Medical system, method for operating a medical system, and computer program product

Abstract

The invention relates to a medical system (15) comprising a medical instrument (16), preferably an electromedical instrument (17) or electrosurgical instrument (18). At least one magnetic field sensor (30), which is preferably in the form of a quantum magnetometer or an NVCD sensor, is provided on a tool part (19) of the instrument. Each magnetic field sensor (30) is designed to detect a magnetic field (38) emanating from the electromedical instrument (17) and / or from a biological tissue (20) and to provide a corresponding sensor signal (S), preferably an optical sensor signal (Sopt), which can be evaluated by means of an evaluation device (35). The evaluation device (35) determines at least one operating parameter (EP). The at least one operating parameter (EP) describes the biological tissue (20) and / or the effect generated by the medical instrument (16) or the tool part (19) on the biological tissue (20). For example, an operating parameter (EP) can describe the tissue type, a temporal and / or local change in the tissue, or the current temperature (T) or a local and / or temporal change in the temperature (T) of the biological tissue (20). Such operating parameters (EP) can be monitored very dynamically by measuring the magnetic field.

Description

Erbe Elektromedizin GmbH, August 7, 2024, Waldhörnlestraße 17, ERBE P342 WO prrn, 72072 Tübingen, Keyword: Quantum Sensors Medical system, method for operating a medical system, and computer program product

[0001] The invention relates to a medical system. The medical system comprises a medical instrument with a tool component designed to influence biological tissue. A high-frequency current can be introduced into the biological tissue to influence it. This influence can be achieved through direct contact between the tool component and the biological tissue. Alternatively, the influence can be achieved without contact, for example, by means of a spark discharge between the tool component and the biological tissue, or by means of a plasma generated and ignited in the area of ​​the tool component, which then acts upon the biological tissue.

[0002] The medical instrument can be designed for open surgical, laparoscopic, or endoscopic use. It can be a monopolar or bipolar electromedical or electrosurgical instrument. The medical system can include a power supply unit to provide the medical instrument with electrical energy and, optionally, at least one other operating medium, in particular a fluid (for example, a gas for plasma generation).

[0003] Such medical systems or medical instruments can be used for various applications. For example, the medical system or medical instrument can be configured to... Tool component used to coagulate, cut, ablate, devitalize, or fuse biological tissue.

[0004] In principle, it is desirable to monitor and control the use or application of the medical instrument. For example, information can be provided to a surgeon indicating the current operation and / or the tissue type of the biological tissue currently being treated and / or the progress of the treatment.

[0005] For example, Fenbart EP 3 831 291 Al is an instrument for the electrosurgical treatment of biological tissue, which has a color marking at a distal end. To achieve a desired dosage or energy input into the tissue to be treated, the color marking can be compared with the color of the treated tissue.

[0006] EP 0 813 387 A of fenbart discloses an electrosurgical system in which a measuring voltage can be applied between the electrodes of an electrosurgical instrument to perform an impedance measurement for tissue identification. A similar system is also known from EP 1 511 534 B.

[0007] Electrosurgical systems also utilize magnetic field sensors. For example, US 11,207,092 B2 describes the use of magnetic field sensors in the form of Hall sensors. These sensors detect the relative position of an instrument part equipped with a magnet relative to an instrument part equipped with the Hall sensor. It is also proposed to equip interchangeable probes with different magnets, so that an associated Hall sensor can measure the different magnetic field strengths and thus identify which probe is being used.

[0008] Starting from the prior art, it is an object of the present invention to provide a medical system, a method for its operation and a computer program product in order to determine a usage parameter of the medical instrument quickly and accurately, wherein the usage parameter characterizes the biological tissue and / or the action of the tool part on the biological tissue.

[0009] This problem is solved by a medical system with the features of claim 1, by a method with the features of claim 14 and by a computer program product with the features of claim 15.

[0010] The medical system according to the invention comprises a medical instrument with a tool part. The tool part is configured to influence biological tissue, for example by direct contact of the tool part or at least a section thereof with the biological tissue, or indirectly by generating a spark between the tool part and the biological tissue, or by generating a plasma that is emitted onto the biological tissue.

[0011] The medical instrument can be an electromedical instrument, and in particular an electrosurgical instrument. The instrument may be an electrosurgical instrument. It can be designed for open surgical, laparoscopic, or endoscopic use. In its electrosurgical design, the medical instrument may have one or more electrodes, such as at least one cutting electrode, at least one coagulation electrode, and / or at least one electrode for plasma ignition. The electrosurgical instrument (especially an electrosurgical instrument) may be monopolar or bipolar.

[0012] The tool component can have movable components in all embodiments, for example, two jaws that can be moved or pivoted relative to each other, between which biological tissue can be grasped. The tool component can optionally include a movable blade for cutting tissue in all embodiments.

[0013] In all embodiments, the medical system and in particular the medical instrument can be configured to perform at least one type of tissue treatment, for example, coagulation and / or dissection (cutting) and / or thermofusion and / or ablation (devitalization) of biological tissue.

[0014] The medical system is designed to determine at least one operational parameter during its operation. This parameter describes the biological tissue on which the medical instrument acts and / or the effect or action achieved on the biological tissue through the use of the medical instrument. The effect or treatment of the biological tissue can be monitored using this at least one operational parameter. become .

[0015] To determine at least one operating parameter, at least one magnetic field sensor is arranged on the tool part of the medical instrument. This magnetic field sensor is configured to detect a magnetic field emanating from biological tissue and to generate a sensor signal that describes the detected magnetic field. The sensor signal can, for example, describe the magnitude of a magnetic field strength and / or the direction of magnetic field lines. Additionally or alternatively, the at least one sensor signal from the at least one magnetic field sensor can be used to measure or determine a location-dependent magnetic field strength and / or a spatial change in the magnetic field strength and / or a temporal change in the magnetic field strength.

[0016] The magnetic field is generated by the flow of an electric current in the biological tissue. This current can be introduced into the biological tissue by the medical instrument, and in particular by the tool component, or it can flow through the patient's bodily functions within the biological tissue. For example, action potentials (APs) propagate along nerve fibers (axons), creating a magnetic field around the nerve fiber or nerve fiber bundle. Such a magnetic field can be detected by means of at least one magnetic field sensor on the tool component.

[0017] The medical system has an evaluation unit that is connected to the at least one magnetic field sensor via a transmission link. The transmission link is preferably an optical transmission link, in particular an exclusively optical one. Transmission link. The optical transmission link is insensitive to interference, particularly from interference caused by the high-frequency currents and voltages in an electromedical instrument. Such an optical transmission link can be implemented, for example, using at least one optical fiber. It is advantageous if the at least one magnetic field sensor is configured to provide an optical sensor signal as the sensor signal, thus eliminating the need for an additional converter unit coupled to the magnetic field sensor in the instrument for generating an optical sensor signal.

