WO2008014671A1 - Dispositif de positionnement de ponction ultrasonore en mode b pour chirurgie micro-invasive - Google Patents

Dispositif de positionnement de ponction ultrasonore en mode b pour chirurgie micro-invasive Download PDF

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Publication number
WO2008014671A1
WO2008014671A1 PCT/CN2007/002174 CN2007002174W WO2008014671A1 WO 2008014671 A1 WO2008014671 A1 WO 2008014671A1 CN 2007002174 W CN2007002174 W CN 2007002174W WO 2008014671 A1 WO2008014671 A1 WO 2008014671A1
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WO
WIPO (PCT)
Prior art keywords
axis
ultrasound
puncture needle
guiding cylinder
support member
Prior art date
Application number
PCT/CN2007/002174
Other languages
English (en)
French (fr)
Inventor
Xiangshen Ni
Weihui Zhu
Original Assignee
Xiangshen Ni
Weihui Zhu
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 Xiangshen Ni, Weihui Zhu filed Critical Xiangshen Ni
Publication of WO2008014671A1 publication Critical patent/WO2008014671A1/zh

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Classifications

    • 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
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
    • A61B8/0833—Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
    • A61B8/0833—Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures
    • A61B8/0841—Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures for locating instruments
    • 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
    • A61B2017/3413—Needle locating or guiding means guided by ultrasound
    • 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
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A61B2090/378—Surgical systems with images on a monitor during operation using ultrasound
    • 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
    • A61B90/50—Supports for surgical instruments, e.g. articulated arms

Definitions

  • the present invention relates to the field of medical devices, and more particularly to a medical device for use in minimally invasive surgery.
  • the technical problem to be solved by the present invention is to overcome the deficiencies of the prior art and provide a minimally invasive surgical B-ultrasound positioning device and method capable of positioning the piercing position, thereby effectively reducing the risk and difficulty of minimally invasive surgery.
  • the minimally invasive surgery B-ultrasound positioning device comprises a piercing needle guiding cylinder, a B-ultrasound probe assembly with a B-ultrasound probe and an XYZ table, and the XYZ table drives the B
  • the ultra-probe assembly and the perforating needle guiding cylinder move in the XYZ rectangular coordinate system, and the perforating needle guiding cylinder can move relative to the B-ultrasonic probe to its axis and the axis of the B-ultrasound probe to the lesion point.
  • the piercing needle guiding cylinder is rotatable relative to the B-ultrasound probe or about the axis of the B-ultrasonic probe.
  • the XYZ table includes a Y-direction support member, a Z-direction support member, a Z-direction slide member, an X-direction support member and an X-direction slide member, and the Z-direction support member is slidably mounted on the Y-direction support member, the Z The slider is slidably mounted on the Z-direction support member, the X-direction support member is mounted on the Z-direction slider, and the X-direction slider is slidably mounted on the X-direction support member, and the B-mode probe assembly is mounted On the X-direction slider.
  • the X-direction support member is further slidably mounted with another X-direction slider, and the puncture needle guiding cylinder is mounted on the other X-direction slider.
  • the B-ultrasonic probe assembly is fixed on the X-direction slider by a Y-axis fixed, the axis of the B-ultrasonic probe coincides with the axis of the Y-axis fixed axis, and the connecting arm is rotatably mounted on the Y-axis.
  • the puncture needle guiding barrel is mounted on the connecting arm.
  • the connecting arm includes a rotating arm sequentially connected, a C-shaped first arm and a second arm, the rotating arm is looped on the Y-axis, the C-shaped first arm is swingable relative to the rotating arm and
  • the pivot axis is perpendicular to the axis of the Y-axis, the puncture needle guiding cylinder is mounted on the second arm, and the axis of the puncture needle guiding cylinder and the plane formed by the axis of the B-ultrasound probe are parallel to the C-shaped first arm Side surface.
  • a puncture needle is mounted in the puncture needle guiding cylinder, the axis of the puncture needle coincides with the axis of the puncture needle guiding cylinder, and the displacement of the puncture needle and the B-ultrasound probe are monitored by a linear displacement sensor.
  • the minimally invasive surgery B-ultrasound positioning method includes the following steps:
  • the patient's lesion point is determined by parallel and rotating B-ultrasound probes.
  • the step c) according to the angular displacement and linear displacement of the B-ultrasound probe, the initial B-ultrasound probe and the puncture needle guiding cylinder The relative position of the needle to determine the displacement of the needle.
  • the invention has the beneficial effects that the positioning device can accurately position the piercing position, reduce the risk and difficulty of the minimally invasive surgery, and facilitate the promotion.
