CN110934627A - 3D prints slotted percutaneous tissue puncture baffle - Google Patents
3D prints slotted percutaneous tissue puncture baffle Download PDFInfo
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- CN110934627A CN110934627A CN201911292768.XA CN201911292768A CN110934627A CN 110934627 A CN110934627 A CN 110934627A CN 201911292768 A CN201911292768 A CN 201911292768A CN 110934627 A CN110934627 A CN 110934627A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- 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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- A61B10/02—Instruments for taking cell samples or for biopsy
- A61B10/0233—Pointed or sharp biopsy instruments
- A61B10/025—Pointed or sharp biopsy instruments for taking bone, bone marrow or cartilage samples
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- B33Y—ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
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- A61B10/02—Instruments for taking cell samples or for biopsy
- A61B10/0233—Pointed or sharp biopsy instruments
- A61B10/025—Pointed or sharp biopsy instruments for taking bone, bone marrow or cartilage samples
- A61B2010/0258—Marrow samples
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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 the field of medical instruments, in particular to a percutaneous tissue puncture guide plate and a construction method thereof. The invention provides a method for constructing a percutaneous tissue puncture guide plate model, which comprises the following steps: providing a three-dimensional model of a part to be punctured; acquiring a puncture point A based on the puncture point O; acquiring a puncture point B based on the puncture point O and the puncture point C; constructing a guide plate body based on the puncture point A and the puncture point B; constructing a sliding groove based on the puncture point A and the puncture point B; constructing a first puncture guide based on the puncture point a; a second puncture guide is constructed based on puncture point B. The percutaneous tissue puncture guide plate provided by the invention can guide a deep puncture operation at a part, gives consideration to the operation access, reduces the pollution to surrounding tissues, reduces the perspective in the operation, reduces the puncture failure rate, assists the accurate positioning of tumor lesion in the operation, provides convenience for puncture, shortens the puncture time and has good industrialization prospect.
Description
Technical Field
The invention relates to the field of medical instruments, in particular to a percutaneous tissue puncture guide plate and a construction method thereof.
Background
Clinically, the pelvic tumor aspiration biopsy operation is an important link for definite diagnosis and operation plan formulation, and has great significance for guiding subsequent treatment. For tumors with large volume and shallow position in the pelvis, the needle biopsy is simpler. However, most tumors in the pelvic region are deep, complex in anatomical location (e.g., deep in the acetabulum and ilium), adjacent to important blood vessels and nerves around the pelvis, and percutaneous precise needle biopsy is not easy, and often requires precise preoperative planning and operation.
For such biopsy procedures, it is currently often necessary to assist with imaging procedures. The biopsy under X-ray fluoroscopy cannot accurately locate a tumor in a pelvic region because it is difficult to provide three-dimensional spatial information of a lesion. The puncture biopsy operation guided by CT is mostly used for the lesion with deeper lesion and smaller range or the lesion close to the vascular nerve bundle. Its disadvantages include the possibility to guide the puncture only in a defined scanning section, limiting the biopsy path; the radiation dose is larger; the operation is not flexible when the patient with fat body shape and the region such as pelvis are punctured due to the limitation of the CT examination coil. MRI has the advantages of high soft tissue contrast ratio, multi-plane imaging, accurate positioning, no radiation and the like, but the clinical application of MRI is limited because of the lack of corresponding specific matching instruments for guiding bone biopsy. Other imaging technologies are still in the exploration stage, have high requirements on imaging equipment, and are difficult to popularize clinically.
Disclosure of Invention
In view of the above-described shortcomings of the prior art, it is an object of the present invention to provide a percutaneous tissue penetration guide and a method of constructing the same, which solve the problems of the prior art.
To achieve the above and other related objects, an aspect of the present invention provides a method for constructing a percutaneous tissue penetration guide model, including:
providing a three-dimensional model of a part to be punctured, wherein the three-dimensional model comprises a puncture point O and a target puncture point C, the puncture point O is positioned on the surface of cortical bone, and the puncture point C is positioned in a puncturing target area;
acquiring a puncture point A based on the puncture point O, wherein the puncture point A is positioned at the outer edge of the iliac crest and is 2-3 cm behind the anterior superior iliac spine;
acquiring a puncture point B based on the puncture point O and the puncture point C, wherein the puncture point B is an intersection point of a connecting line of the puncture point O and the puncture point C and a body surface;
constructing a guide plate body based on a puncture point A and a puncture point B, wherein the guide plate body covers the surface of the skin and comprises a first puncture hole and a second puncture hole, and the positions of the first puncture hole and the second puncture hole are respectively matched with the positions of the puncture point A and the puncture point B;
constructing a sliding groove based on the puncture point A and the puncture point B, wherein the sliding groove is positioned on the guide plate body and is connected with the first puncture hole and the second puncture hole;
constructing a first puncture guide part based on the puncture point A, wherein the extending direction of the first puncture guide part is consistent with the connecting line of the puncture point A and the puncture point O, and an opening is formed in one side, facing the sliding groove, of the first puncture guide part;
and a second puncture guide is constructed based on the puncture point B, the extending direction of the second puncture guide is consistent with the connecting line of the puncture point C and the puncture point O, and an opening is formed in one side of the second puncture guide facing the sliding groove.
In some embodiments of the invention, the tissue is selected from pelvic tissue.
In some embodiments of the invention, the tissue is selected from diseased tissue, preferably tumor tissue.
In some embodiments of the invention, the puncture point O is located on the cortical bone surface at the acetabulum.
In some embodiments of the present invention, the specific method of constructing the fence body based on the pierce points a and B is: the guide plate body datum plane is constructed on the basis of the skin surface comprising the puncture points A and B, and the guide plate body is constructed on the basis of the guide plate body datum plane.
