CN113781861B - Single-channel interventional operation simulation device and simulation control method - Google Patents
Single-channel interventional operation simulation device and simulation control method Download PDFInfo
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- CN113781861B CN113781861B CN202111096055.3A CN202111096055A CN113781861B CN 113781861 B CN113781861 B CN 113781861B CN 202111096055 A CN202111096055 A CN 202111096055A CN 113781861 B CN113781861 B CN 113781861B
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Abstract
The invention discloses a single-channel interventional operation simulation device and a simulation control method. The simulation device comprises a base body, wherein three detection stations are arranged on the base body, intervention channels serving as walking channels of interventional surgical instruments are respectively arranged on the detection stations, and detection assemblies used for detecting the passed interventional surgical instruments are respectively arranged at the detection stations; the detection station comprises an inlet detection station, a middle detection station and a tail end detection station. The invention can respectively introduce the inserted guide wires into the channels, simulate the operation of interventional operations, ensure that the hand feeling of the guide wire insertion operation is fit for clinic, detect the state of the guide wires and achieve the aim of simulation training.
Description
Technical Field
The invention relates to an interventional operation simulation device and a control method based on the simulation device.
Background
The interventional operation is a common surgical minimally invasive operation and is mainly used for operations such as acute coronary occlusion, chronic coronary occlusion, cerebrovascular blockage, cerebral hemangioma, thoracic aortic aneurysm, lower limb stenosis and the like, and the operation is difficult and has high requirements on the skills of doctors.
Instruments used in the operation mainly comprise a catheter, a stent, a guide wire and the like. The catheter firstly enters the body, and the guide wire and the stent are both arranged in the catheter; the guide wire runs along the catheter under the support of the bracket and is used as a core operation tool to reach a target position for corresponding operation.
In order to assist doctors in performing double-guide-wire interventional operation practice, accumulate operation experience and improve operation level, a device capable of simulating an interventional operation is needed. The device must be able to introduce a guide wire into the channel and enable detection of instruments such as catheters, stents and guide wires. The prior art does not have the device, and the purpose of simulated training cannot be achieved.
Disclosure of Invention
The invention provides a single-channel interventional operation simulation device and a simulation control method, and aims to provide the following steps: an interventional operation simulation device is provided, which can introduce a guide wire into a channel, detect a catheter, a bracket and the guide wire and provide feedback data for simulation training.
The technical scheme of the invention is as follows:
a single-channel type interventional operation simulation device comprises a base body, wherein a plurality of detection stations are arranged on the base body, interventional channels used as walking channels of interventional surgical instruments are respectively arranged on the detection stations, and detection assemblies used for detecting the passing interventional surgical instruments are respectively arranged at the detection stations;
the detection stations comprise an inlet detection station, a middle detection station and a tail end detection station;
the intervention channel of the inlet detection station is communicated with the rear end of the intervention channel of the middle detection station through a connecting pipe assembly; the front end of the intervention channel of the middle detection station is communicated with the rear end of the intervention channel of the tail end detection station through a connecting pipe assembly;
the connecting pipe assembly is telescopic.
As a further improvement of the above simulation apparatus: each detection station is provided with a diameter detection mechanism serving as the detection assembly; the diameter detection mechanism comprises an encoder, a rotating block and a return spring;
the encoder is arranged on the base body, and the rotating block is arranged on a rotating shaft of the encoder;
an opening is formed in the intervention channel, and the rotating block is located at the opening;
the rotating block is provided with a first extending part; the reset spring is connected with the rotating block and used for pushing the rotating block to rotate so that the first extending part is contacted with the inner wall part on the intervention channel, which is positioned on the opposite side of the opening.
As a further improvement of the above simulation apparatus: at least one detection station is provided with a clamping mechanism for simulating plaque obstruction; the clamping mechanism comprises a movable contact block arranged in a through hole at the bottom of the intervention channel and a pushing mechanism used for pushing the movable contact block to move upwards.