  • Fig. 1 is a perspective structural view showing a first embodiment of the present invention.
  • Figure 2 is a view taken along the line A in Figure 1.
  • Figure 3 is a schematic diagram of a first embodiment of the present invention.
  • Fig. 4 is a perspective structural view showing a second embodiment of the present invention.
  • Figure 5 is a view taken along the line A in Figure 4 .
  • Figure 6 is an A-direction view of the C-arm of Figure 4 rotated 90 degrees counterclockwise about the Y-axis.
  • Fig. 7 to Fig. 9 are schematic views of the puncture needle in the initial position, the skin position and the position of the lesion point during the puncture.
  • Figure 10 is a block diagram of the circuit of the present invention.
  • Figure 11 is a flow chart of the present invention.
  • the minimally invasive surgery B-ultrasound positioning device comprises a puncture needle guiding cylinder, a B-ultrasound probe assembly with a B-ultrasound probe and an XYZ table, and the XYZ table drives the B-ultrasonic probe assembly and the puncture needle guiding cylinder in an XYZ rectangular coordinate system
  • the inner movement, and the perforating needle guiding cylinder can move relative to the B-ultrasound probe to its axis and the axis of the B-ultrasound probe to the lesion point.
  • the positioning device comprises an XYZ axis table, a B-ultrasound probe assembly and a puncture needle guiding cylinder.
  • the XYZ table includes a Y-direction support member 23, a Z-direction support member 20, a Z-direction slider 22, an X-direction support member 7, a first X-direction slider 18, and a second X-direction slider 12, the Z-direction support
  • the member 20 is slidably (moved up and down along Y) mounted on the Y-direction support member 23, and the Z-direction slider 22 is slidably mounted on the Z-direction support member 20 (moving forward and backward along Z), the X-direction support
  • the member 7 is mounted on the Z-direction slider 22 and is rotatable relative to the slider 22 about the X-axis.
  • the first and second X-direction sliders 18, 12 is slidable (moving left and right along X) to be mounted on the X-direction support member 7.
  • First and second Y-direction guide rails 17 and 10 are respectively mounted on the first and second X-direction sliders 18 and 12, and the first and second Y-direction guide rails 17 and 10 are respectively slidably mounted with the first, The second Y-direction sliders 4, 9.
  • the first and second X-direction sliders 18, 12 are connected to the first and second linear displacement sensors 25, 26, respectively.
  • the second X-direction slider 12 is driven by the motor 27 and the lead screw pair 28 to slide left and right on the X-direction support member 7.
  • the X, Y, and slanting support members mean that the support members respectively extend along the X, ⁇ , and ⁇ directions, and the X and ⁇ slides indicate that the sliders can be along the X, ⁇ on the corresponding support members. Sliding in.
  • the ⁇ super probe assembly comprises a ⁇ super probe rotating rod 3, a ⁇ super probe base 1 and a ⁇ super probe 2, and the ⁇ super probe 2 is fixed on the ⁇ super probe base 1, and the ⁇ super probe 2 and the ⁇ super probe base 1 coaxial line, the ⁇ super probe base 1 is fixedly connected to one end of the ⁇ super probe rotating rod 3, and the other end of the ⁇ super probe rotating rod 3 is connected to the angular displacement sensor 15, and the angular displacement sensor 15 is fixed at the first ⁇ To the slider 4, the first slanting slider 4 is connected to the third linear displacement sensor 14.
  • the puncture needle guiding cylinder 6 is axially penetrated, and is fixed to the second lateral sliding block 9 via a connecting rod 29, which is connected to the fourth linear displacement sensor 8.
  • the vertical distance of the axis of the ⁇ super probe holder to the side surface 30 of the X-direction support member is equal to the vertical distance of the lance needle guiding cylinder axis to the plane, that is, the axis of the ⁇ super probe holder (ie, the axis of the ⁇ super probe) has the same ⁇ coordinate value as the axis of the lancet guide barrel, and the plane formed by the ⁇ super probe holder axis and the ⁇ needle guiding cylinder axis is parallel to the plane 30 of the X-direction support.
  • the positioning device works as follows:
  • the positioning device is fixed to the operating bed and is placed over the lesion area of the patient's body by adjusting the iliac support and the X-direction support (locked by the handles 21, 24, respectively, in place).
