Arrangement and method for supplying a hand-held surgical instrument with radiofrequency power

Abstract

The invention relates to an arrangement (1) having an actuating element (4), a hand-held surgical instrument (8), a generator (13) and a control unit (24), wherein the control unit (24) is configured to detect an actuation (6) of the actuating element (4) and, in response to the actuation (6) detected thus, to trigger a control signal switching on the power output of the generator (13), and the control unit (24) is configured such that, in the event of an actuation duration (5) of the actuation (6) being longer than a reference period (21), letting go (7) of the actuating element (4) leads to an interruption in the power output and that, in the event of an actuation duration (5) of the actuation (6) being shorter than the reference period (21), letting go (7) of the actuating element (4) does not lead to an interruption in the power output; the invention also relates to a method for supplying a hand-held surgical instrument (8).

Description

[0001] Arrangement and method for supplying a surgical hand instrument with high-frequency energy

[0002] The invention relates to an arrangement comprising an actuating element, a surgical hand instrument, and a generator supplying the hand instrument with high-frequency energy. The arrangement further comprises a control unit connected to the actuating element, the control unit being configured to generate a control signal from actuations of the actuating element, which controls the energy output of the generator. The invention further relates to a method for supplying a surgical hand instrument with high-frequency energy by means of a generator.

[0003] High frequency can be understood to mean a frequency of more than 100 kHz, preferably more than 200 kHz, particularly preferably more than 300 kHz.

[0004] Such arrangements and procedures are known in practice, for example in electrosurgery. The energy that powers the hand instrument is introduced into the patient's tissue as electrical energy when the arrangement is used.

[0005] In practice, it is common for energy to be delivered for exactly as long as a surgeon operates the actuating element, which is typically designed as a finger or foot switch.

[0006] The invention is based on the objective of improving usability.

[0007] To solve this problem, an arrangement with the features of claim 1 is proposed. In particular, an arrangement of the type described above is proposed, in which the control unit is configured to detect actuation of the actuating element and, in response to the actuation thus detected, to trigger a control signal that activates the energy output. Furthermore, the control unit is configured such that if the actuation duration exceeds a reference time, releasing the actuating element leads to an interruption of the energy output, and if the actuation duration is less than a reference time, releasing the actuating element does not lead to an interruption of the energy output. The surgeon operating the arrangement thus has the option of operating the arrangement in two different ways for an identical procedure.The first operating mode, in which he activates the control element for as long as energy is to be delivered, is already familiar to him from practical experience. This now allows him to release the control element again with only a brief initial press, without interrupting the energy delivery. This second operating mode enables less tiring work, especially during longer treatments, as continuous activation of the control element is not required.

[0008] The reference time is preferably between two hundred milliseconds and one and a half seconds. Particularly preferably between three hundred milliseconds and one second, and most preferably between four hundred and six hundred milliseconds. For example, the reference time can be 500 ms.

[0009] Preferably, the control unit is configured such that if the actuation duration is less than the reference duration, a subsequent actuation of the actuator leads to an interruption of the energy output. Such an interruption of the energy output offers the surgeon a simple and easily understandable procedure.

[0010] Preferably, the reference time duration is adjustable. This allows the arrangement to be adapted to the specific needs of the operator.

[0011] As an alternative solution to the aforementioned problem, the features of a dependent claim directed to an arrangement are proposed. This claim proposes an arrangement of the type described above to solve the problem, in which the control unit is configured to generate an identical control signal from two different sequences of actuation states of the actuating element. This can be achieved, in particular, in the manner described above; that is, the arrangement can be designed and configured as previously described. The variants described below therefore further develop both the previously described concrete solution and the previously described more general solution. In an advantageous embodiment of the arrangement, it can be provided that the sequence of actuation states of the actuating element required to generate the identical control signal depends on the duration of the actuation of the actuating element.

[0012] Alternatively or additionally, a reference time, for example the previously mentioned reference time, can be specified for the actuation of the actuator. Below this reference time, a first sequence of actuation states of the actuator generates the control signal, and above this reference time, a different second sequence of actuation states of the actuator generates the identical control signal. The aforementioned configurations allow for particularly simple handling of the arrangement, since the actuation of the actuator and its duration are especially well suited for defining different sequences for identical control.

