CN111467051A - Head restraint support for operation - Google Patents
Head restraint support for operation Download PDFInfo
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- CN111467051A CN111467051A CN202010292604.3A CN202010292604A CN111467051A CN 111467051 A CN111467051 A CN 111467051A CN 202010292604 A CN202010292604 A CN 202010292604A CN 111467051 A CN111467051 A CN 111467051A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
- A61B90/14—Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
- A61G13/00—Operating tables; Auxiliary appliances therefor
- A61G13/10—Parts, details or accessories
- A61G13/12—Rests specially adapted therefor; Arrangements of patient-supporting surfaces
- A61G13/1205—Rests specially adapted therefor; Arrangements of patient-supporting surfaces for specific parts of the body
- A61G13/121—Head or neck
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Abstract
The invention relates to a surgical restraint support, comprising at least a control device and a restraint support, the control device being configured to: the method comprises the steps of drawing up at least three fixed points based on a scanned image of a head, adjusting at least two opposite multi-dimensional positioning units on one axis to fix the head and determine positioning parameters, and determining the positioning parameters of at least one multi-dimensional positioning unit based on the positioning parameters of the at least two opposite multi-dimensional positioning units, so that the directions and the extensions of the positioning pressures of the at least three multi-dimensional positioning units intersect at one point. Under the condition that the head has micro motion, the invention can adaptively adjust the head position or cooperate with the operation angle of the robot for operation, and avoid the movement and change of the operation position, thereby assisting the doctor in the operation.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to a head restraint bracket for an operation.
Background
The surgical robot is called a third-generation surgical revolution and is a novel medical instrument integrating multiple disciplines such as clinical medicine, biomechanics, mechanics, materials science, computer science, microelectronics, mechatronics and the like. For example, in 6 months 1 and 2020, the first example of the chinese robotic total knee joint replacement TKA procedure was performed by the HURWA joint surgery robot in beijing collaborating with hospital orthopedics. Therefore, in the future, an automated auxiliary device in surgery will become a main assistant for the doctor to perform surgery, and help the doctor to perform simple and tedious non-critical work.
Among the current automated support devices for medical technology, devices capable of automatically immobilizing non-anesthetized patients are very lacking. In some simple, non-anesthesia procedures, the physician needs to order the patient to maintain an action or to use a simple restraint strap to secure the patient's surgical site. Such as skin treatment operations, local minimally invasive operations, etc., the effectiveness of the immobilization depends on the individual control of the patient. Particularly, for the elderly with poor control ability or children patients with poor control ability, the micro-movement action is inevitable. Slight movement can cause the change of the angle of the operation and the change of the position of the operation, which is obviously unfavorable for the operation of a doctor, and the displacement of the patient by the doctor can not be adjusted and changed in time, thereby affecting the progress and the effect of the operation. In order to avoid unnecessary surgical accidents, even to increase the speed of the operation, surgeons often use local anesthesia procedures, which results in unnecessary anesthetic abuse for a substantial portion of the surgery, increasing the risk of side effects of exposure of the body to anesthetic agents. Currently, some surgeries implement robotic operation and physicians assist in monitoring. It is more advantageous to use a robot to perform a simple operation on a patient, so that the robot can adjust the operation angle and the operation position according to the displacement of the patient and the change of the operation wound, thereby obtaining the success of the operation without using anesthetic for a slightly painful operation, improving the safety of the operation, and reducing the risk of the operation. Moreover, performing a minimally painful surgery using a robot can reduce the dependence of the physician on local anesthetic measures, and can also reduce the risk of patient side effects to the anesthetic, especially for patients allergic to anesthetic, and can improve the safety during the surgery. However, how to make the robot perform the operation to perform the real-time coordinated adjustment along with the micro-displacement of the patient in the operation process is still an unsolved technical problem. The accuracy of the instant adjustment is the premise of realizing safe operation of the patient.
Chinese patent CN 110522524A discloses a medical standard 90-degree lateral position operation fixing frame and a used sterile assembly, wherein the sterile assembly is made of high-temperature plastic or silica gel and comprises a third support and a second support, one end of the third support is connected to the upper end of the medical standard 90-degree lateral position operation fixing frame, the lower end of the medical standard 90-degree lateral position operation fixing frame is provided with the first support, the second support and the third support are respectively provided with a first fixing plate, a second fixing plate and a third fixing plate, and the first fixing plate is used for fixing lateral anterior superior iliac spines below the body of a patient; the third fixing plate fixes the lateral anterior superior iliac spine above the body of the patient; the second fixing plate fixes the sacrum position of the patient, and the fixing frame adopting the structure of the invention can quickly fix the human body, save the time before the operation and has good fixing effect. However, this patent fixes the head by means of absolute fixation. In actual practice, however, absolute fixation is not achievable. The head cannot be absolutely fixed and always has a certain slight movement with respect to the constraint frame. And a plurality of small movements can shift relative to the restraint frame. In the course of surgery, particularly in the course of surgery performed by a robot, a doctor or the robot needs to adjust the angle and the operation angle of the surgical instrument according to the minute movement, thereby avoiding surgical deviation due to the minute movement of the head. In the operation implementation process, when the head has some micro-motions, the restraint bracket is adjusted in an adaptive manner to achieve the fixing effect, and the technical problem to be solved in the operation purpose is achieved. Furthermore, on the one hand, due to the differences in understanding to the person skilled in the art; on the other hand, since the inventor has studied a lot of documents and patents when making the present invention, but the space is not limited to the details and contents listed in the above, however, the present invention is by no means free of the features of the prior art, but the present invention has been provided with all the features of the prior art, and the applicant reserves the right to increase the related prior art in the background.
