Medical device, controller and storage medium

Abstract

This application provides a medical device, controller, and storage medium. A method and system for treating biological tissue using high-frequency electrical energy includes a cycle having a drying phase, a cutting phase, and a coagulation phase. During the drying phase of this cycle, a first high-frequency electrical energy is modulated and applied to the tissue to dry it. A first parameter associated with applying the first high-frequency electrical energy to the tissue to dry it is estimated. During the cutting phase, a cutting energy is then modulated and applied to the tissue to cut it based on the first parameter. During the coagulation phase, a second high-frequency electrical energy is modulated and applied to the tissue to coagulate the cut tissue.

Description

Technical Field

[0001] The systems, apparatus, and methods disclosed herein relate to electrosurgery, and more specifically to the use of high-frequency electrical energy to cut biological tissues. Background Technology

[0002] In the following discussion, certain structures and / or methods are referenced. However, these references should not be construed as an admission that these structures and / or methods constitute prior art. The applicant expressly reserves the right to describe these structures and / or methods as not being prior art to this invention.

[0003] Many medical procedures involve cutting biological tissue, such as when making incisions or removing mucosa or submucosa. One technique used for cutting biological tissue involves using high-frequency electrical energy to first dehydrate or dry the tissue by heating it with a high-frequency current, and then cutting the dehydrated / dried tissue by generating an electric arc discharge between the tissue and an end effector of the medical device. The cut tissue is then coagulated or sealed by providing additional high-frequency electrical energy to stop bleeding after the cutting.

[0004] When high-frequency electrical energy is applied, the tissue's impedance increases as the tissue is dehydrated / dried. This increased impedance leads to a rise in voltage across the tissue, and when this voltage reaches the breakdown voltage, a discharge occurs, cutting the tissue. During an arc discharge, the high-frequency voltage across the tissue is low, but the current is high and flows through a narrow path dependent on the contact area between the end effector and the tissue. Furthermore, when the arc discharge occurs, a DC voltage is generated across the tissue through rectification. The high current density caused by the high current flowing through a small area generates heat that cuts the tissue.

[0005] Depending on the type and location of the tissue being operated on, end effectors of varying shapes and sizes are already used in medical devices for cutting biological tissue. These differences in shape and size lead to undesirable variations in the performance of the medical device. Therefore, an improved control mechanism is desired for controlling the power supplied to the end effector during electrosurgical cutting procedures. Summary of the Invention

[0006] To address the aforementioned issues in high-frequency cutting of biological tissues, improved techniques are needed to reduce performance variations in medical devices for different types of end effectors. On one hand, performance variations can be reduced by adjusting parameters associated with the application of high-frequency electrical energy to the biological tissue based on the contact area between the end effector and the tissue being cut. On the other hand, the contact area between the end effector and the tissue can be estimated during processes that dehydrate or dry the tissue, and such a contact area determined during these processes can serve as a basis for adjusting parameters associated with the application of high-frequency electrical energy to the biological tissue.

[0007] For example, when high-frequency electrical energy is applied to tissue, the tissue dehydrates or dries, and its impedance increases. This increase in impedance leads to an increase in voltage across the tissue. The rate of increase in impedance, and consequently the rate of increase in voltage across the tissue, depends on the contact area between the end effector and the tissue. Therefore, by measuring the time required for the voltage across the tissue to reach a certain threshold, the contact area between the tissue and the end effector can be estimated. Thus, parameters for controlling the high-frequency electrical energy applied to the tissue can be estimated based on the time it takes for the voltage across the tissue to reach a predetermined threshold.

[0008] Advantageously, controlling the electrical energy applied to the tissue during tissue cutting surgery based on the contact area between the end effector and the tissue can reduce performance variations dependent on the end effector.

[0009] Therefore, the method disclosed herein for treating biological tissues using high-frequency electrical energy uses a first parameter estimated during tissue drying to modulate the energy supplied to the tissue during tissue cutting.

[0010] In one aspect of this disclosure, a method of treating biological tissue using high-frequency electrical energy includes: (a) modulating a first high-frequency electrical energy applied to the tissue to dry the tissue; (b) estimating a first parameter associated with the application of the first high-frequency electrical energy to the tissue during step (a); and (c) modulating a cutting energy applied to the tissue to cut the tissue based on the first parameter.

[0011] In some embodiments, the method further includes: (d) modulating a second high-frequency electrical energy applied to the tissue to coagulate the tissue cut in (c).

[0012] In some embodiments, the method further includes performing (a)-(d) sequentially in a first cycle and repeating (a)-(d) sequentially in a second cycle to dispose of the tissue.

[0013] In some embodiments, the cutting energy in the second period is modulated based on a first parameter estimated during the first period.

[0014] In some embodiments, the method further includes a second parameter during estimation (d).

[0015] In some embodiments, the cutting energy in the second modulation cycle is based on a first parameter and a second parameter estimated during the first cycle.

[0016] In some embodiments, the second parameter includes the high-frequency power output during (d).

[0017] In some embodiments, the method further includes repeating a second cycle, wherein the modulation cutting energy is based on a first parameter and a second parameter estimated during the immediately preceding first cycle.

[0018] In some embodiments, the method further includes repeating a second cycle, wherein the modulation cutting energy is based on a second parameter estimated during the immediately preceding first cycle and on a first parameter estimated during the second cycle.

[0019] In some embodiments, the first parameter includes the time during which the DC component of the voltage on the tissue reaches a first threshold during (a).

[0020] In some embodiments, modulating the cutting energy includes estimating the contact area between the tissue and the end effector of the medical device based on a first parameter, and changing the cutting energy parameter associated with the application of the cutting energy based on the contact area.

[0021] In some embodiments, the cutting energy parameter includes the amount of time for applying a cutting voltage to the tissue, and wherein modulating the cutting energy includes increasing the amount of time for applying the cutting voltage if the contact area exceeds an area threshold.

[0022] In some embodiments, the cutting energy parameter includes a DC component of the voltage on the tissue, and wherein modulating the cutting energy includes increasing the DC component of the voltage if the contact area exceeds an area threshold.

[0023] In some embodiments, the cutting energy parameter includes the value of the cutting voltage applied to the tissue, and wherein modulating the cutting energy includes increasing the value of the cutting voltage if the contact area exceeds an area threshold.

[0024] In one aspect, this disclosure describes a controller for a medical device configured to treat tissue using high-frequency electrical energy. The controller is operatively coupled to a power source of the medical device and configured to: (a) control the power source to modulate a first high-frequency electrical energy applied to the tissue to dry it; (b) estimate a first parameter associated with the application of the first high-frequency electrical energy to the tissue during step (a); and (c) control the power source to modulate a cutting energy applied to the tissue to cut it based on the first parameter.

