RU2569720C1 - Passive navigation device for medical instrument - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: device comprises a trajectory detector fastened by means of a ring clamp in a window formed by crossing guide grooves in arc-shaped brackets pivotally mounted in two mutually perpendicular vertical planes on a carrier in the form of a ring with fasteners. The clamp is configured as three thread-connected coaxial sleeves, inner and intermediate of which have a shoulder at the bottom to comprise guide bars of the lower and upper brackets respectively. The inner sleeve is provided with a projection above the two others and configured to comprise the trajectory detector, which is presented in the form of a removable tube with an inner diameter ensuring a clear passage of a medical instrument, and has a bearing flange to mount the clamp on an end face of the inner sleeve, whereas the fasteners are configured in the form of belts with openings for fastening into the carrier.

EFFECT: using the invention enables reducing the length of operation by improving an accuracy of instrument positioning.

2 cl, 7 dwg

Description

 The invention relates to medicine, namely to devices for positioning medical instruments during surgical intervention, for example, standard bone biopsy needles 12G or more, cluster electrodes of radiofrequency ablation Cool-Tip, endoscopes and trocars, etc.

A device for guiding a medical instrument is known, including a trajectory indicator in the form of a hollow tube, fixed by means of an annular clip in a window formed by the intersection of guide grooves in arcuate brackets, mounted to rotate in two mutually perpendicular vertical planes in an annular base with tabs for mounting the device on the body patient (EP 1958588 (A2), IPC A61B 19/00, published 08/20/2008).

The known device allows you to perform minimally invasive interventions under the control of x-ray computed tomography.

The most significant disadvantages of the known device are:

- difficulties with additional positioning of a known device already equipped with a medical tool. The mechanism for fixing the trajectory pointer in the guide brackets in the form of an annular clamp and one screw allows simultaneous movement along both guide arc-shaped brackets in two vertical planes. If it is necessary to move the tool in one plane, the possibility of excessive movement in another plane is not excluded due to loosening of the screw lock. A small free play of the path indicator leads to an angular deviation of the medical instrument and a miss, which requires repositioning. Due to the design features of the fixation mechanism, repositioning of a known device equipped with an instrument on the patient’s skin is difficult due to load of tissues, muscle traction through which the instrument passed, which in some cases leads to deformation and spontaneous disassembly of the device, its removal and the search for another trajectory . This increases the duration of the operation;

- restrictions on the diameter of the used medical instrument in one standard size. The fixed inner diameter of the trajectory pointer does not allow changing the tool during the operation, in cases where it is necessary. For example, a diagnostic puncture of a volumetric formation in a human body after receiving a histological examination can immediately go into a medical procedure - radio frequency ablation using a cluster electrode. To carry out the treatment procedure with a known device, the latter must be removed and changed to another with the diameter of the tube of the trajectory pointer for the cluster electrode;

- restrictions on the location and fixation of the device due to the structural features of the base with support legs.

The presence of the latter makes it difficult, and in some cases makes it impossible to securely fix the device, for example, inguinal, axillary, perineum, forearm, lower leg, etc. Unstable fixation affects the error and accuracy of pointing the medical instrument to the target.

The objective of the invention is the expansion of the functionality of the device for passive navigation of a medical instrument and improving the quality of surgical intervention.

The technical result is to reduce the time of the operation by increasing the accuracy of the positioning of the medical instrument and the ability to change the latter during the operation without replacing the navigation device.

The technical result is achieved in that a device for passive navigation of a medical instrument, including at least

at least one path indicator, fixed by means of an annular clamp in a window formed by the intersection of guide grooves in arcuate brackets, mounted to rotate in two mutually perpendicular vertical planes on the base in the form of a ring with fasteners, characterized in that the clamp is made in the form of three coaxial bushings, threaded, of which the inner and intermediate have a flange in the lower part to accommodate the guides of the lower and upper brackets, respectively s, while the inner sleeve is provided with a protruding part above the other two and is configured to place a trajectory pointer in it, which is made in the form of a removable tube with an inner diameter that provides unhindered passage of the medical instrument, and has a support flange for installation on the end of the inner sleeve of the clamp, and fasteners are made in the form of straps with holes for fastening in the base.

The device may be made of aluminum material.

