JP5685008B2 - 虚数インピーダンス処理モニタリングおよびインテリジェント遮断 - Google Patents
虚数インピーダンス処理モニタリングおよびインテリジェント遮断 Download PDFInfo
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Description
本出願は、「ENERGY DELIVERY ALGORITHM FOR MEDICAL DEVICES」と題する米国特許出願第12/351,935号、「ENERGY DELIVERY ALGORITHM FILTER PRE−LOADING」と題する米国特許出願第12/351,970号、「ENERGY DELIVERY ALGORITHM IMPEDANCE TREND ADAPTATION」と題する米国特許出願第12/351,960号の一部継続であり、これらのすべては、2009年1月12日にRonald J.Podhajskyによって出願され、これらのすべての全開示は、本明細書において参考として援用されている。
本開示は、電気外科用装置、システムおよび方法に関する。さらに詳細には、本開示は、虚数インピーダンスに基づいて、電気外科処置をモニタリングし、そのインテリジェントな終止のための電気外科用システムおよび方法に関する。
エネルギーベースの組織治療は、当該分野で周知である。様々なタイプのエネルギー(例えば、電気的、オーム性、抵抗性、超音波、マイクロ波、低温、レーザ、など)が組織に印加されて、所望の結果を達成する。電気外科は、高周波電流を外科手術部位に印加して、組織を切断、切除、凝固、または密封することを含む。単極の電気外科手術においては、ソース電極または活性電極は、電気外科用発電器から組織へ無線周波数エネルギーを送達し、リターン電極は、電流を発電器に戻す。単極の電気外科手術においては、ソース電極は通常、外科医によって保持されて組織に当てられる外科用器具の一部である。患者リターン電極は、活性電極から遠く離れて配置されて、電流を発電器に戻す。
電気外科エネルギーを組織に供給するための電気外科用発電器であって、
組織の虚数インピーダンスおよび該虚数インピーダンスの変化率のうちの少なくとも1つを測定するように構成されたセンサ回路と、
該虚数インピーダンスおよび該虚数インピーダンスの該変化率のうちの少なくとも1つに基づいて、該電気外科用発電器の出力を調節するように構成されたコントローラと
を備えている、電気外科用発電器。
上記コントローラは、マイクロプロセッサを含み、該マイクロプロセッサは、上記虚数インピーダンスを再帰的に処理するように構成された少なくとも2つの再帰フィルタを実行するように構成されている、上記項目のいずれか一項に記載の電気外科用発電器。
上記マイクロプロセッサは、上記少なくとも2つの再帰フィルタに上記虚数インピーダンスの初期値をプリロードするように構成されている、上記項目のいずれか一項に記載の電気外科用発電器。
上記コントローラは、上記虚数インピーダンスの変化率に基づいて上記電気外科用発電器を調節するように構成され、該虚数インピーダンスの該変化率が、第1の所定の閾値よりも高いとき、電気外科エネルギーの印加を継続するように該発電器を制御するように構成されている、上記項目のいずれか一項に記載の電気外科用発電器。
上記コントローラは、上記虚数インピーダンスの上記変化率が、第2の所定の閾値よりも低いとき、上記電気外科エネルギーの印加を中断するように上記電気外科用発電器を調節するように構成されている、上記項目のいずれか一項に記載の電気外科用発電器。
上記コントローラは、上記虚数インピーダンスの上記変化率が、上記第1の所定の閾値と上記第2の所定の閾値との間にあるとき、所定の時間遅延の持続の間上記電気外科エネルギーのインテリジェント遮断を開始するように上記電気外科用発電器を調節するように構成されている、上記項目のいずれか一項に記載の電気外科用発電器。
上記コントローラは、上記虚数インピーダンスの上記変化率が、上記時間遅延の間、上記第1の所定の閾値よりも高いとき、上記電気外科エネルギーの印加を再始動するように上記電気外科用発電器を調節するように構成されている、上記項目のいずれか一項に記載の電気外科用発電器。
組織に電気外科エネルギーを供給するシステムであって、
組織の虚数インピーダンスおよび該虚数インピーダンスの変化率のうちの少なくとも1つを測定する手段と、
該虚数インピーダンスおよび該虚数インピーダンスの変化率のうちの該少なくとも1つに基づいて、電気外科用発電器の出力を調節する手段と
を備えている、システム。
上記虚数インピーダンスを再帰的に処理して、該虚数インピーダンスの平均値を取得する手段をさらに備えている、上記項目のいずれか一項に記載のシステム。
上記虚数インピーダンスを再帰的に処理する上記手段は、少なくとも2つの再帰フィルタに該虚数インピーダンスの初期値をプリロードする手段を含む、上記項目のいずれか一項に記載のシステム。