As a further improvement of the above simulation apparatus: the pushing mechanism comprises a push rod motor, a connecting rod, a rotary connecting block and a flexible ejector head;
the push rod motor is arranged on the base body, and the rotary connecting block is arranged on the base body in a rotating fit manner;
one end of the connecting rod is rotatably connected with a telescopic rod of the push rod motor, the other end of the connecting rod is rotatably connected with one end of the rotating connecting block, and the flexible ejecting head is installed at the other end of the rotating connecting block and is used for being in contact with the bottom of the movable contact block.
As a further improvement of the above simulation apparatus: the detection assembly at least at one of the middle detection station and the tail end detection station comprises a diameter detection mechanism, a movement state detection device for detecting the displacement and/or rotation angle of an interventional surgical instrument in an interventional channel and a clamping mechanism for simulating plaque obstruction;
the diameter detection mechanism comprises an encoder, a rotating block and a return spring; the encoder is arranged on the base body, and the rotating block is arranged on a rotating shaft of the encoder; an opening is formed in the intervention channel, and the rotating block is located at the opening; the rotating block is provided with a first extending part; the reset spring is connected with the rotating block and used for pushing the rotating block to rotate so as to enable the first extending part to be in contact with the inner wall part of the intervention channel, which is positioned on the opposite side of the opening;
the detection point of the moving state detection device and the clamping point of the clamping mechanism are respectively positioned at two sides of the opening.
As a further improvement of the above simulation apparatus: the connecting pipe assembly comprises an inner pipe, an outer pipe, a positioning sleeve and a compression spring; the front end of the inner tube is inserted into the rear end of the outer tube, the positioning sleeve is fixed on the outer wall of the inner tube, the front end of the compression spring is in contact with the rear end face of the outer tube, and the rear end of the compression spring is in contact with the front end face of the positioning sleeve.
The invention also provides a simulation control method based on the simulation device, which comprises the following steps:
in the execution process of the steps, the detection assembly sends the detected data to the upper computer in real time, and the upper computer compares the detected data with preset operation data and judges whether the requirements are met.
As a further improvement of the above control method: and if the sequence of the detection data obtained by the upper computer does not accord with the steps 1 to 3, or the judgment result of the upper computer after the detection data is obtained does not meet the requirement, the upper computer sends an alarm to prompt an operation error.
As a further improvement of the above control method: at least one detection station is also provided with a clamping mechanism for simulating plaque obstruction;
when the upper computer detects that the interventional surgical instrument reaches the preset plaque position, the corresponding clamping mechanism is controlled to clamp the interventional surgical instrument in the interventional channel at the position, and the situation that the interventional surgical instrument meets the plaque is simulated.
Compared with the prior art, the invention has the following beneficial effects: (1) The device can introduce the guide wire into the channel, simulate interventional operation, enable the hand feeling of the guide wire insertion operation to be fitted clinically, further arrange detection components at different stations, and respectively and independently detect the catheter, the bracket and the guide wire so as to achieve the aim of simulation training; (2) For the guide wire with a small diameter, the relative positions of the clamping mechanism, the diameter detection mechanism and the moving state detection device are reasonably arranged, and the detection of the moving state detection device is prevented from being influenced when the clamping mechanism acts.
Drawings
FIG. 1 is a schematic view of the overall structure of the apparatus;
FIG. 2 is a schematic structural view of a detection assembly of an inlet detection station and a corresponding clamping mechanism of the device;
FIG. 3 is a schematic view of the structure of the intermediate/end sensing assembly portion and the corresponding clamping mechanism portion;
FIG. 4 is a schematic structural view of a connector assembly;
fig. 5 is an exploded view of the connector assembly.
Detailed Description
The technical scheme of the invention is explained in detail in the following with the accompanying drawings:
referring to fig. 1, a single-channel interventional operation simulation device and a simulation control method thereof include a base 1 formed by a metal frame body processed by CNC, and three detection stations, namely an entrance detection station 2, a middle detection station 4 and a tail end detection station 5, are arranged on the base 1. Referring to fig. 2 and 3, each detection station is provided with an intervention channel 100 as a walking channel of an intervention surgical instrument, and each detection station is also provided with a detection assembly for detecting the passed intervention surgical instrument.