[0013] In a further embodiment of the arrangement, a first sequence of actuation states of the actuating element can be defined by the initiation and termination of actuation, and a second sequence of actuation states of the actuating element can be defined by the actuating element being actuated twice. Preferably, the actuation duration in the first sequence is longer than the actuation duration in the second sequence. This increases the flexibility in operating the arrangement.

[0014] For example, in the first sequence, energy release can be activated by the start of the actuation and interrupted by the subsequent termination of the actuation. Similarly, in the second sequence, energy release can be activated with the first actuation and interrupted with the second actuation.

[0015] Particularly advantageous practical applications are offered by a design in which, in a first actuation state, the actuating element is actuated, in particular pressed, and in a second actuation state, the actuating element is not actuated, in particular released. In an advantageous embodiment, the surgical hand instrument may be an electrosurgical instrument.

[0016] The hand instrument may have a handle. The hand instrument may also have two branches.

[0017] The surgical hand instrument may be designed to seal and / or coagulate and / or cut tissue.

[0018] The surgical hand instrument may consist of forceps with two arms. The arms may be shaped like jaws. The hand instrument may also be shaped like scissors and / or clamps.

[0019] Bipolar coagulation involves tissue denaturation to achieve hemostasis. An electrosurgical instrument uses high-frequency alternating current to generate a thermal effect in the tissue. Due to the specific resistance of the current, the electrical energy is converted into thermal energy in the tissue, thus heating it. Bipolar coagulation is frequently used to stop diffuse bleeding.

[0020] The energy output can be in the form of a high-frequency current. In this configuration, the generator is preferably a high-frequency current generator. The high-frequency current can be transmitted to the handheld instrument via a conductor.

[0021] Preferably, the generator is configured to produce more than one type of high-frequency energy. A high-frequency energy type can be characterized, for example, by a frequency, a power, or a pulse shape of the energy transmission. "HF" is used in this description as an abbreviation for the word "high frequency." An HF current generator is preferably configured to produce more than one type of HF current. A type of HF current can be characterized, for example, by its maximum voltage, its frequency, a time modulation, or current limiting. For example, a first type of HF energy, in particular a first type of HF current, can be suitable for sealing, a second type for coagulation, and / or a third type for cutting.

[0022] When coagulation is performed with bipolar forceps, the tissue is grasped and / or the forceps tips are pressed onto the bleeding surface. The high-frequency current can be activated, for example, via a foot or finger switch. As a result, the tissue can coagulate to achieve hemostasis.

[0023] Preferably, the actuating element is designed as a hand actuating element or as a foot actuating element.

[0024] Preferably, the actuating element is part of the hand instrument. This is the case, at least, when the actuating element is designed as a hand-operated actuating element. If the actuating element is designed as a foot-operated actuating element, it is preferably designed as a separate component, which is preferably directly connected to the generator. Alternatively, it can also be connected to the hand instrument, which transmits an actuation signal generated by the actuating element to the generator.

[0025] The actuating element can, for example, be a button. A button can be a control element that is activated by pressing it and automatically returns to its initial position when released. This automatic return to the initial position can simplify operation. For example, the button can be a self-resetting, non-latching switch.

[0026] The button could be, for example, an electrical button where electrical contacts make contact when pressed. It could also be a sensor button, such as a touchpad or a capacitive button.

[0027] The handheld instrument preferably has a connection for transferring energy from the generator. This connection can be connected to a corresponding connection on the generator and is connected during operation. Furthermore, the handheld instrument preferably has a control connection for controlling the generator. This control connection can be connected to a corresponding control connection on the generator and is connected during operation. The connections for energy transfer and control can form a common connection.

[0028] The connection can be made primarily via a cable. However, alternatively, the power and / or signal transmission for control can also be wireless.

[0029] The control unit can be built into the generator, it can form a separate module, or it can be integrated into the hand instrument.

[0030] Preferably, the arrangement includes a processing unit and / or a data storage device. The preferably permanent data storage device can, for example, store reference sequences of actuation states of the actuating element. Furthermore, a volatile memory can be provided, which can, among other things, temporarily store completed actuation sequences. The processing unit can be configured, for example, to compare the reference sequences with the executed sequences.