  • the handles 16, 19 are locked by the first and second linear displacement sensors 14, 25 ⁇ Super probe vertical direction (g ⁇ direction) and horizontal direction (g ⁇ X direction) moving distance ⁇ , ⁇ , through the angular displacement sensor 15, can be obtained by the ⁇ super probe rotation angle cn, by the ⁇ super probe display
  • the screen can know the distance from the lesion point 0 to the surface of the skin ⁇ , calculated by computer software:
  • AI A— (ab+Bi+B)
  • the motor 27 is activated by the computer command, and the screw pair 28 drives the second X-direction slider 12 to move a distance Ai (the movement of the handle 11 and the second X-direction slider 12 are positioned after the movement is in place), so that the needle is guided.
  • the axis of the barrel 6 passes through the lesion point 0.
  • the puncture needle 5 is inserted into the puncture needle guiding cylinder 6, so that the tail end of the puncture needle 5 abuts against the upper end surface of the puncture needle guiding cylinder 6 (the puncture needle 5 is coaxial with the perforating needle guiding cylinder 6), and the puncture needle 5 is measured.
  • the hand pushing the puncture needle drives the puncture needle guiding cylinder 6 to move downward (in the ⁇ direction), when the puncture needle 5 just touches the human skin (the puncture needle 5 is extended at this time)
  • the length of the needle guiding cylinder 6 is ⁇ 2), and the vertical movement distance ⁇ 3 of the needle guiding cylinder 6 can be obtained by the linear displacement sensor 8, which is calculated by the computer: .
  • the puncture needle 5 is pushed linearly, and from the surface of the skin, the process of piercing from 0 ⁇ ⁇ Y3 is completed under the digital prompt of the computer.
  • the movement of the puncture needle guiding cylinder 12 of the positioning device can be realized electrically or manually.
  • the angle of puncture of the puncture needle can be adjusted by rotating the X-direction support member 7 relative to the Z-direction slider 22.
  • the positioning device includes an XYZ table, a B-ultrasound probe assembly, and a piercing needle guide.
  • the XYZ axis table includes a Y-direction support member 14, a Z-direction support member 12, a Z-direction slider 11, an X-direction support member 9, and an X-direction slider 10, and the Z-direction support member 12 is slidable through the Y-direction slider 13.
  • the Z-direction slider 11 is slidably mounted on the Z-direction support member 12 (i.e., the Z-direction slider 11)
  • the X-direction support member 9 is slidably mounted on the Z-direction slide member 11
  • the X-direction slide member 10 is slidably mounted on the X-direction support member 9 (the X-direction slide member 10 can be along) X slides left and right)
  • the X-direction slider 10 has a Z-direction beam 8 extending in the Z direction, and a Y-direction fixed shaft 15 is fixed to the end of the Z-direction beam 8.
  • the B-ultrasound probe assembly includes a B-ultrasound probe holder 16 and a B-ultrasound probe 18, and the B-ultrasound probe holder 16 is fixed on the Y-direction fixed shaft 15, and the B-ultrasound probe 18 is slidably mounted on the B-ultrasound probe holder 16. And the axis of the B-ultrasound probe base, the axis of the B-ultrasound probe, and the axis of the Y-axis fixed axis coincide.
  • the B-ultrasound probe 18 is connected to the first linear displacement sensor 17 and is movable up and down along Y.
  • the Y-direction fixed shaft 15 is also looped with a rotating arm 7, and the end of the rotating arm 7 is mounted with a C-arm 5, which includes an integrally connected first arm 51 and a second arm 52, the first arm 51 is of the "C" type, and its peripheral wall surface is composed of concentric inner and outer circular arc surfaces 511, 512 and mutually parallel inner and outer wall surfaces 513, 514, and the inner and outer wall surfaces 513, 514 are plane, the first Arm 51 with engraved And the radius of the inner circular arc surface 511 is R, and the rotating arm 7 is provided with a guiding block 71 having a guiding groove of a "C" type cross section, and the "C" type first arm 51 is inserted into the guiding The groove is slidable along the guide groove, and the plane of the swinging trajectory of the first arm 51 is parallel to the axis of the Y-axis.
  • the second arm 52 is rectangular, and is bent from the front end of the first arm 51.
  • the front end of the second arm is mounted with a sliding seat 4 on which the sliding bar 3 is mounted, the sliding bar 3 and the second straight line
  • the displacement sensor 6 is connected and drives the puncture needle guiding cylinder 2 to slide relative to the sliding seat 4.
  • the axis of the Y-axis (ie, the axis of the B-ultrasound) and the axis of the thread-through guiding cylinder are parallel to the inner wall surface 513 of the C-shaped first arm, and are parallel to the inner and outer wall surfaces 513 of the first arm.
