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KR-102961623-B1 - Device and method for tissue identification

KR102961623B1KR 102961623 B1KR102961623 B1KR 102961623B1KR-102961623-B1

Abstract

A temperature measurement method including the following steps: A step of emitting light having an illumination spectrum into a tissue by at least one illumination; a step of receiving a remission of light having a remission spectrum from the tissue by at least one detector; a step of converting the remission spectrum into a detector signal by the detector; a step of sending the detector signal to a computing unit; a step of calculating a first theoretical remission spectrum by the computing unit based on a solution for explaining the propagation of light in the tissue, preferably based on radiative transfer theory and its approximation, assuming an estimated volume fraction of individual tissue components present in the tissue; a step of fitting the theoretical remission spectrum to a measured remission spectrum by the computing unit (1144), for example, by nonlinear regression, a neural network, or a lookup table; and a step of calculating at least one volume fraction of a tissue component from the remission spectrum by a minimization algorithm used to fit the theoretically calculated remission spectrum to the measured remission spectrum using a change in the volume fraction of individual tissue components present in the tissue by the computing unit (1144).

Inventors

  • 휴버, 크리스티안
  • 바이스하웁트, 디터
  • 로스와일러, 크리스토프
  • 러스, 데트레프
  • 푸거, 홀리버
  • 힙스트, 라이문트
  • 키엔레, 앨윈
  • 포섬, 플로리안

Assignees

  • 아에스쿨랍 아게

Dates

Publication Date
20260507
Application Date
20200805
Priority Date
20190807

Claims (15)