Disclosure of Invention
In the prior art, the number of the fixed points of the fixed head part is two, and the fixed end of the fixed head part can only be adjusted in one or two degrees of freedom, so that the fixation is relatively rigid and unstable. Therefore, the fixation effect is generally not ideal at present unless the head is subjected to a large pressure to perform extremely uncomfortable fixation. That is, in the prior art, the head is always fixed in an absolute fixing way, but in practical situations, absolute fixing does not exist, and micro-motion cannot be avoided. In view of the deficiencies of the prior art, the present invention provides a surgical head restraint support, characterized by comprising at least a control device and a restraint support, the control device being configured to: the method comprises the steps of drawing up at least three fixed points based on a scanned image of a head, adjusting at least two opposite multi-dimensional positioning units on one axis to fix the head and determine positioning parameters, and determining the positioning parameters of at least one multi-dimensional positioning unit based on the positioning parameters of the at least two opposite multi-dimensional positioning units, so that the directions and the extensions of the positioning pressures of the at least three multi-dimensional positioning units intersect at one point. According to the invention, each positioning end can move in three degrees of freedom and can be adjusted and fixed at three different angles, so that the stable positioning of the head is realized. The advantage of crossing over one point is that it is advantageous for the head, for example the head, so that the force focus of the head can be concentrated, the basic positioning of the respective positioning ends is stable, and the tendency of a slight movement or displacement of the head can be monitored more sensitively. .
Preferably, the control device is further configured to: adjusting a positioning angle and/or a positioning pressure of at least one multi-dimensional positioning unit based on a movement trend of the head to fix the head to an initial positioning position. The advantage of adjusting the head to the initial positioning position is that the positioning pressure parameter of the positioning end can be adjusted under the condition of timely detecting the change of the positioning pressure or the positioning angle, so that the actual movement of the head is avoided, the head is prevented from shifting, and the smooth operation is ensured.
Preferably, the control device is further configured to: determining a movement trend of the head based on a change in positioning pressure of at least two multi-dimensional positioning units. The control device reduces the moving trend of the head by adjusting the change of each positioning pressure, so that the pressure curve of the positioning pressure at the positioning end is changed in a certain range without actual displacement. Because the positioning end fixes the positioning main body, absolute positioning pressure parameters do not exist, and the positioning pressure value can have a changed condition. The control device adjusts the moving trend of the head based on the curve change of the positioning pressure of the at least one multi-dimensional positioning unit, avoids substantial displacement of the head, and is a preferable technical means for realizing the fixation of the position of the operation.
In the prior art, the head is generally fixed by adopting a pressurizing and fixing mode, the effect of absolute fixing is expected to be approached, and the fixed part has large pressure and is uncomfortable. Absolute fixation is impossible to achieve and small movements are unavoidable. The restraint bracket at least comprises three multi-dimensional positioning units and at least one supporting component, wherein the second multi-dimensional positioning unit and the third multi-dimensional positioning unit are arranged at two ends of the U-shaped bracket in a mutually opposite and respectively multi-dimensionally adjustable mode, at least one first multi-dimensional positioning unit is arranged at least one end of the U-shaped bracket through a rotatable moving rod, and the third multi-dimensional positioning unit moves to a preset fixed point in response to the instruction of a control device. The invention realizes the basic fixation of the head by the way that each positioning end can move in three degrees of freedom and can be adjusted and fixed in three different angles and the fixation center is centralized. Under the condition of micro movement, the micro movement in any direction can be monitored by at least one positioning end, so that the monitoring sensitivity of the micro movement is improved, and the control device can obtain micro movement data of the head. .
Preferably, the multi-dimensional positioning unit at least comprises a linear shaft assembly, a multi-directional joint assembly and a fixing assembly, wherein the linear shaft assembly is fixedly connected with a multi-directional shell of the multi-directional joint assembly through a connecting piece, the linear shaft assembly moves in three degrees of freedom based on multi-angle change of the multi-directional joint assembly, and the multi-directional joint assembly is fixedly connected with the fixing assembly. Due to the arrangement, the linear shaft assembly can move at the first degree of freedom, the second degree of freedom and the third degree of freedom, and the angle adjustment and the displacement adjustment of the positioning end arranged at one end of the linear shaft assembly at three degrees of freedom are realized.
Preferably, the linear shaft assembly comprises a guide rail, in which the carriage is moved without play by means of a threaded spindle, wherein the thread pitch of the threaded spindle is arranged with a pitch angle smaller than a friction angle so that the carriage maintains an instantaneous position in the guide rail in a self-locking manner on the basis of the threaded spindle. This arrangement is such that the carriage does not move in the guide rail due to the weight, and immediate locking of the carriage is achieved.
Preferably, a first stop block is arranged at one end of a slide rail of the multidimensional positioning unit, a second stop block adjacent to the rotating member is arranged at the control end of the lead screw, and the second stop block limits the moving amplitude of the lead screw in a manner between the first stop block and the rotating member under the condition that the rotating member at the control end approaches the first stop block based on the movement of the lead screw. The sliding guide rail is favorable for preventing the sliding guide from sliding off the guide rail, and the distance between the first stop block and the rotating piece can avoid the sliding guide from falling off due to the fact that the screw rod is screwed too tightly.
Preferably, the fixed frame of the carriage of the multi-dimensional positioning unit is detachably defined with a holder, which is connected with a fourth positioning end that moves in an axial direction in parallel with the guide rail with respect to the positioning point of the head in a state where the rotary member is rotated, and that performs three degrees of freedom adjustment based on the rotation of the multi-directional joint assembly connected with the guide rail. This has the advantage that the fourth positioning end is able to adjust the positioning pressure range, the positioning angle with the head, and also to perform a further fixation of the head movement range based on the instructions of the control device.
