CN109009415A - A kind of low-temperature plasma snare knife surgical apparatus - Google Patents

A kind of low-temperature plasma snare knife surgical apparatus Download PDF

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Publication number
CN109009415A
CN109009415A CN201810976750.0A CN201810976750A CN109009415A CN 109009415 A CN109009415 A CN 109009415A CN 201810976750 A CN201810976750 A CN 201810976750A CN 109009415 A CN109009415 A CN 109009415A
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mode
electrode
snare
low
plasma
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周平红
严航
郑忠伟
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Shanghai Andaxin Medical Devices Co
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Shanghai Andaxin Medical Devices Co
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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
    • A61B18/042—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating using additional gas becoming plasma
    • 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
    • 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
    • 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
    • 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
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00107—Coatings on the energy applicator
    • 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
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00172—Connectors and adapters therefor
    • A61B2018/00178—Electrical connectors
    • 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
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00482—Digestive system
    • 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
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577—Ablation
    • 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
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577—Ablation
    • A61B2018/00583—Coblation, i.e. ablation using a cold plasma
    • 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
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00595—Cauterization
    • 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
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00601—Cutting
    • 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
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00607—Coagulation and cutting with the same instrument
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • 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
    • A61B2018/00696—Controlled or regulated parameters
    • A61B2018/00732—Frequency
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    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00898—Alarms or notifications created in response to an abnormal condition
    • 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
    • A61B2018/1246—Generators therefor characterised by the output polarity
    • A61B2018/126—Generators therefor characterised by the output polarity bipolar
    • 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
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1412—Blade

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Abstract

The invention discloses a kind of low-temperature plasma snare knife surgical apparatus, the equipment includes: liquid input unit, in response to liquid input signal, to objective body at input liquid between emission electrode and loop electrode formed conducting medium thin layer；Bipolar electrode socket connector is connect, for receiving the first input voltage caused by radio-frequency generator with radio-frequency generator by high frequency connecting line；Emission electrode, the first input voltage caused by radio-frequency generator is received via bipolar electrode socket connector, apply first voltage between emission electrode and loop electrode, so that conducting medium reaches the first temperature and the conducting medium is promoted to be converted into plasmasphere, to generate plasma using electric energy excitation conducting medium, and snare cutting is vaporized to objective body based on the RF energy of plasma, loop electrode is imported by identical conduit with emission electrode and forms galvanic circle in objective body.

Description

A kind of low-temperature plasma snare knife surgical apparatus
Technical field
The present invention relates to radio frequency arts, and more particularly, to a kind of low-temperature plasma snare knife surgical apparatus.
Background technique
With the continuous development of digestive endoscopy technology, also more more and more universal electric circle covers knife to the Endoscopic Treatment of disease of digestive tract It is matched with endoscope, for removing polyp or other excess tissues use in alimentary canal inscribe using high-frequency current.Biography can be exempted It is high to have the characteristics that small wound, good effect, surgical technic require for system operative treatment risk.
High frequency snare cutting electric knife is a kind of electrosurgical unit for replacing mechanical operation knife to carry out tissue snare cutting.High frequency The working principle of snare cutting electric knife is when the high-frequency high-voltage current generated by active electrode tip is contacted with body to tissue It is heated, realizes the separation and solidification to body tissue, to play the purpose of snare cutting and hemostasis.The cutting of high frequency snare The crest voltage of electric knife coagulation mode is big compared with cutting mode, when high-frequency current passes through the tissue of high impedance, understands heat in the tissue, Cause tissue to gasify or solidify, generates good haemostatic effect, but will also result in more obvious thermal damage simultaneously.High frequency snare It cutting electric knife moment and stablizes up to 150 DEG C or more, energy snare cuts the heating effect of the high frequency snare cutting electric knife of tissue, and It is not as caused by heating electrode or cutter head.It is that the high-frequency current of high current density gathers together, directly destroy in The tissue that active electrode tip is in contact.When being in contact with active electrode or the temperature of adjoining tissue or cell rises to carefully When protein denaturation in born of the same parents, the effect of snare cutting and solidification is just generated.
The operating temperature of common high frequency snare cutting electric knife is usually 100~150 DEG C, this operating temperature counterpart tissue High temperature is still fallen within, after histocyte is influenced by this temperature, the histone due to caused by snare cutting is denaturalized.It is especially common high Frequency snare cutting electric knife continues working after a certain period of time, can cause thermal damage to tissue.And histiocytic degeneration necrosis is one A process gradually developed, common high frequency snare cutting electric knife will appear the reaction such as the swelling of art area, postoperative pain.
In the actual environment, high frequency snare cutting electric knife, which is applied, carries out such as polyp inside alimentary canal in hospital or dashes forward It is easy to produce complication in the snare stereotomy of tumor locus out, this is because temperature has damage tissue.High frequency snare Cutting electric knife, there are two electrodes, and an electrode paste is with patient, another electrode is placed on snare knife position, and in handle Upper setting electric pathway.High-frequency emission temperature is up to 400-500 degree, this temperature can accidentally injure the good tissue in periphery, and then make It obtains the probability height of bleeding problems generation, be easily damaged pathological tissue.In this case, doctor can not carry out pathological analysis, and And trouble is caused when arranging effectively analysis to slice.
Such as application No. is the patents of invention of CN201180055284.9 to disclose a kind of bipolar snare, the bipolar snare Device includes: elongate tubular electrical isolation sheath, and a pair of of elongated, flexible conductor wire in sheath, and the distal end that setting is online is arranged in The electrical isolation connector at place, the electrical isolation connector mechanically connect the distal end of this pair of of line and are formed from the remote of sheath Hold lasso outstanding.Line is provided with electrical insulator, the electrical insulator cover line in every line other than selected part All parts.Bipolar snare device further includes guiding elements, which is positioned in sheath, and is formed for conduction The compartment of every conductor wire in line, guiding elements can rotate in sheath.Guiding elements is also moved backward from the distal end of sheath To enabling the entire lasso including at least part of connector to be accepted in the degree in sheath.However, this pair Pole snare not can avoid yet temperature it is excessively high caused by accidentally injure problem.
Summary of the invention
According to an aspect of the present invention, a kind of low-temperature plasma snare knife surgical apparatus is provided, the equipment includes:
Liquid input unit, in response to liquid input signal, to objective body at input liquid to emission electrode and return The thin layer of conducting medium is formed between path electrode；
Bipolar electrode socket connector is connect by high frequency connecting line with radio-frequency generator, is occurred for receiving the high frequency First input voltage caused by device；
Emission electrode receives the first input voltage caused by the radio-frequency generator via bipolar electrode socket connector, Apply first voltage between emission electrode and loop electrode, so that the conducting medium reaches the first temperature and promotes described Conducting medium is converted into plasmasphere, to generate plasma using electric energy excitation conducting medium, and is based on plasma The RF energy of body is vaporized snare cutting to objective body,
Loop electrode is imported by identical conduit with the emission electrode and forms conductive return in the objective body Road.
