Systems and methods for controlling tissue adhesion and de-adhesion

Abstract

A system, a method and a medical apparatus for treatment of body tissue which comprises at least partially one or more electrically conductive element, an energy source configured to provide a DC energy to the medical device and / or the tissue and a first control unit configured to control the energy source, wherein the first control unit causes the energy source to provide DC energy that establishes a direct electroadhesion bonding between the tissue and the medical device when the tissue and the medical device are in a direct contact or that establishes an indirect electroadhesion bonding between the tissue and the medical device via conductive means.

Description

[0001] SYSTEMS AND METHODS FOR CONTROLLING TISSUE ADHESION AND DE¬

[0002] ADHESION

[0003] TECHNICAL FIELD

[0004] The present application generally relates to systems, medical apparatuses, use and methods for controlling tissue adhesion and de-adhesion, and more particularly to techniques for manipulating the adhesion properties of tissues in medical, surgical, and diagnostic applications. Related domains include diagnosis, surgery, identification, methods or apparatus for sterilising materials or objects in general, disinfection, sterilisation or deodorisation of air, chemical aspects of bandages, dressings, absorbent pads or surgical articles, materials for bandages, dressings, absorbent pads or surgical articles and devices for introducing media into, or onto, the body, devices for transducing body media or for taking media from the body, devices for producing or ending sleep or stupor.

[0005] BACKGROUND ART

[0006] An article disclosed on the following link https: / / spectrum.ieee.org / electroadhesion-for- better-im plants reveals a study showing that by applying electricity to a soft material such as a raw tomato or chicken slice for a few seconds, it can be firmly bonded to a hard object such as a graphite plate, without the need for tape or glue. This unexpected effect is also reversible - because when the direction of the electric current is changed, the materials can often be easily separated, according to the University of Maryland scientists. Potential applications for this "electroadhesion", which can even work underwater, could include improved biomedical implants and bio-inspired robots.

[0007] This approach presents limitations.

[0008] PROBLEM STATEMENT

[0009] This application addresses the problem of controlling the adhesion or de-adhesion of body tissue during medical procedures.

[0010] The application provides solutions for actively creating or releasing adhesive bonds between a hard object and body tissue using electrical energy, thereby improving the precision and effectiveness of medical procedures such as biopsy and electrosurgery. SUMMARY

[0011] Embodiments of the invention are associated with various advantages and / or technical effects.

[0012] There is disclosed a system for actively controlling the adhesion or de-adhesion of body tissue with a hard object during medical procedures, comprising: a. an energy source configured to provide electrical energy to the body tissue and the hard object; b. means for reversing the polarity of the electrical energy provided by the energy source; c. a processor configured to control the activation, deactivation, and polarity switching of the electrical energy to facilitate the adhesion or deadhesion process between the hard object and the body tissue.

[0013] The main advantage of this invention is the active control when an adhesion or deadhesion should take place. Adhesion or deadhesion is currently random and cannot be controlled. However, active control is advantageous as it enables targeted adhesion if desired and also allows adhesion to be released again at a desired time. The system offers precise control over the adhesion / deadhesion process, allowing for targeted attachment or detachment of body tissue, which can improve the outcome of medical procedures.

[0014] By incorporating a processor to manage the electrical energy's activation, deactivation, and polarity, the system ensures consistent performance and reduces the risk of human error during operation.

[0015] The reversibility of the electrical energy polarity provides versatility in medical applications, enabling the system to be adapted for various procedures that require either temporary or permanent tissue adhesion.

[0016] The system allows for the use of a hard object, such as a biopsy probe or electrosurgical instrument, to facilitate the adhesion or deadhesion process, enhancing the versatility and applicability of the system. The system utilizes a low DC energy source, specifically in a DC current range of 2 - 90 mA or a DC voltage range of 0,1 - 20 V, ensuring safe and controlled electrical energy supply to the hard object and body tissue.

[0017] The system incorporates a processor that controls the activation, deactivation, and polarity switching of the electrical energy, enabling precise and customizable control over the adhesion or deadhesion process.

[0018] The system includes a sensor that detects the adhesion status between the hard object and the body tissue, providing feedback to the processor and enhancing the overall efficiency and effectiveness of the system.

[0019] Preferably the electrical energy is a DC energy or a DC component of an electrical energy.

[0020] The hard object could be make out or consist of graphite, metal or any other material which is biocompatible or can be make biocompatible and which is preferable conductive.

[0021] In a development, the system further comprises a hard object being a biopsy probe.

[0022] The integration of the system with a biopsy probe enhances the precision of tissue sampling, as it can selectively adhere to and retrieve targeted tissue samples with minimal contamination from surrounding tissues.

[0023] In a development, the system further comprises a hard object being an electrosurgical instrument.

[0024] When applied to an electrosurgical instrument, the system can improve surgical accuracy by allowing the instrument to adhere to specific tissue sites, providing stability and control during cutting or cauterization.

