WO2016208711A1 - Dispositif de guidage d'équipement médical - Google Patents

Dispositif de guidage d'équipement médical Download PDF

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Publication number
WO2016208711A1
WO2016208711A1 PCT/JP2016/068799 JP2016068799W WO2016208711A1 WO 2016208711 A1 WO2016208711 A1 WO 2016208711A1 JP 2016068799 W JP2016068799 W JP 2016068799W WO 2016208711 A1 WO2016208711 A1 WO 2016208711A1
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WIPO (PCT)
Prior art keywords
covering
medical instrument
instrument guide
positioning
covering portion
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PCT/JP2016/068799
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English (en)
Japanese (ja)
Inventor
安倫 有満
藤本　幸輔
Original Assignee
キヤノン ユーエスエイ，インコーポレイテッド
キヤノン株式会社
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Publication of WO2016208711A1 publication Critical patent/WO2016208711A1/fr

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    • 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 a medical instrument guide device for holding and positioning a medical instrument.
  • Puncture treatment includes ablation in which treatment is performed by burning tumors and cancer cells by radio waves, and cryotherapy in which the tumors and cancer cells are frozen by a freezer or cooling gas.
  • biopsy by puncture is widely performed as part of pathological diagnosis based on tissue collection.
  • a medical image captured by X-ray CT, MRI or the like is used as a means for visualizing the needle in the body.
  • Patent Document 1 and Patent Document 2 relate to a Needle placement manipulator that performs needle positioning based on a biaxial RCM (Remote Center of Motion) mechanism.
  • first rotary guide 3.
  • second rotary guide 7.
  • Means for determining the orientation of the needle are disclosed.
  • Patent Documents 1 and 2 disclose that: first rotary guide, 3. 512 in the second rotary guide. actuator, 514.
  • the Needle placement manipulator incorporating a sensor.
  • the base body is described as having to be sterilized because it may touch the doctor or the patient.
  • sterilization methods by heating, electromagnetic waves, and chemical action are generally used.
  • high temperature and high pressure steam sterilization methods using autoclaves which have been introduced into a relatively large number of medical institutions and used for various medical instruments, are metal such as forceps and fibrous materials such as gauze. Suitable for medical devices.
  • this sterilization method since sterilization is performed under a temperature condition of about 150 [° C.], electronic parts, those made of general-purpose plastics with low heat resistance, those containing adhesives that soften or deteriorate under high heat, etc.
  • Patent Documents 1 and 2 the need for sterilization is recognized for needle holder 6 and base body 5. However, in fact, it is necessary to sterilize parts other than needle holder 6 and base body 5, so that these parts are either directly sterilized or non-sterile parts do not touch doctors and patients directly. There is a need to incorporate a complicated process such as sterilization sheet (Drape) or covering with a plastic bag into a part of a surgical procedure (workflow).
  • a sterilization sheet Drape
  • covering with a plastic bag into a part of a surgical procedure (workflow).
  • first rotary guide 2 and second rotary guide 3 are equipped with electronic devices that are difficult to sterilize, so it may be difficult to sterilize. It is done. In such a case where sterilization is difficult, there is a problem that an expensive sterilization method must be taken if an electronic device is directly sterilized.
  • a holding unit that holds and guides at least one medical device, a positioning unit that determines an orientation of the holding unit, and at least one coating unit, the coating unit covers the positioning unit.
  • the medical instrument guide device is characterized in that the medical instrument is disposed with respect to the covered positioning means.
  • the accompanying drawings are included in the specification, constitute a part thereof, show an embodiment of the present invention, and are used to explain the principle of the present invention together with the description.
  • the schematic perspective view of the medical instrument guide apparatus 1 in 1st Embodiment is shown.
  • the schematic sectional drawing of the medical instrument guide apparatus 1 in 1st Embodiment is shown.
  • region C of the medical instrument guide apparatus 1 is shown.
  • the schematic sectional drawing of the medical instrument guide apparatus 1 in 1st Embodiment is shown.
  • the surgical procedure (workflow) in 1st Embodiment is shown.
  • the schematic perspective view of the medical instrument guide apparatus 101 in 2nd Embodiment is shown.