[0031] The arrangement can include one or more sensors capable of detecting the state of the arrangement or properties of an output energy, particularly an output RF current. For example, a position sensor can be configured to detect whether the branches are open or closed. Preferably, the energy output is interrupted when it is detected that the branches are being opened or are open. For example, a sensor can be configured to detect the resistance, current, and / or voltage of an applied current, particularly an RF current.

[0032] The processing unit can be configured to determine, based on signals detected by sensors, such as those already mentioned, and in particular on detected properties of an applied energy, especially an RF current, whether an application has been successful, according to a calculation rule or through other automatically performed calculations. For example, an application may be successful if the sealing process is completed. Preferably, the energy output is interrupted when an application is detected, particularly by the processing unit.

[0033] The arrangement may include a fault detection unit. This unit may be connected to a control unit. The fault detection unit is configured to detect fault conditions in the arrangement or a connected generator. Preferably, the power output is interrupted when the fault detection unit detects a fault condition.

[0034] To ensure the safe use of the device, the control unit can be configured to switch off the generator's power output independently of any actuation of the actuator when an opening of the hand instrument's branches is detected, when a fault condition is detected, or when an application success, such as a completed seal, is detected. This shutdown increases safety when using the device, as the power output is switched off in safety-relevant situations even if the user does not initiate it.

[0035] A further solution to the aforementioned problem is proposed by the features of the dependent claim, which relates to a method for supplying a surgical hand instrument. In particular, it is proposed that the actuation of an actuating element is detected, and that the detected actuation triggers a control signal that initiates energy output from the generator. Furthermore, it is provided that if the actuation duration exceeds a reference time, releasing the actuating element leads to an interruption of the energy output, and if the actuation duration is less than a reference time, releasing the actuating element does not lead to an interruption of the energy output. The advantages associated with this method have already been described previously in the description of the arrangement.Advantageous reference time durations have also been described previously.

[0036] In an advantageous embodiment, it can be provided that if the actuation duration is less than the reference duration, a subsequent actuation of the actuating element leads to an interruption of the energy output. As a further solution to the aforementioned problem, the features of the dependent claim, which relates to a method for supplying a surgical hand instrument, are proposed in accordance with the descriptions of the arrangement. In particular, it is thus proposed to solve the aforementioned problem that a control signal controlling the energy output of the generator is generated from actuations of an actuating element, and that an identical control signal is generated from two different sequences of actuation states of the actuating element.

[0037] This can be done in the manner described above, i.e., the procedure can be designed as previously described. The variants described below therefore further develop both the more specific and the more general solutions described above.

[0038] Preferably, the described methods are carried out using an arrangement which is preferably designed as described above.

[0039] The variants previously described in connection with the device can also further develop the disclosed methods. Likewise, the variants of the described methods described below can also further develop the arrangement by being configured to execute the corresponding method variants.

[0040] In an advantageous embodiment, it can be provided that an actuation duration of an actuation of the actuating element determines the sequence of actuation states of the actuating element by which the control signal is generated.

[0041] In a further advantageous embodiment, it can be provided that a reference time duration is specified for a first actuation of the actuating element, below which a first sequence of actuation states of the actuating element generates the control signal and above which a different second sequence of actuation states of the actuating element generates the identical control signal.

[0042] It may be provided that a first sequence of actuation states of the actuating element is determined by the initiation and termination of actuation of the actuating element, and that a second sequence of actuation states of the actuating element is determined by the actuating element being actuated twice, in particular wherein the actuation duration in the first sequence is longer than the actuation duration in the second sequence.

[0043] It can also be provided that in a first actuation state the actuating element is actuated, in particular pressed, and that in a second actuation state the actuating element is not actuated, in particular released.

[0044] Furthermore, to increase safety, it may be provided that the energy output is switched off if an opening of branches of the hand instrument is detected, if a fault condition is detected, or if an application success, such as a completed seal, is detected.

[0045] The invention will now be described in more detail with reference to exemplary embodiments, but is not limited to these embodiments. Further variants result from combining the features of one or more claims with each other and / or with one or more features of the exemplary embodiments and / or the variants described above.

