CN104337569A - 用于通过电外科电缆测量组织阻抗的系统和方法 - Google Patents

用于通过电外科电缆测量组织阻抗的系统和方法 Download PDF

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CN104337569A
CN104337569A CN201410361583.0A CN201410361583A CN104337569A CN 104337569 A CN104337569 A CN 104337569A CN 201410361583 A CN201410361583 A CN 201410361583A CN 104337569 A CN104337569 A CN 104337569A
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electrosurgical
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E·J·拉森
C·福特
A·M·瓦斯克维茨
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Covidien LP
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/1206Generators therefor
    • A61B18/1233Generators therefor with circuits for assuring patient safety
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/1442Probes having pivoting end effectors, e.g. forceps
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/16Indifferent or passive electrodes for grounding
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577Ablation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00607Coagulation and cutting with the same instrument
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00773Sensed parameters
    • A61B2018/00875Resistance or impedance

Abstract

本发明涉及用于通过电外科电缆测量组织阻抗的系统和方法。本公开的电外科系统和方法包括组织电阻测量系统,其补偿将电外科发生器连接到电外科器械的电缆中的电容寄生效应以估计组织负载的真实电阻。电外科发生器包括耦合到电能量源并且生成电外科能量的输出级。电外科发生器包括感测电外科能量的电压和电流的多个传感器和控制输出级的控制器。控制器包括:计算器,其基于被感测电压和电流计算阻抗的实部;估计器,其使用作为阻抗的实部的函数的二次方程的解估计组织的电阻;以及控制信号发生器,其配置成基于组织的电阻生成用于输出级的控制信号。

Description

用于通过电外科电缆测量组织阻抗的系统和方法
技术领域
本公开涉及电外科手术。更特别地,本公开涉及用于通过电外科电缆测量组织阻抗的电外科系统和方法。
背景技术
电外科手术包括在电外科程序期间施加高频电流以切割或改变生物组织。使用电外科发生器、有源电极和返回电极执行电外科手术。电外科发生器(也称为电源或波形发生器)生成交流电流(AC),所述交流电流通过有源电极施加到患者的组织并且通过返回电极返回到电外科发生器。交流电流典型地具有高于100千赫(kHz)的频率以避免肌肉和/或神经刺激。
在电外科手术期间,由电外科发生器生成的AC传导通过布置在有源和返回电极之间的组织。组织的阻抗将与AC关联的电能(也称为电外科能量)转换成导致组织温度上升的热。电外科发生器通过控制提供给组织的电功率(即,单位时间的电能)控制组织的加热。尽管许多其它变量影响组织的总加热,但是增加的电流密度通常导致增加的加热。电外科能量典型地用于切割、剖切、消融、凝固和/或闭合组织。
