FR2824466A1 - Positioning accessory for use with an ultrasonic Doppler transducer device for vein cartography enables improved marking of the position of the vein as determined from the ultrasonic transducer position - Google Patents

Abstract

Device has the form of a set square with two legs (12, 14). An assembly (22, 26) is free to move along the transverse branch (14) of the device and comprises a slide (28) that moves perpendicular to the transverse leg. It includes a hole (32) through which e.g. a pen can be inserted for marking purposes. The position of a transducer is determined relative to the square, a measurement of vein position is made with the transducer and then the square is used for accurate marking of vein position.

Description

compress. The present invention relates to an aid accessory to the

cartography

  venous, intended in particular for surgeons and phiebologists.

  It is intended to be used in combination with a Doppler probe, no-

  a pulsed ultrasound Doppler probe, an instrument which is conventionally used to non-invasively determine the path of a

  vessel under the skin, usually a vein.

  Such a probe has a quasi-point measurement transducer on one of its faces. To find the path of the vein, the practitioner scans the surface of the skin until a maximum signal is found, and the place where the measurement transducer is located then corresponds to the position of the underlying vein. The measurement is repeated for different points on the

trejet of the vein.

  In this way, the practitioner locates point by point the path of the vein and

  traces on the skin of the marks corresponding to each measurement point.

  The difficulty consists in transferring the exact position of the transducer of the probe with the pen, which has so far been done more or less empirically by visually estimating the position of the transducer (in the center of the face applied against the skin) after to have removed the probe from

the surface of the skin.

  The problem arises in the same terms when it comes to pricking the

  skin to reach an inconspicuous vein, the difficulty being to find

  check with the needle the exact position detected by the probe transducer. To overcome this difficulty, it has already been proposed to give the probe a particular configuration allowing, as described for example in the

  US-A4 667 679, to guide a needle by pressing it against a formed groove

  mé in the probe, the latter remaining applied against the skin.

  These solutions, however, involve modifying the shape of the probe body and have a specific character, which does not make it possible to resolve the difficulty which a practitioner using

  pre-existing, unsuitable probes of various shapes and sizes

  his. One of the aims of the invention is to provide an accessory making it possible to accurately transfer onto the skin a position identified by the transducer of the probe after the latter has been removed, and this whatever

  either the type of probe used, the accessory being, as we can see,

  ra, very easily adapted to probes of very varied shapes and dimensions. To this end, the accessory of the invention comprises a body in the form of a square with two orthogonal branches, namely a longitudinal branch and a transverse branch each having, on the inner side

  of the square, a substantially rectilinear face capable of cooperating with, res-

  pectively, a lateral face and an upper face of the probe, as well as a mobile assembly according to a first degree of freedom in translation the

  along the transverse branch, this mobile assembly comprising a cou-

  saddle itself mobile according to a second degree of freedom in longitudinal translation and carrying a mark such as an orifice capable of receiving the

  tip of a pen. After placing the probe against the body of the access-

  In the evening, the position of the moving element and that of the slide are adjusted according to the thickness and the width of the probe housing so that, after having carried out a measurement with the probe and removed it, the mark of the issuer coulter is positioned at the point of incidence of the transducer of the

  probe when it was in measurement position.

  Advantageously, the moving assembly comprises a slider, mounted at the

  smoothing on the transverse branch of the square, and a stirrup carrying the

  slide and mounted to slide on this stirrup. The stirrup is preferably

  rence pivotally pivoted on the slider around a transverse axis, so as to be able to move the slider between a raised or folded position clearing the space between the two branches so as to allow the probe to be placed there in order to carry out a measurement with this one, and a lowered position placing the slide in this same space with the

  mark at the place previously occupied by the transducer of the probe.

  o We will now describe an example of implementation of the invention, in

reference to the accompanying drawings.

  Figure 1 is a perspective view of the accessory of the invention, in

  showing the different components.

  Figure 2 is a schematic perspective view of a measurement probe

  uDUsable in filler with the accesoim of ia figure 1.

  Figures 3 e1 4 son1 views, respeement of c616 e1 of this, ia gu probe 2 in posTn measurement, appqude con1m sucks

of the skin.

