JP2000175937A - Medical cephalo-retainer - Google Patents

Abstract

PROBLEM TO BE SOLVED: To properly rock the head part of a patient in the middle of an encephalo surgery without physically and mentally burdening an operator. SOLUTION: In this retainer, a cephalo-retainer fixture 1 for retaining the head part Ma of the patient M is reciprocatively attached and supported to an operating table B by an attaching supporting part 2, and the fixture 1 to which the site Ma of the patient M is retained is continually reciprocated by a head rocking part 3. Consequently, since the site Ma of the patient M is mechanically rocked with the retainer 1 with continuous reciprocating of the retainer 1 without rocking it manually by the operator, the region Ma of the patient M can properly be rocked without burdening the operator at all.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical head fixing device used to fix the head of a subject (patient) during brain surgery.

[0002]

2. Description of the Related Art Normally, in brain surgery, a patient's head is fixed with a head fixture so that the patient's head does not move during the operation, and the operation is performed. However, among brain surgery, for example, in the case of surgery to dissolve blood clots generated in the brain due to intracerebral hemorrhage with a drug, after incising the skull and administering the drug, the patient's head is moved from the head fixture. Then, the surgeon (a doctor or the like) performs a surgical operation in which the patient's head is shaken by directly holding the patient's head with his / her hand. This is because shaking the patient's head enhances the clot dissolving effect of the drug.

[0003]

However, in the case of the conventional surgical operation in which the surgeon holds the patient's head by hand and shakes during the operation, not only is the physical and mental burden on the surgeon large, but also the head is severe. There is a problem that it is difficult to shake the part properly.

[0004] That is, the time to keep shaking the patient's head is usually as long as about 20 minutes, and the operator's hand is removed with the heavy head in the state of skull incision removed from the head fixture. In particular, if the user holds the robot and shakes it for 20 minutes, the physical and mental burden on the operator is particularly great.

[0005] In addition, in the case of a conventional method that relies on human power (manually), 2
Continuing to shake the patient's head for as long as 0 minutes in such a manner as to sufficiently enhance the clot dissolving effect of the drug is not easy for an experienced surgeon.

An object of the present invention is to provide a medical head fixing device capable of appropriately shaking the head of a subject without imposing a burden on an operator in view of the above circumstances.

[0007]

In order to solve the above problems, a medical head fixing device according to the present invention is a medical head fixing device for fixing a head of a subject during brain surgery. A head fixing means for holding and fixing the head of the subject placed on the operating table, an attaching and supporting means for attaching and supporting the head fixing means to the operating table in a reciprocating manner, And a head swinging means for continuously reciprocating the head fixing means to which the head is fixed and shaking the head of the subject together with the head fixing means. is there.

[Operation] Next, the operation when the head of the subject is shaken by the medical head fixing apparatus of the present invention will be described. When using the medical head fixing device of the present invention, first, the head fixing means for holding the subject's head is reciprocally attached to and supported on the operating table by the mounting and supporting means. Then, the head of the subject placed on the operating table is clamped and fixed by the head fixing means. Further, at the time when it is necessary to shake the subject's head due to the progress of the brain surgery, the head fixing means to which the subject's head is fixed is continuously reciprocated a predetermined distance by the head swinging means. Move.
Then, with the continuous reciprocation of the head fixing means, the head of the subject fixed to the head fixing means is also shaken together with the head fixing means.

That is, in the medical head fixing device of the present invention, the head fixing means to which the head of the subject is fixed is continuously reciprocated, and the head of the subject is Even if the surgeon does not hold the hand and shakes, the head fixing means is mechanically shaken together with the continuous reciprocating movement of the head fixing means.

[0010]

Next, an embodiment of the present invention will be described with reference to the drawings. FIG. 1 is a front view showing the entire configuration of a medical head fixing device according to an embodiment, and FIG. 2 is a perspective view showing the vicinity of the head side of an operating table on which the embodiment device is set.

