Device and method for generating high-frequency currents for treating tissue

Abstract

The invention relates to a device for generating high-frequency currents for the cosmetic and / or therapeutic treatment of tissue by means of electrodes of the device, comprising: a high-frequency energy source for generating high-frequency currents and at least one first electrode pair having two electrodes for applying the high-frequency currents to the tissue, which electrodes are each connected to an output of the high-frequency energy source, which device is designed to generate the high-frequency currents at a plurality of different frequencies fj by means of the high-frequency energy source, characterised in that the device is designed to generate the currents at a plurality of different frequencies fj by means of the high-frequency energy source in a temporal sequence having sequence steps Sj where j=1, 2, …, M; M ∈ ℕ; at least one current generated in said sequence step Sj and having the frequency fj and a duration Tj for which the current at the frequency fj is generated in the sequence step Sj is assigned to each sequence step Sj, and at least one sequence of the frequencies fj is a random sequence. In addition, at least one of the following additional features is implemented: The current intensity of the currents lies between 100 mA and 2 A, preferably between 300 mA and 1 A. The frequencies fj lie in a frequency range between 0.1 MHz and 20 MHz, preferably between 0.1 MHz and 10 MHz, most preferably between 0.1 MHz and 3 MHz. The duration Tj is less than 100 ms, preferably less than 50 ms. The invention further relates to a corresponding treatment method, in particular a cosmetic treatment method.

Description

[0001] title

[0002] Device and method for generating high-frequency currents for the treatment of

[0003] tissue

[0004] Description

[0005] The invention relates to a device according to the preamble of claim 1 for generating high-frequency currents for the cosmetic and / or therapeutic treatment of tissue using electrodes of the device. Such a device comprises a high-frequency energy source for generating high-frequency currents and at least one first electrode pair with two electrodes for applying the high-frequency currents to the tissue, each electrode being connected to an output of the high-frequency energy source. The device is configured to generate the high-frequency currents with several different frequencies fj using the high-frequency energy source.

[0006] The invention also relates to a method according to the preamble of claim 13 for the particularly cosmetic treatment of tissue by means of high-frequency currents, comprising the method steps: arranging at least one pair of electrodes on the tissue and applying high-frequency current to the tissue by means of the pair of electrodes.

[0007] Such devices and methods are known, in particular from the patents DE 10 2016 120 138 B4, EP 2 022 429 Bl and EP 3 097 881 Bl of the applicant.

[0008] Such devices and procedures are used in the thermotherapy of tissue, particularly human tissue. The basic principle is the heating of the tissue, thereby generating reversible or irreversible changes. Typical applications include the thermal treatment of unstable joint capsules using thermal capsulorrhaphy ("thermal collagen shrinkage"), thermokeratoplasty, skin resurfacing, and skin tightening. All these applications share the common feature of altering collagen network structures through the application of heat. The best-known heating methods for collagen tissue are laser heating and heating with high-frequency currents, also known as "radiofrequency currents" or RF currents.

[0009] The basic principle of heating using high-frequency currents, which is at least partially the basis of the present invention, is the introduction of high-frequency currents into the tissue via electrodes. Typical devices for this purpose include a high-frequency energy source for generating the high-frequency currents, as well as at least one pair of electrodes. The electrodes of the electrode pair are connected to the high-frequency energy source and each has a contact surface by means of which they are applied to the tissue to be treated. The tissue is exposed to the currents generated by the high-frequency energy source via these contact surfaces, so that the current flow causes the tissue to be heated by Joule heating.

[0010] A key aspect of such treatments is ensuring that, on the one hand, the patient's pain threshold is not exceeded, and on the other hand, that the thermal tolerance limit for tissue damage is respected. These problems arise particularly at the contact surfaces between the electrodes and the tissue.

[0011] In the past, attempts have been made to address this problem by adjusting the power of the current used and / or the duration of exposure (so-called "high rate" applications with relatively high power and only a single exposure, or so-called "low rate" applications where a lower power is used over a longer period).

[0012] From relevant research by the inventor, it is known that, especially when treating indications with significant changes in skin structure, particular attention should be paid to interfaces within the skin, which represent the so-called "weak links", cf. Ilja L. Kruglikov, "Assessment of Mechanical Stress Induced by Radiofrequency Currents on Skin Interfaces", Hindawi, 2021, Volume 2021, 2021 (1): 6623757.