[0025] In some embodiments, the controller is further configured to: (d) control the power supply to modulate a second high-frequency electrical energy applied to the tissue to coagulate the tissue cut in (c).

[0026] In some embodiments, the controller is also configured to sequentially perform (a)-(d) in a first cycle and sequentially repeat (a)-(d) in a second cycle to dispose of the tissue.

[0027] In some embodiments, the controller is configured to modulate the cutting energy in the second cycle based on a first parameter estimated during the first cycle.

[0028] In some embodiments, it is also configured as a second parameter during estimation (d).

[0029] In some embodiments, the controller is configured to modulate the cutting energy in the second cycle based on a first parameter and a second parameter estimated during the first cycle.

[0030] In some embodiments, the second parameter includes the high-frequency power output during (d).

[0031] In some embodiments, the controller is also configured to repeat a second cycle, wherein the modulation cutting energy is based on a first parameter and a second parameter estimated during the immediately preceding first cycle.

[0032] In some embodiments, the controller is further configured to repeat a second cycle, wherein the modulation cutting energy is based on a second parameter estimated during the immediately preceding first cycle and on a first parameter estimated during the second cycle.

[0033] In some embodiments, the first parameter includes the time during which the DC component of the voltage on the tissue reaches a first threshold during (a).

[0034] In some embodiments, the controller is configured to modulate the cutting energy by estimating the contact area between the tissue and the end effector of the medical device based on a first parameter, and by changing a cutting energy parameter associated with the application of cutting energy based on the contact area.

[0035] In some embodiments, the cutting energy parameter includes the amount of time for which a cutting voltage is applied to the tissue, and wherein the controller is configured to modulate the cutting energy by increasing the amount of time for which the cutting voltage is applied if the contact area exceeds an area threshold.

[0036] In some embodiments, the cutting energy parameter includes a DC component of the voltage on the tissue, and wherein the controller is configured to modulate the cutting energy by increasing the DC component of the voltage when the contact area exceeds an area threshold.

[0037] In some embodiments, the cutting energy parameter includes the value of a cutting voltage applied to the tissue, and wherein the controller is configured to modulate the cutting energy by increasing the value of the cutting voltage when the contact area exceeds an area threshold.

[0038] In another aspect of this disclosure, a medical device for disposing of biological tissue includes a power source configured to generate high-frequency electrical energy. An end effector is operatively coupled to the power source and configured to supply electrical energy to the tissue. A controller is operatively coupled to the power source and the end effector. The controller is configured to: (a) control the power source to modulate a first high-frequency electrical energy applied to the tissue to dry the tissue; (b) estimate a first parameter associated with the application of the first high-frequency electrical energy to the tissue during step (a); and (c) control the power source based on the first parameter to modulate a cutting energy applied to the tissue to cut the tissue.

[0039] In some embodiments, the controller is further configured to: (d) control the power supply to modulate a second high-frequency electrical energy applied to the tissue to coagulate the tissue cut in (c).

[0040] In some embodiments, the controller is also configured to sequentially perform (a)-(d) in a first cycle and sequentially repeat (a)-(d) in a second cycle to dispose of the tissue.

[0041] In some embodiments, the controller is also configured to modulate the cutting energy in the second cycle based on a first parameter estimated during the first cycle.

[0042] In some embodiments, the controller is also configured to estimate a second parameter during (d).

[0043] In some embodiments, the controller is also configured to modulate the cutting energy in the second cycle based on a first parameter and a second parameter estimated during the first cycle.

[0044] In some embodiments, the second parameter includes the high-frequency power output during (d).

[0045] In some embodiments, the controller is also configured to repeat a second cycle, wherein the modulation cutting energy is based on a first parameter and a second parameter estimated during the immediately preceding first cycle.

[0046] In some embodiments, the controller is further configured to repeat a second cycle, wherein the modulation cutting energy is based on a second parameter estimated during the immediately preceding first cycle and on a first parameter estimated during the second cycle.

[0047] In some embodiments, the first parameter includes the time during which the DC component of the voltage on the tissue reaches a first threshold during (a).

[0048] In some embodiments, the controller is further configured to modulate the cutting energy by estimating the contact area between the tissue and the end effector of the medical device based on a first parameter, and by changing a cutting energy parameter associated with the application of cutting energy based on the contact area.

[0049] In some embodiments, the cutting energy parameter includes the amount of time for which a cutting voltage is applied to the tissue, and wherein the controller is configured to modulate the cutting energy by increasing the amount of time for which the cutting voltage is applied if the contact area exceeds an area threshold.

[0050] In some embodiments, the cutting energy parameter includes a DC component of the cutting voltage applied to the tissue, and wherein the controller is configured to modulate the cutting energy by increasing the DC component of the voltage if the contact area exceeds an area threshold.

[0051] In some embodiments, the cutting energy parameter includes the value of a cutting voltage applied to the tissue, and wherein the controller is configured to modulate the cutting energy by increasing the value of the cutting voltage if the contact area exceeds an area threshold.

[0052] In another aspect, this disclosure describes a computer-readable storage medium storing instructions that, when executed by a processor, cause the processor to: (a) modulate a first high-frequency electrical energy applied to a tissue to dry the tissue; (b) estimate a first parameter associated with the application of the first high-frequency electrical energy to the tissue during step (a); and (c) modulate a cutting energy applied to the tissue to cut the tissue based on the first parameter.

[0053] Further features and advantages will be set forth in the description which follows, and will be apparent in part from the description, or may be learned by practice of the invention. The objects and other advantages of the disclosed input device will be realized and obtained through the structures particularly pointed out in the written description and the accompanying drawings. Attached Figure Description

[0054] The disclosed aspects will be described below in conjunction with the accompanying drawings, which are provided for illustrative purposes and not for limiting the disclosed aspects, wherein the same reference numerals denote the same elements.

[0055] Figure 1 A schematic diagram of an exemplary medical device for disposing of tissues, according to some embodiments, is shown.

[0056] Figure 2A , Figure 2B and Figure 2C These are examples of various end effectors for disposing of biological tissue by applying high-frequency electrical energy, according to some embodiments.

[0057] Figure 3 A schematic diagram of a controller according to some embodiments is shown.

[0058] Figure 4A graph showing the power output to the tissue as a function of time during surgery for tissue disposal, according to an embodiment (power (in watts) as a function of time (in seconds)).

[0059] Figure 5 This is a flowchart of an exemplary method for disposing of biological tissue according to some embodiments.

[0060] Figure 6A and Figure 6B It is a graph showing the corresponding behavior of HPCS current (graph (I)) and DC voltage as a function of time (graph (II) and (III)) for the operation applied to the disclosed small contact area example (graph (II)) and large contact area example (graph (III)).

