CN108635025A - A kind of operating method of laseropuncture guiding system - Google Patents
A kind of operating method of laseropuncture guiding system Download PDFInfo
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- CN108635025A CN108635025A CN201810818188.9A CN201810818188A CN108635025A CN 108635025 A CN108635025 A CN 108635025A CN 201810818188 A CN201810818188 A CN 201810818188A CN 108635025 A CN108635025 A CN 108635025A
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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
- A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
- A61B10/02—Instruments for taking cell samples or for biopsy
- A61B10/0233—Pointed or sharp biopsy instruments
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Abstract
The invention discloses the operating method that a kind of laseropuncture guides system, when use, includes the following steps：(1) laser angle selects systematic vertical zero-in；(2) first on positioning CT images, point of puncture and sampling target area, measurement setup puncture angle and depth are determined；(3) after setting crevice projection angle, laser rays is moved horizontally to respective angles, then by sliding rail, makes it through the entry point marked by rotary laser angle Selection system angle scale；(4) first needle point is fixed on the point of puncture marked when puncturing, is moved forward and backward the position of shank, when it is illuminated by laser rays, virtual puncture path is just set up.
Description
Technical field
The present invention relates to medical auxiliary equipment and its application method field, specifically a kind of laseropuncture guides system
Operating method.
Background technology
Lung cancer is most common malignant tumour, and lung is also the position for being easiest to transfer.Since the iconography of lung tumors is normal
Lack specificity, carrying out Drug eluting stent under CT guiding is still important one of diagnostic means, particularly with periphery
The sample of type lump, acquisition may be additionally used for genetic test for instructing targeted therapy.Percutaneous lung puncture technology is also lung brief summary
The technical foundation of the treatments such as the positioning of Hookwire steel wires and the treatment of tumour seeds implanted before section video-assisted thoracoscope resection.It is different from
Ultrasonic guiding in real time, it is often very time-consuming manually to puncture, especially when lesion volume is small or position is deep.
A variety of auxiliary lancing systems are developed in order to improve puncture precision and efficiency, many scholars：From the simple of low cost
Needle device is held, to the complicated Mechatronic Systems for needing to be integrated into CT scan hardware and communicated with system software, such as machine
People's lancing system, electromagnetism or Laser navigation system etc..These systems are other than fancy price, Systems Sterilizer and complicated image
Registration, more makes surgical procedure extremely cumbersome.In addition, Laser navigation system also needs to install trapped orbit on CT Room ceiling,
The demand for changing computer room structure is difficult to be received by hospital administrators, and the laser locating apparatus on scanning gantry also faces
Similar problem.
The PTNB still overwhelming majority under CT guiding at present is unarmed puncture technique, and the control of puncture angle places one's entire reliance upon
The experience of operator.Often need repeatedly CT scan to help to adjust the position of puncture needle, so be very time-consuming, particularly with small
And deep lesion or new hand.Many scholars devise various devices to improve angle control when unarmed puncture, hence it is evident that high to wear
Efficiency is pierced, but they are all based on CT platforms.Compared with as long as routine autopsy reaches lesion, nucleic functional image is situated between
The target area selection led, needs accurately for puncture needle to be shipped to specified intake area, thus requires higher to the technology of operator.
Somebody devises through protractor, is measured into needle angle in patient's skin surface.But it on the one hand requires in this way
The operation level of unarmed puncture person is relatively high, when on the other hand puncturing, there is protractor on entering pin mark, has to Aseptic sterilisation negative
Face is rung.
Invention content
This research is directed to SPECT/CT platform characters, devises a kind of laser navigation auxiliary lancing system simple in structure
(Laser navigation system, LNS), and carried out the PTNB mediated based on the fusion evaluation on SPECT/CT platforms
Checking research, propose it is a kind of need not be contacted before entering needle patient skin surface, can conveniently accurately establish into needle passageway
Even, new hand can also accurately hold the laser navigation auxiliary lancing system of puncture angle and depth.
