ES2372311T3 - Sistema de tratamiento médico que funciona con energía. - Google Patents
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- ES2372311T3 ES2372311T3 ES07250615T ES07250615T ES2372311T3 ES 2372311 T3 ES2372311 T3 ES 2372311T3 ES 07250615 T ES07250615 T ES 07250615T ES 07250615 T ES07250615 T ES 07250615T ES 2372311 T3 ES2372311 T3 ES 2372311T3
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
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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
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical 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
- A61B18/14—Probes or electrodes therefor
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00022—Sensing or detecting at the treatment site
- A61B2017/00026—Conductivity or impedance, e.g. of tissue
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00022—Sensing or detecting at the treatment site
- A61B2017/00084—Temperature
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
- A61B2017/320094—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw additional movable means performing clamping operation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
- A61B2017/320095—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw with sealing or cauterizing means
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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
- A61B2018/00875—Resistance or impedance
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/06—Measuring instruments not otherwise provided for
- A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
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Abstract
Un sistema de tratamiento médico (10) que funciona con energía, que comprende: a) un coagulador de pinzas (14) que funciona con energía adaptado para pinzar el tejido de un paciente; b) un medidor (38) de la impedancia acústica operativamente conectado al coagulador de pinzas (14) que funciona con energía para medir una impedancia acústica del tejido pinzado (18) del paciente; y c) un medidor (40) de la fuerza operativamente conectado al coagulador de pinzas (14) que funciona con energía para medir una fuerza de pinzamiento aplicada sobre el tejido pinzado (18) del paciente, caracterizado porque dicho sistema incluye, así mismo, un controlador (42) el cual compensa la impedancia acústica medida del tejido (18) del paciente con respecto a la presión de pinzamiento utilizando al menos la fuerza de pinzamiento medida.
Description
Sistema de tratamiento medico que funciona con energia
Campo de la invención
La presente invencion se refiere, en general, al campo de los sistemas y procedimientos de tratamiento medico y, 5 mas concretamente, a un sistema de tratamiento medico que funciona con energia.
Antecedentes de la invención
Son conocidos los sistemas de tratamiento medico que funciona con energia, los cuales incluyen un coagulador de pinzas bajo la forma de una cizalla quirurgica ultrasonica que incorpora una cuchilla quirurgica ultrasonica, un brazo de pinzamiento accionable para abrirse y cerrarse hacia la cuchilla, pliegue del tejido fijada al brazo de pinzamiento, 10 y, un dispositivo para ejercer una fuerza de pinzamiento sobre el brazo de pinzamiento la cual crea una presion de pinzamiento sobre un vaso sanguineo que esta situado entre el area de la superficie de pinzamiento del pliegue del tejido y la cuchilla. El resultado de la cuchilla quirurgica ultrasonica que vibra de forma ultrasonica y de la presion de pinzamiento sobre el vaso sanguineo es una coagulacion del vaso sanguineo (un acercamiento de las paredes del vaso sanguineo, una transeccion (un corte) del vaso sanguineo coaptado, y una coagulacion (un sellado) de los
15 extremos del corte coaptado del vaso sanguineo. Son asi mismo conocidos los sistemas de tratamiento medico bajo la forma de coaguladores de pinzas de RF (radiofrecuencia). De acuerdo con el documento EP 065535, se divulga un instrumento de corte quirurgico ultrasonico que esta provisto de unos medios para detectar una carga anormal acoplada sobre una cuchilla de dicho instrumento, bajo la forma de un detector de la presion o de un calibrador de la deformacion o bajo la forma de un elemento piezoelectrico pasivo de una pila de generador ultrasonico.
20 Sin embargo, cientificos e ingenieros continuan buscando sistemas de tratamiento medico mejorados que funcionan con energia y procedimientos de tratamiento medico mejorados que funcionan con energia.
