CN107361822A - Ultrasonic guidance S3Sacral nerve positioner and localization method - Google Patents
Ultrasonic guidance S3Sacral nerve positioner and localization method Download PDFInfo
- Publication number
- CN107361822A CN107361822A CN201710520209.4A CN201710520209A CN107361822A CN 107361822 A CN107361822 A CN 107361822A CN 201710520209 A CN201710520209 A CN 201710520209A CN 107361822 A CN107361822 A CN 107361822A
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- China
- Prior art keywords
- locating rack
- transverse arm
- trailing arm
- sacral nerve
- arm
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- 210000005036 nerve Anatomy 0.000 title claims abstract description 41
- 238000000034 method Methods 0.000 title claims description 14
- 230000004807 localization Effects 0.000 title claims description 8
- 238000002604 ultrasonography Methods 0.000 claims abstract description 7
- 230000004044 response Effects 0.000 claims description 9
- 239000000523 sample Substances 0.000 claims description 7
- 238000012360 testing method Methods 0.000 claims description 7
- 206010002091 Anaesthesia Diseases 0.000 claims description 4
- 238000001949 anaesthesia Methods 0.000 claims description 4
- 230000037005 anaesthesia Effects 0.000 claims description 4
- 238000011282 treatment Methods 0.000 abstract description 11
- 230000004007 neuromodulation Effects 0.000 abstract description 5
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 5
- 201000010099 disease Diseases 0.000 description 4
- 210000001217 buttock Anatomy 0.000 description 3
- 238000002560 therapeutic procedure Methods 0.000 description 3
- 206010058109 Hangnail Diseases 0.000 description 2
- 230000033228 biological regulation Effects 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 210000000056 organ Anatomy 0.000 description 2
- 230000011514 reflex Effects 0.000 description 2
- 230000000638 stimulation Effects 0.000 description 2
- 238000007920 subcutaneous administration Methods 0.000 description 2
- 230000001225 therapeutic effect Effects 0.000 description 2
- 230000002159 abnormal effect Effects 0.000 description 1
- 230000008901 benefit Effects 0.000 description 1
- 230000003115 biocidal effect Effects 0.000 description 1
- 230000013872 defecation Effects 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 230000004064 dysfunction Effects 0.000 description 1
- 230000008482 dysregulation Effects 0.000 description 1
- 238000004070 electrodeposition Methods 0.000 description 1
- 210000004392 genitalia Anatomy 0.000 description 1
- 230000036541 health Effects 0.000 description 1
- 238000000338 in vitro Methods 0.000 description 1
- 238000003780 insertion Methods 0.000 description 1
- 230000037431 insertion Effects 0.000 description 1
- 230000027939 micturition Effects 0.000 description 1
- 230000007433 nerve pathway Effects 0.000 description 1
- 230000007383 nerve stimulation Effects 0.000 description 1
- 230000001537 neural effect Effects 0.000 description 1
- 230000004768 organ dysfunction Effects 0.000 description 1
- 230000002980 postoperative effect Effects 0.000 description 1
- 238000011321 prophylaxis Methods 0.000 description 1
- 230000001568 sexual effect Effects 0.000 description 1
- 210000005070 sphincter Anatomy 0.000 description 1
- 230000001954 sterilising effect Effects 0.000 description 1
- 238000004659 sterilization and disinfection Methods 0.000 description 1
- 230000001629 suppression Effects 0.000 description 1
- 210000003708 urethra Anatomy 0.000 description 1
- 210000002700 urine Anatomy 0.000 description 1
- 230000000007 visual effect Effects 0.000 description 1
Classifications
-
- 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
-
- 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
-
- 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
- A61B2017/3413—Needle locating or guiding means guided by ultrasound
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- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Pathology (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
- Electrotherapy Devices (AREA)
Abstract
Ultrasonic guidance S provided by the invention3Sacral nerve positioner,Including trailing arm and transverse arm,The trailing arm is connected with transverse arm by screw riveting,The transverse arm is free to rotate as axle using screw riveting,The transverse arm respectively has the transverse arm locating rack of a semi-circular shape away from left and right at screw riveting central point 1.5cm,The transverse arm locating rack distance of center circle screw riveting central point distance of the semi-circular shape is 2cm,The a diameter of 1cm of transverse arm locating rack of the semi-circular shape,The trailing arm is the curved panel that tail end is provided with trailing arm locating rack,The distance of the trailing arm locating rack distance of center circle screw riveting central point is 9cm,The trailing arm locating rack tail end circular diameter is 1.5cm,The present invention is accurately positioned sacral nerve under B ultrasound guiding,While ensuring that patient's acquisition sacral nerve neuromodulation is effectively treated,It completely avoid the exposure of the x-ray of medical personnel and patient,It significantly shorten pre-operative surgical equipment time and operation time,The unnecessary treatment of patient is reduced simultaneously to spend.
