DE19717411A1 - Monitoring of thermal loading of patient tissue in contact region of neutral electrode of HF treatment unit - Google Patents

Monitoring of thermal loading of patient tissue in contact region of neutral electrode of HF treatment unit

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Publication number
DE19717411A1
DE19717411A1 DE1997117411 DE19717411A DE19717411A1 DE 19717411 A1 DE19717411 A1 DE 19717411A1 DE 1997117411 DE1997117411 DE 1997117411 DE 19717411 A DE19717411 A DE 19717411A DE 19717411 A1 DE19717411 A1 DE 19717411A1
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Germany
Prior art keywords
current
neutral electrode
signal
integration signal
memory
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DE1997117411
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German (de)
Inventor
Roland Dipl Ing Haeberlen
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Aesculap AG
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Aesculap AG
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Priority to DE1997117411 priority Critical patent/DE19717411A1/en
Publication of DE19717411A1 publication Critical patent/DE19717411A1/en
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves 
    • 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
    • A61B18/1233—Generators therefor with circuits for assuring patient safety
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7235—Details of waveform analysis
    • A61B5/7242—Details of waveform analysis using integration
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/16—Indifferent or passive electrodes for grounding

Abstract

The method involves measuring the HF current flowing across the neutral electrode. A signal is produced corresponding to the square of this current. This signal during the entire treatment duration is led to an integrator for integration. The integration signal is used as a measure for the thermal loading of the tissue. The HF current flowing across the neutral electrode may be determined by a direct current measurement in the line leading from the HF treatment unit to the neutral electrode. The HF current flowing across the neutral electrode may be measured indirectly by measuring the primary side current measurement in the HF treatment unit.

Description

Die Erfindung betrifft ein Verfahren zur Überwachung der thermischen Belastung des Gewebes eines Patienten im Anlagebereich einer Neutralelektrode einer Hochfre­ quenzbehandlungseinrichtung sowie eine Vorrichtung zur Durchführung dieses Verfahrens.The invention relates to a method for monitoring the thermal load on a patient's tissue in the contact area of a neutral electrode of a high frequency sequence treatment device and a device for Performing this procedure.

In der Chirurgie werden Hochfrequenzbehandlungseinrich­ tungen verwendet, um bestimmte Bereiche des Körpers stark zu erwärmen. Hochfrequenzstrom wird dabei über eine Arbeitselektrode einem bestimmten Körperbereich zugeführt, an dem die Behandlung stattfinden soll, über eine Neutralelektrode wird der Hochfrequenzstrom vom Körper wieder der Hochfrequenzeinrichtung zugeführt. Während im Bereich der Arbeitselektrode der Hochfre­ quenzstrom eine lokale Erwärmung hervorrufen soll, ist dies im Bereich der Neutralelektrode unerwünscht. Auf­ grund des Übergangswiderstandes im Anlagebereich der Neutralelektrode am Körper des Patienten ist eine Er­ wärmung jedoch nicht zu vermeiden und kann unter Um­ ständen zu unerwünschten Gewebeschädigungen führen.In surgery, high-frequency treatment facilities are used used to certain areas of the body to warm up strongly. High frequency current is over a working electrode in a certain area of the body at which the treatment is to take place via the high-frequency current from the Body fed back to the radio frequency device. While the Hochfre local current is supposed to cause local warming this is undesirable in the area of the neutral electrode. On due to the contact resistance in the area of the Neutral electrode on the patient's body is an Er However, heating cannot be avoided and can be avoided under Um can lead to undesirable tissue damage.

Um diese Erwärmung möglichst gering zu halten, ist es bereits bekannt, die Neutralelektroden großflächig aus­ zubilden und dadurch die Stromdichte im Anlagebereich herabzusetzen. In order to keep this warming as low as possible, it is already known, the neutral electrodes over a large area form and thereby the current density in the system area belittling.  

Es ist weiterhin bekannt, die Leistung eines Hochfre­ quenzgerätes während der Behandlungsdauer dadurch zu bestimmen, daß die Spannung zwischen den mit dem Körper verbundenen Elektroden einerseits und der über diese Elektroden fließende Strom andererseits bestimmt wer­ den, so daß abhängig von dem Widerstand des in den Stromkreis eingeschalteten Gewebes die jeweils abge­ gebene Leistung gemessen und zur Regelung der Abgabe­ leistung der Hochfrequenzeinrichtung verwendet werden kann (WO95/09577). Durch dieses Verfahren ist es mög­ lich, Gewebeänderungen im Behandlungsbereich, bei­ spielsweise durch Verdampfen von Flüssigkeit, zu be­ rücksichtigen, die zu einer Veränderung des Ohm'schen Widerstandes des Gewebes und damit auch zu einer Verän­ derung der im Operationsbereich abgegebenen Leistung führen. Die Wärmeentwicklung im Bereich der Neutral­ elektrode kann dadurch in keiner Weise bestimmt oder beeinflußt werden.It is also known the performance of a Hochfre quenzgerätes during the treatment period determine the tension between those with the body connected electrodes on the one hand and the one above them Electrode flowing current on the other hand determines who the, so that depending on the resistance of the in the Circuit switched tissue each abge output measured and to regulate the delivery power of the high-frequency device can be used can (WO95 / 09577). This procedure makes it possible Lich, tissue changes in the treatment area, at for example by evaporation of liquid take into account that to change the ohmic Resistance of the fabric and thus to a change change in the output in the operating area to lead. The heat development in the area of neutral electrode cannot be determined in any way or to be influenced.