[0025] The system's controlled de-adhesion capability can facilitate the easy release of the electrosurgical instrument from the tissue during an operation which allows to release bonded tissue at the instrument during a surgery. In a development, the system further comprises an energy source being configured to provide a low DC voltage in the range of 0.1 - 10 V

[0026] In a development, the system further comprises a low DC Energy being specifically in the current range of 2 - 90 mA.

[0027] The specific range of 2 - 90 mA for the low DC current allows for fine-tuning the adhesion strength, enabling the system to be tailored to the specific requirements of different tissue types and procedural needs.

[0028] Operating within this defined range of low DC energy can enhance the energy efficiency of the system, potentially leading to longer operational times and reduced power consumption during medical procedures.

[0029] In a development, the system further comprises a processor being further configured to control the duration of electrical energy supply between 1 second and 5 minutes.

[0030] The ability to control the duration of electrical energy supply within a specific range allows for precise management of the adhesion process, ensuring that the bond is maintained for an adequate period without causing damage to the body tissue or the hard object.

[0031] The flexibility in setting the duration from 1 second to 5 minutes enables the system to be adaptable to various medical procedures, accommodating different requirements for temporary or semi-permanent adhesion.

[0032] In a development, the system further comprises a duration being specifically controlled between 20 seconds and 3 minutes.

[0033] By narrowing the control range of the duration to between 20 seconds and 3 minutes, the system can provide a more targeted approach to adhesion, optimizing the time for effective bonding while minimizing the risk of tissue damage or prolonged exposure to electrical energy. The specific control over the duration enhances the predictability and repeatability of the adhesion process, which is critical for medical procedures that demand high precision and reliability.

[0034] In a development, the system further comprises a sensor configured to detect the adhesion status between the hard object and the body tissue and to provide feedback to the processor.

[0035] The inclusion of a sensor that detects the adhesion status allows for real-time monitoring and adjustment of the adhesion process, leading to improved safety and effectiveness of the medical procedure.

[0036] Feedback provided by the sensor to the processor enables automatic control of the adhesion process, reducing the need for manual intervention and potentially decreasing the duration of the medical procedure.

[0037] In a development, the system further comprises a system being configured to operate underwater.

[0038] Configuring the system to operate underwater expands its utility to a wider range of medical procedures, including those performed in fluid-rich environments or where immersion is necessary.

[0039] The underwater operation capability ensures that the system's performance is not compromised by the presence of fluids, maintaining the integrity of the adhesion or debonding process during aquatic medical applications.

[0040] There is disclosed a method for actively creating an adhesion or debonding of body tissue to a hard object during medical procedures, comprising: a. contacting the hard object with the body tissue; b. applying electrical energy to the hard object to create or release an adhesive bond between the hard object and the body tissue. The method allows for active control over the creation and release of adhesive bonds, providing surgeons with a tool to manipulate body tissue with precision during complex medical procedures.

[0041] Applying electrical energy to facilitate adhesion or debonding offers a non-mechanical, potentially less invasive means of manipulating tissues, which may reduce trauma and improve patient outcomes.

[0042] In a development, the method further comprises an electrical energy being a low DC voltage in the range of

[0043] Utilizing a low DC voltage in the specified range ensures the safety of the operation, as it reduces the risk of electrical hazards that may arise from higher voltages.

[0044] The specified voltage range is energy-efficient, potentially lowering the operational costs of the method by minimizing power consumption during the debonding process.

[0045] In a development, the method further comprises a low DC energy being specifically in the current range of 2 - 90 mA.

[0046] The narrow range of 2 - 90 mA for the low DC energy allows for precise control over the electrical current, which can lead to consistent and repeatable results in the debonding process.

[0047] Operating within this specific current range can optimize the effectiveness of the debonding process, ensuring that sufficient energy is delivered without causing damage to the materials involved.

[0048] In a development, the method further comprises a duration of applying electrical energy being between 1 second and 5 minutes.

[0049] The defined duration range for applying electrical energy provides a sufficient time frame to achieve effective debonding while preventing excessive exposure that could compromise the integrity of the materials. By setting a clear time window, the method can be standardized, facilitating easier integration into automated processes and improving overall process efficiency.

[0050] In a development, the method further comprises a duration being specifically between 20 seconds and 3 minutes.

[0051] Specifying a duration between 20 seconds and 3 minutes allows for a rapid debonding process, which can increase throughput and reduce cycle times in manufacturing or repair operations.

[0052] This particular duration range balances the need for quick debonding with the requirement for thoroughness, ensuring a complete separation without resorting to prolonged application that could lead to energy waste.

[0053] In a development, the method further comprises reversing the polarity of the electrical energy to facilitate the debonding process.

