WO2022045530A1 - Appareil chirurgical haute fréquence et système associé pour un blocage nerveux - Google Patents

Appareil chirurgical haute fréquence et système associé pour un blocage nerveux Download PDF

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Publication number
WO2022045530A1
WO2022045530A1 PCT/KR2021/006363 KR2021006363W WO2022045530A1 WO 2022045530 A1 WO2022045530 A1 WO 2022045530A1 KR 2021006363 W KR2021006363 W KR 2021006363W WO 2022045530 A1 WO2022045530 A1 WO 2022045530A1
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Prior art keywords
electrode
tube
frequency
temperature
wall
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Korean (ko)
Inventor
양순철
이상용
서승완
송민철
최창준
유성근
박성민
백진환
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POSTECH Research and Business Development Foundation
Osong Medical Innovation Foundation
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POSTECH Research and Business Development Foundation
Osong Medical Innovation Foundation
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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
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves
    • A61B5/053—Measuring electrical impedance or conductance of a portion of the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves
    • A61B5/053—Measuring electrical impedance or conductance of a portion of the body
    • A61B5/0538—Measuring electrical impedance or conductance of a portion of the body invasively, e.g. using a catheter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/40—Detecting, measuring or recording for evaluating the nervous system
    • A61B5/4029—Detecting, measuring or recording for evaluating the nervous system for evaluating the peripheral nervous systems
    • A61B5/4041—Evaluating nerves condition
    • 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
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345—Vascular system
    • A61B2018/00404—Blood vessels other than those in or around the heart
    • 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
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00434—Neural system
    • 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
    • A61B2018/00696—Controlled or regulated parameters
    • A61B2018/00702—Power or energy
    • 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
    • A61B2018/00696—Controlled or regulated parameters
    • A61B2018/00714—Temperature
    • 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
    • A61B2018/00791—Temperature
    • 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
    • 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
    • A61B2018/0091—Handpieces of the surgical instrument or device
    • A61B2018/00916—Handpieces of the surgical instrument or device with means for switching or controlling the main function of the instrument or device
    • A61B2018/00958—Handpieces of the surgical instrument or device with means for switching or controlling the main function of the instrument or device for switching between different working modes of the main function
    • 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
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/142—Electrodes having a specific shape at least partly surrounding the target, e.g. concave, curved or in the form of a cave
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
    • A61B2562/02—Details of sensors specially adapted for in-vivo measurements
    • A61B2562/028—Microscale sensors, e.g. electromechanical sensors [MEMS]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
    • A61B2562/16—Details of sensor housings or probes; Details of structural supports for sensors
    • A61B2562/164—Details of sensor housings or probes; Details of structural supports for sensors the sensor is mounted in or on a conformable substrate or carrier