Es ist Aufgabe der Erfindung, ein Verfahren anzugeben, mit dem die thermische Belastung des Gewebes eines Pa­ tienten im Anlagebereich einer Neutralelektrode einer Hochfrequenzbehandlungseinrichtung bestimmt werden kann.It is an object of the invention to provide a method with which the thermal load on the tissue of a Pa tients in the area of a neutral electrode High-frequency treatment device can be determined can.

Diese Aufgabe wird bei einem solchen Verfahren erfin­ dungsgemäß dadurch gelöst, daß man den über die Neu­ tralelektrode fließenden HF-Strom mißt, ein dem Quadrat dieses Stromes entsprechendes Signal erzeugt, dieses Signal während der gesamten Behandlungsdauer einem In­ tegrator zu führt und aufintegriert und das erzeugte In­ tegrationssignal als Maß für die thermische Belastung des Gewebes verwendet.This task is invented in such a method solved accordingly in that one over the new Tralelektrode flowing HF current measures, the square generates a signal corresponding to this current Signal during the entire treatment period  leads to and integrates and the generated In integration signal as a measure of the thermal load of the fabric used.

Das Integrationssignal, das in dieser Weise gewonnen wird, ist ein Maß für die Energie, die während der Be­ handlungsdauer im Bereich der Neutralelektrode in Wärme umgesetzt wird, denn diese Energie ergibt sich aus ei­ nem Produkt aus der Einschaltzeit, dem Übergangswider­ stand Neutralelektrode/Körpergewebe und dem Quadrat des Momentanwertes des HF-Stromes in der Neutralelektrode. Dieser Momentanwert des HF-Stromes ändert sich während der Behandlungsdauer abhängig von der jeweiligen Be­ handlungstätigkeit und den behandelten Gewebeteilen, so daß durch eine Integration der Quadrate des sich än­ dernden HF-Stromes insgesamt ein Maß zur Verfügung steht für die im Bereich der Neutralelektrode während der gesamten Behandlungsdauer erzeugte Wärme.The integration signal obtained in this way is a measure of the energy used during loading Duration of action in the area of the neutral electrode in heat is implemented, because this energy results from egg product of the switch-on time, the transition resistance stood neutral electrode / body tissue and the square of the Instantaneous value of the HF current in the neutral electrode. This instantaneous value of the HF current changes during the duration of treatment depends on the respective Be action and the treated tissue parts, so that by integrating the squares of the derender HF current a measure available stands for in the area of the neutral electrode during heat generated during the entire treatment period.

Der über die Neutralelektrode fließende HF-Strom kann direkt durch eine Strommessung in der Leitung bestimmt werden, die von der Behandlungseinheit zur Neutralelek­ trode führt.The HF current flowing through the neutral electrode can determined directly by a current measurement in the line from the treatment center to the neutral elec trode leads.

Es ist aber grundsätzlich auch möglich, die Größe des über die Neutralelektrode fließenden HF-Stromes indi­ rekt zu bestimmen, beispielsweise durch eine Messung des HF-Stromes auf der Primärseite des HF-Stromkreises, also in der Behandlungseinheit selbst, oder durch eine Messung des zur Behandlungseinheit fließenden Versor­ gungsstromes, es kann sich dabei auch um einen Gleich­ strom handeln.In principle, it is also possible to change the size of the over the neutral electrode flowing HF current to be determined directly, for example by a measurement the HF current on the primary side of the HF circuit, So in the treatment center itself, or by one Measurement of the supplier flowing to the treatment center  supply current, it can also be an equal trade electricity.

Es ist dabei besonders vorteilhaft, wenn man das Inte­ grationssignal über den gesamten Behandlungszeitraum kontinuierlich reduziert. Diese Reduzierung entspricht einer Abkühlung im Anlagebereich der Neutralelektrode, diese Abkühlung kann durch Wärmeabstrahlung in die Um­ gebung, durch Wärmeabfuhr durch Körperflüssigkeiten oder durch Wärmeleitung im Körpergewebe erfolgen, sie wird während der gesamten Behandlungsdauer stattfinden, so daß es sinnvoll ist, das in der oben beschriebenen Weise erzeugte Integrationssignal während der gesamten Behandlungsdauer kontinuierlich zu erniedrigen, um die­ ser Abkühlung Rechnung zu tragen.It is particularly advantageous if you have the Inte Gration signal over the entire treatment period continuously reduced. This reduction corresponds cooling in the contact area of the neutral electrode, this cooling can be caused by heat radiation in the order by heat dissipation through body fluids or by conduction in the body tissue, they will take place throughout the treatment period so that it makes sense to do that in the above Wise integration signal generated throughout To continuously decrease the duration of treatment in order to cooling.

