CN102665585A - 用于超声装置和用于电外科装置的外科发生器 - Google Patents

用于超声装置和用于电外科装置的外科发生器 Download PDF

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CN102665585A
CN102665585A CN201080056086XA CN201080056086A CN102665585A CN 102665585 A CN102665585 A CN 102665585A CN 201080056086X A CN201080056086X A CN 201080056086XA CN 201080056086 A CN201080056086 A CN 201080056086A CN 102665585 A CN102665585 A CN 102665585A
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generator
tissue
resistance
circuit
electrode
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CN102665585B (zh
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E·T·韦纳
J·L·奥尔德里奇
J·D·梅瑟利
J·R·乔达诺
F·B·斯图恩
M·C·米勒
J·P·威利
D·W·普赖斯
R·L·科克
J·A·布罗茨
J·E·海因
A·C·沃格勒
D·J·艾博特
S·B·基林格
M·A·戴维森
D·C·耶茨
G·M·莫
M·E·特比
W·E·克莱姆
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Ethicon Endo Surgery Inc
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Ethicon Endo Surgery Inc
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Abstract

本发明公开了一种外科发生器(102)，所述外科发生器可产生特定电压、电流和频率(如55，500周期/秒(Hz))的驱动信号。可将所述驱动信号提供到超声外科装置(104)，并且具体地讲提供到换能器。在一个实施例中，所述发生器可能够产生特定电压、电流和/或频率输出信号的驱动信号，所述输出信号可在高分辨率、精确性和再现性的情况下阶跃。另外，所述外科发生器可产生驱动信号，所述驱动信号具有足以使用射频(RF)能量进行双极电外科手术的输出功率。可将所述驱动信号提供到(例如)所述电外科装置(106)的电极。因此，所述发生器能够通过以下方法而被构造用于治疗目的：将电信号施加到超声换能器、或将足以用于处理所述组织(如切割、凝固、烧灼、组织焊接等)的电功率施加到所述组织。

Description

用于超声装置和用于电外科装置的外科发生器
相关专利申请的交叉引用
本申请根据Title 35，United States Code§119(e)(美国法典第35篇第119条(e))要求下述美国临时专利申请的优先权：该申请的序列号为61/250,217，于2009年10月9日提交，名称为“A DUALBIPOLAR AND ULTRASONIC GENERATOR FOR ELECTRO-SURGICAL INSTRUMENTS”(用于电外科器械的双重双极性和超声发生器)，其全文以引用方式并入本文。
本申请涉及下列同时提交的美国专利申请，其全文以引用方式并入本文：
(1)美国专利申请序列No.12/896,351，名称为“DEVICES ANDTECHNIQUES FOR CUTTING AND COAGULATINGTISSUE”(用于切割和凝固组织的装置和技术)，代理人案卷号为END6427USCIP1/080591CIP；
(2)美国专利申请序列No.12/896,360，名称为“SURGICALGENERATOR FOR ULTRASONIC AND ELECTROSURGICALDEVICES”(用于超声和电外科装置的外科发生器)，代理人案卷号为END6673USNP/100558；
(3)美国专利申请序列No.12/896,479，名称为“SURGICALGENERATOR FOR ULTRASONIC AND ELECTRO SURGICALDEVICES”(用于超声和电外科装置的外科发生器)，代理人案卷号为END6673USNP1/100557；
(4)美国专利申请序列No.12/869,345，名称为“SURGICALGENERATOR FOR ULTRASONIC AND ELECTROSURGICALDEVICES”(用于超声和电外科装置的外科发生器)，代理人案卷号为END6673USNP2/100559；
(5)美国专利申请序列No.12/896,384，名称为“SURGICALGENERATOR FOR ULTRASONIC AND ELECTROSURGICALDEVICES”(用于超声和电外科装置的外科发生器)，代理人案卷号为END6673USNP3/100560；
(6)美国专利申请序列No.12/896,467，名称为“SURGICALGENERATOR FOR ULTRASONIC AND ELECTROSURGICALDEVICES”(用于超声和电外科装置的外科发生器)，代理人案卷号为END6673USNP4/100562
(7)美国专利申请序列No.12/896,451，名称为“SURGICALGENERATOR FOR ULTRASONIC AND ELECTROSURGICALDEVICES”(用于超声和电外科装置的外科发生器)，代理人案卷号为END6673USNP5/100563；和
(8)美国专利申请序列No.12/896,470，名称为“SURGICALGENERATOR FOR ULTRASONIC AND ELECTROSURGICALDEVICES”(用于超声和电外科装置的外科发生器)，代理人案卷号为END6673USNP6/100564。
背景技术
多种实施例涉及外科装置和用于将能量提供到外科装置的发生器，以用于开放性或微创外科手术环境中。
超声外科装置(诸如超声刀)凭其独特的性能特性而在外科手术中日益得到广泛的应用。根据具体装置构型和操作参数，超声外科装置能够通过凝固提供基本上同时的组织切割和止血，从而有利地将患者创伤最小化。超声外科装置可包括：手持件，其包含超声换能器，和器械，其连接到超声换能器，超声换能器具有远端安装的端部执行器(如刀头)，以切割和密封组织。在一些情况下，该器械可永久性地固定到手持件。在其他情况下，该器械可从手持件拆卸，如就一次性器械或可在不同手持件之间互换的器械而言。端部执行器将超声能量传输到接触端部执行器的组织，以实现切割和密封动作。这一性质的超声外科装置可被构造用于开放性外科用途、腹腔镜或内窥镜手术操作，包括机器人辅助操作。
与电外科手术所用温度相比，超声能量使用较低的温度来切割和凝固组织，并且能够通过与手持件连通的超声发生器传输到端部执行器。通过高频振动(如55,500次/秒)，超声刀使组织中的蛋白变性，以形成粘的凝固物。通过刀片表面施加到组织上的压力使血管塌缩，并允许所述凝固物形成止血密封。外科医生能够通过如下参数来控制切割速度和凝固：通过端部执行器施加到组织的力、施加力的时间和端部执行器的选定偏移水平。
可将超声换能器建模成等效电路，所述等效电路包括第一支路，其具有静态电容；和第二“动态”支路，其具有限定共振器的机电特性的串联的电感、电阻和电容。已知的超声发生器可包括调谐感应器，所述调谐感应器用于使共振频率下的静态电容失谐，以使得发生器的基本上所有驱动信号电流都流入动态支路中。因此，通过使用调谐感应器，发生器的驱动信号电流表示动态支路电流，并且发生器因而能够控制其驱动信号，以保持超声换能器的共振频率。调谐感应器还可转化超声换能器的相位电阻图，以改善发生器的频锁能力。然而，调谐感应器必须与可操作共振频率下的超声换能器的具体静态电容相匹配。换句话讲，具有不同静态电容的不同超声换能器需要不同的调谐感应器。
另外，在一些超声发生器结构中，发生器的驱动信号显示具有非对称谐波失真，所述非对称谐波失真使电阻大小和相位测定值复杂化。例如，可因电流和电压信号的谐波失真而降低电阻相位测定值的精确性。
此外，噪声环境中的电磁干扰会降低发生器保持对超声换能器的共振频率的锁定的能力，从而增加无效控制算法输入的可能性。
用于将电功率施加到组织以便处理和/或破坏组织的电外科装置也在外科手术中日益得到广泛的应用。电外科装置可包括手持件和器械，该器械具有远端安装的端部执行器(如一根或多根电极)。端部执行器可设置为紧靠组织，使得电流被引入到组织中。电外科装置可被构造用于双极或单极操作。在双极操作期间，电流分别通过端部执行器的有源电极和回流电极引入组织中和从组织返回。在单极操作期间，电流通过端部执行器的有源电极引入组织中并且通过单独设置在患者身体上的回流电极(如接地垫)返回。由流过组织的电流产生的热可在组织内和/或在组织之间形成止血密封，并因此可尤其可用于(例如)密封血管。电外科装置的端部执行器还可包括可相对于组织移动的切割构件和横切组织的电极。
可将电外科装置施加的电功率通过与手持件连通的发生器传输到所述器械。电功率可为射频(“RF”)能量形式。RF能量为可位于300kHz至1MHz频率范围内的电功率形式。电外科装置在其工作期间可将低频RF能量传输通过组织，这会引起离子激化或摩擦(实际上为电阻生热)，从而增加组织的温度。由于可在受影响组织和周围组织之间形成清晰的边界，因此外科医生可以高度的精确性和可控性来操作，而不破坏非目标向的邻近组织。操作温度低的RF能量可用于在密封血管的同时移除、收缩或定型软组织。RF能量可尤其奏效地适用于结缔组织，所述结缔组织主要由胶原构成，并且在接触热时收缩。
超声和电外科装置因其独特的驱动信号、感测和反馈需要而通常需要不同的发生器。另外，在器械为一次性的或可与手持件互换的情况下，超声和电外科发生器的能力受限于识别所用的具体器械构型和相应地优化控制和诊断方法。此外，发生器的非隔离电路和患者隔离电路之间的电容连接，尤其是在使用较高电压和频率的情况下，可导致患者暴露于不合格水平的泄露电流。
发明内容
本发明公开了将驱动信号传送到外科装置的发生器的多种实施例。在一个实施例中，发生器可包括功率放大器，以接收时变驱动信号波形。能够通过多个驱动信号波形样本的至少一部分的数字-模转换来产生驱动信号波形。功率放大器的输出可用于产生驱动信号。驱动信号可包括如下信号中的一种：有待传送到超声外科装置的第一驱动信号、有待传送到电外科装置的第二驱动信号。发生器还可包括采样电路，以在将驱动信号传送到外科装置时产生驱动信号的电流和电压样本。该样本的产生可与驱动信号波形样本的数字-模转换同步，使得对于驱动信号波形样本的每一次数字-模转换而言，采样电路都产生对应组的电流和电压样本。发生器还可包括至少一个装置，所述至少一个装置被编程为针对每一个驱动信号波形样本和对应组的电流和电压样本都将所述电流和电压样本储存在所述至少一个装置的存储器中，以将储存的样本与驱动信号波形样本相关联。所述至少一个装置还可被编程为当驱动信号包括第一驱动信号时：基于储存的电流和电压样本来确定超声外科装置的动态支路电流样本；将动态支路电流样本与目标样本比较，所述目标样本选自限定目标波形的多个目标样本，所述目标样本是基于驱动信号波形样本进行选择的；确定目标样本和动态支路电流样本之间的大小误差；以及修改的驱动信号波形样本，使得在目标样本和后续动态支路电流样本之间确定的大小误差减小，所述后续动态支路电流样本取决于与所修改的驱动信号波形样本相关的电流和电压样本。
在一个实施例中，发生器可包括存储器和连接到存储器的装置，所述装置针对用于合成驱动信号的多个驱动信号波形样本中的每一个来接收驱动信号的对应组的电流和电压样本。对于每一个驱动信号波形样本和对应组的电流和电压样本而言，所述装置都可将所述样本储存在其存储器中，以将储存的样本与驱动信号波形样本相关联。另外，对于每一个驱动信号波形样本和对应组的电流和电压样本而言，所述装置都可在驱动信号包括有待传送到超声外科装置的第一驱动信号时，基于储存的样本确定超声外科装置的动态支路电流样本；将动态支路电流样本与目标样本比较，所述目标样本选自限定目标波形的多个目标样本，所述目标样本是基于驱动信号波形样本进行选择的；确定目标样本和动态支路电流样本之间的大小误差；以及修改的驱动信号波形样本，使得目标样本和后续动态支路电流样本之间测定的大小误差减小，所述后续动态支路电流样本取决于与所修改的驱动信号波形样本相关的电流和电压样本。
本发明还公开了如下方法的实施例，在换能器驱动信号的多个频率上，所述方法用于确定超声外科装置的超声换能器中的动态支路电流。在一个实施例中，所述方法可包括在换能器驱动信号的多个频率中的每一个下，过采换能器驱动信号的电流和电压；通过处理器接收电流和电压样本；以及由处理器基于电流和电压样本、超声换能器的静态电容和换能器驱动信号的频率来确定动态支路电流。
本发明还公开了如下方法的实施例，所述方法用于控制外科装置的超声换能器中的动态支路电流的波形形状。在一个实施例中，所述方法可包括通过使用直接数字合成(DDS)算法选择性地调用储存在查找表(LUT)中的驱动信号波形样本，产生换能器驱动信号；当将换能器驱动信号传送到外科装置时产生换能器驱动信号的电流和电压的样本；基于电流和电压样本、超声换能器的静态电容和换能器驱动信号的频率来确定动态支路电流的样本；将动态支路电流的每一个样本都与目标波形的相应目标样本进行比较，以确定大小误差；以及修改储存在LUT中的驱动信号波形样本，使得动态支路电流的后续样本和相应目标样本之间的大小误差减小。
根据多种实施例，用于将驱动信号提供到外科装置的外科发生器可包括第一变压器和第二变压器。第一变压器可包括第一主线圈和第一次线圈。第二变压器可包括第二主线圈和第二次线圈。外科发生器还可包括发生器电路，以产生驱动信号。发生器电路可电连接到第一主线圈，从而在整个第一主线圈上得到驱动信号。外科发生器还可包括与发生器电路电隔离的患者侧电路。患者侧电路可电连接到第一次线圈。此外，患者侧电路可包括第一输出线路和第二输出线路，以将驱动信号提供到外科装置。另外，外科发生器可包括电容器。电容器和第二次线圈可在第一输出线路和大地之间被串联电连接。
另外，根据多种实施例，用于将驱动信号提供到外科装置的外科发生器可包括第一变压器、患者侧电路和电容器。第一变压器可包括主线圈、第一次线圈和第二次线圈。第一次线圈相对于主线圈的极性可与第二次线圈的极性相反。发生器电路可产生驱动信号，并且可电连接到第一主线圈，从而在整个第一主线圈上得到驱动信号。患者侧电路可与发生器电路电隔离，并且可电连接到第一次线圈。另外，患者侧电路可包括第一输出线路和第二输出线路，以将驱动信号提供到外科装置。电容器和第二次线圈可在第一输出线路和大地之间被串联电连接。
另外，根据多种实施例，用于将驱动信号提供到外科装置的外科发生器可包括第一变压器、发生器电路、患者侧电路和电容器。第一变压器可包括主线圈和次线圈。发生器电路可产生驱动信号，并且可电连接到第一主线圈，从而在整个第一主线圈上得到驱动信号。患者侧电路可与发生器电路电隔离，并且可电连接到次线圈。此外，患者侧电路可包括第一输出线路和第二输出线路，以将驱动信号提供到外科装置。电容器可电连接到主线圈和第一输出线路。
根据多种实施例，用于将驱动信号提供到外科装置的外科发生器可包括第一变压器、发生器电路、患者侧电路以及第一电容器、第二电容器和第三电容器。第一变压器可包括主线圈和次线圈。发生器电路可产生驱动信号，并且可电连接到第一主线圈，从而在整个第一主线圈上得到驱动信号。患者侧电路可与发生器电路电隔离，并且可电连接到次线圈。此外，患者侧电路可包括第一输出线路和第二输出线路，以将驱动信号提供到外科装置。第一电容器的第一电极可电连接到主线圈。第二电容器的第一电极可电连接到第一输出线路，并且第二电容器的第二电极可电连接到第一电容器的第二电极。第三电容器的第一电极可电连接到第一电容器的第二电极和第二电容器的第二电极。第三电容器的第二电极可电连接到大地。
本发明还公开了外科装置控制电路的多种实施例。在一个实施例中，控制电路可包括具有至少一个第一开关的第一电路部分。第一电路部分能够通过导线对与外科发生器通信。控制电路还可包括具有数据电路元件的第二电路部分。数据电路元件可设置在外科装置的器械中，并且可发送或接收数据。数据电路元件能够通过导线对中的至少一条导线实施与外科发生器的数据通信。
在一个实施例中，控制电路可包括具有至少一个第一开关的第一电路部分。第一电路部分能够通过导线对与外科发生器通信。控制电路还可包括具有数据电路元件的第二电路部分。数据电路元件可设置在外科装置的器械中，并且可发送或接收数据。数据电路元件能够通过导线对中的至少一条导线实施与外科发生器的数据通信。第一电路部分可接收从外科发生器以第一频带发送的第一询问信号。数据电路元件可使用以第二频带发送的调幅通信协议与外科发生器通信。第二频带可高于第一频带。
在一个实施例中，控制电路可包括具有至少一个第一开关的第一电路部分。第一电路部分可接收从外科发生器通过导线对发送的第一询问信号。控制电路还可包括第二电路部分，所述第二电路部分包括设置在所述装置的器械中的电阻元件和感应元件中的至少一个。第二电路部分可接收从外科发生器通过导线对发送的第二询问信号。第二电路部分可与第一电路部分频带分离。当通过第一电路部分接收到第一询问信号时，第一询问信号的特性可表征至少一个第一开关的状态。当通过第二电路部分接收到第二询问信号时，第二询问信号的特性可独特地识别所述装置的器械。
在一个实施例中，控制电路可包括具有第一开关网络和第二开关网络的第一电路部分。第一开关网络可包括至少一个第一开关，并且第二开关网络可包括至少一个第二开关。第一电路部分能够通过导线对与外科发生器通信。控制电路还可包括具有数据电路元件的第二电路部分。数据电路元件可设置在外科装置的器械中，并且可发送或接收数据。数据电路元件能够通过导线对中的至少一条导线与外科发生器进行数据通信。
根据多种实施例，用于将驱动信号提供到外科装置的外科发生器可包括具有孔口的外科发生器主体。外科发生器还可包括设置在孔口中的插座组件。插座组件可包括插座主体和具有内壁和外壁的凸缘。内壁能够由至少一个弯曲部分和至少一个线性部分构成。内壁可限定腔体。中央凸出部分可设置在腔体中，并且可包括：多个承窝；和磁体。中央凸出部分的外周边可包括至少一个弯曲部分和至少一个线性部分。
根据多种实施例，外科器械可包括电连接器组件。电连接器组件可包括限定中央腔体的凸缘和延伸到中央腔体中的磁性相容引脚。电连接器组件可包括电路板和连接到电路板的多个导电引脚。多个导电引脚中的每一个都可延伸到中央腔体中。电连接器组件还可包括应变减轻构件和防护罩。
根据多种实施例，外科器械系统可包括具有插座组件的外科发生器。插座组件可包括至少一个弯曲部分和至少一个线性部分。外科器械系统可包括具有连接器组件和适配器组件的外科器械，所述适配器组件操作地连接到插座组件和连接器组件。适配器组件可包括接触插座组件的远端部分。远端部分可包括凸缘，其中所述凸缘具有至少一个弯曲部分和至少一个线性部分。适配器组件可包括接触连接器组件的近端部分。近端部分可限定尺寸被设计为接纳连接器组件的至少一部分的腔体。适配器组件还可包括电路板。
根据多种实施例，可使用方法(如结合外科器械)来实现多个外科目的。例如，用于控制通过第一电极和第二电极提供到组织的电功率的方法可包括：通过第一电极和第二电极将驱动信号提供到组织，并且根据感测的组织电阻，根据第一功率曲线，通过驱动信号调制提供到组织的电功率。第一功率曲线可为多个潜在感测的组织电阻中的每一个都限定第一对应功率。所述方法还可包括通过第一电极和第二电极监测提供到组织的总能量。当总能量达到第一能量阈值时，所述方法可包括确定组织的电阻是否已达到第一电阻阈值。所述方法还可包括：如果组织的电阻不能达到第一电阻阈值，则根据感测的组织电阻，根据第二功率曲线，通过驱动信号调制提供到组织的电功率。第二功率曲线可为多个潜在感测的组织电阻中的每一个都限定第二对应功率。
根据多种实施例，用于控制通过第一电极和第二电极提供到组织的电功率的方法可包括：通过第一电极和第二电极将驱动信号提供到组织，以及确定有待提供到组织的电功率。所述确定的步骤可包括：接收感测的组织电阻的指示；根据功率曲线确定用于感测的组织电阻的第一对应功率；以及通过倍增器来倍增对应功率。功率曲线可为多个潜在感测的组织电阻中的每一个都限定对应功率。所述方法还可包括：调制驱动信号，以将确定的电功率提供到组织，以及如果组织的电阻不能达到第一电阻阈值，则随着提供到组织的总能量来增加倍增器。
根据多种实施例，用于控制通过第一电极和第二电极提供到组织的电功率的方法可包括：通过第一电极和第二电极将驱动信号提供到组织，以及确定有待提供到组织的电功率。所述确定的步骤可包括：接收感测的组织电阻的指示；根据功率曲线确定用于感测的组织电阻的第一对应功率；以及通过第一倍增器来倍增对应功率，以找到确定的电功率。功率曲线可为多个潜在感测的组织电阻中的每一个都限定对应功率。所述方法还可包括：调制驱动信号，以将确定的电功率提供到组织，以及通过第一电极和第二电极监测提供到组织的总能量。另外，所述方法还可包括：当总能量达到第一能量阈值时，确定组织的电阻是否已达到第一电阻阈值；以及如果组织的电阻不能达到第一电阻阈值，则将第一倍增器增加第一量。
根据多种实施例，用于控制通过外科装置提供到组织的电功率的方法可包括：将驱动信号提供到外科装置；接收组织电阻的指示；计算组织电阻的增加速率；以及调制驱动信号，以将电阻的增加速率保持为大于或等于预定常数。
根据多种实施例，用于控制通过外科装置提供到组织的电功率的方法可包括提供驱动信号。驱动信号的功率可与通过外科装置提供到组织的电功率成比例。所述方法还可包括周期性地接收组织电阻的指示，并且将第一复合功率曲线应用到组织，其中将第一复合功率曲线应用到组织的步骤包括：将第一复合功率曲线应用到组织的步骤可包括：将第一预定数量的第一复合功率曲线脉冲调制到驱动信号上；以及对于第一复合功率曲线脉冲中的每一个而言，根据组织电阻的第一函数来确定脉冲功率和脉冲宽度。所述方法还可包括将第二复合功率曲线应用到组织。将第二复合功率曲线应用到组织的步骤可包括：将至少一个第二复合功率曲线脉冲调制到驱动信号上；以及对于至少一个第二复合功率曲线脉冲中的每一个而言，根据组织电阻的第二函数来确定脉冲功率和脉冲宽度。
附图说明
多种实施例的新型特征在所附权利要求书中进行了详细描述。然而，对组织和操作方法来说皆可以通过参照以下具体实施方式并结合附图最深刻地理解所描述的实施例，其中：
图1示出了包括发生器和可与其结合使用的多种外科器械的外科系统的一个实施例；
图2示出了可用于横切和/或密封的实例超声装置的一个实施例；
图3示出了图2的实例超声装置的端部执行器的一个实施例；
图4示出了也可用于横切和密封的实例电外科装置的一个实施例；
图5、图6和图7示出了图4所示的端部执行器的一个实施例；
图8为图1的外科系统的示意图；
图9为示出一个实施例中的动态支路电流的模型；
图10为一个实施例中的发生器结构的结构视图；
图11A-11C为一个实施例中的发生器结构的功能视图；
图12示出了在一个实施例中用于监测输入装置和控制输出装置的控制器；
图13示出了发生器的一个实施例的结构和功能方面；
图14-32和图33A-33C示出了控制电路的实施例；
图33D-33I示出了用于连接多种发生器和多种外科器械的电缆布线和适配器构型的实施例；
图34示出了用于漏电流的有源降噪的电路300的一个实施例；
图35示出了能够通过图1的发生器实施的用于提供漏电流的有源降噪的电路的一个实施例；
图36示出了能够通过图1的发生器实施的用于提供漏电流的有源降噪的电路的替代性实施例；
图37示出了能够通过图1的发生器实施的用于提供漏电流的有源降噪的电路的替代性实施例；
图38示出了能够通过图1的发生器实施的用于提供漏电流的有源降噪的电路的另一个实施例；
图39示出了能够通过图1的发生器实施的用于提供漏电流的有源降噪的电路的实施例；
图40示出了能够通过图1的发生器实施的用于提供漏电流的有源降噪的电路的另一个实施例；
图41示出了一个实施例中的插座组件和连接器组件接口；
图42为一个实施例中的插座组件的分解侧视图；
图43为一个实施例中的连接器组件的分解侧视图；
图44为图41所示的插座组件的透视图；
图45为一个实施例中的插座组件的分解透视图；
图46为一个实施例中的插座组件的前正视图；
图47为一个实施例中的插座组件的侧正视图；
图48为一个实施例中的承窝的放大视图；
图49为一个实施例中的连接器组件的透视图；
图50为一个实施例中的连接器组件的分解透视图；
图51为一个实施例中的连接器组件主体的侧正视图；
图52为一个实施例中的连接器组件主体的远端的透视图；
图53为一个实施例中的连接器组件主体的近端的透视图；
图54示出了一个实施例中的铁质引脚；
图55示出了一个实施例中的导电引脚和电路板；
图56示出了一个实施例中的应变减轻构件；
图57示出了一个实施例中的防护罩；
图58示出了根据多种非限制性实施例的两个适配器组件；
图59示出了一个实施例中的外科发生器；
图60示出了一个实施例中的连接到适配器组件的连接器组件；
图61示出了一个实施例中的插入到外科发生器的插座组件中的适配器组件；
图62示出了一个实施例中的连接到适配器组件的连接器组件；
图63示出了一个实施例中的发生器的后片的透视图；
图64示出了一个实施例中的发生器的后片；
图65和图66示出了一个实施例中的发生器的后片的不同部分；
图67示出了一个实施例中的用于控制发生器的神经网络；
图68示出了一个实施例中的测定温度与估算温度的对比图，估算温度由通过发生器控制的外科器械输出；
图69示出了显示实例功率曲线的图表的一个实施例；
图70示出了用于将一个或多个功率曲线应用到组织切口的工艺流程的一个实施例；
