CN102083386A - 电灼方法和设备 - Google Patents

电灼方法和设备 Download PDF

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CN102083386A
CN102083386A CN2008800054292A CN200880005429A CN102083386A CN 102083386 A CN102083386 A CN 102083386A CN 2008800054292 A CN2008800054292 A CN 2008800054292A CN 200880005429 A CN200880005429 A CN 200880005429A CN 102083386 A CN102083386 A CN 102083386A
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约瑟夫·查尔斯·埃德
本杰明·西奥多·诺代尔二世
彼得·塞恩·埃德尔斯坦
卡姆兰·内扎特
马克·凯恩
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Aesculap AG
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Abstract

公开了一种用于电极的自动或用户选择操作或补偿的电极结构和机制，例如确定组织覆盖和/或防止在电灼过程中在底部电极之间的电弧放电。

Description

电灼方法和设备
技术领域
本发明涉及组织烧灼。更具体地，本发明涉及包括多种电极的电灼系统和用于电极的自动或用户选择操作或补偿的机制。
背景技术
多种生理状况需要组织和器官切除。组织切除过程中的重要事项是止血，即停止出血。必需通过缝合或者烧灼封闭给将要切除的器官或组织部分供血的全部血管，从而当切除该组织时阻止出血。例如，当在子宫切除术中切除子宫时，必需在子宫颈内阻止出血，必需沿着给子宫供血的某些血管切除所述子宫颈。类似地，当因为切除肿瘤或其它目的而切除一部分肝脏时，必需分别封闭肝脏内的血管。实现止血在开放外科手术过程中以及最小侵入外科手术过程中是必需的。在最小侵入外科手术过程中，封闭血管可能是特别耗费时间和难以解决的，因为通过插管和其它小型通道的接触受限。
实现止血在接触受限的过程中尤其重要，其中必需在切除之前切碎器官或其它组织。大部分器官对于完整切除并通过插管或其它接触受限通道来说过大，因而需要在切除之前切碎组织，例如切割、沉淀或者粉碎成更小的块。
除了上述例子之外，还存在各种其它电外科仪器以封闭和分离活体组织块，例如动脉、静脉、淋巴、神经、脂肪、韧带和其它软体组织结构。多种已知的系统施加射频(RF)能量以使身体组织坏死。实际上，其中一些具有明显的优势并且当前被广泛地使用。尽管如此，本发明人尝试识别并纠正先前方法的缺点，研究可能的改进，即使已知的方法是尚可的。
在这一方面，本发明人认识到的一个问题涉及当今电极结构的小型化。具体而言，许多电外科仪器制造商限制电极的总长度和表面积以改善组织完全覆盖电极的可能性。该小型电极策略导致外科医生必需多次封闭和分离以充分地封闭和分离狭长组织块。这种耗费时间的过程对病患也是有害的，增加了麻醉时间，并潜在地增加损伤周围结构的风险，因为不断地重复发送能量和分离组织。
部分电极覆盖的后果可能是明显的。这种状况可能导致电弧放电、组织碳化和不充分的组织封闭。在组织封闭之后立即执行组织的机械，例如刀，或者电外科手术分离，未充分封闭组织的分离可能给病患带来风险，因为未封闭血管可能出血。电弧放电存在其自身的很多问题。如果电灼电极在它们之间生成电弧，而不是使射频能量穿过目标组织，则组织未经过预期的电灼。此外，取决于电弧路径，这可能会损坏非目标组织。另一问题在于多电极系统内的相邻电极可能产生电交叉干扰或者在顺序放电的两个相邻电极之间的转变区内产生过热效应。先前的设计通过为电极所固定到的夹头设置机械间隔来防止此现象。然而，该间隔阻止细小组织接触相对电极，阻止在这些区域内的最佳电封闭。如果过浅，这些间隔还可能导致在电极之间的电弧放电。
在300kHz至10MHz范围内的典型射频能量(RF)频率上，阻止阻抗是很大的。在阻止干燥之前，初始阻抗可能根据组织类型和位置、血管分布等而变化很大。因而，仅仅根据本地阻抗确定组织电极覆盖的足够状态是不准确和不实际的。用于确定组织电极覆盖的可行和可靠方法将允许在外科手术过程中在安全和快速组织块封闭和分离中使用的更长和更大表面积的电极的开发。因此，提供用于确定一个或多个电极的组织覆盖面积的方法将是有利的。
发明内容
公开了一种用于电极的自动或用户选择操作或补偿，例如以在电灼过程中确定组织覆盖和/或防止底部电极之间的电弧放电的电极结构和机制。
