JP2008194144A - Head fixing device - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a head fixing device which can fix the head part of a person to be treated at a desired position of an examination table of an image diagnostic device and enables the photographing of images of a site undergoing operation as required for the checking of the acceptability of the treating operation or the effect of treatment in the course of the operation or others by making it applicable for the examination table of the existing image diagnostic device without modifying the examination table of the image diagnostic device. <P>SOLUTION: The device is constituted of a planar pedestal 2 made by forming a plate-like member in a U shape, a fixing frame 3 which is formed into an arm with one end opened encircling the subject's head part and has fixing pins 11 and 12 protruding to the inside of the arm 10 near its opened end to fix the subject's head part, a double-axis rotary support mechanism 4 which is provided on the planar pedestal 2 and supports the fixing frame 3 so as to be rotatable around two axes orthogonal to each other at a position facing the opened end part of the arm 10 and a support member 5 which has its one end disposed on the planar pedestal 2 and the other end on the arm 10 of the fixing frame 3 and securely supports the arm 10 of the fixing frame 3 at a position that allows the arm 10 of the fixing frame 3 to be fixed with the fixing pins 11 and 12 encircling the subject's head part. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

  The present invention relates to imaging of a subject or a subject's head using an image diagnostic apparatus in diagnosis or surgery, or during surgery in a surgical operation, the subject or the subject's head is The present invention relates to a head fixing device that fixes the head of an examiner or a subject so as not to move.

  Conventionally, in brain surgery, a person to be treated is laid on his / her back on an operating table fixed in an operating room. Since this brain surgery is performed with a scalpel in a very small part of the brain, if the head of the person to be moved moves even a little during the operation, the operation fails and results in serious matters related to human life. . For this reason, conventionally, in brain surgery, it is necessary to place the patient on his / her back on an operating table fixed in the operating room and firmly fix the patient's head so that the patient's head does not move. is there.

  However, brain surgery is performed by a doctor operating a brain spatula or surgical instrument, but in order to secure a good surgical field for the surgical site of the patient, it is necessary to move the head of the patient a little. There is. Therefore, conventionally, the base frame is fixed to the semicircular arc head fixing frame, and the semicircular arc holding frame is movably provided on the semicircular arc head fixing frame via the guide frame, thereby fixing the head. The base frame fixed to the frame and the semicircular arc-shaped holding frame that holds the head of the patient to be moved separately, so that the surgeon's head can be moved to widen the surgical site. A head frame for brain surgery that secures a field has been proposed (see, for example, Patent Document 1).

  The head frame for brain surgery of Patent Document 1 is used at the end of an operating table fixed to the floor, and is installed so that the head of the person to be treated comes out from the end of the operating table. Since the head of the person to be treated is held and fixed at the installation position of the head frame for brain surgery, the head fixing frame is supported by the multi-joint arm structure.

  However, in recent years, in brain surgery, doctors have been able to perform complete resection of tumors while confirming the size, position, and surrounding conditions of the tumor in the brain using MR images before or during surgery. Has come to be done. For this reason, the brain surgical head frame of Patent Document 1 is not suitable for such treatment.

Therefore, there has been proposed a head support device that can fix the head easily and safely for surgery, and that can make a clear image diagnosis of the affected area by image diagnosis such as an MRI apparatus during the operation ( For example, see Patent Document 2.) The head support device of this Patent Document 2 prepares a special operating table, and is attached to the operating table end so that the head comes out from the operating table end. In this state, in the middle stage of surgery, In order to confirm the quality of the treatment operation and the effect of the treatment, the operating table device is inserted into the MRI apparatus, and an image of the head of the patient to be treated and excision are performed.
JP-A-11-4837 JP2000-30058

  The head frame for brain surgery of Patent Literature 1 and the head support device of Patent Literature 2 are both attached to the end of the operating table of the operating table device such that the head protrudes outward from the end of the operating table. It has become.

  On the other hand, an examination table of a general diagnostic imaging apparatus does not have a head fixing device attached to an end portion, and cannot use the head fixing device of Patent Document 1. Moreover, if a special operating table is prepared like the head support apparatus of patent document 2, an imaging | photography and excision operation can be performed so that a head may protrude outside from an operating table edge part.

  However, the inspection table of a general diagnostic imaging apparatus does not have a head fixing device attached to the end, and cannot use the head fixing device of Patent Document 2.