In this embodiment, the access passage 100 is defined by a through groove at the top of the base on the substrate 1 and a cover plate located above the through groove.
As shown in fig. 1, the intervention channel 100 of the entrance detection station 2 is communicated with the rear end of the intervention channel 100 of the intermediate detection station 4 through a connecting tube assembly 3; the front end of the intervention channel 100 of the middle detection station 4 is communicated with the rear end of the intervention channel 100 of the tail end detection station 5 through a connecting pipe component 3.
The connecting pipe assembly 3 is telescopic. As shown in fig. 4 and 5, the connection pipe assembly 3 includes an inner pipe 3-1, an outer pipe 3-4, a positioning sleeve 3-2, and a compression spring 3-3; the front end of the inner tube 3-1 is inserted into the rear end of the outer tube 3-4, a set screw at the side of the positioning sleeve 3-2 is fixed on the outer wall of the inner tube 3-1, the front end of the compression spring 3-3 is in contact with the rear end face of the outer tube 3-4, and the rear end of the compression spring is in contact with the front end face of the positioning sleeve 3-2. During installation, the length of the connecting pipe assembly 3 is firstly shortened, the front end and the rear end of the connecting pipe assembly are respectively aligned to the front channel and the rear channel, and then the connecting pipe assembly 3 is gradually loosened to extend to complete installation. The telescopic structure can reduce the installation difficulty, and the installation can be completed without disassembling the base body 1.
As shown in fig. 2 and 3, each detection station is provided with a diameter detection mechanism (one of the detection components); the diameter detection mechanism comprises an encoder 200-1, a rotating block 200-2 and a return spring 200-3.
The encoder 200-1 is an absolute type and is installed on the base body 1, and the rotating block 200-2 is installed on a rotating shaft of the encoder 200-1.
An opening is formed in the intervention channel 100, and the rotating block 200-2 is located at the opening. The turning block 200-2 is provided with a first extending part and a second extending part. The upper end of the return spring 200-3 is in contact with the bottom of the second extending part of the rotating block 200-2, and the lower end of the return spring is sleeved on the positioning column on the base body 1, so as to push the rotating block 200-2 to rotate, and thus the first extending part is in contact with the inner wall part of the intervention channel 100, which is positioned on the opposite side of the opening. Furthermore, more than two positioning columns are arranged on the base body 1 side by side, so that the position of the return spring 200-3 can be conveniently adjusted.
Preferably, the first extending portion extends toward the outlet end of the access passage 100, and an inclined surface facing one side of the inlet end of the access passage 100 is disposed on the first extending portion. When the guide wire and the catheter enter the interventional channel 100, the front end touches the inclined plane first, and the rotating block 200-2 is directly pushed to rotate, so that the resistance of the relative movement of the guide wire and the catheter is reduced.
The tail end of the first extending part is also provided with a round angle, so that the guide wire and the catheter are prevented from being scratched when passing through the tail end of the first extending part.
When a catheter, guidewire, or like instrument passes through the first extension, the turning block 200-2 is urged to rotate and pass through the access channel 100. Under the action of the return spring 200-3, the first extending part always rotates upwards to clamp the instrument together with the top cover plate, the gap between the first extending part and the cover plate is the diameter of the instrument, and the size of the gap also determines the angular position of the rotating block 200-2, so that the rotating angle of the rotating block 200-2 is obtained through the encoder 200-1, and the diameter size can be further obtained according to the corresponding relation between the rotating angle of the rotating block 200-2 and the diameters of the inserted guide wire and the inserted guide pipe.