[0018] The evaluation unit can receive at least one sensor signal (in particular, at least one optical sensor signal) via the transmission link. The evaluation unit then determines at least one operating parameter based on this sensor signal. Information can be output to an operator via a user interface based on this parameter. The information output can be visual, audible, and / or haptic (e.g., display, speaker, and / or haptic feedback on the instrument).

[0019] Based on the detection of the magnetic field emanating from the tissue, changes can be detected very quickly, and the determined operating parameters can be updated accordingly. The medical system therefore operates very dynamically. By monitoring the magnetic field, different operating parameters can be determined depending on the application, and information based on these parameters can be output. at least one operating parameter and / or the sensor Signals describing at least one operating parameter allow one or more settings (parameters, modes, etc.) of the medical system, and in particular the supply device, to be checked and adjusted if necessary.

[0020] It is advantageous to arrange two or more magnetic field sensors on the tool component. This allows for the acquisition of additional information about the magnetic field, such as spatially varying magnetic field strength. Depending on the design of the tool component, the magnetic field sensors can be positioned relative to each other in a suitable spatial arrangement.

[0021] For example, each existing electrode can be assigned a separate magnetic field sensor. Additionally or alternatively, at least one magnetic field sensor can be present on each of the tool components that are movable relative to one another. For example, one or more magnetic field sensors can be arranged on each of the branches that are movable or pivotable relative to one another. The magnetic field sensors on the branches can be opposite each other when the branches are fully closed. If several magnetic field sensors are present on each branch, they can be arranged at a distance from each other in at least one spatial direction.

[0022] It is particularly preferred if the sensor signal is not an electrical sensor signal, but rather an optical sensor signal. The wavelength of the optical sensor signal can be in the visible light range and / or in the infrared range. Preferably, the The wavelength of the optical sensor signal must be at least 560 nm or at least 600 nm. The wavelength can additionally or alternatively be a maximum of 830 nm.

[0023] If at least one sensor signal from at least one magnetic field sensor is available directly in the form of an optical sensor signal, the transmission link between the evaluation device and the at least one magnetic field sensor is designed as an optical transmission link, as already described at the beginning.

[0024] The evaluation unit can be configured to provide an electrical signal. This electrical signal can be an electrical sensor signal generated by converting the optical sensor signal and / or a result or evaluation signal generated by evaluating the at least one sensor signal, which specifies the at least one operating parameter. The result or evaluation signal can be provided to a user interface and used there—as explained—to output acoustic and / or optical and / or haptic information to an operator.

[0025] In one embodiment, the evaluation unit can include a photodetector that converts the optical sensor signal into an electrical sensor signal. The electrical sensor signal at the photodetector's output can be provided to a processing unit connected to the photodetector. Additionally or alternatively, the evaluation unit can include a spectrometer, for example a slit spectrometer, to which at least one optical sensor signal is provided for evaluation.

[0026] In a particularly preferred embodiment, the magnetic field sensor is a quantum magnetometer or quantum gradiometer based on an NVCD sensor. The abbreviation NVCD stands for "Nitrogen Vacancy Centers in Diamonds." The magnetic field sensor features a diamond with nitrogen vacancy centers (NV centers). Such a magnetic field sensor is advantageous for detecting low-intensity magnetic fields and can be miniaturized very effectively for integration into the tooling component of a medical instrument.

[0027] Magnetic field sensors or magnetometers used so far in medical instruments have disadvantages: 1) Hall sensors can be implemented cost-effectively, but are less sensitive than, for example, NVCD sensors. The same applies to so-called XMR sensors (thin-film sensors), which change their resistance under the influence of a magnetic flux. 2) A fluxgate magnetometer (also known as a Förster probe) is designed to determine the direction of a magnetic field vector. However, such magnetometers are very difficult to realize in a sufficiently small dimension. The magnetic fields must have a magnetic strength of at least 0.1 nT to 1 mT in order to be detected. 3) Superconducting quantum interference sensors (“SQUIDs”) detect a magnetic flux through a superconducting ring. Creating superconductivity is very complex because extremely low temperatures are required. 4) Proton magnetometers are used for medical instruments unsuitable due to their size.

[0028] Preferably, the evaluation unit is provided with a magnetic field characteristic that describes a relationship between the at least one operating parameter and the at least one sensor signal of the at least one magnetic field sensor. The magnetic field characteristic can also describe one or more relationships between the at least one operating parameter and at least one further input parameter. The at least one input parameter can, for example, be a current electrical operating parameter of the medical system and / or an environmental parameter and / or a tissue parameter. The at least one input parameter can be measured using a suitable sensor and / or can be known or predetermined based on the settings of the medical system and / or can be calculated, estimated, or determined in another way.For example, such an additional input parameter can be determined empirically, based on a simulation or an observer, or in another suitable way.

[0029] For example, the conductivity or impedance of the biological tissue can be considered as an input parameter. Additionally or alternatively, electrical parameters that characterize or influence an electric current flowing through the biological tissue can be considered as input parameters, such as the frequency and / or amplitude and / or waveform and / or crest factor of an electric voltage and / or electric current for at least one electrode of a medical instrument.

[0030] Based on such a magnetic field characteristic, at least one operating parameter can be determined in the evaluation unit. In all embodiments, one of the following operating parameters, or several of the following operating parameters in any combination, can be determined in the evaluation unit: - a distance parameter that describes the distance of the magnetic field sensor or of at least one of the existing magnetic field sensors to a peripheral nerve - and thus, for example, indirectly also the distance of the tool part to the peripheral nerve; - a temperature parameter that describes a temperature in the area of ​​the detected magnetic field and / or the medical instrument and / or the tool part, and / or in the area of ​​biological tissue when in contact with biological tissue; - a moisture parameter that describes moisture in the area of ​​the detected magnetic field, especially in the biological tissue from which the magnetic field originates; - a tissue type parameter that describes a tissue type of the biological tissue from which the detected magnetic field originates; - at least one length parameter that describes a dimension in a respective assigned spatial direction of an area of ​​the biological tissue influenced by the medical instrument, whereby several length parameters can also be determined in different spatial directions; - at least one contact parameter that describes contact between the tool parts and the biological tissue, for example a penetration depth of the tool part into the biological tissue and / or a contact pressure between the at least one tool part and the biological tissue; - a change over time in the magnetic field strength and / or the magnetic field direction; - a spatial change in the magnetic field strength and / or the magnetic field direction of the magnetic field; - a current tissue state and / or a current change in tissue state, whereby the tissue state and / or the change in tissue state can be determined depending on location or time.