Sumario de la invención
De acuerdo con la invencion, se proporciona un sistema de tratamiento medico que funciona con energia que incluye un coagulador de pinzas que funciona con energia, un medidor de la impedancia acustica, y un medidor de 25 la fuerza. El coagulador de pinzas que funciona con energia esta adaptado para pinzar el tejido de un paciente. El medidor de la impedancia acustica esta conectado operativamente al coagulador de pinzas que funciona con energia para medir la impedancia acustica del tejido pinzado del paciente. El medidor de la fuerza esta operativamente conectado al coagulador de pinzas que funciona con energia para medir una fuerza de pinzamiento sobre el tejido pinzado del paciente. El sistema incluye, asi mismo, un controlador el cual compensa la impedancia
30 acustica medida del tejido del paciente respecto de la presion de pinzamiento utilizando al menos la fuerza de pinzamiento medida. El sistema de acuerdo con la invencion se define en la reivindicacion adjunta 1. Otras caracteristicas distintivas adicionales del sistema se definen en las reivindicaciones dependientes 2 a 12.
Una forma de realizacion adicional que no es parte de la invencion se refiere a un sistema de tratamiento medico que funciona con energia que incluye un coagulador de pinzas que funciona con energia, en el que el coagulador de
35 pinzas incorpora dos miembros de pinzamiento adaptados para coagular el tejido del paciente pinzado entre los dos miembros de pinzamiento, y en el que los dos miembros de pinzamiento incluyen ademas, o estan adicionalmente adaptados para funcionar como unos electrodos de medicion de la impedancia electrica para medir una impedancia electrica del tejido pinzado del paciente.
Una forma de realizacion adicional que no es parte de la invencion se refiere a un sistema de tratamiento medico
40 que funciona con energia que incluye un coagulador de pinzas que funciona con energia, en el que el coagulador de pinzas incorpora dos miembros de pinzamiento adaptados para coagular el tejido del paciente pinzado entre los dos miembros de pinzamiento, y en el que al menos uno de los dos miembros de pinzamiento incluye adicionalmente, o esta adicionalmente adaptado para funcionar como, un sensor de la temperatura para medir una temperatura del tejido pinzado del paciente.
45 Un procedimiento de utilizacion del sistema que no es parte de la invencion se refiere a un tratamiento medico que incluye las etapas a) a g). La etapa a) incluye la provision de un coagulador de pinzas que funciona con energia. La etapa b) incluye la aplicacion de una fuerza de pinzamiento al tejido del paciente utilizando el coagulador de pinzas que funciona con energia. La etapa c) incluye el inicio de la coagulacion del tejido del paciente utilizando el coagulador de pinzas que funciona con energia. La etapa d) incluye la determinacion de la fuerza de pinzamiento. La
50 etapa e) incluye la medicion de la impedancia acustica del tejido del paciente. La etapa f) incluye la compensacion de la impedancia medida del tejido del paciente respecto de la presion de las pinzas utilizando al menos la fuerza de pinzamiento determinada. La etapa g) incluye la verificacion de la coagulacion del tejido del paciente utilizando al menos la impedancia acustica medida compensada.
Diversos beneficios y ventajas se obtienen de la invencion. En un ejemplo, la verificacion de la coagulacion del tejido 55 del paciente permite que un controlador desactive, o active un indicador que indica a un usuario que desactive el coagulador de pinzas que funciona con energia cuando la coagulacion del tejido se ha completado y que la
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coagulacion avance hasta el tejido de no actuacion y sin que la energia deseque en mayor medida o dane el tejido de actuacion.
La presente invencion tiene, sin limitacion, aplicacion en cuchillas quirurgicas ultrasonicas rectas o curvadas (cuando la energia utilizada es ultrasonica) y, asi mismo, en instrumentos accionados a mano, asi como a instrumentos con asistencia robotica.