[0061] In all the accompanying drawings, the sizes of the corresponding components have been appropriately adjusted for clarity, illustration, and convenience. For ease of viewing, in some instances, only certain named features in the drawings are labeled with reference numerals. Detailed Implementation

[0062] During some electrosurgical procedures, high-frequency electrical energy is applied to biological tissue to cut it. The current flowing through the tissue during this treatment causes localized heating, leading to tissue drying and denaturation. Generally, as the tissue's impedance increases, the voltage across the tissue increases, and when the voltage reaches the breakdown voltage (also referred to herein as the threshold voltage), an arc discharge occurs. When an arc discharge occurs, a DC voltage is established across the treated tissue due to rectification. During an arc discharge, the current flowing through the tissue increases through the path formed by the contact between the tissue and the end effector used to apply the electrical energy. Because the contact area between the tissue and the end effector is typically small, the increased current generates a significant amount of heat in this small area, causing cell rupture around the contact area between the end effector and the tissue. Therefore, arc discharge is used to cut tissue.

[0063] Once an electric arc discharge occurs and the tissue is cut, the electrical energy applied to the tissue is reduced to allow the cut tissue to coagulate, thereby stopping the bleeding from the cut tissue.

[0064] The contact area between the tissue and the end effector depends on the shape and size of the end effector (and the shape and size of the end effector generally do not change during surgery). Therefore, the DC voltage on the tissue can be adjusted by adjusting the discharge intensity, which in turn can be adjusted by adjusting the power supplied to the end effector (i.e., the high-frequency current and voltage). However, during surgery, the contact area between the tissue and the end effector does not remain constant but depends on factors such as the exact shape of the end effector and the angle at which the end effector contacts the tissue. Therefore, accurately estimating the contact area between the tissue and the end effector is considered an important factor in determining the power to be supplied to the end effector to achieve arc discharge. Furthermore, parameters such as the rate of rise of the DC voltage on the tissue can be used as a representative parameter for estimating the contact area between the tissue and the end effector.

[0065] Therefore, methods for treating biological tissue using high-frequency electrical energy may include estimating a first parameter based on the first application of high-frequency electrical energy to the tissue or estimating the first parameter during the first application of high-frequency electrical energy to the tissue. The first parameter may be used to estimate the contact area between the tissue and the end effector during that particular procedure, and this contact area may then be used to estimate the power to be supplied to the end effector to achieve an arc discharge.

[0066] As used herein, high frequency refers to frequencies ranging from about 200 kHz to about 5 MHz. Therefore, depending on the specific application, a device (such as one for electrothermal cutting) can supply electrical energy to tissue by applying a voltage at a frequency of, for example, 200 kHz, 250 kHz, 300 kHz, 350 kHz, 400 kHz, 450 kHz, 500 kHz, 600 kHz, 700 kHz, 800 kHz, 900 kHz, 1000 kHz, 1500 kHz, 2000 kHz, 2500 kHz, 3000 kHz, 3500 kHz, 4000 kHz, 4500 kHz, 5000 kHz, or any frequency between any two of these frequencies.

[0067] In one aspect of this disclosure, a system for cutting tissue using high-frequency electrical energy supplied to the tissue is disclosed. The system may include a power supply configured to generate high-frequency electrical energy and an end effector operatively connected to the power supply and configured to supply high-frequency electrical energy to the tissue. The system also includes a controller operatively connected to the power supply and configured to control the power supply and estimate one or more parameters when high-frequency electrical energy is applied to the tissue. The controller is configured to control the power supply to modulate a first high-frequency electrical energy applied to the tissue for drying the tissue, and to estimate a first parameter during the modulation of the first high-frequency electrical energy. The controller then controls the power supply based on the first parameter to modulate the cutting energy applied to the tissue for cutting the tissue. The first parameter may be, for example, the rate of increase of DC voltage on the tissue during tissue drying. The first parameter may be used to estimate the contact area between the tissue and the end effector, which may then be used to estimate the power to be supplied to the end effector to achieve an arc discharge for cutting the tissue.

[0068] As used herein, the term "patient" includes any and all living beings, and includes the term "subject". Patients can be humans and animals.

[0069] Medical devices for heating tissues

[0070] Figure 1 A schematic diagram of a medical device for heating tissue according to an embodiment of the present disclosure is shown. Figure 1 As shown, a medical device 1 for cutting tissue includes an instrument 2, a controller 3 with a processor, and an actuation switch 4. The instrument 2 may include, for example, a clamp for grasping biological tissue during electrosurgery.

[0071] The treatment device 2 has a handle 2A1, a shaft 2A2, and a treatment section consisting of an end effector 10, which is, for example, a pair of openable or pivotable gripping parts (including a first gripping part 11A and a second gripping part 11B) for grasping living tissue (LT) for treatment. The gripping part as a whole is also referred to herein as the “treatment section” or “treatment part” of the medical device. Note that in the following text, when referring to constituent elements having the same function and having reference numerals A and B respectively appended to the end of the reference numerals, the symbols A or B may be omitted. For example, the first gripping part 11A and the second gripping part 11B may each be referred to as a gripping part.

[0072] Handle 2A1 is connected to controller 3 via cable 2L. Handle 2A1 has an open / close actuator 2A3, such as a trigger, for the surgeon to operate the treatment unit in a shape that allows the surgeon to easily grip the tissue. The open / close actuator 2A3 is disposed at one end of handle 2A1 and integrated with the treatment unit to transmit the operation of the open / close actuator 2A3 to the treatment unit. On the other side of handle 2A1, a gripping part 2A4 is provided for the clinician to grip when operating instrument 2.

[0073] Although Figure 1 An end effector for tissue grasping is shown, but depending on the type of surgery, end effectors with other shapes and sizes may be used. Figure 2A , Figure 2B and Figure 2C Examples of end effectors with different shapes and sizes are shown. Each of these shapes and sizes has its advantages and is therefore more suitable for certain types of surgery. For example, Figure 2A The end effector 200 shown has a larger contact area with tissue, thus providing higher coagulation and hemostatic performance. Similarly, Figure 2B The end actuator 210 with a hook shape is more suitable for excising mucosa, wherein the mucosa can be hooked in the hook and separated from the submucosa. Figure 2C The end effector 220 with a sharp tip is better suited for functions such as marking tissue, mucosal incisions, detachment, and hemostasis.

[0074] Regardless of the exact shape of the end effector, those skilled in the art will readily understand the organization and... Figure 1 as well as Figures 2A to 2C The contact areas between the end effectors shown are different.

[0075] Figure 3 A schematic diagram of a controller according to an embodiment of the present disclosure is shown. The controller 3 may include a processor 32, a display 36, an input unit 42, a sensor unit 48, and a power supply 44.

