JP2015023996A - Puncture needle guide, medical treatment tool using the same and ultrasonic diagnostic apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a puncture needle guide which is a treatment tool used for a brachytherapy device of prostate cancer and can be easily detached so that the puncture needle guide does not interfere with the treatment even in a state where a puncture needle is stuck, in order to solve the problem in which a conventional puncture needle guide interferes with a treatment work when the puncture needle guided by the puncture needle guide is inserted into an affected part to perform treatment by using a tomographic image obtained by an ultrasonic probe.SOLUTION: A guide of a puncture needle is constituted by a plurality of parts and has a configuration in which a fixing member for fixing the plurality of parts can be canceled with only one spot. Thereby the puncture needle guide which can be disintegrated with the puncture needle inserted can be provided.

Description

  The present invention relates to a brachytherapy device for prostate cancer, and more particularly to a puncture needle guide mechanism for placing a brachytherapy source in the prostate.

As a method for treating prostate cancer, prostate cancer brachytherapy is known in which a brachytherapy source is inserted into prostate cancer in the body. Such a brachytherapy device for prostate cancer has an ultrasonic diagnostic apparatus main body, a display device, and a treatment jig, and the treatment jig displays an tomographic image on the display device. A child and a guide mechanism for a puncture needle for placing a brachytherapy source in the prostate gland.
As such a technique, for example, there is JP-A-2009-77972 (Patent Document 1).
In Patent Document 1, as a prostate cancer sealed brachytherapy source insertion aid, a grid template provided with needle insertion holes arranged in a matrix on the main surface of a transparent material substrate is formed. It is described that the position of the puncture needle can be adjusted visually.

JP 2009-77972 A

Patent Document 1 does not describe a case where the prostate cancer sealed brachytherapy source insertion aid becomes an obstacle to the treatment work after puncturing the puncture needle. For example, when performing fine adjustment of the position of the puncture needle, It has not been considered about the trouble such as the auxiliary tool moving and external force being applied to the puncture needle.
Therefore, an object of the present invention is to provide a puncture needle guide that can easily remove the guide mechanism of the puncture needle even when the puncture needle is inserted, a treatment jig using the same, and an ultrasonic diagnostic apparatus. .

  In order to solve the above-described problems, the present invention is configured such that the puncture needle guide is composed of a plurality of parts, and a fixing member for fixing them can be released at only one place.

  According to the present invention, it is possible to provide a puncture needle guide that can be disassembled even while the puncture needle is inserted, a treatment jig using the same, and an ultrasonic diagnostic apparatus.

1 is an overall external configuration diagram of an ultrasonic diagnostic apparatus according to an embodiment. It is a functional block diagram of the ultrasonic diagnostic apparatus of a present Example. It is a detailed external view of the treatment jig of a present Example. It is a mechanism figure of the puncture needle guide of a present Example. It is the figure which decomposed | disassembled the longitudinal guide in the puncture needle guide of a present Example. It is the figure which decomposed | disassembled the vertical guide, the horizontal guide, and the base in the puncture needle guide of a present Example.

Embodiments of the present invention will be described below with reference to the drawings.
FIG. 1 is an overall external configuration diagram of the ultrasonic diagnostic apparatus of this embodiment. In FIG. 1, the ultrasonic diagnostic apparatus includes an ultrasonic diagnostic apparatus main body 1, a treatment jig 2, and an image display apparatus 3.
The ultrasonic diagnostic apparatus transmits a two-dimensional ultrasonic image, a three-dimensional ultrasonic image, or a two-dimensional ultrasonic image of a diagnostic region using an echo signal obtained by an ultrasonic probe that transmits an ultrasonic wave to a subject and receives an echo reflected. Various Doppler images are constructed and displayed.

The treatment jig 2 includes ultrasonic transducer groups 4A and 4B arranged in parallel at least in the longitudinal direction, is supported by a fixed base 7, and is at least rotated in the axial direction. And a puncture needle guide 6 provided with a plurality of guide holes capable of guiding the puncture needle 5 supported by the acoustic probe and movable in the longitudinal direction of the ultrasonic probe. The puncture needle guide 6 may be supported by the fixed base 7. The ultrasonic probe 4 is arranged in the circumferential direction at the tip, and a first ultrasonic transducer group 4A that can acquire image information including a so-called convex image, and a second ultrasonic wave that can acquire image information including a so-called linear image. It consists of a transducer group 4B.
The puncture needle 5 is provided with, for example, a capsule containing a radioactive substance at its distal end, and when the distal end of the puncture needle 5 is positioned at a predetermined location on the prostate of the patient 8, It is treated by being released into the prostate.