[0013] In this context, the inventor recognized that these interfaces, e.g. between epidermis and dermis or between dermis and subcutis, cannot be selectively influenced by temperature alone (so-called hyperthermia), which is, however, essential for a successful treatment outcome.

[0014] Furthermore, when treating tissue with electricity, there is a general risk that the tissue will become accustomed to the effect of the electricity if the treatment duration is too long, which can further reduce the success of the treatment.

[0015] The present invention aims to further improve the known device for generating high-frequency currents and the method defined above, such that an increase in the energy that can be introduced into the tissue, and thus in the heat generated in the tissue, is made possible without a significant increase in the thermal stress on the tissue surface at the contact points with the electrodes. Furthermore, the increase in heat generation should occur without exceeding the patient's pain threshold on the one hand or a thermal tolerance limit for tissue damage at the contact points on the other. The total power supplied should be increased, if possible, without causing damage or habituation effects that could impair the efficiency of the treatment. Finally, the invention should enable the targeted manipulation of the aforementioned "weak links" in the form of interfaces within the tissue structure.

[0016] This problem is solved by a device for generating high-frequency currents for the cosmetic and / or therapeutic treatment of tissue using electrodes of the device, according to claim 1, and by a method for treating tissue, in particular for the cosmetic treatment of tissue, using high-frequency currents according to claim 13. Advantageous embodiments of the device and method according to the invention are found in the dependent claims.

[0017] An inventive device for generating high-frequency currents for the cosmetic and / or therapeutic treatment of tissue using electrodes of the device comprises a high-frequency energy source for generating high-frequency currents and at least one first electrode pair with two electrodes for applying the high-frequency currents to the tissue, each electrode being connected to an output of the high-frequency energy source. The device is configured to generate the high-frequency currents with several different frequencies fj in a temporal sequence with sequence steps Sj where j = 1, 2, ... by means of the high-frequency energy source., M; M ≤ N, wherein each sequence step Sj is associated with at least one current with frequency fj generated in that sequence step Sj and a time period Tj for which the current with frequency fj is generated in the sequence step Sj, and wherein at least one sequence of frequencies fj is a random sequence. The device is further configured to generate the currents with a current strength between 100 mA and 2 A, preferably between 300 mA and 1 A, and / or to generate the currents in a frequency range between 0.1 MHz and 20 MHz, preferably between 0.1 MHz and 10 MHz, most preferably between 0.1 MHz and 3 MHz, and / or to generate the currents for a time period Tj of less than 100 ms, preferably less than 50 ms.

[0018] A method according to the invention for the particularly cosmetic treatment of tissue using high-frequency currents comprises the process steps of arranging at least one pair of electrodes on the tissue and applying a high-frequency current to the tissue via the electrode pair. The method is characterized in that the tissue is sequentially exposed to currents with several different frequencies fj, which are applied in a temporal sequence with sequence steps Sj where j = 1, 2, ..., M; M 6 H, successively, wherein in each sequence step Sj the tissue is subjected to a current of a frequency fj assigned to this sequence step for a duration Tj, and at least the frequencies fj follow each other randomly, while additionally at least one of the following further features is realized: 1) a current strength of the currents is selected between 100 mA and 2 A, preferably between 300 mA and 1 A; and / or 2) the tissue is subjected to currents with a frequency fj in a frequency range between 0.1 MHz and 20 MHz, preferably between 0.1 MHz and 10 MHz, most preferably between 0.1 MHz and 3 MHz; and / or 3) the duration Tj is less than 100 ms, preferably less than 50 ms.

[0019] The procedure is explicitly not limited to purely cosmetic tissue treatment, but can be used for all indications associated with significant changes at skin interfaces. Examples of cosmetic treatments include skin aging or cellulite, and skin tightening.

[0020] The sequence steps Sj thus define time intervals during which the tissue is exposed to a high-frequency current of frequency fj. The duration of the exposure itself is Tj, where Tj can cover the entire time interval of the respective sequence step Sj or only a fraction thereof. Furthermore, Tj can be positioned arbitrarily within the time interval Sj, for example, exactly in the middle, at the beginning, or at the end. A separate, corresponding time Tj can also be selected for each sequence step Sj. The sequence steps Sj can be, but do not necessarily have to be, of the same length.

