CN210727837U - Guide plate for assisting liver puncture operation - Google Patents
Guide plate for assisting liver puncture operation Download PDFInfo
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- CN210727837U CN210727837U CN201920817140.6U CN201920817140U CN210727837U CN 210727837 U CN210727837 U CN 210727837U CN 201920817140 U CN201920817140 U CN 201920817140U CN 210727837 U CN210727837 U CN 210727837U
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Abstract
The guide plate is used for assisting the liver puncture operation. Belongs to the field of liver puncture instruments. The existing invasive tumor in-situ treatment technology lacks instruments for assisting puncture operation, so that the trend of a puncture needle path is inaccurate. The design method of the guide plate for assisting the liver puncture operation is characterized in that CT scanning data of a chest part with a positioning point group on the chest skin are obtained; reconstructing a three-dimensional model of the liver, peripheral blood vessels, organs, bones and skin; simulating liver puncture in the obtained three-dimensional model, and determining a design scheme of a needle channel; designing a guide plate with a puncture needle channel and a positioning point group by utilizing the determined needle channel scheme and the positioning point group on the skin; and 3D printing is carried out on the designed guide plate model. And obtaining a guide plate finished product for assisting the liver puncture operation. The utility model discloses the method can improve the security of operation, accuracy through the formulation of operation scheme before the art. The product has simple structure and low manufacturing cost.
Description
Technical Field
The utility model relates to a baffle for assisting liver puncture operation.
Background
The radio frequency ablation is a minimally invasive tumor in-situ treatment technology, an electrode needle is positioned and guided to be directly inserted into a tumor by means of an image technology such as ultrasound or CT (computed tomography), local tissues of a focus are heated by radio frequency energy, and soft tissues and the tumor are solidified and inactivated finally after drying. In the operation, not only important blood vessels, bile ducts and other adjacent organs and other structures need to be avoided, but also the needle insertion stroke needs to be monitored and planned at any time according to the imaging equipment so as to determine the angle and the needle insertion distance. Due to the fact that the spatial resolution of B-ultrasound is relatively low, interference of surrounding tissues is easy to occur, and the interference of intestinal gas, obesity and ribs often affects judgment, in traditional B-ultrasound-guided radio frequency ablation, for small liver cancer with the diameter being less than or equal to 20mm or occupied areas close to surrounding organs (such as esophagus, stomach, intestinal tract and the like) and blood vessels (such as hepatic artery, hepatic vein, right gastric artery and the like), ultrasonic-guided percutaneous puncture operation is difficult to achieve, positioning error is large, accurate positioning is difficult to achieve in a short time, and therefore preoperative positioning efficiency is low, and treatment difficulty is large. However, although CT has sufficient resolution to display the anatomical positions and forms of organs and blood vessels in the body of a patient, because the operation time is long, in the process of guiding puncture positioning, CT needs to be repeatedly performed to correct to ensure the accuracy of puncture, not only is the resources of the examination bed consumed, but also the radiation exposure time of the patient is greatly increased, and the potential side effects are large.
Disclosure of Invention
The utility model aims at solving the problem that the puncture needle path is inaccurate in order to solve the instrument of the auxiliary puncture operation that the existing invasive tumor in-situ treatment technology lacks, and providing a guide plate for assisting the liver puncture operation.
The guide plate for assisting the liver puncture operation comprises a guide plate body, wherein the surface of the guide plate body is provided with a reinforcing rib net formed by vertically crossing a group of transverse reinforcing ribs and longitudinal reinforcing ribs,
one side of the guide plate body is provided with a group of positioning holes, a cross-shaped positioning body is arranged in each positioning hole, the positioning holes are superposed with the circle center of the cross-shaped positioning body,
the other side of the guide plate body is provided with a puncture operation window, a first needle track insert and a second needle track insert are embedded in the puncture operation window, the butt joint surfaces of the first needle track insert and the second needle track insert are respectively provided with a groove, the cross section of each groove is semicircular, the grooves of the butt joint surfaces of the first needle track insert and the second needle track insert are buckled to form a needle track with a circular cross section, and the central axis of the needle track is intersected with the guide plate body;
one side of the puncture operation window is communicated with one side of the guide plate body.
