JP3033037B2 - Puncturing needle insertion angle and puncturing point determiner for CT guide and puncturing needle support - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to biopsy and treatment using a medical CT guide, and more particularly to a puncture needle insertion angle and insertion point determiner for a CT guide and its puncture needle support. is there.

[0002]

2. Description of the Related Art Conventionally, there is a large-sized device dedicated to a head for determining an insertion angle and an insertion point of a puncture needle under a CT guide and holding the puncture needle (for example, see Japanese Unexamined Patent Application Publication No. 62
-227349, JP-A-62-327) It cannot be used on the chest and abdomen, and the above-mentioned puncturing technique has been largely based on experience and intuition.

[0003]

In the conventional method, the insertion point on the skin surface is determined, and although a certain insertion angle is known, since the puncture is performed by visual measurement, the tip of the puncture needle is moved to the target portion due to lack of accuracy. Axial sca many times before reaching
n until the tip of the puncture needle settles at the best position.
There was a problem that the position of the tip of the puncture needle and the insertion angle of the puncture needle had to be corrected every time xiaI scan.

[0004] In addition, there is a problem in that it is often not parallel to the scan plane of the axial scan, and it is necessary to take a plurality of times of imaging in order to confirm the position of the tip of the puncture needle, which takes time.

Accordingly, the present invention provides a CT guide puncture needle insertion angle and an insertion point determiner which can easily determine an insertion angle, an insertion point and an insertion depth by photographing together with a target portion. An object of the present invention is to provide the puncture needle support.

[0006]

Means for Solving the Problems In order to solve the above problems, a puncture needle insertion angle and an insertion point determiner for a CT guide according to the present invention are provided with symmetrical open windows on two opposing faces of a rectangular cylindrical body. A plurality of strings made of an elastic material having X-ray absorption are stretched in parallel at equal intervals in the release window, and cuts provided in parallel with the strings symmetrical on both side surfaces of the cylindrical body are provided at the center. The slide plate is formed so that it can slide back and forth and right and left with a hole.

[0007] Each of the strings of the CT guide puncture needle insertion angle and insertion point determiner is provided with a scale in which a plurality of colors are repeated in the same order.

The puncture needle support of the present invention comprises a frame which is rotated by an axis parallel to the longitudinal direction of the slide plate in a hole of the slide plate of the puncture needle insertion angle and the insertion point determiner for the CT guide. The frame was constituted by a ring provided in the frame and rotated by an axis perpendicular to the axis.

A solution is provided by providing a sheath which is inserted into the ring and can be separated in the longitudinal direction.

[0010]

The puncture needle insertion angle and puncture point determiner for CT guide according to the present invention and the puncture needle supporter are fixed on the body surface near the puncture point, and X-ray absorption and graduation when photographed together with the target part. The insertion angle, the insertion point, and the insertion depth can be easily determined by the action of a string having a puncture needle, or a puncture needle support that can rotate freely back and forth and left and right.

If there is an obstacle or an important organ in the path of entry of the puncture needle and it is impossible to enter the puncture needle in parallel with the scan plane, the movement distance of the puncture point is measured from the scale of the chord on the lower surface.
The passing point of the puncture needle on the upper surface is grasped by calculation, and the angle in the body axis direction can be determined by using the scale of the chord on the upper surface. Similarly, the position of the tip of the puncture needle in the body can be grasped by calculation.

By determining the two points of the visible part as described above, the target part is determined on an extension of the two points, and more reliable sampling and injection of the drug solution can be performed.

[0013]

An embodiment of the present invention will be described in detail with reference to the drawings.

