CN101023883B - 基于能量的医疗处理系统 - Google Patents

基于能量的医疗处理系统 Download PDF

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CN101023883B
CN101023883B CN2007100788096A CN200710078809A CN101023883B CN 101023883 B CN101023883 B CN 101023883B CN 2007100788096 A CN2007100788096 A CN 2007100788096A CN 200710078809 A CN200710078809 A CN 200710078809A CN 101023883 B CN101023883 B CN 101023883B
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clamp
patient tissue
medical treatment
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CN101023883A (zh
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K·L·豪泽
S·A·诺斯钱格
J·N·古铁雷斯
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Ethicon Endo Surgery Inc
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00026—Conductivity or impedance, e.g. of tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00084—Temperature
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
    • A61B2017/320094—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw additional movable means performing clamping operation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
    • A61B2017/320095—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw with sealing or cauterizing means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A61B2018/00875—Resistance or impedance
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension

Abstract

一种用于医疗处理的方法，包括使用基于能量的夹钳凝结器开始凝结患者组织，确定夹钳力以及测定所述患者组织的声阻抗。该方法还包括补偿对于夹钳压力的患者组织的测定声阻抗，并至少使用补偿的测定声阻抗监控凝结。第一种基于能量的医疗处理系统包括基于能量的夹钳凝结器，声阻抗测定器和力测定器。第二种系统包括具有夹钳元件的基于能量的夹钳凝结器，其中所述夹钳元件包括或者适于用作电阻抗测定电极，以测定夹钳的患者组织的电阻抗。第三种系统包括具有夹钳元件的基于能量的夹钳凝结器，其中所述夹钳元件包括或者适于用作温度传感器，以测定夹钳的患者组织的温度。

Description

基于能量的医疗处理系统
技术领域
本发明总的涉及医疗处理系统和方法，更具体地涉及基于能量的医疗处理系统和基于能量的医疗处理方法。
背景技术
