Integrated Microwave Amplifiers for Electrosurgical Applications

现代外科技术虽然在治愈危及生命的疾病方面非常成功，但可能涉及大量组织切除和可能的失血，影响康复时间、感染风险，从长远来看，还会影响生活质量。射频和微波能量可用于外科系统，用于治疗多种医疗疾病，如良性和癌症病变、心脏、肝脏和眼睛疾病以及肥胖(微波辅助吸脂术)，其有益效果包括去除组织、加热、凝血和干燥。2012年，肺癌、肠癌、乳腺癌和前列腺癌占英国所有癌症死亡人数的近一半(46%)，超过三分之一的人将在有生之年被诊断出患有某种形式的癌症。然而，许多临床应用目前仍未实现，被以单独方式解决发电和应用到治疗地点的要求的技术所禁止，极大地限制了整体功能。现有的系统已经证明了微波的能力；现在是实现其在手术中的全部潜力的时候了。因此，拟议的研究旨在优化手术，以实现使用定向、非电离微波和毫米波能量的高精度、微创手术。随着癌症和其他疾病的治疗发生革命性变化，疗效最终将得到提高，现有放射治疗、化疗或手术所遇到的副作用或干扰将会减少。通过天线或涂抹器进行锁孔腹腔镜或内窥镜手术，对患者的风险最小。然而，微波功率源目前被过度指定，以克服体内治疗部位的系统损失。只有不到25%的应用微波能量到达治疗部位；其余的浪费和潜在危险地散失在电缆中，因为热量横跨身体不是治疗目标的区域。随着高功率密度微波半导体器件的出现，通过改变系统架构并将微波功率源安置在治疗敷贴器内的需求点，可以更有效和高效地实现临床效果。低成本的商用设备能够提供所需的功率水平，芯片尺寸为0.85x1.1 mm，可提供令人难以置信的紧凑型解决方案。在与克里斯蒂和克里奥医疗公司的合作下，微波开发将针对已经对肠道疾病进行临床前研究的技术。应用集成将为典型的组织模型测试提供一个可操作的概念演示。必须解决制造挑战，将电子设备与复杂的天线结构集成在一起，并将利用未来的制造技术，如3D打印，生产具有成本效益的应用程序。该项目将实现临床驱动的微波系统向紧凑型喷头发展的轨迹，这将使诊断、能量剂量计算、高度受控和有针对性的治疗、疗效评估和安全退出以防止播撒成为可能，所有这些都将在单一的微创干预程序中完成。可以设想，一系列临床程序可以在门诊环境中或在患者家中实现，否则将在手术室内进行。

Modern surgical techniques, while extremely successful in curing life threatening diseases, can involve large volumes of tissue removal and possibly blood loss, with impacts upon recovery times, risk of infection and, in the longer term, quality of life. Radio frequency and microwave energy can be and is used in surgical systems to treat a vast range of medical conditions, such as benign and cancerous lesions, heart, liver and eye conditions and obesity (microwave assisted liposuction), with beneficial effects including tissue removal, heating, blood clotting and drying. Cancers of the lung, bowel, breast and prostate accounted for almost half (46%) of all cancer deaths in the UK in 2012 and more than 1 in 3 people will be diagnosed with some form of cancer during their lifetime. However, many clinical applications currently remain unrealised, prohibited by technology that addresses the requirements for power generation and application to the treatment site in a separate manner, greatly limiting overall functionality. Existing systems have proven the capabilities of microwaves; now is the time to realise their full potential in surgery.Accordingly, the proposed research is targeted towards optimising surgery to achieve high precision, minimally invasive surgery using targeted, non-ionising microwave and mm-wave energy. Revolutionising treatments for cancer and other diseases, efficacy will ultimately be improved and the side effects or disruption encountered with existing radiotherapy, chemotherapy or surgery reduced. Performed via an antenna, or applicator, keyhole laparoscopic or endoscopic surgery can be performed with minimal risk to the patient. However, the microwave power source is currently over specified to overcome system losses to the treatment site inside the body. Less than 25% of the applied microwave energy reaches the treatment site; the rest wastefully and potentially dangerously dissipated in the cable as heat over traversed regions of the body not targeted for treatment. The opportunity exists to greatly reduce the cost and size of the source.With the advent of high power density microwave semiconductor devices, clinical effects are achievable much more effectively and efficiently by transforming the system architecture and housing the microwave power source at the point of demand - inside the treatment applicator. Low cost commercial devices are capable of providing the required power levels, with chip dimensions of 0.85 x 1.1 mm to provide an incredibly compact solution. In collaboration with the Christie and Creo Medical, microwave developments will target technology that has undergone preclinical studies for bowel conditions. Applicator integration will deliver an operational concept demonstrator for representative tissue model testing. Manufacturing challenges must be solved to integrate the electronics together with complex antenna structures and future manufacturing technologies, such as 3D printing, will be exploited to produce cost effective applicators. The project will enable a clinically driven trajectory of microwave system developments towards compact applicators that will enable confirmation of diagnosis, energy dose calculation, highly controlled and targeted treatment, efficacy assessment and safe exit to prevent seeding, all in a single minimally invasive intervention procedure. It is envisaged that a range of clinical procedures could be enabled in an outpatient environment or within the patient's home that would otherwise have occurred within an operating theatre.