Preferably, the multi-directional joint assembly comprises a spherical third joint and a multi-directional housing clampingly arranged with the third joint, the third joint being fixed in relative position with respect to the multi-directional housing by means of a fastening element. So set up, can realize the differentiation fixed to the individualized difference of human body, improve the fixed stability of health especially head.
Preferably, the fourth positioning end of the multi-dimensional positioning unit at least comprises a positioning element and/or a surgical element. The positioning element is mechanically connected to the multi-dimensional positioning unit in such a way that it can move with a fixed point within a small range of motion.
The present invention allows for some minimal movement of the head in the event that the conventional surgical restraint frame is not absolutely stationary. When the head slightly moves, the constraint support avoids the operation angle error formed by the slight movement by adaptively adjusting the operation angle of the robot, thereby avoiding operation errors. Moreover, the head restraint frame can adjust the head to return to the original position through the fixed end under the conditions that micro-movement exceeds a certain range and is not beneficial to the adjustment of the surgical angle.
Drawings
FIG. 1 is a simplified schematic of the mechanical structure of the present invention;
FIG. 2 is a schematic diagram of the multi-dimensional positioning unit of the present invention; and
figure 3 is a schematic view of the multi-dimensional positioning unit of the present invention in combination with a retractor.
List of reference numerals
10: a first multi-dimensional positioning unit; 11: a first positioning end; 20: a second multi-dimensional positioning unit; 21: a second positioning end; 30: a third positioning end; 41: a first movable bar; 42: a multi-angle rotating shaft; 43: a second movable bar; 44: a first support assembly; 45: a first connecting rod; 46: a first joint; 47: a support arm; 48: a second joint; 49: a base; 50: fixing a bracket; 51: a support; 202: a linear shaft assembly; 203: a multi-dimensional joint component; 204: a fixing assembly; 205: a guide rail; 206: a carriage; 207: a lead screw; 208: a rotating member; 209: a first blocking speed; 210: a second stopper; 211: a fixing frame; 212: a holder; 213: an opening; 214: a fourth positioning end; 215: axial direction; 216: positioning points; 217: a head portion; 218: a connecting member; 219: a multidirectional housing; 220: a fastening element; 221: a third joint; 222: a first degree of freedom; 223: a second degree of freedom; 224: a third degree of freedom; 225: a joint connecting column; 227: a retractor; 228: a fixed port; 229: detecting a visual object; 230: an optical axis.
Detailed Description
The following detailed description is made with reference to the accompanying drawings.
A surgical head restraint support is characterized by at least comprising a control device and a head restraint support. The control device and the head restraint support are connected in a wired or wireless manner. Preferably, the control device at least comprises one or more of a chip, a server or a processor for sending control instructions. The control device controls the movement of the restraint bracket to realize the fixation of the head of the patient and/or the performance of the minimally invasive surgery.
The invention can be used for realizing minimally invasive surgery by cooperating with a robot at the same time of the head. Therefore, the present invention may also be a fixing device for assisting a minimally invasive surgery, a surgical robot or a surgical assisting device.
In the present invention, the minute movement means a movement within a movement range of 1 cm. Preferably, the micro-movements include angles of rotation and displacements of the head with respect to the head, for example, a deflection of the head by a certain angle belongs to the micro-movements. The angle of head deflection is, for example, 1 degree. Preferably, the head-deflecting angle also includes smaller angles, for example, an angle of 3 minutes to 30 minutes, and an angle of 1 degree to 60 minutes.
A head restraint brace is a brace used to restrain the head and monitor small movements of the head. Preferably, at least one pressure sensor or at least one angle sensor capable of monitoring the moving angle and displacement of the head is arranged on the head restraint bracket.
The head restraint bracket is used for cooperating with a surgical robot to carry out head surgery. Preferably, the surgical robot adjusts the surgical operation angle based on the head micro-motion data monitored by the head restraint bracket. Or, preferably, the head restraint bracket adjusts the head to move to a specified angle or displacement to a specified position based on head movement data sent by the surgical robot, so that the surgical robot can continue to perform the surgery conveniently.
Preferably, the head restraint support carries out instant removal in coordination with the surgical robot based on the removal data that controlling means sent to reduce surgical robot's regulation time and regulation degree of difficulty, improve surgical robot and do accuracy and the degree of safety of performing the operation.
The surgical robot in the present invention is a robot for performing surgery. The surgical robot of the present invention is not limited to a specific type of robot that performs a head surgery, and broadly refers to a robot that can perform a head surgery and any body surgery. The surgical robot can perform data transmission with the head restraint support to perform coordinated movement, so that the surgical site of the patient has a relatively better operation surgical angle or surgical position.
As shown in fig. 1, the constraining scaffold includes at least three multi-dimensional positioning units and at least one support assembly. Preferably, the positioning end of the multi-dimensional positioning unit of the present invention can be detachably positioned at the head. For example, on the surface of the head. In the case of a control command for movement not issued by the control device, the positioning end performs a fine movement within the permissible range in a manner of moving adaptively with the head, and in the case of a control command output by the control device performs a corresponding adjustment of the head movement. The mechanical connection mode of the positioning end and the multi-dimensional positioning unit is an achievable mechanical connection mode.