In some embodiments of the invention, the guide body extends to a bony landmark point on the body surface, preferably the bony landmark point is selected from the group consisting of one or more of the anterior superior iliac spine, the greater trochanter of the femur, and the groin.
In some embodiments of the present invention, the guide plate body has a thickness of 2mm to 3 mm.
In some embodiments of the present invention, further comprising constructing a bony landmark fit based on the bony landmark, preferably the bony landmark fit is selected from the group consisting of an anterior superior iliac spine fit, a femoral greater tuberosity fit, and a groin fit.
In some embodiments of the present invention, the first puncture hole has a pore diameter of 3 to 5mm, and the second puncture hole has a pore diameter of 3 to 5 mm.
In some embodiments of the present invention, the first penetration guide has a length of 10 to 20mm, and the second penetration guide has a length of 10 to 20 mm.
In some embodiments of the present invention, the angle between the first and second piercing guides is 15 to 45 °.
In some embodiments of the present invention, the sliding groove is sized to fit the first puncture and/or the second puncture.
In some embodiments of the invention, the sliding groove extends linearly.
In another aspect, the present invention provides a method for preparing a guide plate for percutaneous tissue penetration, the method comprising: and constructing the obtained percutaneous tissue puncture guide plate model according to the construction method of the percutaneous tissue puncture guide plate model to prepare the percutaneous tissue puncture guide plate.
The invention also provides a percutaneous tissue puncture guide plate which is constructed by the construction method of the percutaneous tissue puncture guide plate model or prepared by the preparation method of the percutaneous tissue puncture guide plate.
Another aspect of the present invention provides a computer-readable storage medium, on which a computer program is stored, which, when being executed by a processor, implements the steps of the method for constructing a model of a percutaneous tissue penetration guide or the steps of the method for preparing a percutaneous tissue penetration guide.
In another aspect, the invention provides an apparatus comprising: a processor and a memory, the memory being configured to store a computer program, the processor being configured to execute the computer program stored by the memory to cause the apparatus to perform the steps of the method of constructing a model of a percutaneous tissue penetration guide or the steps of the method of preparing a model of a percutaneous tissue penetration guide.
Another aspect of the present invention provides an apparatus, which may include:
the three-dimensional model providing module is used for providing a three-dimensional model of a part to be punctured, the three-dimensional model comprises a puncturing point O and a target puncturing point C, the puncturing point O is located on the surface of a pelvis acetabulum cortical bone, and the puncturing point C is located in a puncturing target area;
the puncture point A acquisition module is used for acquiring a puncture point A based on a puncture point O, and the puncture point A is positioned at the outer edge of the iliac crest and is positioned 2-3 cm behind the anterior superior iliac spine;
the puncture point B acquisition module is used for acquiring a puncture point B based on a puncture point O and a puncture point C, and the puncture point B is an intersection point of a connecting line of the puncture point O and the puncture point C and a body surface;
the guide plate body construction module is used for constructing a guide plate body based on a puncture point A and a puncture point B, the guide plate body covers the surface of the skin, the guide plate body comprises a first puncture hole and a second puncture hole, and the positions of the first puncture hole and the second puncture hole are respectively matched with the positions of the puncture point A and the puncture point B;
the sliding groove building module is used for building a sliding groove on the guide plate body based on the puncture point A and the puncture point B, and the sliding groove is connected with the first puncture hole and the second puncture hole;
the first puncture guide construction module is used for constructing a first puncture guide based on a puncture point A, and the extending direction of the first puncture guide is consistent with the connecting line of the puncture point A and the puncture point O;
and the second puncture guide construction module is used for constructing a second puncture guide based on the puncture point B, and the extending direction of the second puncture guide is consistent with the connecting line of the puncture point C and the puncture point O.
Optionally, the method further includes: the bone mark point fitting part construction module is used for constructing the bone mark point fitting part based on the bone mark points, preferably, the bone mark point fitting part is selected from an anterior superior iliac spine fitting part, a femoral greater tuberosity fitting part and a groin fitting part.
The invention provides a percutaneous tissue puncture guide plate, which comprises a guide plate body, wherein the guide plate body further comprises a first puncture hole, a second puncture hole, a sliding groove and a bony mark point fitting part, the sliding groove is positioned between the first puncture hole and the second puncture hole, the guide plate body is further provided with a first puncture guide part and a second puncture guide part, the position of the first puncture guide part is matched with the first puncture hole, an opening is formed in one side, facing the sliding groove, of the first puncture guide part, the position of the second puncture guide part is matched with the second puncture hole, and an opening is formed in one side, facing the sliding groove, of the second puncture guide part.
In some embodiments of the invention, the tissue is selected from pelvic lesion tissue.
In some embodiments of the invention, the guide plate body comprises a plurality of bony landmark abutments including an anterior superior iliac spine abutment, a femoral greater tuberosity abutment, and a groin abutment.
In some embodiments of the present invention, the guide plate body has a thickness of 2mm to 3 mm.
In some embodiments of the present invention, the first puncture hole has a pore diameter of 3 to 5mm, and the second puncture hole has a pore diameter of 3 to 5 mm.
In some embodiments of the present invention, the extending direction of the first penetration guide coincides with the viewing direction of the external iliac plate, and the intersection point of the extending direction of the first penetration guide and the extending direction of the second penetration guide is located on the surface of the pelvic acetabular cortical bone.
In some embodiments of the present invention, the first penetration guide has a length of 10 to 20mm, and the second penetration guide has a length of 10 to 20 mm.
In some embodiments of the present invention, the angle between the first and second piercing guides is 15 to 45 °.