Dabei kann in einer ersten Ausführungsform vorgesehen sein, daß man das Integrationssignal pro Zeiteinheit um einen gleichbleibenden Betrag reduziert, dies ent­ spricht der angenäherten Annahme, daß die Wärmeabfuhr im Anlagebereich der Neutralelektrode über den Zeitraum konstant erfolgt. Es kann aber auch vorgesehen sein, daß man das Integrationssignal pro Zeiteinheit um einen Betrag reduziert, der dem Integrationssignal zu Beginn der Zeiteinheit proportional ist. Dies würde der Tatsa­ che Rechnung tragen, daß die Wärmeabfuhr im Anlagebe­ reich der Neutralelektrode tatsächlich der erreichten Temperatur in diesem Bereich proportional ist, also hö­ her ausfällt, wenn die Erwärmung in diesem Bereich größer ist, und dies wird durch das Integrationssignal repräsentiert. It can be provided in a first embodiment be that one around the integration signal per unit time reduced a constant amount, this ent speaks to the approximate assumption that heat dissipation in the contact area of the neutral electrode over the period takes place constantly. But it can also be provided that the integration signal per unit of time by one Reduced amount of the integration signal at the beginning is proportional to the time unit. This would be the Tatsa che take into account that the heat dissipation in the system range of the neutral electrode actually reached The temperature in this area is proportional, i.e. higher forth fails if the warming in this area is larger, and this is due to the integration signal represents.  

Es kann weiterhin vorgesehen sein, daß man die Größe des dem Quadrat des HF-Stromes entsprechenden Signals und/oder die Größe des Integrationssignals während des Behandlungszeitraumes einem Datenspeicher zuführt und in bestimmten Zeitabständen speichert. Auf diese Weise erhält man eine vollständige Dokumentation der pro Zeiteinheit im Anlagebereich der Neutralelektrode in Wärme umgesetzten Energiemenge bzw. der Erwärmung im Anlagebereich, so daß auch am Ende des Behandlungszeit­ raumes diese Vorgänge exakt überprüft und reproduziert werden können.It can also be provided that the size of the signal corresponding to the square of the RF current and / or the size of the integration signal during the Treatment period leads to a data storage and saves at certain intervals. In this way you get a complete documentation of the pro Unit of time in the contact area of the neutral electrode in Heat implemented amount of energy or the warming in Investment area so that even at the end of the treatment period Raumes exactly checked and reproduced these processes can be.

Günstig ist es, wenn man das Integrationssignal mit ei­ nem Maximalwert vergleicht und bei dessen Überschreiten eine Anzeigeeinrichtung und/oder eine Abschalteinrich­ tung für den HF-Strom betätigt. Da das Integrations­ signal ein Maß für die Erwärmung des Anlagebereiches ist, läßt sich dadurch sicherstellen, daß beim Errei­ chen einer maximalen Erwärmung in diesem Bereich die Behandlungsperson gewarnt wird oder der HF-Strom voll­ ständig abgeschaltet wird, um eine weitere Erwärmung zu verhindern.It is favorable if the integration signal with egg compares the maximum value and when it is exceeded a display device and / or a shutdown device device operated for the HF current. Since the integration signal a measure of the heating of the plant area , it can be ensured that when reaching maximum heating in this area The patient is warned or the HF current is full is constantly turned off to prevent further warming prevent.

Die angegebene Aufgabe läßt sich durch eine Überwa­ chungsschaltung zur Bestimmung der thermischen Bela­ stung des Gewebes eines Patienten im Anlagebereich ei­ ner neutralen Elektrode einer Hochfrequenzbehandlungs­ einrichtung lösen, die gekennzeichnet ist durch eine Meßeinrichtung zur Bestimmung des über die Neutralelek­ trode fließenden HF-Stromes, durch eine Quadriereinheit zur Erzeugung eines dem Quadrat dieses Stromes entspre­ chenden Signals und durch einen Speicher zur Integra­ tion dieses Signals über den gesamten Behandlungszeit­ raum zur Erzeugung eines Integrationssignales als Maß für die thermische Belastung des Gewebes.The specified task can be monitored Circuit for determining the thermal load a patient's tissue in the plant area ner neutral electrode of a high frequency treatment solve the device, which is characterized by a Measuring device for determining the over the neutral electr trode flowing HF current, through a squaring unit  correspond to the generation of a square of this current signal and through a memory for integra tion of this signal over the entire treatment time space for generating an integration signal as a measure for the thermal load on the fabric.