图71示出了显示可结合图70的工艺流程使用的实例功率曲线的图表的一个实施例；
图72示出了显示可结合图70的工艺流程使用的实例通用形状功率曲线的图表的一个实施例；
图73A示出了能够通过图1的发生器的数字装置进行的作用于新组织切口的例程的一个实施例；
图73B示出了能够通过图1的发生器的数字装置进行的监测组织电阻的例程的一个实施例；
图73C示出了能够通过图1的发生器的数字装置进行的将一个或多个功率曲线提供到组织切口的例程的一个实施例；
图74示出了用于将一个或多个功率曲线应用到组织切口的工艺流程的一个实施例；
图75示出了描述通过图1的发生器选择和施加复合负载曲线的框图的一个实施例；
图76示出了显示如通过图1的发生器实施的图75的算法的一个实施例的工艺流程；
图77示出了用于产生第一复合负载曲线脉冲的工艺流程的一个实施例；
图78示出了脉冲计时图的一个实施例，所述脉冲计时图示出了图76的算法通过图1的发生器的实例应用。
图79示出了根据实例复合负载曲线的驱动信号电压、电流和功率的图形表示；
图80-85示出了实例复合负载曲线的图形表示；并且
图86示出了描述应用算法以用于保持恒定的组织电阻变化速率的框图的一个实施例。
具体实施方式
在详细说明外科装置和发生器的多种实施例之前，应该指出的是，示例性实施例的应用或使用并不局限于附图和具体实施方式中详细示出的部件的构型和布置。示例性实施例可以单独实施，也可以与其它实施例、变更形式和修改形式结合在一起实施，并可以通过多种方式实践或执行。此外，除非另外指明，否则本文所用的术语和表达是为了方便读者而对示例性实施例进行描述目的所选的，并非为了限制性的目的。另外，应当理解，下述实施例、实施例表达和/或实例中的一个或多个可与下述其他实施例、实施例表达和/或实例中的任何一个或多个结合。
多种实施例涉及改善的超声外科装置、电外科装置以及与它们结合使用的发生器。超声外科装置的实施例可被构造用于例如在外科手术期间横切和/或凝固组织。电外科装置的实施例可被构造用于例如在外科手术期间横切、凝固、剥落、焊接和/或干燥组织。
发生器的实施例使用发生器驱动信号电流和电压的高速模-数字采样(如大约200x过采，这取决于频率)连同数字信号处理，从而与已知发生器结构相比得到多个优点和有益效果。在一个实施例中，例如，基于电流和电压反馈数据、超声换能器静态电容的值和驱动信号频率的值，发生器可确定超声换能器的动态支路电流。这提供实际调谐系统的有益效果并且模如下系统的存在，所述系统可利用任何频率下的静态电容(如图9中的C0)的任何值进行调谐或共振。因此，能够通过使静态电容的效果失谐来实现动态支路电流的控制，且无需使用调谐感应器。另外，消除调谐感应器的步骤可能不会降低发生器的频锁能力，因为能够通过适当地处理电流和电压反馈数据来实现频锁。
发生器驱动信号电流和电压的高速模-数字采样连同数字信号处理的步骤也可能使样本能够进行精确数字滤波。例如，发生器的实施例可使用在基础驱动信号频率和第二级谐波之间衰减的低通数字滤波器(如有限脉冲响应(FIR)滤波器)，以减少电流和电压反馈样本中的不对称谐波失真和EMI感应的噪声。过滤的电流和电压反馈样本基本上表示基础驱动信号频率，由此能够相对于基础驱动信号频率来进行更精确的电阻相位测定以及改善发生器保持共振频率锁定的能力。能够通过如下方式进一步地提高电阻相位测定的精确性：使下降沿和上升沿相位测定值平均化以及将测定的电阻相位调节至0°。
发生器的多种实施例也可使用发生器驱动信号电流和电压的高速模-数字采样连同数字信号处理来高精度地确定真实功耗和其他数量。这可允许发生器实施多种可用算法，诸如(例如)，控制当组织电阻变化时递送到组织的电功率量和控制电功率的递送，以保持组织电阻增加的恒定速率。
发生器的多种实施例可具有宽频率范围以及驱动超声外科装置和电外科装置所必要的增加的输出功率。能够通过宽带电源变压器上的专用分接头来满足电外科装置的较低电压、较高电流要求，由此就无需单独的功率放大器和输出变压器。此外，发生器的感测和反馈电路可支持大动态范围，由此解决具有最小失真的超声和电外科应用的需要。
多种实施例可为发生器提供简单经济的装置，以读取和任选地写入设置在如下器械中的数据电路(如单线总线装置，例如1-wire
Figure BPA00001564218000161
协议EEPROM)，所述器械使用现有多导线发生器/手持件电缆附接到手持件。这样，发生器能够从附接到手持件的器械检索和处理器械专用数据。这可使发生器能够提供较好的控制以及改善的诊断和误差检测。另外，发生器将数据写入所述器械的能力使如下形式的新功能成为可能，例如，跟踪器械用法和采集可操作数据。此外，频带的使用允许包含总线装置的器械与现有发生器的向后兼容性。
本发明所公开的发生器的实施例提供漏电流的有源降噪，所述漏电流是由发生器的在非隔离和患者隔离电路之间的非预期电容连接引起的。除了降低患者风险之外，减少漏电流的步骤也可降低电磁发射。
通过下文的具体实施方式，本发明的实施例的这些和其他有益效果将显而易见。
应当理解，本文使用的术语“近端”和“远端”是相对于紧握手持件的临床医生而言的。因此，端部执行器相对于较近的手持件而言处于远端。还应当理解，为方便和清晰起见，本文相对于紧握手持件的临床医生也可使用诸如“顶部”和“底部”之类的空间术语。然而，外科装置可在许多取向和位置使用，并且这些术语并非意图进行限制和绝对化的。
图1示出了外科系统100的一个实施例，所述外科系统100包括可能够与外科装置结合使用的发生器102。根据多种实施例，发生器102可能够与不同类型的外科装置结合使用，包括(例如)超声外科装置104和电外科或RF外科装置106。尽管在图1的实施例中，发生器102示出为与外科装置104、106分离，但在某些实施例中，发生器102可与外科装置104、106中的任一者一体地形成，以形成一体化外科系统。
图2示出了可用于横切和/或密封的实例超声装置104的一个实施例。装置104可包括手持件116，所述手持件116又可包括超声换能器114。换能器114可(例如)通过电缆122(如多导线电缆)与发生器102电气连通。换能器114可包括适用于将驱动信号的电功率转换成机械振动的压电陶瓷元件或其他元件或部件。当通过发生器102启动时，超声换能器114可引起纵向振动。振动能够通过装置104的器械部分124(如通过嵌入在外套管内的波导)传送到器械部分124的端部执行器126。
图3示出了实例超声装置104的端部执行器126的一个实施例。端部执行器126可包括能够通过波导(未示出)连接到超声换能器114的刀片151。当通过换能器114驱动时，刀片151可振动，并且当接触组织时，可切割和/或凝固组织，如本文所述。根据多种实施例，并且如图3所示，端部执行器126还可包括夹持臂155，该夹持臂155可能够与端部执行器126的刀片151协同作用。结合刀片151，夹持臂155可包括一组钳口140。夹持臂155可以可枢转地连接到器械部分124的轴153的远端。夹持臂155可包括夹持臂组织垫163，该夹持臂组织垫163能够由TEFLON
Figure BPA00001564218000171
或其他合适的低摩擦材料形成。垫163可被安装用于与刀片151协作，其中夹持臂155的枢转移动将夹持垫163设置为与刀片151呈大致平行关系或相接触。通过这种构造，有待夹持的组织切口可在组织垫163和刀片151之间被抓住。组织垫163可设置有锯齿状构型(包括多个轴向间隔的、向近端延伸的紧握齿161)以与刀片151协作来提高对组织的紧握效果。夹持臂155可以任何合适的方式从图3所示的打开位置过渡到关闭位置(其中夹持臂155接触或靠近刀片151)。例如，手持件116可包括钳口闭合扳机138。当通过临床医生致动时，钳口闭合扳机138可以任何合适的方式来枢转夹持臂155。
可启动发生器102以将驱动信号以任何合适的方式提供到换能器114。例如，发生器102可包括通过脚踏开关电缆122(图8)连接到发生器102的脚踏开关120。临床医生能够通过压下脚踏开关120来启动换能器114并由此启动换能器114和刀片151。除脚踏开关120之外或取代脚踏开关120，装置104的一些实施例还可使用设置在手持件116上的一个或多个开关，所述一个或多个开关在启动时可引起发生器102启动换能器114。在一个实施例中，例如，所述一个或多个开关可包括一对触发按钮136a、136b，以(例如)确定装置104的操作模式。当压下触发按钮136a时，例如，超声发生器102可将最大驱动信号提供到换能器114，从而使其产生最大的超声能量输出。压下触发按钮136b可引起超声发生器102将用户可选的驱动信号提供到换能器114，从而使其产生小于最大值的超声能量输出。另外或作为另外一种选择，装置104还可包括第二开关，以(例如)指示用于操作端部执行器126的钳口140的钳口闭合扳机138的位置。另外，在一些实施例中，可基于钳口闭合扳机138的位置来启动超声发生器102(如当临床医生压下钳口闭合扳机138以闭合钳口140时，可施加超声能量)。
另外或作为另外一种选择，所述一个或多个开关还可包括触发按钮136c，所述触发按钮136c在压下时使得发生器102提供脉冲输出。可(例如)以任何合适的频率和编组提供脉冲。在某些实施例中，脉冲的功率水平可为(例如)与触发按钮136a、b相关的功率水平(最大值、小于最大值)。
应当理解，装置104可包括触发按钮136a、b、c的任何组合。例如，装置104可能够仅具有两个触发按钮：用于产生最大超声能量输出的触发按钮136a和用于产生最大或小于最大的功率水平下的脉冲输出的触发按钮136c。这样，发生器102的驱动信号输出模式可为5个连续信号和5个或4个或3个或2个或1个脉冲信号。在某些实施例中，可基于(例如)发生器102中的EEPROM设置和/或用户功率水平选择来控制具体的驱动信号模式。
在某些实施例中，可将两位开关提供为触发按钮136c的替代形式。例如，装置104可包括：触发按钮136a，其用于在最大功率水平下产生连续输出；和两位触发按钮136b。在第一关闭位置中，触发按钮136b可在小于最大的功率水平下产生连续输出，并且在第二关闭位置中，触发按钮136b可产生脉冲输出(如最大或小于最大的功率水平下的脉冲输出，这取决于EEPROM设置)。
在一些实施例中，端部执行器126还可包括一对电极159、157。电极159、157可(例如)通过电缆122与发生器102通信。电极159、157可用于(例如)测定存在于夹持臂155和刀片151之间的组织切口的电阻。发生器102可将信号(如非治疗信号)提供到电极159、157。可(例如)通过监测信号的电流、电压等来找到组织切口的电阻。
图4示出了也可用于横切和密封的实例电外科装置106的一个实施例。根据多种实施例，横切和密封装置106可包括手持件组件130、轴165和端部执行器132。轴165可为刚性的(如，对于腹腔镜和/或开放性外科应用)或柔性的(如，对于内窥镜应用)，如图所示。在多种实施例中，轴165可包括一个或多个接合点。端部执行器132可包括具有第一钳口构件167和第二钳口构件169的钳口144。第一钳口构件167和第二钳口构件169可连接到U形夹171，所述U形夹171又可连接到轴165。平移构件173可在轴165内从端部执行器132延伸到手持件130。在手持件130处，轴165可直接或间接地连接到钳口闭合扳机142(图4)。
端部执行器132的钳口构件167、169可包括相应的电极177、179。电极177、179能够通过电导线187a、187b(图5)(如通过多导线电缆128)连接到发生器102，所述电导线187a、187b从端部执行器132穿过轴165和手持件130并最终延伸到发生器102。发生器102可将驱动信号提供到电极177、179，以对存在于钳口构件167、169内的组织产生治疗效果。电极177、179可包括有源电极和回流电极，其中所述有源电极和所述回流电极可抵靠或邻近有待处理的组织进行设置，使得电流可从有源电极通过组织流到回流电极。如图4所示，端部执行器132显示具有处于打开位置的钳口构件167、169。往复式刀片175示于钳口构件167、169之间。
图5、图6和图7示出了图4所示的端部执行器132的一个实施例。为了闭合端部执行器132的钳口144，临床医生可使钳口闭合扳机142沿箭头183从第一位置枢转到第二位置。这可根据任何合适的方式使钳口144打开和闭合。例如，钳口闭合扳机142的运动又可引起平移构件173在轴165的腔体185内平移。平移构件173的远端部分可连接到往复式构件197，使得平移构件173的远端和近端运动引起往复式构件的对应远端和近端运动。往复式构件197可具有肩部191a、191b，而钳口构件167、169可具有对应凸轮表面189a、189b。当往复式构件197从图6所示的位置向远端平移到图7所示的位置时，肩部191a、191b可接触凸轮表面189a、189b，从而使得钳口构件167、169过渡到关闭位置。另外，在多种实施例中，刀片175可设置在往复式构件197的远端处。随着往复式构件延伸到图7所示的完全远端位置，刀片175可在该过程中推过存在于钳口构件167、169之间的任何组织，从而切割该组织。
使用时，临床医生可设置端部执行器132，并且(例如)通过沿如所述箭头183枢转钳口闭合扳机142来闭合围绕将被作用的组织切口的钳口144。一旦组织切口固定在钳口144之间，临床医生就可开始通过发生器102和穿过电极177、179来提供RF或其他电外科能量。可以任何合适的方式来完成RF能量的提供。例如，临床医生可启动发生器102的脚踏开关120(图8)以开始提供RF能量。另外，例如，手持件130可包括一个或多个开关181，所述一个或多个开关181能够由临床医生致动，以引起发生器102开始提供RF能量。另外，在一些实施例中，可基于钳口闭合扳机142的位置来提供RF能量。例如，当完全压下扳机142(表明钳口144被闭合)时，可提供RF能量。另外，根据多种实施例，可在钳口144闭合期间推进刀片175或可在钳口144闭合之后(如在RF能量已施加到组织之后)由临床医生独立地推进刀片175。
图8为图1的外科系统100的示意图。在多种实施例中，发生器102可包括若干单独的功能性元件，诸如模块和/或区块。不同的功能性元件或模块可被构造用于驱动不同类型的外科装置104、106。例如，超声发生器模块108可驱动超声装置，诸如超声装置104。电外科/RF发生器模块110可驱动电外科装置106。例如，相应的模块108、110可产生用于驱动外科装置104、106的相应的驱动信号。在多种实施例中，超声发生器模块108和/或电外科/RF发生器模块110可各自与发生器102一体地形成。作为另外一种选择，模块108、110中的一个或多个可提供为电连接到发生器102的单独电路模块。(模块108和110以虚线显示以示出这种选择。)另外，在一些实施例中，电外科/RF发生器模块110可与超声发生器模块108一体地形成，反之亦然。
根据所述实施例，超声发生器模块108可产生特定电压、电流和频率(如55,500周期/秒(Hz))的驱动信号。可将驱动信号提供到超声装置104，并且具体地讲提供到可(例如)如上文所述进行工作的换能器114。在一个实施例中，发生器102可能够产生特定电压、电流和/或频率输出信号的驱动信号，所述输出信号可在高分辨率、精确性和再现性的情况下阶跃。
根据所述实施例，电外科/RF发生器模块110可产生驱动信号，该驱动信号具有足以使用射频(RF)能量进行双极电外科手术的输出功率。在双极电外科手术应用中，驱动信号可提供到(例如)电外科装置106的电极177、179，例如，如上文所述。因此，发生器102能够通过将足以用于处理组织(如凝固、烧灼、组织焊接等)的电功率施加到组织而被构造用于治疗目的。
发生器102可包括位于(例如)发生器102控制台的前面板上的输入装置145(图1)。输入装置145可包括产生适于对发生器102的操作进行编程的信号的任何合适装置。操作中，用户可使用输入装置145对发生器102的操作进行编程或换句话讲控制发生器102的操作。输入装置145可包括产生如下信号的任何合适装置，所述信号可被发生器使用(如被包含在发生器中的一个或多个处理器使用)，以控制发生器102的操作(如超声发生器模块108和/或电外科/RF发生器模块110的操作)。在多种实施例中，输入装置145包括按钮、开关、指轮、键盘、小键盘、触摸屏监视器、指点器中的一个或多个，所述输入装置远程连接到通用或专用计算机。在其他实施例中，输入装置145可包括合适的用户界面，诸如显示在(例如)触摸屏监视器上的一个或多个用户界面屏。因此，通过输入装置145，用户可设定发生器的多种操作参数或对发生器的多种操作参数进行编程，诸如(例如)，通过超声发生器模块108和/或电外科/RF发生器模块110产生的驱动信号的电流(I)、电压(V)、频率(f)和/或周期(T)。
发生器102还可包括位于(例如)发生器102控制台的前面板上的输出装置147(图1)。输出装置147包括用于为用户提供感观反馈的一个或多个装置。此类装置可包括(例如)视觉反馈装置(如LCD显示屏、LED指示器)、听觉反馈装置(如扬声器、蜂鸣器)或触觉反馈装置(如触觉致动器)。
尽管发生器102的某些模块和/或区块可以举例的方式进行描述，但可以理解，更大或更小数量的模块和/或区块可被使用，并仍在实施例的范围内。此外，虽然多种实施例可按照模块和/或区块的形式描述，以有利于说明，但这些模块和/或区块能够通过一个或多个硬件部件和/或软件部件和/或硬件和软件部件的组合加以实施，所述硬件部件为如处理器、数字信号处理器(DSP)、可编程逻辑装置(PLD)、专用集成电路(ASIC)、电路、寄存器，所述软件部件为如程序、子例程、逻辑。
在一个实施例中，超声发生器驱动模块108和电外科/RF驱动模块110可包括实施为固件、软件、硬件或它们的任何组合的一个或多个嵌入式应用程序。模块108、110可包括多种可执行模块，诸如软件、程序、数据、驱动器、应用程序接口(API)等。所述固件可储存在非易失性存储器(NVM)(诸如位屏蔽只读存储器(ROM)或闪速存储器)中。在多种具体实施中，将固件储存在ROM中的步骤可保护闪速存储器。NVM可包括其它类型的存储器，包括(例如)可编程ROM(PROM)、可擦除可编程ROM(EPROM)、电可擦除可编程ROM(EEPROM)或电池支持的随机存取存储器(RAM)(诸如动态RAM(DRAM)、双数据率DRAM(DDRAM)和/或同步DRAM(SDRAM))。
在一个实施例中，模块108、110包括实施为处理器的硬件部件，所述处理器用于执行监测装置104、106的多种可测量特性的程序指令并产生用于操作装置104、106的相应输出驱动信号。在其中发生器102与装置104结合使用的实施例中，驱动信号可驱动切割和/或凝固操作模式中的超声换能器114。可测量装置104和/或组织的电特性并将其用于控制发生器102的可操作方面和/或为用户提供反馈。在其中发生器102与装置106结合使用的实施例中，驱动信号可将电功率(如RF能量)提供到切割、凝固和/或干燥模式中的端部执行器132。可测量装置106和/或组织的电特性并将其用于控制发生器102的可操作方面和/或为用户提供反馈。在多种实施例中，如此前讨论，硬件部件可实施为DSP、PLD、ASIC、电路和/或寄存器。在一个实施例中，处理器可能够储存和执行计算机软件程序指令，以产生用于驱动装置104、106的多种部件(诸如超声换能器114和端部执行器126、132)的阶跃函数输出信号。
图9示出了根据一个实施例的超声换能器(诸如超声换能器114)的等效电路150。电路150包括具有串联的电感Ls、电阻Rs和电容Cs的第一“动态”支路(限定共振器的机电特性)和具有静态电容C0的第二电容支路。可从驱动电压Vg下的发生器接收驱动电流Ig，其中动态电流Im流过第一支路并且电流Ig-Im流过电容支路。能够通过适当控制Ig和Vg来实现超声换能器的机电特性的控制。如上所述，已知的发生器结构可包括调谐感应器Lt(在图9中以虚线显示)，该调谐感应器Lt用于使并联共振电路中共振频率下的静态电容C0失谐，以使得发生器的基本上全部的输出电流Ig均流过动态支路。这样，通过控制发生器的输出电流Ig来实现动态支路电流Im的控制。然而，调谐感应器Lt专用于超声换能器的静态电容C0，并且具有不同静态电容的不同超声换能器需要不同的调谐感应器Lt。此外，由于调谐感应器Lt匹配单一共振频率下的静态电容C0的标称值，因此仅能确保该频率下的动态支路电流Im的精确控制，并且当频率随换能器温度下移时，动态支路电流的精确控制将失能。
发生器102的多种实施例可以不依赖于调谐感应器Lt来监测动态支路电流Im。相反，发生器102可使用在专用超声外科装置104的功率应用中间的静态电容C0的测量值(连同驱动信号电压和电流反馈数据)来动态和持续地(如实时地)确定动态支路电流Im的值。发生器102的这种实施例因此能够提供实际的调谐，以模如下系统，所述系统可利用任何频率且并非只是单一共振频率(通过静态电容C0的标称值指定)下的静态电容C0的任何值进行调谐或共振。
图10为发生器102的一个实施例的简化框图，除了其他有益效果之外，所述发生器102还用于验证如上所述的非电感调谐。图11A-11C示出了根据一个实施例的图10的发生器102的结构。参照图10，发生器102可包括通过电源变压器156与非隔离工位154通信的患者隔离工位152。电源变压器156的次线圈158包含在隔离工位152中，并且可包括分接头构造(如中心分接头或非中心分接头构造)，以限定驱动信号输出端160a、160b、160c，以用于将驱动信号输出到不同的外科装置，诸如(例如)，超声外科装置104和电外科装置106。具体地讲，驱动信号输出端160a、160c可将驱动信号(如420V RMS驱动信号)输出到超声外科装置104，并且驱动信号输出端160b、160c可将驱动信号(如100V RMS驱动信号)输出到电外科装置106，其中输出端160b对应于电源变压器156的中心分接头。非隔离工位154可包括功率放大器162，所述功率放大器162具有连接到电源变压器156的主线圈164的输出端。在某些实施例中，功率放大器162可包括(例如)推挽放大器。非隔离工位154还可包括用于将数字输出提供到数字-模转换器(DAC)168的可编程逻辑器件166，所述数字-模转换器(DAC)168继而将相应的模信号提供到功率放大器162的输入端。在某些实施例中，可编程逻辑器件166可包括(例如)现场可编程门阵列(FPGA)。可编程逻辑器件166通过DAC 168来控制功率放大器162的输入，因此可控制出现在驱动信号输出端160a、160b、160c处的驱动信号的多个参数(如频率、波形形状、波形大小)中的任何者。在某些实施例中并且如下文所述，可编程逻辑器件166与处理器(如下文所述的处理器174)相结合可实施多个基于数字信号处理(DSP)的控制算法和/或其他控制算法，以控制通过发生器102输出的驱动信号的参数。
能够通过开关模式调节器170将功率提供到功率放大器162的功率干线。在某些实施例中，开关模式调节器170可包括(例如)可调式降压调节器。非隔离工位154还可包括处理器174，在一个实施例中所述处理器174可包括(例如)得自Analog Devices(Norwood，MA)的DSP处理器(诸如Analog Devices ADSP-21469SHARC DSP)。在某些实施例中，处理器174可响应由处理器174通过模数字转换器(ADC)176从功率放大器162接收的电压反馈数据来控制开关模式功率转换器170的操作。在一个实施例中，例如，处理器174能够通过ADC 176接收通过功率放大器162放大的信号(如RF信号)的波形包络作为输入。处理器174随后可控制开关模式调节器170(如通过脉冲宽度调制(PWM)输出)，使得提供到功率放大器162的干线电压跟踪放大信号的波形包络。相对于固定干线电压放大器方案而言，通过基于波形包络来动态地调制功率放大器162的干线电压，可显著改善功率放大器162的效率。
在某些实施例中并且如结合图13更详细所述，可编程逻辑器件166与处理器174相结合可实施直接数字合成器(DDS)控制方案，以控制通过发生器102输出的驱动信号的波形形状、频率和/或大小。在一个实施例中，例如，可编程逻辑器件166能够通过调用储存在动态更新查找表(LUT)(诸如可嵌入在FPGA中的RAM LUT)中的波形样本来实施DDS控制算法268。该控制算法尤其可用于如下超声应用，其中超声换能器(诸如超声换能器144)能够由其共振频率下的纯正弦电流驱动。由于其他频率可激发寄生共振，因此使动态支路电流的总失真最小化或降低的步骤可相应地使不利的共振效应最小化或降低。由于发生器102输出的驱动信号的波形形状受存在于输出驱动电路(如电源变压器156、功率放大器162)中的多种失真源影响，因此可将基于驱动信号的电压和电流反馈数据输入到算法(诸如通过处理器174实施的误差控制算法)中，从而通过动态和持续地(如实时地)适当预失真或修改储存在LUT中的波形样本来补偿失真。在一个实施例中，施加到LUT样本的预失真的数量或程度可取决于在计算的动态支路电流和所需电流波形形状之间的误差，其中所述误差是基于逐个样本确定的。这样，预失真的LUT样本，在通过驱动电路进行处理时，可产生具有所需波形形状(如正弦)的动态支路驱动信号，以用于最佳地驱动超声换能器。在此类实施例中，LUT波形样本将因此并不表示驱动信号的所需波形形状，而是表示如下波形形状，其要求用于最终产生考虑失真效果时的动态支路驱动信号的所需波形形状。