  • the projection of the axis of the piercing needle guiding cylinder and the B-ultrasound probe on the plane passes through the center of the circle where the projection of the circular arc surface 511 of the first arm on the plane is located, and therefore, regardless of the C-type One arm swings at any position with respect to the rotating arm 7, and the axis of the penetrating needle guiding cylinder 2 and the axis of the Y-axis are intersected at the same point (i.e., the center of the circle).
  • the positioning device works as follows:
  • the Z-direction support member 12, the X-direction support member 9 and the Z-direction cross member 8 are adjusted so that the B-ultrasound probe 18 is substantially above the patient's lesion area.
  • the vertical distance a() of the end face of the B-ultrasound probe 18 to the inner circular arc surface 511 of the C-type first arm is calibrated.
  • the rotating arm 7 is placed in an initial position parallel to the Z-beam 8 (as shown in Fig. 4), and the B-ultrasound 18 is held against the patient's skin and drives the Z-beam 8 along the X-direction support member 9. Pan to scan the human body.
  • the depth of the lesion point 0 to the human epidermis a 2 is obtained on the B-ultrasound display, by adjusting the height of the Z-direction support member 12 (electric or manual), through the first straight
  • the line displacement sensor 17 takes the downward displacement of the B-ultrasound probe and makes:
  • the B-ultrasound probe holder 16 is locked so that the B-ultrasound probe 18 is in close contact with the surface of the human body (at this time, the axis of the needle-guided cylinder 2 must pass through the lesion point 0).
  • the rotating arm 7 is rotated 90° counterclockwise (as shown in Figure 6). Inserting the puncture needle 1 into the perforating needle guiding cylinder 2, causing the tail handle 19 to abut against the upper end surface of the perforating needle guiding cylinder 2, and calibrating the vertical distance b Q of the tip of the puncture needle 1 to the circular arc surface 511 of the C-arm 5, By moving the puncture needle 1 up to the human skin, the displacement of the piercing needle is known by the second linear displacement sensor 6.
