ISCHEMIA CONTROL DEVICE

Abstract

An ischemia control device is connected to a control unit that receives inputs from sensors and other surgical devices that senses patient conditions. The control unit uses the data inputs, as well as direct inputs from the medical operators, to output opening and closing instructions to the ischemia control device. The actuator on the ischemia control device receives the opening and closing instructions and manipulates the ischemia control device. The ischemia control device can be automatically operated using the sensed information to intermittently and alternately achieve ischemia of the organs and reperfuse the organs and, thereby, protect the organs from being damaged by the ischemia.

Claims

1. An ischemia control device, comprising: a clamp unit that is adjustable between an open state and a closed state to regulate a flow of blood through a blood vessel positioned within the clamp unit; an actuator unit operably connected to the clamp unit to provide a driving force to adjust the clamp unit between the open state and the closed state; and a control unit operably connected to the actuator unit, wherein the control unit receives procedure condition information, generates an opening instruction and a closing instruction, and outputs the opening instruction and the closing instruction.

2. The ischemia control device according to claim 1, wherein the clamp unit includes a tape.

3. The ischemia control device according to claim 1, wherein the clamp unit includes a tube.

4. The ischemia control device according to claim 1, wherein the clamp unit includes forceps.

5. The ischemia control device according to claim 1, wherein the clamp unit includes clips.

6. The ischemia control device according to claim 1, wherein the procedure condition information includes image data.

7. A method to restrict a blood flow of an area in a subject, comprising: attaching a clamp unit to the blood vessel; opening and closing the clamp unit with an actuator unit; outputting opening and closing instructions to the actuator unit through a control unit; and sending procedure condition information to the control unit for constructing the opening and closing instructions.

8. The method according to claim 7, wherein the clamp unit clamps portal vein and hepatic artery.

9. The method according to claim 7, wherein the opening and closing instructions include instructions to open and close the clamp unit at varying levels.

10. The method according to claim 7, wherein the opening and closing instructions include instructions to halt the opening and closing of the clamp unit for a certain period of time.

11. The method according to claim 7, wherein the procedure condition information includes image data.

12. The method according to claim 7, wherein the procedure condition information includes medical device usage information.

13. The method according to claim 7, wherein the control unit does not utilize the procedure condition information.

14. The method according to claim 7, wherein the control unit receives information other than procedure condition information.

15. The method according to claim 14, wherein the information other than procedure condition information includes direction from the operator.

16. The method according to claim 13, wherein the control unit does not utilize the procedure condition information and periodically outputs opening and closing instructions to the actuator.

17. The method according to claim 7, wherein the procedure condition information includes at least one of color of organs or blood vessels, amount of pressure the organs or the blood vessels, amount of blood current, and speed of the blood current.

18. The method according to claim 7, further comprising notifying a medical operator of a status regarding the opening and the closing of the clamp unit through the control unit.

19. The method according to claim 7, wherein the procedure condition information includes image data or video data, and the opening and closing instructions include a closing instruction to allow the actuator unit to close the clamp unit to stop blood flow if a treatment device is seen in the video image, and an opening instruction to allow the actuator unit to open the clamp unit to release the blood flow if no treatment device is seen in the video image.

20. The method according to claim 7, further comprising controlling the opening and closing of the clamp unit to control a blood flow in conjunction with an operation of an energy device or a suction volume.

Description

BRIEF DESCRIPTION OF THE DRAWING

[0016] The following detailed description of preferred embodiments can be read in connection with the accompanying drawings in which like numerals designate like elements and in which:

[0017] FIG. 1A is a flow chart of a conventional surgery method using manual operation of an ischemia control device.

[0018] FIG. 1B is a flow chart of a surgery method using automated operation of the ischemia control device as disclosed herein.

[0019] FIGS. 2A to 2C are examples of ischemia control devices used in conventional surgery methods using manual operation of the ischemia control device.

[0020] FIG. 3 is an illustration of the embodiment using automated operation of the ischemia control device.

[0021] FIG. 4 is a flow chart of the embodiment using automated operation of the ischemia control device.

