ES2368789T3 - Sistema para reducir la corriente de derivación en un generador electroquirúrgico. - Google Patents
Sistema para reducir la corriente de derivación en un generador electroquirúrgico. Download PDFInfo
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- 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
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- A61B18/1233—Generators therefor with circuits for assuring patient safety
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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
- A61B2018/00636—Sensing and controlling the application of energy
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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
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00696—Controlled or regulated parameters
- A61B2018/00702—Power or energy
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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
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00696—Controlled or regulated parameters
- A61B2018/00732—Frequency
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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
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00773—Sensed parameters
- A61B2018/00845—Frequency
- A61B2018/00851—Frequency fundamental
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Abstract
Generador (10) electroquirúrgico configurado para proporcionar energía electroquirúrgica de alta frecuencia a una frecuencia fundamental, comprendiendo el generador: al menos una placa (64) de circuito que tiene una toma (66) de puesta a masa de placa; una etapa (8) de salida de RF configurada para generar formas de onda sinusoidales de energía electroquirúrgica de alta frecuencia para al menos un modo electroquirúrgico; una fuente (60) de alimentación de CC de alto y bajo voltaje configurada para proporcionar corriente CC de alto voltaje a la etapa de salida de RF; y una línea (50) de CA que puede conectarse a una salida eléctrica que proporciona una potencia de CA, en la que la línea de CA incluye tres contactos: un contacto (52) de línea, un contacto (54) neutro y un contacto (56) de puesta a tierra y caracterizado porque un filtro (70) bobina-condensador conectado en serie con la toma de puesta a masa de placa y el contacto (56) de puesta a tierra, el filtro bobina-condensador incluye un condensador (72) conectado en paralelo con una bobina (74) y se sintoniza para estar a una frecuencia de funcionamiento que es resonante en o cerca de la frecuencia fundamental.
Description
Sistema para reducir la corriente de derivación en un generador electroquirúrgico
Antecedentes
Campo de la técnica
La presente descripción se refiere a un sistema electroquirúrgico, y más particularmente, la presente descripción se refiere a un sistema para reducir el riesgo de daño de tejido de sitio alternativo reduciendo la corriente de derivación global en el sistema electroquirúrgico.
Antecedentes de la técnica relacionada
La electrocirugía implica la aplicación de una corriente eléctrica de alta radiofrecuencia a un sitio quirúrgico para cortar, extirpar, o coagular tejido. En la electrocirugía monopolar, una fuente o electrodo activo entrega una energía de radiofrecuencia del generador electroquirúrgico al tejido y un electrodo de retorno lleva la corriente de vuelta al generador. En la electrocirugía monopolar, el electrodo fuente normalmente es parte del instrumento quirúrgico sujetado por el cirujano y se aplica al tejido que va a tratarse. Se coloca un electrodo de retorno del paciente alejado del electrodo activo para llevar la corriente de vuelta al generador.
En la electrocirugía bipolar, uno de los electrodos del instrumento portátil funciona como el electrodo activo y el otro como el electrodo de retorno. El electrodo de retorno se coloca muy próximo al electrodo activo de manera que se forma un circuito eléctrico entre los dos electrodos (por ejemplo, fórceps electroquirúrgico). De esta manera, la corriente eléctrica aplicada está limitada al tejido del cuerpo situado entre los electrodos. Cuando los electrodos están suficientemente separados entre sí, el circuito eléctrico está abierto y por tanto el contacto involuntario de tejido del cuerpo con cualquiera de los electrodos separados no provoca que la corriente fluya.
El daño de tejido puede producirse cuando se rompe o bien el cable de toma de puesta a masa o bien el cable de retorno que conecta las placas de electrodo de retorno a la fuente de RF o el paciente se aleja del contacto con el electrodo de retorno. Cuando se produce cualquiera de estas condiciones y también hay un contacto de toma de puesta a masa secundaria u otro hacia el paciente, la corriente fluirá a través del contacto de toma de puesta a masa secundaria y provocará daño de tejido ubicado al paciente en el punto en el que la toma de puesta a masa secundaria hace contacto con el paciente. Tal toma de puesta a masa secundaria puede crearse mediante los electrodos de monitorización conectados al paciente, el equipo metálico adyacente unido a tierra, etc. En otras palabras, cuando se rompe el retorno de toma de puesta a masa normal o se separa del paciente, la energía eléctrica que fluye a través del electrodo activo busca si existen trayectorias de corriente alternativas. Ya que estas otras trayectorias habitualmente hacen contacto con el paciente sobre pequeñas zonas, las densidades de corriente pueden ser muy altas, lo que puede dar como resultado en el daño de tejido.