非隔离工位154还可包括ADC 178和ADC 180，所述ADC 178和ADC 180通过相应的隔离变压器182、184连接到电源变压器156的输出端，以分别对通过发生器102输出的驱动信号的电压和电流采样。在某些实施例中，ADC 178、180可能够以高速(如80Msps)采样80，以使得能够对驱动信号进行过采。在一个实施例中，例如，ADC178、180的采样速率可使得能够对大约200x(取决于驱动频率)驱动信号进行过采。在某些实施例中，能够通过单个ADC来执行ADC178、180的采样操作，所述单个ADC通过双路复用器来接收输入电压和电流信号。除了别的以外，在发生器102的实施例中使用高速采样的步骤还可使得能够计算流过动态支路的复合电流(这在某些实施例中可用于实施上述基于DDS的波形形状控制)、精确地数字滤波所采样信号和高精度地计算真实功耗。ADC 178、180输出的电压和电流反馈数据能够由可编程逻辑器件166接收和处理(如FIFO缓冲、复用)，并将其储存在数据存储器中，以用于由(例如)处理器174后续检索。如上所述，可将电压和电流反馈数据用作如下算法的输入，所述算法用于动态和持续地预失真或修改LUT波形样本。在某些实施例中，这可能需要每一个储存的电压和电流反馈数据对基于对应的LUT样本都进行索引或换句话讲与对应的LUT样本相关联，在采集电压和电流反馈数据对时，所述对应的LUT样本由可编程逻辑器件166输出。以此方式使LUT样本与电压和电流反馈数据同步的步骤有助于预失真算法的准确计时和稳定性。
在某些实施例中，可使用电压和电流反馈数据来控制驱动信号的频率和/或大小(如电流大小)。在一个实施例中，例如，可使用电压和电流反馈数据来确定电阻相位。然后可控制驱动信号的频率，以使在所确定电阻相位和电阻相位设定点(如0°)之间的差值最小化或减小，从而使谐波失真的影响最小化或减小，并相应地增加电阻相位测量准确性。可在处理器174中实施相位电阻和频率控制信号的测定，例如，其中将频率控制信号作为输入提供到由可编程逻辑器件166实施的DDS控制算法。
在另一个实施例中，例如，可监测电流反馈数据，以便保持电流大小设定点下的驱动信号的电流大小。可直接指定或根据指定的电压大小和功率设定点来间接地确定电流大小设定点。在某些实施例中，能够通过处理器174中的控制算法(诸如(例如)，比例积分微分(PID)控制算法)来实现电流大小的控制。通过控制算法控制以适当控制驱动信号的电流大小的变量可包括(例如)储存在可编程逻辑器件166中的LUT波形样本的定标和/或经由DAC 186的DAC 168(其为功率放大器162提供输入)的最大定标输出电压。
除了别的以外，非隔离工位154还可包括用于提供用户接口(UI)功能的处理器190。在一个实施例中，处理器190可包括(例如)得自Atmel Corporation(San Jose，California)的具有ARM 926EJ-S核的AtmelAT91SAM9263处理器。处理器190支持的UI功能的实例可包括听觉和视觉用户反馈、与外围设备通信(如通过通用串行总(USB)接口线)、与脚踏开关120通信、与输入装置112(如触摸屏显示器)通信以及与输出装置147(如扬声器)通信。处理器190可与处理器174和可编程逻辑器件(如经由串行外围接口(SPI)总线)通信。尽管处理器190可主要支持UI功能，但在某些实施例中其也可与处理器174配合来实施危险的减轻。例如，可以对处理器190进行编程，以监测用户输入和/或其他输入(如触摸屏输入、脚踏开关120输入、温度传感器输入)的各个方面，并且可在检测到错误情况时使发生器102的驱动输出无效。
在某些实施例中，处理器174和处理器190均可测定和监测发生器102的操作状态。对于处理器174，发生器102的操作状态可指示(例如)处理器174实施了哪些控制和/或诊断方法。对于处理器190，发生器102的操作状态可指示(例如)用户接口的哪些元素(如显示屏、声音)提供给用户。处理器174、190可独立地保持发生器102的当前工作状态，并且识别和评价当前操作状态中的可能过渡。处理器174可充当此关系中的主机，并且确定何时将发生操作状态间的过渡。处理器190可知道操作状态间的有效过渡并且可确定某个过渡是否适当。例如，当处理器174指示处理器190过渡到特定状态时，处理器190可验证所请求过渡的有效性。如果状态间的所请求过渡经处理器190确定为无效，则处理器190可使发生器102进入失效模式。
非隔离工位154还可包括用于监测输入装置145的控制器196(如用于打开和关闭发生器102的电容触摸传感器、电容触摸屏)。在某些实施例中，控制器196可包括至少一个处理器和/或与处理器190通信的其他控制器装置。在一个实施例中，例如，控制器196可包括处理器(如得自Atmel的Mega168 8位控制器)，所述处理器能够监测通过一个或多个电容触摸传感器提供的用户输入。在一个实施例中，控制器196可包括触摸屏控制器(如得自Atmel的QT5480触摸屏控制器)，以控制和管理从电容触摸屏采集的触摸数据。
在某些实施例中，当发生器102处于“断电”状态时，控制器196可继续接收工作电源(如通过来自发生器102的电源(例如下述电源211)的线路)。这样，控制器196可继续监测用于打开和关闭发生器102的输入装置145(如位于发生器102的前面板上的电容触摸传感器)。当发生器102处于断电状态时，如果检测到用户激活“打开/关闭”输入装置145，则控制器196可唤醒电源(如启用操作电源211的一个或多个DC/DC电压转换器)。控制器196可因此引发用于将发生器102过渡成“通电”状态的序列。反之，当发生器102处于通电状态时，如果检测到激活“打开/关闭”输入装置145，则控制器196可引发用于将发生器102过渡成断电状态的序列。在某些实施例中，例如，控制器196可将“打开/关闭”输入装置145的激活报告给处理器190，所述处理器190继而实施用于将发生器102过渡成断电状态的必要处理序列。在此类实施例中，控制器196可能无法在发生器102的通电状态已确立之后独立地导致从发生器102移除电源。
在某些实施例中，控制器196可使发生器102提供听觉或其他感观反馈，以用于提醒用户已引发通电或断电序列。可在通电或断电序列开始时以及在与该序列相关的其他过程开始之前提供这种提醒。
在某些实施例中，隔离工位152可包括器械接口电路198，以(例如)提供在外科装置的控制电路(如包括手持件开关的控制电路)和非隔离工位154的部件(诸如(例如)，可编程逻辑器件166、处理器174和/或处理器190)之间的通信接口。器械接口电路198能够通过通信连接装置(诸如(例如)基于红外(IR)的通信连接装置)与非隔离工位154的部件交换信息，所述通信连接装置保持工位152、154之间适当程度的电隔离。可使用(例如)低压降稳压器将功率提供到器械接口电路198，所述低压降稳压器通过从非隔离工位154驱动的隔离变压器供能。
在一个实施例中，器械接口电路198可包括与信号调节电路202通信的可编程逻辑器件200(如FPGA)。信号调节电路202可能够接收得自可编程逻辑器件200的周期信号(如2kHz方波)，以产生具有相同频率的双极性询问信号。可(例如)使用由差动放大器馈送的双极性电流源来产生询问信号。询问信号可被传送到外科装置控制电路(如通过使用将发生器102连接到外科装置的电缆中的导线对)并且可被监测，以确定控制电路的状态或模式。如下文结合图16-32所述，例如，控制电路可包括多个开关、电阻器和/或二极管，以修改询问信号的一个或多个特性(如大小、整流)，使得基于所述一个或多个特性可独特地识别控制电路的状态或模式。在一个实施例中，例如，信号调节电路202可包括ADC，所述ADC用于产生出现在控制电路的整个输入端上的电压信号(因询问信号从中穿过而引起)的样本。可编程逻辑器件200(或非隔离工位154的部件)然后可基于ADC样本来确定控制电路的状态或模式。
在一个实施例中，器械接口电路198可包括第一数据电路接口204，所述第一数据电路接口204使得在可编程逻辑器件200(或器械接口电路198的其他元件)和设置在外科装置内或换句话讲与外科装置相关的第一数据电路之间能够进行信息交换。在某些实施例中并且参照图33E-33G，例如，第一数据电路206可设置在一体化附接到外科装置手持件的电缆中或用于接合具有发生器102的专用外科装置类型或模型的适配器中。在某些实施例中，第一数据电路可包括非易失性存储装置，诸如电可擦可编程只读存储器(EEPROM)装置。在某些实施例中并且再次参考图10，第一数据电路接口204可独立于可编程逻辑器件200而实现，并且包括适当的电路(如离散逻辑器件、处理器)，以使得在可编程逻辑器件200和第一数据电路之间能够进行通信。在其他实施例中，第一数据电路接口204与可编程逻辑器件200可为一体的。
在某些实施例中，第一数据电路206可储存属于与其相关的具体外科装置的信息。此类信息可包括(例如)型号、序列号、其中已使用外科装置的多个操作和/或任何其他类型的信息。此信息能够由器械接口电路198(如由可编程逻辑器件200)读取、传送到非隔离工位154的部件(如传送到可编程逻辑器件166、处理器174和/或处理器190)，以用于通过输出装置147提供给用户和/或用于控制发生器102的功能或操作。另外，能够通过第一数据电路接口204(如使用可编程逻辑器件200)将任何类型的信息传送到第一数据电路206，以用于在其中储存。此类信息可包括(例如)其中已使用外科装置的已更新的操作次数以及/或其使用的日期和/或时间。
如此前所述，外科器械可从手持件拆卸(如器械124可从手持件116拆卸)，以提高器械的互换性和/或可任意处置性。在这种情况下，已知发生器的能力可限于识别所用的具体器械构型和由此优化控制和诊断方法。然而，从相容性观点来看，仍然难以将可读数据电路添加到外科装置器械来解决上述情况。例如，由于(例如)不同的信号方案、设计复杂性和成本的缘故，所以，设计与不含必要数据读取功能的发生器保持向后兼容性的外科装置是不切实际的。下文结合图16-32所述的器械的实施例，通过使用如下数据电路解决了这些问题，所述数据电路可在现有外科器械中以经济且设计变更最小的方式实现，以保持外科装置与当前发生器平台的兼容性。
另外，发生器的实施例102可使得能够与基于器械的数据电路(诸如下文结合图16-32和图33A-33C所述的那些)进行通信。例如，发生器102可能够与包含在外科装置的器械(如器械124或134)中的第二数据电路(如图16的数据电路284)通信。器械接口电路198可包括能够进行该通信的第二数据电路接口210。在一个实施例中，第二数据电路接口210可包括三态数字接口，但也可使用其他接口。在某些实施例中，第二数据电路通常可为用于发送和/或接收数据的任何电路。在一个实施例中，例如，第二数据电路可储存属于与其相关的具体外科装置的信息。此类信息可包括(例如)型号、序列号、其中已使用外科器械的多个操作和/或任何其他类型的信息。另外或作为另外一种选择，能够通过第二数据电路接口210(如使用可编程逻辑器件200)将任何类型的信息传送到第二数据电路，以用于在其中储存。此类信息可包括(例如)其中已使用器械的已更新的操作次数以及/或其使用的日期和/或时间。在某些实施例中，第二数据电路可发送由一个或多个传感器(如基于器械的温度传感器)采集的数据。在某些实施例中，第二数据电路可从发生器102接收数据并且基于所接收数据向用户提供指示(如LED指示或其他可见指示)。
在某些实施例中，第二数据电路和第二数据电路接口210可能够使得可实施在可编程逻辑器件200和第二数据电路之间的通信，而无需为此目的提供额外的导线(如将手持件连接到发生器102的电缆的专用导线)。在一个实施例中，例如，可使用实施于现有电缆(诸如用于将询问信号从信号调节电路202发送到手持件中的控制电路的导线中的一个)上的单线总线通信方案，将信息传送到第二数据电路以及从第二数据电路传送信息。这样，使可能另外必要的对外科装置进行的设计变更或修改最小化或减少。此外，如下文结合图16-32和图33A-33C更详细所述，由于可在公用物理通道(具有或没有频带分离)上实施不同类型的通信，第二数据电路的存在对没有必要数据读取功能的发生器而言可能“不可见”，从而使外科装置器械能够具有向后兼容性。
在某些实施例中，隔离工位152可包括连接到驱动信号输出端160b的至少一个阻隔电容器296-1，以阻止DC电流流到患者。单个阻隔电容器可能需要符合(例如)医疗条例或标准。尽管单个电容器设计的失效为相对不常见的，但这种失效可能具有不良后果。在一个实施例中，可提供与阻隔电容器296-1串联的第二阻隔电容器296-2，其中通过(例如)ADC 298(用于采样由漏电流引起的电压)来监测从阻隔电容器296-1、296-2之间的点漏出的电流。可(例如)通过可编程逻辑器件200接收样本。基于漏电流的变化(如通过图10的实施例中的电压样本所指出的那样)，发生器102可确定何时阻隔电容器296-1、296-2中的至少一个已失效。因此，图10的实施例与具有单个失效点的单个电容器设计相比可提供有益效果。
在某些实施例中，非隔离工位154可包括用于输出合适电压和电流下的DC电的电源211。电源可包括(例如)用于输出48VDC系统电压的400W电源。电源211还可包括一个或多个DC/DC电压转换器213，所述DC/DC电压转换器213用于接收电源的输出，以产生发生器102的各个部件所需的电压和电流下的DC输出。如上文结合控制器196所述，当控制器196检测到用户激活“打开/关闭”输入装置145以启用操作或唤醒DC/DC电压转换器213时，DC/DC电压转换器213中的一个或多个可从控制器196接收输入。
图13示出了发生器102的一个实施例的某些功能和结构方面。指示从电源变压器156的次线圈158输出的电流和电压的反馈分别通过ADC 178、180来接收。如图所示，ADC 178、180可实施为双通道ADC并且可以高速(如80Msps)采样反馈信号，以使得能够进行驱动信号的过采(如大约200x过采)。在通过ADC 178、180处理之前，可在模域中适当调节(如放大、滤波)电流和电压反馈信号。在可编程逻辑器件166的区块212内，可将得自ADC 178、180的电流和电压反馈样本单独缓冲，并且随后复用或交叉成单个数据流。在图13的实施例中，可编程逻辑器件166包括FPGA。
能够通过在处理器174的区块214内实施的并行数据采集端口(PDAP)来接收复用的电流和电压反馈样本。PDAP可包括用于实施使复用反馈样本与存储器地址相关联的多种方法中的任何者的组件。在一个实施例中，例如，可将与可编程逻辑器件166输出的特定LUT样本相对应的反馈样本储存在一个或多个存储器地址处，所述存储器地址与LUT样本的LUT地址相关联或利用LUT样本的LUT地址进行索引。在另一个实施例中，可将与可编程逻辑器件166输出的特定LUT样本相对应的反馈样本以及LUT样本的LUT地址储存在公用存储器位置处。在任何情况下，反馈样本都可被储存，使得特定组的反馈样本起源的LUT样本的地址可随后被确定。如上文所述，以此方式使LUT样本地址和反馈样本同步的步骤有助于预失真算法的准确计时和稳定性。在处理器174的区块216处实施的存储器直接存取(DMA)控制器可将反馈样本(以及任何LUT样本地址数据，如果适用)储存在处理器174的指定存储器位置218(如内部RAM)处。
处理器174的区块220可实施预失真算法，所述预失真算法用于动态、持续地预失真或修改储存在可编程逻辑器件166中的LUT样本。如上所述，LUT样本的预失真可补偿存在于发生器102的输出驱动电路中的多种失真源。预失真的LUT样本，在通过驱动电路进行处理时，将因此产生具有所需波形形状(如正弦)的驱动信号，以用于最佳地驱动超声换能器。
在预失真算法的区块222处，确定通过超声换能器的动态支路的电流。可根据(例如)储存在存储器位置218处的电流和电压反馈样本(其在适当定标时可表示上述图9的模型中的Ig和Vg)、超声换能器静态电容C0的值(测定的或先验已知的)和驱动频率的已知值来使用基尔霍夫电流定律确定动态支路电流。可确定与LUT样本相关的每一组储存的电流和电压反馈样本的动态支路电流样本。
在预失真算法的区块224处，将在区块222处确定的每一个动态支路电流样本都与具有所需电流波形形状的样本进行比较，以确定所比较样本之间的差值或样本大小误差。为了该确定过程，可(例如)从波形形状LUT 226(包含具有所需电流波形形状的一个周期的大小样本)提供具有所需电流波形形状的样本。得自LUT 226的用于该比较的具有所需电流波形形状的特定样本能够通过LUT样本地址指定，所述LUT样本地址与用于该比较的动态支路电流样本相关。因此，区块224的动态支路电流输入可与区块224的相关LUT样本地址输入同步。储存在可编程逻辑器件166中的LUT样本与储存在波形形状LUT226中的LUT样本可因此在数量上相等。在某些实施例中，由储存在波形形状LUT 226中的LUT样本表示的所需电流波形形状可为基本正弦波。其他波形形状可为可取的。例如，应当设想到，可使用叠加有一个或多个其他频率下的其他驱动信号(诸如第三级谐波，其用于驱动至少两种机械共振以用于横向或其他模式的有益振动)的基本正弦波来驱动超声换能器的主纵向运动。
可将在区块224处确定的样本大小误差的每一个值连同其相关LUT地址的指示都发送到可编程逻辑器件166的LUT(示于图13中的区块228处)。基于样本大小误差的值及其相关地址(以及可任选地先前接收的同一LUT地址的样本大小误差的值)，LUT 228(或可编程逻辑器件166的其他控制区块)可预失真或修改储存在该LUT地址处的LUT样本的值，使得样本大小误差减小或最小化。应当理解，在LUT地址的整个范围内以迭代方式对每一个LUT样本都进行这种预失真或修改将使得发生器的输出电流的波形形状匹配或符合由具有波形形状LUT 226的样本表示的所需电流波形形状。
可在处理器174的区块230处基于储存在存储器位置218处的电流和电压反馈样本来确定电流和电压大小测量值、功率测量值和电阻测量值。在确定这些数量之前，可将反馈样本进行适当定标，并且在某些实施例中通过合适的滤波器232进行处理，以除去得自(例如)数据采集过程和感应谐波成分的噪声。滤波的电压和电流样本因此可基本上表示发生器的驱动输出信号的基本频率。在某些实施例中，滤波器232可为在频域中应用的有限脉冲响应(FIR)滤波器。此类实施例可使用输出驱动信号电流和电压信号的快速傅里叶变换(FFT)。在某些实施例中，所得的频谱可用于提供附加发生器功能。在一个实施例中，例如，第二和/或第三级谐波成分相对于基本频率成分的比率可用作诊断指示器。
在区块234处，可对表示整数周期的驱动信号的一定样本大小的电流反馈样本应用均方根(RMS)计算，以产生表示驱动信号输出电流的测量值Irms。
在区块236处，可对表示整数周期的驱动信号的一定样本大小的电压反馈样本应用均方根(RMS)计算，以确定表示驱动信号输出电压的测量值rms。
在区块238处，可将电流和电压反馈样本进行逐点相乘，并且可对表示整数周期的驱动信号的样本进行平均计算，以确定发生器的真实输出功率的测量值Pr。
在区块240处，可以乘积Vrms·Irms来确定发生器的表观输出功率的测量值Pa。
在区块242处，可以商Vrms/Irms来确定负载电阻大小的测量值Zm。
在某些实施例中，发生器102可使用在区块234、236、238、240和242处确定的数量Irms、Vrms、Pr、Pa和Zm来实施多个控制和/或诊断过程中的任何者。在某些实施例中，能够通过(例如)与发生器102形成一体的输出装置147或通过合适的通信接口(如USB接口)连接到发生器102的输出装置147，将这些数量中的任何者传送给用户。多种诊断过程可包括(但不限于)，例如手持件完整性、器械完整性、器械附接完整性、器械过载、邻近器械过载、频锁失效、过电压、过电流、过功率、电压感测失效、电流感测失效、听觉指示失效、视觉指示失效、短路、功率递送失效、阻隔电容器失效。
处理器174的区块244可实施相位控制算法，以用于确定和控制通过发生器102驱动的电负载(如超声换能器)的电阻相位。如上所述，通过控制驱动信号的频率以使在所确定电阻相位和电阻相位设定点(如0°)之间的差值最小化或减小，可使谐波失真的影响最小化或减小，并增加相位测量的准确性。
相位控制算法接收储存在存储器位置218中的电流和电压反馈样本作为输入。在将反馈样本用于相位控制算法之前，可将反馈样本进行适当定标，并且在某些实施例中，通过合适的滤波器246(可与滤波器232相同)进行处理，以除去得自(例如)数据采集过程和感应谐波成分的噪声。滤波的电压和电流样本因此可基本上表示发生器的驱动输出信号的基本频率。
在相位控制算法的区块248处，确定通过超声换能器的动态支路的电流。该确定过程可与上文结合预失真算法的区块222所述的确定过程相同。对于与LUT样本相关的每一组储存的电流和电压反馈样本，区块248的输出都可因而为动态支路电流样本。
在相位控制算法的区块250处，基于在区块248处确定的动态支路电流样本的同步输入和相应的电压反馈样本来确定电阻相位。在某些实施例中，该电阻相位以在波形的上升沿测定的电阻相位和在波形的下降沿测定的电阻相位的平均值来确定。
在相位控制算法的区块252处，将在区块222处确定的电阻相位值与相位设定点254进行比较，以确定所比较值之间的差值或相位误差。
在相位控制算法的区块256处，基于在区块252处确定的相位误差值和在区块242处确定的电阻值，来确定用于控制驱动信号的频率的频率输出。频率输出值能够通过区块256进行连续调节并且传送到DDS控制区块268(下文所述)，以便保持在区块250处确定的在相位设定点(如零相位误差)下的电阻相位。在某些实施例中，电阻相位可调节至0°相位设定点。这样，任何谐波失真的中心都将位于电压波形的波峰附近，从而提高电阻相位测定的准确性。
处理器174的区块258可实施用于调制驱动信号的电流大小的算法，以便根据用户指定的设定点或根据由发生器102实施的其他方法或算法指定的要求来控制驱动信号电流、电压和功率。这些数量的控制能够通过如下方式实现，例如，通过定标LUT 228中的LUT样本和/或通过利用DAC 186调整DAC 168(其为功率放大器162提供输入)的最大定标输出电压。区块260(其在某些实施例中可实施为PID控制器)可从存储器位置218接收输入电流反馈样本(其可进行适当定标和滤波)作为输入。可将电流反馈样本与通过可控变量(如电流、电压或功率)指定的“电流需求”Id值进行比较，以确定驱动信号是否正提供所需的电流。在其中驱动信号电流为控制变量的实施例中，电流需求Id能够由电流设定点262A(Isp)直接指定。例如，可将电流反馈数据(如在区块234中所测定)的RMS值与用户指定的RMS电流设定点Isp进行比较，以确定适当的控制器动作。如果(例如)电流反馈数据指示RMS值小于电流设定点Isp，则能够通过区块260来调整LUT定标和/或DAC 168的最大定标输出电压，使得驱动信号电流增加。反之，当电流反馈数据指示RMS值大于电流设定点Isp时，区块260可调整LUT定标和/或DAC 168的最大定标输出电压，以降低驱动信号电流。
在其中驱动信号电压为控制变量的实施例中，可(例如)基于在给定负载电阻值Zm(在区块242处测定)的情况下，保持期望电压设定点262B(Vsp)所需的电流来间接地指定电流需要Id(如Id＝Vsp/Zm)。相似地，在其中驱动信号功率为控制变量的实施例中，可(例如)基于在给定电压Vrms(在区块236处测定)的情况下，保持期望功率设定点262C(Psp)所需的电流来间接地指定电流需求Id(如Id＝Psp/Vrms)。
区块268可实施DDS控制算法，以用于通过调用储存在LUT 228中的LUT样本来控制驱动信号。在某些实施例中，DDS控制算法可为数控振荡器(NCO)算法，所述数控振荡器(NCO)算法使用点(存储器位置)跳跃技术产生具有固定时钟频率下的波形的样本。NCO算法可实施相位累加器或频率-相位转换器(用作从LUT 228调用LUT样本的地址指示器)。在一个实施例中，相位累加器可为D步长、模数N的相位累加器，其中D为表示频率控制值的正整数，并且N为LUT 228中的LUT样本的数量。D＝1的频率控制值(例如)可使相位累加器按序地指向LUT 228的每个地址，从而导致复制储存在LUT 228中的波形的波形输出。当D＞1时，相位累加器可跳过LUT 228中的某些地址，从而导致具有较高频率的波形输出。因此，能够通过适当地改变频率控制值来控制由DDS控制算法产生的波形的频率。在某些实施例中，可基于在区块244处实施的相位控制算法的输出来确定频率控制值。区块268的输出可提供(DAC)168的输入，该输入继而将相应的模信号提供到功率放大器162的输入端。
处理器174的区块270可实施开关模式转换器控制算法，以用于基于被放大的信号的波形包络来动态地调制功率放大器162的干线电压，由此改善功率放大器162的效率。在某些实施例中，能够通过监测包含在功率放大器162中的一个或多个信号来确定波形包络的特性。在一个实施例中，例如，能够通过监测漏电压(如MOSFET漏电压)的最小值来确定波形包络的特性，所述漏电压是根据放大信号的包络进行调制的。可(例如)通过连接到漏电压的电压最小值检测器来产生最小电压信号。能够通过ADC 176来采样最小电压信号，其中在开关模式转换器控制算法的区块272处接收输出最小电压样本。基于最小电压样本的值，区块274能够通过PWM发生器276来控制PWM信号输出，所述PWM发生器276继而通过开关模式调节器170来控制提供到功率放大器162的干线电压。在某些实施例中，只要最小电压样本的值小于输入到区块262中的最低目标278，就可根据通过最小电压样本表征的波形网络来调制干线电压。当最小电压样本指示包络功率水平低时，例如，区块274可引起低干线电压被提供到功率放大器162，其中仅当最小电压样本指示最大包络功率水平时才提供满干线电压。当最小电压样本降至最低目标278之下时，区块274可引起干线电压保持在适于确保功率放大器162的适当操作的最小值。
图33A-33C示出了根据多种实施例的外科装置的控制电路。如上文结合图10所述，控制电路可修改由发生器102发送的询问信号的特性。询问信号的特性(可独特地指示控制电路的状态或模式)能够通过发生器102进行识别并用于控制其操作方面。控制电路可包含在超声外科装置中(如超声外科装置104的手持件116中)或电外科装置中(如电外科装置106的手持件130中)。