The first pair of dimensional positioning units 10 are arranged at least one end of the U-shaped bracket through a rotatable moving rod, and the first multi-dimensional positioning unit 10 moves to a preset fixed point in response to the instruction of the control device. The second multi-dimensional positioning unit 20 and the third multi-dimensional positioning unit 30 are arranged at two ends of the U-shaped bracket in a mutually opposite and respectively multi-dimensionally adjustable manner. The three multi-dimensional positioning units relatively fix the head with a non-standard shape from three fixing points, and particularly, the three multi-dimensional positioning units respectively fix the head together at different positioning angles and positioning pressures, so that the initial fixation of the head is realized. In the prior art, the number of the fixed points of the fixed head part is two, and the fixed end of the fixed head part can only be adjusted in one or two degrees of freedom, so that the fixation is relatively rigid and unstable. At present, the movement fixation with only one degree of freedom can be generally carried out, the movement fixation can be relatively stable only under the condition that the head does not rotate, and the rotation of the head cannot be effectively prevented under the condition without anesthesia. Therefore, the fixing effect of absolute fixing is generally not ideal unless the head is subjected to great pressure to perform extremely uncomfortable fixing. The head fixing device has the advantages that each positioning end can move in three degrees of freedom and can be adjusted and fixed at three different angles, and the stable positioning of the head is realized. The present invention allows for small movements of the head while stationary without adjusting the position of the head if the small movements do not affect the performance of the procedure. If the head needs to slightly move in the operation to match the implementation of the operation angle, the positioning end drives the head to realize the slight rotation or slight movement of the head. In particular, in the case of a slight movement of the head, the surgical robot working in cooperation with the head restraint support can adaptively adjust the surgical operation angle and the surgical operation position based on the movement data of the head. The invention breaks through the traditional mode that the head is fixed by absolute fixation in the operation constraint bracket, improves the operation by adapting to the micro movement and improves the operation treatment effect.
The overall structure of the U-shaped bracket is as shown in fig. 1, the second supporting component 60 is movably arranged on the through hole of the cross bar of the U-shaped bracket, and the second supporting component 60 performs height adjustment on the symmetry axis of the U-shaped bracket. Preferably, the second support assembly is adapted to support the head of the patient and provide a support point for the head of the patient. The second support assembly is connected to a first rotatable joint 46. The first joint 46 is a bar joint that enables the support assembly 60 to rotate about the axis of symmetry of the U-shaped bracket. The first joint 46 is connected to the second joint 48 via a support arm 47. The second joint is a rotary joint for adjusting the height of the second support assembly by adjusting the angle of the support arm 47. The second joint 48 is fixed to a cross bar of a base 49. Two ends of the cross rod are erected on the bed body through the fixed support. Preferably, the cross bar 50 is fixed by inserting two brackets 51 on the bed body.
Preferably, the second supporting component 60 includes a seat body and a connecting member, one side of the seat body is provided with a silica gel layer, and the top surface of the silica gel layer is an arc surface. Wherein, the surface of silica gel layer can be provided with sweat-absorbing cloth. The comfort of the head can be improved by the arrangement.
Preferably, the two vertical rods of the U-shaped bracket are each provided with a first support member 44. Wherein first supporting component 44 sets up on the montant with rotatable mode to realize medical personnel's arm support when necessary moment, avoid medical personnel to appear the not enough condition that influences the operation effect of strength under the condition that the arm needs supplementary strength to support.
Preferably, the first multi-dimensional positioning unit of the present invention comprises a multi-dimensional positioning unit and a first positioning terminal 11. The first positioning end is C-shaped so as to fix the forehead, the nose or the back brain of the patient. The radian of the C-shaped part can be different or special-shaped according to different fixing parts. The second multi-dimensional positioning unit comprises a multi-dimensional positioning unit and a second positioning end 21. The second positioning end 21 is a rod-shaped fixture so that it can be fixed in a smaller hole, such as an earhole. The third multi-dimensional positioning unit comprises a multi-dimensional positioning unit and a third positioning end 31. The third positioning end 31 is shaped like an ear profile and is used for fixing the ear skull of the patient.
Preferably, the types and the numbers of the first positioning end, the second positioning end and the third positioning end are not limited to the installation sequence shown in the figure, and the installation can be performed as required, for example, all the first positioning ends, all the second positioning ends and the like. For example, all three first multi-dimensional positioning units can fix the local surgical area of the leg, so that skin-like surgery is performed without anesthesia. Preferably, the first positioning end, the second positioning end and the third positioning end are provided with sensors or sensing layers for monitoring the positioning pressure or the positioning angle of the fixed point. Preferably, the sensor comprises a pressure sensor.
Preferably, as shown in fig. 2, the multi-dimensional positioning unit at least comprises a linear shaft assembly 202, a multi-directional joint assembly 203 and a fixing assembly 204, wherein the linear shaft assembly 202 is fixedly connected with a multi-directional housing 219 of the multi-directional joint assembly 203 through a connecting piece 218, the connecting piece is shaped like L, the long end is fixedly connected with the linear shaft assembly 202 through a bolt, and the short end is fixedly connected with the multi-directional housing 219 of the multi-directional joint assembly 203, such as welding or bolting.
The linear shaft assembly 202 moves in three degrees of freedom based on the multi-angle change of the multi-directional joint assembly 203, and the multi-directional joint assembly 203 is fixedly connected with the fixing assembly 204. The arrangement is such that the linear shaft assembly 202 can move in the first degree of freedom 222, the second degree of freedom 223 and the third degree of freedom 224, and the angle adjustment and the displacement adjustment of the positioning end arranged at one end of the linear shaft assembly 202 in three degrees of freedom are realized. Preferably, the linear shaft assembly 202 includes a guide rail 205. The carriage 206 is guided by the spindle 207 in the guide rail 205 without play, so that the carriage 206 is guided without play. Wherein the pitch of the lead screw 207 is set with a pitch angle smaller than a friction angle, so that the carriage 206 maintains an instantaneous position within the guide rail 205 based on the lead screw 207 being self-locking. This arrangement is such that the carriage 206 does not move in the guide rail 205 due to the weight, and immediate locking of the carriage 206 is achieved.