[0021] The fact that the frequencies fj used follow each other randomly or stochastically means, within the scope of the invention, that there is no correlation between the frequencies used in the individual sequence steps. Those skilled in the art are aware of various possibilities or methods for generating such randomness, which can be used within the scope of the invention, for example, by using a random number generator that produces these numbers according to the pattern of white or colored noise.

[0022] Specifically, this means: in one sequence step Sj-i, the tissue is subjected to a current of frequency fj-i for a duration Tj-i, which is also referred to as a pulse; in the following sequence step Sj, the tissue is subjected to a current of frequency fj for a duration Tj; in the following sequence step S J+i The tissue will be affected during the time period T J+i with current of frequency f J+iapplied, etc. The durations of the application (i.e., the pulses) can essentially correspond in length to the sequence steps, except for short interruptions when changing the frequency.

[0023] Typically, a specific, finite number of pulses follow one another before the treatment is stopped or interrupted and then, if necessary, preferably continued at another location.

[0024] The applicant has recognized that the values ​​for current intensity, frequency, and pulse length (duration) contained in claims 1 and 13 are particularly advantageous for the desired treatment outcome. This applies to each of the aforementioned values ​​individually, but preferably also to the combination of two or even all of these features contained in the claims.

[0025] Particularly when the focus is specifically on selectively influencing tissue interfaces (the aforementioned "weak links," see Kruglikov and Scherer, "Skin n Aging as a mechanical phenomenon. The main weak links," Nutrition and healthy aging, 2018, 4(4), pp. 291-307), selecting a frequency within the specified range allows for influencing the tissue through both heat (at higher frequencies) and pressure (at lower frequencies), specifically at these interfaces. The choice of a relatively short pulse duration and the random frequencies prevent any habituation effects. The relatively high current intensity ensures sufficient therapeutic effect. The current intensity used is significantly higher than in previously known devices and is facilitated, or even made possible, by the stochastic frequency selection, which can improve treatment success.

[0026] It has already been emphasized that each of these parameters—current intensity, frequency, and pulse length (duration)—represents a substantial improvement over the prior art on its own. However, it is the combination of all three parameters that allows the full potential of these advantages to be realized. Advantageously, the random frequency sequence, when appropriately selected, results not only in further reduced habituation effects but also in a constant alternation between thermal and pressure-based effects, which further improves treatment success. The inventor recognized that a boundary between these two regimes can be drawn at a frequency of approximately 300 kHz; see Kruglikov, op. cit., Table 4.In this way, the treated tissue is exposed to a kind of “biological interference”, in which the different effects occur physically sequentially, but virtually simultaneously on biological timescales, which, according to the applicant, has a very positive effect.

[0027] The high-frequency energy source can be configured in a manner known per se. Within the scope of the invention, "high-frequency" means that the current has a frequency between 0.1 MHz and 20 MHz, preferably between 0.1 MHz and 10 MHz, most preferably between 0.1 MHz and 3 MHz, as already specified above.

[0028] The currents corresponding to the frequencies fj can be chosen with fixed or free (random) current strength (amplitude Aj) between certain limits, or a weighting can be applied, in particular a color weighting, as is known from physical noise effects.

[0029] As already stated, the minimum current is in particular 100 mA, preferably 300 mA. Furthermore, the maximum current is in particular 2 A, preferably 1 A.

[0030] Colored or color-weighted frequency generation, as defined in the invention, means that the selected frequencies fj are distributed in a specific way within the aforementioned limits. Analogous to white noise, it is particularly preferred that the frequencies are evenly distributed between these limits. On average, different spectral ranges of equal size within the limits are then addressed with equal frequency. In particular, the tissue then experiences approximately equal thermal and pressure-based exposure. However, a different (color-based) frequency weighting can also be applied, generally using a weighting function g(f), in order to, for example, selectively achieve more thermal or more pressure-based exposure on average.

[0031] The applicant has recognized that the stochastic selection of frequencies avoids tissue habituation effects, as already mentioned above. Furthermore, it is possible to work for longer periods and / or with higher current intensities than in the prior art without causing tissue damage. It is also possible to use higher current intensities, which can improve the therapeutic effect.

[0032] The following configurations of the device and the method have proven to be particularly advantageous:

[0033] A further development of the device according to the invention provides that, in addition, a sequence of time durations Tj is a random sequence.

[0034] A further development of the inventive method provides that the time durations Tj additionally follow one another randomly.

