Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B17/34—Trocars; Puncturing needles
  • A61B17/3403—Needle locating or guiding means
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
  • A61B2017/22072—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an instrument channel, e.g. for replacing one instrument by the other
  • A61B2017/22074—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an instrument channel, e.g. for replacing one instrument by the other the instrument being only slidable in a channel, e.g. advancing optical fibre through a channel
  • A61B2017/22075—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an instrument channel, e.g. for replacing one instrument by the other the instrument being only slidable in a channel, e.g. advancing optical fibre through a channel with motorized advancing or retracting means
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
  • A61B90/50—Supports for surgical instruments, e.g. articulated arms
  • A61B2090/506—Supports for surgical instruments, e.g. articulated arms using a parallelogram linkage, e.g. panthograph
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
  • A61B34/70—Manipulators specially adapted for use in surgery
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
  • A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
  • A61B90/11—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis with guides for needles or instruments, e.g. arcuate slides or ball joints

Definitions

• the invention relates to a medical device with a guide for receiving a needle, in particular a puncture needle, and a drive device for a needle located in the guide.
• Puncture needles are used, which are pierced through the patient's skin and advanced to a specific target point (often a tumor or metastasis). Of particular importance is the precise alignment of the needle with the target point before the puncture.
• Various imaging modalities can be used to visually control the alignment process and the actual insertion of the needle. The most common imaging methods that are used for this purpose are ultrasound, X-rays or computer tomography.
• X-rays are generated for image acquisition.
• handling surgical instruments or a puncture needle close to the x-ray radiation field or even within the x-ray radiation field means a considerable radiation exposure.
• lead aprons and other protective measures reduce the radiation dose, the radiation exposure remains significant, especially for the hands. This could be remedied by devices that would manipulate the instruments in the radiation field.
• the devices could be operated manually or remotely by the doctor outside the radiation field. depending on whether it is a passive or active (motorized) device.
• the needles used are either punch biopsy needles (diameter 1 to 2.5 mm) for obtaining tissue samples for histological examination, or fine needles (diameter approx. 0.8 to 1.4 mm with a length of up to 20 mm) for aspiration biopsy for cytological tissue samples. Fine needles are always used for injections.
• the doctor must ensure that he inserts the needle safely and without kinks.
• the fine needles are usually held close to the puncture site with one hand and the driving force is exerted with the other at the end of the needle.
• the subject of this invention notification is the constructive design of a needle drive for remote insertion of the needle without the risk of needle kinks.
• the invention has for its object to provide a device of the type mentioned, in which the risk of needle kinking is reduced.
• this object is achieved by a medical device with a guide for receiving a needle, in particular a puncture needle, and a drive device for a needle located in the guide, the guide being divided into two sections and the drive device being arranged between the sections , With the needle has cooperating drive means for driving it.
• the drive means preferably have at least one drive roller that cooperates with the needle in a frictional engagement, so that no changes to the needle are required in order to be able to drive it, but rather commercially available needles can be used.
• FIG. 1 is a view of a medical device according to the invention
• Fig. 2 is a perspective view of a detail of the device of FIG. 1, and
• Fig. 3 is a view of the device according to FIGS. 1 and 2 in use.
• a medical device in Fig. 1, with a needle guide system 2 for a needle 3, e.g. a puncture needle, shown schematically, which, as will be explained later, allows the needle 3 accommodated in the needle guide system 2 to pivot three-dimensionally about a rotation point R.
• a needle guide system 2 for a needle 3 e.g. a puncture needle, shown schematically, which, as will be explained later, allows the needle 3 accommodated in the needle guide system 2 to pivot three-dimensionally about a rotation point R.
• the device 1 has an articulated arm 4 in the form of a parallelogram drive, at the free end of which the needle guide system 2 is arranged.
• a pivoting about the axis AI which is perpendicular to the plane of the parallelogram drive and thus the plane of FIG. 1, by an angle ⁇ also causes a pivoting about the angle ⁇ about a parallel to the axis AI axis running through the rotation point R predetermined by the geometry of the parallelogram drive.
• the articulated arm 4 is also pivotable in a bearing 5 about an axis A2 running through the rotation point R in the direction ⁇ .
• Both axes AI and A2 intersect and are perpendicular to each other. Since the axis A2 also runs through the rotation point R, this represents, so to speak, an invariant pivot point of the needle 3, the position of which is determined solely by the geometry of the construction.
• the needle 3 can be swiveled three-dimensionally about the rotation point R, which in medical applications is the same as the puncture point.
• One of the possible positions of the needle 3 is indicated by dashed lines in FIG. 1.
