US3058470A - Apparatus for electrical highfrequency surgery - Google Patents

Description

0d- 16, 1952 E. SEELIGER ETAI. 3,058,470

APPARATUS FOR ELECTRICAL.HIGH-FREQUENCY SURGERY Filed April 19, 1957 2 Sheets-Sheet 1 park? ap Voz-num mbe energ/'or /70 Gene/'afar Z0 'IHM 72 tahi- Jaa i Va-"1 .Zia/VX Pall '33 T30 l [ga- L J States Uite The invention relates to apparatus for electrical highfrequency surgery, in which high-frequency electrical oscillations are fed selectively to active electrodes either undamped, that is, suitable for cutting, or damped and consequently suitable for coagulating.

In a known apparatus of this type three outputs with separate power control are provided for the connection of the active electrodes. The switching over from the one to the other kind of current is effected by a foot switch. The switching on of the treatment current can also be effected by a foot switch or by actuating a switch fitted in a handle carrying the electrode. In this known apparatus it is possible for a surgeon to use the same electrode always connected to the same output alternatively for coagulation with one kind of current and. for cutting with the other kind of current (prostate-resecuon) or to carry out the cutting and coagulation with different electrodes each of which is connected to a different output of the apparatus. ln the first instance, in addition to the switching over of the kind of current, an alteration in the power adjustment is necessary, because coagulation currents and cutting currents have dilferent magnitudes, and in the second instance, in which the dilferent power can be pre-set, the surgeon must both change the electrode and also actuate a current type selector.

The invention is based upon the thought that the surgeon should not be expected to manipulate the apparatus in any way during an operation, except for the unavoidable choice of the electrode and the switching on and off of the treatment current. It is, therefore, the object of the present invention to provide apparatus for electrical high-frequency surgery comprising a plurality of outputs and a current type selector cooperatively associated with each output, for the purpose of vseparately preselecting the kind of treatment current for each outut. p The various objects and features of the invention will appear from the description of two preferred embodiments which will -be rendered below with reference t the accompanying drawings, in which:

FiG. l is a circuit diagram of a rst embodiment of the invention comprising two electrode outputs and switch parts cooperatively associated with each output and assembled to form channels I `and Il, as well as a spark gap generator and a tube generator;

FlG. 2 is a unit-type connecting diagram of a second embodiment of the invention comprising four electrode outputs and consequently four channels I, Il, III and IV, as well as a tube generator, which supplies selectively damped or undamped high-frequency electric oscillations;

FlG. 3 is a circuit diagram of the second embodiment of the invention; and

FIGS. 4, 5 and 6 show the time slope of the adjustable treatment currents in the case of the second embodiment of the invention.

In the embodiment shown in FIG. l,numerals 11 and 12 designate outputs of aspark gap generator 10, and 21 and 22 designate outputs of a vacuum tube generator 2i?, said outputs 'being grounded on one side and connected on the other side to twofixed contacts 33 and 33a, and 32 and 32a, respectively, ofcurrent selectors 30 3,058,470 Patented Get. 16, 1962 and 35i-a, respectively. Output regulators 4) and 46a with regulatingpotentiometers 41 and 41a are respectively connected in series with thecurrent selectors 30 and 30a by way ofassociatedswitch arms 31 and 31a, respectively. Then follow, successively along the line, operating contacts Sti and Stia ofrelays 61 and 61a of relay units 6@ and 60a and finallyinner contact rings 71 and 7M, respectively, of electrode outputs '70 and 70a which are connected toelectrodes 81 fitted in handles Sil, only one of which is shown in the drawings. The relay units 6i) and 60a comprise respectively therelays 61 and 61a,input chokes 63, 64, and 63a, 64a, yand sources of current 62 and 62a in series connection, and are connected on the one hand wth theinner contact rings 71 and 71a and on the other hand withouter contact rings 72 and 72a of the electrode outputs 7i) and 70a, respectively. The handle il@ carrying theelectrode 81 is provided with a key button '52 for closing aswitch 83, 84 which in turn is connected on the one hand to the inner contact ring '71 and on the other hmd to theouter contact ring 72 of theelectrode output 70.

