CN108852473B - Puncture operation system - Google Patents
Puncture operation system Download PDFInfo
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- CN108852473B CN108852473B CN201810756325.0A CN201810756325A CN108852473B CN 108852473 B CN108852473 B CN 108852473B CN 201810756325 A CN201810756325 A CN 201810756325A CN 108852473 B CN108852473 B CN 108852473B
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- 230000007246 mechanism Effects 0.000 claims abstract description 127
- 239000000523 sample Substances 0.000 claims abstract description 45
- 238000003384 imaging method Methods 0.000 claims abstract description 19
- 238000012544 monitoring process Methods 0.000 claims abstract description 4
- 238000001356 surgical procedure Methods 0.000 claims description 9
- 230000004927 fusion Effects 0.000 claims description 6
- 230000000149 penetrating effect Effects 0.000 claims description 4
- 230000003902 lesion Effects 0.000 claims description 3
- 210000001519 tissue Anatomy 0.000 description 8
- 238000000034 method Methods 0.000 description 6
- 238000001574 biopsy Methods 0.000 description 4
- 238000002591 computed tomography Methods 0.000 description 4
- 238000012273 nephrostomy Methods 0.000 description 3
- 230000035515 penetration Effects 0.000 description 3
- 210000002700 urine Anatomy 0.000 description 3
- 241001164374 Calyx Species 0.000 description 2
- 208000000913 Kidney Calculi Diseases 0.000 description 2
- 206010029148 Nephrolithiasis Diseases 0.000 description 2
- 230000009471 action Effects 0.000 description 2
- 238000010586 diagram Methods 0.000 description 2
- 210000000244 kidney pelvis Anatomy 0.000 description 2
- 238000002324 minimally invasive surgery Methods 0.000 description 2
- 230000001154 acute effect Effects 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000003139 buffering effect Effects 0.000 description 1
- 230000008859 change Effects 0.000 description 1
- 210000001072 colon Anatomy 0.000 description 1
- 239000002131 composite material Substances 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 230000003993 interaction Effects 0.000 description 1
- 210000003734 kidney Anatomy 0.000 description 1
- 210000004185 liver Anatomy 0.000 description 1
- 230000008569 process Effects 0.000 description 1
- 230000002035 prolonged effect Effects 0.000 description 1
- 230000008707 rearrangement Effects 0.000 description 1
- 238000011084 recovery Methods 0.000 description 1
- 210000005084 renal tissue Anatomy 0.000 description 1
- 230000029058 respiratory gaseous exchange Effects 0.000 description 1
- 210000000614 rib Anatomy 0.000 description 1
- 210000000952 spleen Anatomy 0.000 description 1
- 238000006467 substitution reaction Methods 0.000 description 1
- 238000011282 treatment Methods 0.000 description 1
- 210000000626 ureter Anatomy 0.000 description 1
- 210000003932 urinary bladder Anatomy 0.000 description 1
Classifications
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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
-
- 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
-
- 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
- A61B17/3494—Trocars; Puncturing needles with safety means for protection against accidental cutting or pricking, e.g. limiting insertion depth, pressure sensors
-
- 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)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Biomedical Technology (AREA)
- Engineering & Computer Science (AREA)
- Pathology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Ultra Sonic Daignosis Equipment (AREA)
Abstract
The invention discloses a puncture operation system, and relates to the technical field of puncture operations. The puncture operation system comprises a lying bed, an imaging device, a puncture mechanism, a target object, a CT scanner, a camera and a B-ultrasonic probe, wherein the target object is fixed at an operation position of a patient; the CT scanner is used for scanning the target object and the tissue of the operation part before puncturing to acquire images of the target object and the tissue of the operation part; the camera is used for photographing the target object and the skin of the operation part before puncturing to acquire images of the target object and the skin of the operation part; the puncture mechanism is provided with a puncture needle, and the position and the angle of the puncture needle are adjustable; the B ultrasonic probe is used for monitoring tissues around the puncture point and puncture paths during puncture so as to acquire images around the puncture point; the imaging device is used for displaying the image obtained by the B ultrasonic probe. The puncture operation system can adjust the position and the angle of the puncture needle in real time, and ensure the puncture accuracy.
Description
Technical Field
The invention relates to the technical field of puncture surgery, in particular to a puncture surgery system.