基于能量的医疗处理系统是已知的，其包括超声外科剪形式的夹钳凝结器，所述超声外科剪具有超声外科刀、可操作地向着所述刀打开和闭合的夹钳臂、与所述夹钳臂连接的组织垫和将夹钳力施加到所述夹钳臂上的装置，所述夹钳臂将夹钳压力施加到定位在组织垫的夹钳表面区域和所述刀之间的血管上。超声振动超声外科刀和施加到血管上的夹钳压力的结果是血管的凝结(将血管壁连接在一起)、凝结的血管的横切(切割)以及血管的接合切割端的凝结(封闭)。RF(射频)夹钳凝结器形式的基于能量的医疗处理系统同样是已知的。
然而，科学家和工程师仍在继续探索改进的基于能量的医疗处理系统和改进的基于能量的医疗处理方法。
发明内容
本发明的方法用于医疗处理并包括步骤a)到g)。步骤a)包括获得基于能量的夹钳凝结器。步骤b)包括使用基于能量的夹钳凝结器将夹钳力施加到患者组织上。步骤c)包括使用基于能量的夹钳凝结器开始凝结患者组织。步骤d)包括确定夹钳力。步骤e)包括测定患者组织的声阻抗。步骤f)包括至少使用所述确定的夹钳力补偿对于夹钳压力的所测定的患者组织的声阻抗。步骤g)包括至少使用所述补偿的测定声阻抗监控患者组织的凝结。
本发明的第一种实施方式是基于能量的医疗处理系统，包括基于能量的夹钳凝结器，声阻抗测定器和力测定器。所述基于能量的夹钳凝结器适于夹钳患者组织。所述声阻抗测定器可操作地连接到所述基于能量的夹钳凝结器以测定夹钳的患者组织的声阻抗。所述力测定器可操作地与所述基于能量的夹钳凝结器连接以测定夹钳的患者组织上的夹钳力。
本发明的第二种实施方式是基于能量的医疗处理系统，包括基于能量的夹钳凝结器，所述夹钳凝结器具有两个适于凝结夹钳在其间的患者组织的夹钳元件，其中所述两个夹钳元件包括或者适于用作电阻抗测定电极，用于测定夹钳的患者组织的电阻抗。
本发明的第三种实施方式是基于能量的医疗处理系统，包括基于能量的夹钳凝结器，所述夹钳凝结器具有两个适于凝结夹钳在其间的患者组织的夹钳元件，其中所述两个夹钳元件中的至少一个包括或者适于用作温度传感器，用于测定夹钳的患者组织的温度。
通过本发明的一种或多种方法和实施方式得到许多益处和优点。在一个例子中，监控患者组织的凝结允许控制器断开，或者致动指示器，向用户指示当组织凝结完成而没有凝结进展到非目标组织并且没有能量进一步干燥或损害目标组织时断开所述基于能量的夹钳凝结器。
本发明具有但不限于使用直或者弯曲的超声外科刀的应用(当使用的能量是超声波时)以及用于手致动的器械和机器人辅助的器械。
更具体地说，本发明涉及如下内容：
(1)一种用于医疗处理的方法，包括如下步骤：
a)获得基于能量的夹钳凝结器；
b)使用所述基于能量的夹钳凝结器将夹钳力施加到患者组织上；
c)使用所述基于能量的夹钳凝结器开始凝结所述患者组织；
d)确定夹钳力；
e)测定所述患者组织的声阻抗；
f)至少使用确定的夹钳力补偿对于夹钳压力的患者组织的所述测定声阻抗；和
g)至少使用所述补偿的测定声阻抗监控所述患者组织的凝结。
(2)如第(1)项所述的方法，其中，基于能量的夹钳凝结器由发电机的输出电力供电，并且还包括根据所述监控的患者组织的凝结来调节所述输出电力的步骤。
(3)如第(1)项所述的方法，还包括向所述基于能量的夹钳凝结器的用户通知所述患者组织的监控凝结的步骤。
(4)如第(1)项所述的方法，其中，所述基于能量的夹钳凝结器是具有超声刀和夹钳臂的超声外科剪。
(5)如第(1)项所述的方法，其中，所述基于能量的夹钳凝结器是RF(射频)夹钳凝结器。
(6)一种基于能量的医疗处理系统，包括：
a)基于能量的夹钳凝结器，其适于夹钳患者组织；
b)声阻抗测定器，其可操作地连接到所述基于能量的夹钳凝结器，以测定夹钳的患者组织的声阻抗；和
c)力测定器，其可操作地连接到所述基于能量的夹钳凝结器，以测定所述夹钳的患者组织上的夹钳力。
(7)如第(6)项所述的基于能量的医疗处理系统，还包括控制器，其至少使用所述测定的夹钳力补偿对于夹钳压力的患者组织的测定声阻抗。
(8)如第(7)项所述的基于能量的医疗处理系统，其中，所述控制器还至少使用所述补偿的测定声阻抗监控所述患者组织的凝结。
(9)如第(8)项所述的基于能量的医疗处理系统，其中，所述控制器根据所述患者组织的监控的凝结控制发电机的电力输出，其中所述电力输出为基于能量的夹钳凝结器供电。
(10)如第(8)项所述的基于能量的医疗处理系统，其中，所 述控制器控制视觉和/或听觉指示器，所述指示器向基于能量的夹钳凝结器的用户指示患者组织的监控的凝结。
(11)如第(10)项所述的基于能量的医疗处理系统，其中，所述基于能量的夹钳凝结器是具有超声刀和夹钳臂的超声外科剪。
