RU2138223C1 - Device for stereotaxic guiding of surgical tool - Google Patents

Device for stereotaxic guiding of surgical tool

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Publication number
RU2138223C1
RU2138223C1 RU98103641A RU98103641A RU2138223C1 RU 2138223 C1 RU2138223 C1 RU 2138223C1 RU 98103641 A RU98103641 A RU 98103641A RU 98103641 A RU98103641 A RU 98103641A RU 2138223 C1 RU2138223 C1 RU 2138223C1
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ring
segment
device
guiding
stereotaxic
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RU98103641A
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Russian (ru)
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А.С. Иова
Ю.А. Гармашов
А.Ю. Гармашов
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Иова Александр Сергеевич
Гармашов Юрий Анатольевич
Гармашов Андрей Юрьевич
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Abstract

FIELD: medicine, neurosurgery; applicable in performance of operations on head and neck, and in other fields of medicine. SUBSTANCE: device has main ring, phantom ring with coordinate appliance and transfer bow with guide module for surgical tool. Rings are made with removable segment. Transfer bow is secured to removable segment with the help of axle and may move and turn relative to axle. Axle is mounted on segment for moving along it. Removable segment may be alternately installed on both rings. EFFECT: higher accuracy in guiding of surgical tool, extended access to operation field in stereotaxic operations and provided use of stereotaxic guiding in all main types of neurosurgical operations on head and neck. 1 cl, 2 dwg

Description

Изобретение относится к медицине и может быть использовано в нейрохирургии для операций на голове и шее, а также в других областях медицины. The invention relates to medicine and can be used in neurosurgery for operations on the head and neck, as well as in other areas of medicine.

Известно устройство для стереотаксического наведения хирургических инструментов, состоящее из рабочего кольца, идентичного ему фантомного кольца с координатным приспособлением, а также переносной дуги с направляющим модулем для хирургического инструмента (см. Абраков Л.В. Основы стереотаксической нейрохирургии, 1975, с. 189-214 - прототип). A device for stereotactic guidance of surgical instruments, consisting of a working ring identical with the ring it coordinate phantom device and portable arc module with the guide for a surgical instrument (see. Abrakov L. Fundamentals of stereotactic neurosurgery, 1975, pp. 189-214 - prototype).

Композиционная схема прототипа представлена на фиг. Compositional diagram of the prototype represented in FIG. 1, где показаны замкнутое целое основное кольцо 1, такое же фантомное кольцо 2, переносная дуга 3, на которой устанавливается направляющий модуль 4 для хирургического инструмента 5. Дуга 3 может вращаться относительно оси 6 обоих колец и закрепляется в выбранном положении с помощью специального устройства (см. описание прототипа, стр. 192, рис. 84, деталь 3). 1, which shows a closed ring main unit 1, the same phantom ring 2, a portable arc 3, in which the guide unit 4 is set to the surgical tool 5. An arc 3 can rotate about axis 6 and the two rings is fixed in the selected position by a special device ( cm. prototype description, pp. 192, Fig. 84, item 3).

Порядок работы с данным устройством подробно приведен в представленной копии материала. Operation with this device is shown in detail in the submitted copy material.

Недостатками прототипа являются недостаточная точность наведения хирургического инструмента, а также ограниченность доступа к операционному полю из-за замкнутой конструкции основного кольца и расположения дуги и элементов ее крепления в области операционного поля (см. описание прототипа, стр. 192, рис.84, детали 2 и 3). Disadvantages of the prototype are inadequate pointing accuracy of the surgical instrument, and the limited access to the surgical site because ground ring closed structure and location of the arc and its attachment elements in the area of ​​the surgical field (see. Prototype description, p. 192, ris.84, 2 parts and 3).

Цель изобретения - повышение точности наведения хирургического инструмента, расширение доступа к операционному полю при стереотаксических операциях и возможность использования стереотаксического наведения при всех основных видах нейрохирургических операций на голове и шее. The purpose of the invention - improving the accuracy of the guidance of a surgical instrument, improving access to the surgical site during stereotactic operations and the use of stereotactic guidance for all the main types of brain surgery on the head and neck.