  FIG. 2 shows a functional block diagram of the ultrasonic diagnostic apparatus of this embodiment. As described above, the ultrasonic diagnostic apparatus includes the ultrasonic diagnostic apparatus main body 1, the treatment jig 2, and the image display apparatus 3, and the ultrasonic diagnostic apparatus main body 1 transmits to the ultrasonic probe 4. Ultrasonic wave transmission / reception including a transmission pulse generation unit that generates and transmits a pulsed electric signal for generating an ultrasonic signal, and a conversion unit that converts an echo signal received by the ultrasonic probe 4 into an electric signal Unit 1-1, an ultrasonic image forming unit 1-2 that forms a two-dimensional ultrasonic image, a three-dimensional ultrasonic image, or various Doppler images from a received signal, a control unit 1-3 that controls each element, and a control And a control panel 1-4 for giving an instruction to the unit 1-3. The image display device 3 includes a display unit 3-1 that displays the ultrasonic image formed by the ultrasonic image forming unit 1-2 and displays a tomographic image obtained from the ultrasonic probe. The treatment jig 2 performs treatment by operating the puncture needle 5 with the puncture needle guide 6 based on the ultrasonic image obtained by the ultrasonic probe 4.

  In FIG. 3, the detailed external view of the treatment jig 2 of a present Example is shown. The treatment jig 2 of the present embodiment is a treatment jig used in a brachytherapy apparatus for prostate cancer, and FIG. 3A is a front view seen from the side where the puncture needle 5 is inserted, and FIG. It is a perspective view. Further, (C) shows a cross-sectional view taken along the line AA of (B). Further, 4C in (B) is an ultrasonic probe grip, which is operated to operate the ultrasonic probe. Further, the whole including the ultrasonic transducer groups 4A and 4B and the ultrasonic probe grip 4C is the ultrasonic probe 4.

  As shown in FIG. 3, the treatment jig of the present embodiment is a treatment jig for treating by inserting a puncture needle guided by a puncture needle guide into a diseased part using a tomographic image obtained by an ultrasonic probe. The puncture needle guide 6 is provided with a plurality of guide holes through which the puncture needle 5 can be guided, and in which guide hole the puncture needle is inserted based on the ultrasonic image obtained by the ultrasonic probe 4. Is determined. In addition, the positional relationship between the ultrasound probe 4 and the puncture needle guide 6 is as shown in FIG. The protrusion perpendicular to the axial direction is positioned by being fitted to a recess provided in a base base 6D1 (described later) of the puncture needle guide 6 and fixed by a needle guide mechanism fixing band 6E2.

  FIG. 4 shows a mechanism diagram of the puncture needle guide 6. 4A is a front view and FIG. 4B is a perspective view. In FIG. 4, 6A is a grid fixing screw, 6B is a vertical guide, 6C is a horizontal guide, 6D is a base, 6E1 is a needle guide mechanism fixing screw, and 6E2 is a needle guide mechanism fixing band. As shown in FIG. 4, the mechanism of the puncture needle guide 6 is roughly divided into three sets of parts, and fixes the ultrasonic probe and the puncture needle guide, a base 6D, a needle guide mechanism fixing screw 6E1, a needle It consists of a fixed part composed of a guide mechanism fixing band 6E2, a vertical guide 6B that suppresses the movement of the needle in the horizontal direction, and a horizontal guide 6C that suppresses the movement of the needle in the vertical direction. The base portion 6D is a basic member for assembling the longitudinal guide 6B and the lateral guide 6C as well as for fixing the ultrasonic probe and the puncture needle guide. Further, the horizontal direction and the vertical direction are determined based on the base 6D.

  In addition, these three sets of parts can be disassembled by the grid fixing screw 6A. Details will be described below with reference to FIGS.