Los generadores electroquirúrgicos convencionales aíslan la salida RF mediante el uso de un transformador. El acoplamiento capacitivo de este transformador controla la cantidad de corriente de derivación que fluye desde la salida RF hacia el contacto de toma de puesta a masa y de vuelta al generador. Sin embargo, puesto que sólo se usa el transformador para aislar la salida, la corriente de derivación puede tener una trayectoria alternativa para la tomas de puesta a masa de placa interior del generador y, por tanto, puede provocar daño de tejido.
EL documento US 4.615.330 da a conocer un endoscopio electrónico que tiene una línea de transmisión que conduce corriente de alta frecuencia y medios de impedancia conectados con la misma con el fin de evitar la derivación de la corriente de alta frecuencia a través de una capacidad distribuida entre la línea de transmisión y el elemento conductor. El documento US 3.699.967 da a conocer un generador electroquirúrgico que proporciona aislamiento electroquirúrgico en todas las conexiones de salida para evitar que las trayectorias de corriente de retorno alternativas provoquen quemaduras en el paciente. El preámbulo de la reivindicación 1 se basa en este documento.
Sumario
La presente descripción se refiere a un sistema electroquirúrgico que incluye un generador electroquirúrgico configurado para minimizar el flujo de corriente de derivación. En particular, el generador está configurado para producir una energía de alta frecuencia electroquirúrgica a una frecuencia fundamental e incluye una o más placas de circuitos que comprenden componentes electrónicos del generador, tal como una etapa de salida de RF. La placa de circuito incluye una toma de puesta a masa de placa que se conecta en serie con un filtro bobina-condensador en paralelo. El filtro bobina-condensador se sintoniza para resonar en o cerca de la frecuencia de salida fundamental del generador, bloqueando así el flujo de corriente de derivación y provocando que la corriente de derivación fluya de vuelta al generador.
La presente invención proporciona un generador electroquirúrgico según las reivindicaciones. El generador está configurado para proporcionar energía electroquirúrgica de alta frecuencia a una frecuencia fundamental dada a conocer. El generador incluye una o más placas de circuito que tienen una toma de puesta a masa de placa. El generador incluye además un filtro bobina-condensador conectado en serie con la toma de puesta a masa de placa. El filtro bobina-condensador incluye un condensador conectado en paralelo con una bobina y se sintoniza para estar a una frecuencia de funcionamiento, que es resonante en o cerca de la frecuencia fundamental. El generador incluye una etapa de salida de RF configurada para generar formas de onda sinusoidales de energía electroquirúrgica de alta frecuencia para al menos un modo electroquirúrgico. Una fuente de alimentación de CC de alto y bajo voltaje está configurada para proporcionar corriente CC de alto voltaje a la etapa de salida de RF.
La placa de circuito puede incluir la etapa de salida de RF que genera formas de onda sinusoidales de energía electroquirúrgica de alta frecuencia en la frecuencia fundamental para uno o más modos electroquirúrgicos. La placa de circuito también puede incluir el filtro bobina-condensador conectado en serie con la toma de puesta a masa de placa.
Breve descripción de los dibujos
Diversas realizaciones de la presente descripción se describen en el presente documento con referencia a los dibujos en los que:
la figura 1 es un diagrama de bloques esquemático de un sistema electroquirúrgico según la presente descripción;
la figura 2 es un diagrama de bloques esquemático de un generador según la presente descripción; y
la figura 3 es un diagrama de circuito esquemático del generador electroquirúrgico de la figura 2.
Descripción detallada
Las realizaciones particulares de la presente descripción se describen a continuación en el presente documento con referencia a los dibujos adjuntos. En la siguiente descripción, no se describen en detalle funciones o construcciones ampliamente conocidas para evitar confundir la presente descripción con detalles innecesarios. Los expertos en la técnica entenderán que la invención según la presente descripción puede adaptarse para su uso con sistemas electroquirúrgicos o bien monopolares o bien bipolares.
Se da a conocer un método para reducir la corriente de derivación en un generador electroquirúrgico, aunque el método no está enumerado en las reivindicaciones. El método incluye las etapas de proporcionar una o más placas de circuito que tienen una toma de puesta a masa de placa y conectar un filtro bobina-condensador en serie con la toma de puesta a masa de placa. El filtro bobina-condensador incluye un condensador conectado en paralelo con un inductor y se sintoniza para estar a una frecuencia de funcionamiento, que es resonante en o cerca de la frecuencia fundamental.