[0054] Reversing the polarity of the electrical energy can enhance the debonding process by disrupting the adhesive bond from different directions, potentially leading to a cleaner and more complete separation.

[0055] Polarity reversal may also reduce the likelihood of residual adhesive remaining on the substrates, which can decrease the need for additional cleaning steps and further streamline the debonding process.

[0056] In a development, the method further comprises a method being performed as part of an endoscopic diagnostic procedure.

[0057] The integration of the method with an endoscopic diagnostic procedure allows for realtime data acquisition and analysis, which can lead to immediate clinical decision-making and potentially reduce the need for multiple patient visits.

[0058] By combining the method with endoscopy, the overall invasiveness of diagnostic procedures can be minimized, enhancing patient comfort and reducing recovery times. The concurrent use of the method with endoscopic techniques may improve the accuracy of diagnoses by providing additional layers of information that can be correlated with visual observations.

[0059] In a development, the method further comprises a method being performed as part of an electrosurgical procedure.

[0060] The combination of the method with an electrosurgical procedure enables precise tissue targeting and ablation, which can result in reduced collateral damage to surrounding healthy tissues.

[0061] Implementing the method in conjunction with electrosurgery may enhance procedural efficiency by providing real-time feedback on tissue characteristics, thus optimizing energy delivery and minimizing procedure time.

[0062] The method's integration into electrosurgical protocols can potentially improve patient outcomes by ensuring that the extent of tissue treatment is appropriate, thereby reducing the likelihood of incomplete ablation or the need for repeat procedures.

[0063] In a development, the method further comprises a method being performed by a robot- controlled electrosurgical system.

[0064] The use of a robot-controlled electrosurgical system to perform the method can increase the precision and consistency of surgical interventions, as robotic systems can execute complex maneuvers with high repeatability.

[0065] Robot-assisted execution of the method may reduce surgeon fatigue and the potential for human error, particularly during lengthy or complex electrosurgical procedures.

[0066] The application of the method through a robotic platform can facilitate minimally invasive surgery, leading to smaller incisions, less postoperative pain, and quicker recovery times for patients. A further exemplary embodiment of the invention relates to the design of a medical apparatus for creating an electroadhesion bonding between a medical device and body tissue.

[0067] According to the invention, the medical apparatus comprises at least one medical device for the treatment of body tissue. The term "medical devices" encompasses all types of means used in medical applications, such as means for electrosurgical procedures (e.g., all types of electrosurgical instruments or means to assist in electrosurgical procedures, etc.), means for medical diagnostic procedures (e.g., biopsy probes), or means for medical applications within a body (e.g., implants, stents, or tools to support wound healing).

[0068] The medical device according to the invention is further designed to at least partially include one or more electrically conductive elements, wherein the electrically conductive element preferably being located in the area of the medical device that comes into contact with the body tissue. For electrosurgical instruments or biopsy probes, this is preferably the tip of the instrument or probe. For implants or stents for example, this is the area where attachment between the implant or stent and body tissue is appropriate.

[0069] Furthermore, the medical apparatus includes an energy source configured to provide DC energy to the medical device and / or the tissue, as well as a first control unit configured to control the energy source.

[0070] It is possible for the electrically conductive element of the medical device to be in direct contact with the body tissue. In this arrangement, when the first control unit causes the energy source to provide DC energy, the DC energy establishes a direct electroadhesion bonding between the tissue and the medical device. This electroadhesion bonding is permanent and remains intact even when no DC energy is applied to the medical device or body tissue.

[0071] However, it is also conceivable that a conductive means may be provided between the electrically conductive element of the medical device and the body tissue. In this case, the medical device acts as a transmitter of the DC voltage to the conductive means. When, at the instruction of the first control unit, the energy source provides DC energy, an indirect electroadhesion bond is created between the tissue and the medical device via the conductive means, thereby forming a bonding between the conductive element and the body tissue.

[0072] Unlike electrostatic adhesive bonding, the present invention enables the establishment of an electroadhesion bonding between electrically conductive elements and body tissue that remains permanent even after DC energy is no longer applied.

[0073] In addition to establishing a permanent electroadhesion bond, a medical apparatus is also claimed that enables the release of a permanent electroadhesion bond.

[0074] The medical apparatus according to the invention comprises at least one medical device for the treatment of body tissue, which at least partially includes one or more electrically conductive elements, an energy source configured to provide DC energy to the medical device and / or the tissue, and a second control unit configured to control the energy source. The second control unit causes the energy source to provide DC energy that, when applied to the medical device and / or the tissue, facilitates the release of a direct electroadhesion bond between the tissue and the medical device or the release of an indirect electroadhesion bond between the medical device and the tissue via conductive means.

[0075] The release of an electroadhesion bond is performed analogously to the creation of an electroadhesion bond; however, the DC voltage used has a reversed polarity compared to the DC voltage used to create the bond.