組織の上記虚数インピーダンスの変化率を測定する手段をさらに備え、上記調節する手段は、該虚数インピーダンスの該変化率が、第1の所定の閾値よりも高いとき、上記電気外科エネルギーの印加を継続する手段を含む、上記項目のいずれか一項に記載のシステム。
上記虚数インピーダンスの上記変化率が、第2の所定の閾値よりも低いとき、上記電気外科エネルギーの印加を中断する手段をさらに備えている、上記項目のいずれか一項に記載のシステム。
上記虚数インピーダンスの上記変化率が、第1の所定の閾値と第2の所定の閾値との間にあるとき、所定の時間遅延の持続の間、上記電気外科エネルギーのインテリジェント遮断を開始する手段をさらに備えている、上記項目のいずれか一項に記載のシステム。
上記虚数インピーダンスの上記変化率が、上記時間遅延の間、上記第1の所定の閾値よりも高いとき、上記電気外科エネルギーの印加を再始動する手段をさらに備えている、上記項目のいずれか一項に記載のシステム。
電気外科エネルギーを組織に供給するためのシステムであって、
組織の虚数インピーダンスおよび該虚数インピーダンスの変化率を測定する手段と、
該虚数インピーダンスおよび該虚数インピーダンスの該変化率のうちの少なくとも1つに基づいて、電気外科用発電器の出力を調節する手段と、
該虚数インピーダンスの該変化率を第1の所定の閾値および第2の所定の閾値と比較する手段と
を備えている、システム。
上記虚数インピーダンスを再帰的に処理して、該虚数インピーダンスの平均値を取得する手段をさらに備えている、上記項目のいずれか一項に記載のシステム。
上記虚数インピーダンスを再帰的に処理する上記手段は、少なくとも2つの再帰フィルタに該虚数インピーダンスの初期値をプリロードする手段を含む、上記項目のいずれか一項に記載のシステム。
上記虚数インピーダンスの上記変化率が、第1の所定の閾値よりも高いとき、上記電気外科エネルギーの印加を継続する手段をさらに備えている、上記項目のいずれか一項に記載のシステム。
上記虚数インピーダンスの上記変化率が、第2の所定の閾値よりも低いとき、上記電気外科エネルギーの印加を中断する手段をさらに備えている、上記項目のいずれか一項に記載のシステム。
上記虚数インピーダンスの上記変化率が、上記第1の所定の閾値と上記第2の所定の閾値との間にあるとき、所定の時間遅延の持続の間、上記電気外科エネルギーのインテリジェント遮断を開始する手段と、
該虚数インピーダンスの該変化率が、該時間遅延の間該第1の所定の閾値よりも高いとき、該電気外科エネルギーの印加を再始動する手段と
をさらに備えている、上記項目のいずれか一項に記載のシステム。
電気外科エネルギーを組織に供給するための電気外科用発電器であって、
組織の虚数インピーダンスおよび該虚数インピーダンスの変化率のうちの少なくとも1つを測定するように構成されたセンサ回路と、
該虚数インピーダンスおよび該虚数インピーダンスの該変化率のうちの少なくとも1つに基づいて、該電気外科用発電器の出力を調節するように構成されたコントローラと
を備えている、電気外科用発電器。
上記コントローラは、マイクロプロセッサを含み、該マイクロプロセッサは、上記虚数インピーダンスを再帰的に処理するように構成された少なくとも2つの再帰フィルタを実行するように構成されている、上記項目のいずれか一項に記載の電気外科用発電器。
上記マイクロプロセッサは、上記少なくとも2つの再帰フィルタに上記虚数インピーダンスの初期値をプリロードするように構成されている、上記項目のいずれか一項に記載の電気外科用発電器。
上記コントローラは、上記虚数インピーダンスの変化率に基づいて上記電気外科用発電器を調節するように構成され、該虚数インピーダンスの該変化率が、第1の所定の閾値よりも高いとき、電気外科エネルギーの印加を継続するように該発電器を制御するように構成されている、上記項目のいずれか一項に記載の電気外科用発電器。
上記コントローラは、上記虚数インピーダンスの上記変化率が、第2の所定の閾値よりも低いとき、上記電気外科エネルギーの印加を中断するように上記電気外科用発電器を調節するように構成されている、上記項目のいずれか一項に記載の電気外科用発電器。
上記コントローラは、上記虚数インピーダンスの上記変化率が、上記第1の所定の閾値と上記第2の所定の閾値との間にあるとき、所定の時間遅延の持続の間上記電気外科エネルギーのインテリジェント遮断を開始するように上記電気外科用発電器を調節するように構成されている、上記項目のいずれか一項に記載の電気外科用発電器。
上記コントローラは、上記虚数インピーダンスの上記変化率が、上記時間遅延の間、上記第1の所定の閾値よりも高いとき、上記電気外科エネルギーの印加を再始動するように上記電気外科用発電器を調節するように構成されている、上記項目のいずれか一項に記載の電気外科用発電器。