(12)如第(11)项所述的基于能量的医疗处理系统，其中，所述力测定器适于测定施加到所述夹钳臂上的力。
(13)如第(6)项所述的基于能量的医疗处理系统，其中，所述基于能量的夹钳凝结器是具有超声刀和夹钳臂的超声外科剪。
(14)如第(13)项所述的基于能量的医疗处理系统，其中，所述力测定器适于测定施加到所述夹钳臂上的力。
(15)一种基于能量的医疗处理系统，包括基于能量的夹钳凝结器，所述基于能量的夹钳凝结器具有两个适于凝结夹钳在其间的患者组织的夹钳元件，其中所述两个夹钳元件中的至少一个包括或者适于用作电阻抗测定电极，以测定夹钳的患者组织的电阻抗。
(16)如第(15)项所述的基于能量的医疗处理系统，还包括监控器，其至少使用所述夹钳的患者组织的测定电阻抗监控夹钳的患者组织的凝结，所述夹钳的患者组织的测定电阻抗通过至少使用电阻抗测定电极而获得。
(17)如第(16)项所述的基于能量的医疗处理系统，其中，所述基于能量的夹钳凝结器是具有超声刀和夹钳臂的超声外科剪，其中所述两个夹钳元件中的一个包括超声刀，并且所述两个夹钳元件中的另一个包括夹钳臂。
(18)一种基于能量的医疗处理系统，包括基于能量的夹钳凝结器，所述基于能量的夹钳凝结器具有两个适于凝结夹钳在其间的患者组织的夹钳元件，其中所述两个夹钳元件中的至少一个包括或者适于用作温度传感器，以测定所述夹钳的患者组织的温度。
(19)如第(18)项所述的基于能量的医疗处理系统，还包括监控器，其至少使用所述夹钳的患者组织的测定温度监控所述夹钳的患者组织的凝结，所述夹钳的患者组织的测定温度通过至少使用 温度传感器而获得。
(20)如第(19)项所述的基于能量的医疗处理系统，其中，所述基于能量的夹钳凝结器是具有超声刀和夹钳臂的超声外科剪，其中所述两个夹钳元件中的一个包括夹钳臂，所述两个夹钳元件中的另一个包括超声刀。
附图说明
图1是本发明的方法的框图；
图2是本发明的基于能量的医疗处理系统的第一种实施方式的示意性框图，所述系统包括基于能量的夹钳凝结器，声阻抗测定器和力测定器；
图3是图2的基于能量的夹钳凝结器的示意性侧视图；
图4是本发明的基于能量的医疗处理系统的第二种实施方式的示意性框图，所述系统包括具有两个夹钳元件的基于能量的夹钳凝结器，所述夹钳元件包括或者适于用作电阻抗测定电极；
图5是图4的基于能量的夹钳凝结器的示意性侧视图；
图6是本发明的基于能量的医疗处理系统的第三种实施方式的示意性框图，所述系统包括具有两个夹钳元件的基于能量的夹钳凝结器，其中至少一个夹钳元件包括或适于用作温度传感器；和
图7是图6的基于能量的夹钳凝结器的示意性侧视图。
具体实施方式
在详细解释本发明之前，应当理解的是，本发明不限于在附图和说明书中示出的部件的构造和设置的细节的应用或使用。所示的本发明的实施方式可以在其它实施方式、变化和修改中来实现或者包含于其中，并可以各种方式实践或者实现。此外，除非特别指明，为方便读者，在本文中使用的术语和表达方式为描述本发明的典型实施方式的目的而选择，而不是出于限制本发明的目的。
应理解，任何一个或多个下述实施方式、例子等可与任何一个 或多个其它下述实施方式、例子等结合。
现在参见附图，其中相同的附图标记表示相同的元件，图1示出了本发明的方法，图2-3示出了作为执行所述方法的器械的一个例子的基于能量的医疗处理系统10的实施方式。所述方法用于医疗处理并包括步骤a)到g)。步骤a)在图1中的框12中标记为“获得夹钳凝结器”。步骤a)包括获得基于能量的夹钳凝结器14。步骤b)在图1的框16中标记为“施加夹钳力”。步骤b)包括使用基于能量的夹钳凝结器14将夹钳力施加到患者组织18上。步骤c)在图1的框20中标记为“开始凝结患者组织”。步骤c)包括使用基于能量的夹钳凝结器14开始凝结患者组织18。步骤d)在图1的框22中标记为“确定夹钳力”。步骤d)包括确定夹钳力。步骤e)在图1的框24中标记为“测定声阻抗”。步骤e)包括测定患者组织18的声阻抗。步骤f)在图1的框26中标记为“补偿测定的阻抗”。步骤f)包括至少使用所述确定的夹钳力补偿对于夹钳压力的所述测定的患者组织18的声阻抗。步骤g)在图1的框28中标记为“监控凝结”。步骤g)包括使用至少补偿的测定声阻抗监控患者组织18的凝结。