La figura 1 es una ilustración esquemática de un sistema electroquirúrgico que incluye una trayectoria de derivación para puesta a tierra. El sistema 1 es un sistema electroquirúrgico monopolar que incluye un instrumento 10 electroquirúrgico que tiene uno o más electrodos para tratar el tejido de un paciente P. El sistema incluye un generador 10 electroquirúrgico que suministra una energía de radiofrecuencia (“RF”) electroquirúrgica a un instrumento 12 monopolar que tiene un electrodo 14 activo. La energía de RF electroquirúrgica se suministra al electrodo 14 activo mediante un generador 10 a través de una línea 18 de suministro, que está conectada a un terminal de salida activo que permite al electrodo 14 activo coagular, sellar y/o de otro modo tratar el tejido. La energía de RF se retorna al generador 10 a través de un electrodo 16 de retorno (mostrado como una almohadilla de retorno) a través de una línea 19 de transmisión de retorno, que está conectada a un terminal de salida de retorno. Hay derivación de puesta a tierra desde el electrodo 16 de retorno.
El sistema 1 puede incluir una pluralidad de electrodos 16 de retorno, lo que se cree que minimiza las posibilidades de que se dañe tejido, maximizando la zona de contacto global con el paciente P. Además, el generador 2 y el electrodo 16 de retorno pueden configurarse para monitorizar el denominado contacto “tejido a paciente” para asegurar que existe contacto suficiente entre los mismos para minimizar adicionalmente las posibilidades de daño de tejido. El generador 2 también puede incluir una pluralidad de terminales de suministro y retorno y el número correspondiente de cables de transmisión (por ejemplo, dos de cada).
El generador 10 incluye controles de entrada adecuados (por ejemplo, botones, activadores, conmutadores, pantalla táctil, etc.) para controlar el generador 10. Además, el generador 10 puede incluir una o más pantallas táctiles para dotar al cirujano de una variedad de información de salida adecuada (por ejemplo, configuraciones de intensidad, indicadores de tratamiento concluido, etc.). Los controles permiten al cirujano ajustar la potencia de la energía de RF, seleccionar la forma de onda, y modificar otros parámetros para lograr la forma de onda deseada adecuada para una tarea particular (por ejemplo, coagulación, sellado tejido, configuración de intensidad, etc.). El instrumento 12 monopolar, que incluye una pluralidad de controles de entrada que pueden redundar con ciertos controles de entrada del generador 10 está dispuesto entre el generador 10 y el electrodo 14 activo en la línea 18 de suministro. Colocar los controles de entrada en la pieza 12 manual permite su más fácil y rápida modificación de parámetros de energía de RF durante el procedimiento quirúrgico sin requerir interacción con el generador 10. También puede conectarse un conmutador de pedal al generador 10 para controlar la entrega de energía durante procedimientos monopolares.
La figura 2 muestra un diagrama de bloques esquemático del generador 10 que tiene un controlador 4, una fuente 7 de alimentación de CC de alto voltaje (“HVPS”, high voltage DC supply) y una etapa 8 de salida de RF, todos ellos conectados a la toma 11 de puesta a masa. La toma 11 de puesta a masa no se cortocircuita a tierra y en su lugar se aísla mediante un filtro 70 tal como se muestra en la figura 3 a la frecuencia de funcionamiento del generador. La HVPS 7 proporciona potencia de CC de alto voltaje a una etapa 8 de salida de RF, la que luego convierte la potencia de CC de alto voltaje en una energía de RF y entrega la energía de RF al electrodo 14 activo. En particular, la etapa 8 de salida de RF genera formas de onda sinusoidales de energía de RF de alta frecuencia. La etapa 8 de salida de RF está configurada para generar una pluralidad de formas de onda que tienen diversos ciclos de trabajo, tensiones pico, factores de amplitud, y otros parámetros adecuados. Ciertos tipos de formas de onda se adecuan para modos electroquirúrgicos específicos. Por ejemplo, la etapa 8 de salida de RF genera una forma de onda sinusoidal de ciclo de trabajo del 100% en modo de corte, que es el más adecuado para diseccionar tejido y una forma de onda de ciclo de trabajo del 25% en modo de coagulación, que es más usado para cauterizar tejido para detener la hemorragia.
