CN104958099A - 3D printing intervertebrale foramen mirror targeting puncturing percutaneous surgery guide plate and puncturing method thereof - Google Patents
3D printing intervertebrale foramen mirror targeting puncturing percutaneous surgery guide plate and puncturing method thereof Download PDFInfo
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- CN104958099A CN104958099A CN201510414907.7A CN201510414907A CN104958099A CN 104958099 A CN104958099 A CN 104958099A CN 201510414907 A CN201510414907 A CN 201510414907A CN 104958099 A CN104958099 A CN 104958099A
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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
- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
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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
- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
- A61B2017/3405—Needle locating or guiding means using mechanical guide means
- A61B2017/3407—Needle locating or guiding means using mechanical guide means including a base for support on the body
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Abstract
The invention relates to a 3D printing intervertebrale foramen mirror targeting puncturing percutaneous surgery guide plate, and further provides a puncturing method by adopting the surgery guide plate. The 3D printing intervertebrale foramen mirror targeting puncturing percutaneous surgery guide plate comprises a base and a guide plate body; the guide plate body is supported by the base and positioned on a human body, the guide plate body is internally formed by a positioning segment connected with the base and a puncturing guide segment used for puncturing and positioning, a positioning groove formed in a guide plate positioning hole is exactly matched with a positioning protrusion of the base in an embedded mode, and then puncturing is carried out along an oblique guide channel of a guide pipe arranged at the front end of the puncturing guide segment. The 3D printing intervertebrale foramen mirror targeting puncturing percutaneous surgery guide plate and the puncturing method have the advantages that a puncturing route is decided by the 3D printing percutaneous surgery guide plate before surgery is carried out, the puncturing depth is measured, nerves and vessels are prevented from being damaged in the surgery, puncturing is carried out along guide holes in the surgery, the surgery time can be obviously shortened, the fluoroscopy radiant quantity is reduced, preconditions are provided for hole expanding, pipe arranging and under mirror operating in follow-up periods, and meanwhile the damage probabilities of the nerves and the vessels are reduced.
Description
Technical field
The present invention relates to a kind of 3D and print foramen intervertebrale lens targeting puncture percutaneous surgical guide, also relate to a kind of this guide plate that adopts and carry out the method punctured.
Background technology
3D is printed on being applied in of medical domain and progressively spreads out and go deep into, and be the product highly customized to copying of human body position, printed by 3D, these parts can agree with completely with health, combine together with health.
Farthest can keep the integrity of fibrous ring as foramen intervertebrale lens vertebral column minimally invasive technology and keep the stability of spinal column, minimum to patient trauma in similar operation, effect is best.Current international field of spinal surgery has generally acknowledged that foramen intervertebrale lens Nucleus resection is developing into the leading modus operandi in this field in the future.
This technology can be divided into three parts: 1, targeting puncture technique, 2, reaming, tube indwelling technology, 3, operating technology under mirror.Wherein targeting puncture technique is the most key, and whether it directly determines successful surgery.
Current foramen intervertebrale lens targeting puncture technique (for waist 4/5 intervertebral disk hernia): according to the check result of preoperative CT, MRI of patient, find the outstanding target spot position of pressuring nerve, set puncture path by the personal experience of operator.Waist 4/5 gap and intervertebral foramina position is determined under the perspective of position, C arm machine positive side in operation process, and mark waist 4/5 Interstitial Water horizontal line with oil pen, the hand-held Kirschner wire of patient, repeatedly had an X-rayed by position, C arm machine positive side and determine that needle point arrives the puncture path at intervertebral disk hernia target spot position, rule along Kirschner wire with oil pen simultaneously, be with above-mentioned horizontal line point of interface percutaneous puncture point of performing the operation.Get percutaneous needle to thrust from point of puncture, inserting needle limit, limit perspective is until needle point arrives at target spot position namely complete puncture.The method can not avoid injured nerve in art, blood vessel, more cannot realize a step and precisely put in place.
Therefore, research and development one can arrive target spot position accurately, shortens the puncture time, reduces perspective radiation, and the foramen intervertebrale lens targeting puncture aid material of minimizing patients' neural, blood vessel injury probability is imperative.
Summary of the invention
The technical problem to be solved in the present invention is to provide a kind of arrival target spot position that can be precisely safe, shortens the puncture time, reduces perspective radiation, reduces the 3D printing foramen intervertebrale lens targeting puncture percutaneous surgical guide of patients' neural, blood vessel injury probability; A kind of 3D of employing printing foramen intervertebrale lens targeting puncture percutaneous surgical guide is also provided to carry out the method punctured.