Definitions

  • the present application relates to a high-frequency surgical device and system for nerve block.
  • Nerve block is a method of alleviating inflammation and pain by injuring nerves.
  • nerve block using a catheter is used to damage nerves distributed from the inner wall to the outer wall of an artery or bronchus.
  • the catheter used in the existing nerve block cannot directly measure the temperature of the target nerve located on the outer wall of the tube, so it cannot be guaranteed whether the nerve is blocked.
  • an embodiment of the present invention provides a high-frequency surgical device for nerve block.
  • the high-frequency surgical device for nerve block includes an electrode surrounding the outer wall of the tube and selectively performing any one of impedance measurement and high-frequency energy transfer; a thermometer embedded in the electrode and measuring the surface temperature of the tube; a central control unit for controlling an operation to selectively perform any one of impedance measurement and high-frequency energy transfer through the electrode; an impedance analyzer for calculating an inner diameter and an outer diameter of a tube by analyzing the impedance measured by the electrode; and a function generator for generating high-frequency energy required for nerve block.
  • another embodiment of the present invention provides a high-frequency surgical system for nerve block.
  • the high-frequency surgical system for nerve block includes: a high-frequency surgical device that surrounds the outer wall of the tube and transmits high-frequency energy to block the nerve at the outer wall of the tube, and measures the surface temperature of the tube; and a computing device for calculating a temperature distribution between the inner and outer walls of the tube by performing an operation on the real-time data received from the surgical device.
  • another embodiment of the present invention provides a high-frequency surgical device for nerve block.
  • the high-frequency surgical device for nerve block includes: an electrode in which a shape memory alloy and an electrode are combined; a handle part having a slide structure for driving the electrode part; and a connection part connecting the electrode part and the handle part and fixing the electrode part so that the electrode part does not move.
  • the surface temperature of the tube can be measured.
  • the electrode can completely surround the outer wall of the tube by 360 degrees, and it is possible to minimize damage to the tube by concentrating heat on the outer wall of the tube and protecting the inner wall.
  • the temperature of the outer wall of the tube can be directly measured, and the temperature inside the tube can be monitored. This makes it possible to proceed with nerve block on the outer wall of the tube.
  • the present invention it is possible to block all neural signals passing around the tube.
  • the sympathetic nerve signal it can be applied to renal nerve block surgery for the treatment of heart diseases such as intractable hypertension and arrhythmia.
  • it can be applied to pulmonary nerve block to treat chronic obstructive pulmonary disease by blocking parasympathetic nerve signals.
  • FIG. 1 is a schematic diagram of a high-frequency surgical instrument and system for nerve block according to an embodiment of the present invention.
  • FIG. 2 is an operation flowchart of the high-frequency surgical instrument and system shown in FIG. 1 .
  • FIG 3 is a view showing a MEMS flexible electrode according to an embodiment of the present invention.
  • Figure 4 is a view showing a manufacturing process of the MEMS flexible electrode according to an embodiment of the present invention.
  • FIG. 5 is a view showing a MEMS flexible electrode and a flexible PCB according to an embodiment of the present invention.
  • FIG. 6 is a view for explaining a stacked structure of a flexible PCB according to an embodiment of the present invention.
  • FIG. 7 is a diagram illustrating a concept of adjusting a diameter of a flexible PCB to fit arteries of various sizes according to an embodiment of the present invention.
  • FIG. 8 is a diagram illustrating the shape of an end that is detachably implemented so that a temperature line can be inserted into the flexible PCB according to an embodiment of the present invention.
  • FIG. 9 is a diagram illustrating an integrated flexible PCB capable of adjusting a diameter according to an embodiment of the present invention.
  • FIG. 10 is a diagram illustrating a stacked structure of an integrated flexible PCB capable of adjusting a diameter according to an embodiment of the present invention.
  • FIG. 11 is a cross-sectional view showing the overall structure of a high-frequency surgical device for nerve block according to an embodiment of the present invention.
  • FIG. 12 is an enlarged cross-sectional view of the handle portion of the high-frequency surgical device for nerve block shown in FIG. 11 .
  • FIG. 13 is an enlarged cross-sectional view of an electrode in the case of applying the MEMS flexible electrode to the high-frequency surgical device for nerve block shown in FIG. 11 .
  • FIG. 14 is an enlarged cross-sectional view of an electrode when an integrated flexible PCB capable of adjusting a diameter is applied to the high-frequency surgical device for nerve block shown in FIG. 11 .
  • FIG. 1 is a schematic diagram of a high-frequency surgical instrument and system for nerve block according to an embodiment of the present invention.
  • a high-frequency surgical system 100 for nerve block may include a surgical device 110 , a computing device 120 , and an imaging device 130 .
  • the surgical device 110 includes a central control unit 111 , an impedance analyzer 112 , a function generator 113 , an amplifier 114 , a codec 115 , a data communication unit 116 , an electrode 117 and a thermometer 118 . It may be composed of
