CN1984601A - System and method for removing fat tissue - Google Patents
System and method for removing fat tissue Download PDFInfo
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- CN1984601A CN1984601A CN 200480035622 CN200480035622A CN1984601A CN 1984601 A CN1984601 A CN 1984601A CN 200480035622 CN200480035622 CN 200480035622 CN 200480035622 A CN200480035622 A CN 200480035622A CN 1984601 A CN1984601 A CN 1984601A
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Abstract
Described is a system and method for the destruction of adipose tissue using an energy applicator such as a HIFU transducer. The system has a scan head containing an energy applicator, a mechanical arm for carrying the weight of the scan head, and a therapy controlle such as a computer for controlling the operation of the scan head. The therapy controller may be part of a general purpose, and may be used as a robotic controller to automate the procedure. Methods are included for destroying adipose tissue in a quick, non-invasive manner.
Description
Related application
The application is in the application No.10/750 of December in 2003 submission on the 30th, the continuation part of 370 (lawyer's case No.021356-000500US), and in the application No.10/751 of December in 2003 submission on the 30th, the continuation part of 344 (lawyer's case No.021356-000600US).
The application also requires in the No.60/533 of provisional application formerly of December in 2003 submission on the 30th, the priority of 988 (lawyer's case No.021356-001000US), and in the No.60/533 of provisional application formerly of December in 2003 submission on the 30th, the priority of 958 (lawyer's case No.021356-001200US).The full content of each above application discloses all incorporated herein by reference.
The application's theme relates to following application: be entitled as " Disposable Transducer Seal " (disposable sensor sealant) 10/750,369; Be entitled as " Position Tracking Device " (position tracking device) 60/533,528; Be entitled as " Ultrasound Therapy Head with Movement Control " (ultrasonic therapy head) with motor control 60/534,036; Be entitled as " Component Ultrasound Transducer " (combined ultrasonic wave transducer) 60/534,034; The full content of each these application discloses all incorporated herein by reference.
Technical field
The present invention relates to remove the system and method for fatty tissue (fat).
Background technology
Body shaping has developed into and has reduced people's body weight and make that its recovery is more fine, the senior pursuit of slenderrer physical shapes.Esthetic surgery obtains developing quite rapidly along with the exploitation of instrument and technology.A kind of general treatment method that is used for losing weight fast and get into shape is a subcutaneous fat suction art.
Subcutaneous fat suction art is to improve the shape of different body regions and the health formative method of profile significantly by moulding with removing undesired fat.Annual all can have the above subcutaneous fat of 200,000 examples to aspirate art.Up-to-date reform and development in the subcutaneous fat suction art field comprises tumescent technique and ultrasound wave ancillary technique.Conventional subcutaneous fat suction art is by making some little otch, carrying out at subcutaneous layer of fat implantation hollow pipe or intubate then in the needs position.This intubate links to each other with vacuum, and fat is absorbed under higher suction force.This Therapeutic Method is removed fat, connective tissue, blood vessel and nervous tissue indiscriminately.That this Therapeutic Method causes is hemorrhage, injury with blood-stasis, wound and lose blood, thus the fat mass that restriction may be removed.
Tumescent technique allows to remove much more fat and blood loss is less at intra-operative.Swelling subcutaneous fat suction art was injected a large amount of salt and epinephrine solution to fat deposit before suction.Intubate is used for pumping equipment once more to remove fat.This Therapeutic Method has reduced the amount of bleeding of conventional subcutaneous fat suction art.But this Therapeutic Method has still been removed a large amount of structure organizations, blood and teleneuron.
Up-to-date generally acknowledged innovation is the auxiliary fat grafting (UAL) of ultrasound wave.UAL utilizes most advanced and sophisticated titanium intubate with the ultrasonic frequency vibration.This vibration makes contiguous significant quantities of fat cell division and they is liquefied basically, so that remove.UAL uses the low-power suction and only extract fatty material near cannula tip.This technology is more meticulous and more soft to organizing, thereby amount of bleeding is less, injury with blood-stasis is less, pain and restore faster not too.
The use of ultrasound wave in surgical operation is not limited to UAL.High intensity focused ultrasound (HIFU) technology is used for treatment for cancer by other people.
People's such as Cain United States Patent (USP) 6,309,355 has disclosed and has a kind ofly produced microbubble in destination organization, used ultrasound source to make microbubble produce void effect, near the method to organize the removal then.Preferred embodiment uses low frequency ultrasound wave source (being lower than 500kHz) to cause air pocket.One diagnostic instruments is used to determine the position of each surgical injury.
People's such as Eshel PCT application WO 02/054018 A2 is provided at dissolved fat tissue in the human region, the method for not dissolving non-fat tissue simultaneously.This method is described in uses HIFU to link to each other with diagnostic imaging system and computer in the health, follow the tracks of the zone with the HIFU energy exposure.
In the past few decades some innovations have been arranged in the exploitation of HIFU.Intensity has increased to when bubble forms because of air pocket, and boiling can take place in utmost point short time period (～1 second).Bubble greatly increased hyperacoustic absorption and follow to the tissue Fast Heating.Haifu (Chinese Chongqing) company has produced the therapeutic equipment that uses the ultrasonic therapy solid tumor.When applicator around comprising in the water bag of tumor tissues when mobile, apply ultrasonic energy.
Other therapies depends primarily on the heating mechanism that makes tissue necrosis.Some papers are reported in generation air pocket in the tissue and will be increased to degree of necrosis by tissue temperature.These methods apply high strength continuous wave (CW) ultrasound therapy to tissue, so that produce hole bubble (being sometimes referred to as " stablizing " air pocket), the main purpose of these bubbles is to strengthen absorption and reduce heat time heating time.Adopt to the treatment of the ultrasonic similar quick multiple very high strength short pulse of impulse wave (PW) and can produce hole bubble with utmost point short life (microsecond).These bubbles cause the very big mechanical damage to tissue, and it can periodically be repeated and the heating of the tissue that need not to follow in a large number by short pulse (～5-30 second).Carefully considering the therapy parameter can for example strengthen mechanical damage by shearing force, instantaneous cavitation impacts ripple or stable air pocket pressure, and need not tissue is heated to hot degree of necrosis.
The HIFU therapy can make up with Several Methods and method and use.Most of HIFU therapies by HIFU is applied to a point and the energising section preset time (being generally 1～4 second) use.Intensity level is selected as the tissue at applicator focus place is heated to the point of coagulation necrosis usually, although other report is heated to boiling point (100 ℃) above water with this tissue.After an insonify cycle, new position is closed and moved on to applicator; Usually from before apply several millimeters at place.Up to organizing the period of having cooled off from several seconds to a few minutes, applicator is just opened once more.New wound is opened and produced to applicator once more.Treat a large amount of tissues with this method and will change a few hours.
Following additional reference document is relevant in this area: 5,769,790; 6,113,558; 5,827,204; 5,143,063; 5,219,401; 5,419,761; 5,618,275; 6,039,048; 6,425,867; 5,928,169; 6,387,380; 6,350,245; 6,241,753; 5,526,815; 6,071,239; 5,143,063; 6,685,639 and WO 00/36982.
Above-mentioned list of references has been described ultrasonic technology related to the present invention, and removes the method for people's in-vivo tissue with them.Yet a remarkable shortcoming is arranged in the prior art.Do not allow patient and doctor can design the body shaping plan of expectation together to realize the result's that the patient is desired teaching.There is not accurately storage to treat information has been made and so in next one treatment to the patient device in the prior art from one.This makes once finishes all treatments and necessitates, produce patient treatment over-drastic may, perhaps the doctor must or check that patient's adipose tissue regions makes conjecture by sensation, to determine what having done in last treatment.When the patient has carried out Noninvasive HIFU treatment, the doctor will lose direction fully and need can't determine what suitable successive treatment.
In addition, the ultrasound treatment of prior art be subjected to deeply can not fast processing the puzzlements of a large amount of tissues.Thereby as long as handle bulk or a large amount of, the invasive therapy is exactly preferable.
Therefore, an object of the present invention is to provide a kind of device, can determine suitable therapeutic method and feel attainable result by its patient and doctor.
Another object of the present invention provides the device that is used for accurately determining patient's adipose tissue mass.
Another purpose of the present invention provides and is used for accurate tracking treatment and to the device of patient's effect, thus the patient expectation treatment can be prolonged with reduce or eliminate because of disposable carry out extensive therapy do not accommodate danger.
A further object of the present invention provides the device that is used for accurately shining upon operation wound position in the human body.
Another object of the present invention provides the apparatus and method of similarly removing the significant quantities of fat tissue with the intrusive mood therapy fast.
Any of these purposes or a plurality ofly in following announcement, solve.
Summary of the invention
Described herein is the system and method that is used to remove fatty tissue.In first embodiment, be useful on the system that applies energy to body region, this system comprises: comprise the energy applicator probe, be used for treatment controller that probe is suspended in spatial device and links to each other with suspending apparatus with probe.Position and energy that this treatment controller is suitable for the monitor scans head transmit, and provide simultaneously locating the guiding of this probe.
In a second embodiment, be useful on produce the physical shapes be complementary, near the system of the subcutaneous tissue figure of body surface, this system comprises: be used to produce the body surface image of patient body three-dimensional image forming apparatus, be used to produce the imaging of tissue device of the subcutaneous image of patient body; And the related surgical equipment that is complementary of a plurality of labellings that are used to make body surface image and subcutaneous image.
In the 3rd embodiment, be useful on the system of location armarium, this system comprises: mechanical arm; Be used to control the first control device of mechanical arm: removable localized armarium in the treatment head, this treatment head links to each other with mechanical arm; Be used to control the second control device that move of armarium in the treatment head; And with mechanical arm, first control device, armarium and second control device electronic communication and be used for the electronic controller of collaborative operation.
In another embodiment, be useful on the system of location armarium, this system comprises: mechanical arm; Be used to control the control device of mechanical arm; Be fixed positioned in the armarium in the treatment head, this treatment head links to each other with mechanical arm; And be used to translate move that receives from control device and the electronic controller that is used for the move relaying is given mechanical arm.
In another embodiment, be useful on the device that move of guiding energy emitter on patient body, this device comprises: the removable treatment head with at least one energy emitter; Lead ring; And be used to follow lead ring and move and make the treatment head be located substantially on the tracking system of lead ring central authorities.
In another embodiment, be useful on the system of location armarium, described system comprises: the load balance arm; Removable localized armarium in the treatment head, this treatment head links to each other with the load balance arm; And be used to control the mobile device of armarium in the treatment head.
Use the method for described system in addition.In the embodiment that the method that energy is applied to body region is arranged, this method may further comprise the steps: the first, provide therapeutic scheme to the treatment controller; The second, in response to the treatment guiding that controller produced, on body surface, manually scan probe, energy transmits from described probe simultaneously; The 3rd, the position of monitor scans head and energy transmit, to produce position data and to send this position data to the treatment controller; At last, fall within outside the therapeutic scheme, then produce alarm if manual position and/or energy transmit.
In a second embodiment, the method for carrying out fat grafting is arranged, may further comprise the steps: determine that (a) people is to treating the adaptability of ultrasonic art; (b) labelling human zone to be processed on one's body; (c) be the ultrasonic art position patient of treatment; (d) marked region scans in the computer; (e) use the therapy plot software bag that the ultrasonic art of treatment is set; (f) use computer system to activate the ultrasonic art of treatment by therapy plot software control; (g) progress of using the therapy plot software record to treat; And (h) provide assignable any additional postoperative auxiliary to this patient.
In another embodiment, the method for using the treatment ultrasound wave to remove patient's fatty tissue is arranged, may further comprise the steps: one or more positions of determining patient's fatty tissue; The patient is positioned on the therapeutic bed; Position with treatment ultrasonic transducer irradiation patient fatty tissue.
In another embodiment, disclosed the method that produces 3D health diagrammatic sketch.The method of 3D health diagrammatic sketch that generation has the position of adipose tissue mass may further comprise the steps: use the 3D imaging system to produce the 3D rendering of health; The 3D rendering of health is entered as computer-readable format; Produce the 3D health diagrammatic sketch of health with 3D mapping software application program, and use the diagnostic ultrasound equipment scanning health with 3D mapping software application program electronic communication, make the adipose tissue regions that detects by diagnostic ultrasound equipment suitably be placed 3D health diagrammatic sketch.