The utility model has the advantages that:
the utility model discloses a puncture baffle based on 3D prints can assist the doctor to fix a position fast, accomplishes the operation fast, and is especially less to the diameter, and spatial position is special complicated, and multiple tumour has special advantage. By making a preoperative surgical scheme, the safety and accuracy of the operation can be further improved, and particularly important blood vessels and organs at risk can be avoided. The 3D printing processing cycle is short, and the material cost is low, not only meets the clinical time requirement, but also can greatly reduce the economic burden of patients.
Three-dimensional reconstruction is performed on CTA-based image data: the puncture outfit comprises skin, ribs, focus, liver blood vessel, stomach, bile duct and the like, an optimal puncture scheme is designed according to a reconstructed model, and preoperative simulation of needle insertion, needle insertion angle and distance are completed simultaneously. And designing a corresponding puncture guide plate according to the confirmed preoperative simulation scheme, and finishing the manufacture of the puncture guide plate by using a 3D printing technology.
The guide plate for assisting the liver puncture operation of the patient in customization can realize quick and accurate positioning in the liver puncture process, greatly improve the operation efficiency and the treatment accuracy, design the puncture needle channel into a unique modular structure, is convenient to assemble and disassemble, and can ensure the continuity of the operation process. The whole using and operating process can not bring burden to treatment, the operation is simple, and the medicine can be used by hands.
The utility model discloses a location bed for assisting liver puncture operation, location bed board both sides have the handrail, spacing roof beam and height adjustment screw rod three cooperation, realize height adjustment, can carry out the adjustment of spacing roof beam height to the patient of different fat thin sizes, with fixed patient, there is scalable chest fixed bolster above the bed of location simultaneously, CT scans the in-process flexible chest support and withstands the diaphysis region, in the chest scanning process, can effectively restrain the chest expansion and the shrink that the breathing brought, thereby improve the positioning accuracy of mark point mark step among the baffle design method process.
Drawings
FIG. 1 is a flow chart of a method according to the present invention;
fig. 2 is a schematic view of the puncture simulation according to step three of the present invention;
FIG. 3 is a schematic view of a skin thickening operation;
fig. 4 and 5 are schematic structural views of a guide plate for assisting a liver puncturing operation according to the present invention;
fig. 6 is a schematic structural view of a positioning bed for assisting a liver puncturing operation according to the present invention;
fig. 7 is the utility model discloses carry out the error analysis schematic diagram when utility model carries out the analysis to prior art.
Detailed Description
The first embodiment is as follows:
the guide plate for assisting the liver puncture operation of the embodiment, as shown in fig. 3 and 5, comprises a guide plate body 1, a set of convex transverse reinforcing ribs 2 and a set of convex longitudinal reinforcing ribs 3 are arranged on the surface of the guide plate body 1 and vertically crossed to form a reinforcing rib net,
one side of the guide plate body 1 is provided with a group of positioning holes 4, a cross-shaped positioning body 5 is arranged in each positioning hole 4, the positioning holes 4 are coincided with the circle center of the cross-shaped positioning body 5,
the other side of the guide plate body 1 is provided with a puncture operation window 6, a first needle track insert 7 and a second needle track insert 8 are embedded in the puncture operation window 6, the butt joint surfaces of the first needle track insert 7 and the second needle track insert 8 are respectively provided with a groove 9, the cross section of each groove 9 is semicircular, the grooves 9 of the butt joint surfaces of the first needle track insert 7 and the second needle track insert 8 are buckled with each other to form a needle track 10 with a circular cross section, and the central axis of the needle track is intersected with the guide plate body;
one side of the puncture operation window is communicated with one side of the guide plate body, so that the operation of detaching the guide plate body 1 after needle insertion is facilitated.
