SU1489725A1 - Method and apparatus for puncture - Google Patents

Description

The invention relates to medicine and medical technology and can be used in the puncture diagnosis of internal organs.

The aim of the invention is to simplify the method by using x-rays with radiopaque marks, as well as reducing the morbidity by providing the possibility of introducing a puncture tool, taking into account the anatomical structure of the object.

FIG. 1 shows a device for the puncture of the organs, front view; in fig. 2 - carriage, section; in FIG. Zvid A in FIG. 2

The device for puncturing the internal organs contains two arcs 1 of a semicircle, equipped with measuring scales and installed on the deck of a 2 X-ray table with the ability to move along guides 3, which have measuring scales, and fixation in a predetermined position. On deck 2 applied radiopaque grid. Arcs 1 are interconnected with clamps 4. On arcs 1, a carriage 5 is mounted for movement and fixation on it, carrying a jig 6 of a puncture tool, made in the form of a threaded sleeve on which a linear scale is applied.

. On the carriage 5 perpendicular to its plane fixed rod 7 with the measuring scale 8, on which is mounted for moving along it and fixing the suspension 9.

The device is equipped with a mechanism for rotation of the puncture tool conductor, made in the form installed on the plate 10 of the suspension 9 of the ball joint. The latter includes a support 11 fixed on the plate 10, a ball 12 with a central cylindrical hole for the jig 6 and a nut 13. On the support 11 of the ball joint with the possibility of rotation around the axis of symmetry of the support there is a second limb in the form of a disk 14 with a scale 15, on which, perpendicular to its plane, is fixed a bracket 16 with a scale of 17 in the form of a first limb. On the plate 10 of the suspension is fixed pointer 18 rotation, and on the conductor 6 arrow 19 with the locking nut 20.

The device is used as follows.

Previously, after the usual radiography of the chest organs in two projections, the segmental localization of the formation (the target of the intended puncture) is established, optimizing the area for inserting the puncture tool at the intercostal space according to the lung segmental structure. At the same time, a system of at least three radiopaque marks, for example rings of 5 mm in diameter, is fixed on the adhesive tape to the selected area of the pathological focus. The patient is placed on the x-ray table and fixed on it. Using well-known X-ray diffraction methods, the production of two conjugated chest radiographs together with a radiopaque grid installed on the deck of the x-ray table fixed in the base system of rectangular Cartesian coordinates fixed on the deck of the x-ray table determine the coordinates of the marks on the code and the puncture target (education in the lung) ..

After determining the coordinates of the points on the skin and the puncture target, an optimal puncture point is selected. The optimal point is a point on the skin, with puncture from which minimal penetration of the puncture instrument into the patient’s body is ensured, i.e. minimum distance from the skin to the target. Two conjugated radiographs are produced under the control of spirometry, i.e. on the same volume of inhalation or exhalation. If the study is performed under anesthesia, then dispense the volume of the gas mixture introduced during artificial ventilation.

A device for puncturing the internal organs, moving along the guides 3 decks 2 of the x-ray table, is set above the patient and fixed in the desired position. The carriage 5 is moved to the desired position and also fixed. Arc 1 for stiffness clamps 4 in convenient for work places. Suspension 9 is fixed at the required height, determined on a scale of 8 on the rod 7. On scales 15 and 17, the jig 6 is mounted in the right direction and fixed with a nut 13. If necessary, a replaceable adjustable nozzle is installed on the jig 6, limiting the puncture tool stroke (penetration depth into the patient's body).

1489725

After inserting a puncture tool, such as a needle, into the jig 6, a puncture is performed to a predetermined depth by moving the puncture tool to the stop.

The puncture is performed on the same volume of inhalation, on which radiography was performed. This ensures high puncture accuracy.

The amount of inspiration at which puncture is performed should be 6080% of the vital capacity of the lungs, since with less inspiration there is a risk of bleeding due to an increase in the specific density of the vessels, and at maximum inspiration the probability of pneumothorax increases with significant inspiration of the cortical sections of the lung.

Claim

1. A method for puncturing organs, including the production of two radiographs25 perpendicular to its plane, is fixed — at different positions of the focus, the bar on which the gene tube is mounted together with X-rays can be moved along it by a contrasting grid, the definition of lo-and fixation suspension, the mechanism of rotation the pathological focus and the conductor of the puncture tool of the puncture tool of the mid-30 is made in the form of a ball joint

stereotactic device, which differs from me by the fact that, in order to reduce trauma and improve puncture accuracy, at least three radiopaque marks are applied to the skin in the area of the nidus,

the respiration phase, determine the distance from each point to the pathological focus, puncture is performed on the same respiration phase through a point whose distance to the focus is minimal.

2. A device for the puncture of organs, containing an arc with a scale mounted on the deck of the X-ray table,

10 a carriage made with the possibility of moving along the arc and fixation, the jig of the puncture tool with the mechanism of rotation and the first limb, characterized in that

15 in order to reduce the morbidity by, ensuring the possibility of introducing a puncture tool with regard to. the anatomical structure of the object, it contains a second arc with a scale, a gesture connected to the first, and the arcs are installed so that they can move along the guides along the deck of the X-ray table, on which the coordinate grid is applied, on the carriage

35

and mounted on a hanger, the guides and the rod are provided with linear scales, and a second limb is pivotally mounted on the ball joint support, on which the first limb is rigidly fixed perpendicular to its plane.

Phi .1

1489725

θιιιιιιιιιιιπΰ

Fm, 3

Claims (1)

The purpose of the invention is to simplify the method and reduce trauma by providing the possibility of introducing a puncture tool, taking into account the anatomical structure of the object. The method includes the definition of a segmental— . localization of the puncture target, optimization of the puncture instrument insertion area on the patient's skin, fixation of the radiopaque markers on the selected zone, production of two conjugated radiographs together with the basic coordinate system (radiopaque grid on the deck of the table), determination of the coordinates of the marks and puncture target, and determination of the optimal point for puncture. The device contains two arcs 1, mounted on rails 3 along the deck of the table. Along the arcs moves the carriage 5 with the rod 7, with the possibility of moving along which is mounted the suspension 9 with the mechanism of rotation of the conductor 6 of the puncture tool in the form of a ball joint consisting of a support 11, a ball 12 and a nut 13. II h > - and and / II s 00 WITH <1 Yu cl FIG. 2 3 1489725 four