[0022] FIGS. 5A and 5B are examples of ischemia control devices used in automated surgery methods.

[0023] FIGS. 6A and 6B are examples of ischemia control devices used in automated surgery methods.

[0024] FIGS. 7 and 8 are illustrations of related art ischemia devices.

[0025] Throughout all of the drawings, dimensions of respective constituent elements are appropriately adjusted for clarity. For ease of viewing, in some instances only some of the named features in the figures are labeled with reference numerals.

DETAILED DESCRIPTION

[0026] FIG. 1A illustrates a flow chart of the conventional surgical procedure using the manual clamping method, wherein the medical operator manually opens and closes (pringles) the clamp unit during the surgery. The clamping of the blood vessels supplying blood stream into the treated organs (e.g. liver) is necessary during the surgical procedure (e.g. excision and coagulation procedures) in order to limit the amount of blood lost during the surgical procedure. The clamp unit is manually operated to first pringle the veins and arteries prior to the surgical procedures being performed. After some time (e.g. 15 minutes), the surgical procedure needs to be halted and clamping of the blood vessels needs to be re-opened in order to lower the risk of necrosis for the treated organs due to the lack of blood flow during the pringle. The medical operators would manually re-open the clamps and perform hemostasis procedures on the treated organs while the treated organs recover using now abundant blood stream. After some time (e.g. 15 minutes), the clamp unit is manually pringled and the surgical procedure is reinstituted. This procedure repeats itself until the surgical procedure is completed. The issue with the above mentioned conventional surgical procedure is that the medical operators need to manually open and close the clamp unit at certain intervals during the surgery, adding workload for the medical operators and adding time to the overall surgery time for the patient.

[0027] Various manually operated surgical devices and tools can be used to perform the surgical procedures, including the noted Pringle maneuver in hepatoectomy. FIG. 2A illustrates an ischemia control device 200 used for conventional surgical procedure. A tape 202 goes through a shaft 204, forming a loop portion 206 at one end. At the end of the shat 204 opposite from the loop portion 206, forceps 208 is placed for tightening and opening the loop portion 206. In case the loop portion 206 needs to be tightened, the forceps 208 would be used to push the shaft 204 towards loop portion 206 and shortens the amount of tape of the loop portion 206. On the contrary, when the loop portion 206 needs to be loosened, the tweezer 208 would be used to pull back the shaft 204 in the opposite direction of the loop portion 206 and lengthens the amount of tape of the loop portion 206. FIG. 2B illustrates a hemostat forceps 210 used for directly clamping the blood vessels during the conventional surgical procedure. The tips 212 of the hemostat forceps 210 may be directly applied to the veins and arteries of the patient and used to clamp the blood stream going into the treated organs. FIG. 2C illustrates various types of clip devices 214 for directly clamping the blood vessels during the conventional surgical procedure. For example, the clips 216 of the clip device 218 may be directly applied to the veins and arteries of the patient and used to clamp the blood stream going into the treated organs using the clamping mechanism 220.

[0028] FIG. 1B illustrates a flow chart of the surgical procedure using an embodiment of the ischemia control device utilizing the automatic control of blood blockage. Unlike the conventional surgical procedure using manual clamping and as illustrated in FIG. 1A, the opening and closing (pringling) of the clamp unit during the surgery is automated in accordance to the condition of the patient sensed by various devices. The medical operator need not halt the surgical procedure throughout the surgery, since the blood stream going into the treated organs would be automatically controlled. The medical operators need not manually open and close the clamp unit at certain intervals, leading to less workload for the medical operators and shortened surgery time, which would ease risk and burden for the patient. Thus, the time of surgical procedure (t1) in FIG. 1B is less than the time of surgical procedure (t1) in FIG. 1B. Various surgical devices and tools, including those shown in FIGS. 2A-C, can be adapted and configured for automatic operation to automatically control blood flood in accordance to the condition of the patient as sensed by various devices.