In an embodiment again, the method for using the body shaping of 3D health diagrammatic sketch is arranged, may further comprise the steps: analyze 3D health diagrammatic sketch to draw the adipose tissue mass that will remove; Determine to use the adipose tissue mass of body shaping art safety removal; The adipose tissue mass that deduction will be removed to be to produce second 3D health diagrammatic sketch, and wherein doctor and patient can compare a 3D health diagrammatic sketch and a plurality of the 2nd 3D health diagrammatic sketch arbitrarily, with the aequum of the art of selecting to get into shape.
In another embodiment, be useful on the method for removing fatty tissue, may further comprise the steps: the volume and the zone of the definite tissue that will treat; And treat this volume in order to inswept impulse wave (PW) the HIFU transducer that should the zone of serial movement.
In another embodiment, the method for the locus of working load counter-jib location ultrasonic therapeutic head is arranged, this treatment head comprises the motion controller that is used to be suspended at the energy applicator in the treatment head.This method may further comprise the steps, and at first power is applied on the treatment head, secondly provides electronic guide to motion controller.
Description of drawings
Fig. 1 illustrates side view of the present invention.
Fig. 2 illustrates probe.
Fig. 3 illustrates the sketch map of degasification circuit.
Fig. 4 A-B illustrates the element of treatment head.
Fig. 5 illustrates the arm of the input equipment with similar computer.
Fig. 5 A-B illustrates the lead ring control device.
Fig. 6 illustrates optics lead ring control device.
Fig. 7 illustrates expansion joint.
Fig. 8 illustrates the 3D stereo imaging system.
The method of Fig. 9 A-C flag activation patient body.
The specific embodiment
Definition
In this manual, we claim " treatment controller " for being responsible for plan, coordination and the apparatus operating of therapy used in the present invention.This treatment controller is a computer equipment.It can be the computer system or the general purpose computer of the special structure of special use, has order and control that enough hardware and software resources provide native system: be about to treatment head, energy emitter and mechanical arm control within the required range.Sometimes we are called therapeutic scheme software, treatment controller or are used to carry out the program of ultrasonic therapeutic.Each these element is usually all in the list of treatment controller, as the particular sub-unit of primary element of the present invention or treatment controller.
In addition, we use term " electronic communication " to comprise the electronic signal and the power coupling of form of ownership between component (no matter being hardware or software) at this.Thereby we claim the electronic communication that is sent as of data, instruction, code and/or power, no matter this transmission be unidirectional, two-way, also be in response to inquiry or instruction or needs to this electrical power or information.Any moving intentionally of electronics all is " electronic communication " between the parts.
By " treatment head ", we represent to be used to comprise the shell of energy applicator.This shell can be designed to profile match energy applicator especially, makes shell or the volume that has in conjunction with the shell of the additional volume of some optional equipments minimizes.These equipment can comprise the fractional motor system that is used to make the energy applicator to move or use liquid storage pool in the enclosure or has additional sensor, be used for giving a guiding device that places the outside assembly of treatment head with the information relaying.In the description formerly, we give term " end action head " or " action head " on " treatment head ".Term " treatment head ", " probe " and " end action head " are considered to be interchangeable.
The HIFU system description
The present invention is the system that is used for energy is applied to a certain body region.This system has three main subsystems: probe, suspend equipment and the treatment controller.Probe comprises energy applicator and liquid storage pool.Normally mechanical arm of equipment suspends.The 3rd assembly is and the suspend treatment controller of device electronic communication of probe of probe and being used to.Position and/or energy that the treatment controller is used for the monitor scans head transmit, and the guidance system of location scanning head is provided simultaneously.
System 10 of the present invention has the probe 500 that comprises energy applicator 600 (referring to Fig. 1).System 10 also has probe is suspended at aerial device, such as mechanical arm 200.Suspending apparatus supports most of weight of probe 500, and allows the user manually probe 500 to be reorientated aloft, perhaps comes movable scan head by robot controller.Suspending apparatus also can provide the information relevant with respect to the position of patient body with probe.When probe 500 is mobile, can collect data aloft, so that the trace information of probe to be provided from this probe 500.Also have and probe and the coupled treatment controller 250 of suspending apparatus.This treatment controller can be the part of computer 400 or smart machine independently.The position and the energy of this treatment controller monitor scans head transmit, and provide with respect to patient body to the user simultaneously probe is moved on to guiding where.
System 10 has the base 100 that can randomly be installed on a plurality of castors 102.Hub brake 110 can be used to go up in position pedestal 100 is fixing.Optional handle 120 can be used to mobile foundation 100.Pedestal 100 comprises as autonomous device or as the treatment controller 250 than the part of computation machine 400.Optional motion generation equipment such as motor 232 also can be included in the pedestal 100.Mechanical arm 200 is anchored on the pedestal 100 by bar 202.Swivel joint 212 also can comprise rotary encoder 222.
Each arm section all has corresponding joint 214,216,218 and optional encoder 224,226,228.Arm section 204,206,208 is stretched out and Supporting Therapy's head (or probe) 500 from pedestal.Holder 260 is used for connecting the section 208 farthest of treatment 500 and mechanical arm 200.Plus couplings 240,210 provides additional degree of freedom to treatment 500 or optional display device 242.What comprised in each arm section is to be used for moving treatment 500 aloft or to produce equipment 234,236,238 with the power of the weight balancing of treatment head.
We discuss each subsystem successively now.
Probe
Probe (be also referred to as treatment head) is to comprise the energy applicator and the shell of the required any optional equipment of the valid function of energy applicator during treating.Multiple design can select to be used for the probe subsystem.The treatment head is configured to inverted cup or clock usually, has the chamber that slit, a hole is arranged in its bottom.But this chamber separated into two parts, formation has the upper chamber and the lower chambers of sealant therebetween.Upper chamber comprises the manipulation of energy applicator and controls required electronics and motor drive unit.Lower chambers comprises energy applicator, ultrasound wave coupling liquid and the required pick off of this system's proper handling.
Preferably the design of the outside of treatment head is ergonomical, so the user can move with the skin surface that a hands is caught it and propped up the patient or during the targeted therapy head.Man-machine control cooperates and is used for grasping and guiding and is not used for load capacity, because the treatment head is intended to be supported by machinery.Treatment head (Fig. 2) links to each other with mechanical arm 200 by holder 260.From the top of treatment head many lines 531 are arranged, be used for making the assembly in the treatment head to link to each other with treatment controller 250, electronic controller (computer) 400 and off gas system 7.These lines make and keep electronic communication to be connected with fluid between treatment 500 and the base unit 100.
In the present embodiment, the treatment head has upper chamber 504 and lower chambers 502.The fluid tight layer of isolating two chambers is arranged, and one or more through holes can be arranged.If present through hole, then they are used for mechanical linkages 520,528, electronic communication circuit and possibility fluid flow lines 712.Upper chamber 504 preferably comprises a pair of motor drive unit 508,510.Lower chambers 502 comprises at least one energy applicator 600.The energy applicator is that transmit in transparent hole 590 by the energy to the use appropriate format.Between motor driving apparatus and energy applicator, connecting device is arranged.In addition, the many cables that motor drive unit, energy applicator and stream are linked to each other with respective element (treatment controller and off gas system 7) in the pedestal are arranged.
Off gas system (Fig. 3) resides in the pedestal 100, but has the stream 712 of lower chambers of extending to 502.Stream has fluid pump 701, vacuum pump 704, vacuum chamber 706 and is used for the exhaust line 726 of gas.Can be randomly, off gas system can have liquid storage pool 708, cooler 710, a pair of input or air bleeding valve 720,722 and bypass valve 724 and bypass tube for transfusion 718.The fluid that pick off 716,714 also can be used in the monitoring circuit.Liquid 502 is used to help coupled transducers 600 and patient, and reduces near any cavitation effect the transducer 600.
Illustrate in greater detail treatment 500 (a Fig. 4 A) now.One energy applicator 600 is arranged in shell 566.This shell has the permission emittance is led to the patient from shell window 590.This treatment 500 is preferably enough little and enough gently, make the doctor can with a have gentle hands change places mobile it.If the doctor is helped by the articulating arm 200 that supports treatment 500 weight, then this treatment 500 can increase on big or small and weight.The data link 572 of extending between treatment 500 and outer computer 400 or treatment controller 250 is arranged.Top or upper chamber 564 are arranged, and bottom or lower chambers 566.
On treatment 500 articulating arm 200 that can be installed in by pedestal 100 supports.This articulating arm 200 will move it with function and monitored or control by computer 400 or treatment controller 250.
Preferably treatment 500 comprises the motor driver 508,510 that is used for mobile in the enclosure energy applicator 600.Motor driver directly or by the gear assembly (not shown) is connected to pair of push rods 520,528.Push rod moves a cross-notching driver 520 ', 528 ' then.The fluting driver moves along the push rod that the intersection two fluting drivers carries the energy applicator.When push rod rotated in response to the motion of motor, the fluting driver supported the energy applicator in the range of movement of fluting push rod.Rotary encoder 530 is placed on the push rod 520,528, and the motion of energy applicator can be measured exactly.
In another may embodiment (Fig. 4 B), motor drive unit 508,510 can be used to control and invest the plate 534a of the plate 534b magnetic couplings of energy applicator.This plate is moved by motor, and the energy applicator also moves in response.Except that magnetic connected, the energy applicator did not all have physics with arbitrary class push rod or mobile device and is connected.Still need through hole, thereby the energy applicator keeps electronic communication with treatment controller 250 and computer 400.Yet communication equipment removes even this through hole still can use short distance " wireless ".
Be allowed in chamber to flow and may disturb this therapy.
Blow-off system 7 utilizes well-designed assembly and step to remove gas from solution.In addition, can add cooler and come cooling liquid.According to hydrodynamics, cooled liquid physical shapes becomes the probability of bubble littler than warm fluid.In addition, help to reduce the temperature of treatment transducer, and allow more long duration and do not accumulate heat of HIFU transducer work through refrigerative coupling liquid.This fluid circulation system can use and be applicable to the coupled any liquid of ultrasound wave, as long as this liquid has relatively low viscosity, it can be circulated and exit effectively.Best solution is water.
Probe or treatment 500 also can be at the many pick offs of the combined outside of lower chambers.Energy-delivering hole leans against on the patient skin places.During the HIFU treatment, can utilize various pick offs to promote to treat the effective tracking of head on patient's body surface, and be convenient to the safety operation of equipment.The treatment head also can be incorporated into touch sensor wherein.Touch sensor provides pressure feedback by first control device or by display or alert device to the user.Sensor measurement treatment head is applied to the pressure on the patient body, and provides resistance feedback or calibration pressure information to the user, so that the user can feel that the treatment head is applied to the pressure size on the patient skin during treating.Feedback can be used to give the user enough haptic response degree, to prevent the mechanical arm patient harm.Perhaps, mechanical arm can make security limitations place on the resistance feedback, preventing the injury to the patient, or prevents the excessive deformation of patient skin profile in treatment.Particularly, be or comprise when being used to handle the treatment transducer of fatty tissue that the focus area that does not importantly make tissue volume excess compression or distortion reach transducer no longer falls within the degree in the adipose tissue volume when armarium.Because this organizer are " soft " (opposite with muscular tissue with skeleton or hard tissue or zone near body surface), it is convenient to be out of shape.Thereby, even being necessary to be adjusted to, touch sensor have less pressure that response is also arranged to patient skin.This allows that with the minimum organization distortion user being made stronger resistance feeds back.
Touch sensor is in conjunction with the load sensor device work that is used for treatment head and patient body are kept in touch.Load equipment can be the part that mechanical arm strength produces mechanism, or the part of the nose heave amount of treatment that is used for contending with, simultaneously enough weight can be transmitted to keep the independent balancing equipment that engages of treatment and skin surface by the treatment head.
Various tracking transducers can be used to detect and follow the tracks of its position and direction on one's body when treatment head patient Yu is mobile.Positional information can be stored as required and be attached in the accurate mapping member.The cubing tracing program can provide the real time information (referring to following content) of relevant reason tissue of living in.
In an optional embodiment, probe has only a topping up chamber.Motor sub-assembly can be positioned at this topping up chamber (using the motor at the liquid seal shell), and perhaps motor sub-assembly is arranged on the outside of treatment head.In the present embodiment, motor sub-assembly can be positioned on the distal arm section 208 of arm 200, and is relative with the treatment head.Motor sub-assembly can be passed to energy applicator 600 with motion by driving cable, synchronous cog belt or other plant equipment.
The liquid that moving device drives provides.In the present embodiment, the fluid force that produces in the treatment head also can be used to provide the motive power of mobile energy applicator.
