FI93607C - Leikkaustoimenpidelaite - Google Patents

Leikkaustoimenpidelaite Download PDF

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FI93607C
FI93607C FI912520A FI912520A FI93607C FI 93607 C FI93607 C FI 93607C FI 912520 A FI912520 A FI 912520A FI 912520 A FI912520 A FI 912520A FI 93607 C FI93607 C FI 93607C
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guide arm
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FI912520A
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FI912520L (fi
FI93607B (fi
FI912520A0 (fi
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John Koivukangas
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John Koivukangas
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Priority to FI912520A priority Critical patent/FI93607C/fi
Publication of FI912520A0 publication Critical patent/FI912520A0/fi
Priority to PCT/FI1992/000162 priority patent/WO1992020295A1/en
Priority to DE69226637T priority patent/DE69226637T2/de
Priority to AU17732/92A priority patent/AU1773292A/en
Priority to EP92910792A priority patent/EP0586464B1/en
Priority to US08/142,405 priority patent/US5413573A/en
Publication of FI912520L publication Critical patent/FI912520L/fi
Publication of FI93607B publication Critical patent/FI93607B/fi
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    • 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
    • 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
    • A61B34/30—Surgical robots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B46/00—Surgical drapes
    • A61B46/10—Surgical drapes specially adapted for instruments, e.g. microscopes
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/0046—Surgical instruments, devices or methods with a releasable handle; with handle and operating part separable
    • A61B2017/00464—Surgical instruments, devices or methods with a releasable handle; with handle and operating part separable for use with different instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00477—Coupling
    • A61B2017/00482—Coupling with a code
    • 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
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046—Tracking techniques
    • A61B2034/2059—Mechanical position encoders

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Biomedical Technology (AREA)
  • General Health & Medical Sciences (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Pathology (AREA)
  • Robotics (AREA)
  • Surgical Instruments (AREA)
  • Ultra Sonic Daignosis Equipment (AREA)

Description

93607
Leikkaustoimenpidelaite
Keksinnön kohteena on leikkaustoimenpidelaite, jota käytetään esimerkiksi aivoleikkauksen tai muun lääketie-5 teellisen toimenpiteen yhteydessä, joka laite käsittää suunnistinvarren tai vastaavan välineen, joka on sovitettu käytettäväksi toimenpiteen vaatimien liikkeiden suorittamiseen ja/tai ohjaamiseen, ja joka suunnistinvarsi on suojattu tai suojattavissa steriilin tai steriloitavissa olevan 10 suojavälineen kuten suojapussin, suojasukan tai vastaavan välineen avulla, ja johon suunnistinvarteen tai vastaavaan välineeseen on kytketty tai kytkettävissä leikkausinstrumentti, kuten neula, ultraäänianturi tai vastaava väline, ja suunnistinvarsi on kytketty tai kytkettävissä leik-15 kausinstrumenttiin steriloitavissa olevasta materiaalista valmistetulla välikappaleella tai vastaavalla.
Kyseessä olevaa leikkaustoimenpidelaitetta voidaan hyväksikäyttää esimerkiksi neurokirurgisissa leikkauksissa eli ihmisen aivoihin kohdistuvissa leikkauksissa. Lääketie-20 teessä käytettäville laitteille on asetettu erittäin tiukat ja tarkat vaatimukset niiden toiminnan, käyttö- ja potilasturvallisuuden sekä hygienian suhteen. Leikkauksissa käytettävien laitteiden tulee myös olla toimintavarmoja ja leikkausta suorittavan kirurgin kannalta käyttökelpoisia.
25 Nykyisin esimerkiksi aivokirurgiassa käytetään tie tokoneavusteisia menetelmiä ja laitteita, joissa hyödynnetään digitaalista kuvaustekniikkaa ja interaktiivisia tietokoneita. Menetelmissä käytetään esimerkiksi tietokonetomografiaa ja magneettikuvausta. Kuvaustapahtuman jälkeen 30 saatu data siirretään tietokoneelle, jossa dataa muokataan. Nyt esillä oleva leikkaustoimenpidelaite soveltuu käytettäväksi esimerkiksi edellä kuvatun kaltaisten kehittyneiden leikkausmenetelmien ja laitteiden yhteydessä.