[0029] FIG. 3 is an illustration of an ischemia control device 300 attached to the portal vein 302 and hepatic artery 304 of the patient's liver 306. One embodiment of an ischemia control device 300 is comprised of a medical tape 308, an actuator 310, shaft 312, and tape loop 314. The actuator 310 can be, for example, a motor or other device that operates to adjust a relative position of the medical tape 308 and shaft 312, particularly to close and open the tape loop 314. During an endoscopic surgery using an endoscope device 316 and surgical device 318 for the excision and coagulation procedures, the ischemia control device 300 is used to control the blood stream flowing into the liver 306. The tape loop 314 goes around the portal vein 302 and hepatic artery 304 and serves as a clamp unit. Upon actuator 310 receiving an input from the control unit 320 (such as a closing instruction or other input operating signal), the actuator 310 pushes the shaft 312 towards the tape loop 314 using a motor or other device, thereby shortening and tightening the tape loop 314, resulting in ischemia of portal vein 302 and hepatic artery 304. In alternative embodiments, the actuator 310 retracts the tape loop 314 into the shaft 312 using a motor or other device, thereby shortening and tightening the tape loop 314, or the actuator 310 uses a motor or other device to both push the shaft 312 towards the tape loop 314 and to retract the tape loop 314 into the shaft 312, thereby shortening and tightening the tape loop 314.

[0030] Upon actuator 310 receiving opening instruction from the control unit 320, the actuator 310 pulls the shaft 312 backwards from the tape loop 314 using the motor, thereby loosening the tape loop 314, resulting in the blood stream to flow back into the portal vein 302 and hepatic artery 304. In alternative embodiments, the actuator 310 extends the tape loop 314 from the shaft 312 using a motor or other device, thereby loosening the tape loop 314, or the actuator 310 uses a motor or other device to both move the shaft 312 away the tape loop 314 and to extend the tape loop 314 from the shaft 312, thereby loosening the tape loop 31.

[0031] The control unit 320 may send both opening and closing instructions to the actuator 310. The control unit may send the opening and closing instructions to the actuator intermittently or continuously. Additionally, the actuator can be operated in a control scheme between on (to shorten and tighten or to lengthen and loosen) and off conditions, for example, an on-off control scheme, or can be operated in a control scheme in which the actuator is operated between tightening and loosening conditions, for example, a tightening-loosening control scheme. In optional embodiments, a neutral operating state can be included between tightening and loosening condition, with the actuator stationary and neither tightening nor loosening, for example, a tightening-neutral-loosening control scheme.

[0032] The control unit 320 may receive inputs from one or more devices, medical instruments and equipment. In one embodiment, the control unit 320 receives inputs from an endoscope device 316 and uses the input data to determine which instructions should be sent to the actuator 310. The input data received by the control unit from the endoscope device 316 may include procedure condition information such as color of the organs and blood vessels, amount of pressure the organs and blood vessels are under, the amount and speed of blood current, suction volume, and other input data related to the surgery. The control unit 320 may also use inputs from surgery device 318 and other units 322 (e.g. foot switches) for the determination on the instructions to the actuator 310. The input data received by the control unit from the surgery device 318 may include procedure condition information such as duration of the surgery, amount of energy used for the excision or the coagulation procedure, ultrasound data, x-ray data, suction volume, and other data related to the condition of the organs and blood vessels the surgery is performed on. In some embodiments, input data received by the control unit can include both procedure condition information from the endoscope device 316 and surgery device 318.

[0033] In another embodiment, the control unit 320 receives inputs from another unit 322, such as image data or video data. Based on that input, and based on that input, procedure condition information is generated. That procedure condition information can, for example, include a closing instruction to allow the actuator unit to close the clamp unit to stop blood flow if a treatment device is seen in the image data or video data, and an opening instruction to allow the actuator unit to open the clamp unit to release the blood flow if no treatment device is seen in the image data or video data.

[0034] Controlling the opening and closing of the clamp unit to control a blood flow can occur in conjunction with an operation of an energy device or a suction volume. For example, suction volume may be monitored and, in a state where the suction volume is large (such as where there is a high amount of bleeding), the blood flow may be restricted. In a related way, in a state where the suction volume is low (such as where there is a low amount of bleeding), the blood flow may be released.