[0035] This was already mentioned above. The time durations Tj can vary randomly from sequence step to sequence step. This can affect the duration of the current application itself and / or the position of the application period (the pulse) within the sequence step. This helps to protect the tissue. Furthermore, it also helps to prevent habituation effects.

[0036] A particularly preferred embodiment of the device provides that the time length of the sequence steps and the associated durations Tj essentially correspond to each other, meaning that each sequence step is used practically completely for current application, except for any technically necessary interruptions of 1 ms or less. The durations Tj are preferably shorter than 100 ms or even shorter than 50 ms. The individual sequence steps can be of equal length, or they can have different durations. A further development of the device according to the invention provides that the device is configured to generate currents with several different frequencies fj using the high-frequency energy source, such that the frequencies fj are distributed evenly or according to a predetermined weighting function g(f) across the frequency range, as already mentioned above.

[0037] A particular advantage here is that a targeted weighting of the different treatment regimes (thermally or mechanically generating pressure) can be achieved, depending on the intended effect or tissue to be treated.

[0038] Corresponding embodiments of the method according to the invention provide that the currents are generated with several different frequencies fj, which are distributed uniformly (analogous to white noise) or according to another predetermined weighting function g(f) over the frequency range.

[0039] Yet another embodiment of the device according to the invention provides that the device is designed to generate long pulses (also referred to as pulse trains) with a duration of at least 1 s, preferably 5 s, most preferably 10 s, during which the tissue at a predetermined, fixed location is subjected to the high-frequency currents.

[0040] Such so-called "long pulses" or "pulse trains" are only made possible by the inventive design of the device because they would lead to tissue damage in previously known devices. These long pulses do not, in particular, involve increasing the duration of the individual frequency applications, but rather remain constant for the duration of the treatment at a predetermined, fixed location.

[0041] A further development of the method provides that the electrode pair is positioned or remains in a fixed location on the tissue for a duration of at least 1 s, preferably 5 s, most preferably 10 s, during which the tissue is exposed to the high-frequency currents. This can be done automatically or manually.

[0042] A further embodiment of the device according to the invention provides that the device has at least a second electrode pair with two electrodes, each connected to an output of the high-frequency energy source. Furthermore, the high-frequency energy source is configured to supply the two electrode pairs with currents of different frequencies fi in at least one sequence step Sj, preferably in substantially all sequence steps Sj.

[0043] This can further improve the treatment outcome. In this context, it is possible, but not necessary, to subject both electrode pairs to randomly selected frequencies fi.

[0044] A particularly advantageous embodiment of the device according to the invention provides that one of the electrode pairs is designed as a monopolar electrode pair, which is a surface contact electrode with a tissue contact area preferably larger than 5 cm². 2 and a small contact electrode with a tissue contact area preferably smaller than 2 cm² 2 The other electrode pair is designed as a bipolar electrode pair, comprising two small-contact electrodes, each with a tissue contact area preferably less than 2 cm². 2 includes.

[0045] The properties and advantages of such electrodes are known from EP 2 022 429 Bl, the disclosure of which is incorporated in its entirety into the present description by reference. The advantages described therein can be further improved by the random control of at least one pair of electrodes.

[0046] In general, the use of electrodes with a surface area of ​​approximately 50 mm² has become established. 2 and about 2 cm 2 proved to be useful and advantageous.

[0047] Yet another, particularly advantageous embodiment of the device according to the invention provides that one of the electrode pairs is supplied with currents with a random sequence of frequencies fj, preferably the monopolar electrode pair mentioned above, while the other electrode pair is supplied with currents with a predetermined sequence of frequencies fj (or with a fixed frequency).

[0048] By randomly applying current, especially to the monopolar electrode pair, health risks inherently associated with the design of an electrode as a relatively large surface contact electrode can be safely avoided without having to forgo the use of such electrodes and / or relatively strong currents.

[0049] A further development of this embodiment of the device according to the invention provides that both electrode pairs are supplied with currents with a random sequence of frequencies fj.

[0050] In this way, the advantages of the inventive approach are particularly well utilized.

[0051] In a further development of the device according to the invention, it can also be provided that both electrode pairs are alternately supplied with currents with a random sequence of frequencies fj.

[0052] This means that one pair of electrodes is stimulated stochastically, while the other pair is stimulated at a fixed frequency (or a predetermined frequency sequence), and that this stimulation alternates after a certain period of time. The applicant has achieved particularly good treatment results with this method.