Tunnetun tekniikan mukaiset laitteet käsittävät 35 leikkaussuunnistimen, joka käsittää varren, jota liikutta- 93607 2 maila voidaan varren päässä olevaa leikkausinstrumenttia liikuttaa potilaan pään yläpuolella. Kehittyneissä laitteissa suunnistinvarsi käsittää nivelpisteissään antureita, joiden perusteella laitteen yhteydessä oleva tietokonelait-5 teisto tietää mikä on suunnistinvarren ja samalla instrumentin sijainti, jolloin laitteilla voidaan esimerkiksi potilaan pään kuvaukseen kuvaruudulle sijoittaa leikkausinstrumentin sijainti. Suunnistinvarsi on yleensä jotakin epä-steriiliä materiaalia tai suunnistinvarren sterilointi ei 10 ole mahdollista tai ainakaan helposti suoritettavissa ja tämän vuoksi suunnistinvarsi peitetään steriilillä suojavälineellä, esimerkiksi steriilillä suojasukalla.
Tunnetun tekniikan mukaisissa laitteissa leikkauksessa käytettävät leikkausinstrumentit liittyvät suunnis-15 tinvarteen suoraan suojasukan lävitse, jolloin leikkaus-instrumentti kuten neula, ultraäänianturi tai muu vastaava instrumentti kiinnitetään suunnistinvarteen siten, että suunnistinvartta suojaava steriili suojasukka jää suunnistinvarren ja leikkausinstrumentin väliin. Esimerkiksi aivo-20 leikkauksia valmisteltaessa ja itse leikkauksia suoritettaessa esiintyy kuitenkin tarvetta vaihtaa suunnistinvarren päässä oleva leikkausinstrumentti johonkin toiseen leikkausinstrumenttiin. Steriilin suojasukan kestokyky on kuitenkin rajallinen ja tämän vuoksi useiden irrotusten ja 25 kiinnitysten seurauksena voi suojasukkaan syntyä kulumisen johdosta reikä, jonka johdosta epästeriili suunnistinvarsi ei enää ole eristetty steriilistä leikkausinstrumentista. Suojasukan puristuksessa oleminen suunnistinvarren ja leikkausinstrumentin välillä aiheuttaa kulumista. Operoitavan 30 potilaan kannalta epästeriiliys aiheuttaa huomattavan riskin operaation onnistumiselle ja samalla potilaan terveydelle.
Tunnetun tekniikan haitat ja epäkohdat ovat moninaisia. Nykyisissä, tunnetun tekniikan mukaisissa laitteissa 35 on ongelmallista suorittaa liittyminen epästeriilin ja ste- 93607 3 rillin alueen välillä. Laitteiden käyttöturvallisuutta olisi myös pystyttävä parantamaan, sillä steriiliin suojasukkaan syntyneen pienen reiän havaitseminen on usein vaikeaa, erityisesti silloin, kun itse leikkausoperaatio on käynnis-5 sä ja leikkausta suorittavan kirurgin ja muun henkilökunnan huomio on luonnollisesti kiinnittyneenä itse leikkaustapah-tuman suorittamiseen. Nykyisin epästeriilin ja steriilin alueen rajapinta on luonteeltaan passiivinen, eikä rajapinnassa suoriteta muita toimenpiteitä kuin eri osien liittä-10 minen toisiinsa. Tämän vuoksi leikkausinstrumentteja ei voida vaivattomasti ja luotettavalla tavalla tunnistaa.
Tämän keksinnön tarkoituksena on aikaansaada uusi leikkaustoimenpidelaite, joka välttää tunnetun tekniikan mukaisten laitteiden sisältämät ongelmat ja haitat.
15 Tämä tarkoitus saavutetaan keksinnön mukaisella leikkaustoimenpidelaitteella, jolle on tunnusomaista, että välikappale ja/tai suunnistinvarsi käsittää tunnistinväli-neet välikappaleeseen liitettävissä olevan leikkausinstrumentin tunnistamiseksi.