The configuration of the present invention will be described with reference to a perspective view showing an example of a puncture needle insertion angle and an insertion point determiner for a CT guide of FIG. Symmetrical open windows (1) are provided on the opposing upper surface (A) and lower surface (B) of a rectangular cylindrical shape, and strings (2, 3) made of an elastic material having X-ray absorption in the open windows (1) are 5 mm. The sliding cuts (4, 5) are arranged in two upper and lower stages so as to be parallel to the strings (2, 3) at symmetrical positions on both sides (C, D) of the release window (1). Provided on both sides (C,
D) For setting a puncture needle support that penetrates through the sliding cuts (4, 5) and can freely slide back and forth and right and left so as to be orthogonal to the strings (2, 3) and serves as a puncture needle support in the center. Slender plate-like slide plates (6, 7) having windows (9, 10)
Is provided. Further, a positioning line (L, M) in the Y direction corresponding to a line corresponding to the light projector is provided on the slide plate in the longitudinal direction of the slide plate. Further, in consideration of the convenience of use, both side surfaces (C, D) of the quadrangular cylindrical body are protruded further below the lower surface (B), and the protruding portion is provided longer in the longitudinal direction (Y) of the cylindrical body. Tape fixing feet (11, 12, 13, 1
4), and the end piece of the side surface (C, D) was formed as a semicircular cut (16) shape.

Each of the strings (2, 3) was provided with a scale at intervals of 2 mm, and the scale was colored by repeating five colors in the same order.

The configuration of an embodiment of the puncture needle support of the present invention will be described with reference to FIGS. A central portion of the slide plate (6, 7) is squared out to form a puncture needle support installation window (9). The puncture needle support installation window (9) is parallel to the longitudinal direction of the slide plate. Rotary shaft (20, 21) rotatable in the short direction (R) of the slide plate
To fit the square frame (24),
4) a rotating shaft (22, 23) perpendicular to the rotating shaft (20, 21) and rotatable in the longitudinal direction (S) of the slide plate;
And a ring (25) attached to the housing.

Further, the ring (2) serves as a passage for facilitating attachment of the puncture needle to the puncture needle support of the present invention.
A sheath (15) to be inserted into 5) was provided. Further, the sheath (15) is configured to be separable in the longitudinal direction, which constitutes an embodiment of the present invention.

A puncture needle insertion angle and a puncture point determiner for a CT guide of the embodiment and an example of use thereof using the puncture needle support will be described in detail.

An approximate puncture position on the skin surface is determined from a preliminary inspection, and the puncture needle insertion angle for the CT guide and the strings (2, 3) of the puncture point determiner are shown in FIG. ) Perpendicular to the tape fixing foot (1) shown in FIG.
1, 12, 13, 14) is firmly fixed to the patient's body with tape, and is scanned several times to determine the optimal position for puncture.

When the target portion can be photographed, a straight line connecting the target portion (26) and the puncture point on the skin surface so as to provide an optimal route for puncturing on a CT monitor as shown in FIG. The line (27) for determining the insertion direction is set so as to exceed the insertion angle of the puncture needle for CT guide and the upper surface (A) of the insertion point determiner. At this time, the length from the target portion (26) to the skin surface is measured and used as a reference for the insertion depth at the time of insertion. When the straight line (27) is determined, it is confirmed which position of the cross section of the chord (2, 3) of each of the upper surface (A) and the lower surface (B) passes.

The upper and lower slide plates (6, 7) are slid in the head-to-tail direction (Y) at the position where the target portion is photographed, and the Y-direction positioning lines (L, M) on the slide plates (6, 7) are moved. Is adjusted to the light of the projector, and the ring (25) on the slide plate (6, 7) is connected to the strings (2, 3) of the upper surface (A) and the lower surface (B), which have been confirmed earlier.
To determine the two visible points through which the puncture needle should pass in three dimensions.

As a reconfirmation for more reliable puncture, the sheath (1) is attached to each ring (25) of the slide plate (6, 7).
Perform axial scan with 5) held,
It is confirmed that the target portion is on the extension of the sheath (15), and if a deviation is recognized, it is corrected.

When the insertion point and the insertion angle are determined, the sheath (1
The puncture needle may be passed through 5) and advanced by the length measured in advance.

When performing puncturing, rather than holding only the upper part of the puncture needle and puncturing, insert the thumb and forefinger of one hand into the body, hold the tip of sheath (15), and puncture with the other hand. By holding the upper part of the needle and applying force toward the tip of the puncture needle, smooth puncture becomes possible.