Background
With the development of modern technology, minimally invasive surgery is beginning to be widely used. Percutaneous nephrostomy, for example, is a minimally invasive surgical technique that can be used to drain kidney urine out of the body. In percutaneous nephrostomy drainage, a doctor inserts a drainage tube into a renal calyx or renal pelvis through skin by using perspective, ultrasonic imaging or computer tomography as guidance, and then discharges urine from the drainage tube to the outside of the body, so that the operation effect is achieved, the wound is very small, the pain is reduced, the operation risk is reduced, and the recovery is very fast. However, the problem that the puncture point and the puncture angle are difficult to determine is unavoidable in the minimally invasive surgery, so that more time is wasted when the puncture point and the puncture angle are determined, and the surgery time is prolonged; and manual penetration requires a high degree of experience from the surgeon.
Based on the problems of the manual puncture operation, a puncture robot is developed in the prior art, and the puncture operation is performed through the puncture robot. However, the existing puncture robots have a plurality of problems, such as failure of the puncture robot system to match with physiological actions (including breathing and unintentional movement) of a patient, and easy deviation of puncture position and puncture angle, which causes medical accidents. In addition, the speed of penetration by the penetration surgical robot cannot take into account the patient's body bearing capacity.
Based on the above, there is a need for a lancing surgical system that overcomes the problems of existing lancing surgical robots and lancing procedures.
Disclosure of Invention
The invention aims to provide a puncture operation system which aims to overcome the problems in the existing puncture operation.
To achieve the purpose, the invention adopts the following technical scheme:
a puncture surgical system comprising:
the target object is fixed at the operation position of the patient and is used for marking and positioning the operation position;
the CT scanner is used for scanning the target object and the tissue of the operation part before puncturing to acquire images of the target object and the tissue of the operation part;
the camera is used for photographing the target object and the skin of the operation position before puncturing, and acquiring images of the target object and the skin of the operation position;
the puncture mechanism is provided with a puncture needle, and the position and the angle of the puncture needle are adjustable;
the B ultrasonic probe is used for monitoring tissues around the puncture point and the puncture path during puncture so as to acquire images around the puncture point;
and the imaging device is used for displaying the image obtained by the B ultrasonic probe.
As a preferred scheme of the puncture operation system, the puncture mechanism further comprises a movable mechanical arm and a first positioning system for installing the puncture needle and positioning the puncture needle, the first positioning system and the camera are both arranged on the mechanical arm, and the first positioning system can adjust the position and the angle of the puncture needle according to a fusion image of an image acquired by the CT scanner and an image acquired by the camera and aim at a prestored lesion position.
As a preferable scheme of the puncture operation system, the first positioning system comprises a first connecting rod mechanism, a second connecting rod mechanism and a puncture needle holder, wherein the input end of the first connecting rod mechanism is connected with a first power system, the output end of the first connecting rod mechanism is hinged with the upper part or the lower part of the puncture needle holder in a spherical surface manner, the input end of the second connecting rod mechanism is connected with a second power system, and the output end of the second connecting rod mechanism is hinged with the lower part or the upper part of the puncture needle holder.
As a preferable scheme of the puncture operation system, the first connecting rod mechanism comprises a first main connecting rod, one end of the first main connecting rod is in spherical hinge connection with the puncture needle holder, the other end of the first main connecting rod is in hinge connection with a first supporting rod, and the middle part of the first main connecting rod is in hinge connection with a second supporting rod; the first power system comprises two first driving mechanisms, the two first driving mechanisms are respectively hinged with the first supporting rod and the second supporting rod, and the two first driving mechanisms are all linear driving mechanisms.
As a preferable mode of the puncture operation system, the first driving mechanism includes a first motor, a first threaded rod connected to an output shaft of the first motor, and a first slider screwed to the first threaded rod.
As a preferable scheme of the puncture operation system, the second link mechanism comprises a second main link, one end of the second main link is hinged on the puncture needle holder, the other end of the second main link is hinged with a third supporting rod, and the middle part of the second main link is hinged with a fourth supporting rod; the second power system comprises two second driving mechanisms, the two second driving mechanisms are respectively hinged with the third supporting rod and the fourth supporting rod, and the two second driving mechanisms are all linear driving mechanisms.
As a preferable scheme of the puncture operation system, the puncture needle holder comprises a shell, a third driving mechanism is arranged in the shell, the output end of the third driving mechanism is a linear driving mechanism, the output end of the third driving mechanism is connected with a supporting rod extending out of the shell, a stop block is fixed on the supporting rod, and the puncture needle is arranged on the stop block in a penetrating mode.
As a preferable mode of the puncture operation system, the third driving mechanism comprises a second motor fixed on the housing, a first gear is connected to an output shaft of the second motor, the first gear is meshed with a second gear, the second gear is coaxially connected with a second threaded rod, an axis of the second threaded rod is parallel to an axis of an output shaft of the second motor, a second sliding block is connected to the second threaded rod in a threaded mode, and the second sliding block is connected with the supporting rod.