参见图33A的实施例，控制电路300-1可连接到发生器102，以从信号调节电路202(如从发生器端子HS和SR(图10)通过电缆112或电缆128的导线对)接收询问信号(如2kHz的双极性询问信号)。控制电路300-1可包括第一支路，所述第一支路包括串联的二极管D1和D2以及与D2并联的开关SW1。控制电路300-1还可包括第二支路，所述第二支路包括串联的二极管D3、D4和D5、与D4并联的开关SW2以及与D5并联的电阻器R1。在某些实施例中并且如图所示，D5可为齐纳二极管。控制电路300-1可另外包括数据存储元件302，所述数据存储元件302与第二支路的一个或多个部件(如D5、R1)一起限定数据电路304。在某些实施例中，数据存储元件302以及可能地数据电路304的其他部件可包含在外科装置的器械(如器械124、器械134)中，其中控制电路300-1的其他部件(如SW1、SW2、D1、D2、D3、D4)包含在手持件(如手持件116、手持件130)中。在某些实施例中，数据存储元件302可为单线总线装置(如单线协议EEPROM)或其他单线协议或局域互连网络(LIN)协议装置。在一个实施例中，例如，数据存储元件302可包括得自Maxim IntegratedProducts，Inc.(Sunnyvale，CA)的Maxim DS28EC20 1-Wire
Figure BPA00001564218000391
EEPROM。数据存储元件302为可包含在数据电路304中的电路元件的一个实例。数据电路304可另外或作为另外一种选择包括能够发送或接收数据的一个或多个其他电路元件或部件。这些电路元件或部件可能够(例如)发送由一个或多个传感器(基于器械的温度传感器)采集的数据和/或从发生器102接收数据，并且基于所接收数据向用户提供指示(如LED指示或其他可见指示)。
在操作期间，可将得自信号调节电路202的询问信号(如2kHz的双极性询问信号)施加在控制电路300-1的整个两个支路上。这样，能够通过SW1和SW2的状态独特地确定在整个支路上显现的电压。例如，当SW1打开时，在用于询问信号的负值的整个控制电路300-1上的电压降将为在整个D1和D2上的正向电压降之和。当SW1关闭时，用于询问信号的负值的电压降将仅由D1的正向电压降确定。因此，例如，如果对于D1和D2中的每一个都具有0.7伏的正向电压降，则SW1的打开和关闭状态可分别对应于1.4伏和0.7伏的电压降。同样，在用于询问信号的正值的整个控制电路300-1上的电压降能够由SW2的状态独特地确定。例如，当SW2打开时，在整个控制电路300-1上的电压降将为在整个D3和D4上的正向电压降(如1.4伏)与D5的击穿电压(如3.3伏)之和。当SW2关闭时，在整个控制电路300-1上的电压降将为在整个D3上的正向电压降与D5的击穿电压之和。因此，发生器102可基于显现在控制电路300-1的整个输入端上的询问信号电压(如通过信号调节电路202的ADC测定)来识别SW1和SW2的状态或模式。
在某些实施例中，发生器102可能够通过第二数据电路接口210(图10)和电缆112或电缆128的导线对来与数据电路304并且具体地讲与数据存储元件302通信。用于与数据电路304通信的通信协议的频带可以高于询问信号的频带。在某些实施例中，例如，用于数据存储元件302的通信协议的频率可为(例如)200kHz或显著更高的频率，而用于确定SW1和SW2的不同状态的询问信号的频率可为(例如)2kHz。二极管D5可将提供到数据存储元件302的电压限制到合适的工作范围(如3.3-5V)。
如上文结合图10所述，数据电路304并且具体地讲数据存储元件302可储存涉及与其相关的具体外科器械的信息。此类信息能够由发生器102检索并且包括(例如)型号、序列号、其中已使用外科器械的多个操作和/或任何其他类型的信息。另外，可将任何类型的信息从发生器102传送到数据电路304，以用于储存在数据存储元件302中。此类信息可包括(例如)其中已使用器械的已更新的操作次数以及/或其使用的日期和/或时间。
如上所述，数据电路304可另外或作为另外一种选择包括除数据存储元件302之外的用于发送或接收数据的部件或元件。这些部件或元件可能够(例如)发送由一个或多个传感器(如基于器械的温度传感器)采集的数据和/或从发生器102接收数据，并且基于所接收数据向用户提供指示(如LED指示或其他可见指示)。
控制电路的实施例可包括额外的开关。参照图33B的实施例，例如，控制电路300-2(共计三个开关)可包括具有第一开关SW1和第二开关SW2的第一支路，其中SW1和SW2状态的每一种组合都对应于在整个控制电路300-2上的唯一电压降，以用于询问信号的负值。例如，SW1的打开和关闭状态分别添加或移除D2和D3的正向电压降，并且SW2的打开和关闭状态分别添加或移除D4的正向电压降。在图33C的实施例中，控制电路300-3的第一支路包括三个开关(共计四个开关)，其中齐纳二极管D2的击穿电压用于辨别操作SW1导致的电压降变化和操作SW2和SW3导致的电压变化。
图14和图15示出了根据多种实施例的外科装置的控制电路。如上文结合图10所述，控制电路可修改由发生器102发送的询问信号的特性。询问信号的特性(可独特地指示控制电路的状态或模式)能够通过发生器102进行识别并用于控制其操作方面。图14的控制电路280可包含在超声外科装置中(如超声外科装置104的手持件116中)，并且图15的控制电路282可包含在电外科装置中(如电外科装置106的手持件130中)。
参见图14，控制电路280可连接到发生器102，以从信号调节电路202(如从发生器端子HS和SR(图10)通过电缆112的导线对)接收询问信号(如2kHz的双极性询问信号)。控制电路280可包括第一开关SW1和第二开关SW2，第一开关SW1与第一二极管D1串联，以限定第一支路，第二开关SW2与第二二极管D2串联，以限定第二支路。第一支路和第二支路可为并联的，使得D2的正向导电方向与D1的正向导电方向相反。询问信号可施加在整个两个支路上。当SW1和SW2均打开时，控制电路280可限定开路。当SW1闭合并且SW2打开时，询问信号可沿第一方向发生半波整流(如询问信号的正半波被阻隔)。当SW1打开并且SW2闭合时，询问信号可沿第二方向发生半波整流(如询问信号的负半波被阻隔)。当SW1和SW2均闭合时，可能不进行整流。因此，基于对应于SW1和SW2的不同状态的询问信号的不同特性，发生器102可根据显现在控制电路280的整个输入端上的电压信号(如通过信号调节电路202的ADC测定)来识别控制电路280的状态或模式。
在某些实施例中并且如图14所示，电缆112可包括数据电路206。数据电路206可包括(例如)非易失性存储装置，例如EEPROM装置。发生器102能够通过第一数据电路接口204与数据电路206交换信息，如上文结合图10所述。此类信息可专用于与电缆112形成一体或能够结合电缆112使用的外科装置，并且可包括(例如)型号、序列号、其中已使用外科装置的多个操作和/或任何其他类型的信息。信息也可从发生器102传送到数据电路206，以用于在其中储存，如上文结合图10所述。在某些实施例中并且参照图33E-33G，数据电路206可设置在用于接合具有发生器102的专用外科装置类型或模型的适配器中。
参见图15，控制电路282可连接到发生器102，以从信号调节电路202(如从发生器端子HS和SR(图10)通过电缆128的导线对)接收询问信号(如2kHz的双极性询问信号)。控制电路282可包括串联的电阻器R2、R3和R4，其中开关SW1和SW2分别连接在整个R2和R4上。询问信号可施加在整个串联电阻器的至少一个上，以在控制电路282上产生电压降。例如，当SW1和SW2均打开时，能够通过R2、R3和R4来确定电压降。当SW1闭合并且SW2打开时，能够通过R3和R4来确定电压降。当SW1打开并且SW2闭合时，能够通过R2和R3来确定电压降。当SW1和SW2均闭合时，能够通过R3来确定电压降。因此，发生器102可基于在整个控制电路282上的电压降(如通过信号调节电路202的ADC测定)来识别控制电路282的状态或模式。
图16示出了超声外科装置(例如超声外科装置104)的控制电路280-1的一个实施例。控制电路280-1，除了包括图14的控制电路280的部件之外，还可包括具有数据存储元件286的数据电路284。在某些实施例中，数据存储元件286以及可能地数据电路284的其他部件可包含在超声外科装置的器械(如器械124)中，其中控制电路280-1的其他部件(如SW1、SW2、D1、D2、D3、D4、C1)包含在手持件(如手持件116)中。在某些实施例中，数据存储元件286可为单线总线装置(如单线协议EEPROM)或其他单线协议或局域互连网络(LIN)协议装置。在一个实施例中，例如，数据存储元件286可包括得自Maxim Integrated Products，Inc.(Sunnyvale，CA)的Maxim DS28EC20 1-Wire
Figure BPA00001564218000431
EEPROM。
在某些实施例中，发生器102可能够通过第二数据电路接口210(图10)和电缆112的导线对来与数据电路284并且具体地讲与数据存储元件286通信。具体地讲，用于与数据电路284通信的通信协议的频带可高于询问信号的频带。在某些实施例中，例如，用于数据存储元件286的通信协议的频率可为(例如)200kHz或显著更高的频率，而用于确定SW1和SW2的不同状态的询问信号的频率可为(例如)2kHz。因此，数据电路284的电容器C1的值可被选择为使得数据存储元件286对相对低频的询问信号被“隐藏”，同时允许发生器102在较高频率的通信协议下与数据存储元件286通信。串联的二极管D3可保护数据存储元件286以防经受询问信号的负向周期，并且并联的齐纳二极管D4可将提供到数据存储元件286的电压限制到合适的工作范围(如3.3-5V)。当处于正向导电模式时，D4也可使询问信号的负向周期夹接到大地。
如上文结合图10所述，数据电路284并且具体地讲数据存储元件286可储存涉及与其相关的具体外科器械的信息。此类信息能够由发生器102检索并且包括(例如)型号、序列号、其中已使用外科器械的多个操作和/或任何其他类型的信息。另外，可将任何类型的信息从发生器102传送到数据电路284，以用于储存在数据存储元件286中。此类信息可包括(例如)其中已使用器械的已更新的操作次数以及/或其使用的日期和/或时间。此外，由于发生器102和外科装置之间的不同类型的通信可为频带分离的，因此所存在的数据存储元件286对没有必要数据读取功能的发生器而言可能“不可见”，从而使得外科装置能够具有向后兼容性。
在某些实施例中并且如图17所示，数据电路284-1可包括感应器L1，以将数据存储元件286与SW1和SW2的状态隔离开。添加L1可另外使得在电外科装置中能够使用数据电路284-1。图18(例如)示出了结合图15的控制电路282和图17的数据电路284-1的控制电路282-1的一个实施例。
在某些实施例中，数据电路可包括一个或多个开关，以修改通过数据电路接收的询问信号的一个或多个特性(如大小、整流)，使得基于所述一个或多个特性可独特地识别一个或多个开关的状态或模式。图19(例如)示出了控制电路282-2的一个实施例，其中数据电路284-2包括与D4并联的开关SW3。可从发生器102(如从图10的信号调节电路202)以如下频率发送询问信号，所述频率足以使询问信号通过C1被数据电路284-2接收，但通过L1与控制电路282-2的其他部分阻隔开。这样，可使用第一询问信号(如25kHz下的双极性询问信号)的一个或多个特性来识别SW3的状态，并且可使用较低频率下的第二询问信号(如2kHz下的双极性询问信号)的一个或多个特性来识别SW1和SW2的状态。尽管所添加的SW3是结合电外科装置中的控制电路282-2示出的，但应当理解，SW3可添加到超声外科装置的控制电路，诸如(例如)，图17的控制电路280-2。
另外应当理解，除SW3之外，还可将开关添加到数据电路。如图20和图21所示，例如，数据电路284-3和284-4的实施例可分别包括第二开关SW4。在图20中，可选择齐纳二极管D5和D6的电压值，使得它们的电压值为足够不同，以允许在存在噪声的情况下可靠地分辨询问信号。D5和D6的电压值之和可等于或小于D4的电压值。在某些实施例中，根据D5和D6的电压值，可以从图20所示的数据电路284-3的实施例中移除D4。
在某些情况下，开关(如SW1-SW4)可阻碍发生器102与数据存储元件286通信的能力。在一个实施例中，如果开关的状态使其妨碍发生器102与数据存储元件286之间的通信，则通过说明错误来解决该问题。在另一个实施例中，仅当发生器102确定开关状态不会妨碍通信时，发生器102才可允许与数据存储元件286通信。由于开关的状态在某种程度上可能无法预测，因此发生器102可重复性地进行这种测定。在某些实施例中，添加L1可防止由数据电路外部的开关(如SW1和SW2)引起的干扰。对于包含在数据电路内的开关(如SW3和SW4)，能够通过添加电容值显著小于C1的电容器C2(如C2＜＜C1)来实现利用频带分离的开关隔离。包括C2的数据电路284-5、284-6、284-7的实施例分别示于图22-24中。
在图16-24的实施例的任何者中，根据D4的频率响应特性，可能期望或有必要添加与D4并联且指向同一方向的快速二极管。
图25示出了控制电路280-5的一个实施例，其中使用大小调制的通信协议(如大小调制的1-Wire协议，大小调制的LIN协议)实施发生器102和数据存储元件之间的通信。高频载波(如8MHz或更高)上的通信协议的大小调制显著增加低频询问信号(如2kHz的询问信号)和用于图16-24的实施例中的通信协议的本征“基带”频率之间的频带分离。控制电路280-5可类似于图16的控制电路280-1，其中数据电路288包括附加的电容器C3和电阻器R5，所述电容器C3和电阻器R5与D3相结合来解调由数据存储元件286接收的幅度调制的通信协议。如在图16的实施例中，D3可保护数据存储元件286以防经受询问信号的负向周期，D4可将提供到数据存储元件286的电压限制到合适的工作范围(如3.3-5V)并且当处于正向导电模式时，可将询问信号的负向周期夹接到大地。增加的频率分离可允许C1稍小于图16-24的实施例。另外，载波信号的较高频率也可改善与数据存储元件的通信的噪声抗扰度，因为该频率还远离能够由用于同一手术室环境中的其他外科装置产生的电噪声的频率范围。在某些实施例中，载波的相对较高频率与D4的频率响应特性相结合可能期望或有必要添加与D4并联且指向同一方向的快速二极管。
通过添加感应器L1来阻止对通过数据电路288外部的开关(如SW1和SW2)引起的数据存储元件286通信的干扰，可将数据电路288用于电外科器械的控制电路中，如图26的数据电路288-1的实施例所示。
除C2和R3以及较可能需要使用的D7之外，图25和图26中的实施例类似于图16-24的“基带”实施例。例如，可将开关添加到图19-21的数据电路的方式可直接适用于图25和图26的实施例(包括从图20的调制载波等效形式中除去D4的可能性)。实施于图22-24中的数据电路的调制载波等效形式可仅需要添加与C2串联的适当大小的感应器L2，以便将附加开关(如SW3、SW4)的询问频率与如下中间频带隔离，所述中间频带位于载波频率和数据电路外部的开关的较低询问频率之间。一个这种数据电路282-7的实施例示于图27中。
在图27的实施例中，可解决通过SW1和SW2的状态引起的对发生器与数据存储元件286通信的能力的干扰，如上文结合图19-24的实施例所述。例如，如果开关状态将阻止通信，则发生器102可说明错误，或仅当发生器102确定开关状态将不引起干扰时，发生器102才可允许通信。
在某些实施例中，数据电路可不包括存储信息的数据存储元件286(如EEPROM装置)。图28-32示出了下述控制电路的实施例，所述控制电路使用电阻和/或感应元件来修改询问信号的一个或多个特性(如大小、相位)，使得可基于所述一个或多个特性来唯一地识别控制电路的状态或模式。
在图28中，例如，数据电路290可包括识别电阻器R1，其中选择C1的值，使得R1对用于确定SW1和SW2的状态的第一低频询问信号(如2kHz的询问信号)被“隐藏”。通过在控制电路280-6输入端测量得自位于显著较高频带内的第二询问信号的电压和/或电流(如大小，相位)，发生器102可利用C1来测量R1的值，以便确定多个识别电阻器中的哪一个包含在器械中。发生器102可使用这种信息来识别器械或器械的具体特性，以使得可最优化控制和诊断方法。能够通过如下方式解决由SW1和SW2的状态引起的对发生器测量R1的能力的任何干扰：如果开关状态将阻止测量，则说明错误，或将第二频率较高的询问信号的电压保持在D1和D2的开启电压之下。也能够通过如下方式来解决这种干扰：添加与开关电路串联的感应器(图29中的L1)，以阻截第二频率较高的询问信号，同时通过第一频率较低的询问信号。以此方式添加感应器也可使得能够使用电外科器械的控制电路中的数据电路290，如图30的数据电路290-2的实施例中所示。
在某些实施例中，可使用允许多个频率下的询问的多个电容器C1来对于给定的信噪比或给定组的部件公差而在较多数量的不同R1值之间进行区分。在一个此类实施例中，感应器可设置为与除最低值的C1之外的全部元件串联，以产生用于不同询问频率的特定通带，如图31中的数据电路290-3的实施例所示。
在基于图14的控制电路280的控制电路的实施例中，可在无需频带分离的情况下来测量识别电阻器。图32示出了一个此类实施例，其中R1被选择为具有相对较高的值。
图33D-33I示出了可用于在发生器102和外科装置的手持件之间建立电气连通的多导线的电缆和适配器的实施例。具体地讲，电缆可将发生器驱动信号发送到外科装置，并且使得在发生器102和外科装置的控制电路之间能够进行基于控制的通信。在某些实施例中，电缆可与外科装置一体地形成，或可能够被外科装置的合适连接器组件可拆除地接合。电缆112-1、112-2和112-3(分别为图33E-33G)可能够与超声外科装置(如超声外科装置104)结合使用，并且电缆128-1(图33D)可能够与电外科装置(如电外科装置106)结合使用。电缆中的一个或多个可能够与发生器102直接连接，诸如(例如)，电缆112-1。在此类实施例中，电缆可包括数据电路(如数据电路206)，所述数据电路用于储存涉及与其相关的具体外科装置的信息(如型号、序列号、其中已使用外科装置的多个操作和/或任何其他类型的信息)。在某些实施例中，电缆中的一个或多个能够通过适配器连接到发生器102。例如，电缆112-2和112-3能够通过第一适配器292(图33I)连接到发生器102，并且电缆128-1能够通过第二适配器294(图33H)连接到发生器102。在此类实施例中，数据电路(如数据电路206)可设置在电缆(如电缆112-2和112-3)中或适配器(如第二适配器294)中。
在多种实施例中，发生器102可与外科装置104、106电隔离，以便防止患者体内的不利和可能有害的电流。例如，如果发生器102和外科装置104、106不是电隔离的，则通过驱动信号提供到装置104、106的电压能够潜在地改变由装置104、106作用的患者组织的电势，并由此导致患者体内的不利电流。应当理解，当使用并非旨在使任何电流通过组织的超声外科装置104时，这种问题更为严重。因此，漏电流的有源降噪的描述的其余是参照超声外科装置104进行描述的。然而，应当理解，本文所述的系统和方法也可适用于电外科装置106。
根据多种实施例，可使用隔离变压器(诸如隔离变压器156)，以在发生器102和外科装置104之间提供电隔离。例如，变压器156可在上述非隔离工位154和隔离工位152之间提供隔离。隔离工位154可与外科装置104通信。驱动信号能够通过发生器102(如发生器模块108)提供到隔离变压器156的主线圈164，并且从隔离变压器的次线圈158提供到外科装置104。然而考虑到实际变压器的非理想因素，这种装置可能不提供完全电隔离。例如，实际变压器可在主线圈和次线圈之间具有杂散电容。杂散电容可防止完全电隔离，并且允许存在于主线圈上的电势影响次线圈上的电势。这可导致患者体内的漏电流。
现代行业标准(诸如国际电工技术委员会(IEC)60601-1标准)将可容许的患者漏电流限制为10μA或更小。能够通过在隔离变压器的次线圈和大地(如地球地)之间提供漏电电容器来无源地减少漏电流。漏电电容器可用于稳定通过隔离变压器的杂散电容从非隔离侧连接的患者侧电势的变化并由此减少漏电流。然而，当发生器102提供的驱动信号的电压、电流、功率和/或频率增加时，漏电流也可增加。在多种实施例中，感应的漏电流可增加至超出无源漏电电容器将其保持在10μA和/或其他漏电流标准之下的容量。
因此，多种实施例涉及用于漏电流的有源降噪的系统和方法。图34示出了用于漏电流的有源降噪的电路800的一个实施例。可作为发生器102的一部分或结合发生器102来实施电路800。该电路可包括具有主线圈804和次线圈806的隔离变压器802。可在整个主线圈804上提供驱动信号816，由此在整个次线圈806上产生隔离的驱动信号。除了隔离的驱动信号，隔离变压器802的杂散电容808还可将驱动信号相对于大地818的电势的一些分量连接到患者侧的次线圈806。
漏电电容器810和有源降噪电路812可按如图所示进行提供，并且连接在次线圈806和大地818之间。有源降噪电路812可产生反相驱动信号814，所述反相驱动信号814可与驱动信号816具有约180°的相位差。有源降噪电路812可电连接到漏电电容器810，以将漏电电容器驱动到如下电势，所述电势相对于大地818而言与驱动信号816具有约180°的相位差。因此，患者侧次线圈806上的电荷能够通过漏电电容器810而非通过患者而到达大地818，从而减少漏电流。根据多种实施例，漏电电容器810可被设计为满足足够的行业、政府和/或设计的稳健性标准。例如，漏电电容器810可为符合IEC 60384-14标准的Y型电容器，并且/或可包括多个串联的物理电容器。
图35示出了能够通过发生器102实施的用于提供漏电流的有源降噪的电路820的一个实施例。电路820可包括发生器电路824和患者侧电路822。发生器电路824可产生和/或调制驱动信号，如本文所述。例如，在一些实施例中，发生器电路824可以类似于上述非隔离工位154的方式工作。另外，例如，患者侧电路822可以类似于上述隔离工位152的方式工作。
能够通过隔离变压器826在发生器电路824和患者侧电路822之间提供电隔离。隔离变压器826的主线圈828可连接到发生器电路824。例如，发生器电路824可在整个主线圈828上产生驱动信号。可根据任何合适的方法在整个主线圈828上产生驱动信号。例如，根据多种实施例，主线圈828可包括可保持为DC电压(如48伏)的中心分接头829。发生器电路824可包括分别连接到主线圈828的其他端部的输出级825、827。输出级825、827可使得与驱动信号相对应的电流流入主线圈828。例如，当输出级827将其输出电压降到低于中心分接头电压由此使得输出级827从整个主线圈828吸收电流时，可实施驱动信号的正性部分。可在次线圈830中感应相应的电流。同样，当输出级827将其输出电压降到低于中心分接头电压由此使得输出级825从整个主线圈828吸收相反电流时，可实施驱动信号的负性部分。这可在次线圈830中感应相应的、相反的电流。患者侧电路822可对所分离的驱动信号进行多种信号调节和/或其他处理，所述驱动信号能够通过输出线路821、823提供到装置104。
有源降噪变压器832可具有主线圈834和次线圈836。主线圈834可电连接到隔离变压器826的主线圈828，使得在整个线圈834上提供驱动信号。例如，主线圈834可包括两个线圈843、845。第一线圈845的第一端835和第二线圈843的第一端839可电连接到线圈828的中心分接头829。第一线圈845的第二端841可电连接到输出级827，而第二线圈843的第二端837可电连接到输出级825。降噪变压器832的次线圈836可连接到大地818和降噪电容器840的第一电极。降噪电容器840的另一个电极可连接到输出线路823。也可在整个次线圈836上并联地电连接任选的负载电阻器838。
根据多种实施例，有源降噪变压器的次线圈836可卷绕和/或用线连接到其他部件840、838、818，使得其极性与主线圈834的极性相反。例如，可在整个次线圈836上感应反相驱动信号。相对于大地818而言，反相驱动信号与在有源降噪变压器832的整个主线圈834上提供的驱动信号可具有180°的相位差。与负载电阻器838相结合，次线圈836可在降噪电容器840处提供反相驱动信号。因此，因驱动信号而引起出现在患者侧电路822处的泄漏电势的电荷可被吸引到降噪电容器840。这样，电容器840、次线圈836和负载电阻器838可将潜在漏电流扩散到大地818，从而使患者漏电流最小化。
根据多种实施例，可选择组件832、838、840的参数，以使漏电流降噪最大化，并且在多种实施例中减少电磁发射。例如，有源降噪变压器832能够由材料并且根据如下结构制成，所述结构允许其匹配隔离变压器826的频率、温度、湿度和其他特性。可选择有源变压器832的其他参数(如匝数、匝数比等)，以在使输出感应电流、电磁(EM)发射最小化与因所施加的外部电压产生的漏电流之间实现平衡。例如，电路820可能够满足IEC 60601或其他合适的行业或政府标准。可类似地选择负载电阻器838的值。另外，可选择降噪电容器840的参数(如电容等)，以尽可能地匹配产生感应漏电流的杂散电容的特性。
图36示出了能够通过发生器102实施的用于提供漏电流的有源降噪的电路842的替代实施例。电路842可类似于电路820，然而，有源降噪变压器832的次线圈836可电连接到输出线路823。降噪电容器823可串联地连接在次线圈836和大地818之间。电路842可以类似于电路820的方式工作。根据多种实施例，(如当有源降噪变压器832为升压变压器时)，可使总工作电压(例如，如IEC 60601-1中所限定的)最小化。
图37示出了能够通过发生器102实施的用于提供漏电流的有源降噪的电路844的替代实施例。电路844可省去有源降噪变压器832并且将其替换为隔离变压器826的第二次线圈846。第二次线圈846可连接到输出线路823。降噪电容器840可串联地连接在第二次线圈846和大地之间。第二次线圈可卷绕和/或用线连接成具有与主线圈828和次线圈830相反的极性。因此，当在整个主线圈828上存在驱动信号时，则如上文所述，可在整个次线圈846上存在反相驱动信号。因此，电路844可以类似于上文参照电路820和842所述的方式来消除漏电流。省去有源降噪变压器832(如电路844所示)可降低部件数量、成本和复杂度。