[0076] A permanent electroadhesion bond is not only understood to mean the electroadhesion bonds described above but also electroadhesion bonds that, for example, can occur when cutting body tissue with electrosurgical instruments using RF energy, between the instruments and the body tissue. Experiments conducted by the applicant have shown that such electroadhesion bonds can also be almost completely released by applying a DC voltage, meaning that body tissue adhering to the cutting body of an electrosurgical instrument can be almost residue-free detached from the cutting body.

[0077] The medical apparatus according to the present invention can also be designed to include both the first and the second control unit, enabling both the creation of an electroadhesion bonding and the release of the bonding. In a further embodiment of the invention, the first and second control units are integrated into one another and form a combined control unit.

[0078] To release an electroadhesion bonding, at least one of the control units causes the energy source to provide DC energy with a reversed polarity compared to the DC energy that established the electroadhesion bond, in order to release the electroadhesion bond.

[0079] The range of the applied DC energy is in a low DC voltage range and / or a low current range, where the low DC voltage is up to 20V, preferably up to 10V, and in particular at least 5V, and for current, DC current is in the range of up to 200mA, preferably up to 80mA, and in particular at least 2mA.

[0080] For the production of the invention according to the invention, it is necessary that at least the part that is to be connected to the body tissue is electrically conductive. Accordingly, the electrically conductive element and / or the conductive means can consist of metal, a conductive polymer, a liquid, or a gel.

[0081] According to the invention, it is provided that at least one of the control units controls the duration of the application of the DC energy. The duration of the application can depend on the type and structure of the bond. Advantageously, the medical apparatus further comprises detection means configured to detect the status of the direct or indirect electroadhesion bond / release of the electroadhesion bond between the medical device and the tissue. Additionally, feedback on the detected status of the adhesion / deadhesion bond could be provided to at least one of the control units, and the control unit provides DC energy based on the received feedback. Furthermore, the medical apparatus can also be designed such that the control unit is configured to use artificial intelligence to evaluate the feedback.

[0082] The present invention also includes a system for a medical procedure, including the establishment of an electroadhesion bond between at least one medical device and body tissue, with a medical apparatus comprising an energy source configured to provide DC energy to the medical device and / or the tissue. This energy establishes a direct electroadhesion bond between the tissue and the medical device when the tissue and the medical device are in direct contact, or it establishes an indirect electroadhesion bond between the tissue and the medical device via conductive means. The invention further includes a system for a medical procedure involving the release of an electroadhesion bond between at least one medical device and body tissue, with a medical apparatus comprising an energy source configured to provide DC energy to the medical device and / or the body tissue, which causes the release of a direct electroadhesion bond with body tissue or an indirect electroadhesion bond with body tissue via conductive means.

[0083] The above-mentioned systems can, for example, include an endoscopic diagnostic system, an electrosurgical system, a system for inserting an implant or stent, a part of a robot-controlled electrosurgical system, and / or a system for wound closure.

[0084] A further aspect according to the invention is the use of a medical apparatus to establish an electroadhesion bonding between at least one medical device and body tissue, wherein the medical apparatus comprises an energy source configured to provide a DC energy to the medical device and / or the tissue that establishes a direct electroadhesion bonding between the tissue and the medical device when the tissue and the medical device are in a direct contact or that establishes an indirect electroadhesion bonding between the tissue and the medical device via conductive means as well as the use of a medical apparatus to release an electroadhesion bonding between at least one medical device and body tissue, wherein the medical apparatus comprises an energy source configured to provide a DC energy to the medical device and / or the body tissue which causes the release of a direct electroadhesion bonding with body tissue or an indirect electroadhesion bonding with body tissue via conductive means.

[0085] For the use the medical apparatus is adapted to establish a direct or indirect electroadhesion bonding between a medical device and body tissue as well as to release a direct or indirect electroadhesion bonding between a medical device and body tissue, wherein the used DC energy to release the electroadhesion bonding has a reversed polarity to the DC energy that established the electroadhesion bonding. For the use of the medical apparatus the DC energy is preferably in a low DC voltage range and / or a low current range.

[0086] A further aspect according to the invention is the use of a medical apparatus to establish an electroadhesion bonding between at least one medical device and body tissue, wherein the medical apparatus comprises an energy source configured to provide a DC energy to the medical device and / or the tissue that establishes a direct electroadhesion bonding between the tissue and the medical device when the tissue and the medical device are in a direct contact or that establishes an indirect electroadhesion bonding between the tissue and the medical device via conductive means as well as the use of a medical apparatus to release an electroadhesion bonding between at least one medical device and body tissue, wherein the medical apparatus comprises an energy source configured to provide a DC energy to the medical device and / or the body tissue which causes the release of a direct electroadhesion bonding with body tissue or an indirect electroadhesion bonding with body tissue via conductive means.