One end of the slide rail 205 of the multi-dimensional positioning unit is provided with a first stopper 209. The first stopper is arranged at one end of the principle head of the slide rail. The control end of the lead screw 207 is provided with a second stop 210 adjacent to the rotary member 208. The rotating member may be a fixed knob. Preferably, the control end is the end remote from the head. When the rotary member 208 on the control end approaches the first stopper 209 based on the movement of the lead screw 207, the second stopper 210 limits the movement range of the lead screw 207 so as to be interposed between the first stopper 209 and the rotary member 208. This has the advantage, firstly, of preventing the carriage from sliding off the guide 205, and, secondly, of providing a distance between the first stop and the rotary member to avoid that the carriage will fall off due to too tight a tightening of the screw 207. By turning the rotary member 208, the pitch of the lead screw 207 is selected according to the direction of the thread, and an axial displacement of the carriage in the guide rail is achieved. Wherein the carriage 206 is continuously moved within a distance limited by the first and second stoppers and maintains an instantaneous position due to the self-locking function
Preferably, the fixed frame 211 of the carriage 206 of the multi-dimensional positioning unit is removably defined with a holder 212. The end of the holder 212 facing the head is provided with an opening 213. The shape of the opening 213 is not limited, and may be various shapes. The retainer 212 is coupled to the fourth alignment end 214 through the opening 213. In the rotated state of the rotary member 208, the fourth positioning end 214 is moved in an axial direction 215 parallel to the guide rail relative to the positioning point 216 of the head, so that the fourth positioning end is also moved in an axial direction parallel to the guide rail. The fourth positioning end 214 is adjustable in three degrees of freedom based on rotation of the multi-directional joint assembly 203 coupled to the guide track 205. The fourth positioning end is a generic name of the first positioning end, the second positioning end or the third positioning end. The advantage of this is that the fourth locating end can adjust the locating pressure and the locating angle with the head, and can also be further adjusted and fixed based on the moving trend of the patient.
Preferably, the holder 212 in the fixing frame 211 may also be a laser for guiding a surgical operation, a flexible miniature endoscope for performing an examination throughout the valley region, a small noise source for intra-operative audiometry, etc., thereby assisting the medical staff to obtain more accurate data of the medical condition.
Preferably, the multi-directional joint assembly 203 comprises a spherical third joint 221 and a multi-directional housing 219 clampingly arranged with the third joint 221. Preferably, the spherical third joint enables rotation and fixation of the multidirectional housing 219 in any direction. The third joint 221 is secured to the fixation assembly 204 by a joint connection post 225. It is preferred. The fixed component 204 is a base. Preferably, an angle sensor is disposed on a side of the multi-directional housing 219 that contacts the third joint 221. Preferably, the angle sensor may be a magnetic field direction sensor. Preferably, the spherical third joint is provided with a dipole field transmitter, and the multidirectional housing 219 is provided with at least two magnetic field direction sensors. The magnetic field direction sensor interacts with the magnetic field generated by the field transmitter. Wherein the measurement coordinate axes (X, Y) of the magnetic field direction sensor lie in a plane and are not parallel to each other. Only one pole of a two-pole field transmitter is arranged on the spherical surface of the third joint. The two magnetic field direction sensors are arranged on the circuit board at an angle of 90 degrees. The circuit board is arranged inside the multidirectional housing 219. The magnetic field direction sensor determines the angle of rotation by detecting the reluctance of the field transmitter. Preferably, a fastening element 220 for clamping the spherical third joint 221 is provided in the multidirectional housing 219. The third joint 221 is fixed in relative position with respect to the multidirectional housing 219 by a fastening element 220. The fastening element 220 is snapped into and out of the multidirectional housing 219. The fixing assembly 204 is fixed on the U-shaped bracket at the required position. In the relaxed state of the fastening element 220, the linear axis assembly 202 can be rotated in three degrees of freedom about a third joint 221 fixed to the base. Preferably, the three-dimensional position of the three degrees of freedom is maintained by spring clamping. The fastening element is a clamping screw. The momentary position is maintained by the spring force and the axial force of the clamping screw 220 on the spherical third joint surface. Preferably, the clamping screw 220 is connected to the control device in an implementable manner, for example, to enable automatic control of the three degrees of freedom of the fourth positioning end based on instructions from the control device. The rotating member at the control end of the lead screw 207 is a micro rotating motor, and the motor is connected with the control device to automatically control the axial displacement and the positioning pressure at the fourth positioning end. So set up, can realize the differentiation fixed to the individualized difference of human body, improve the fixed stability of health especially head.
Therefore, the fourth positioning end of the multi-dimensional positioning unit can freely and flexibly perform four-dimensional positioning on the axial direction 215, the first degree of freedom 222, the second degree of freedom 223 and the third degree of freedom 224, and can further realize the directions and angles of various positioning forces, so as to fix the head under a comfortable condition.
As shown in fig. 3, the multi-dimensional positioning unit can be used in conjunction with a retractor to assist in performing minimally invasive surgery of a wound. The fixation assembly 204 is also attached to one end of the retractor by a connector. A surgical device, such as a laser or an illumination device, is mounted within the fixed frame 211 to operate or illuminate the area within the wound with the wound pulled open.
The multi-dimensional positioning unit can be automatically controlled by a control unit, can also be semi-automatically controlled, and even can be completely manually controlled. As shown in fig. 3, a laser surgical device is installed in the fixing frame 211, and a medical staff checks and confirms the location point of the laser by looking at the wound inner area through a microscope or an optical axis of eyes. After confirming the error-free, the laser surgery was performed. This has the advantage that on the basis of assisting wound pull-apart, it can be flexibly moved in four dimensions to accurately reach any positioning point and the axial distance of the laser can be adjusted, thus better cutting the wound, the opening in the external auditory canal or the skull for various operations. The fourth positioning end in the multi-dimensional positioning unit at least comprises a positioning element and/or a surgical element. Preferably, the fourth positioning end further comprises a micro-scalpel blade capable of cutting soft tissue.