One achievable diameter calculation method is: the inclined angle of the inclined plane of the rotating block 200-2 relative to the interventional channel 100 in the initial period is recorded in advance, and the diameter of the instrument is obtained through geometric calculation by combining the rotating angle of the guide wire passing through the rotating block 200-2 and the size of the component.
On the other hand, since the diameter specification is limited, it is also possible to insert instruments of different diameters into the interventional channel 100 in advance, record the angle of rotation of the rotating block 200-2, construct a look-up table by associating the diameters with the angles, and then rapidly obtain the diameter size by a table look-up method in the simulation operation.
During clinical surgery, catheters and guide wires often encounter plaque blockage in blood vessels. When a plurality of doctors with insufficient experience meet the situations, the emotions are fluctuated due to the sudden change of the hand feeling, and misoperation occurs. In order to simulate the situation of encountering plaques, the device is also provided with a clamping mechanism, so that a trained doctor can experience and be familiar with the hand feeling under the situation, and can face more leisurely under the similar situation encountered in a clinical state.
As shown in fig. 2 and 3, the clamping mechanism is also provided near the inspection station, and includes a movable contact 300-5 installed in a through hole at the bottom of the intervention channel 100 and a pushing mechanism for pushing the movable contact 300-5 to move upward. Specifically, the pushing mechanism comprises a push rod motor 300-1, a connecting rod 300-2, a rotary connecting block 300-3 and a flexible plug 300-4.
The push rod motor 300-1 is horizontally arranged on the base body 1, and the rotary connecting block 300-3 is arranged on the base body 1 through a rotary shaft. One end of the connecting rod 300-2 is rotatably connected with the telescopic rod of the push rod motor 300-1, the other end is rotatably connected with one end of the rotating connecting block 300-3, and the flexible top 300-4 is mounted at the other end of the rotating connecting block 300-3 through a screw and is used for contacting with the bottom of the movable contact block 300-5.
When the push rod motor 300-1 extends, the rotary connecting block 300-3 rotates, the jacking head 300-4 moves upwards, the movable contact block 300-5 is jacked up, and the movable contact block and the upper wall of the interventional channel 100 clamp a catheter or a guide wire together, so that the situation of encountering plaques is simulated. When the push rod motor 300-1 is shortened, the top head 300-4 falls, the movable contact block 300-5 automatically falls under the action of gravity, and a guide wire or a guide pipe is loosened.
The rated thrust of the push rod motor 300-1 is 60N. The output thrust is changed by adjusting the input voltage of the push rod motor 300-1, so that the upward thrust of the movable contact block 300-5 is controlled, and the purpose of adjusting the clamping force is achieved.
The detection assembly at the detection station further comprises a movement state detection means 400 for detecting a displacement and/or a rotation angle of the interventional surgical instrument in the interventional channel 100. In this embodiment, a VL53L1X laser ranging sensor is used to detect the moving speed, displacement, and rotation angle of a guide wire, a catheter, and the like in the intervention channel 100. Other detection mechanisms can be adopted, such as an operation information acquisition unit used in Chinese patent invention CN109730779A, namely a vessel intervention operation robot catheter guide wire cooperative control system and method.
As shown in fig. 2, the inlet inspection station 2 inspects the conduit, and since the conduit has the largest diameter and better rigidity, even if the clamping mechanism clamps the conduit, the conduit will not be greatly displaced, which results in an error in the detection of the moving state inspection device 400 (especially, non-contact type, not shown). However, as in fig. 3, the situation is different between the intermediate inspection station 4 and the end inspection station 5. If the clamping mechanism is close to the moving state detection device 400, the guide wire is very thin, and after the clamping mechanism clamps the guide wire, the guide wire can be greatly deviated, which easily causes an obvious error in the detection result of the moving state detection device 400. In order to solve the problem, in the middle detection station 4 and the end detection station 5, the detection point of the moving state detection device 400 and the clamping point of the clamping mechanism are respectively arranged at two sides of the opening, the guide wire is automatically and slightly clamped by the rotating block 200-2 of the diameter detection mechanism, the clamping mechanism is separated from the moving state detection device 400, the guide wire at the front side of the rotating block 200-2 is ensured to be stable all the time, the guide wire cannot shake along with the action of the clamping mechanism, and the detection error is eliminated.