[0031] Treatment progress can be detected using one or more of the aforementioned application parameters. For example, it can be determined whether the temperature in the biological tissue within the instrument's influence is sufficiently high for tissue ablation (devitalization). Based on changes in the magnetic field over time, and especially in its strength, it can be determined whether sufficient dosage, i.e., sufficient energy input into the affected or treated tissue, has occurred. It is therefore possible to ascertain whether the required dosage and / or depth of penetration for the desired treatment has been achieved, for example, to monitor whether complete coagulation and / or complete ablation has been achieved in a desired area of ​​the biological tissue. Additionally or alternatively, The spatial size of the area of ​​biological tissue influenced by the instrument will be determined.

[0032] The invention further relates to a method for operating a medical system, in particular any embodiment of a medical system described above. A magnetic field emanating from biological tissue is detected by means of at least one magnetic field sensor arranged on a tool part of a medical instrument. The at least one magnetic field sensor provides a sensor signal to an evaluation unit, which then determines the at least one operating parameter.

[0033] The invention also relates to a computer program product comprising a program code which, when executed on a computing device, causes the medical system to operate as described above or to execute the method according to the invention.

[0034] Advantageous embodiments of the invention will become apparent from the dependent claims, the description, and the drawing. Preferred embodiments of the invention are explained in detail below with reference to the accompanying drawing. The drawing shows:

[0035] Figure 1 shows a schematic, block diagram-like representation of an embodiment of a medical system with a medical instrument comprising a tool part and a magnetic field sensor arranged on the tool part.

[0036] Figure 2 shows a schematic, block diagram-like representation of another embodiment of a medical system with a medical instrument. which has a tool part and a magnetic field sensor arranged on the tool part,

[0037] Figure 3 shows an embodiment of a medical instrument in a schematic partial view, which can be used in a medical system according to Figures 1 or 2.

[0038] Figures 4 and 5 each show a schematic, block-diagram-like representation of a further embodiment of a medical system with a medical instrument comprising a tool part and a magnetic field sensor arranged on the tool part.

[0039] Figure 6 shows a block diagram of an embodiment for the realization of an evaluation unit, an excitation unit and an associated magnetic field sensor for any embodiment of a medical system.

[0040] Figure 7 shows a schematic view of a spatial arrangement of several magnetic field sensors on the tool part of a medical instrument, in particular on a branch of a medical instrument.

[0041] Figure 8 shows a schematic cross-sectional view of an embodiment of a tool part with an exemplary arrangement of several magnetic field sensors on the sides of the tool part.

[0042] Figures 9 and 10 each show a schematic representation of a preferred embodiment of a magnetic field sensor.

[0043] Figure 11 shows a schematic representation of the time course of an electrical voltage at at least one Electrode of a medical instrument and of a sensor signal generated by an evaluation unit, and

[0044] Figure 12 shows a schematic representation of the determination of at least one operating parameter as a function of at least one sensor signal and optionally at least one further input parameter using a magnetic field characteristic.

[0045] Figure 1 shows a schematic block diagram illustrating an embodiment of a medical system 15. The medical system 15 includes a medical instrument 16, which in this embodiment is designed as an electromedical instrument 17, and in particular as an electrosurgical instrument 18. Where reference is subsequently made to an electromedical instrument 17, this can refer to an electrosurgical instrument 18 in all embodiments.

[0046] The medical instrument 16 has a tool part 19, which serves to influence biological tissue 20. For this purpose, at least one electrode 21 can be present on the tool part 19. Schematic representations of tool parts 19 with at least one electrode 21 are shown in Figures 4, 5, 7, and 8. The number of electrodes 21 present can vary. An electric current can be introduced into the biological tissue 20 via the at least one electrode 21 in order to influence or treat the biological tissue 20. This influence or effect on the biological tissue 20 can be effected by contact of the at least one electrode 21 with the biological tissue 20 or alternatively without contact by generating a A spark is generated between the electrode 21 or one of the electrodes 21 and the biological tissue 20. In another embodiment of the electromedical instrument 17, a plasma can be generated by means of the at least one electrode 21 using a supplied gas and directed onto the biological tissue 20.

[0047] Using the medical system 15 or the electromedical instrument 17, biological tissue can be coagulated and / or cut and / or ablated. (devitalized) and / or fused. These different types of action on the biological tissue 20 can be realized in any combination in a single electromedical instrument 17 or in different electromedical instruments 17 that can be used in the medical system 15 according to the invention.

[0048] To supply the medical instrument 16 and, for example, the electromedical instrument 17, the medical system 15 includes a power supply unit 25. In particular, the power supply unit 25 has a high-frequency generator 26 for generating a high-frequency voltage U. G or a high-frequency current I G for the electro-medical instrument 17 or electrosurgical instrument 18. The frequency of the high-frequency voltage U G or a high-frequency current I G lies particularly in a range of 100 kHz to 10 MHz.

[0049] The electromedical instrument 17 can be configured as a monopolar or bipolar instrument. Figure 1 shows an example of a monopolar electromedical instrument 17, in which a treatment circuit originates from the high-frequency generator. The treatment circuit leads from the high-frequency generator 26 via the electrode 21 or one of the electrodes 21, the biological tissue 20, and a neutral electrode 27 attached to the biological tissue 20, back to the high-frequency generator 26. If the electromedical instrument 17 is designed as a bipolar instrument (as shown, for example, in Figures 2, 4, and 5), at least two electrodes 21 are present, which may have different electrical voltage potentials. The treatment circuit then leads from the high-frequency generator 26 via one of the electrodes 21, the biological tissue 20, to another electrode 21, and from there back to the high-frequency generator 26 of the power supply unit 25.

[0050] The number of available electrodes 21 is not limited to one or two. If several electrodes 21 are present, an electrode group with two or more electrodes 21 can have the same electrical voltage potential.

[0051] In all exemplary embodiments, the at least one available electrode 21 can be used for one or more types of application. For example, an electromedical instrument 17 can have at least one coagulation electrode for coagulating biological tissue 20 and / or at least one cutting electrode for cutting biological tissue 20 and / or at least one ablation electrode for ablating biological tissue 20.

[0052] The medical instrument 16 or electromedical instrument 17 can have a handle 22 to which the tool part 19 is directly or indirectly attached (Figures 1 and 2). Such instruments can be used for open surgical or laparoscopic procedures. The electromedical instrument 16 can be set up for use (e.g., Figures 1, 2, 4 and 5). The electromedical instrument 16 can also be set up for endoscopic use and guided through a working channel of an endoscope 23, as shown schematically in Figure 3.