20 Keksinnön mukainen leikkaustoimenpidelaite perustuu siihen ajatukseen, että hyväksikäytetään erityistä välikappaletta yhdistämään leikkaustoimenpidelaitteen epästeriilit ja steriilit osat, ja nimenomaan sellaista aktiivista välikappaletta, jonka avulla suunnistinvarren ja leikkausinst-25 rumentin liittymäkohdassa voidaan toteuttaa leikkausinstrumenttien tunnistus ilman lisätoimenpiteitä.
Keksinnön mukaisella leikkaustoimenpidelaitteella saavutetaan useita etuja. Keksinnön perusajatuksen mukainen välikappale mahdollistaa epästeriilin ja steriilin välisen 30 alueen eli nyt siis välikappaleen toiminnan myös muussa käytössä kuin pelkästään passiivisena laitosalueena eri osien välillä. Edellä esitetyllä tarkoitetaan välikappaleen ja/tai suunnistinvarren pään toimimista suunnistinvarteen kiinnitettävien leikkausinstrumenttien tunnistajina. Näin 35 saatu tunnistetieto saadaan siirrettyä leikkaustoimenpide- 93607 4 laitteen yhteydessä olevalle tietokonelaitteelle, joka näin ollen saa automaattisesti tiedon siitä, mikä instrumentti kulloinkin on liitetty välikappaleeseen. Keksinnön mukaisella ratkaisulla steriilien leikkausinstrumenttien yhdis-5 täminen steriilisti peitettyihin epästeriileihin osiin kuten suunnistinvarteen on helppoa ja steriiliyden kannalta turvallista suorittaa. Nyt esillä olevan keksinnön mukaisessa leikkaustoimenpidelaitteessa epästeriilit osat suo-jaava suojasukka tai vastaava väline ei joudu alttiiksi 10 niin koville rasituksille kuin tunnetun tekniikan mukaisissa laitteissa ja näin ollen suojasukka ei kulu käytössä niin paljon.
Keksintöä selitetään seuraavassa lähemmin viitaten oheisiin piirustuksiin, joissa 15 kuvio 1 esittää leikkaustoimenpidelaitetta ja sen toimintaympäristöä, kuvio 2 esittää kaaviomaisesti sivulta välikappaleen sijoitusta suunnistinvarren ja leikkausinstrumentin väliin, kuvio 3 esittää kaaviomaisesti sivulta välikappaleen 20 sijoitusta, kuvio 4 esittää kaaviomaisesti sivulta välikappaleen sijoitusta, kuvio 5a esittää välikappaleen käsittämää kehyskap-paletta, 25 kuvio 5b esittää välikappaleen erästä kontaktikappa- letta, kuvio 5c esittää välikappaleen erästä toista kontak-tikappaletta.
Kuvion 1 mukaisesti leikkaustoimenpidelaite 1 on si-30 joitettu leikkaussalin leikkauspöydän 2 yhteyteen. Leik kaustoimenpidelaite 1 käsittää esimerkiksi suunnistinvarren 3, joka on yhteydessä leikkausinstrumenttiin 4. Suunnistin-varsi 3 on vain yksi mahdollinen väline, jolla leikkaus-instrumenttia 4 liikutellaan eikä keksintö näin ollen luon-35 nollisestikaan rajoitu ainoastaan suunnistinvartta 3 käyt- il.
93607 5 täviin leikkaustoimenpidelaitteisiin. Olennaista on se, että leikkaustoimenpidelaite 1 käsittää välineen leikkaus-instrumentin 4 liikuttamiseen.
Leikkausinstrumenttina 4 on kuviossa 1 esitetty 5 osoitinpuikko tai biopsiapihdin ohjain, jonka kautta voidaan ottaa näyte leikkauspöydällä 2 makaavan potilaan 5 päästä 6. Muita mahdollisia leikkausinstrumentteja ovat esimerkiksi ultraäänianturi, leikkausadapteri, endoskooppi tai leikkausmikroskooppi ja sen yhteydessä oleva laserlai-10 te.
