WO1999025258A1 - Dispositif destine, de preference, a des ponctions medicales et procede correspondant - Google Patents

Dispositif destine, de preference, a des ponctions medicales et procede correspondant Download PDF

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Publication number
WO1999025258A1
WO1999025258A1 PCT/EP1998/007260 EP9807260W WO9925258A1 WO 1999025258 A1 WO1999025258 A1 WO 1999025258A1 EP 9807260 W EP9807260 W EP 9807260W WO 9925258 A1 WO9925258 A1 WO 9925258A1
Authority
WO
WIPO (PCT)
Prior art keywords
signal
probe element
signal converter
converter
probe
Prior art date
Application number
PCT/EP1998/007260
Other languages
German (de)
English (en)
Inventor
Bernhard Kleffner
Thomas Hahn
Original Assignee
Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V. filed Critical Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V.
Publication of WO1999025258A1 publication Critical patent/WO1999025258A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/12—Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3403—Needle locating or guiding means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3925—Markers, e.g. radio-opaque or breast lesions markers ultrasonic
    • A61B2090/3929—Active markers

Definitions

  • the invention relates to a device preferably for performing medical puncture surgery, with a probe element that can be inserted in particular in biological tissue such as the human body, and to a corresponding method according to the preamble of claim 20.
  • Devices and methods of this type are used for a wide variety of medical interventions, in particular for puncture interventions, in which volumes located in the interior of the body are sought for diagnostic or therapeutic purposes with flexible or, in some cases, rigid hollow needles by piercing from the outside and advancing within the biological tissue.
  • the guidance of the hollow probe from the skin to the target structure, which may be deep inside the body, is often based solely on the experience and tactile ability of the operating doctor.
  • the destination can be guided by sound from outside with the help of ultra-
  • this object is achieved for the device by a signal converter which is provided in the region of the probe element and is used for guidance. While the quality of destination guidance according to the conventional methods can only be assessed by large-scale external influences and with correspondingly limited precision, the device according to the invention enables local and therefore much more precise observation of the interior of the body; Puncture needles or the like can be guided more reliably than before.
  • An embodiment of the invention provides that the signal converter is or can be arranged at an end of the probe element which is at the front in an insertion direction.
  • the transducer provided directly on the insertion-side probe tip is used for direct observation of the body areas located in the vicinity of the probe tip and in particular in front of it.
  • the probe element is designed essentially as a hollow needle is.
  • the signal converter is automatically carried before liquids are sucked out of the target area of the body through the hollow needle.
  • the signal converter - preferably movable - is arranged or can be arranged in a channel of the hollow needle.
  • the signal converter provided in the interior of the cannula tip as “eye w ” points the way while the probe is being driven.
  • a further embodiment provides that a signal directing element, such as a wedge, is arranged in front of or on the signal converter, which has similar signal transmission properties as the material to be observed at the front end of the probe element, in particular biological tissue.
  • a signal directing element such as a wedge
  • Such a leading wedge is advantageously used within an attached probe tip and serves to optimize the radiation angle or the radiation characteristic of the signal converter.
  • the signal converter is inclined or inclinable with respect to an insertion direction of the front end of the probe element. This facilitates the observation of tissue areas laterally from or in front of the probe tip.
  • the signal converter can run around the tip of the probe along its edge and so on overall be inclined with respect to the direction of impact of the probe tip.
  • Another embodiment provides a shaft for moving and / or rotating the signal converter.
  • the transducer can be positioned exactly in the region of the probe tip and oriented in such a way that, depending on the intended further advance, it is possible to observe the corresponding spatial neighboring areas.
  • the signal converter is provided at an end of the probe element at the rear in an insertion direction, that the signal converter is a ring converter surrounding the channel of the probe element, and that the probe element is a signal conductor, in particular a waveguide, at least in some areas.
  • the signal converter can surround the probe element at its rear end, for example in a ring shape, or - likewise in a ring shape - connect to its rear end.
  • the ultrasound signal generated by the signal converter at the rear end of the probe is transported to the tip of the probe, which is designed as a waveguide, and from there is passed on to the inside of the body.
  • the cannula can also be surrounded at its tip or in another area by the ring transducer.
  • the signal converter is a signal transmitter.
  • a separate signal receiver can be provided, and the signal converter can also be a signal receiver or both a signal transmitter and a signal receiver.
  • the signal converter is a piezo converter, or a sound or ultrasound converter.