In some embodiments of the present invention, the sliding groove is sized to fit the first puncture and/or the second puncture, and the sliding groove extends linearly.
In some embodiments of the present invention, the material of the puncture guide plate is photosensitive resin.
Drawings
FIG. 1 is a schematic view of the percutaneous tissue penetration guide of the present invention.
Fig. 2 shows a schematic view of the construction of the percutaneous tissue penetration guide plate of the invention.
FIG. 3 is a schematic view of the percutaneous tissue penetration guide of the present invention in use.
Description of the element reference numerals
1 guide plate body
11 bony mark point attaching part
111 anterior superior iliac spine attaching part
112 femoral greater trochanter attachment
113 groin fitting part
12 first puncture hole
13 second puncture hole
14 sliding groove
2 first puncture guide
3 second piercing guide
Detailed Description
The inventor of the invention provides a percutaneous tissue puncture guide plate and a construction method thereof through a large amount of exploratory researches, the percutaneous tissue puncture guide plate can realize accurate puncture of pelvic tumors by utilizing ductility of skin, and a feasible method is provided for accurate tumor biopsy of complex anatomical parts, and the invention is completed on the basis.
The invention provides a method for constructing a percutaneous tissue puncture guide plate model, which comprises the following steps:
s1), providing a three-dimensional model of a part to be punctured, wherein the three-dimensional model comprises a puncturing point O and a target puncturing point C, the puncturing point O is positioned on the surface of cortical bone, and the puncturing point C is positioned in a puncturing target area;
s2) acquiring a puncture point A based on the puncture point O, wherein the puncture point A is positioned at the outer edge of the iliac crest and is 2-3 cm behind the anterior superior iliac spine;
s3) acquiring a puncture point B based on the puncture point O and the puncture point C, wherein the puncture point B is an intersection point of a connecting line of the puncture point O and the puncture point C and the body surface;
s4) constructing a guide plate body based on the puncture point A and the puncture point B, wherein the guide plate body covers the surface of the skin and comprises a first puncture hole and a second puncture hole, and the positions of the first puncture hole and the second puncture hole are respectively matched with the positions of the puncture point A and the puncture point B;
s5) constructing a sliding groove based on the puncture point A and the puncture point B, wherein the sliding groove is located on the guide plate body and is connected with the first puncture hole and the second puncture hole;
s6) constructing a first puncture guide piece based on the puncture point A, wherein the extending direction of the first puncture guide piece is consistent with the connecting line of the puncture point A and the puncture point O, and an opening is formed in one side, facing the sliding groove, of the first puncture guide piece;
s7) constructing a second puncture guide based on the puncture point B, wherein the extending direction of the second puncture guide is consistent with the connecting line of the puncture point C and the puncture point O, and one side of the second puncture guide facing the sliding groove is provided with an opening.
The construction method of the percutaneous tissue puncture guide plate model provided by the invention can comprise the following steps: providing a three-dimensional model of a part to be punctured, wherein the three-dimensional model comprises a puncturing point O and a target puncturing point C, the puncturing point O is positioned on the surface of cortical bone, and the puncturing point C is positioned in a puncturing target area. The percutaneous tissue puncture guide plate provided by the invention can be generally used for treating tissues (generally pathological tissues, such as tumor tissues and the like) which are small in volume and deep in position, for example, deep acetabulum parts. The three-dimensional model typically includes a three-dimensional model of the patient's bone and a three-dimensional model of the surrounding tissue. The three-dimensional model of the bone generally includes parts such as ilium, acetabulum, ischium, etc., which can be generally obtained by CT data importing software, and specifically, the three-dimensional model may be software such as simplan, Mimics, Proplan, etc. The three-dimensional model of the surrounding tissue is generally directed to a three-dimensional model of the relevant tissue surrounding the bone of the patient, and may generally include tumor lesion tissue, muscle, blood vessel (may include skin surface), which may be generally obtained by CT data importing software, and may specifically be software such as mimics, medraw and the like. After the three-dimensional model of the skeleton and the three-dimensional model of the surrounding tissue are integrated, the overall three-dimensional model of the part to be punctured can be obtained, and the software used in the integration process can be, for example, 3-matic software, geoimagic software and the like. In the three-dimensional model of the part to be punctured, the puncture point O is usually located on the surface of the cortical bone, so that a certain fulcrum can be provided for the puncture needle when the puncture needle slides, for example, the puncture point O can be located on the surface of the cortical bone at the acetabulum in the pelvis. In the three-dimensional model of the to-be-punctured site, the puncture point C is usually located in the puncture target region, i.e. corresponding to the tissue to be punctured and sampled, for example, the puncture point C may be located in a diseased tissue region, more specifically, a tumor diseased region, preferably, a region with the strongest tumor lesion activity, and the diseased region may be usually determined according to the imaging, for example, the puncture point C may be located in an acetabular diseased region.
The method for constructing the percutaneous tissue puncture guide plate model provided by the invention can also comprise the following steps: and obtaining a puncture point A based on the puncture point O, wherein the puncture point A is usually positioned at the outer edge of the iliac crest and 2-3 cm behind the anterior superior iliac spine. The puncture point A is usually positioned on the surface of the skin, and is positioned at the outer edge of the iliac crest and can obviously reach the point on the body surface, and the connecting line of the puncture point O and the puncture point A is usually consistent with the direction of an external iliac plate (namely the external side of the iliac), so that the tissues such as hip muscles, blood vessels, sciatic nerves and the like can be prevented from being damaged. During puncturing, the puncture needle can enter from the puncture point A and is led to the puncture point O, so that a certain support is formed. In addition, the part where the puncture point A is located usually corresponds to a subsequent surgical incision (iliac-abdominal sulcus access), and preferably can be located in the surgical incision, so that the puncture and the subsequent surgical incision can be consistent, and secondary injury is avoided. In the present invention, the puncture needle may be any puncture needle suitable for bone puncture, and the puncture needle generally includes a linearly extending puncture needle body, and a sleeve sleeved on the puncture needle body is arranged outside the puncture needle body, and the puncture needle body and the sleeve are in close contact with each other.