[0035] Also, monitoring is not limited to looking at the liver or related blood flow, but may be, for example, monitoring for the presence or absence of treatment tools. In this case, the blood flow can be stopped when there is a treatment tool detected in the treatment area and blood flow can be restored when the treatment tool is no longer detected in the treatment area. Also, if the procedure is long and the treatment tool has been detected for a period of time longer than a setpoint time, a warning may be initiated to alert an operator that the procedure should be interrupted and blood flow resumed.

[0036] Further, the control unit may be linked with the generator of an energy device. Here, the energy device is operative to provide output when the blood flow is restricted and the output from the energy device is disabled with the blood flow is in the open state. Alternatively, the blood flow may be restricted when the energy device is operating, e.g., is providing an output, and the blood flow may be released when the energy device is not operating, e.g., is not providing an output.

[0037] FIG. 4 is a flow chart of the operation of the ischemia control device 300. The control unit 320 sends opening and closing instructions to the actuator 310 based on the inputs received from the endoscope device 316, surgery device 318, and other units 322. The actuator would actuate the motor to tighten or loosen (or open or close) the clamp unit 314 to achieve ischemia of the blood vessels or allow the blood stream to flow. The control unit may also send instructions to a notification unit 402 alerting the medical operator of the state of the tightening or loosening (or open or close) of the clamp unit 314 through sound, light, or other notification means.

[0038] FIG. 5A illustrates the ischemia control device 300 by itself. The tape loop 314 goes around the blood vessels and serves as a clamp unit by activating the motor in the actuator 310 that pushes the shaft 312 towards the tape loop 314, thereby shortening and tightening the tape loop 314. The tape loop 314 may be loosened by activating the motor in the actuator 310 that pulls the shaft 312 in the opposite direction from the tape loop 314, thereby lengthening and loosening the tape loop 314. The instructions from the control unit 320 may be received by the actuator 318 through wired or through wireless communication.

[0039] FIG. 5B illustrates another embodiment of an ischemia control device 500. The forceps 502 are connected to an automated open and close device 504 that receives instructions from the control unit 320. Upon receiving a close instruction from the control unit 320, the automated open and close device 504 closes the forceps 502, which results in the tips 504 to close on to the blood vessels aimed at achieving ischemia. Upon receiving an open instruction from the control unit 320, the automated open and close device 504 opens the forceps 502, which results in the tips 504 to open up the blood vessels and blood stream to flow back into the treated organ. The instructions from the control unit 320 may be received by the automated open and close device 504 through wired or through wireless communication.

[0040] FIG. 6A illustrates another embodiment of an ischemia control device 600. The clips 602 are connected to an automated open and close device 604 that receives instructions from the control unit 320. Upon receiving a close instruction from the control unit 320, the automated open and close device 604 works on the closing mechanism that goes through shaft 606 that serves to close the clips 602, resulting in the clips 602 to close on to the blood vessels aimed at achieving ischemia. Upon receiving an open instruction from the control unit 320, the automated open and close device 604 opens the clips 602, which results in the tips 504 to open up the blood vessels and blood stream to flow back into the treated organ. The instructions from the control unit 320 may be received by the automated open and close device 604 through wires or through wireless communication.

[0041] FIG. 6B illustrates another embodiment of the ischemia control device 600. The clips 602 are connected to an automated open and close device 604 that receives instructions from the control unit 320. Upon receiving a close instruction from the control unit 320, the automated open and close device 604 works on the closing mechanism that goes through shaft 606 that serves to close the clips 602, resulting in the clips 602 to close on to the blood vessels aimed at achieving ischemia. Upon receiving an open instruction from the control unit 320, the automated open and close device 604 opens the clips 602, which results in the tips 504 to open up the blood vessels and blood stream to flow back into the treated organ. The instructions from the control unit 320 may be received by the automated open and close device 604 through wires or through wireless communication.

[0042] Although the present invention has been described in connection with preferred embodiments thereof, it will be appreciated by those skilled in the art that additions, deletions, modifications, and substitutions not specifically described may be made without department from the spirit and scope of the invention as defined in the appended claims.