CN1154445C - 电外科发生器 - Google Patents
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
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- A—HUMAN NECESSITIES
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- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/0066—Sensing and controlling the application of energy without feedback, i.e. open loop control
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00773—Sensed parameters
- A61B2018/00827—Current
Abstract
公开了一种电外科发生器，它提供射频电信号，用于执行对组织体的外科手术。包括：DC调节器装置，用于将来自电源的第一DC信号转换成具有预定电压的第二DC信号，该DC调节器装置包括：DC调节器感性输入装置，用于减少第一DC信号中的电流纹波，容性能量存储装置，用于存储和释放能量，DC调节器开关装置，用于交替地用所述第一DC信号对所述容性能量存储装置充电和使所述容性能量存储装置放电，以产生第二DC信号，和DC调节器感性输出装置，用于减少第二DC信号的电流纹波；放大器装置，用于将第二DC信号转换为具有预定频率的输出信号；以及控制装置，用于向DC调节器装置和放大器装置提供控制信号，以建立至少一个所述预定频率和预定电压。
Description
技术领域
本发明主要涉及一种电外科发生器(electrosurgical generator)，尤其涉及一种改进的电外科发生器，能够为外科作业提供多个射频的电波形。
背景技术
电外科涉及将射频电能作用到组织以便做外科手术。电外科通常用一发生器来进行，该发生器从电源将电能转换为预定射频的波形，该波形通过放射电极和返回通路被发送到组织。
根据从发生器输出的射频波形，基本上有四种在组织上进行的电外科手术。这些手术通常被描述为干燥法(desiccation)，电灼疗法，切割法(cutting)和止血切割法(cutting with hemostasis)。
对于干燥法手术，发生器输出射频波形，通过由于流经组织的电流产生的电阻热，加热组织，足够产生坏死的区域。
对于电灼疗法手术，发生器通常输出脉冲串波形，它有高的峰值电压，但占空比低。由于电灼疗法波形的低占空比，作用到组织的单位时间的功率很低，从而使细胞液的突然蒸发最小化。脉冲串波形在放射电极和组织之间形成射频火花或电弧，从而将火花或电弧的区域的功率送给组织触点和提供在火花和电弧附近的组织的凝聚。
其它的手术也可以用由电外科发生器输出的不同波形来进行。当每单位时间足够的功率被传送到组织以蒸发细胞液时，切割法就实现了。切割法通常用重复的电压波形(诸如正弦波)来执行，其产生的切割很少出血和很少坏死。
通过变化由发生器产生的电波形，也可能实现上述手术的结合。特别是，切割法和干燥法的结合(称为止血或融合切割法)可以通过周期性地中断通常用于实现电外科切割的连续的正弦电压来实现。
能够实现一个或多个上述外科手术的已知电发生器通常如图1所示来设计。AC输电线260将AC电源供给AC/DC转换器202，AC/DC转换器202将未调节的DC电源供给DC调节器206。在临床医师208的控制下，控制和定时电路210使DC调节器206产生特定值的DC电源给调谐RF放大器212。控制和定时电路210也产生由调谐RF放大器212放大的RF信号。这导致RF功率信号被送给病人214。
专利申请US 5,318,563公开了一种包括双电极的电外科双极RF发生器。高频信号的统一宽度脉冲的非周期序列被电同步。对高频信号脉冲加完全相同的衰变幅度包络。每个包络从预选的最初幅度具有预定的变化率。被加了包络的高频信号脉冲被施加到所述电极。电子装置以切割方式或凝结方式操作。所述装置包括电源，用于提供可变的DC电压；短路检测电路，用于检测电极处的短路状态；以及开路检测器，用于检测电极处的开路状态。