As shown in FIG. 1, a medical head fixing device according to an embodiment includes a head fixing tool 1 for holding and fixing a head Ma of a patient (subject) M placed on an operating table B, Head fixture 1
And a mounting fixture 2 for mounting and supporting the operating table B in a reciprocating manner, and a head fixing device 1 to which the head Ma is fixed, so that the head Ma of the patient M is fixed to the head fixing device. 1
And a head swinging part 3 that swings.

The head fixing device 1 corresponds to the head fixing means of the present invention, the mounting support 2 corresponds to the mounting support means, and the head swinging section 3 corresponds to the head swinging means.

On the other hand, on both sides (both sides) of the operating table B,
As shown in FIG. 2, side rails Ba, Ba extending along the longitudinal direction of the operating table B to a position where the tip slightly protrudes from the end of the operating table B are attached.

Hereinafter, the configuration of each of these units will be described more specifically.

The head fixture 1 is a general fixture conventionally known as a Mayfield type three-point clamping type. The head fixing device 1 includes a holding part 4 including a fixed piece 4a, a movable piece 4b, and a pressing piece 4c, and a holding part 4 so that the inclination angle of the holding part 4 can be adjusted with respect to a direction indicated by an arrow RA. And a joint portion 6 composed of joint pieces 6a and 6b for attaching and supporting the rotary adapter 5 to the attachment support portion 2 side.

In the case of the holding section 4 of the embodiment, the head Ma of the patient M is held in a fixed state by being clamped at a total of three places: the tip and the horizontal side of the fixed piece 4a and the tip of the pressing piece 4c. I have.

The holding portion 4 is mounted on the upper end of the rotary adapter 5 with mounting screws 5a in a state where the holding portion 4 is inclined at a desired inclination angle.

The lower end of the rotary adapter 5 is connected to the upper ends of the coupling pieces 6a, 6b by mounting screws 6d, and the lower ends of the coupling pieces 6a, 6b are mounted to the mounting pieces 2a of the mounting support 2 by mounting screws 6c. It is configured to be coupled to

On the other hand, the mounting support 2 of the embodiment
As shown in FIG. 2, the side rails Ba, Ba of the operating table B are provided.
A movable piece 2c engaged with the bridging bar 2 so as to be able to reciprocate only along the longitudinal direction of the bridging bar 2b as shown by an arrow RB. , Standing bars 2d and 2e erected on the upper side of the movable piece 2c, and horizontal bars 2f passed between the standing bars 2d and 2e, and mounting pieces 2a attached to the horizontal bars 2f. are doing. The movable piece 2c can move only horizontally in a linear guide system.

The standing bars 2d and 2e and the horizontal bar 2f and the mounting piece 2a are integrally connected to the movable piece 2c. As a result, the head fixing device 1 mounted and supported on the mounting piece 2a is also connected to the movable piece 2c. This means that they are integrally configured.

Further, as shown in FIG. 2, locking recesses 2g are provided at both ends of the bridging bar 2b of the mounting support portion 2, respectively.
Are provided so that the two locking recesses 2g are fitted upside down in the side rails Ba, Ba and fastened with the fixing screws 2i. Also, side rail B
In addition to the configuration in which a bridging bar 2b is bridged between a and Ba, a disc-shaped cam engaged with an eccentric roller 3a of a head swinging unit 3 (described later) is provided on a lower side of a movable piece 2c. 2
h is provided integrally.

On the other hand, the head swinging portion 3 of the embodiment device is provided with a cam 2h on the lower side of the movable piece 2c in the mounting support portion 2.
An induction motor 3b for rotating the eccentric roller 3a engaged with the motor, a timer 3c for setting a rotation time of the induction motor 3b, and an induction motor 3b.
And a switch 3e for turning on and off the rotation of the induction motor 3b.