The bipolar electrode socket connector receives the second input voltage caused by the radio-frequency generator and will be described Second input voltage is transferred to emission electrode, applies second voltage between emission electrode and loop electrode, so that objective body Second temperature is remained, so that objective body be promoted to carry out ablation solidification.
The emission electrode of the low-temperature plasma snare knife surgical apparatus is connected to bipolar electrode by emission electrode conducting wire and inserts Mouth connector, emission electrode conducting wire cladding insulating layer, insulating layer has been used to insulate and heat-insulated effect.
The low-temperature plasma snare knife surgical apparatus further includes fluid-through chamber, inputs list to liquid based on liquid input instruction Member inputs the liquid, wherein the current surplus of liquid described in the liquid input unit real-time measurement and will it is described it is current more than Amount is sent to control unit, described control unit be based on the current surplus determine whether to generate the liquid input instruction and Liquid input instruction is sent to liquid input unit after the liquid input instructs determining to generate.
The liquid input unit carries out liquid input: titration mode and continuous liquid supply mould by one of following mode Formula, and the fluid-through chamber is the annular chamber except loop electrode.
For the snare cutter head of the emission electrode far from the low-temperature plasma snare knife surgical apparatus of the emission electrode Oval, hexagon or semilune.
The infusion port of the liquid input unit is between the emission electrode and loop electrode.
The low-temperature plasma snare knife surgical apparatus further includes pull rod, for making operator by providing branch pull rod Support force, and the low-temperature plasma snare knife surgical apparatus further includes outer tube, for providing external sheath function.
The emission electrode of the low-temperature plasma snare knife surgical apparatus is telescopically arranged by sliding block.
The range of the first voltage be 100Vrms to 300Vrms, and the range of the second voltage be 60Vrms extremely 80Vrms。
Preferably, the range of the first voltage is 100Vrms to 300Vrms, and the range of the second voltage is 60Vrms to 80Vrms.
There was only 40-70 degree according to the temperature of the work of the low-temperature plasma snare knife surgical apparatus of the application, to solve To the accidental injury problem of periphery good organization, bleeding problems and reduce complication.In addition, the low-temperature plasma snare of the application Bipolar fashion is used in knife surgical apparatus structure, is directly formed into a loop on conduit.
Detailed description of the invention
By reference to the following drawings, exemplary embodiments of the present invention can be more fully understood by:
Fig. 1 is the major part schematic diagram according to the plasma therapeutic apparatus of the preferred embodiment for the present invention；
Fig. 2 is the structural schematic diagram according to the plasma therapeutic apparatus of the preferred embodiment for the present invention；
Fig. 3 is the structural schematic diagram according to the low-temperature plasma snare knife surgery systems of the preferred embodiment for the present invention；
Fig. 4 is the flow chart according to the low-temperature plasma snare knife operation method of the preferred embodiment for the present invention；
Fig. 5 is the structural schematic diagram according to the low-temperature plasma snare knife surgical apparatus of the preferred embodiment for the present invention；With And
Fig. 6-8 is the partial enlargement according to the low-temperature plasma snare knife surgical apparatus of the preferred embodiment for the present invention or cuts Face schematic diagram.
Specific embodiment
Embodiments of the present invention are illustrated by particular specific embodiment below, those skilled in the art can be by this specification Revealed content is understood other advantages and efficacy of the present invention easily.
Exemplary embodiments of the present invention are introduced referring now to the drawings, however, the present invention can use many different shapes Formula is implemented, and is not limited to the embodiment described herein, and to provide these embodiments be at large and fully disclose The present invention, and the scope of the present invention is sufficiently conveyed to person of ordinary skill in the field.Show for what is be illustrated in the accompanying drawings Term in example property embodiment is not limitation of the invention.In the accompanying drawings, identical cells/elements use identical attached Icon note.
Unless otherwise indicated, term (including scientific and technical terminology) used herein has person of ordinary skill in the field It is common to understand meaning.Further it will be understood that with the term that usually used dictionary limits, should be understood as and its The context of related fields has consistent meaning, and is not construed as Utopian or too formal meaning.
Fig. 1 is the functional schematic according to the plasma therapeutic apparatus 100 of the preferred embodiment for the present invention.Plasma therapeutic apparatus 100 can be used in snare cutting, ablation and the solidification of such as polyp or outstanding tumor locus inside alimentary canal and stop Blood.In addition, plasma therapeutic apparatus 100 can also be used to the circle of soft tissue in the surgical operations such as joint, backbone, skin, ear nose larynx Set cutting, ablation, solidification and hemostasis.The plasma therapeutic apparatus 100 of the application is within 24 hours using the time, according to contact when Between classification belong to brought into temporary contact, belong to external access instrument (with tissue/bone/dentine) according to contact human body qualitative classification and Belong to active medical instrument according to the classification of medical instrument structure feature.Attachment bipolar operation electrode (the circle of plasma therapeutic apparatus 100 Set knife) head belongs to disposable sterilized product.
Plasma therapeutic apparatus 100 uses bipolar scheme, and its working frequency is 110kHz.Plasma therapeutic apparatus 100 is logical Cross snare cutting, ablation, solidification and hemostasis of the plasma technology realization to soft tissue in the operation such as ear nose larynx.When work, wait from Sub- therapeutic equipment 100, as conduction liquid, forms a thin layer by physiological saline when activating between emission electrode and loop electrode.When When plasma therapeutic apparatus 100 gives enough energy (voltage), physiological saline translates into one and is made of charged particle of energizing Gas blanket (plasmasphere).That is, plasma therapeutic apparatus 100 is generated using energy excitation conducting medium (for example, physiological saline) Plasma, and tissue element key is interrupted by the energy of plasma.The energy of plasma is big by the biology such as protein Molecule Direct Pyrolysis is at O2, CO2, N2Equal gases, to complete to cut the vaporization snare of tissue.When to plasma therapeutic apparatus 100 Work cutter head when giving low-voltage, electric field requires lower than the thresholding for generating plasmasphere and generates tissue resistance heat, thus Tissue is subjected to ablation solidification and hemostasis.
As shown in Figure 1, the functional architecture of plasma therapeutic apparatus 100 includes: primary control program, alarm unit, interface list Member, output control unit, bipolar operation electrode (snare knife) interface, bipolar operation electrode (snare knife), floor push, foot control connect Mouth, dropping liquid control valve and dropping liquid control valve interface.Wherein, primary control program, alarm unit, boundary element, output control, are bipolar Procedures electrode interface, foot control interface and dropping liquid control valve interface belong to the software section of plasma therapeutic apparatus 100.Plasma is controlled The function introduction for treating the section components of instrument 100 is as shown in table 1,
The function introduction of 1 section components of table
Preferably, floor push can control the operating mode of plasma therapeutic apparatus 100.The work of plasma therapeutic apparatus 100 Operation mode is divided into snare cut mode and coagulation mode.The waterproofing grade of floor push is waterproofing grade standard IPX8, and foot Stepping on switch is that electric pedal switchs.
