DE2946728C2 - - Google Patents
Info
- Publication number
- DE2946728C2 DE2946728C2 DE19792946728 DE2946728A DE2946728C2 DE 2946728 C2 DE2946728 C2 DE 2946728C2 DE 19792946728 DE19792946728 DE 19792946728 DE 2946728 A DE2946728 A DE 2946728A DE 2946728 C2 DE2946728 C2 DE 2946728C2
- Authority
- DE
- Germany
- Prior art keywords
- switch
- frequency
- coagulation
- duration
- finger
- Prior art date
- Legal status (The legal status 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 status listed.)
- Expired
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/1206—Generators therefor
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- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/0066—Sensing and controlling the application of energy without feedback, i.e. open loop control
Description
Die Erfindung geht aus von einem Hochfrequenz-Chirurgiegerät ent sprechend dem Oberbegriff des Patentanspruchs 1.The invention is based on a high-frequency surgical device speaking the preamble of claim 1.
Bekannte Hochfrequenz-Chirurgiegeräte erzeugen kontinuierliche hochfrequente Wechselströme mit geringer Modulation für glatte Schnitte, mehr oder weniger stark in the Amplitude modulierte Wechselströme für koagulierende bzw. verschorfende Schnitte, so wie stark modulierte hochfrequente Wechselströme für Blutstillung bzw. Koagulation. Die hochfrequenten Wechselströme werden über Fingerschalter oder Fußschalter angeschaltet bzw. ausgeschaltet.Known high-frequency surgical devices produce continuous high-frequency alternating currents with low modulation for smooth Cuts, more or less strongly modulated in the amplitude AC currents for coagulating or eschar cuts, see above how strongly modulated high-frequency alternating currents for hemostasis or coagulation. The high-frequency alternating currents are over Finger switch or foot switch switched on or off.
Insbesondere bei endoskopischen Operationen, wie bei der Poly pektomie, der Papillotomie oder bei transurethralen Resektionen besteht jedoch die Gefahr, daß die Schneidelektrode zu tief in das Gewebe einschneidet, weil der Operateur die Schneidelektro de nicht ausreichend feinfühlig führen kann. Bei einer derarti gen Operation drückt der Operateur die Schneidelektrode über endoskopische Instrumente gegen das zu schneidende oder zu ko agulierende Gewebe und schaltet über Fingerschalter oder Fuß schalter den hochfrequenten Wechselstrom ein. Dabei kann es vor kommen, daß die Schneidelektrode schneller und tiefer in das Gewebe eindringt, als es der Operateur beabsichtigte, bevor er den hochfrequenten Wechselstrom abschalten kann.Especially in endoscopic operations such as the poly pectomy, papillotomy or transurethral resections however, there is a risk that the cutting electrode is too deep the tissue cuts because the surgeon cuts the electrical de cannot lead with sufficient sensitivity. With such a The operator presses the cutting electrode over during the operation endoscopic instruments against the material to be cut or knocked out agulating tissue and switches via finger switch or foot switch on the high-frequency alternating current. It can be done before come that the cutting electrode faster and deeper into that Tissue penetrates as the surgeon intended before he can switch off the high-frequency alternating current.
Diese Schwierigkeit besteht auch bei dem bekannten Hoch frequenz-Chirurgiegerät der eingangs genannten Art (DE-OS 21 40 832), bei dem durch den Hersteller des Geräts geeignete Hochfrequenz-Stromarten voreinstellbar sind, so daß bei ge schlossenem Hand- oder Fußschalter impulsförmiger Hochfrequenz strom zugeführt werden kann, wobei die Impulsdauer größen ordnungsgemäßig 10 Mikrosekunden beträgt und die Pausendauer zwischen den Impulsen größenordnungsgemäßig 40 Mikrosekunden be trägt, so daß es praktisch nicht möglich ist, z. B. gewünschte Schnittiefen mit ausreichender Genauigkeit anzunähern.This difficulty also exists with the well-known high Frequency surgical device of the type mentioned at the beginning (DE-OS 21 40 832), by the manufacturer of the device High-frequency current types are preset, so that at ge closed hand or foot switch pulsed high frequency current can be supplied, the pulse duration is properly 10 microseconds and the pause time be between 40 microseconds between the pulses carries, so that it is practically not possible, for. B. desired Approach depths of cut with sufficient accuracy.
Es ist deshalb Aufgabe der Erfindung, ein Hochfrequenz- Chirurgiegerät der eingangs genannten Art unter möglichst weit gehender Vermeidung der genannten Nachteile und Schwierigkeiten derart zu verbessern, daß es die Wirkungsweise des Chirurgie geräts dem Operateur ermöglicht, die Tiefe bzw. Geschwindigkeit der Schnittführung oder Koagulation genauer durchführen zu können.It is therefore an object of the invention to provide a radio frequency Surgical device of the type mentioned under as far as possible avoiding the disadvantages and difficulties mentioned to improve such that it is the mode of operation of the surgery device enables the surgeon to determine the depth or speed perform the incision or coagulation more precisely can.