所使用的电外科手术的两种基本类型是单极和双极电外科手术。这些类型的电外科手术都使用有源电极和返回电极。在双极电外科手术中,外科器械包括在相同器械上或彼此很接近的有源电极和返回电极,其导致电流流动通过少量组织。在单极电外科手术中,返回电极位于患者的身体上的其它位置并且典型地不是电外科器械自身的一部分。在单极电外科手术中,返回电极是典型地称为返回垫的装置的一部分。
电外科发生器使用电压和电流传感器来测量诸如功率和组织阻抗的量以便控制电外科发生器的输出以获得期望临床效果。电压和电流传感器常常位于电外科发生器的内部以节约与将传感器包含到外科器械中关联的成本。在长度上可以超过一米的电缆将电外科发生器连接到有源和返回电极并且用于将电外科能量输送到正在治疗的组织。
电缆产生电压和电流传感器与正在治疗的组织之间的电路网络,其导致不精确的功率和阻抗测量。因此,为了更精确地测量功率和阻抗,许多发生器使用解释电缆的电路网络的阻抗的补偿算法。这些补偿算法典型地包括求解建模电缆的电路网络的电路模型中的多个节点的基尔霍夫电流和电压方程。然而,当由实时嵌入式软件系统执行时,这些方程的解可能需要相当大的存储量和处理能力。
发明内容
本公开的电外科系统和方法通过使用基于AC滤波器的阻抗方程减小精确地测量功率和组织阻抗所需的存储量和处理能力。
在一方面,本公开的特征在于经由电外科电缆和电外科器械将电外科能量输送到组织的另一种电外科发生器。所述电外科发生器包括:输出级,所述输出级生成用于所述电外科器械的电外科能量;多个传感器,所述多个传感器感测生成的电外科能量的电压波形和电流波形;以及控制器,所述控制器控制所述输出级以生成期望水平的电外科能量。所述控制器包括:计算器,所述计算器基于被感测电压和电流波形计算阻抗的实部;阻抗补偿器,所述阻抗补偿器使用建模所述电外科电缆的电抗部件的二次方程的解修正目标阻抗曲线;以及控制信号发生器,所述控制信号发生器生成控制信号以控制所述输出级使得阻抗的被计算实部遵循经修正的目标阻抗曲线。
所述二次方程的解可以是其中Rload是组织的电阻,ω是生成的电外科能量的频率,Ccable是将所述电外科发生器连接到电外科器械的电缆的并联电容,并且Re(Z)是阻抗的实部。
所述二次方程可以从具有串联电感器和并联电容器的所述电缆的模型导出。所述方法可以包括当所述电压波形和所述电流波形之间的相位差小于或等于-45度时使用所述二次方程的较大解作为组织的电阻的估计值,当所述相位差大于-45度时使用所述二次方程的较小解作为组织的电阻的估计值。
所述电外科发生器可以包括电感器,所述电感器耦合到所述输出级并且被调谐以适应所述电缆的并联电容和串联电感使得阻抗的被计算实部是充分电阻性的。所述电缆的并联电容可以是当器械的电极不与组织接触时测量的电容值。所述电感器的电感值可以等于其中Lcable是所述电缆的串联电感。所述电感器的电感值可以等于
在又一方面,本公开的特征在于一种控制电外科发生器的方法,所述电外科发生器经由电外科电缆和耦合到所述电外科电缆的电外科器械将电外科能量输送到组织。所述方法包括:感测生成的电外科能量的电压波形和电流波形;基于被感测电压和电流波形计算阻抗的实部;使用建模所述电外科电缆的电抗部件的二次方程的解修正目标阻抗曲线;以及生成控制信号以控制从所述电外科发生器的输出级输出的电外科能量的水平使得阻抗的被计算实部遵循经修正的目标阻抗曲线。
所述二次方程的解可以是其中Rload是组织的电阻,ω是生成的电外科能量的频率,Ccable是将所述电外科发生器连接到电外科器械的电缆的并联电容,并且Re(Z)是阻抗的实部。
所述二次方程可以从具有串联电感器和并联电容器的所述电缆的模型导出。所述方法可以包括当所述电压波形和所述电流波形之间的相位差小于或等于-45度时使用所述二次方程的较大解作为组织的电阻的估计值,当所述相位差大于-45度时使用所述二次方程的较小解作为组织的电阻的估计值。
所述电外科发生器可以包括电感器,所述电感器耦合到所述输出级并且被调谐以适应所述电缆的并联电容和串联电感使得阻抗的被计算实部是充分电阻性的。所述电缆的并联电容可以是当器械的电极不与组织接触时测量的电容值。所述电感器的电感值可以等于其中Lcable是所述电缆的串联电感。所述电感器的电感值可以等于
附图说明
参考附图描述本公开的各实施例,其中:
图1是根据本公开的实施例的电外科系统;
图2是图1的电外科系统的电路方块图;
图3是包括电外科电缆的模型的图1的电外科系统的简化电路方块图;