Suunnistinvartta 3 käytetään leikkausinstrumentin 4 liikuttamiseen. Suunnistinvarsi 3 on nivelöity ja käsittää nivelpisteissään 7 suunnistinvarren 3 liikettä ja asemaa mittaavia paikka-antureita 8. Paikka-antureilta saatu tie-15 to suunnistinvarren 3 eli käytännössä suunnistinvarressa 3 olevan leikkausinstrumentin 4 asemasta syötetään tietokonelaitteistolle 9. Tietokonelaitteistolle 9 on aikaisemmin esimerkiksi MRI-kuvauksella (Magnetic Resonance Image) talletettu kuvausdataa potilaan pään rakenteesta. Suunnistin-20 varren 3 paikka-antureilta 8 saatu asematieto on yhtenä parametrinä tietokonelaitteiston 9 toiminnassa esimerkiksi siten, että leikkausinstrumentin 3 asema suhteessa potilaan pään rakenteeseen kuvausdatassa voidaan esittää esimerkiksi tietokonelaitteistoon yhteydessä olevalla kuvaruudulla 10, 25 jolloin leikkausta suorittava kirurgi näkee reaaliaikaisesti kuvaruudulta 10 leikkausinstrumentin 4 aseman.
Suunnistinvarsi 3 on epästeriili, joten se on peitetty steriilillä suojavälineellä 11. Suojaväline 11 voi olla esimerkiksi muovinen suojasukka tai suojapussi. Leik-.30 kaustoimenpidelaitteessa 1 suunnistinvarsi 3 on kytketty leikkausinstrumenttiin 4 steriloitavissa olevasta materiaalista valmistetulla välikappaleella 12 tai vastaavalla, joka näin on sovitettu yhdistämään epästeriilin, mutta ste-riilisti peitetyn suunnistinvarren 3 ja steriilin leikkaus-35 instrumentin 4 toisiinsa. Välikappaleen 12 valmistusmateri- 93607 6 aali voi olla jokin metalli tai muovi, kuten teflon tai polyasetaali.
Suunnistinvarsi 3 voi olla suojattu steriilillä suo-jasukalla 11 siten, että suunnistinvarren pää sijaitsee 5 suojasukan umpinaisessa pohjukassa 13, jolloin koko välikappale 12 sijaitsee suojasukan 11 ulkopuolella kuvion 2 mukaisesti. Tällöin suunnistinvarren 3 pää ja välikappaleen 12 suunnistinvarren puoleinen pää on muotoiltu siten, että osapuolet voivat kiinnittyä toisiinsa, ja vielä sillä ta-10 valla, että suojapussi 11 jää osapuolten väliin kuvion 2 mukaisesti. Kuviossa 2 on havainnollisuuden parantamiseksi esitetty suunnistinvarsi 3 ja välikappale 12 erillään toisistaan.
Vaihtoehtoisesti, kuvion 3 mukaisesti suojasukka 11 15 voi olla päästään avonainen, mutta tällöin suojasukan 11 avonaiset reunat on esimerkiksi teipillä 14 tai liimalla kiinnitetty pussin sulkemiseksi, jolloin eräs mahdollinen toteutusmuoto kuvion 3 mukaisesti on teipata suojasukan 11 eli suojapussin reunat kiinni välikappaleeseen 12, ja täl-20 löin ainakin osa välikappaleesta 12 jää suojasukan 11 sisään.