  FIG. 5 shows an exploded view of the longitudinal guide of the puncture needle guide 6. FIG. 5A is a front view, and FIG. 5B is a perspective view. In FIG. 5, 6B1 is a vertical guide base, 6B2 is a vertical guide plate, 6B3 is a vertical guide plate fixing screw, 6B4 is a vertical guide rail, and 6B5 is a vertical guide rail fixing screw. Other configurations have the same functions as the configurations denoted by the same reference numerals as those illustrated in FIG. 4 described above, and thus the description thereof is omitted.

  As shown in FIG. 5, by operating the grid fixing screw 6A, the vertical guide 6B and the horizontal guide 6C can be separated as shown above and below each of FIGS. 5 (A) and 5 (B). The vertical guide plate 6B2 is fixed to the vertical guide base 6B1 with vertical guide plate fixing screws 6B3. The vertical guide plate 6B2 fixed to the vertical guide base 6B1 is fixed to the vertical guide rail 6B4 by the vertical guide rail fixing screw 6B5. The vertical guide rail 6B4 is a member that serves as a guide when assembling and disassembling, and will be described later.

  FIG. 6 shows an exploded view of the longitudinal guide 6B, the lateral guide 6C, and the base 6D of the puncture needle guide 6. FIG. FIG. 6A is a front view, and FIG. 6B is a perspective view. In FIG. 6, 6C1 is a lateral guide base, 6C2 is a lateral guide plate, 6C3 is a lateral guide plate fixing screw, 6C4 is a lateral guide rail, 6C5 is a lateral guide rail fixing screw, 6D1 is a base base, and 6D2 is a base side plate. 1, 6D3 are base side plate 1 fixing screws, 6D4 is base side plate 2, and 6D5 is base side plate 2 fixing screws. Other configurations have the same functions as the configurations denoted by the same reference numerals as those already described in FIGS. 4 and 5, and thus the description thereof is omitted.

  As shown in FIG. 6, the lateral guide plate 6C2 is fixed to the lateral guide base 6C1 with a lateral guide plate fixing screw 6C3. Further, the horizontal guide plate 6C2 fixed to the horizontal guide base 6C1 is fixed to the horizontal guide rail 6C4 by a horizontal guide rail fixing screw 6C5.

The horizontal guide rail 6C4 is a member that serves as a guide when assembling and disassembling, and a convex groove provided in the base base 6D1 and a concave groove provided inside the horizontal guide rail 6C4 slide. Thereby, the horizontal guide rail 6C4 serves as a guide when the horizontal guide plate 6C2 is attached to the base base 6D1 or removed from the base base 6D1. Moreover, also about the vertical guide rail 6B4 mentioned above, the convex groove provided in the base part side surface board 1 and 6D2 and the concave groove provided inside the vertical guide rail 6B4 slide. Accordingly, the vertical guide rail 6B4 serves as a guide when the vertical guide plate 6B2 is attached to or removed from the base 6D.
Although the guide rail has been described as a concave groove and the base side as a convex groove, it is only necessary to have a structure that restricts and guides the movement of the members so that assembly and disassembly can be easily performed. For example, a concave groove and a convex groove may be provided in reverse, and any structure that slides in a relationship between the convex groove and the concave groove may be used. Moreover, you may provide a protrusion in several places instead of a convex groove.

  Further, the horizontal guide plate 6C2 is provided with a plurality of holes, and the vertical guide plate 6B2 passes through the holes. Accordingly, the vertical guide plate 6B2 and the horizontal guide plate 6C2 are configured not to be wobbled. A similar effect may be obtained by providing a through hole on the vertical guide plate side. In addition, instead of a penetrating structure, a structure in which the horizontal guide plate and the vertical guide plate intersect each other may be used. In this case, there is an advantage that the structure of the guide plate can be simplified.

  Further, the base side plates 2 and 6D4 and the vertical guide base 6B1 are fixed by the grid fixing screws 6A, and the base side plates 2 and 6D4 are fixed to the horizontal guide base 6C1. Since the plate 6C2 is configured to penetrate, the vertical guide 6B, the horizontal guide 6C, and the base 6C can be assembled and disassembled by operating the grid fixing screw 6A. That is, by releasing one fixing member such as the grid fixing screw 6A, the puncture needle guide can be easily disassembled, and can be disassembled without interfering with the puncture needle even when the puncture needle is inserted into the affected area.

