CN1899221A - X-ray puncture positioning device and method for microtrauma operation - Google Patents

X-ray puncture positioning device and method for microtrauma operation Download PDF

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Publication number
CN1899221A
CN1899221A CNA200610061825XA CN200610061825A CN1899221A CN 1899221 A CN1899221 A CN 1899221A CN A200610061825X A CNA200610061825X A CN A200610061825XA CN 200610061825 A CN200610061825 A CN 200610061825A CN 1899221 A CN1899221 A CN 1899221A
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China
Prior art keywords
puncture needle
puncture
type arm
type
ray
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CNA200610061825XA
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CN100444800C (en
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倪湘申
朱伟辉
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Priority to CNB200610061825XA priority Critical patent/CN100444800C/en
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Priority to PCT/CN2007/002173 priority patent/WO2008014670A1/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/12Devices for detecting or locating foreign bodies
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, 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
    • A61B90/10Instruments, 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
    • A61B90/11Instruments, 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 with guides for needles or instruments, e.g. arcuate slides or ball joints
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, 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
    • A61B90/36Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37Surgical systems with images on a monitor during operation
    • A61B2090/376Surgical systems with images on a monitor during operation using X-rays, e.g. fluoroscopy

Abstract

The X-ray puncture positioning device for micro trauma operation includes a C-shaped arm X-ray unit, a guide tube seat and a puncture needle guiding tube. The C-shaped arm X-ray unit includes a C-shaped arm mounted on the main shaft, an image intensifier and a bulb tube coaxial with the image intensifier, and the intersection point of the axis and the main shaft axis is the center of the C-shaped arm. The puncture needle guiding tube is mounted on the guide tube seat and has axis through the center of the C-shaped arm. By means of the X-ray puncture positioning device, the puncture position may be determined precisely to reduce the risk and difficulty of micro trauma operation.