Kuviossa 2 on esitetty yksityiskohtaisemmin välikappaleen sijoitus suunnistinvarren 3 ja instrumentin 4 väliin. Keksinnön mukaisesti välikappale 12 ja/tai suunnis-25 tinvarsi 3 käsittää tunnistinvälineet 15, 16 välikappaleeseen 12 liitettävissä olevan leikkausinstrumentin 4 tunnistamiseksi. Tällöin välikappale 12 ei siis ole ainoastaan mekaaninen yhdistämiskappale, vaan välikappale 12 ja/tai suunnistinvarsi 3 lisäksi käsittää mekaaniset, sähköiset 30 tai muunlaiset tunnistinvälineet, joiden avulla kukin leikkausinstrumentti 4 tai muu välikappaleeseen 12 liitetty laite on tunnistettavissa. Näin saatu tunnistetieto saadaan siirrettyä leikkaustoimenpidelaitteen yhteydessä olevalle tietokonelaitteelle 9, joka näin ollen saa automaattisesti 35 tiedon siitä, mikä instrumentti 4 kulloinkin on liitetty tl· 93607 7 välikappaleeseen 12. Tunnistinvälineiden avulla tietokonelaitteistolle 9 saadaan varmasti aina oikea tieto siitä, mikä leikkausinstrumentti 4 tai muu laite on liitetty välikappaleen 12 avulla suunnistinvarteen 3.
5 Eräässä edullisessa toteutusmuodossa tunnistinväli- neet käsittävät suunnistinvarren 3 päähän tai lähialueelle sovitetun yhden tai useamman kytkinvälineen 15 ja välikappaleeseen sovitetun yhden tai useamman kontaktivälineen 16, joiden antama kontaktitieto on riippuvainen välikappalee-10 seen 12 yhdistetystä leikkausinstrumentista 4.
Keksinnön edullisessa toteutusmuodossa suunnistinvarren 3 käsittämät kytkinvälineet 15 ovat sähköisen signaalin kytkemiseen tarkoitettuja painokytkimiä, ja välikappaleen 12 käsittämät kontaktivälineet 16 ovat välikappalee-15 seen 12 muodostettuja muotoja, kuten syvennyksiä ja/tai kohoumia ja/tai tasaisia alueita, jotka on sovitettu painamaan painokytkimiä tai olemaan painamatta. Mikäli välikappaleessa 12 on kontaktivälineenä 16 aukko, niin tällöin kytkentävälineenä oleva painokytkin 15 asettuu aukkoon 16, 20 eikä painokytkin näin ollen painu eikä anna signaalia. Mikäli välikappaleessa 12 kontaktivälineenä 16 on tasainen alue tai kohouma, niin tällöin kytkinvälineenä olevaan pai-nokytkimeen 15 kohdistuu painoa, ja näin ollen painokytkin antaa signaalin. Kahdellakytkinväline/kontaktivälineparil-25 la voidaan saada aikaan neljä eri kombinaatiota. Jos tarkastellaan kombinaatioita kytkinvälineen 15 kannalta, niin tällöin kombinaatiot ovat: kumpikaan kytkimistä ei kytke, ensimmäinen kytkin kytkee, toinen kytkin kytkee ja neljäntenä kombinaationa tilanne, jossa kummatkin kytkimet kyt-.30 kevät. Vastaavasti, kytkimien kombinaatioiden järjestys huomioiden, jos tarkastellaan tilannetta välikappaleen 12 kontaktivälineiden 16 kannalta, ja käytetään välikappaleen 12 aukkoja ja tasaista aluetta hyväksi, niin tällöin neljä kombinaatiota ovat; kummatkin aukkoja, ensimmäinen tasainen 35 alue ja toinen aukko, ensimmäinen aukko ja toinen tasainen 93607 8 alue ja neljäntenä kombinaationa tilanne, jossa kummatkin kontaktivälineet ovat tasaisia alueita. Tietokonelaitteistolle 9 voidaan määrittää, mikä kombinaatio tarkoittaa mitäkin leikkausinstrumenttia. Kuviossa 3 kontaktivälineinä 5 16 esiintyy kaksi tasaista aluetta.