The operation is as follows:

When thekey button 82 of theelectrode handle 80 is depressed and consequently theswitch 83, 84 closed, the circuit for therelay 61 of therelay unit 60 is also closed, with the result that this relay is energized, closes its operating contact Sii and, according to the setting of thecurrent selector 30, connects theelectrode 81 either to thevacuum tube generator 20 or to the spark gap generator it?. Such an arrangement presents the advantage that the kinds of current and the high-frequency power desired for carrying out the surgical operation in the course of the treatment can be separately preset for each electrode before commencing an operation, so that the surgeon can, during the treatment, concentrate chiefly on the selection of the electrode for the treatment and on carrying out the treatment, and his attention is not diverted by being obliged to change the kinds of current and readjust the strength of the treatment current during the treatment.

Theoperating contacts 50a and 50 for switching on the treatment current in channels I and ll need not necessarily be controlled -f-rom each handle through the medium ofseparate relays 61 and 61a, respectively, but a common relay with separate contacts for the vtwo channels or a similarly constructed foot switch may be provided. Similarly, `switches for the treatment current need not be arranged in the channels but may be disposed in the generator circuits or in the power-supply lead to the generator-s. In the latter case a single switch for the treatment current will be sufficient in the common power-supply lead to the twogenerators 10 and 2t).

In the embodiment shown in FIG. 2, designates a tube generator capable of being switched over from damped to undamped electric high-frequency oscillations, and designates an amplifier connected in series with thegenerator 90.Parts 30, 40, 50, 60, 70 and 80 correspond to similarly designated parts of FIG. 1, that is, in the unit-type connecting diagram of FIG. 2, the selectors for the desired kind of current are designated by 30, the output regulators by 40; the operating contacts of therelay units 60, which are connected in series with the output regulators by 50, and the electrode outputs by '70 which are also provided with electrode components 80' to 84. Theamplifier 100 is disposed directly ahead of theelectrode outputs 70. LIn addition to theoperating contacts 50, therelays 61 of therelay units 60` have operatingcontacts 51 which are disposed between theselectors 30 for the kind of current and the high-frequency tube generator 90. These,additional operating contacts 51 respectively connect only one current selector Conductors 67 interconnecting therelay units 60, 60a, 60h indicate that each relay unit has normal or resting contacts arranged in the relay unit circuits of the other units, the function of which will be shown in connection with FIG. 3. A socket unit Iv contains, in addition to an electrode socket 70e, with an inner contact ring 71e and an outer contact ring 72C, aselector unit 110 with the aid of which the output 70C can be selectively connected to channels I, II or III. In this structure, the kind of current and power can be pre-set independently for each of the channels I, II and III. The output 70C (channel IV) permits use of one an the same electrode both for coagulation and also for cutting without changing the handle or the channel, that is without the necessity of changing the power setting; this being possible since all the other channels can be selectively controlled from the channel IV, such control being indicated by connectinglines 68, 68a, and 68b extending between theselector unit 110 and therelay units 60 in 4the channels I, II and III.

In FIG. 3,parts 30 40, 50, 51 60, 70, S0, 90, 100 and 110 correspond t'o similarly designated parts of FIG. 2. -Each current `type selector 30, 30a and 3012 is provided with a multicontact switch having amovable contact arm 31 which is grounded, aiixed contact 32 which is dead, alixed contact 33 which is connected with one of the layers of a condenser 35 and afixed contact 34 connected with one of the layers of acondenser 36, The other layers of Ithecondensers 35 and 36 are connected to the output of theselector 30. Each of theselectors 30 can be connected to the input circuit of thegenerator unit 90 by way of acontact 51. Thegenerator unit 90 comprises agenerator tube 91 in a blocking oscillator circuit. The grid of thetube 91 is connected to one of the layers of acondenser 93 and the generator input by way of a blocking choke 92. The other layer of thecondenser 93 is grounded. One end of a resistor 94 is connected to the circuit, connecting thecondenser 93 and the blocking choke 92, whereas the other end thereof is connected to the positive pole of an anode voltage source 97 by way of an operating Contact 59 of arelay 57. The anode of thetube 91 is connected by Way of an oscillating circuit coil 96, which is in parallel with an oscillatingcircuit condenser 95, also by way of the contact 59 to the positive pole of the source of anode voltage 97, the negative pole of which is grounded. The oscillating circuit coil 96 is coupled with acoil 98 having one end of its winding grounded while its other end is connected to the generator output. Eachoutput regulator 40, 40a `and L10b has a variable potentiometer orresistance 41, one end of the winding of which is grounded while the other end may be connected to the input of the corresponding output regulator through the medium of an operating contact 52 respectively controlled by a relay such as 61, 61a and 61b. Theslide contact 42 ofthevariable resistance 41 is connected to the output. Theampli fier 100 contains an amplier tube 101 which has its cathode grounded by way of acathode resistor 104, and its grid grounded by Way of a blockingchoke 102 forming a grid leak resistance. One layer of acondenser 103 is connected to the connecting point between the grid of the tube 101 and theblocking choke 102, while the other layer of this condenser -forms the input of theamplifier 100. The anode of the tube 101 is connected by Wav of aresonant circuit coil 106, which is in parallel with a resonant circuit condenser 10S, and anoperating contact 58 of therelay 57 to the positive pole of a source ofanode Voltage 108, the negative pole of which is grounded. Theresonant circuit 105, 106 is tuned to the frequency of thegenerator 90. Theresonant circuit coil 106 is coupled with acoil 107, one end of the Winding of which is grounded While its other end forms the output ofthe amplier unit. Eachrelay unit 60, 60a and 60b comprises a relay respectively indicated at 61, 61u and 61b, one end of the Winding of each relay being respectively connected in series with a normally closed contact 54a (of on to thegenerator 90.