Die Größe des über die Neutralelektrode fließenden HF- Stromes kann durch eine Strommeßeinrichtung in der von der Behandlungseinheit zur Neutralelektrode führenden Leitung bestimmt werden. Bei einer abgewandelten Aus­ führungsform ist vorgesehen, daß diese Bestimmung des über die Neutralelektrode fließenden HF-Stromes indi­ rekt erfolgt, und zwar durch eine Strommeßeinrichtung in der Primärseite des HF-Stromkreises oder aber durch eine Strommeßeinrichtung in der zur Behandlungseinheit führenden Versorgungsleitung.The size of the HF- flowing over the neutral electrode Current can be measured by a current measuring device in the leading the treatment center to the neutral electrode Line can be determined. With a modified Aus is intended that this provision of the over the neutral electrode flowing HF current takes place directly, namely by a current measuring device in the primary side of the HF circuit or through a current measuring device in the treatment unit leading supply line.

Es ist dabei vorteilhaft, wenn dem Speicher eine Spei­ cherabflußsteuerung zugeordnet ist, die das Intregra­ tionssignal über den gesamten Behandlungszeitraum kon­ tinuierlich reduziert.It is advantageous if the memory has a memory drain control is associated with the Intregra tion signal over the entire treatment period con temporarily reduced.

Gemäß einer bevorzugten Ausführungsform kann die Spei­ cherabflußsteuerung dabei das Intregrationssignal pro Zeiteinheit um einen gleichbleibenden Betrag reduzieren oder aber bevorzugt um einen Betrag, der dem Integrati­ onssignal zu Beginn der Zeiteinheit proportional ist.According to a preferred embodiment, the Spei cherabflußführung the integration signal pro Reduce the unit of time by a constant amount or preferably by an amount equal to the integrati on signal at the beginning of the time unit is proportional.

Die Überwachungsschaltung kann gemäß einer bevorzugten Ausführungsform durch einen Datenspeicher gekennzeich­ net sein, der der Quadriereinheit und/oder dem Speicher zugeordnet ist und der die Größe des dem Quadrat des HF-Stromes entsprechenden Signals und/oder die Größe des Integrationssignales während des Behandlungszeit­ raumes in bestimmten Zeitabständen speichert.The monitoring circuit can be according to a preferred one Embodiment characterized by a data memory net be that of the squaring unit and / or the memory  and which is the size of the square of the HF current corresponding signal and / or the size of the integration signal during the treatment period saves space at certain intervals.

Weiterhin kann eine Vergleichseinheit vorgesehen sein, die das Integrationssignal mit einem Maximalwert ver­ gleicht und bei dessen Überschreiten eine Anzeigeein­ richtung und/oder eine Abschalteinrichtung für den HF- Strom betätigt.Furthermore, a comparison unit can be provided which ver the integration signal with a maximum value equal and an ad is displayed when it is exceeded direction and / or a shutdown device for the HF Current operated.

Die nachfolgende Beschreibung einer bevorzugten Ausfüh­ rungsform der Erfindung dient im Zusammenhang mit der Zeichnung der näheren Erläuterung. Die Zeichnung zeigt schematisch eine Überwachungsschaltung zur Bestimmung der thermischen Belastung des Gewebes eines Patienten im Anlagebereich einer Neutralelektrode.The following description of a preferred embodiment tion form of the invention serves in connection with the Drawing of the detailed explanation. The drawing shows schematically a monitoring circuit for determination the thermal load on a patient's tissue in the contact area of a neutral electrode.

Eine Hochfrequenz-Behandlungseinheit 1 weist zwei An­ schlüsse 2, 3 auf. An den ersten Anschluß 2 ist über einen Antifaradisationskondensator 4 ein HF-Behand­ lungsgerät 5 angeschlossen, beispielsweise eine Haken­ elektrode, der zweite Anschluß 3 steht mit einer Neu­ tralelektrode 6 in Verbindung, die großflächig ausge­ bildet ist und an den Körper eines Patienten 7 flächig angelegt ist, es kann sich dabei um bekannte folienför­ mige Elektroden handeln.A high-frequency treatment unit 1 has two connections 2 , 3 . At the first terminal 2 , an HF treatment device 5 is connected via an antifaradization capacitor 4 , for example a hook electrode, the second terminal 3 is connected to a neutral electrode 6 , which forms a large area and is applied to the body of a patient 7 is, it can be known foil-shaped electrodes.

Bei der Behandlung eines Patienten wird das Behand­ lungsgerät 5 mit seinem Elektrodenbereich an das zu be­ handelnde Gewebe des Patienten herangeführt, so daß der Patient 7 in den Hochfrequenzstromkreis eingeschaltet wird, Hochfrequenzstrom fließt dann von der Behand­ lungseinheit 1 über das Behandlungsgerät 5, die behan­ delten Gewebebereiche und andere Gewebebereiche des Patienten zu der Neutralelektrode 6 zurück zur Behand­ lungseinheit 1. Im Behandlungsbereich sollen hohe Stromdichten erreicht werden, da durch Wärmeentwicklung das Gewebe behandelt wird, im Bereich der Neutralelek­ trode 6 hingegen, in der eine solche Erwärmung vermie­ den werden soll, wird durch großflächige Ausbildung der Elektroden versucht, die Stromdichte niedrig zu halten.In the treatment of a patient, the treatment device 5 is brought up with its electrode area to the patient's tissue to be treated, so that the patient 7 is switched into the high-frequency circuit, high-frequency current then flows from the treatment unit 1 via the treatment device 5 , which are treated Tissue areas and other tissue areas of the patient to the neutral electrode 6 back to the treatment unit 1 . In the treatment area, high current densities are to be achieved, since the tissue is treated by the development of heat, but in the area of the neutral electrode 6 , in which such heating is to be avoided, attempts are made to keep the current density low by forming the electrodes over a large area.