[0087] For the use the medical apparatus is adapted to establish a direct or indirect electroadhesion bonding between a medical device and body tissue as well as to release a direct or indirect electroadhesion bonding between a medical device and body tissue, wherein the used DC energy to release the electroadhesion bonding has a reversed polarity to the DC energy that established the electroadhesion bonding. For the use of the medical apparatus the DC energy is preferably in a low DC voltage range and / or a low current range.

[0088] Another aspect according to the invention is a method for a medical procedure including the establishment of an electroadhesion bonding between at least one medical device and body tissue by using a medical apparatus comprising an energy source configured to provide a DC energy comprising in a first step the contacting of body tissue with the medical device directly or indirectly via conductive means and in a next step the application of the DC energy to the medical device and / or tissue via the energy source that causes the establishment of a direct electroadhesion bonding between the medical device and the body tissue or an indirect electroadhesion bonding between the medical device and the body tissue via conductive means as well as a method for a medical procedure including the release of an electroadhesion bonding between at least one medical device and body tissue by using a medical apparatus comprising an energy source configured to provide a DC energy comprising in a first step the application of a DC energy to the medical device and / or the body tissue which causes the release of a direct electroadhesion bonding with body tissue or an indirect electroadhesion bonding with body tissue via conductive means. In one embodiment of the method in a first step a direct or indirect electroadhesion bonding between the medical device and the body tissue is established via a DC energy and in a second step the electroadhesion bonding is released via a DC energy, wherein the DC energy used to release the electroadhesion bonding has a reversed polarity to the DC energy that established the electroadhesion bonding and wherein the DC energy is a low DC energy.

[0089] BRIEF DESCRIPTION OF DRAWINGS

[0090] In the following, the present invention will be explained in more detail with reference to the accompanying drawings. The accompanying drawings, which form part of the description, illustrate various aspects of the present invention and, together with the description, serve to explain the principles of the invention; however, it is to be understood that the present invention is not limited to the precise embodiments shown.

[0091] The drawings are not intended to be limiting in any way, and it is understood that various embodiments of the invention may be practiced in other ways, including those not necessarily shown in the drawings. The present disclosure is illustrated by way of example and not limited in the accompanying figures in which like reference numerals indicate similar elements. Embodiments of the application will now be described with reference to the attached drawings:

[0092] Fig. 1 shows schematic illustration of the invention;

[0093] Fig. 2 shows the invention in a Flowchart;

[0094] Fig. 3 shows a first embodiment of establishing and releasing an electroadhesion bonding;

[0095] Fig. 4 shows a second embodiment of establishing and releasing an electroadhesion bonding;

[0096] Fig. 5 shows a third embodiment of establishing and releasing an electroadhesion bonding and

[0097] Fig. 6 schematic structure of a medical apparatus. DETAILED DESCRIPTION

[0098] The following description of certain embodiments of the invention is not intended to limit the scope of the present invention. Other examples, features, aspects, embodiments and advantages of the invention will be apparent to those skilled in the art from the following description, which is illustrative of one of the best ways contemplated for practicing the invention. As will become apparent, the invention is capable of other different and obvious aspects without departing from the invention. Accordingly, the drawings and descriptions should be considered illustrative and not limiting.

[0099] Fig. 1 shows a system according to the invention comprising a hard object 10 and an energy source 1. The hard object 10 is configured to contact body tissue 20, while the energy source 1 is configured to provide electrical energy 8 to the hard object 10. The system further includes means for reversing the polarity of the electrical energy 8 provided by the energy source 1. Additionally, a processor 5 is included in the system, which is configured to control the activation, deactivation, and polarity switching of the electrical energy 8. The purpose of this control is to facilitate the adhesion or deadhesion process between the hard object 10 and the body tissue 20.

[0100] Fig. 2 shows the following steps: Contacting the hard object 10 with the body tissue 20 is a step that precedes applying 9 electrical energy 8 to the hard object 10 to create or release an adhesive bond between the hard object 10 and the body tissue 20.

[0101] Fig. 3 shows a further embodiment of the present invention for supporting diagnostic and / or therapeutic procedures. Diagnostic procedures include all methods used in medicine to detect and diagnose diseases and encompass all procedures that help physicians make accurate diagnoses and plan the best possible treatment. Examples include: endoscopy (examination of internal organs with an endoscope, including biopsy, e.g., gastroscopy or colonoscopy), medical history taking (gathering information about the patient's medical history), physical examination (including inspection, palpation, percussion, and auscultation), imaging techniques such as X-ray, ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI), as well as functional tests (tests to check the function of specific organs, such as lung function tests or ECG (electrocardiogram)). Therapeutic procedures include all methods for treating diseases and promoting health, such as surgical procedures, particularly electrosurgical procedures.