[0053] On tool part 19 of the medical instrument 16 and, for example, the electromedical instrument At least one magnetic field sensor 30 is arranged at 17. The at least one magnetic field sensor 30 is preferably an NVCD sensor. For this purpose, the at least one magnetic field sensor 30 has a diamond 32 doped with several nitrogen vacancy centers 31 (Figures 4 to 6, 9 and 10). The nitrogen vacancy centers 31 are realized by replacing a carbon atom in the diamond lattice of the diamond 32 in combination with an immediately adjacent vacancy. The nitrogen vacancy center 31 has an excess of electrons and is therefore negative. It is also referred to below as the NV center 31, and the magnetic field sensor 30 can also be referred to as the NVCD sensor. The abbreviation NVCD stands for "Nitrogen Vacancy Centers in Diamonds".

[0054] The diamond 32 of the magnetic field sensor 30 is connected to an evaluation unit 35 of the medical system 15 via a transmission link 33 and, for example, an optical transmission link 34. The evaluation unit 35 can be part of the power supply unit 25 or alternatively be designed separately. The evaluation unit 35 can be communicatively connected to a display unit 36. The display unit 36 ​​can, for example, be part of a user interface of the medical system 15 and can, for example, be part of the power supply unit 25. The display device 36 can have optical and / or acoustic and / or haptic display means. It is also possible to use the handle 22 of the medical instrument 16 or electromedical instrument 17 as a haptic display means.

[0055] In the exemplary embodiments illustrated here, the optical transmission link 34 is designed such that only optical signals or light signals are transmitted. In particular, the optical transmission link 34 is not designed for the transmission of electrical signals. The optical transmission link 34 between the magnetic field sensor 30 and the evaluation unit 35 has, in particular, one or more optical waveguides 37. The at least one optical waveguide 37 is, for example, a glass fiber conductor. Single-mode fibers are preferably used as the optical waveguide 37.

[0056] By means of the transmission link 33, at least one magnetic field sensor 30 can transmit a sensor signal S and, for example, an optical sensor signal S. op t is transmitted to the evaluation unit 35. The sensor signal S or the optical sensor signal S opt describes a magnetic field 38 detected by the respective magnetic field sensor 30, in particular the magnitude of the field strength B at the respective position of the magnetic field sensor 30.

[0057] The magnetic field 38 to be detected by means of at least one magnetic field sensor 30 originates from the biological tissue 20 when a current I is present there. B through the biological tissue 20 (Figures 1, 3 and 5). For example, such a magnetic field 38 is created when in one or more nerve fibers (axons) of a peripheral Nerve 30 spreads an action potential along the peripheral nerve 30 (Figure 3). The current through the biological tissue 20 can also be introduced into the tissue 20 by means of at least one electrode 21 or the treatment circuit and generate the magnetic field 38 there due to the current flow (Figures 1 and 5).

[0058] By detecting the magnetic field 38 emanating from the biological tissue 20 and evaluating it in the evaluation unit 35, at least one application parameter EP can be determined. An application parameter EP is understood to be a parameter that specifies the biological tissue 20 and, in particular, the type of biological tissue 20, and / or that describes an effect or influence exerted on the biological tissue 20 by the medical instrument 16 or electromedical instrument 17. Depending on the application and the design of the medical instrument 16 or electromedical instrument 17 used, one or more application parameters EP can be determined as required.

[0059] In one embodiment, a magnetic field characteristic C can be known in the evaluation unit 35. The magnetic field characteristic C can be stored in a memory of the evaluation unit 35 and / or provided to the evaluation unit 35 in another way, for example by an internet service (cloud service) or another external device with which the evaluation unit 35 is connected (exemplarily shown in Figures 1 and 2). The magnetic field characteristic C specifies a relationship between the at least one operating parameter EP and the at least one sensor signal S of the at least one magnetic field sensor 30, which optionally also depends on at least one further parameter. can ( Figure 12 ).

[0060] The magnetic field characteristic C can be in the form of one or more characteristic curves, functions, tables, or maps. Additionally or alternatively, the magnetic field characteristic C can also incorporate or utilize an artificial intelligence (AI) component or a machine learning component. In this context, a component is understood to be a device and / or a procedure and / or a method. Such a component can be part of the evaluation unit 35 or provided by an external device or an internet service (cloud service). An artificial intelligence component can be any known form, such as an artificial neural network (ANN), a semantic network, frames, predicate logic, or support vector machines (SVMs).Well-known methods can be used for machine learning, such as supervised machine learning, unsupervised machine learning, reinforcement learning, etc. For example, methods for pattern recognition, pattern analysis, or pattern prediction can be employed.

[0061] Depending on the specific application, one, several, or all of the following application parameters EP can be determined in any combination: 1. A distance parameter that specifies a distance d of the magnetic field sensor 30 or of at least one of the existing magnetic field sensors 30 and thus of the tool part 19 to a peripheral nerve 39 (Figure 3). Such a distance d can, for example, indicate to an operator displayed on the display device 36. Additionally or alternatively, if a minimum distance is not maintained, a signal can also be generated via the display device 36 (optical and / or acoustic and / or haptic). This prevents the tool part 19 from coming too close to a peripheral nerve 39 and injuring it when the medical instrument 16 is used to influence or treat biological tissue 20 in the immediate vicinity of a peripheral nerve 39. A temperature parameter that describes a temperature T in biological tissue 20 from which the detected magnetic field 38 originates. A humidity parameter that describes a humidity A in the biological tissue 20 from which the detected magnetic field 38 originates. A tissue type parameter that describes a tissue type Y of the biological tissue 20 from which the detected magnetic field 38 originates. At least one length parameter that specifies a dimension or...A length L of a means of the medical instrument 16 or electromedical instrument 17 describes the area of ​​the biological tissue 20 affected in an associated spatial direction. A length parameter or a length L can be determined for each of the different spatial directions. At least one contact parameter, which describes a contact effect between the tool part 19 and the biological tissue 20, such as a pressure or a force F between the tool part 19 and the biological tissue 20. biological tissue 20 and / or a penetration depth pd of the tool part 19 into the biological tissue 20 . 6. A change in the magnetic field strength B and / or the magnetic field direction of the magnetic field 38. The change can be a spatial change and / or a temporal change. To detect the magnetic field direction, preferably two or more magnetic field sensors 30 are arranged on the tool part 19. 7. A current tissue state Z and / or a current tissue state change DZ. The current tissue state Z and the current tissue state change DZ can optionally be determined location-dependently, for example by using multiple magnetic field sensors 30.

[0062] If one or more of the aforementioned operating parameters EP are determined or known by other means, these parameters can also be used as input parameters PI for the magnetic field characteristic C. For example, the force F between the tool part 19 and the biological tissue 20 and / or the temperature T of the biological tissue 20 and / or the humidity H of the biological tissue 20 can be sensorily detected and used as input parameters PI.