Description
Technical field
The present invention relates to technical field of medical equipment, and in particular to draws applied to a kind of ultrasound in sacral nerve therapeutic process
Lead S3Sacral nerve positioner and localization method.
Background technology
Basin bottom organ dysfunction disease be it is a kind of have a strong impact on health of people and the wider disease of patient groups, its disease
Disease is numerous and diverse, treatment is intractable, is badly in need of a kind of new treatment means to solve, sacral nerve neuromodulation therapy in such disease treatment, into
Fail the treatment that latter is effective and is recommended by various countries' practice guidelines for traditional conservative therapy in recent years or operative treatment
Method.
Sacral nerve neuromodulation art（SNM）It is that low-frequency electric pulse is continuously put on to specific sacral nerve using interventional technique（S2-4）,
With this excited or suppression nerve pathway, dysregulation sacral nerve reflex arc, abnormal neural reflex is set to reach balance again, and then
Influence and adjust bladder, urethra/anal sphincter, basin bottom and genitals official rank sacral nerve domination target organ function, so as to reach
To a kind of nervous centralis regulation technology of therapeutic effect, Medtronic Sacral nerve electrical stimulation system is international unique authentication treatment at present
Equipment, by implantable nerve stimulator and electrode, two-way stimulation regulation sacral nerve reflection and control urine, excrement storage and
Release and men and women's sexual organ partial function, effectively improve urination, defecation and sex dysfunction safely.Sacral nerve S3Positioning
Vital link in Stage1 is treated as sacral nerve neuromodulation, existing treatment method can not depart from x-ray or CT equipment,
Operation must be chronically exposed under X when implementing, and considerable influence can be produced to medical personnel and patient.
The content of the invention
In order to solve the above-mentioned technical problem the present invention provides ultrasonic guidance S3Sacral nerve positioner and localization method, in B
S is accurately positioned under super guiding3Sacral nerve, then carry out puncture for treating.
The technical scheme is that：Ultrasonic guidance S3Sacral nerve positioner, including trailing arm and transverse arm, the trailing arm with
Transverse arm is connected by screw riveting, and the transverse arm is free to rotate as axle using screw riveting, away from screw riveting central point on the transverse arm
Respectively there are the transverse arm locating rack of a semi-circular shape, the transverse arm locating rack distance of center circle screw riveting central point distance in left and right at 1.5cm
For 2cm, a diameter of 1cm of transverse arm locating rack, the trailing arm is the curved panel that tail end is provided with trailing arm locating rack, described vertical
The distance of arm locating rack distance of center circle screw riveting central point is 9cm, and the trailing arm locating rack tail end circular diameter is 1.5cm.
Ultrasonic guidance S3The localization method of sacral nerve positioner comprises the following steps：1. mark S3Sacral nerve hole, by trailing arm
On circular trailing arm locating rack be fixed at patient's coccyx, the trailing arm locating rack tail end center of circle and coccyx tip are corresponding, thus position
The location of two semicircle transverse arm locating rack centers of circle on device transverse arm are the S to be positioned when treating3Sacral nerve hole；
2. ultrasonic guidance confirms, in the S of mark3About 2 cm of top places are used as entry point at the sites of sacral nerve hole, after local anaesthesia, use
Puncture needle punctures from entry point, and needle angle points to tail end in sagittal plain and skin in 60 ° of angles, is entered with ultrasound direct-view, probe side
Method enters pin puncture and enters S3Sacral nerve hole, that is, interim stimulator is connected, test the motion response of patient and feel response, to enter one
Step determines whether site of puncture correct and electrode placed-depth, and rotatable transverse arm is with convenience for ultrasonic probe operation when confirming position
And Real Time Observation in art.