As an optimized scheme of the puncture operation system, the puncture operation system further comprises a second positioning system, the second positioning system is connected with the B-ultrasonic probe, and the second positioning system controls the B-ultrasonic probe to monitor tissues around a puncture point and a puncture path.
As a preferable scheme of the puncture operation system, the second positioning system comprises a third connecting rod mechanism, a fourth connecting rod mechanism and a B ultrasonic probe fixing device, wherein the input end of the third connecting rod mechanism is connected with a third power system, the output end of the third connecting rod mechanism is in ball joint with the upper part or the lower part of the B ultrasonic probe fixing device, the input end of the fourth connecting rod mechanism is connected with a fourth power system, and the output end of the second connecting rod mechanism is in hinge joint with the lower part or the upper part of the B ultrasonic probe fixing device.
As a preferable mode of the puncture operation system, the imaging device comprises an operation table, and the mechanical arm is hinged on the operation table;
the mechanical arm comprises a first arm and a second arm, the first arm is hinged with the operation table, the second arm is connected with the first positioning system, and the first arm and the second arm are rotatably connected.
As a preferable mode of the above-described method of the puncture operation, a biopsy needle, a drainage catheter, or a lithotripsy scalpel can be inserted into the puncture needle.
The invention has the beneficial effects that:
the puncture operation system comprises a camera, a B-ultrasonic probe, a puncture mechanism and an imaging device which are respectively connected, wherein before puncture, the puncture mechanism can timely adjust the position and angle of a puncture needle according to a fusion image of an image acquired by a CT scanner and an image acquired by the camera so as to ensure the accuracy of puncture; the B ultrasonic probe acquires an image during puncture and sends the image to the imaging device for display so as to monitor the puncture path of the puncture needle in real time and ensure the accuracy of the puncture operation.
Drawings
FIG. 1 is a schematic view of a puncture surgical system according to an embodiment of the present invention;
FIG. 2 is a schematic view of a lancing mechanism according to an embodiment of the present invention;
FIG. 3 is a schematic view of a relative fixed connection between a first arm and a second arm according to an embodiment of the present invention;
FIG. 4 is a schematic view of a structure of a connection capable of rotating relative to each other between a first arm and a second arm according to an embodiment of the present invention;
FIG. 5 is a schematic diagram of the first positioning system and the second positioning system according to an embodiment of the present invention;
FIG. 6 is a schematic view of a first positioning system according to an embodiment of the present invention;
FIG. 7 is a schematic view of another angle of the first positioning system according to an embodiment of the present invention;
FIG. 8 is a schematic structural view of a third driving mechanism according to an embodiment of the present invention;
FIG. 9 is a schematic diagram of a second positioning system according to an embodiment of the present invention;
fig. 10 is a flow chart of a method of operation of a puncture surgical system provided in an embodiment of the present invention.
Wherein, 1 bed; 11. a bed body; 12. a support structure; 13. a pulley;
2. an imaging device; 21. an operation table; 22. a display screen; 23. a roller;
3. a puncture mechanism;
31. a mechanical arm; 311. a first arm; 312. a second arm; 313. a first connection portion; 314. a second connecting portion; 315. a knob; 3141. a stud; 3151. a manual part; 3152. a locking member;
32. a puncture needle;
33. a first positioning system;
331. a first housing; 332. a first driving mechanism; 333. a second driving mechanism;
334. a first link mechanism; 3341. a first main link; 3342. a first strut; 3343. a second strut;
335. a second link mechanism; 3351. a second main link; 3352. a third strut; 3353. a fourth strut;
336. a puncture needle holder; 3361. a second housing; 3362. a third driving mechanism; 3363. a support rod; 3364. a stop block; 3365. a hinge rod; 3366. a sleeve;
33621. a second motor; 33622. a first gear; 33623. a second gear; 33624. a second threaded rod; 33625. a second slider;
4. a target;
5. a camera;
6. a B ultrasonic probe;
7. a second positioning system; 71. a third housing; 72. a third link mechanism; 73. a fourth link mechanism; 74. a fourth driving mechanism; 75. a fifth driving mechanism; 76. b ultrasonic probe fixing device.
Detailed Description
The technical scheme of the invention is further described below by the specific embodiments with reference to the accompanying drawings.