If there is an obstacle or important equipment in the approach direction and it is impossible to puncture in parallel to the scan plane (a) shown in FIG. 6, the insertion point must be moved in the body axis direction. . In this case, when the insertion point for avoiding an obstacle or an important organ is determined from the position where the target part was photographed, the scale of the chord on the lower surface (B) is used, and the point moved to avoid the obstacle or the important organ described above is used. The puncture needle may be advanced so as to connect the points of the chord on the upper surface (A) moved by the length calculated from the distance moved on the lower surface (B).

When it is necessary to insert the puncture needle deeply, the sheath (15) is separated into two parts, the puncture needle is sipped, and the elastic string (2) is spread on both sides. By removing the fixing of the puncture needle insertion angle and the insertion point determiner from the skin surface, it is possible to penetrate deeper.

[0027]

Since the present invention is configured as described above, it has the following effects.

According to the present invention, the insertion point and the insertion angle can be easily and accurately determined, so that the same posture can be maintained for a long time and the X-ray irradiation time (number of times) can be reduced as before, The risk to the line can also be reduced, which is of considerable benefit to patients and operators.

By fixing two points of each ring (25) on the slide plates (6, 7) shown in FIG. 4, it becomes possible to visually check two points through which the puncture needle should pass, and In the method (1), even when the puncture angle was shifted, the shift could not be confirmed because there was no fixed mark, but the shift was prevented and the accuracy of guiding the needle tip to the target portion was improved.

It works quite effectively in sympathetic ganglion blocks, celiac plexus blocks, and lung tumor biopsies, which cannot be punctured with ultrasound.

[Brief description of the drawings]

FIG. 1 is a perspective view of a puncture needle insertion angle for a CT guide and an insertion point determiner.

FIG. 2 is a cross-sectional view taken along lines L and M in which a puncture needle support is mounted and a sheath is held in FIG.

FIG. 3 is an enlarged view in which a puncture needle support is mounted on a slide plate.

FIG. 4 is a cross-sectional perspective view of a main part of FIG. 3;

FIG. 5 is a CT image obtained by mounting a CT guide puncture needle insertion angle and an insertion point determiner on a body surface and photographing the puncture needle.

FIG. 6 is a view in which a puncture needle insertion angle for a CT guide and an insertion point determiner are mounted.

[Explanation of symbols]

 A upper surface B lower surface C, D side surface R, S rotation direction X, Y movement direction L, MY direction positioning line a scan surface 1 open window 2, 3rd chord 4, 5 cut for slide 6, 7 slide plate 9, 10 Puncture needle support installation window 11, 12, 13, 14 Tape fixing foot 15 Sheath 16 Semicircular cut 20, 21 Rotation axis in R direction 22, 23 Rotation axis in S direction 24 Ring support frame 25 Ring 26 Target Part 27 Line that determines insertion direction

Claims (4)

(57) [Claims] 1. A tubular body provided with release windows on two opposing surfaces of a quadrangular cylindrical shape, and provided with a large number of chords of X-ray absorbing elastic material stretched in parallel at equal intervals in the release windows. Notches are provided at symmetrical positions on both sides of the shape release window in parallel with the string,
A puncture needle insertion angle and a puncture needle for a CT guide, characterized by having an elongated plate-like slide plate having a puncture needle support portion provided at the center thereof, which is slidable back and forth freely through both sides of the cut. Point determiner. 2. The puncture needle insertion angle and the insertion point for a CT guide according to claim 1, wherein the strings of the first aspect are provided with scales at equal intervals, and the scales repeat a plurality of colors in the same order. Decider. 3. A slide hole is provided at a center portion of the slide plate according to claim 1, a shaft parallel to a longitudinal direction of the slide plate is provided inside the hole, and a frame rotatable by the shaft is housed therein. A puncture needle support, wherein a shaft that is perpendicular to the shaft is provided therein and a ring rotatable by the shaft is housed therein. 4. The puncture needle support according to claim 3, further comprising a sheath inserted into the ring according to claim 3, wherein the sheath is separable in a longitudinal direction.