[0102] In the illustrated case, a patient 30 is positioned on a treatment table 31 for a diagnostic or therapeutic procedure. During the procedure, it is necessary to establish an electroadhesive bonding with a part of the patient's body tissue. For this purpose, a medical device 32 with a distal end that includes an electrically conductive element 33 can be brought into contact with the body tissue. The medical device 32 is connected to a medical apparatus 34, which includes an energy source 35 that supplies DC energy to the medical device 33.

[0103] Fig. 3 also shows a direct current (DC) voltage diagram with three procedural states a), b), and c) represented in the diagram. In state a), to establish the electroadhesive bonding, the distal end of the medical device 32 is brought into contact with the body tissue, and a DC voltage (in the example shown, U_ = 5V) is supplied to the body tissue via the DC energy source 35 of the medical apparatus through the medical device 32. The DC voltage is provided until an electroadhesive bonding is formed, e.g., for 0.5 minutes. Subsequently, the DC voltage supply is turned off (DC voltage = 0 V), and the distal end of the medical device is firmly connected to the body tissue (state b). When the procedure reaches a stage where the medical device 32 needs to be detached from the body tissue 30, a DC voltage with reversed polarity is supplied via the DC energy source 35 of the medical apparatus 34. This reversed polarity DC voltage is used to dissolve the electroadhesive bonding. In the example shown, the DC voltage provided to release the electroadhesive bonding is -5V. After applying the reversed polarity DC voltage, the medical device and the body tissue are separated again (state c), and the medical device can be reused in other areas if needed.

[0104] An example application of the present invention is a lung biopsy. In this case, the biopsy sample is connected to a DC energy source and has an electrically conductive element at its distal end. The electrically conductive end is guided to the area of the lung to be examined. Subsequently, by applying the DC voltage, an electroadhesive bonding is established between the electrically conductive element and the tissue to be examined, which is secure. By pulling out the biopsy sample with the electrically conductive element, the part of the tissue to be examined that is connected to the electrically conductive element is detached from the remaining tissue and can be safely removed from the lung due to its adhesion to the biopsy sample.

[0105] Fig. 4 shows an embodiment of the present invention which is similar to the embodiment shown in Fig. 3. This example also relates to the use of the invention in the context of a diagnostic or therapeutic procedure, although in this example a medical means is to be connected to the body tissue of a patient. Up to now, such bondings have been made, for example, by means of a suture, plaster or also, for example, by means of clamp or press connections. However, if the medical means has conductive properties according to the present invention, it is possible to create a permanent bonding between the medical means and the body tissue by applying a DC voltage, which can also be released again without residue if the bonding is no longer required. Possible applications include the bonding of implants or stents to body tissue, the bonding of wound healing materials to body tissue to support healing processes or the use in computer-assisted procedures.

[0106] As in Fig. 3, Fig. 4 also shows a medical device 32 with a distal end that has an electrically conductive element 33. However, a medical means with conductive properties (hereinafter referred to as conductive means 36) is also arranged between the electrically conductive element and the body tissue. The medical device 32 is connected to a medical apparatus 34, which comprises an energy supply 35 that supplies DC energy to the medical device 33.

[0107] Fig. 4 also shows a DC voltage diagram with three process states a), b), c). In state a), the conductive means 36 is brought into contact with the body tissue and the medical device 32 is brought into contact with the conductive means 36 in order to establish an electroadhesion bonding between a medical means designed as a conductive means 36 and body tissue. A DC voltage (in the example shown, U_=5V) is then supplied via the DC voltage source 35 of the medical apparatus via the medical device 32 to the conductive means 36 and via the conductive member 36 to the body tissue, whereby the DC voltage is supplied until an electroadhesive bonding has been established between the medical means and the body tissue, whereby the duration of the application may vary depending on the application. The provision of the DC voltage is then switched off (DC voltage = 0 V) and the distal end of the medical device is removed from the medical means. The conductive means 36 is now firmly and permanently connected to the body tissue (state b). When the process reaches a stage in which the conductive means 36 is to be detached from the body tissue 30 again, a DC voltage is provided via the DC energy source 35 of the medical apparatus 34, which preferably has a polarity opposite to the DC voltage via which the electroadhesion bond was generated. In the example shown, the DC voltage provided to release the electroadhesion bond is e.g. -5V. After applying the DC voltage with reversed polarity, the conductive means 36 and the body tissue are separated from each other again (state c)).

[0108] Another advantageous embodiment of the invention is shown in Fig. 5. This pertains to its application in connection with an electrosurgical procedure. Electrosurgical procedures use high-frequency alternating current to cut, coagulate, or vaporize tissue. During the application of high-frequency alternating current, it often happens that adhesions occur between the cutting or coagulation instrument and the body tissue. As previously mentioned, it has been found that this type of adhesion can also be resolved by applying direct current (DC).