已知的电外科发生器受到一种或多种限制。例如，某些发生器受限于，在某种程度上它们不能产生多于一种单独波形而同时不产生不适当影响的附加，因而它们受限于适合外科手术的电波形的数目。
另一个限制的问题是，已知的发生器忽略了相当大量的对环境的电磁干扰。电磁干扰在手术室形成严重的危险，它可以引起电子设备的误动作或故障。电磁干扰的主要来源是在电外科发生器电路中产生的基本脉动电流。
在已知的发生器中，有两种主要电磁干扰(EMI)源。这种EMI包括传导EMI、近场EMI和辐射EMI。传导EMI被送回到AC电源线，并被带到医院内和远处的位置的设备，其主要来源是在DC调节器206中产生的基本脉动电流。近场EMI和辐射EMI的主要来源是调谐放大器输出的谐波量。谐波分量能更好地扩展到环境，并更有效地辐射出去。正如将示出的，本发明的关键方面是传导EMI、近场EMI和辐射EMI的同时减少。
已知的电外科发生器的另一限制是其在从电源到组织的电功率的转换和放大的较低效率，导致电能以热量的方式耗散。在手术室内由电外科单元(ESU)的热耗散是令人讨厌的，由于产生了对流的气流和相关的空气传播的病菌的流动。附加的热耗散需要增加了ESU的重量和体积。另外，电外科单元的可靠性一般随热耗散的增加而降低。
ESU的低效率是一系列因素造成的：
1.所选择的拓扑结构，它确定内在的效率(在最优条件下可取得的最大效率)；
2.负载，它确定外在的效率(用给定的拓扑结构对给定的负载可取得的效率)；
3.部件选择，它确定所实现的效率(用给定的拓扑结构、负载和选择的部件可取得的效率)。
理想的情况是，所选择的拓扑结构在宽的范围的条件下，使外在的效率和所实现的效率最大化。在已知的ESU中，为了实现用最小止血的切割，在DC调节器输出上出现的AC纹波电压应最小化。同时，传导EMI应尽可能减少。为了做到这一点，有时就要将大体积的电容器加到AC/DC转换器202，在图1中，极力要平滑电流纹波，减少传导EMI，同时大的电容器被加到DC调节器206的输出端，以减少输出波动，从而减少止血。这些电容器通过将纹波分量经电容器的ESR通到地来滤波该电流，因而浪费了功率。如果产生较少的AC纹波，该损耗和笨重的体积将大大减少，从而使耗费的功率变少。
控制设备，诸如晶体管，常同时用于DC调节器206和RF放大器212电路，以合成和调节加到组织的电波形。这些控制设备可以以不同方式使用。在现有技术中非常普通的方法是将控制设备用作可变阻抗电流源，它导致同时有电压和电流施加在晶体管上，从而导致了晶体管内功率的耗散。控制设备也被用作交替的低阻抗(即，关闭)和高阻抗(即，打开)的开关。在现有技术中，一些发生器电路在这样的开关中耗散相当量的功率，由于在电压存在于开关上时将开关变换为低阻抗，从而由于在开关中同时存在电压和电流而耗散了功率。包含晶体管的发生器电路的某些拓扑结构通常不能将晶体管的偏压接到公共参考节点，从而需要较复杂的电平切换电路。
一些已知的电外科发生器的拓扑结构将输入电压通过一种处理转换到输出电压，该处理包括在一间隔期间以DC磁场的形式感应地存储输入的能量和在随后的间隔期间在负载上以振荡电压释放该能量。这一对能量的存储和释放处理导致了阻尼正弦形式的波形，在下一存储周期的时间保持很大的幅值。对于有些输出波形，诸如脉动能量波形，未由脉动的终端送到负载的能量保持在发生器中，以热量的方式被耗散，降低了发生器的效率。
因此，需要有一种发生器来克服已知的电外科发生器的这类限制。
发明内容
相应地，本发明的目的如下：
提供一种减少电磁干扰产生的电外科发生器。
提供一种具有提高的效率的电外科发生器。
提供一种在输入电源和输出负载之间有电流绝缘的电外科发生器。
提供一种具有数量和体积减少的电气部件的电外科发生器。
提供一种用于电外科发生器的DC调节器，其中的输入和输出电流纹波显著减少。
提供一种用于电外科发生器的DC调节器，该电外科发生器中有可调节的输出DC电压，相对于输入的DC电压，该输出DC电压可以增加(升压)或减低(降压)。
提供一种用于电外科发生器的放大器，将DC输入电压转换为射频信号，对组织提供外科作业，可减少电磁干扰产生和提高效率。
提供一种用于电外科发生器的能量恢复电路，有选择地存储和释放发生器内的能量，以增加能量传送到组织的效率。