Preferably, the yellow pedal of floor push corresponds to snare cut mode, and the gear grade of snare cut mode It Wei not be 1 to 9 grade.That is, plasma therapeutic apparatus 100 enters snare cut mode when trampling the yellow pedal of floor push.Snare The gear regulative mode of cut mode are as follows: in the state of being adjusted to snare cut mode by dark buttons on floor push (or Manually adjust yellow button on host panel) it is adjusted.Snare cutting gear can choose any one shelves in from 1 to 9 grade. Wherein, gear is higher, and output voltage is bigger.In snare cut mode, 1 to 9 grade of output voltage is as shown in table 2:
Output gear in 2 snare cut mode of table
Preferably, the blue pedal of floor push corresponds to coagulation mode, and the gear range of coagulation mode is 1 to 5 Shelves.That is, plasma therapeutic apparatus 100 enters coagulation mode when trampling the blue pedal of floor push.The gear tune of coagulation mode Section mode are as follows: (snare cut mode and coagulation mode can be switched by mode key) by blue in the state of being adjusted to coagulation mode Dark buttons (or manually adjusting host panel blue buttons up and down) are adjusted on pedal.When foot-operated dark buttons, blood coagulation shelves Position can choose any one shelves in from 1 to 5 grade, and middle gear more high output voltage is bigger.When needing to carry out in clinical use When blood coagulation, depresses blue pedal and carry out blood coagulation.In coagulation mode, 1 to 5 grade of output voltage is as shown in table 3:
Output gear in 3 coagulation mode of table
Preferably, foot control interface is used to receive the control instruction of floor push, and the control instruction is transmitted to master Control program.Wherein, control instruction be binary group<mode, power>.Mode includes: snare cut mode and coagulation mode.It is enclosing It covers in cut mode, power includes 9 gears, and in coagulation mode, and power includes 5 gears.
Preferably, primary control program carries out parsing to the control instruction and when the control instruction indicates first mode First mode instruction is generated, is calculated according to present impedance and the control instruction for the output power under first mode, by the It is single that one mode instruction and first voltage associated with the output power under first mode instruction are sent to output control Member.Wherein, initial present impedance is zero, i.e., when the booting of plasma therapeutic apparatus 100 is operated, the present impedance of default is Zero.The primary control program carries out parsing to the control instruction and generates second when the control instruction indicates second mode Mode instruction calculates for the output power under second mode according to present impedance and the control instruction, second mode is referred to It enables and second voltage associated with the output power under second mode instruction is sent to output control unit.Wherein institute Stating present impedance includes high impedance, middle impedance and Low ESR (0 impedance is Low ESR).Preferably, according to present impedance and described If it is high impedance and the control instruction that control instruction calculating, which includes: present impedance for the output power under first mode, It indicates the 2nd grade under first mode, then sets the 4th grade for the output power under first mode；If present impedance is middle resistance The 2nd grade under the anti-and described control instruction instruction first mode, then the 3rd grade is set by the output power under first mode； It, will be under first mode and if present impedance is Low ESR and the control instruction indicates the 2nd grade under first mode Output power be set as the 2nd grade.Preferably, it is calculated according to present impedance and the control instruction for defeated under second mode If power includes: present impedance for high impedance out and the control instruction indicates the 2nd grade under second mode, by second Output power under mode is set as the 4th grade；If present impedance is middle impedance and the control instruction indicates second mode Under the 2nd grade, then set the 3rd grade for the output power under second mode；And if present impedance is Low ESR and institute The 2nd grade under control instruction instruction second mode is stated, then sets the 2nd grade for the output power under second mode.Preferably, when It is defeated using highest gear as reality when the output power being calculated is more than the highest gear in first mode or second mode Power out.
Preferably, output control unit is used to receive first mode instruction and first voltage instruction from the primary control program, And first mode instruction and first voltage instruction are transmitted to bipolar operation electrode interface, and from bipolar operation electrode The present impedance of interface target contact jaw and the present impedance is sent to the primary control program.And the output Control unit from the primary control program receive second mode instruction and second voltage instruction, and by the second mode instruction and Second voltage instruction is transmitted to bipolar operation electrode interface.
Preferably, bipolar operation electrode interface is used to receive the power indication of primary control program and sends out the power indication Bipolar operation electrode is given, and the real-time impedance of bipolar operation electrode is measured and is passed through the real-time impedance defeated Control unit passes to primary control program out.
Preferably, bipolar operation electrode from the bipolar operation electrode interface first mode in response to instructing and first Voltage instruction, into first mode: passing through emission electrode of the conducting medium at the target contact jaw of the bipolar operation electrode Circuit activation is carried out between loop electrode to form thin layer, applies first voltage between emission electrode and loop electrode, make It obtains the conducting medium to reach the first temperature and be converted into plasmasphere, to utilize electric energy excitation conducting medium generation etc. Gas ions, and snare cutting is vaporized to objective body based on the RF energy of plasma.In response to from the bipolar hand Received second instruction of art electrode interface and second voltage instruction, the bipolar operation electrode enter second mode: applying second Voltage is to remain second temperature for the target contact jaw of the bipolar operation electrode, so that objective body is carried out ablation solidification.
Preferably, alarm unit is used for when receiving alarm signal, passes through auditory tone cues, text prompt and/or instruction Lamp, which is shown, alarms.Alarm signal wherein is sent to primary control program after the bipolar operation electrode detects operation troubles, Alarm signal is sent to the alarm unit by the primary control program.
Preferably, boundary element, the operating status for low-temperature plasma snare knife surgery systems described in real-time display.
Preferably, dropping liquid control valve is instructed for the conducting medium input based on the primary control program to bipolar operation electrode The conducting medium is inputted, wherein the current surplus of conducting medium described in the bipolar operation electrode real-time measurement and will be described Current surplus is sent to primary control program, the primary control program be based on the current surplus determine whether to generate the conducting medium it is defeated Enter instruction and conducting medium input instruction is sent to dropping liquid control after the conducting medium input instructs determining to generate Valve processed.Preferably, dropping liquid control valve interface is for realizing the two-way communication between dropping liquid control valve and primary control program.
Preferably, the emission electrode at bipolar operation electrode tip catheter, plasmasphere, loop electrode and target contact End forming circuit.In snare cut mode, the operating temperature of bipolar operation electrode is 35 to 40 DEG C, and conventional electrosurgical knife Operating temperature is 350 to 700 DEG C.The thermal break-through distance of bipolar operation electrode than the thermal break-through of conventional electrosurgical knife apart from small, The thermal break-through distance that the thermal break-through distance being trapped in cut mode is less than or equal in 150 microns and coagulation mode be less than or Equal to 200 microns, and the thermal break-through of conventional electrosurgical knife distance is greater than 9000 microns.