[0076] The processor 32 may include a memory 34, a computing unit 46, and a control unit 40. The computing unit 46 and the control unit 40 are formed of integrated circuits including a CPU (Central Processing Unit), an ASIC (Application-Specific Integrated Circuit), or a FPGA (Field-Programmable Gate Array). The computing unit 46 and the control unit 40 may be formed of a single integrated circuit or multiple integrated circuits.

[0077] The control unit 40 is configured to control the power supply 44 and the display 36 using parameters calculated by the computing unit 46 based on commands provided by the processor 32.

[0078] A display 36 showing treatment conditions, etc., and a setting operation unit 35 for clinicians or operators to set treatment conditions, etc., are located on the front panel of the controller 3. In some embodiments, the controller 3 may be connected to a switch 4 via a cable 4L, such as... Figure 1 As shown. Actuation switch 4 can be used by clinicians to control the power applied to the instrument, for example, between different parts of the tissue being cut.

[0079] In some embodiments, various parameters for determining the power to be supplied for cutting tissue can be stored in memory 34, for example, in a lookup table stored in memory 34. These factors may include, but are not limited to, tissue size, tissue type, tissue impedance, factors determining tissue impedance, contact area between the tissue and the end effector, tissue shape and size, end effector shape and size, DC voltage on the tissue, etc. The lookup table may include values ​​of corresponding parameters for different parts of the tissue to be cut. For example, the lookup table may include parameters for muscle tissue, adipose tissue, blood vessels, intestinal wall, or other tissue types. As another example, the lookup table may include magnitude-based variations in parameters, such as impedance (Z), the rate of increase in impedance, etc. And the rate of increase of DC voltage on the tissue. This size-based variation of the parameter can be quantified based on a predetermined small, medium, or large contact area, based on a predetermined size range of the end effector, or based on a continuity according to the size of the end effector.

[0080] The calculation unit 46 is configured to estimate the rate of increase of the DC voltage on the tissue before or during heating, as well as other parameters required to calculate the contact area between the tissue and the end effector.

[0081] Sensor unit 48 is configured to determine a first parameter associated with tissue drying. For example, in some embodiments, sensor unit 48 may be configured to determine the rate of increase of DC voltage on the tissue during the drying process. Additionally or alternatively, in some embodiments, sensor unit 48 may be configured to determine the rate of increase of the tissue's impedance (Z) or resistance during or after the drying process. In some embodiments, the first parameter may be the time it takes for the DC voltage on the tissue to reach a first threshold during the drying process.

[0082] In some embodiments, sensor unit 48 may be further configured to determine a second parameter associated with the coagulation of tissue. For example, sensor unit 48 may be configured to determine a high-frequency power output by a power source during the coagulation process as a function of time or total power output.

[0083] In some embodiments, the calculation unit 46 is configured to determine the contact area between the tissue and the end effector based on inputs received from the control unit 40 and / or the sensor unit 48. For example, in some embodiments, the calculation unit 46 may determine the contact area between the tissue and the end effector based on a first parameter measured by the sensor unit 48. The contact area between the tissue and the end effector may be estimated using a mathematical formula or by using a lookup table based on the first parameter, which may include pre-calculated values ​​of the contact area of ​​certain types of end effectors on a quantized or continuous basis and the value of the first parameter.

[0084] Figure 4 This is a graph illustrating the power output from a power source to an end effector as a function of time during the disposal of biological tissue, according to some embodiments. Such a graph can be used to create lookup tables for determining first and second parameters associated with estimating the contact area between the tissue and the end effector, as well as other parameters associated with the disposal of the tissue.

[0085] like Figure 4 As shown, the tissue treatment comprises a cycle 400 with three phases. In the first phase 410 (also known as the High Power Cut Support (HPCS) phase), the end effector outputs high power for a short time (t1) to dry the tissue. During this first phase 410, the tissue impedance increases. Furthermore, the DC voltage on the tissue increases proportionally to the probability of discharge. This increase depends on the contact area between the tissue and the end effector.

[0086] Therefore, in some embodiments, the contact area between the tissue and the end effector can be estimated based on the time it takes for the DC voltage on the tissue to increase to a specific threshold. For example, if the time it takes for the DC voltage on the tissue to increase to a first threshold is less than or equal to a first time threshold (t... t1 If the contact area is small, it can be determined as "small" or less than the area threshold. On the other hand, if the time taken for the DC voltage on the tissue to increase to the first threshold is greater than the first time threshold (t...), then the contact area can be determined as "small" or less than the area threshold. t1 If so, then the contact area can be determined to be "large" or greater than the area threshold.

[0087] During the second phase 420 (also referred to herein as the cutting phase), the power output to the end effector is slightly reduced to achieve arc discharge 415 by increasing the current on the tissue. The duration of the second phase 420 is t2, which is determined based on the contact area between the tissue and the end effector. Similarly, other parameters, such as the voltage output to the end effector, are also determined based on the contact area between the tissue and the end effector.

[0088] During the third stage 430 (also referred to herein as the coagulation stage (or COAG stage)), the power output to the end effector is further reduced to allow the tissue cut during the cutting stage to coagulate (or seal). The COAG stage is typically the longest stage and lasts for t3.

[0089] During surgeries involving the disposal of biological tissue, cycle 400 can be repeated several times depending on the size of the incision. As an example, Figure 4 The second cycle 400' is shown after the first cycle 400. However, surgeries with various numbers of cycles can be used, such as up to 3 cycles, up to 5 cycles, up to 10 cycles, up to 20 cycles, or more, as long as the clinician / operator intends to do so, for example, by activating the actuation switch 4. Therefore, various parameters for modulating the high-frequency electrical energy output to the end effector in the second and subsequent cycles can be determined based on parameters determined in the previous cycle, particularly those determined in the immediately preceding cycle. For example, the contact area between the tissue and the end effector may change in subsequent cycles depending on how the cutting is performed and the purpose of the cutting. Therefore, estimates related to the contact area based on the previous cycle may be inaccurate. Consequently, any one or more of the time t1 of the HPCS phase, the time t2 of the cutting phase, and the time t3 of the COAG phase can vary between cycles.

[0090] For example, the time t1 of the HPCS phase in a subsequent cycle can be determined based on the COAG phase of the preceding cycle, which determines the initial contact area between the tissue and the end effector, and thus the power required to dry the tissue. Therefore, in some embodiments, the power output to the end effector during the HPCS phase of the third and subsequent cycles can be determined based on the power output to the end effector during the COAG phase of the preceding cycle.

[0091] For example, after the second cycle, the output during the CUT (cutting) period is determined based on the arrival time of the DC voltage threshold during the HPCS (HP-CS) period of that cycle and the output during the COAG (CO-AG) period of the immediately preceding cycle. When determined in this way, the output of the CUT period in each cycle can be refined even if the contact area between the treatment tool and the living tissue changes for each cycle.