图38示出了能够通过发生器102实施的用于提供漏电流的有源降噪的电路848的另一个实施例。电路848可能够消除因电容连接(如上文所述)以及其他外部效应(诸如(例如)频率特异性效应(如得自电源的60Hz或其他频率噪声)、路径效应、负载效应等)在患者侧电路822中产生的外部电流。取代电连接到大地818，降噪电容器840可连接到校正控制电路851，如电路848中所示。电路851可包括数字信号处理器(DSP)850或其他处理器。DSP 850可接收输入858(如通过模-数字转换器)。输入858可为往往指示可引起附加漏电流的外部效应的值。这种输入的实例可为(例如)电源参数、负载数据(例如电阻)、或描述从电路848到装置104的路径的其他值等。基于输入858，DSP 85可产生降噪电势，所述降噪电势在提供给降噪电容器840时可消除因外部效应产生的患者侧电流。降噪电势可以数字形式提供给数字-模转换器852，所述数字-模转换器852可将降噪电势的模形式提供给降噪电容器840。因此，在整个降噪电容器840上的电压降可取决于整个第二次线圈846上存在的反相驱动信号以及由电路851的建立的降噪电势。
示出的电路848省去了有源降噪变压器832并且具有电路844构型中的电容器840和第二次线圈846。然而，应当理解，校正控制电路851可用于本文所述的构型(如820、842、844等)中的任何者中。例如，在电路820、842、844中的任何者中，校正控制电路851可被替换成大地818。
图39示出了能够通过发生器102实施的用于提供漏电流的降噪的电路860的实施例。根据电路860，降噪电容器840可连接在隔离变压器826的主线圈828和输出线路823(如公用输出线路)之间。这样，反相驱动信号可出现在整个降噪电容器840上，由此产生与上述那些类似的漏电流降噪效果。
图40示出了能够通过发生器102实施的用于提供漏电流的降噪的电路862的另一个实施例。电路862可类似于电路860，不同的是降噪电容器可连接在输出线路823(如公用输出线路)和两个附加电容器864、866之间。电容器864可连接在降噪电容器840和隔离变压器826的主线圈828之间。电容器866可连接在降噪电容器840和大地818之间。电容器864、866的组合可提供到大地的射频(RF)路径，由此可提高发生器102的RF性能(如通过减少电磁发射)。
外科发生器(诸如示意性地示于图10中的发生器102)(例如)可电连接到多种外科器械。外科器械可包括(例如)基于RF的器械和基于超声的装置两者。图41示出了根据本发明的一个非限制性实施例的插座组件和连接器组件接口900。在一个实施例中，接口900包括插座组件902和连接器组件920。连接器组件920可电连接到电缆921的远端，所述电缆921最终连接到(例如)手持式外科器械。图59示出了根据一个非限制性实施例的外科发生器1050。外科发生器1050可包括外科发生器主体1052，所述外科发生器主体1052通常包括发生器的外壳。外科主体1052可限定用于接收插座组件(诸如图59所示的插座组件1058)的孔口1054。现在参见图41和图59，插座组件902可包括密封件906，所述密封件906通常阻止液体通过孔口1054进入外科发生器1050中。在一个实施例中，密封件906为环氧树脂密封件。
图42为根据一个非限制性实施例的插座组件902的分解侧视图。插座组件902可包括多个部件，诸如磁体212。插座组件902还可包括可排列成大致圆形构造或任何其他合适构造的多个承窝908。图48为根据一个非限制性实施例的承窝908的放大视图。在一个实施例中，承窝908为分叉的并且插座组件902包括九个分叉承窝908，而在其他实施例中可使用更多或更少的承窝。承窝908中的每一个都可限定用于接收导电引脚的内腔910，如下文更详细所述。在一些实施例中，多种承窝908将以不同高度安装在插座组件902内，使得当连接器组件插入到插座组件中时首先接触某些承窝而后接触其他承窝。
图43为根据一个非限制性实施例的连接器组件920的分解侧视图。连接器组件920可包括(例如)连接器组件主体922，所述连接器组件主体922包括插入部分924，所述插入部分924的尺寸被设计为由插座组件902接收，如在下文更详细所述。连接器组件920可包括多个其他部件，诸如铁质引脚926、电路板928和多个导电引脚930。如图54所示，铁质引脚926可为圆柱形的。例如，在其他实施例中，铁质引脚926可为其他形状，诸如矩形。铁质引脚926可为钢、铁、或任何其他的磁性相容材料(被吸引到磁场或可被磁化)。铁质引脚926也可具有肩部927或其他类型的横向延伸特征。现在参见图55，导电引脚930可附连到电路板928或从电路板928延伸。电路板928还可包括装置识别电路，诸如图33E-33G所示的电路。因此，在多种实施例中，电路板928可带有EEPROM、电阻器、或任何其他电子部件。在一些实施例中，电路板928的部分可进行灌封或换句话讲封装，以改善外科装置的无菌性和有助于耐水性。
再次参见图43，连接器组件920还可包括应变减轻构件932。如图56所示，应变减轻构件932通常接纳电缆负载，以防止该负载施加到电路板928和/或承窝908。在一些实施例中，应变减轻构件932可包括有助于组装的对准凹口934。再次参见图43，连接器组件920还可包括连接到连接器组件主体922的防护罩936。图57示出了根据一个非限制性实施例的防护罩936。防护罩936通常可用作相关电缆的弯曲减轻件并且可有助于密封连接器组件920。在一些实施例中，防护罩936可按扣到连接器组件主体922上。对于高压釜应用，防护罩936可为包覆成型部件。在其他实施例中，可使用其他附接技术，诸如粘合剂或旋转焊接。
图44为图41所示的插座组件902的透视图。图45为插座组件902的分解透视图。图46为插座组件902的前正视图。图47为插座组件902的侧正视图。参见图44-47，插座组件902可包括凸缘950。凸缘950可具有内壁952和外壁954。凸缘表面956跨过内壁952和外壁954。内壁952可包括至少一个弯曲部分和至少一个线性部分。凸缘950的内壁952限定具有独特几何形状的腔体960。在一个实施例中，腔体960由约270度的圆和两个线性部分限定，所述两个线性部分相切于所述圆并且相交以形成Θ角。在一个实施例中，Θ角为约90度。在一个实施例中，具有外周边964的中央凸出部分962设置在腔体960中。中央凸出部分962可具有限定凹槽968的中央表面966。磁体912(图42)可设置为紧邻凹槽968。如图所示，承窝908可设置为穿过由中央凸出部分962的中央表面966限定的孔口972。在使用圆形排列的承窝908的实施例中，磁体912可设置在由承窝限定的圆的内部。插座主体904还可限定后凹槽976(图47)。后凹槽976的尺寸可被设计为接纳密封件906。凸缘表面966可倾斜成β角(图47)。如图61所示，外科发生器1050的主体1052的表面也可倾斜成β角。
图49为连接器组件920的透视图，图50为连接器组件920的分解透视图。图51为连接器组件主体922的侧正视图，图52和图53分别示出连接器组件主体922的近端和远端的透视图。现在参见图49-53，连接器组件主体922可具有凸缘980。凸缘980可包括至少一个弯曲部分和至少一个线性部分。
适配器组件1002和1004可包括由连接器组件主体922(图50)包含的基本上类似的部件。例如，适配器组件1002和1004可各自容纳具有装置识别电路的电路板。适配器组件1002和1004也可各自容纳铁质引脚和磁体中的一者，以有助于与外科发生器的连接。凸缘980的外壁982通常可被相似地成型为插座组件902(图46)的内壁952。凸缘980的内壁984可被相似地成型为中央凸出部分962的外周边964。连接器组件主体922还可具有包括多个孔口990的壁988。孔口990的尺寸可被设计为接纳导电引脚930和铁质引脚926。在一个实施例中，铁质引脚926的肩部927的尺寸被设定为使得其不能穿过孔口990。在一些实施例中，铁质引脚926可以能够相对于壁988平移。当组装时，铁质引脚926的肩部927可设置在壁988和电路板928中间。铁质引脚926可被设置为使得其在连接器组件920插入到插座组件902中时遇到磁体912的磁场。在一些实施例中，当铁质引脚926平移到壁988并且碰撞磁体912时，将通过可听的咔嗒声指示适当的连接。应当理解，可在铁质引脚926和磁体912中间设置多种部件，诸如(例如)垫圈，以减小接合部件的偶然磨损。另外，在一些实施例中，磁体912可连接到连接器组件920，并且铁质引脚926可连接到插座组件902。
图58示出了根据多种非限制性实施例的两个适配器组件1002和1004。适配器组件1002和1004允许具有多种几何形状的连接器组件电连接到外科发生器的插座组件。适配器组件1002能够适应具有连接器组件1006的外科器械，并且适配器组件1004能够适应具有连接器组件1008的外科器械。在一个实施例中，连接器组件1006通过电缆1060与基于RF的外科装置相联，并且连接器组件1008通过电缆1062与基于超声的装置相联。应当理解，适配器组件的其他实施例也可适应具有与图58所示的那些不同的连接器组件的外科器械。图59示出了根据一个非限制性实施例的插入到外科发生器1050的插座组件1058中之后的适配器组件1002。图60示出了插入到接适配器组件1002中之后并由此电连接到外科发生器1050的连接器组件1006。类似地，图61示出了根据一个非限制性实施例的插入到外科发生器1050的插座组件1058中之后的适配器组件1004。图62示出了插入到适配器组件1004中之后的连接器组件1008。因此，尽管连接器组件1006和1008各自具有不同的几何形状，但两者均可与外科发生器1050结合使用。
参见图58-62，在一个实施例中，适配器组件1002具有包括凸缘1012的远端部分1010。凸缘1012能够插入到外科器械1050的插座组件1058中并且可类似于(例如)图52所示的凸缘980。可将任何数量的导电引脚或其他连接部件设置在远端部分中，以接合插座组件1058。在一个实施例中，适配器组件1002还具有限定腔体1016的近端部分1014。腔体1016可能够接纳特定的连接器组件，诸如连接器组件1006。应当理解，近端部分1014可基于将与其结合使用的连接器组件的类型进行适当地构造。在一个实施例中，适配器组件1006具有包括凸缘1022的远端部分1020。凸缘1022能够插入到外科器械1050的插座组件1058中并且可类似于(例如)图52所示的凸缘980。适配器组件1004还具有限定腔体1026的近端部分1024。在图示实施例中，中央部分1028设置在腔体1026中并且能够接纳连接器组件1008。
图63示出了根据一个非限制性实施例的发生器1102的后片1100的透视图。发生器1102可(例如)类似于图10所示的发生器102。后片1100可包括多种输入和/或输出端口1104。后片1110还可包括电子纸显示装置1106。电子纸显示装置1106可基于电泳，其中将电磁场施加到导电材料，使得导电材料具有迁移性。将具有导电性的微粒分布在薄型柔性基底之间，并且微粒(或调色剂粒子)的位置因电磁场的极性的改变而改变，由此显示数据。实现电子纸的技术方法可使用任何合适的技术来实施，诸如液晶、有机电致发光(EL)、反射膜反射型显示、电泳、扭转球或机械反射型显示。一般来讲，电泳为如下现象，其中当粒子悬浮于介质(即，分散介质)中时，粒子为带电荷的，并且当将电场施加到带电粒子时，所述粒子通过分散基质移动到具有相反电荷的电极。与电子纸显示装置有关的其他论述可见于名称为ELECTRONIC PAPER DISPLAY DEVICE，MANUFACTURINGMETHOD AND DRIVING METHOD THEREOF(电子纸显示装置、其制备方法和驱动方法)的美国专利号7,751,115，该专利全文以引用方式并入。
图64示出了图63所示的后片1110。图65和图66提供了后片1110的放大视图。参见图64-66，电子纸显示装置1106可显示多个信息，诸如序列号、部件号、专利号、警告标记、端口标识符、指示、供应商信息、服务信息、制造商信息、操作信息或任何其他类型的信息。在一个实施例中，能够通过将计算装置连接到发生器1102的通信端口(如USB端口)来改变或更新显示在电子纸显示装置1106上的信息。
如图66所示，在一些实施例中，后片1100可包括交互部分1108。在一个实施例中，交互部分1108允许用户使用输入装置(诸如按钮1110)将信息输入到发生器1102。交互部分1108还可显示同时显示在发生器1102的前面板(未示出)上的信息。
在使用超声外科装置(诸如超声外科装置104)的外科手术中，端部执行器126将超声能量发送到接触端部执行器126的组织，以实现切割和密封动作。以此方式施加超声能量可引起组织的局部加热。可能需要监测和控制这种加热，以使不期望的组织损害最小化和/或优化切割和密封动作的有效性。超声加热的直接测量需要端部执行器126中或附近的温度感测装置。尽管基于传感器的超声加热测量在技术上是可行的，但设计复杂性和其他考虑因素可使得直接测量不切实际。发生器102的多种实施例能够通过对施加超声能量引起的温度或加热产生估计值来解决该问题。
具体地讲，发生器102的一个实施例可实施人工神经网络，以基于多个输入变量1218来估计超声加热。人工神经网络为基于所经受的已知输入和输出模式来学习输入和输出之间的复杂、非线性关系(该过程通常称为“训练”)的数学模型。人工神经网络可包括连接在一起以执行数据处理任务的简单处理单元或节点的网络。人工神经网络的结构可在一定程度上类似于大脑中的生物神经网络的结构。当为人工神经网络提供输入数据模式时，其产生输出模式。对于特定的处理任务，能够通过提供大量的训练数据来训练人工神经网络。这样，人工神经网络能够通过改变节点间的通信“强度”来改变其结构，以基于训练数据来改善其性能
。图67示出了人工神经网络1200的一个实施例，所述人工神经网络1200用于产生从使用超声外科装置(诸如超声外科装置104)施加超声能量导致的估计温度Test。在某些实施例中，可在发生器102的处理器174和/或可编程逻辑器件166中实施神经网络。神经网络1200可包括输入层1202、限定隐藏层1206的一个或多个节点1204和限定输出层1210的一个或多个节点1208。为清晰起见，仅示出一个隐藏层1206。在某些实施例中，神经网络1200可包括一个或多个级联排列的附加隐藏层，其中每一个附加隐藏层中的节点1204的数量都可等于或不同于隐藏层1206中的节点1204的数量。
层1202、1210中的每一个节点1204、1208都可包括一个或多个权值w 1212、偏值b 1214和转换函数f 1216。在图67中，对这些值和函数使用不同的下标旨在示出这些值和函数中的每一个都可不同于其他值和函数。输入层1202包括一个或多个输入变量p 1218，其中隐藏层1206的每一个节点1204都接收输入变量p 1218中的至少一个作为输入。如图67所示，例如，每一个节点1204都可接收输入变量p1218中的全部。在其他实施例中，输入变量p 1218中的小于全部的量可被节点1204接收。将特定节点1204接收的每一个输入变量p 1218都通过相应的权值w 1212进行加权，然后加上任何其他以类似方式加权的输入变量p 1218和偏值b 1214。然后将节点1204的转换函数f1216应用到所得之和，以产生节点的输出。在图67中，例如，节点1204-1的输出可以f1(n1)给出，其中n1＝(w1，1·p1+w1，2·p2+…+w1，j·pj)+b1。
输出层1210的特定节点1208可接收得自隐藏层1206的节点1204中的一个或多个的输出(如每一个节点1208都接收得自图67中的相应节点1204-1、1204-2、…、1204-i的输出f1(·)、f2(·)、…、fi(·))，其中将每一个接收的输出都通过相应权值w 1212进行加权，并且随后加上任何其他以类似方式加权的所接收输入和偏值b 1214。然后将节点1208的转换函数f 1216应用到所得之和，以产生节点的输出，该节点的输出对应于神经网络1200的输出(如图67的实施例中的估计温度Test)。尽管图67中的神经网络1200的实施例在输出层1210中包括仅一个节点1208，但在其他实施例中神经网络1200可包括不止一个输出，在这种情况下输出层1210可包括多个节点1208。
在某些实施例中，节点1204、1208的转换函数f 1216可为非线性传递函数。在一个实施例中，例如，转换函数f 1216中的一个或多个可为S形函数。在其他实施例中，转换函数f 1216可包括正切S形函数、双曲正切S形函数、对数S形函数、线性传递函数、饱和线性传递函数、径向基传递函数或一些其他类型的传递函数。特定节点1204、1208的转换函数f 1216可与另一个节点1204、1208的转换函数f 1216相同或不同。
在某些实施例中，通过隐藏层1206的节点1204所接收的输入变量p 1218可表示(例如)已知或据信对温度或加热(因施加超声能量产生)有影响的信号和/或其他数量或状态。这种变量可包括(例如)如下中的一个或多个：通过发生器102输出的驱动电压、通过发生器102输出的驱动电流、发生器输出102的驱动频率、通过发生器102输出的驱动功率、通过发生器102输出的驱动能量、超声换能器114的电阻和施加超声能量的持续时间。另外，输入变量p 1218中的一个或多个可与发生器102的输出无关，并且可包括(例如)端部执行器126的特征(如刀头尺寸、几何形状和/或材料)和超声能量目标向的组织的具体类型。
可训练神经网络1200(如通过改变或更改权值w 1212、偏值b1214和转换函数f 1216)，使得其输出(如图67的实施例中的估计温度Test)适当地逼近对于已知值的输入变量p 1218测量的相关性输出。能够通过(例如)如下方式完成训练：提供已知组的输入变量p1218，将神经网络1200的输入与对应于已知组的输入变量p 1218的测量输出进行比较，并且修改权值w 1212、偏值b 1214和/或转换函数f1216，直到神经网络1200的输出和相应测量输出之间的误差低于预定误差水平。例如，可训练神经网络1200，直到均方误差低于预定误差阈值。在某些实施例中，能够通过神经网络1200来实施训练过程的某些方面(如通过网络1200后向传播误差以适应性地调整权值w 1212和/或偏值b 1214)。
图68示出了对于神经网络1200的一个实施例的具体实施而言的在估计温度值Test和测量温度值Tm之间的比较。用于产生图68中的Test的神经网络1200包括六个输入变量p 1218：驱动电压、驱动电流、驱动频率、驱动功率、超声换能器的电阻和施加超声能量的持续时间。隐藏层1206包括25个节点，并且输出层1210包括单个节点1208。基于对颈动脉血管施加13次超声能量来产生训练数据。在改变输入变量p 1218值的250个样本范围内基于IR测量方法来测定实际温度(Tm)，其中基于相应的输入变量p 1218的值通过神经网络1200产生估计温度Test。基于从训练数据排除的运行来产生图68所示的数据。在110-190℉的区域内，估计温度Test经证实相当精确地逼近测量温度Tm。据信，出现在某些区域(诸如110℉后的区域)中的估计温度Test的不一致性能够通过实施对这些区域具有特异性的附加神经网络来最小化或减小。另外，可偏移神经网络1200的经训练输出的数据的不一致性可被识别和编程为特殊情况，以进一步改善性能。
在某些实施例中，当估计温度超过用户定义的温度阈值Tth时，发生器102可能够控制超声能量的施加，使得估计温度Test保持为等于或低于温度阈值Tth。例如，在其中驱动电流为神经网络1200的输入变量p 1218的实施例中，驱动电流可作为控制变量进行处理和调节，以使Test和Tth之间的差值最小化或减小。可使用反馈控制算法(如PID控制算法)来实施这种实施例，其中Tth输入到控制算法作为设定点，Test输入到算法作为处理变量反馈，并且驱动电流对应于算法的可控输出。在其中驱动电流用作控制变量的情况下，驱动电流值的适当改变应体现在用于训练神经网络1200的输入变量p 1218组中。具体地讲，如果训练数据反映出恒定驱动电流值，则可降低作为控制变量的驱动电流的有效性，因为神经网络1200可因驱动电流明显对温度不具有影响而减小与其相关的权值w 1212。应当理解，可使用除驱动电流之外的输入变量p 1218(如驱动电压)来使Test和Tth之间的差值最小化或减小。
根据多种实施例，发生器102可根据一个或多个功率曲线来将功率提供到组织切口。功率曲线可限定递送到组织的电功率和组织电阻之间的关系。例如，当组织电阻在凝固期间改变(如增加)时，通过发生器102提供的功率也可根据所应用的功率曲线而改变(如降低)。
不同的功率曲线可尤其适用于或不适用于不同类型和/或尺寸的组织切口。强力功率曲线(如，需要高功率水平的功率曲线)可适用于大组织切口。当将力度更强的功率曲线应用到较小的组织切口(诸如小血管)时，可导致外部灼热。外部灼热可降低外部的凝固/焊接质量并且还可抑制组织内部的完全凝固。类似地，当将不太强力的功率曲线应用到较大组织切口(如较大股)时，可能不能实现止血。
图69示出了显示实例功率曲线1306、1308、1310的图表1300的一个实施例。图表1300包括电阻轴1302，所述电阻轴1302示出了从左向右递增的潜在组织电阻。功率轴1304示出了从下向上递增的功率。功率曲线1306、1308、1310中的每一个都可限定沿功率轴1304的一组功率水平，所述功率水平对应于沿电阻轴1302的多个潜在感测的组织电阻。通常，功率曲线可呈现不同的形状，并且示于图69中。功率曲线1306显示具有阶梯式形状，而功率曲线1308、1310显示具有弯曲形状。应当理解，多种实施例所使用的功率曲线可呈现任何可用的连续或非连续形状。功率曲线的功率递送速率或强度能够由其在图表1300上的位置来指示。例如，对于给定组织电阻递送较高功率的功率曲线可视为力度较强。因此，在两个功率曲线之间，设置在沿功率轴1304的最上方的曲线可为力度较强。应当理解，一些功率曲线可交叠。
可根据任何合适的方法来比较两个功率曲线的强度。例如，如果第一功率曲线具有与在潜在组织电阻的范围的至少一半相对应的较高递送功率，则第一功率曲线在给定的潜在组织电阻范围内可视为比第二功率曲线的力度更强。另外，例如，在给定的潜在组织电阻范围内，如果第一曲线下方在该范围内的面积大于第二曲线下方在该范围内的面积，则第一功率曲线可视为比第二功率曲线的力度更强。换句话讲，当功率曲线以离散形式进行表示时，如果第一功率曲线在给定组的潜在组织电阻上的功率值的总和大于第二功率曲线在所述组的潜在组织电阻上的功率值的总和，则第一功率曲线在所述组的潜在组织电阻上可视为比第二功率曲线的力度更强。
根据多种实施例，本文所述的功率曲线移变算法可与任何种类的外科装置(如超声装置104、电外科装置106)结合使用。在使用超声装置104的实施例中，可利用电极157、159来获取组织电阻读数。对于电外科装置，诸如106，可利用第一电极177和第二电极179来获取组织电阻读数。
在一些实施例中，电外科装置104可包括设置在电极177、179中的一个或两个与组织切口之间的正温度系数(PTC)材料。PTC材料在其达到阈值或触发温度(此时，PTC材料的电阻可增加)之前可具有保持相对较低和相对恒定的电阻分布。使用时，PTC材料可设置为接触组织，同时施加功率。PTC材料的触发温度可被选择为使得其对应于指示焊接或凝固完成的组织温度。因此，当焊接或凝固过程完成时，PTC材料的电阻可增加，从而使得实际提供到组织的电功率相应地降低。
应当理解，在凝固或焊接过程期间，组织电阻通常可增加。在一些实施例中，组织电阻可显示电阻的突然增加，从而指示凝固成功。这种增加可因组织中的生理变化、PTC材料达到其触发阈值等而产生，并且可发生在凝固过程中的任何点处。形成电阻突然增加可能需要的能量可与所作用的组织的热量有关。任何给定组织切口的热量又都可与切口中的组织的类型和数量有关。
多种实施例可利用组织电阻的这种突然增加来为给定组织切口选择合适的功率曲线。例如，发生器102可选择并且相继地应用力度较强的功率曲线，直到组织电阻达到指示已产生突然增加的电阻阈值。例如，达到电阻阈值的步骤可指示已利用当前应用的功率曲线适当地进行凝固。电阻阈值可为组织电阻值、组织电阻的变化速率和/或电阻和变化速率的组合。例如，当观察到特定电阻值和/或变化速率时，可达到电阻阈值。根据多种实施例，不同的功率曲线可具有不同的电阻阈值，如本文所述。
图70示出了用于将一个或多个功率曲线应用到组织切口的工艺流程1330的一个实施例。可使用任何合适数量的功率曲线。可按强度顺序相继地应用功率曲线，直到功率曲线中的一个将组织驱动到电阻阈值。在1332处，发生器102可应用第一功率曲线。根据多种实施例，第一功率曲线可被选择为以相对低的速率来递送功率。例如，第一功率曲线可被选择为在具有最小和最易受损的预期组织切口的情况下避免组织灼热。
可将第一功率曲线以任何合适的方式应用到组织。例如，发生器102可产生实施第一功率曲线的驱动信号。能够通过调制驱动信号的功率来实施功率曲线。可以任何合适的方式来调制驱动信号的功率。例如，可调制信号的电压和/或电流。另外，在多种实施例中，驱动信号可为脉动的。例如，发生器102能够通过改变驱动信号的脉冲宽度、占空比等来调制平均功率。驱动信号可提供到电外科装置106的第一电极177和第二电极179。另外，在一些实施例中，可将实施第一功率曲线的驱动信号提供到上述超声装置104的超声发生器114。
当应用第一功率曲线时，发生器102可监测提供到组织的总能量。可在一个或多个能量阈值下，将组织电阻与电阻阈值进行比较。可存在任何合适数量的能量阈值，所述能量阈值可根据任何合适的方法进行选择。例如，能量阈值可被选择为对应于不同组织类型达到电阻阈值的已知点。在1334处，发生器102可确定递送到组织的总能量是否已达到或超过第一能量阈值。如果总能量仍未达到第一能量阈值，则发生器102可继续在1332处应用第一功率曲线。