附图说明
图1是根据本发明的电灼系统的组件和互连的方框图；
图2是图示根据本发明的具有补偿电路的第一实施例的电灼设备的组合方框和示意图；
图3是图示根据本发明的具有补偿电路的第二实施例的电灼设备的组合方框和示意图；
图4是图示根据本发明的具有补偿电路的第三实施例的电灼设备的组合方框和示意图；
图5是图示根据本发明的具有用于选择放电电极的电路的电灼设备的组合方框和示意图；和
图6是图示根据本发明的具有绝缘涂层的电极的方框图。
具体实施方式
鉴于本发明人已经认识到的常规技术的问题(如上文讨论的)，本发明人尝试改善在已经将电灼电极插入体内之后用户控制所述电极的能力。其进一步的关键领域包括改善将功率传输至电极结构的效率，和改善在原位自电极结构测量的准确性。实现这些改善的一个优点在于使用更大电极表面的能力，具有如上文讨论的有利结果。
图1图示电灼系统100的一种实施例。该系统100包括由电源电驱动的电极结构102、电极选择器和补偿器模块108。该模块108根据通过一个或多个用户接口110传送的用户输入而操作。
如下文更详细解释的，可以使用数字数据处理特征来实现系统100的某些组件。这可以以各种形式实现。
一些例子包括通用处理器、数字信号处理器(DSP)、专用集成电路(ASIC)、现场可编程门阵列(FPGA)或其它可编程逻辑设备、分立的门或晶体管逻辑、分立的硬件组件或者设计以执行在此所述功能的其任意组合。通用处理器可以是微处理器，但是可替换地，该处理器可以是任意常规处理器、控制器、微控制器或状态机。还可以将处理器实施为计算设备的组合，例如DSP和微处理器的组合、多个微处理器、结合DSP内核的一个或多个微处理器或者任何其它此类配置。
作为更具体的例子，数字数据处理包括耦合到数字数据存储器的处理器，例如微处理器、个人计算机、工作站、控制器、微控制器、状态机或者其它处理机器。在当前的例子中，存储器包括快速访问存储器以及非易失性存储器。快速访问存储器例如可以用于存储由处理器执行的编程指令。存储器可以通过各种设备实现。多种替代选项是可能的。例如，可以取消组件之一。此外，存储器可提供在处理器主板上，甚至提供在设备外部。
该设备还包括输入/输出，例如连接器、线路、总线、电缆、缓存器、电磁链路、天线、红外端口、换能器、网络、调制解调器或用于该处理器与该设备外部的其它硬件交换数据的其它装置。
如上所述，可以使用数字数据存储器的各种实例，例如以提供由系统100(图1)使用的存储器，以实现存储器，等等。取决于其应用，该数字数据存储器可以用于各种功能，例如存储数据，或者存储机器可读指令。这些指令本身可以协助执行各种处理功能，或者它们可以用于在计算机上安装软件程序，其中随后可以执行该软件程序以执行与该公开内容相关的其它功能。
将示例的存储介质耦合到处理器，以便该处理器可以从该存储介质读取信息和向其写入信息。作为替代选项，该存储介质可以集成至该处理器。在另一个例子中，处理器和存储介质可以位于ASIC或其它集成电路内。
与包含机器可执行指令的存储介质(如上文讨论的)不同，不同的实施例使用逻辑电路来实现处理该系统的数据处理特征。
取决于该应用在速度、费用、加工成本等领域内的特定需要，通过构建具有数以千计的微小集成晶体管的专用集成电路(ASIC)可以实现该逻辑。可以使用CMOS、TTL、VLSI或其它适当结构实现这样一个ASIC。其它替代选项包括数字信号处理芯片(DSP)、分立电路(例如电阻、电容、二极管、电感和晶体管)、现场可编程门阵列(FPGA)、可编程逻辑阵列(PLA)、可编程逻辑设备(PLD)、等等。
电极结构102
参见图1，电极结构102包括第一和第二电极表面103-104。电极表面104由一组电极、例如单独电极104a、104b等形成。在一个例子中，电极可以是紧密相邻的。在一个例子中，电极表面103包括如图所示的单个电极。在另一个例子中，表面103包括与电极104相同或不同数量的多个电极。
在一种实施例中，设置电极表面103-104以使用相对的双极电极将电能提供给目标组织区域。使用相对的双极电极是有利的，因为它将能量流动集中在电极之间，并限制对未包含在相对电极内的相邻组织的影响。
在一种情况下，电极结构103-104可以具有基本类似的形状从而以对称方式接触组织。可选择地，电极结构103-104可以具有不同形状。例如，一个电极结构可以包括用于插入组织体开口的探针，并构造另一电极结构以配合远离组织体开口的外部组织。在一些例子中，可以使用两个以上的电极结构，但是使用相反的极性激励至少两个电极结构或单结构的分离区域以将射频能量施加给目标组织。在一些例子中，电极结构可以是形成为单个支撑结构一部分的不同区域，例如可以放置在器官或者其它组织块之上和具有在其上形成的两个或更多电极表面的单个弹性管材或外壳。