[0046] They show:

[0047] Fig. 1 shows an embodiment of an arrangement designed according to the invention,

[0048] Fig. 2 shows a further embodiment of an arrangement designed according to the invention,

[0049] Fig. 3 shows a first operating mode of the arrangement according to the invention and

[0050] Fig. 4 shows a second operating mode of the arrangement according to the invention.

[0051] Figure 1 shows an arrangement 1 comprising a surgical hand instrument 8 and a generator 13 connected to it. The generator 13 supplies the hand instrument 8 with energy. The hand instrument 8 has a handle 2, two jaws 3, and an actuating element 4. In the embodiment shown here, an electrosurgical hand instrument is shown, each jaw 3 of which comprises an electrode 26.

[0052] The hand instrument 8 can be configured, in particular, as a high-frequency sealing instrument. The prongs 3 can be applied to a patient's tissue sample. The applied electrical voltage 12 seals the tissue sample in the manner previously described in more detail.

[0053] The actuating element 4 is designed as a hand actuating element 18, so that an operator of the arrangement 1 can operate the actuating element 4 with one finger.

[0054] In the embodiment shown in Fig. 1, the actuating element 4 is designed as a button 20. In this case, the button 20 is an electrical button 20. By actuating the button 20, in this case by pressing the button 20, energy output from the generator 13 can be triggered. For this purpose, an electrical voltage 12 can be applied between the electrodes 26 in the illustrated embodiment.

[0055] Arrangement 1 includes a connection 14 for the generator 13. The generator 13 also has a connection 27 and can be connected to the connection 14 via a cable 22, and is indeed connected in the arrangement shown. The generator 13 can transmit energy to the hand instrument 8 via the cable 22. In the example shown, the generator 13 is a high-frequency current generator that enables the application of the electrical voltage 12 to the branches 3. The electrical voltage 12 is a high-frequency alternating voltage.

[0056] The terminal 27 is also a control terminal 28, which receives an actuation signal from the actuating element 4 via a control line running in the cable 22. The actuation signal, which indicates whether the actuating element 4 is actuated or not, is present at the input of a control unit 24. The control unit 24 is configured to generate a control signal from the actuations 6, 7 of the actuating element 4, which controls the energy output of the generator 13. The arrangement 1 includes a sensor 29, preferably installed in the generator 13, with which a property of the current that supplies the hand instrument 8 with energy is measured. Furthermore, the arrangement 1 includes a position sensor 30 on the hand instrument 8, which can measure the position of the branches 3. The generator 13 further includes a processing unit 31 and a data storage unit 32.The sensors 29, 30, the computing unit 31 and the data storage unit 32 can perform the functions that are described in more detail above.

[0057] Figure 2 shows another variant of arrangement 1. Arrangement 1 is identical to arrangement 1 in Figure 1. Only the design of the actuating element 4 differs: In this embodiment, the actuating element 4 is designed as a foot-operated actuating element 19. Thus, the operator can activate the control unit 24 by pressing the actuating element 4, which is designed as a button 20, and thereby cause energy to be supplied to the hand instrument 8.

[0058] The embodiments of the arrangement 1 shown in Fig. 1 and Fig. 2 are designed such that, depending on an actuation duration 5 between an initial actuation 6 of the actuating element 4 and a subsequent release 7 of the actuating element 4, different sequences of actuation states 11 of the actuating element 4 generate an identical control signal.

[0059] This and other variations have already been described in more detail. Furthermore, this will be explained in more detail below using a specific example.

[0060] Figure 3 shows two diagrams, 9 and 10, which illustrate the principle of a first operating mode of the arrangement 1. The horizontal axes of diagrams 9 and 10 each represent the course of time 23. Diagram 9 shows a sequence of actuation states 11 of the actuating element 4. Diagram 10 schematically shows the voltage amplitude 17 applied to the branches 3.

[0061] The first operating mode comprises a first sequence of actuation states 11 of the actuating element 4. A first actuation state 11 is defined by actuating 6, in the case of button 20, by pressing, the actuating element 4. A second actuation state 11 is defined by releasing 7 of the actuating element 4. In Fig. 3, the sequence of actuation states 11 consists of actuating 6, a subsequent release 7 after an actuation duration 5, and a subsequent actuation 6 of the actuating element 4. Actuation 6 activates energy output by the generator 13 from the control unit 24, so that a voltage is applied to the branches 3. The actuating element 4 is released after an actuation duration 5, which is shorter than a reference duration 21, which can be, for example, 500 ms. The energy output is not interrupted.The energy output is then interrupted by reactivating the actuating element 4 at a later time.