100 working principle of plasma therapeutic apparatus is effect of plasma radiofrequency ablation at low temperature.Energy is generated using bipolar cutter head, will be given birth to Reason salt water is converted into plasma thin layer, dissociates the molecular link that cell component is constituted in target tissue, causes tissue coagulation downright bad, Form the effect of ablation or snare cutting.Due to working at relatively low temperature, cut than the high frequency snare that tradition uses Electric knife is minimized degree to the thermal damage of perienchyma.Target volume can be made to reduce in 35 DEG C or so operating temperatures, target group Capilary closing in knitting, cuts off lesion.Its low temperature and tissue volume reduction Ablation characteristic, more common Single-pole electric knife is with more shortening Post-operative recovery time mitigates the advantages of postoperative pain and reduction expenses of surgical treatment.Wherein, plasma therapeutic apparatus and common high frequency The temperature that snare cuts electric knife is more as shown in table 4:
Table 4
Cutter head ambient temperature (is detailed in isolated experiment research tissue thermal damage to report plasma therapeutic apparatus lower than 70 DEG C at work Accuse), operating temperature is lower compared with traditional common high frequency snare cutting electric knife (100~150 DEG C of high temperature), although low The treatment temperature counterpart tissue of warm plasma blade still falls within high temperature and equally will appear electricity after histocyte is influenced by this temperature Cutter ring set cutting causes histone to be denaturalized, and especially after certain time, also can cause thermal damage to tissue.And it organizes thin The degeneration necrosis of born of the same parents is the process gradually developed, therefore after the operation of some patientss row low-temperature plasma, it is the swelling of art area, postoperative The reaction such as pain cuts electric knife response light unlike high frequency snare.The damage of plasma therapeutic apparatus and common high frequency snare cutting electric knife Thermal damage's depth is compared as follows shown in table 5:
Table 5
Thermal damage's depth when snare is cut Thermal damage's depth when blood coagulation
Plasma therapeutic apparatus 150 microns of average value 200 microns of average value
High frequency snare cuts electric knife 1.23±0.24mm 1.37±0.26mm
Since each operating time has differences so plasma therapeutic apparatus is in isolated experiment research tissue thermal damage report In selected maximum operating time, by comparing the visible maximum plasma therapeutic apparatus of operating time and the high frequency snare of normal use Cut electric knife heat waste depth.Therefore the heat waste depth of the plasma therapeutic apparatus of normal use should cut electric knife heat waste lower than high frequency snare Depth.
Fig. 2 is the major part schematic diagram according to the plasma therapeutic apparatus 200 of the preferred embodiment for the present invention.Such as Fig. 2 institute Show, the major part of plasma therapeutic apparatus 200 includes: bipolar operation electrode interface 201, dropping liquid control valve interface 202, tramples out Close interface 203, display screen 204, mainboard 205, loudspeaker 206, front panel 207, trouble lamp 208, lower die 209, upper mold 210, Power module 211, dropping liquid control valve 212 and fan 213.
Preferably, trample switch interface 203 is used to receive the instruction of floor push, floor push and can control etc. from The operating mode of sub- therapeutic equipment 200.The operating mode of plasma therapeutic apparatus 200 is divided into snare cut mode and coagulation mode.Foot The waterproofing grade for stepping on switch is waterproofing grade standard IPX8, and floor push is electric pedal switch.
Preferably, the yellow pedal of floor push corresponds to snare cut mode, and the gear grade of snare cut mode It Wei not be 1 to 9 grade.That is, plasma therapeutic apparatus 200 enters snare cut mode when trampling the yellow pedal of floor push.Snare The gear regulative mode of cut mode are as follows: in the state of being adjusted to snare cut mode by dark buttons on floor push (or Manually adjust yellow button on host panel) it is adjusted.Snare cutting gear can choose any one shelves in from 1 to 9 grade. Wherein, gear is higher, and output voltage is bigger.
Preferably, the blue pedal of floor push corresponds to coagulation mode, and the gear range of coagulation mode is 1 to 5 Shelves.That is, plasma therapeutic apparatus 200 enters coagulation mode when trampling the blue pedal of floor push.The gear tune of coagulation mode Section mode are as follows: (snare cut mode and coagulation mode can be switched by mode key) by blue in the state of being adjusted to coagulation mode Dark buttons (or manually adjusting host panel blue buttons up and down) are adjusted on pedal.When foot-operated dark buttons, blood coagulation shelves Position can choose any one shelves in from 1 to 5 grade, and middle gear more high output voltage is bigger.When needing to carry out in clinical use When blood coagulation, depresses blue pedal and carry out blood coagulation.
Preferably, trample switch interface 203 is used to receive the control instruction of floor push, and the control instruction is turned Issue primary control program.Wherein, control instruction be binary group<mode, power>.Mode includes: snare cut mode and blood coagulation mould Formula.In snare cut mode, power includes 9 gears, and in coagulation mode, and power includes 5 gears.
Preferably, mainboard 205 stores primary control program in the firmware for accommodating firmware.Wherein, primary control program is to described Control instruction carries out parsing and generates first mode instruction when the control instruction indicates first mode, according to present impedance Calculate with the control instruction for the output power under first mode, by first mode instruct and under the first mode Output power associated first voltage instruction be sent to output control unit.Wherein, initial present impedance is zero, that is, is existed When the booting of plasma therapeutic apparatus 200 is operated, the present impedance of default is zero.The primary control program to the control instruction into Row parsing and the generation second mode instruction when the control instruction indicates second mode, according to present impedance and the control Instruction is calculated for the output power under second mode, by second mode instruct and with the output power under the second mode Associated second voltage instruction is sent to output control unit.Wherein the present impedance includes high impedance, middle impedance and low Impedance (0 impedance is Low ESR).Preferably, it is calculated according to present impedance and the control instruction for the output under first mode If power includes: present impedance for high impedance and the control instruction indicates the 2nd grade under first mode, by the first mould Output power under formula is set as the 4th grade；If present impedance is middle impedance and the control instruction indicates under first mode The 2nd grade, then set the 3rd grade for the output power under first mode；And if present impedance is Low ESR and described Control instruction indicates the 2nd grade under first mode, then sets the 2nd grade for the output power under first mode.Preferably, according to If present impedance and the control instruction calculate for the output power under second mode include: present impedance be high impedance simultaneously And the 2nd grade under the control instruction instruction second mode, then the 4th grade is set by the output power under second mode；If Present impedance is middle impedance and the control instruction indicates the 2nd grade under second mode, then by the output work under second mode Rate is set as the 3rd grade；And if present impedance is Low ESR and the control instruction indicates the 2nd grade under second mode, Then the 2nd grade is set by the output power under second mode.Preferably, when the output power being calculated is more than first mode Or when highest gear in second mode, using highest gear as real output.
Preferably, output control unit (being not shown in Fig. 2) be used for from the primary control program receive first mode instruction and First voltage instruction, and first mode instruction and first voltage instruction are transmitted to bipolar operation electrode interface 201, with And the present impedance of target contact jaw is received from bipolar operation electrode interface 201 and the present impedance is sent to the master Control program.And the output control unit receives second mode instruction and second voltage instruction from the primary control program, and Second mode instruction and second voltage instruction are transmitted to bipolar operation electrode interface 201.
Preferably, bipolar operation electrode interface 201 is used to receive the power indication of primary control program and refers to the power Show and be sent to bipolar operation electrode, and the real-time impedance of bipolar operation electrode is measured and leads to the real-time impedance It crosses output control unit and passes to primary control program.