In FIG. 1 shows a construction of a device in longitudinal section without a path indicator; in FIG. 2 - in axometry; in FIG. 3 is a view aa of FIG. 1, in FIG. 4, FIG. 5 shows trajectory pointers for different sizes of a medical instrument in longitudinal section; in FIG. 6, FIG. 7 is a longitudinal section through the structure of the device in a perspective view with the path indicator of FIG. 4, FIG. 5.

A device for passive navigation of a medical instrument contains a base 1 in the form of a ring, arcuate brackets 2, 3 with guide grooves (not shown). The brackets 2, 3 are fixed on the base on the axes 9 with the possibility of rotation in two mutually perpendicular vertical planes. In the window formed by the intersection of the guide grooves of the brackets 2, 3, there is a clamp of the trajectory pointer in the form of three coaxial bushings 4, 5, 6 connected by a thread. Moreover, the inner sleeve 6 has a left-handed thread, and the outer sleeve 5 have a right-handed thread, which ensures the convenience of twisting them (clockwise), untwisting (counterclockwise). The inner sleeve 6 and the intermediate sleeve 4 in the lower part, respectively, have shoulders 8, 7, the surfaces of which are associated with the arcuate surface of the guide brackets 3, 2, respectively. Two flats are made on the intermediate sleeve 5, forming contact surfaces with the guide grooves in the brackets 2, 3 The inner sleeve 6 is made higher than the sleeve 4, 5, and the protruding part allows its rotation. In the ring of the base 1 there are four symmetrical holes 10 for straps (not shown) for mounting the device on the patient’s body.

The trajectory pointer is removable in the form of a tube 11 with a length not exceeding the height of the sleeve 6 and with a support flange 12, the diameter of which is equal to the outer diameter of the sleeve 6. The inner diameter of the tube 11 is selected from the condition of unhindered passage of a medical instrument.

The device is equipped with a set of trajectory pointers for standard sizes of medical instruments with a caliber of up to 10 mm, while the inner diameter of the sleeve 6 is selected from the condition of the possibility of installing any trajectory pointer from this range, for example 10 mm.

Before starting work, the device is fixed on the patient’s body at the site of surgical intervention with the help of straps fixed in the holes 10 of the base 1.

In the inner sleeve 6 of the clamp set the guide tube 11 of the path indicator for the required size of the medical instrument. If necessary, replace the tool during surgery in the device, the trajectory pointer is replaced without removing the device from the patient’s body and then work with the selected tool.

In the process of operation of the device, if necessary, turn the trajectory pointer in the plane of the arc of the bracket 2, the clamp is fixed on the guides of the bracket 3 between the shoulders 7, 8, respectively, of the bushings 4, 6 by turning the protruding part of the latter relative to the intermediate sleeve 4.

If it is necessary to rotate the trajectory pointer in the plane of the arc of the bracket 3, the clamp is fixed on the guides of the bracket 2 between the shoulder 7 and the outer sleeve 5 by turning the latter relative to the sleeve 4.

If necessary, turn the trajectory pointer in two vertical planes (by analogy with the prototype), the clamp is fixed to the guides of both brackets 2, 3 with loosening.

With the selected position of the trajectory pointer with a medical tool, the clamp position on the guide brackets 2, 3 is fixed by twisting the bushes 6, 5 until it stops.

The implementation of the device from aluminum material provides not only the stability of the structure in the process of working with a medical instrument, but also the possibility of repeated use due to the absence of temperature limitations of sterilization before reuse.

Claims (2)

 1. Device for passive navigation of a medical instrument, comprising at least one trajectory pointer, fixed by means of an annular clip in a window formed by the intersection of the guide grooves in the arcuate brackets, mounted to rotate in two mutually perpendicular vertical planes on the base in the form of a ring with fasteners, characterized in that the clamp is made in the form of three coaxial bushings connected by a thread, of which the inner and intermediate are at the bottom and a collar for accommodating the guides of the lower and upper brackets, respectively, wherein the inner sleeve is provided with a protruding part above the other two and is configured to place a trajectory pointer in it, which is made in the form of a removable tube with an inner diameter that allows unhindered passage of a medical instrument, and has a supporting flange for installation on the end of the inner sleeve of the clamp, and the fasteners are made in the form of straps with holes for mounting in the base. 2. The device according to claim 1, characterized in that it is made of aluminum material.

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