图4是组织的真实阻抗和在图2的电外科发生器的传感器处测量的阻抗的实部的图表;
图5是根据本公开的另一实施例的组织的真实阻抗和在图2的电外科发生器的传感器处测量的目标阻抗的图表;
图6是根据本公开的另一实施例的传感器处的理想目标真实阻抗和多项式拟合到图2的电外科发生器的传感器处的目标真实阻抗的图表;
图7是根据本公开的另一实施例的包括独立电感器的图1的电外科系统的简化电路方块图;以及
图8和9是根据本公开的实施例的控制发生器的输出级以补偿电外科电缆的阻抗的方法的流程图。
具体实施方式
如上所述,电外科系统中的电缆产生电压和电流传感器与正在治疗的组织之间的电路网络,其导致不精确的功率和阻抗测量。因此,为了更精确地测量功率和阻抗,许多发生器使用解释电缆的电路网络的阻抗的补偿算法。这些补偿算法包括测量并且存储多个电缆参数,例如串联电感、并联电容和电阻,所述电缆参数在电缆的电路网络的模型中的多个节点的基尔霍夫电流和电压方程的解中用作常数。补偿算法也包括对具有实部和虚部的复数的许多数学运算,例如乘和加。
本公开的电外科系统和方法减小精确地测量组织阻抗所需的存储量和处理能力。根据本公开的系统和方法使用电缆的简单模型以便估计实际组织阻抗。电缆模型包括与正在治疗的组织串联的电感器和电阻,以及与正在治疗的组织并联的并联电容器。电缆715(图7中所示)的电阻与正在治疗的组织的电阻相比较小并且因此可以被忽略。基于被感测电流和电压波形,计算阻抗的实部,并且基于阻抗的被计算实部估计实际组织阻抗。
如通过引用完整地被合并的美国专利申请第61/794,191号中所公开,可以通过使用窄带滤波器确定复值电压和复值电流并且使用复值电压和复值电流计算组织的阻抗的实部而获得阻抗的实部。可以根据以下方程计算组织阻抗的实部:
ac + bd c 2 + d 2
其中a是复值电压的实部,b是复值电压的虚部,c是复值电流的实部,并且d是复值电流的虚部。窄带滤波器可以是多相抽取滤波器或Goertzel DFT滤波器。多相抽取滤波器可以是外差载波中心多相滤波器,其具有的中心频率是电外科能量的频率的谐波倍数。
图1示出根据本公开的实施例的电外科系统100。电外科系统100包括生成电外科能量以治疗患者的组织的电外科发生器102。电外科发生器102基于选定操作模式(例如,切割、凝固、消融或闭合)和/或生成的电外科能量的被感测电压和电流波形生成适当水平的电外科能量。电外科系统100也可以包括对应于各种电外科器械的多个输出连接器。
电外科系统100还包括具有用于治疗患者的组织的电极的单极电外科器械110(例如,电外科切割探针或消融电极)和返回垫120。单极电外科器械110可以经由多个输出连接器中的一个连接到电外科发生器102。电外科发生器102可以以射频(RF)能量的形式生成电外科能量。电外科能量被施加到单极电外科器械110,所述单极电外科器械将电外科能量施加到组织。电外科能量通过返回垫120返回到电外科发生器102。返回垫120提供与患者的组织的足够接触面积从而最小化由于施加到组织的电外科能量引起的组织损伤的风险。
电外科系统100也包括双极电外科器械130。双极电外科器械130可以经由多个输出连接器中的一个连接到电外科发生器102。电外科能量被供应到两个钳中的一个、施加到组织并且通过另一钳返回到电外科发生器102。
电外科发生器102可以是任何合适类型的发生器并且可以包括多个连接器以适应各种类型的电外科器械(例如,单极电外科器械110和双极电外科器械130)。电外科发生器102也可以配置成以各种模式操作,例如消融、切割、凝固和闭合。电外科发生器102可以包括切换机构(例如,继电器)以在各种电外科器械可以连接到的连接器之间切换RF能量的供应。例如,当单极电外科器械110连接到电外科发生器102时,切换机构将RF能量的供应切换到单极插头。在实施例中,电外科发生器102可以配置成同时将RF能量提供给多个器械。
电外科发生器102包括用户接口,所述用户接口具有合适的用户控制(例如,按钮、启动器、开关或触摸屏)以便将控制参数提供给电外科发生器102。这些控制允许用户调节电外科能量的参数(例如,功率水平或输出波形的形状)使得电外科能量适合于特定外科程序(例如,凝固、消融、组织闭合或切割)。电外科器械110和130也可以包括多个用户控制。另外,电外科发生器102可以包括一个或多个显示屏以便显示与电外科发生器102的操作相关的各种信息(例如,强度设置和治疗完成指示)。