組織に電気外科エネルギーを供給する方法であって、
組織の虚数インピーダンスおよび該虚数インピーダンスの変化率のうちの少なくとも1つを測定するステップと、
該虚数インピーダンスおよび該虚数インピーダンスの変化率のうちの該少なくとも1つに基づいて、電気外科用発電器の出力を調節するステップと
を包含する、方法。
上記虚数インピーダンスを再帰的に処理して、該虚数インピーダンスの平均値を取得するステップをさらに包含する、上記項目のいずれか一項に記載の方法。
上記再帰的に処理するステップは、少なくとも2つの再帰フィルタに上記虚数インピーダンスの初期値をプリロードするステップをさらに含む、上記項目のいずれか一項に記載の方法。
上記方法は、組織の上記虚数インピーダンスの変化率を測定するステップをさらに含み、上記調節するステップは、該虚数インピーダンスの該変化率が、第1の所定の閾値よりも高いとき、上記電気外科エネルギーの印加を継続するステップをさらに含む、上記項目のいずれか一項に記載の方法。
上記調節するステップは、上記虚数インピーダンスの上記変化率が、第2の所定の閾値よりも低いとき、上記電気外科エネルギーの印加を中断するステップをさらに含む、上記項目のいずれか一項に記載の方法。
上記調節するステップは、上記虚数インピーダンスの上記変化率が、第1の所定の閾値と第2の所定の閾値との間にあるとき、所定の時間遅延の持続の間、上記電気外科エネルギーのインテリジェント遮断を開始するステップをさらに含む、上記項目のいずれか一項に記載の方法。
上記調節するステップは、上記虚数インピーダンスの上記変化率が、上記時間遅延の間、上記第1の所定の閾値よりも高いとき、上記電気外科エネルギーの印加を再始動するステップをさらに含む、上記項目のいずれか一項に記載の方法。
電気外科エネルギーを組織に供給するための方法であって、
組織の虚数インピーダンスおよび該虚数インピーダンスの変化率を測定するステップと、
該虚数インピーダンスおよび該虚数インピーダンスの該変化率のうちの少なくとも1つに基づいて、電気外科用発電器の出力を調節するステップであって、該虚数インピーダンスの該変化率を第1の所定の閾値および第2の所定の閾値と比較するステップをさらに含む、ステップと
を包含する、方法。
上記虚数インピーダンスを再帰的に処理して、該虚数インピーダンスの平均値を取得するステップをさらに包含する、上記項目のいずれか一項に記載の方法。
上記再帰的に処理するステップは、少なくとも2つの再帰フィルタに上記虚数インピーダンスの初期値をプリロードするステップをさらに含む、上記項目のいずれか一項に記載の方法。
上記調節するステップは、上記虚数インピーダンスの上記変化率が、第1の所定の閾値よりも高いとき、上記電気外科エネルギーの印加を継続するステップをさらに含む、上記項目のいずれか一項に記載の方法。
上記調節するステップは、上記虚数インピーダンスの上記変化率が、第2の所定の閾値よりも低いとき、上記電気外科エネルギーの印加を中断するステップをさらに含む、上記項目のいずれか一項に記載の方法。
上記調節するステップは、
上記虚数インピーダンスの上記変化率が、上記第1の所定の閾値と上記第2の所定の閾値との間にあるとき、所定の時間遅延の持続の間、上記電気外科エネルギーのインテリジェント遮断を開始するステップと、
該虚数インピーダンスの該変化率が、該時間遅延の間該第1の所定の閾値よりも高いとき、該電気外科エネルギーの印加を再始動するステップと
をさらに含む、上記項目のいずれか一項に記載の方法。
電気外科エネルギーを組織に供給するための電気外科用発電器が開示される。発電器は、組織の虚数インピーダンスおよび/または虚数インピーダンスの変化率を測定するように構成されたセンサ回路を含む。発電器はまた、測定された虚数インピーダンスおよび/または虚数インピーダンスの変化率に基づいて電気外科発電器の出力を調節するように構成されたコントローラを含む。
(1) ZfXn=Zin*A+ZfXn−1*B
AとBとは、時定数に依存し、そして、各特定のインピーダンスフィルタZfXに対して、発電器20の入力制御装置を介して、ユーザによって特定され得る。AとBとを計算するときには、下記の式が使用され得る。
B=e^(−1/サンプル数)
A=1−B
4 供給線
6、16 リターン電極
8 リターン線
10 電気外科用鉗子
14 活性電極
18 ケーブル
20 電気外科用発電器
21 コネクタ
P 患者
Claims (12)
- 電気外科エネルギーを組織に供給するための電気外科用発電器であって、
組織の虚数インピーダンスおよび該虚数インピーダンスの変化率のうちの少なくとも1つを測定するように構成されたセンサ回路と、
該虚数インピーダンスおよび該虚数インピーダンスの該変化率のうちの該少なくとも1つに基づいて、該電気外科用発電器の出力を調節するように構成されたコントローラと
を含み、
該コントローラは、該電気外科用発電器の出力を調節することにより、