Preferably, bipolar operation electrode (not shown) is in response to receiving the from the bipolar operation electrode interface 201 One mode instruction and first voltage instruction, connect into first mode: the target by conducting medium in the bipolar operation electrode Circuit activation is carried out between emission electrode and loop electrode at contravention to form thin layer, between emission electrode and loop electrode Apply first voltage, so that the conducting medium reaches the first temperature and is converted into plasmasphere, to swash using electric energy It sends out conducting medium and generates plasma, and snare cutting is vaporized to objective body based on the RF energy of plasma.It rings Bipolar operation electrode interface 201 received second described in Ying Yucong instruction and second voltage instruction, the bipolar operation electrode into Enter second mode: applying second voltage so that the target contact jaw of the bipolar operation electrode is remained second temperature, thus will Objective body carries out ablation solidification.
Preferably, trouble lamp 208 is used for when receiving alarm signal, is shown and is alarmed by indicator light.Its In after the bipolar operation electrode detects operation troubles to primary control program send alarm signal, the primary control program will alarm Signal is sent to the trouble lamp 208.Loudspeaker 206 are used for when receiving alarm signal, are alarmed by sound.Its In after the bipolar operation electrode detects operation troubles to primary control program send alarm signal, the primary control program will alarm Signal is sent to the loudspeaker 206.
Preferably, operating status of the display screen 204 for low-temperature plasma snare knife surgery systems described in real-time display.
Preferably, dropping liquid control valve 212 is instructed for the conducting medium input based on the primary control program to bipolar surgery Electrode inputs the conducting medium, wherein the current surplus of conducting medium described in the bipolar operation electrode real-time measurement and general The current surplus is sent to primary control program, and the primary control program is based on the current surplus and determines whether to generate conductive Jie Matter input, which instructs and the conducting medium is inputted instruction after determining the generation conducting medium input instruction, is sent to drop Hydraulic control valve 212.Preferably, dropping liquid control valve interface 202 is for realizing two-way between dropping liquid control valve 212 and primary control program Communication.
Preferably, the application uses double mode liquid outlet: 1, titration mode, i.e., a drop as the mode of infusion The supply of one drop；And 2, continuous supply model, i.e., the mode of liquid flow without interruption.Bipolar operation electrode interface (snare knife Interface) it is connect by patch with the bipolar electrode socket connector (snare knife connector) of Fig. 5 as described below, dropping liquid control valve connects Mouth is connected by the fluid-through chamber of connecting tube and Fig. 5.Floor push mouth is connect by connecting line with external foot pedal, for controlling The supply and disconnection of energy and dropping liquid.When foot pedal is stepped on, energy and dropping liquid supply；When foot pedal unclamps, energy and drop Liquid disconnects.
Preferably, the emission electrode at bipolar operation electrode tip catheter, plasmasphere, loop electrode and target contact End forming circuit.In snare cut mode, the operating temperature of bipolar operation electrode is 35 to 40 DEG C, and conventional electrosurgical knife Operating temperature is 350 to 700 DEG C.The thermal break-through distance of bipolar operation electrode than the thermal break-through of conventional electrosurgical knife apart from small, The thermal break-through distance that the thermal break-through distance being trapped in cut mode is less than or equal in 150 microns and coagulation mode be less than or Equal to 200 microns, and the thermal break-through of conventional electrosurgical knife distance is greater than 9000 microns.
Preferably, upper mold 210 and lower die 209 protect mainboard by way of combination.Fan 213 is used to radiate, and Power module 211 is used to provide electric power for plasma therapeutic apparatus 200.Front panel 207 is for displaying data and operating control.
Fig. 3 is the structural schematic diagram according to the low-temperature plasma snare knife surgery systems 300 of the preferred embodiment for the present invention. Low-temperature plasma snare knife surgery systems 300 can be used in such as polyp inside alimentary canal or outstanding tumor locus Snare cutting, ablation and solidification and hemostasis.In addition, low-temperature plasma snare knife surgery systems 300 can also be used to joint, ridge Snare cutting, ablation, solidification and the hemostasis of soft tissue in the surgical operations such as column, skin, ear nose larynx.The low-temperature plasma of the application Snare knife surgery systems 300 are to belong to brought into temporary contact, according to contact people within 24 hours, according to time of contact classification using the time Volume property classification belongs to external access instrument (with tissue/bone/dentine) and belongs to according to the classification of medical instrument structure feature Active medical instrument.
Low-temperature plasma snare knife surgery systems 300 use bipolar scheme, and its working frequency is 110kHz.Low temperature etc. Ion snare knife surgery systems 300 by plasma technology realize to ear nose larynx etc. operation in soft tissue snare cutting, ablation, Solidification and hemostasis.When work, low-temperature plasma snare knife surgery systems 300 are by physiological saline as conduction liquid, activation transmitting A thin layer is formed when between electrode and loop electrode.When low-temperature plasma snare knife surgery systems 300 give enough energy When (voltage), physiological saline translates into the gas blanket being made of charged particle of energizing (plasmasphere).That is, low temperature etc. from Subloop covers knife surgery systems 300 using energy excitation conducting medium (for example, physiological saline) generation plasma, and by etc. The energy of gas ions interrupts tissue element key.The energy of plasma is by protein and other Direct Pyrolysis at O2, CO2, N2Equal gases, to complete to cut the vaporization snare of tissue.When the work cutter head to plasma therapeutic apparatus 100 gives low-voltage When, electric field lower than generate plasmasphere thresholding require and generate tissue resistance heat, thus by tissue carry out ablation solidification with Hemostasis.
As shown in figure 3, low-temperature plasma snare knife surgery systems 300 include: input unit 301, control unit 302, connect Mouth unit 303, plasma cell 304, alarm unit 305, dropping liquid input unit 306 and display unit 307.Preferably, defeated Entering unit 301 is, for example, floor push, and floor push can control 300 Working mould of low-temperature plasma snare knife surgery systems Formula.The operating mode of low-temperature plasma snare knife surgery systems 300 is divided into snare cut mode and coagulation mode.Floor push Waterproofing grade is waterproofing grade standard IPX8, and floor push is electric pedal switch.
Preferably, the yellow pedal of floor push corresponds to snare cut mode, and the gear grade of snare cut mode It Wei not be 1 to 9 grade.That is, low-temperature plasma snare knife surgery systems 300 enter snare when trampling the yellow pedal of floor push Cut mode.The gear regulative mode of snare cut mode are as follows: by floor push in the state of being adjusted to snare cut mode Upper dark buttons (or manually adjusting yellow button on host panel) are adjusted.Snare cutting gear can choose from 1 to 9 grade In any one shelves.Wherein, gear is higher, and output voltage is bigger.
Preferably, the blue pedal of floor push corresponds to coagulation mode, and the gear range of coagulation mode is 1 to 5 Shelves.That is, low-temperature plasma snare knife surgery systems 300 enter coagulation mode when trampling the blue pedal of floor push.Blood coagulation The gear regulative mode of mode are as follows: in the state of being adjusted to coagulation mode (snare cut mode can be switched by mode key and coagulate Blood mode) it is adjusted by dark buttons on blue pedal (or manually adjusting host panel blue buttons up and down).Foot-operated black When button, blood coagulation gear can choose any one shelves in from 1 to 5 grade, and middle gear more high output voltage is bigger.When clinic makes When needing to carry out blood coagulation in, depresses blue pedal and carry out blood coagulation.