Breve descripción de las figuras
La FIGURA 1 es un diagramade bloques de un procedimiento dela invencion;
la FIGURA 2 es un diagrama de bloques esquematico de una primera forma de realizacion de un sistema de tratamiento medico que funciona con energia de la invencion que incluye un coagulador de pinzas que funciona con energia, un medidor de la impedancia acustica, y un medidor de la fuerza,
la FIGURA3 es una vista enalzado lateral esquematica del coagulador de pinzasque funciona con energia de la Figura 2;
la FIGURA 4 es un diagrama de bloques esquematico de una forma de realizacion adicional de un sistema de tratamiento medico que funciona con energia que no es parte de la invencion y que incluye adicionalmente un coagulador de pinzas que funciona con energia que incorpora dos miembros de pinzamiento los cuales incluyen, o estan adaptados para funcionar como, unos electrodos de medicion de la impedancia electrica;
la FIGURA5 es una vista enalzado lateral esquematica del coagulador de pinzasquefunciona con energia dela Figura 4;
la FIGURA 6 es un diagrama de bloques esquematico de una forma de realizacion adicional de un sistema de tratamiento medico que funciona con energia que no es parte de la invencion y que incluye adicionalmente un coagulador de pinzas que funciona con energia que incorpora dos miembros de pinzamiento al menos uno de los cuales incluye, o esta adaptado para funcionar como, un sensor de la temperatura, y
la FIGURA7es una vista en alzado lateral esquematicadel coagulador de pinzas quefunciona conenergiadela Figura 6.
Descripción detallada de la invención
Antes de exponer la presente invencion con detalle, debe destacarse que la invencion no esta limitada en su aplicacion o su uso a los detalles de estructura y disposicion de las partes ilustradas en los dibujos que se acompanan y en la descripcion. Las formas de realizacion ilustrativas de la invencion pueden ser puestas en practica o incorporadas en otras formas de realizacion, variantes y modificaciones, y pueden llevarse a la practica o ejecutarse de diversas maneras. Asi mismo, a menos que se indique lo contrario, los terminos y expresiones empleadas en la presente memoria han sido elegidos con la finalidad de describir las formas de realizacion ilustrativas de la presente invencion para comodidad del lector y no con el proposito de limitar la invencion.
Se entiende que una cualquiera o mas de las formas de realizacion, ejemplos, etc. descritos seguidamente pueden ser combinadas con una cualquiera o mas de las formas de realizacion, los ejemplos, etc. descritos a continuacion.
Con referencia ahora a las Figuras, en las cuales los mismos numeros indican los mismos elementos, la Figura 1 ilustra un procedimiento que no es parte de la invencion, ilustrando las Figuras 2 y 3 una forma de realizacion de un sistema de tratamiento medico 10 que funciona con energia, como ejemplo de aparato para llevar a cabo el procedimiento. El procedimiento tiene por finalidad el tratamiento medico e incluye las etapas a) a g). La etapa a) se etiqueta como "Obtener el coagulador de pinas", en bloque 12 de la Figura 1. La etapa a) incluye la obtencion de un coagulador de pinzas 14 que funciona con energia. La etapa b) se etiqueta como "Aplicar una Fuerza de Pinzamiento" en el bloque 16 de la Figura 1. La etapa b) incluye la aplicacion de una fuerza de pinzamiento al tejido 18 del paciente utilizando el coagulador de pinzas 14 que funciona con energia. La etapa c) se etiqueta como "Comenzar la Coagulacion del Tejido del Paciente" en el bloque 20 de la Figura 1. La etapa c) incluye el inicio de la coagulacion del tejido 18 del paciente utilizando el coagulador de pinzas 14 que funciona con energia. La etapa d) se etiqueta como "Determinar la Fuerza de Pinzamiento" en el bloque 22 de la Figura 1. La etapa d) incluye la determinacion de la fuerza de pinzamiento. La etapa e) se etiqueta como "Medir la Impedancia Acustica" en el bloque 24 de la Figura 1. La etapa e) incluye la medicion de la impedancia acustica del tejido 18 del paciente. La etapa 1) se etiqueta como "Compensar la Impedancia Medida" en el bloque 26 de la Figura 1. La etapa f) incluye la compensacion de la impedancia medica medida del tejido 18 del paciente para la presion de las pinzas utilizando al menos la fuerza de pinzamiento determinada. La etapa g) se etiqueta como "Verificar la Coagulacion" en el bloque 28 de la Figura 1. La etapa g) incluye la verificacion de la coagulacion del tejido del paciente 18 utilizando al menos la impedancia acustica medida compensada.