当将相同或相反极性的高频能量施加给不同的电极表面时，它们相互隔离。在其它例子中，单电极结构可以具有多个导电或活动区域，其中可以使用相同或相反的极性激励导电区域。
在一些例子中，可能希望在电极结构上提供附加结构或组件以增强或增加在电极结构和组织之间的有效电接触面积。具体而言，电极结构可以包括组织穿透单元以增强电接触，即降低在电极和组织之间的电阻抗和增加在电极和组织之间的总接触表面积。示例的组织穿透单元包括针、钉、突起、通道、等等。具体的例子包括钉，其具有锋利的尖端，以便它们可以穿透组织表面并进入下层组织块。钉的深度可以在1mm至5cm或者3mm至1cm的范围内。钉的直径在0.1mm至5mm或者0.5mm至3mm的范围内。在一个例子中，钉均匀分布在电极结构的组织接触区域上，钉密度在0.1钉/cm2至10钉/cm2或者0.5钉/cm2至5钉/cm2的范围内。当使用组织穿透单元时，它们可以以基本均匀方式分散在电极结构的电活动区域上。除了导电适应或刚性电极表面之外，可以提供钉或其它组织穿透单元，但是在一些例子中，钉可以提供电极结构的完全导电或活动区域。
在一个例子中，电极包括多个不同的导电区域，其中这些区域可以彼此电隔离或者可以相互电耦合。单电极结构可以包括在其上的三个、四个、五个和多达十个或者更多的分立导电区域。这些导电区域可以由它们之间的电绝缘区域或结构来限定。
多电极表面104的一个例子是多个导电条，其由可以是空气间隙、塑料件或其它绝缘体等的间隙分离。该间隙最好小于0.5mm。此外，可以沿着每个导电条的长度设置多个组织穿透钉。可以在交替极性配置中激励导电条。最简单地，将相对条连接至单个电源上的相对接点。然而，可以重新设置电连接以在实际上的任意模式内给导电条供电。而且，还可以电隔离每条的不同区域以允许在不同极性上给这些区域供电；或者将电极设置为相同极性但是具有可以包括放电每个电极、放电特定电极或者同时放电多个电极的放电模式的多种顺序。
尽管图示为平板，在不脱离本发明范围的情况下，也可以将电极结构102实施为多种不同形状。例如，可以弯曲电极结构103-104以便于放置在管状人体结构或组织块上。在一种情况下，具体配置电极配置以具有将配合特定器官或组织形状的形状。在其它情况下，电极配置是适应的，以便它们可以配合和适应有很多不同的组织表面。在这一方面，可以利用诸如适应网等材料构造电极条，允许该电极结构变平或者采用各种其它配置。此外，还可以利用弹性或适应材料构造绝缘结构，允许电极结构的进一步再配置。可以根据本领域普通技术人员熟悉的任一已知形状配置或其组合实现结构102。一些示例形状包括相对夹片、圆柱体、探针、平板、等等。在这一方面，可以以适合于配合组织表面的任意方式配置电极。
因而，电极可以是刚性的、柔软的、弹性的、非弹性的(非可扩张的)、平面的、非平面的、等等，并可以选择使用组织穿透单元以增加电极结构和组织之间的电接触，以及增加电极面积。电极配置可以是可适应的，以便它们可以配合并适应很不相同的组织表面，或者可以具体配置它们以具有将配合特定器官或组织形状的形状。在这两个例子中，电极结构还可以装配有组织穿透单元。
可选地，电极结构可以包括导电表面和非导电表面。在一些实施例中，通过使一个表面为暴露金属面，而用例如绝缘材料覆盖或隔离电极的另一表面，可以实现这种情况。在刚性电极的情况下，绝缘可以是层压、涂层或者直接应用于相对表面。在柔软和弹性电极的情况下，绝缘层是柔软的，以便它们可以与电极一起扩展和收缩，而没有丢失或消除。在一些情况下，分立、可扩展的材料片覆盖希望绝缘的表面。在一些实施例中，所有电极表面可以涂覆绝缘材料。
在一种实施例中，电极结构的电活动区域具有1至50cm2范围的或更大范围的面积。在上文在此引用作为参考的美国专利申请中解释了电极结构的具体细节和例子。
电源106
电源106包括一个或多个电源。基本上，电源106生成诸如射频等高频功率，用于通过电极结构102的一个或多个电活动区域应用于目标组织。如下文描述的，功率的持续时间和幅度烧灼或坏死电极表面103-104之间的组织。
示例的频带包括100kHz至10MHz或者200kHz至750kHz。功率等级取决于所处理组织的表面积和体积，一些例子包括10W至500W或者25W至250W或者50W至200W的范围。例如，可以在从1W/cm2至500W/cm2或者10W/cm2至100W/cm2的等级上施加功率。
可以使用各种常规通用电外科电源实现电源106。电源106可以使用正弦或非正弦波形，并可以使用固定或受控功率等级操作。合适的电源可以从商业供货商处获得。