[0092] Return to reference Figure 3 In some embodiments, the controller 3 includes a processor 32 that determines various parameters for controlling the application of power to the end effector 10 via the power supply 44. The controller 3 controls the power supply 44 to appropriately modulate the electrical energy output to the end effector 10 and thus to the tissue during different phases of the treatment cycle, such as the HPCS phase, the cutting phase, and the COAG phase.

[0093] To control the power input to the end effector 10, the processor 32 can determine various parameters for controlling the power supply 44 to modulate the power output to the end effector 10. For example, the processor 32 can determine the contact area between the tissue and the end effector, the power to be output to the end effector during each of the three phases of the treatment cycle, the duration of each phase of the treatment cycle (e.g., the amount of time a cutting voltage is applied to the tissue), etc. In some embodiments, these parameters can be determined based on a first parameter and a second parameter measured by the sensor unit 48. The first parameter may be, for example, the time it takes for the DC voltage on the tissue to reach a certain threshold, or the rate of increase of the DC voltage during the HPCS phase of a given cycle. The second parameter may be, for example, the power output to the end effector during all three phases of the treatment cycle, and particularly during the COAG phase of the treatment cycle.

[0094] In some embodiments, the processor 32 controls the electrical energy supplied to the end effector 10 by controlling the power output of the power supply 44. Therefore, the processor 32 can increase or decrease the power output of the power supply 44 to the end effector 10, and change the rate of increase or decrease of the supplied power, as well as the duration of power supply at different levels. Additionally, the processor 32 can stop the power supply 44 from outputting power to the end effector 10.

[0095] For example, in some embodiments, before or in conjunction with the start of the procedure, i.e., during the HPCS phase, the processor 32 may control the power supply 44 to apply constant power to the tissue for a period of time t1. In some embodiments, t1 may be, for example, about 10 ms, about 20 ms, about 30 ms, about 40 ms, about 50 ms, about 60 ms, about 70 ms, about 80 ms, about 90 ms, about 100 ms, about 120 ms, about 140 ms, about 160 ms, about 180 ms, about 200 ms, about 250 ms, about 300 ms, about 400 ms, or any other amount of time between any two of these values. The sensor unit 48 may measure the DC voltage during the HPCS phase. The processor 32 may then determine the rate of increase of the DC voltage and the time taken for the DC voltage to reach a voltage threshold.

[0096] The processor can then control the power supply to modulate the electrical energy supplied to the tissue during the cutting phase based on the rate of increase of the DC voltage and the time it takes for the DC voltage to reach a voltage threshold. The electrical energy supplied to the tissue can be modulated by changing cutting energy parameters associated with the application of cutting energy. Cutting energy parameters can be, for example, the power output to the end effector, the amount of time the cutting voltage is applied to the tissue, or the DC voltage on the tissue. Therefore, the electrical energy supplied to the tissue can be modulated by controlling the amount of time power is output to the end effector (i.e., applied to the tissue), or by allowing the DC voltage on the tissue to increase to the cutting voltage value.

[0097] For example, if the amount of time it takes for the DC voltage to reach a voltage threshold is greater than or equal to a first time threshold, then the contact area is determined to be greater than an area threshold. If it is determined that the contact area exceeds the area threshold, the processor 32 can control the power supply 44 to increase the duration of the cutting phase. Alternatively or additionally, the processor 32 can control the power supply 44 to increase the power output to the end effector 10. Similarly, in some embodiments, the processor 32 can control the power supply 44 to continue outputting power to the end effector 10 until the DC voltage on the tissue increases above the cutting voltage threshold.

[0098] In some embodiments, the amount of time for which power is output to the end effector 10 during the cutting phase can be approximately 1 ms, approximately 2 ms, approximately 3 ms, approximately 4 ms, approximately 5 ms, approximately 6 ms, approximately 7 ms, approximately 8 ms, approximately 9 ms, approximately 10 ms, approximately 11 ms, approximately 12 ms, approximately 13 ms, approximately 14 ms, approximately 15 ms, approximately 16 ms, approximately 17 ms, approximately 18 ms, approximately 19 ms, approximately 20 ms, approximately 22 ms, approximately 24 ms, approximately 26 ms, approximately 28 ms, approximately 30 ms, approximately 35 ms, approximately 40 ms, approximately 50 ms, approximately 55 ms, approximately 60 ms, approximately 65 ms, approximately 70 ms, approximately 80 ms, approximately 90 ms, approximately 100 ms, approximately 120 ms, approximately 140 ms, approximately 160 ms, approximately 180 ms, approximately 200 ms, or any amount of time between any two of these values.

[0099] Once the tissue has been cut, the processor can further control the power supply to transition the cycle to the COAG phase. For example, processor 32 can cause power supply 44 to reduce the power output to end effector 10 to a predetermined value to allow the cut tissue to coagulate, thereby stopping bleeding from the cut tissue. Processor 32 can also determine the duration of the COAG phase based on various parameters, such as the size of the cut tissue. The size of the cut tissue can typically be determined based on the contact area between the tissue and the end effector. Therefore, in some embodiments, processor 32 can determine the duration of the COAG phase based on the rate of increase of the DC voltage and the time taken for the DC voltage to reach a voltage threshold. Additionally or alternatively, processor 32 can determine the duration of the COAG phase based on the duration of the cutting phase and the power output to end effector 10 during the cutting phase.

[0100] In some embodiments, the amount of time for power output to the end effector 10 during the COAG phase can be 10 ms, approximately 20 ms, approximately 30 ms, approximately 40 ms, approximately 50 ms, approximately 60 ms, approximately 70 ms, approximately 80 ms, approximately 90 ms, approximately 100 ms, approximately 120 ms, approximately 140 ms, approximately 160 ms, approximately 180 ms, approximately 200 ms, approximately 250 ms, approximately 300 ms, approximately 400 ms, approximately 500 ms, approximately 600 ms, approximately 700 ms, approximately 8 ...800 ms, approximately 800 ms, approximately 800 ms, approximately 800 ms, approximately 800 ms, approximately 800 ms, approximately 800 ms, approximately 800 ms, approximately 800 ms, approximately 800 ms, approximately 800 ms, approximately 800 ms, approximately 800 ms, approximately 800 ms, approximately 800 ms, approximately 800 ms, approximately 800 ms, approximately 800 ms, approximately 800 ms, approximately 800 ms, approximately 800 ms, approximately 800 ms, approximately 800 ms, approximately 800 ms, approximately 800 ms 00ms, approximately 900ms, approximately 1000ms, approximately 1200ms, approximately 1300ms, approximately 1400ms, approximately 1500ms, approximately 1600ms, approximately 1700ms, approximately 1800ms, approximately 1900ms, approximately 2000ms, approximately 2200ms, approximately 2400ms, approximately 2600ms, approximately 2800ms, approximately 3000ms, approximately 3500ms, approximately 4000ms, approximately 5000ms, or any other amount of time between any two of these values.