The energy applicator preferably has the HIFU ultrasonic transducer of the one or more diagnostic ultrasound elements that can be used for tissue scanning.During can putting, " string formula " (" a-line ") scanning device, perhaps can line up array to check near the tissue the focus area at the periphery of HIFU transducer with the focus area of perspective HIFU transducer.String formula scanning can before the HIFU scanning, during or carry out afterwards, and preferably the imaging of string formula is carried out concomitantly with array energy transducer, perhaps interweaves with the pulse wave form of HIFU transducer or with by the HIFU focus area or center on its lasting scanning form.Energy applicator 600 can be combined into individual equipment and co-operating during treating by a plurality of element 602,604,606 expressions to represent multiple energy applicator.Transducer container 640 is used in the situation of using the combination transducer assemblies a plurality of element of transducers being kept in position.
The HIFU transducer can parameter be enough to cause operating on any scope of necrocytosis.In one embodiment, the HIFU transducer up to the pressure of 30Mpa is operated, is had in system of the present invention utilization on the frequency of 1-4MHz, uses 1KHz or higher pulse recurrence frequency (PRF).Transducer is made folk prescription to moving with the speed of 4-30 mm/second on patient's skin surface.Transducer is similar to the carriage return of manual typewriter and returns a side like that.The line space scope of treatment row is the 1-3 millimeter.
Probe uses ultrasound wave couplant and patient's coupling.Couplant can be acoustic gel or the coupling liquid of using in conjunction with circulation system in the probe.
If the couplant of degasification in the use pipeline, then liquid is by probe circulation and turn back to the fluid degasification or refrigerative master unit.Fluid is flowed through before the energy applicator by liner or by the Xiao Chi 502 that fills with complete dipping bath energy applicator.The energy applicator can transmit its energy of window " broadcasting " by acoustic window or other then.Window can be attached in the probe, and perhaps it can be an adnexa, such as the form with disposable transducer sealing member.
The device of probe is used to suspend
Arm with position coder
An embodiment who is used for probe is suspended in aerial device is the arm with position coder.This is the arm that designs for carry load during treating.This arm comprises the pedestal that is used for fixing articulating arm.This articulating arm has the near-end that movably is fixed on the pedestal, and far-end.There is at least one to be attached to the position coder of arm.Container is positioned at far-end and is used to carry probe.Also be useful on the device that when probe connects, makes the arm load balance, thereby position coder can be followed the tracks of the position of arm in real time.
One or more position coders are used for following the tracks of the motion of articulating arm.Position coder is preferably enough sensitive little of 1 millimeter or littler change in location to follow the tracks of.Rotary encoder is preferable, and can be included in the joint of articulating arm, make each arm section with respect to pedestal or with respect in another arm section or the joint, each arm section can be followed the tracks of with respect to pedestal or with respect to another arm section or with respect to the motion of treatment head with respect to the fortune armed lever for the treatment of head.Rotary encoder is measured the variation of the angle between the arm section when articulating arm moves.By following the tracks of the variation of angle between the moving-member, and know the regular length of each arm section, then the position of any joint can use mathematical calculation to determine.If probe or other armarium are fixed on the articulating arm by the joint that also has encoder, then the change of joint angle will help to determine exactly the position of probe.Although rotary encoder may be on-line equipment of following the tracks of the arm position, also can use the encoder of other type.
Load balance can be taked active or passive form.In passive form, the device that is used for load balance comprises that the variation to articulating arm between the operating period provides equilibrated frame for movement.This frame for movement is guaranteed the always enough balances of arm, so that any moving that the treatment head causes because of gravity, joint sliding or arm lag behind minimizes.This arm has the device of the known method that is used to comprise load balance, and is used to produce or the equipment of retentivity.The power that is produced is used for load balance, and can be that active power produces equipment (for example motor of any kind) or passive power produces equipment (for example pressure cylinder of spring or balance weight or some types).The definite form of power generation equipment or method is particular importance not, because the present invention depends on well-established power production method and equipment in corresponding field.
How all arm invests has the increasing the weight of on the pedestal of enough weight, no matter position that arm moves when additional treatment and angle this arm of grappling.Thereby arm can reach its maximum extension scope, and reaches and cause the maximum angle that moves in center of gravity place, but pedestal must enough heavy or fully grappling, makes this arm can the overturning or the instability that becomes.Be used for the joint permission arm of knee-joint to pedestal moved with respect to the rotation of pedestal, and/or arm is with respect to the inclination and the deflection of pedestal.Joint between pedestal and the arm near-end comprises that passive or Active Force produces the load balance equipment of apparatus-form.
Arm comprises two or more sections, and load balance structure (each section is with respect to other section self-balancing of arm) or (each section is in conjunction with one or more adjacent segment balances) use independently relatively between each section.Farthest the load balance of arm section also must to treatment head and during treating its producible any change in location regulate.
In order to keep the load balance feature, the weight compensating ability that the weight that invests the treatment head of arm far-end must be no more than load balance device is self-evident.Similarly, the moving range of arm itself should be restricted, and becomes uneven to prevent arm.The load balance structure should (least equilibrated configuration) compensation be treated the load of head and the variation of center of gravity when the treatment head is stretched over away from pedestal on horizontal plane.Preferably the load balance structure also compensates any hysteresis that can follow arm to move.Thereby the load balance institutional capability is big more, and admissible moving range is also big more on the articulating arm.Use the encoder of arm to determine the position, just may depend on the moving range that the weight for the treatment of is come control arm.The form of the data chip that treatment head itself can be read by arm provides data to articulating arm.Data chip can comprise action head or the quality of treatment head and the information of operational design thereof.That is to say that when new treatment head appended to the far-end of arm, the mobile controller of arm just can be pointed out the moving range of being permitted " intelligence ".Thereby the scope that moves restriction or " stopping " can realizing on the arm of working load balancing equipment (but in situation of its electrical control), and perhaps controller can give the alarm when moving range is approaching can accept to limit the time.This alarm can be that tone, caution light or other are easy to send to user's signal.Perhaps mechanical obstacles can be set manually or automatically, to forbid before the begin treatment that arm moves on to outside the range of balance.
Given controller by the data that encoder produces by relaying.Controller is the computer equipment that is used for providing to device position tracking device or closed loop control mechanism.In passive mode, controller does not provide Active Force to articulating arm, on the contrary its signal of providing arm where should move, where should not move to the user.
In passive mode, load balance device can be heavy and spring with the co-axial simple balance of articulating arm, thereby moving of arm will produce the position of balance weight and/or spring or the respective change of arm itself as required.The four-bar arm can be considered as an example.The use of independent passive load balanced controls is preferable.Use this mode, when arm moved, each arm section and all other arm sections be balance simultaneously.
In relevant passive mode, can re-use a series of springs and balance weight, lax gas, hydraulic pressure or air motor will be more effective when pressure is applied to arm far-end (or treatment head) or in response to the activation of trigger mechanism although use is designed to.In case producing the pressure of equipment or power from these passive power is that arm is rebuild when manually placing desired location.This pressure on the arm section or power prevent that arm from moving once more, till operator discharge this fixed pressure or power.
In another embodiment, use Active Force generation equipment (such as cylinder/hydraulic cylinder or air motor) the active load balanced controls of any kind available.These can come independent or operation relatively based on the order that the user provides by the robot driver.An advantage of active load balanced controls be during treating articulating arm automatically compensator arm location, make the treatment head be in the method for desired location simultaneously.For example, when the user wants to change rolling, pitching or the yawing of the treatment head local configuration with the coupling patient body, this can realize by move the treatment head in being used for probe is connected to the joint of arm far-end.The change in probe orientation can be depending on the size of probe and weight and causes equilibrated trace or great change to articulating arm.Use the active load balanced controls, the variation in robot driver's scalable probe orientation, and do not change the position of arm far-end.
Position coder of the present invention can be machinery or the optical encoder that is combined in the arm itself, and perhaps it can be at the outside one or more feedback devices that use of arm.The optional embodiment of encoder comprises that the one or more optical devices of use are used for following the tracks of its position when arm moves.Arm can easy sign with combined sensor and a plurality of optical readable labels of tracking.Another possibility is at the proximal tip place single RF emitter to be arranged, and the RF receptor that is positioned at pedestal or external stability position.The RF data will make controller can follow the tracks of moving of far-end, and know where action head places.These embodiment and any equivalents all are not considered as preferred embodiment, but still in the open scope of the present invention.
Controller can be software application or the hardware device (or both combinations) that receives data from encoder, and the position of calculating the treatment head.But controller is the position of each section of accountant also, and mapping device is skyborne mobile.Because encoder and controller electronic communication are used to know treatment head data wherein and occur in real time basically.Delay during the data computing machine is handled is too small so that the non-detectable interval of user.Even in the process that treatment is carried out, use the present invention also can not experience any tangible or feasible delay by the treatment that the doctor manually carries out.
Except accountant spatial position, controller can provide mobile message to arm by the robot controller as any actuation control assembly of device.This controller also receives data from outside feed-in, or reads information from data file.Can be used as robot controller with this mode controller, deferring to real-time command, or read a series of movement directives that provide mapped data file or treatment head to defer to from user or another computer.In addition, if the treatment head need accurately activate on preferred coordinates, then controller also can be handled these operations.
Far-end has the treatment head that adds on it.It must be fixed should adding, but also should be movably, thereby the treatment head can move between the treatment step, or can treat between the step in difference and exchange.Moving range between the far-end of treatment head and articulating arm can use the rotary encoder in the joint that connects treatment head and articulating arm to determine similarly.Joint between treatment head and the articulating arm can have a plurality of swivel joints or globe joint, to allow the bigger activeness of treatment head.Encoder in each joint or can accurately measure encoder that angle in the Three dimensional joint changes and provide information needed to determine the definite position of treatment.Similarly, in case and the angle and distance between the pedestal is determined, comprise any additional information, such as the length of last encoder in the chain of specific medical arm distance from the pedestal to the far-end, and the definite three-dimensional coordinate position of definite action head or treatment head is just simple.
Perhaps, joint of robot formula armed lever can be according to following criteria construction, and perhaps it can be a large equipment.Again, pedestal is anchored on floor or wall or the desktop.The size that the type of the treatment or the armarium that uses will be arranged joint of robot formula armed lever.Need the armarium of more firm supporting structure can need the arm that has bigger bearing capacity and be attached to the bigger stabilizing factor in the pedestal naturally.Than skinny device can use can be portable, and can use anchor clamps or similar device grappling arm on the table.
The load balance arm of no position coder
With aforementioned load balance hands unit affinity, the treatment head can be suspended in the air from load balance or mechanical arm, and does not utilize position coder.Describe the manual variant of arm at this, wherein arm provides previous described load-carrying ability, and does not have location sensing and trace ability.This arm both had been convenient to make and produce, and be convenient to again safeguard, but it lacked the degree of accuracy of last embodiment.
Do not have the arm of position coder mainly to can be used as the load-carrying arm, make the user needn't bear the weight of treatment head.Shown arm is shared previous described many elements.Arm 200 has pedestal 100 and a plurality of arm section 204,206,208.Arm 200 is fixed on the pedestal 100 by platform 202, and has a plurality of tensioning devices 234,236,238 that are used for keeping arm position when mobile.Treatment 500 be placed on can container 260 with respect to 208 rotations of distal arm section in.The user is used as the position that control device comes motion arm by treating head.The user can catch treatment head and move a treatment head aloft, and the weight of arm Supporting Therapy head and make the treatment head be positioned at the user to expect part.In the present embodiment, arm lacks according to the ability that can treat the position of head by any position correction that the treatment controller provides.Opposite user will have to keep suitable location.Perhaps, one of arm section of the basic load of carrying treatment 500 can be used balance weight 238 ', does not firmly produce arm 238 and do not make.
In the present embodiment, replace Robot Force with tension force generation equipment and produce equipment.These provide enough resistances that overcomes joint sliding, hysteresis and gravity, but such as move in user's application of force the treatment the time can adapt to applying of additional force.In case institute's reinforcing is released, then tension equipment keeps the position of treatment head.
The guidance system of arm
Place the guidance system of the therapeutic equipment on the mechanical arm preferably to form by two assemblies of co-ordination.First control device moves by the control mechanical arm, and " macroscopic view " level control to therapeutic equipment is provided.The armarium of second control device in the treatment head provides the control of " microcosmic " level.