  1. As a medical high-frequency surgical instrument (1000, 1100), - At least one mechanism branch (1, 101, 201, 301, 401, 501, 601, 701, 801, 901, 1001, 1002), - At least one light source (10, 110, 210, 310, 410, 510, 610, 710, 810, 910, 1110) or light source assembly generating a first light having a specific illumination light spectrum that can be emitted in a direction toward the tissue, and - Includes at least one sensor (12, 112, 212, 312, 412, 510, 610, 710, 810, 910, 1110) provided and configured to detect a second light having a restriction spectrum reflected by the tissue as a result of light collision by the light source (10, 110, 210, 310, 412, 512, 612, 712, 812, 912, 1112), and to convert the second light into a detector signal according to the restriction spectrum. Here, the calculation unit (1144) is - Receives a detector signal from at least one sensor (12, 112, 212, 312, 412, 512, 612, 712, 812, 912, 1112), and - Calculate a theoretical remission spectrum based on a solution to explain light propagation in the tissue, assuming the estimated volume fractions of individual tissue components present in the tissue, and - Fit the theoretical limit spectrum to the limit spectrum measured by nonlinear regression, neural networks, or lookup tables, and - Calculate at least one volume fraction of a tissue component from a restriction spectrum through a minimization algorithm in which a theoretically calculated restriction spectrum is fitted to a measured restriction spectrum by changing the volume fractions of individual tissue components present in the above tissue, and - Calculate at least the maximum absorption from the absorption spectrum, and - Calculate the temperature of the tissue by comparing the maximum absorption value with at least one reference, and - A medical high-frequency surgical instrument (1000, 1100) provided and configured to control, adjust, or switch off the medical high-frequency surgical instrument based on a calculated volume fraction and a calculated temperature of a tissue component, or a calculated volume fraction, a calculated temperature of a tissue component, and a calculated tissue impedance of said tissue.
  2. In paragraph 1, - A medical high-frequency surgical instrument (1000, 1100) further provided and configured to store at least one reference in the form of a maximum absorption value at a specific temperature in the above calculation unit (1144).
  3. In paragraph 1, - A medical high-frequency surgical instrument (1000, 1100), further provided and configured to apply the above at least one light source (10, 110, 210, 310, 410, 510, 610, 710, 810, 910, 1110) and the above at least one sensor (12, 112, 212, 312, 412, 512, 612, 712, 812, 912, 1112) to the tissue.
  4. In paragraph 1, A medical high-frequency surgical instrument (1000, 1100) further provided and configured to control, adjust, or switch off the medical high-frequency surgical instrument when a predetermined temperature is reached.
  5. In paragraph 1, A medical high-frequency surgical instrument (1000, 1100) provided and configured to control, adjust, or switch off the medical high-frequency surgical instrument online.
  6. In paragraph 1, A medical high-frequency surgical instrument (1000, 1100) provided and configured to perform tissue identification during the sealing process.
  7. In paragraph 1, A medical high-frequency surgical instrument (1000, 1100), wherein at least one sensor (12, 112, 212, 312, 412, 512, 612, 712, 812, 912, 1112) is provided and configured to measure the limit.
  8. In paragraph 1, A medical high-frequency surgical instrument (1000, 1100), wherein the above-mentioned at least one light source (10, 110, 210, 310, 410, 510, 610, 710, 810, 910, 1100) and the above-mentioned at least one sensor (12, 112, 212, 312, 412, 512, 712, 812, 912, 1112) are spaced apart from each other.
  9. In paragraph 1, The above instrument branch (1, 101, 201, 301, 401, 501, 601, 701, 801, 901) forms an instrument branch body (8, 108, 208, 308, 408, 508, 608, 708, 808, 908, 1128) that forms half of an operable instrument jaw of a medical high-frequency surgical instrument (1000, 1100), and is provided and configured to contact said tissue and has at least one electrode (2, 102, 202, 302, 402, 502) disposed in or on said instrument branch body (8, 108, 208, 308, 408, 508, 608, 708, 808, 908, 1128), which is disposed in or on said instrument branch body (8, 108, 208, 308, 408, 508, 608, 708, 808, 908, 1128). Includes 602, 702, 802, 902), Herein, the at least one light source (10, 510, 810, 1100) and the at least one sensor (12, 512, 812, 1112) are disposed within or on the instrument branch body (8, 508, 808, 1128), a medical high-frequency surgical instrument (1000, 1100).
  10. In paragraph 1, The above instrument branch (1, 101, 201, 301, 401, 501, 601, 701, 801, 901, 1001, 1002) forms an instrument branch body (8, 108, 208, 308, 408, 508, 608, 708, 808, 908, 1128) that forms half of the operable instrument jaw of a medical high-frequency surgical instrument (1100), and is provided and configured to contact the tissue and has at least one electrode (2, 102, 202, 302, 402) disposed in or on the instrument branch body (8, 108, 208, 308, 408, 508, 608, 708, 808, 908, 1128), Includes 502, 602, 702, 802, 902), A medical high-frequency surgical instrument (1000, 1100), wherein at least one light tunnel (120, 220, 320, 420, 620, 720, 820, 920) is disposed within or on the instrument branch (1, 101, 201, 301, 401, 501, 601, 701, 801, 901, 1001, 1002), thereby allowing the first light or the second light from the at least one light source (110, 210, 310, 410, 510, 610, 710, 810, 910) to be directed from the tissue.
  11. A tissue identification method for controlling a medical high-frequency surgical instrument (1000, 1100) having at least one instrument branch (1, 101, 201, 301, 401, 501, 601, 701, 801, 901, 1001, 1002), - A step of generating a first light having an illumination spectrum that can be emitted in a direction toward the tissue by at least one light source (10, 110, 210, 310, 410, 510, 610, 710, 810, 910, 1110), - A step of measuring a second light having a restriction spectrum from a tissue, obtained by the restriction of a first light irradiated by at least one sensor (12, 112, 212, 312, 412, 512, 612, 712, 812, 912, 1112), - A step of converting a restriction spectrum measured by at least one sensor (12, 112, 212, 312, 412, 512, 612, 712, 812, 912, 1112) into a detector signal, - The step of sending the above detector signal to the calculation unit (1144), - A step of calculating a theoretical remission spectrum based on a solution for explaining light propagation in the tissue by the calculation unit (1144), assuming the estimated volume fraction of individual tissue components present in the tissue, - A step of calculating at least one volume fraction of a tissue component by changing the volume fractions of individual tissue components present in the tissue through a minimization algorithm in which a theoretical limit spectrum calculated by regression, a neural network, or a lookup table is fitted or matched to a measured limit spectrum by the calculation unit (1144), - A step of calculating at least one absorption maximum from the absorption spectrum, - A step of calculating the temperature of the tissue by comparing the above maximum absorption value with at least one reference, and A method for identifying tissue, comprising the step of controlling, adjusting, or switching off a medical high-frequency surgical instrument (1000, 1100) by the calculation unit (1144) based on the calculated volume fraction and calculated temperature of the tissue component, or the calculated volume fraction, calculated temperature, and calculated tissue impedance of the tissue component.
  12. As a machine-readable storage medium, A storage medium characterized by control steps stored in the storage medium, which are performed by a calculation unit (1144) of a medical high-frequency surgical instrument (1000, 1100) according to any one of claims 1 to 10, or by control steps stored in the storage medium according to claim 11.
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Description