  Gures 5 e1 G lustren1 the preload adjustment steps

re to adapt the probe used.

  Figs 7 and B illustrate the use phase of the accolera, for pointing a venous bet on the bs of a padent. , which is presented under the general line a square with two perpendicular branches, namely a long branch

  dinale 12 and a branch bansveme 14, with dimensions respei-

  ves of g5 x 6S mm for example (these values being in no way limited

  ves and depending on it probes with which the accessory will be used). The longudinal branch 12 extends its erAmitd nbre by a ldque pad 1G, ageuseme -indé by an OND 18 -a pode-stylO, desOnd cevolr the pen which seim to the polntage of the hets

venous by the prAuCian.

  The hansversa branch 14 compodes on its length a minuge 20

  receiving a cursor 22, by eme by a Haon donde dlaronde.

  The strength of this house between the slider 22 and the groove 20 is a tight fit so that, after having been placed in a position given by the praUcian, the hand cannot move freely

  of the stresses -Arieure (jolts, etc.) that it could undergo.

  This cursor thus defines a first degree of bed6, kansversalemen1 en

  banslabon, schAmISA by arrow 24.

  The slider 22 podes an Aier 2G comprising two parallel branches extending in longitudinal direction and a slider 28 movable on the Abiep with a device tightened in the same way as it is with the accumulator 22 on the miniature 20. The coubssaau 28 pode in his cenhe an od

  ce 32 desnA receive the tip of a pen.

  This slide thus defines a second degree of freedom, longitudinal-

  ment in translation, shown diagrammatically by arrow 30.

  Furthermore, the stirrup 26 is pivotally mounted on the slider 22, ma-

  so that it can be folded down easily from a lowered position (that shown in FIG. 1), towards a raised position, which can even go as far as a folded position. In the lowered position, the moving element formed by the stirrup and the slide is placed between the two branches 12 and

  14 of the accessory, while in the raised or folded position, the space

  killed between these two branches is entirely cleared.

  This defines for the assembly a third degree of freedom, in pivoting around a transverse axis (the axis of the cursor 22), shown diagrammatically by the arrow 34.

  The two inner faces of the longitudinal 12 and transverse branches

  the 14, which are substantially rectilinear, define two orthogonal reference faces, namely a longitudinal reference face 36 and a transverse bearing face 38, intended to cooperate with homologous faces of a measurement probe so that we will describe below. Figures 2 to 4 schematically illustrate a Doppler probe, of the

  type used in particular in venous mapping.

  Such a probe 40 carries, on a front face 42, a transducer 44

  quasi-punctual for the emission / reception of ultrasound. The measuring face

  re 42 is generally an end face of the probe, the other faces 46, 48 of which are larger. As illustrated in Figures 3 and 4, for the measurement the practitioner applies the end face 42

  against the surface S of the skin so as to bring the trans-

conductor 44 with the latter.

  In practice, the probes 40 can, depending on the model, present forms

  mes and variable dimensions, in particular as regards the front face 42 and the position of the transducer 44 thereon (generally in the center), that is to say that the dimensions x and y corresponding to the median axes of the probe by compared to the lateral faces 46 and 48 may

  vary significantly from one probe model to another.

  We will now describe with reference to FIGS. 5 to 8 the manner in which

  the accessory according to the invention is used.

  A preliminary step, illustrated in FIGS. 5 and 6, consists in adjusting the various elements of the accessory as a function of the probe used. First of all (FIG. 5) the probe is supported by its lateral face 46 against the first reference face 36 of the longitudinal branch of the accessory 10. The position of the cursor 22 is then adjusted (arrow 24) so to place the center of this cursor 22 (and therefore the center of the bucket grout 28, to which corresponds the orifice 32) in alignment with the transducer of the probe, that is to say in principle in the median axis of the latter. In other words, the center of the cursor 24, and therefore the orifice 32 of the bucket grout 28, is positioned at a distance x from the reference face 36 corresponding to this same distance _ separating (FIG. 2) the axis trans

  conductor of the probe of the lateral face 46 of the latter.