Description

Minimally Invasive Surgery X-ray puncture positioning device and method
Technical field
The present invention relates to medical instruments field, especially about a kind of medical apparatus and instruments that is applied to Minimally Invasive Surgery.
Background technology
In recent years, along with the development of technology, Minimally Invasive Surgery more and more comes into one's own in the application of hospital, and is universal just day by day in the use of Urology Surgery, chamber surgery, orthopaedics etc., but the key of many Minimally Invasive Surgery successes depends on the proficiency level of doctor's puncture technique, and this is one of difficult point of less invasive techniques.Now, many doctors' puncture location is what to be carried out under the guide of common C arm X line machine, and what it provided only is plane picture, is not locus accurately, can only be as a reference, and the still experience that the doctor leans on.Risk and difficulty that this has increased operation greatly allow a lot of doctors step back, and have hindered this broad application and development.
Summary of the invention
Technical problem to be solved by this invention is, overcomes the deficiencies in the prior art, and providing a kind of can position puncture position, thereby can effectively reduce the Minimally Invasive Surgery X-ray puncture positioning device and the method for Minimally Invasive Surgery risk and difficulty.
The technical solution adopted for the present invention to solve the technical problems is: this Minimally Invasive Surgery X-ray puncture positioning device comprises C type arm X-ray machine, guiding cylinder base and puncture needle guide barrel, this C type arm X-ray machine comprises C type arm, image amplifier and X ray tube, this C type arm is installed on the main shaft, this image amplifier and X ray tube coaxial line, and the intersection point of the axis of this axis and this main shaft is the center of this C type arm, and this puncture needle guide barrel is installed on this guiding cylinder base and the center of the axis of this puncture needle guide barrel by C type arm.
Described guiding cylinder base comprises C type cursor slide, and the centre of sphere of this C type cursor slide is the center of this C type arm.
Described guiding cylinder base comprises also and the C type guide rail of C type arm with rotation axis that C type cursor slide slidably is installed on this C type guide rail, this C type guide rail and the same centre of sphere of this C type cursor slide, and this puncture needle guide barrel slidably is installed in the end of this C type cursor slide by slide block.
Described guiding cylinder base comprises first, second parallel-crank mechanism, this is first years old, second parallel-crank mechanism is hinged on first hinge point, this first parallel-crank mechanism connects first of this first hinge point, second bar is connected the 3rd of this first hinge point with second parallel-crank mechanism respectively, the 4th bar is bar altogether, another hinge point of this second bar is connected with the outfan of a driving device, be fixed with take-up housing on this second parallel-crank mechanism the 5th bar parallel with the 4th bar, this puncture needle guide barrel slidably is installed on this take-up housing, and the projection of this puncture needle guide barrel axis overlaps with the projection of the 5th rod axis.
Described driving device comprise Z to cramp bar, Z to bearing sleeve, rotation disc, X to regulating part and Z to regulating part, this Z is connected to the hinge point of cramp bar one end with first parallel-crank mechanism, second bar, its other end is supported on Z on bearing sleeve, this Z is installed on this rotation disc to bearing sleeve, this Z moves in Z to bearing sleeve to relative this Z of cramp bar up and down to this Z of regulating part transmission, this X moves leftwards and rightwards in X to relative this rotating seat of bearing sleeve to this Z of regulating part transmission, and the rotation axis of this rotation disc is by the center of this C type arm.
Described puncture needle guide barrel is connected with linear displacement transducer.
This Minimally Invasive Surgery X line puncture localization method comprises the steps:
A) by regulate operation table with body foci's point location in X-ray machine C type arm in the heart;
B) by adjusting the guiding cylinder base, make the center of this C type arm of axis alignment that is installed in the puncture needle guide barrel on this guiding cylinder base.
In the described step a), make C type arm place two different positions respectively, and carry out the roentgen radiation x focus respectively, by adjusting the position of operation table, the image of last roentgen radiation x focus point on imaging system overlapped, promptly the focus point location in C type arm in the heart.
C1 in steps also after the described step b)): determine its puncture total displacement according to the initial position of this puncture needle; C2) drive the central motion of puncture needle, determine first displacement when puncture needle moves to human body skin, determine the paracentesis depth of puncture needle according to this total displacement and first displacement to C type arm.
The invention has the beneficial effects as follows, can realize accurate location, reduced the risk and the difficulty of Minimally Invasive Surgery, be convenient to promote puncture position by this positioner.
Description of drawings
Fig. 1 is the structural representation of first embodiment of the invention.
Fig. 2 is the schematic diagram of location focus point in the first embodiment of the invention.
Fig. 3 is the schematic diagram of first embodiment of the invention.
Fig. 4 is the schematic diagram of second embodiment of the invention.
Fig. 5 is the front view of second embodiment of the invention.
Fig. 6 is the side view of second embodiment of the invention.
Fig. 7 is the schematic diagram of location focus point in the second embodiment of the invention.
Fig. 8 to Figure 10 is that puncture needle is in initial position respectively, the sketch map when contacting skin and arrival focus point.