  • the central controller 111 is for controlling the operation of the surgical device 110 .
  • the central controller 111 may control the operation to selectively perform any one of impedance measurement and high-frequency energy transfer through an electrode 117 to be described later.
  • the central controller 111 may adjust the amount of high-frequency energy applied to the electrode 117 during transmission of high-frequency energy so that the temperature of the tube is kept constant during the nerve block operation. In other words, the central control unit 111 may maintain a constant temperature by adjusting the amount of high-frequency energy transmitted based on a temperature value measured by a thermometer 118 to be described later.
  • the impedance analyzer 112 is to perform impedance analysis in conjunction with an electrode 117 to be described later.
  • the impedance analyzer 112 may calculate the inner diameter and the outer diameter of the tube by analyzing the measured impedance when the electrode 117, which will be described later, measures the impedance.
  • the impedance measured after the electrode 117 wraps the artery is composed of the impedance of the artery wall between the inside diameter and the outside diameter of the blood flowing inside the artery.
  • the outer diameter of the artery is the same, the impedance decreases as the blood volume increases (ie, the artery wall becomes thinner), and increases when the blood volume decreases (ie the artery wall becomes thicker).
  • the outer diameter of the artery may be regarded as the diameter of the electrode surrounding the electrode. Based on this logic, it is possible to calculate the inner diameter and outer diameter of the pipe.
  • the function generator 113 and the amplifier 114 are for generating high-frequency energy required for nerve block according to the control of the central controller 111 .
  • the codec 115 is for signal conversion and may be implemented as an analog-to-digital converter (ADC) that converts an analog signal into a digital signal.
  • ADC analog-to-digital converter
  • the data communication unit 116 is for data communication between the surgical device 110 and the computing device 120 , and may be implemented by applying a wired method, a wireless method, or a wired/wireless method known to those of ordinary skill in the art.
  • the electrode 117 surrounds the outer wall of a tube such as an artery or a bronchus and selectively performs any one of impedance measurement and high-frequency energy transfer, and may be implemented as, for example, a bipolar parallel electrode.
  • the electrode 117 may be implemented in a form combined with a shape memory alloy so as to wind the outer wall of the tube.
  • the electrode 117 can wind the outer wall of the tube by itself, and after the procedure, it is possible to gently unwind the wound tube and come out.
  • the electrode 117 may be implemented as an electrode in which a MEMS flexible electrode and a flexible PCB are combined (see FIG. 5 ) or an integrated flexible PCB electrode with an adjustable diameter (see FIG. 9 ). to be described later.
  • the thermometer 118 is for measuring the temperature of the outer wall of the tube, and at least one temperature sensor may be implemented in a form in which the electrode 117 is embedded.
  • the thermometer 118 may include a plurality of temperature sensors located at a plurality of points of the electrode 117 .
  • the temperature sensor may be, for example, a resistance temperature detector (RTD), a thermistor, or a metal substrate contact temperature sensor (Thermocouple), and the metal substrate contact temperature sensor is a K type (Chromel and Alumel) depending on the type. ), type J (Fe and Mangan), type E (Chromel and Mangan), type T (Cu and Mangan), or type R (Pt and Pt-Rh (13%)).
  • the temperature of the tube measured by the thermometer 118 may be input to the central control unit 111 through the codec 115 , and may also be transmitted to the calculation unit 120 .
  • the computing device 120 is for performing an operation on data received from the surgical device 110 , and may include, for example, a Field Programmable Gate Array (FPGA) 121 capable of performing parallel processing.
  • FPGA Field Programmable Gate Array
  • the computing device 120 receives real-time data (eg, temperature value) related to the nerve block procedure from the surgical device 110 through the data communication unit 122 , and receives the real-time data from the FPGA 121 .
  • the temperature distribution between the inner wall and the outer wall of the tube can be calculated by performing parallel processing on the data, and in this case, optionally input patient information can be additionally considered.
  • various numerical analysis methods such as finite difference method (FDM), finite volume method (FVM), finite element method (FEM), and boundary element method (BEM) can be used to monitor the temperature distribution between the inner and outer walls of the tube.
  • FDM finite difference method
  • FVM finite volume method
  • FEM finite element method
  • BEM boundary element method
  • results can be derived within a short time based on real-time data obtained during the execution of nerve block.
  • the FPGA 121 may be replaced with a multi-processor of a high-performance MCU.
  • the imaging device 130 is for outputting information received from the computing device 120 .
  • the imaging device 130 may output the temperature distribution between the inner wall and the outer wall of the tube calculated by the calculating device 120 in the form of an image or the like.
  • the imaging apparatus 130 may output various types of information related to the nerve block operation, for example, patient information, energy transfer information, operation time information, and the like.