[0053] In a further development of the device according to the invention, it can also be provided that the first electrode pair is designed as a bipolar electrode pair, and the device has a plurality of further bipolar electrode pairs, in particular at least 5, preferably at least 10, more preferably at least 50 further bipolar electrode pairs. Each of these bipolar electrode pairs comprises two small contact electrodes, each with a tissue contact area of ​​less than 2 cm². 2 Each electrode is connected to an output of the high-frequency power source. When it is stated before and below that each electrode of a pair is connected to an output of the high-frequency power source, this means that each electrode of that particular pair is connected to an output of the high-frequency power source in such a way that a current can flow between the electrodes (via the tissue).

[0054] Such or similar electrode arrangements are known from DE 10 2016 120 138 B4 and EP 3 097 881 Bl, the disclosures of which are fully incorporated into the present description by reference.

[0055] In a further development of this idea, it can be specifically provided that a first electrode of each electrode pair is connected with the first electrodes of the other electrode pairs to form a first total electrode, and that a second electrode of each electrode pair is connected with the second electrodes of the other electrode pairs to form a second total electrode, wherein an electrode pair formed from the first total electrode and the second total electrode is subjected to a random sequence of frequencies fj.

[0056] This circuit arrangement is specifically known from DE 10 2016 120 138 B4, and its efficiency can be further improved by the proposed random application of pressure to the electrodes.

[0057] In a further development of this idea, it is possible to arrange the electrodes in a preferably regular pattern of rows and columns, as is also known from DE 10 2016 120 138 B4. Preferably, electrodes connected to a first output of the high-frequency energy source are arranged in at least a first row, and electrodes connected to a second output of the high-frequency energy source are arranged in at least a second row. Most preferably, the first and second rows are arranged alternately.

[0058] The applicant recognized that the proposed random application could achieve good results, particularly with such an electrode arrangement. Further features and advantages of the invention will become apparent from the following description of exemplary embodiments with reference to the drawing.

[0059] Figure 1 shows a first embodiment of the device according to the invention;

[0060] Figure 2 shows a second embodiment of the device according to the invention;

[0061] Figure 3 shows a third embodiment of the device according to the invention;

[0062] Figure 4 shows a first sequence of frequencies for applying frequencies to electrodes of a device according to the invention;

[0063] Figure 5 shows a second sequence of frequencies for applying pressure to electrodes of a device according to the invention; and

[0064] Figure 6 shows a third sequence of frequencies for applying pressure to electrodes of a device according to the invention.

[0065] The same reference symbols denote identical or at least equivalent elements in all figures.

[0066] The device shown in Figure 1 is used for the cosmetic and / or therapeutic treatment of tissue 1. For this purpose, high-frequency currents are generated by means of a high-frequency energy source 2, which are applied to the tissue 1 by means of electrodes.

[0067] The device comprises two pairs of electrodes, a first pair 3a, 3b being a monopolar electrode pair and a second pair 4a, 4b being a bipolar electrode pair. The device in Figure 1 is therefore a tripolar device. Accordingly, electrodes 3a, 4a, and 4b are designed as small-contact electrodes, each with a tissue contact area of ​​approximately 5 mm².2 Electrode 3b, on the other hand, is designed as a surface contact electrode and has a tissue contact area of ​​approximately 40 cm². 2 on.

[0068] The high-frequency (HF) power source 2 has two outputs, with the first electrode pair connected to a first output A and the second electrode pair connected to a second output B. A frequency can be set for each electrode pair using (not shown) selection buttons or other controls on the HF power source 2. In particular, a minimum frequency of, for example, 0.1 MHz and a maximum frequency of, for example, 20 MHz can be set.

[0069] Furthermore, the power (current intensity) and pulse length applied to tissue 1 via the electrodes of the respective output can be set. It is also possible to select which of the electrode pairs should be subjected to a random sequence of frequencies. This can apply to both electrode pairs simultaneously, or an alternating application of a random sequence of frequencies to the two electrode pairs can be selected. For each random sequence of frequencies, it is preferably possible to set whether and how the frequencies (i.e., the corresponding currents) should be color-coded. All parameters can be specified separately for each electrode pair; in particular, identical parameters can be specified for both electrode pairs.

[0070] It is particularly preferred to stochastically apply at least (also) to the monopolar electrode pair 3a, 3b, i.e. to apply a current whose frequency varies randomly, preferably within the above limits.