Sekä aukkojen ja tasaisten alueiden/kohoumien käyttö yhtäaikaa ei kuitenkaan ole välttämätöntä, sillä erilaiset kombinaatiot voidaan toteuttaa kuvion 4 mukaisesti esimerkiksi siten, että käytetään välikappaleessa 12 kontaktivä-10 lineenä tavallista aukkoa 17 ja vielä syvempää aukkoa 18, jolloin tavallinen aukko 17 on niin matala, jotta painokyt-kin 15 painuu ja antaa signaalin, ja syvä aukko 18 niin syvä, että painokytkin 15 ei painu, eikä anna signaalia. Mahdollinen signaali kytketään johtimien 19 avulla tietokone-15 laitteistolle 9. Johtimet 19 voidaan kuljettaa suunnistin-varren 3 yhteydessä tai sisällä, jolloin johtimet 19 eivät ole haittana toimenpiteitä suoritettaessa. Tietokonelaitteisto 9 käsittää tarvittavat välineet, esimerkiksi logiikkapiirin, kytkinvälineiltä 15 saatujen signaalien mittaami-20 seen ja tulkitsemiseen, ja tällä tavoin tietokonelaitteisto 9 potilaan kuvausdataa käsitellessään käyttää hyväksi tun-nistinvälineiltä 15, 16 saatua tietoa siitä, mikä leikkaus-instrumentti 4 kulloinkin on kytketty suunnistinvarteen 3 välikappaleen 12 kautta.
25 Keksinnön edullisessa toteutusmuodossa suunnistin- varsi 3 tai sen pää käsittää suunnistinvarresta 3 ulkonevan ulokkeen 20, johon kytkinvälineet on sovitettu, tällöin uloke 20 käytännössä muodostaa suunnistinvarren 3 pään. Suunnistinvarren 3 ulokkeen 20 ansiosta kytkinvälineet 15 . 30 ovat hyvin esillä, ja lisäksi välikappale saadaan asettumaan paremmin ja helpommin suunnistinvarteen 3.
Välikappale 3 edullisesti muodostuu ainakin kahdesta toisiinsa yhdistettävissä olevasta osasta, jolloin ensimmäinen osa on kehyskappale 23 tai vastaava, joka on sovi-35 tettu suojavälineellä 11 suojatun suunnistinvarren 3 pään tl : 93607 9 eli siis ulokkeen 20 ympärille. Kuvioiden 4 ja 5 mukaisesti keksinnön mukaisen laitteen eräs toteutusmuoto on sellainen, jossa suunnistinvarren 3 uloke 20 on ulkopuoleltaan sylinterin muotoinen, jolloin välikappaleen 12 kehyskappale 5 23 on ontto ja ainakin sisäpuoleltaan sylinterinmuotoinen kappale, eli suunnistinvarren 3 ulokkeen 20 ulkopuolen muotoa seuraava, jolloin välikappaleen 12 kehyskappale 23 voidaan asettaa ulokkeen 20 päälle. Välikappaleen 12 kehyskappale muodostaa kehyksen välikappaleen 12 toisen osan eli 10 kontaktikappaleen 24 asennukselle. Välikappaleen 12 kehys-kappale 23 on tehty niin pitkäksi, että kehyskappaleen sisään mahtuu sekä yhdeltä suunnalta tuleva suunnistinvarren 3 pää tai uloke 20, että myös vastakkaiselta suunnalta ke-hyskappaleeseen 23 tuleva välikappaleen 12 kontaktikappale 15 24. Välikappaleen 12 kehyskappale 23 voi olla samanlainen kaikille leikkausinstrumenteille 4, mutta välikappaleen 12 toinen osa eli kontaktikappale 24 on vaihdettavissa oleva, kontaktivälineet 16 eli aukot ja/tai tasaiset alueet ja/tai kohoumat käsittävä ja kullekin leikkausinstrumentille 4 20 ominainen kontaktikappale 24, joka on sovitettavissa kehys-kappaleeseen 23 siten, että kontaktikappaleen 24 käsittämät kontaktivälineet 16 ovat yhteydessä suunnistinvarren 3 kä-sittämiin kytkinvälineisiin 15 suunnistinvartta 3 suojaavan suojavälineen 11 kautta. Leikkauksen aikana kehyskappale 23 25 pysyy paikallaan, mutta kehyskappaleen sisälle voidaan vaihtaa erilaisia, esimerkiksi kuvioissa 5b ja 5c esitettyjä kontaktikappaleita, mikäli leikkauksen aikana on tarvetta vaihtaa leikkausinstrumenttia.