图2是图1的电外科系统100的方块图。电外科系统包括包含在图1的电外科发生器102中的发生器电路105,和电外科器械225。发生器电路105包括逆变器210、谐振储能电路215、多个传感器220、多个模数转换器(ADC)230和数字信号处理器235。发生器电路105配置成连接到生成具有低功率(例如,25Hz、50Hz或60Hz)的AC的交流(AC)电源,例如电源插座。AC电源将AC功率提供给发生器电路105,所述发生器电路将低频率AC转换成适合于期望电外科程序的高频率AC。具体地,逆变器210将DC变换为AC。AC波形具有适合于电外科程序的频率(例如,472kHz、29.5kHz和19.7kHz)。
电外科能量的合适频率可以基于电外科程序和电外科手术的模式而不同。例如,神经和肌肉刺激在大约每秒100,000周期(100kHz)停止并且一些电外科程序可以在100kHz以上的射频(RF)安全地执行。在超过100kHz的频率,电外科能量可以以微小的神经肌肉刺激穿过患者到达目标组织。例如,消融使用472kHz的频率。其它电外科程序可以在低于100kHz(例如29.5kHz或19.7kHz)的频率执行并且损伤神经和肌肉的风险很小。逆变器210可以输出具有适合于电外科程序的各种频率的AC信号。
谐振储能电路215耦合到逆变器210。谐振储能电路215使逆变器210处的阻抗匹配组织的阻抗使得存在从逆变器210到正在治疗的组织的最大或最佳功率输送。多个传感器220耦合到谐振储能电路215和电外科器械225以感测从发生器电路105输出到电外科器械225的电压和电流。点指示从发生器电路105的视角看到的阻抗。换句话说,发生器电路105在点一起看到电外科器械225和正在治疗的组织的阻抗。发生器电路105配置成补偿布置在点之间的电缆中的阻抗使得发生器电路105可以确定点处的组织的实际阻抗。
多个传感器220可以包括提供电压和电流波形的冗余测量的电压和电流传感器的两个或更多对或组。该冗余保证逆变器210的输出处的电压和电流测量的可靠性、精确性和稳定性。在实施例中,多个传感器220可以取决于应用或设计要求包括电压和电流传感器的或多或少组。
被感测电压和电流波形由多个ADC 230数字地采样以获得由传感器220感测的电压和电流波形的数字样本。多个ADC 230可以以一定频率采样被感测电压和电流波形,所述频率是由电外科发生器102生成的电压和电流的频率的整数倍。被采样电流和电压波形被提供给DSP 235,所述DSP包括用于使用被采样电流和电压波形计算正被治疗的组织的阻抗的实部的计算器,和用于基于组织阻抗的被计算实部估计正被治疗的组织的电阻的估计器。DSP 235还包括控制信号发生器,所述控制信号发生器生成控制信号以基于组织的估计电阻控制逆变器210的输出电压和电流波形。DSP 235包括存储设备240,所述存储设备存储执行用于控制逆变器210的功能的指令和包括查找表245的信息,根据本公开的实施例,所述查找表用于估计组织的实际阻抗值。
图3是示出包括电缆305的电外科系统300的简化电路方块图,所述电缆耦合在发生器电路105和组织负载320之间。如上所述,发生器电路105经由电缆305将电外科能量输送到组织320。电缆305可以建模为耦合到并联电容器Ccable315的串联电感器Lcable310。模型也可以包括串联电阻,但是由于电阻部件相比于正在治疗的组织的电阻较小,因此模型不需要包括串联电阻。
根据本公开,发生器电路105通过补偿电缆305的电抗(即串联电感器Lcable310和并联电容器Ccable315)确定负载RL320的实际阻抗。如图2中所述,在点处看到的阻抗是电缆305和负载320的总阻抗的组合。理论上,总阻抗由下式给出:
其中Ztotal是总阻抗,Vm是传感器220处的测得电压,Im是传感器220处的测得电流,并且是测得电压和测得电流之间的相位差。相位差由电缆305的电抗部件(即电感310和电容315)导致。
电缆补偿是确定负载320的实际电阻RL的过程。基于图3中所示的电缆模型,如下计算总阻抗:
Z total = jω L C + ( 1 jω C C / / R L ) = jω L C + R L jω R L C C + 1 - - - ( 2 )
其中ω是电压和电流的频率。由于总阻抗是复值,因此总阻抗具有如下的实部和虚部:
Z total = Re ( Z total ) + j Im ( Z total ) = R L 1 + ( ω R L C C ) 2 + j ( ω L C - ω R L 2 C C 1 + ( ω R L C C ) 2 ) - - - ( 3 )