En una ilustracion de un procedimiento de utilizacion del sistema que no forma parte de la invencion, el coagulador de pinzas 14 que funciona con energia es energizado por una energia de salida de un generador 30. En esta
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ilustracion, el procedimiento incluye, asi mismo, la etapa del ajuste de la energia de salida en base a la coagulacion verificada del tejido 18 del paciente. En una variante, la energia de salida se ajusta mas baja cuando la coagulacion verificada se acerca a su culminacion, y el generador 30 es desactivado cuando la coagulacion verificada llega a su culminacion. En una ilustracion diferente, el procedimiento incluye, asi mismo, la etapa de notificacion (como por ejemplo mediante avisos visuales y � o auditivos y � o de otro tipo a un usuario del coagulador de pinzas 14 que funciona con energia de la coagulacion verificada del tejido 18 del paciente (como por ejemplo notificando cuando se ha completado la coagulacion, de forma que el usuario pueda desactivar el coagulador de pinzas 14 que funciona con energia).
En un procedimiento adicional, el coagulador de pinzas 14 que funciona con energia es una cizalla quirurgica ultrasonica 32 que incorpora una cuchilla ultrasonica 24 y un brazo de pinzamiento 36 (cuyo acolchamiento de tejido ha sido omitida de la Figura 1 para mayor claridad). En una aplicacion diferente, no mostrada, el coagulador de pinzas que funciona con energia es un coagulador de pinzas de RF (radiofrecuencia) que incorpora un electrodo monopolar o un electrodo bipolar. En una variante, el coagulador de pinzas 14 incorpora dos miembros de pinzamiento cada uno de los cuales soporta, o esta adaptado para funcionar como, un electrodo bipolar para que la corriente electrica fluya entre los dos miembros de pinzamiento.
De acuerdo con la invencion, se proporciona un sistema de tratamiento medico 10 que funciona con energia mostrado a modo de ejemplo en las Figuras 2 y 3. El sistema de tratamiento medico 10 que funciona con energia incluye un coagulador de pintas 14 que funciona con energia, un medidor 38 de la impedancia acustica, y un medidor 40 de la fuerza. El coagulador de pinzas 14 que funciona con energia esta adaptado para pinzar el tejido 18 del paciente. El medidor 38 de la impedancia acustica esta operativamente conectado al coagulador de pinzas 14 que funciona con energia para medir una impedancia acustica del tejido pinzado 18 del paciente. El medidor 40 de la fuerza esta operativamente conectado al coagulador 14 que funciona con energia para medir una fuerza de pinzamiento sobre el tejido pinzado 18 del paciente.
En una aplicacion de la forma de realizacion de las Figuras 2 y 3, el medidor 38 de la impedancia acustica incluye una circuiteria (no mostrada) la cual determina, durante el tratamiento medico la energia de salida del generador 30, la cual determina que la corriente fluya desde el generador 30, y la cual divide la energia de salida determinada por el cuadrado de la corriente determinada dado que la impedancia acustica es apreciada como una cantidad electrica por el generador 30. En la misma o en una aplicacion diferente, el medidor 40 de la fuerza incluye un transductor de la fuerza (no mostrado) el cual mide una fuerza (una fuerza aplicada manualmente sobre un brazo de pinzamiento accionado de forma manual o una fuerza aplicada por un motor �en el que un par de torsion es considerado una fuerza rotacional� por un brazo de pinzamiento accionado por motor) ejercida por un usuario o por un motor sobre el mecanismo de pinzamiento del coagulador de pinzas 14 que funciona con energia sobre el coagulador de pinzas 14 que funciona con energia para aplicar una fuerza de pinzamiento sobre el tejido 18 del paciente, e incluye una circuiteria (no mostrada), la cual convierte la fuerza manual o motriz en una fuerza de pinzamiento medida. Otras aplicaciones de medidores de impedancia acustica y de medidores de la fuerza seran advertidos por los expertos en la materia.