Diese Aufgabe wird bei einem Hochfrequenz-Chirurgiegerät der eingangs genannten Art erfindungsgemäß durch den Gegenstand des Patentanspruchs 1 gelöst.This task is done with a high frequency surgical device of the type mentioned in the invention by the subject of claim 1 solved.
Eine vorteilhafte Ausgestaltung der Erfindung ist Gegenstand des Patentanspruchs 2. An advantageous embodiment The invention is the subject of claim 2.
Bei einem derartigen Hochfrequenz-Chirurgiegerät wird deshalb der hochfrequente Wechselstrom unmoduliert für glatte Schnitte, mehr oder weniger moduliert für koagulierende Schnitte, bzw. stark moduliert für Koagulationen, nicht kontinuierlich sondern in einem oder mehreren zeitlichen Intervallen erzeugt, wobei die Intervalldauer sowie die Pausendauer zwischen zwei Intervallen in weiten Grenzen am Gerät eingestellt werden kann. Dabei erfolgen Schnitte und Koagulationen nicht kontinuierlich, sondern impuls förmig in Etappen. So ist es zum Beispiel möglich, durch ge eignete Wahl der Intervalldauer Schnitte in Etappen von 1 mm zu führen, die von einer Pause unterbrochen werden, die es dem Operateur ermöglicht, nach jedem Intervall den Schnittvorgang oder Koagulationsvorgang zu beenden oder weiterzuführen.In such a high-frequency surgical device is therefore the high-frequency alternating current unmodulated for smooth cuts, more or less modulated for coagulating cuts, or strongly modulated for coagulation, not continuously but generated in one or more time intervals, the Interval duration as well as the pause duration between two intervals in wide limits can be set on the device. In doing so Cuts and coagulations are not continuous, but impulsive shaped in stages. For example, it is possible to use ge suitable choice of the interval duration cuts in stages of 1 mm to be interrupted by a pause, which the The surgeon enables the cutting process after each interval or to end or continue the coagulation process.
Anhand der Zeichnung soll die Erfindung beispielsweise näher erläutert werden. Es zeigtBased on the drawing, the invention is intended to be more specific, for example are explained. It shows
Fig. 1 eine perspektivische Ansicht der Bedienungsplatte eines Hochfrequenz-Chirurgiegeräts gemäß der Erfindung; und Figure 1 is a perspective view of the control panel of a high frequency surgical device according to the invention. and
Fig. 2 graphische Darstellungen zur Erläuterung der Arbeits weise bekannter Hochfrequenz-Chirurgiegeräte im Ver gleich zu einem Hochfrequenz-Chirurgiegerät gemäß der Erfindung. Fig. 2 are graphical representations for explaining the way of working known high-frequency surgical devices in comparison to a high-frequency surgical device according to the invention.
Bei dem dargestellten Ausführungsbeispiel ist in an sich be kannter Weise ein Stellglied 1 vorgesehen, an dem die Intensi tät des Schneidestroms eingestellt wird, sowie ein Stellglied 2, an dem die Intensität des Koagulationsstromes eingestellt wird. An einem Schalter 3 kann der Schneidestrom oder der Ko agulationsstrom ausgewählt werden.In the illustrated embodiment, an actuator 1 is provided in a manner known per se, on which the intensity of the cutting current is set, and an actuator 2 , on which the intensity of the coagulation current is set. The cutting current or the coagulation current can be selected at a switch 3 .