Preferably, foot control interface is used to receive the control instruction of floor push, and the control instruction is transmitted to master Control program.Wherein, control instruction be binary group<mode, power>.Mode includes: snare cut mode and coagulation mode.It is enclosing It covers in cut mode, power includes 9 gears, and in coagulation mode, and power includes 5 gears.
Preferably, control unit 302 parse and when the control instruction indicates the first mould to the control instruction First mode instruction is generated when formula, is calculated according to present impedance and the control instruction for the output power under first mode, First mode instruction and first voltage associated with the output power under first mode instruction are sent to interface list Member 303.Wherein, initial present impedance is zero, i.e., when the booting of low-temperature plasma snare knife surgery systems 300 is operated, The present impedance of default is zero.Described control unit 302 parse and when the control instruction refers to the control instruction Second mode instruction is generated when showing second mode, is calculated according to present impedance and the control instruction for defeated under second mode Second mode instruction and second voltage associated with the output power under second mode instruction are sent to by power out Interface unit 303.Wherein the present impedance includes high impedance, middle impedance and Low ESR (0 impedance is Low ESR).Preferably, If including: present impedance for the output power under first mode according to present impedance and control instruction calculating is high resistant The 2nd grade under the anti-and described control instruction instruction first mode, then the 4th grade is set by the output power under first mode； If present impedance is middle impedance and the control instruction indicates the 2nd grade under first mode, will be defeated under first mode Power setting is the 3rd grade out；And if present impedance is Low ESR and the control instruction indicates the 2nd under first mode Shelves, then set the 2nd grade for the output power under first mode.Preferably, it is calculated according to present impedance and the control instruction If including: present impedance for the output power under second mode is high impedance and control instruction instruction second mode Under the 2nd grade, then set the 4th grade for the output power under second mode；If present impedance is middle impedance and the control The 2nd grade under system instruction instruction second mode, then the 3rd grade is set by the output power under second mode；And it is if current Impedance is Low ESR and the control instruction indicates the 2nd grade under second mode, then sets the output power under second mode It is set to the 2nd grade.Preferably, when the output power being calculated is more than the highest gear in first mode or second mode, Using highest gear as real output.
Preferably, interface unit 303 is used to receive first mode instruction from described control unit 302 and first voltage refers to Show, and first mode instruction and first voltage instruction are transmitted to plasma cell 304, and from plasma cell 304 receive the present impedance of target contact jaws and the present impedance are sent to described control unit 302.And it described connects Mouth unit 303 receives second mode instruction and second voltage instruction from described control unit 302, and the second mode is referred to It enables and second voltage instruction is transmitted to plasma cell 304.
Preferably, interface unit 303 is used for the power indication of reception control unit 302 and sends the power indication To plasma cell 304, and the real-time impedance of plasma cell 304 is measured and by the real-time impedance by connecing Mouth unit 303 passes to control unit 302.
Preferably, plasma cell 304 is in response to receiving first mode instruction and the first electricity from the plasma cell 304 Pressure instruction, into first mode: by emission electrode of the conducting medium at the target contact jaw of the plasma cell 304 and Circuit activation is carried out between loop electrode to form thin layer, applies first voltage between emission electrode and loop electrode, so that The conducting medium reaches the first temperature and is converted into plasmasphere, thus using electric energy excitation conducting medium generate etc. from Daughter, and snare cutting is vaporized to objective body based on the RF energy of plasma.In response to from the plasma list Received second instruction of member 304 and second voltage instruction, the plasma cell 304 enter second mode: applying second voltage The target contact jaw of the plasma cell 304 is remained second temperature, so that objective body is carried out ablation solidification.
Preferably, alarm unit 305 is used for when receiving alarm signal, by auditory tone cues, text prompt and/or is referred to Show that lamp is shown to alarm.It wherein sends and alarms to control unit 302 after the plasma cell 304 detects operation troubles Alarm signal is sent to the alarm unit 305 by signal, described control unit 302.
Preferably, dropping liquid input unit 306 for the conducting medium input instruction based on described control unit 302 to it is equal from Subelement 304 inputs the conducting medium, wherein the current surplus of conducting medium described in 304 real-time measurement of the plasma cell And the current surplus is sent to control unit 302, described control unit 302 is based on the current surplus and determines whether to give birth to Instruction is inputted at the conducting medium and inputs the conducting medium after the conducting medium inputs instruction determining to generate Instruction is sent to dropping liquid input unit 306.
Preferably, emission electrode, plasmasphere, loop electrode and the target at 304 tip catheter of plasma cell connect Contravention forming circuit.In snare cut mode, the operating temperature of plasma cell 304 is 35 to 40 DEG C, and conventional electrosurgical The operating temperature of knife is 350 to 700 DEG C.Thermal break-through distance of the thermal break-through distance of plasma cell 304 than conventional electrosurgical knife Small, the thermal break-through distance being trapped in cut mode is less than or equal to the thermal break-through distance in 150 microns and coagulation mode Less than or equal to 200 microns, and the thermal break-through of conventional electrosurgical knife distance is greater than 9000 microns.
Preferably, display unit 307, the operation shape for low-temperature plasma snare knife surgery systems described in real-time display State.300 working principle of low-temperature plasma snare knife surgery systems is effect of plasma radiofrequency ablation at low temperature.Energy is generated using bipolar cutter head Physiological saline is converted into plasma thin layer by amount, is dissociated the molecular link for constituting cell component in target tissue, is caused tissue coagulation Property necrosis, formed ablation or snare cutting effect.Due to working at relatively low temperature, than traditional high-frequency ring used Set cutting electric knife is minimized degree to the thermal damage of perienchyma.Target volume can be made to contract in 35 DEG C or so operating temperatures Small, the capilary closing in target tissue cuts off lesion.Its low temperature and tissue volume reduction Ablation characteristic, more common Single-pole electric knife is more Have the advantages that shorten post-operative recovery time, mitigate postoperative pain and reduce expenses of surgical treatment.Low-temperature plasma snare knife hand Cutter head ambient temperature is lower than 70 DEG C (being detailed in isolated experiment research tissue thermal damage report) to art system 300 at work, with tradition Common high frequency snare cutting electric knife (100~150 DEG C of high temperature) in meaning is lower compared to operating temperature, although low temperature-controlled plasma radio-frequency ablation Treatment temperature counterpart tissue still fall within high temperature, after histocyte is influenced by this temperature, equally will appear electric knife snare cutting It causes histone to be denaturalized, especially after certain time, can also cause thermal damage to tissue.And it is histiocytic denaturation it is bad It is extremely the process gradually developed, therefore after the operation of some patientss row low-temperature plasma, the reaction such as the swelling of art area, postoperative pain Electric knife response light is cut unlike high frequency snare.Since each operating time has differences so plasma therapeutic apparatus is in isolated experiment Selected maximum operating time in research tissue thermal damage report, by compare visible maximum operating time plasma therapeutic apparatus and The high frequency snare of normal use cuts electric knife heat waste depth.Therefore the heat waste depth of the plasma therapeutic apparatus of normal use should be lower than height Frequency snare cuts electric knife heat waste depth.