En una aplicacion de la forma de realizacion de las Figuras 2 y 3, el sistema de tratamiento medico 10 que funciona con energia incluye, asi mismo, un controlador 42 el cual compensa (esto es, corrige) la medicion de la impedancia acustica del tejido 18 del paciente respecto de la presion de pinzamiento utilizando al menos la fuerza de pinzamiento medida. Debe destacarse que la impedancia acustica medida aumenta con la fuerza de pinzamiento creciente, y dicha compensacion de la medicion de la impedancia acustica respecto de la presion de pinzamiento puede ser determinada de manera experimental y � o de forma matematica por los expertos en la materia y ejecutada mediante una tabla matematica, un algoritmo de soft�are y � o una circuiteria que produzca un valor de la medicion de la impedancia acustica compensada para un valor de la impedancia acustica medida y un valor para la fuerza de pinzamiento medida.
En una variante de la aplicacion descrita con anterioridad, el controlador 42 verifica, asi mismo, la coagulacion (esto es, el grado o el estado de la coagulacion) del tejido 18 del paciente utilizando al menos la impedancia acustica medida compensada. En una aplicacion, cuando la impedancia acustica medida compensada alcanza un limite superior determinado de forma experimental y � o matematica, o cuando la configuracion del grafico de impedancia con respecto al tiempo alcanza una configuracion determinada, la coagulacion se considera que ha sido completada. En una primera disposicion, el controlador 42 controla una salida de energia de un generador 30 en base a la coagulacion verificada del tejido 18 del paciente, en la que la salida de energia energiza el coagulador de pinzas 14 que funciona con energia. En una segunda disposicion, el controlador 42 controla un controlador visual y � o auditivo 44 (el cual, en un ejemplo, emite una luz o un pitido) el cual indica, a un usuario del coagulador de pinzas 14 que funciona con energia, la coagulacion verificada del tejido 18 del paciente.
En una aplicacion de la forma de realizacion de las Figuras 2 y 3, el coagulador de pinas 14 que funciona con energia es una cizalla quirurgica ultrasonica 32 que incorpora una cuchilla ultrasonica 34 y un brazo de pinzamiento
36. En una variante, el medidor 40 de la fuerza esta adaptado para medir la fuerza aplicada al brazo de pinzamiento
36. En una aplicacion diferente, no mostrada, el coagulador de pinzas que funciona con energia es un coagulador de pinzas de RF (radiofrecuencia) que incorpora un electrodo monopolar o un electrodo bipolar.
55 E07250615 21-11-2011
Una segunda forma de realizacion que no forma parte de la invencion se refiere a un sistema de tratamiento medico 46 que funciona con energia y se muestra en las Figuras 4 y 5. El sistema de tratamiento medico 46 que funciona con energia incluye un coagulador de pinzas 48 que funciona con energia. El coagulador de pinzas 48 que funciona con energia incorpora dos miembros de pinzamiento 50 y 52, en el que al menos uno 50 de los dos miembros de pinzamiento 50 y 52 incluye, o esta adaptado para funcionar como, un electrodo de medicion 54 de la impedancia electrica para medir una impedancia electrica del tejido pinzado 56 del paciente.
En un ejemplo de la forma de realizacion de las Figuras 4 y 5, el otro 52 de los miembros de pinzamiento 50 y 52 incluyen, asi mismo, un electrodo de medicion 58 de la impedancia electrica, en el que una pequena corriente de deteccion pasa entre los dos electrodos 54 y 58 y se utiliza para determinar la impedancia electrica del tejido pinzado 56 del paciente, como sera advertido por el experto en la materia. En otro ejemplo, no mostrado, un miembro de pinzamiento incorpora dos electrodos y una pequena corriente de deteccion pasa entre los dos electrodos.
En una aplicacion de la forma de realizacion de las Figuras 4 y 5, el sistema de tratamiento medico 46 que funciona con energia incluye un monitor 60, como por ejemplo un controlador similar al controlador 42 y con las funciones de control anadidas del controlador 42 el cual monitoriza la coagulacion (esto es, el grado o el estado de la coagulacion) del tejido pinzado 56 del paciente utilizando al menos la impedancia electrica medida del tejido pinzado 56 del paciente obtenida mediante el uso de al menos el electrodo de medicion 54 de la impedancia electrica. En una variante, la impedancia electrica del tejido 56 del paciente es utilizada como una medida del grado de coagulacion. Cuando el tejido 54 del paciente esta coagulando debido a que se calienta mediante el coagulador de pinzas 48 que funciona con energia, la capacidad de coagulacion del tejido 54 del paciente para conducir a que la corriente se reduzca, lo cual se refleja mediante incrementos en la impedancia electrica del tejido 54 del paciente. En una variante diferente, la configuracion de la curva de la impedancia electrica con respecto al tiempo se utiliza para determinar el estado de la coagulacion del tejido.