Figure 11 is a schematic block circuit diagram of the present invention.
Figure 12 is a FB(flow block) of the present invention.
The specific embodiment
Minimally Invasive Surgery X-ray puncture positioning device of the present invention comprises C type arm X-ray machine, guiding cylinder base and puncture needle guide barrel, this C type arm X-ray machine comprises C type arm, image amplifier and X ray tube, this C type arm is installed on the main shaft, this image amplifier and X ray tube coaxial line, and the intersection point of the axis of this axis and this main shaft is the center of this C type arm, and this puncture needle guide barrel is installed on this guiding cylinder base and the center of the axis of this puncture needle guide barrel by C type arm.
See also Fig. 1 to Fig. 3, it is first specific embodiment of the present invention.This positioner comprises C type arm X-ray machine, guiding cylinder base and puncture needle guide barrel.This C type arm X-ray machine comprises C type arm 11, image amplifier 10, X ray tube 16 and imaging system, this C type arm 11 can be around its main shaft 13 rotations, this image amplifier 10 and X ray tube 16 coaxial lines, the axis of this main shaft 13 is O ' O ', the axis of this image amplifier 10 and X ray tube 16 is YY, this axes O ' the intersection point O of O ' and axis YY is defined as the center O (when this C type arm was hemispherical, this center was the centre of sphere of C type arm) of this C type arm.This guiding cylinder base comprises C type guide rail 15, C type cursor slide 9, motor 12, slide block 4 and take-up housing 8, and this C type guide rail 15 is fixed on (i.e. this C type guide rail 15 and C type arm 11 same rotation axiss) on the main shaft 13.This C type cursor slide 9 can slide along this C type guide rail 15, and the radius of its inner arc surface is R, and this motor 12 drives this C type cursor slide 9 and slides along this C type guide rail 15, and the centre of sphere of this C type guide rail 15 and C type cursor slide 9 is the center O of this C type arm 11.This take-up housing 8 is fixed on the end face of this C type cursor slide 9, and this slide block 4 slidably is installed on this take-up housing 8, and this puncture needle guide barrel 5 is fixed on this slide block 4, and the center O of this C type cursor slide 9 of the orientation of its axis of this puncture needle guide barrel 5.In addition, on this take-up housing 8 linear displacement transducer 7 is installed also, this linear displacement transducer 7 is connected with puncture needle guide barrel 5.
The operation principle of this positioner is as follows: selected C type arm 11 places A respectively 1B 1Position and A 2B 2The position, and carry out roentgen radiation x focus (3 indication places are people's body section among Fig. 1) respectively, by adjusting height, all around of operation table 1, the image of last roentgen radiation x focus point on imaging system (as computer screen or monitor) overlapped, illustrate that then focus point has placed on the center O of this C type arm 11.
Selected puncture angle m (realizing the adjusting of puncture angle m) by C type cursor slide is slided along C type guide rail, puncture needle 6 is inserted puncture needle guide barrel 5 (this puncture needle and this puncture needle guide barrel coaxial lines, and this axis is by the center O of C type arm), and make the upper surface of the handle of this puncture needle afterbody near puncture needle guide barrel 5, demarcate the vertical dimension a of puncture needle 6 tops to C type cursor slide 9 inner arc surfaces 0, hand push puncture needle 6 drives puncture needle guide barrel 5, slide block 4 moves downward along take-up housing 8, when contact human body skin surface, puncture needle top, obtains the displacement a of puncture needle 6 from linear displacement transducer 7 1, and input computer, can get puncture needle from human body surface to the displacement a of focus point O 2,
a 2=R-(a 0+a)
At this moment, under the digital designation of computer, puncture needle 6 is finished the puncture from 0 → a2.
For the purpose of safer, can when puncturing, set alarm indicator in advance on computers near the a2 certain distance, with operation caution is proposed to the doctor.
The circular arc stretching motion mobile and C type cursor slide 9 of the puncture needle guide barrel 5 of this machine can utilize electronic or manual realization.
See also Fig. 4 to Figure 10, it is second specific embodiment of the present invention.This positioner comprises C type arm X-ray machine, guiding cylinder base and puncture needle guide barrel.This C type arm X-ray machine comprises C type arm 14, image amplifier 13, X ray tube 20 and imaging system, this C type arm 14 is by main shaft 17 rotatable being installed on the main engine bed of X-ray machine, this main engine bed also has locating shaft 19, the axis of this main shaft 17 is defined as X-axis, the axis of this locating shaft 19 is defined as the Z axle, the intersection point of this X-axis and Z axle is defined as the center O of C type arm 14, thereby can determines Y-axis, and then set up an XYZ axle rectangular coordinate system.This image amplifier 13 and X ray tube 20 are installed in this C type arm 14 two ends and coaxial line respectively, when this C type arm 14 is in initial position, and this image amplifier 13, X ray tube 20 and locating shaft 19 coaxial lines.This guiding cylinder base comprises the linkage 7 that is made of first parallel-crank mechanism 71 and second parallel-crank mechanism 72, the bar C of this first parallel-crank mechanism 2C 1, O 1C 1Respectively with the bar C of second parallel-crank mechanism 1d 2, C 1C 3Bar (promptly forms bar C altogether 2d 2With bar O 1C 3), this first, second parallel-crank mechanism is articulated in hinge point C 1(be bar C 2d 2With bar O 1C 3Meet at hinge point C 1), and the axis coplane of each bar of this first, second parallel-crank mechanism.This guiding cylinder base is driven by driving device, this driving device comprise cramp bar 6, bearing sleeve 4, rotation disc 1, X to regulating part 3 and Z to regulating part 5, this cramp bar 6 comprise along Z to