In die Leitung 8 zwischen Neutralelektrode 6 und An­ schluß 3 ist eine Meßeinrichtung 9 zur Messung des Ef­ fektiv-HF-Stromes in der Leitung 8 eingeschaltet. Diese erzeugt ein dem Effektivstrom proportionales elektri­ sches Signal, das über eine Leitung 10 einer Quadrier­ einheit 11 zugeführt wird. Diese erzeugt ein dem Qua­ drat des gemessenen effektiven HF-Stromes entsprechen­ des elektrisches Signal und führt dies über eine Lei­ tung 12 einer Speicherzuflußsteuerung 13 zu. Diese wird von einem Zeitgeber 14 über eine Leitung 15 angesteuert und diese bestimmt für einen bestimmten kurzen Zeitraum Δt, der beispielsweise 100 ms betragen kann, einen für diesen kurzen Zeitraum Δt repräsentativen Wert des von der Quadriereinheit 11 gelieferten Signals.In the line 8 between the neutral electrode 6 and circuit 3 , a measuring device 9 for measuring the effective RF current in line 8 is turned on. This generates a rms current proportional electrical signal, which is fed via line 10 to a squaring unit 11 . This generates a square of the measured effective RF current corresponding to the electrical signal and this leads via a line 12 to a memory inflow control 13 . This is controlled by a timer 14 via a line 15 and this determines a value of the signal supplied by the squaring unit 11 representative of this short period of time .DELTA.t, which may be, for example, 100 ms.

Da sich der Wert des HF-Effektivstroms während der Be­ handlung stark ändern kann, ist es notwendig, für klei­ ne Zeiteinheiten einen solchen repräsentativen Wert zu bestimmen, dies kann beispielsweise dadurch geschehen, daß im Zeitraum Δt über alle anfallenden Werte des qua­ drierten HF-Effektivstromes integriert wird, so daß die Speicherzuflußsteuerung ein Signal erzeugt, welches ein Maß für die Energie ist, die im Zeitraum Δt im Bereich der Neutralelektrode in Wärme umgesetzt wird.Since the value of the HF rms current during the loading action can change greatly, it is necessary for small ne time units such a representative value  determine, this can happen, for example, that in the period Δt over all values of the qua third HF effective current is integrated, so that the Memory inflow control generates a signal which is a Measure of the energy that is in the range Δt in the period the neutral electrode is converted into heat.

Diese Einzelsignale werden über eine Leitung 16 einem integrierenden Speicher 17 zugeführt, der diese pro Zeiteinheit Δt umgesetzten Wärmemengen über den gesam­ ten Behandlungszeitraum auf integriert und somit ein In­ tegrationssignal erzeugt, welches ein Maß für die durch den HF-Strom im Bereich der Neutralelektrode in Wärme umgesetzte Energie bildet.These individual signals are supplied via a line 16 to an integrating memory 17 , which integrates these amounts of heat converted per unit time Δt over the entire treatment period and thus generates an integration signal which is a measure of the heat generated by the HF current in the area of the neutral electrode converted energy forms.

Der integrierende Speicher 17 ist über eine Leitung 18 mit einer Speicherabflußsteuerung 19 verbunden, die ih­ rerseits über eine Leitung 20 mit dem Zeitgeber 14 in Verbindung steht. Der Zeitgeber 14 steuert die Spei­ cherabflußsteuerung 19 derart, daß diese pro Zeitein­ heit das Integrationssignal des integrierenden Spei­ chers 17 um einen bestimmten Betrag erniedrigt, dies kann ein für jede Zeiteinheit gleicher Betrag sein, dieser Betrag kann aber auch der jeweiligen Größe des Integrationssignales proportional sein. Diese Reduzie­ rung des Integrationssignales ist ein Maß dafür, wie im Bereich der Neutralelektrode erzeugte Verlustwärme in die Umgebung abgegeben wird, sei es durch Abstrahlung, durch Wärmeleitung über das Körpergewebe oder durch Konvektion in der umgebenden Luft. The integrating memory 17 is connected via a line 18 to a memory drain control 19 , which in turn is connected to the timer 14 via a line 20 . The timer 14 controls the memory drain control 19 in such a way that it reduces the integration signal of the integrating memory 17 by a certain amount per unit time, this can be an equal amount for each time unit, but this amount can also be proportional to the respective size of the integration signal . This reduction of the integration signal is a measure of how lost heat generated in the area of the neutral electrode is released into the environment, be it by radiation, by heat conduction through the body tissue or by convection in the surrounding air.