En una aplicacion de la forma de realizacion de las Figuras 4 y 5, el coagulador de pinzas 46 que funciona con energia es una cizalla quirurgica ultrasonica que incorpora una cuchilla ultrasonica 64 energizada por un generador (no mostrado) y un brazo de pinzamiento 66. Debe destacarse que, en esta aplicacion, uno 50 de los dos miembros de pinzamiento 50 y 52 incluye una cuchilla ultrasonica 64 y el otro 52 de los dos miembros de pinzamiento 50 y 52 incluye el brazo de pinzamiento 66. En una aplicacion diferente, no mostrada, el coagulador de pinzas que funciona con energia es un coagulador de pinzas de RF (radiofrecuencia) que incorpora un electrodo monopolar y un electrodo bipolar.
Una forma de realizacion adicional que no forma parte de la invencion se refiere a un sistema de tratamiento medico 68 que funciona con energia y que se muestra en las Figuras 6 y 7. El sistema de tratamiento medico 68 que funciona con energia incluye un coagulador de pinzas 70 que funciona con energia. El coagulador de pinzas760 que funciona con energia incorpora los miembros de pinzamiento 72 y 74, en el que al menos uno 72 de los dos miembros de pinzamiento 72 y 74 incluye adicionalmente, o esta adicionalmente adaptado para funcionar como, un sensor 76 de la temperatura para medir una temperatura del tejido pinzado 78 del paciente.
En una aplicacion de la forma de realizacion de las Figuras 6 y 7, el sistema de tratamiento medico 68 que funciona con energia, incluye un monitor 80 (como por ejemplo un controlador similar al controlador 42 y con las funciones de control anadidas del controlador 42) el cual monitoriza la coagulacion (esto es, el grado o el estado de la coagulacion) del tejido pinzado 78 del paciente utilizando al menos la temperatura medida del tejido pinzado 78 del paciente obtenida mediante la utilizacion de al menos el sensor 76 de la temperatura. Debe destacarse que la temperatura del tejido 78 del paciente es una medida del grado de coagulacion. Cuando el tejido 78 del paciente esta coagulando cuando es calentado por el coagulador de pinzas 70 que funciona con energia, el tejido es, en primer termino, desnaturalizado y coagulado, despues de lo cual, el tejido resulta desecado y la temperatura del tejido aumenta.
En una aplicacion de la forma de realizacion de las Figuras 6 y 7, el coagulador de pinzas 18 que funciona con energia es una cizalla quirurgica ultrasonica 82 que incorpora una cuchilla ultrasonica 84 (energizada por un generador, no mostrado) y un brazo de pinzamiento 86. Debe destacarse que, en esta aplicacion, uno 72 de los dos miembros de pinzamiento 72 y 74 incluye un brazo de pinzamiento 86 y el otro 74 de los dos miembros de pinzamiento 72 y 74 incluye la cuchilla ultrasonica 84. En una aplicacion diferente, no mostrada, el coagulador de pinzas que funciona con energia es un coagulador de pinzas de RF (radiofrecuencia) que incorpora un electrodo monopolar o un electrodo bipolar.
Diversos beneficios y ventajas se obtienen de la invencion. En un ejemplo, la monitorizacion de la coagulacion del tejido del paciente permite que un controlador desactive, o active un indicador que indique al usuario desactivar el coagulador de pinzas que funciona con energia cuando la coagulacion del tejido se ha completado sin que la coagulacion avance hasta un tejido no de actuacion y sin que la energia deseque en mayor medida o dane el tejido de actuacion.