[0101] In another respect, this disclosure relates to a method of treating biological tissue using a medical device configured to treat the tissue using high-frequency electrical energy. Figure 5 A flowchart illustrating a method for disposing of biological tissue according to some embodiments.

[0102] Method 500 may include setting an initial cutting power output at S501. At S502, the number of cycles N is set to 1. At S504, the power output for the HPCS phase is set. S504 corresponds to the HPCS phase of the surgical procedure cycle (i.e., the first phase 410, see...). Figure 4 As discussed herein, setting the high-frequency electrical energy applied to the tissue can be done, for example, by controlling the power output to the end effector, controlling the amount of time the power is output to the end effector, and allowing the DC voltage on the tissue to reach a certain voltage threshold.

[0103] Unwilling to be bound by theory, when tissue is not fully dry, a sharp rise in voltage on the tissue during the HPCS phase may lead to rapid arc discharge (i.e., 415, see below). Figure 4 Since the tissue is not yet fully dry, a rapid arc may not produce the desired cut or may cause excessive bleeding. Therefore, in some embodiments, setting the high-frequency electrical energy applied to the tissue can be done by controlling the rate of increase of the DC voltage on the tissue, for example by controlling the rate of increase of the current on the tissue during the HPCS phase. The current on the tissue can be increased over a period of time exceeding approximately 2 ms, approximately 4 ms, approximately 6 ms, approximately 8 ms, approximately 10 ms, 12 ms, approximately 14 ms, approximately 16 ms, approximately 18 ms, approximately 20 ms, approximately 25 ms, approximately 30 ms, approximately 35 ms, approximately 40 ms, approximately 45 ms, approximately 50 ms, or any other time period between any two of these values.

[0104] At S506, a first parameter for the Nth cycle is estimated. In some embodiments, the first parameter may be the time it takes for the DC voltage on the tissue to reach a first threshold during the HPCS phase. For example, a time below the threshold time indicates a small contact area between the treatment tool and the living tissue; a time above the threshold time indicates a large contact area between the treatment tool and the living tissue. Figure 6A The figure shows the HPCS current (I) for small and large contact areas. HF ) and DC voltage (V DC Examples of the corresponding behaviors.

[0105] In some embodiments, the first parameter may be the rate of increase of the voltage on the tissue during the HPCS phase. For example, a rate of increase of the voltage on the tissue reaching a first threshold during the HPCS phase below a threshold rate indicates a large contact area between the treatment tool and the living tissue; a rate of increase of the DC component of the voltage on the tissue reaching the first threshold during the HPCS phase above a threshold rate indicates a small contact area between the treatment tool and the living tissue. Furthermore, by having a small HPCS current increase rate, for example, the HPCS current (I0) can be used. HF When the increase in ) reaches 10ms or greater, the DC voltage (V) caused by discharge can be detected more easily. DC The corresponding changes, especially for small changes. Figure 6B The figure shows examples of the corresponding behavior of HPCS current and DC voltage for small and large contact areas.

[0106] Subsequently, high-frequency electrical energy is modulated and applied to the tissue to cut it. This stage corresponds to the cutting phase of the cycle; therefore, in this cycle (i.e., the second stage 420, see...) Figure 4 The high-frequency electrical energy applied to the tissue during this period is also known as the cutting energy. The cutting energy is modulated based on the first parameter of the Nth cycle and (for cycles after N=1) the second parameter of the (N-1)th cycle, based on the power applied after cutting to coagulate the tissue.

[0107] It is important to note that for the first cycle, there is no second parameter for the previous cycle. Therefore, at S508, it is determined whether N = 1. If N = 1, then at S510, the cutting energy is modulated based on the first parameter of the Nth cycle (i.e., the first cycle) to cut the tissue. On the other hand, if N is not equal to 1 (i.e., greater than 1), then at S512, the cutting energy is modulated based on the first parameter of the Nth cycle and the second parameter of the (N-1)th cycle based on the power applied to coagulate the tissue.

[0108] Modulation of the cutting energy may include, but is not limited to, changing one or more of the following: the voltage applied to the tissue during the cutting phase, the power output to the end effector during the cutting phase, the duration of power output to the end effector during the cutting phase, the DC voltage on the tissue, and the rate of increase of the DC voltage on the tissue. Therefore, in some embodiments, the duration of power output to the end effector may be changed based on a first parameter of the Nth period and a second parameter of the (N-1)th period. For example, if the first parameter is less than or equal to a first threshold, the cutting energy is modulated by outputting power to the end effector within a first time threshold. If the first parameter is greater than the first threshold, the cutting energy is modulated by increasing the duration of power output to the end effector to a second time threshold.

[0109] As discussed herein, modulating the cutting energy may further include determining the contact area between the tissue and the end effector based on a first parameter, and varying the cutting energy parameters based on the contact area between the tissue and the end effector. Since the contact area between the tissue and the end effector typically depends on the shape and size of the end effector (which is usually known in advance), the cutting energy parameters corresponding to various end effector shapes and sizes can be stored in memory, for example, in a lookup table. Therefore, after determining the contact area between the tissue and the end effector based on the first parameter, the cutting energy parameters can be determined from memory.

[0110] S514 corresponds to the coagulation phase, during which a second high-frequency electrical energy is modulated and applied to the tissue cut in the cutting phase to coagulate the tissue. The coagulation phase is performed to seal blood vessels exposed by the cut tissue through coagulation. During the coagulation phase, modulating the second high-frequency electrical energy may include, but is not limited to, changing the power output to the end effector, changing the amount of time the power is output to the end effector, etc.

[0111] To avoid being bound by theory, larger tissues will require a longer time to solidify. Therefore, in some embodiments, modulating the second high-frequency electrical energy may include varying the amount of time at which power is output to the end effector based on the contact area between the tissue and the end effector (e.g., as determined during S508).

[0112] Furthermore, if the size of the tissue being cut is larger, the power output to the end effector for coagulating the tissue is greater. Therefore, the power output to the end effector during the coagulation phase is an indicator of the size of the tissue being cut, and thus can be used to determine the parameters of the electrical energy applied in subsequent cycles to dry the tissue. Therefore, at S516, a second parameter is determined, for example, the power output to the end effector during the coagulation phase of the Nth cycle. As discussed herein, the second parameter indicates the size of the tissue to be dried during the third and subsequent cycles, and is therefore used to determine the power to be output to the end effector during the HPCS phase, as well as other parameters associated with modulating the first high-frequency electrical energy.