  • coated means 122 of the medical instrument guide apparatus 101 in 2nd Embodiment is shown.
  • the schematic sectional drawing of the medical instrument guide apparatus 101 in 2nd Embodiment is shown.
  • the schematic sectional drawing of the medical instrument guide apparatus 101 in 2nd Embodiment is shown.
  • the surgical procedure (workflow) in 2nd Embodiment is shown.
  • the schematic perspective view of the medical instrument guide apparatus 201 in 3rd Embodiment is shown.
  • the schematic sectional drawing of the medical instrument guide apparatus 201 in 3rd Embodiment is shown.
  • coated means 224 in 3rd Embodiment is shown.
  • the surgical procedure (workflow) in 3rd Embodiment is shown.
  • coated means 310 in 4th Embodiment is shown.
  • the schematic sectional drawing of the medical instrument guide apparatus 301 in 4th Embodiment is shown.
  • coated means 404 in 5th Embodiment is shown.
  • coated means 404 in 5th Embodiment is shown.
  • the schematic sectional drawing of the medical instrument guide apparatus 401 in 5th Embodiment is shown.
  • the schematic perspective view of the medical instrument guide apparatus 501 in 6th Embodiment is shown.
  • the schematic sectional drawing of the medical instrument guide apparatus 501 in 6th Embodiment is shown.
  • a holding unit that holds and guides at least one medical device, a positioning unit that determines an orientation of the holding unit, and at least one covering unit are provided,
  • a medical instrument guide device in which the covering means covers the positioning and the medical instrument is arranged with respect to the coated positioning means will be described below.
  • new embodiments derived from combinations of the embodiments are also within the scope of the present invention.
  • FIG. 1 is a schematic perspective view of a medical instrument guide apparatus 1 according to the first embodiment.
  • FIG. 2A is a schematic cross-sectional view of the medical instrument guide apparatus cut along a plane parallel to the zx plane passing through the center of the medical instrument 2.
  • FIG. 3 shows a state where the medical instrument guide device 1 shown in FIG. 2 is mounted on the abdomen 13 of a human body, and shows a state of a minimally invasive puncture operation in a simulated manner.
  • the medical instrument guide apparatus in the present embodiment is an RCM (Remote Center of Motion) mechanism having two degrees of freedom of rotation, and details thereof will be described.
  • the nuclear magnetic resonance imaging apparatus MRI is used as a means for visualizing the inside of the body, a medical instrument, a medical instrument guide apparatus, and the like, but is not limited thereto.
  • FIG. 3 a sterilized sheet 15 having a hole is covered on a human body 13, and the medical instrument guide device 1 is installed thereon.
  • a hollow RF coil 5 having an opening is placed on the second covering means 4.
  • the RF coil 5 is wrapped with a sterilization sheet 16.
  • a base 6 having an opening 6a is installed on the second covering means 4 having the opening 4a.
  • a first positioning means 7 having a first opening 7a is attached on the base 6, and a first covering means 8 is attached on the first positioning means 7, and the first positioning means 7 is located outside the opening 8 a of the first covering means 8.
  • the outside of the opening 8a refers to the outside of the surface of the inner wall of the first covering means.
  • the first positioning means 7 is a rotary positioning means capable of causing a relative displacement in the rotational direction between the base 6 and the first covering means 8 around the LL ′ axis in FIG. It is.
  • a second positioning means 9 is attached to the first covering means 8.
  • a third covering means 10 having an opening 10 a is attached to the upper end portion of the second positioning means 9.
  • a holder 3 for holding and guiding the medical instrument 2 is attached to the third covering means 10, and an ablation needle for puncture surgery is attached as the medical instrument 2 in the present embodiment.
  • the medical instrument 2 is disposed inside the openings 10a, 8a and 4a.
  • the holding unit 3 restrains the degree of freedom in the longitudinal direction of the medical instrument 2 and four degrees of freedom other than the degree of freedom of rotation with the longitudinal direction as the rotation axis, and slides the medical instrument 2 in the longitudinal direction of the medical instrument 2.
  • the medical device 2 can be held and guided.
  • the second positioning means 9 may cause a relative displacement in the rotational direction between the first covering means 8 and the second covering means 4 around the UU ′ axis as shown in FIG. Possible rotary positioning means.