Aunque la presente invencion ha sido ilustrada mediante una descripcion de diversas formas de realizacion y de un procedimiento, no es la intencion de los solicitantes restringir o limitar el alcance de las reivindicaciones adjuntas a dichos puntos especificos. Los expertos en la materia advertiran la existencia de otras numerosas variantes, cambios y sustituciones sin apartarse del alcance de la invencion tal y como queda definida en las reivindicaciones adjuntas. Por ejemplo, los sistemas de tratamiento medico que funcionan con energia de la invencion tienen aplicacion en cirugia asistida por robot teniendo en cuenta las obvias modificaciones de dichos sistemas, componentes y procedimientos que sean compatibles con dicho sistema robotico. Debe entenderse que la descripcion precedente se ofrece a modo de ejemplo, y que otras modificaciones pueden ser advertidas por los expertos en la materia sin apartarse del alcance de las Reivindicaciones adjuntas.
45 E07250615 21-11-2011
Claims (11)
- REIVINDICACIONES1.- Un sistema de tratamiento medico (10) que funciona con energia, que comprende�a) un coagulador de pinzas (14) que funciona con energia adaptado para pinzar el tejido de un paciente;b) un medidor (38) de la impedancia acustica operativamente conectado al coagulador de pinzas (14) que funciona con energia para medir una impedancia acustica del tejido pinzado (18) del paciente; yc) un medidor (40) de la fuerza operativamente conectado al coagulador de pinzas (14) que funciona con energia para medir una fuerza de pinzamiento aplicada sobre el tejido pinzado (18) del paciente, caracterizado porque dicho sistema incluye, asi mismo, un controlador (42) el cual compensa la impedancia acustica medida del tejido(18) del paciente con respecto a la presion de pinzamiento utilizando al menos la fuerza de pinzamiento medida.
- 2.- El sistema de tratamiento medico (10) que funciona con energia de la reivindicacion 1, en el que el controlador (42), asi mismo, verifica una coagulacion del tejido (18) del paciente utilizando al menos la impedancia acustica medida compensada.
- 3.- El sistema de tratamiento medico (10) que funciona con energia de la reivindicacion 2, en el que el controlador
- (42)
- controla una salida de energia de un generador (30) en base a la coagulacion verificada del tejido (18) del paciente, en el que la salida de energia energiza el coagulador de pinzas (14) que funciona con energia.
- 4.- El sistema de tratamiento medico (10) que funciona con energia de la reivindicacion 2, en el que el controlador
- (42)
- controla un indicador visual y � o auditivo (44) el cual indica, a un usuario del coagulador de pinzas (14) que funciona con energia, la coagulacion verificada del tejido (18) del paciente.
- 5.- El sistema de tratamiento medico (10) que funciona con energia de cualquier reivindicacion anterior, en el que el coagulador de pinzas (14) que funciona con energia es una cizalla quirurgica ultrasonica que incorpora una cuchilla ultrasonica (34) y un brazo de pinzamiento (36).
- 6.- El sistema de tratamiento medico (10) que funciona con energia de la reivindicacion 5, en el que el medidor de la fuerza esta adaptado para medir una fuerza aplicada sobre el brazo de pinzamiento (36).
- 7.- El sistema de tratamiento medico (10) que funciona con energia de acuerdo con cualquier reivindicacion anterior, en el que el coagulador de pinzas (14, 48) incorpora dos miembros de pinzamiento (50, 52) adaptados para coagular el tejido (18, 56) del paciente pinzado entre los dos miembros de pinzamiento, y en el que al menos uno de los dos miembros de pinzamiento incluye, o esta adaptado para funcionar como, un electrodo de medicion (56, 58) de la impedancia electrica, para medir una impedancia electrica del tejido pinzado (18, 56) del paciente.
- 8.- El sistema de tratamiento medico que funciona con energia de la reivindicacion 7, que incluye, asi mismo, un monitor (60) el cual monitoriza una coagulacion del tejido pinzado (18, 56) del paciente utilizando al menos la impedancia medica medida del tejido pinzado (18, 56) del paciente obtenida mediante la utilizacion de al menos el electrodo de medicion (54, 58) de la impedancia electrica.�.-El sistema de tratamiento medico que funciona con energia de la reivindicacion 8, en el que el coagulador de pinzas (14, 48) que funciona con energia es una cizalla electrica ultrasonica que incorpora una cuchilla ultrasonica (34, 64) y un brazo de pinzamiento (36, 66), en el que uno de los dos miembros de pinzamiento incluye la cuchilla ultrasonica (34, 64) y el otro de los dos miembros de pinzamiento incluye el brazo de pinzamiento (36, 66).