[0063] The input parameters PI for the magnetic field characteristic C can also be parameters known from the power supply 25 or the high-frequency generator 26, such as one or more of the following parameters: an amplitude and / or a frequency of the high-frequency voltage u. G ; an amplitude and / or a frequency of the high-frequency current i G ; - a phase angle of the high-frequency current I G relative to the high-frequency voltage U G ; - an impedance of the tissue 20, which is based, for example, on the high-frequency voltage U G and the high-frequency current I G can be determined; - a crest factor CF of the high-frequency voltage U G and / or the high-frequency current I G ; - a waveform WF of the high-frequency voltage U G and / or the high-frequency current I G .

[0064] The magnetic field characteristic C can be determined using training data, machine learning, simulations, empirical tests, or similar methods. For the various electrical parameters of the high-frequency generator 36, the different types of electromedical instruments 17 connected to the power supply 25, and for different tissue types, the expected magnetic fields 38 or magnetic field strengths B and / or temporal and / or spatial distributions or changes of the magnetic field 38 (magnetic field strength B and / or direction of the field lines) can be determined.During the application of the medical system 15, the at least one input parameter EP can then be determined by determining and monitoring the magnetic field 38 based on the magnetic field characteristic C, for example by checking whether, in the current application, the available input parameters PI and / or the at least one sensor value S represent a pattern that is identical or sufficiently similar to one in the magnetic field characteristic. C defined comparison patterns. Such comparison patterns can be generated, stored, and optionally updated, for example, through machine learning.

[0065] The evaluation unit 35 has a photodetector in the exemplary embodiments illustrated here. 42 and a computing unit connected to the photodetector 43 on (Figures 1, 2 and 4 to 6). The photodetector 42 is connected to the optical transmission link 34 and generates, depending on the at least one received optical sensor signal S op t of at least one magnetic field sensor 30 at least one corresponding electrical sensor signal Let - The electrical sensor signal S ei The electrical sensor signal S is provided to the processing unit 43. In the processing unit 43, the electrical sensor signal S can be processed. ei The data are processed and / or evaluated to determine at least one operational parameter (EP). Based on this at least one operational parameter (EP), 15 measures can then be initiated by controlling other components of the medical system, such as: - Output of information (visual and / or acoustic and / or haptic), e.g. by means of the display device 36; - Changing the operating state of the power supply unit 25 and in particular the high-frequency generator 26, such as changing an electrical parameter (amplitude, frequency, waveform, crest factor, etc.) of the high-frequency voltage U G and / or the high-frequency current I G ) or also the switching off of the electrical power supplied to the instrument.

[0066] Instead of the photodetector 42 and the associated processing unit 43, the evaluation device 35 can also have a spectrometer 44, as shown schematically in Figures 1 and 2. The embodiment of the evaluation device 35 with a spectrometer 44 or with a photodetector 42 and a processing unit 43 connected thereto can be used in all embodiments.

[0067] To bring the magnetic field sensor 30, with its diamond 32 having the NV centers 31, into an operating state in which it can detect the magnetic field 38, the medical system 15 has an excitation device 50. The excitation device 50 is shown in a highly schematic form in Figures 1 and 2. An exemplary setup is shown in the block diagrams according to Figures 4 to 6, whereby this design of the excitation device 50 can be used in all embodiments.

[0068] To change the spin population of diamond 31 from a ground state 3 A2 in an excited state 3To increase the energy of E2, the diamond 32 is optically excited, for example, using excitation light AL provided by a light source 51 of the excitation device 50. A laser or a light-emitting diode (LED) can be used as the light source 51. The excitation light AL emitted by the light source 51 can have a defined wavelength or wavelength range, adapted to the diamond 32 doped with the NV centers 31. In the exemplary embodiment, excitation light in the green visible range (500 nm to 560 nm) is used, for example, laser light with a wavelength of 532 nm.

[0069] By supplying energy in the form of excitation light AL, the internal state of the NV centers 31 of the diamond 32 is influenced and can be changed from the ground state. 3 A2 in the excited state 3E2 are brought. Electrons from the NV centers 31 fall from the excited state. 3 E2 to the ground state 3 When A2 is reflected back, fluorescent light (FL) is generated. The wavelength of this fluorescent light lies, for example, in a wavelength range of 600 nm to 830 nm. The generation of this fluorescent light (FL) creates the optical sensor signal S. op t, which is transmitted from the diamond 32 of the magnetic field sensor 30 via the optical transmission link 34 to the evaluation unit 35 .

[0070] The optical transmission link 34, or at least a part thereof, can also be used to transmit the excitation light AL. For example, the optical transmission link 34 can have a beam splitter 52 that transmits the excitation light AL from the light source 51 towards the magnetic field sensor 30 or the diamond 32, and transmits the optical sensor signal S generated by the magnetic field sensor 30 or the doped diamond 32 based on the fluorescence light FL. op The beam splitter 52 directs the light to the evaluation unit 35 and does not transmit it, or only transmits it in an insignificant proportion, towards the light source 51. The beam splitter 52 can, for example, be connected to the light source 51, the evaluation unit 35, and the magnetic sensor 30 for optical transmission via optical waveguides 37, as illustrated by way of example in Figures 4 to 6 and 10. A dichroic mirror, for example, can be used as the beam splitter.

[0071] As shown schematically in Figures 6, 9 and 10, in the light path from the magnetic field sensor 30 to the Evaluation unit 35 (for example, for the photodetector 42 or the spectrometer 44) and, for example, between the beam splitter 52 and the evaluation unit 35, optionally a filter 53 and / or a lens 54 may be arranged. The filter 53 serves to reduce the optical sensor signal S transmitted by the magnetic field sensor 30. op to remove wavelength components from the light that do not originate from the fluorescent light FL, but are present as background light. This background light can, for example, be a component of the excitation light AL. The filter 53 can, for example, have a high-pass or a band-pass characteristic.

[0072] The optional lens 54 is arranged in particular directly adjacent to the photodetector 42 or the spectrometer 44 and serves to focus the optical sensor signal S opt (here: fluorescent light FL ) onto the slit of the spectrometer 44 and / or a light-sensitive receiving surface of the photodetector 42. In the transmission direction of the optical sensor signal S op As seen, the optionally available filter 53 is located in front of the lens 54.

[0073] To couple the excitation light AL into the magnetic field sensor 30 or the diamond 32, the relevant optical waveguide 37 of the optical transmission link 34 can be coupled to the diamond 32 via a coupling device 55. The coupling device 55 can include a lens, for example a GRIN lens.

[0074] Optionally, another filter 56 can be present in the light path of the excitation light AL from the light source to the magnetic field sensor 30 or to the coupling device 55, for example a neutral density filter .

[0075] In addition to the light source 51, the excitation device 50, in the exemplary embodiments illustrated here, also includes a vibration excitation arrangement 58. The vibration excitation arrangement 58 has a microwave generator 59 for generating a microwave signal pW. The microwave generator 59 is connected to a microwave antenna 60 of the vibration excitation arrangement 58 for transmitting the microwave signal pW. The microwave antenna 60 can, for example, be annular, hollow cylindrical, or helical and surround the diamond 32 of the magnetic field sensor 30, as can be seen by way of example in Figures 4 to 6.