first cramp bar 61 that extends and perpendicular and along Y to second cramp bar 62 that extends, the end of this first cramp bar 61 is installed on this bearing sleeve 4, and the end of this second cramp bar 62 is fixed in the hinge point O of first parallel-crank mechanism 71 1This bearing sleeve 4 along Z to extension, it slidably is installed on this rotating seat 1, and an end of this rotating seat 1 is stuck on this locating shaft 19, and its other end is equipped with roller 2, thereby this rotating seat 1 can be rotated around this fixed locating shaft 19, and promptly the rotation axis of rotating seat 1 is by the center O of C type arm 14.This Z is used to regulate cramp bar 6 to regulating part 5, makes this cramp bar 6 be with relative this bearing sleeve of whole linkage 74 to move up and down at Z, promptly is used to regulate the hinge point O of linkage 7 1To the distance A between the ground.This X is used to regulate bearing sleeve 4 to regulating part 3, make this bearing sleeve 4 be with relative this rotating seat of cramp bar 6 and linkage 71 to move leftwards and rightwards at X, the axis that promptly is used to regulate this first cramp bar 61 is between locating shaft 19 axis (also being hinge point O apart from a 1To the distance between locating shaft 19 axis is a).This puncture needle guide barrel 12 axially runs through, and it is fixed on the slide block 11, and this slide block 11 slidably is installed on the take-up housing 8, and this take-up housing 8 is articulated in the bar d of linkage 7 1d 2Go up (this bar d 1d 2With bar O 1C 3Parallel).On the plane that axis coexisted of these linkage 7 each bars, projection and the bar d of these puncture needle guide barrel 12 axis on this plane 1d 2The projection of axis on this plane overlap.The axis of the axis of this puncture needle guide barrel 12 and first cramp bar 61 is on the same plane (this plane parallel XZ plane), and this plane is parallel with first, second parallel- crank mechanism 71,72 by center O and this plane of C type arm.On this take-up housing 8 linear displacement transducer 9 is installed also, this linear displacement transducer 9 links to each other with puncture needle guide barrel 12.
The operation principle of this positioner is as follows: selected C type arm 14 places A respectively 1B 1Position and A 2B 2On the position, and respectively focus is carried out roentgen radiation x (label 16 indication places are people's body section among Fig. 5), by X, the Y that adjusts operation table 18, the displacement of three directions of Z, make the body foci put 15 and place on the O point (being the center of C type arm and the initial point of rectangular coordinate system), determined that the body foci puts 15 to the vertical dimension B between the ground this moment.
This linkage 7 is projected on the plane that axis constituted of the axis of first cramp bar 61 and puncture needle guide barrel 12, the projection of each hinge point on this plane of this linkage 7 also is defined as O respectively 1, O 2, C 1, C 2, C 3, d 1, d 2(as shown in Figure 4).The vertical dimension of setting the axis of cramp bar 6 and image amplifier 13 and X ray tube 20 is a, adjusts A and a, makes O 1O=a/cosm=C 1d 2=C 3d 1, satisfy above condition, adjust arbitrarily angle n (this angle n is the puncture angle of puncture needle, 0<n<90 °), can both guarantee that the axis of puncture needle guide barrel 12 passes the center O of C type arm 14.
Please, puncture needle 10 is inserted puncture needle guide barrel 12, and make the upper surface of its afterbody handle 21, measure puncture needle 10 needle points to hinge point d near puncture needle guide barrel 12 in conjunction with consulting Fig. 4, Fig. 8 to Figure 10 2Length e, promote puncture needle 10 when its needle point contact human body skin surface, obtain needle point shift length e by linear displacement transducer 9 1, by computer, can draw from human body surface to the displacement e of focus point O 2,
e 2=C 1O 1-(e+e 1)
Like this, under the guiding of puncture needle guide barrel 12, count from skin surface, under the computer numeral prompting, puncture needle 10 is finished from 0 → e 2Piercing process.
For the purpose of safer, report to the police in the time of can setting puncture near focus point on computers in advance, with operation caution is proposed to the doctor.
Moving of the puncture needle guide barrel 12 of this positioner navigator can utilize electronic or manual realization.
See also Figure 12, this Minimally Invasive Surgery X line puncture localization method comprises the steps:
A) by regulate operation table with body foci's point location in X-ray machine C type arm in the heart;
B) by adjusting the guiding cylinder base, make the center of this C type arm of axis alignment that is installed in the puncture needle guide barrel on this guiding cylinder base.
C) determine its puncture total displacement according to the initial position of this puncture needle;
D) drive the puncture needle guide barrel and drive the central motion of puncture needle, when this puncture needle contact human body skin, determine first displacement, thereby follow the paracentesis depth of determining puncture needle according to this total displacement and first displacement to C type arm.
See also Figure 11, among the present invention, the output of each linear displacement transducer, image amplifier all is connected with control unit (as host computer), the output of this control unit connects imaging system (as computer screen or display), and the output of this control unit also meets executor's (as motor), and this executor's output connects driving device.
Above content be in conjunction with concrete preferred implementation to further describing that the present invention did, can not assert that concrete enforcement of the present invention is confined to these explanations.For the general technical staff of the technical field of the invention, without departing from the inventive concept of the premise, can also make some simple deduction or replace, all should be considered as belonging to the scope of patent protection that the present invention is determined by claims of being submitted to.