the relay 61) and 55h (of a relay 61h) as well as with a choke respectively indicated at 63, 63a and 63h. The other end of the winding of the relay 61 (6141; 61b) is connected to the positive pole of the current source or -battery 62, the negative pole of which is connected to theblocking choke 64 64a; 64b). One end of theblocking chokes 63 and 64 leads to the terminals -for a foot Switch 65. A series arrangement comprising a signal lamp 66 and an operating contact 53 of therelay 61 is connecteai in parallel to thevoltage source 62. Parallel to thevoltage source 62 is also a series arrangement comprising the relay S7 and a contact arrangement which includes parallel connected make contacts 56 (of the relay 61), 56a (of therelay 61a) and 56b (of the relay 611;). Cooperatively associated with therelay 61 are normally closed contacts 54 (in therelay unit 60a) and 55 (in a relay unit 60b). Cooperatively associated with the relay 611; Aare normally closed contacts 541; (in therelay unit 60a) and 55b (in the relay unit 60).

The selector unit in the channel IV has one end of blocking chokes 63C and 64e connected to its output 70e, the other ends of these chokes being connected to the terminals of a foot switch 65C. A conductor leads from the `foot `switch terminal at the choke 64e to the foot switch terminals at thechokes 64, 64a, and 64b in each of therelay units 60, 60a and 606. Theselector unit 110 also comprises amulticontact switch 111 with two switch arms orwipers 112 and 113 mounted on a common pivot' but insulated from each other. Thewiper 112 is connected with the foot switch terminal at the choke 63e and can be set consecutively onfixed contacts 114, 115 and 116. From each of Ithese contacts a conductor leads to the respective terminals of the foot switches 65 at thechokes 63 in therelay units 60, 60a, 601). TheWiper 113 of themulticontact switch 111 is connected to the positive pole of thebattery 62 and can be set consecutively onxed contacts 117, 118 and 119, of which contact 117 is connected by way of a lamp 120, contact 118 by way of a lamp .121 and contact 119 by way of a .lamp 122, to the negative pole of the source ofvoltage 62.

The circuit arrangement according to FIG. 3 operates as follows:

It is assumed that channel I is to -be preset for an undamped, uninterrupted high-frequency current suitable for cutting, the time slope of Which is shown in FIG. 4, Whereas channel II is to be preset for supplying a damped high-frequency current suitable for coagulation, having 'the time slope shown in FIG. 5, and that channel III is to be preset for supplying a damped, interrupted highfrequency current suitable for coagulation, having the time slope shown in FIG. 6.