在一种实施例中，电源提供具有可变电压和电流的恒定输出功率，其中功率输出根据负载而变化。因而，如果系统发现很高阻抗的负载，则将电压维持在合理电平上以避免电弧放电。使用组织烧灼，阻抗范围例如从2欧姆至1000欧姆。通过施加恒定功率，电源106可以在低阻抗上提供足够的电流以在首次烧灼该组织时实现初始干燥，随着烧灼继续，施加更高电压以完成组织封闭处理。因而，电源106可以在烧灼处理开始时提供较大电流和较小电压，和在该处理的封闭阶段提供更高电压和更低电流。该电源发生器的控制至少部分地基于系统100监视功率。
在一种实施例中，电源106包括用于设置期望功率的机制。该设置可以通过实时控制、用户的预置选择、缺省设置、预定概图选择等出现。在一种实施例中，结合回扫变压器使用脉宽调制。该系统充电回扫变压器的初级并生成调节输出。例如可以将次级调节至期望安培数上的15伏以生成期望功率输出。根据周期，如由充电初级的脉冲宽度确定的，确定功率曲线。因而，本发明建立了在回扫变压器初级内的某功率等级，由次级提供相同的功率等级，而与负载即组织的阻抗无关。
电源106可以包括数字数据处理装置，如上所述。如果实施，使用该可选装置建立并控制电源106的特征和操作。
如图所示，电源106是用于结构102的多个电极的电源。因此，电源106或模块108提供多个输出通道，其中每个都是独立可调整的。在该实施例中，系统100包括多个导体108c的导电路径以将功率提供给电极，并包括返回路径108b，用于提供接地路径和/或反馈回电源，或者反之亦然，取决于电流方向。
在更具体的实施例中，模块108具有通过模块108的数字数据处理器择路到各个电极的多个输出108c。这多个输出独立地由处理器操作，并易于调制和可分配。因而，处理器可以在烧灼周期操作中的某点上将输出分配给任意一个或多个电极单元，并在其它时间点上动态地重新分配它们。例如，如果电源是四通道电源和电外科设备具有十六个电极，则每个通道可以支持电外科设备内的四个电极。然而，该配置可以改变，以便一些通道比其它通道支持更多的电极。
用户接口110
用户接口110包括用于操作者与包括电源106的模块108交换信息的一个或多个设备。可以存在公共用户接口或者用于每个组件106、108的分立用户接口。可以通过多种方式实施用户接口，在下文中举一些例子。对于人机流程，接口110的一些例子包括按钮、转盘、开关、键盘、遥控台或者其它机械设备。其它例子包括诸如鼠标、跟踪球等指示设备。另外的例子包括数字键盘、触摸屏、语音输入或者适合于在此所述目的的任何其它例子。对于机人交换，接口110可以使用视频监视器、显示屏、LED、机械指示器、音频系统或者适合于在此所述目的的其它例子。
通过链路108a将用户输入从接口传送至模块108。
传感器
系统100还可以包括贴附于系统100各个组件的各种传感器。传感器，在图1中未图示以使该图简洁清楚，可以贴附于组件，例如电极103-104、模块108的子部件、电源106的装置、等等。这些传感器的例子包括用于传感电压、电流、阻抗、所施加电压和电流之间的相位角、温度、能量、频率等的设备。更具体地，这些设备中的一些包括电压计、模数转换器、电热调节器、换能器、安培计等。
模块108
如上文所述，模块108包括一个或多个电源106。除了该功能之外，可以实现模块108以通过下文所述的方式执行电极的一些或全部的自动或用户选择操作或补偿。根据一个方面，可以使用模块108以通过选择限制到电极的功率应用，其选择是预先确定的、机器选择或用户选择的，定向组织的特定区域或者电极的控制放电顺序。根据另一方面，模块108可以将阻抗引入电极电路以提供预先确定的、机器选择或用户选择的阻抗匹配或补偿。
根据模块108的一个可选方面，模块108可以通过选择限制到电极的功率应用，其选择是预先确定的、机器选择或用户选择的，定向组织的特定区域。在这一方面，模块108具有分别耦合至每个电极103-104的多种输出108b-108c。举例来说，输出108b-108c可以包括线缆、电缆、总线或其它电导体。在所图示的例子中，存在连接到多个电极104a、104b等的多个导体108c。
模块108自电源106施加电压通过第一和第二电极表面103-104，以便该电压专门施加于选定的一个电极。可以根据自接口110的用户输入选择，由机器执行的分析选择和/或通过缺省状态选择这些电极。在这一方面，模块108可以包括电和/或机械开关、中继器或其它机制的开关网络以提供到选定一个电极的功率。如图所示，将电源106集成到模块108内，计算机控制选择启动选定的输出导体。
无论通过独立的开关网络还是输出导体的计算机调节启动，模块108根据自用户接口110的输入，或者自诸如如上所述的数字数据处理设备等机器的输入启动电极。根据应用的属性，可以根据机器选择标准或分析、缺省状态或用户输入执行此将功率控制施加给电极。
图5图示处理器受控开关网络的一个例子的典型应用，在两个电源、电极结构和目标组织区域的情况下图示。在该例子中，将电极表面配置如下。电极表面在电灼执行过程中基本上平行，一个表面的每个电极对准其在另一电极表面内的配对电极。在该例子中，存在与下表面的每个电极对应的上表面的两个电极。