The second embodiment is as follows:
different from the first specific embodiment, in the guide plate for assisting the liver puncture operation of the present embodiment, an included angle formed by the intersection of the central axis of the needle channel formed by the oppositely buckled grooves of the abutting surfaces of the first needle channel insert and the second needle channel insert and the guide plate body is 1 to 89 °.
The third concrete implementation mode:
a design method of a guide plate for assisting a liver puncture operation by using the positioning bed comprises the following steps:
fixing a patient on a positioning bed through the positioning bed for assisting the liver puncture operation, marking the position of the liver on the chest skin in a mode of marking a group of positioning points, displaying the positioning points in a convex mode, and then obtaining CT scanning data of the chest part with the positioning point group on the chest skin;
step two, reconstructing a three-dimensional model of the liver, peripheral blood vessels, organs, bones and skin by utilizing the CT scanning data with the positioning point group obtained in the step one;
step three, simulating liver puncture in the three-dimensional model obtained in the step two, and determining a design scheme of a needle channel;
step four, designing a guide plate with a puncture needle channel and a positioning point group by using the needle channel scheme determined in the step three and the positioning point group on the skin;
and fifthly, 3D printing is carried out on the designed guide plate model to obtain a guide plate finished product for assisting the liver puncture operation.
The utility model discloses core operation technique point lies in body surface mark point location technique, through above-mentioned error integrated analysis, can know puncture needle way main reason of deviation and lie in pressing the deformation that the sebum layer produced, the angle of puncture has been influenced, and the image data of supersound feedback only can observe roughly skew direction, and can not guide the needle way fine setting, puncture the operation in the thinnest department of corpus sternum department sebum layer thickness, the gliding error of sebum that produces can be minimum when the baffle laminating location promptly, combine baffle column needle way 0.4 mm's fine setting clearance, can guarantee best puncture precision.
The positioning bed for assisting liver puncture operation is shown in fig. 6 and comprises a bed plate B1, a neck support frame B3 is arranged at the bed head position of the bed plate B1, two side long edges of the bed plate B1 are respectively provided with a handrail B6 at the position close to the bed head, a horizontal slideway is arranged on the handrail B6, two ends of a limiting beam B2 are respectively provided with a rolling pulley B5, the limiting beam B2 is arranged above the bed plate B1, two ends of the limiting beam B2 are respectively arranged with slideways of the handrail B6 at the corresponding side in a rolling manner, a beam body of the limiting beam B2 is screwed with a height adjusting screw B4, the moving direction of the height adjusting screw B4 is perpendicular to the plate surface of the bed plate B1, one end, far away from the bed plate B1, of the height adjusting screw B4 is a nut, one end, close to the bed plate B1, of the height adjusting screw B4 is fixedly provided with a pressing.
The limiting beam B2 is arc-shaped.
Utilize the standard location bed of CT bore, location bed board both sides have the handrail, spacing roof beam and the cooperation of height adjustment screw rod three, realize height adjustment, can carry out the adjustment of spacing roof beam height to the patient of different fat thin sizes, with fixed patient, there is scalable chest fixed bolster above the location bed simultaneously, CT scans the flexible chest support of in-process and withstands the diaphysis region, at the chest scanning in-process, can effectively restrain the chest expansion and the shrink that the breathing brought, thereby further guarantee the positioning accuracy of mark point.
And (3) error analysis: the main errors of B-ultrasonic guided percutaneous puncture include errors affecting reconstruction measurement, individual difference errors of patients and human errors of operators, the former two errors are generally considered as absolute errors, and the operation errors of operators are human controllable errors, namely the errors are affected by experience operation skills of the operators. The individual error mainly considers the obesity degree, the tumor size and the relationship between the occupied position and the main blood vessel viscera of the patient. I.e. individual differences affect the difficulty of the final surgery.