It is an advantage of the invention that：For the present invention according to skeleton shape, trailing arm is the arcwall face to be matched with rumpbone shape
Plate, S is accurately positioned under B ultrasound guiding3Sacral nerve, then carry out puncture for treating, it is ensured that patient obtains sacral nerve neuromodulation and effectively controlled
While treatment, it is entirely avoided the exposure of the x-ray of medical personnel and patient, significantly shorten pre-operative surgical equipment time with
Operation time, while reduce the unnecessary treatment of patient and spend.
Figure of description
Fig. 1 is the positive structure schematic of the present invention.
Fig. 2 is side structure schematic diagram of the present invention.
Wherein：1st, transverse arm, 2, screw riveting, 3, transverse arm locating rack, 4, trailing arm, 5, trailing arm locating rack.
Embodiment
Clearly complete description is done to the present invention below in conjunction with the accompanying drawings, so that those skilled in the art need not make
Under conditions of creative work, it can fully implement the present invention.
The present invention embodiment be：As shown in Figure 1, 2, ultrasonic guidance S3Sacral nerve positioner, including trailing arm 4
With transverse arm 1, the trailing arm 4 is connected with transverse arm 1 by screw riveting 2, and the transverse arm 1 is that axle is free to rotate with screw riveting 2, described
Transverse arm 1 respectively has the transverse arm locating rack 3 of a semi-circular shape, the transverse arm locating rack circle away from left and right at the central point 1.5cm of screw riveting 2
The heart is 2cm away from screw riveting central point distance, and 3 a diameter of 1cm of transverse arm locating rack, the tail end of trailing arm 4 is provided with circular trailing arm
One curved panel of locating rack 5, the distance of the central point of 5 tail end distance of center circle screw riveting of trailing arm locating rack 2 is 9cm, described vertical
The tail end circular diameter of arm locating rack 5 is 1.5cm.
Ultrasonic guidance S3The localization method of sacral nerve positioner comprises the following steps：1. mark S3Sacral nerve hole, by trailing arm
On circular trailing arm locating rack be fixed at patient's coccyx, the trailing arm locating rack tail end center of circle and coccyx tip are corresponding, thus position
The location of two semicircle transverse arm locating rack centers of circle on device transverse arm are the S to be positioned when treating3Sacral nerve hole；
2. ultrasonic guidance confirms, in the S of mark3About 2 cm of top places are used as entry point at the sites of sacral nerve hole, after local anaesthesia, use
Puncture needle punctures from entry point, and needle angle points to tail end in sagittal plain and skin in 60 ° of angles, is entered with ultrasound direct-view, probe side
Method enters pin puncture and enters S3Sacral nerve hole, that is, interim stimulator is connected, test the motion response of patient and feel response, to enter one
Step determines whether site of puncture correct and electrode placed-depth, and rotatable transverse arm is with convenience for ultrasonic probe operation when confirming position
And Real Time Observation in art.