For solving the problems of the technologies described above, technical scheme of the present invention is: a kind of 3D prints foramen intervertebrale lens targeting puncture percutaneous surgical guide, and its innovative point is: comprise pedestal and guide plate body, and this guide plate body is by base supports and be positioned on human body; Described pedestal assumes diamond in shape, and its cornerwise point of intersection has a vertically disposed locating dowel, and its four angular vertexs place and locating dowel lower surface have one respectively for being connected with medical sheet of pasting the connecting hole realizing pedestal and fix; Described guide plate body is strip, and by for being connected the positioning section of locating with pedestal and forming for the puncture guide section entirety of Needle localization, the center of described positioning section has a locating hole stretched into for base stand location post; The front end of described puncture guide section has a guide pipe be obliquely installed, and is formed centrally one for the guide channel of biopsy needle guide in this guide pipe.
Preferably, the locating dowel top of described pedestal is provided with locking screw thread section, and bottom is provided with the positioning convex that at least one stretches out locating dowel surface; The locating hole of described guide plate is provided with along the axial extension of locating hole and locating slot that just can be chimeric with positioning convex.
Preferably, described guide plate positioning section top is an arcuate structure being convenient to grip.
Preferably, a reinforcement is also provided with between described arcuate structure and puncture guide section.
Preferably, the structure of lower surface for just fitting with body surface molded line in penetrating area needed for individuality of described guide plate puncture guide section.
A kind of 3D printing foramen intervertebrale lens targeting puncture percutaneous surgical guide is also provided to complete the method for puncture, its innovative point is: the concrete steps of described method are as follows: the first step: allow patient get ventricumbent position, abdominal part bolster reaches position in art, place at pathological changes lumbar intervertebral disc body surface projection place and medically paste sheet, medical paste sheet center have one can be chimeric with pedestal lower end connecting hole projection, and then load onto pedestal, utilize pedestal connecting hole position with the medical projection pasting sheet and be connected; Second step: carry out CT examination, preoperative image data, checks out and requires that patient keeps prostrate or lateral position, ensures that medical sheet of pasting is not shifted distortion; 3rd step: utilize the CT data gathered to carry out three-dimensional reconstruction spine model, find prolapse of lumbar intervertebral disc target spot position, set puncture path and paracentesis depth, according to the guide plate body of puncture path design percutaneous surgery, and prints guide plate body with 3D printer; 4th step: the guide plate body placing percutaneous surgery guide plate in art; The locating hole of guide plate body is sleeved on base stand location post, and after locating slot and positioning convex being fitted together to, the top locking screw thread section of locating dowel is threaded locking nut, and then guide plate body, pedestal and medical sheet of pasting are connected to form an entirety; 5th step: along the puncture of guide plate puncturing hole, paracentesis depth one pin according to preoperative measurement puts in place, only needs position, positive side respectively to have an X-rayed and once checks puncture situation when having punctured.
The invention has the advantages that:
(1) a kind of 3D of the present invention prints foramen intervertebrale lens targeting puncture percutaneous surgical guide, comprise pedestal and the guide plate body of 3D printing shaping, this guide plate body is by base supports and be positioned on human body, is convenient to better resting guide between guide plate and pedestal by thread connection; Guide plate is arranged the stability that reinforcement can increase guide plate; Guide plate sets the gripping that arcuate structure is convenient to medical worker;
(2) 3D prints percutaneous surgery guide plate and drafts puncture path by preoperative, measure paracentesis depth, avoid injured nerve in art, blood vessel, puncture along guide hole in art, one step precisely puts in place, obviously can shorten operating time, reduces perspective amount of radiation, and for reaming below, put operation under pipe, mirror prerequisite be provided, reduce patients' neural, blood vessel injury probability simultaneously.
Accompanying drawing explanation
Fig. 1 is the front view that 3D prints foramen intervertebrale lens targeting puncture percutaneous surgical guide.
Fig. 2 is the top view that 3D prints foramen intervertebrale lens targeting puncture percutaneous surgical guide.
Fig. 3 is the A direction view in Fig. 1.
Fig. 4 is the front view that 3D prints foramen intervertebrale lens targeting puncture percutaneous surgical guide pedestal.
Fig. 5 is the side view that 3D prints foramen intervertebrale lens targeting puncture percutaneous surgical guide pedestal.
Fig. 6 is the locking nut be connected with base stand location male screw.
Fig. 7 is that 3D prints foramen intervertebrale lens targeting puncture percutaneous surgical guide operating diagram.
Detailed description of the invention
As shown in Figures 1 to 6, the invention discloses a kind of 3D and print pedestal 8 and the guide plate body 6 that foramen intervertebrale lens targeting puncture percutaneous surgical guide comprises 3D printing shaping, this guide plate body is by base supports and be positioned on human body; Pedestal assumes diamond in shape, and its cornerwise point of intersection has a vertically disposed locating dowel 10, and its four angular vertexs place and locating dowel lower surface have one respectively for being connected with medical sheet of pasting the connecting hole 9 realizing pedestal and fix; Guide plate body is strip, and by for being connected the positioning section 5 of locating with pedestal and forming for puncture guide section 6 entirety of Needle localization, the center of guide plate positioning section has a locating hole 4 stretched into for base stand location post; The front end of puncture guide section has a guide pipe be obliquely installed 7, is formed centrally one for the guide channel of biopsy needle guide in this guide pipe.