Therefore, the utility model discloses a baffle mainly has special assistance-localization real-time function to the multiple liver cancer of cell, carries out the simulation of digital operation scheme before the art, confirms best puncture route and avoids main portal vessel and important viscera, can effectual control artificial operation error, ignores the overweight structure measuring error of B simultaneously to accurate puncture is to the focus affected part.
Based on the average result of statistical analysis, a trigonometric function data model is used for simulating that a puncture needle punctures the tumor in the IV and V regions with the tumor diameter of 20mm, the puncture needle deviates from the theoretical puncture track by 3.82 degrees at the initial body surface through simulation calculation, and the puncture needle completely deviates from the center of the tumor at the final drop point, as shown in figure 7, the needle inserting distance S, the deviation distance L and the deviation angle α are set,
L=sinα*S
2cm small cell liver cancer in IV and V regions of a B-ultrasonic guided puncture liver is simulated and calculated through a trigonometric function mathematical model, an error is generated when an initial puncture deviation angle deviates 4 degrees from a theoretical needle path, and for the operation with higher risk, a radio frequency ablation operation is usually abandoned and an open operation is used clinically. In the puncture process, the tumor center needs to be punctured as far as possible so as to ensure that the tumor focus is completely ablated. There is also a risk of postoperative recurrence once ablation is incomplete. Therefore, the accurate puncture auxiliary guide plate can improve the puncture precision and reduce the operation risk by positioning and navigating the needle channel.
Because the patient can breathe involuntarily in the CT scanning process, the rib part of the thoracic cavity can expand and contract to a larger extent, a certain positioning error is generated on the spatial position relation among the three mark points, therefore, in the process of CT and operation, an external fixed bed device is used to be matched with a body surface mark positioning means to form a novel positioning technology, the positioning technology mainly uses a standard positioning bed suitable for the caliber of the CT, handrails are arranged on two sides, the handrails, the limiting beam and the height adjusting screw rod are matched to realize height adjustment, the height of the limiting beam can be adjusted aiming at patients with different fat body types so as to fix the patients, meanwhile, a telescopic chest fixing bracket is arranged above the positioning bed, the telescopic chest bracket props against the corpus sternum area in the CT scanning process, in the chest scanning process, the chest expansion and contraction caused by respiration can be effectively inhibited, so that the positioning accuracy of the mark point is further ensured.
The fourth concrete implementation mode:
different from the third embodiment, in the first step of the design method of the guide plate for assisting the liver puncture operation of the present embodiment, the liver position is marked on the chest skin by marking a group of positioning points, and the positioning points are displayed in a convex manner, specifically:
an oily mark pen is used for marking the mark on the body surface near the liver, the mark position is required to meet the anatomical requirement (the position between the 10 th and 11 th costal bones), the mark position is uniformly distributed on the body surface around the liver, the lead point is accurately pasted on the mark position, and the characteristic of skin bulge is manufactured to facilitate the positioning of the guide plate positioning hole. Push-in to CT for enhanced CT scanning.
The fifth concrete implementation mode:
in the second step, the process of reconstructing the three-dimensional model of the liver and the peripheral blood vessels, organs, bones, and skin using the CT scan data with the anchor point group obtained in the first step is specifically:
and importing the CT data of the patient by using a new project command, wherein the data format is dicom, and threshold value adjustment is carried out by using a threshold command under a segment menu, so as to respectively carry out three-dimensional reconstruction on the liver, the blood vessel, the tumor, the rib bone, the skin and the peripheral organs, and obtain a three-dimensional model of the three-dimensional reconstruction.
The sixth specific implementation mode:
different from the fifth embodiment, in the third step, the process of simulating liver puncture and determining the needle path design plan in the three-dimensional model obtained in the second step is specifically as follows:
storing three-dimensional models of skin, bones, tumors, blood vessels and the like in stl format, and introducing the three-dimensional models into the geographic design direct software of industrial design software to carry out simulation design of puncture needle channels, wherein the design principle is as follows: avoiding ribs of the chest and main blood vessels around the ribs, accurately placing a needle head into the center of the tumor, ensuring the shortest needle inserting stroke, designing a needle path according to the standard diameter of a puncture needle, wherein the diameter of the puncture needle is 2.7mm, and considering the actual processing precision, the puncture aperture is designed to be 3.1 mm; the wall thickness of the needle channel is designed to be 3mm, and the needle channel stretches out of the skin and is 5cm higher than the body surface. And finishing the puncture simulation scheme. As shown in fig. 2.