提供一种电外科发生器，响应于检测的组织状况来控制其能量流到组织，以提供改进的外科作业。
上述的一个或多个目的通过提供一种发生器来实现，该发生器包括改进的DC调节器、放大器和能量恢复电路。这些发生器的部件可以以本发明的方式被控制，以将来自电源的能量转换为一定范围的预定射频波形，以提供给电外科手术，例如，干燥法，电灼疗法，切割法和止血切割法。
DC调节器和放大器串联连接在电源(例如，电池或AC-DC变换器)和组织之间。通常，电源提供DC电源给DC调节器。DC调节器将输入的DC电压转换成一定范围的DC输出电压，它可以大于(升压)或小于(降压)DC输入电压。DC输出电压流入放大器，在那里它被转换为一定范围的射频电压波形，该波形被传送给组织。能量恢复电路存储和释放由放大器产生的能量，以增加能量从电源传送到组织的效率。
根据本发明的一个方面，提供了改进的开关DC调节器，实现增加效率、减少电磁干扰的产生和减少电路部件的数量。开关DC调节器将来自电源的第一DC信号转换成具有预定电压的第二DC信号。
本发明的电外科发生器，用于提供输出信号，用在对组织体的外科手术的操作中，所述电外科发生器包括：a)DC调节器装置，用于将来自电源的第一DC信号转换成具有预定电压的第二DC信号，该DC调节器装置包括：DC调节器感性输入装置，用于减少所述第一DC信号中的电流纹波，容性能量存储装置，用于存储和释放能量，DC调节器开关装置，用于交替地用所述第一DC信号对所述容性能量存储装置充电和使所述容性能量存储装置放电，以产生所述第二DC信号，和DC调节器感性输出装置，用于减少所述第二DC信号的电流纹波；b)放大器装置，用于将所述第二DC信号转换为具有预定的频率的输出信号；以及c)控制装置，用于向所述DC调节器装置和所述放大器装置提供控制信号，以建立至少一个所述的预定频率和所述的预定电压。
感性输入装置串联连接在电源和电容装置之间。容性能量存储装置串联连接在感性输入装置和感性输出装置之间。通过第一开关装置用第一DC信号对容性能量存储装置充电和第二开关装置经感性输出装置使容性能量存储装置放电以产生第二DC信号，能量从感性输入装置容性地传送到感性输出装置。通过调整第一和第二开关装置的占空比，即调整容性能量存储装置充电的时间和容性能量存储装置充放电的总时间的比值，控制第二DC信号的电压。第二DC信号电压可以高于(升压)或低于(降压)第一DC信号电压。
通过适当地磁耦合感性输入装置和感性输出装置，在第一DC信号和第二DC信号中的电流纹波可以进一步减少。适当地磁耦合是通过考虑变压器的匝数比N和耦合系数K来实现的。另外，适当地磁耦合发生在变压器的N基本上等于K时。或者通过使用设计成N基本等于K的变压器，或者通过使用连接一个或多个附加电感器的变压器(该附加电感器的选择使K基本上等于N)，可以获得这样的基本相等值。通过容性能量存储装置包括第一和第二电容器和在它们之间插入的绝缘变压器，来实现第一DC信号和第二DC信号之间的DC绝缘。通过磁耦合输入和感性输出装置和绝缘变压器，在第一DC信号和第二DC信号中的电流纹波被基本减少到零。
通过选择感性输入装置、感性输出装置和容性能量存储装置，以便在开关装置关闭以对容性能量存储装置充电以前提供开关装置上的大致的零电压和在开关装置上的大致的零电压瞬时变化率，DC调节器的效率被显著提高。以这种方式，通过避免同时给开关装置加上电压和使电流流过开关装置，在开关装置内的能量耗散被显著消除。
附图说明
为了更全面地理解本发明及其他优点，参照附图进行了以下的详细描述，附图中：
图1是电外科发生器的现有技术的实施例；
图2是说明发生器的部件的方框图；
图3是根据本发明的DC调节器实施例的示意图；
图4是根据本发明的绝缘的DC调节器实施例的示意图；
图5是根据本发明的放大器实施例的示意图；
图6是能量恢复电路的一个实施例的示意图；
图7是根据本发明的与图5的放大器相结合的能量恢复电路的实施例的示意图；
图8a是组织样品的分布复数组织阻抗模型；
图8b是组织结构的样品；和
图9是根据本发明的的组织阻抗控制器的方框图。
具体实施方式
参见图2，示出了根据本发明的原理构造的电外科发生器的方框图。电外科发生器包括DC调节器10、放大器100、能量恢复电路90和控制器70。