Before starting the surgical treatment, the operator sets Ifor this purpose thecurrent selector 30 on thedead contact 32, theselector 30a on thecontact 33 and theselector 30b on thecontact 34. In addition, thevariable potentiometer 41 in theoutput regulator 40 is set for a power value suitable for carrying out a cutting operation and ythevariable potentiometers 41 in theoutput regulators 40a and 40b are respectively set for power values suitable for coagulation. Whenrelay 61 becomes energized responsive to actuation either of the handle switch y82, 83, 84 or of the foot switch 65, thecontact 56 of therelay 61 is closed and relay 5-'7 is consequently actuated; as a result the contacts 5S (in the amplier 100) and 59 (in the generator unit 90) are closed. Through the medium of these contacts, anode voltage is supplied both to the generator tube 9'1 and also to the amplifier tube 101. In the grid circuit of thegenerator tube 91, owing to the idle setting of thecurrent selector 30, only the condenser '93 becomes operative and the capacity of this condenser is so small that undamped, uninterrupted high-frequency oscillations are produced the energy of which is transferred by way of thecoil 98 to theoutput regulator 40. Whenrelay 61 becomes energized,contacts 50 and 52 are closed, so that the output voltage on the coil 98 (in the generator unit 90') is ltransmitted to thepotentiometer 41 of theoutput regulator 40. A portion of the generator output voltage, the potential of which is determined by the setting of theslide 42 of thepotentiometer 41, is now applied to the input of theamplifier 100 by way of thecontact 50, fed by way of thecondenser 103 to the grid of the ampliiier tube 161, amplified in the amplifier tube and Iswitched by way of thecoil 107 to theinner ring 71 of theelectrode output socket 70, and consequently to theelectrode 81 in thehandle 80. Whenrelay 61 energizes, the operating contact 53 is also closed which switches on the signal lamp 66 to indicate to the surgeon that the cur-rent preset in channel I, as regards kind and power, is available on thetreatment electrode 81. Finally, by the energizing of therelay 61, the normally closed contacts 54 (in therelay unit 60a) and 55 (in the relay unit 60b) are opened. This ensures that therelays 61a and 61b respectively cannot be unintentionally energized. Thus, during the treatment with the electrode handle 80 connected to theoutput 70, actuation of the foot switches 65a and 65b, respectively, or of the corresponding switches in the electrode handholds connected to theoutputs 70a and 7 0b will remain without etect.

When the cutting operation is terminated, therelay 61 is deenergized by breaking the foot switch 65 or thehand switch 82, 83, 84 in thehandles 80, and the switch arrangement is thus returned into its normal position.

In a similar manner therelay 61a in the channel II may subsequently be energized. By connecting the condenser 35 (in thecurrent selector 30a) in parallel With the condenser 93 (in the generator unit 90) the capacity in the input circuit of the generator unit 90- increases in this case to such an extent that the generator operates as blocking oscillator and produces oscilla-tions of the Itype illustrated in FIG. 5. Thus treatment currents suitable for carrying out coagulation are switched on to the treatment electrode of the channel II. The operation of thesignal lamp 66a indicates to the surgeon that this current is available. Energization of therelays 61 and 61b in the channels I and III, respectively, is prevented by the opening ofcontacts 54a and 55a which are controlled by therelay 61a.

The kind of current and power preset for the channel III can be made available at the end of the coagulation treatment effected by the use of the channel II by the excitation of therelay 61b. Actuation of therelay 61b causes the condenser 36 (in the current selector 30h) to be connected in parallel to the condenser 93 (in Vthe generator unit 90). The total capacity in the input of the generator unit is then still further increased as compared with that of the previously considered treatment, so that high-frequency currents are supplied by thegenerator 90 having the time characteristic shown in FIG. 6. In this instance, interrupted treatment currents are consequently produced for carrying out coagulation, having an amplitude which periodically drops rapidly from a high initial value to zero, and in which the individual periods are separated by gaps. 'I'he operation ofsignal lamp 66b indicates to the surgeon the availability of this current. Therelays 61 and 61a in the channels I and II, respectively, are prevented from energizing by the opening of the normally closed contacts 54b and SSb which are controlled by therelay 61b.

The channel IV is intended primarily for operatively connecting electrodes to be used selectively for cutting and coagulation. After an electrode handle suitable for this purpose has been connected to the -outpu-t socket 70e, the operator must, before commencing the treatment, set the kind of operation, Cutting for example, in the channel I and the kind of operation Coagulation in one of the other channels II or III, vfor example, in the channel II, in the manner already described. During the treatment it is then only necessary to manipulate either the switch mounted in the electrode handle or the foot switch 65C for switching on the treatment current and, when changing the kind of treatment, to manipulate themulticontact switch 111 of theselector unit 110. Assuming that themulticontact switch 111 is set so that its switch arms orwipers 112 and 113 lie on the contacts 114 and l117 respectively, the hand controlled switch in the electrode handle connected to theoutput 7 0c, or the foot switch 65e, is connected in parallel with the foot switch 65 in the channel I. Therefore, upon operating the hand or :foot switch in the channel IV, therelay 61 in the channel I is energized and, as above described, cutting current of the strength preset on theoutput regulator 40 is placed on the output socket 70C and consequently on the treatment electrode.