  • FIG. 2 is an operation flowchart of the high-frequency surgical instrument and system shown in FIG. 1 .
  • the operation of the high-frequency surgical device and system may be largely divided into an artery winding process ( S210 ), an artery modeling process ( S220 ), and a nerve block operation process ( S230 ).
  • the electrode is placed and brought into contact with the target artery (S211), and impedance analysis, that is, whether the resistance has changed (S212), is checked to determine whether the electrode is in contact.
  • impedance analysis that is, whether the resistance has changed (S212)
  • S212 the resistance has changed
  • the first thermometer value located at the end of the electrode rises by contacting the target artery from the tip of the electrode (S213)
  • RF energy is applied to the electrode (S214), and the second electrode located in the middle of the electrode is wound in a circle while the electrode is wound in a circle.
  • the thermometer value increases (S215)
  • the arterial modeling process (S220) may proceed. In this way, when the electrode contact is confirmed, high-frequency energy is applied to the electrode to increase heat, and the shape of the shape memory alloy is deformed using this heat so that the electrode completely surrounds the artery.
  • the application of RF energy to the electrodes is stopped ( S221 ), and impedance is measured in a wide frequency band ( S222 ) to obtain the inner and outer diameters of the artery ( S223 ).
  • the appropriate surgical temperature and time are determined according to the calculated inner and outer diameters of the artery (S224), and a simulation model (ie, the artery model) is created with the calculated inner and outer diameters of the artery (S225), and then the RF energy can be applied to the electrode to proceed with nerve block (S226).
  • the operating temperature and time for performing the nerve block may be determined in the arterial model primarily determined through impedance analysis, and the nerve block may be performed by transmitting RF energy according to the primary determination.
  • RF energy is adjusted to maintain a constant electrode temperature (ie, a constant surface temperature of the tube) (S231), and the first and second thermometer values are measured (S232), and the measurement
  • the measured temperature may be set as a boundary condition of the model (S233).
  • the temperature distribution can be expressed and output as an image (S235).
  • the operation temperature and time may be reset using the actual temperature distribution and the arterial model may be modified (S236). In this way, the surgical temperature and time can be determined secondarily based on the values of the first and second thermometers measured in real time during the nerve block operation, and accordingly, the nerve block operation can be performed.
  • Figure 3 is a view showing a MEMS flexible electrode according to an embodiment of the present invention
  • Figure 4 is a view showing a manufacturing process of the MEMS flexible electrode according to an embodiment of the present invention.
  • a bipolar parallel electrode for transmitting high-frequency energy on a biocompatible polymer substrate and a metal substrate contact-type temperature sensor are integrally formed on the same plane. It may be implemented to be formed. As such, since the bipolar parallel electrode and the temperature sensor are integrally formed, it may be more advantageous for integration.
  • the sacrificial layer 42 and the polymer 43 may be sequentially formed on the silicon substrate 41 .
  • the sacrificial layer 42 may be a metal, oxide, polymer, or silicon, and in the embodiment of the present invention, a metal titanium (Ti) sacrificial layer is used.
  • the polymer 43 may be biocompatible parylene, and the polymer 43 may be formed by, for example, chemical vapor deposition (CVD).
  • a metal (eg, Au) film used as the bipolar parallel electrode 44 and a metal substrate contact type temperature sensor ( 44), copper (Cu) and copper nickel alloy (CuNi) may be deposited.
  • a partial region 46 of parylene is etched using a reactive ion etcher (RIE).
  • RIE reactive ion etcher
  • the parylene may have the same thickness as in (a) of FIG. 4 .
  • the etched region 46 may be used for transmission and acquisition of electrical signals.
  • the flexible electrode formed on the silicon substrate may be separated by dissolving the sacrificial layer as shown in FIG. 4(d).
  • the MEMS process as described above has advantages in that various metal films can be deposited, various substrate materials compatible with the semiconductor process can be used, and it is advantageous for miniaturization and integration.
  • FIG 5 is a view showing a MEMS flexible electrode and a flexible PCB according to an embodiment of the present invention, the MEMS flexible electrode and the flexible PCB may be bonded using an ACF (Anisotropic Conductive Film).
  • ACF Anagonal Conductive Film
  • FIG. 6 is a view for explaining a stacked structure of a flexible PCB according to an embodiment of the present invention.
  • an integrated flexible PCB including an electrode wire and a temperature wire may be used to connect the MEMS flexible electrode as shown in FIG. 3 .
  • the flexible PCB may be formed to have the stacked structure shown in FIG. 6 .
  • the MEMS flexible electrode and the flexible PCB can be connected using, for example, ACF bonding on the surface of the shape memory alloy.
  • FIG. 7 is a diagram illustrating a concept of adjusting the diameter of a flexible PCB according to arteries of various sizes according to an embodiment of the present invention
  • FIG. 8 is a view showing a temperature line inserted into the flexible PCB according to an embodiment of the present invention It is a diagram showing the shape of the end that is detachably implemented so as to be able to do so.
