DE102009012387B4 - HF surgery facility and procedure - Google Patents

Abstract

HF surgical device, comprising
- At least two HF generators (10-13);
- At least one neutral electrode output for a neutral electrode (24);
- At least two outputs for connecting HF surgical instruments (20-23) for applying treatment currents to the surgical instruments and
- Switching devices (30), a separate HF generator (10-13) for each HF surgical instrument (20-23) and a single HF generator for all HF surgical instruments (20-23) or generators (10-13) Neutral electrode output is provided, and
the switching device (30, 30 ') with the HF generators (10-13) is arranged in such a controlling connection that the HF generators (10-13) never generate the treatment currents simultaneously and exclusively one after the other and to HF surgical instruments (20 - 23), and where
the switching device (30, 30 ') is designed in such a way that there are pauses between the delivery of treatment currents from the HF generators (10-13).

Description

The invention relates to an HF surgical device, comprising at least two HF generators according to the preamble of claim 1.

A large number of HF surgical devices are known, which generally consist of an HF generator and an instrument. Many HF surgical instruments are designed as so-called monopolar instruments, in which a large, indifferent electrode (usually on the thigh) is attached to the patient with good contact to the body, so that the actual treatment current from a treatment electrode for coagulation or cutting or similar HF -Surgical treatment flows through the body and the indifferent electrode.

In some operations, it is now desired that several surgeons work on one and the same patient at the same time with HF surgical instruments. From the DE 10 2005 007 769 A1 an HF surgical device is known in which several instruments can each be connected via a switch to a single output of a single HF generator. Simultaneous operation is possible with such an HF surgical device, but the instruments can only ever be operated in the same operating mode that is specified by the HF generator. A further problem with the known arrangement is that the instruments or active electrodes are connected in parallel to the output of the HF generator via relays. If both surgeons work at the same time, the HF generator feeds both active electrodes in parallel. The power emitted by the HF generator is, however, distributed unevenly according to the tissue properties on the active electrodes.

A regulation of the set currents, as is usual with HF generators, can no longer be carried out in this way.

In order to ensure that two instruments can work with different settings of the HF generator, it is conceivable to operate two completely independent HF surgical devices each with their own active and their own neutral electrodes. Such a device is for example in the DE 699 21 963 T2 described. In this case, completely independent performance and operating mode settings can be implemented. In the case of an unfavorable arrangement of the neutral electrodes, in particular when both HF currents flow through one area of the body at the same time, neuromuscular stimulation due to beat effects can occur. For this reason, this approach is considered dangerous.

WO 2005/117 735 A1 also shows a surgical device with two HF generators, each of which generates a signal with different frequencies. However, only a single surgical instrument 12, which comprises two electrodes, is connected to the two HF generators. The two electrodes and can then be fed with the different frequencies of the two HF generators. The current is fed back via the common neutral electrode. In a first mode, one of the two HF generators is selected as the electricity supplier. In a second mode, the alternating connection of the HF generators creates a “blended output power signal”, i.e. a superimposed or mixed signal consisting of both treatment currents. The second "blended mode" effects a superposition of the treatment currents that can trigger neuromuscular stimulation. It is the object of the invention, based on WO 2005/117 735 A1, to develop an HF surgical device of the type mentioned at the beginning in such a way that neuromuscular stimulation is avoided, but the HF surgical instruments can still be operated in different operating modes.

This object is achieved by an HF surgical device according to claim 1 and a method according to claim 6.

In particular, the object is achieved by an HF surgical device which has at least two HF generators, at least one neutral electrode output for a neutral electrode, at least two outputs for connecting HF surgical instruments for applying treatment currents and switching devices to the HF surgical instruments. A separate HF generator is provided for each HF surgical instrument and a single neutral electrode arrangement is provided for all instruments or HF generators. The switching device is arranged in such a controlling connection with the HF generators that the HF generators never generate the treatment currents simultaneously and only one after the other and deliver them to the instruments. The switching device is designed in such a way that there are pauses between the delivery of treatment currents from the HF generators.