重要的是，模块108选择地限制将功率施加给某些电极，施加给特定的组织区域。也可以为不同目的选择电极。即，模块108可以监视或控制电极选择以防止相同电极表面相邻电极的同时或顺序放电。确保电极放电以该间隔方式出现防止了电极之间的非故意电弧放电，并改善了电灼的效率。在一种实施例中，通过计算机控制，和部分地通过模块108的数字数据处理组件实现受控放电顺序。作为计算机控制的替代方式，可以使用机械装置，例如电机分配器或其它设备。
在另一实施例中，模块108可以将阻抗引入电极电路以提供预定、机器选择、固定或用户选择的阻抗匹配或补偿。换句话说，模块108包括将阻抗电引入包含电源、输出108b-108c和电极103-104的电路的机制。
更具体地，模块108包括可调整或选择引入以控制在包含电源和电极103-104的电路内的阻抗量的电容、电感和/或其它阻抗单元。这些阻抗单元可以包括分立单元、集成电路特征或适合于在此所述目的的其它结构。模块108根据来自用户的指令、机器执行的分析和/或缺省设置建立该阻抗匹配或补偿。
可调整阻抗的一个例子是可调整电感，其可以包括任意已知的感应器，例如缠绕可调铁磁核心的导电材料线圈或分立电感。在该例子中，通过关闭可手动、机械、电启动的开关，或者通过适合于此公开内容目的的任何装置，例如通过用户接口110，选择性地提高整体电感。
图2图示具有与上电极表面的每个电极串联的电感的电极配置(如图所示)。图3图示不同的例子，包括与下电极表面的每个电极串联的电感(如图所示)。在又一不同的例子中，图4包含“T”型网络，其中电容与上电极表面的每个电极串联放置。此外，将不同的电感与设计同时启动的每对电极平行放置。图2-4的例子可以使用固定、可调整或者固定与可调整之组合的阻抗单元。此外，结合在其表面上具有绝缘涂层的电极，对于在本公开内容教导下的本领域普通技术人员来说，几乎无数个用于阻抗匹配和/或补偿的附加电路配置将是显而易见的。
除了用于将阻抗引入该电极电路的配置之外，另一个考虑因素是这些阻抗单元的值。在一个例子中，选择阻抗以实现最大功率转换和进行精确的功率测量。在这一方面，选择阻抗以维持在射频生成器即电源106和组织之间的阻抗匹配。当所施加电压和电流之间的相位角度是零时，实现阻抗匹配。即，增加附加电感以补偿增加的容抗。在一个例子中，这使用具有有限范围和接近无限解析度的连续可变电感来执行。可以将这样一个电感调整至接近零相位。在不同的例子中，通过在例如如图2-4所示的适当配置中使用分立电感单元执行阻抗匹配，以发现最小可能的相位角度，尽管这不可能完全为零。
已经描述了本发明的结构特征，将描述本发明的操作方面。可以将结合在此公开的实施例描述的任意方法、处理或算法步骤直接实施为硬件、由硬件执行的软件模块、人执行步骤或者其组合。
用于执行电灼过程的序列使用包括电极结构的电灼系统和用于电极的自动或用户选择操作或补偿的机制。为了便于解释但没有任何限制意图，在图1的系统100的特定环境下描述该例子。
在第一步，选择用于操作系统100的不同参数。在一个例子中，一个或多个用户选择这些参数并将它们通过用户接口110传送至系统100。在不同的例子中，由在模块108上的数字数据处理装置选择用于操作系统100的参数。在这种情况下，根据用户输入、缺省值、由在系统102内安装的各种传感器收集的测量值、模块108的编程等设置参数。
在没有任何预期限制的情况下，下面是在第一步骤内可以选择的参数的一些非排除的例子：
(1)将要启动的各个电极的标识，例如图5，从而将电极103-104的能量集中于组织的特定区域。
(2)电极的放电顺序。
(3)在电源106和电极103-104之间的补偿和/或阻抗匹配中将要使用的阻抗幅度的估计或测量，例如图2-4。
(4)在电灼中将要应用的电功率参数，例如幅度、频率、相位或者电压、电流、功率的其它特征、等。
(5)系统100操作可以改变的任何其它参数。
在下一步骤，适当培训的人员将电极103-104施加给将要电灼的目标组织区域。根据电极103-104的结构、目标身体部分的属性、将要执行的程序和其它此类因素，施加电极103-104的方式可变。如本领域所公知的，可能存在在身体内使用两个电极结构103-104的情况，其中将一个电极插入身体和在外部使用另一电极的其它实施例，即双极或单极应用。
在该下一步骤的具体例子中，存在一个表面的多个电极，例如104，其对应于另一表面的一个电极，例如103。可选择地，操作员设置第一和第二电极表面103-104以便电极表面基本上平行，每个第二电极对准其相应的第一电极，尽管该对准最好在设备制造过程中获得。图2-5图示最后配置的例子。