DC调节器10从电源12接收输入的DC电压，将输入的DC电压转换为输出的DC电压，提供给放大器100。放大器100将来自DC调节器10的DC电压转换为射频输出信号，提供给组织体11。能量恢复电路90交替地存储来自放大器100的能量和释放能量给放大器100，以增加能量从电源12传送到组织11的效率。控制器70控制DC调节器10、放大器100和能量恢复电路90，以便从电外科发生器产生预定射频输出信号，该电外科发生器可用于执行期望的电外科手术，例如，干燥法，电灼疗法，切割法和止血切割法手术。
首先描述改进的DC调节器10。接着描述改进的放大器100和改进的能量恢复电路90。最后描述组织阻抗控制器109(图9)，它响应于检测的组织状况来控制能量流到组织，以提供改进的手术效果。
在本发明的一个方面中，DC调节器10(图3)将来自电源12的输入的DC电压转换成输出的DC电压，它可以高于或低于第一DC电压。DC调节器10以与已知的电外科发生器相比较高的效率、大大减少的电磁干扰的辐射和较少的部件数量和较小的部件体积来实现这一转换，
DC调节器10包括：输入电感器16，与DC电源12串联；输出电感器18，与放大器100串联；和能量传送电路20。能量传送电路20包括：存储电容器24；开关26(例如，绝缘栅双极型晶体管)，用于交替地连接(即，关闭开关)和断开(即，打开开关)在输入电感器16和存储电容器24之间的第一连接点28到电源12的电流返回通路30；和二极管32，用于交替地连接(即，二极管前向偏置)和断开(即，二极管反向偏置)在存储电容器24和输出电感器18之间的第二连接点34到电流返回通路30。滤波电容器36连接在DC调节器10的输出端上。
在开关26打开的间隔期间，二极管32前向偏置，存储电容器24通过输入电感器16充电，输入电感器16减少了输入电流纹波和辐射的电磁干扰。在开关26关闭的间隔期间，存储电容器24连接在二极管32两端，从而反向偏置二极管32。存储电容器24通过输出电感器18和放大器100放电。输出电感器18减少了输出电流纹波和辐射的电磁干扰。然后，通过开关26打开来前向偏置二极管32和通过输入电感器16对存储电容器24重新充电，重复了该开关周期。
以这种方式，DC调节器10从电源12将能量容性地传送到放大器100。容性的能量传送比现有技术的电外科发生器中所用的感性的能量传送在每单位尺寸和重量下有效得多。例如，1毫法的电容器充电到50V具有1.25mJ的存储能量，等于2.5mH的电容器通过1A的电流。然而，1毫法50V的电容器的体积比2.5mH 1A的电感器小得多。另外，感性能量传送由于电感器的电阻发热而具有较高的传送能量损耗，容性能量传送比感性能量传送效率高。
DC调节器10的DC输出电压可以高于或低于来自电源12的DC输入电压，根据以下公式来调整：
Voutput/Vinput＝D/D’
其中：
Voutput是DC输出电压；
Vinput是DC输入电压；
D是开关26关闭的分数时间(即，开关26关闭的时间除以在开关第一次关闭和第二次关闭之间的一个时段的时间)，和
D’是开关26打开的分数时间(即，D’＝(1-D))。
以这种方式，对于D＜0.5，输出电压可以被调整到低于输入电压(降压变换)，或者对于D＞0.5，输出电压可以被调整到高于输入电压(升压变换)。
控制器70根据上面的公式，通过打开开关26(即，偏置晶体管以实现低阻抗)和关闭开关26(即，偏置晶体管以实现高阻抗)来调节输出电压。在图3中的控制器70通过检测节点38的输出电流和调整开关26的占空比来执行电流反馈控制，以在预定范围内保持DC调节器10的电压和/或电流以提供所需的外科效果。
通过在开关26上出现基本零电压和零电压变化率时由控制器70关闭开关26，以避免同时加在开关26上电压和流过开关26电流，开关中的能量耗散被显著消除。通过选择存储电容器24和电感器16和18，在这些零电压条件下可以操作开关26的频率可以被增加，以提供存储电容器24通过输出电感器18和放大器100的快速放电。
在另一个实施例中，在输入电感器16和/或输出电感器18中电流纹波，通过磁耦合电感器16和18进一步减少。通过将这些电感器一起绕在一个磁心上来提供磁耦合39。对于耦合的电感器，能量从源通过存储电容器24(即，通过电场)和直接通过耦合的电感器39(即，通过磁场)传送到负载。在磁心中总的DC磁化电流是输入和输出电流的之和。可以选择电感器16和18的匝数比和耦合系数，这样其一的电流纹波，但非两者的电流纹波被减少到零。