  • the diameter of the flexible PCB may be embodied to be adjustable to fit arteries of various sizes.
  • Fig. 8 it can be implemented to be detachable so that an electrode wire for real-time RF energy application and a temperature wire for temperature measurement can be inserted inside the flexible PCB, and the end can be separated for connection with the control system.
  • FIG. 9 is a diagram illustrating an integrated flexible PCB with adjustable diameter according to an embodiment of the present invention
  • FIG. 10 is a diagram illustrating a stacked structure of an integrated flexible PCB with adjustable diameter according to an embodiment of the present invention. .
  • an integrated flexible PCB having an adjustable diameter, including an electrode wire and a temperature wire, and having a bipolar parallel electrode and a metal substrate contact temperature sensor integrally formed can be used.
  • the integrated flexible PCB capable of adjusting a diameter may be formed to have the stacked structure shown in FIG. 10 .
  • FIG. 11 is a cross-sectional view showing the overall structure of the high-frequency surgical device for nerve block according to an embodiment of the present invention
  • FIG. 12 is an enlarged cross-sectional view of the handle part of the high-frequency surgical device for nerve block shown in FIG. 11
  • FIG. 13 is an enlarged cross-sectional view of the electrode part when the MEMS flexible electrode is applied to the high-frequency surgical device for nerve block shown in FIG. 11,
  • FIG. 14 is the high-frequency surgical device for nerve block shown in FIG. It is a cross-sectional view showing an enlarged electrode part when an integrated flexible PCB with adjustable diameter is applied.
  • the high frequency surgical device may be largely composed of an electrode unit 1100 , a connection unit 1200 , and a handle unit 1300 .
  • the electrode unit 1100 may be in a form in which a shape memory alloy and an electrode are combined, and the electrode is an electrode in which a MEMS flexible electrode and a flexible PCB are combined (see FIG. 5 ) or an integrated flexible PCB electrode with an adjustable diameter ( FIG. 9 ). see) can be implemented.
  • the connection part 1200 connects between the electrode part 1100 and the handle part 1300 and may be fixed so that the electrode part 1100 does not move.
  • connection part 1200 may use a biocompatible polymer material (PC, PP, etc.) and a metallic stainless material.
  • the connection part 1200 has a diameter that can use a trocar of, for example, 5 mm, so it can be used for laparoscopic and robotic surgery.
  • the connection part 1200 can be separated from the handle part 1300, and the size of the electrode (MEMS electrode) of the electrode part 1100 is selected according to the size of the artery so that the handle part 1300 and the connection part 1200 are combined.
  • the electrode part 1100 may be selectively mounted in the groove formed in the connection part 1200 in the clamping type and used.
  • the handle unit 1300 may have a slide structure for driving the electrode unit 1100, for example, a case 1310 constituting the outside of the handle, and a stop function according to the pitch interval.
  • a flexible PCB moving unit 1320 for moving the flexible PCB 1360 with a function of pushing and pulling a slide, a guide fixing unit 1330 for fixing the shape memory alloy guide 1340, and a shape memory alloy rod 1350 guide For supporting the shape memory alloy guide 1340, the shape memory alloy rod 1350, the flexible PCB 1360 and the flexible PCB moving unit 1320 to .
  • the diameter of the electrode may be adjusted according to the size of the tube.
  • Such a configuration of the handle portion is merely an example, and if it is a structure capable of moving the flexible PCB 1360 , it may be implemented by being modified in various forms.
  • the electrode part 1100 in the case of applying the MEMS flexible electrode is a MEMS flexible electrode 1110, a shape memory alloy 1120, a tip cap for protecting the MEMS flexible electrode 1110 (Tip cap) ( 1130 and a tip cap lever 1140 for fixing and separating the tip cap 1130 may be included.
  • the tip cap 1130 having a rigid structure in consideration of the flexibility of the electrode and the tip cap lever 1140 may be included to prevent the tip cap 1130 from being separated by any impact.
  • the surface in which the inner surface of the tip cap 1130 and the connection part 1200 is in contact with the maximum frictional force to prevent the tip cap 1130 from being easily separated, the tip cap 1130 and the tip cap lever 1140 The diameter can be minimized as much as possible.
  • the electrode part 1100 in the case of applying an integrated flexible PCB with adjustable diameter is a shape memory alloy 1120 , a tip cap 1130 and a tip cap lever 1140 , and a flexible PCB. 1150 may be included.
  • the electrode part 110 shown in FIG. 14 is implemented in the same way as the electrode part 1100 shown in FIG. 13 except that it is composed of an integrated flexible PCB 1150 with an adjustable diameter instead of the MEMS flexible electrode 1110. can
  • the electrode can completely wind the outer wall of the tube by 360 degrees, and it is possible to minimize damage to the tube by concentrating heat on the outer wall of the tube and protecting the inner wall.
  • the temperature of the outer wall of the tube can be directly measured, and the temperature inside the tube can be monitored. This makes it possible to proceed with nerve block on the outer wall of the tube.
  • the present invention it is possible to block all neural signals passing around the tube.
  • the sympathetic nerve signal it can be applied to renal nerve block surgery for the treatment of heart diseases such as intractable hypertension and arrhythmia.
  • it can be applied to pulmonary nerve block to treat chronic obstructive pulmonary disease by blocking parasympathetic nerve signals.