In the present embodiment, locating dowel 10 top of pedestal is provided with locking screw thread section 11, and this locking screw thread section 11 is for the locking nut 13 that is threaded; Bottom is provided with at least one positioning convex 12 stretching out locating dowel surface; The locating hole 4 of guide plate is provided with along the axial extension of locating hole and locating slot that just can be chimeric with positioning convex, conveniently operates, guide plate positioning section also has an arcuate structure 3 being convenient to grip; In addition in order to strengthen structure, be also provided with reinforcement 2(see Fig. 1 at positioning section).The structure of lower surface for just fitting with body surface molded line in penetrating area needed for individuality of guide plate puncture guide section.
3D print foramen intervertebrale lens targeting puncture percutaneous surgical guide complete the method for puncture, its concrete grammar step is: as shown in Figure 7,
The first step: allow patient get ventricumbent position, abdominal part bolster reaches position in art, place at pathological changes lumbar intervertebral disc body surface projection place and medically paste sheet, medical paste sheet center have one can be chimeric with pedestal lower end connecting hole projection, and then load onto pedestal, utilize pedestal connecting hole position with the medical projection pasting sheet and be connected;
Second step: carry out CT examination, preoperative image data, checks out and requires that patient keeps prostrate or lateral position, ensures that medical sheet of pasting is not shifted distortion;
3rd step: utilize the CT data gathered to carry out three-dimensional reconstruction spine model, find prolapse of lumbar intervertebral disc target spot position, set puncture path and paracentesis depth, according to the guide plate body of puncture path design percutaneous surgery, and prints guide plate body with 3D printer;
4th step: the guide plate body placing percutaneous surgery guide plate in art; The locating hole of guide plate body is sleeved on base stand location post, and after locating slot and positioning convex being fitted together to, the top locking screw thread section of locating dowel is threaded locking nut, and then guide plate body, pedestal and medical sheet of pasting are connected to form an entirety;
5th step: along the puncture of guide plate puncturing hole, paracentesis depth one pin according to preoperative measurement puts in place, only needs position, positive side respectively to have an X-rayed and once checks puncture situation when having punctured.
Through clinical trial, the parameter comparison of itself and traditional piercing method is:
| Tradition piercing method | Piercing method of the present invention | |
| The puncture time | 15-30min | 4-5min |
| Perspective number of times | 6-8 time | 2 ~ 3 times |
| Precision reliability | Experience with doctor punctures, and puncture effect differs | A precise positioning |
In sum, piercing method of the present invention can avoid injured nerve in art, blood vessel, puncture along guide hole in art, one step precisely puts in place, obviously can shorten operating time, reduce perspective amount of radiation, and for reaming below, put to operate under pipe, mirror prerequisite be provided, reduce patients' neural, blood vessel injury probability simultaneously.
Claims (6)
1. 3D prints a foramen intervertebrale lens targeting puncture percutaneous surgical guide, it is characterized in that: comprise pedestal and guide plate body, and this guide plate body is by base supports and be positioned on human body;
Described pedestal assumes diamond in shape, and its cornerwise point of intersection has a vertically disposed locating dowel, and its four angular vertexs place and locating dowel lower surface have one respectively for being connected with medical sheet of pasting the connecting hole realizing pedestal and fix;
Described guide plate body is strip, and by for being connected the positioning section of locating with pedestal and forming for the puncture guide section entirety of Needle localization, the center of described positioning section has a locating hole stretched into for base stand location post; The front end of described puncture guide section has a guide pipe be obliquely installed, and is formed centrally one for the guide channel of biopsy needle guide in this guide pipe.
2. 3D according to claim 1 prints foramen intervertebrale lens targeting puncture percutaneous surgical guide, it is characterized in that:
The locating dowel top of described pedestal is provided with locking screw thread section, and bottom is provided with the positioning convex that at least one stretches out locating dowel surface; The locating hole of described guide plate is provided with along the axial extension of locating hole and locating slot that just can be chimeric with positioning convex.
3. 3D according to claim 1 prints foramen intervertebrale lens targeting puncture percutaneous surgical guide, it is characterized in that: described guide plate positioning section top is an arcuate structure being convenient to grip.
4. 3D according to claim 3 prints foramen intervertebrale lens targeting puncture percutaneous surgical guide, it is characterized in that: be also provided with a reinforcement between described arcuate structure and puncture guide section.