According to the invention, two different HF surgical HF generators are provided, each of which can be switched to an operating mode that corresponds to the HF surgical instrument to be used. Control operations can also be carried out as each HF generator is operated individually or alone, even if only for a short time.

The switching device can be provided as a separate unit. However, the switching device preferably comprises a controlling unit or a master generator which controls the other HF generators as slave generators via SYNC pulses. In this way, the entire HF surgical device can be constructed in a compact manner. In particular, the master generator should be one of the HF generators mentioned at the beginning.

The switching device is preferably designed in such a way that the number of HF generators connected to it is determined and their control takes place in a sequence according to the determined number. In this way, it is possible for the surgical team to work with one, two or more HF generators (and HF surgical instruments) without having to set the equipment separately.

The switching device and the HF generators are equipped with communication interfaces, for example a fieldbus, and are designed in such a way that the HF generators _{are informed of defined start times and / or time windows (T On1 / 2} ) from which and / or during which the HF generators generate a treatment current. These time windows are now preferably set in such a way that a sufficient duration is available for each HF generator so that it emits a signal that is effective in terms of treatment and can also regulate it.

The switching device is designed in such a way that there are pauses between the delivery of treatment currents from the HF generators. This ensures that the circuits can decay, that is to say that no residual currents from a current delivery process overlap with the start of a subsequent current delivery process. The advantages of this method have already been described above.

The clock frequency is preferably 10 kHz to 100 kHz. This ensures that, on the one hand, a quasi-continuous operation can take place without the surgeon noticing any significant difference to working with a single HF generator (and connected single HF surgical instrument). On the other hand, it is still possible to operate several HF generators and HF surgical instruments.

• - 1 Ein stark schematisiertes Blockschaltbild einer Ausführungsform der erfindungsgemäßen HF-Chirurgieeinrichtung,
• - 2 eine erste Möglichkeit der Steuerung von zwei HF-Chirurgiegeneratoren anhand von Ausgangssignalen und
• - 3 eine zweite Ausführungsform einer Steuerung von mehreren HF-Chirurgiegeneratoren.

Preferred embodiments of the invention emerge from the following exemplary embodiments of the invention, which are explained in more detail with reference to figures. Show here

• - 1 A highly schematic block diagram of an embodiment of the HF surgical device according to the invention,
• - 2 a first possibility of controlling two electrosurgical generators based on output signals and
• - 3 a second embodiment of a control of multiple HF surgical generators.

In the following description, the same reference numerals are used for parts that are the same and have the same effect.

According to 1 is a wide variety of RF generators 10 , 11 , 12th and 13th intended. The outputs of these HF generators 10 until 13th , which are normally each with a neutral electrode 24 are connected, are now interconnected and lie on this single neutral electrode 24 . The other outputs of the HF generators 10 until 13th are using electrosurgical instruments 20th , 21 , 22nd and 23 connected, which are only indicated very schematically here. The dotted lines depicting the HF generator 12th and the associated HF surgical instrument 22nd are intended to indicate that the number of HF generators is essentially arbitrary.

All HF generators 10 until 13th stand over a shared bus 33 with each other as well as with a switching device 30th in connection. This switching device 30th can also be used as a switching device in one of the HF generators 30 ' (here HF generator 11 ) be arranged. The bus so named here 33 has the particular function of synchronizing the HF generators, which, as is known, can be controlled in such a way that they can switch their HF signal (typically 300 kHz to 4 MHz) on and off in extremely short times.

In 2 a timing diagram is now shown which shows the use of only two RF generators.

The switching device 30th (or 30 ' ) emits a pulse train SYNC _Master , which is repeated with a period T _Mod. Furthermore, the switching device ( 30th , 30 ' ) communicated _{a delay time T delay} and switch-on _times T On1 and T _On2 to the second connected HF generator.

As a result, a control signal Contr _{1 is emitted following each SYNC master} , which is the first HF generator 10 _controls such that it emits an output signal UA ₁ for the time T On1. After the delay time Tdelay, a second control signal Contr _{2 is} generated, during which (T _On2 ) the second HF generator emits _{an output signal UA 2.} As a result, a current INE flows through the neutral electrode, which in 2 is shown in the bottom diagram and is composed of the two substreams UA ₁ and UA ₂ . The rule here must be that Tdelay is greater than T _On1 and T _delay + T _{On2 is} less than T _Mod .

the end 2 it can also be seen that the time periods are selected such that the output voltages UA ₁ and UA ₂ have decayed before the next output voltage rises again.