Gemäß der Erfindung ist eine Einrichtung zur Erzeugung des hoch frequenten Schneide- und/oder Koagulationsstromes in zeitlich vorherbestimmten Intervallen vorgesehen, an der die Intervall dauer t I an einem Stellglied 4 und die Pausendauer t p zwi schen aufeinanderfolgenden Intervallen an einem Stellglied 5 einstellbar ist. An einem Schalter 6 kann der Operateur wäh len, ob er Einzelimpulse oder Impulsserien mit Hilfe an sich bekannter Fingerschalter oder Fußschalter auslösen möchte. Wählt der Operateur die Schalterstellung Einzelimpuls, so er zeugt das Hochfrequenz-Chirurgiegerät nach jeder Betätigung eines Fingerschalters oder Fußschalters nur ein einziges Inter vall der vorher am Stellglied 4 eingestellten Dauer und der am Stellglied 1 oder 2 eingestellten Intensität. Wählt der Opera teur die Schalterstellung Impulsserie so erzeugt das Hochfre quenz-Chirurgiegerät so lange aufeinanderfolgende Intervalle der am Stellglied 4 eingestellten Intervalldauer und der am Stellglied 5 eingestellten Pausendauer, wie der Operateur den Fingerschalter oder Fußschalter des Hochfrequenz-Chirurgiege räts betätigt.According to the invention, a device for generating the high-frequency cutting and / or coagulation current is provided at predetermined intervals, at which the interval duration t I on an actuator 4 and the pause duration t p between successive intervals on an actuator 5 is adjustable. At a switch 6 , the surgeon can select whether he would like to trigger individual pulses or pulse series with the aid of finger switches or foot switches known per se. If the operator selects the switch position single pulse, he generates the high-frequency surgical device after each actuation of a finger switch or foot switch only a single interval of the duration previously set on the actuator 4 and the intensity set on the actuator 1 or 2 . If the operator chooses the pulse series switch position, the high-frequency surgical device generates consecutive intervals of the interval duration set on the actuator 4 and the pause duration set on the actuator 5 , as the operator actuates the finger switch or foot switch of the high-frequency surgical unit.
In Fig. 2 zeigt das Diagramm 1 das Zeit-Leistungsdiagramm und das Diagramm 3 das Zeit-Schnittiefe- bzw. Koagulationstiefe diagramm bekannter Hochfrequenz-Chirurgiegeräte im Vergleich zu entsprechenden Diagrammen 2 und 4 eines Hochfrequenz-Chirurgie geräts gemäß der Erfindung. Wie aus Diagramm 1 ersichtlich ist, erzeugen bekannte Hochfrequenz-Chirurgiegeräte einen weitgehend kontinuierlichen Schneidestrom bzw. Koagulationsstrom vom Ein schalten bis zum Ausschalten des Schneidestroms bzw. Koagula tionsstroms über Fingerschalter oder Fußschalter. Wie aus Dia gramm 2 ersichtlich ist, erzeugt dagegen ein Hochfrequenz- Chirurgiegerät gemäß der Erfindung den Schneidestrom bzw. Ko agulationsstrom in Intervallen der einstellbaren Dauer t I und mit Pausen der einstellbaren Dauer t p . In Fig. 2, diagram 1 shows the time-performance diagram and diagram 3 the time-depth of cut or coagulation depth diagram of known high-frequency surgical devices in comparison to corresponding diagrams 2 and 4 of a high-frequency surgery device according to the invention. As can be seen from diagram 1 , known high-frequency surgical devices generate a largely continuous cutting current or coagulation current from switching on until the cutting current or coagulation current is switched off via finger switches or foot switches. As can be seen from diagram 2 , on the other hand, a high-frequency surgical device according to the invention generates the cutting current or coagulation current at intervals of the adjustable duration t I and with pauses of the adjustable duration t p .
Wie aus Diagramm 3 ersichtlich ist, ergibt sich bei bekannten Hochfrequenz-Chirurgiegeräten eine kontinuierliche Vergröße rung der Schnittiefe bzw. Koagulationstiefe, während bei einem Hochfrequenz-Chirurgiegerät gemäß der Erfindung entsprechend Diagramm 4 eine Vergrößerung der Schnittiefe in Etappen von Δ s erfolgt. Auf diese Weise ist es möglich, eine optimale Schnittiefe in zuverlässiger Weise zu erzielen.As can be seen from diagram 3 , known high-frequency surgical devices result in a continuous enlargement of the depth of cut or coagulation depth, while in a high-frequency surgical device according to the invention, according to diagram 4, the depth of cut is increased in stages of Δ s . In this way it is possible to achieve an optimal depth of cut in a reliable manner.
Claims (2)
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
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DE19792946728 DE2946728A1 (en) | 1979-11-20 | 1979-11-20 | HF surgical appts. for use with endoscope - provides cutting or coagulation current at preset intervals and of selected duration |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE19792946728 DE2946728A1 (en) | 1979-11-20 | 1979-11-20 | HF surgical appts. for use with endoscope - provides cutting or coagulation current at preset intervals and of selected duration |
Publications (2)
Publication Number | Publication Date |
---|---|
DE2946728A1 DE2946728A1 (en) | 1981-05-27 |
DE2946728C2 true DE2946728C2 (en) | 1987-07-30 |
Family
ID=6086429
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE19792946728 Granted DE2946728A1 (en) | 1979-11-20 | 1979-11-20 | HF surgical appts. for use with endoscope - provides cutting or coagulation current at preset intervals and of selected duration |
Country Status (1)
Country | Link |
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DE (1) | DE2946728A1 (en) |
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D2 | Grant after examination | ||
8363 | Opposition against the patent | ||
8331 | Complete revocation |