The present invention adopts the following technical scheme that：
A kind of operating method of laseropuncture guiding system, characterized in that including：
CT machines, puncture needle, laser demarcation device, rotatable dial, horizontal slide rail and pedestal；
The rotation scale is vertical, is movably disposed on horizontal slide rail, the laser demarcation device coaxial arrangement in
In rotation scale so that the light curtain and rotation scale Plane of rotation of laser demarcation device projection keep vertical, described horizontal sliding
Rail is fixed on the pedestal equipped with level governor, and (such horizontal slide rail is with regard to face CT machines so that swashs for the pedestal face CT machines
Light throws the light curtain of line device projection and CT machines keep vertical), and position when lying low CT machines in patient on the outside of the crown so that swash
Light is thrown the light curtain that line device projects and is irradiated from head to foot, and the horizontal slide rail and CT scan bed bottom surface keep level (in this way
The motion track of laser demarcation device and rotatable dial is exactly and CT scan bed bottom surface keeps horizontal so that laser demarcation device and
Rotatable dial moves anyway, and the light curtain of laser demarcation device projection is lain low in CT scan bed with human body, the crown
With the line keeping parallelism of sole), for the laser demarcation device by battery power, it is 400- that the laser demarcation device, which can project wavelength,
The sector optical curtain of the red of 700nm or the intensive laser beam composition of the multiple tracks of green；
The operating method includes the following steps：
1. preoperative chest CT result carries out Preliminary design, patient lies low into the line and CT of CT machines, the body crown and sole
Machine longitudinal centre line keeping parallelism, row positions CT scan after metal location grid is placed on default penetrating area skin surface, then
Carry out SPECT Image Acquisition；After SPECT original image application Astonish programs rebuild tomography, merged with CT images, with
The dense poly- degree of radioactivity is most apparent and has safe puncture path position as planned sampling target area, determines that skin is worn on CT images
Piercing point, (point of puncture arrives between planned sampling target area without important blood vessels, important neural, bone, i.e. puncture needle is from the puncture pricking method
When entering and reaching planned sampling target area, important blood vessels, important nerve, bone will not be encountered on path) and surveyed on CT images
Measure corresponding puncture angle (angle between line and plumb line between skin penetrating point and planned sampling target area) and depth
(the line distance between skin penetrating point and planned sampling target area)；With black water pen skin has been marked in patient's skin surface
Point of puncture --- skin penetrating point is determined on CT images, and it is one that the point of puncture is marked in patient's skin surface
The prior art mainly counts skin penetrating point on CT images and is located at which metal location grid (has metal fixed on CT images
The contrast label of position grid) between, then can easily it be looked on the corresponding metal location grid of patient's skin surface
To the skin penetrating point --- period advises patient to keep position motionless；
2. laser angle selects systematic vertical zero-in；
3. the light curtain that laser demarcation device projects is torqued into respective angles (puncture angle) by rotation scale, then passes through cunning
Rail moves horizontally rotation scale, and the light curtain that laser demarcation device projects is made to pass through the entry point marked on skin
(from the beginning portion is radiated on the human body to lie low linear light curtain, and when side view, linear light curtain passes through the entry point that has been marked on skin)；
4, prepare first to be fixed on the point of puncture marked before puncturing and (skin need not be punctured) needle point of puncture needle,
It is moved forward and backward the position (needle point is motionless) of shank, (the angle of puncture needle=linear light curtain angle at this time when it is illuminated by laser rays
Angle between the line and plumb line of degree=puncture angle=between skin penetrating point and lesion), virtual puncture path is just built
It erects and.
Further, the laser angle selection systematic vertical zero-in of (2) step is specially：
2.1 are adjusted to horizontal by the height of adjustment base, by horizontal slide rail；
2.2 light curtain or light wall is made to be adjusted to vertical zero degree, rotation scale is shown as zero degree at this time；
2.3 open CT laser localized light comparings, and CT laser projection position lines are shown in CT scan bed rack；
2.4 move laser demarcation device along horizontal slide rail, and the light curtain or light wall for so that it is projected are projected with CT laser localized light comparings
Longitudinal register laser rays be completely superposed (at this time laser demarcation device projection light curtain and human body lie low in CT scan bed, the crown
With the line coincident of sole, because when making CT film, the longitudinal register laser rays of CT laser localized light comparings projection is lain low with human body
When CT scan bed, the line coincident of the crown and sole.)