Поставленная цель достигается тем, что в устройстве для стереотаксического наведения хирургического инструмента, содержащем основное кольцо, фантомное кольцо с координатным приспособлением, а также переносную дугу с направляющим модулем для хирургического инструмента, кольца выполнены со съемным сегментом, переносная дуга закреплена на съемном сегменте посредством оси с возможностью смещения и поворота относительно указанной оси, которая смонтирована на сегменте с возможностью смещения вдоль него, а съемный сегмент выполнен с возм The goal is achieved in that the device for stereotactic guidance of a surgical instrument comprising a base ring, phantom ring with the coordinate device, and portable arc with a guide unit for a surgical instrument, the ring formed with the removable segment portable arc fastened on the removable segment through the axis is displaceable and pivotable relative to said axis, which is mounted on the segment to be displaceable along it, and a detachable segment adapted poss жностью поочередной установки на обоих кольцах. zhnosti alternate mounting on both rings.

Введение в устройство съемного сегмента позволяет исключить установку на кольцах имитатора трепанационного отверстия с помощью координатных шкал, что исключает неточность расчета и установки, а следовательно, повышает точность наведения хирургического инструмента. Introduction to the removable segment device eliminates installation on rings simulator burr hole by means of the coordinate scale, which eliminates the inaccuracy of calculation and installation and, hence, increases the accuracy of the guidance of the surgical instrument. Съемный сегмент, кроме того, позволяет освободить операционное поле от инструментов, что расширяет сферу применения предлагаемого устройства, распространив его на все основные виды нейрохирургических операций. Removable segment, moreover, allows to release from the surgical field instruments, which expands the scope of application of the device, extending it to all major species of neurosurgical operations. Наличие подвижных узлов дуги, оси, направляющего модуля для хирургического инструмента обеспечивает оптимальность их пространственного расположения над операционным полем или возможность вывести их за рамки операционного поля. The presence of mobile nodes of the arc, the axis of the guide unit for a surgical instrument provides optimal their spatial arrangement over the operating field or the ability to bring them outside the scope of the operative field.

Устройство поясняется фиг. The apparatus illustrated FIG. 2, где показана композиционная схема предлагаемого устройства. 2, which shows the compositional diagram of the proposed device. Это устройство содержит основное кольцо 1, фантомное кольцо 2, общий для них съемный сегмент 3. На сегменте 3 закреплена посредством оси 4 переносная дуга 5. Дуга 5 на оси 4 закреплена с возможностью смещения по отношению к оси, вращения вокруг нее и качания относительно оси 4. Сама ось 4 имеет возможность смещения вдоль сегмента 3. На дуге 5 смонтирован направляющий модуль 6 с хирургическим инструментом 7. Кроме того, устройство содержит элементы фиксации всех подвижных узлов (как в прототипе, на фиг. 2 не показаны). This device comprises a main ring 1, ring 2 phantom common to them removable segment 3. In segment 3 is fixed by the axle 4 carrying arc 5. Arc 5 is fixed on axle 4 is displaceable with respect to the axis of rotation and around the axis of oscillation relative 4. The axis 4 itself is displaceable along an arc segment 3. 5 mounted guide unit 6 with a surgical tool 7. Furthermore, the device comprises fixing elements of all moving parts (as in the prior art, Fig. 2 not shown).

Имеется также имитатор трепанационного отверстия 8, на подвижной штанге которого смонтировано колечко 9. Имитатор может быть установлен на сегменте 3. На фантомном кольце 2 имеется три координатные линейки 10, кончик одной из них 11 имитирует точку цели. There is also a dummy burr hole 8, on which is mounted a movable rod ring 9. The simulator may be mounted on the segment 3. At phantom ring 2 has three coordinate line 10, the tip of one of them 11 simulates the target point.