As shown in fig. 1 to 9, the present embodiment provides a puncture operation system including a couch 1, an imaging apparatus 2, a puncture mechanism 3, a target object 4, a CT scanner (not shown), a camera 5, a B-ultrasonic probe 6, and a controller. Wherein the lying bed 1 is used for lying during operation of a patient, and the pulley 13 is arranged at the bottom of the lying bed 1, so that the lying bed 1 can slide on the ground. The target object 4 is fixed at the operation site of the patient for marking and positioning the operation site. The puncture mechanism 3 is provided with a puncture needle 32, and the position and the angle of the puncture needle 32 are adjustable. The CT scanner is used for scanning the target object 4 and the tissue of the operation part before puncturing to acquire images of the target object 4 and the tissue of the operation part; the camera 5 is fixed on the puncture mechanism 3, and photographs the target object 4 and the operation part during puncture, and obtains images of the target object 4 and the skin of the operation part; the B-ultrasonic probe 6 is used for monitoring the tissue around the puncture point and the puncture path during puncture to acquire an image around the puncture point. The imaging device 2 can display a CT scanner, can display an image obtained by the B ultrasonic probe 6 according to a fusion image of an image obtained by the CT scanner and an image obtained by the camera 5, and the imaging device 2 is arranged on one side of the lying bed 1, so that an operator can observe the image presented on the imaging device 2 at any time. The target object 4 is fixed to the operation site of the patient and can be used as a reference object when matching/fusing images formed by the CT scanner and the camera 5.
The controller is respectively connected with the camera 5, the B ultrasonic probe 6, the puncture mechanism 3 and the imaging device 2, and before puncture, the controller can control the puncture mechanism 3 to act according to the fusion image of the image acquired by the CT scanner and the image acquired by the camera 5 so as to adjust the position and the angle of the puncture needle 32, so that the puncture needle 32 is adjusted in real time, the influence of the physiological action of a patient on the position and the angle of the puncture needle 32 is avoided, and the puncture accuracy is ensured; the controller controls the B ultrasonic probe 6 to acquire images during puncture and send the images to the imaging device 2 for display so as to monitor the puncture path of the puncture needle 32 in real time and ensure the accuracy of the puncture operation.
As shown in fig. 1, the bed 1 in this embodiment includes a bed body 11 and a support structure 12 for supporting the bed body 11, and a pulley 13 is connected to a lower portion of the support structure 12, and the pulley 13 is in direct contact with the ground. The pulley 13 of the bed 1 is provided with a brake mechanism, when the pulley 13 is braked by the brake mechanism, the pulley 13 cannot move, and when the brake of the pulley 13 is released by the brake mechanism, the pulley 13 can flexibly move, and the position of the bed 1 can be conveniently adjusted by the pulley 13 structure. The support structure 12 of the bed 1 is composed of a plurality of telescopic rods, the lifting of the bed body 11 can be adjusted when the rods are telescopic, the bed 1 can adapt to doctors with different heights, and different doctors can perform operations conveniently.
As shown in fig. 1, the imaging apparatus 2 includes an operation table 21 and two display screens 22 provided on the operation table 21. The bottom of the operation table 21 is provided with a roller 23, and the roller 23 can facilitate movement of the imaging device 2. The operation table 21 is of a liftable structure, so that the height of the display screen 22 can be adjusted. One display screen 22 of the two display screens 22 can display a composite image of the image acquired by the camera 5 and the image acquired by the CT scanner, and the other display screen 22 can display the image acquired by the B-ultrasonic probe 6.
As shown in fig. 2, the puncture mechanism 3 further includes a mechanical arm 31 that is movably disposed, and a first positioning system 33 that is used for installing the puncture needle 32 and positioning the puncture needle 32, where the first positioning system 33 and the camera 5 are both disposed on the mechanical arm 31, and the first positioning system 33 is connected to a controller, and the controller can control the first positioning system 33 to adjust the position and angle of the puncture needle 32 according to a fused image of an image acquired by the CT scanner and an image acquired by the camera 5. The arm 31 may be hinged to the bed 1 or to the console 21. The mechanical arm 31 comprises a first arm 311 and a second arm 312, the first arm 311 being hinged to the bed 1 or the table 21, the second arm 312 being connected to the first positioning system 33, the first arm 311 being rotatably connected to the second arm 312. Adjustment of the relative rotation and relative fixation of the first arm 311 and the second arm 312 is achieved by means of a knob 315.
The camera 5 is fixed on the second arm 312 and the first positioning system 33 is fixed on the side of the camera 5 remote from the second arm 312.