The steps of the simulation control method are as follows:
And 2, waiting for the guide wire entering along the catheter to pass through the intermediate detection station 4 (diameter detection and plaque simulation clamping can be performed in advance during passing), and reaching the tail end detection station 5, wherein the detection component of the tail end detection station 5 detects the guide wire and the diameter of the guide wire meets the requirement, and then, turning to the step 3.
And 3, waiting for the arrival of the support corresponding to the guide wire at the intermediate detection station 4, and detecting whether the diameter of the support meets the requirement.
In the execution process of the steps, the diameter detection mechanism can send the detected data to the upper computer in real time, and the upper computer compares the diameter detection value with preset data and judges whether the requirements are met. And if the sequence of the detection data obtained by the upper computer does not accord with the steps 1 to 3, or the judgment result of the upper computer after the detection data is obtained does not meet the requirement, the upper computer sends an alarm to prompt an operation error.
On the other hand, when the upper computer detects that the interventional operation instrument reaches the preset plaque position, the corresponding clamping mechanism can be controlled to clamp the interventional operation instrument in the interventional channel 100 at the position, and the situation that the interventional operation instrument meets the plaque is simulated.
During operation, the movement state detection device 400 can detect the movement speed, displacement and rotation angle of a guide wire, a catheter and the like in the intervention channel 100 in real time. Obviously, in combination with the diameter data obtained by the diameter detection mechanism, the upper computer can determine which type of interventional device the current movement state detection device 400 detects. The obtained speed, displacement and rotation angle can be used as the display content of an upper computer for reference of a doctor, and the running tracks and positions of guide wires and the like in a human body can be further calculated based on the data, superposed on the cardiovascular and cerebrovascular tissue images and displayed on a screen for perception and comparison of an operator, so that the aim of simulation training is fulfilled.
Claims (8)
1. A single-channel interventional surgery simulation device, comprising a base body (1), characterized in that: the base body (1) is provided with a plurality of detection stations, each detection station is provided with an intervention channel (100) serving as a walking channel of an intervention surgical instrument, and each detection station is also provided with a detection assembly for detecting the passed intervention surgical instrument;
the detection stations comprise an inlet detection station (2), a middle detection station (4) and a tail end detection station (5);
the intervention channel (100) of the inlet detection station (2) is communicated with the rear end of the intervention channel (100) of the middle detection station (4) through a connecting pipe component (3); the front end of an intervention channel (100) of the middle detection station (4) is communicated with the rear end of the intervention channel (100) of the tail end detection station (5) through a connecting pipe component (3);
the connecting pipe assembly (3) is telescopic;
each detection station is provided with a diameter detection mechanism as the detection assembly; the diameter detection mechanism comprises an encoder (200-1), a rotating block (200-2) and a return spring (200-3);
the encoder (200-1) is arranged on the base body (1), and the rotating block (200-2) is arranged on a rotating shaft of the encoder (200-1);
an opening is formed in the intervention channel (100), and the rotating block (200-2) is located at the opening;
the rotating block (200-2) is provided with a first extending part; the return spring (200-3) is connected with the rotating block (200-2) and used for pushing the rotating block (200-2) to rotate so as to enable the first extending part to be in contact with the inner wall part, located on the opposite side of the opening, of the intervention channel (100).
2. The single-channel interventional procedure simulation device of claim 1, wherein: at least one detection station is provided with a clamping mechanism for simulating plaque obstruction; the clamping mechanism comprises a movable contact block (300-5) arranged in a through hole at the bottom of the intervention channel (100) and a pushing mechanism used for pushing the movable contact block (300-5) to move upwards.