Kuviossa 5a on esitetty kehyskappale 23. Sylinteri-30 mäinen ja ontto kehyskappale 23 käsittää lisäksi lukitus-välineen 25 tai vastaavan, jonka avulla kehyskappale 23 ja kontaktikappale 24 voidaan lukita toisiinsa. Lukitusväline 25 on painike, josta painamalla lukitus vapautuu. Painike on edullisesti tehty samasta, esimerkiksi muovivalusta kuin 35 varsinainen kontaktikappale, jolloin painiketta painettaes- 93607 10 sa painike joustaa ja mahdollistaa kehyskappaleen 23 ja kontaktikappaleen 24 erottamisen toisistaan. Kontaktikappa-leen 24 muoto on porrastettu, joten kehyskappaleen sisäke-hää syvemmälle ulottuva painikkeen 25 kärki lukitsee por-5 rastuksen ansiosta kontaktikappaleen 24 kehyskappaleeseen 23.
Kuvioissa 5b ja 5c on esitetty kaksi erilaista kytkentäkappaletta. Kytkentäkappaleita voidaan valmistaa niin monta kuin on erilaista leikkausinstrumenttia.
10 Kytkentäkappale 24 toisessa päädyssään käsittävät kontaktivälineet 16 eli esimerkiksi aukot, tasaiset alueet tai kohoumat, ja vastakkaisessa päädyssään kontaktikappale 24 käsittää liitosvälineet 26, joihin leikkausinstrumentti voidaan liittää.
15 Biopsiaohjaimelle tarkoitettu kytkentäkappale on esitetty kuviossa 5b, jossa kontaktivälineinä on kaksi kon-taktikappaleeseen muodostettua aukkoa 16, ja liitosvälinee-nä 26 toisessa päädyssä reikä biopsiaohjainta varten.
Ultraäänianturille, tai muulle pyöreänmuotoisen ko-20 telon omaavalle leikkausinstrumentille tai laitteelle tar koitettu kontaktikappale esiintyy kuviossa 5c, jossa kontaktivälineinä on yksi aukko 27 ja tasainen alue 28, ja liitosvälineenä esiintyy olennaisesti ympyrän muotoinen aukko 29 reunoineen 30, jonka määräämään aukkoon leikkaus-25 instrumentti voidaan sijoittaa.
Vaikka keksintöä on edellä selostettu viitaten oheisten piirustusten mukaisiin esimerkkeihin, on selvää ettei keksintö ole rajoittunut niihin, vaan sitä voidaan monin tavoin muunnella oheisten patenttivaatimusten esittä-30 män keksinnöllisen ajatuksen puitteissa.

Claims (7)

1X 93607
1. Leikkaustoimenpidelaite, jota käytetään esimerkiksi aivoleikkauksen tai muun lääketieteellisen toimenpi-5 teen yhteydessä, joka laite käsittää - suunnistinvarren (3) tai vastaavan välineen, joka on sovitettu käytettäväksi toimenpiteen vaatimien liikkeiden suorittamiseen ja/tai ohjaamiseen, - ja joka suunnistinvarsi (3) on suojattu tai suo-10 jättävissä steriilin tai steriloitavissa olevan suojavälineen (11) kuten suojapussin, suojasukan tai vastaavan välineen avulla, - ja johon suunnistinvarteen (3) tai vastaavaan välineeseen on kytketty tai kytkettävissä leikkausinstruraent- 15 ti (4), kuten neula, ultraäänianturi tai vastaava väline, ja - suunnistinvarsi (3) on kytketty tai kytkettävissä leikkausinstrumenttiin (4) steriloitavissa olevasta materiaalista valmistetulla välikappaleella (12) tai vastaaval- 20 la, tunnettu siitä, että välikappale (12) ja/tai suunnistinvarsi (3) käsittää tunnistinvälineet (15, 16) välikappaleeseen (12) liitettävissä olevan leikkausinstrumentin (4) tunnistamiseksi.