Fig. 4 is the flow chart according to the low-temperature plasma snare knife operation method 400 of the preferred embodiment for the present invention.Such as figure Shown in 4, method 400 is since step 401 place.In step 401, the control instruction of user's input is received.
In step 402, parsing and the generation when the control instruction indicates first mode are carried out to the control instruction First mode instruction, calculates according to present impedance and the control instruction for the output power under first mode.
In step 403, first voltage instruction associated with the output power under the first mode is determined.
In step 404, first mode instruction and first voltage instruction are transmitted to plasma apparatus, and from described The present impedance of plasma apparatus reception target contact jaw.
In step 405, indicated in response to receiving first mode instruction and first voltage, promote the plasma apparatus into Enter first mode: by conducting medium between the emission electrode and loop electrode of the target contact jaw of the plasma cell into Row Circuit activation applies first voltage to form thin layer between emission electrode and loop electrode, so that the conducting medium reaches To the first temperature and it is converted into plasmasphere, to generate plasma using electric energy excitation conducting medium, and is based on The RF energy of plasma is vaporized snare cutting to objective body；
The wherein emission electrode, plasmasphere, loop electrode and target contact jaw forming circuit.
It further include carrying out parsing to the control instruction and generating second when the control instruction indicates second mode Mode instruction is calculated according to present impedance and the control instruction for the output power under second mode, and determining and institute State the associated second voltage instruction of output power under second mode.Second mode instruction and second voltage instruction are turned Issue plasma apparatus.In response to from the second instruction and second voltage instruction is received, the plasma apparatus enters the second mould Apply second voltage the target contact jaw of the plasma apparatus is remained second temperature, so that objective body be carried out likes: Ablation solidification.
It further include being shown and being reported by auditory tone cues, text prompt and/or indicator light when receiving alarm signal It is alert；Alarm signal is wherein generated after detecting operation troubles.
Wherein user generates the control instruction by being operable to foot-operated input equipment, wherein the control refers to Enabling is binary group<mode, power>.
It further include that the conducting medium is inputted to the plasma apparatus based on conducting medium input instruction, wherein described etc. The current surplus of conducting medium described in ion device real-time measurement and based on the current surplus determine whether generate described in lead Dielectric input instruction.The operating status of plasma apparatus described in 400 real-time display of method.
Fig. 5 is the structural schematic diagram according to the low-temperature plasma snare knife surgical apparatus of the preferred embodiment for the present invention.Such as Shown in Fig. 5, low-temperature plasma snare knife surgical apparatus include: emission electrode (snare cutter head) 501, loop electrode (circle set) 502, Pipe sheath 503, injecting cavity interface 505, rod cap 506, cushion block 507, sliding block (band socket aperture) 508, socket Pin 509 and pull rod 510.Preferably, emission electrode (snare cutter head) 501 and loop electrode (circle set) 502 are imported by identical conduit and in mesh Standard type forms galvanic circle.Emission electrode (snare cutter head) 501, receives the radio-frequency generator via socket Pin 509 and is produced The first raw input voltage applies first voltage between emission electrode (snare cutter head) 501 and loop electrode (circle set) 502, So that the conducting medium reaches the first temperature and the conducting medium is promoted to be converted into plasmasphere, to utilize electric energy It excites conducting medium to generate plasma, and snare cutting is vaporized to objective body based on the RF energy of plasma. Pipe sheath 503, for providing external sheath function.Injecting cavity interface 505 is based on liquid input instruction and inputs to liquid input unit The liquid, wherein the current surplus of liquid described in the liquid input unit real-time measurement and sending the current surplus To control unit, described control unit determines whether to generate the liquid input instruction and in determination based on the current surplus It generates and liquid input instruction is sent to dropping liquid input unit after the liquid input instructs.Injecting cavity interface 505 is position In the annular chamber of aftermentioned emission electrode conducting wire (snare cutter head conducting wire) outside.
Pull rod 510 is for making operator by providing support force pull rod 510.Socket Pin 509 is connected by high frequency Line is connect with radio-frequency generator, for receiving the first input voltage caused by the radio-frequency generator.Socket Pin 509 is received Second input voltage caused by the radio-frequency generator and second input voltage is transferred to emission electrode, emitted Apply second voltage between electrode 501 and loop electrode 502, so that objective body remains second temperature, to promote target Body carries out ablation solidification.Liquid input unit (is not shown) in Fig. 5, in response to liquid input signal, to objective body at input liquid Body between emission electrode and loop electrode so that form the thin layer of conducting medium.Liquid input unit passes through in following mode A kind of progress liquid input: titration mode and continuous liquid supply mode.
Wherein, the material of emission electrode (snare cutter head) 501 be stainless steel 304, loop electrode (circle set) 502 material be Stainless steel 304, pipe sheath 503 material be polytetrafluoroethylene PTFE, injecting cavity interface 505 material be acrylonitrile-butadiene-benzene Ethylene copolymer ABS, rod cap 506 material be ABS, cushion block 507 material be ABS, sliding block (with socket aperture) material be ABS, socket Pin material be the material of stainless steel 304 and pull rod 510 be ABS.
As shown in figure 5, emission electrode 2 forms closed snare cutter head around objective body as ellipse, it can also be six Side shape or semilune carry out snare cutting to adapt to different target shapes.Further, the head of lasso can have Convenient for the tip of contraction, the both sides seal wire at tip is bonded to each other, and guiding function can be played when lasso is shunk into sheath, just In the contraction and opening of lasso.
The length of loop electrode 502 can be any reasonable numerical value, such as 4 to 5 millimeters.Wherein, loop electrode 502 It can be any reasonable numerical value, such as 2 to 3 millis at a distance from the top end face of pipe sheath 503 close to the one end at 503 top of pipe sheath Rice.Wherein, water outlet 511 (or referred to as infusion port) sets the top end face of tube-placing sheath 503.
Emission electrode 501 is telescopically arranged by sliding block 508.In the initial state, the retraction of emission electrode 501 causes pipe sheath In 503, to facilitate the front end of pipe sheath 503 to enter human body.After reaching designated position, sliding block 508 is moved forward, by emission electrode 501 release the top end face of pipe sheath 503.Sliding block 508 is at socket aperture, and socket Pin 509 is arranged in socket aperture.
Fig. 6-8 is the partial enlargement according to the low-temperature plasma snare knife surgical apparatus of the preferred embodiment for the present invention or cuts Face schematic diagram.Fig. 6 shows the partial enlargement diagram of bipolar electrode socket connector (snare knife connector) 600, including: hair Radio polar conductor (snare cutter head conducting wire) 601 and loop electrode conducting wire 602.Low-temperature plasma snare knife surgical apparatus can be used in Snare cutting, ablation and the solidification and hemostasis of such as polyp or outstanding tumor locus inside alimentary canal.In addition, low temperature The snare that plasma snare knife surgical apparatus can also be used to soft tissue in the surgical operations such as joint, backbone, skin, ear nose larynx is cut It cuts, melt, solidifying and hemostasis.The low-temperature plasma snare knife surgical apparatus of the application using the time be 24 hours within, according to Time of contact classification belongs to brought into temporary contact, belongs to external access instrument according to contact human body qualitative classification (with tissue/bone/tooth sheet Matter) and according to medical instrument structure feature classification belong to active medical instrument.Low-temperature plasma snare knife surgical apparatus it is attached Part bipolar operation electrode belongs to disposable sterilized product.