As shown in fig. 3 and 4, the first arm 311 is connected to the first connection portion 313, and the second arm 312 is connected to the second connection portion 314. The middle of the first connection portion 313 is a through hole. The knob 315 and the second connecting portion 314 are respectively located at two sides of the first connecting portion 313, a stud 3141 is convexly arranged at one side of the second connecting portion 314, which is close to the first connecting portion 313, and the stud 3141 extends into the through hole of the first connecting portion 313. The knob 315 includes a manual portion 3151, a locking member 3152 is fixed to the manual portion 3151, and an internal thread hole is formed in the locking member 3152. The manual portion 3151 is pressed against the end of the first connecting portion 313 remote from the second connecting portion 314, and the locking member 3152 is inserted into the through hole of the first connecting portion 313 to be screwed with the stud 3141. When the knob 315 is screwed, as shown in fig. 3, the manual portion 3151 is manually rotated, so that when the connecting area between the locking member 3152 and the stud 3141 is larger, the knob 315 presses the first connecting portion 313 and the second connecting portion 314 together until the first connecting portion 313 and the second connecting portion 314 cannot be relatively rotated, and the relative fixation between the first arm 311 and the second arm 312 is achieved. The knob 315 is rotated in the opposite direction, as shown in fig. 4, so that a relative rotation between the first arm 311 and the second arm 312 is achieved.
In this embodiment, referring to fig. 5-7, the first positioning system 33 includes a first housing 331, a first power system, a second power system, a first linkage 334, a second linkage 335, and a lancet holder 336. The first power system and the second power system are both disposed within the first housing 331, and the first power system includes two first driving mechanisms 332 and the second power system includes two second driving mechanisms 333. The first driving mechanism 332 and the second driving mechanism 333 are both linear driving mechanisms, and have the same structure. The first link mechanism 334 has an input end coupled to the first power system and an output end located outside the first housing 331 and pivotally coupled to the upper spherical surface of the lancet holder 336. The second linkage 335 has an input coupled to the second power system and an output external to the first housing 331 and hinged to a lower portion of the lancet holder 336. Movement of the first and second linkages 334, 335 enables adjustment of the position and angle of the lancet holder 336, and thus the position and angle of the lancet 32. In other embodiments, the positions of the first and second linkages 334, 335 may be interchanged.
As shown in fig. 6 and 7, the first link mechanism 334 includes a first main link 3341, one end of the first main link 3341 is ball-hinged on the puncture needle holder 336, the other end is hinged with a first support rod 3342, and the middle part of the first main link 3341 is hinged with a second support rod 3343; two first drive mechanisms 332 are hinged to the first and second struts 3342 and 3343, respectively. Specifically, the first driving mechanism 332 includes a first motor, a first threaded rod connected to an output shaft of the first motor, and a first slider screwed on the first threaded rod. The first sliders in the two first driving mechanisms 332 are hinged to the first support bar 3342 and the second support bar 3343, respectively.
As shown in fig. 6 and 7, the second link mechanism 335 includes a second main link 3351, one end of the second main link 3351 is hinged to the puncture needle holder 336, the other end is hinged to a third support bar 3352, and a fourth support bar 3353 is hinged to the middle of the second main link 3351; two second drive mechanisms 333 are hinged to the third and fourth struts 3352 and 3353, respectively. Specifically, the second driving mechanism 333 has the same structure as the first driving mechanism 332, and includes a first motor, a first threaded rod connected to an output shaft of the first motor, and a first slider screwed on the first threaded rod. The first slide blocks of the two second driving mechanisms 333 are hinged with the third support rod 3352 and the fourth support rod 3353 respectively.
The two first threaded rods of the first driving mechanism 332 and the two first threaded rods of the second driving mechanism 333 are disposed parallel to each other.
The first motor in the first driving mechanism 332 and the second driving mechanism 333 are connected to a controller, which can control the steering and rotation time of the first motor. The forward and backward rotation of the first motor can control the sliding direction and the rotation time of the first sliding block and control the distance of the first sliding block moving in a certain direction. The change in position of the first slider in the first link mechanism 334 and the second link mechanism 335 on the first threaded rod may allow for adjustment of the position and angle of the lancet holder 336.
The first main link 3341 and the second main link 3351 are bent, and the second support bar 3343 and the fourth support bar 3353 are respectively connected to the corner of the first main link 3341 and the corner of the second main link 3351.
As shown in fig. 5 to 8, the puncture needle holder 336 includes a second housing 3361, a third driving mechanism 3362 is disposed in the second housing 3361, an output end of the third driving mechanism 3362 is a straight line output, a support rod 3363 extending out of the second housing 3361 is connected to the output end, a stop block 3364 is fixed on the support rod 3363, and the puncture needle 32 is inserted through the stop block 3364.