  • the high-frequency ultrasound signals generated with such transducers and scattered back by the tissue can be used for tissue differentiation and for the detection of vessels, nerves, and fluid accumulation, and can thus be used to safely seek out the target volume when the puncture needle is inserted.
  • Another embodiment provides an acoustic matching layer in front of the signal converter and / or a damping layer behind the signal converter. These are used for optimal transmission of the ultrasound signal from the probe into the body tissue or for damping or avoiding signal components that run counter to the direction of insertion.
  • Another embodiment provides for an arrangement of several signal transmitters and / or signal receivers. Such an “array * of transmitters or receivers that can be positioned in any position allows an even better differentiation of spatial tissue structures than the use of one transmitter and one receiver each.
  • the probe element is detachably connected to components used for guiding the destination, i.e. is completely or partially detachable without destruction.
  • the probe can alternately be connected to a guidance device and to a tip or suction device, so that e.g. after a first aspiration of a body fluid, the cannula can be moved in a targeted manner and then, if necessary, liquid can be withdrawn repeatedly.
  • Another embodiment provides a pressure sensor. This provides additional information about the internal pressure of body fluids prevailing at the probe tip or, for example, about the tissue resistance which the probe tip faces from the feed direction.
  • the signal converter or sensor provided according to the invention can be easily removed from the probe element.
  • the object of the invention is achieved in that with the help of a of the signal transducer provided a signal is used for guidance.
  • the signal converter provided in the area of the probe element for example at the probe tip, enables local observation and thus much more reliable guidance of the probe than external, comparatively large-scale observation methods of a conventional type.
  • one embodiment provides that the signal converter in a channel of the probe element or the probe element itself is temporarily shifted in a longitudinal direction and / or rotated about the longitudinal direction. Above all, the movement of the signal converter within the channel of the initially immobile cannula helps to avoid unnecessary movements of the cannula and thus friction in the puncture channel.
  • Another embodiment provides that the signal converter is temporarily removed from the channel of the probe element. In this way, a signal converter provided within the channel clears the way for the puncture that took place following the needle insertion.
  • Doppler effect useful information can be obtained for guidance, and that sonorous noise emitted by the body tissue is received and used for guidance.
  • Fig. 2 shows an exemplary embodiment of a
  • Hollow needle tip with a signal converter according to the invention which can be positioned at an angle to the central axis and by a shaft, 3 a and 3 b, exemplary embodiments of a hollow needle tip according to the invention with an obliquely inclined or perpendicular to the central axis ring transducer and
  • an ultrasonic element transducer 3 is stored in the interior 2 of a cannula 1 as a retractable and retractable stopper.
  • An acoustic matching layer 4 is applied to the front side of the ultrasonic transducer in the feed direction, while a needling 5 is adjacent on the rear. Both interfaces of the preferably piezoceramic sound transducer are contacted with electrical lines 6 which, together with a pull element such as a pull wire, establish the connection between the sound transducer and the route guidance apparatus.
  • 1b shows a lead wedge on the front of the sound transducer instead of the acoustic matching layer 4.
  • Fig. 2 shows an embodiment in which the sound transducer and the acoustic matching layer itself parallel to obliquely inclined hollow needle tip and are attached to a wedge-shaped vaporization part.
  • This wedge is connected to a displaceable and rotatable shaft 12 so that it and thus the transducer surface can be positioned anywhere within the cannula.
  • FIG. 3 a and 3 b show exemplary embodiments of a ring transducer 8 provided on the hollow needle tip, which, as in FIG. 3 a, together with the acoustic adaptation layer 9 parallel to the obliquely inclined cannula tip and thus obliquely to the central axis of the cannula or, according to FIG. 3 b, runs perpendicular to this, while in the second case the acoustic matching layer 9 the oblique cannula tip Fig. et.
  • FIG. 4 a and 4 b show exemplary embodiments in which the ring converter 8 with vaporization ring 5 are provided at the rear end of the cannula 1.
  • Fig. 4 a they connect axially to the rear end of the cannula, which they enclose from the outside according to the alternative embodiment according to Fig. 4 b.
  • they are connected to the destination guidance apparatus by a likewise circular cylindrical connecting part 10;
  • the connection 11 between the cannula and the connecting part or destination guidance apparatus can be released.
  • the route guidance according to the invention can be implemented as an independent system or set up for the optional connection to common ultrasound diagnostic devices.
  • the design of the transducer or the interface between the transducer and the puncture needle permits manufacturing costs in the order of magnitude of disposable products usually used in this area.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Pathology (AREA)
  • Veterinary Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Public Health (AREA)
  • Molecular Biology (AREA)
  • General Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Biophysics (AREA)
  • Physics & Mathematics (AREA)
  • Radiology & Medical Imaging (AREA)
  • Ultra Sonic Daignosis Equipment (AREA)