  • the computer shows the distance from the surface of the human skin to the point of the lesion along the axis of the needle 1.
  • the alarm display can be set on the computer in advance when the wear displacement is close to b 2 - the fixed distance, to warn the doctor's operation.
  • the movement of the device B-ultrasound 18 or the piercing needle guiding cylinder 2 can be achieved electrically or manually.
  • the penetrating angle of the puncture needle can be adjusted by swinging the C-arm 5, and the specific puncture angle can be determined based on the scale on the C-arm.
  • the minimally invasive surgery B-ultrasound positioning method includes the following steps: a): determining the initial position of the B-ultrasound probe and the perforating needle guiding cylinder;
  • the outputs of the linear displacement sensor, the angular displacement sensor and the B-ultrasound probe are connected to a control unit (such as a computer mainframe), and the output of the control unit is connected to a display system (such as a B-display). And the output of the control unit is also connected to an actuator (such as a motor) whose output is connected to the XYZ table.
  • a control unit such as a computer mainframe
  • a display system such as a B-display
  • an actuator such as a motor

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Description

微创手术 B超穿剌定位装置及方法 技术领域
本发明涉及医疗器械领域， 尤其是关于一种应用于微创手术的医疗 器械。
背景技术
随着技术的发展， 微创手术在医院的应用越来越受到重视， 在泌尿 外科、 腔腹外科、 骨科等的使用正日益普及， 但微创手术成功的关键之 一是医生穿剌技术的熟练程度， 这也是微创技术的难点之一。 现在， 许 多医生已经在使用 B超机进行穿刺定位， 但他们的操作很不方便， 完全 靠医生的经验。 这无疑增加了手术的难度和风险， 让很多医生却步， 妨 碍了这项技术的广泛应用和发展。
发明内容
本发明所要解决的技术问题是， 克服现有技术的不足， 提供了一种 能对穿剌位置进行定位， 从而能有效降低微创手术风险和难度的微创手 术 B超穿刺定位装置及方法。
本发明解决其技术问题所采用的技术方案是： 该微创手术 B超穿刺 定位装置包括穿剌针引导筒、 具有 B超探头的 B超探头组件及 XYZ工 作台， 该 XYZ工作台带动该 B超探头组件和穿剌针引导筒于 XYZ直角 坐标系内运动， 且该穿剌针引导筒可相对该 B超探头运动至其轴线与 B 超探头的轴线交于病灶点。
所述的穿剌针引导筒可相对该 B超探头平动或绕该 B超探头的轴线 转动。
所述的 XYZ工作台包括 Y向支承件、 Z向支承件、 Z向滑块、 X向 支承件及 X向滑块， 该 Z向支承件可滑动安装在该 Y向支撑件上， 该 Z 向滑块可滑动安装在该 Z向支承件上，该 X向支承件安装在该 Z向滑块 上， 该 X向滑块可滑动安装在该 X向支承件上， 该 B超探头组件安装 在该 X向滑块上。
所述的 X向支承件上还滑动安装有另一 X向滑块，该穿刺针引导筒 安装在该另一 X向滑块上。
所述的 B超探头组件通过 Y向定轴固定在该 X向滑块上， 该 B超 探头的轴线与该 Y向定轴的轴线重合，该 Y向定轴上可转动安装有连接 臂， 该穿刺针引导筒安装在该连接臂上。
所述的连接臂包括顺次相连的旋转臂、 C型第一臂和第二臂， 该旋 转臂活套在该 Y向定轴上，该 C型第一臂可相对该旋转臂摆动且其摆动 轴线垂直 Y向定轴的轴线， 该穿刺针引导筒安装在该第二臂上， 且该穿 刺针引导筒的轴线与 B超探头的轴线构成的平面平行于该 C型第一臂的 侧表面。