[0062] Figure 4 illustrates a second operating mode of arrangement 1. Diagrams 9 and 10 are structured similarly to the diagrams in Figure 3.

[0063] In Fig. 4, the sequence of actuation states 11 consists solely of actuation 6 and subsequent release 7 after an actuation duration 5 that is longer than the reference duration 21 compared to the situation shown in Fig. 3. In the second operating mode shown in Fig. 4, energy output is also switched on with actuation 6. However, unlike in the operating mode described in Fig. 3, energy output is interrupted as soon as the actuating element 4 is released 7.

[0064] The criterion for whether the first or second operating mode is used is whether the actuation duration 5 of an actuation of the actuating element 4 is shorter or longer than a predetermined, preferably adjustable, reference duration 21.

[0065] Thus, an identical control signal can be generated from two different sequences of actuation states 11 of the actuating element 4. List of reference symbols

[0066] arrangement

[0067] Handle

[0068] Industry

[0069] Actuating element

[0070] Operating time

[0071] Actuation of the actuating element 4

[0072] Releasing the actuating element 4

[0073] hand instrument

[0074] diagram

[0075] Further diagram

[0076] Actuation state

[0077] Electrical voltage

[0078] generator

[0079] Connection

[0080] Voltage amplitude

[0081] Manual operating element

[0082] Foot control element

[0083] button

[0084] Reference period

[0085] Cable

[0086] Time

[0087] control unit

[0088] electrode further connection

[0089] Control connection

[0090] sensor

[0091] Position sensor

[0092] computing unit

[0093] Data storage

Claims

Patent claims 1. Arrangement (1) with an actuating element (4), a surgical A hand instrument (8), a generator (13) supplying the hand instrument (8) with high-frequency energy, and a control unit (24), wherein the control unit (24) is signal-connected to the actuating element (4) and is configured to generate a control signal from actuations of the actuating element (4) that controls the energy output of the generator (13), wherein the control unit (24) is configured to detect an actuation (6) of the actuating element (4) and, in response to the actuation (6) thus detected, to trigger a control signal that switches on the energy output, characterized in that the control unit (24) is configured such that if the actuation duration (5) of the actuation (6) is more than a reference time duration (21), for example, more than 500 ms,Releasing (7) the actuating element (4) leads to an interruption of the energy output, and that if the actuation duration (5) of the actuation (6) is less than the reference duration (21), releasing (7) the actuating element (4) does not lead to an interruption of the energy output.

2. Arrangement (1) according to claim 1, characterized in that the control unit (24) is arranged such that if the actuation duration (5) of the actuation (6) is less than the reference time duration (21), a renewed actuation (6) of the actuating element (4) leads to an interruption of the energy output.

3. Arrangement (1) comprising an actuating element (4), a surgical hand instrument (8), a generator (13) supplying the hand instrument (8) with high-frequency energy, and a control unit (24), wherein the control unit (24) is signal-connected to the actuating element (4) and is configured to generate a control signal controlling the energy output of the generator (13) from actuations (6, 7) of the actuating element (4), characterized in that the control unit (24) is configured to generate an identical control signal from two different sequences of actuation states (11) of the actuating element (4).

4. Arrangement (1) according to claim 3, characterized in that the sequence of actuation states (11) of the actuating element (4) required to generate the identical control signal depends on an actuation duration (5) of the actuation (6) of the actuating element (4).

5. Arrangement (1) according to claim 3 or claim 4, characterized in that a reference time duration (21) is specified for the actuation (6) of the actuating element (4), below which a first sequence of actuation states (11) of the actuating element (4) generates the control signal and above which a different second sequence of actuation states (11) of the actuating element (4) generates the identical control signal.

6. Arrangement (1) according to one of the preceding claims, characterized in that the reference time duration (21) is between two hundred milliseconds and one and a half seconds, preferably between three hundred milliseconds and one second, particularly preferably between four hundred and six hundred milliseconds.