When the switch 3e is turned on, the motor control unit 3d of the head swing unit 3 rotates the induction motor 3b for the time set by the timer 3c unless the switch 3e is turned off. Of course, if the switch 3e is turned off while the induction motor 3b is rotating, the motor control unit 3d immediately stops the rotation of the induction motor 3b. The eccentric roller 3
A gear head 3f for adjusting the number of rotations is provided between a and the induction motor 3b.

The induction motor 3b is supported at a required height by the L-shaped frame 3g, and a necessary electric cable is routed between the induction motor 3b and the motor control unit 3d. Further, a timer 3c, a motor control unit 3d, a switch 3e, and the like are also supported at appropriate places by a frame member (not shown).

Further, the cam 2 in the mounting support 2
h, a vertically long engaging hole 2j is bored, and an end face of the eccentric roller 3a in the head swinging part 3 is provided with an engaging pin 3j.
h is projected. The installation position of the engagement pin 3h is slightly displaced laterally from the center of the rotation shaft of the induction motor 3b, so that the roller 3a is an eccentric roller.

Then, as shown in FIG.
The cam 2h and the eccentric roller 3a are engaged by loosely inserting the engaging pin 3h on the side a of the cam 2h into the engaging hole 2j on the side of the cam 2h. As shown by arrows RC to RF, engagement pin 3h moves so as to draw a circle in plan view.

On the other hand, while being pushed in accordance with the movement of the engaging pin 3h, the cam 2h is moved from the position shown by the solid line at the center to the position shown by the dashed line on the left side to the position shown by the solid line at the center to the position shown by the dashed line on the right side. One horizontal reciprocating movement in which only the horizontal position is changed in the order of the position indicated by the solid line at the center.

Therefore, not only the movable piece 2c integrally connected to the cam 2h but also the mounting piece 2a
The head fixture 1, which is integrally connected to the movable piece 2c through the like, also moves the cam 2h with the horizontal reciprocation of the cam 2h.
The horizontal reciprocation is performed between the same distances as in the case of h.

The horizontal movement distance of the head fixture 1 is the center of the eccentric roller 3a (the center of the rotation axis of the induction motor 3b).
2h (2L) of the deviation distance L of the engagement pin 3h from the center. As a result, while the induction motor 3b is rotating, the eccentric roller 3a repeats the rotation, and the head fixture 1 is rotated.
Continuously reciprocate horizontally over a distance of 2L. Further, by adjusting the eccentric distance L of the engaging pin 3h, the distance of the horizontal reciprocating movement of the head fixture 1 can be changed. Therefore, several eccentric rollers having different eccentric distances L are prepared in advance. And may be replaced as needed.

Normally, the distance (2 L) of the horizontal reciprocating movement of the head fixture 1 is usually set to about 2 to 10 mm, and the cycle of the horizontal reciprocating movement is 1 to 10 Hz (60 to 600 rotations / hour).
Minutes). Motor control unit 3d of the embodiment device
Is provided with a mechanism for adjusting the cycle of the horizontal reciprocating movement.

Next, the operation of the apparatus when the head Ma of the patient M is shaken during brain surgery by the apparatus having the above-described configuration will be specifically described with reference to the drawings. FIG.
6 is a flowchart showing a situation over time when the head Ma of the patient M is swung by the apparatus of the embodiment.

[Step S1] The bridging bar 2b of the mounting support section 2 of the embodiment device is connected to the side rails Ba,
Pass over between Ba.

[Step S2] The joint 6 of the head fixture 1 is attached to the attachment piece 2a on the upper side of the movable piece 2c.

[Step S3] At an appropriate time, the head Ma of the patient M placed on the operating table 3 is clamped and fixed by the holder 4. Next, for example, the subject is incised in the head and a lysing agent is injected.

[Step S4] When necessary, the switch 3e of the head swinging unit 3 is turned on to rotate the induction motor 3b.

[Step S5] With the rotation of the induction motor 3b, the head fixture 1 is attached to the mounting piece 2.
The patient Ma is reciprocated horizontally and the head Ma of the patient M is shaken.