如果总能量已达到第一能量阈值，则发生器102可确定是否已达到电阻阈值(1336)。如上文所述，电阻阈值可为预定的电阻变化(如增加)速率、预定电阻、或这两者的组合。如果达到电阻阈值，则发生器102可继续在1332处应用第一功率曲线。例如，在第一功率曲线中达到电阻阈值的步骤可表明第一功率曲线的强度足以形成合适的凝固或焊接。
如果在1336处未达到电阻阈值，则发生器102可在1338处递增至下一个力度最强的功率曲线，并且在1332处将该功率曲线用作当前功率曲线。当在1334处达到下一个能量阈值时，发生器102可再次确定在1336处是否已达到电阻阈值。如果未达到，发生器102可再次在1338处递增至下一个力度最强的功率曲线，并且在1332处递送该功率曲线。
工艺流程1330可持续进行直到终止。例如，当在1336处达到电阻阈值时，可终止工艺流程1330。达到电阻阈值时，发生器102可应用当时的功率曲线，直到完成凝固或焊接。另外，例如，当用尽所有可用功率曲线时，工艺流程1330可终止。可使用任何合适数量的功率曲线。如果力度最强的功率曲线不能将组织驱动到电阻阈值，则发生器102可继续应用力度最强的功率曲线，直到以其他方式(如通过临床医生或在达到最终能量阈值时)终止该处理。
根据多种实施例，工艺流程1330可持续进行，直到出现终止阈值。终止阈值可指示已完成凝固和/或焊接。例如，终止阈值可取决于组织电阻、组织温度、组织电容、组织电感、实耗时间等中的一个或多个。这些可能是单一终止阈值，或在多种实施例中，不同的功率曲线可具有不同的终止阈值。根据多种实施例，不同的功率曲线可使用不同的电阻阈值。例如，如果第一功率曲线已不能将组织驱动到第一组织电阻阈值，则工艺流程1330可从第一功率曲线过渡为第二功率曲线，并且如果第二功率曲线已不能将组织驱动到第二电阻阈值，则工艺流程1330可随后从第二功率曲线改变为第三功率曲线。
图71示出了显示可结合工艺流程1330使用的实例功率曲线1382、1384、1386、1388的图表1380的一个实施例。尽管示出了四条功率曲线1382、1384、1386、1388，但应当理解，可使用任何合适数量的功率曲线。功率曲线1382可表示力度最不强的功率曲线，并且可首先应用。如果在第一能量阈值下未达到电阻阈值，则发生器102可提供第二功率曲线1384。可根据需要(例如)以上述方式使用其他功率曲线1386、1388。
如图71所示，功率曲线1382、1384、1386、1388具有不同的形状。然而，应当理解，通过工艺流程1330实施的一组功率曲线中的一些或全部均可具有相同的形状。图72示出了显示可结合图70的工艺流程使用的实例通用形状功率曲线1392、1394、1396、1398的图表的一个实施例。根据多种实施例，通用形状功率曲线(诸如1392、1394、1396、1398)可为彼此的常数倍数。因此，发生器102能够通过将不同倍数应用到单个功率曲线来实施通用形状功率曲线1392、1394、1396、1398。例如，能够通过曲线1392乘以第一常数倍增器来实施曲线1394。能够通过曲线1392乘以第二常数倍增器来产生曲线1396。同样，能够通过曲线1392乘以第三常数倍增器来产生曲线1398。因此，在多种实施例中，发生器102可在1338处通过改变常数倍增器而递增至下一个力度最强的功率曲线。
根据多种实施例，能够通过发生器102的数字装置(如处理器、数字信号处理器、现场可编程门阵列(FPGA)等)来实施工艺流程1330。这种数字装置的实例包括(例如)处理器174、可编程逻辑器件166、处理器190等。图73A-73C示出了如下工艺流程，所述工艺流程描述能够通过发生器102的数字装置执行，以通常实施上述工艺流程1330的程序。图73A示出了用于准备发生器102以作用于新组织切口的程序1340的一个实施例。可在1342处开始新组织切口的启用或启动。在1344处，数字装置可指向第一功率曲线。如上文所述，第一功率曲线可为以工艺流程1330的一部分实施的力度最不强的功率曲线。指向第一功率曲线的步骤可包括指向指示第一功率曲线的确定性公式、指向表示第一功率曲线的查找表、指向第一功率曲线倍增器等。
在1346处，数字装置可使电阻阈值标志复位。如下文所述，设置电阻阈值标志的步骤可指示已达到电阻阈值。因此，重置标志的步骤可指示仍未达到电阻阈值，如在工艺流程1330的开始处可为适当的。在1348处，数字装置可继续进行到下一个例程1350。
图73B示出了能够通过数字装置进行的监测组织电阻的例程1350的一个实施例。在1352处，可测量负载或组织电阻。可根据任何合适的方法和使用任何合适的硬件来测量组织电阻。例如，根据多种实施例，可使用提供到组织的电流和电压并根据欧姆定律来计算组织电阻。在1354处，数字装置可计算电阻变化速率。同样可根据任何合适的方式来计算电阻变化速率。例如，数字装置可保持组织电阻的先前值，并且通过将当前组织电阻值与先前值进行比较来计算变化速率。另外，应当理解，例程1350假定电阻阈值为变化速率。在电阻阈值为数值的实施例中，可省去1354。如果组织电阻的变化速率(或电阻本身)大于阈值(1356)，则可设置电阻阈值标志。数字装置可在1360处继续进行到下一个例程。
图73C示出了能够通过数字装置执行的用于将一个或多个功率曲线提供到组织切口的例程1362的一个实施例。在1364处，可将功率递送到组织，例如，如上文参照图70的1334所述。数字装置能够通过如下方式指导功率曲线的递送，例如，通过应用功率曲线以找到用于每一个感测的组织电阻的对应功率、将对应功率调制到提供到第一电极A20和第二电极A22、换能器114等的驱动信号上。
在1366处，数字装置可计算递送到组织的总累积能量。例如，数字装置可监测功率曲线递送的总时间和在每一个时间递送的功率。可从这些值计算出总能量。在1368处，数字装置可确定总能量是否大于或等于下一个能量阈值，例如，这类似于上文参照图70的1334所述的方式。如果未达到下一个能量阈值，则可在1378和1364处继续应用当前功率曲线。
如果在1368处达到下一个能量阈值，则在1370处，数字装置可确定是否设置电阻阈值标志。电阻阈值标志的状态可指示是否已达到电阻阈值。例如，如果已达到电阻阈值，则可能已通过例程1350设置电阻阈值标志。如果未设置电阻标志(如未达到电阻阈值)，则数字装置可在1372处确定是否仍需实施任何力度更强的功率曲线。如果需要，则数字装置可在1374处使例程1362指向下一个力度更强的功率曲线。例程1362可根据1364处的新功率曲线继续(1378)递送功率。如果所有可用的功率曲线均已得到应用，则数字装置可在1376处使针对组织操作的其余的累积能量的计算和检查失效。
如果已在1370处设置电阻标志(如已达到电阻阈值)，则数字装置可在1376处使针对组织操作的其余的累积能量的计算和检查失效。应当理解，在一些实施例中，累积能量计算可继续进行，而1370、1372、1374和1376可中断。例如，当累积能量达到预定值时，发生器102和/或数字装置可实施自动关闭。
图74示出了用于将一个或多个功率曲线应用到组织切口的工艺流程1400的一个实施例。例如，能够通过发生器102(如发生器102的数字装置)来实施工艺流程1400。在1402处，发生器102可将功率曲线递送到组织。能够通过将倍增器应用到第一功率曲线来获得功率曲线。在1404处，发生器102可确定是否已达到电阻阈值。如果仍未达到电阻阈值，则发生器102可随总施加能量的变化来增加倍增器。这可具有增加所施加功率曲线的强度的作用。应当理解，可周期性或连续地增加倍增器。例如，发生器102可以预定的周期性间隔来检查电阻阈值(1404)并增加倍增器(1406)。在多种实施例中，发生器102可连续地检查电阻阈值(1404)并增加倍增器(1406)。随总施加能量的变化来增加倍增器的步骤可以任何合适的方式来实现。例如，发生器102可应用确定性公式，所述确定性公式接受总接收能量作为输入，并且提供相应的倍增器值作为输出。另外，例如，发生器102可储存查找表，所述查找表包括用于总施加能量的潜在值和相应倍增器值的表。根据多种实施例，发生器102可将脉动驱动信号提供到组织(如通过外科装置104、106中的一者)。根据多种实施例，当达到电阻阈值时，倍增器可保持恒定。发生器102可继续施加功率，例如，直到达到终止阈值。终止阈值可为常数或可取决于倍增器的最终值。
在使用脉动驱动信号的一些实施例中，发生器102可将一个或多个复合负载曲线施加到驱动信号，并最终施加到组织。与本文所述的其他功率曲线相似的复合负载曲线可随所测量组织特性(如电阻)的变化来限定有待递送到组织的电功率水平。复合负载曲线可(另外)根据所测量的组织特性来限定脉冲特性，诸如脉冲宽度。
图75示出了描述通过发生器102选择和施加复合负载曲线的框图1450的一个实施例。应当理解，可利用任何合适类型的发生器或外科装置来实施框图1450。根据多种实施例，可使用电外科装置(诸如上文参照图4-7所述的装置106)来实施框图1450。另外，在多种实施例中，可使用超声外科装置(诸如上文参照图2-3所述的外科装置104)来实施框图1450。在一些实施例中，框图1450可与具有切割以及凝固能力的外科装置结合使用。例如，RF外科装置(诸如装置106)可包括用于在凝固之前或期间切断组织的刀刃，诸如刀片175。
重新参见图75，能够通过(例如)发生器102的数字装置来执行算法1452，以选择和应用复合负载曲线1456、1458、1460、1462。算法1452可接收得自时钟1454的时间输入，并且还可接收得自传感器1468的回路输入1472。回路输入1472可表示可用于算法1452中以选择和/或施加复合负载曲线的组织性质或特性。这种特性的实例可包括(例如)电流、电压、温度、反射性、施加到组织的力、共振频率、共振频率的变化速率等。传感器1468可为专用传感器(如温度计、压力传感器等)或可为软件实施的传感器，所述软件实施的传感器基于其他系统值来获得组织特性(如基于驱动信号来观察和/或计算电压、电流、组织温度等)。算法1452可(例如)基于回路输入1472和/或得自时钟1454的时间输入来选择复合负载曲线1456、1458、1460、1462中的一者进行应用。尽管示出了四条复合负载曲线，但应当理解，可使用任何合适数量的复合负载曲线。
算法1452可以任何合适的方式应用所选复合负载曲线。例如，算法1452可使用所选复合负载曲线来基于组织电阻(如当前测定的组织电阻可为回路输入的一部分或可获得回路输入)计算功率水平和一个或多个脉冲特性、或超声装置104的共振频率特性。可根据复合负载曲线并基于组织电阻确定的脉冲特性的实例可包括脉冲宽度、斜坡时间和休止时间。
在设置点1464处，可将获得的功率和脉冲特性应用到驱动信号。在多种实施例中，可实施反馈回路1474，以允许更精确地调制驱动信号。在设置点1464的输出端处，可将驱动信号提供到放大器1466，所述放大器1466可提供合适的放大率。可将放大的驱动信号提供到负载1470(如通过传感器1468)。负载1470可包括组织、外科装置104、106和/或将发生器102与外科装置104、106电连接的任何电缆(如电缆112、128)。
图76示出了如下工艺流程，所述工艺流程示出了如通过发生器102(如通过发生器102的数字装置)实施的算法1452的一个实施例。可在1476处激活算法1452。应当理解，可以任何合适的方式激活算法1452。例如，能够由临床医生在启用外科装置104、106时(如通过拉引或换句话讲致动钳口闭合扳机138、142、开关、手柄等)激活算法1452。
根据多种实施例，算法1452可包括多个区域1478、1480、1482、1484。每一个区域都可表示组织切口的切割和凝固的不同阶段。例如，在第一区域1478中，发生器102可进行初始组织条件(如电阻)的分析。在第二区域1480中，发生器102可将能量施加到组织，以便将组织准备用于切割。在第三或切割区域1482中，发生器102可继续施加能量同时外科装置104、106切割组织(如对于电外科装置106，能够通过推进刀片A18来进行切割)。在第四或完成区域1484中，发生器102可施加切割后能量，以完成凝固。
现在参见第一区域1478，发生器102可测量任何合适的组织条件，包括(例如)电流、电压、温度、反射性、施加到组织的力等。在多种实施例中，可根据任何合适的方式来测量组织的初始电阻。例如，发生器102可调制驱动信号，以向组织提供已知电压或电流。电阻可得自已知电压和测量电流，反之亦然。应当理解，作为另外一种选择或除此之外，可以任何其他合适的方式来测量组织电阻。根据算法1452，发生器102可从第一区域1478进行到第二区域1480。在多种实施例中，临床医生可(例如)通过关闭发生器102和/或外科装置104、106而在第一区域1478中结束算法1452。如果临床医生终止算法1542，则另外可在1486处终止RF(和/或超声)递送。
在第二区域1480中，发生器102可开始通过驱动信号将能量施加到组织，以将组织准备用于切割。可根据复合负载曲线1456、1458、1460、1462来施加能量，如下文所述。根据第二区域1480施加能量可包括根据复合负载曲线1456、1458、1460、1462中的一些或全部将脉冲调制到驱动信号上。在多种实施例中，可按照强度顺序来相继地应用复合负载曲线1456、1458、1460、1462(如以适应夹持在器械钳口中的多种类型的组织体积)。
可首先应用第一复合负载曲线1456。发生器102能够通过将一个或多个第一复合负载曲线脉冲调制到驱动信号上来应用第一复合负载曲线1456。每一个第一复合负载曲线脉冲都可具有根据第一复合负载曲线确定的并且考虑所测量组织电阻的功率和脉冲特性。用于第一脉冲的所测量电阻可为在第一区域1478处测量的电阻。在多种实施例中，发生器102可使用第一复合负载曲线脉冲中的全部或一部分来进行组织电阻或共振频率的附加测量。可使用该附加测量来确定后续脉冲的功率和其他脉冲特性。
图77示出了用于产生第一复合负载曲线脉冲的工艺流程1488的一个实施例。能够通过发生器102(如通过发生器102的数字装置)来执行工艺流程1488，例如，作为算法1452的一部分。在1490处，发生器102可计算脉冲宽度(Tpw)。可考虑最近的测量组织电阻(Z)并且根据第一复合负载曲线1456来确定脉冲宽度。
在1492处，发生器102可在斜坡时间(tramp)内将驱动信号的功率斜坡上升到高达脉冲功率(PLimit)，由此将脉冲施加到组织。可再次考虑最近的测量组织电阻(Z)并且根据第一复合负载曲线1456来确定脉冲功率。斜坡时间可根据考虑组织电阻的复合负载曲线来确定或可为恒定的(如对于所有的第一复合负载曲线脉冲而言为恒定的、对于所有脉冲而言为恒定的等)。发生器102可以任何合适的方式(包括，例如调制通过驱动信号提供的电流和/或电压)将脉冲功率施加到驱动信号。根据多种实施例，驱动信号可为交流电(A/C)信号，并且因此脉冲本身可包括多个周期的驱动信号。
在1494处，可针对脉冲宽度将驱动信号保持在脉冲功率。在脉冲结束时，在1496处，驱动信号可在下降时间(Tfall)内倾斜下降。下降时间可根据考虑组织电阻的第一复合负载曲线来确定或可为恒定的(如对于所有的第一复合负载曲线脉冲而言为恒定的、对于所有脉冲而言为恒定的等)。应当理解，根据实施例，斜坡时间和下降时间可视为或可不视为脉冲宽度的一部分。在1498处，发生器102可暂停休止时间(Toff)。与斜坡时间和下降时间相似，休止时间可根据考虑组织电阻的第一复合负载曲线来确定或可为恒定的(如对于所有的第一复合负载曲线脉冲而言为恒定的、对于所有脉冲而言为恒定的等)。
在休止时间完成时，只要是应用了第一复合负载曲线1456，发生器102就可重复工艺流程1488。根据多种实施例，发生器102可将第一复合负载曲线1456应用预定的时间量。因此，可重复工艺流程1488，直到预定的时间量已流逝(如基于从时钟1454接收的时间输入来确定)。另外，在多种实施例中，可将第一复合负载曲线应用预定的脉冲数。由于所应用脉冲宽度根据所测组织电阻而改变，因此第一复合负载曲线的所应用总时间也可随所测组织电阻而改变。根据多种实施例，第一复合负载曲线1456(以及其他复合负载曲线1458、1460、1462)可规定当组织电阻增加时降低脉冲宽度的步骤。因此，较高的初始电阻可导致在第一复合负载曲线中花费较少的时间。
在完成第一复合负载曲线1456时，发生器102可在第二区域1480的整个施加过程中相继地应用其余强化负载曲线1458、1460、1462。可以类似于上述负载曲线1456的方式来应用每一条负载曲线1458、1460、1462。例如，可产生根据当前负载曲线的脉冲，直到该负载曲线完成(如预定的时间量或预定的脉冲数终止)。对于每一条复合负载曲线1456、1458、1460、1462而言，预定的脉冲数都可为相同的或可为不同的。根据多种实施例，可以类似于工艺流程1488的方式产生根据负载曲线1458、1460、1462的脉冲，不同的是可根据当前复合负载曲线获得脉冲功率、脉冲宽度以及一些实施例中的斜坡时间、下降时间和休止时间。
可在发生多个事件时终止第二区域1480。例如，如果总RF施加时间已超过超时时间，则发生器102可在1486处通过终止RF(和/或超声)递送来结束组织工作。另外，多个事件可使发生器102从第二区域1480过渡到第三区域1482。例如，当组织电阻(Z)超过阈值组织电阻(Zterm)并且RF能量已递送至少超过最少时间(Tstart)时，发生器102可过渡到第三区域1482。阈值组织电阻可为指示组织切口得以充分准备以便通过刀片175进行切割的电阻和/或电阻变化速率。
根据多种实施例，如果在第二区域1480完成之前，最终负载曲线1462在第二区域1480中结束，则可继续应用最终功率曲线1462，例如，直到达到组织电阻阈值、达到最大第二区域时间和/或达到超时时间。另外，应当理解，对于一些组织切口而言，第二区域1480可在执行所有可用的强化负载曲线1456、1458、1460、1462之前来完成。
在第三区域1482处，发生器102可继续将脉冲调制到驱动信号上。一般来讲，可根据任何合适的方式(包括例如上文参照工艺流程1488所述的方式)将第三区域脉冲调制到驱动信号上。第三区域脉冲的功率和脉冲特性可根据任何合适的方式来确定，并且在多种实施例中，可基于在第二区域1480完成时执行的复合负载曲线(当前负载曲线)来确定。根据多种实施例，可使用当前负载曲线来确定第三区域脉冲的脉冲功率，但无论复合负载曲线如何，脉冲特性(如脉冲宽度、斜坡时间、下降时间、休止时间等)都可以为常数。在一些实施例中，第三区域1482可使用第三区域特异性复合负载曲线，所述第三区域特异性复合负载曲线可为用于第二区域1480中的负载曲线1456、1458、1460、1462中的一条、或可为不同的复合负载曲线(未示出)。
发生器102可继续执行第三区域1482，直到接收到组织切割完成的指示。在使用具有刀片(诸如175)的外科工具的实施例中，当刀片175到达其最远端位置时(如图6所示)，可接收到所述指示。这可使指示刀片175已到达其推进端的闸刀限位传感器(未示出)脱扣。在接收到组织切割完成的指示时，发生器102可继续进行到第四区域1484。另外应当理解，在一些实施例中，(例如)如果已达到超时时间，则发生器102可从第三区域1482直接过渡到1486处的RF(和/或超声)终止端。
在第四区域1484中，发生器102可提供如下能量分布，所述能量分布被设计为完成目前切口组织的凝固。例如，根据多种实施例，发生器102可提供预定的脉冲数。可以类似于上文参照工艺流程1488所述的方式来提供脉冲。可根据任何合适的方式来确定脉冲的功率和脉冲特性。例如，可基于当前复合负载区域、第三区域特异性负载曲线、或第四区域特异性复合负载曲线来确定第四区域脉冲的功率和脉冲特性。在一些实施例中，可基于当前复合负载曲线来确定的电功率，而脉冲特性可为第四区域特异性的。另外，根据多种实施例，可独立于当前复合负载曲线来确定第四区域脉冲的功率和脉冲特性。
图78示出了脉冲计时图1474的一个实施例，所述脉冲计时图1474示出了算法1452通过发生器102(如通过发生器102的数字装置)的实例应用。第一区域脉冲1502示为位于第一区域1478中。如本文所述，第一区域脉冲1502可用于测量初始组织电阻。在第一区域脉冲(1509)完成时，第二区域1480可开始于所施加的第二区域脉冲1504。可根据各个复合负载曲线1456、1458、1460、1462来施加第二区域脉冲1504，例如，如本文所述。在实例图表1474中，第二区域1480在1510处结束，此时组织达到阈值电阻(Zterm)。然后如上文所述，利用所施加的第三区域脉冲1506来实施第三区域1482，直到在1512处接收到闸刀限位信号。此时，第四区域1484可以施加的第四区域脉冲1508开始，如上文所述，直到在1514处完成循环。
根据多种实施例，发生器102可实施结合算法1452的用户界面。例如，用户界面可指示算法的当前区域。可在视觉上和/或在听觉上来实施用户界面。例如，发生器102可包括用于产生可听音或其他听觉指示的扬声器。至少一个听觉指示可对应第二区域1480。第三区域1482和第四区域1484也可具有区域特异性听觉指示。根据多种实施例，第一区域1478也可具有区域特异性听觉指示。根据多种实施例，听觉指示可包括通过发生器102产生的脉冲音。声音的频率和/或声音的音调本身可指示当前区域。除听觉指示之外或取代听觉指示，发生器102也可提供当前区域的视觉指示(如在输出装置147上)。应当理解，临床医生可利用所述用户界面来适当地使用发生器102和相关外科装置104、106。例如，第二区域1480的指示可让临床医生知道组织处理已开始。第三区域1482的指示可让临床医生知道组织已准备用于切割操作。第四区域1484的指示可让临床医生知道切割操作完成。指示和/或最终指示的停止可表明总切割/凝固操作完成。
图79示出了根据实例负载曲线1520的驱动信号电压、电流和功率的图形表示。在图表1520中，驱动信号电压由线条1522表示，驱动信号电流由线条1524表示，并且驱动信号功率由线条1526表示。脉冲宽度未示于图79中。在多种实施例中，由图表1520指出的电压1522、电流1524和功率1526的值可表示单个脉冲内的潜在值。因此，能够通过添加如下曲线(未示出)将负载曲线1520表示为复合负载曲线，所述曲线指示随组织电阻或另一个组织条件变化的脉冲宽度。如针对负载曲线1520所示，最大电压1522为100伏均方根(RMS)电压，最大电流为3安RMS电流，并且最大功率为135瓦RMS功率。
图79-84示出了多种实例复合负载曲线1530、1532、1534、1536、1538、1540的图形表示。复合负载曲线1530、1532、1534、1536、1538、1540中的每一条都可指示基于所测量组织电阻的脉冲功率和脉冲宽度。复合负载曲线1530、1532、1534、1536可单独地或作为连续较强力复合负载曲线的模式的一部分来进行实施，如上文参照算法1452所述。
图80示出了第一实例复合负载曲线1530的图形表示。复合负载曲线1530的最大RMS脉冲功率可以为45瓦，最大脉冲宽度可以为0.35秒。在图80中，通过1542指示出随组织电阻变化的功率，同时通过1544指示出随组织电阻变化的脉冲宽度。下表1示出了对于组织电阻为0Ω至475Ω而言的复合负载曲线1530的值。
表1
Figure BPA00001564218000761
在多种实施例中，复合负载曲线1530可适用于较小的外科装置和/或较小的组织切口。
图81示出了第二实例复合负载曲线1532的图形表示。复合负载曲线1532的最大RMS脉冲功率可以为45瓦，最大脉冲宽度可以为0.5秒。在图81中，通过1546指示出随组织电阻变化的功率，同时通过1548指示出随组织电阻变化的脉冲宽度。下表2示出了对于组织电阻为0Ω至475Ω而言的复合负载曲线1532的值。
表2
Figure BPA00001564218000771
复合负载曲线1532可作用于小的单个血管组织切口，并且根据多种实施例可为应用于区域二1480中的第一复合功率曲线。
图82示出了第三实例复合负载曲线1534的图形表示。复合负载曲线1534的最大RMS脉冲功率可以为60瓦，最大脉冲宽度可以为2秒。在图82中，通过1550指示出随组织电阻变化的功率，同时通过1552指示出随组织电阻变化的脉冲宽度。下表3示出了对于组织电阻为0Ω至475Ω而言的复合负载曲线1534的值。
表3
Figure BPA00001564218000791
复合负载曲线1534因其通常较高的功率而比先前曲线1532的力度更强。复合负载曲线1534另外与先前曲线1532相比可初始具有较高的脉冲宽度，但复合负载曲线1534的脉冲宽度可在仅150Ω。处开始下降。根据多种实施例，复合负载曲线1536可用于算法1542中，作为在复合负载曲线1532之后相继实施的负载曲线。
图83示出了第四实例复合负载曲线1536的图形表示。复合负载曲线1536的最大RMS脉冲功率可以为90瓦，最大脉冲宽度可以为2秒。在图83中，通过1554指示出随组织电阻变化的功率，同时通过1556指示出随组织电阻变化的脉冲宽度。下表4示出了对于组织电阻为0Ω至475Ω而言的复合负载曲线1536的值。
表4
复合负载曲线1536可又比先前曲线1534的力度更强，并且因此可在算法1452中在曲线1534之后进行实施。另外，根据多种实施例，复合负载曲线1536可适用于较大的组织束。
图84示出了第五实例复合负载曲线1538的图形表示。复合负载曲线1538的最大RMS脉冲功率可以为135瓦，最大脉冲宽度可以为2秒。在图84中，通过1558指示出随组织电阻变化的功率，同时通过1560指示出随组织电阻变化的脉冲宽度。下表5示出了对于组织电阻为0Ω至475Ω而言的复合负载曲线1538的值。
表5
Figure BPA00001564218000802
可在算法1452中在先前曲线1536之后相继地使用复合负载曲线1538。