The method for constructing the percutaneous tissue puncture guide plate model provided by the invention can also comprise the following steps: and acquiring a puncture point B based on the puncture point O and the puncture point C, wherein the puncture point B is an intersection point of a connecting line of the puncture point O and the puncture point C and the body surface. The puncture point A is usually positioned on the surface of the skin, the connecting lines of the puncture point B, the puncture point O and the puncture point C usually correspond to the path of the target tissue needing to be punctured in the actual operation, however, on the connecting line between the puncture points B and O, there are usually the tensor fascia lata, gluteus medius and gluteus minimus, and blood vessel distribution, therefore, at the time of puncture, after the puncture needle is guided to the puncture point O from the connecting line path between the puncture point O and the puncture point A, the puncture needle can slide from the connecting line path of the puncture point O and the puncture point A to the connecting line path of the puncture point O and the puncture point B by utilizing the supporting function of the puncture point O and the ductility of surrounding tissues, then the cortical bone can be punctured by the puncture needle, the puncture needle body is taken out, the sleeve is still maintained at the connecting line path of the puncture point O and the puncture point B, and then the target area can be sampled by the sleeve.
The method for constructing the percutaneous tissue puncture guide plate model provided by the invention can also comprise the following steps: construct the baffle body based on puncture point A and puncture point B, the baffle body covers on the skin surface, the baffle body includes first puncture hole and second puncture hole to be used for introducing the pjncture needle and carry out the puncture, the position of first puncture hole and second puncture hole cooperatees with puncture point A and puncture point B's position respectively, and its size is corresponding with the size of pjncture needle (for example, the telescopic external diameter of pjncture needle) usually, for example, the aperture of first puncture hole can be 3 ~ 5mm, for example again, the aperture of second puncture hole is 3 ~ 5 mm. 2 the guide plate body is generally used for being attached to the surface of the skin, and provides a basis for the puncture direction through puncture holes on the surface of the guide plate body, and ensures the stability of puncture.
The method for constructing the percutaneous tissue puncture guide plate model provided by the invention can also comprise the following steps: and constructing a bony marking point fitting part based on the bony marking points. The guide plate body can usually extend to bony mark points on the body surface, so that a bony mark point attaching part can be formed to accurately determine the fixing position of the guide plate. The bony landmark points on the body surface usually refer to the more obvious bumps or depressions formed on the body surface of a human by the native soil of some parts of the human body. Generally, the guide plate body can extend to a plurality of bony landmark points on the body surface, and a plurality of bony landmark point attaching parts can be constructed based on the plurality of bony landmark points so as to facilitate more accurate positioning. For example, the bony landmark points can be a combination of one or more of an anterior superior iliac spine, a femoral greater tuberosity, a groin, etc., and for example the bony landmark point attachments can be a combination of one or more of an anterior superior iliac spine attachment, a femoral greater tuberosity attachment, a groin attachment, etc. Those skilled in the art can select a suitable shape of the bony landmark attachments that generally matches the body surface topography, for example, the bony landmark attachments can be placed around the bony landmarks or can cover part or all of the bony landmark surfaces.
In the present invention, the thickness of the guide body (including the bony landmark point attachment portions) may be adjusted by those skilled in the art so as to provide a suitable support strength, and for example, the thickness of the guide body may be 2mm to 3 mm. In a preferred embodiment of the present invention, a specific method for constructing the fence body based on the piercing points a and B is as follows: the guide plate body datum plane is constructed on the basis of the skin surface comprising the puncture points A and B, and the guide plate body is constructed on the basis of the guide plate body datum plane. The guide plate body datum plane is usually matched with the body surface and can cover the puncture points A and the puncture points B, and preferably, the guide plate body datum plane can also be usually extended to the surface of one or more bony mark points, so that a better fitting effect is provided integrally, and a better guiding and supporting effect is provided. The resulting fence body is constructed by extending the fence body datum plane outward (i.e., in a direction opposite to that facing the skin surface) by a distance. The distance by which the fence body reference surface extends outwardly generally corresponds to the thickness of the fence body, for example, the distance may be 2mm to 3 mm.
The method for constructing the percutaneous tissue puncture guide plate model provided by the invention can also comprise the following steps: a sliding groove is constructed based on the puncture points A and B, and the sliding groove is located on the guide plate body and connected with the first puncture hole and the second puncture hole. The sliding groove is generally used to realize the sliding of the puncture needle, and after the puncture needle is guided to the puncture point O from the line path of the puncture point O and the puncture point a as described above, the puncture needle can be slid to the line path of the puncture point O and the puncture point B from the line path of the puncture point O and the puncture point a through the sliding groove by utilizing the supporting function of the puncture point O and the ductility of the surrounding tissue. The sliding groove is generally matched with the first puncture hole and/or the second puncture hole in size, so that the puncture needle can smoothly slide from the first puncture hole to the second puncture hole. The sliding groove preferably extends linearly so as to avoid excessive entrainment of the patient's tissue, and may have a length of 2-5 cm in the direction of extension.