  In general, the examination table of the diagnostic imaging apparatus does not have a structure for attaching a head fixture to the end, and even if a head fixture is attached to the end of the examination table, a high-accuracy neurosurgery region is available. Not rigid enough for surgery. Further, when the head fixing device is attached to the end of the examination table of the image diagnostic apparatus, the examination table of the image diagnostic apparatus does not have a structure for attaching the head fixing tool to the end. For this reason, the operation of the head of the patient is performed by attaching a head fixing tool for fixing the head of the patient to be ejected from the end of the table together with the inspection table of a general diagnostic imaging apparatus. For this, it is necessary to remodel the diagnostic imaging apparatus such as reinforcing the examination table or replacing it with a dedicated operating table. If the structure is strengthened in order to increase the rigidity of the examination table of the diagnostic imaging apparatus, there is a problem in that the imaging of the portion corresponding to the abdominal region is affected and the versatility is impaired.

  Further, when a modification is made to the examination table of an existing diagnostic imaging apparatus, the diagnostic imaging apparatus becomes a non-approved device and has a disadvantage that it cannot receive medical insurance.

  The object of the present invention can be applied to an examination table of an existing diagnostic imaging apparatus without improving the examination table of the diagnostic imaging apparatus, and the head of the patient is fixed at an arbitrary position on the examination table of the diagnostic imaging apparatus. An object of the present invention is to provide a head fixing device that can take an image of a surgical site as needed, such as checking the quality of a treatment operation and the effect of treatment during surgery.

  The present invention is a flat pedestal formed by forming a plate-like member in a horseshoe shape, and an arm shape that is formed so as to go around the head of the subject or the subject and is open at one end. A fixed frame having a fixing pin which is formed and protrudes toward the inside of the arm in the vicinity of the open end of the arm and fixes the head of the subject or the patient; and the arm provided on the planar pedestal. A biaxially rotating support mechanism for supporting the fixed frame so as to be rotatable on two axes orthogonal to each other at a position facing the open end of the frame, one end is provided on the planar base, and the other end is provided on the arm of the fixed frame. A support member configured to support and fix the arm of the fixed frame at a position where the arm of the fixed frame goes around the head of the subject or the patient and is fixed by the fixing pin. .

  According to the present invention, it can be applied to an examination table of an existing diagnostic imaging apparatus without improving the examination table of the diagnostic imaging apparatus, and the head of the patient is fixed at an arbitrary position on the examination table of the diagnostic imaging apparatus. If necessary, it is possible to take an image of the surgical site, such as checking the quality of the treatment operation or the effect of the treatment during the operation.

Embodiments of the present invention will be described below with reference to the drawings.
FIG. 1 shows a first embodiment of a head fixing device according to the present invention. FIG. 1 is a perspective view of the overall configuration of a head fixing device according to the present invention.
In FIG. 1, the head fixing device 1 includes a planar base 2, a fixing frame 3, a support mechanism 4, and a support member 5.

  The planar pedestal 2 is configured by forming a plate-like member 6 in a horseshoe shape (U-shape). The planar base 2 has a strength sufficient to support the head. Screws 7A, 7B, 7C, and 7D (in FIG. 1, the screws 7D are hidden and do not appear) are attached to the member 6. These screws 7A, 7B, 7C and 7D correspond to the fixing means in the claims. These screws 7A, 7B, 7C and 7D are for detachably attaching to the top plate of the examination table of the diagnostic imaging apparatus (not shown).

  Further, as shown in FIG. 5, concave portions 8A and 8B (only the concave portion 8A in FIG. 5 are provided on the upper surface side (the surface side opposite to the top plate side of the inspection table of the diagnostic imaging apparatus). Is formed). One end of a support member 5 to be described later is fitted into the recess 8A. The support member 5 can be positioned on the planar base 2 by fitting one end of the support member 5 into the recess 8A.

  Further, as shown in FIG. 5, a countersink hole 9 is formed on the top plate side of the inspection table of the diagnostic imaging apparatus at the position where the concave portion 8A of the planar base 2 is formed. The counterbore 9 is fitted with a frame attached to one end of a string that fixes a support member 5 described later. The frame attached to one end of the string is fitted into the counterbore 9 and the other end of the string is tightened to fix the support member 5 to the flat base 2.