In the present embodiment, patient is treated after the device and localization method in the application present invention, patient
Therapeutic progresses in two steps, the first step：Out treatment stage, after determining that puncture needle position is correct, pull out nook closing member, insertion depth
Indicator, puncture and do 0.5cm otch at skin, puncture needle, only indwelling depth indicator are pulled out, by expander together with inducting device set
S is inserted along depth indicator3In sacral nerve hole, determine that inducting device covers sophisticated mark and is located at by B ultrasound secondary combined scale mark
The slightly biased lower place of center line of rumpbone thickness, pulls out expander and depth indicator, only indwelling inducting device set.By hangnail sample permanent electrode
Insert in inducting device set, 4 electrode contacts in front is pressed close to S as far as possible3Sacral nerve, by testing and debugging electrode depth in art, lead to
It is often the inner side and outer side that contact 2 and contact 3 are across rumpbone sacrum hole ventral surface respectively, interim stimulated in vitro device test is each
The motion response of contact and feel response, the number of contacts for obtaining response is more, electrode position is better, after test is errorless, keeps
Tined-lead electrode is motionless in original position, pulls out inducting device set, hangnail is discharged fixed electrode.The outer top of electrode homonymy buttocks is chosen to intend planting
Enter permanent stimulator position and take 3cm or so otch, drawn tined-lead electrode tail end with tunneler, and connect percutaneous extension wire,
Further percutaneous extension wire subcutaneous tunnel is led to outside offside skin of buttock；Second step：The permanent implanted stage：Patient takes
Prone position, conventional visual area sterilization, drape, former buttocks otch local anaesthesia, takes the long otch of 5cm, finds electrode and percutaneous extension is led
Line, both being separated with torque spanner, percutaneous extension wire is removed, and in the suitable sacral nerve stimulation body that subcutaneously dissociates entirely
Long-pending gap, electrode is connected to sacral nerve stimulator by extension wire, is placed into the subcutaneous space to have dissociated, is being closed
Need to carry out the dependence tests such as impedance using Medical program-controlled instrument before otch, to ensure that each several part connection is normal, close otch, it is postoperative to make
Infected with antibiotic prophylaxis.
Presently preferred embodiments of the present invention is described above, it should be pointed out that the invention is not limited in above-mentioned
Particular implementation, wherein the equipment and structure be not described in detail to the greatest extent are construed as giving reality with the common mode in this area
Apply；Any those skilled in the art, without departing from the scope of the technical proposal of the invention, the technology according to the present invention
Essence still falls within technical solution of the present invention protection to any simple modifications, equivalents, and modifications made for any of the above embodiments
In the range of.
Claims (2)
1. ultrasonic guidance S3Sacral nerve positioner, it is characterised in that including trailing arm and transverse arm, the trailing arm passes through spiral shell with transverse arm
Silk riveting connection, the transverse arm is free to rotate as axle using screw riveting, and the transverse arm respectively has away from left and right at screw riveting central point 1.5cm
The transverse arm locating rack of one semi-circular shape, transverse arm locating rack distance of center circle screw riveting central point distance are 2cm, the semicircle
The a diameter of 1cm of transverse arm locating rack of shape, the trailing arm are the curved panel that tail end is provided with trailing arm locating rack, the trailing arm positioning
The distance of frame tail end distance of center circle screw riveting central point is 9cm, and the trailing arm locating rack tail end circular diameter is 1.5cm.
A kind of 2. ultrasonic guidance S described in claim 13The localization method of sacral nerve positioner, it is characterised in that including with
Lower step：1. mark S3Sacral nerve hole, the tail end circle trailing arm locating rack on trailing arm is fixed at patient's coccyx, trailing arm positioning
The frame center of circle is corresponding with coccyx tip, and the location of two semicircle transverse arm locating rack centers of circle thus on positioner transverse arm are i.e.