Preferably, a pressure sensor for sensing the pressure is arranged in or at the end part of the fourth positioning end. An angle sensor for detecting angle data is provided in the multidirectional housing 219. The pressure sensor and the angle sensor are connected with the control device.
Preferably, in a semi-automatic control mode, the medical head fixing device further comprises a display device, such as a display screen, the control device collects pressure data and angle data of the multi-dimensional positioning unit and gives prompt information for fixing, and medical staff can conveniently adjust the pressure and the angle of the multi-dimensional positioning unit so as to accurately fix the head. Or, the medical staff presets a positioning point, and the control device adjusts the positioning pressure and the positioning angle of the positioning point.
In the fully automatic control mode, the control device determines a positioning point, a positioning angle, and a positioning direction based on the scanned image of the head. Preferably, in the case of acquiring patient information, the control device determines a pressure threshold value and a positioning angle of positioning based on the patient information and the head, and implements preliminary head fixation.
Preferably, the control device is connected with a database for acquiring pressure threshold and positioning angle reference information, positioning point information and the like corresponding to the patient information.
Preferably, the control device is configured to:
s1: at least three anchor points are drawn up based on the scanned image of the head. Preferably, the apparatus for scanning an image may be an image pickup device. Preferably, the control device develops at least three positioning points whose directions and extensions can intersect at a point based on the scanned image of the head and reference information of the database, and adjusts the positions of the at least three multi-dimensional positioning units based on the reference positioning parameters.
In the prior art, a common positioning device only considers positioning the head from different angles, but does not relate to whether the forces of different positioning points intersect with each other, so that the head cannot be effectively and stably fixed. Particularly, when the skin surface is positioned, the skin is deformed and loosened due to the time of pressure compression, the fixing force is dispersed and not concentrated under the condition that the force does not have an intersection point, and the head is easy to move under the condition of not anaesthetizing and conscious, so that the operation part is displaced. The invention enables the positioning pressure of the head, particularly the head, to be concentrated and the skull of the head not to be easily displaced to a large extent by intersecting the direction and the extension of the positioning pressure at one point. In the case of a minute motion of the head, at least one of the positioning ends can change an angle based on the minute motion of the head, thereby obtaining data of the minute motion of the head. .
S2: at least two opposing multi-dimensional positioning units fix the head in one axis in a manner that allows for minor head movement and determine positioning parameters.
As shown in FIG. 1, the skull fixation will be described as an example. Preferably, the three multi-dimensional positioning units include a first multi-dimensional positioning unit 10, a second multi-dimensional positioning unit 20 and/or a third multi-dimensional positioning unit 30. The first multi-dimensional positioning unit 10 is used for fixing the hindbrain or the forehead and the bridge of the nose. The second multi-dimensional positioning unit 20 and the third multi-dimensional positioning unit 30 are oppositely disposed due to the ears of the fixed head. Wherein the fixed end of the second multi-dimensional positioning unit 20 is a tapered fixation post for fixation of the skull in the region of the external ear canal when the headrest is closed. The positioning end of the third multi-dimensional positioning unit 30 is an ear cup and surrounds the outer ear for fixing the skull from outside the ear, thus avoiding slipping. The earmuff is also advantageous in that it can isolate the ear from external sounds as needed, distracting the patient. Preferably, the second multi-dimensional positioning unit 20 and the third multi-dimensional positioning unit 30 can be both provided as ear cups, or both provided as tapered fixing posts. The fixed end of the second multi-dimensional positioning unit 20 is configured as a conical fixed column, which is advantageous in facilitating the medical staff to communicate information to the patient through the corresponding examination sound.
Preferably, the positioning ends of at least two opposite multi-dimensional positioning units can move based on the micro-motion of the head, and the movement data of the positioning ends is sent to the control device. The advantage of at least two opposing multi-dimensional positioning units securing the head in one axis in a manner allowing a small movement of the head and determining the positioning parameters is that the second multi-dimensional positioning unit 20 and the third multi-dimensional positioning unit 30 are arranged relative to each other creating a slight bi-directional pressure, securing the head from the first dimension painlessly and non-invasively, avoiding a large rotation of the head in the first dimension, only allowing a small movement. The range of large-amplitude rotation here exceeds the range of small movements. In the prior art, due to the lack of consideration on the positioning pressure or the positioning angle, the head is absolutely fixed at an angle, the head is uncomfortable to press due to the huge pressure, and the adaptive adjustment of the operation angle cannot be realized under the condition that the head does a micro motion. The invention can only make the head slightly move in the first dimension by monitoring and adjusting the micro-movement direction and angle of the positioning pressure through the control device. In particular, the control device performs adjustment of the positioning pressure based on a variation of the positioning pressure of the positioning end, so that the second positioning end and the third positioning end are adjusted based on a minute movement of the head in the first dimension to avoid a rotational displacement of the head. For example, if the positioning pressure at the first positioning end becomes small and the positioning pressure at the second positioning end becomes large, the head portion slightly moves in a plane toward the second positioning end. The control device correspondingly adjusts the displacement of the first positioning end and the second positioning end of the first multi-dimensional positioning unit 10 based on the pressure change, so that the multiple multi-dimensional positioning units are adaptively adjusted to adapt to the small displacement of the head, and the head rotation caused by the fact that the pressure of a certain positioning end is reduced and fixed looseness is avoided.
S3: the positioning parameters of at least one multi-dimensional positioning unit are determined based on the positioning parameters of at least two opposite multi-dimensional positioning units, so that the directions of the positioning pressures of at least three multi-dimensional positioning units and the extensions thereof intersect at a point. The advantage of crossing at a point is that the focus of the force of the head can be concentrated, the positioning of each positioning end is stable and does not move to the maximum extent, and the large-amplitude rotation of the head in any direction is avoided.