• the needle 3 can be pivoted about the defined rotation point R by means of the articulated arm 4, the articulated arm 4 causing the needle 3 to pivot about a first axis in a plane containing the rotation point R, and that on the other hand the articulated arm 4 is pivotable about a second axis A2 running through the rotation point R in the sense of pivoting the plane containing the rotation point R about the second axis of rotation.
• the pivots about the axes AI and A2 are motorized, the corresponding motors are not shown in the figures.
• the bearing 5 is in turn attached to an adjustable, for example passive, ie not manually, but manually adjustable holding arm 6.
• the drive device of the device according to the invention is described below with reference to FIGS. 1 and 2, which enables a needle-free insertion of a needle 3 into the body of a patient by means of a motor.
• Fig. 2 which schematically shows the needle guide system 2 and in connection with Fig. 1 the principle of the drive of the needle 3
• the core of the needle guide system 2 is a special guide cannula 7, which on the distal, i.e. is attached to the free end of the articulated arm 4 and, as explained, can be pivoted three-dimensionally within certain limits around the rotation point R corresponding to the puncture point.
• the function of the guide cannula 7 is to safely pick up and guide the needle 3.
• the special feature of the guide cannula 7 is that it has a division into two sections 7a and 7b, drive means for the needle 3 being located between the sections 7a and 7b.
• the drive device has two rollers 8a, 8b, which are preferably provided with a grooved profile, between which the needle 3 is guided.
• the rollers 8a, 8b in particular designed as rubber rollers, as soon as they are driven, carry out their rotational movement by friction, i.e. frictionally, in a translation of the needle 3, so that the needle 3 can be inserted into a patient.
• the drive device In order to apply the drive torque for the rollers 8a, 8b, the drive device has a servo motor 9, which is shown in FIG. 1 in the case of the exemplary embodiment described located in the area of the lower horizontal element of the articulated arm 4.
• the torque is transmitted via a drive gear 11 to the pair of rollers 8a, 8b via a drive shaft 10 and, if necessary, additional (gear) components not shown in FIG. 2.
• a uniform distribution of the torque on both rollers 8a, 8b is achieved via two gear wheels 12a 12b, which are connected directly to the rollers 8a, 8b.
• the needle 3 Due to the two sections 7a and 7b of the guide cannula 7, which are closely attached to the rollers 8a, 8b, the needle 3 is optimally guided in its drive area, which ensures a homogeneous, uniform introduction of force into the needle 3 and largely prevents the needle 3 from kinking when being inserted excludes.
• the guide cannula 7 is attached to the articulated arm 4 in such a way that one end thereof is the point of rotation R corresponds. This arrangement of the guide cannula 7 prevents the needle from kinking between the drive and the puncture point.
• this arrangement of the guide cannula 7 is advantageous because, in medical applications, the device must first be positioned so that the rotation point R is at the selected puncture point, which is very simple since only the tip of the guide cannula 7 is placed on the puncture point must become.
• the constructive design described on the one hand provides sufficient space and freedom of movement, see the dimensions a and b entered in FIG. 3, for versatile clinical use, the patient being designated P in FIG. 3 and the target point, for example a tumor, being designated Z. , On the other hand, the described design provides safe and kink-free puncturing.
• the guide cannula 7 can be easily exchanged in a manner not shown.
• these generally have sufficient flexibility to be able to use needles of different diameters, at least to a limited extent, with the same pair of rollers.
• the servo motor 9 and the drive shaft 10 can be arranged within one of the horizontal elements of the articulated arm 4, if this is tubular.
• the details of the drive device according to the exemplary embodiment described are only to be understood as examples. It is essential to use a guide divided into two sections with, in particular frictional, drive means for the needle arranged between the sections.
• the device If the device is used under X-ray fluoroscopy, all components in the radiation field must be as X-ray transparent as possible so as not to produce any shadowing in the image. Because it is designed as a parallel drive, it is very easy to manufacture the front area of the guide system from X-ray-transparent plastics, while the motors and more heavily loaded components components made of metal are outside the radiation field.
• the parallelogram drive makes it possible that there are no joints in the area of the rotation point and thus there is enough space and freedom of movement for versatile clinical use.

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• Health & Medical Sciences (AREA)
• Surgery (AREA)
• Life Sciences & Earth Sciences (AREA)
• Biomedical Technology (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Engineering & Computer Science (AREA)
• Pathology (AREA)
• Heart & Thoracic Surgery (AREA)
• Medical Informatics (AREA)
• Molecular Biology (AREA)
• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• Infusion, Injection, And Reservoir Apparatuses (AREA)

Applications Claiming Priority (5)

Publications (1)

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Family Applications (1)

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• 2001
  • 2001-03-30 US US10/240,396 patent/US7175635B2/en not_active Expired - Fee Related
  • 2001-03-30 WO PCT/DE2001/001223 patent/WO2001074259A1/de active Application Filing
  • 2001-03-30 JP JP2001572006A patent/JP2003534038A/ja not_active Withdrawn
  • 2001-03-30 EP EP01927629A patent/EP1267732A1/de not_active Withdrawn

Non-Patent Citations (1)

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