7. Arrangement (1) according to one of the preceding claims, characterized in that a first sequence of actuation states (11) of the actuating element (4) is determined by the fact that an actuation (6, 7) of the actuating element (4) is started and ended, and that a second sequence of actuation states (11) of the actuating element (4) is determined by the fact that the actuating element (4) is actuated twice, in particular wherein an actuation duration (5) of the actuation (6) in the first sequence is longer than an actuation duration (5) of the actuation (6) in the second sequence.

8. Arrangement (1) according to one of the preceding claims, characterized in that in a first actuation state (11) the actuating element (4) is actuated, in particular pressed, and that in a second actuation state (11) the actuating element (4) is not actuated, in particular released.

9. Arrangement (1) according to one of the preceding claims, characterized in that the surgical hand instrument (8) is an electrosurgical instrument.

10. Arrangement (1) according to one of the preceding claims, characterized in that the actuating element (4) is designed as a hand actuating element (18) or as a foot actuating element (19) and / or that the actuating element (4) is designed as a button (20), in particular as a self-resetting, non-latching switch.

11. Arrangement (1) according to one of the preceding claims, characterized in that the control unit (24) is configured to switch off the energy output of the generator (13) independently of an actuation (6, 7) of the actuating element (4) when an opening of branches (3) of the hand instrument (8) is detected, when a fault condition is detected, or when an application success, such as a completed seal, is detected.

12. Method for supplying a surgical hand instrument (8) with high-frequency energy by means of a generator (13), in particular using an arrangement (1) according to one of the preceding claims, wherein an actuation (6) of an actuating element (4) is detected, wherein the actuation (6) detected in this way triggers a control signal that switches on an energy output of the generator (13), characterized in that if the actuation duration (5) of the actuation (6) is more than a reference time duration (21), for example more than 500 ms, releasing (7) of the actuating element (4) leads to an interruption of the energy output and that if the actuation duration (5) of the actuation (6) is less than the reference time duration (21), releasing (7) of the actuating element (4) does not lead to an interruption of the energy output.

13. Method according to claim 12, characterized in that if the actuation duration (5) of the actuation (6) is less than the reference time duration (21), a renewed actuation (6) of the actuating element (4) leads to an interruption of the energy output.

14. Method for supplying a surgical hand instrument (8) with high-frequency energy by means of a generator (13), in particular using an arrangement (1) according to one of claims 1 to 11, wherein a control signal controlling an energy output of the generator (13) is generated from actuations (6, 7) of an actuating element (4), characterized in that an identical control signal is generated from two different sequences of actuation states (11) of the actuating element (4).

15. Method according to claim 14, characterized in that an actuation duration (5) of the actuation (6) of the actuating element (4) determines the sequence of actuation states (11) of the actuating element (4) by which the control signal is generated.

16. Method according to claim 14 or 15, characterized in that a reference time duration (21) is specified for a first actuation (6) of the actuating element (4), below which a first sequence of actuation states (11) of the actuating element (4) generates the control signal and above which a different second sequence of actuation states (11) of the actuating element (4) generates the identical control signal, and / or that one or the reference time duration (21) is between two hundred milliseconds and one and a half seconds, preferably between three hundred milliseconds and one second, particularly preferably between four hundred and six hundred milliseconds.

17. Method according to one of claims 12 to 16, characterized in that a first sequence of actuation states (11) of the actuating element (4) is determined by the fact that an actuation (6, 7) of the actuating element (4) is started and ended, and that a second sequence of actuation states (11) of the actuating element (4) is determined by the fact that the actuating element (4) is actuated twice, in particular wherein an actuation duration (5) of the actuation (6) in the first sequence is longer than an actuation duration (5) of the actuation (6) in the second sequence.

18. Method according to one of claims 12 to 17, characterized in that in a first actuation state (11) the actuating element (4) is actuated, in particular pressed, and that in a second actuation state (11) the actuating element (4) is not actuated, in particular released.

19. Method according to one of claims 12 to 18, characterized in that the energy output is switched off when opening of branches (3) of the hand instrument (8) is detected when an error condition is detected or when an application success, such as a completed seal, is detected.

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