The method for constructing the percutaneous tissue puncture guide plate model provided by the invention can also comprise the following steps: construct first puncture guide based on puncture point A, the extending direction of first puncture guide is unanimous in puncture point A and puncture point O's line, one side of first puncture guide towards the sliding tray is equipped with the opening. The first puncture guide is generally used to guide the puncture needle to reach the puncture point O along the route from the puncture point a to the puncture point O during the puncture process, and forms a certain support. The first puncture guide is generally shaped to mate with the shape of a puncture needle (e.g., the hub of a puncture needle), which is generally a cylinder. The first puncture guide part is provided with an opening on one side facing the sliding groove, which usually means that the side wall of the first puncture guide part close to one side of the sliding groove is absent, so that a puncture needle can be guided by utilizing a cylinder structure on one side of the first puncture guide part during puncture, and when the puncture needle needs to be slid, the size of the opening of the first puncture guide part is usually matched with the size of the sliding groove and the size of the puncture needle, so that the puncture needle can be moved out of the opening of the first puncture guide part. The first penetration guide has a certain length in an extending direction thereof, for example, the length of the first penetration guide may be 10 to 20 mm.
The method for constructing the percutaneous tissue puncture guide plate model provided by the invention can also comprise the following steps: and a second puncture guide is constructed based on the puncture point B, the extending direction of the second puncture guide is consistent with the connecting line of the puncture point C and the puncture point O, and an opening is formed in one side of the second puncture guide, which faces the sliding groove. The second puncture guide is generally used for guiding the puncture needle to be capable of keeping the route from the puncture point B to the puncture point O, puncturing the cortical bone according to the route from the puncture point B to the puncture point O, and after the puncture needle body is taken out, the sleeve can still be kept in the route from the puncture point B to the puncture point O through the second puncture guide, so that the sampling needle can pass through the sleeve to sample the tissue of the target area. The second puncture guide is generally shaped to match the shape of the puncture needle (e.g., the hub of the puncture needle), which is generally a cylinder. The side of the second puncture guide part facing the sliding groove is provided with an opening, which usually means that the side wall of the second puncture guide part close to the sliding groove is absent, and the size of the opening is usually matched with the size of the sliding groove and the puncture needle, so that the puncture needle can be moved into the second puncture guide part through the opening of the second puncture guide part after the puncture needle is moved out of the opening of the first puncture guide part, and the puncture needle can be guided by using the cylinder structure on the other side. The second penetration guide has a certain length in an extending direction thereof, for example, the length of the second penetration guide may be 10 to 20 mm.
In the invention, the included angle between the first puncture guide part and the second puncture guide part is not suitable to be too large so as to ensure that the puncture needle does not excessively tear tissues to cause unnecessary damage when moving. For example, the angle between the first and second piercing guides may be 15 to 45 °.
In a second aspect, the present invention provides a method for preparing a guide plate for percutaneous tissue penetration, the method comprising: according to the construction method of the percutaneous tissue puncture guide plate model provided by the first aspect of the invention, the obtained percutaneous tissue puncture guide plate model is constructed, and the percutaneous tissue puncture guide plate is prepared. The method for preparing the percutaneous tissue penetration guide plate according to the model is known to those skilled in the art, and for example, 3D printing and the like can be adopted, and for example, the material used in the 3D printing process can be photosensitive resin and the like.
In a third aspect, the present invention provides a guide plate for percutaneous tissue penetration, which is constructed by the method for constructing the model of the guide plate for percutaneous tissue penetration provided in the first aspect of the present invention, or is prepared by the method for preparing the guide plate for percutaneous tissue penetration provided in the second aspect of the present invention.
As shown in fig. 1, the present invention provides a percutaneous tissue puncture guide plate, which comprises a guide plate body 1, wherein the guide plate body 1 further comprises a first puncture hole 12, a second puncture hole 13, a sliding groove 14 and a bony landmark point attaching portion 11, the sliding groove 14 is positioned between the first puncture hole 12 and the second puncture hole 13, the guide plate body 1 is further provided with a first puncture guide 2 and a second puncture guide 3, the first puncture guide 2 is positioned to match the first puncture hole 12, an opening is provided on one side of the first puncture guide 2 facing the sliding groove 14, the second puncture guide 3 is positioned to match the second puncture hole 13, and an opening is provided on one side of the second puncture guide 3 facing the sliding groove 14. When the percutaneous tissue puncture guide plate provided by the invention is used, the percutaneous tissue puncture guide plate can be attached to the surface of the skin, a puncture needle (for example, a bone marrow biopsy needle as described above) can enter from the first puncture hole 12 first, and is guided to a target point (e.g., the puncture point O as described above) on the surface of the cortical bone through the first puncture guide 2, thereby forming a certain support, then, the puncture needle can be slid along the path guided by the first puncture hole 12 and the first puncture guide 2 to the path guided by the second puncture hole 13 and the second puncture guide 3 by utilizing the supporting function of the target point on the surface of the cortical bone and the ductility of the surrounding tissue, and then the cortical bone can be punctured by the puncture needle, the puncture needle body can be taken out and the sleeve can still be maintained along the path guided by the second puncture hole 13 and the second puncture guide 3, and then the target region can be sampled by the sleeve.
The percutaneous tissue puncture guide plate provided by the invention can be generally used for tissues with larger volume and deep positions, for example, pelvic tissues. The target tissue is typically diseased tissue, which may be tumor tissue, for example, and the diseased region is typically determined from imaging.