3. The single-channel interventional procedure simulation device of claim 2, wherein: the pushing mechanism comprises a push rod motor (300-1), a connecting rod (300-2), a rotary connecting block (300-3) and a flexible ejector head (300-4);
the push rod motor (300-1) is installed on the base body (1), and the rotary connecting block (300-3) is installed on the base body (1) in a rotating fit mode;
one end of the connecting rod (300-2) is rotatably connected with the telescopic rod of the push rod motor (300-1), the other end of the connecting rod is rotatably connected with one end of the rotating connecting block (300-3), and the flexible top head (300-4) is installed at the other end of the rotating connecting block (300-3) and is used for being in contact with the bottom of the movable contact block (300-5).
4. The single-channel interventional procedure simulation device of claim 1, wherein: the detection assembly at least at one of the middle detection station (4) and the tail end detection station (5) comprises a diameter detection mechanism, a movement state detection device (400) for detecting the displacement and/or rotation angle of an interventional surgical instrument in the interventional channel (100) and a clamping mechanism for simulating plaque obstruction;
the diameter detection mechanism comprises an encoder (200-1), a rotating block (200-2) and a return spring (200-3); the encoder (200-1) is arranged on the base body (1), and the rotating block (200-2) is arranged on a rotating shaft of the encoder (200-1); an opening is formed in the intervention channel (100), and the rotating block (200-2) is located at the opening; the rotating block (200-2) is provided with a first extending part; the return spring (200-3) is connected with the rotating block (200-2) and is used for pushing the rotating block (200-2) to rotate so as to enable the first extending part to be in contact with the part, located on the opposite side of the opening, of the inner wall of the intervention channel (100);
the detection point of the moving state detection device (400) and the clamping point of the clamping mechanism are respectively positioned at two sides of the opening.
5. The single-channel interventional procedure simulation device of claim 1, wherein: the connecting pipe assembly (3) comprises an inner pipe (3-1), an outer pipe (3-4), a positioning sleeve (3-2) and a compression spring (3-3); the front end of the inner tube (3-1) is inserted into the rear end of the outer tube (3-4), the positioning sleeve (3-2) is fixed on the outer wall of the inner tube (3-1), the front end of the compression spring (3-3) is in contact with the rear end face of the outer tube (3-4), and the rear end of the compression spring is in contact with the front end face of the positioning sleeve (3-2).
6. The simulation control method of the single-channel interventional operation simulation device according to claim 1, characterized by comprising the steps of:
step 1, a detection assembly positioned at an inlet detection station (2) detects whether a conduit is inserted and detects whether the diameter of the inserted conduit meets the requirement, and the step 2 is switched to after the requirement is met;
step 2, waiting for the guide wire entering along the catheter to reach the tail end detection station (5) through the middle detection station (4), and switching to step 3 after the detection assembly of the tail end detection station (5) detects the guide wire and the diameter of the guide wire meets the requirement;
step 3, the middle detection station (4) waits for the bracket corresponding to the guide wire to arrive, and detects whether the diameter of the bracket meets the requirement;
in the execution process of the steps, the detection assembly sends the detected data to the upper computer in real time, and the upper computer compares the detected data with preset operation data and judges whether the requirements are met.
7. The analog control method of claim 6, wherein: and if the sequence of the detection data obtained by the upper computer does not accord with the steps 1 to 3, or the judgment result of the upper computer after the detection data is obtained does not meet the requirement, the upper computer sends an alarm to prompt an operation error.
8. The analog control method of claim 6, wherein: at least one detection station is also provided with a clamping mechanism for simulating plaque obstruction;
when the upper computer detects that the interventional surgical instrument reaches the preset plaque position, the corresponding clamping mechanism is controlled to clamp the interventional surgical instrument in the interventional channel (100) at the position, and the situation that the interventional surgical instrument meets the plaque is simulated.
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| WO2008041154A2 (en) * | 2006-10-06 | 2008-04-10 | Koninklijke Philips Electronics N. V. | Spatial characterization of a structure located within an object by identifying 2d representations of the structure within section planes |
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