  • the UU ′ axis and the LL ′ axis are designed to form an angle ⁇ .
  • the base 6 is provided with a connector 12 for supplying power and acquiring signals to the first and second positioning means 7 and 9.
  • the first covering means 8 incorporates an electric substrate 11 used for supplying power to the first and second positioning means and relaying signal acquisition.
  • FIGS. 2B and 2C are enlarged views of regions B and C surrounded by a broken line in FIG. 2A, respectively.
  • the first covering means 8 and a part of the third covering means 10 form a nested labyrinth structure 18, and the second positioning shown in FIG. 4 (b).
  • the second opening 9 a of the means 9 is configured not to be exposed inside the opening 8 a of the first covering means 8.
  • a gap 19 is provided between the second positioning means 9 and the first covering means 8 and the third covering means 10, thereby constituting a mechanism in which the second positioning means 9 can rotate. .
  • FIG. 1 the first covering means 8 and a part of the third covering means 10 form a nested labyrinth structure 18, and the second positioning shown in FIG. 4 (b).
  • the second opening 9 a of the means 9 is configured not to be exposed inside the opening 8 a of the first covering means 8.
  • a gap 19 is provided between the second positioning means 9 and the first covering means 8 and the third covering means 10, thereby constituting
  • the first covering means 8 and the opening of the base 6 form a nested labyrinth structure 20, and the opening 6 a of the base 6 and the first positioning means 7. Is configured so as not to be exposed inside the first covering means 8. Further, the first covering means 8 has a gap 21 between the base 6 and the second covering means 4, thereby constituting a mechanism that is relatively movable with respect to the base 6 and the second covering means 4. ing. As described above, the first and second positioning means and the base 6 constitute a positioning device in which the first covering means 8 is not exposed.
  • the material used for each part which comprises the medical instrument guide apparatus 1 is demonstrated.
  • the material forming the third covering means 10 and the holding part 3 it is desirable to apply engineering plastics such as polyetheretherketone (PEEK) in order to cope with sterilization under high temperature conditions.
  • the base 6 corresponds to the wiring and electrical component mounting corresponding to the first and second positioning means, and is applied with an engineering plastic such as polyether ether ketone (PEEK) having high heat resistance in preparation for the risk of ignition of the electric system. Is desirable.
  • the first covering means 8 also serves as a supporting structure material for the first and second positioning means, the first covering means 8 is formed of a transparent engineering plastic such as polycarbonate (PC) having a relatively high rigidity, for example. Is preferred.
  • the electric substrate 11 can be placed inside the first covering means by forming the electric substrate 11 by in-mold injection. Materials for forming the first and second positioning means will be described later.
  • FIGS. 4A and 4B are sectional views of the first and second positioning means, respectively.
  • the positioning unit includes components of a piezoelectric actuator that is a driving source and an optical encoder that is an angular position detection unit in the rotation direction.
  • the present invention is not limited to this, and the drive source may be installed outside or the position may be manually changed by the operator instead of the electrical drive source.
  • the first fixing portion 30 is positioned and fixed in the radial direction to the base 6 via the fitting portion 30a, and is positioned in the circumferential direction via engaging means (not shown).
  • the base 6 is not shown in FIG. 4, as can be seen from FIG.
  • the base 6 is disposed immediately below the first fixing portion 30.
  • the first rotating portion 31 is connected to the first fixed portion 30 via the slide bearing 33 so as to be rotatable around the LL ′ axis in FIG.
  • An electro-mechanical energy conversion element 36 is fixed to the elastic member 37 with an adhesive (not shown).
  • the elastic member 37 and the electromechanical energy conversion element 36 are pressed against the moving body 38 by the pressurizing member 34 provided on the first rotating portion 31 via the nonwoven fabric 35.
  • a voltage in a predetermined frequency band is applied to the electro-mechanical energy conversion element 36 and the elastic member 37 is vibrated in the out-of-plane direction, whereby the moving body 38 pressed against the elastic member 37 is applied.
  • the first rotating part 31 including the elastic member 37 can be relatively frictionally driven in the circumferential direction.
  • the first rotating unit 31 is provided with an optical encoder 39 which is one component of the position detecting unit.