[0071] The tissue 1 is shown in cross-section in Figure 1. The dashed lines in Figure 1 indicate current flow lines along which the currents flow between electrodes 3a and 3b on the one hand, and 4a and 4b on the other. In a superposition region 5, the currents superimpose, resulting in increased heating of the tissue 1. The position and, in particular, the depth of the superposition region 5, that is, the distance of the superposition region 5 from the upper surface of the tissue 1 in Figure 1, can be influenced by the distance between electrodes 4a and 4b, as well as by the choice of frequencies of the high-frequency currents. Within the scope of the present invention, a region that varies randomly over time can therefore also be treated.

[0072] Figure 2 shows a device according to the invention with two electrode pairs, in which both electrode pairs (23a and 23b, and 24a and 24b) are each configured as bipolar electrode pairs. The device in Figure 2 thus represents a tetrapolar device overall.

[0073] The electrode pairs are connected to outputs A, B of a high-frequency energy source 22, which is designed analogously to the RF energy source 2 in Figure 1 and can be operated accordingly.

[0074] The electrodes are arranged on the surface of a tissue 21 such that they lie on the vertices of a square (shown with dashed lines). The tissue 21 is thus shown in top view in Figure 2.

[0075] The electrodes of a bipolar electrode pair are positioned opposite each other on the square. By selecting the power and frequency with which an electrode pair is supplied by the energy source 22, the heat generation in a superposition area 25 can be controlled both in terms of intensity, i.e., the magnitude of the generated temperature difference, and in depth, i.e., the distance to the surface of the tissue 21 (in Figure 2, the distance into the plane of the drawing).

[0076] Both electrode pairs can be individually, jointly, or alternately subjected to a random sequence of frequencies (i.e., currents exhibiting such a frequency sequence). In practice, the use of multipolar electrodes, particularly multiple bipolar electrodes, is often desirable.

[0077] Figure 3 shows an example of an (interchangeable) electrode element 6, as is generally known from DE 10 2016 120 138 B4, in a top view of the treatment side of the electrode element. The electrode element 6 is disc-shaped and has a selecting area 7. This ensures the exact orientation of the electrode element 6 in a base element (not shown here) in the operating configuration.

[0078] The electrode element 6 comprises a large number of bipolar electrodes. Each bipolar electrode has two sub-electrodes. A first sub-electrode consists of a row of point-like contact surfaces (marked "1" in Figure 3), which are electrically connected to each other. A corresponding second sub-electrode also consists of a row of point-like contact surfaces (marked "2" in Figure 2), which are electrically connected to each other. Thus, all point-like contact surfaces in a row are electrically connected to each other. Furthermore, all rows of number 1 and all rows of number 2 are electrically connected to each other and to a (different) output A, B of the RF power source 2, which is preferably configured analogously to the power source 2 in Figure 1 or to the power source 22 in Figure 2 and can be operated accordingly.Lines “1” and “2” are arranged alternately.

[0079] The invention is not limited to the electrode arrangements shown above by way of example. According to the invention, it is sufficient if at least one pair of electrodes is present which can be subjected to currents whose frequencies form a random sequence.

[0080] Figure 4 shows a possible sequence of frequencies fj (i.e., currents with a frequency fj) that can be used to apply current to the electrode arrangements, or at least parts thereof, illustrated by way of example in Figures 1 to 3. Reference symbol t denotes the time axis, while f indicates the frequency axis. The time axis is divided into sequence steps Sj of constant length, i.e., time intervals of equal duration. In each sequence step, the RF power source (see Figures 1 to 3) provides at least one frequency fj or an alternating current with this frequency fj for a duration Tj, which is applied to at least one electrode pair of the device.

[0081] According to Figure 4, all time durations Tj are of equal length, are less than 100 ms, preferably less than 50 ms, and more preferably less than 10 ms, and correspond (essentially, i.e., except for short pauses of approximately 1 ms or less due to technical reasons when switching frequencies) to the length of the individual sequence steps Sj. The frequencies fj-i, fj, and fj+iz follow each other randomly and lie between 0.1 MHz and 20 MHz. The associated currents lie between 100 mA and 2 A; they can be constant or vary between the aforementioned limits.