In the percutaneous tissue puncture guide plate provided by the invention, the guide plate body 1 can comprise a plurality of bony mark point attaching parts 11, and the bony mark point attaching parts 11 can comprise an anterior iliac superior spine attaching part 111, a femoral greater tuberosity attaching part 112 and a groin attaching part 113. Generally, the guide plate body can extend to a plurality of bony landmark points on the body surface, and a plurality of bony landmark point attaching parts can be constructed based on the plurality of bony landmark points so as to facilitate more accurate positioning. One skilled in the art can select a suitable shape for the bony landmark attachments, for example, the bony landmark attachments can be placed around the bony landmark and can cover part or all of the surface of the bony landmark.
In the percutaneous tissue puncture guide provided by the present invention, the thickness of the guide body 1 (including the bony landmark point attachment portions) may be adjusted by those skilled in the art so as to provide a suitable support strength, and for example, the thickness of the guide body may be 2mm to 3 mm.
In the percutaneous tissue penetration guide provided by the present invention, the positions of the first puncture hole 12, the second puncture hole 13, the first penetration guide 2, and the second penetration guide 3 generally correspond to the penetration path, for example, the extending direction of the first penetration guide 2 generally coincides with the viewing direction of the external iliac plate, which generally coincides with the extending direction of the connecting line between the puncture point O and the puncture point a, i.e., the extending direction of the external iliac plate may extend from the outer iliac crest and 2 to 3cm behind the anterior superior iliac spine to the cortical bone surface (e.g., acetabular pelvic cortical bone surface), for example, the intersection point of the extending direction of the first penetration guide 2 and the extending direction of the second penetration guide 3 is located on the cortical bone surface (e.g., puncture point O as described above) and a target puncture point (e.g., puncture point C as described above). The included angle between the first puncture guide and the second puncture guide is not too large, so that the puncture needle can not tear tissues excessively when moving, and unnecessary damage is avoided. For example, the angle between the first and second piercing guides may be 15 to 45 °.
In the percutaneous tissue puncture guide provided by the invention, the size of the puncture hole should be adjustable for a person skilled in the art, for example, the size of the first puncture hole and/or the second puncture hole generally corresponds to the size of a puncture needle (for example, the outer diameter of a sleeve of the puncture needle), for example, the diameter of the first puncture hole 12 may be 2-3 mm, and for example, the diameter of the second puncture hole 13 may be 2-3 mm.
In the percutaneous tissue penetration guide provided by the present invention, the size of the penetration guide should be adjustable for those skilled in the art, and it is generally matched with the shape of the penetration needle (for example, the sleeve of the penetration needle), for example, the length of the first penetration guide 2 (i.e., the length of the penetration guide in the extending direction) is 10 to 20mm, for example, the length of the second penetration guide 3 (i.e., the length of the penetration guide in the extending direction) is 10 to 20mm, for example, the shape of the first penetration guide 2 and/or the second penetration guide 3 is generally a cylinder. The first puncture guide is generally shaped to mate with the shape of a puncture needle (e.g., the hub of a puncture needle), which is generally a cylinder. The side of the first puncture guide 2 facing the sliding groove 14 is provided with an opening, which generally means that the side wall of the first puncture guide 2 close to the sliding groove 14 is absent, and the size of the opening is generally matched with the size of the sliding groove and the puncture needle, so that the puncture needle can be guided by using the column structure on one side of the first puncture guide during puncture, and the puncture needle can be moved out of the opening of the first puncture guide 2 when the puncture needle needs to be slid. The second puncture guide 3 is provided with an opening on one side facing the sliding groove 14, which generally means that the side wall of the second puncture guide 3 close to one side of the sliding groove 14 is absent, and the size of the opening is generally matched with the size of the sliding groove and the size of the puncture needle, so that the puncture needle can be moved into the second puncture guide 3 through the opening of the second puncture guide 3 after the puncture needle is moved out of the opening of the first puncture guide 2, and the puncture needle can be guided by using the column structure on the other side.
In the percutaneous tissue puncture guide plate provided by the invention, the sliding groove is positioned on the guide plate body and is connected with the first puncture hole and the second puncture hole. The sliding groove 14 is generally sized to fit the first puncture hole 12 and/or the second puncture hole 13, so that the puncture needle can smoothly slide from the first puncture hole to the second puncture hole. The sliding groove preferably extends linearly so as to avoid excessive entrainment of the patient's tissue, and may have a length of 2-5 cm in the direction of extension.
In the percutaneous tissue puncture guide plate provided by the invention, a person skilled in the art can select a suitable material to construct the puncture guide plate, for example, the material of the puncture guide plate can be photosensitive resin.
A fourth aspect of the present invention provides a computer readable storage medium having stored thereon a computer program which, when executed by a processor, carries out the steps of the method of constructing a model of a percutaneous tissue penetration guide provided by the first aspect of the present invention or the steps of the method of preparing a percutaneous tissue penetration guide as provided by the second aspect of the present invention.
A fifth aspect of the invention provides an apparatus comprising: a processor and a memory, the memory being configured to store a computer program, the processor being configured to execute the computer program stored by the memory to cause the apparatus to perform the steps of the method for constructing a model of a percutaneous tissue penetration guide provided by the first aspect of the invention or the steps of the method for preparing a model of a percutaneous tissue penetration guide provided by the second aspect of the invention.