在本发明的方法的一种解释中，基于能量的凝结器14由发电机30输出的电力供电。在该解释中，所述方法还包括根据监控的患者组织18的凝结来调节输出电力的步骤。在一种变化中，在监控的凝结接近完成时输出的电力被调节得更低，并且当检测的凝结完成时断开发电机30。在不同的解释中，所述方法还包括通知(诸如通过视觉和/或听觉和/或其它提示)基于能量的夹钳凝结器14的用户患者组织18的监控凝结的的步骤(例如当凝结完成时通知用户可切断基于能量的夹钳凝结器14的电源)。
在本发明的方法的一种应用中，基于能量的夹钳凝结器14是具有超声刀34和夹钳臂36的超声外科剪32(为了清楚起见其组织垫已经从图3中省去)。在未显示的不同应用中，基于能量的夹钳凝结器是具有单极性电极或者双极性电极的RF(射频)夹钳凝结器。 在一种变化中，RF夹钳凝结器具有两个夹钳元件，每个都支撑或者适于用作双极性电极，使电流在两个夹钳元件之间流动。
本发明的第一种实施方式是基于能量的医疗处理系统10并显示于图2-3中。基于能量的医疗处理系统10包括基于能量的夹钳凝结器14，声阻抗测定器38和力测定器40。基于能量的夹钳凝结器14适于夹钳患者组织18。声阻抗测定器38可操作地与基于能量的夹钳凝结器14连接，以测定夹钳的患者组织18的声阻抗。力测定器40可操作地与基于能量的夹钳凝结器14连接，以测定夹钳的患者组织18上的夹钳力。
在图2-3的实施方式的一种执行方式中，声阻抗测定器38包括在医疗处理过程中测定发电机30的输出电力的电路，其测定从发电机30流出的电流，并用确定的输出电力除以确定的电流的平方，因为声阻抗被看作是由发电机30产生的电量。在相同或不同执行方式中，力测定器40包括力换能器(未显示)，其测定由用户或者马达施加在基于能量的夹钳凝结器14的夹钳机构上的力(对于手动驱动的夹钳臂而言是手动施加的力，或者对于马达驱动的夹钳臂而言是马达施加的力[其中扭矩被认为是旋转力])，使夹钳凝结器14将夹钳力施加到患者组织18上，并且力测定器40包括将测定的手动或者马达力转换成测定的夹钳力的电路(未显示)。声阻抗测定器和力测定器的其它执行方式留给本领域技术人员。
在图2-3的实施方式的实现方式中，基于能量的医疗处理系统10还包括控制器42，其至少使用测定的夹钳力补偿(即校正)对于夹钳压力的患者组织18的声阻抗的测定。应当注意的是，测定的声阻抗随夹钳力的增加而增加，并且对于夹钳压力而言的声阻抗测定补偿可由本领域技术人员经试验和/或数学方式确定，并由数学用表、软件算法和/或对于测定声阻抗值和对于测定夹钳力值而言产生补偿的声阻抗测定值的电路执行。
在上述实现方式的一种变化中，控制器42还至少使用补偿的测定声阻抗监控患者组织18的凝结(即凝结程度或状态)。在一种实 现方式中，当补偿的测定声阻抗达到试验和/或数学方式确定的上限时，或者当阻抗-时间图的形状达到一些预定形状时，则认为凝结完成。在第一种设置中，控制器42基于监控的患者组织18的凝结来控制发电机30的电力输出，其中电力输出为基于能量的夹钳凝结器14供电。在第二种设置中，控制器42控制视觉和/或听觉指示器44(在一个例子中其发出光或者哔哔声)，该指示器44向基于能量的夹钳凝结器14的用户指示监控的患者组织18的凝结。
在图2-3的实施方式的一种设置中，基于能量的夹钳凝结器14是具有超声刀34和夹钳臂36的超声外科剪32。在一种变化中，力测定器40适于测定施加到夹钳臂36上的力。在未显示的不同设置中，基于能量的夹钳凝结器是具有单极性电极或者双极性电极的RF(射频)夹钳凝结器。
本发明的第二种实施方式是基于能量的医疗处理系统46并且其显示于图4-5中。基于能量的医疗处理系统46包括基于能量的夹钳凝结器48。基于能量的夹钳凝结器48具有两个夹钳元件50和52，其中两个夹钳元件50和52中的至少一个50包括或者适于用作电阻抗测定电极54，以测定夹钳的患者组织56的电阻抗。
在图4-5的实施方式的一个例子中，两个夹钳元件50和52的另一个52还包括电阻抗测定电极58，其中小的感测电流在两个电极54和58之间通过并被用于确定夹钳的患者组织56的电阻抗，这在本领域技术人员的技术水平之内。在另一个未显示的例子中，夹钳元件具有两个电极并且小感测电流在这两个电极之间通过。