[0113] At S518, the cycle count is incremented by 1. Then, the method returns to S504 to continue and repeat the cycle.

[0114] Figure 6A and 6B It is a graph showing the corresponding behavior of HPCS current (graph (I)) and DC voltage as a function of time (graph (II) and (III)) for the disclosed operation applied to a small contact area example (graph (II)) and a large contact area example (graph (III)). Figure 6A The figure in the diagram shows that the contact area between the treatment tool and the tissue can be increased by applying an HPCS current (I0). HF DC voltage (V) during the period DC The time (t) taken to reach the threshold voltage th This is determined by [the threshold time]. In the example shown, the small contact area has a time less than the threshold (t). th The time (t) to reach the threshold a (See graph (II)), while a large contact area has a time greater than the threshold (t) thThe time (tb) to reach the threshold is calculated (see graph (III)). The output characteristics of the CUT are determined based on the contact area. Furthermore, in the small contact area example (see graph (II)), the CUT output time is short, the output voltage is small, and the DC voltage (V) is... DC In the case of a small contact area (see graph (III)), the CUT output time is long, the output voltage is large, and the DC voltage (V) is small. DC )big.

[0115] Figure 6B The figure in the diagram shows that by increasing the HPCS current (I HF Increasing the time period, for example, to equal or greater than 10 ms, makes it easier to detect the application of HPCS current (I0). HF DC voltage (V) during the period DC When and at what time (t) th The threshold voltage is reached. Figure 6A and 6B In the example shown, the small contact area has a time (t) less than the threshold. th The time (t) to reach the threshold a (See graph (II)), while a large contact area has a time greater than the threshold (t) th The time (t) to reach the threshold b (See graph (III)). The output characteristics during the CUT phase 420 of the cycle are determined based on the contact area.

[0116] The systems and methods disclosed herein improve the efficiency and reliability of electrosurgical procedures for treating biological tissues using high-frequency electrical energy. These systems and methods further reduce the incidence of spontaneous arcing during tissue cutting when the tissue is not fully dry, and thus prevent excessive bleeding caused by cutting partially dried tissue. Furthermore, by controlling the energy input to the tissue based on its size during tissue cutting, the systems and methods disclosed herein improve the speed and efficiency of tissue cutting.

[0117] Although the present invention has been described in conjunction with the exemplary embodiments described above, those skilled in the art will understand that additions, deletions, modifications and substitutions not specifically described may be made without departing from the spirit and scope of the invention.

[0118] The foregoing description is provided to enable those skilled in the art to practice the various configurations described herein. While the subject matter has been specifically described with reference to various accompanying drawings and configurations, it should be understood that these drawings and configurations are for illustrative purposes only and should not be considered as limiting the scope of the subject matter.

[0119] There are many other ways to implement the subject matter. The various functions and elements described herein may be distinguished differently from those shown without departing from the scope of the subject matter. Various modifications to these configurations will be apparent to those skilled in the art, and the general principles defined herein can be applied to other configurations. Therefore, those skilled in the art can make many changes and modifications to the subject matter without departing from its scope.

[0120] It should be understood that the specific order or hierarchy of steps in the disclosed process is an illustration of an exemplary method. It should be understood that the specific order or hierarchy of steps in the process can be rearranged based on design preferences. Some steps may be performed simultaneously. The method of the present invention presents the elements of each step in a sample order and is not intended to be limited to the specific order or hierarchy presented.

[0121] In some embodiments, any provision of this document may be subordinate to any independent provision or any dependent provision. In one aspect, any provision (e.g., dependent or independent provision) may be combined with any other one or more provisions (e.g., dependent or independent provisions). In one aspect, the invention may include some or all of the words (e.g., steps, operations, means, or components) recorded in a provision, sentence, phrase, or paragraph. In one aspect, the invention may include some or all of the words recorded in one or more provisions, sentences, phrases, or paragraphs. In one aspect, some words may be removed from individual provisions, sentences, phrases, or paragraphs. In one aspect, additional words or elements may be added to provisions, sentences, phrases, or paragraphs. In one aspect, the subject matter may be implemented without utilizing some of the components, elements, functions, or operations described herein. In one aspect, the subject matter may be implemented using additional components, elements, functions, or operations.

[0122] For example, a reference to "piston assembly" includes a reference to one or more piston assemblies, and a reference to "magnet" includes a reference to one or more magnets.

[0123] In one or more respects, the terms “about,” “basically,” and “approximately” may provide industry-accepted tolerances for the relevance between their respective terms and / or items, such as from less than one percent to five percent.

[0124] As used in this article, the term “substantially” refers to the complete or nearly complete scope or degree of an action, characteristic, nature, state, structure, item, or result.

[0125] It should be understood that the range format is used for convenience and brevity only, and therefore should be flexibly interpreted to include not only the values ​​explicitly listed as range boundaries, but also all individual values ​​or subranges covered within that range, as if each value and subrange were explicitly listed. For example, the numerical range “approximately 0.5 to 10 cm” should be interpreted to include not only the explicitly listed values ​​of approximately 0.5 cm to approximately 10.0 cm, but also the individual values ​​and subranges within the indicated range. Therefore, what is included in this numerical range are individual values ​​such as 2, 5, and 7, and subranges such as 2 to 8, 4 to 6, etc. The same principle applies to ranges that list only one value. Furthermore, this interpretation should apply regardless of the width of the range or the characteristics described.

[0126] Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this disclosure pertains. Although any methods, apparatuses, and materials similar to or equivalent to those described herein may be used in the practice or testing of this disclosure, representative methods, apparatuses, and materials are described below.

[0127] Unless otherwise stated, references to singular elements are not intended to mean "one and only one," but rather "one or more." Male pronouns (e.g., his) include female and neuter pronouns (e.g., her and its), and vice versa. The term "some" refers to one or more. Underlined and / or italicized headings and subheadings are used for convenience only, do not limit the subject matter, and are not mentioned in connection with the interpretation of the description of the subject matter. All structural and functional equivalents of elements in various configurations throughout the description of this disclosure that are known or will be known later by one of ordinary skill in the art are expressly incorporated herein by reference and are intended to be covered by the subject matter. Furthermore, nothing disclosed herein is intended to be offered to the public, whether or not such disclosure is expressly stated in the foregoing description.

[0128] The techniques described herein can be implemented in hardware, software, firmware, or any combination thereof, unless explicitly described as being implemented in a particular manner. Any feature described as a module or component may also be implemented together in an integrated logic device or separately as a discrete but interoperable logic device. If implemented in software, the technique may be implemented at least in part by a non-transitory processor-readable storage medium comprising instructions that, when executed, perform one or more of the methods described above.