当在本文中使用时,总阻抗Ztotal也被称为阻抗Z。因此,阻抗的被计算实部之间的关系为:
Re ( Z ) = R L 1 + ( ω R L C C ) 2 - - - ( 4 )
方程(4)可以表示为关于负载320的电阻RL的二阶多项式或二次方程,如下:
2CC 2Re(Z))RL 2-RL+Re(Z)=0  (5)
方程(5)可以如下求解负载320的电阻RL
R L = 1 ± 1 - 4 ( ω C C Re ( Z ) ) 2 2 Re ( Z ) ( ω C C ) 2 - - - ( 6 )
基于方程(6),可以使用阻抗的被计算实部Re(Z)、电缆的预定电容Ccable和由发生器电路105生成的电外科能量的频率估计负载320的实际阻抗值。当电外科能量的电压波形和电流波形之间的相位差小于或等于-45度时,方程(6)的较大解可以用作组织电阻的估计值,并且当相位差大于-45度时,方程(6)的较小解可以用作组织电阻的估计值。
图4是示出由发生器电路105感测的阻抗的实部如何与负载320处的阻抗的实际实部(即组织的电阻)相关的图表400。图形400的y轴405表示在图2的发生器电路105的传感器220处测量的以欧姆计的阻抗Re(Z)的实部。图形400的x轴410表示以欧姆计的图3的负载320的电阻RL。理想地,由发生器电路105测量的阻抗的实部和真实负载之间的关系是如曲线415所示的线性关系。曲线420是基于由发生器电路105的传感器220进行的测量计算的阻抗的实部Re(Z)。如图所示,当真实阻抗增加时,曲线420从理想曲线415偏离。然而,在大约250欧姆以前两个曲线415和420是类似的。因此,当阻抗的实部小于或等于250欧姆或另一预定电阻时,发生器电路105可以使用阻抗的测得实部作为真实负载RL的度量。在250欧姆或另一预定电阻之上,发生器电路105可以使用方程(6)来基于阻抗的被计算实部Re(Z)估计真实负载RL
根据本公开的一种方法,对于每个测量周期,DSP 235(图2)计算阻抗的实部并且根据方程(6)估计实际真实负载,例如组织电阻。DSP 235然后生成控制信号以基于实际真实负载的估计值控制逆变器210。该方法的优点之一是它提供每个测量的准确解。
根据另一方法,DSP 235用修正值或修正系数预填充DSP的存储设备240中的查找表245。DSP 235,例如在DSP 235上运行的软件估计器模块,然后可以通过将由发生器电路105的传感器220测量的阻抗的实部映射到实际真实负载值估计实际真实负载值。当阻抗的被计算实部在查找表中的阻抗值的两个实部之间时,DSP 235选择与最靠近阻抗的实部或内插在查找表中的阻抗值的两个实部之间的查找表中的阻抗值的实部对应的组织的估计电阻,以确定组织的估计电阻。尽管查找表方法在计算上是高效的,但是它使用更多的存储并且可能不如涉及根据方程(6)计算实际真实负载的方法精确。
根据又一方法,DSP 235使用方程(6)修正或预弯曲目标阻抗曲线并且生成控制信号以控制发生器电路105的逆变器210使得由传感器220测量的阻抗的实部遵循可以存储在查找表(例如查找表245)中的经修正的目标阻抗曲线。该预弯曲方法在图5的图表中示出,其中y轴表示传感器220处的测得真实阻抗505并且x轴表示电缆510的端部处的真实负载。曲线520是当DSP 235控制来自发生器电路105的输出以遵循目标真实阻抗曲线515时获得的电缆的端部处的真实负载。类似于用于估计真实负载的查找表方法,预弯曲方法在计算上是高效的。与通过在每个测量周期计算方程(6)来估计真实负载的方法相比,预弯曲方法使用更多的存储并且不太精确,原因是:类似于查找表方法,预弯曲方法可能需要内插。
根据又一方法,多项式被拟合到修正系数曲线并且使用多项式计算每个测量的下一个目标Z的修正。例如,如果中心频率为fc=400kHz并且电缆的并联电容Ccable为330pF,则可以从以下二阶多项式方程计算经修正的目标阻抗Zcorrected
Zcorrected=(0.0013*Z*Z)+(0.5221*Z)+26.45  (7)
其中Z是目标阻抗并且经修正的目标阻抗Zcorrected的二阶多项式方程的系数是中心频率fc和电缆的并联电容的函数。在一些实施例中,如果需要更大的精度,则可以根据高阶多项式方程计算经修正的目标阻抗。多项式拟合的优点在于它比以上的连续评价方程(6)在计算上更高效。