在图4-5的实施方式的一种实现方式中，基于能量的医疗处理系统46包括监控器60(诸如与控制器42类似的控制器并具有控制器42的增加的控制功能)，其至少使用夹钳的患者组织56的测定电阻抗来监控患者组织56的凝结(即凝结程度或状态)，所述患者组织56的测定电阻抗通过至少使用电阻抗测定电极54而获得。在一种变化中，患者组织56的电阻抗被用于测定凝结的程度。当患者组织56由基于能量的夹钳凝结器48加热而凝结时，凝结的患者组织56的 导电能力降低，这由患者组织56的电阻抗增加来反映。在不同变化中，电阻抗-时间曲线的形状被用于确定组织的凝结状态。
在图4-5的实施方式的一种设置中，基于能量的夹钳凝结器46是具有超声刀64(由未显示的发电机供电)和夹钳臂66的超声外科剪62。需要注意的是，在该设置中，两个夹钳元件50和52中的一个50包括超声刀64，两个夹钳元件50和52的另一个52包括夹钳臂66。在未显示的不同设置中，基于能量的夹钳凝结器是具有单极性电极或者双极性电极的RF(射频)夹钳凝结器。
本发明的第三种实施方式是基于能量的医疗处理系统68并且其显示于图6-7中。基于能量的医疗处理系统68包括基于能量的夹钳凝结器70。基于能量的夹钳凝结器70具有两个夹钳元件72和74，其中两个夹钳元件72和74中的至少一个72包括或者适于用作温度传感器76，以测定夹钳的患者组织78的温度。
在图6-7的实施方式的一种实现方式中，基于能量的医疗处理系统68包括监控器80(诸如与控制器42类似的控制器并具有控制器42的增加的控制功能)，其至少使用夹钳的患者组织78的测定温度来监控夹钳的患者组织78的凝结(即凝结程度或状态)，所述患者组织78的测定温度通过至少使用温度传感器76而获得。需要注意的是，患者组织78的温度被用于测定凝结的程度。当患者组织78由基于能量的夹钳凝结器70加热而凝结时，组织首先变性并凝结，其后组织变得干燥并且组织的温度升高。
在图6-7的实施方式的一种设置中，基于能量的夹钳凝结器68是具有超声刀84(由未显示的发电机供电)和夹钳臂86的超声外科剪82。需要注意的是，在该设置中，两个夹钳元件72和74中的一个72包括夹钳臂86，两个夹钳元件72和74的另一个74包括超声刀84。在未显示的不同设置中，基于能量的夹钳凝结器是具有单极性电极或者双极性电极的RF(射频)夹钳凝结器。
通过本发明的一种或多种方法和实施方式得到了许多益处和优点。在一个例子中，监控患者组织的凝结允许控制器断开，或者致 动指示器，该指示器向用户指示当组织凝结完成而没有凝结进展到非目标组织并没有能量进一步干燥或损害目标组织时断开基于能量的夹钳凝结器。
虽然已经通过一些实施方式和方法的描述对本发明进行了解释，申请人并不是想将所附的权利要求书的精神和范围限制或限定得如此详细。在不背离本发明的精神的情况下的许多其它变化、改变和替代对本领域技术人员来说都是可以想到的。例如，考虑到所述系统、元件和方法与所述机械系统兼容的明显修改，本发明的医疗器械和医疗系统在机器辅助的外科方面具有应用。应当理解，前述描述仅仅作为例子提供，本领域技术人员在不背离所附的权利要求书的精神和范围的情况下可进行其它修改。

Claims (6)

1.一种基于能量的医疗处理系统，包括：
a)基于能量的夹钳凝结器，其能够夹钳患者组织；
b)声阻抗测定器，其可操作地连接到所述基于能量的夹钳凝结器，以测定夹钳的患者组织的声阻抗；
c)力测定器，其可操作地连接到所述基于能量的夹钳凝结器，以测定所述夹钳的患者组织上的夹钳力；和
d)控制器，其至少使用所述测定的夹钳力校正对于夹钳力下的患者组织的测定声阻抗。
2.根据权利要求1所述的基于能量的医疗处理系统，其中，所述控制器还至少使用所述校正的测定声阻抗监控所述患者组织的凝结。
3.根据权利要求2所述的基于能量的医疗处理系统，其中，所述控制器根据所述患者组织的监控的凝结控制发电机的电力输出，其中所述发电机为基于能量的夹钳凝结器供电。
4.根据权利要求2所述的基于能量的医疗处理系统，其中，所述控制器控制视觉和/或听觉指示器，所述指示器向基于能量的夹钳凝结器的用户指示患者组织的监控的凝结。
5.根据权利要求4所述的基于能量的医疗处理系统，其中，所述基于能量的夹钳凝结器是具有超声刀和夹钳臂的超声外科剪。
6.根据权利要求5所述的基于能量的医疗处理系统，其中，所述力测定器能够测定施加到所述夹钳臂上的力。
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