Устройство используется следующим образом. The apparatus is used as follows. Голова пациента крепится как обычно (см. прототип) в рабочем кольце 1. Фантомное кольцо 2 расположено рядом. The patient's head is fastened as usual (see. prototype) in the working ring 1. Phantom ring 2 positioned nearby. Общепринятым способом осуществляется нейровизуализация (например, вентрикулография, компьютерная томография и пр.) и стереотаксические расчеты координат точки цели. It carried out in conventional manner neuroimaging (e.g., ventriculography, computed tomography and so forth.) And stereotactic coordinates of the target point calculations. В кости черепа формируется трепанационное отверстие. The bones of the skull is formed by a burr hole. Съемный сегмент 3 с имитатором трепанационного отверстия 8 устанавливается на рабочем кольце 1, колечко имитатора 9 фиксируется над сформированным в костях черепа отверстием. Removable segment 3 with the simulator burr hole 8 is mounted on the working ring 1, ring 9 is fixed on the simulator formed in the bones of the skull opening. Затем съемный сегмент с зафиксированным имитатором переносится на фантомное кольцо 2. Таким образом на фантомном кольце точно воспроизводится пространственное положение трепанационного отверстия. Then detachable segment is transferred to the fixed simulator phantom ring 2. Thus in phantom ring accurately reproduced spatial position of the burr hole. С помощью координатных линеек 10 фантомного кольца 2 устанавливается точка цели 11 (как в прототипе). Using the coordinate phantom lines 10 of the ring 2 is set target point 11 (as in the prototype). На съемный сегмент 3 крепится ось 4 с дугой 5. В направляющий модуль 6 дуги 5 помещается хирургический инструмент 7, который ориентируется так, чтобы его конец попадал в точку цели 11, а сам инструмент проходил через колечко имитатора отверстия 9. Фиксируются все подвижные узлы. A removable roof panel 3 is attached to the arc 4 5 7 axis of the surgical instrument is placed in the guide railings 6 5 module, which is oriented so that its end will fit into the target point 11, and the tool is passed through the ring hole simulator 9. captures all moveable parts. Определяется координата погружения хирургического инструмента по шкале модуля 6. После этого инструмент, перемещаясь в модуле, выводится из зоны колечка 9, а имитатор трепанационного отверстия удаляется с сегмента 3. Съемный сегмент 3 с зафиксированным хирургическим инструментом переносится с фантомного кольца 2 на основное кольцо 1. Затем инструмент перемещается в направляющем модуле на глубину ранее установленной координаты, достигая точки цели. Determined by immersing a surgical instrument coordinate scale module 6. The tool moving in the module output from the ringlet zone 9 and the simulator is removed from the burr hole 3. Removable segment with a fixed segment 3 is transferred from the surgical instrument phantom ring 2 on the base ring 1. The tool then moves in the guiding module to a depth previously set coordinates, reaching the target point.

Предлагаемое устройство значительно повышает точность наведения хирургического инструмента за счет жесткой фиксации имитатора трепанационного отверстия и переносной дуги на съемном сегменте. The inventive device considerably increases the accuracy of the guidance of the surgical instrument due to the rigid fixation simulator burr hole and a removable portable arc segment. Этим исключается перенос имитатора и дуги с основного на фантомное кольцо и обратно с использованием координат шкал. This eliminates transfer of the simulator and with the arc on the main ring and back phantom using coordinate scales. Использование этих шкал всегда связано с риском ошибок в расчете и установке. The use of these scales is always associated with the risk of errors in the calculation and installation.

Устранение из области хирургических манипуляций узлов устройства позволяет повысить удобство проведения стереотаксических операций и значительно расширить сферу применения предлагаемого устройства, включив в нее все основные виды нейрохирургических операций на голове и шее, в том числе и новорожденным за счет возможности приближения дуги к голове младенца (при стандартных размерах кольца). Elimination from the area of ​​surgical procedures knots device can improve the convenience of stereotactic operations and significantly expand the scope of application of the device to include all major types of brain surgery on the head and neck, including the newborn due to the possibility of approximating the arc to the baby's head (standard ring sizes).

Использованная литература References
Абраков Л. В. Основы стереотаксической нейрохирургии. Abrakov LV Basics stereotactic neurosurgery. - Л.: Медицина, 1975, с. - L .: Medicine, 1975, p. 189-215. 189-215.

Claims (1)

  1. Устройство для стереотаксического наведения хирургического инструмента, содержащее основное кольцо, фантомное кольцо с координантным приспособлением, а также переносную дугу с направляющим модулем для хирургического инструмента, отличающееся тем, что кольца выполнены со съемным сегментом, переносная дуга закреплена на съемном сегменте посредством оси с возможностью смещения и поворота относительно указанной оси, которая смонтирована на сегменте с возможностью смещения вдоль него, а съемный сегмент выполнен с возможностью поочеред Device for stereotactic guidance of a surgical instrument comprising a base ring, phantom ring koordinantnym device and portable arc with the guide unit to the surgical instrument, characterized in that the rings are made with removable segments, a portable arc fastened on the removable segment through the axis displaceable and relative to said axis of rotation, which is mounted on the segment to be displaceable along it, and a detachable segment adapted to poocheredi ой установки на обоих кольцах. second installation on both rings.
RU98103641A 1998-02-19 1998-02-19 Device for stereotaxic guiding of surgical tool RU2138223C1 (en)

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