所述的穿刺针引导筒内安装有穿刺针， 该穿刺针的轴线与该穿刺针 引导筒的轴线重合， 且该穿刺针和 B超探头的位移均由直线位移传感器 监测。
该微创手术 B超穿刺定位方法包括如下步骤：
a) : 确定 B超探头和穿剌针引导筒的初始位置；
b) : 通过 B超探头确定病人病灶点- c) : 根据 B超探头的位移和其与穿剌针引导筒的相对位置确定穿剌 针的位移。 ，
所述的步骤 b)中， 通过平行和旋转 B超探头来确定病人病灶点， 所 述的步骤 c)中，根据 B超探头的角位移及直线位移、初始时 B超探头与 穿刺针引导筒的相对位置来确定穿刺针的位移。
本发明的有益效果是， 通过该定位装置可以实现对穿剌位置的准确 定位， 降低了微创手术的风险和难度， 便于进行推广。
附图说明
图 1是本发明第一实施方式的立体结构图。
图 2是图 1的 A向视图。
图 3是本发明第一实施方式的原理图。
图 4是本发明第二实施方式的立体结构图。
图 5是图 4的 A向视图。
图 6是图 4中的 C型臂绕 Y向定轴逆时针旋转 90度后的 A向视图。 图 7至图 9是穿刺针在穿刺过程中分别处于初始位置、 到达皮肤位 置和到达病灶点位置时的示意图。
图 10是本发明的电路原理框图。
图 11是本发明的流程框图。
具体实施方式
本发明微创手术 B超穿刺定位装置包括穿刺针引导筒、具有 B超探 头的 B超探头组件及 XYZ工作台，该 XYZ工作台带动该 B超探头组件 和穿刺针引导筒于 XYZ直角坐标系内运动， 且该穿剌针引导筒可相对 该 B超探头运动至其轴线与 B超探头的轴线交于病灶点。
请参阅图 1至图 3， 其为本发明的第一具体实施方式。 该定位装置 包括 XYZ轴工作台、 B超探头组件及穿刺针引导筒。 该 XYZ工作台包 括 Y向支承件 23、 Z向支承件 20、, Z向滑块 22、 X向支承件 7、 第一 X 向滑块 18及第二 X向滑块 12， 该 Z向支承件 20可滑动 (沿 Y向上下运 动)安装在该 Y向支撑件 23上， 该 Z向滑块 22可滑动安装在该 Z向支 承件 20上 (沿 Z向前后运动)， 该 X向支承件 7安装在该 Z向滑块 22上 并可相对该滑块 22绕 X轴旋转一定角度， 该第一、 第二 X向滑块 18、 12均可滑动 (沿 X向左右运动)安装在该 X向支承件 7上。该第一、第二 X向滑块 18、 12上分别安装有第一、 第二 Y向导轨 17、 10， 该第一、 第二 Y向导轨 17、 10上分别可滑动安装有第一、 第二 Y向滑块 4、 9。 该第一、 第二 X向滑块 18、 12分别与第一、 第二直线位移传感器 25、 26相连。该第二 X向滑块 12由电机 27及丝杆副 28驱动而在 X向支承 件 7上左右滑动。 本实施方式中， 该 X、 Y、 Ζ向支承件指该支承件分 别沿 X、 Υ、 Ζ向延伸， 该 X、 Ζ向滑块指该滑块可在对应的支承件上沿 X、 Ζ向滑动。
该 Β超探头组件包括 Β超探头旋转杆 3、 Β超探头座 1及 Β超探头 2， 该 Β超探头 2固定在 Β超探头座 1上， 且该 Β超探头 2与该 Β超探 头座 1同轴线， 该 Β超探头座 1与 Β超探头旋转杆 3的一端固接， 该 Β 超探头旋转杆 3的另一端与角位移传感器 15相连， 该角位移传感器 15 固定在第一 Υ向滑块 4上， 该第一 Υ向滑块 4与第三直线位移传感器 14相连。 穿刺针引导筒 6轴向贯穿， 其通过连杆 29固定在第二 Υ向滑 块 9上， 该第二 Υ向滑块 9与第四直线位移传感器 8相连。该 Β超探头 座的轴线到 X向支承件的侧表面 30(即平行于 ΧΥ平面的表面)的垂直距 离与穿刺针引导筒轴线到该平面的垂直距离相等， 即该 Β超探头座的轴 线 (即 Β超探头的轴线)与穿刺针引导筒的轴线具有相同的 Ζ坐标值， 且 Β超探头座轴线与穿剌针引导筒轴线所构成的平面与 X向支承件的平面 30平行。
该定位装置的工作原理如下：
将该定位装置固定在手术床旁，并通过调整 Ζ向支承件和 X向支承 件 (调整到位后分别通过手柄 21、 24锁定)， 使 Β超探头大致置于病人人 体的病灶区之上。
在电脑 (即控制单元：)上设定 X、 Υ坐标系， 确定 Β超探头 2的初始 坐标 （Β, ΥΒ)， 确立穿剌针引导筒 6的初始坐标 （Α， ΥΑ)。
手握 Β超探头， 使其紧贴着病人皮肤水平移动和摆动， 当 Β超显示 屏上显示病灶后，锁定手柄 16、 19，通过第一、第二直线位移传感器 14、 25， 可得出 Β超探头竖直方向（g卩 Υ方向)和水平方向（g卩 X方向）的移动 距离 Υι、 Βι，通过角位移传感器 15， 可得出 Β超探头的旋转角度 cn, 由 Β超探头显示屏可知病灶点 0到皮肤表层的距离 ΟΟι ,通过电脑软件 计算：
bO=OOi +YI+YB ab=sin a i X bO=sin a i X (001 +YI+YB)
AI=A— (ab+Bi+B) 此时， 通过电脑指令， 电机 27启动， 丝杆副 28带动第二 X向滑块 12移动距离 Ai (运动到位后锁定手柄 11而使第二 X向滑块 12定位)，使 穿剌针引导筒 6的轴线通过病灶点 0。