該虚数インピーダンスの該変化率が、第1の所定の閾値よりも高いとき、該電気外科エネルギーを出力することを継続することと、
該虚数インピーダンスの該変化率が、第2の所定の閾値よりも低いとき、該電気外科エネルギーを出力することを中断することと、
該虚数インピーダンスの該変化率が、所定の時間遅延の持続時間の間、該第1の所定の閾値と該第2の所定の閾値との間にあるとき、該電気外科エネルギーの終止を開始することと
を行うように構成されている、電気外科用発電器。 - 前記コントローラは、マイクロプロセッサを含み、該マイクロプロセッサは、前記虚数インピーダンスを再帰的に処理するように構成された少なくとも2つの再帰フィルタを実行するように構成されている、請求項1に記載の電気外科用発電器。
- 前記マイクロプロセッサは、前記少なくとも2つの再帰フィルタに前記虚数インピーダンスの初期値をプリロードするように構成されている、請求項2に記載の電気外科用発電器。
- 前記コントローラは、前記虚数インピーダンスの前記変化率が、前記時間遅延の間、前記第1の所定の閾値よりも高いとき、前記電気外科エネルギーの出力を再始動するように前記電気外科用発電器を調節するように構成されている、請求項1に記載の電気外科用発電器。
- 組織に電気外科エネルギーを供給するシステムであって、
組織の虚数インピーダンスおよび該虚数インピーダンスの変化率のうちの少なくとも1つを測定する手段と、
該虚数インピーダンスおよび該虚数インピーダンスの変化率のうちの該少なくとも1つに基づいて、電気外科用発電器の出力を調節する手段と
を含み、
該調節する手段は、
該虚数インピーダンスの該変化率が、第1の所定の閾値よりも高いとき、該電気外科エネルギーを出力することを継続する手段と、
該虚数インピーダンスの該変化率が、第2の所定の閾値よりも低いとき、該電気外科エネルギーを出力することを中断する手段と、
該虚数インピーダンスの該変化率が、所定の時間遅延の持続時間の間、該第1の所定の閾値と該第2の所定の閾値との間にあるとき、該電気外科エネルギーの終止を開始する手段と
をさらに含む、システム。 - 前記虚数インピーダンスを再帰的に処理して、該虚数インピーダンスの平均値を取得する手段をさらに含む、請求項5に記載のシステム。
- 前記虚数インピーダンスを再帰的に処理する前記手段は、少なくとも2つの再帰フィルタに該虚数インピーダンスの初期値をプリロードする手段を含む、請求項6に記載のシステム。
- 前記虚数インピーダンスの前記変化率が、前記時間遅延の間、前記第1の所定の閾値よりも高いとき、前記電気外科エネルギーの出力を再始動する手段をさらに含む、請求項5に記載のシステム。
- 電気外科エネルギーを組織に供給するためのシステムであって、
組織の虚数インピーダンスおよび該虚数インピーダンスの変化率を測定する手段と、
該虚数インピーダンスおよび該虚数インピーダンスの該変化率のうちの少なくとも1つに基づいて、電気外科用発電器の出力を調節する手段と、
該虚数インピーダンスの該変化率を第1の所定の閾値および第2の所定の閾値と比較する手段と
を含み、
該調節する手段は、
該虚数インピーダンスの該変化率が、第1の所定の閾値よりも高いとき、該電気外科エネルギーを出力することを継続する手段と、
該虚数インピーダンスの該変化率が、第2の所定の閾値よりも低いとき、該電気外科エネルギーを出力することを中断する手段と、
該虚数インピーダンスの該変化率が、所定の時間遅延の持続時間の間、該第1の所定の閾値と該第2の所定の閾値との間にあるとき、該電気外科エネルギーの終止を開始する手段と
をさらに含む、システム。 - 前記虚数インピーダンスを再帰的に処理して、該虚数インピーダンスの平均値を取得する手段をさらに含む、請求項9に記載のシステム。
- 前記虚数インピーダンスを再帰的に処理する前記手段は、少なくとも2つの再帰フィルタに該虚数インピーダンスの初期値をプリロードする手段を含む、請求項10に記載のシステム。
- 前記虚数インピーダンスの前記変化率が、前記時間遅延の間、前記第1の所定の閾値よりも高いとき、前記電気外科エネルギーの出力を再始動する手段
をさらに含む、請求項9に記載のシステム。
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EP2258293A1 (en) | 2010-12-08 |
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EP2258293B1 (en) | 2015-06-17 |
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US8486061B2 (en) | 2013-07-16 |
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