Claims (9)

1. Minimally Invasive Surgery X-ray puncture positioning device, comprise C type arm X-ray machine, this C type arm X-ray machine comprises C type arm, image amplifier and X ray tube, this C type arm is installed on the main shaft, this image amplifier and X ray tube coaxial line, and the intersection point of the axis of this axis and this main shaft is the center of this C type arm, it is characterized in that: also comprise guiding cylinder base and puncture needle guide barrel, this puncture needle guide barrel is installed on this guiding cylinder base and the axis of this puncture needle guide barrel passes through the center of C type arm.
2. according to the described Minimally Invasive Surgery X-ray puncture positioning device of claim 1, it is characterized in that: described guiding cylinder base comprises C type cursor slide, and the centre of sphere of this C type cursor slide is the center of this C type arm.
3. according to the described Minimally Invasive Surgery X-ray puncture positioning device of claim 2, it is characterized in that: described guiding cylinder base also comprises and the C type guide rail of C type arm with rotation axis, C type cursor slide slidably is installed on this C type guide rail, this C type guide rail and the same centre of sphere of this C type cursor slide, this puncture needle guide barrel slidably is installed in the end of this C type cursor slide by slide block.
4. according to the described Minimally Invasive Surgery X-ray puncture positioning device of claim 1, it is characterized in that: described guiding cylinder base comprises first, second parallel-crank mechanism, this is first years old, second parallel-crank mechanism is hinged on first hinge point, this first parallel-crank mechanism connects first of this first hinge point, second bar is connected the 3rd of this first hinge point with second parallel-crank mechanism respectively, the 4th bar is bar altogether, another hinge point of this second bar is connected with the outfan of a driving device, be fixed with take-up housing on this second parallel-crank mechanism the 5th bar parallel with the 4th bar, this puncture needle guide barrel slidably is installed on this take-up housing, and the projection of this puncture needle guide barrel axis overlaps with the projection of the 5th rod axis.
5. according to the described Minimally Invasive Surgery X-ray puncture positioning device of claim 4, it is characterized in that: described driving device comprises that Z is to cramp bar, Z is to bearing sleeve, rotation disc, X to regulating part and Z to regulating part, this Z is connected to the hinge point of cramp bar one end with first parallel-crank mechanism, second bar, its other end is supported on Z on bearing sleeve, this Z is installed on this rotation disc to bearing sleeve, this Z moves in Z to bearing sleeve to relative this Z of cramp bar up and down to this Z of regulating part transmission, this X moves leftwards and rightwards in X to relative this rotating seat of bearing sleeve to this Z of regulating part transmission, and the rotation axis of this rotation disc is by the center of this C type arm.
6. according to any described Minimally Invasive Surgery X-ray puncture positioning device among the claim 2-5, it is characterized in that: described puncture needle guide barrel is connected with linear displacement transducer.
7. a Minimally Invasive Surgery X line puncture localization method is characterized in that: comprise the steps:
A) by regulate operation table with body foci's point location in X-ray machine C type arm in the heart;
B) by adjusting the guiding cylinder base, make the center of this C type arm of axis alignment that is installed in the puncture needle guide barrel on this guiding cylinder base.
8. according to the described Minimally Invasive Surgery X of claim 7 line puncture localization method, it is characterized in that: in the described step a), make C type arm place two different positions respectively, and carry out the roentgen radiation x focus respectively, by adjusting the position of operation table, the image of last roentgen radiation x focus point on imaging system overlapped, promptly the focus point location in C type arm in the heart.
9. according to the described Minimally Invasive Surgery X of claim 7 line puncture localization method, it is characterized in that: c1 in steps also after the described step b)): determine its puncture total displacement according to the initial position of this puncture needle; C2) drive the central motion of puncture needle, determine first displacement when puncture needle moves to human body skin, determine the paracentesis depth of puncture needle according to this total displacement and first displacement to C type arm.
CNB200610061825XA 2006-07-25 2006-07-25 X-ray puncture positioning device and method for microtrauma operation Expired - Fee Related CN100444800C (en)

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CNB200610061825XA CN100444800C (en) 2006-07-25 2006-07-25 X-ray puncture positioning device and method for microtrauma operation
PCT/CN2007/002173 WO2008014670A1 (en) 2006-07-25 2007-07-16 Micro-invasive surgery x-ray puncturing and locating device and method

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