[0076] Figure 6 shows an exemplary configuration of a microwave generator 59. The microwave generator 59 can, for example, include a function generator 59a, which generates a suitable voltage, such as a sawtooth voltage, a ramp voltage, or the like. A voltage-controlled oscillator can be driven by the voltage from the function generator 59a. The microwave signal generated by the oscillator 59b can be in the range of 2.5 GHz to 3.2 GHz. This microwave signal from the oscillator 59b can optionally be amplified by an amplifier 59c of the microwave generator 59. The configuration of the microwave generator 59 described with reference to Figure 6 is exemplary and can be used in all embodiments of the medical system 15.

[0077] The diamond 32 is irradiated via the microwave signal pW and the microwave antenna 60 using the microwave antenna 60 in order to supply energy and determine the spin quantum number m s = 0 in degenerate spin quantum numbers m s = + 1 or m s = - 1 to raise. The microwave excitation makes the magnetic resonance frequencies of the NV centers 31 optically readable. The degenerate spin quantum numbers m s = + 1 and m s The values ​​of the magnetic fields can differ from each other due to the so-called Zeeman effect, depending on the strength of the magnetic field, where the difference or splitting is proportional to the magnetic field strength B and a constant that depends on the gyromagnetic ratio y between the spin and the corresponding magnetic moment.

[0078] The fluorescent light FL and therefore also the optical sensor signal S opt depends on the frequency f and has local minima whose spacing – analogous to the spacing of the degenerate spin quantum numbers – depends on the magnitude of the magnetic field strength B and the gyromagnetic ratio y. The optical sensor signal S op t is therefore dependent on the magnetic field strength B, so that the optical sensor signal S can be used to determine op t the magnetic field strength B and / or (e.g. by evaluating the asymmetry in the amplitude of the local minima) the orientation of the field lines can be determined.

[0079] Figures 9 and 10 schematically illustrate constructive embodiments for magnetic field sensors 30. The functional principle and basic structure of the embodiments of the magnetic field sensor 30 and the associated components of the medical system 15 (in particular, the evaluation unit 35 and the excitation unit 50) shown in Figures 9 and 10 correspond—apart from the constructive details—to the principle explained above in connection with Figure 6. However, an optical fiber 37 can be omitted in the embodiment according to Figure 9.

[0080] Figure 9 shows an exemplary embodiment of a magnetic field sensor 30 in an exploded view. The magnetic field sensor 30 is designed as an integrated sensor, in which the sensor components can be arranged on the medical instrument 16 or on the tool part 19. For this purpose, the sensor components are arranged on a multilayer substrate 65 (e.g., a multilayer printed circuit board). The substrate 65 contains, for example, the light source 51, the diamond 32 with the nitrogen defect centers 31 in the light path of the light source 51, and the photodetector 42 in the light path of the generated fluorescence light FL. The substrate 65 can have one or more connections 66 to connect the magnetic field sensor 30 electrically and / or optically, for example, to the evaluation unit 35 and / or the excitation arrangement 50.The optical filter 53 is optional and can be arranged between the diamond 32 and the photodetector 42 in the light path of the fluorescence light FL.

[0081] In the embodiment shown in Figure 10, the sensor components are arranged remotely from each other, with the diamond 32 being located on the medical instrument 16 or the tool part 19, while the other components are located remotely from it, for example in the proximal area of ​​the medical instrument 16 or in the area of ​​the supply device 25.

[0082] The medical system 15 has, for example, a control unit 61 which is configured to control one or more components of the medical system 15. In the exemplary embodiment, the control unit 61 can be configured to control the evaluation unit 35 (in particular the processing unit 43) and / or the light source 51 and / or the microwave generator 59 and / or the The high-frequency generator 26 is controlled by means of an assigned control signal OSi (i = 1, 2, 3, ...n). The number of control signals Osi can vary depending on the design of the medical system 15 and the number of components to be controlled.

[0083] The control unit 61 and / or the evaluation unit 35 and / or the excitation unit 50 can be part of the supply unit 25 or be implemented as individual components that are interconnected or linked by communication.

[0084] As already mentioned, the medical instruments 16, electromedical instruments 17, and electrosurgical instruments 18 can be configured for different applications, such as coagulation, cutting, ablation (devitalization), thermofusion, or similar procedures. Accordingly, monopolar or bipolar instruments can be used.

[0085] Figure 4 illustrates an application of an electrosurgical instrument 18, which is a bipolar instrument with two electrodes 21 at different electrical potentials. The electrodes 21 are electrically separated from each other within the tool part 19 by electrically insulating material. The high-frequency voltage U provided by the high-frequency generator 26 can be applied to the electrodes 21. When both electrodes 21 are in contact with electrically conductive biological tissue 20, a current is induced in the tissue 20, flowing from one electrode 21 through the biological tissue 20 to the other electrode 21 and from there The current flows back to the high-frequency generator 26 (treatment circuit in the bipolar instrument). This allows, for example, tumor tissue to be devitalized.

[0086] In this embodiment, the magnetic field sensor 30 is arranged in the electrically insulating area between the two electrodes 21. In one direction of extension of the tool part 19, the two electrodes 21 are spaced apart from each other in this instrument, and the magnetic field sensor 30 can, for example, be located between the two electrodes 21 in the direction of extension of the tool part 19. As previously described, the magnetic field sensor 30 is connected to the excitation device 50 (light source 51 and microwave generator 59) and the evaluation device 35.

[0087] In this embodiment of the medical system 15, a test circuit 62 may optionally be present. The test circuit 62 may correspond to the treatment circuit of a monopolar instrument and may include a test electrode 63 on the tool part 19, which, in the example shown in Figure 4, is arranged at the distal end of the tool part 19. An additional magnetic sensor 30 may be associated with the test electrode 63. This sensor is only schematically indicated in Figure 4 and may be constructed analogously to the previously described embodiments of the magnetic sensor 30. For the sake of clarity, the connection of the magnetic sensor 30 associated with the test electrode 63 to the excitation device 50 and the evaluation device 35 is not shown. The connections are analogous to the embodiments described previously.

[0088] Test circuit 62 includes, for example, au- Furthermore, a neutral electrode 27 is arranged on the biological tissue 20. The high-frequency generator 26 can be electrically connected to the neutral electrode 27 at one terminal and to the test electrode 63 at the other terminal. For this purpose, the medical system 15 can, for example, have a switching device 64 by means of which the high-frequency generator 26 can be connected either to the test circuit 62 or to the treatment circuit and the electrodes 21 intended for treatment as described above. The switching device 64 can, for example, be controlled by a control signal Osi from the control device 61.