The S to be positioned during to treat3Sacral nerve hole；2. ultrasonic guidance confirms, in the S of mark3Above at the sites of sacral nerve hole about
It is used as entry point at 2cm, after local anaesthesia, is punctured with puncture needle from entry point, needle angle points in sagittal plain and skin in 60 ° of angles
Tail end, enter method and enter pin puncture to enter S with ultrasound direct-view, probe side3Neuraforamen, that is, interim stimulator is connected, test the fortune of patient
Dynamic response and feel response, with further determine that site of puncture whether correct and electrode placed-depth, can be revolved when confirming position
Turn transverse arm with Real Time Observation in the operation of convenience for ultrasonic probe and art.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710520209.4A CN107361822B (en) | 2017-06-30 | 2017-06-30 | Ultrasound guided S 3 Sacral nerve positioning device and positioning method |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710520209.4A CN107361822B (en) | 2017-06-30 | 2017-06-30 | Ultrasound guided S 3 Sacral nerve positioning device and positioning method |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN107361822A true CN107361822A (en) | 2017-11-21 |
| CN107361822B CN107361822B (en) | 2024-04-16 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201710520209.4A Active CN107361822B (en) | 2017-06-30 | 2017-06-30 | Ultrasound guided S 3 Sacral nerve positioning device and positioning method |
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| Country | Link |
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Citations (11)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20080039738A1 (en) * | 2006-08-11 | 2008-02-14 | Medtronic, Inc. | Guided medical element implantation |
| US20080039866A1 (en) * | 2006-08-11 | 2008-02-14 | Medtronic, Inc. | Locating guide |
| CN202161402U (en) * | 2011-06-23 | 2012-03-14 | 姚剑飞 | Positioning frame for vertebral arch pedicle screws |
| US20130053854A1 (en) * | 2011-08-31 | 2013-02-28 | Biomet Manufacturing Corp. | Patient-specific sacroiliac guides and associated methods |
| CN203138679U (en) * | 2012-12-04 | 2013-08-21 | 杨双石 | Three-dimensional body-surface positioner for spine |
| US20150080736A1 (en) * | 2007-06-04 | 2015-03-19 | Medtronic, Inc. | Percutaneous needle guide and methods of use |
| CN204428037U (en) * | 2015-01-15 | 2015-07-01 | 秦江 | The measurement and positioning device of posterior sacral foramina |
| US20170049503A1 (en) * | 2014-05-15 | 2017-02-23 | Cosman Medical, Inc. | Electrosurgical system |
| CN106618721A (en) * | 2016-11-07 | 2017-05-10 | 中国人民解放军第四军医大学 | Sacroiliac nail positioning device with distance and angle adjusting function |
| CN206151596U (en) * | 2016-08-17 | 2017-05-10 | 谢雁春 | Chest lumbar vertebrae body surface location ware |
| CN208339576U (en) * | 2017-06-30 | 2019-01-08 | 陈琦 | Ultrasonic guidance S3 sacral nerve positioning device |
-
2017
- 2017-06-30 CN CN201710520209.4A patent/CN107361822B/en active Active
Patent Citations (11)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20080039738A1 (en) * | 2006-08-11 | 2008-02-14 | Medtronic, Inc. | Guided medical element implantation |
| US20080039866A1 (en) * | 2006-08-11 | 2008-02-14 | Medtronic, Inc. | Locating guide |
| US20150080736A1 (en) * | 2007-06-04 | 2015-03-19 | Medtronic, Inc. | Percutaneous needle guide and methods of use |
| CN202161402U (en) * | 2011-06-23 | 2012-03-14 | 姚剑飞 | Positioning frame for vertebral arch pedicle screws |
| US20130053854A1 (en) * | 2011-08-31 | 2013-02-28 | Biomet Manufacturing Corp. | Patient-specific sacroiliac guides and associated methods |
| CN203138679U (en) * | 2012-12-04 | 2013-08-21 | 杨双石 | Three-dimensional body-surface positioner for spine |
| US20170049503A1 (en) * | 2014-05-15 | 2017-02-23 | Cosman Medical, Inc. | Electrosurgical system |
| CN204428037U (en) * | 2015-01-15 | 2015-07-01 | 秦江 | The measurement and positioning device of posterior sacral foramina |
| CN206151596U (en) * | 2016-08-17 | 2017-05-10 | 谢雁春 | Chest lumbar vertebrae body surface location ware |
| CN106618721A (en) * | 2016-11-07 | 2017-05-10 | 中国人民解放军第四军医大学 | Sacroiliac nail positioning device with distance and angle adjusting function |
| CN208339576U (en) * | 2017-06-30 | 2019-01-08 | 陈琦 | Ultrasonic guidance S3 sacral nerve positioning device |
Also Published As
| Publication number | Publication date |
|---|---|
| CN107361822B (en) | 2024-04-16 |
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