在电外科中，在电源和组织/输出负载11之间有DC绝缘是有益的。例如，由于组织/输出负载11的电阻的显著变化(例如，从大致为零到无穷大)，这样的绝缘是有益的。本发明很容易推广到实现这种绝缘。现在参考图4，示出了一个实施例，同时实现了电源12和放大器100之间的绝缘和在输入和输出电流纹波中的电流纹波的进一步减少。通过将图3的存储电容器24分为两个电容器40和42和在它们之间放入绝缘变压器44，提供了绝缘。绝缘变压器44包括主绕组46和副绕组48。一个电容器40与输入电感器16和主绕组46串联连接。另一个电容器42与输出电感器18和副绕组48串联连接。
电感器16和18和绝缘变压器44可以被磁耦合到50，以减少输入和输出电流纹波。在某些条件下，输入和输出电流纹波都可以被减少到零。输入电流纹波可以在以下条件下被减少到零：
Le1＝L11[N2/N1-1]
其中：
Le1是输入电感器16的漏电感；
N1是输入电感器16的匝数；
N2是输出电感器18的匝数；和
L11是输入电感器16的自电感。
这里，输入电流纹波可以通过令N1基本等于N2来减少到零，N1是在输入电感器中绕组的匝数，N2是在输出电感器中绕组的匝数。在一个实施例中，N1和N2只需大致相等，以产生输入电流纹波中的减少。
输出电流纹波可以在以下条件被减少到零：
Le2＝L11(N2/N1)2[N2/N1-1]
其中：
Le2是输出电感器18的漏电感；
N1是输入电感器16的匝数；
N2是输出电感器18的匝数；和
L11是输入电感器16的自电感。
类似地，输出电流纹波可以通过令N2基本等于N1来减少到零。同样，在一个实施例中，N2和N1只需大致相等，以产生输出电流纹波中的减少。
在本发明的另一个方面中，提供了改进的放大器100，用于将来自DC调节器10的DC输出电压变换为提供给组织11的射频输出信号。放大器100以高效率实现了该变换，显著减少了电磁干扰的辐射。
现在参见图5，放大器100包括：输入电感器62，用于减少输入电流纹波；谐振电路64，与输入电感器62串联；和晶体管开关66，用于交替地连接(关闭)和断开(打开)放大器100到输入电感器62和谐振电路64的连接点的电流返回通路68。
谐振电路64通常包括电感器72、电容器74和组织阻抗11的复阻抗。控制器70通过打开开关66(即，偏置晶体管以实现低阻抗)和关闭开关66(即，偏置晶体管以实现高阻抗)来调节放大器100的射频输出电压的频率和幅值。用于放大器100的控制器70可以包括简单的振荡电路或比较复杂的反馈控制器以控制开关66。
由于开关66周期性地由开关控制器70操作，来自DC调节器10的输入信号被转换为对应于开关频率的输出信号。输出信号的频率和幅值通过调节开关66的占空比，即通过调节谐振电路64充电的时间和谐振电路64充放电总时间的比值来调节。在开关66关闭的时间过程中，开关66上的电压基本为零，输入电流流过输入电感器62到地。输入电感器62足够大，从而基本作为恒流源。当开关66打开时，输入电流流过谐振电路64。谐振电路64的瞬态响应是由电感器72、电容器74和组织阻抗11的串联连接生成的阻尼二阶系统的响应。在谐振电路64内的能量在谐振瞬态过程中通过组织阻抗11的阻性分量被耗散。在放大器100和组织阻抗11之间，通过绝缘变压器76和DC滤波电容器78和80提供了DC绝缘。
通过在谐振电路64中选择电感器72和电容器74、以便为阻尼响应提供大致与开关66的关闭同时的开关的零电压和零电压变化率，来提高放大器100的效率。通过反并联二极管67连接到开关66上进一步实现零电压开关。反并联二极管67导通开关66的负电流，该负电流独立于开关的打开和关闭，因而更容易和自动地维持上述的零电压开关。
以这种方式，通过避免同时给开关66加上电压和使电流流过开关66，开关66中的能量耗散被显著消除。与开关关闭基本同时的开关66上的零电压变化率使组织的阻抗范围增大(即第二阶响应范围)，实现了零电压开关。
根据本发明的另一个方面，输出变压器的运行状态可以被检测。这一光学检测可以用检测绕组81来进行，检测绕组81提供电压信号82给控制器70。