[0089] When the high-frequency generator 26 is connected to the test circuit 62, the high-frequency generator 26 can be brought into a test operating state by means of the control device 61 by applying a voltage between the test electrode 63 and the neutral electrode 27 that cannot cause any tissue changes in the biological tissue 20. When the test electrode 63 is brought into contact with the biological tissue 20, a current can flow between the test electrode 63 and the neutral electrode 27, and a magnetic field 38 can be generated based on this current flow. This magnetic field 38 can be used to determine a tissue type parameter EP, which characterizes the type of tissue to be ablated.It is then possible to place the electrodes 21 used for ablation at the desired location in the biological tissue 20 and / or to adjust the control of the high-frequency generator 26 during the treatment of the tissue depending on the detected tissue type.

[0090] In a variation of the one shown in Figure 4 In this example, the existing treatment circuit can also be used for testing. In this case, the test electrode 63, the switching device 64, and the additional neutral electrode 27 can be omitted. A test voltage or test current can be generated through the biological tissue using the existing electrodes 21 via the control unit 61 of the high-frequency generator 26. Such testing, using the treatment circuit or an additional test circuit 62, can be used in all embodiments of the medical system 15.

[0091] Figure 5 illustrates a tool part 19 of a bipolar instrument with two electrodes 21, each electrode 21 being arranged on a branch 67 of the tool part 19. The two electrodes 21 are located opposite each other on the facing sides of the branches 67. Biological tissue 20 (for example, a blood vessel) can be held or clamped between the branches 67. The two branches 67 are movable relative to each other, and in particular pivotable, via an actuating device of the handle 62, as shown schematically in Figure 2.

[0092] In this embodiment, a magnetic field sensor 30 is arranged in each branch 67j. Each of the magnetic field sensors 30 is connected to a common light source 51 via an optical transmission link 34. A beam splitter 52 can be arranged in each optical transmission link 34 between the common light source and each of the magnetic sensors 30, which in turn is connected via a further section of the optical transmission link 34. A transmission link 34 (for example, an optical fiber 37) is connected to each associated photodetector 42. The photodetectors 42 are part of a common evaluation unit 35 and can be connected to a common processing unit 43 to process the electrical sensor signal S provided by each photodetector. ei to transmit the data from the respective magnetic field sensor 30 to the common computing unit 43.

[0093] The two magnetic field sensors 60 can be connected to a common vibration excitation arrangement 58, as shown in Figure 5.

[0094] In general, the excitation device 50 can be used for all existing magnetic field sensors 30 in all embodiments. It is therefore sufficient to use a single light source 61 and a single microwave generator 59. The light source 51 is connected to each diamond 32 of each magnetic field sensor 30 via the optical transmission link 34, and the microwave generator 59 can be connected analogously to all microwave antennas 60 on each diamond 32.

[0095] Figures 7 and 8 show, using the example of a branch 67 in a top view of an electrode surface of an electrode 21 (Figure 7) and based on a schematic cross-section through the branches 67 of a tool part 19, different spatial arrangement possibilities for magnetic field sensors 30 are shown in a highly simplified schematic manner. In the embodiment shown in Figure 7, a magnetic field sensor 30 is located on each side of an electrode surface of an electrode 21 in the extension direction of the branch 67 towards its distal end. or several magnetic field sensors 30 are arranged. As can be seen schematically in the cross-section of Figure 8, one or more magnetic field sensors 30 can also be arranged on the side faces of a branch adjacent to the electrodes 21. The embodiments according to Figures 7 and 8 can also be combined with each other.

[0096] The number of magnetic sensors 30 used and / or their relative positions on the tool part 19 can vary depending on the type of electromedical instrument 17 used and / or the number of electrodes 21 present. This allows spatial parameters of a magnetic field 18 to be determined, adapted to the required application. For example, magnetic field strengths B can be determined at several locations without relative movement of the tool part 19 with respect to the biological tissue 20. Additionally or alternatively, the number of magnetic field sensors 30 used and / or their spatial arrangement in the tool part 19 can be used to determine at least a length value L of a treated or affected zone in the biological tissue 20 and / or to identify a transition point between different tissue types.

[0097] By determining a location-dependent and / or time-dependent magnetic field strength profile at one or more locations, insights can be gained, for example, about the type of tissue being treated, the progress of the treatment, or tissue boundaries between different types of biological tissue. To determine one or more application parameters (EP) based on the measured magnetic field, other known parameters can also be considered (for example, in the magnetic field characteristic C), such as... Example: the current voltage and / or current provided by the high-frequency generator 26 during treatment or test operation.

[0098] Figure 11 shows a simplified example of a treatment and a measurement of the treatment progress or success. First, a test voltage 70 can be applied using the high-frequency generator 26 during a test time interval t. t The system can be set up, for example, to determine the current initial conditions, such as the tissue type to be treated and / or the current moisture H of the biological tissue 20 and / or the current temperature T of the biological tissue 20. Subsequently, the biological tissue 20 can be influenced using the electromedical instrument 17; for example, a coagulation voltage 71 can be applied during a coagulation time interval t. C oag and / or a cutting voltage of 72 may occur during a dissection time interval t cut can be applied. During treatments, one or more measurements can be performed using at least one magnetic field sensor 30 to monitor and determine the treatment progress or completion (complete coagulation and / or complete transection of the biological tissue 20). It is also optionally possible to apply a test voltage 70 again after each treatment phase (coagulation time interval or dissection time interval) to determine the tissue change caused by the treatment without affecting the tissue.

