Electrosurgical generator

• US 10,639,098 B2
• Filed: 07/07/2014
• Issued: 05/05/2020
• Est. Priority Date: 05/06/2014
• Status: Active Grant

• Current Assignee: Cosman Instruments, LLC
• Original Assignee: Cosman Instruments, LLC
• Inventors: Cosman, Eric R.
• Primary Examiner(s): Peffley, Michael F
• Application Number:
  US14/325,303
• Publication Number:
  US 20150320481A1
• Time in Patent Office: 2,129 Days
• CPC Class Codes: A61B 18/10 Power sources therefor
• CPC Class Codes: A61B 18/1206 Generators therefor
• CPC Class Codes: A61B 18/1233 with circuits for assuring patient safety
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 18/1477 Needle-like probes
• CPC Class Codes: A61B 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 18/16 Indifferent or passive electrodes for grounding
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 2017/00106 ultrasonic
• CPC Class Codes: A61B 2018/00023 closed, i.e. without wound contact by the fluid
• CPC Class Codes: A61B 2018/00351 Heart
• CPC Class Codes: A61B 2018/00434 Neural system
• CPC Class Codes: A61B 2018/0044 Spinal cord
• CPC Class Codes: A61B 2018/00446 Brain
• CPC Class Codes: A61B 2018/00494 Stomach, intestines or bowel
• CPC Class Codes: A61B 2018/00511 Kidney
• CPC Class Codes: A61B 2018/00529 Liver
• CPC Class Codes: A61B 2018/00541 Lung or bronchi
• CPC Class Codes: A61B 2018/00565 Bone
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00642 : with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00648 : using more than one sensed parameter
• CPC Class Codes: A61B 2018/00654 : with individual control of each of a plurality of energy emitting elements
• CPC Class Codes: A61B 2018/00666 : using a threshold value
• CPC Class Codes: A61B 2018/00702 : Power or energy
• CPC Class Codes: A61B 2018/00708 : switching the power on or off
• CPC Class Codes: A61B 2018/00714 : Temperature
• CPC Class Codes: A61B 2018/0072 : Current
• CPC Class Codes: A61B 2018/00726 : Duty cycle
• CPC Class Codes: A61B 2018/00732 : Frequency
• CPC Class Codes: A61B 2018/00744 : Fluid flow
• CPC Class Codes: A61B 2018/00755 : Resistance or impedance
• CPC Class Codes: A61B 2018/00761 : Duration
• CPC Class Codes: A61B 2018/00767 : Voltage
• CPC Class Codes: A61B 2018/00779 : Power or energy
• CPC Class Codes: A61B 2018/00791 : Temperature
• CPC Class Codes: A61B 2018/00827 : Current
• CPC Class Codes: A61B 2018/00833 : Differential current
• CPC Class Codes: A61B 2018/00863 : Fluid flow
• CPC Class Codes: A61B 2018/00875 : Resistance or impedance
• CPC Class Codes: A61B 2018/00892 : Voltage
• CPC Class Codes: A61B 2018/124 : switching the output to different electrodes, e.g. sequentially
• CPC Class Codes: A61B 2018/1253 : monopolar
• CPC Class Codes: A61B 2018/165 : Multiple indifferent electrodes
• CPC Class Codes: A61B 2018/1823 : Generators therefor
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61B 34/10 : Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 90/37 : Surgical systems with images on a monitor during operation
• CPC Class Codes: A61N 1/36017 : with leads or electrodes penetrating the skin
• CPC Class Codes: A61N 1/36021 : for treatment of pain

Abstract

This invention relates to high-frequency ablation of tissue in the body using a cooled high-frequency electrode connected to a high frequency generator including a computer graphic control system and an automatic controller for control the signal output from the generator, and adapted to display on a real time graphic display a measured parameter related to the ablation process and visually monitor the variation of the parameter of the signal output that is controlled by the controller during the ablation process. In one example, one or more measured parameters are displayed simultaneously to visually interpret the relation of their variation and values. In one example, the displayed one or more parameters can be taken from the list of measured voltage, current, power, impedance, electrode temperature, and tissue temperature related to the ablation process. The graphic display gives the clinician an instantaneous and intuitive feeling for the dynamics and stability of the ablation process for safety and control. This invention relates to monitoring and controlling multiple ground pads to optimally carry return currents during high-frequency tissue ablation, and to prevent of ground-pad skin burns. This invention relates to the use of ultrasound imaging intraoperatively during a tissue ablation procedure. This invention relates to the use of nerve stimulation and blocking during a tissue ablation procedure.