The second housing 3361 has a hinge rod 3365 disposed on an outer surface thereof, the hinge rod 3365 is parallel to the outer surface of the housing, and one end of the first main link 3341 is ball-hinged to the hinge rod 3365. A sleeve 3366 is hinged to the outer surface of the side of the second housing 3361 remote from the hinge rod 3365, and the sleeve 3366 is positioned below the stopper 3364. The puncture needle 32 includes a head portion having an outer diameter larger than an outer diameter of the needle portion, and a needle portion penetrating through the stopper 3364 and penetrating into the sleeve 3366, and the sleeve 3366 is hinged to the housing without rattling due to interaction of the puncture needle 32, the stopper 3364 and the sleeve 3366, when the puncture needle 32 is passed through the stopper 3364, the head portion is held by the stopper 3364. The second main link 3351 is hinged at the hinge of the sleeve 3366 and the second housing 3361.
The third driving mechanism 3362 includes a second motor 33621 fixed on a second housing 3361, a first gear 33622 is sleeved on an output shaft of the second motor 33621, the first gear 33622 is meshed with a second gear 33623, the second gear 33623 is coaxially connected with a second threaded rod 33624, an axis of the second threaded rod 33624 is parallel to an axis of an output shaft of the motor, a second sliding block 33625 is in threaded connection with the second threaded rod 33624, and the second sliding block 33625 is connected with a supporting rod 3363. The second threaded rod 33624 is disposed parallel to the support rod 3363 such that the support rod 3363 moves in a straight line, and since the lancet holder 336 is generally vertically or at an acute angle to the vertical, the support rod 3363 can move up and down to adjust the height of the lancet 32.
As shown in fig. 5 and 9, the puncture surgery system further comprises a second positioning system 7, the second positioning system 7 being fixed to the side of the camera 5 remote from the second arm 312. The second positioning system 7 is connected with the B-ultrasonic probe 6 and a controller, and the controller controls the second positioning system 7 to act so that the B-ultrasonic probe 6 monitors the tissues around the puncture point and the puncture path.
The second positioning system 7 includes a third housing 71, a third power system, a fourth power system, a third linkage 72, a fourth linkage 73, and a B-ultrasonic probe fixture 76. A third power system including two fourth drive mechanisms 74 and a fourth power system including two fifth drive mechanisms 75 are provided within the third housing 71. The input end of the third link mechanism 72 is connected with a third power system, and the output end of the third link mechanism 72 is hinged with the lower spherical surface of the B ultrasonic probe fixing device 76. The input end of the fourth link mechanism 73 is connected with a fourth power system, and the output end of the fourth link mechanism 73 is hinged with the upper part of the B ultrasonic probe fixing device 76.
The third power system includes two fourth driving mechanisms 74, the fourth power system includes two fifth driving mechanisms 75, the fourth driving mechanism 74 and the fifth driving mechanism 75 are basically the same as the first driving mechanism 332 in structure, except that a first slider in the fourth driving mechanism 74 is connected with the third link mechanism 72, and a first slider in the fifth driving mechanism 75 is connected with the fourth link mechanism 73.
The third link mechanism 72 comprises a third main link, a fifth supporting rod and a sixth supporting rod, one end of the third main link is in spherical hinge on the B ultrasonic probe fixing device 76, the other end of the third main link is in hinge connection with the fifth supporting rod, and the middle part of the third main link is in hinge connection with the sixth supporting rod. The first slides in the two fourth drive mechanisms 74 are hinged to the fifth strut and the sixth strut, respectively.
The fourth link mechanism 73 comprises a fourth main link, a seventh support rod and an eighth support rod, one end of the fourth main link is in spherical hinge with the B ultrasonic probe fixing device 76, the other end of the fourth main link is in hinge joint with the seventh support rod, and the middle part of the fourth main link is in hinge joint with the eighth support rod. The second slide blocks 33625 in the two fifth driving mechanisms 75 are hinged to the seventh and eighth struts, respectively.
The B-ultrasonic probe 6 is slidably provided on the B-ultrasonic probe fixing device 76, and the B-ultrasonic probe 6 can be moved up and down.
Be provided with spring assembly on the B ultrasonic probe fixing device 76, spring assembly connects B ultrasonic probe 6, and when B ultrasonic probe fixing device 76 pushed down B ultrasonic probe 6 and monitored, spring assembly can compress tightly B ultrasonic probe 6 on the human skin surface on the one hand, and on the other hand can also make and produce the buffering between B ultrasonic probe 6 and the human skin, avoids producing uncomfortable pressure to the human body.