根据本发明的另一个方面，提供了能量恢复电路，用于电外科发生器中，以改进能量传送到组织的效率。能量恢复电路通常包括至少一个能量存储器件(例如，电容器、电感器或它们的组合)和至少一个开关(例如，双极型晶体管、绝缘栅双极型晶体管、或场效应晶体管)，用于交替地存储和释放电外科发生器中的电能。
参见图6，示出了能量恢复电路150，它包括：感性存储装置156，它具有电感L；和容性存储装置154，它具有电容C，其中两个存储装置都用于存储电能。另外，电路150也实际上包括：电压V的DC电源152；和阻性负载158，具有代表病人的复阻抗。在手术中，能量恢复电路150的状态是，第一开关160关闭，电感器156被允许充电到1/2LI2的存储能量，其中I是通过电感器156的电流。当第一开关160打开时，由于二极管166的作用，电感器156传送能量到电容器154。当二极管166导通时，第二开关162就被关闭。当第二开关162被打开时，所有保持在电路150中的能量将存储在电容器154中，而不是被作为热量耗散。当另一个能量传送周期开始时，电容器154的电压Vc被测量，电感器156用电流充电，其中：
每时段的能量＝1/2LI2+1/2CVc 2+∫0|VR 2/Z|dt
其中：VR是病人158上的RMS电压
τ是能量传送周期的时段
因而，没有从电路150耗散的和存储在电容器154中的的能量被用于下一能量传送周期，而不是作为热量耗散。
现在参见图7，示出的能量恢复电路90的实施例和图5的放大器100相结合。能量恢复电路90和图5的放大器100的结合使用只是为了说明能量恢复电路90的运行，而不限制其和放大器100的结合使用。能量恢复电路90包括：晶体管开关92、能量存储电感器96、和与放大器100串联且与能量存储电感器96并联的二极管94。控制器70控制开关92，以选择地存储和释放能量恢复电路90和放大器100之间的能量。
如前所述，对于某些电外科手术，由放大器100传送到组织阻抗11的输出信号的瞬态响应是阻尼二阶系统的瞬态响应。在谐振电路64内的功率以脉冲串传送到组织，在由电感器72、电容器74和组织阻抗11确定的时间常数下衰减。在来自放大器100的脉冲串的末端，没有传送到组织11的能量通常保持在发生器内，在那里以热量方式耗散。
为避免这种能量损失，控制器70通过打开开关92和经能量存储电感器96流过电流，在放大器100中存储部分能量。在脉冲串的末端，在控制器70打开放大器开关66时，控制器70关闭开关92以截留(trap)存储在连接能量存储电感器96、二极管94和开关92的闭合回路中的能量。在随后的脉冲串过程中(即，在控制器70关闭放大器开关66之后)，控制器70打开开关92，从而将保留在能量存储电感器96中的能量传送给放大器100。通过包括在开关92上的一反向并联二极管93，开关92中的功率耗散被最小化。在开关92上是负电压时，反向并联二极管93导通，以帮助获得开关92的零电压开关。
在这种方式下，能量有选择地在能量恢复电路90和放大器100之间存储和释放，以增加能量传送到组织的效率。能量恢复电路90还具有在脉冲末端快速阻尼发生器的输出功率的优点。
参见图8a和图8b，本发明人相信，从要做电外科手术的组织结构，可以获得分布的复组织阻抗模型。具体说，组织400的复阻抗300包括电阻310和电容320。通常，组织400包括细胞404和405，和体液402。组织电阻310由通过体液402的导电通路产生。组织电容320由细胞膜408产生，细胞膜408提供围绕细胞内导电体液410的电绝缘效果。当足够的电压施加在组织400时，细胞膜刺破/爆破，如406所示。在细胞膜406爆破后，细胞膜406的容性作用显著减少，如由短路330所示，相关的组织400的复阻抗300变为更多的阻性和更少的容性。当足够的能量在组织400中耗散以蒸发一些体液402时，组织400的复阻抗300进一步变化，从而引起电阻的增加，如由附加电阻340所示。通过诸如由于加热而引起的蛋白质的变性和复合的影响，在复阻抗300中产生附加的变化。
可以进一步发现，组织的复阻抗可以在一段时间内被测量，以观察细胞膜重新填缝的程度(如果存在)。例如，没有被电外科能量毁坏的细胞，可以在大约一毫秒到一秒的时间段内，在细胞膜内重新填缝小的孔。测量在电外科能量传送之间或过程中的组织的复阻抗的变化和变化率，提供了关于组织的状况和相关的外科手术效果的状况的信息。