[0109] As shown in Fig. 5, the medical apparatus 34 includes an RF energy source 37 for generating high-frequency alternating current, which is used to cut or coagulate body tissue via a medical device 32. If adhesion occurs between the body tissue and the electrically conductive element 33 of the medical device 32 during the cutting or coagulation process, it can be resolved. As illustrated in the DC voltage diagram in Fig. 5, after detecting an adhesion, a DC voltage is applied via a DC energy source until the adhesion is resolved, allowing the medical device to be used further.

[0110] Fig. 6 shows the schematic structure of a medical apparatus 34 for providing DC energy. The medical apparatus according to the invention includes a power supply unit 1 , which can be connected to the electrical grid via a power plug 2. The power supply unit 1 is connected to a DC energy unit 6, which in turn is connected to the medical device 32 and supplies it with DC energy. Additionally, DC energy voltage and current sensors 8 are provided between the DC energy unit 6 and the medical device 32.

[0111] The measurement data from the DC energy voltage and current sensors 8 are transmitted to the feedback circuit 11 , which processes this data and makes it available to the control unit 10. Based on the requirements of the procedure to be applied (adhesion or deadhesion), the control unit 10 regulates the amount of energy that the power supply unit 1 delivers to the DC energy unit 6.

Claims

CLAIMS1 . A system for actively controlling the adhesion or de-adhesion of body tissue with a hard object during medical procedures, comprising: a. an energy source configured to provide electrical energy to the body tissue and the hard object; b. means for reversing the polarity of the electrical energy provided by the energy source; c. a processor configured to control the activation, deactivation, and polarity switching of the electrical energy to facilitate the bonding or debonding process between the hard object and the body tissue.

2. The system of claim 1 , wherein the electrical energy is a DC energy or a DC component of the electrical energy.

3. The system of claim 1 or 2, wherein the hard object could be make out or consist of graphite, metal or any other material which is biocompatible or can be make biocompatible and which is preferable conductive.

4. The system of any of claims 1 to 3, wherein the hard object is a biopsy probe.

5. The system of any of claims 1 to 3, wherein the hard object is an electrosurgical instrument.

6. The system of any of the preceding claims, wherein the energy source is configured to provide a low DC voltage in the range of 0.1 - 10 V.

7. The system of claim 6, wherein a low DC current is provided specifically in the range of 2 - 90 mA.

8. The system of any of the preceding claims, wherein the processor is further configured to control the duration of electrical energy supply between 1 second and 5 minutes.

9. The system of claim 8, wherein the duration is specifically controlled between 20 seconds and 3 minutes.

10. The system of any of the preceding claims, further comprising a sensor configured to detect the adhesion status between the hard object and the body tissue and to provide feedback to the processor.

11. A method for actively creating an adhesion or deadhesion of body tissue to a hard object during medical procedures, comprising: a. bringing the body tissue and or the hard object into contact; b. applying electrical energy to the hard object or the body tissue to create or release an adhesive bond between the hard object and the body tissue.

12. The method of claim 11 , wherein the electrical energy is a low DC energy in the range of 0.1 - 10 V.

13. The method of claim 12, wherein the low DC energy is specifically in the range of 2 - 90 mA.

14. The method of any of claims 11 to 13, wherein the duration of applying electrical energy is between 1 second and 5 minutes.

15. The method of claim 14, wherein the duration is specifically between 20 seconds and 3 minutes.

16. The method of any of claims 11 to 15, further comprising reversing the polarity of the electrical energy to facilitate the debonding process.

17. The method of any of claims 11 to 16, wherein the method is performed as part of an endoscopic diagnostic procedure.

18. The method of any of claims 11 to 16, wherein the method is performed as part of an electrosurgical procedure.

19. The method of any of claims 11 to 18, wherein the method is performed by a robot- controlled electrosurgical system.

20. A medical apparatus, comprising:- at least one medical device for treatment of body tissue which comprises at least partially one or more electrically conductive element;- an energy source configured to provide a DC energy to the medical device and / or the tissue;- a first control unit configured to control the energy source; wherein the first control unit causes the energy source to provide DC energy that establishes a direct electroadhesion bonding between the tissue and the medical device when the tissue and the medical device are in a direct contact or that establishes an indirect electroadhesion bonding between the tissue and the medical device via conductive means.21 . A medical apparatus, comprising:- at least one medical device for treatment of body tissue which comprises at least partially one or more electrically conductive elements;- an energy source configured to provide a DC energy to the medical device and / or the tissue;- a second control unit configured to control the energy source; wherein the second control unit causes the energy source to provide DC energy that effects by application to the medical device and / or the tissue a release of a direct electroadhesion bonding between the tissue and the medical device or a release of an indirect electroadhesion bonding between the medical device and the tissue via conductive means.

22. The medical apparatus of claim 20, wherein the apparatus further comprises a first control unit according to claim 21 .

23. The medical apparatus of the previous claim, wherein the first and the second control unit are integrated into one another and build a combined control unit.