2. Patenttivaatimuksen 1 mukainen laite, tun nettu siitä, että tunnistinvälineet (15, 16) käsittävät suunnistinvarren (3) päähän tai lähialueelle sovitetun yhden tai useamman kytkinvälineen (15) ja välikappaleeseen (12) sovitetun yhden tai useamman kontaktivälineen (16), ,30 joiden antama kontaktitieto on riippuvainen välikappalee seen (12) yhdistetystä leikkausinstrumentista (4).
3. Patenttivaatimuksen 2 mukainen laite, tunnettu siitä, että suunnistinvarren (3) käsittämät kyt-kinvälineet (15) ovat sähköisen signaalin kytkemiseen tar-35 koitettuja painokytkimiä, ja välikappaleen (12) käsittämät 93607 kontaktivälineet (16) ovat välikappaleeseen 12 muodostettuja muotoja, kuten syvennyksiä (16, 17, 18, 27) ja/tai kohoumia ja/tai tasaisia alueita (28).
4. Patenttivaatimuksen 2 tai 3 mukainen laite, 5 tunnettu siitä, että suunnistinvarsi (3) tai sen pää käsittää suunnistinvarresta (3) ulkonevan ulokkeen (20), johon kytkinvälineet (15) on sovitettu.
5. Patenttivaatimuksen 1, 2, 3 tai 4 mukainen laite, tunnettu siitä, että välikappale (12) muodostuu 10 ainakin kahdesta toisiinsa yhdistettävissä olevasta osasta (23 ja 24).
6. Patenttivaatimuksen 5 mukainen laite, tunnettu siitä, että välikappaleen ensimmäinen osa on kehyskappale (23) tai vastaava, joka on sovitettu suojavä- 15 lineellä (11) suojatun suunnistinvarren (3) pään ympärille, jolloin välikappaleen (12) toinen osa on vaihdettavissa oleva, kontaktivälineet (16) käsittävä ja kullekin leikkausinstrumentille (4) ominainen kontaktikappale, joka on sovitettavissa kehyskappaleeseen (23) siten, että kontakti- 20 kappaleen (24) käsittämät kontaktivälineet (16) ovat yhteydessä suunnistinvarren (3) käsittämiin kytkinvälineisiin (15) suunnistinvartta (3) suojaavan suojavälineen (11) kautta.
7. Patenttivaatimuksen 5 tai 6 mukainen laite, 25 tunnettu siitä, että ainakin yksi osa välikappaleen (12) yhdistettävissä olevista osista (23 ja/tai 24) käsittää lukitusvälineen (25) kuten painikkeen välikappaleiden (12) osien (23 ja 24) lukitsemiseksi toisiinsa. 93607
FI912520A 1991-05-24 1991-05-24 Leikkaustoimenpidelaite FI93607C (fi)

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FI912520A FI93607C (fi) 1991-05-24 1991-05-24 Leikkaustoimenpidelaite
PCT/FI1992/000162 WO1992020295A1 (en) 1991-05-24 1992-05-22 Surgical operation device
DE69226637T DE69226637T2 (de) 1991-05-24 1992-05-22 Chirurgische operationsvorrichtung
AU17732/92A AU1773292A (en) 1991-05-24 1992-05-22 Surgical operation device
EP92910792A EP0586464B1 (en) 1991-05-24 1992-05-22 Surgical operation device
US08/142,405 US5413573A (en) 1991-05-24 1992-05-22 Device for surgical procedures

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FI912520A FI93607C (fi) 1991-05-24 1991-05-24 Leikkaustoimenpidelaite
FI912520 1991-05-24

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Publication number Publication date
FI912520L (fi) 1992-11-25
EP0586464B1 (en) 1998-08-12
EP0586464A1 (en) 1994-03-16
DE69226637D1 (de) 1998-09-17
FI93607B (fi) 1995-01-31
DE69226637T2 (de) 1999-02-11
FI912520A0 (fi) 1991-05-24
US5413573A (en) 1995-05-09
WO1992020295A1 (en) 1992-11-26
AU1773292A (en) 1992-12-30

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