The order of mechanical arm and control are provided by first control device (Fig. 5).Shown in system have as hereinbefore element, add the input arm 244 of the similar computer that is installed on the distal arm section 208 in addition.Also has optional slip joint 216 ' (Fig. 7).First control device provides move to other force generating apparatus of motor or mechanical arm.Except the move to mechanical arm, first control device also can provide effective positional information to the user by visual displays 242.
First control device can be the various distinct devices that can guide mechanical arm to move.In first embodiment of first control device, computer entry device can be used to provide effective location of treatment head, and provides move to mechanical arm.Computer entry device can be to be commonly used to pointer (cursor) on computer screen according to for arbitrary class input equipment of movement directive.These are the bidimensional input equipment normally, such as mouse, clipboard mouse or tracking ball.In addition, three-dimensional input equipment can be used to provide the location in the 3D vision frame on computer screen.These equipment are illustrated as stick, D controller etc. usually.The real degree of freedom that moves in the last virtual environment can provide by six-freedom degree (DOF) equipment such as " the space ball " that use in computer-aided design (CAD) is used usually.Input equipment as first control device can be the computer entry device that can be purchased off the shelf, or special design is used for the mechanical arm apparatus operating.The equipment that is used for first control device is interchangeable, thereby depends on user preferences or treatment requirement, even when using same mechanical arm, also can treat next from one and use different input equipments remedially.
Use different input equipments remedially to next.
Although preferably mechanical arm has identical degree of freedom with input equipment, this is not to be essential.The input equipment that is used for first control device is interchangeable.That is to say that input equipment there is no need for good and all or regularly to be attached on the mechanical arm.Input equipment can be by linking to each other such as the computer interface that is generally used for computer entry device.Thereby input equipment can have three DOF and another can have six DOF, and the both is fit to bring in order and control mechanical arm by common interface.Ideally, mechanical arm has six DOF by treatment head, and has enough motilities and range of extension makes six DOF can send the treatment head to, and can Physical Interference not arranged with other object that presents (such as patient or user) during treating.
Input equipment mobile uses the same procedure that produces the virtual location information of the cursor that will show or other dummy object with computer entry device on computer screen to produce move.Yet except the virtual mobile and positional information that input equipment provided, mobile message also is translated into being used for controlling the motor of mechanical arm or the actual movement directive that power produces equipment.With this mode use a computer input equipment make the user can operate may be heavier and heavy armarium, and need not to use than operation computer entry device required more strength.Different with more fixed computer entry devices of direction (such as I-font or cursor arrow), the direction of the cursor that shows on the computer screen of described input equipment is preferably corresponding with the known orientation of armarium.For example, cursor arrow can be pointed to the direction identical or opposite with the direction of armarium emitted energy.Thereby the variation mobile and cursor orientation in virtual environment of input equipment will produce armarium or the position of treatment head and the respective change in the direction.
Similar to normal computer entry device, the employed input equipment of system of the present invention can have button or roller or other driver thereon, but that they can be programmed to is corresponding with the specific operation element of system.For example, the button on the input equipment can be used to switch between the motor on the open/close machinery arm, carries out treatment or refreshes some sensing data thereby activate armarium.
Input equipment application and the important difference of the general application of these equipment aspect of reorientating that is these input equipments in the present invention.It may be general knowledge that computer entry device can be convenient to compensate user's man-machine demand for control and reorientate.For example, mouse or stick can be obtained and move, and the physical location of mouse pointer, I font etc. remains unchanged simultaneously.This advantage of computer entry device can be at the input equipment of certain limit endoadaptation in the first control device that is used as mechanical arm.
This advantage can be converted to when reorientating input equipment, when mobile time-out of treatment head, armarium or mechanical arm to the control of mechanical arm.Yet, when input equipment is used for following the tracks of treatment head, armarium or the mechanical arm path (vide infra) with respect to patient's actual placement, or treatment head, armarium or mechanical arm be when representing with respect to the representativeness of the position of patient body, and this advantage can not transform.
The representative placement relates to figure or the model that substitutes the patient skin surface of using on the actual skin surface.In an optional embodiment of tracking system, the figure of patient skin surface can use projected image and photographing unit to produce.Projector with image projection on the rule grid lines or the patient body of grid block at interval.These lines throw from template, and this template has known lines at interval.The distance that needs only between the every line is known, and lines just can be regular or irregular at interval.The string diagram picture that is throwed falls within on the patient surface of being detected by photographing unit with the angle that departs from projection line.Photographing unit reads the distance between the lines, thereby produces right angled triangle second distance value on one side.Thereby use simple trigonometry, can determine the height distance between the lines.
Tracking system can be followed the tracks of the two dimensional image of projection, and wherein the actual range on the inclined-plane is by mathematical calculation rather than directly measure determine.Provide the good approximation of distance and slope with this mode graphics, made ultrasonic system be applicable to long (or short) slope distance, and transmit suitable energy level.
Similarly, in another embodiment of tracking system, can use patient's three dimensional representation.This three dimensional representation can be to be decorated with isocontour model, or the projection of deriving from the health of actual patient.This three dimensional representation need not too greatly or is too accurate, as long as it can not project in the muscular tissue or other tissue that should not treat even as big as comprising required area for treatment, be accurate to the focus area that makes the transducer that will follow the tracks of on the actual patient health.
In any of these tracking systems embodiment, should understand that to keep enough accuracy in the model of the succedaneum that uses patient skin surface or tracking system be necessary and favourable, thereby the therapeutic equipment of reality only continues to treat unwanted fatty tissue.Imaging or string formula scanning transducer can be used to guarantee that the treatment strictness is applied on the fatty tissue during treating.This allows to detect in real time fatty tissue, and is provided at the detection means that makes system closing or cut-out when imaging sensor detects the situation of non-fat tissue.Head is on the suitable adipose tissue regions even the user feels treatment, and equipment itself also has carrying out safety backup.
Placing in the situation in reality, is unwanted for reorientating of above same cause input equipment, unless reorientating of input equipment will be corresponding to the direct variation in the placement of armarium, treatment head or mechanical arm.
Computer entry device as first control device can be directly installed on the mechanical arm.Preferably the input equipment of six DOF of tool is mounted in this case, and is positioned at basic near a treatment part.The user can come operation input apparatus by the movement directive of manually handling input equipment (such as stick or space ball) and checking the input equipment that moves that converts mechanical arm to.User thereby " being in the work loop " also can be decision making to the angle and the location of treatment head as long as pay close attention to the control and the guiding of mechanical arm, and need not to check the display screen of the virtual representation that moves with mechanical arm.The user can be in six DOF the location of adjustment of treatment head, simultaneously as a user in the control loop of mechanical arm.
Visual display device 242 can be installed on the mechanical arm, thereby the user can handle treatment 500 when checking display device 242.Can estimate sensor information and data on the display screen with this mode user, use this input equipment to guide moving of armarium, treatment head or mechanical arm simultaneously.The data that pick off provided show on screen, and make the user can handle effectiveness and safety maximum that input equipment makes medical arm or treatment head, and are not forced to along watching on some different directions to collect the required information of this system of guiding.
In another embodiment, first control device can be the lead ring 267 (Fig. 6) that places on the patient body.In this embodiment, lead ring 267 provides target data, and have be attached in the mechanical arm 200 or treatment 500 in the tracking system of (or in both, all having element).For explaining, guidance system can be the optictracking device that the emitter 256 from the mechanical arm 200 emits beam.Light reflects from the emitter 258 on the lead ring.The light that reflected forms pattern or the direction that places the fluorescence detector 262 around the treatment 500 to read.Where optical pickocff 262 thereby the center that can determine lead ring 267 and provide to mechanical arm and to move or the direction command instruction, thereby mechanical arm moves and makes the treatment head remain on the intra-annular central authorities of target.
The target ring is transparent in the centre, or has a hole.Hole or transparent material must not can obviously disturb the missile any energy of armarium, also can not disturb the pick off that can be attached in the armarium.Ring can be made by flexible material, thereby when placing on leaning against patient body, it can comply with patient's profile, and perhaps it can be inflexible, so that provide definite reference plane to user and/or treatment controller.The user of system can be along moving target ring, the mobile and angle variation in the tracking system tracking target ring simultaneously manually of patient's body surface.Tracking system provides appropriate command and control information and the treatment head is moved again to mechanical arm, thereby armarium remains on target ring center as much as possible, makes armarium vertical with the general closed planar of target ring.
Perhaps the user can place the target ring patient place on one's body, and allows microprocessor (second control device) to treat zone intracardiac in the lead ring.
The target ring can manufacture a side and be adapted at smoothly sliding on the patient body.Should handle it with silicon or polymeric material, with the frictional force of reduction equipment when the patient is mobile on one's body.Side (deviating from patient body) towards tracking system has enough visual cues or labelling thereon, to produce asymmetric reflection or refraction diagram.Like this, tracking system can be determined the direction of facing and rotate that to adapt to the rotation of target ring, making armarium or treat head if having time all can be suitably directed in institute.
Perhaps, tracking system can be made into to follow and describes on patient body or the path detected of the marking.In this embodiment, user or operator can place treatment head on the patient body (physics contact or near patient body).Thereby tracking system is as first control device, and follows the path on the patient body automatically.Second control device can be that user's may command provides the microcontrolled input equipment of armarium position when treatment head is followed the tracks of path on the patient body.Perhaps, electronic controller or treatment controller can have a program, and it is with acting on second input equipment that moves or vibrate treatment head or armarium.Should move or vibrate will be as " waving " similar effect, a zone under the patient skin that the removing transducer once focused on when it operated tracking system.
Datum mark can place on the patient skin, so that tracking system is followed.If electronic controller has program or the specified response of following the tracks of on the surf zone that is limited by discrete datum mark, just there is no need on patient body, to draw the path in case tracking system follow.In this case, first control device can be used to mechanical arm and treatment headband are gone in the zone that is limited by the datum mark labelling.The treatment head be obtained and be moved to second control device can according to its program parameter in the datum mark labelling.The software program that moves of guiding armarium or treatment head becomes second control device.When the surf zone that will treat is big, the co-operating simultaneously of first and second control device.That is, the bootable mechanical arm of user is handled armarium moving in limiting area for treatment and treat preface as the treatment of second control device operation.
Another embodiment makes tracking system and input equipment combination, thereby the user can use input equipment to come manual guidance mechanical arm, treatment head and medical arm, to follow the path of depicting on patient body.Second control device can be the automated path regulating command again, provides artificial swing to treatment head mobile when mechanical arm marks the path on patient body.
Another embodiment advocates and uses and the similar customization input equipment of computer entry device design, but is attached in the mechanical arm when making up.In this embodiment, control device is incorporated into the far-end of the mechanical arm of approaching basically treatment head.Bonded first control device utilization and the similar technology of computer entry device such as optical tracking element, deformeter, power torque transducer etc.But input equipment is built into has the DOF identical with arm, and is placed with user-friendly.
Second control device provides the movement directive and the control of medical arm in the treatment head.Second control device has that the micromotor that is used for moving armarium in the treatment head itself makes up or uses during other force generating apparatus at treatment head.Can obtain order with this mode mechanical arm and will treat head and move on to desired location or place, and second control device can be used for the accurate placement of armarium with respect to patient body.Thereby first control device provides the control of " macroscopic view " level, and second control device provides the control of " microcosmic " level.
Perhaps, second control device can be the software program that the micromotor combination provides move in the treatment head.Thereby the accurate placement of armarium during treating can be left automated system for.This makes system place the exact position to reach the accurate period armarium in response to parameter preset or in response to the real time sensor data.
In another optional embodiment of second control device, direction variation or " swing " can be incorporated into from first control device and be relayed to the move of mechanical arm automatically.Still provide the move of " macroscopic view " level with this mode first control device, and variation provides some " microcosmic " level movement directives that the direct conversion of the moving direction of the first control device reception of can obstructedly associating is simulated or realized automatically.
In another embodiment, the input equipment as first control device can switch between macroscopical guided mode and microcosmic guided mode.An available switch switches between pattern, thereby the permission user can be mutual with single input equipment, and makes first and second control device all available.During operation, the user can be with input equipment as first control device, with macroscopic view location that mechanical arm is provided and the placement for the treatment of head or armarium.In case the treatment head is in the adjacent domain that will treat, guidance can preferably be determined as macro-level, and the user switches to microscopic level control.Input equipment becomes the second control device that is used for armarium in the meticulous control treatment head now.Perhaps, the meticulous motor that is attached to the main force generating apparatus that is used for mechanical arm is controlled and can be provided microscopic level to control when using identical power to produce equipment.This is similar with vernier focusing to the coarse adjustment of finding on optical microscope.Application in the motor of mechanical arm uses will be that the meticulous meshing gear of control is to ordinary gear or meticulous to one of rough power producing component.