  As shown in FIG. 2, the fixed frame 3 has a square bar-shaped or round bar-shaped arm 10 formed in an arc shape (U-shape) so as to go around the head of the subject or the subject. . As shown in FIG. 3, the arm 10 is open at one end, and has a shape bent or bent upward toward the open end. The reason why the arm 10 of the fixed frame 3 is bent or bent upward toward the open end is to prevent the arm 10 of the fixed frame 3 from interfering with the doctor performing the operation.

  The fixed frame 3 may be formed in a U shape and may have a shape with a corner cut as shown in FIG. By configuring in this way, the degree of freedom of the angle of the fixed frame 3 can be increased. In the vicinity of the open end of the arm 10, fixing pins 11 and 12 project inward from the inside of each arm 10. One fixing pin 11 provided on one end side of the arm 10 is provided with two pins 11A and 11B fixed thereto. The other fixing pin 12 provided on the other end side of the arm 10 is configured to be screwed with one pin 12A. The fixing frame 3 is fixed to the head of the subject or the subject by inserting the head of the subject or the subject between the fixing pins 11 and 12 and tightening the fixing pins 11 and 12. The

  Further, the fixed frame 3 is provided with two support portions 13 and 14 facing outward at a position (center position) opposite to the open end. A support mechanism 4 is attached to the two support portions 13 and 14. Further, the fixed frame 3 is provided with recesses 15A and 15B (only the recess 15A is shown in FIG. 5) for attaching the support member 5 to the inner side of both ends of the arm 10, as shown in FIG. Yes. The recess 15A is provided with a through hole 16 at the bottom, and the recess 15B is provided with a through hole 17 at the bottom. The through holes 16 and 17 are for passing a string 18 for fixing the support member 5. A frame 19 is attached to one end of the string 18. The top 19 is fitted into countersink holes 9A and 9B (only the countersink hole 9A is shown in FIG. 5) provided on the top plate side of the examination table of the diagnostic imaging apparatus. .

  A fastener 20 is attached to the other end of the string 18. The fastener 20 is fastened to fix the support member 5 between the flat pedestal 2 and the fixed frame 3, and then the extra length is wound around the fixed frame 3 to fix the string 18. Further, stop holes 21 </ b> A and 21 </ b> B for inserting fasteners 20 attached to the other end of the string 18 are provided on the outer sides of both ends of the arm 9 of the fixed frame 3. The fasteners 20 of the straps 18 for fixing the two support members 5 are fitted into the stop holes 21 </ b> A and 21 </ b> B to fix the support member 5 between the planar base 2 and the fixed frame 3.

  As described above, in this embodiment, the top 19 is attached to one end of the string 18, and the other end of the support rods 27 and 28 and the hole of the fixed frame 3 are connected to the fixed frame 3. 3 and the planar pedestal 2 are combined. The string 18 may be fixed by a winder or the like.

  The support mechanism 4 includes two rotary shaft support members 22 and 23 provided on the planar base 2, a shaft 24 supported by the two rotary shaft support members 22 and 23, and a rotation that is rotatably attached to the shaft 24. The arm 25 is constituted. A shaft 26 is fixed to the rotary arm 25, and the shaft 26 is rotatably attached to the support portions 13 and 14 of the fixed frame 3.

  Further, a shaft 24 may be attached to the rotating shaft support members 22 and 23, and a rotating arm 25 may be attached to the shaft 24 so as to be rotatable. Further, a shaft 26 is rotatably fitted to the rotary arm 25, and both ends of the shaft 26 may be fixed to the support portions 13 and 14 of the fixed frame 3.

  In this way, the fixed frame 3 is supported by the support mechanism 4, and the fixed frame 3 is rotated in the horizontal direction by the shaft 24 (the fixed frame 3 is rotated in the horizontal swing direction), and the vertical direction by the shaft 26. The fixed frame 3 is rotatably supported by two mutually orthogonal axes that rotate (rotate in the vertical swing direction).

  The support members 5 are respectively provided on both end sides of the arm 10 of the fixed frame 3, and the support members 5 are constituted by two support rods 27 and 28 as shown in FIG. The support rod 27 has a male screw formed on the outer periphery of the support rod 27, and a blind female screw is formed at the center of the support rod 28 so that the support rod 27 is screwed. The support member 5 is configured in a state in which the support rod 27 is screwed to the support rod 28, and the entire length of the support member 5 is adjusted by turning the support rod 27.