[0099] The invention relates to a medical system 15 with a medical instrument 16, preferably a- an electromedical instrument 17 or electrosurgical instrument 18. At least one magnetic field sensor 30, preferably designed as a quantum magnetometer or NVCD sensor, is arranged on a tool part 19 of the instrument. Each magnetic field sensor 30 is configured to detect a magnetic field 38 emanating from the electromedical instrument (17) and / or from a biological tissue 20 and to generate a corresponding sensor signal S, preferably an optical sensor signal S. opto provide a data set that can be evaluated by means of an evaluation unit 35. The evaluation unit 35 determines at least one application parameter EP. The at least one application parameter EP describes the biological tissue 20 and / or the effect exerted on the biological tissue 20 by the medical instrument 16 or the tool part 19. For example, an application parameter EP can describe a tissue type, a temporal and / or spatial change in the tissue, a current temperature T, or a spatial and / or temporal change in the temperature T of the biological tissue 20. Such application parameters EP can be monitored very dynamically by measuring the magnetic field. Reference character list: 15 medical system 16 medical instruments 17 electromedical instrument 18 electrosurgical instruments 19 Tool part 20 biological tissue 21 electrode 22 handle pieces 23 Endoscope 25 supply unit 26 High-frequency generator 27 Neutral electrode 30 Magnetic field sensor 31 S ticks to f f- Fehl st eilen- Zent rum 32 diamonds 33 Transmission connection 34 optical transmission link 35 Evaluation unit 36 Display unit 37 optical fibers 38 Magnetic field 39 peripheral nerve 42 Photodetector 43 Calculation unit 44 spectrometers 50 Stimulation device 51 Light source 52 beam splitters 53 filters 54 lens 55 Coupling device 56 more filters 58 Vibration excitation arrangement 59 Microwave generator 59a Function ion generator 59b Os zillator 59c Amplifier 60 microwave antenna 61 Control unit 62 Test circuit 63 Test electrode 64 Switching device 65 carriers 66 connection 67 Industry 70 Test voltage interval 71 Coagulate ion voltage interval 72 Cutting voltage interval Ground state excited state Y gyromagnetic ratio AL excitation light B Magnetic field strength C Magnetic field characteristics CF Crest factor d distance to a peripheral nerve DZ current tissue condition EP operating parameters F force FL Fluorescent light H humidity I B Electricity through biological tissue I G High-frequency current L Length of an affected area OSi control signal i ( i=l , 2 , 3 , n) pd penetration depth PI input parameters S Sensor signal Be electrical sensor signal S O pt optical sensor signal t time tcoag coagulation time interval t cu t Dissection time interval t t Test time interval Temperature U High-frequency voltage WF waveform Y tissue type Z current tissue condition

Claims

Patent claims:

1. Medical system (15) exhibiting: - a medical instrument (16) with a tool part (19) designed to act on biological tissue (20), - at least one magnetic field sensor (30) arranged on the medical instrument (16) which is designed to detect a magnetic field (38) emanating from the biological tissue (20) and to generate a sensor signal (S) dependent on the detected magnetic field (38), - an evaluation device (35) which is connected to the at least one magnetic field sensor (30) by means of a transmission link (33) and is configured to determine at least one operating parameter (EP) based on the sensor signal (S) of the at least one magnetic field sensor (30), wherein the at least one operating parameter (EP) describes the biological tissue (20) and / or the action of the tool part (19) on the biological tissue (20).

2. Medical system according to claim 1, wherein at least two magnetic field sensors (30) are provided.

3. Medical system according to one of the preceding claims, wherein the tool part (19) of the medical instrument (16) has two branches (67) movable relative to each other, wherein at least one of the branches (67) or at both branches (30) is attached to each branch. magnetic field sensor (30) is arranged.

4. Medical system according to any of the preceding claims, wherein the sensor signal (S) is an optical sensor signal (S op t) is.

5. Medical system according to claim 4, wherein the transmission link between the evaluation device (35) and the at least one magnetic field sensor (30) is an optical transmission link (34) for the optical sensor signal (S). op t) is, which in particular has at least one optical fiber (37).

6. Medical system according to one of the preceding claims, wherein the evaluation device (35) comprises a photodetector (42) and a computing unit (43) connected to the photodetector (42) or wherein the evaluation device (35) comprises a spectrometer (44).

7. Medical system according to one of claims 4 to 6, wherein the at least one magnetic field sensor (30) has a diamond (32) with nitrogen vacancy centers (31).

8. Medical system according to claim 7, wherein the magnetic field sensor (30) is an NVCD sensor or comprises an NVCD sensor.

9. Medical system according to claim 7 or 8, further comprising an excitation device (50) which is configured to influence the internal state of the nitrogen defect centers (31) of the diamond (32).

10. Medical system according to claim 9, wherein the excitation device (50) comprises a light source (51) configured to emit excitation light (AL) to the to transmit diamonds (32) of each magnetic field sensor (30) and / or wherein the excitation device (50) has a vibration excitation arrangement (58) configured to vibrate the diamond (32).

11. Medical system according to claim 10, wherein excitation device (50) comprises a microwave antenna (60) attached to the diamond (32) and connected to a microwave generator (59).

12. Medical system according to one of the preceding claims, wherein the evaluation device (35) is provided with a magnetic field characteristic (C) which establishes a relationship between the at least one operating parameter (EP) and the at least one sensor signal (S) indicates.

13. Medical system according to claim 12, wherein the evaluation device (35) is configured to determine, as the at least one operating parameter (EP), one, several or all of the following parameters: - a distance parameter that describes a distance (d) of the magnetic field sensor (30) or of at least one of the existing magnetic field sensors (30) to a peripheral nerve (39); - a temperature parameter that describes a temperature (T) in the area of ​​the detected magnetic field (38) ; - a humidity parameter that describes humidity (H); - a tissue type parameter that describes a tissue type (Y) of the biological tissue (20) from which the detected magnetic field (38) originates; - at least one length parameter that describes a length (L) of an area of ​​the biological tissue (20) affected by the medical instrument (16) in a respective spatial direction; - at least one contact parameter that describes contact between the tool part (19) and the biological tissue (20); - a spatial change in the magnetic field strength (B) and / or magnetic field direction of the magnetic field (38) ; - a change over time in the magnetic field strength (B) and / or magnetic field direction of the magnetic field (38) ; - a current tissue state (Z) and / or a current tissue state change (DZ) .

14. Medical system according to one of the preceding claims, wherein the medical instrument (16) is an electromedical instrument (17), in particular an electrosurgical instrument (18), and wherein the tool part (19) has at least one electrode (21).

15. Procedures for operating a medical system (15) comprising a medical instrument (16) with a tool part (19), at least one magnetic field sensor (30) arranged on the tool part (19) and an evaluation device (35) which is connected to the at least one magnetic field sensor (30) by means of a transmission link (33), wherein the method comprises: - Detection of a magnetic field (38) emanating from biological tissue and generation of a sensor signal (S) dependent on the detected magnetic field (38) by means of the at least one magnetic field sensor (30) , - Determining at least one application parameter (EP) based on the sensor signal (S) using the evaluation device (35) , wherein the at least one application parameter (EP) describes the biological tissue (20) and / or the action of the tool part (19) on the biological tissue (20).

16. Computer program product comprising program code which, when executed on a computing device of a medical system (15), causes the medical system (15) to operate as follows: - Detection of a magnetic field (38) emanating from biological tissue and generation of a sensor signal (S) dependent on the detected magnetic field (38) by means of at least one magnetic field sensor (30) which is arranged on a tool part (19) of a medical instrument (16) of the medical system (15), - Determining at least one operational parameter (EP) based on the sensor signal (S) using an evaluation unit (35) of the medical system (15) , which is connected to the at least one magnetic field sensor (30) by means of a transmission link (33), wherein the at least one operating parameter (EP) describes the biological tissue (20) and / or the action of the tool part (19) on the biological tissue (20).

Images