多项式也可以拟合到图5的目标真实阻抗曲线515。如图6中所示,曲线615是拟合到目标真实阻抗曲线515的二阶多项式。在操作期间,DSP 235控制发生器电路105的逆变器210使得由发生器电路105测量的阻抗的实部遵循拟合到目标真实阻抗曲线615的多项式。
图7显示电外科系统700的电路方块图,示出补偿电缆电容Ccable(315)的硬件方法。这通过将具有电感Lgen的串联电感器710加入发生器705实现,使得:
L gen = - 1 ω Im ag { R load / / 1 jω C cable } - L cable - - - ( 8 )
其中//表示“与…串联”,ω是生成的电外科能量的角频率,Rload是负载320的电阻,Ccable是连接到电外科发生器705的电缆305的并联电容315,并且Lcable是电缆305的串联电感310。在并联地组合负载的电阻Rload和电缆电容的阻抗之后,方程(8)变为:
L gen = - 1 ω Im ag { R load jω R load C cable + 1 } - L cable - - - ( 9 )
串联电感器710可以在发生器电路105的外部或内部串联地连接在传感器220与在图2的点和点之间(例如,靠近点)延伸的电缆之间。
方程(9)可以改写以分离出负载电阻Rload和电缆电容的阻抗的并联组合的实部和虚部,如下:
L gen = - 1 ω Im ag { R load - jω R load 2 C cable 1 + ω 2 R load 2 C cable 2 } - L cable - - - ( 10 )
在取并联组合的虚部之后,方程(10)变为:
L gen = R load 2 C cable 1 + ω 2 R load 2 C cable 2 - L cable - - - ( 11 )
用于电感Lgen的方程(11)也可以如下面所示通过以除第一项的分子和分母表示:
L gen = C cable 1 R load 2 + ω 2 C cable 2 - L cable - - - ( 11 - a )
在这里,远小于并且因此是可忽略的。然后可以如下表示电感Lgen
L gen ≅ C cable ω 2 C cable 2 - L cable = 1 ω 2 C cable - L cable - - - ( 11 - b )
可见,用于电感Lgen的方程(11-b)与负载的电阻Rload(即,组织的电阻)无关。因此,可以通过将具有根据方程(11-b)确定的电感Lgen的串联电感器710加入发生器705而补偿电缆电容Ccable(315)。
因此,在发生器705处由传感器220(参见图2)看到的总阻抗Ztotal变为:
Z total = jω ( L gen + L cable ) + R cable + R load / / 1 jω C cable - - - ( 12 )
用方程(8)代替方程(12)的串联电感Lgen导致以下方程:
Z total = jω { - 1 ω Im ag { R load / / 1 jω C cable } - L cable + L cable } + R cable + Re { R load / / 1 jω C cable } + j Im ag { R load / / 1 jω C cable } . - - - ( 13 )
由于从方程(13)减去了电缆的电感Lcable,因此方程(13)可以改写如下:
Z total = - j Im ag { R load / / 1 jω C cable } + R cable + Re { R load / / 1 jω C cable } + j Im ag { R load / / 1 jω C cable } . - - - ( 14 )
此外,如方程(14)中所示,减去了并联组合的虚部。因此,方程(14)变为:
Z total = R cable + Re { R load / / 1 jω C cable } - - - ( 15 )
在并联地组合负载的电阻Rload和电缆电容的阻抗之后,方程(15)变为:
Z total = R cable + Re { R load jω R load C cable + 1 } - - - ( 16 )
方程(16)可以改写以分离出负载电阻Rload和电缆电容的阻抗的并联组合的实部和虚部,如下:
Z total = R cable + Re { R load - jω R load 2 C cable 1 + ω 2 R load 2 C cable 2 } - - - ( 17 )
在取并联组合的实部之后,方程(17)变为:
Z total = R cable + R load 1 + ω 2 R load 2 C cable 2 - - - ( 18 )
方程(18)指示如果适当地调谐串联电感器710的电感Lgen,则提供给发生器电路105的负载是纯电阻性的。硬件补偿的优点在于如果适当地调谐电感Lgen则不需要软件补偿。即使未适当地调谐电感Lgen,加入的串联电感器710也将减小电缆中的并联电容的影响。上述的软件补偿方法可以与串联电感器710组合使用以进一步减小电缆中的并联电容的影响。对于硬件补偿,将需要针对使用的不同电缆中的每一个调谐串联电感器710。串联电感器710可以放置在传感器之后并且与电缆和负载串联。串联电感器710可以替代地紧接着电外科发生器的输出放置。
可以通过在器械的钳夹打开(即将真实负载设置为实质上无穷大)的情况下开启发生器而确定电缆电容C。然后,图3的开路形式简化为:
|Z|=ωC  (19)
因此,当在发生器电路105的传感器220处测量|Z|时,可以确定电容C。
上述的测量组织阻抗的系统和方法可以在各种组织治疗算法中使用,所述组织治疗算法包括具有预加热阶段和阻抗控制阶段的组织治疗算法。在预加热阶段的开始时,由发生器生成并且供应到组织的电流的水平低并且组织的阻抗以初始阻抗值开始。在预加热阶段期间,供应到组织的电流的水平以预定速率增加或向上斜升使得组织的温度增加并且组织阻抗减小。电流的斜升继续直到(1)达到最大容许电流值;或(2)有“组织反应”。术语“组织反应”表示细胞内和/或细胞外液开始沸腾和/或蒸发从而导致组织阻抗增加的点。在达到最大容许电流值时的情况下,最大电流值保持直到组织反应。
当组织反应时,组织治疗算法过渡到阻抗控制阶段。在阻抗控制阶段期间,组织治疗算法首先计算目标组织阻抗曲线或轨迹和组织阻抗的目标变化率(dZ/dt)。然后,组织治疗算法控制从发生器输出的电外科能量的功率水平使得根据本公开的系统和方法测量的测得组织阻抗遵循目标组织阻抗轨迹和组织阻抗的目标变化率。
图8示出在阻抗控制阶段期间控制发生器的输出级以补偿电外科电缆中的寄生效应的方法800。该方法可以在图2的电外科发生器102的DSP 235中执行,所述DSP可以由任何合适类型的处理器代替。在步骤802中开始阻抗控制阶段之后,方法800首先包括在步骤805中感测生成的电外科能量的电压波形和电流波形。在步骤810中,基于被感测电压和电流波形计算阻抗的实部。在步骤815中,确定被计算阻抗Re(Z)是否小于预定阻抗值Z0。预定阻抗值Z0表示阻抗阈值,阻抗的被计算实部Re(Z)靠近所述阻抗阈值开始从组织负载的实际电阻偏离。
如果在步骤815中确定阻抗的被计算实部小于预定阻抗值,则在步骤820中控制输出级以基于阻抗的被计算实部生成电外科能量。然后,方法800返回步骤805以重复控制过程。如果在步骤815中确定阻抗的被计算实部不小于预定阻抗值,则在步骤825中使用作为阻抗的被计算实部的函数的二次方程的解估计组织的电阻。然后,在步骤830中,基于组织的估计电阻生成用于控制输出级的控制信号。
接着,在步骤835中,确定组织的估计电阻是否大于预定组织电阻R0。如果组织的估计电阻大于预定组织电阻R0,则方法结束。否则,方法800返回到步骤805以重复方法800。
图9示出控制发生器的输出级以补偿电外科电缆中的寄生效应的输出级的另一方法900。与图8中一样,在阻抗控制算法在步骤802中开始之后,在步骤805中在发生器处感测电压和电流波形并且在步骤810中计算阻抗的实部。接着,在步骤915中,使用建模电外科电缆的二次方程的解修正目标阻抗曲线,如上面关于图6所述。然后,在步骤920中,生成控制信号以控制从输出级输出的电外科能量的水平使得阻抗的实部遵循经修正的目标阻抗曲线。
接着,在步骤925中,确定阻抗的实部Re(Z)是否大于预定阻抗Z1。如果阻抗的实部大于预定组织阻抗Z1,则方法结束。否则,方法900返回到步骤805以重复方法900。
尽管已在本文中参考附图描述了本公开的示例性实施例,但是应当理解本公开不限于那些具体实施例,而是本领域的技术人员可以在其中实现各种其它变化和修改而不脱离本公开的范围或精神。

Claims (17)

1.一种经由电外科电缆和电外科器械将电外科能量输送到组织的电外科发生器,所述电外科发生器包括:
输出级,所述输出级耦合到电能量源并且配置成生成到达所述电外科器械的电外科能量;