  As shown in FIG. 5, the support member 5 is inserted between the flat pedestal 2 and the fixed frame 3 and supports the fixed frame 3 that fixes the head of the subject or the subject. That is, the support member 5 has the tip of the support rod 27 fitted into the recess 15A of the fixed frame 3, the tip of the support rod 28 fitted into the recess 8A of the planar pedestal 2, and the support rod 27 is turned to rotate the fixed frame. 3 is held at an appropriate place. Through holes 27 </ b> A and 28 </ b> A for communicating the support rod 27 with the central axis of the support rod 28 are provided. A string 18 is inserted into the through holes 27A and 28A, and the distance between the fixed frame 3 and the planar base 2 is fixed to a distance determined by the support member 5 by tightening the string 18.

FIG. 6 shows another embodiment of a fixing method for fixing the support member 5 with the string 18.
6, in this embodiment, the support member 5 is not structurally different from the holding member 5 shown in FIG. Further, with respect to the fixed frame 3, the recesses 15 </ b> A and 15 </ b> B for attaching the support member 5 formed on the inner sides of both ends of the arm 10 have the same configuration. The embodiment shown in FIG. 6 differs from the embodiment shown in FIG. 5 in that a stepped hole 31 is provided through the flat base 2 and the top plate 30 of the inspection table of the diagnostic imaging apparatus. . That is, the stepped hole 31 is provided with a top hole 31A for fitting the top 19 attached to one end of the string 18 on the lower surface side of the top plate 30 of the inspection table of the diagnostic imaging apparatus. A through hole 31B having a diameter smaller than the diameter of the coma hole 31A is formed through the top plate 30 and the flat base 2 of the inspection table of the diagnostic imaging apparatus. As shown in FIG. 6, the top 19 is fitted into the top hole 31 </ b> A, and the tip of the support rod 28 is attached to the through hole 31 </ b> B of the planar base 2.

FIG. 7 shows still another embodiment of the fixing method for fixing the support member 5 with the string 18.
In FIG. 7, a plurality of long holes (may be slit-like holes) 32 are formed in the planar base 2 in the direction in which the length direction is orthogonal to the open end side. In addition, a plurality of long holes (may be slit-shaped holes) 33 are formed in the top plate 30 of the examination table of the diagnostic imaging apparatus. The long hole 33 formed in the top plate 30 of the examination table of the diagnostic imaging apparatus has a length direction of the long hole 32 formed in the planar base 2 when the planar base 2 is placed. It is formed so as to be in a direction orthogonal to the direction. By forming in this way, when the planar pedestal 2 is overlaid on the top plate 30 of the examination table of the diagnostic imaging apparatus, an overlapping hole of the long hole 32 and the long hole 33 is formed somewhere. Thus, the attachment position of the frame 19 attached to the string 18 can have a degree of freedom.

  Here, the top plate 30 of the examination table of the image diagnostic apparatus is described as an example, but in general, the top plate of the examination table (the top plate of the operating table of the operating table device, the top plate of the moving bed, the image of the diagnostic imaging device) There may be a top plate of the inspection table).

  As shown in FIG. 8, the head fixing device 1 configured as described above can be placed at an arbitrary position on the top plate 30 of the examination table of the diagnostic imaging apparatus, and the fixing frame 3 of the head fixing device 1 is covered. When the head 101 of the examiner or the subject 100 is fixed and placed on the top board 30 of the examination table of the image diagnostic apparatus, the head 101 of the subject or the subject 100 is image diagnostic apparatus. It does not protrude from the top plate 30 of the inspection table.

FIG. 9 shows a second embodiment of the head fixing device according to the present invention. FIG. 9 is a perspective view of the overall configuration of the head fixing device according to the present invention.
9, the embodiment shown in FIG. 9 differs from the embodiment shown in FIG. 1 in the portion of the support mechanism 4 in the embodiment shown in FIG. 1 and the portion of the fixing frame 3 attached to the support mechanism 4. . The structure of the other planar base 2 and the supporting member 5 is not different from the embodiment shown in FIG.