El controlador 4 incluye un microprocesador 5 conectado a una memoria 6, que puede ser una memoria de tipo volátil (por ejemplo, RAM) y/o una memoria de tipo no volátil (por ejemplo, medios de flash, medios de disco, etc.). El microprocesador 5 incluye un puerto de salida que está conectado a la HVPS 7 y/o a la etapa 8 de salida de RF permitiendo al microprocesador 5 controlar la salida del generador 10 según algunos esquemas de control de lazos abiertos y/o cerrados. Un esquema de control de lazo cerrado puede ser un lazo de control de retroalimentación en el que el conjunto 11 de circuitos de sensor, que puede incluir una pluralidad de mecanismos de detección (por ejemplo, impedancia de tejido, temperatura de tejido, corriente y/o voltaje de salida, etc.), proporcionan retroalimentación al controlador 4. El controlador 4 entonces envía la señal a la HVPS 7 y/o la etapa 8 de salida de RF, que luego ajusta la fuente de alimentación de CC y/o RF, respectivamente. El controlador 4 también recibe señales de entrada desde los controles de entrada del generador 10 y el instrumento 12. El controlador 4 utiliza las señales de entrada para sintonizar la potencia producida por el generador 10 y/o realizar otras funciones de control adecuadas en el mismo.
La figura 3 muestra un esquema de circuito eléctrico del generador 10. El generador 10 está conectado a través de una línea 50 de CA a una salida eléctrica que proporciona potencia de CA. La línea 50 de CA incluye tres contactos: un contacto 52 de línea; un contacto 54 neutro; y un contacto 56 de puesta a tierra. La potencia de CA se proporciona a una fuente 60 de alimentación de CC, que incluye una fuente de alimentación de bajo voltaje (no mostrada explícitamente) y la HVPS 7. La fuente de alimentación de bajo voltaje proporciona potencia a diversos componentes del generador (por ejemplo, controles de entrada, visualizadores, etc.). La fuente 60 de alimentación de CC convierte la potencia de CA en potencia de CC de bajo y alto voltaje correspondiente.
El generador 10 incluye además al menos una placa 64 de circuito en la que están dispuestos los componentes del generador 10 (por ejemplo, la etapa 8 de salida de RF). La placa 64 de circuito incluye una toma 66 de puesta a masa de placa que la conecta a masa al chasis del generador 10 (por ejemplo, la carcasa) o al contacto 56 de puesta a tierra. Además, un filtro 70 bobina-condensador (LC) está conectado en serie con la toma 66 de puesta a masa de placa a la puesta 56 a tierra. El filtro 70 incluye un condensador 72 conectado en paralelo con una bobina 74 y se sintoniza a una frecuencia de funcionamiento que hace resonante al filtro 70 en o cerca de la frecuencia fundamental del generador 10. La bobina 74 en el filtro 70 se sintoniza para resonar con la capacidad de la línea 50 de CA, la capacidad de transformador de la fuente 60 de alimentación de CC y el condensador 72 en o cerca de la frecuencia fundamental del generador 10. Esto indica que la frecuencia en la que la etapa 8 de salida de RF produce formas de onda electroquirúrgicas. La frecuencia fundamental del generador 10 es aproximadamente 472 kHz, y puede ser desde aproximadamente 100 kHz hasta 3,3 MHz. El filtro 70 crea una alta impedancia en la frecuencia de resonancia, lo que permite que una corriente en las frecuencias inferiores o superiores de la frecuencia fundamental, pase a través del filtro. Esto permite una corriente en las frecuencias distintas de las frecuencias fundamentales, por ejemplo, corriente CC, que va a derivarse por la puesta 56 a tierra. La corriente en la frecuencia fundamental fluye de vuelta al generador 10, en particular, la placa 64 de circuito y la toma 66 de puesta a masa de placa. Esto, a su vez, reduce la cantidad de corriente de derivación que fluye a través del sistema 1. Esta resonancia crea una alta impedancia entre la puesta 56 a tierra y la toma 66 de puesta a masa de placa. En consecuencia, la toma 66 de puesta a masa de placa es la trayectoria principal para corriente de derivación de alta frecuencia para fluir desde la puesta 56 a tierra de vuelta a la etapa 8 de salida de RF. Colocando una alta carga de resistencia entre la puesta 56 a tierra y la toma 66 de puesta a masa de placa la etapa 8 de salida de RF además está aislada de la puesta 56 a tierra reduciendo así además una derivación de alta frecuencia.
La cantidad de corriente de derivación del generador se expresa mediante la siguiente formula (1):
En la formula (1), f es la frecuencia fundamental, V es el voltaje de salida en rms, C es el acoplamiento capacitivo entre la salida y el contacto 56 de puesta a tierra. Existe un límite en cuanto a la cantidad en que puede reducirse el acoplamiento capacitivo con el fin de reducir la Iderivación. Para limitar la corriente de derivación aún más, el generador 10 necesita aislarse del contacto 56 de puesta a tierra. La mera eliminación del contacto 56 de puesta a tierra respecto de la toma 66 de puesta a masa de placa es insuficiente debido a la capacidad natural de la entrada de potencia de CA (por ejemplo, a través de la línea 50 de CA) del contacto 56 de puesta a tierra a la toma 66 de puesta a masa de placa. El filtro 70 tiene en cuenta esta capacidad C y la usa para resonar a la frecuencia de salida fundamental de la manera explicada anteriormente para reducir la cantidad de corriente de derivación. En particular, el filtro 70 provoca que la corriente de derivación en la frecuencia fundamental fluya de vuelta al generador 10.