24. The medical apparatus of any of the previous claims 20 to 23, wherein at least one of the control units causes the energy source to provide a DC energy with a reversed polarity to the DC energy that established an electroadhesion bonding according to claim 1 in order to release the electroadhesion bonding.

25. The medical apparatus of any of the previous claims 20 to 24, wherein the DC energy is in a low DC voltage range and / or a low current range.

26. The medical apparatus of the previous claim, wherein the low DC voltage is up to 20V preferably up to 10V and in particular at least 5 volts and for current DC current in the range up to 200mA preferably up to 80mA and in particular at least 2 mA.

27. The medical apparatus of any of the previous claims 20 to 26, wherein the electrically conductive element and / or the conductive means consist of metal, a conductive polymer, a liquid or a gel.

28. The medical apparatus according to any of the previous claims 20 to 27, wherein at least one of the control units controls the duration of the application of the DC energy.

29. The medical apparatus of any of the previous claims 20 to 28, further comprising detection means configured to detect the status of the direct or indirect electroadhesion bonding / release of the electroadhesion bond between the medical device and the tissue.

30. The medical apparatus of the previous claim, wherein a feedback of the detected status of the adhesion / deadhesion bond is provided to at least one of the control units and the control unit provides DC energy based on the received feedback.31 . The medical apparatus of the previous claim, wherein the control unit is configured to use artificial intelligence to evaluate the feedback.

32. A system for a medical procedure including the establishment of an electroadhesion bonding between at least one medical device and body tissue with a medical apparatus comprising an energy source configured to provide a DC energy to the medical device and / or the tissue that establishes a direct electroadhesion bonding between the tissue and the medical device when the tissue and the medical device are in a direct contact or that establishes an indirect electroadhesion bonding between the tissue and the medical device via conductive means.

33. A system for a medical procedure including the release of an electroadhesion bonding between at least one medical device and body tissue with a medical apparatus comprising an energy source configured to provide a DC energy to the medical device and / or the body tissue which causes the release of a direct electroadhesion bonding with body tissue or an indirect electroadhesion bonding with body tissue via conductive means.

34. The system of one of the claims 32 and 33, wherein the system is an endoscopic diagnostic system, an electrosurgical system, a system for inserting an implant or stent, a part of a robot-controlled electrosurgical system and / or a system for wound closure.

35. Use of a medical apparatus to establish an electroadhesion bonding between at least one medical device and body tissue, wherein the medical apparatus comprises an energy source configured to provide a DC energy to the medical device and / or the tissue that establishes a direct electroadhesion bonding between the tissue and the medical device when the tissue and the medical device are in a direct contact or that establishes an indirect electroadhesion bonding between the tissue and the medical device via conductive means.

36. Use of a medical apparatus to release an electroadhesion bonding between at least one medical device and body tissue, wherein the medical apparatus comprises an energy source configured to provide a DC energy to the medical device and / or the body tissue which causes the release of a direct electroadhesion bonding with body tissue or an indirect electroadhesion bonding with body tissue via conductive means.

37. Use of the medical apparatus of claims 35 and 36, wherein the medical apparatus is adapted to establish a direct or indirect electroadhesion bonding between a medical device and body tissue as well as to release a direct or indirect electroadhesion bonding between a medical device and body tissue.

38. Use of the medical apparatus of one of claim 36 or 37, wherein the used DC energy to release the electroadhesion bonding has a reversed polarity to the DC energy that established the electroadhesion bonding.

39. Use of the medical apparatus of one of the previous claims 35 to 38, wherein the DC energy is in a low DC voltage range and / or a low current range.

40. A method for a medical procedure including the establishment of an electroadhesion bonding between at least one medical device and body tissue by using a medical apparatus comprising an energy source configured to provide a DC energy comprising: a. contacting body tissue with the medical device directly or indirectly via conductive means; b. applying the DC energy to the medical device and / or tissue via the energy source that causes the establishment of a direct electroadhesion bonding between the medical device and the body tissue or an indirect electroadhesion bonding between the medical device and the body tissue via conductive means.

41. A method for a medical procedure including the release of an electroadhesion bonding between at least one medical device and body tissue by using a medical apparatus comprising an energy source configured to provide a DC energy comprising:- applying a DC energy to the medical device and / or the body tissue which causes the release of a direct electroadhesion bonding with body tissue or an indirect electroadhesion bonding with body tissue via conductive means.

42. The method of one of claim 40 and 41 , wherein in a first step a direct or indirect electroadhesion bonding between the medical device and the body tissue is established via a DC energy and in a second step the electroadhesion bonding is released via a DC energy.

43. The method of the previous claim, wherein the DC energy used to release the electroadhesion bonding has a reversed polarity to the DC energy that established the electroadhesion bonding.

44. The method of one of the previous claims 40 to 43, wherein the DC energy is a low DC energy.

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