在下一步骤中，提供指令以开始电灼。通过用户经接口110提交输入出现该步骤。例如，用户可以按下启动按钮，发出开始命令，按下脚踏开关，触发操作杆或者执行其它动作。在不同的例子中，一旦用户启动定时器过期即电子地出现。
在下一步骤中，系统100响应于启动命令并执行电灼。在此，系统100将双极射频功率定向在由电极结构103-104的间隔放置限定的组织区域上。使用相对双极电极将能量集中于电极之间，并限制对未限定在相对电极内的相邻组织的影响。实际上，可以在足以将在正在处理的组织块内的组织温度提高到高于电灼或坏死所需阈值等级之上，例如60-80℃，甚至更高的时间内施加功率。
更具体地，根据配置设置执行电灼。例如，电源106根据所建立的功率设置操作。而且，模块108执行以根据选定的电极组合调用各个电极。换句话说，模块108将电压自电源106施加通过第一和第二电极表面103-104，以便该电压排他地施加给选定电极。在计算机控制的情况下，这通过选择将功率施加给选定电极的模块108实现。
作为对使用选定电极的进一步增强，可以使用选定放电顺序启动电极。在该例子中，模块108将电压自电源106施加通过第一和第二电极表面103-104，以便将电压在任一时间施加给一个或多个第一电极102和一个或多个第二电极103，模块108防止同一电极表面的相邻电极同时或顺序放电。模块108可以进一步执行预定或用户选择的放电顺序。
例如，防止在具有多个电极的射频设备内两个或更多电极之间的热或电相互影响的一种方式是改变电极的放电顺序，以便相邻电极从不顺序充电。例如，并不顺序放电四电极系统，其中电极顺序编号为1，2，3，4，本发明以诸如3，1，4，2，4，2，4，1，3，1，3，的顺序给它们放电，以便相邻电极并不顺序放电。每个电极的放电时间可以不同以平衡在这样一个顺序内发出的能量，其中一些电极比其它电极更频繁地放电。这防止了在从一个电极传输至另一个电极过程中的交叉干扰以及在两个电极之间的转变区域内连续加热积聚的累积影响。此外，圆形电极可以最小化在电极之间和在任意转变表面上出现的边缘效应。
此外，如果一个电极表面或通常为金属的导电电极的两个相对表面涂覆有绝缘非导电材料，射频能量通过电容耦合依然可以传输通过它们之间的组织。图6是图示根据本发明的具有绝缘涂层的电极的方框图。然而，由于表面涂层的非导电属性，如果将其靠近或接触，电极表面并不形成短路。这样，如果电极对的一部分仅部分捕获组织，即在一部分电极之间存在很小的5mm空气间隙，则与在组织周围环绕和在临近电极之间直接流动相对比，射频能量依然穿透该组织。随着组织阻抗提高，这在随后的封闭周期内尤其重要。当组织阻抗很高时，能量寻求较低阻抗的替代路径，例如在暴露电极部分之间。这些绝缘层可以是聚合物薄层，例如特富龙，金属氧化物，例如钛、钨、钽或陶瓷。为了获得足够的电容，这些层的厚度可以在微米范围内。
在替代实施例中，通过选择激励不同的电极表面或区域，可以使用该系统100实现各种不同的组织烧灼模式。通过选择激励两个相邻电极，同时留下所有其它电极未激励，烧灼有限的组织区域。相反地，通过激励其它多个电极表面，烧灼更大区域。根据电极表面极性的精确模式，实现略微不同的模式。在其它实施例中，可以在极性交替模式中激励电极表面以生成组织烧灼模式。也可以使用不同模式以生成烧灼组织的稍微不同模式。
使用选择放电的不同方法来防止高阻抗的本地区域沿着整个电极影响整体系统阻抗，因而潜在地降低了当电压达到其最大容量时整个系统的功率输出。在此，激励电极以防止已经完全封闭和已经达到很高阻抗值的一个区域影响其中组织尚未封闭和因而处于较低阻抗的其它区域。可选地，根据在特定电极位置/区域内的组织属性，模块108可以使用用于每个电极或电极对的唯一功率和能量发送概表。
电灼的执行使用选定的阻抗补偿和/或选定的匹配。因此，将自电源106发送的功率以较小的电损失发送至目标组织区域。
系统100可以进一步传感和自动调整共轭匹配阻抗。作为响应，模块108调整施加给包含电极表面103-104和电源106的导电路径的阻抗。
可选择地，传感器可以将原始数据提供给模块108，其分析是否和如何调整阻抗。在不同的例子中，模块108可以响应于来自传感器的指令和数据调整阻抗。通过改变由电源106发送的射频能量的频率，可以执行该操作。例如，在一种实施例中，通过测量这些和/或其它参数的任意阻抗、压力或任意组合，模块108传感在烧灼周期开始时在每个电极上是否存在组织。如果在任一电极上未存在组织，则这个电极对空闲；模块108禁止该电极放电，和/或通过用户接口110将报警提供给操作者。模块108还可以为每个电极对提供状态指示器，其指示与每个电极对相关的封闭周期活动或完成。在该实施例中，每个电极对可以包括模式状态指示器，例如LED，一旦烧灼周期开始，其指示空闲、活动或完成状态中的任一个。