[0129] Non-transitory processor-readable storage media may include random access memory (RAM) (such as synchronous dynamic random access memory (SDRAM), read-only memory (ROM), non-volatile random access memory (NVRAM), electrically erasable programmable read-only memory (EEPROM), flash memory, and other known storage media. Additionally or alternatively, these techniques may be implemented at least in part by a processor-readable communication medium that carries or conveys code in the form of instructions or data structures and can be accessed, read, and / or executed by a computer or other processor. For example, a carrier wave may be used to carry computer-readable electronic data, such as data used in sending and receiving emails or accessing networks such as the Internet or a local area network (LAN). Many modifications to this configuration may be made without departing from the scope or spirit of the claimed subject matter.

[0130] Although the detailed description contains many details, these details should not be construed as limiting the scope of the subject matter, but merely as illustrating different examples and aspects of the subject matter. It should be understood that the scope of the subject matter includes some embodiments not discussed in detail above. Various other modifications, alterations, and variations can be made to the arrangement, operation, and details of the methods and apparatus of the subject matter disclosed herein without departing from the scope of this disclosure. Unless otherwise stated, references to singular elements are not intended to mean "one and only one," but rather "one or more." Furthermore, an apparatus or method need not be designed to address every problem (or possess every achievable advantage) that can be solved by the different embodiments of this disclosure to be included within the scope of this disclosure. The word "may" and its derivatives as used herein should be understood to mean "possibly" or "optionally," rather than an affirmative capability.

[0131] Relevant application data

[0132] Pursuant to 35 U.SC §119, this application is based on and claims priority to U.S. Provisional Application 63 / 155,808, filed March 3, 2021, the entire contents of which are incorporated herein by reference.

Claims

1. A medical device for disposing of biological tissue, comprising: A power source configured to generate high-frequency electrical energy; An end effector, operable for coupling to the power source and configured to supply electrical energy to the tissue; as well as A controller, operable for coupling to the power supply and the end effector, wherein the controller is configured to: (a) Modulating a first high-frequency electrical energy applied to the tissue to dry the tissue; (b) Estimating a first parameter associated with the application of the first high-frequency electrical energy to the tissue during step (a), wherein the first parameter reflects the contact area between the tissue and the end effector of the medical device; and (c) Modulate the cutting energy applied to the tissue to cut the tissue based on the first parameter.

2. The medical device of claim 1, wherein the controller is further configured to: (d) modulate a second high-frequency electrical energy applied to the tissue to coagulate the tissue cut in step (c).

3. The medical device of claim 2, wherein the controller is further configured to sequentially perform steps (a)-(d) in a first cycle and sequentially repeat steps (a)-(d) in a second cycle to dispose of the tissue.

4. The medical device according to any one of claims 1 to 3, wherein, The first parameter includes the time during which the DC voltage on the tissue reaches a first threshold during step (a).

5. The medical device according to claim 4, wherein, Modulating the cutting energy includes estimating the contact area between the tissue and the end effector of the medical device based on the first parameter, and changing the cutting energy parameter associated with the application of the cutting energy on the contact area.

6. The medical device according to claim 5, wherein, The cutting energy parameters include the amount of time for applying a cutting voltage to the tissue, and wherein modulating the cutting energy includes increasing the amount of time for applying the cutting voltage when the contact area exceeds an area threshold.

7. The medical device according to claim 5, wherein, The cutting energy parameters include a DC voltage on the tissue, and wherein modulating the cutting energy includes increasing the DC voltage when the contact area exceeds an area threshold.

8. The medical device of claim 3, wherein the controller is further configured to estimate a second parameter indicating the size of the tissue during step (d), wherein, The cutting energy in the second cycle is modulated based on the second parameter estimated during the first cycle and the first parameter estimated during the second cycle.

9. The medical device according to claim 8, wherein, The second parameter includes the high-frequency power output during step (d).

10. The medical device according to claim 8, wherein, The cutting energy is modulated during the repeated second cycle based on the second parameter estimated during the completed first cycle and based on the first parameter estimated during the repeated second cycle.

11. A controller for a medical device configured to treat tissue using high-frequency electrical energy, the controller being operatively coupled to a power source of the medical device and configured to: (a) Controlling the power supply to modulate a first high-frequency electrical energy applied to the tissue to dry the tissue; (b) Estimate a first parameter associated with the application of the first high-frequency electrical energy to the tissue during step (a), wherein, The first parameter reflects the contact area between the tissue and the end effector of the medical device; as well as (c) Control the power supply to modulate the cutting energy applied to the tissue to cut the tissue based on the first parameter.

12. The controller of claim 11 is further configured to: (d) control the power supply to modulate a second high-frequency electrical energy applied to the tissue to coagulate the tissue cut in step (c).

13. The controller according to claim 12 is further configured to sequentially perform steps (a)-(d) in a first cycle and sequentially repeat steps (a)-(d) in a second cycle to dispose of the tissue.

14. The controller according to claim 11, wherein, The first parameter includes the time during which the DC voltage on the tissue reaches a first threshold during step (a).

15. The controller according to claim 14, wherein, The controller is configured to modulate the cutting energy by estimating the contact area between the tissue and the end effector of the medical device based on the first parameter, and by changing the cutting energy parameter associated with the application of the cutting energy based on the contact area.

16. The controller according to claim 15, wherein, The cutting energy parameters include the amount of time for applying a cutting voltage to the tissue, and wherein the controller is configured to modulate the cutting energy by increasing the amount of time for applying the cutting voltage when the contact area exceeds an area threshold.

17. The controller according to claim 15, wherein, The cutting energy parameters include a DC voltage applied to the tissue, and wherein the controller is configured to modulate the cutting energy by increasing the DC voltage when the contact area exceeds an area threshold.

18. The controller of claim 13, further configured to estimate a second parameter indicating the size of the tissue during step (d), wherein, The controller is configured to modulate the cutting energy in the second cycle based on the second parameter estimated during the first cycle and based on the first parameter estimated during the second cycle.

19. The controller according to claim 18, wherein, The second parameter includes the high-frequency power output during step (d).

20. The controller according to claim 18, wherein, The cutting energy is modulated during the repeated second cycle based on the second parameter estimated during the completed first cycle and based on the first parameter estimated during the repeated second cycle.

21. A computer-readable storage medium storing instructions that, when executed by a processor, cause the processor to perform: (a) Modulating a first high-frequency electrical energy applied to the tissue to dry the tissue; (b) Estimate a first parameter associated with the application of the first high-frequency electrical energy to the tissue during step (a), wherein, The first parameter reflects the contact area between the tissue and the end effector of the medical device; as well as (c) Modulate the cutting energy applied to the tissue to cut the tissue based on the first parameter.

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