Mechanical arm also can make position or mobile encoder set up therein.Encoder is used to follow the tracks of the position of therapeutic equipment and moving of each arm section during using system.Mechanical arm preferably had teaching model.Teaching model can be come lead arm manually by one group of required move operation by operator.Electronic controller can " be observed " path of institute's warp between moving of arm and memory starting position, final position and beginning and the final position.Should move and to remember by electronic controller, and come often to repeat as required by calling move again.Many mobile route can be stored in the computer storage as required.
Be installed among the embodiment of arm at input equipment, slip joint (Fig. 7) can be attached in the arm, with the shift position that helps to make some the excess power used on the input equipment or moment of torsion can not influence mechanical arm.Slip joint is designed to help to absorb or reduce excess power.For example, revolving force can be added on the input equipment, so that the treatment head changes its axial rotation.If the user has applied too many revolving force, then input equipment can be pulled to physics or artificial block.At this moment, excessive revolving force can consume in slip joint.The rotating shaft of input equipment can be installed in the double wheel axle bearing assembly 2163.In case input equipment arrives at its block, additional force just overcomes the threshold force level and makes the platform can be at twin shaft carrier ring internal rotation.Thereby extra revolving force is harmlessly consumed.Slip joint is necessary to have through hole, makes data message be sent to electronic controller from input equipment.Slip joint also can comprise the physical holes that is used as with any physical connection of arm or the through hole from input equipment to the treatment head.
Except that duplex bearing wheel 2163, slip joint can comprise additional shaft, and wherein power can be absorbed so that make arm and unnecessary power isolation.Use this mode, rotation in a plurality of planes and torsional forces can be known, with the accuracy of protection mechanical arm.Input equipment can absorb the power above maximum, force, and the power of not offset by slip joint can be subjected to the restriction of mechanical arm.But mechanical arm sensing external force (those are not the power that is derived from the instruction that receives from input equipment) also compensates by applying opposite power.When the user handles input equipment energetically with trial and suitable locating therapy head, should " website maintenance " be useful in complex environment.
The DOF of first control device can be divided into robot composition and manual composition.Mechanical arm can make up with any amount of DOF, and the treatment head is made manual adjustments to remaining required DOF.For example, if mechanical arm makes up with three DOF, and first input equipment is the computer entry device with three DOF, and then the treatment head can be installed on the joint of three additional DOF that permission do not provide by mechanical arm.Tracking system can still be followed the tracks of the position of armarium, and manual and robot DOF composition are edited into single locus, is used for visual representation and treatment tracking purpose.This system can make the treatment head axially be installed to input equipment, and wherein mechanical arm can pass through to import the arm adjusting, and the treatment head can the while manual " aiming ".
Attention can be first or the component of second control device to the manual additional use of control device.If treatment head has a microcosmic position motor that is used for moving armarium in the treatment head, then the manual allocation to the DOF of treatment head will be the component of first control device.First component in this situation will be the order and the control of mechanical arm.Can be this user with treatment head itself as input equipment, with targeted therapy head and mechanical arm.The microcosmic Position Control will keep with treatment controller or electronic controller, and move the energy emitter in the treatment head.Perhaps, if armarium is fixed in the treatment head, then the manual component of DOF will constitute second control device, and the order of mechanical arm and control can remain first control device in addition.Replace robot path or the artificial automatic adjusting that guides swing at this manual positioning.
First input equipment and nonessential being placed near a treatment part.First and second control device can be placed on from treatment distant place on first watch.For example when mechanical arm and treatment head plan operated from a distance, control device can be placed near the remote computer place, and wherein the user follows the vision or the virtual representation that move of treatment head on patient body.This optional embodiment is preserved for distinguished the needs in the treatment of doctor near patient body.
The mobile device of articulating arm or motor should have rate limit, thereby arm is not easy to any moving patient or operator's injury that cause.Mobile controller thereby not only will control the speed of reorientating of end action head, and will control the speed that any single hop arm moves in the space, thus avoid or reduce the probability of meeting operator or observer in careless at least.
Can randomly show that arm 242 can be placed near the far-end of arm 208, thereby during treating, provide visual feedback and information to show to the user.
The medical treatment controller
Electronic controller is used for the function of each element of coherent system.Electronic controller can be one or more computers or be applicable to other special electronic equipment of the present invention.Electronic controller receives input information from first control device, no matter this first control device is computer entry device, lead ring, or tracking system.Electronic controller converts input information to the move that is used for mechanical arm then.Can realize second data path, it can provide the virtual vision object that will reappear showing on the arm.Moving must be suitably related with the data flow in video data path, and making this move the visual representation that moves with system can overlap exactly.
Electronic controller also must be coordinated the input of second control device.If second control device and first control device simultaneously operating, then electronic controller must be coordinated it and moves, and makes armarium with according to the mode of the performed treatment area for treatment by patient body.Electronic controller is necessary to compile exactly the movement directive of first control device and second control device, thereby the patient is safe from danger.If the second control device independent time frame operation that separates with first control device, then electronic controller only needs to guarantee the order of armarium position and the suitable control that control obtains suitable controller.Similarly, electronic controller must by prevent armarium on patient body without permission or inappropriate move, guarantee the safety of patient body.
Electronic controller can be used as the treatment controller.If computer is used as electronic controller, then it can possess the ability of the pre-loaded software of carrying out the controller that can be used as armarium, perhaps it can have the expansion slot such as pci bus interface, and this expansion slot can be accepted the one or more plates as the treatment controller function.For electronic controller of the present invention, with the treatment controller of armarium have close electronic communication with guarantee armarium and treatment head move and physics places according to treatment to realize it being favourable but and nonessential.
Second control device can be the physical equipment that is used to provide input, such as the secondary computer input equipment, or the first control device that provides fine location to control after switching.Perhaps, second control device can be the software program that armarium in treatment head provides the move of programming in advance.Similarly, second control device can be the fixing or restricted variable motion of adding the first control device move automatically to, changes so that swing or other stable status to be provided to manipulator motion.
The treatment controller is preferably in the graphics (referring to following trifle 3.0) that treatment just has area for treatment before really beginning.The treatment controller can be during actual therapeutic the progress of monitor scans head, and with its with want the figure of treated tissue to make comparisons.The part progress of treatment can be handled by the position tracking device for the treatment of first use in conjunction with the present invention.
The Position Control of energy applicator and tracking are a kind of method that fatty tissue can effectively be removed by system of the present invention on program.Can in fatty tissue, produce significant precision, so that produce the wound or the tissue necrosis of the tissue of eliminating.Precision can produce by the control device that utilizes all places pick off and being used to regulate the position of energy applicator.
The position of treatment 500 a self-energy applicator 600 can use the motor coding 508,510 that links with the micromotor combination to be connected to the amount of movement of the executive component 508,520,516 of energy applicator 600.This is the first step of isolating the position of energy applicator.In case the position of energy applicator 600 is known, should determine the position of probe 500 with respect to patient's human body in the shell of probe 500.Can use a series of optical pickocffs 555
1, 555
2Accurately measure the physical distance that probe is advanced on patient skin.These optical pickocffs also can be used to determine rotation change (probe around its basically with the amount of the vertical central shaft rotation of patient skin), and angle changes (with respect to not in the rotation of the axle at probe center).In addition, the encoder in the articulating arm can be used to determine the variation of position in three-dimensional of probe 500.Thereby, if probe 500 is moving at the human body laterosurtrusion, then will can not lose three location sensing mechanisms.Computer 400 or treatment controller 250 tunable data, and with accurate mode tracing positional and the dosage highly organized.Can be randomly, all data can use airborne processor 532 to follow the tracks of on machine.The division of processor responsibility can help to alleviate load, and expedited data receives and the response time between operator's output signal.
If do not follow the tracks of patient skin for some reason probe, then tracking system allows that probe turned back to patient skin and guarantees the suitable orientation of probe, thereby this process can begin immediately, attempt not to determine which is organized and treats and which organizes still untreated conjecture and do not have to relate to.Reorientate to relate to probe is placed the reference position, and according to this probe that aligns of the flange (not shown) around shell the latter half.
Any use of three equipment of determining and following the tracks of the position of energy applicator allows the organization charts or the bedding figure of the current therapy that display process will show on monitor, LCD or miscellaneous equipment, thus they can be by user's proper interpretation he or she can determine probe will be moved on to where to continue this treatment.The designator of being convenient to treat can be equally simple as the audible tone (a kind of tone is used for moving on the untreated zone, and a kind of tone is used for moving on the area for treatment) of varying strength, comes guidance light, detailed especially video to show.Display can be installed in the outside of native system, or uses in conjunction with computer, treatment control device, or be installed on the probe or near probe than small displays.
Also disclosed the method for the present invention of using.At first be useful on the method that energy is applied to body region.This method comprises: the first, provide therapeutic scheme to the treatment controller.The second, the guiding in response to the treatment controller produces manually scans with probe on body surface, transmits energy from probe simultaneously.The 3rd, the position of monitor scans head and energy therefrom transmit with the generation position data, and send position data to the treatment controller, and the 4th, if transmitting, manual position and/or energy fall within outside the therapeutic scheme, then produce alarm.Then figure is loaded into the treatment controller.Other treatment parameter should be input in the treatment controller as much as possible.This helps to produce therapeutic scheme based on virtual graph and other treatment data.
Be used to produce the system of the three-dimensional organization charts of 3D
Also be useful on and produce the physical shapes be complementary and near the system (Fig. 8) of the subcutaneous tissue figure of body surface.Should
Also be useful on and produce the physical shapes be complementary and near the system (Fig. 8) of the subcutaneous tissue figure of body surface.There are three assemblies in this system.First is three-dimensional image forming apparatus 802, is used to produce the body surface image of patient body.Second is imaging of tissue device 850, is used to produce the subcutaneous image of patient body.The 3rd is operation associated equipment 875, is used to make a plurality of labellings of described body surface image and described subcutaneous image to be complementary.
Three-dimensional image forming apparatus can be high-resolution camera system or other photographic camera that can take the detail image mapping of patient skin surface.As long as camera arrangement can accurately be followed the tracks of the curvature and the shape in interested patient body zone, it is the important component of camera arrangement that the resolution member of skin need not.Stereo imaging system can be 3D ultrasonic system or interpolation 2D supersonic imaging device.Perhaps, imaging of tissue equipment can be MRI or X-ray equipment.Best visual imaging system and tissue imaging systems will produce can be by the electronic image of Computer Processing.
Operation associated equipment can be universal or special computer, or similar intelligent logical equipment.This equipment can also be software program.The coupling of a plurality of labellings between this operation associated processing body surface and the subcutaneous image is so that produce the figure of three-dimensional tissue accurately.Employed labelling can be the patient's that is easy to identify a natural labelling.Yet labelling is two a plurality of datum marks that imaging device can detect preferably.In case image is caught in and the electronics storage, the data of two images just can be used the datum mark association.For two imaging systems, there is no need to catch image, because this operation associatedly also can carry out the convergent-divergent operation to guarantee that one or two image all is adjusted to required ratio before association takes place with the same ratio chi.
In case image is associated, just produce new graphics.New figure has the body surface shape that is complementary and near the subdermal features of body surface.The employed datum mark of system can have and helps each parameter that image mapped is associated.For example, benchmark can comprise or under designator, thereby imaging system can be determined the direction of datum mark after capturing image.Use has a plurality of datum marks of bearing data, determines that accurately the coupling superposed positions of second image that produced by system just may.Datum mark preferably can be detected by two picture systems (body surface and subcutaneous), but is not to be essential.The user can be with an imaging system but not the detectable a plurality of datum marks of another imaging system be placed on the patient body.As long as the user replaces with second detectable other datum mark of system, operation associatedly just can use effectively.
Using method
Method right and wrong described herein are invasive.Unlike the subcutaneous fat of traditional use vacuum intubate suction art, here not to the puncture of patient skin.The elimination of adipose cell or fatty tissue realizes by heat or mechanical disintegration that air pocket produces, and these two kinds of effects are by direct irradiation, preferably produced by high intensity focused ultrasound (HIFU).Thereby, there is not direct observation how much to organize affected method in the Noninvasive process that is used for reducing fatty tissue.In subcutaneous fat suction art, the doctor in charge can observe the fat mass of removing or eliminating, but in the Noninvasive process, this direct observation is impossible.User of the present invention will have to rely on the amount that diagnostic ultrasound equipment or other pick off help determine processed tissue.