According to normal process into pin puncture；CT scan is carried out after reaching plan paracentesis depth, the position of needle point is confirmed, goes forward side by side
Row biopsy procedure.One-time puncture or substep inserting needle can be determined into when pin puncture according to default size of tumor and position.
The technical effects of the invention are that：
A kind of operating method of laseropuncture guiding system according to the present invention, operation is flexibly convenient, and accuracy is high, greatly
Big working efficiency and the accuracy for improving medical personnel located.
Preliminary result of study is shown, compared with simple manually puncture, this method can reduce by 53% CT guiding scannings
Number reduces the radiation of patient to also shorten the entire PTNB operating times.The shortening of puncture procedure time, also implies that
The reduction of the ionising radiation from patient itself suffered by operator.
Description of the drawings
Attached drawing is used to provide further understanding of the present invention, and a part for constitution instruction, the reality with the present invention
It applies example to be used to explain the present invention together, not be construed as limiting the invention.In the accompanying drawings：
Fig. 1 is the placement position schematic diagram that laseropuncture of the present invention guides system hardware；
Fig. 2 is the piercing step figure of the embodiment of the present invention 1；
Fig. 3 be the present invention operation embodiment 1 when, from patient head view to inserting needle block diagram.
Specific implementation mode
Hereinafter, preferred embodiments of the present invention will be described with reference to the accompanying drawings, it should be understood that preferred reality described herein
Apply example only for the purpose of illustrating and explaining the present invention and is not intended to limit the present invention.
Embodiment 1：
Such as Fig. 1, laseropuncture guides system to constitute (figure by laser level, rotation scale, horizontal slide rail and pedestal
1a).It is placed on the laseropuncture guiding system of CT scan bed distal end, a word laser rays of predetermined angle can be projected to scanning gantry
(Fig. 1 b).It guides the laser rays of system to be transferred to vertical zero degree laseropuncture using preceding, opens CT laser localized light comparings (Fig. 1 c), adjust
The position of whole laseropuncture guiding system base and laser rays, makes it be completely superposed (Fig. 1 d) with longitudinal register laser rays, with reality
Existing systematic vertical zero-in.
The SPECT/CT-PTNB assisted such as Fig. 2,3, LNS.Man, 54 years old.Preoperative enhanced CT shows upper left lung neoplasms (Fig. 2 a).
The fusion acquisition of dorsal position 99mTc-MIBISPECT/CT tomographies, the metallic grid placed according to body surface determine skin penetrating point and meter
Draw sampling target area (*), the distance (white line) and puncture angle (Fig. 2 b) of measurement point of puncture to pleura and target area edge.By LNS tune
The puncture angle of setting is saved, mobile laser rays (short arrow) makes it through the skin entry point (long arrow, Fig. 2 c) marked.
Needle point is pressed on skin entry point, front and back adjustment punctures pin position, when puncture needle is illuminated completely by red laser line,
It is exactly preset puncture angle (Fig. 2 d).The method for taking an inserting needle or substep inserting needle, predetermined depth is pushed by puncture needle.Again
Carry out a Local C T scanning (Fig. 2 e), and with SPECT image co-registrations, display needle point, which arrives at, presets target area (Fig. 2 f).