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  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Biophysics (AREA)
  • Pathology (AREA)
  • Neurology (AREA)
  • Otolaryngology (AREA)
  • Neurosurgery (AREA)
  • Plasma & Fusion (AREA)
  • Radiology & Medical Imaging (AREA)
  • Physiology (AREA)
  • Surgical Instruments (AREA)

Abstract

Conformément à un mode de réalisation, la présente invention concerne un appareil chirurgical haute fréquence pour un blocage nerveux, qui peut comprendre : une électrode qui englobe la paroi externe d'un tube et qui effectue de manière sélective soit une mesure d'impédance soit un transfert d'énergie haute fréquence ; un thermomètre qui est intégré dans l'électrode et qui mesure la température de surface du tube ; un dispositif de commande central pour commander une opération de telle sorte que soit une mesure d'impédance soit un transfert d'énergie haute fréquence est effectué(e) de manière sélective par l'intermédiaire de l'électrode ; un analyseur d'impédance pour calculer le diamètre interne et le diamètre externe du tube en analysant l'impédance mesurée par l'électrode ; et un générateur de fonction pour générer de l'énergie haute fréquence nécessaire pour une intervention de blocage nerveux.
PCT/KR2021/006363 2020-08-28 2021-05-21 Appareil chirurgical haute fréquence et système associé pour un blocage nerveux Ceased WO2022045530A1 (fr)

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KR102818849B1 (ko) * 2022-10-25 2025-06-16 주식회사 딥큐어 체내의 신경을 차단 또는 조절하기 위한 전극 장치
KR102884573B1 (ko) * 2023-04-04 2025-11-17 주식회사 딥큐어 체내의 신경을 차단 또는 조절하기 위한 전극 장치

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WO2015196164A2 (fr) * 2014-06-21 2015-12-23 Accelemed, Llc Procédé et appareil de traitements de neuromodulation de la douleur et d'autres états
US20190133681A1 (en) * 2016-09-07 2019-05-09 Chang Wook Jeong Systems and methods for perivascular nerve denervation
US10368775B2 (en) * 2014-10-01 2019-08-06 Medtronic Ardian Luxembourg S.A.R.L. Systems and methods for evaluating neuromodulation therapy via hemodynamic responses
US20200179045A1 (en) * 2016-07-29 2020-06-11 Axon Therapies, Inc. Devices, systems, and methods for treatment of heart failure by splanchnic nerve ablation
JP2020089718A (ja) * 2018-12-07 2020-06-11 アヴェント インコーポレイテッド 神経系構造を選択的かつ可逆的に調節して疼痛を抑制する装置及び方法

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WO2015196164A2 (fr) * 2014-06-21 2015-12-23 Accelemed, Llc Procédé et appareil de traitements de neuromodulation de la douleur et d'autres états
US10368775B2 (en) * 2014-10-01 2019-08-06 Medtronic Ardian Luxembourg S.A.R.L. Systems and methods for evaluating neuromodulation therapy via hemodynamic responses
US20200179045A1 (en) * 2016-07-29 2020-06-11 Axon Therapies, Inc. Devices, systems, and methods for treatment of heart failure by splanchnic nerve ablation
US20190133681A1 (en) * 2016-09-07 2019-05-09 Chang Wook Jeong Systems and methods for perivascular nerve denervation
JP2020089718A (ja) * 2018-12-07 2020-06-11 アヴェント インコーポレイテッド 神経系構造を選択的かつ可逆的に調節して疼痛を抑制する装置及び方法

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