  This first phase of the preliminary adjustment stage corresponded to a

  adjustment according to the width of the probe.

  In a second phase of this same preliminary step, an adjustment

  is operated according to the thickness of the probe.

  To this end, as illustrated in FIG. 6, the position of the slide 28 on the stirrup 26 is adjusted (arrow 30) so as to bring the orifice 32 of the

  slide with transducer 44 of the probe.

  The position of the probe, the lateral face 46 of which remains always applied against the reference face 36 of the branch 12 of the bracket, is placed so that the lower face 48 of the probe reaches the level of the

  underside of the transverse branch 14 of the accessory.

  In other words, the position of the slide 28 on the stirrup 26 is adjusted so that the orifice 32 is at a distance y from the transverse branch 14, corresponding to this same distance separating there (FIG. 2) I axis of the transducer of the probe of the lower face 48 of the latter. The accessory, thus adjusted as a function of the width and thickness of the probe in the manner just indicated, can then be used by the practitioner in the following manner, which will be described in reference to figures 7 and 8. To find the route of the vein, the practitioner scans the surface of the skin

  until you find a maximum signal. The location of the transducer-

  tor therefore corresponds to the position of the underlying vein: it is this position that the practitioner must identify as precisely as possible by marking it with a pen on the patient's skin (the problem would be the same if, instead of marking, it was necessary to prick a needle at the location identified). After having identified the desired position, the practitioner holds the probe 40 against the skin with one hand and places the accessory 10 against the probe, by wedging the two faces of the probe against the two faces 36 and 38 of the two branches of the accessory 10, the latter being pressed against the skin by the flat transverse branch 14. The stirrup 26 and the slide 28 are then in the folded position, in order to be able to clear the space included

  between the two branches of the accessory, occupied by the probe.

  While leaving the accessory pressed against the skin, the practitioner removes the probe and lowers the stirrup 26 and the slide 28 until the latter

  come to rest on the skin, in the space between the two branches

accessory ches.

  In this configuration, thanks to the previous settings that have been made

  res at the steps of FIGS. 5 and 6, the orifice 32 of the slide is very exactly positioned (FIG. 8) at the place where the transducer was located

  before the probe is removed (Figure 7).

  It then suffices for the practitioner to mark this position by inserting the point of a pen 50 into the orifice 32. The transfer of this position is thus

  carried out in a way that is both very simple and very precise.

Claims (4)

  1. An accessory (10) intended to be used in combination with a probe (40) provided on a front face (42) with a transducer (44) that is only one point, in particular an ultrasonic Doppler probe for the venous mapping , accessory characterized in that it comprises: - a body in the form of a square with two orthogonal branches, in its view a longitudinal branch (12) and a transverse branch (14) each having, on the inner side of the square, a face (36, 38) substantially rectilinear capable of cooperating with, respectively, a lateral face (46) and an upper face (48) of the probe, - an assembly (22, 26) movable according to a first degree of freedom of translation along the transverse branch, this movable assembly comprising a slide (28) itself movable according to a second dogré of freedom in longitudinal translation and carrying a mark (32), so that, after placing the probe against the body of the accessory, the position of the equ ipage mobile and that of the slide then feels to be adjusted according to the thickness and width of the probe housing so that, after having carried out a measurement with the probe and removed the latter, the reference mark of the slide is positioned at point d incident of the probe transducer when it was in the measurement position. 2. The accessory of claim 1, in which the reference is an orifice   (32) able to receive the tip of a pen.   3. The accessory of claim 1, wherein the movable assembly com carries a slider (22), slidably mounted on the transverse branch (14) of the bracket, and a stirrup (26) carrying the slide (28 ) and mounted at sliding on this stirrup.   4. The accessory of claim 3, wherein the stirrup (26) is pivotally articulated on the slider (22) about a transverse axis, so as to be able to move the slider between: - a lifted postman or baQue dgagean1 respace Campus ends has two branches to allow placement place the probe to carry out a measurement with this one - a postman abase plegan1 le Rousseau dens mime respace with the repertory return occupied by the transducer