图85示出了第六实例复合负载曲线1540的图形表示。复合负载曲线1540的最大RMS脉冲功率可以为90瓦，最大脉冲宽度可以为2秒。在图85中，通过1562指示出随组织电阻变化的功率，同时通过1564指示出随组织电阻变化的脉冲宽度。下表6示出了对于组织电阻为0Ω至475Ω而言的复合负载曲线1540的值。
表6
Figure BPA00001564218000821
复合功率曲线1540不如先前功率曲线1538的力度强。根据多种实施例，可在算法1452中在曲线1538之后相继地实施复合功率曲线1540。另外，在一些实施例中，复合功率曲线1540可在算法1452中实施为第三或第四区域特异性复合功率曲线。
如上文所述，用于算法1452中的各个复合功率曲线可各自针对预定的脉冲数进行实施。下表7示出了对于在算法1452中相继地使用功率曲线1532、1534、1536、1540的实例实施例而言每个复合功率曲线的脉冲数。
表7
Figure BPA00001564218000831
最后的复合功率曲线1540显示不具有相应的脉冲数。例如，可实施复合功率曲线1540直到临床医生终止操作、直到达到超时时间、直到达到阈值组织电阻等。
根据多种实施例，发生器102可以如下方式将功率提供到组织切口，所述方式产生其他组织参数的所需值。图86示出了描述应用算法1572以用于保持恒定的组织电阻变化速率的框图1570的一个实施例。能够通过发生器102(如通过发生器102的数字装置)来实施算法1572。例如，发生器102可利用算法1572来调制驱动信号。传感器1574可感测组织条件，诸如组织电阻和/或组织电阻的变化速率。传感器1574可为硬件传感器，或在多种实施例中可为软件实施的传感器。例如，传感器1574可基于所测量的驱动信号电流和电压来计算组织电阻。能够通过发生器102将驱动信号提供到电缆/工具/负载1576，所述电缆/工具/负载1576可为组织、外科装置104、106和将发生器102电连接到装置104、106的电缆112、128的电气组合。
发生器102通过实施算法1572，可监测组织或负载的电阻，包括(例如)电阻的变化速率。发生器102可调制通过驱动信号提供的电压、电流和/或功率中的一者或多者，以保持预定常数值下的组织电阻变化速率。另外，根据多种实施例，发生器102可将组织电阻变化速率保持为高于最小的电阻变化速率。
应当理解，可结合本文所述的多种其他算法来实施算法1572。例如，根据多种实施例，发生器102可将组织电阻相继地调制为不同的、强度递增的速率，这类似于本文参照本文图70所述的方法1330。例如，可保持第一电阻变化速率，直到递送到组织的总能量超过预定的能量阈值。在能量阈值下，如果组织条件仍未达到预定水平(如预定的组织电阻)，则发生器102可利用驱动信号将组织驱动到第二较高的电阻变化速率。另外，在多种实施例中，可以类似于上文参照复合负载曲线所述的方式来使用组织电阻变化速率。例如，取代使用多个复合负载曲线，图75的算法1452可能需要应用多个组织电阻变化速率。可将每一个组织电阻变化速率都保持预定的时间量和/或预定的脉冲数。所述速率可为按照数值顺序而相继施加的(如速率可相继地增加)。然而，在一些实施例中，组织电阻变化的驱动速率可达到峰值并且随后降低。
虽然本文已结合某些公开的实施例对所述装置的多种实施例作了描述，但也可以实施这些实施例的许多修改形式和变型形式。例如，可以采用不同类型的端部执行器。另外，凡是公开了用于某些元件的材料的，均可使用其它材料。上述具体实施方式和下述权利要求旨在涵盖所有这样的修改形式和变型形式。
以引用方式全文或部分地并入本文的任何专利、公布或其它公开材料都仅在所并入的材料不与本发明所述的现有定义、陈述或其它公开材料相冲突的范围内并入本文。同样地并且在必要的程度下，本文明确阐述的公开内容取代了以引用方式并入本文的任何冲突材料。如果任何材料或其部分据述以引用方式并入本文，但与本文所述的现有定义、陈述或其它公开材料相冲突，那么仅在所并入的材料和现有公开材料之间不产生冲突的程度下才将其并入本文。

Claims (187)

1.一种将驱动信号传送到外科装置的发生器，所述发生器包括：
功率放大器，所述功率放大器用于接收时变驱动信号波形，所述驱动信号波形通过多个驱动信号波形样本的至少一部分的数字-模转换产生，所述功率放大器的输出用于产生驱动信号，所述驱动信号包括第一驱动信号和第二驱动信号之一，所述第一驱动信号有待传送到超声外科装置，所述第二驱动信号有待传送到电外科装置；
采样电路，在将所述驱动信号传送到所述外科装置时，所述采样电路用于产生所述驱动信号的电流和电压的样本，所述样本的产生与所述驱动信号波形样本的所述数字-模转换同步，使得对于驱动信号波形样本的每一次数字-模转换而言，所述采样电路均产生对应组的电流和电压样本；
至少一个装置，对于每一个驱动信号波形样本和对应组的电流和电压样本，所述至少一个装置都被编程为：
将所述电流和电压样本储存在所述至少一个装置的存储器中，以使所述储存的样本和所述驱动信号波形样本相关联；
当所述驱动信号包括所述第一驱动信号时：
根据所述储存的电流和电压样本，确定所述超声外科装置的动态支路电流样本；
将所述动态支路电流样本与目标样本进行比较，所述目标样本选自限定目标波形的多个目标样本，并且根据所述驱动信号波形样本加以选择；
确定所述目标样本和所述动态支路电流样本之间的大小误差；以及
修改所述驱动信号波形样本，使得在所述目标样本和后续动态支路电流样本之间确定的大小误差减小，所述后续动态支路电流样本取决于与所述修改的驱动信号波形样本相关的电流和电压样本。
2.根据权利要求1所述的发生器，包括电源变压器，所述电源变压器用于根据所述功率放大器输出来产生所述驱动信号，所述第一驱动信号有待通过第一电源变压器输出端传送到所述超声外科装置，所述第二驱动信号有待通过第二电源变压器输出端传送到所述电外科装置。
3.根据权利要求1所述的发生器，其中所述多个驱动信号波形样本储存在查找表(LUT)中，并且其中所述至少一个装置被编程为从所述LUT中选择性地调用所述多个驱动信号波形样本的所述至少一部分，所述多个驱动信号波形样本的所述至少一部分用于产生所述驱动信号波形。
4.根据权利要求3所述的发生器，其中所述至少一个装置被编程为实施直接数字合成(DDS)算法，以选择性地调用所述多个驱动信号波形样本的所述至少一部分，所述多个驱动信号波形样本的所述至少一部分用于产生所述驱动信号波形。
5.根据权利要求3所述的发生器，其中所述至少一个装置被编程为：
当所述驱动信号包括所述第一驱动信号时：
根据多个动态支路电流样本和对应于所述多个动态支路电流样本的多个电压样本，确定所述超声外科器械的电阻相位；以及
控制所述驱动信号波形的频率，以将所述电阻相位调节到0度电阻相位设定点。
6.根据权利要求3所述的发生器，其中所述至少一个装置被编程为：
根据驱动信号电流设定点、驱动信号电压设定点和驱动信号功率设定点中的至少一个来控制所述驱动信号电流的大小，其中所述驱动信号电流的所述大小通过下述方式中的至少一种来控制：
控制储存在所述LUT中的所述驱动信号波形样本的定标；以及
控制数字-模转换器(DAC)的最大定标输出电压，所述数字-模转换器(DAC)用于执行所述多个驱动信号波形样本的所述至少一部分的所述数字-模转换。
7.根据权利要求1所述的发生器，其中所述至少一个装置被编程为：
根据由所述功率放大器接收的所述时变驱动信号波形的信号包络，控制所述功率放大器的干线电压。
8.根据权利要求1所述的发生器，其中所述至少一个装置被编程为：
确定下述值中的至少一个：所述驱动信号的均方根(RMS)电流、所述驱动信号的RMS电压、所述驱动信号的真实功率、所述驱动信号的表观功率和由所述驱动信号驱动的负载的电阻大小。
9.根据权利要求1所述的发生器，其中所述至少一个装置被编程为：
将滤波器应用到所述电流和电压样本，以降低所述样本的谐波失真成分。
10.根据权利要求1所述的发生器，其中所述采样电路包括第一模-数字转换器(ADC)和第二ADC，所述第一模-数字转换器(ADC)和所述第二ADC分别产生所述驱动信号的电流和电压样本。
11.根据权利要求1所述的发生器，其中所述采样电路包括第一模-数字转换器(ADC)和双路复用器，所述双路复用器连接到所述第一ADC的输入端。
12.根据权利要求1所述的发生器，其中所述采样电路能够以200x过采。
13.根据权利要求1所述的发生器，其中所述至少一个装置包括逻辑电路，所述逻辑电路与第一处理器通信，其中所述第一处理器包括数字信号处理器。
14.根据权利要求13所述的发生器，其中所述逻辑电路包括现场可编程门阵列(FPGA)。
15.根据权利要求13所述的发生器，其中所述至少一个装置包括第二处理器，所述第二处理器与所述逻辑电路和所述第一处理器通信，并且被编程为通过至少一个输入装置接收用户输入以及通过至少一个输出装置提供用户反馈。
16.根据权利要求1所述的发生器，其中所述发生器包括器械接口电路，以使得所述发生器和所述外科装置的控制电路能够通过导线对进行通信。
17.根据权利要求16所述的发生器，其中所述器械接口使得在所述发生器和所述外科装置的控制电路之间能够使用多个通信通道进行通信。
18.根据权利要求17所述的发生器，其中所述器械接口使得在所述发生器和所述外科装置的控制电路之间能够使用频带分离的通信通道进行通信。
19.根据权利要求18所述的发生器，其中所述器械接口电路使用以第一频带发送的询问信号与所述控制电路的第一部分进行通信，并且其中所述器械接口电路能够通过以第二频带发送的通信协议与所述控制电路的第二部分进行通信。
20.根据权利要求19所述的发生器，其中所述通信协议为单线通信协议。
21.根据权利要求2所述的发生器，其中所述第二电源变压器输出端具有第一阻隔电容器，所述第一阻隔电容器与第二阻隔电容器串联，并且其中所述至少一个装置被编程为监测所述第一电容器和所述第二电容器之间的电压，以确定所述第一电容器和所述第二电容器之一何时失效。
22.一种用于确定超声外科装置的超声换能器中的在换能器驱动信号的多个频率上的动态支路电流的方法，所述方法包括：
在所述换能器驱动信号的多个频率中的每一个下：
过采所述换能器驱动信号的电流和电压；
通过处理器接收所述电流和电压样本；
根据所述电流和电压样本、所述超声换能器的静态电容和所述换能器驱动信号的所述频率，由所述处理器确定所述动态支路电流。
23.一种用于控制外科装置的超声换能器中的动态支路电流的波形形状的方法，所述方法包括：
通过使用直接数字合成(DDS)算法选择性地调用储存在查找表(LUT)中的驱动信号波形样本，产生换能器驱动信号；
当所述换能器驱动信号被传送到所述外科装置时，产生所述换能器驱动信号的电流和电压样本；
根据所述电流和电压样本、所述超声换能器的静态电容和所述换能器驱动信号的频率，确定所述动态支路电流的样本；
将所述动态支路电流的每一个样本与目标波形的相应目标样本进行比较，以确定大小误差；以及
修改储存在所述LUT中的所述驱动信号波形样本，使得所述动态支路电流的后续样本和相应目标样本之间的大小误差减小。
24.根据权利要求23所述的方法，其中所述目标波形包括正弦波形。
25.根据权利要求23所述的方法，其中所述目标波形包括至少两个叠加波形。
26.根据权利要求25所述的方法，其中所述目标波形包括正弦波形，所述正弦波形与所述正弦波形的n级谐波叠加，其中n为正整数。
27.一种将驱动信号传送到外科装置的发生器，所述发生器包括：
存储器；
连接到所述存储器的装置，所述装置针对用于合成所述驱动信号的多个驱动信号波形样本中的每一个来接收所述驱动信号的对应组的电流和电压样本，并且对于每一个驱动信号波形样本和对应组的电流和电压样本而言，所述装置都用于：
将所述样本储存在所述装置的存储器中，以使所述储存的样本和所述驱动信号波形样本相关联；
当所述驱动信号包括有待传送到超声外科装置的第一驱动信号时：
根据所述储存的样本，确定所述超声外科装置的动态支路电流样本；
将所述动态支路电流样本与目标样本进行比较，所述目标样本选自限定目标波形的多个目标样本，并且根据所述驱动信号波形样本加以选择；
确定所述目标样本和所述动态支路电流样本之间的大小误差；以及
修改所述驱动信号波形样本，使得在所述目标样本和后续动态支路电流样本之间确定的大小误差减小，所述后续动态支路电流样本取决于与所述修改的驱动信号波形样本相关的电流和电压样本。
28.一种用于将驱动信号提供到外科装置的外科发生器，所述发生器包括：
第一变压器，所述第一变压器具有第一主线圈和第一次线圈；
第二变压器，所述第二变压器具有第二主线圈和第二次线圈；
发生器电路，所述发生器电路用于产生所述驱动信号，其中所述发生器电路被电连接到所述第一主线圈，以在所述第一主线圈上提供所述驱动信号；
患者侧电路，所述患者侧电路与所述发生器电路电隔离，其中所述患者侧电路被电连接到所述第一次线圈，并且其中所述患者侧电路包括第一输出线路和第二输出线路，以将所述驱动信号提供到所述外科装置；和
电容器，其中所述电容器和所述第二次线圈在所述第一输出线路和大地之间被串联电连接。
29.根据权利要求28所述的外科发生器，其中所述电容器具有第一电极和第二电极，所述第一电极被电连接到所述第一输出线路，所述第二电极被电连接到所述第二次线圈。
30.根据权利要求29所述的外科发生器，其中所述第二次线圈具有第一电极和第二电极，该第一电极被电连接到所述电容器的所述第二电极，该第二电极被电连接到大地。
31.根据权利要求30所述的外科发生器，其中所述负载电阻器具有第一电极和第二电极，该第一电极被电连接到所述第二次线圈的所述第一电极，该第二电极被电连接到所述第二次线圈的所述第二电极。
32.根据权利要求28所述的外科发生器，其中所述第二次线圈具有第一电极和第二电极，该第一电极被电连接到所述第一输出线路，该第二电极被电连接到所述电容器。
33.根据权利要求28所述的外科发生器，其中所述电容器具有第一电极和第二电极，该第一电极被电连接到所述第二次线圈的所述第二电极，该第二电极被电连接到大地。
34.根据权利要求28所述的外科发生器，还包括：
校正电路，所述校正电路串联地设置在所述电容器和大地之间；和
校正控制电路，其中所述校正电路被编程为：
接收输入，所述输入描述所述驱动信号的电流、所述驱动信号的电压和负载条件中的至少一个，所述负载条件描述由所述驱动信号所作用的组织的特性；
计算校正信号；以及
将所述校正信号提供到所述校正电路。
35.根据权利要求34所述的外科发生器，其中所述校正控制电路包括：
至少一个处理器；
至少一个模-数字转换器，所述至少一个模-数字转换器将所述输入转换成数字信号；和
至少一个数字-模转换器，所述至少一个数字-模转换器将所述校正信号转换成模信号。
36.根据权利要求28所述的外科发生器，其中所述电容器为Y型电容器。
37.根据权利要求28所述的外科发生器，还包括负载电阻器，所述负载电阻器与所述第二次线圈并联电连接，其中所述第二次线圈相对于第二主线圈的极性与所述第一次线圈的极性相反。
38.一种用于将驱动信号提供到外科装置的外科发生器，所述发生器包括：
第一变压器，所述第一变压器具有主线圈、第一次线圈和第二次线圈，其中所述第一次线圈相对于所述主线圈的极性与所述第二次线圈的所述极性相反；
发生器电路，所述发生器电路用于产生所述驱动信号，其中所述发生器电路被电连接到所述第一主线圈，以在所述第一主线圈上提供所述驱动信号；
患者侧电路，所述患者侧电路与所述发生器电路电隔离，其中所述患者侧电路被电连接到所述第一次线圈，并且其中所述患者侧电路包括第一输出线路和第二输出线路，以将所述驱动信号提供到所述外科装置；和
电容器，其中所述电容器和第二次线圈在所述第一输出线路和大地之间被串联电连接。
39.根据权利要求38所述的外科发生器，其中所述电容器具有第一电极和第二电极，所述第一电极被电连接到所述第一输出线路，所述第二电极被电连接到所述第二次线圈。
40.根据权利要求39所述的外科发生器，其中所述第二次线圈具有第一电极和第二电极，该第一电极被电连接到所述电容器的所述第二电极，该第二电极被电连接到大地。
41.根据权利要求40所述的外科发生器，还包括负载电阻器，所述负载电阻器与所述第二次线圈并联电连接，其中所述负载电阻器具有第一电极和第二电极，该第一电极被电连接到所述第二次线圈的所述第一电极，该第二电极被电连接到所述第二次线圈的所述第二电极。
42.根据权利要求38所述的外科发生器，其中所述第二次线圈具有第一电极和第二电极，该第一电极被电连接到所述第一输出线路，该第二电极被电连接到所述电容器。
43.根据权利要求38所述的外科发生器，其中所述电容器具有第一电极和第二电极，该第一电极被电连接到所述第二次线圈的所述第二电极，该第二电极被电连接到大地。
44.根据权利要求38所述的外科发生器，还包括：
校正控制电路，所述校正控制电路串联地设置在所述电容器和大地之间；和
校正控制电路，其中所述校正电路被编程为：
接收输入，所述输入描述所述驱动信号的电流、所述驱动信号的电压和负载条件中的至少一个，所述负载条件描述由所述驱动信号所作用的组织的特性；
计算校正信号；以及
将所述校正信号提供到所述校正电路。
45.根据权利要求44所述的外科发生器，其中所述校正控制电路包括：
至少一个处理器；
至少一个模-数字转换器，所述至少一个模-数字转换器将所述输入转换成数字信号；和
至少一个数字-模转换器，所述至少一个数字-模转换器将所述校正信号转换成模信号。
46.根据权利要求38所述的外科发生器，其中所述电容器为Y型电容器。
47.一种用于将驱动信号提供到外科装置的外科发生器，所述发生器包括：
第一变压器，所述第一变压器具有主线圈和次线圈；
发生器电路，所述发生器电路用于产生所述驱动信号，其中所述发生器电路被电连接到所述第一主线圈，以在所述第一主线圈上提供所述驱动信号；
患者侧电路，所述患者侧电路与所述发生器电路电隔离，其中所述患者侧电路被电连接到所述次线圈，并且其中所述患者侧电路包括第一输出线路和第二输出线路，以将所述驱动信号提供到所述外科装置；
电容器，其中所述电容器被电连接到所述主线圈并且被电连接到所述第一输出线路。
48.根据权利要求47所述的外科发生器，其中所述电容器为Y型电容器。
49.一种用于将驱动信号提供到外科装置的外科发生器，所述发生器包括：
第一变压器，所述第一变压器具有主线圈和次线圈；
发生器电路，所述发生器电路用于产生所述驱动信号，其中所述发生器电路被电连接到所述第一主线圈，以在所述第一主线圈上提供所述驱动信号；
患者侧电路，所述患者侧电路与所述发生器电路电隔离，其中所述患者侧电路被电连接到所述次线圈，并且其中所述患者侧电路包括第一输出线路和第二输出线路，以将所述驱动信号提供到所述外科装置；
第一电容器，其中所述第一电容器的第一电极被电连接到所述主线圈；
第二电容器，其中所述第二电容器的第一电极被电连接到所述第一输出线路，并且所述第二电容器的第二电极被电连接到所述第一电容器的第二电极；
第三电容器，其中所述第三电容器的第一电极被电连接到所述第一电容器的所述第二电极以及所述第二电容器的所述第二电极，并且其中所述第三电容器的第二电极被电连接到大地。
50.根据权利要求49所述的外科发生器，其中所述第二电容器为Y型电容器。
51.一种外科装置的控制电路，所述控制电路包括：
第一电路部分，所述第一电路部分包括至少一个第一开关，所述第一电路部分通过导线对与外科发生器通信；和
第二电路部分，所述第二电路部分包括数据电路元件，所述数据电路元件设置在所述外科装置的器械中，并且用于发送或接收数据，所述数据电路元件通过所述导线对中的至少一条导线实施与所述外科发生器的数据通信。
52.根据权利要求51所述的控制电路，其中所述数据电路元件包括单线总线装置，所述单线总线装置通过所述导线对中的单条导线实施与所述外科发生器的数据通信。
53.根据权利要求51所述的控制电路，其中所述数据电路元件包括数据存储器件，所述数据存储器件用于储存有待所述外科发生器检索的数据。
54.根据权利要求53所述的控制电路，其中由所述数据存储器件储存的所述数据的至少一部分通过所述外科发生器发送到所述数据存储器件。
55.根据权利要求53所述的控制电路，其中所述数据存储器件包括电可擦可编程只读存储器(EEPROM)。
56.根据权利要求51所述的控制电路，其中所述数据电路元件包括数据输入装置。
57.根据权利要求56所述的控制电路，其中所述数据电路元件包括指示器，以根据所述数据电路元件从所述外科发生器接收的数据提供用户指示。
58.根据权利要求51所述的控制电路，其中所述数据电路元件包括数据输出装置。
59.根据权利要求58所述的控制电路，其中所述数据电路元件与设置在所述器械中的传感器通信，并且其中所述数据电路元件将传感器数据发送到所述外科发生器。
60.根据权利要求51所述的控制电路，其中所述外科发生器与所述第一电路部分和所述第二电路部分之间的通信为频带分离的。
61.根据权利要求60所述的控制电路，其中所述第一电路部分接收从所述外科发生器以第一频带发送的第一询问信号，并且其中所述第一询问信号与所述第二电路部分隔离。
62.根据权利要求61所述的控制电路，其中所述数据电路元件利用以第二频带发送的通信协议与所述外科发生器通信。
63.根据权利要求61所述的控制电路，其中当通过所述第一电路部分接收到所述第一询问信号时，所述第一询问信号的特性表征所述至少一个第一开关的状态。
64.根据权利要求63所述的控制电路，其中所述第一询问信号的所述特性包括电压、电流、大小和相位中的至少一个。
65.根据权利要求61所述的控制电路，其中所述第一询问信号包括双极性电流信号。
66.根据权利要求61所述的控制电路，其中所述第一询问信号的频率为约2kHz。
67.根据权利要求60所述的控制电路，其中所述第二电路部分包括感应元件，以将所述至少一个第一开关与所述数据电路元件隔离。
68.根据权利要求61所述的控制电路，其中所述第二电路部分包括至少一个第二开关。
69.根据权利要求68所述的控制电路，其中所述第二电路部分接收从所述外科发生器以第三频带发送的第二询问信号。
70.根据权利要求69所述的控制电路，其中当通过所述第二电路部分接收到所述第二询问信号时，所述第二询问信号的特性表征所述至少一个第二开关的状态。
71.根据权利要求69所述的控制电路，其中所述至少一个第二开关与所述数据电路元件和与所述第一电路部分频带分离，使得所述第二询问信号与所述数据电路元件和所述第一电路部分隔离。
72.一种外科装置的控制电路，所述控制电路包括：
第一电路部分，所述第一电路部分包括至少一个第一开关，所述第一电路部分通过导线对与外科发生器通信；和
第二电路部分，所述第二电路部分包括数据电路元件，所述数据电路元件设置在所述外科装置的器械中，并且用于发送或接收数据，所述数据电路元件通过所述导线对中的至少一条导线实施与所述外科发生器的数据通信；
其中所述第一电路部分接收从所述外科发生器以第一频带发送的第一询问信号；并且
其中所述数据电路元件利用以第二频带发送的大小调制的通信协议与所述外科发生器通信，其中所述第二频带高于所述第一频带。
73.根据权利要求72所述的控制电路，其中所述第一询问信号包括频率为约2kHz的双极性电流信号，并且其中所述大小调制的通信协议的载波频率为至少8MHz。
74.根据权利要求72所述的控制电路，其中所述第二电路部分包括解调电路，以解调所述大小调制的通信协议。
75.根据权利要求72所述的控制电路，其中所述第二电路部分包括感应元件，以将所述至少一个第一开关与所述数据电路元件隔离。
76.根据权利要求72所述的控制电路，其中所述第二电路部分包括至少一个第二开关。
77.根据权利要求76所述的控制电路，其中所述第二电路部分接收从所述外科发生器以第三频带发送的第二询问信号，其中当通过所述第二电路部分接收到所述第二询问信号时，所述第二询问信号的特性表征所述至少一个第二开关的状态。
78.根据权利要求77所述的控制电路，其中所述至少一个第二开关与所述数据电路元件和与所述第一电路部分频带分离，使得所述第二询问信号与所述数据电路元件和所述第一电路部分隔离。
79.一种外科装置的控制电路，所述控制电路包括：
第一电路部分，所述第一电路部分包括至少一个第一开关，其中所述第一电路部分通过导线对接收从外科发生器发送的第一询问信号；和
第二电路部分，所述第二电路部分包括设置在所述装置的器械中的电阻元件和感应元件中的至少一个，其中所述第二电路部分通过所述导线对接收从所述外科发生器发送的第二询问信号；
其中所述第二电路部分与所述第一电路部分频带分离；
其中当通过所述第一电路部分接收到所述第一询问信号时，所述第一询问信号的特性表征所述至少一个第一开关的状态；并且
其中当通过所述第二电路部分接收到所述第二询问信号时，所述第二询问信号的特性独特地识别所述装置的所述器械。
80.一种外科装置的控制电路，所述控制电路包括：
第一电路部分，所述第一电路部分包括第一开关网络和第二开关网络，所述第一开关网络包括至少一个第一开关，所述第二开关网络包括至少一个第二开关，所述第一电路部分通过导线对与外科发生器通信；和
第二电路部分，所述第二电路部分包括数据电路元件，所述数据电路元件设置在所述外科装置的器械中，以发送或接收数据，所述数据电路元件通过所述导线对中的至少一条导线与所述外科发生器进行数据通信。
81.根据权利要求80所述的控制电路，其中所述数据电路元件包括单线总线装置，所述单线总线装置通过所述导线对中的单条导线与所述外科发生器进行数据通信。
82.根据权利要求80所述的控制电路，其中所述数据电路元件包括数据存储器件，所述数据存储器件用于储存能够由所述外科发生器检索的数据。
83.根据权利要求82所述的控制电路，其中由所述数据存储器件储存的所述数据的至少一部分通过所述外科发生器发送到所述数据存储器件。
84.根据权利要求82所述的控制电路，其中所述数据存储器件包括电可擦可编程只读存储器(EEPROM)。
85.根据权利要求80所述的控制电路，其中所述数据电路元件包括数据输入装置。
86.根据权利要求85所述的控制电路，其中所述数据电路元件包括指示器，以根据所述数据电路元件从所述外科发生器接收的数据提供用户指示。
87.根据权利要求80所述的控制电路，其中所述数据电路元件包括数据输出装置。
88.根据权利要求87所述的控制电路，其中所述数据电路元件与设置在所述器械中的传感器通信，所述数据电路元件将传感器数据发送到所述外科发生器。