本发明还解决了通过使用绝缘涂层电极表面(参见图6)确定一个或多个电极的组织覆盖面积的问题。使用合适的射频生成器和使用涂覆绝缘涂层的电极表面，通过测量射频电压和电流的相位角度可以获得组织覆盖的确定。因为绝缘涂层基本上构成与组织的电容耦合，对于给定的绝缘材料厚度，电容是覆盖面积的函数。
用于电容器的基本公式是：
C＝ε0εrA/d
用法拉表示，其中ε0是自由空间的介电常数(8.854E-12)，εr是绝缘体的相对介电常数，A/d是面积和绝缘体厚度的比值。
在给定频率上，将电抗表示为：
Xc＝1/ωC
其中ω是2*Pi*频率。
需要适当的射频生成器以插入在这种情况下的共轭阻抗感应，从而消除使用全覆盖电极的容抗，并测量射频电压和电流的相位角度。当仅部分覆盖电极时，电容改变，即变得较小，因为有效面积较小。因此，电抗和最终射频电压和电流的相位角度改变。虽然改变的幅度部分受组织阻抗的影响，但是相信该方法允许最大程度地确定组织的电极覆盖。
这样一种方法的另一优点可以通知射频生成器的控制算法改变频率，例如使用较小的表面积提高频率，从而维持最大的功率转换，同时最小化电弧放电和组织碳化的可能性。通过在相位和/或阻抗内的快速改变和通过认识到可以使用仅由组织部分覆盖的电极通知射频生成器控制算法缩短或改变处理参数，可以快速地检测潜在的电弧放电和组织碳化状态。
为了实现最大功率转换和进行精确的功率测量，希望维持在射频生成器和组织之间的阻抗匹配。当相位角度是零时实现阻抗匹配。可以使用若干方法获得接近零的相位。一种这样的方法使用附加电抗单元，例如更大的电感，以补偿增加的容抗。可以通过两种不同方式实现该方法：
(1)通过插入具有有限范围和接近无限解析度的连续可变电感，可以将这样一个电感调整至接近零的相位；或者
(2)通过插入分立单元，例如电感，以发现最低相位，尽管这可能不是接近零的相位。
在两种情况下，在射频生成器内都需要电机设备。
实现诸如零相位的最大功率转换的另一方法是通过改变射频频率。假如阻抗是频率相关的，该方法允许射频生成器通过电子改变频率来补偿相位差。这可能不需要任何机械设备，例如中继器、伺服系统等。此外，射频生成器可以在操作过程中改变频率，而不是首先中断射频功率以改变单元。因而，这可能是最期望的方法。
尽管在此参考优选实施例描述了本发明，但是本领域的技术人员将容易理解在不脱离本发明的精神和范围的情况下其它应用可以替代在此阐述的应用。因此，本发明应当仅由权利要求书来限制。

Claims (39)

1.一种电灼设备，包括：
形成第一电极阵列的多个相邻第一电极；
至少一个第二电极；
具有电耦合至第一电极和所述至少一个第二电极的输出的电源；
装置，用于选择地将电源电压施加在第一电极阵列和所述至少一个第二电极中的任意电极之中的两个或多个电极之间，以防止相邻电极同时或顺序放电的选定放电顺序启动所述电极。
2.权利要求1的设备，所述用于选择地施加电压的装置启动所述电极以便绝不顺序地充电相邻电极。
3.权利要求1的设备，其中所述至少一个第二电极包括至少一个返回电极。
4.权利要求1的设备，所述用于选择地施加电压的装置在对于一个或多个每个所述电极而不同的放电时间上启动所述电极以平衡由所述电极发送的能量。
5.权利要求1的设备，所述用于选择地施加电压的装置以一些电极比其它电极更频繁放电的顺序启动所述电极。
6.权利要求1的设备，所述第一电极和所述第二电极中的至少之一具有圆形边缘以最小化在电极之间和在任意转变表面上出现的边缘效应。
7.权利要求1的设备，所述第一电极和所述至少一个第二电极中的至少一个还包括：
涂覆允许通过电容耦合在所述电极之间传输射频能量的绝缘或非导电材料的电极表面。
8.权利要求7的设备，所述第一电极和所述至少一个第二电极的至少一部分具有限定它们之间小于0.5mm的绝缘间隙的间隔关系。
9.权利要求7的设备，所述电极表面涂覆包括聚合体。
10.权利要求9的设备，所述聚合体包括下述任意一个：
特富龙
Figure F2008800054292C00011
钛、钨或钽中任一个的金属氧化物或者陶瓷材料。
11.权利要求7的设备，所述表面涂覆包括：
至少一个涂覆层。
12.权利要求1的设备，所述用于选择地施加电源电压的装置还包括：
装置，用于在多种不同烧灼模式中的任一模式中选择激励所述电极中的不同电极。
13.权利要求1的设备，所述用于选择地施加电源电压的装置还包括：
装置，用于选择放电电极以防止高阻抗的本地区域跨越所述第一电极阵列影响整体阻抗。
14.权利要求13的设备，所述用于选择放电电极的装置启动所述电极以防止已经完全封闭并因而达到高阻抗值的一个区域影响该设备封闭其它区域的能力。
15.权利要求1的设备，所述用于选择施加电源电压的装置还包括：
装置，用于根据在特定电极位置/区域内的属性，选择激励所述电极中的不同电极以使用用于每个电极或电极对的唯一功率和能量发送概表。