In the operation, the operation angle is very important, and if the operation angle is not changed, the movement of the head basically does not influence the progress of the operation. Therefore, the head restraint bracket and the surgical robot are cooperatively adjusted to realize that the surgical operation angle is relatively unchanged, and the surgical progress is not influenced by the micro motion of the patient.
Preferably, the control device sends a cooperative adjustment instruction for cooperatively adjusting the surgical operation angle to the surgical robot based on the head micro-motion monitored by the head restraint bracket, so that the mobile robot responds to the cooperative adjustment instruction to perform the instant adjustment of the surgical operation angle in a manner that the surgical operation angle is matched with the surgical position. The control device indicates the surgical robot to coordinate and adjust based on the micro movement of the head, and has the advantages that under the condition that the micro movement of the patient occurs, the surgical robot can coordinate and adjust based on the change of the surgical position, so that the micro movement amplitude of the patient cannot influence the surgical progress, and the safety of the patient is ensured.
Preferably, the control device selectively adjusts the positioning pressure of the positioning end of the multi-dimensional positioning unit of the relevant angle based on the change of the surgical operation angle of the surgical robot, thereby promoting the head to make a small movement in a direction favorable for the surgical operation angle. The arrangement can avoid surgical errors caused by small movement amplitude of the head in the process of surgical operation. For example, when the surgical robot performs a certain surgical operation, any micro-motion in the first direction is not beneficial to the surgical operation, and the positioning end of the head restraint bracket related to the force application in the first direction increases the positioning pressure, so that the possibility that the patient performs micro-motion in the first direction is avoided, and the micro-motion can occur in other directions under the condition that the patient cannot tolerate the micro-motion.
Preferably, the manner of coordinating the head restraint support with the surgical robot further comprises:
the surgical robot adjusts the compensation distance of the surgical operation device based on the adjustment instruction sent by the control device according to the change of the micro-motion of at least one positioning end of the head restraint bracket, so that the surgical progress is not affected, and surgical deviation caused by the change of the distance is avoided.
The control device continuously compares the comprehensive movement amplitude formed by at least two continuous micro movement amplitudes with a movement threshold value, and under the condition that the comprehensive movement amplitude exceeds or pre-exceeds the movement threshold value, the control device adjusts the position of the head in a mode of promoting the head to move to an initial positioning state through positioning of the positioning end in a time interval when the operation of the surgical robot is stopped, so that the head is prevented from generating larger change of the operation position due to the continuous micro movement amplitudes. The amount of change causes qualitative change, and the accumulation of multiple minute movements tends to cause a large range of rotation amplitude or displacement in the position of the head from the initial position. Therefore, the operation angle of the surgical robot is adjusted based on the displacement of the head, and meanwhile, the overall movement or rotation trend of the head is monitored, so that the adjustment state of the surgical robot is in the range of the achievable adjustment state, and the smooth operation is favorably ensured.
The control device selectively adjusts the positioning pressure and/or the positioning angle of at least one positioning end based on the difficulty index of the surgical operation angle adjustment fed back by the surgical robot based on the head movement tendency so as to promote the head movement tendency toward a slight movement amplitude corresponding to a lower difficulty index of the surgical operation angle adjustment in a manner of changing the head movement tendency. The adjustment of the surgical robot is not unlimited and universal, and there is a certain adjustment limit. Therefore, how to realize the adjustment with lower difficulty index in the head restraint bracket and the surgical robot are also important problems that the control device needs to coordinate. The control device needs a control plan with the cooperative movement of the surgical robot based on the movement trend of the head. The control plan necessarily has a corresponding difficulty index of the adjustment of the surgical operation angle. With a higher difficulty index adjustment, the risk of failure is also relatively high. Therefore, the reduction of the operation adjusting difficulty of the operation robot is also an important factor for ensuring the accuracy and smoothness of the operation, and is beneficial to improving the safety of the operation.
Preferably, the control device is further configured to: determining a movement trend of the head based on changes of the positioning pressure of at least two multi-dimensional positioning units to adjust an adjustment plan of the surgical robot for surgical operation angle adjustment. For example, when the pressure curve of the positioning pressure at the second positioning end tends to become smaller and the pressure curve of the positioning pressure at the third positioning end tends to become larger, the head portion has a tendency to move toward the third positioning end, and the control device determines the adjustment plans of the at least two surgical robots based on the tendency to move. The advantage of such an arrangement is that the control device reduces the tendency of the head to move by adjusting the respective positioning pressure change before the actual displacement of the head, for example, of the head, so that the pressure curve of the positioning pressure at the positioning end changes within a certain range without the actual displacement or rotation which is unfavorable for the operation. That is, the control means fixes the head in such a manner that the pressure value of the positioning pressure of the adjustment at least one positioning end varies within a preset range to adjust the movement tendency of the head. Because the positioning end fixes the head, absolute positioning pressure parameters do not exist, and the positioning pressure value can have a changed condition. The control device adjusts the movement trend of the head on the basis of the curve change of the positioning pressure of the at least one multi-dimensional positioning unit, and avoids substantial unfavorable displacement of the head.
Preferably, the control device is connected with at least one database in which the adjustment plan information and the difficulty index information of the surgical robot are prestored. The database can be one or more of a server and a storage chip for storage. Preferably, before the surgery is started, the control device updates the difficulty index in the database in such a manner that each operation of the surgical robot is detected. In practical cases, the flexibility of each joint of the surgical robot is also related to maintenance, and therefore, the difficulty index of the surgical operation adjustment plan of the surgical robot is not a fixed value. The updating of the difficulty index of the database by the control device can be beneficial to the cooperative adjustment of the head restraint bracket and the surgical robot, the risk that the surgical robot breaks down or acts for a long time due to the large difficulty index of the adjustment in the operation process is avoided, the safety of the operation completion is improved, and the risk of operation failure is reduced.