89.根据权利要求80所述的控制电路，其中所述第一开关网络包括多个串联的第一二极管，其中每一个第一开关都与所述第一二极管中的至少一个并联连接，其中所述第二开关网络包括多个串联的第二二极管，并且其中每一个第二开关都与所述第二二极管中的至少一个并联连接。
90.根据权利要求89所述的控制电路，其中所述第一电路部分接收从所述外科发生器发送的双极性电流信号，其中通过所述第一开关网络接收所述双极性电流信号的第一极性，以在所述第一电路部分上产生第一电压，并且其中通过所述第二开关网络接收所述双极性电流信号的第二极性，以在所述第一电路部分上产生第二电压。
91.根据权利要求90所述的控制电路，其中所述双极性电流信号的频率为约2kHz。
92.根据权利要求90所述的控制电路，其中能够通过所述外科发生器测量所述第一电压，以确定所述至少一个第一开关的状态，并且其中能够通过所述外科发生器测量所述第二电压，以确定所述至少一个第二开关的状态。
93.一种用于将驱动信号提供到外科装置的外科发生器，包括：
外科发生器主体，所述外科发生器主体具有孔口；和
插座组件，所述插座组件设置在所述孔口中，所述插座组件包括：
插座主体；
凸缘，所述凸缘具有内壁和外壁，所述内壁由至少一个弯曲部分和至少一个线性部分构成，所述内壁限定腔体；和
中央凸出部分，所述中央凸出部分设置在所述腔体中，所述中央凸出部分包括：
多个承窝；
磁体；
外周边，所述外周边具有至少一个弯曲部分和至少一个线性部分。
94.根据权利要求93所述的外科发生器，其中所述外周边的所述至少一个弯曲部分平行于所述内壁的所述至少一个弯曲部分。
95.根据权利要求94所述的外科发生器，其中所述外周边的所述至少一个线性部分平行于所述内壁的所述至少一个线性部分。
96.根据权利要求93所述的外科发生器，其中所述中央凸出部分限定中央凹槽，其中所述磁体被设置成靠近所述中央凹槽。
97.根据权利要求93所述的外科发生器，其中所述凸缘具有凸缘表面，并且所述中央凸出部分具有中央表面，其中所述凸缘表面相对于所述中央表面倾斜。
98.根据权利要求97所述的外科发生器，其中所述外科发生器主体具有倾斜表面，其中所述孔口被设置在所述倾斜表面上，并且其中所述倾斜表面大致平行于所述凸缘外表面。
99.一种外科器械，包括：
电连接器组件，所述电连接器组件包括：
凸缘，所述凸缘限定中央腔体；
磁性相容引脚，所述磁性相容引脚延伸到所述中央腔体中；
电路板；
多个导电引脚，所述多个导电引脚连接到所述电路板，所述多个导电引脚中的每一个都延伸到所述中央腔体中；
应变减轻构件；和
防护罩。
100.根据权利要求99所述的外科器械，其中所述凸缘包括至少一个弯曲部分和至少一个线性部分。
101.根据权利要求99所述的外科器械，其中所述电连接器组件包括壁，所述壁限定孔口以接纳所述磁性相容引脚和所述多个导电引脚。
102.根据权利要求101所述的外科器械，其中所述磁性相容引脚具有肩部，其中所述肩部被设置在所述壁和所述电路板中间。
103.根据权利要求99所述的外科器械，包括外科器械识别电路。
104.根据权利要求103所述的外科器械，其中所述外科器械识别电路包括EEPROM和电阻器中的至少一者。
105.一种外科器械系统，包括：
外科发生器，所述外科发生器包括插座组件，所述插座组件具有至少一个弯曲部分和至少一个线性部分；
外科器械，所述外科器械包括连接器组件；
适配器组件，所述适配器组件操作地连接到所述插座组件和所述连接器组件，所述适配器组件包括：
远端部分，所述远端部分接触所述插座组件，所述远端部分包括凸缘，所述凸缘具有至少一个弯曲部分和至少一个线性部分；
近端部分，所述近端部分接触所述连接器组件，所述近端部分限定腔体，所述腔体的尺寸被设计为接纳所述连接器组件的至少一部分；
电路板。
106.根据权利要求105所述的外科器械系统，包括连接到所述电路板的外科器械识别电路。
107.根据权利要求106所述的外科器械系统，其中所述外科器械识别电路包括EEPROM和电阻器中的至少一者。
108.根据权利要求105所述的外科器械系统，其中所述插座组件包括凸缘，该凸缘具有内壁和外壁，所述内壁由所述至少一个弯曲部分和所述至少一个线性部分构成，所述内壁限定腔体。
109.根据权利要求108所述的外科器械系统，其中所述插座组件包括设置在所述腔体中的中央凸出部分，所述中央凸出部分包括：
多个承窝，所述多个承窝排列成大致圆形构造；
磁体，所述磁体设置在所述大致圆形构造的内部；
外周边，所述外周边具有至少一个弯曲部分和至少一个线性部分。
110.根据权利要求109所述的外科器械系统，其中所述适配器组件具有铁质引脚，所述铁质引脚延伸到由所述远端凸缘限定的中央腔体中。
111.根据权利要求110所述的外科器械系统，其中所述铁质引脚为圆柱形的，并且具有肩部。
112.根据权利要求110所述的外科器械系统，其中所述适配器组件具有多个导电引脚，所述多个导电引脚被连接到所述电路板，并且延伸到由所述远端凸缘限定的所述中央腔体中。
113.一种用于控制通过第一电极和第二电极提供到组织的电功率的方法，所述方法包括：
通过所述第一电极和所述第二电极将驱动信号提供到所述组织；
根据所感测组织电阻，根据第一功率曲线，调制通过所述驱动信号提供到所述组织的功率，其中所述第一功率曲线为多个潜在感测的组织电阻中的每一个都限定第一对应功率；
通过所述第一电极和所述第二电极来监测提供到所述组织的总能量；
当所述总能量达到第一能量阈值时，确定所述组织的电阻是否已达到第一电阻阈值；以及
如果所述组织的所述电阻不能达到所述第一电阻阈值，则根据所述感测的组织电阻，根据第二功率曲线，调制通过所述驱动信号提供到所述组织的所述功率，其中所述第二功率曲线为所述多个潜在感测的组织电阻中的每一个都限定第二对应功率。
114.根据权利要求113所述的方法，其中对于所述多个潜在感测的组织电阻中的至少一半而言，所述第一对应功率小于所述第二对应功率。
115.根据权利要求113所述的方法，其中所述多个潜在感测的组织电阻上的所述第一对应功率之和小于所述多个潜在感测的组织电阻上的所述第二对应功率之和。
116.根据权利要求113所述的方法，还包括：
在根据所述第二功率曲线调制通过所述驱动信号提供到第二组织的所述功率期间，当所述总能量达到第二能量阈值时，确定所述感测的组织电阻是否已达到所述第一电阻阈值；以及
如果所述感测的组织电阻不能达到所述第一电阻阈值，则根据第三功率曲线，调制通过所述驱动信号提供到所述组织的所述功率，其中所述第三功率曲线为所述多个潜在感测的组织电阻中的每一个都限定第三对应功率。
117.根据权利要求116所述的方法，其中对于所述多个潜在感测的组织电阻中的至少一半而言，所述第二对应功率小于所述第三对应功率。
118.根据权利要求113所述的方法，还包括：
在根据所述第二功率曲线调制通过所述驱动信号提供到第二组织的所述功率期间，当所述总能量达到第二能量阈值时，确定所述感测的组织电阻是否已达到第二电阻阈值；以及
如果所述感测的组织电阻不能达到第二电阻阈值，则根据第三功率曲线，调制通过所述驱动信号提供到所述组织的所述功率，其中所述第三功率曲线为所述多个潜在感测的组织电阻中的每一个都限定第三对应功率。
119.根据权利要求113所述的方法，其中所述第一电阻阈值为预定的组织电阻。
120.根据权利要求113所述的方法，其中所述第一电阻阈值为预定的组织电阻变化速率。
121.根据权利要求113所述的方法，其中所述第一电阻阈值取决于预定的组织电阻和预定的组织电阻变化速率两者。
122.根据权利要求113所述的方法，其中调制通过所述驱动信号提供到所述组织的所述功率的步骤包括选自下述动作中的至少一个：调制所述驱动信号的电流水平；调制所述驱动信号的电压水平；以及调制所述驱动信号的占空比。
123.根据权利要求113所述的方法，其中对于所述多个潜在感测的组织电阻中的每一个而言，所述第二对应功率都等于所述第一对应功率乘以常数。
124.根据权利要求113所述的方法，还包括在达到终止阈值时终止对所述组织提供能量。
125.根据权利要求124所述的方法，其中所述终止阈值取决于功率曲线。
126.一种外科系统，所述外科系统包括：
发生器，所述发生器包括至少一个处理器和操作地相联的存储器，其中所述存储器具有指令，当所述指令由所述至少一个处理器执行时，所述指令使所述外科系统进行以下操作：
通过第一电极和第二电极将驱动信号提供到所述组织；
根据感测的组织电阻，根据第一功率曲线，调制通过所述驱动信号提供到所述组织的功率，其中所述第一功率曲线为多个潜在感测的组织电阻中的每一个都限定第一对应功率；
通过所述第一电极和所述第二电极来监测提供到所述组织的总能量；
当所述总能量达到第一能量阈值时，确定所述组织的电阻是否已达到第一电阻阈值；以及
如果所述组织的所述电阻不能达到所述第一电阻阈值，则根据所述感测的组织电阻，根据第二功率曲线，调制通过所述驱动信号提供到所述组织的所述功率，其中所述第二功率曲线为所述多个潜在感测的组织电阻中的每一个都限定第二对应功率。
127.根据权利要求126所述的外科装置，其中所述外科系统还包括与所述发生器通信的外科装置，其中所述外科装置包括所述第一电极和所述第二电极。
128.一种用于控制通过第一电极和第二电极提供到组织的电功率的方法，所述方法包括：
通过所述第一电极和所述第二电极将驱动信号提供到所述组织；
确定有待提供到所述组织的功率，其中所述确定步骤包括：
接收感测的组织电阻的指示；
根据功率曲线确定用于所述感测的组织电阻的第一对应功率，其中所述功率曲线为多个潜在感测的组织电阻中的每一个都限定对应功率；
通过倍增器来倍增所述对应功率；
调制所述驱动信号，以将所述确定的功率提供到所述组织；
如果所述组织的所述电阻不能达到第一电阻阈值，则随着提供到所述组织的所述总能量来增加所述倍增器。
129.根据权利要求128所述的方法，还包括：如果所述组织的所述电阻达到所述第一电阻阈值，则将所述倍增器保持在其当前值。
130.根据权利要求126所述的方法，还包括：利用所述倍增器在其当前值下继续施加能量，直到达到终止阈值。
131.根据权利要求130所述的方法，其中所述终止阈值至少部分地取决于所述倍增器的所述当前值。
132.根据权利要求128所述的方法，其中调制所述驱动信号以将所述确定的功率提供到所述组织的步骤包括选自下述动作中的至少一个：调制所述驱动信号的电流水平；调制所述驱动信号的电压水平；以及调制所述驱动信号的占空比。
133.根据权利要求128所述的方法，其中所述第一电阻阈值为预定的组织电阻。
134.根据权利要求128所述的方法，其中所述第一电阻阈值为预定的组织电阻变化速率。
135.根据权利要求128所述的方法，其中所述第一电阻阈值取决于预定的组织电阻和预定的组织电阻变化速率两者。
136.一种外科系统，所述外科系统包括：
发生器，所述发生器包括至少一个处理器和操作地相联的存储器，其中所述存储器具有指令，当所述指令由所述至少一个处理器执行时，所述指令使所述外科系统进行以下操作：
通过第一电极和第二电极将驱动信号提供到所述组织；
确定有待提供到所述组织的功率，其中所述确定步骤包括：
接收感测的组织电阻的指示；
根据功率曲线确定用于所述感测的组织电阻的第一对应功率，其中所述功率曲线为多个潜在感测的组织电阻中的每一个都限定对应功率；
通过倍增器来倍增所述对应功率；
调制所述驱动信号，以将所述确定的功率提供到所述组织；
如果所述组织的所述电阻不能达到第一电阻阈值，则随着提供到所述组织的所述总能量来增加所述倍增器。
137.根据权利要求136所述的外科装置，其中所述外科系统还包括与所述发生器通信的外科装置，其中所述外科装置包括所述第一电极和所述第二电极。
138.一种用于控制通过第一电极和第二电极提供到组织的电功率的方法，所述方法包括：
通过所述第一电极和所述第二电极将驱动信号提供到所述组织；
确定有待提供到所述组织的功率，其中所述确定步骤包括：
接收感测的组织电阻的指示；
根据功率曲线确定用于所述感测的组织电阻的第一对应功率，其中所述功率曲线为多个潜在感测的组织电阻中的每一个都限定对应功率；
通过第一倍增器来倍增所述对应功率，以找到确定的功率；
调制所述驱动信号，以将所述确定的功率提供到所述组织；
通过所述第一电极和所述第二电极来监测提供到所述组织的总能量；
当所述总能量达到第一能量阈值时，确定所述组织的所述电阻是否已达到第一电阻阈值；以及
如果所述组织的所述电阻未达到所述第一电阻阈值，则将所述第一倍增器增加第一量。
139.根据权利要求138所述的方法，还包括：
当所述总能量达到第二能量阈值时，确定所述组织的所述电阻是否已达到第二电阻阈值；以及
如果所述组织的所述电阻未达到所述第二电阻阈值，则将所述第一倍增器增加第二量。
140.根据权利要求138所述的方法，其中所述第一电阻阈值为预定的组织电阻。
141.根据权利要求138所述的方法，其中所述第一电阻阈值为预定的组织电阻变化速率。
142.根据权利要求138所述的方法，其中所述第一电阻阈值取决于预定的组织电阻和预定的组织电阻变化速率两者。
143.根据权利要求138所述的方法，其中调制通过所述驱动信号提供到所述组织的功率的步骤包括选自下述动作中的至少一个：
调制所述驱动信号的电流水平；调制所述驱动信号的电压水平；以及调制所述驱动信号的占空比。
144.一种外科系统，所述外科系统包括：
发生器，所述发生器包括至少一个处理器和操作地相联的存储器，其中所述存储器具有指令，当所述指令由所述至少一个处理器执行时，所述指令使所述外科装置进行以下操作：
通过第一电极和第二电极将驱动信号提供到组织；
确定有待提供到所述组织的功率，其中所述确定步骤包括：
接收感测的组织电阻的指示；
根据功率曲线确定用于所述感测的组织电阻的第一对应功率，其中所述功率曲线为所述多个潜在感测的组织电阻中的每一个都限定对应功率；
通过第一倍增器来倍增所述对应功率；
调制所述驱动信号，以将所述确定的功率提供到所述组织；
通过所述第一电极和所述第二电极来监测提供到所述组织的总能量；
当所述总能量达到第一能量阈值时，确定所述组织的所述电阻是否已达到第一电阻阈值；以及
如果所述组织的所述电阻未达到所述第一电阻阈值，则将所述第一倍增器增加第一量。
145.根据权利要求144所述的外科系统，其中所述外科系统还包括与所述发生器通信的外科装置，其中所述外科装置包括所述第一电极和所述第二电极。
146.一种用于控制通过外科装置提供到组织的电功率的方法，所述方法包括：
将驱动信号提供到外科装置；
接收所述组织的电阻的指示；
计算所述组织的所述电阻的增加速率；
调制所述驱动信号，以将所述电阻的所述增加速率保持为大于或等于预定常数。
147.根据权利要求146所述的方法，还包括调制所述驱动信号，以将所述电阻的所述增加速率保持为等于所述预定常数。
148.根据权利要求146所述的方法，还包括：
确定在第一时间通过所述外科装置提供到所述组织的总能量；
如果所述总能量超过第一能量阈值，则确定所述组织的所述电阻是否已达到第一电阻阈值；
如果所述组织仍未达到所述第一电阻阈值，则调制所述驱动信号，以将所述电阻的所述增加速率保持为大于或等于第二预定常数，其中所述第二预定常数大于所述第一预定常数。
149.根据权利要求148所述的方法，还包括：
确定在第二时间通过所述外科装置提供到所述组织的总能量；
如果所述第二总能量超过第二能量阈值，则确定所述组织的所述电阻是否已达到第二电阻阈值；
如果所述组织仍未达到所述第二电阻阈值，则调制所述驱动信号，以将所述电阻的所述增加速率保持为大于或等于第三预定常数，其中所述第三预定常数大于所述第一预定常数。
150.根据权利要求146所述的方法，还包括：
调制所述驱动信号，以将所述电阻的所述增加速率保持为大于或等于预定常数且长达第一预定时间段；以及
在所述第一预定时间段结束时，调制所述驱动信号，以将所述电阻的所述增加速率保持为大于或等于第二预定常数。
151.根据权利要求150所述的方法，其中所述第二预定常数大于所述第一预定常数。
152.根据权利要求150所述的方法，还包括：
在所述第一预定时间段结束时，调制所述驱动信号，以将所述电阻的所述增加速率保持为大于或等于第二预定常数且长达第二预定时间段；以及
在所述第二预定时间段结束时，调制所述驱动信号，以将所述电阻的所述增加速率保持为大于或等于第三预定常数。
153.根据权利要求152所述的方法，其中所述第三预定常数大于所述第二预定常数。
154.根据权利要求152所述的方法，其中所述第三预定常数小于所述第二预定常数。
155.根据权利要求146所述的方法，其中提供所述驱动信号的步骤包括将所述驱动信号提供到第一电极和第二电极，其中所述组织与所述第一电极和所述第二电极电气连通。
156.一种外科系统，所述外科系统包括：
发生器，所述发生器包括至少一个处理器和操作地相联的存储器，其中所述存储器具有指令，当所述指令由所述至少一个处理器执行时，所述指令使所述发生器进行以下操作：
将驱动信号提供到外科装置；
接收所述组织的电阻的指示；
计算所述组织的所述电阻的增加速率；
调制所述驱动信号，以将所述电阻的所述增加速率保持为大于或等于预定常数。
157.根据权利要求156所述的系统，其中所述存储器还具有指令，当所述指令由所述至少一个处理器执行时，所述指令使所述发生器调制所述驱动信号，以将所述电阻的所述增加速率保持为等于所述预定常数。
158.根据权利要求156所述的系统，其中所述存储器还具有指令，当所述指令由所述至少一个处理器执行时，所述指令使所述发生器进行以下操作：
确定在第一时间通过所述外科装置提供到所述组织的总能量；
如果所述总能量超过第一能量阈值，则确定所述组织的所述电阻是否已达到第一电阻阈值；
如果所述组织仍未达到所述第一电阻阈值，则调制所述驱动信号，以将所述电阻的所述增加速率保持为大于或等于第二预定常数，其中所述第二预定常数大于所述第一预定常数。
159.根据权利要求158所述的系统，其中所述存储器还具有指令，当所述指令由所述至少一个处理器执行时，所述指令使所述发生器进行以下操作：
确定在第二时间通过所述外科装置提供到所述组织的总能量；
如果所述第二总能量超过第二能量阈值，则确定所述组织的所述电阻是否已达到第二电阻阈值；
如果所述组织仍未达到所述第二电阻阈值，则调制所述驱动信号，以将所述电阻的所述增加速率保持为大于或等于第三预定常数，其中所述第三预定常数大于所述第一预定常数。
160.根据权利要求156所述的系统，其中所述存储器还具有指令，当所述指令由所述至少一个处理器执行时，所述指令使所述发生器进行以下操作：
调制所述驱动信号，以将所述电阻的所述增加速率保持为大于或等于预定常数且长达第一预定时间段；以及
在所述第一预定时间段结束时，调制所述驱动信号，以将所述电阻的所述增加速率保持为大于或等于第二预定常数。
161.根据权利要求160所述的系统，其中所述第二预定常数大于所述第一预定常数。
162.根据权利要求160所述的系统，其中所述存储器还具有指令，当所述指令由所述至少一个处理器执行时，所述指令使所述发生器进行以下操作：
在所述第一预定时间段结束时，调制所述驱动信号，以将所述电阻的所述增加速率保持为大于或等于第二预定常数且长达第二预定时间段；以及
在所述第二预定时间段结束时，调制所述驱动信号，以将所述电阻的所述增加速率保持为大于或等于第三预定常数。
163.根据权利要求162所述的系统，其中所述第三预定常数大于所述第二预定常数。
164.根据权利要求162所述的系统，其中所述第三预定常数小于所述第二预定常数。
165.根据权利要求156所述的系统，其中提供所述驱动信号的步骤包括将所述驱动信号提供到第一电极和第二电极，其中所述组织与所述第一电极和所述第二电极电气连通。
166.一种用于控制通过外科装置提供到组织的电功率的方法：
提供驱动信号，其中所述驱动信号的功率与通过所述外科装置提供到所述组织的功率成比例；
周期性地接收所述组织的电阻的指示；
将第一复合功率曲线应用到所述组织，其中将所述第一复合功率曲线应用到所述组织的步骤包括：
调制所述驱动信号上的第一预定数量的第一复合功率曲线脉冲；以及
对于所述第一复合功率曲线脉冲中的每一个，都根据所述组织的所述电阻的第一函数来确定脉冲功率和脉冲宽度；
将第二复合功率曲线应用到所述组织，其中将所述第二复合功率曲线应用到所述组织的步骤包括：
调制所述驱动信号上的至少一个第二复合功率曲线脉冲；以及
对于所述至少一个第二复合功率曲线脉冲中的每一个，都根据所述组织的所述电阻的第二函数来确定脉冲功率和脉冲宽度。
167.根据权利要求166所述的方法，还包括：
如果所述组织的所述电阻上升到高于所述预定电阻阈值，则中断所述第二复合功率曲线的所述应用。
168.根据权利要求167所述的方法，还包括：
如果所述组织的所述电阻上升到高于所述预定电阻阈值，则调制所述驱动信号上的至少一个切口区域功率曲线脉冲；以及
根据所述组织的所述电阻的所述第二函数来确定用于所述至少一个切口区域脉冲的脉冲功率。
169.根据权利要求168所述的方法，其中用于所述至少一个切口区域脉冲的脉冲宽度为恒定的。
170.根据权利要求168所述的方法，还包括：
接收切口完成的指示；
在接收到所述切口完成的所述指示时，调制所述驱动信号上的预定数量的完成脉冲。
171.根据权利要求168所述的方法，还包括根据所述组织的所述电阻的所述第二函数来确定所述预定数量的完成脉冲的功率。
172.根据权利要求166所述的方法，还包括当所述驱动信号的总时间超过超时时间时终止所述驱动信号。
173.根据权利要求166所述的方法，其中确定第一复合功率曲线脉冲的脉冲功率和脉冲宽度的步骤包括访问查找表，所述查找表包括所述组织的所述电阻的潜在值以及脉冲功率和脉冲宽度的对应值的指示。
174.根据权利要求166所述的方法，其中调制所述驱动信号上的所述至少一个第二复合功率曲线脉冲的步骤包括调制所述驱动信号上的第二预定数量的第二复合功率曲线脉冲，并且其中所述方法还包括：
将第三复合功率曲线应用到所述组织，其中将所述第三复合功率曲线应用到所述组织的步骤包括调制所述驱动信号上的至少一个第三复合功率曲线脉冲，其中所述至少一个第三复合功率曲线脉冲中的每一个都具有根据所述组织的所述电阻的第三函数选择的脉冲功率和脉冲宽度。
175.根据权利要求166所述的方法，其中提供所述驱动信号的步骤包括将所述驱动信号提供到与谐波端部执行器机械连通的谐波换能器。
176.根据权利要求166所述的方法，其中提供所述驱动信号的步骤包括将所述驱动信号提供到与所述组织电气连通的第一电极和第二电极。
177.一种用于将驱动信号提供到外科装置的外科发生器，所述发生器包括至少一个处理器和操作地相联的存储器，其中所述存储器具有指令，当所述指令由所述至少一个处理器执行时，所述指令使所述发生器进行以下操作：
产生驱动信号，其中所述驱动信号的功率与通过所述外科装置提供到组织的功率成比例；
周期性地接收所述组织的电阻的指示；
将第一复合功率曲线应用到所述组织，其中将所述第一复合功率曲线应用到所述组织的步骤包括：
调制所述驱动信号上的第一预定数量的第一复合功率曲线脉冲；以及
对于所述第一复合功率曲线脉冲中的每一个，都根据所述组织的所述电阻的第一函数来确定脉冲功率和脉冲宽度；
将第二复合功率曲线应用到所述组织，其中将所述第二复合功率曲线应用到所述组织的步骤包括：
调制所述驱动信号上的至少一个第二复合功率曲线脉冲；以及
对于所述至少一个第二复合功率曲线脉冲中的每一个，都根据所述组织的所述电阻的第二函数来确定脉冲功率和脉冲宽度。
178.根据权利要求177所述的外科发生器，其中所述存储器具有指令，当所述指令由所述至少一个处理器执行时，所述指令使所述发生器进行以下操作：
如果所述组织的所述电阻上升到高于所述预定电阻阈值，则中断所述第二复合功率曲线的所述应用。
179.根据权利要求178所述的外科发生器，其中所述存储器具有指令，当所述指令由所述至少一个处理器执行时，所述指令使所述发生器进行以下操作：
如果所述组织的所述电阻上升到高于所述预定电阻阈值，则调制所述驱动信号上的至少一个切口区域功率曲线脉冲；以及
根据所述组织的所述电阻的所述第二函数来确定用于所述至少一个切口区域脉冲的脉冲功率。
180.根据权利要求179所述的外科发生器，其中用于所述至少一个切口区域脉冲的脉冲宽度为恒定的。
181.根据权利要求179所述的外科发生器，其中所述存储器具有指令，当所述指令由所述至少一个处理器执行时，所述指令使所述发生器进行以下操作：
接收切口完成的指示；
在接收到所述切口完成的所述指示时，调制所述驱动信号上的预定数量的完成脉冲。
182.根据权利要求179所述的外科发生器，其中所述存储器具有指令，当所述指令由所述至少一个处理器执行时，所述指令使所述发生器根据所述组织的所述电阻的所述第二函数来确定所述预定数量的完成脉冲的功率。
183.根据权利要求177所述的外科发生器，其中所述存储器具有指令，当所述指令由所述至少一个处理器执行时，所述指令使所述发生器在所述驱动信号的总时间超过超时时间时终止所述驱动信号。
184.根据权利要求177所述的外科发生器，其中确定第一复合功率曲线脉冲的脉冲功率和脉冲宽度的步骤包括访问查找表，所述查找表包括所述组织的所述电阻的潜在值以及脉冲功率和脉冲宽度的对应值的指示。
185.根据权利要求177所述的外科发生器，其中调制所述驱动信号上的所述至少一个第二复合功率曲线脉冲的步骤包括调制所述驱动信号上的第二预定数量的第二复合功率曲线脉冲，并且其中所述存储器具有指令，当所述指令由所述至少一个处理器执行时，所述指令使所述发生器进行以下操作：
将第三复合功率曲线应用到所述组织，其中将所述第三复合功率曲线应用到所述组织的步骤包括调制所述驱动信号上的至少一个第三复合功率曲线脉冲，其中所述至少一个第三复合功率曲线脉冲中的每一个都具有根据所述组织的所述电阻的第三函数选择的脉冲功率和脉冲宽度。
186.根据权利要求177所述的外科发生器，其中提供所述驱动信号的步骤包括将所述驱动信号提供到与谐波端部执行器机械连通的谐波换能器。
187.根据权利要求177所述的外科发生器，其中提供所述驱动信号的步骤包括将所述驱动信号提供到与所述组织电气连通的第一电极和第二电极。
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