[Step S6] When the time set by the timer 3c elapses, the horizontal reciprocation of the head fixture 1 stops as the rotation of the induction motor 3b stops, and the head Ma of the patient M swings. The movement ends.

According to the apparatus of the embodiment described in detail above, the head fixture 1 to which the head Ma of the patient M is fixed can be continuously horizontally reciprocated in the same state. The head Ma is mechanically shaken together with the head fixture 1 with the continuous reciprocation of the head fixture 1 without the operator holding and shaking the hand, so that no burden is imposed on the operator. Patient M
Can be appropriately swung.

The present invention is not limited to the above embodiment, but can be modified as follows.

(1) The medical head fixing device of the embodiment has a configuration in which the head Ma of the patient M is swung in the horizontal direction.
An apparatus having a configuration in which the head Ma of the patient M is swung in a vertical direction or an oblique direction is a modified example.

Further, as a modified example, a device in which the head Ma of the patient M is swung in the left-right direction with the fulcrum at the base of the neck as a fulcrum.

(2) In the case of the embodiment, the movable piece 2c
The cam 2h integrally connected to the cam 2h has a vertically long engagement hole 2i.
However, instead of such a cam 2h, two rod-shaped members are formed so that a vertically long narrow gap (slit) corresponding to the engagement hole 2i is formed therebetween. An apparatus having a configuration in which cams arranged in parallel are used is a modified example.

(3) In the case of the embodiment, the movable piece 2c
Has been configured to be capable of reciprocating movement by a linear guide system. However, the movable piece 2c is screwed to a horizontally arranged screw shaft, and an electric motor for rotating the screw shaft is provided. As a modified example, an apparatus configured to reciprocate the movable piece 2c horizontally by repeating the rotation and the reverse rotation is mentioned.

(4) In the case of the embodiment, the rotation of the induction motor is automatically stopped when the rotation of the induction motor is performed for a time determined by the timer 4c. However, the timer 4c is provided. Alternatively, a device having a configuration in which the rotation of the induction motor is stopped by the switch 4c is also a modified example.

(5) In the embodiment, the head fixing device 1 is of the Mayfield type, but the head fixing device 1 provided in the device of the present invention is not limited to the Mayfield type. Absent.

(6) It goes without saying that the medical head fixing device of the present invention is widely applicable not only to the operation of dissolving a blood clot generated in the brain with a drug but also to a wide range of brain surgery.

[0047]

As described in detail above, according to the medical head fixing device of the present invention, the head fixing means to which the subject's head is fixed can be continuously reciprocated. Since the subject's head is naturally mechanically shaken together with the head fixing means with the continuous reciprocating movement of the head fixing means without the operator shaking the hand, The subject's head can be shaken appropriately without placing any burden on the patient.

[Brief description of the drawings]

FIG. 1 is a front view showing the overall configuration of a medical head fixing device according to an embodiment.

FIG. 2 is a perspective view showing the vicinity of the head side of an operating table on which the embodiment device is set.

FIG. 3 is a schematic diagram showing a relationship between rotation of an eccentric roller and horizontal movement of a cam in the embodiment device.

FIG. 4 is a flowchart showing a situation over time when a patient's head is swung by the embodiment apparatus.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Head fixing device 2 ... Mounting support part 3 ... Head swing part 2a ... Mounting piece 2c ... Movable piece 2h ... Cam 3a ... Eccentric roller 3b ... Induction motor B ... Operating table M ... Patient Ma ... Head

Claims (1)

[Claims] 1. A medical head fixing device for fixing a head of a subject during a brain surgery, wherein the head fixes and holds the head of the subject placed on an operating table. The fixing means, the mounting and supporting means for attaching and supporting the head fixing means to the operating table so as to be capable of reciprocating movement, and the subject by continuously reciprocating the head fixing means to which the head of the subject is fixed A head swinging means for swinging the head of the patient together with the head fixing means.