[0082] Figure 5 shows the modified case in which the time durations Tj are of equal length (each less than 100 ms, preferably less than 50 ms, preferably less than 10 ms), but shorter than the length of the sequence steps Sj. By way of example and without limitation, the application always occurs exactly in the middle of each sequence step Sj. The frequencies fj-i, fj, fj+i, ... again follow each other randomly and lie between 0.1 MHz and 20 MHz. The corresponding currents again lie between 100 mA and 2 A; they can be constant or vary between the aforementioned limits.

[0083] Figure 6 shows a further modified case in which neither the time durations Tj are of equal length (each less than 100 ms, preferably less than 50 ms), nor does the application always occur exactly in the middle of each sequence step Sj. Rather, the time durations Tj-i, Tj, Tj+i, ... are also randomly selected (according to their respective duration and position within the corresponding sequence step Sj, whereby either of the two parameters is generally sufficient). The frequencies fj-i, fj, fj+i, ... again follow each other randomly and lie between 0.1 MHz and 20 MHz. The corresponding currents lie between 100 mA and 2 A; they can be constant or vary between the aforementioned limits. In a variation of the teaching of Figure 6, it can also be provided, as described in the introduction, that the individual sequence steps Sj-i, Sj, Sj+i, ... are each chosen to have different lengths and that the time durations T .i, Tj, T +i, ...in turn correspond to the sequence steps with respect to their respective duration (except for short, technically determined switching times of approximately 1 ms or less), as shown in Figure 4.

[0084] In a specific application example, this latter scheme generates 45 pulses (a so-called pulse train or "long pulse") with stochastically chosen frequencies between 0.1 MHz and approximately 7 MHz, exhibiting a pulse width (duration) between 10 ms and 30 ms and a current between 200 mA and 500 mA. Analogous to white

[0085] In noise, the frequencies are evenly distributed between the aforementioned boundaries.

[0086] A "pulse train" or "long pulse" therefore comprises a specific number of pulses, after which the treatment preferably ends automatically. There is usually a button, for example on a treatment handpiece that is guided by a practitioner: pressing the button – typically after moving the handpiece to a different location – then initiates the next pulse train or "long pulse".

Claims

Claims 1.Device for generating high-frequency currents for the cosmetic and / or therapeutic treatment of tissue (1, 21) by means of electrodes (3a, 3b; 4a, 4b; 23a, 23b; 24a, 24b) of the device, comprising: a high-frequency energy source (2, 22) for generating high-frequency currents and at least one first electrode pair with two electrodes (3a, 3b; 4a, 4b; 23a, 23b; 24a, 24b) for applying the high-frequency currents to the tissue (1, 21), which electrodes (3a, 3b; 4a, 4b; 23a, 23b; 24a, 24b) are each connected to an output (A, B) of the high-frequency energy source (2, 22), which device is configured by means of the high-frequency energy source (2, 22) to generate the high-frequency currents with several different frequencies fj, characterized in that the device is configured to generate the currents with several different frequencies fj in a temporal sequence with sequence steps Sj with j=l, 2, .. by means of the high-frequency energy source (2, 22)., M; M 6 H, to generate, each sequence step Sj is assigned at least one current with frequency fj generated in this sequence step Sj and a time period Tj for which the current with frequency fj is generated in the sequence step Sj, and at least one sequence of frequencies fj is a random sequence, and that the device is additionally configured to generate currents with a current strength between 100 mA and 2 A, preferably between. to generate 300 mA and 1 A, and / or to generate the currents in a frequency range between 0.1 MHz and 20 MHz, preferably between 0.1 MHz and 10 MHz, most preferably between 0.1 MHz and 3 MHz, and / or to generate the currents for a duration Tj, less than 100 ms, preferably less than 50 ms.

2. Device according to claim 1, characterized in that additionally a sequence of time durations T J; a random sequence.

3. Device according to claim 1 or 2, characterized in that the device is configured to generate currents with several different frequencies fj by means of the high-frequency energy source (2, 22), such that the frequencies fj are distributed evenly or according to a predetermined weighting function g(f) over the frequency range.

4. Device according to one of claims 1 to 3, characterized in that the device is designed to generate long pulses with a duration of at least 1 s, preferably 5 s, most preferably 10 s, during which the tissue is subjected to the high-frequency currents at a fixed location.