将穿刺针 5穿入穿刺针引导筒 6， 使穿刺针 5尾部手柄紧靠穿刺针 引导筒 6的上端面 (该穿刺针 5与穿剌针引导筒 6同轴线)，测得穿刺针 5 露出穿刺针引导筒 6的长度 Y2， 并输入电脑， 手推动穿刺针带动穿刺针 引导筒 6向下（沿 Υ方向)移动， 当穿刺针 5刚接触人体皮肤时（此时穿 刺针 5伸出穿剌针引导筒 6的长度即为 Υ2)， 通过直线位移传感器 8可 得穿刺针引导筒 6的垂直移动距离 Υ3， 通过电脑计算： . aO=cos i X bO= cos α ι(ΟΟι+Υι+ΥΒ) 得知穿剌人体的深度为：
Y3-aO- (YA+Yi+Y2)
这样， 在穿刺针引导筒 6的引导下， 推动穿刺针 5直线运动， 从皮 肤表层算起， 在电脑的数字提示下， 完成穿剌从 0 ^ ^ Y3的过程。
为安全起见， 可事先在电脑上设定穿剌接近 Y3—定距离时， 电脑 上先设定报警显示， 以对医生的操作提出警示。
本定位装置的穿刺针引导筒 12的移动可利用电动或手动实现。本实 施方式中， 通过使 X向支承件 7相对 Z向滑块 22旋转， 从而可以调节 穿刺针的穿刺角度。
请参阅图 4至图 9， 其为发明的第二具体实施方式。 该定位装置包 括 XYZ工作台、 B超探头组件及穿剌针导筒。 该 XYZ轴工作台包括 Y 向支承件 14、 Z向支承件 12、 Z向滑块 11、 X向支承件 9及 X向滑块 10， 该 Z向支承件 12通过 Y向滑块 13可滑动安装在该 Y向支撑件 14 上 (即该 Z向支承件 12可沿 Y向上下滑动)， 该 Z向滑块 11可滑动安装 在该 Z向支承件 12上 (即该 Z向滑块 11可沿 Z向前后滑动)， 该 X向支 承件 9固定在该 Z向滑块 11上，该 X向滑块 10可滑动安装在该 X向支 承件 9上 (该 X向滑块 10可沿 X向左右滑动），且该 X向滑块 10具有沿 Z向延伸的 Z向横梁 8， 该 Z向横梁 8的末端固设有 Y向定轴 15。 该 B 超探头组件包括 B超探头座 16及 B超探头 18， 该 B超探头座 16固定 在该 Y向定轴 15上，该 B超探头 18可滑动安装在该 B超探头座 16上， 且该 B超探头座的轴线、 B超探头的轴线及该 Y向定轴的轴线重合。该 B超探头 18与第一直线位移传感器 17相连， 并可沿 Y向上下移动。 该 Y向定轴 15上还活套有旋转臂 7， 该旋转臂 7的末端安装 C型臂 5， 该 C型臂 5包括一体连接的第一臂 51和第二臂 52， 该第一臂 51呈 " C " 型， 其周壁面由同心的内、外圆弧面 511、 512及相互平行的内、 外壁面 513、 514组成， 该内、 外壁面 513、 514均为平面， 该第一臂 51带有刻 度且其内圆弧面 511的半径为 R, 该旋转臂 7上设有导向块 71， 该导向 块 71具有 "C"型截面的导向槽， 该 "C"型第一臂 51插入该导向槽中 并可沿着该导向槽摆动，且该第一臂 51的摆动轨迹所在的平面平行于 Y 向定轴 15的轴线。该第二臂 52为矩形， 其自第一臂 51的前端弯折， 该 第二臂的前端安装有滑座 4，该滑座 4上安装有滑杆 3，该滑杆 3与第二 直线位移传感器 6相连， 并带动穿刺针引导筒 2相对滑座 4滑动。
该 Y向定轴的轴线 (即 B超探头的轴线)与穿剌针引导筒的轴线构成 的平面与 C型第一臂的内壁面 513平行，在平行第一臂的内、外壁面 513、 514的平面上， 该穿剌针引导筒和 B超探头的轴线在该平面上的投影均 通过第一臂内圆弧面 511在该平面上的投影所在圆的圆心， 因此， 不论 C型第一臂相对旋转臂 7摆动在任何位置， 穿剌针引导筒 2的轴线与 Y 向定轴的轴线都交于同一点 (即该圆的圆心)。
该定位装置的工作原理如下：
调整 Z向支承件 12、 X向支承件 9及 Z向横梁 8， 使 B超探头 18 大致处于病人病灶区上方。 '
标定 B超探头 18端面到 C型第一臂内圆弧面 511的垂直距离 a()。 将旋转臂 7置于与 Z向横梁 8平行的初始位置 (如图 4所示)， 手握 B超探头 18， 使其紧贴着病人皮肤， 并带动 Z向横梁 8沿 X向支承件 9 平移以对人体扫描。 当在 B超显示屏上找到病灶点 O后， 在 B超显示 屏上取得病灶点 0到人体表皮的深度 a2， 通过调整 Z向支承件 12的高 度（电动或手动）， 通过第一直线位移传感器 17取得 B超探头向下的位 移 ^， 并使得：
Figure imgf000007_0001
此时，锁紧 B超探头座 16，使 B超探头 18紧贴人体表面 (此时穿剌 针引导筒 2的轴线必定通过病灶点 0)。
请结合参阅图 7至图 9, 为利于医生穿剌， 将旋转臂 7逆时针旋转 90° (如图 6所示)。将穿刺针 1插入穿剌针引导筒 2， 使其尾部手柄 19紧 靠穿剌针引导筒 2的上端面，标定穿刺针 1顶端到 C型臂 5内圆弧面 511 的垂直距离 bQ， 移动穿刺针 1直到人体皮肤， 通过第二直线位移传感器 6可知穿剌针的位移 1^。
_ 电脑显示出沿穿刺针 1的轴线方向， 从人体皮肤表面到病灶点的距 离：
b2 = R -( bo + b
这样， 在穿剌针引导筒 2的引导下， 推动穿刺针， 从皮肤表面算起， 在电脑的数字提示下， 完成穿剌深度从 0—" b2的过程。.