A common aspect of several different methods described herein is the zone that estimation will be handled fatty tissue.Use " pinch and pinch " (pinch) current techniques of test can be provided for said system and method rationally begin the place.Pinch and pinch test is used for estimating fatty tissue by the plastic surgery zone.Patient P can have him or she and want the regional adipose tissue removed.The doctor can be by drawing a series of contour line C on one's body the patient
1, C
2, C
3..., C
x(Fig. 9 A) estimates fatty tissue.
Ultrasonic energy is applied to the method for body region
In one embodiment, method of the present invention is provided for energy is applied to the method for body region.This method has four steps.First step is to provide therapeutic scheme to the treatment controller.Second step is in response to the guiding that the treatment controller produces, and with probe scanning, transmits energy from probe simultaneously on body surface.Third step is that the position of monitor scans head and the energy of probe transmit with the generation position data, and sends this position data to the treatment controller.The 4th step is if position and/or energy transmission fall within outside the therapeutic scheme, then to produce alarm.
In step 1, therapeutic scheme is provided for the treatment controller.In this ID patient's treatment demand, and according to patient demand selection therapeutic scheme.In the preferred application of removing fatty tissue, the user will be from selecting to remove how many fatty tissuees, the fatty stride of removing, the degree of depth, energy stream and required other parameter the option list.The user may and be unfamiliar with the technology essential factor of facilitating each therapeutic scheme, but will select based on required result.Such as selecting a scheme to remove fatty tissue along 8 centimetres of wide 2 centimetres of dark 12 centimeter length.The accessible program variable of user realizes that than machine operation result's method more meets the result.In case selected therapeutic scheme, the user is just with required therapeutic scheme input treatment controller.This treatment controller determines to produce the operating protocol of required therapeutic scheme.
Second step relates to uses the probe scan patients.Probe (or treatment head) is active, makes ultrasonic energy can be transmitted to the patient to remove fatty tissue.This probe moves according to the agreement of treatment controller.Should move and to realize by hand gear or automaton.In manual mode, the clue that the treatment controller provides the user to follow.The user is in response to these clues movable scan head on one's body the patient.In automaton, the treatment controller is directly controlled equipment or device, such as mechanical arm, with moving of boot scan head.
Third step is monitored position and the energy that transmitted by probe.Position and transmission information with treatment controller (by user or mechanical arm) the comparable data feed-in form of the agreement of being used send the treatment controller to.The treatment controller is according to these agreement persistent surveillance input data, to guarantee patient's safety during treating.
The 4th step is alarm.If position or energy are transmitted in outside the tolerance interval of agreement, then treat controller and give the alarm.This alarm can be clear and definite so that the user monitors, perhaps can be that embedded cut-out switch is to turn-off any energy emitter in the probe immediately.
Step 1 is selected when the beginning of treatment, but step 2, three and four continues to carry out to guarantee that suitable therapy is applied to the patient.
Be used to carry out the method for fatty orthopedic treatment
In a second embodiment, a kind of method that is used to carry out fatty orthopedic treatment is arranged.This method has following steps: the first, determine the adaptability of patient to ultrasound treatment.The second, the zone that the labelling patient will treat on one's body.The 3rd, position patient is to carry out ultrasonic therapy.The 4th, institute's marked region is scanned in the computer.The 5th, use the therapy plot software bag that ultrasonic therapy is set.The 6th, use computer system to activate ultrasonic therapy by therapy plot software control.The 7th, use the progress of therapy plot software record treatment, and provide desired any other postoperative to help to the patient at last.
Each method of the present invention all is suitable for providing the maximum safety of body shaping treatment to proofread and correct for a long time ideally, can select additional treatment and pharmacotherapy to use, and keeping patient's virtual graph simultaneously is permanently effective and safe to guarantee to treat.
In a word, each method that is disclosed is attached to the another aspect of the method for carrying out lipoplasty, may further comprise the steps:
(a) determine the adaptability of patient to ultrasound treatment;
(b) zone that will treat on one's body of labelling patient;
(c) position patient is to carry out ultrasonic therapy;
(d) institute's marked region is scanned in the computer:
(e) use the therapy plot software bag that ultrasonic therapy is set;
(f) use computer system to activate ultrasonic therapy by therapy plot software control;
(g) progress of using the therapy plot software record to treat; And
(h) provide desired any other postoperative to help to the patient.
Following example illustrates described method.
Example I
Step 1: patient's visiting is seeked advice from for the first time, as traditional fatty shaping.If the patient determines to continue treatment, then can provide and specifically to prepare with during treating or meal supplement, medicine, the special-purpose milk wet goods of some benefits be provided afterwards.Example is included in the arnica montana of taking after the bromelain taken before the treatment and Tricetin and the treatment (Arnica Montana), to promote rehabilitation and to reduce swelling.
Step 2: treating the same day, the doctor uses the similar manner labelling patient that the fatty shaping patient of tradition is done.Ink in the marker pen can comprise additive reagent (for example ultraviolet ink) to strengthen by the detectability of pick off to ink on the skin.This is particularly useful to dark skin.
Step 3: the patient locatees and treats.The patient should be at same position during treating.In most of situations, the patient who lies on a bed is treated, thereby step is carried out the prone position patient before this art.Patient's fat thickness can draw on the area for treatment wanting with ultrasound wave for example.The diagnostic ultrasound system can and detect the image analysis system combination of strong reflection from the border between fat and the lower floor's muscle, and writes down this thickness and positional information.This positional information comes from the location sensing equipment that invests ultrasonic transducer.Because only need depth information, the diagnostic ultrasound unit can replace with simpler pulse echo string formula system.Reference marker can be drawn on patient body, or uses the another way labelling such as paster, to be provided for the reference position of position sensing.This fat thickness mapping or its subclass can be stored, and the reference when seeking medical advice as next patient is for example visually to show the true effect of being realized.
Step 4: body marker also uses above-mentioned position sensing to scan in the computer before the treatment.This can by tracking use with the coupled electronics stroke of navigation system under labelling, or realize by the optical detection of combined positioning system to labelling.Ideally, this scans signature quotability in the computer to the fat thickness figure that obtains as mentioned above.Navigation system writes down three～six-freedom degree (being x, y, z, pitching, yawing, rolling) usually in whole situations.
Step 5: the therapy plot software that provides on professional and the computer is mutual now, labelling and thickness data that visit is as above obtained.We expect that we can control the aesthetic of treatment partly, and for example the degree of depth, time or the density for the treatment of by change influences tissue more or less.The point of therapy plot software is that these system variables are linked to each other with the expectation overall appearance effect that will realize.For example, the professional can judge: should reduce 2 centimetres at central area fat, then diminish gradually to reducing 1 centimetre in outer peripheral areas, then " emergence " (minimizing) is 0 outside this zone.The professional is undertaken by desired effects and the optional fat thickness on the visual representation of the sign profile of painting.Institute's profile of painting and labelling can be in therapy plot software inediting or changes.The user for example can identify 2 cm section or points out it on touch screen, and key in or select from menu this zone corresponding to 2 centimetres of thickness by clicking in the labelling before corresponding treatment with mouse.If profile needs change, then they can come to change by software by the method for finding in the mapping software of similar Adobe Illustrator usually.For example, if the Bezier of the profile of painting is represented to be preserved by software, then can provide Bezier " handle ", " control point " or " knot " to be used for typical user interactions of mapping software and change.1 cm section identifies with similarity method.Transition region can be gradient to 1 centimetre fixed range by the one or both sides of 2 centimetres of profiles of simple selection and be transformed into 0 fixed range from 1 centimetre and identify.Conversion distance is variable, and in fact available pointing device is plotted in the computer, maybe can by scan in the computer and be designated the art of transition region before labelling represent in the planning software.The user also can notify the treatment controller expect what effect in transition region, for example linear decline or some other curve shapes, and answer using system variable (for example degree of depth, power, time, density) what make up and realize effect.Available different color such as the degree of depth, transition region, influenced variable or difference are marked at visually and show, so that identification.When editor and identifying when finishing, COMPUTER CALCULATION reaches the therapeutic scheme that relates to all related system variablees of desired aesthetic.
Step 6: during the process of actual therapeutic, the treatment head that comprises the high strength supersonic wave transducer links to each other with above-mentioned navigation system, and the current location that the permission component computer will be treated head is relevant with the computer representation of therapeutic scheme.Computer control treatment variable is to realize the aesthetic of expectation then.In above example, when treatment head moved past 2 cm section, suitable power, pulse period etc. all were applied to the treatment head and go up affected tissue to realize 2 centimetres.When treatment head moves on to 1 cm section by transition region, can reduce power and cycle so that the variable thickness of influence tissue up to reaching 1 centimetre of effect.Similarly, should " emergence " effect when the treatment head is mobile outside 1 cm section, realize, and if treat head outside area for treatment, transducer is not allowed to cause.Whole therapeutic scheme and record can be stored, so that reference in the future.
Step 7: the same with the lipoplasty of routine after treatment, the patient is required on area for treatment to dress the protection clothes, and can take other medicines or nutritional supplementation to promote to recover or alleviate sense of discomfort.
Use HIFU to remove the method for fatty tissue
In the 3rd embodiment, the method for using the treatment ultrasound wave to remove patient's fatty tissue is arranged.This method has following steps: the first, determine patient one or more positions of fatty tissue on one's body.Second step is a position patient, makes fatty tissue distribute (preferably facing up) relatively equably, and third step, shines the position of patient's fatty tissue with the treatment ultrasonic transducer.
Use this method, at first must determine the position and the size of the adipose tissue regions that will treat.This can be undertaken by the conventional method that picture " is pinched and pinched " or " clamping " (clamp) tested, and perhaps it can be determined such as the medical scanner or the aforementioned 3 D stereo mapped device of diagnostic ultrasound system by using.So a technology of pinching test is pinched in use although the doctor can depend on him or she like a cork, the border of fatty tissue and the degree of depth must be estimated as far as possible exactly.Thereby, need the imagine scanner of some type.In case determined the volume and the degree of depth of tissue, come labelling skin with regard to available surgical operation pen or miscellaneous equipment, so the user can clearly identify the zone that will treat.
The patient uses the mode orientation that will impel the irradiating step success then.This patient with a mode orientation in bed or on the chair, thereby fatty tissue to be processed faces up as much as possible.This makes fatty tissue can be placed into around the center distribution relatively equably, so that the tissue depth that will treat is preferably symmetric.
Treat adipose tissue regions at last.Adipose tissue volume is treated with the treatment ultrasonic transducer.If as one man lay in that step 2 organized layer is all even, then treatment can be implemented equably.
Create the method for three dimensional body figure
The method of creating three dimensional body figure is also described.The method of 3D health figure that establishment has the position of adipose tissue volume has following steps: the first, and use the 3D imaging system to produce the 3D rendering of health.The second, the 3D rendering of health is entered as computer-readable format.The 3rd, create the 3D health figure of health with 3D mapping software application, and the 4th, use the diagnostic ultrasound device scan health that shines upon the software program electronic communication with 3D, the adipose tissue regions that the diagnostic ultrasound wave device is detected suitably is placed among the 3D health figure.
The details of this first method is as follows.The 3D imaging system comprises: a plurality of photographing units of taking patient's snapshot.Snapshot relates to the photographing unit of all 3D imaging systems of pictures taken simultaneously.Thereby visual pattern can be caught whole health from all sides.For this reason, the patient may must take off clothes, and nude or topless the focus place that stand in imaging system.Imaging system to be used for taking that the imaging system of the automotive advertising of display automobiles is similar simultaneously from whole angles.Image from the 3D camera arrangement is applied and suitably regulates, thereby produces the single integrated figure of human body.Employed imaging system is a pin-point accuracy, and is convertible into machine-readable form.
Photographing unit in the 3D imaging system can be taken normal film image or digital picture.Yet no matter what captured image type is, image must suitably be superposeed and be produced single human body image.Image is converted into the 3D physical shapes figure of human body and is stored in the computer then.This process depends on the accuracy of 3D rendering capture system and comes reconstruct human body image exactly.Software must suitably convert image to physical shapes figure then.In case produce the physical shapes figure of human body, can store these data as afterwards retrieval.3D figure before the art that this first image is the patient.