  Further, even if the puncture needle guide is disassembled, it is possible to carry out the treatment operation while the base 6C is fixed to the ultrasonic probe 4, and to assemble the puncture needle guide again. The treatment using the puncture needle guide can be performed again while maintaining the positional relationship with the needle guide.

  As described above, according to the present embodiment, the puncture needle guide is configured by a plurality of parts, and the fixing member that fixes them can be released at only one place. Thereby, there is an effect that the puncture needle guide can be disassembled and removed without affecting the puncture needle even when the puncture needle is inserted.

Instead of the grid fixing screw, a lock mechanism that fixes the vertical guide 6B, the horizontal guide 6C, and the base portion 6C may be used. .
A plurality of vertical guide plates 6B2 are fixed to the vertical guide base 6B1 at a predetermined interval, and a plurality of horizontal guide plates 6C2 are fixed to the horizontal guide base 6C1 at a predetermined interval. Although the hole is formed, the size of the guide hole can be changed by thinning out the installation of the vertical guide plate or the horizontal guide plate, so that it is possible to correspond to needles having different thicknesses.

  In addition, as a guide base that can fix a plurality of vertical or horizontal guide plates at a predetermined interval, a plurality of guide bases with different intervals are prepared, and by replacing these guide bases, the size of the guide hole is reduced. It can be changed, and it is possible to correspond to needles with different thicknesses.

  Also, when fixing the vertical guide plate or horizontal guide plate to the vertical guide base or horizontal guide base, it was fixed with the vertical guide plate fixing screw or horizontal guide plate fixing screw, but it is also possible to use a structure that does not use screws. It is. For example, as a fitting type, it is possible to fit the guide plate on the guide base. Accordingly, there is an effect that it is possible to save the trouble of operating each screw when removing a plurality of guide plates during assembly and disassembly.

  Further, if it is not necessary to remove a plurality of guide plates, a structure in which the guide plate and the guide base are integrally formed may be used.

  In addition, the puncture needle guide of the present embodiment is basically made of stainless steel in consideration of sterilization, considering reuse, but if it can be disposable, the cost can be reduced, and it can be made of resin such as plastic. But it ’s okay.

  Although the embodiments have been described above, the present invention is not limited to the above-described embodiments, and includes various modifications. For example, the above-described embodiments have been described in detail for easy understanding of the present invention. For example, in the above-described embodiments, the vertical and horizontal relations may be reversed, and the problem can be solved similarly. Moreover, it is not necessarily limited to what has all the structures demonstrated. Further, a part of the configuration of one embodiment can be replaced with the configuration of another embodiment, and the configuration of another embodiment can be added to the configuration of one embodiment. Moreover, it is also possible to add, delete, and replace other configurations for a part of the configuration of each embodiment.

DESCRIPTION OF SYMBOLS 1 ... Ultrasonic diagnostic apparatus main body, 2 ... Treatment jig, 4 ... Ultrasonic probe, 5 ... Treatment puncture needle 6 ... Needle guide mechanism, 6A ... Grid fixing screw, 6B ... Vertical guide, 6C ... Lateral guide 6D ... Base, 6B1 ... Vertical guide base, 6D1 ... Base base

Claims (8)