Claims

1. A system for tissue ablation that includes a radiofrequency signal generator, a user interface, an ablation electrode, at least two ground pads, and a current-measurement system;

wherein current from the radiofrequency signal generator is adapted to flow between the electrode and each ground pad through a living body;

wherein the current-measurement system measures the current flowing through each ground pad; and

wherein the user interface includes a numerical or graphical display of the currents measured for the ground pads.

2. The system of claim 1 wherein the display includes a display of the current measured for a ground pad.

3. The system of claim 1 wherein the display includes a display of the RMS value of the radiofrequency current measured for a ground pad.

4. The system of claim 1 wherein the display includes a display of a mathematical function of the current measured for a ground pad.

5. The system of claim 1 wherein the display includes a display of the current measured for each ground pad.

6. The system of claim 1 wherein the display includes a display of the portion of the total current flowing through all ground pads, that is flowing to ground pad.

7. The system of claim 6 wherein the portion is displayed as a fraction, a percentage, a fraction relative to a desired fraction, a fraction minus the quotient of one (1) divided by the total number of ground pads, a percentage relative to a desired percentage, or a percentage minus the quotient of one hundred (100) divided by the total number of ground pads.

8. The system of claim 1 wherein the display includes a display of a quotient wherein the dividend is the current measured for a ground pad and the devisor is the sum of the currents measured for all ground pads.

9. The system of claim 1 wherein the display includes a display of a measurement of the portion of the total current flowing to all ground pads, that is flowing to each ground pad.

10. The system of claim 1 wherein the display includes a display of a mathematical function of the current measured for a first ground pad and the current measured for a second ground pad.

11. The system of claim 1 wherein the display includes a display of an average of the current measured for a ground pad over a time window.

12. The system of claim 1 wherein the display includes a display of the root-mean-square value of the current flowing through a ground pad over a time window.

13. The system of claim 1 wherein the display includes a substantially real-time display of the current measured for a ground pad.

14. The system of claim 1 wherein the display includes a digital display.

15. The system of claim 1 wherein the display includes a display of the root-mean-squared current measured for each ground pad.

16. The system of claim 1 wherein the display includes a bar graph.

17. The system of claim 1 wherein the display includes a plot of a measured current as function of a time axis.

18. The system of claim 1 wherein the display includes a graph of the current measured for each ground pad as a function of time.

19. The system of claim 1 and further including a switching system by means of which each ground pad can be connected to and disconnected from the radiofrequency signal generator, wherein connecting a ground pad to the radiofrequency signal generator allows the flow of current from the radiofrequency signal generator through the ground pad, and wherein disconnecting a ground pad from the radio frequency signal generator substantially stops the flow of current from the radiofrequency signal generator through the ground pad;

and further including a controller that automatically connects and disconnects a ground pad from the radiofrequency signal generator to regulate the parameter that is measured and displayed for the ground pad.

20. The system of claim 19 wherein the display includes a display of a moving average of the current flowing through a ground pad over at least one time period during which at least one ground-pad switch either opens or closes.

21. The system of claim 19 wherein the display includes a display of a root-mean-square moving average of the current flowing through a ground pad over at least one time window during which at least one ground-pad switch either opens or doses.

22. The system of claim 19 wherein the controller turns off the radiofrequency signal generator during the time periods when the switching system is in the process of connecting a ground pad to the radiofrequency signal generator, and during the time periods when the switching system is in the process of disconnecting a ground pad from the radiofrequency signal generator, during a tissue ablation process.

23. The system of claim 19 wherein the switching system includes a switch for each ground pad, wherein opening the switch for a ground pad disconnects the ground pad from the radiofrequency signal generator, and wherein closing the switch for a ground pad connects the ground pad to the radiofrequency signal generator.

24. The system of claim 19 wherein the controller automatically connects and disconnects one or more ground pads from the radiofrequency signal generator to regulate the current that is measured and displayed for each ground pad.

25. The system of claim 1 and further including more than one ablation electrodes wherein current from the radiofrequency signal generator is adapted to flow between each electrode and each ground pad through the living body.

26. The system of claim 1 and further including a nerve-stimulation signal generator wherein current from the nerve-stimulation signal generator is adapted to flow between the electrode and at least one of the ground pads through the living body.

27. The system of claim 1 wherein the displayed currents are real-time operating measurements selected from the list:

current, portion of total current flowing to all ground pads, or a function thereof.

28. The system of claim 9 wherein for each of all but one ground pad, the display includes a display of a measurement of the portion of the total current flowing to all ground pads, that is flowing to the ground pad, and wherein for the said one ground pad, the display includes a display of a measurement of the total current flowing to all ground pads.