现在参见图9，根据本发明的另一方面，示出了用于电外科发生器中的组织阻抗控制器109。组织阻抗控制器109包括：发生器电路110；阻抗测量器件130；和响应于阻抗测量器件130的控制器120。发生器电路110合成施加到组织的射频脉冲，以产生电外科效果。阻抗测量器件130测量组织11的复阻抗。控制器120响应于测量的组织11的复阻抗和阻抗变化率来控制发生器电路110，以提供改进的电外科效果。
在图9所示的实施例中，组织阻抗11在电外科脉冲之间测量。在电外科脉冲之间，控制器120控制发生器电路110以施加预定的测量信号给组织11，用于由阻抗测量器件130使用。阻抗测量器件130测量组织11的复阻抗(即，通过将组织上的电压信号除以通过组织的电流)。控制器120分析在一段预定时间内所测量的阻抗和/或所测量的阻抗的变化率，以确定组织11的当前状况。控制器120比较当前组织状况和所需的手术效果，控制发生器电路110以获得所需的手术效果。
在另一实施例中，组织阻抗在电外科脉冲过程中周期地或连续地测量。阻抗测量器件130将预定频率电压时间在组织11上，它具有和由发生器电路110合成的用于电外科效果的信号不同的频率。阻抗测量器件130以预定频率测量通过组织11的电流，以确定组织11的复阻抗和从而确定组织状况。控制器120然后响应于所测量的组织状况来控制发生器电路110，以获得所需的手术效果。
本发明的DC调节器10、放大器100和能量恢复电路90每个都适用于本发生器电路110。DC调节器10和放大器100使控制器120能够响应于所测量的组织复阻抗11来快速改变输出信号的特征，包括频率、幅值、脉宽。通过能量恢复电路90，组织复阻抗11可以在脉冲之间被更快和更精确测量地测量，能量恢复电路90在脉冲的末端有效地捕获了保留在发生器电路110中的能量，从而快速衰减了发生器电路110的输出信号，使阻抗测量信号快速施加到组织11。
尽管已经详细描述了本发明的各种实施例，但很明显，本领域的技术人员可以对本发明进行进一步修正和变化。然而，应清楚的理解的是，这些修正和变化是在本发明的精神和范围之内的。
Claims (12)
1.一种电外科发生器，用于提供输出信号，用在对组织体的外科手术的操作中，其特征在于，所述电外科发生器包括：
a)DC调节器装置，用于将来自电源的第一DC信号转换成具有预定电压的第二DC信号，该DC调节器装置包括：
DC调节器感性输入装置，用于减少所述第一DC信号中的电流纹波，
容性能量存储装置，用于存储和释放能量，
DC调节器开关装置，用于交替地用所述第一DC信号对所述容性能量存储装置充电和使所述容性能量存储装置放电，以产生所述第二DC信号，和
DC调节器感性输出装置，用于减少所述第二DC信号的电流纹波；
b)放大器装置，用于将所述第二DC信号转换为具有预定的频率的输出信号；以及
c)控制装置，用于向所述DC调节器装置和所述放大器装置提供控制信号，以建立至少一个所述的预定频率和所述的预定电压。
2.如权利要求1所述的电外科发生器，其中所述的电外科发生器还包括一铁心材料，其磁耦合所述DC调节器感性输入装置和所述DC调节器感性输出装置，用于显著地减少在所述DC调节器感性输入装置和所述DC调节器感性输出装置之一中的电流纹波。
3.如权利要求1所述的电外科发生器，其中所述的容性能量存储装置包括：
第一电容器；
第二电容器；和
绝缘变压器装置，用于使所述第一DC信号的电流和所述第二DC信号的电流绝缘。
4.如权利要求3所述的电外科发生器，其中所述的绝缘变压器装置包括：主绕组，与所述第一电容器、所述DC调节器感性输入装置、和所述电源串联连接；和副绕组，与所述第二电容器、所述DC调节器感性输出装置、和所述放大器装置串联连接。
5.如权利要求3所述的电外科发生器，还包括一铁心材料，磁耦合所述绝缘变压器装置、所述DC调节器感性输入装置、和所述DC调节器感性输出装置，用于减少在所述DC调节器感性输入装置和所述DC调节器感性输出装置中的电流纹波。
6.如权利要求1所述的电外科发生器，其中所述的DC调节器开关装置包括：
晶体管，将所述DC调节器感性输入装置和所述容性能量存储装置之间的连接点连接到所述电源的返回电流通路；和