Low-temperature plasma snare knife surgical apparatus uses bipolar scheme, and its working frequency is 110kHz.Plasma is controlled Treat snare cutting, ablation, solidification and hemostasis of the instrument 100 by plasma technology realization to soft tissue in the operation such as ear nose larynx.Work When making, low-temperature plasma snare knife surgical apparatus by physiological saline be used as conduction liquid, activation emission electrode and loop electrode it Between when formed a thin layer.When plasma therapeutic apparatus gives enough energy (voltage), physiological saline translate into one by The gas blanket (plasmasphere) of charged particle of energizing composition.That is, low-temperature plasma snare knife surgical apparatus is led using energy excitation Dielectric (for example, physiological saline) generates plasma, and interrupts tissue element key by the energy of plasma.Plasma The energy of body is by protein and other Direct Pyrolysis at O2, CO2, N2Equal gases, to complete the vaporization snare to tissue Cutting.When the work cutter head to low-temperature plasma snare knife surgical apparatus gives low-voltage, electric field is lower than generation plasmasphere Thresholding require and generate tissue resistance heat, thus by tissue carry out ablation solidification and hemostasis.
Fig. 7 shows the schematic cross-section along B-B, including: emission electrode conducting wire (snare cutter head conducting wire) 701 returns Path electrode conducting wire 702, fluid-through chamber 704 and emission electrode chamber 705.In more detail, Fig. 7 shows emission electrode conducting wire (snare Cutter head conducting wire) 701 sectional view 706, including insulating layer 707 and wire 708.Emission electrode conducting wire (lead by snare cutter head Line) insulating layer is needed, insulation and heat-insulated effect are acted as, loop electrode conducting wire 702 can be not provided with insulating layer.
In addition, those skilled in the art is as needed, loop electrode chamber 705 can also be regard as fluid-through chamber, in circuit When electrode cavity 705 is as fluid-through chamber, insulating layer need to be arranged in loop electrode conducting wire 702.
Fig. 8 shows the schematic cross-section along C-C, including emission electrode conducting wire (snare cutter head conducting wire) 801 and returns Path electrode conducting wire 802.
The present invention is described by reference to a small amount of embodiment.However, it is known in those skilled in the art, as Defined by subsidiary Patent right requirement, in addition to the present invention other embodiments disclosed above equally fall in it is of the invention In range.
Normally, all terms used in the claims are all solved according to them in the common meaning of technical field It releases, unless in addition clearly being defined wherein.All references " one/described/be somebody's turn to do [device, component etc.] " are all opened ground At least one example being construed in described device, component etc., unless otherwise expressly specified.Any method disclosed herein Step need not all be run with disclosed accurate sequence, unless explicitly stated otherwise.

Claims (10)

1. a kind of low-temperature plasma snare knife surgical apparatus, which is characterized in that the equipment includes:
Liquid input unit, in response to liquid input signal, to objective body at input liquid to emission electrode and circuit electricity The thin layer of conducting medium is formed between pole；
Bipolar electrode socket connector is connect by high frequency connecting line with radio-frequency generator, for receiving the radio-frequency generator institute The first input voltage generated；
Emission electrode receives the first input voltage caused by the radio-frequency generator via bipolar electrode socket connector, is sending out Apply first voltage between radio pole and loop electrode, so that the conducting medium reaches the first temperature and promotes the conduction Medium is converted into plasmasphere, to generate plasma using electric energy excitation conducting medium, and based on plasma RF energy is vaporized snare cutting to objective body,
Loop electrode is imported by identical conduit with the emission electrode and forms galvanic circle in the objective body.
2. low-temperature plasma snare knife surgical apparatus according to claim 1, which is characterized in that the bipolar electrode socket Connector receives the second input voltage caused by the radio-frequency generator and second input voltage is transferred to transmitting electricity Pole applies second voltage between emission electrode and loop electrode, so that objective body remains second temperature, to promote mesh Standard type carries out ablation solidification.
3. low-temperature plasma snare knife surgical apparatus according to claim 1, which is characterized in that the emission electrode passes through Emission electrode conducting wire is connected to the bipolar electrode socket connector, the emission electrode conducting wire cladding insulating layer, and the insulating layer is used It insulate in and heat-insulated effect.
4. low-temperature plasma snare knife surgical apparatus according to claim 1, which is characterized in that further include fluid-through chamber, base The liquid is inputted to liquid input unit in liquid input instruction, wherein liquid described in the liquid input unit real-time measurement Current surplus and the current surplus is sent to control unit, described control unit is based on the current surplus determination It is no to generate the liquid input instruction and the liquid is inputted into instruction transmission after determining the generation liquid input instruction Give liquid input unit.
5. low-temperature plasma snare knife surgical apparatus according to claim 4, which is characterized in that the liquid input unit Liquid input: titration mode and continuous liquid supply mode is carried out by one of following mode, and the fluid-through chamber is to be located at Annular chamber except loop electrode.
6. low-temperature plasma snare knife surgical apparatus according to claim 1, which is characterized in that the circle of the emission electrode Cover oval cutter head, hexagon or semilune.
7. low-temperature plasma snare knife surgical apparatus according to claim 6, which is characterized in that the liquid input unit Infusion port between the emission electrode and loop electrode.
8. low-temperature plasma snare knife surgical apparatus according to claim 1, which is characterized in that further include pull rod, be used for Make operator by pull rod being provided support force, and the low-temperature plasma snare knife surgical apparatus further includes outer tube, uses In offer external sheath function.
9. low-temperature plasma snare knife surgical apparatus according to claim 1, which is characterized in that the emission electrode passes through Sliding block is telescopically arranged.
10. low-temperature plasma snare knife surgical apparatus according to claim 1, which is characterized in that the first voltage Range is 100Vrms to 300Vrms, and the range of the second voltage is 60Vrms to 80Vrms.
CN201810976750.0A 2017-10-27 2018-08-25 A kind of low-temperature plasma snare knife surgical apparatus Pending CN109009415A (en)

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CN110464445A (en) * 2018-05-13 2019-11-19 上海诺英医疗器械有限公司 A kind of seal assembly for snare
CN110013301A (en) * 2019-05-28 2019-07-16 张家港市第一人民医院 Pen electrocoagulator
CN110507383A (en) * 2019-07-23 2019-11-29 江苏黛希芬生物科技有限公司 A kind of Novel medical plasma end effector mechanism
CN112168333A (en) * 2020-09-21 2021-01-05 扬州发特利医疗器械科技有限公司 Bipolar electric snare
CN114431948B (en) * 2021-08-25 2023-10-13 深圳高性能医疗器械国家研究院有限公司 Plasma surgical knife and operation method thereof

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Application publication date: 20181218