Durch die Speicherabflußsteuerung wird also das Inte­ grationssignal korrigiert, so daß es tatsächlich dem Erwärmungsverhalten im Bereich der Neutralelektrode 6 entspricht, so daß ein niedriges Integrationssignal auf eine geringe resultierende Erwärmung hindeutet, ein großes Integrationssignal dagegen auf eine große resul­ tierende Erwärmung.By the memory drain control, the integration signal is corrected so that it actually corresponds to the heating behavior in the area of the neutral electrode 6 , so that a low integration signal indicates a low resultant heating, whereas a large integration signal indicates a large resulting heating.

Das in dieser Weise erzeugte und gegebenenfalls durch die Speicherabflußsteuerung korrigierte Integrations­ signal wird über eine Leitung 21 einer Anzeigeeinrich­ tung 22 zugeführt, in der das Integrationssignal mit einem fest vorgegebenen Maximalsignal verglichen wird. Wenn das Integrationssignal diesen Maximalwert über­ steigt, wird die Anzeigeeinrichtung 22 aktiviert, die dann Warnsignale abgibt oder die Behandlungseinheit 1 abschaltet oder in der abgegebenen Leistung reduziert.The integration signal generated in this way and possibly corrected by the memory drain control is fed via line 21 to a display device 22 in which the integration signal is compared with a predetermined maximum signal. If the integration signal exceeds this maximum value, the display device 22 is activated, which then emits warning signals or switches off the treatment unit 1 or reduces the output.

Mit dem Ausgang der Speicherzuflußsteuerung 13 und mit dem integrierenden Speicher 17 ist ein Dokumentations­ speicher 23 verbunden, der die von der Speicherzufluß­ steuerung dem integrierenden Speicher 17 zugeführten Signale in Abhängigkeit von der Behandlungszeit spei­ chert und der außerdem die jeweilige Größe des im inte­ grierenden Speicher 17 erzeugten Integrationssignales während der Behandlungszeit speichert. Im Dokumenten­ speicher ist somit der gesamte Behandlungsablauf nach­ prüfbar, und zwar einerseits durch die einzelnen pro Zeiteinheit Δt über die Neutralelektrode fließenden Energiepakete und zum anderen hinsichtlich der durch das Integrationssignal repräsentierten Gesamterwärmung. Es ist dadurch überprüfbar, ob beispielsweise eine Schädigung des Gewebes im Anlagebereich der Neutral­ elektrode 6 auf eine zu hohe Erwärmung zurückzuführen ist oder auf andere Effekte, beispielsweise auf eine Drucknekrose oder auf eine chemische Verätzung.With the output of the memory inflow control 13 and with the integrating memory 17 , a documentation memory 23 is connected, which stores the signals supplied by the memory inflow control to the integrating memory 17 as a function of the treatment time and which also stores the respective size of the integrating memory 17 generated integration signals during the treatment time. The entire treatment process can thus be checked in the document memory, on the one hand by the individual energy packets flowing per unit time Δt via the neutral electrode and on the other hand with regard to the total heating represented by the integration signal. This makes it possible to check whether, for example, damage to the tissue in the contact area of the neutral electrode 6 is due to excessive heating or to other effects, for example to pressure necrosis or to chemical burns.

Die beschriebene Überwachungsschaltung kann auch wäh­ rend der Behandlungspausen weiterbetrieben werden. In dieser Zeit ist der gemessene HF-Strom Null, es werden also über die Speicherzuflußsteuerung keine Signale dem integrierenden Speicher 17 zugeführt, die das Integra­ tionssignal erhöhen könnten jedoch wird über die Spei­ cherabflußsteuerung weiterhin das Integrationssignal entsprechend der Abkühlung des Anlagebereichs der Neu­ tralelektrode reduziert, so daß damit die wirklichen Verhältnisse im Anlagebereich reproduziert werden. Wenn nach einer längeren Behandlungspause erneut behandelt wird, ist der Anlagebereich abgekühlt, und dies spie­ gelt sich darin wider, daß das Integrationssignal im integrierenden Speicher 17 einen Minimalwert erreicht hat, der von der Speicherabflußsteuerung nicht weiter erniedrigt werden kann.The monitoring circuit described can also be operated during the breaks in treatment. During this time, the measured HF current is zero, so no signals are fed to the integrating memory 17 via the storage inflow control, which could increase the integration signal, but the integration signal is further reduced via the storage outflow control in accordance with the cooling of the system area of the neutral electrode, so that the real conditions in the plant area are reproduced. If treatment is carried out again after a long break in treatment, the system area has cooled down, and this is reflected in the fact that the integration signal in the integrating memory 17 has reached a minimum value which cannot be reduced further by the memory drain control.