In case scheme before having drawn art, the patient just carries out diagnostic ultrasound scanning.This scanning can be simple as string formula or b mode scanning, to determine the fat attenuation and the degree of depth in the given area.Yet better model is high-resolution imaging system, thereby can see and write down the details of fat deposit.Figure carries out electronic communication before diagnostic imaging system and computer, software and the art.By use location alignment sensor or accurate register control, diagnostic scan is recorded and is added on before the art on the figure with respect to the position of health and direction.This allows the doctor to produce the volume diagram of patient's lipidosis.Superimposed imaging makes patient and doctor can both see that what zone can be used for treatment (intrusive mood or non-intrusion type) and a certain amount of fat that will remove by sampling and checks that the patient seems what to play each model as.This relates to and uses preoperative cast to produce abstract model as benchmark, and any projection of preoperative cast changed checks final result.
Use the method for 3D health figure
In another embodiment, the method for using 3D health figure body shaping is arranged.This method has following steps: the first, analyze 3D health figure, and draw the adipose tissue volume that will remove.Second step is to determine to use body shaping to treat the volume of the fatty tissue that can remove safely.Third step is to deduct the adipose tissue volume that will remove to produce the 2nd 3D health figure, and wherein doctor and patient can compare a 3D health figure and any amount of the 2nd 3D health figure, with the desired amount of the body shaping treatment selecting to carry out.
In the method, the first health figure uses the abstract system in this announcement to produce.This first health figure is illustrated in any treatment of beginning patient's starting point before.The treatment controller can be used to create and shows second figure that removes the body contour after the adipose tissue volume.May see the finally therapeutic outcome that obtains with the multiclass Therapeutic Method by use treatment controller, patient with this method.Thereby patient and doctor can obtain one or more treatments back patient based on patient's 3D health figure and seem estimation how.This information can be used to refer to training by doctor and patient and treat, and is defined as the safe treatment number of times of expectation target, or determines can remove for the treatment of some number of times the maximum of fatty tissue.
Other removes the method for fatty tissue
At another embodiment that is used for removing fatty tissue, a kind of method that is used to remove fatty tissue is arranged, have following steps: at first, determine the volume and the zone of wanting treated tissue; Secondly, use the impulse wave HIFU transducer of inswept tissue regions to treat this volume with continuous-mode.
During operation, determine fatty tissue present with the step of position can be to aforesaid and to use the 3D abstract system with computer to create the method for preoperative cast very similar.Yet the treatment of current fatty shaping provides the one side of determining adipose tissue regions by usage flag on patient skin fast.Use his or she experience and hands-on with this mode doctor, can identify " problem " zone of needs of patients operation.Doctor's usage flag marks skin area, the zone of expression fatty tissue.In case this has obtained execution, then the patient can as above enter the process of creating the 3D preoperative cast, but photographing unit has the marked region on can detection of skin and it is attached to the advantage of 3D physical shapes figure.Employed ink can comprise and allows photographing unit to check its particular dye or pigment under particular condition in the labelling.For example, use visible fluorescent dye under particular light ray.
Position patient and aforementioned therapies are similarly carried out.The patient is with the treatment of high intensity focused ultrasound (HIFU) equipment, to remove selected adipose tissue regions then.HIFU equipment is designed to be combined in accurate alignment sensor or the detent mechanism that uses in the above-mentioned ultrasonic diagnosis step especially.Use this mode, the direction of ultrasonic therapy and position are known, and can add on patient's the preceding figure of art.If the high intensity focused ultrasound device also invests imaging system, then can write down other details, thereby each pulse of HIFU transducer or send can and add art to by real time record before on the figure.Use this mode, the irradiating step of treatment can be carried out safely and accurately, because computer can write down each treatment position.
Can realize the enhanced security feature by using at the computer of record HIFU treatment and the feedback communication loop between the HIFU transducer, because can preventing the HIFU transducer, causes by computer, perhaps by guaranteeing to have between the wound gap of some minimum level to the zone of having treated.This gap can be the wound of 3 dimensional coil geometry or more complicated gap on the time.When the patient can repeatedly treat, the position of the previous HIFU wound of system log (SYSLOG), and prevent that irradiation with volume is up to having crossed sufficiently long interval.The combination of 3D geometry and wound seasonal effect in time series, and also can be by computer system control in conjunction with other parameter of intensity, size and the persistent period of HIFU treatment.
When irradiation treatment was finished, the patient can use diagnostic imaging apparatus to rescan, to determine the successful continuity of treatment according to plan.From postoperative evaluation, the doctor can plan and arrange additional treatment, or the change timetable of having planned additional treatment caters to patient's needs in mode safely and effectively.
Depend on the treatment degree that the patient is carried out, the patient can be aided with medicine, or helps the recovery or the body shaping of health with the protection clothes.
Example II
The method of removing fatty tissue relates to synchronous scanning and impulse wave transformation approach uses the aforementioned therapies head.Use this method, the patient prepares as previously mentioned.Drawing one group of contour line identifies corresponding to the zone of wanting the treated tissue body (Fig. 9 A).Line or grid block may be superimposed on (Fig. 9 B) on the contour line.The treatment head is used to the scanning group tissue region, to confirm to have the fatty tissue (Fig. 9 C) of enough degree of depth.In case finish, with regard to begin treatment.
By using the treatment transducer of impulse wave pattern, treat with speed movable scan head on the treatment piece of 3～50 mm/second.The removable transducer of mechanical arm, perhaps the user can move the treatment head with the instrument of following the tracks of the mobile distance of scanning each time.
The microposition system also can be used in the treatment head, to skim over the portable cord of treatment head.This allows the bigger zone of treatment, allows more volume subsequently.This volume of allowing slough is increased, and reduces the treatment required time of this tissue volume, and noninvasive laser therapy is more treated near invasive in time.
In the other method that is used for removing fatty tissue, carry out three general steps.First step is the volume and the zone of the definite tissue that will treat.The secondth, treat this volume and regional tissue, and last definite this volume of treatment and regional effectiveness.
First step relates to definite volume and zone of wanting treated tissue.Current plastic surgery depends on their experience for many years and determines the fatty tissue that the patient may have.Palpation makes the doctor set up contour line around the adipose tissue regions that will remove with lipoplasty.This same procedure can be used as the starting point that the doctor sets up contour line.The degree of depth of fatty tissue under contour line need use ultrasonic scanning to come verification.
In case set up contour line, the patient just must be oriented such that the contour line that will treat can be placed by a treatment approaching mode with tissue.The treatment head need have the moving range of broad, but patient's direction is important, because treatment adoptable many directions are both uncomfortable also impracticable for the patient that the instrument user maybe will treat.Generally speaking, direction should be that the surf zone of fatty tissue faces up and normally smooth.This allows fatty tissue " to lay " the stable volume of Cheng Buhui concentrations in a certain side, volume and the surface opposite that will treat to organize the mode of laying brokenly to present during with patient's rest.Regularity in tissue depth and the volume will help the user to carry out more balanced and effective treatment.
With after being of value to the comfortable directed patient of mode of user, treatment head and patient, treat head and in the contour line zone, use with the diagnostic scan pattern.Want the verification fatty tissue degree of depth to provide information accurately, to make the treatment head can not remove the fatty tissue that should not remove to patient scan to system and user.In brief, before the treatment beginning, be necessary that verification has the fatty tissue of enough degree of depth in the contour line zone.If find fatty tissue degree of depth deficiency, then must repaint contour line to meet safety criterion.
Suppose that the fatty tissue degree of depth and volume are enough to start therapeutic process, then the user can be on patient body beginning label area for treatment grid.Expectation area for treatment grid is the same big with contour line institute area surrounded at least, and may extend to outside the contour line.The area for treatment grid can be marked the patient on one's body with operation marker pen, ink cylinder or aerosol apparatus with template or model.Other mode that produces the area for treatment grid also is possible.
After confirming tissue volume and having settled the area for treatment grid, the user can use main interface with patient data and expectation treatment parameter input therapeutic equipment.Each parameter can be imported in the equipment, and the user can obtain any information required or expectation.In case machine is suitably programmed, just finish and determine to want the volume of treated tissue and the key step in zone, and the user can proceed to second key step of the tissue in this volume of actual therapeutic and zone.
At first the user will treat head and place on the patient body, and align with the area for treatment grid.If the treatment head has the reference mark that can align with the area for treatment grid thereon, then also should align with benchmark.This makes the treatment head accurately to locate to treat.If the pattern that is easy to identify is arranged, fall or the remarkable original position of other position such as image angle in the area for treatment grid, then the user can begin therefrom.In addition, treatment controller or main interface can have and be used for determining to have treated those regional tracking systems, thereby the user need not to follow the tracks of this information.
Then, ID will be with treating the area for treatment that head scans.This will be first scanning area, and the as many scanning area of number of times that can lay the contour line zone as the footmark (area coverage) of probe can be arranged.When the treatment head put in place, diagnosis scanner can move once more with the enough tissue depth of verification.Diagnostic scan can move with the treatment scanner with interweaving, or only moves when the treatment BOB(beginning of block).
The treatment frame is the zone that the treatment head will be treated down.The HIFU transducer is according to the parameter operation from the treatment controller.Transducer or move the zone of mechanically scanning this frame by miniature navigation system perhaps uses the HIFU transducer (such as phased array) of electrically operated to come moving focal point zone electronically.The degree of depth of wound, density and big I are subjected to the scanning speed of transducer to influence (focus how soon electronics or mechanically move past this tissue).Changing intensity, PRF or stack treatment row also can influence the size and the shape of wound.By adjusting one or more these parameters, just might produce big or little, dark or shallow wound, and the permission user carries out control to a certain degree on degree of necrosis.Thereby the user can reduce downright bad amount and produce feather effect, thereby when treatment head during near the border of fatty tissue, the volume of tissue necrosis obtains minimizing.This allows desirable tissue treatment and does not damage the risk of non-fat tissue.It also allows the user to enlarge necrotic zone in the deep fat tissue regions, producing the necrosis in bigger zone, thereby produces expected result.
Wound is sprouted wings and evenly the treatment value-between contour line, treatment density is along with the emergence therapeutical effect changes from uniform treatment value.
Although the present invention is easy to do various changes and can have the plurality of optional form, its specific example is shown in the drawings and made detailed description at this.Yet, should be appreciated that the present invention is not limited to particular form and the method that is disclosed, but all changes, equivalent and the possibility that falls within the appended claims scope contained in opposite the present invention.
Claims (65)
1. system that is used for applying energy to body region, described system comprises:
The probe that comprises the energy applicator;
Be used for probe is suspended in spatial device; And
With the treatment controller that probe links to each other with suspending apparatus, position and energy that described treatment controller is suitable for the monitor scans head transmit, and provide simultaneously locating the guiding of described probe.
2. the system as claimed in claim 1 is characterized in that, described suspending apparatus also comprises the device of the locus that is used to follow the tracks of described probe.
3. the system as claimed in claim 1 is characterized in that, is used for that probe is suspended in spatial device and allows manually to reorientate in the space described probe.
4. the system as claimed in claim 1 is characterized in that, is used for that probe is suspended in spatial device and comprises the mechanical arm that can reorientate described probe in response to the input indication.
5. the system as claimed in claim 1, also comprise the treatment controller that links to each other with described probe, determine area for treatment with the position that monitors described probe and based on the manual positioning of described probe, described treatment controller is suitable for receiving other treatment information from the user.
6. system as claimed in claim 5 is characterized in that, described treatment controller physically separates with controller, and is fit to produce therapeutic scheme based on determined area for treatment and other treatment information.
7. system as claimed in claim 6 is characterized in that, described treatment controller also is fit to send described therapeutic scheme to controller.
8. the system as claimed in claim 1 is characterized in that, described energy applicator comprises at least one vibration transducer.
9. system as claimed in claim 8 is characterized in that, described energy applicator can be installed in the probe with locating.
10. system as claimed in claim 9 is characterized in that, described probe comprises the servo-controlled energy applicator installation system that links to each other with the treatment controller, thus the position of described treatment controller scalable probe self-energy applicator.
11. the system as claimed in claim 1 is characterized in that, described probe comprises the navigation indicator with described treatment controller electronic communication, thereby described treatment controller can show guidance information to the user.
12. system as claimed in claim 11 is characterized in that, described navigation indicator comprise video screen, LED matrix, discrete light-emitting component and with the communicator of described treatment controller.
13. system as claimed in claim 12 is characterized in that, described navigation indicator is installed on the described probe.
14. the system as claimed in claim 1 is characterized in that, described suspending apparatus comprises articulating arm.
15. system as claimed in claim 14 is characterized in that, described articulating arm is installed on the independent pedestal.