多个传感器,所述多个传感器配置成感测所生成的电外科能量的电压波形和电流波形;以及
控制器,所述控制器配置成控制所述输出级以生成期望水平的电外科能量,所述控制器包括:
计算器,所述计算器配置成基于所感测的电压和电流波形计算阻抗的实部;
阻抗补偿器,所述阻抗补偿器配置成使用建模所述电外科电缆的电抗部件的二次方程的解修正目标阻抗曲线;以及
控制信号发生器,所述控制信号发生器配置成生成控制信号以控制所述输出级使得阻抗的被计算实部遵循经修正的目标阻抗曲线。
2.根据权利要求1所述的电外科发生器,其中所述二次方程的解是其中Rload是组织的电阻,ω是所生成的电外科能量的频率,Ccable是将所述电外科发生器连接到电外科器械的电缆的并联电容,并且Re(Z)是阻抗的实部。
3.根据权利要求2所述的电外科发生器,其中,当所述电压波形和所述电流波形之间的相位差小于或等于-45度时,组织的电阻是所述二次方程的较大解,或者,当所述相位差大于-45度时,组织的电阻是较小解。
4.根据权利要求1所述的电外科发生器,其中所述电外科电缆的电抗部件的模型包括与组织串联的电感器和与组织并联的并联电容器。
5.根据权利要求1所述的电外科发生器,其还包括电感器,所述电感器耦合到所述输出级并且被调谐以适应所述电缆的并联电容和串联电感使得阻抗的被计算实部是充分电阻性的。
6.根据权利要求5所述的电外科发生器,其中所述电缆的并联电容是当器械的电极不与组织接触时测量的电容值。
7.根据权利要求5所述的电外科发生器,其中所述电感器的电感值等于其中ω是所生成的电外科能量的频率,Ccable是将所述电外科发生器连接到电外科器械的电缆的并联电容,Rload是组织的电阻,并且Lcable是所述电缆的串联电感。
8.根据权利要求5所述的电外科发生器,其中所述电感器的电感值等于其中ω是所生成的电外科能量的频率,Ccable是将所述电外科发生器连接到电外科器械的电缆的并联电容,并且Lcable是所述电缆的串联电感。
9.一种控制电外科发生器的方法,所述电外科发生器经由电外科电缆和电外科器械将电外科能量输送到组织,所述方法包括:
感测生成的电外科能量的电压波形和电流波形;
基于所感测的电压和电流波形计算阻抗的实部;
使用建模所述电外科电缆的电抗部件的二次方程的解修正目标阻抗曲线;以及
生成控制信号以控制来自所述电外科发生器的输出级的输出使得阻抗的被计算实部遵循经修正的目标阻抗曲线。
10.根据权利要求9所述的方法,其中所述二次方程的解是其中Rload是组织的电阻,ω是生成的电外科能量的频率,Ccable是将所述电外科发生器连接到电外科器械的电缆的并联电容,并且Re(Z)是阻抗的实部。
11.根据权利要求10所述的方法,其中,当所述电压波形和所述电流波形之间的相位差小于或等于-45度时,组织的电阻是所述二次方程的较大解,或者,当所述相位差大于-45度时,组织的电阻是较小解。
12.根据权利要求9所述的方法,其中所述电外科电缆的电抗部件的模型包括与组织串联的电感器和与组织并联的并联电容器。
13.根据权利要求9所述的方法,其还包括电感器,所述电感器耦合到所述输出级并且被调谐以适应所述电缆的并联电容和串联电感使得阻抗的被计算实部是充分电阻性的。
14.根据权利要求13所述的方法,其中所述电缆的并联电容是当器械的电极不与组织接触时测量的电容值。
15.根据权利要求13所述的方法,其中所述电感器的电感值等于其中ω是生成的电外科能量的频率,Ccable是将所述电外科发生器连接到电外科器械的电缆的并联电容,Rload是组织的电阻,并且Lcable是所述电缆的串联电感。
16.根据权利要求13所述的方法,其中所述电感器的电感值等于其中ω是生成的电外科能量的频率,Ccable是将所述电外科发生器连接到电外科器械的电缆的并联电容,并且Lcable是所述电缆的串联电感。
17.一种存储程序的非暂时性计算机可读存储介质,当由处理器执行时,所述程序执行控制电外科发生器的方法,所述电外科发生器经由电外科电缆和电外科器械将电外科能量输送到组织,所述方法包括:
感测生成的电外科能量的电压波形和电流波形;
基于所感测的电压和电流波形计算阻抗的实部;
使用建模所述电外科电缆的电抗部件的二次方程的解修正目标阻抗曲线;以及
生成控制信号以控制来自所述电外科发生器的输出级的输出使得阻抗的被计算实部遵循经修正的目标阻抗曲线。
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