As shown in fig. 10, the present embodiment further provides an operation method of the puncture surgery system, including the following steps:
the first step: five targets 4 that can be captured by a CT scanner and camera 5 are fixed to the skin outside the surgical site.
The number of the target objects 4 is not limited to five, and more than three can be selected, and the images acquired by the CT scanner and the images acquired by the camera 5 can be registered by the target objects.
And a second step of: the CT scanner is controlled to scan the operation part and the target object 4 to form a first image, and a puncture plan is formulated according to the first image to determine the lesion position.
CT scanning is mainly performed for scanning imaging of ribs, bladder, ureter, kidney tissue, kidney stones, liver, spleen, colon and target 4. CT scans are typically performed the day prior to surgery. After the CT scanning is completed, the target object 4 is removed, and the fixed position of the target object 4 is marked by a waterproof pen.
And a third step of: the camera 5 shoots the target object 4 in real time to form a second image, and the controller acquires the real-time position of the target object 4 according to the second image.
On the day of the operation, before the camera 5 takes a picture, the target object 4 is fixed in the original position, and then the picture is taken.
Fourth step: the controller accurately positions the puncture needle according to the fusion image of the first image and the second image, and executes puncture planning.
Fifth step: the doctor penetrates the puncture needle 32 into the operation site, and the puncture path of the puncture needle 32 is monitored in real time through the B-ultrasonic probe 6 during the puncture process.
Sixth step: and performing subsequent operation.
To meet the needs of different treatments, the present puncture surgical system and method of puncture surgery may be used for percutaneous nephroaspiration biopsy, percutaneous nephrostomy drainage and percutaneous nephrolithotripsy, and correspondingly, biopsy needles, drainage catheters, lithotripsy scalpels, etc. may be inserted into the puncture needle 32. Wherein, the biopsy needle can sample and analyze the focus; the drainage catheter may drain urine from the renal calyx or renal pelvis; the lithotripsy scalpel can accurately crush kidney stones.
Note that the above is only a preferred embodiment of the present invention. It will be understood by those skilled in the art that the present invention is not limited to the particular embodiments described herein, but is capable of various obvious changes, rearrangements and substitutions as will now become apparent to those skilled in the art without departing from the scope of the invention. Therefore, while the invention has been described in connection with the above embodiments, the invention is not limited to the embodiments, but may be embodied in many other equivalent forms without departing from the spirit or scope of the invention, which is set forth in the following claims.
Claims (6)
1. A puncture surgical system, comprising:
the target object (4) is fixed at the operation position of the patient and used for marking and positioning the operation position;
the CT scanner is used for scanning the target object (4) and the tissue of the operation part before puncturing to acquire images of the target object (4) and the tissue of the operation part;
a camera (5) for photographing the target object (4) and the skin of the operation site before puncturing, and acquiring images of the target object (4) and the skin of the operation site;
a puncture mechanism (3) on which a puncture needle (32) is arranged, wherein the position and the angle of the puncture needle (32) are adjustable;
the B ultrasonic probe (6) is used for monitoring tissues around the puncture point and the puncture path during puncture so as to acquire images around the puncture point;
an imaging device (2) for displaying an image obtained by the B-ultrasonic probe (6);
the puncture mechanism (3) further comprises a movable mechanical arm (31) and a first positioning system (33) for installing the puncture needle (32) and positioning the puncture needle (32), the first positioning system (33) and the camera (5) are arranged on the mechanical arm (31), and the first positioning system (33) can adjust the position and the angle of the puncture needle (32) according to a fusion image of an image acquired by a CT scanner and an image acquired by the camera (5) and aim at a prestored lesion position;
the first positioning system (33) comprises a first connecting rod mechanism (334), a second connecting rod mechanism (335) and a puncture needle holder (336), wherein the input end of the first connecting rod mechanism (334) is connected with a first power system, the output end of the first connecting rod mechanism (334) is hinged with the upper part or the lower part of the puncture needle holder (336) in a spherical surface, the input end of the second connecting rod mechanism (335) is connected with a second power system, and the output end of the second connecting rod mechanism (335) is hinged with the lower part or the upper part of the puncture needle holder (336);
the imaging device (2) comprises an operation table (21), and the mechanical arm (31) is hinged on the operation table (21);
the mechanical arm (31) comprises a first arm (311) and a second arm (312), the first arm (311) is hinged with the operation table (21), the second arm (312) is connected with the first positioning system (33), and the first arm (311) and the second arm (312) are rotatably connected;
the puncture operation system further comprises a second positioning system (7), the second positioning system (7) is fixed on one side, far away from the second arm (312), of the camera (5), the second positioning system (7) is connected with the B-ultrasonic probe (6), and the second positioning system (7) controls the B-ultrasonic probe (6) to monitor tissues and puncture paths around a puncture point;
the second positioning system (7) comprises a third connecting rod mechanism (72), a fourth connecting rod mechanism (73) and a B ultrasonic probe fixing device (76), wherein the input end of the third connecting rod mechanism (72) is connected with a third power system, the output end of the third connecting rod mechanism (72) is in spherical hinge with the upper part or the lower part of the B ultrasonic probe fixing device (76), the input end of the fourth connecting rod mechanism (73) is connected with a fourth power system, and the output end of the fourth connecting rod mechanism (73) is in hinge with the lower part or the upper part of the B ultrasonic probe fixing device (76).