5. Device according to one of claims 1 to 4, characterized in that the device has at least a second electrode pair with two electrodes (3a, 3b; 4a, 4b; 23a, 23b; 24a, 24b) having each output (A, B) of the high-frequency energy source (2, 22), and the high-frequency energy source (2, 22) is configured to supply two pairs of electrodes with currents of different frequencies fi in at least one sequence step Sj, preferably in substantially all sequence steps Sj.

6. Device according to claim 5, characterized in that one of the electrode pairs is designed as a monopolar electrode pair comprising a surface contact electrode (3b) with a tissue contact area greater than 5 cm² 2 and a small contact electrode (3a) with a tissue contact area of ​​less than 2 cm² 2 includes, and the other electrode pair is designed as a bipolar electrode pair, comprising two small contact electrodes (4a, 4b; 23a, 23b; 24a, 24b) with a tissue contact area of ​​less than 2 cm² each 2 includes.

7. Device according to claim 5 or 6, characterized in that one of the electrode pairs is supplied with currents with a random sequence of frequencies fj, preferably the monopolar electrode pair (3a, 3b), and the other electrode pair (4a, 4b) is supplied with currents with a predetermined sequence of frequencies fj.

8. Device according to claim 5 or 6, characterized in that both electrode pairs are supplied with currents having a random sequence of frequencies fj.

9. Device according to claim 5 or 6, characterized in that both electrode pairs are alternately supplied with currents having a random sequence of frequencies fj.

10. Device according to one of claims 1 to 4, characterized in that the first electrode pair is designed as a bipolar electrode pair (23a, 23b), and the device has a plurality of further bipolar electrode pairs (24a, 24b), in particular at least 5, preferably at least 10, more preferably at least 50 further bipolar electrode pairs, each of which has two small contact electrodes (23b, 23b; 24a, 24b) with a tissue contact area of ​​less than 2 cm each 2 comprises and each electrode is connected to an output (A, B) of the high-frequency energy source (2, 22).

11. Device according to claim 10, characterized in that a first electrode of each electrode pair is connected to the first electrodes of the other electrode pairs to form a first total electrode and a second electrode of each electrode pair is connected to the second electrodes of the other electrode pairs to form a second total electrode, wherein an electrode pair formed from the first total electrode and the second total electrode is subjected to a random sequence of frequencies fj.

12. Device according to claim 10 or 11, characterized in that the electrodes are arranged in a preferably regular pattern of rows and columns, wherein preferably electrodes connected to a first output (A) of the high-frequency energy source (2) are arranged in at least a first row and electrodes connected to a second output (B) of the high-frequency energy source (2) are arranged in at least a second row, wherein most preferably the first rows and the second rows are arranged alternately.

13. Methods for treating tissue (1, 21), in particular for cosmetic treatment of tissue (1, 21), using high-frequency currents, comprising the process steps Arranging at least one pair of electrodes (3a, 3b; 4a, 4b; 23a, 23b; 24a, 24b) on the tissue (1, 21), Applying the electrode pair (3a, 3b; 4a, 4b; 23a, 23b; 24a, 24b) with high-frequency current, characterized in that the tissue (1, 21) is sequentially subjected to currents with several different frequencies fj, which follow one another in a temporal sequence with sequence steps Sj with j=l, 2, ..., M; M 6 H, wherein in each sequence step Sj the tissue is subjected to a current of a frequency fj assigned to this sequence step for a time period T), and at least the frequencies fj follow each other randomly, while additionally at least one of the following further features is realized: a current strength of the currents is selected between 100 mA and 2 A, preferably between 300 mA and 1 A; and / or the tissue (1, 21) is subjected to currents with a frequency fj in a frequency range between 0.1 MHz and 20 MHz, preferably between 0.1 MHz and 10 MHz, most preferably between 0.1 MHz and 3 MHz; and / or the time duration Tj is less than 100 ms, preferably less than 50 ms.

14. Method according to claim 13, characterized in that the time durations Tj additionally follow one another randomly.

15. Method according to claim 13 or 14, characterized in that the currents are generated with several different frequencies fj, which are distributed uniformly or according to a predetermined weighting function g(f) over the frequency range.

16. Method according to one of claims 13 to 15, characterized in that the electrode pair (3a, 3b; 4a, 4b; 23a, 23b; 24a, 24b) is arranged at a fixed location on the tissue (1, 21) for a duration of at least 1 s, preferably 5 s, most preferably 10 s, during which the tissue is exposed to the high-frequency currents.

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