为安全起见， 可事先在穿剌位移接近 b2—定距离时， 在电脑上设定 报警显示， 以对医生的操作提出警示。 本装置 B超探头 18或穿剌针引导筒 2的移动可利用电动或手动实 现。
'本实施方式中，通过使 C型臂 5摆动，可以调节穿刺针的穿剌角度， 且其具体的穿刺角度可以根据 C型臂上的刻度来确定。
请参阅图 11， 该微创手术 B超穿刺定位方法包括如下步骤： a) : 确定 B超探头和穿剌针引导筒的初始位置；
b) : 通过 B超探头确定病人病灶点：
c) : 根据 B超探头的位移和其与穿刺针引导筒的相对位置确定穿刺 针的位移。
请参阅图 10， 本发明中， 各个直线位移传感器、 角位移传感器及 B 超探头的输出均与控制单元连接 (如电脑主机)， 该控制单元的输出接显 像系统 (如 B超显示屏)， 且该控制单元的输出还接执行器 (如电机)， 该 执行器的输出接 XYZ工作台。
以上内容是结合具体的优选实施方式对本发明所作的进一步详细说 明， 不能认定本发明的具体实施只局限于这些说明。 对于本发明所属技 术领域的普通技术人员来说， 在不脱离本发明构思的前提下， 还可以做 出若干简单推演或替换， 都应当视为属于本发明由所提交的权利要求书 确定的专利保护范围。

Claims

权 利 要 求
1. 一种微创手术 B超穿刺定位装置， 其特征在于： 包括穿刺针引导筒、 具有 B超探头的 B超探头组件及 XYZ工作台，该 XYZ工作台带动该 B 超探头组件和穿剌针引导筒于 XYZ直角坐标系内运动， 且该穿剌针引 导筒可相对该 B超探头运动至其轴线与 B超探头的轴线交于病灶点。
2. 按照权利要求 1所述的微创手术 B超穿刺定位装置，其特征在于： 所 述的穿剌针引导筒可相对该 B超探头平动或绕该 B超探头的轴线转动。
3. 按照权利要求 1所述的微创手术 B超穿剌定位装置，其特征在于： 所 述的 XYZ工作台包括 Y向支承件、 Z向支承件、 Z向滑块、 X向支承件 及 X向滑块， 该 z向支承件可滑动安装在该 Y向支撑件上， 该 Z向滑 块可滑动安装在该 z向支承件上， 该 X向支承件安装在该 Z向滑块上， 该 X向滑块可滑动安装在该 X向支承件上，该 B超探头组件安装在该 X 向滑块上。
4. 按照权利要求 3所述的微创手术 B超穿剌定位装置，其特征在于： 所 述的 X向支承件上还滑动安装有另一 X向滑块，该穿刺针引导筒安装在 该另一 X向滑块上。.
5. 按照权利要求 3所述的微创手术 B超穿刺定位装置，其特征在于： 所 述的 B超探头组件通过 Y向定轴固定在该 X向滑块上， 该 B超探头的 轴线与该 Y向定轴的轴线重合，该 Y向定轴上安装有连接臂，该连接臂 可绕该 Y向定轴转动， 该穿刺针引导筒安装在该连接臂上。
6. 按照权利要求 5所述的微创手术 B超穿刺定位装置，其特征在于： 所 述的连接臂包括顺次相连的旋转臂、 C型第一臂和第二臂， 该旋转臂活 套在该 Y向定轴上，该 c型第一臂可相对该旋转臂摆动且其摆动轨迹所 在的平面与 Y向定轴的轴线平行， 该穿剌针引导筒安装在该第二臂上， 且该穿刺针引导筒的轴线与 B超探头的轴线构成的平面平行于该 C型第 一臂的内壁面。
7. 按照权利要求 2-6中任意一项所述的微创手术 B超穿刺定位装置，其 特征在于：所述的穿刺针引导筒和 B超探头的位移均由位移传感器监测。
8. —种微创手术 B超穿剌定位方法， 其特征在于： 包括如下步骤：
a) : 确定 B超探头和穿刺针引导筒的初始位置；
b) : 通过 B超探头确定病人病灶点：
c) : 根据 B超探头的位移和其与穿刺针引导筒的相对位置确定穿刺 针的位移。
9. 按照权利要求 8所述的一种微创手术 B超穿剌定位方法，其特征在于： 所述的步骤 b)中， 通过平行和旋转 B超探头来确定病人病灶点， 所述的 步骤 c)中， 根据 B超探头的角位移及直线位移、初始时 B超探头与穿剌 针引导筒的相对位置来确定穿刺针的位移'
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CN114042233A (zh) * 2021-12-06 2022-02-15 首都医科大学附属北京天坛医院 一种脑室转流术旁通系统

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