Claims (7)
- REIVINDICACIONES1. Generador (10) electroquirúrgico configurado para proporcionar energía electroquirúrgica de alta frecuencia a una frecuencia fundamental, comprendiendo el generador:al menos una placa (64) de circuito que tiene una toma (66) de puesta a masa de placa;una etapa (8) de salida de RF configurada para generar formas de onda sinusoidales de energía electroquirúrgica de alta frecuencia para al menos un modo electroquirúrgico;una fuente (60) de alimentación de CC de alto y bajo voltaje configurada para proporcionar corriente CC de alto voltaje a la etapa de salida de RF; yuna línea (50) de CA que puede conectarse a una salida eléctrica que proporciona una potencia de CA, en la que la línea de CA incluye tres contactos: un contacto (52) de línea, un contacto (54) neutro y un contacto(56) de puesta a tierray caracterizado porqueun filtro (70) bobina-condensador conectado en serie con la toma de puesta a masa de placa y el contacto(56) de puesta a tierra, el filtro bobina-condensador incluye un condensador (72) conectado en paralelo con una bobina (74) y se sintoniza para estar a una frecuencia de funcionamiento que es resonante en o cerca de la frecuencia fundamental.
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- 2.
- Generador electroquirúrgico según la reivindicación 1, en el que la frecuencia fundamental va desde aproximadamente 100 kHz hasta aproximadamente 3,3 MHz.
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- 3.
- Generador electroquirúrgico según cualquier reivindicación anterior, en el que la frecuencia de funcionamiento va desde aproximadamente 100 kHz hasta aproximadamente 3,3 MHz.
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- 4.
- Generador electroquirúrgico según la reivindicación 1, 2 ó 3, en el que la etapa de salida de RF está dispuesta en la al menos una placa de circuito.
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- 5.
- Generador electroquirúrgico según la reivindicación 1, en el que la línea de CA está conectada para proporcionar potencia de CA a la fuente (60) de alimentación de CC.
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- 6.
- Generador electroquirúrgico según la reivindicación 1 ó 5, en el que la bobina del filtro bobina-condensador se sintoniza para resonar con una capacidad de la línea de CA, una capacidad de transformador de la fuente de alimentación de CC y el condensador del filtro bobina-condensador en o cerca de la frecuencia fundamental del generador.
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- 7.
- Generador electroquirúrgico según una cualquiera de las reivindicaciones anteriores, en el que el filtro bobina-condensador está configurado para impedir una corriente a la frecuencia de resonancia y permitir que la corriente a otras frecuencias se derive por la puesta a tierra, incluyendo la corriente CC proporcionada por la fuente de alimentación de CC.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
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US431449 | 1982-09-30 | ||
US11/431,449 US8753334B2 (en) | 2006-05-10 | 2006-05-10 | System and method for reducing leakage current in an electrosurgical generator |
Publications (1)
Publication Number | Publication Date |
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ES2368789T3 true ES2368789T3 (es) | 2011-11-22 |
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Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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ES07009322T Active ES2368789T3 (es) | 2006-05-10 | 2007-05-09 | Sistema para reducir la corriente de derivación en un generador electroquirúrgico. |
Country Status (5)
Country | Link |
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US (1) | US8753334B2 (es) |
EP (1) | EP1854423B1 (es) |
AU (1) | AU2007202069B2 (es) |
CA (1) | CA2588075A1 (es) |
ES (1) | ES2368789T3 (es) |
Families Citing this family (46)
Publication number | Priority date | Publication date | Assignee | Title |
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US7137980B2 (en) | 1998-10-23 | 2006-11-21 | Sherwood Services Ag | Method and system for controlling output of RF medical generator |
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2006
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2007
- 2007-05-08 CA CA002588075A patent/CA2588075A1/en not_active Abandoned
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US20070265612A1 (en) | 2007-11-15 |
EP1854423B1 (en) | 2011-07-13 |
CA2588075A1 (en) | 2007-11-10 |
US8753334B2 (en) | 2014-06-17 |
EP1854423A3 (en) | 2008-02-13 |
AU2007202069A1 (en) | 2007-11-29 |
AU2007202069B2 (en) | 2013-03-14 |
EP1854423A2 (en) | 2007-11-14 |
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