Claims (18)

1. Verfahren zur Überwachung der thermischen Bela­ stung des Gewebes eines Patienten im Anlagebe­ reich einer Neutralelektrode einer Hochfrequenz­ behandlungseinrichtung, dadurch gekennzeichnet, daß man den über die Neutralelektrode fließenden HF-Strom mißt, ein dem Quadrat dieses Stromes entsprechendes Signal erzeugt, dieses Signal wäh­ rend der gesamten Behandlungsdauer einem Integra­ tor zu führt und aufintegriert und das erzeugte Integrationssignal als Maß für die thermische Be­ lastung des Gewebes verwendet.1. A method for monitoring the thermal loading of the tissue of a patient in the investment area rich a neutral electrode of a high-frequency treatment device, characterized in that one measures the HF current flowing through the neutral electrode, generates a signal corresponding to the square of this current, this signal while the entire duration of treatment leads to an integrator and is integrated and the generated integration signal is used as a measure of the thermal load on the tissue. 2. Verfahren nach Anspruch 1, dadurch gekennzeich­ net, daß man den über die Neutralelektrode flie­ ßenden HF-Strom durch eine direkte Strommessung in der von der Hochfrequenzbehandlungseinrichtung zur Neutralelektrode führenden Leitung bestimmt.2. The method according to claim 1, characterized in net that one flows over the neutral electrode HF current through a direct current measurement in that from the radio frequency treatment facility determined to lead to the neutral electrode. 3. Verfahren nach Anspruch 1, dadurch gekennzeich­ net, daß man den über die Neutralelektrode flie­ ßenden HF-Strom auf indirekte Weise durch eine primärseitige Strommessung in der Hochfrequenzbe­ handlungseinrichtung bestimmt. 3. The method according to claim 1, characterized in net that one flows over the neutral electrode HF current in an indirect way through a primary-side current measurement in high-frequency action facility determined.   4. Verfahren nach Anspruch 1, dadurch gekennzeich­ net, daß man den über die Neutralelektrode flie­ ßenden HF-Strom indirekt durch eine Messung des zur Hochfrequenzbehandlungseinrichtung fließenden Versorgungsstromes bestimmt.4. The method according to claim 1, characterized in net that one flows over the neutral electrode HF current by measuring the flowing to the high-frequency treatment device Determined supply current. 5. Verfahren nach einem der voranstehenden Ansprü­ che, dadurch gekennzeichnet, daß man das Integra­ tionssignal über den gesamten Behandlungszeitraum kontinuierlich reduziert.5. Method according to one of the preceding claims che, characterized in that the Integra tion signal over the entire treatment period continuously reduced. 6. Verfahren nach Anspruch 5, dadurch gekennzeich­ net, daß man das Integrationssignal über den ge­ samten Behandlungszeitraum pro Zeiteinheit um ei­ nen gleichbleibenden Betrag reduziert.6. The method according to claim 5, characterized in net that the integration signal on the ge entire treatment period per unit of time by one egg reduced a constant amount. 7. Verfahren nach Anspruch 5, dadurch gekennzeich­ net, daß man das Integrationssignal über den ge­ samten Behandlungszeitraum pro Zeiteinheit um ei­ nen Betrag reduziert, der dem Integrationssignal zu Beginn der Zeiteinheit proportional ist. 7. The method according to claim 5, characterized in net that the integration signal on the ge entire treatment period per unit of time by one egg NEN reduced the amount of the integration signal is proportional to the start of the time unit.   8. Verfahren nach einem der voranstehenden Ansprü­ che, dadurch gekennzeichnet, daß man die Größe des dem Quadrat des HF-Stromes entsprechenden Si­ gnals und/oder die Größe des Integrationssignals während des Behandlungszeitraumes einem Daten­ speicher zuführt und in bestimmten Zeitabständen speichert.8. Method according to one of the preceding claims che, characterized in that the size of the Si corresponding to the square of the HF current gnals and / or the size of the integration signal a data during the treatment period memory supplies and at certain time intervals saves. 9. Verfahren nach einem der voranstehenden Ansprü­ che, dadurch gekennzeichnet, daß man das Integra­ tionssignal mit einem Maximalwert vergleicht und bei dessen Überschreiten eine Anzeigeeinrichtung und/oder eine Abschalteinrichtung für den HF- Strom betätigt.9. Method according to one of the preceding claims che, characterized in that the Integra comparison signal with a maximum value and if it is exceeded, a display device and / or a shutdown device for the HF Current operated. 10. Überwachungsschaltung zur Bestimmung der thermi­ schen Belastung des Gewebes eines Patienten im Anlagebereich einer Neutralelektrode einer Hoch­ frequenzbehandlungseinrichtung, gekennzeichnet durch eine Meßeinrichtung (9) zur Bestimmung des über die Neutralelektrode (6) fließenden HF-Stro­ mes, durch eine Quadriereinheit (11) zur Erzeu­ gung eines dem Quadrat dieses Stromes entspre­ chenden Signals, durch einen Speicher (17) zur Integration dieses Signals über den gesamten Be­ handlungszeitraum zur Erzeugung eines Integrati­ onssignals als Maß für die thermische Belastung des Gewebes. 