16.权利要求1的设备，所述用于选择施加电源电压的装置还包括：
装置，用于检测和自动调整共轭匹配阻抗。
17.权利要求1的设备，所述用于选择施加电源电压的装置还包括：
传感器，用于收集分析是否和如何调整阻抗所用的数据。
18.权利要求1的设备，所述用于选择施加电源电压的装置还包括：
装置，用于通过改变由所述电源发送的射频能量的频率来调整阻抗。
19.权利要求1的设备，所述用于选择施加电源电压的装置还包括：
装置，用于通过测量阻抗、压力中的任一个或者这些参数的任意组合在烧灼周期开始时检测组织是否被每个电极部分地覆盖。
20.权利要求19的设备，其中如果组织未存在于任一电极上，则此电极空闲；其中禁止所述电极放电，和/或将警告提供给操作者。
21.权利要求1的设备，还包括：
用于每个电极的状态指示器，其指示与此电极相关的封闭周期是否活动或完成。
22.一种电灼方法，包括步骤：
提供构成第一电极阵列的多个相邻第一电极；
提供至少一个第二电极；
提供具有电耦合至第一电极和所述至少一个第二电极的输出的电源；
选择性地将电源电压施加在第一电极阵列和所述至少一个第二电极中的任意电极之中的两个或多个电极之间，以防止相邻电极同时或顺序放电的选定放电顺序启动所述电极。
23.权利要求22的方法，其中所述至少一个第二电极包括至少一个返回电极。
24.权利要求22的方法，所述选择地施加电压的步骤还包括步骤：
启动所述电极以便绝不顺序地充电相邻电极。
25.权利要求22的方法，所述选择施加电压的步骤还包括步骤：
在对于一个或多个每个所述电极而不同的放电时间上启动所述电极以平衡由所述电极发送的能量。
26.权利要求22的方法，所述选择施加电压的步骤还包括步骤：
以一些电极比其它电极更频繁放电的顺序启动所述电极。
27.权利要求22的方法，提供构成第一电极阵列的多个相邻第一电极和提供至少一个第二电极的所述步骤还包括步骤：
提供至少一个电极表面，其涂覆允许通过电容耦合在所述电极之间传输射频能量的绝缘或非导电材料。
28.权利要求22的方法，所述选择施加电源电压的步骤还包括步骤：
在多种不同烧灼模式中的任一模式中选择激励所述电极中的不同电极。
29.权利要求22的方法，所述选择施加电源电压的步骤还包括步骤：
选择放电电极以防止高阻抗的本地区域跨越所述第一电极阵列影响整体阻抗。
30.权利要求22的方法，所述选择施加电源电压的步骤还包括步骤：
启动所述电极以防止已经完全封闭并因而达到高阻抗值的一个区域影响其它区域。
31.权利要求22的方法，所述选择施加电源电压的步骤还包括步骤：
根据在特定电极位置/区域内的属性，选择激励所述电极中的不同电极以使用用于每个电极或电极对的唯一功率和能量发送概表。
32.权利要求22的方法，所述选择施加电源电压的步骤还包括步骤：
检测和自动调整共轭匹配阻抗。
33.权利要求32的方法，所述选择施加电源电压的步骤还包括步骤：
收集分析是否和如何调整阻抗所用的数据。
34.权利要求32的方法，所述选择施加电源电压的步骤还包括步骤：
通过改变由所述电源发送的射频能量的频率来调整阻抗。
35.权利要求22的方法，所述选择施加电源电压的步骤还包括步骤：
通过测量阻抗、压力中的任一个或者这些参数的任意组合在烧灼周期开始时检测组织是否被每个电极部分地覆盖。
36.权利要求35的方法，其中如果组织未存在于任一电极上，则此电极空闲；其中禁止所述电极放电，和/或将警告提供给操作者。
37.权利要求22的方法，还包括步骤：
提供用于每个电极的状态指示器，其指示与此电极相关的封闭周期是否活动或完成。
38.一种电灼设备，包括：
形成第一电极阵列的多个相邻第一电极；
至少一个第二电极；
具有电耦合至第一电极和所述至少一个第二电极的输出的电源；
装置，用于选择性地将电源电压施加在第一电极阵列中和所述至少一个第二电极中的任意电极之中的两个或多个电极之间，以防止相邻电极同时或顺序放电的选定放电顺序启动所述电极；
其中所述第一电极和所述至少一个第二电极中的至少一个还包括：
涂覆允许通过电容耦合在所述电极之间传输射频能量的绝缘或非导电材料的电极表面。
39.一种电灼方法，包括步骤：
提供构成第一电极阵列的多个相邻第一电极；
提供至少一个第二电极；
提供具有电耦合至第一电极和所述至少一个第二电极的输出的电源；
选择性地将电源电压施加在第一电极阵列和所述至少一个第二电极中的任意电极之中的两个或多个电极之间，以防止相邻电极同时或顺序放电的选定放电顺序启动所述电极；
其中所述提供形成第一电极阵列的多个相邻第一电极和提供至少一个第二电极的步骤还包括步骤：
提供涂覆允许通过电容耦合在所述电极之间传输射频能量的绝缘或非导电材料的至少一个电极表面。
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