Preferably, the control device includes not only a single-function server but also a data analysis unit, an instruction issuing unit, and a control machine. The data analysis unit may be an application specific integrated chip. The instruction issue unit may be an application specific integrated chip. The control mechanism is a device for mechanically adjusting at least one multi-dimensional positioning unit in response to a command from the command issuing unit, such as a rotation motor for controlling a rotation knob and an angle adjusting mechanism. The angle adjusting mechanism may be a lever structure, a robot structure, or the like in response to a command of the command issuing unit.
It should be noted that the above-mentioned embodiments are exemplary, and that those skilled in the art, having benefit of the present disclosure, may devise various arrangements that are within the scope of the present disclosure and that fall within the scope of the invention. It should be understood by those skilled in the art that the present specification and figures are illustrative only and are not limiting upon the claims. The scope of the invention is defined by the claims and their equivalents.
Claims (10)
1. A surgical head restraint bracket is characterized by at least comprising a control device and a restraint bracket,
the control device is configured to:
at least three fixation points are drawn up based on the scanned image of the head,
adjusting at least two opposing multi-dimensional positioning units in one axis to fix the head and determine positioning parameters,
determining the positioning parameters of at least one multi-dimensional positioning unit based on the positioning parameters of the at least two opposite multi-dimensional positioning units, so that the directions and the extensions of the positioning pressures of at least three multi-dimensional positioning units intersect at a point.
2. The surgical head restraint cradle of claim 1, wherein the control device is further configured to:
adjusting a positioning angle and/or a positioning pressure of at least one multi-dimensional positioning unit based on a movement trend of the head to fix the head to an initial positioning position.
3. The surgical head restraint cradle of claim 2, wherein the control device is further configured to:
determining a movement trend of the head based on a change in positioning pressure of at least two multi-dimensional positioning units.
4. A surgical head restraint cradle according to any one of the preceding claims, characterized in that the restraint cradle comprises at least three multi-dimensional positioning units and at least one support assembly,
the second multi-dimensional positioning unit (20) and the third multi-dimensional positioning unit (30) are arranged at two ends of the U-shaped bracket in a mutually opposite and respectively multi-dimensionally adjustable mode,
at least one first multi-dimensional positioning unit (10) is arranged at least one end of the U-shaped bracket through a rotatable moving rod, and the third multi-dimensional positioning unit (10) moves to a preset fixed point in response to the instruction of a control device.
5. Surgical head restraint support according to one of the preceding claims, characterized in that the multi-dimensional positioning unit comprises at least a linear shaft assembly (202), a multi-directional joint assembly (203) and a fixation assembly (204), wherein,
the linear shaft assembly (202) is fixedly connected with a multidirectional shell (219) of the multidirectional joint assembly (203) through a connecting piece (218), the linear shaft assembly (202) moves in three degrees of freedom based on multi-angle change of the multidirectional joint assembly (203),
the multi-directional joint component (203) is fixedly connected with the fixing component (204).
6. The surgical head restraint cradle according to claim 5, characterized in that the linear shaft assembly (202) includes a guide rail (205),
the carriage (206) is moved in the guide rail (205) without play by means of a spindle (207), wherein,
the pitch of the threaded spindle (207) is arranged at a pitch angle that is smaller than the friction angle so that the carriage (206) maintains an instantaneous position within the guide rail (205) on the basis of the threaded spindle (207) being self-locking.
7. Surgical head restraint bracket according to one of the preceding claims, characterized in that one end of the slide rail (205) of the multi-dimensional positioning unit is provided with a first stop (209),
a second stopper (210) adjacent to the rotating member (208) is provided at the control end of the lead screw (207), and the second stopper (210) limits the movement range of the lead screw (207) so as to be interposed between the first stopper (209) and the rotating member (208) when the rotating member (208) at the control end approaches the first stopper (209) based on the movement of the lead screw (207).
8. Surgical head restraint bracket according to one of the preceding claims, characterized in that a fixing frame (211) of the carriage (206) of the multi-dimensional positioning unit detachably defines a holder (212), the holder (212) being connected with a fourth positioning end (214),
in the state that the rotating member (208) is rotated, the fourth positioning end (214) moves in parallel with the guide rail in the axial direction (215) with respect to the positioning point (216) of the head, and
the fourth positioning end (214) is adjusted in three degrees of freedom based on the rotation of a multi-directional joint assembly (203) connected with the guide rail (205).
9. Surgical head restraint support according to one of the preceding claims, characterized in that the multidirectional joint assembly (203) comprises a spherical third joint (221) and a multidirectional housing (219) arranged clampingly with the third joint (221),
the third joint (221) is fixed in relative position with respect to the multidirectional housing (219) by a fastening element (220).
10. A surgical head restraint cradle according to any one of the preceding claims, wherein a fourth positioning end in the multi-dimensional positioning unit comprises at least a positioning element and/or a surgical element.
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| CN202010292604.3A CN111467051B (en) | 2020-04-16 | 2020-04-16 | Head restraint support for operation |
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| CN202010292604.3A CN111467051B (en) | 2020-04-16 | 2020-04-16 | Head restraint support for operation |
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| CN111467051B CN111467051B (en) | 2021-01-12 |
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| CN202010292604.3A Expired - Fee Related CN111467051B (en) | 2020-04-16 | 2020-04-16 | Head restraint support for operation |
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| CN112168591A (en) * | 2020-09-29 | 2021-01-05 | 黑龙江省医院 | Head restraint device for ophthalmologic operation and operation method |
| CN112402032A (en) * | 2020-12-03 | 2021-02-26 | 曹科 | Head fixing device for ophthalmic therapy |
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| CN114748299A (en) * | 2022-04-02 | 2022-07-15 | 郑州大学第一附属医院 | Head fixing device for nerve intervention operation |
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