In this way, the two HF generators are each assigned “time slices” T _On1 and T _On2 within the modulation, which are time-synchronized _{via the SYNC Master signal.} The time slices must not overlap so that no pulsating currents - and thus neuromuscular stimulation - can occur in the current through the common neutral electrode.

Both HF generators can now be operated in different operating modes and power settings, as they are controlled and activated independently of one another.

Of course, there are also restrictions with regard to the selection of the operating mode. For example, continuous operating modes of the HF generators without modulation are not permitted. The sum of the relative activation times (duty cycle) must be less than 1, whereby the relative activation time τ is defined as: $${\tau }_{1/2}=\frac{{\text{T}}_{\text{On1}\text{, 2}}}{{\text{T}}_{\text{Mod}}}$$

At the in 3 The SYNC _master pulse only controls the first HF generator in such a way that it emits a signal _{during its on-time T 1.} The further HF generator is then activated to emit an output signal UA ₂ when the activation time T _{On1 of} the first HF generator has passed. The third HF generator is also controlled by the second HF generator, and then the fourth HF generator as well. Only then is it controlled again by the SYNC _Master pulse after the period T _Mod . The resulting current INE through the indifferent electrode is in again 3 recorded at the very bottom. The main difference between this embodiment and that according to 2 This is because the HF generators are controlled one after the other as a chain, so to speak, and only the first HF generator is controlled by a superordinate pulse sequence.

It can be seen from the above that the method according to the invention of alternately driving the HF generators can be carried out in various ways.

List of reference symbols

10

HF generator

11

HF generator

12th

HF generator

13th

HF generator

20th

HF surgical instrument

21

HF surgical instrument

22nd

HF surgical instrument

23

HF surgical instrument

24

Neutral electrode

30th

Switching device

30 '

Switching device

33

bus

Claims (7)

HF surgical device, comprising - At least two HF generators (10-13); - At least one neutral electrode output for a neutral electrode (24); - At least two outputs for connecting HF surgical instruments (20-23) for applying treatment currents to the surgical instruments and - Switching devices (30), with a separate HF generator (10-13) for each HF surgical instrument (20-23) and a single HF generator for all HF surgical instruments (20-23) or generators (10-13) Neutral electrode output is provided, and the switching device (30, 30 ') is arranged with the HF generators (10-13) in such a controlling connection that the HF generators (10-13) never generate the treatment currents simultaneously and exclusively one after the other and to HF surgical instruments (20 - 23), and where the switching device (30, 30 ') is designed in such a way that there are pauses between the delivery of treatment currents from the HF generators (10-13). HF surgical facility according to Claim 1 , characterized in that the switching device comprises a controlling unit or a master generator which controls the other HF generators (10-13) as slave generators via SYNC pulses. HF surgical facility according to Claim 2 , characterized in that one of the HF generators (11) is the master generator. HF surgical device according to one of the preceding claims, characterized in that the switching device is designed in such a way that the number of HF generators (10-13) connected to it is determined and their control takes place in a sequence according to the determined number. HF surgical device according to one of the preceding claims, characterized in that the switching device (30, 30 ') and the HF generators (10-13) comprise communication interfaces, for example a field bus (33) and are designed in such a way that the HF generators (10-13) defined start times and / or time windows (T _{On1 / 2} ) are communicated from which and / or during which the HF generators (10-13) generate a treatment current. Procedure for operating an HF surgical facility, wherein the HF surgical device has at least two HF generators, each with an output for delivering a treatment current to an HF surgical instrument and an output for connecting a common neutral electrode arrangement, wherein the HF generators are operated alternately with a predetermined clock frequency in such a way that only a single HF generator delivers a treatment current at any point in time, and there are pauses between the delivery of treatment currents from the HF generators (10-13). Procedure according to Claim 6 , characterized in that the clock frequency is 10 to 100 kHz.

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