10. Monitoring circuit for determining the thermal load on the tissue of a patient in the contact area of a neutral electrode of a high-frequency treatment device, characterized by a measuring device ( 9 ) for determining the HF current flowing through the neutral electrode ( 6 ), by a squaring unit ( 11 ) Generation of a signal corresponding to the square of this current, by means of a memory ( 17 ) for the integration of this signal over the entire treatment period for the generation of an integration signal as a measure of the thermal load on the tissue. 11. Überwachungsschaltung nach Anspruch 10, dadurch gekennzeichnet, daß die Meßeinrichtung (9) eine Strommeßeinrichtung ist, die in die Leitung (8) zwischen Neutralelektrode (6) und Behandlungsein­ heit (1) eingeschaltet ist.11. Monitoring circuit according to claim 10, characterized in that the measuring device ( 9 ) is a current measuring device which is switched on in the line ( 8 ) between the neutral electrode ( 6 ) and treatment unit ( 1 ). 12. Schaltung nach Anspruch 10, dadurch gekennzeich­ net, daß die Meßeinrichtung zur Bestimmung des über die Neutralelektrode (6) fließenden HF-Stro­ mes eine direkte Meßeinrichtung ist, die den pri­ märseitig in der Hochfrequenz-Behandlungseinheit (1) fließenden Strom bestimmt.12. The circuit according to claim 10, characterized in that the measuring device for determining the flowing via the neutral electrode ( 6 ) HF-Stro mes is a direct measuring device which determines the pri märseitig in the high-frequency treatment unit ( 1 ) flowing current. 13. Schaltung nach Anspruch 10, dadurch gekennzeich­ net, daß die Meßeinrichtung zur Bestimmung des über die Neutralelektrode (6) fließenden HF-Stro­ mes durch eine indirekte Strommeßeinrichtung ge­ bildet wird, die in die Stromversorgungsleitung der Hochfrequenz-Behandlungseinheit (1) einge­ schaltet ist.13. The circuit according to claim 10, characterized in that the measuring device for determining the flowing via the neutral electrode ( 6 ) HF-Stro mes is formed by an indirect current measuring device GE, which is switched on in the power supply line of the high-frequency treatment unit ( 1 ) . 14. Schaltung nach einem der Ansprüche 10 bis 13, da­ durch gekennzeichnet, daß dem Speicher (17) eine Speicherabflußsteuerung (19) zugeordnet ist, die das Intregrationssignal über den gesamten Behand­ lungszeitraum kontinuierlich reduziert. 14. Circuit according to one of claims 10 to 13, characterized in that the memory ( 17 ) is associated with a memory drain control ( 19 ) which continuously reduces the integration signal over the entire treatment period. 15. Schaltung nach einem der Ansprüche 12 bis 14, da­ durch gekennzeichnet, daß die Speicherabflußsteu­ erung (19) das Intregrationssignal pro Zeitein­ heit um einen gleichbleibenden Betrag reduziert.15. Circuit according to one of claims 12 to 14, characterized in that the memory drain control ( 19 ) reduces the integration signal per unit time by a constant amount. 16. Schaltung nach einem der Ansprüche 12 bis 14, da­ durch gekennzeichnet, daß die Speicherabflußsteu­ erung (19) das Intregrationssignal pro Zeitein­ heit um einen Betrag reduziert, der dem Integra­ tionssignal zu Beginn der Zeiteinheit proportio­ nal ist.16. Circuit according to one of claims 12 to 14, characterized in that the memory drain control ( 19 ) reduces the integration signal per unit time by an amount which is proportional to the integration signal at the beginning of the time unit. 17. Schaltung nach einem der Ansprüche 12 bis 16, ge­ kennzeichnet durch einen Datenspeicher (23), der der Quadriereinheit (11) und/oder dem Speicher (17) zugeordnet ist und der die Größe des dem Quadrat des HF-Stromes entsprechenden Signals und/oder die Größe des Integrationssignals wäh­ rend des Behandlungszeitraumes in bestimmten Zeitabständen speichert.17. Circuit according to one of claims 12 to 16, characterized by a data memory ( 23 ) which is assigned to the squaring unit ( 11 ) and / or the memory ( 17 ) and which is the size of the signal corresponding to the square of the HF current and / or saves the size of the integration signal during the treatment period at certain time intervals. 18. Schaltung nach einem der Ansprüche 12 bis 17, ge­ kennzeichnet durch eine Vergleichseinheit (22), die das Integrationssignal mit einem Maximalwert vergleicht und bei dessen Überschreiten eine An­ zeigeeinrichtung und/oder eine Abschalteinrich­ tung für den HF-Strom betätigt.18. Circuit according to one of claims 12 to 17, characterized by a comparison unit ( 22 ) which compares the integration signal with a maximum value and, when exceeded, actuates a display device and / or a switch-off device for the HF current.
DE1997117411 1997-04-25 1997-04-25 Monitoring of thermal loading of patient tissue in contact region of neutral electrode of HF treatment unit Ceased DE19717411A1 (en)

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