The seventh embodiment:
different from the sixth specific embodiment, the method for designing the guide plate for assisting the liver puncture operation of the present embodiment includes, in the fourth step, a process of designing the guide plate with the puncture needle track and the positioning point group by using the needle track scheme determined in the third step and the positioning point group on the skin, specifically:
step four, the simulated needle track model and the positioning point group on the skin are together led into the geomagic studio2014 software, and the skin data are firstly subjected to outward bias thickening, wherein the thickness is 2 mm; as shown in fig. 3;
designing a positioning hole, designing a corresponding positioning hole according to the position of a lead point on the CT image, and designing a cross structure on the positioning hole for better aligning the mark central point;
step four and three, in order to further strengthen the rigidity of the guide plate and prevent the guide plate from bending and deforming in use, a reinforcing rib structure is designed on the outer surface of the guide plate
And step four, in order to match with the ultrasonic examination in the operation, the guide plate needs to be detached in the operation, so that the puncture port position needs to be designed into an assembled insert structure, the inserts are detached respectively when the puncture needle is used, then the guide plate is taken out from the puncture needle, the puncture position can be examined by using the B ultrasonic, and meanwhile, the guide plate is marked with the personal case information of the patient.
The present invention is capable of other embodiments, and various modifications and changes can be made by those skilled in the art without departing from the spirit and essence of the present invention, and these modifications and changes are intended to fall within the scope of the appended claims.
Claims (2)
1. A baffle for assisting liver puncture operations, characterized in that: the guide plate comprises a guide plate body, the surface of the guide plate body is provided with a reinforcing rib net formed by vertically crossing a group of transverse reinforcing ribs and longitudinal reinforcing ribs,
one side of the guide plate body is provided with a group of positioning holes, a cross-shaped positioning body is arranged in each positioning hole, the positioning holes are superposed with the circle center of the cross-shaped positioning body,
the other side of the guide plate body is provided with a puncture operation window, a first needle track insert and a second needle track insert are embedded in the puncture operation window, the butt joint surfaces of the first needle track insert and the second needle track insert are respectively provided with a groove, the cross section of each groove is semicircular, the grooves of the butt joint surfaces of the first needle track insert and the second needle track insert are buckled to form a needle track with a circular cross section, and the central axis of the needle track is intersected with the guide plate body;
one side of the puncture operation window is communicated with one side of the guide plate body.
2. A guide plate for assisting a liver puncturing operation according to claim 1, wherein: the included angle formed by the intersection of the central axis of the needle channel formed by buckling the grooves of the butting surfaces of the first needle channel insert and the second needle channel insert and the guide plate body is 1-89 degrees.
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| CN201920817140.6U CN210727837U (en) | 2019-06-03 | 2019-06-03 | Guide plate for assisting liver puncture operation |
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| CN201920817140.6U CN210727837U (en) | 2019-06-03 | 2019-06-03 | Guide plate for assisting liver puncture operation |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN110269768A (en) * | 2019-06-03 | 2019-09-24 | 南京医科大学 | For the location bed of Auxiliary Liver puncture procedure, guide plate and guide plate design method |
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- 2019-06-03 CN CN201920817140.6U patent/CN210727837U/en active Active
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN110269768A (en) * | 2019-06-03 | 2019-09-24 | 南京医科大学 | For the location bed of Auxiliary Liver puncture procedure, guide plate and guide plate design method |
| CN110269768B (en) * | 2019-06-03 | 2024-07-26 | 南京医科大学 | Positioning bed for assisting liver puncture operation, guide plate and guide plate design method |
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