark control device also being designed to ascertain the setpoint spark value in dependence on the power value selected by a user.
High-frequency surgical appliances for cutting and/or coagulating biological tissue have a high-frequency generator which generates high-frequency alternating current. A power setting device allows the output power of the high-frequency surgical appliance to be selected by a user. For this purpose, the power setting device is preferably connected to a user interface, via which the user can select and stipulate the desired power value, for example by way of a for the controllers. The power setting device is preferably connected in signaling terms to the high-frequency generator in such a way that the power value selected by the user can be set.
A spark control device also provides a spark control of the high-frequency surgical appliance, in that the spark intensity is controlled by way of a limitation of the spark voltage to a setpoint spark value.
In the case of the high-frequency surgical appliances known in the prior art with a spark control that keeps the spark intensity constant independently of the power setting, it may happen, in particular with low spark intensities, that—although a spark is present—electrodes stick to the tissue, in particular relatively large, for example spatula-shaped electrodes, or the cutting quality in the case of a cutting electrode deteriorates. A common user reaction in such cases, that of using the power setting to increase the power, in most cases does not however have a positive influence on the disadvantages mentioned, since the spark control continues to limit the high-frequency generator to the preset constant spark intensity. Also irrespective of the disadvantages mentioned by way of example, in certain application cases it may be useful to be able to vary the spark intensity even for a spark-controlled high-frequency surgical appliance.
The invention is based here on the finding of providing a high-frequency surgical appliance in which a setpoint spark value to which the spark voltage is limited is ascertained in a spark control device in dependence on the power value chosen by the user. For this purpose, which setpoint spark values are to be used for various power values selected by a user to limit the spark voltage by the spark control device may be stored in the control device (or for example in a computing and/or storing unit connected to it). The setpoint spark values may for example be stored in the form of a characteristic curve that represents the setpoint spark value in dependence on the power value selected by the user.
By coupling the setpoint spark value to which the spark voltage is limited to the power setting that is selected by the user, and consequently can be influenced or varied by the user, it is possible to achieve the effect that on the one hand spark control is retained, and consequently the spark intensity is controlled, but at the same time the user is given the possibility of also influencing the spark intensity indirectly by varying the power value. The setting of the output power to the power value and the spark control for limiting the spark voltage to the setpoint spark value in this case preferably remain independent of one another, and are merely coupled by the spark control device ascertaining the setpoint spark value in dependence on the power value.
A preferred refinement of the high-frequency surgical appliance is obtained by the spark control device being arranged and designed to ascertain the setpoint spark value in such a way that, at least in a certain range of values, the setpoint spark value increases as the power value increases. Here it is provided that a higher power value, selected by the user, is also assigned a higher setpoint spark value, and a correspondingly lower power value, selected by the user, is also assigned a lower setpoint spark value, or a correspondingly lower setpoint spark value is ascertained by the spark control device. In this way, the intuitive user expectation that, as the power value increases, the spark intensity also increases, can be replicated in the spark control device, making it particularly easy for the user to operate.
This coupling of an increasing setpoint spark value to an increasing power value is preferably provided at least in a certain range of values. This coupling may, however, also be formed over the entire output power range of the high-frequency surgical appliance. Alternatively, different couplings of the setpoint spark value to the power value may be provided in different ranges of values of the overall spectrum of the output power of the high-frequency surgical appliance. For example, it may be provided in one specific range of values, preferably at the lower end of the spectrum of the output power of the high-frequency surgical appliance, that even as the power value increases the setpoint spark value remains constant, and only increases as the power value increases in a range of values of a higher output power.
In a further refinement of the high-frequency surgical appliance, it is preferred that the spark control device is arranged and designed to ascertain the respective setpoint spark value in such a way that, at least in a certain range of values, the setpoint spark value increases in proportion to the power value.
A proportional coupling of the setpoint spark value to the power value has the advantage of a predictable and uniform increase in the spark intensity with the power value. Here, too, such a coupling is possible over the entire spectrum of the possible output power of the high-frequency surgical appliance or in one or more certain ranges of values within this overall spectrum.
It may also be provided that the spark control device is arranged and designed to ascertain the setpoint spark value in such a way that the setpoint spark value does not undershoot a predetermined minimum spark value and/or does not overshoot a predetermined maximum spark value.
A restriction of the spark value to a maximum value may be preferred for safety reasons. A restriction of the setpoint spark value to a minimum value may be preferred if for example the setting of spark values below the minimum spark value proves to be difficult or unreliable. This may be the case in particular with setpoint spark values of less than 5 V, so that a minimum spark value of for example 5 V is preferred.
High-frequency surgical appliances may have two, three or more operating modes. Such operating modes may differ in the setting of various parameters and preferably serve the purpose of providing parameter settings that for example support different cutting speeds. In such an operating mode, furthermore, one, two, three or more effect modes may be provided or be selectable by users.
It is particularly preferred if the spark control device is arranged and designed to ascertain the setpoint spark value in dependence on the respective operating mode and/or in dependence on the respective effect mode. In particular, different characteristic curves may be provided for the setpoint spark value in dependence on the various operating or effect modes.
Also preferred are high-frequency surgical appliances in which the power setting device is arranged and designed to limit the power value such that the power value does not undershoot a predetermined minimum power value and/or does not overshoot a predetermined maximum power value. The limitation of the output power to a range between a minimum power value and a maximum power value may in particular serve the purpose of limiting the output power to a range that is required for the application area and at the same time is safe both for the patient and for the user.
The ascertainment of the setpoint spark value by the spark control device may in this case preferably take place by a minimum power value being assigned a specific setpoint spark value. From this setpoint spark value assigned to the minimum power value, an increase, for example a proportional increase, in the setpoint spark value can then advantageously take place with the increase in the power value.
According to a further aspect of the invention, the object mentioned at the beginning is achieved by a method for operating a high-frequency surgical appliance, in particular a high-frequency surgical appliance described above, in which a high-frequency alternating current is generated by means of a high-frequency generator for cutting and/or coagulating biological tissue, an output power of the high-frequency surgical appliance being set by means of a power setting device to a power value selected by a user and a setpoint spark value of a spark voltage being ascertained by means of a spark control device in dependence on the power value selected by a user, and the spark voltage also being limited to the setpoint spark value by means of the spark control device.
The method according to the invention serves in particular for operating a high-frequency surgical appliance as described above. For the advantages, implementing variants and implementing details of this method and its possible developments, reference is made to the foregoing description concerning the corresponding device features.
A preferred embodiment of the invention is described by way of example on the basis of the accompanying figures, in which:
Stored in the high-frequency surgical appliance 1, preferably in the spark control unit 70, is how the setpoint spark value is ascertained in dependence on the power value chosen by the user. Assignments in the form of characteristic curves, as represented in
By storing certain couplings, for example in the form of characteristic curves, of the setpoint spark values for certain power values, a user can consequently be given the possibility in an easy way of using a variation of the power value to bring about at the same time a variation of the spark intensity, without having to forego the advantages of spark control.
1 High-frequency surgical appliance
10 Power supply unit
20 High-frequency generator
30 Connection socket
31 Connecting cable
40 Electrosurgical instrument
50 User interface
60 Power setting device
70 Spark control device
100 Non-proportional range of spark values
C1, C2, C3 Operating modes
Number | Date | Country | Kind |
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10 2013 223 561.5 | Nov 2013 | DE | national |
Filing Document | Filing Date | Country | Kind |
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PCT/EP2014/074683 | 11/14/2014 | WO | 00 |