二极管，将所述容性能量存储装置和所述DC调节器感性输出装置之间的连接点连接到所述返回电流通路。
7.如权利要求1所述的电外科发生器，其中所述的DC调节器开关装置包括：
晶体管，将所述容性能量存储装置和所述DC调节器感性输出装置之间的连接点连接到返回电流通路。
8.如权利要求1所述的电外科发生器，其中所述的DC调节器开关装置包括：
能够支持电流双向流动并连接所述DC调节器感性输入装置和所述容性能量存储装置之间的连接点到所述电源的返回电流通路的开关装置。
能量支持电流双向流动并连接所述容性能量存储装置和所述DC调节器感性输出装置之间的连接点到所述返回电流通路的开关装置。
9.如权利要求8所述的系统，其中所述的开关装置由一个或多个晶体管组成。
10.如权利要求1所述的电外科发生器，其中所述的放大器装置包括：
放大器感性输入装置，用于减少所述第二DC信号的电流纹波；
谐振电路，可连接到组织体上，所述谐振电路与所述放大器感性输入装置串联连接，包括电感器、电容器；和
放大器开关装置，用于交替地连接和断开所述放大器装置的电流返回通路到在所述感性输入装置和所述谐振电路之间的连接点，从而提供输出信号。
11.如权利要求10所述的电外科发生器，其中：
选择所述谐振电路的所述电感器和所述电容器，以使在由所述放大器开关装置连接以前，提供所述放大器开关装置上的零电压和所述放大器开关装置上的零电压瞬时变化率，从而减少所述放大器开关装置的能量耗散。
12.如权利要求10所述的电外科发生器，还包括：
能量恢复电路，它电连接到所述放大器开关装置，用于存储或释放所述输出信号的能量。
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US08/702,282 US5836943A (en) | 1996-08-23 | 1996-08-23 | Electrosurgical generator |
| US08/702,282 | 1996-08-23 |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN1233944A CN1233944A (zh) | 1999-11-03 |
| CN1154445C true CN1154445C (zh) | 2004-06-23 |
Family
ID=24820570
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CNB971990646A Expired - Fee Related CN1154445C (zh) | 1996-08-23 | 1997-08-19 | 电外科发生器 |
Country Status (7)
| Country | Link |
|---|---|
| US (2) | US5836943A (zh) |
| EP (1) | EP0999798A1 (zh) |
| JP (2) | JP2000516516A (zh) |
| CN (1) | CN1154445C (zh) |
| AU (1) | AU735926B2 (zh) |
| CA (1) | CA2263600C (zh) |
| WO (1) | WO1998007378A1 (zh) |
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| EP0999798A4 (en) | 2000-05-17 |
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| JP2007203088A (ja) | 2007-08-16 |
| WO1998007378A1 (en) | 1998-02-26 |
| US6238387B1 (en) | 2001-05-29 |
| AU735926B2 (en) | 2001-07-19 |
| CN1233944A (zh) | 1999-11-03 |
| CA2263600C (en) | 2005-11-22 |
| EP0999798A1 (en) | 2000-05-17 |
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