A sixth aspect of the present invention provides an apparatus, which may comprise:
the three-dimensional model providing module is used for providing a three-dimensional model of a part to be punctured, the three-dimensional model comprises a puncturing point O and a target puncturing point C, the puncturing point O is located on the surface of a pelvis acetabulum cortical bone, and the puncturing point C is located in a puncturing target area;
the puncture point A acquisition module is used for acquiring a puncture point A based on a puncture point O, and the puncture point A is positioned at the outer edge of the iliac crest and is positioned 2-3 cm behind the anterior superior iliac spine;
the puncture point B acquisition module is used for acquiring a puncture point B based on a puncture point O and a puncture point C, and the puncture point B is an intersection point of a connecting line of the puncture point O and the puncture point C and a body surface;
the guide plate body construction module is used for constructing a guide plate body based on a puncture point A and a puncture point B, the guide plate body covers the surface of the skin, the guide plate body comprises a first puncture hole and a second puncture hole, and the positions of the first puncture hole and the second puncture hole are respectively matched with the positions of the puncture point A and the puncture point B;
the sliding groove building module is used for building a sliding groove on the guide plate body based on the puncture point A and the puncture point B, and the sliding groove is connected with the first puncture hole and the second puncture hole;
the first puncture guide construction module is used for constructing a first puncture guide based on a puncture point A, and the extending direction of the first puncture guide is consistent with the connecting line of the puncture point A and the puncture point O;
and the second puncture guide construction module is used for constructing a second puncture guide based on the puncture point B, and the extending direction of the second puncture guide is consistent with the connecting line of the puncture point C and the puncture point O.
Optionally, the method further includes: the bone mark point fitting part construction module is used for constructing the bone mark point fitting part based on the bone mark points, preferably, the bone mark point fitting part is selected from an anterior superior iliac spine fitting part, a femoral greater tuberosity fitting part and a groin fitting part.
In the present invention, the operation principle of each module in the above device may refer to the above-mentioned method for constructing the model of the guide plate for percutaneous tissue penetration and/or the method for preparing the guide plate for percutaneous tissue penetration, which is not described herein again.
The percutaneous tissue puncture guide plate provided by the invention can guide a deep puncture operation at a part, gives consideration to the operation access, reduces the pollution to surrounding tissues, reduces the perspective in the operation, reduces the puncture failure rate, assists the accurate positioning of tumor lesion in the operation, provides convenience for puncture, shortens the puncture time and has good industrialization prospect.
The embodiments of the present invention are described below with reference to specific embodiments, and other advantages and effects of the present invention will be easily understood by those skilled in the art from the disclosure of the present specification. The invention is capable of other and different embodiments and of being practiced or of being carried out in various ways, and its several details are capable of modification in various respects, all without departing from the spirit and scope of the present invention.
Example 1
And (3) importing the patient pelvis thin layer CT containing the tumor focus and MRI data into image reconstruction software to carry out three-dimensional reconstruction on the (medraw, mimics) operation region, and determining the tumor range. A puncture point O is determined on the surface of a pelvis acetabulum cortical bone, and a projection point A (namely the puncture point A) of the puncture point on the body surface is determined through the ilium in a visual angle direction parallel to and close to an external ilium plate, and the projection point is a needle insertion point. The region with the highest tumor lesion activity is determined by imaging, and the point is defined as the lesion core point C (i.e. puncture point C). Connecting the puncture point O on the surface of the bone to generate a connecting line OC, extending the connecting line OC and crossing the body surface at the puncture point B;
designing a percutaneous puncture guide plate in three-dimensional reconstruction software according to the combination of a bony mark point for reference and body surface morphological characteristics of a space position of a tumor, wherein the guide plate extends to a front superior iliac spine, a femoral greater tuberosity and a groin and comprises a front superior iliac spine joint part, a femoral greater tuberosity joint part and a groin joint part, the groin joint part covers the surface of the groin, the front superior iliac spine joint part and the femoral greater tuberosity joint part are arranged around the bony mark point, and the thickness of the guide plate is 2 mm;
based on the guide plate model, two puncture holes are determined on the guide plate along the OA and OB directions, a sliding groove is constructed between the two puncture holes, two guide posts are constructed at the corresponding positions of the puncture holes along the OA and OB directions, and the sides of the two guide posts facing each other are lost.
And (3) importing the STL file of the designed pelvic tumor puncture guide plate into 3D printing equipment, printing the puncture guide plate by using photosensitive resin, and sterilizing and packaging after printing.
Use the effectual operating time of having practiced thrift of this operation baffle in the art, put the baffle after will disinfecting to the operation region, can directly carry out the puncture, the operation puncture is more accurate, has reduced the time of perspective in the art, avoids the art person too much radiation, and the operating time has reduced about 70% overall, has also reduced the risk of patient's operation simultaneously.
In conclusion, the present invention effectively overcomes various disadvantages of the prior art and has high industrial utilization value.
The foregoing embodiments are merely illustrative of the principles and utilities of the present invention and are not intended to limit the invention. Any person skilled in the art can modify or change the above-mentioned embodiments without departing from the spirit and scope of the present invention. Accordingly, it is intended that all equivalent modifications or changes which can be made by those skilled in the art without departing from the spirit and technical spirit of the present invention be covered by the claims of the present invention.
Claims (10)
1. A method for constructing a percutaneous tissue puncture guide plate model comprises the following steps:
providing a three-dimensional model of a part to be punctured, wherein the three-dimensional model comprises a puncture point O and a target puncture point C, the puncture point O is positioned on the surface of cortical bone, and the puncture point C is positioned in a puncturing target area;
acquiring a puncture point A based on the puncture point O, wherein the puncture point A is positioned at the outer edge of the iliac crest and is 2-3 cm behind the anterior superior iliac spine;
acquiring a puncture point B based on the puncture point O and the puncture point C, wherein the puncture point B is an intersection point of a connecting line of the puncture point O and the puncture point C and a body surface;
constructing a guide plate body based on a puncture point A and a puncture point B, wherein the guide plate body covers the surface of the skin and comprises a first puncture hole and a second puncture hole, and the positions of the first puncture hole and the second puncture hole are respectively matched with the positions of the puncture point A and the puncture point B;
constructing a sliding groove based on the puncture point A and the puncture point B, wherein the sliding groove is positioned on the guide plate body and is connected with the first puncture hole and the second puncture hole;
constructing a first puncture guide part based on the puncture point A, wherein the extending direction of the first puncture guide part is consistent with the connecting line of the puncture point A and the puncture point O, and an opening is formed in one side, facing the sliding groove, of the first puncture guide part;
and a second puncture guide is constructed based on the puncture point B, the extending direction of the second puncture guide is consistent with the connecting line of the puncture point C and the puncture point O, and an opening is formed in one side of the second puncture guide, which faces the sliding groove.