- 10.- El sistema de tratamiento medico que funciona con energia de cualquier reivindicacion anterior, en el que el coagulador de pinzas (14, 70) incorpora dos miembros de pinzamiento (72, 74) adaptados para coagular el tejido (18, 78) del paciente pinzado entre los dos miembros de pinzamiento, y en el que al menos uno de los dos miembros de pinzamiento (72, 74) incluye, o esta adaptado para funcionar como, un sensor (76) de la temperatura para medir una temperatura del tejido pinzado (18, 78) del paciente.
- 11.- El sistema de tratamiento medico (10) que funciona con energia de la reivindicacion 10, que incluye, asi mismo, un monitor (80) el cual monitoriza una coagulacion del tejido pinzado (18, 78) del paciente utilizando al menos la temperatura medida del tejido pinzado (18, 78) del paciente obtenida mediante la utilizacion de al menos el sensor(76) de la temperatura.
- 12.- El sistema de tratamiento medico (10) que funciona con energia de la reivindicacion 11, en el que el coagulador de pinzas (14, 78) que funciona con energia es una cizalla electrica ultrasonica que incorpora una cuchilla ultrasonica (34, 84) y un brazo de pinzamiento (36, 86), en el que un miembro de pinzamiento incluye el brazo de pinzamiento (36, 86) y el otro miembro de pinzamiento incluye la cuchilla ultrasonica (34, 84)
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| US11/355,463 US7854735B2 (en) | 2006-02-16 | 2006-02-16 | Energy-based medical treatment system and method |
| US355463 | 2006-02-16 |
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| ES2372311T3 true ES2372311T3 (es) | 2012-01-18 |
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| ES07250615T Active ES2372311T3 (es) | 2006-02-16 | 2007-02-15 | Sistema de tratamiento médico que funciona con energía. |
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| EP (1) | EP1820460B1 (es) |
| JP (1) | JP5031395B2 (es) |
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| AT (1) | ATE527945T1 (es) |
| AU (1) | AU2007200415B2 (es) |
| CA (1) | CA2577032C (es) |
| ES (1) | ES2372311T3 (es) |
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-
2006
- 2006-02-16 US US11/355,463 patent/US7854735B2/en active Active
-
2007
- 2007-01-31 AU AU2007200415A patent/AU2007200415B2/en not_active Ceased
- 2007-02-05 CA CA2577032A patent/CA2577032C/en not_active Expired - Fee Related
- 2007-02-15 JP JP2007035199A patent/JP5031395B2/ja active Active
- 2007-02-15 EP EP07250615A patent/EP1820460B1/en active Active
- 2007-02-15 AT AT07250615T patent/ATE527945T1/de not_active IP Right Cessation
- 2007-02-15 ES ES07250615T patent/ES2372311T3/es active Active
- 2007-02-15 CN CN2007100788096A patent/CN101023883B/zh active Active
Also Published As
| Publication number | Publication date |
|---|---|
| JP5031395B2 (ja) | 2012-09-19 |
| CN101023883B (zh) | 2011-07-20 |
| EP1820460B1 (en) | 2011-10-12 |
| JP2007229454A (ja) | 2007-09-13 |
| US7854735B2 (en) | 2010-12-21 |
| CA2577032A1 (en) | 2007-08-16 |
| CN101023883A (zh) | 2007-08-29 |
| CA2577032C (en) | 2016-10-04 |
| EP1820460A2 (en) | 2007-08-22 |
| EP1820460A3 (en) | 2007-10-17 |
| AU2007200415A1 (en) | 2007-08-30 |
| US20070191828A1 (en) | 2007-08-16 |
| AU2007200415B2 (en) | 2011-11-03 |
| ATE527945T1 (de) | 2011-10-15 |
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