Should it be necessary to change over from cutting to coagulation during the treatment, that is, for example, with the foot controlled switch 65C closed, theswitch arms 112 and 113 of theselector switch 111 must be positioned to thecontacts 115 and 118 respectively. By changing over from one contact position to another, oftheselector switch 111, an interruption of the circuit which incorporates therelay 61 a-nd which is then closed by the foot switch 65C, is effected and therelay 61 in the channel I will be de-energ-ized. When thesecond switch position 115 is reached, therelay 61a in the channel II is energized by way of the switch 65C now in parallel with theswitch 65a in the channel II, and through its contacts thegenerator 90 is switched over in the manner described -for producing treatment currents suitable for coagulation. As the current strengths suitable for the cutting and also for the coagulation treatment are positively preset, a readjustment of power is not necessary after switching over from one type of treatment to the other.

When theswitch arm 113 of theselector switch 111 is set on the conta-ct 117, the signal lamp is actuated, Whereas thesignal lamps 121 `and 122 are illuminated when the switch arm is moved over to thecontacts 118 and 119 respectively. Consequently, the surgeon or operator has a means of checking the correct channel selection. For this purpose the pairs of signal lamps 66/120, 66a/'121 and 66b/122 may be provided with different channel markings or different color characteristics.

The current supply is effected in the examples above described by batteries to simplify the illustration thereof, but it is obvious that it can also be made available with a -power unit which is arranged -for connecting to direct current mains and/or alternating current mains.

From the above detailed description ofthe invention, it is believed that the construction will at once be apparent, and while there are herein shown and described preferred embodiments of the invention, it is nevertheless to be understood that changes may be made therein without departing from the spirit 'and scope of the appended claims.

We claim:

l. Apparat-us for electrical high-frequency surgery, comprising generator means for producing damped and nndamped electric oscillations, said generator means including an oscillator stage and a power stage, a plurality of outputs operatively connected to said generator means for connecting a plurality of active treatment electrodes to said apparatus, means cooperatively associated with each of said outputs Lfor preselecting a desired treatment current form attainable by `said generator means, means cooperatively associated with each of said outputs for preselecting the power to be respectively delivered thereby, said power preselecting means being interposed in parallel between the oscillator stage and the power stage of said generator means, and switching means cooperatively associated with each output for connecting the high frequency current of preselected oscillation yform and power to said output.

2. Apparatus for electrical high-frequency surgery, comprising generator means for producing damped and undamped electric oscillations, a plurality of outputs operatively connected to said generator'means for connecting a plurality of `active treatment electrodes to said apparatus, means cooperatively associated with each of said outputs for preselecting a desired treatment current form attainable by said generator means, means cooperatvely associated with each of said outputs for preselecting the power to be respectively delivered thereby, and switching means cooperatively associated with leach output for connecting .the high frequency current of preselected oscillation form and power to said output, a relay included in the switching means cooperatively associated with each output, a make contact controlled by one of said relays and disposed in the corresponding output circuit, and normally closed contact means also controlled by said relay and respectively disposed in series with windings of relays Vcooperatively associated with the other outputs.

3. Surgical apparatus operating with high frequency oscillations, comprising generator means for producing at least two kinds of electrical high frequency oscillations, namely, damped and undamped oscillations, means operatively connected to said generator means forming a plurality of outputs for the high frequency energy thereof, each output assigned to one of a plurality of active surgical electrodes, a plurality of current-type selectors corresponding in number to the number of outputs, an output regulator and relay means for control by the operator, said current-type selectors being operative to select the generator means for the production of the type of current for the respective output, said ouput regulator controlling the magnitude of the high frequency energy to be transmitted from the selected generator means to the respective output and said relays being operative to connect over the contacts thereof the selected generator means with the adjusted output at the respectively assigned output, a relay operatively controlled by the operator for each output for the high frequency energy, each such relay comprising make contact means for connecting the selected generator means with the respective output and comprising normal contace means corresponding in number to the number of outputs for the high frequency energy, less one, and means for interconnecting said contact means with the remaining relays, whereby one normal con-tact of one relay is connected in series with the energizing winding of one of the remaining relays.

References Cited in the file of this patent UNITED STATES PATENTS 1,645,215 Bauer Oct. 11, 1927 1,695,485 Payer Dec. 18, 1928 1,752,632 De Beaumond et al Apr` 1, 1930 1,863,118 Liebel June 14, 1932 1,945,867 Rawls Feb. 6, 1934

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