2. The method of constructing according to claim 1, wherein the tissue is selected from the group consisting of pelvic tissue;
and/or, the tissue is selected from diseased tissue, preferably tumor tissue;
and/or the puncture point O is positioned on the surface of cortical bone at the acetabulum;
and/or the specific method for constructing the guide plate body based on the puncture points A and B comprises the following steps: constructing a guide plate body datum plane based on the skin surface comprising the puncture point A and the puncture point B, and constructing a guide plate body based on the guide plate body datum plane;
and/or, the guide plate body extends to a bone marker point on the body surface, preferably, the bone marker point is selected from one or more of anterior superior iliac spine, greater trochanter femur and groin;
and/or the thickness of the guide plate body is 2 mm-3 mm.
3. The method of claim 1, further comprising constructing a bony landmark fit based on bony landmarks, preferably the bony landmark fit is selected from the group consisting of an anterior superior iliac spine fit, a femoral greater tuberosity fit, and a groin fit.
4. The method of constructing according to claim 1, wherein the first penetration hole has a pore diameter of 3 to 5mm, and the second penetration hole has a pore diameter of 3 to 5 mm;
and/or the length of the first puncture guide part is 10-20 mm, and the length of the second puncture guide part is 10-20 mm;
and/or the included angle between the first puncture guide part and the second puncture guide part is 15-45 degrees.
5. The method of constructing according to claim 1, wherein the sliding groove is sized to fit the first puncture and/or the second puncture;
and/or the sliding groove extends linearly.
6. A method of making a percutaneous tissue penetration guide, the method comprising: the percutaneous tissue puncture guide model is constructed according to the construction method of the percutaneous tissue puncture guide model as claimed in any one of claims 1 to 5, and the percutaneous tissue puncture guide is prepared.
7. A percutaneous tissue puncture guide plate constructed by the method for constructing a percutaneous tissue puncture guide plate model according to any one of claims 1 to 5 or prepared by the method for preparing a percutaneous tissue puncture guide plate according to claim 6.
8. A computer-readable storage medium, having stored thereon a computer program, wherein the program, when executed by a processor, performs the steps of the method of constructing a model of a percutaneous tissue penetration guide as claimed in any one of claims 1 to 5, or the steps of the method of preparing a percutaneous tissue penetration guide as claimed in claim 6.
9. An apparatus, comprising: a processor and a memory, the memory for storing a computer program, the processor for executing the computer program stored by the memory to cause the apparatus to perform the steps of the method of constructing a percutaneous tissue penetration guide model as claimed in any one of claims 1 to 5 or the steps of the method of preparing a percutaneous tissue penetration guide model as claimed in claim 6.
10. An apparatus, the apparatus may comprise:
the three-dimensional model providing module is used for providing a three-dimensional model of a part to be punctured, the three-dimensional model comprises a puncturing point O and a target puncturing point C, the puncturing point O is located on the surface of a pelvis acetabulum cortical bone, and the puncturing point C is located in a puncturing target area;
the puncture point A acquisition module is used for acquiring a puncture point A based on a puncture point O, and the puncture point A is positioned at the outer edge of the iliac crest and is positioned 2-3 cm behind the anterior superior iliac spine;
the puncture point B acquisition module is used for acquiring a puncture point B based on a puncture point O and a puncture point C, and the puncture point B is an intersection point of a connecting line of the puncture point O and the puncture point C and a body surface;
the guide plate body construction module is used for constructing a guide plate body based on a puncture point A and a puncture point B, the guide plate body covers the surface of the skin, the guide plate body comprises a first puncture hole and a second puncture hole, and the positions of the first puncture hole and the second puncture hole are respectively matched with the positions of the puncture point A and the puncture point B;
the sliding groove building module is used for building a sliding groove on the guide plate body based on the puncture point A and the puncture point B, and the sliding groove is connected with the first puncture hole and the second puncture hole;
the first puncture guide construction module is used for constructing a first puncture guide based on a puncture point A, and the extending direction of the first puncture guide is consistent with the connecting line of the puncture point A and the puncture point O;
the second puncture guide construction module is used for constructing a second puncture guide based on the puncture point B, and the extending direction of the second puncture guide is consistent with the connecting line of the puncture point C and the puncture point O;
optionally, the method further includes: the bone mark point fitting part construction module is used for constructing the bone mark point fitting part based on the bone mark points, preferably, the bone mark point fitting part is selected from an anterior superior iliac spine fitting part, a femoral greater tuberosity fitting part and a groin fitting part.
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CN113244516A (en) * | 2021-07-05 | 2021-08-13 | 真实维度科技控股(珠海)有限公司 | Non-coplanar puncture template manufacturing method based on bony multipoint positioning and template |
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CN113244516A (en) * | 2021-07-05 | 2021-08-13 | 真实维度科技控股(珠海)有限公司 | Non-coplanar puncture template manufacturing method based on bony multipoint positioning and template |
CN113244516B (en) * | 2021-07-05 | 2021-10-08 | 真实维度科技控股(珠海)有限公司 | Non-coplanar puncture template manufacturing method based on bony multipoint positioning and template |
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