Abstract

L'invention concerne un dispositif destiné, de préférence, à des ponctions médicales et comprenant une sonde pouvant être introduite notamment dans un tissu biologique tel que le corps humain. L'invention concerne également un procédé correspondant. L'invention est caractérisée par un convertisseur de signaux implanté dans la zone de la sonde, servant au guidage ciblé et permettant de produire un signal destiné au guidage ciblé. Contrairement aux techniques classiques, le dispositif doté d'un convertisseur de signaux sur la sonde permet de faire une observation locale directe des zones de tissus entourant la pointe de la sonde.
PCT/EP1998/007260 1997-11-13 1998-11-13 Dispositif destine, de preference, a des ponctions medicales et procede correspondant WO1999025258A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE19750335A DE19750335A1 (de) 1997-11-13 1997-11-13 Vorrichtung vorzugsweise zur Durchführung medizinischer Punktionseingriffe und Verfahren
DE19750335.7 1997-11-13

Publications (1)

Publication Number Publication Date
WO1999025258A1 true WO1999025258A1 (fr) 1999-05-27

Family

ID=7848636

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP1998/007260 WO1999025258A1 (fr) 1997-11-13 1998-11-13 Dispositif destine, de preference, a des ponctions medicales et procede correspondant

Country Status (2)

Country Link
DE (1) DE19750335A1 (fr)
WO (1) WO1999025258A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111386080A (zh) * 2017-11-29 2020-07-07 阿文特公司 用于将超声换能器安装在针上的系统和方法

Families Citing this family (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE10034520A1 (de) * 2000-07-15 2002-01-24 Alexander Wannenwetsch Meßsonde
FR2856577A1 (fr) * 2003-06-27 2004-12-31 Medicrea International Dispositif d'examen des caracteristiques d'un os
HRP20030990A2 (en) * 2003-11-27 2006-02-28 Branko Breyer Ivo Čikeš System for guidance and control of minimum invasive delivery of therapy with medical agents
GB201304798D0 (en) 2013-03-15 2013-05-01 Univ Dundee Medical apparatus visualisation

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE1927868A1 (de) * 1969-05-31 1970-12-03 Siemens Ag Vorrichtung zum genauen und schnellen Orten von Blutgefaessen od.dgl. und zum treffsicheren Einfuehren einer Injektionskanuele in diese Gefaesse
EP0083973A1 (fr) * 1982-01-07 1983-07-20 Technicare Corporation Indicateur pour la localisation d'une sonde à ultrasons
EP0260953A2 (fr) * 1986-09-18 1988-03-23 Paul G. Yock Dispositif destiné à être utilisé dans la canalisation de vaisseaux sanguins
US4742829A (en) * 1986-08-11 1988-05-10 General Electric Company Intracavitary ultrasound and biopsy probe for transvaginal imaging
US5630416A (en) * 1994-09-19 1997-05-20 Fujitsu, Ltd. Ultrasonic diagnostic probe
WO1997029710A1 (fr) * 1996-02-15 1997-08-21 Biosense, Inc. Sondes medicales a transducteurs de champ
US5678565A (en) * 1992-12-21 1997-10-21 Artann Corporation Ultrasonic elasticity imaging method and device

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4249539A (en) * 1979-02-09 1981-02-10 Technicare Corporation Ultrasound needle tip localization system
DE3909140A1 (de) * 1989-03-21 1990-09-27 Sauerwein Isotopen Tech Spritze zum dopplersonographisch unterstuetzten punktieren
US5311871A (en) * 1993-01-12 1994-05-17 Yock Paul G Syringe with ultrasound emitting transducer for flow-directed cannulation of arteries and veins

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE1927868A1 (de) * 1969-05-31 1970-12-03 Siemens Ag Vorrichtung zum genauen und schnellen Orten von Blutgefaessen od.dgl. und zum treffsicheren Einfuehren einer Injektionskanuele in diese Gefaesse
EP0083973A1 (fr) * 1982-01-07 1983-07-20 Technicare Corporation Indicateur pour la localisation d'une sonde à ultrasons
US4742829A (en) * 1986-08-11 1988-05-10 General Electric Company Intracavitary ultrasound and biopsy probe for transvaginal imaging
EP0260953A2 (fr) * 1986-09-18 1988-03-23 Paul G. Yock Dispositif destiné à être utilisé dans la canalisation de vaisseaux sanguins
US5678565A (en) * 1992-12-21 1997-10-21 Artann Corporation Ultrasonic elasticity imaging method and device
US5630416A (en) * 1994-09-19 1997-05-20 Fujitsu, Ltd. Ultrasonic diagnostic probe
WO1997029710A1 (fr) * 1996-02-15 1997-08-21 Biosense, Inc. Sondes medicales a transducteurs de champ

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111386080A (zh) * 2017-11-29 2020-07-07 阿文特公司 用于将超声换能器安装在针上的系统和方法

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Publication number Publication date
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