2. The puncture surgical system according to claim 1, wherein the first link mechanism (334) comprises a first main link (3341), one end of the first main link (3341) is spherically hinged on the puncture needle holder (336), the other end is hinged with a first support rod (3342), and the middle part of the first main link (3341) is hinged with a second support rod (3343); the first power system comprises two first driving mechanisms (332), the two first driving mechanisms (332) are respectively hinged with the first supporting rod (3342) and the second supporting rod (3343), and the two first driving mechanisms (332) are all linear driving mechanisms.
3. The puncture surgical system of claim 2, wherein the first drive mechanism (332) comprises a first motor, a first threaded rod coupled to an output shaft of the first motor, and a first slider threadably coupled to the first threaded rod.
4. A puncture surgery system according to claim 2 or 3, characterized in that the second linkage (335) comprises a second main link (3351), which second main link (3351) is hinged at one end to the puncture needle holder (336) and at the other end to a third strut (3352), which second main link (3351) is hinged at its middle to a fourth strut (3353); the second power system comprises two second driving mechanisms (333), the two second driving mechanisms (333) are respectively hinged with the third support rod (3352) and the fourth support rod (3353), and the two second driving mechanisms (333) are all linear driving mechanisms.
5. The puncture surgical system according to claim 1, wherein the puncture needle holder (336) comprises a housing, a third driving mechanism (3362) is disposed in the housing, the third driving mechanism (3362) is a linear driving mechanism, an output end of the third driving mechanism is connected with a supporting rod (3363) extending out of the housing, a stop block (3364) is fixed on the supporting rod (3363), and the puncture needle (32) is arranged on the stop block (3364) in a penetrating manner.
6. The puncture surgical system according to claim 5, wherein the third drive mechanism (3362) comprises a second motor (33621) fixed on the housing, a first gear (33622) is connected to an output shaft of the second motor (33621), the first gear (33622) is meshed with a second gear (33623), the second gear (33623) is coaxially connected with a second threaded rod (33624), an axis of the second threaded rod (33624) is parallel to an axis of an output shaft of the second motor (33621), a second slider (33625) is screwed to the second threaded rod (33624), and the second slider (33625) is connected to the support rod (3363).
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| CN201810756325.0A CN108852473B (en) | 2018-07-11 | 2018-07-11 | Puncture operation system |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN110353774B (en) * | 2018-12-15 | 2023-05-12 | 深圳铭杰医疗科技有限公司 | Auxiliary puncture robot, control method thereof, computer device, and storage medium |
| CN109820574B (en) * | 2019-01-31 | 2021-08-20 | 张囡囡 | Liver positioning and puncturing device |
| CN110368040A (en) * | 2019-07-01 | 2019-10-25 | 中奕智创医疗科技有限公司 | Needle pierces minimally invasive robot |
| CN111374740B (en) * | 2020-04-22 | 2021-10-08 | 重庆市江津区中心医院 | Interatrial septum puncture art is with supplementary puncture system of augmented reality |
| CN113768590A (en) * | 2021-08-16 | 2021-12-10 | 郴州市第一人民医院 | Auxiliary system for B-ultrasonic guided puncture |
| CN113693690B (en) * | 2021-08-30 | 2022-09-02 | 广东工业大学 | Nuclear magnetic resonance compatible two-degree-of-freedom needle inserting angle adjusting mechanism for puncture surgery |
| CN114569212A (en) * | 2022-03-04 | 2022-06-03 | 汕头市超声仪器研究所股份有限公司 | Automatic guider of transperineal prostate puncture system |
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