Device and method for tissue identification The present invention relates to a medical high-frequency surgical instrument (HF, ultrasound, laser instrument, etc.) for tissue identification, particularly for tissue identification of human tissue, and preferably to the application of a method for tissue identification in a medical high-frequency surgical instrument (HF, ultrasound, laser instrument, etc.) according to the present invention. In high-frequency surgery (hereinafter referred to as HF surgery), high-frequency alternating current flows through the human body or body parts to selectively remove (coagulate) and/or cut (electrocut) tissue due to the heat generated during the process. The damaged tissue is subsequently reabsorbed by surrounding healthy tissue. A significant advantage compared to conventional cutting techniques using a scalpel is that hemostasis can occur within the context of coagulation by closing the affected blood vessel simultaneously with the cut. To safely close the blood vessel, a so-called Seal & Cut tool must be used. The device used is also referred to as an electric scalpel. In relation to the frequencies used in HF surgery (high-frequency surgery), body tissues behave like ohmic resistance (impedance). Resistivity depends significantly on the type of tissue. Muscle tissue and tissues with high perfusion have relatively low resistivity. Fat is approximately 15 times higher than bone and 1,000 times higher than bone. Therefore, the frequency, shape, and level of the current must be adjusted to the type of tissue on which the surgery is performed. Currently, monopolar radiofrequency techniques are most widely used in HF surgery. In this case, the pole of the radiofrequency voltage source is connected to the patient via the largest possible counter electrode, for example, via the contact point on the operating table where the patient lies, a contact bracelet or ankle strap, or an adhesive electrode. These counter electrodes are often referred to as neutral electrodes. The other pole is connected to a surgical instrument that constitutes the so-called active electrode. Current flows from the active electrode to the neutral electrode through the path of least resistance. Current density is highest and the thermal effect is strongest when the electrode is close to the active electrode. Current density decreases with the square of the distance. To maintain low current density within the body and prevent burns, the neutral electrode must be as large as possible and securely connected to the body. The skin over the neutral electrode does not heat up noticeably due to its large surface area. Strict safety measures are applied when attaching the neutral electrode. To avoid burns, proper positioning and good contact of the neutral electrode (depending on the surgical site) are critical. In the case of bipolar radiofrequency technology, unlike monopolar technology, current flows to a small part of the body requiring a surgical effect (cutting or coagulation). Two mutually insulated electrodes to which HF voltage is applied (e.g., housed in instrument branches) are guided directly to the surgical site. The electrical circuit is closed through the tissue between them. A thermal effect occurs within the tissue between the electrodes. Coagulation clamps are known. High-frequency connections are typically provided in the handles. A screw provided with an insulating coating often serves as the axis of a joint where two clamping legs with handles are rotatably attached to each other. By a bipolar HF vessel sealing and/or cutting system, vessels or tissue bundles can be effectively and permanently sealed generally or during cutting. Therefore, lateral thermal damage to surrounding tissues is limited and tissue adhesions are minimized. In medicine, tissue is defined as an organic substance composed of groups of similarly or differently differentiated cells that share a common function or structure. In addition to cells, tissue also includes the extracellular matrix (ECM). An example of human tissue is blood vessels. The human body is composed of a chemical composition of approximately 56% oxygen (O), 28% carbon (C), 9% hydrogen (H), 2% nitrogen (N), 1.5% calcium, 1% chlorine (Cl), 1% phosphorus (P), 0.25% potassium (K), 0.2% sulfur (S), and smaller proportions of other chemicals (all data are weight percent). The material composition of the human body consists of approximately 67% water, 16% protein (e.g., collagen), 10% lipids (e.g., fat), 1% carbohydrates, 1% nucleic acids, and 5% various minerals (all data are weight percentages). Collagen is a group of structural proteins ("proteins" that form fiber bundles) found in humans and animals, primarily in connective tissues (more precisely, the extracellular matrix). Collagen is found, among other things, in the white, inelastic fibers of tendons, ligaments, bones, and cartilage. The layers of the skin (subcutaneous tissue) are also composed of col