A puncture needle guide for guiding a puncture needle,
A fixing portion for fixing the ultrasonic probe and the puncture needle guide;
A longitudinal guide composed of a plurality of longitudinal guide plates that suppress the movement of the puncture needle in the horizontal direction when the fixing portion is used as a reference;
It consists of a lateral guide consisting of a plurality of lateral guide plates that suppress the movement of the puncture needle in the vertical direction with respect to the fixed portion,
Utilizing gaps generated when the plurality of horizontal guide plates and the plurality of vertical guide plates intersect as guide holes for the puncture needle,
The puncture needle guide, wherein the fixing portion, the vertical guide, and the horizontal guide are connected to each other by a single fixing member so as to be fixed or releasable. The puncture needle guide according to claim 1,
The puncture needle guide, wherein the fixing member is a fixing screw. The puncture needle guide according to any one of claims 1 and 2,
The fixing part is a base part composed of a base base and a base side plate and fixed to an ultrasonic probe,
The vertical guide is formed by fixing the plurality of vertical guide plates to a vertical guide base,
The lateral guide is formed by fixing the plurality of lateral guide plates to a lateral guide base.
A puncture needle guide characterized in that the movement is restricted and guided when the base part, the vertical guide and the horizontal guide are assembled so as to be integrated. The puncture needle guide according to claim 3,
The vertical guide is formed by fixing the vertical guide base to a vertical guide rail,
The lateral guide has the lateral guide base fixed to a lateral guide rail,
The structure in which the movement is restricted and guided is a structure in which the vertical guide rail and the horizontal guide rail slide on the base base and the base side plate in a relation of a convex groove and a concave groove. Puncture needle guide. The puncture needle guide according to any one of claims 3 and 4,
A plurality of horizontal guides having different intervals at which the plurality of horizontal guide plates are fixed to the horizontal guide base and a plurality of vertical guides having different intervals at which the plurality of vertical guide plates are fixed to the vertical guide base are used. And
By combining any one of the plurality of horizontal guides and the plurality of vertical guides, the size of the gap generated when the plurality of horizontal guide plates and the plurality of vertical guide plates are crossed is changed. A puncture needle guide comprising a puncture needle guide hole corresponding to the thickness of the puncture needle. A treatment jig used in a brachytherapy device for prostate cancer,
The treatment jig includes an ultrasonic transducer group having at least ultrasonic transducer groups arranged side by side in the longitudinal direction, and an ultrasonic probe supported by a fixed base, and the ultrasonic probe supported by the ultrasonic probe. A puncture needle guide provided with a plurality of guide holes capable of guiding a puncture needle movable in the longitudinal direction;
The puncture needle guide is
A fixing portion for fixing the ultrasonic probe and the puncture needle guide;
A longitudinal guide composed of a plurality of longitudinal guide plates that suppress the movement of the puncture needle in the horizontal direction when the fixing portion is used as a reference;
It consists of a lateral guide consisting of a plurality of lateral guide plates that suppress the movement of the puncture needle in the vertical direction with respect to the fixed portion,
Utilizing gaps generated when the plurality of horizontal guide plates and the plurality of vertical guide plates intersect as guide holes for the puncture needle,
The treatment jig, wherein the fixing portion, the vertical guide, and the horizontal guide are connected to each other by a single fixing member so as to be fixed or releasable. The treatment jig according to claim 6,
The treatment jig is a treatment jig for inserting and treating a puncture needle guided by the puncture needle guide using a tomographic image obtained by the ultrasonic probe into an affected area,
A treatment jig, wherein the fixing portion, the longitudinal guide, and the lateral guide can be disassembled by releasing the fixing member while the puncture needle is inserted into the affected area. An ultrasonic probe that transmits and receives ultrasonic waves to and from the subject, an ultrasonic image forming unit that forms an ultrasonic image based on a signal received by the ultrasonic probe, and a display unit that displays the ultrasonic image; An ultrasonic diagnostic apparatus comprising:
Furthermore, it has a treatment jig,
The treatment jig includes at least an ultrasonic transducer group arranged in parallel in the longitudinal direction, and an ultrasonic probe supported by a fixed base, and the ultrasonic probe supported by the ultrasonic probe. A puncture needle guide provided with a plurality of guide holes capable of guiding a puncture needle movable in the longitudinal direction;
The puncture needle guide is
A fixing portion for fixing the ultrasonic probe and the puncture needle guide;
A longitudinal guide composed of a plurality of longitudinal guide plates that suppress the movement of the puncture needle in the horizontal direction when the fixing portion is used as a reference;
It consists of a lateral guide consisting of a plurality of lateral guide plates that suppress the movement of the puncture needle in the vertical direction with respect to the fixed portion,
Utilizing gaps generated when the plurality of horizontal guide plates and the plurality of vertical guide plates intersect as guide holes for the puncture needle,
The ultrasonic diagnostic apparatus, wherein the fixing portion, the vertical guide, and the horizontal guide are connected to each other by a single fixing member so as to be fixed or releasable.

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