  In FIG. 9, the support mechanism 40 includes two support shaft members 41, 42 provided on the planar pedestal 2, a shaft 43 supported by the two support shaft members 41, 42, and a rotatably attached to the shaft 43. And a support arm 44 to be formed. An adjustment screw 45 is screwed into the upper end portion of the support arm 44, and the central portion of the arm 9 of the fixed frame 3 is rotatably attached between the adjustment screw 45 and the upper end portion of the support arm 44. ing. That is, the arm 9 of the fixed frame 3 loosens the adjustment screw 45 and rotates the arm 9 of the fixed frame 3 in the horizontal direction (lateral swinging direction), and tightens and fixes the adjustment screw 45 at an appropriate position, thereby fixing the fixed frame 3. The three arms 9 can be rotated to an arbitrary position. Further, when the arm 9 of the fixed frame 3 is rotated in the vertical direction (vertical swinging direction), the shaft 43 that is pivotally supported by the support shaft members 41 and 42 by moving the arm 9 of the fixed frame 3 up and down. This is done by rotating the support arm 44 around the center. The height position of the arm 10 of the fixed frame 3 is adjusted by the support member 5.

  Thus, according to the present invention, the fixed frame 3 is held by the support mechanism 4 having a biaxial rotational degree of freedom with respect to the planar base 2. The planar base 2 is formed in a U shape in this embodiment, but may be formed in a B shape.

1 is an overall configuration perspective view showing a first embodiment of a head fixing device according to the present invention. It is a top view of the arm of the fixing frame of the head fixing device shown in FIG. It is a side view of the arm of the fixing frame of the head fixing device shown in FIG. It is a top view which shows another Example of the arm of the fixing frame of the head fixing device shown in FIG. It is sectional drawing of the spindle member of the head fixing device shown in FIG. It is sectional drawing which shows another Example of the spindle member of the head fixing device shown in FIG. It is a figure which shows another Example of the method of fixing the spindle member of the head fixing device shown in FIG. 1 with a string. It is a figure which shows the state which laid down the subject or the to-be-treated person on the top plate of the examination stand of an image diagnostic apparatus using the head fixing device shown in FIG. It is a whole composition perspective view showing the 2nd example of the head fixation device concerning the present invention.

Explanation of symbols

1 ……………………… Head fixing device 2 ………………………… Plane base 3 ………………………… Fixing frame 4 ……………………… Support Mechanism 5 ………………………… Supporting member 10 …………………… Arms 11, 12 …………… Fixing pin 40 …………………… The top of the examination table of the diagnostic imaging apparatus Plate 100 …………………… Subject or patient 101 ………………… Head

Claims (8)

A planar pedestal formed by forming a plate-like member into a horseshoe shape;
The arm is formed so as to circulate around the head of the subject or the subject, and is formed in an arm shape with one end open, and protrudes toward the inside of the arm in the vicinity of the open end of the arm. A fixing frame having fixing pins for fixing the head of the therapist;
A biaxial rotation support mechanism that is provided on the planar pedestal and supports the fixed frame so as to be rotatable about two axes orthogonal to each other at a position facing the open end of the arm;
One end is provided on the flat pedestal and the other end is provided on the arm of the fixed frame. The fixed frame is fixed at the position where the arm of the fixed frame wraps around the head of the subject or the patient and is fixed by the fixing pin. A support member for supporting and fixing the arm of the frame;
The head fixing device characterized by comprising. The head fixing according to claim 1, wherein the support member is provided with a through-hole through which a string passes in the center, and is fixed to the planar base and the arm of the fixing frame through the string through the through-hole. apparatus. The support member is attached to the planar pedestal with the string by forming a countersink hole in the planar pedestal, and fitting a piece that binds the string to the countersink hole, and attaching the string to the support member. The head fixing device according to claim 1, wherein the head fixing device is performed through the through hole. 4. The head fixing device according to claim 1, wherein the flat base is configured to be detachably attached to a top plate of an examination table of an image diagnostic apparatus by fixing means. The flat pedestal is fixed to the top plate of the inspection table of the diagnostic imaging apparatus by providing a plurality of long holes in the flat pedestal and forming the flat pedestal on the top plate of the diagnostic imaging table. A plurality of long holes are provided so that their length directions are orthogonal to each other, a countersink hole is formed in the slot forming position on the back side of the top plate of the inspection table of the diagnostic imaging apparatus, and the string is inserted into the countersink hole. The tied piece is fitted, and the string is passed through the long hole of the top plate of the inspection table of the diagnostic imaging apparatus and the long hole of the planar base, and through the through hole of the support member. The head fixing device according to 2. The head fixing device according to claim 1, 2, 3, 4, or 5, wherein the fixing frame is bent or bent upward toward an open end. The head fixing device according to claim 1, 2, 3, 4, 5 or 6, wherein the fixing frame is formed in a U-shape. The head fixing device according to claim 7, wherein the fixing frame has a shape with a corner cut off.

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