5. 3D according to claim 1 prints foramen intervertebrale lens targeting puncture percutaneous surgical guide, it is characterized in that: the structure of lower surface for just fitting with body surface molded line in penetrating area needed for individuality of described guide plate puncture guide section.
6. use the printing of the 3D described in claim 1 foramen intervertebrale lens targeting puncture percutaneous surgical guide to complete a method for puncture, it is characterized in that: the concrete steps of described method are as follows:
The first step: allow patient get ventricumbent position, abdominal part bolster reaches position in art, place at pathological changes lumbar intervertebral disc body surface projection place and medically paste sheet, medical paste sheet center have one can be chimeric with pedestal lower end connecting hole projection, and then load onto pedestal, utilize pedestal connecting hole position with the medical projection pasting sheet and be connected;
Second step: carry out CT examination, preoperative image data, checks out and requires that patient keeps prostrate or lateral position, ensures that medical sheet of pasting is not shifted distortion;
3rd step: utilize the CT data gathered to carry out three-dimensional reconstruction spine model, find prolapse of lumbar intervertebral disc target spot position, set puncture path and paracentesis depth, according to the guide plate body of puncture path design percutaneous surgery, and prints guide plate body with 3D printer;
4th step: the guide plate body placing percutaneous surgery guide plate in art; The locating hole of guide plate body is sleeved on base stand location post, and after locating slot and positioning convex being fitted together to, the top locking screw thread section of locating dowel is threaded locking nut, and then guide plate body, pedestal and medical sheet of pasting are connected to form an entirety;
5th step: along the puncture of guide plate puncturing hole, paracentesis depth one pin according to preoperative measurement puts in place, only needs position, positive side respectively to have an X-rayed and once checks puncture situation when having punctured.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201510414907.7A CN104958099B (en) | 2015-07-15 | 2015-07-15 | 3D printing foramen intervertebrale lens targeting puncture percutaneous surgical guide and its piercing method |
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| CN201510414907.7A CN104958099B (en) | 2015-07-15 | 2015-07-15 | 3D printing foramen intervertebrale lens targeting puncture percutaneous surgical guide and its piercing method |
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| CN104958099A true CN104958099A (en) | 2015-10-07 |
| CN104958099B CN104958099B (en) | 2017-04-05 |
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Cited By (6)
| Publication number | Priority date | Publication date | Assignee | Title |
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| CN105852967A (en) * | 2016-04-21 | 2016-08-17 | 南京鼓楼医院 | Percutaneous puncture thoracolumbar and surrounding tissue organ 3D-printing navigator and navigation method thereof |
| CN108784795A (en) * | 2018-04-17 | 2018-11-13 | 北京麦格优品商贸有限公司 | Puncturing operation targeting guide plate |
| CN110269768A (en) * | 2019-06-03 | 2019-09-24 | 南京医科大学 | For the location bed of Auxiliary Liver puncture procedure, guide plate and guide plate design method |
| CN112367938A (en) * | 2018-06-26 | 2021-02-12 | 皇家飞利浦有限公司 | Plan-specific instrument template for percutaneous interventional procedures |
| CN113576616A (en) * | 2021-08-04 | 2021-11-02 | 北京市春立正达医疗器械股份有限公司 | Tool for positioning center of glenoid |
| CN114869432A (en) * | 2022-05-09 | 2022-08-09 | 四川华曙图灵增材制造技术有限责任公司 | 3D printing customized hysteromyoma stripping operation guide plate and using method thereof |
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| CN204890128U (en) * | 2015-07-15 | 2015-12-23 | 江苏舟可医疗器械科技有限公司 | 3D prints intervertebral foramen mirror target puncture percutaneous operation baffle |
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| WO2004021898A1 (en) * | 2002-09-05 | 2004-03-18 | Radi Medical Systems Ab | Guide for a medical device |
| CN102300512A (en) * | 2008-12-01 | 2011-12-28 | 马佐尔机器人有限公司 | Robot Guided Oblique Spinal Stabilization |
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Cited By (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN105852967A (en) * | 2016-04-21 | 2016-08-17 | 南京鼓楼医院 | Percutaneous puncture thoracolumbar and surrounding tissue organ 3D-printing navigator and navigation method thereof |
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| CN110269768A (en) * | 2019-06-03 | 2019-09-24 | 南京医科大学 | For the location bed of Auxiliary Liver puncture procedure, guide plate and guide plate design method |
| CN113576616A (en) * | 2021-08-04 | 2021-11-02 | 北京市春立正达医疗器械股份有限公司 | Tool for positioning center of glenoid |
| CN114869432A (en) * | 2022-05-09 | 2022-08-09 | 四川华曙图灵增材制造技术有限责任公司 | 3D printing customized hysteromyoma stripping operation guide plate and using method thereof |
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| CN104958099B (en) | 2017-04-05 |
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