Claims (2)
1. a kind of operating method of laseropuncture guiding system, characterized in that including：
CT machines, puncture needle, laser demarcation device, rotatable dial, horizontal slide rail and pedestal；
The rotation scale is vertical, is movably disposed on horizontal slide rail, and the laser demarcation device coaxial arrangement is in rotation
In dial so that the light curtain and rotation scale Plane of rotation of laser demarcation device projection keep vertical, and the horizontal slide rail is solid
When being scheduled on the pedestal equipped with level governor, the pedestal face CT machines, and CT machines lain low in patient on the outside of the crown
Position so that the light curtain that laser demarcation device projects is irradiated from head to foot, and the horizontal slide rail and CT scan bed bottom surface are protected
Water holding is flat, and for the laser demarcation device by battery power, it is the red or green of 400-700nm that the laser demarcation device, which can project wavelength,
The sector optical curtain of the intensive laser beam composition of multiple tracks of color；
The operating method includes the following steps：
1. preoperative chest CT result carries out Preliminary design, patient lie low CT machines, the crown and sole line and CT machines longitudinal direction in
Heart line keeping parallelism, row positions CT scan after metal location grid is placed on default penetrating area skin surface, then carries out SPECT
Image Acquisition；After SPECT original image application Astonish programs rebuild tomography, merged with CT images, it is dense with radioactivity
Poly- degree is most apparent and has safe puncture path position as planned sampling target area, and skin penetrating point is determined on CT images, and
Corresponding puncture angle and depth are measured on CT images；With black water pen skin penetrating has been marked in patient's skin surface
During which point advises patient to keep position motionless；
2. laser angle selects systematic vertical zero-in；
3. the light curtain that laser demarcation device projects is torqued into puncture angle by rotation scale, then by sliding rail, by rotating scale
Disk is moved horizontally, and the light curtain that laser demarcation device projects is made to pass through the entry point marked on skin；
4, prepare that first the needle point of puncture needle is fixed on the point of puncture marked before puncturing, is moved forward and backward the position of shank,
When it is illuminated by laser rays, virtual puncture path is just set up.
2. a kind of operating method of laseropuncture guiding system as described in claim 1, it is characterized in that：The laser angle of 2nd step
Selection systematic vertical zero-in be specially：
2.1 are adjusted to horizontal by the height of adjustment base, by horizontal slide rail；
2.2 make light curtain or light wall be adjusted to vertical zero degree, and rotation scale is shown as zero degree at this time；
2.3 open CT laser localized light comparings, and CT laser projection position lines are shown in CT scan bed rack；
2.4 move laser demarcation device along horizontal slide rail, and the light curtain or light wall for so that it is projected project vertical with CT laser localized light comparings
It is completely superposed to positioning laser rays.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201810818188.9A CN108635025B (en) | 2018-07-24 | 2018-07-24 | Laser puncture guiding system |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201810818188.9A CN108635025B (en) | 2018-07-24 | 2018-07-24 | Laser puncture guiding system |
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| CN108635025A true CN108635025A (en) | 2018-10-12 |
| CN108635025B CN108635025B (en) | 2023-09-05 |
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Cited By (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN110123273A (en) * | 2019-04-26 | 2019-08-16 | 上海市肺科医院 | A kind of the tubercle body surface positioning device and tubercle body surface localization method of combination CT image |
| CN113367779A (en) * | 2021-06-16 | 2021-09-10 | 张涛 | Puncture system and method based on C-arm CT and semiconductor laser |
| CN114424978A (en) * | 2021-11-22 | 2022-05-03 | 赛诺威盛科技(北京)股份有限公司 | Fusion registration method and device, electronic equipment and storage medium |
| CN115137453A (en) * | 2019-07-05 | 2022-10-04 | 湖南卓世创思科技有限公司 | Continuous scanning cross section dimension-increasing space positioning system |
| CN117338387A (en) * | 2023-10-09 | 2024-01-05 | 上海市胸科医院 | Laser guided lung puncture positioning method |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN110123273A (en) * | 2019-04-26 | 2019-08-16 | 上海市肺科医院 | A kind of the tubercle body surface positioning device and tubercle body surface localization method of combination CT image |
| CN115137453A (en) * | 2019-07-05 | 2022-10-04 | 湖南卓世创思科技有限公司 | Continuous scanning cross section dimension-increasing space positioning system |
| CN113367779A (en) * | 2021-06-16 | 2021-09-10 | 张涛 | Puncture system and method based on C-arm CT and semiconductor laser |
| CN114424978A (en) * | 2021-11-22 | 2022-05-03 | 赛诺威盛科技(北京)股份有限公司 | Fusion registration method and device, electronic equipment and storage medium |
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|---|---|
| CN108635025B (en) | 2023-09-05 |
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