16. system as claimed in claim 15 is characterized in that, described articulating arm comprises the digital encoder of the tracking that is used to provide described probe position.
17. the system as claimed in claim 1 is characterized in that, being used for probe is suspended in spatial device is a mechanical arm.
18. one kind is used to produce the physical shapes that is complementary and near the system of the subcutaneous tissue figure of body surface, described system comprises:
Be used to produce the three-dimensional image forming apparatus of the body surface image of patient body;
Be used to produce the imaging of tissue device of the subcutaneous image of described patient body; And
The related surgical equipment that is used to make a plurality of labellings of described body surface image and described subcutaneous image to be complementary.
19. system as claimed in claim 18 is characterized in that, described related surgical equipment also comprises the computer with described three-dimensional image forming apparatus and described imaging of tissue device electronic communication.
20. system as claimed in claim 18 is characterized in that, described three-dimensional image forming apparatus is one or more photographic cameras.
21. system as claimed in claim 20 is characterized in that, described photographic camera is a high-resolution camera.
22. system as claimed in claim 20 is characterized in that, described photographic camera provides digital picture output.
23. system as claimed in claim 18 is characterized in that, described imaging of tissue device is a MRI equipment.
24. system as claimed in claim 18 is characterized in that, described imaging of tissue device is a ultrasonic equipment.
25. a system that is used to locate armarium, described system comprises:
Mechanical arm;
Be used to control the first control device of mechanical arm;
The armarium of running fix in the treatment head, described treatment head links to each other with mechanical arm;
Be used to control the second control device that move of armarium in the treatment head; And
With mechanical arm, first control device, armarium and second control device electronic communication and be used for the electronic controller of collaborative operation.
26. a system that is used to locate armarium, described system comprises:
Mechanical arm;
Be used to control the control device of mechanical arm;
Be fixed positioned in the armarium in the treatment head, described treatment head links to each other with mechanical arm; And
Be used to translate move that receives from described control device and the electronic controller that is used for described move relaying is given described mechanical arm.
27. one kind is used for the device that the guiding energy emitter moves on patient body, described device comprises:
Removable treatment head with at least one energy emitter;
Lead ring; And
Being used to follow lead ring moves and makes the treatment head be located substantially on the tracking system of lead ring central authorities.
28. a system that is used to locate armarium, described system comprises:
The load balance arm;
The armarium of running fix in the treatment head, described treatment head links to each other with the load balance arm; And
Be used to control the device that move of armarium in the treatment head.
29. one kind is applied to the method for a body region with energy, described method comprises:
Provide therapeutic scheme to the treatment controller;
In response to the treatment guiding that controller produced, on body surface, scan probe, energy transmits from described probe simultaneously;
The position of monitor scans head and energy transmit, to produce position data and to send described position data to the treatment controller; And
If position and/or energy transmit and fall within outside the therapeutic scheme, then produce alarm.
30. method as claimed in claim 28 is characterized in that, provides described therapeutic scheme to be included in the energy transmission and manually scans on body region with probe before, to produce the volume diagram of wanting area for treatment, wherein said figure is provided for the treatment plan program.
31. method as claimed in claim 29 is characterized in that, provides described therapeutic scheme also to comprise other treatment parameter is input in the treatment plan program, to produce therapeutic scheme based on volume diagram and a plurality of other treatment data.
32. method as claimed in claim 30 is characterized in that, described therapeutic scheme was sent to the treatment controller by electronics before sending energy datum, and comprised the information of relevant energy delivering position and energy dose.
33. method as claimed in claim 28 is characterized in that, manual scanning is carried out in response to the guidance information that described probe provides.
34. method as claimed in claim 32 is characterized in that, described guidance information comprise visual information and audible information one of at least.
35. method as claimed in claim 28 also comprises in response to the data that produced by monitored position of treatment plan program because of the responding scanning head, automatically the energy applicator in the location scanning head is monitored the error of location with respect to therapeutic scheme with compensation.
36. method as claimed in claim 34 is characterized in that, described probe advances on successive treatment position incrementally, wherein reorientates described energy when described probe is on each position and applies.
37. method as claimed in claim 28 is characterized in that, produce alarm comprise produce earcon, produce optical signal, reduce the energy transmission, shutdown system or cut off the probe power supply one of at least.
38. carry out the fat treatment method of the course of treatment, may further comprise the steps for one kind:
(a) determine that the people is to the adaptability of treatment with ultrasonic therapeutic;
(b) zone that will treat on one's body of labelling human;
(c) be treatment ultrasonic therapeutic position patient;
(d) marked region scans in the computer;
(e) use the therapy plot software bag that treatment ultrasonic therapeutic step is set;
(f) use computer system to activate treatment ultrasonic therapeutic step by therapy plot software control;
(g) progress of using the therapy plot software record to treat; And
(h) auxiliary after described patient provides any additional treatment that may need.
39. a method of using treatment with ultrasound wave destruction patient's fatty tissue may further comprise the steps:
(a) determine one or more positions of patient's fatty tissue;
(b) position patient makes described fatty tissue be arranged to distribution relatively equably;
(c) shine the position of patient's fatty tissue with the treatment ultrasonic transducer.
40. method as claimed in claim 38 is characterized in that, determines that the step (step (a)) of one or more positions of patient's fatty tissue may further comprise the steps:
(a1) mark the profile of skin area with marker pen, described profile meets the estimation borderline region of fatty tissue; And
(a2) by carrying out the existence of imaging ultrasound ripple scanned for checkout fatty tissue.
41. method as claimed in claim 39 is further comprising the steps of:
(a3) position of the described adipose tissue volume of record in computer.
42. method as claimed in claim 39 is characterized in that, the marker pen of step (a1) also comprises can be by the particular ink of electronic sensor detection.
43. method as claimed in claim 38 is further comprising the steps of:
(d) one or more positions of estimation fatty tissue after step (c).
44. method as claimed in claim 38 is characterized in that, determines that one or more positions (step (a)) of patient's fatty tissue are carried out by the 3D imaging system.
45. a generation has the method for 3D health diagrammatic sketch of the position of adipose tissue volume, may further comprise the steps:
(a) use the 3D imaging system to produce the 3D rendering of health;
(b) 3D rendering with health is entered as computer-readable format;
(c) use 3D mapping software application program to produce the 3D health diagrammatic sketch of health; And
(d) use diagnostic ultrasound equipment scanning health with 3D mapping software application program electronic communication, make the adipose tissue regions that detects by diagnostic ultrasound equipment suitably be placed 3D health diagrammatic sketch.
46. method as claimed in claim 44 is characterized in that, the step of the 3D rendering of generation health is further comprising the steps of:
(a) use a plurality of photographing units that health is positioned in the 3D rendering capture device;
(b) use combination picture to make up 3D rendering from the 3D rendering capture device.
47. a method of using the body shaping of 3D health diagrammatic sketch may further comprise the steps:
(a) analyze 3D health diagrammatic sketch to draw the adipose tissue volume that to remove;
(b) the definite adipose tissue mass that can use body shaping art safety to remove;
(c) adipose tissue volume that will remove in step (b) of deduction is to produce the 2nd 3D health diagrammatic sketch;
Wherein doctor and patient can compare a 3D health diagrammatic sketch and any a plurality of the 2nd 3D health diagrammatic sketch, with the aequum of the art of selecting to get into shape.
48. method as claimed in claim 46 is characterized in that, described body shaping art is a subcutaneous fat suction art.
49. method as claimed in claim 46 is characterized in that, described body shaping art is the treatment ultrasonic operation.
50. method as claimed in claim 46 is characterized in that, described body shaping art is a pharmacotherapy.
51. method as claimed in claim 46 is characterized in that, described body shaping art is subcutaneous fat suction art, treatment with one or more combination of ultrasonic operation or pharmacotherapy.
52. a method that is used to remove fatty tissue may further comprise the steps:
(A) determine the volume and the zone of tissue to be processed; And
(B) handle described volume in order to the impulse wave PWHIFU transducer of the inswept described tissue regions of serial movement.
53. method as claimed in claim 51 is characterized in that, (a) is further comprising the steps of for step:
(A1) touch off area for treatment by on patient body, setting up one or more contour line;
(A2) described area for treatment is oriented described adipose tissue volume and has symmetric substantially tissue depth;
(A3) the described area for treatment of scanning is with the verification fatty tissue degree of depth; And
(A4) labelling area for treatment grid on described area for treatment.
54. method as claimed in claim 52 is characterized in that, the step of labelling area for treatment grid realizes with the operation marker pen on one's body the patient.
55. method as claimed in claim 52 is characterized in that, the step of labelling area for treatment grid realizes with ink roller on one's body the patient.
56. method as claimed in claim 52 is characterized in that, the step of labelling area for treatment grid realizes with ink aerosol apparatus and screen template on one's body the patient.
57. the method that is used to remove fatty tissue as claimed in claim 51 is characterized in that, step (B) also comprises:
(B1) will treat head and place on the patient body, and align with the area for treatment grid;
(B2) sign will be with treating the area for treatment that head scans;
(B3) select a plurality of treatment parameters;
(B4) the verification tissue depth be connected; And
(B5) when described transducer activates, use linearly moving impulse wave HIFU transducer to apply the treatment ultrasound wave.
58. method as claimed in claim 56 is further comprising the steps of:
(B6) remember all previous treatment positions.
59. method as claimed in claim 56 is further comprising the steps of:
(B7) repeating step B1-B6 is inferior arbitrarily as required.
60. the method for the locus of a working load counter-jib location ultrasonic therapeutic head, described treatment head comprises the motion controller that is used to be suspended at the energy applicator in the treatment head, said method comprising the steps of:
(A) power is applied on the treatment head; And
(B) provide electronic guide to described motion controller.
61. method as claimed in claim 59 is characterized in that, the power that applies in the step (A) is less than the weight of described treatment head.
62. method as claimed in claim 59 is characterized in that, the power that applies in the step (A) is manpower.
63. method as claimed in claim 59 is characterized in that, the power that applies in the step (A) is mechanical force.
64. method as claimed in claim 59 is characterized in that, the electronic guide in the step (B) receives from computer entry device.
65. method as claimed in claim 59 is characterized in that, the electronic guide in the step (B) receives from the treatment controller.
Applications Claiming Priority (5)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US53398803P | 2003-12-30 | 2003-12-30 | |
| US10/750,370 | 2003-12-30 | ||
| US10/751,344 | 2003-12-30 | ||
| US60/533,988 | 2003-12-30 | ||
| US60/533,958 | 2003-12-30 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN1984601A true CN1984601A (en) | 2007-06-20 |
Family
ID=38166661
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN 200480035622 Pending CN1984601A (en) | 2003-12-30 | 2004-12-29 | System and method for removing fat tissue |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN1984601A (en) |
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| CN107981888A (en) * | 2017-12-21 | 2018-05-04 | 浙江深博医疗技术有限公司 | Computer galactophore scanning automation alignment system |
| CN109011182A (en) * | 2018-08-29 | 2018-12-18 | 成都清大华科微晶材料有限责任公司 | A kind of wideband is infrared and terahertz emission device |
| CN109674571A (en) * | 2018-12-14 | 2019-04-26 | 张洪延 | It is a kind of can be by the refrigeration and heating device that human body contour outline shape freely converts |
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| CN107981888A (en) * | 2017-12-21 | 2018-05-04 | 浙江深博医疗技术有限公司 | Computer galactophore scanning automation alignment system |
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| WO2020087573A1 (en) * | 2018-10-29 | 2020-05-07 | 罗俭富 | Beauty assistance system, three-dimensional coordinate information acquisition method based thereon, and beauty method thereof |
| CN109674571A (en) * | 2018-12-14 | 2019-04-26 | 张洪延 | It is a kind of can be by the refrigeration and heating device that human body contour outline shape freely converts |
| CN109674571B (en) * | 2018-12-14 | 2023-10-20 | 张洪延 | Refrigerating and heating device capable of freely changing according to contour shape of human body |
| CN110302046A (en) * | 2019-07-12 | 2019-10-08 | 李卫 | A kind of handle and system for extracorporeal impact wave therapy |
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| CN113878590A (en) * | 2021-04-22 | 2022-01-04 | 北京邮电大学 | Robot system with automatic planning and liposuction functions |
| CN114288567A (en) * | 2022-01-05 | 2022-04-08 | 北京邮电大学 | Robot system capable of performing physical action on biological body surface and tissues below biological body surface |
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Application publication date: 20070620 |