  • the first rotary unit 31 is a component of the position detecting unit on the first fixed unit 30 at the radial position facing the first encoder.
  • a certain scale 40 is arranged. With this configuration, it is possible to detect the relative position or relative displacement of the first rotating unit 31 with respect to the first fixed unit 30.
  • the connection part 32 provided in the first rotating part 31 is electrically connected to the electric substrate 11 by the connection between the first covering means 8 and the first rotating part 31, and supplies power to the piezoelectric actuator and the position detecting means. Signal acquisition is possible.
  • the second fixing portion 41 is fixed to the first covering means 8, positioned and fixed in the radial direction via the fitting portion 41a, and circumferentially via the engaging means (not shown). Is positioned.
  • the second rotating portion 42 is connected to the second fixed portion 41 via the slide bearing 43 so as to be rotatable around the U ′ axis in FIG.
  • the configuration of the piezoelectric actuator and the position detection means is the same as that of the first positioning means 7.
  • the connection portion 32 provided in the second fixing portion 41 is electrically connected to the electric substrate 11 by the connection of the first covering means 8 and the second fixing portion 41, and supplies power to the piezoelectric actuator and the position detection means. And signal acquisition.
  • the second position detecting means can be engaged with the third covering means 10 via the pin hole 44. Note that reference numerals 34 to 40 in FIG. 4B are the same as those in FIG.
  • the material for forming the first and second positioning means will be described.
  • the first and second fixed parts and the first and second rotating parts directly affect the arrival position accuracy of the medical device relative to the tumor, so that the non-magnetic metal, polyether ether ketone (PEEK), etc. It is desirable to form with hard plastic, ceramics, etc.
  • the elastic member 37 is preferably formed of a non-magnetic metal, high toughness ceramic such as partially stabilized zirconia (PSZ), or the like.
  • the electro-mechanical energy conversion element 36 is preferably formed of a piezoelectric ceramic such as lead zirconate titanate.
  • the moving body 38 is preferably selected from materials for obtaining stable sliding characteristics and wear resistance characteristics with respect to the elastic member 37, such as a hardened magnesium-based aluminum alloy surface by alumite treatment or nitriding treatment, carbon fiber, or the like.
  • fiber reinforced resin such as polyether ether ketone (PEEK) is preferable.
  • the nonwoven fabric 35 is preferably formed of a felt material such as wool or glass wool, and the pressure member 34 is formed of a nonmagnetic metal such as phosphor bronze or a high toughness ceramic such as partially stabilized zirconia (PSZ).
  • the part touched by the non-sterile person must be treated as not sterilized. Items that have been sterilized are sealed and packaged in a pouch-shaped bag, and when used, they are opened by a non-sterile person, and the non-sterile person is packed on a sterilized sheet or sterilized bat so as not to touch the contents. Put the finished parts.
  • the sterilization sheets 15 to 17, the first covering means 8, the second covering means 4, the third covering means 10, the holding unit 3, and the medical instrument 2 are sterilized.
  • the RF coil 5, the base 6, the first positioning means 7, and the second positioning means 9 are treated as being not sterilized and not sterilized depending on the electrical or mechanical characteristics of the components included therein. .
  • FIG. 5 shows an example of a workflow.
  • the operation is started (A00).
  • a doctor, studio person puts a sterilized sheet 15 having a hole on the human body (A01).
  • A01 the puncture point and the center of the hole of the sterilization sheet 15 are substantially aligned, and the hole has a size necessary for operations such as puncture and disinfection.
  • the second covering means 4 is placed on the sterilizing sheet 15 so that the center person aligns the center of the opening 4a of the second covering means 4 and the hole of the sterilizing sheet 15 (A02). At this time, it is desirable to fix the second covering means 4 to the human body 13 so as not to be displaced by a tape, a band, or other fixing means (not shown).
  • the serial person installs the RF coil 5 on the second covering means 4 for receiving the RF wave (A03).
  • the RF coil 5 has an opening larger than the opening of the second covering means 4 as shown in the figure. Further, it is assumed that the RF coil 5 is not sterilized, and as shown in FIG. 3, the RF coil 5 is covered with a sterilization sheet 16 and can be touched by a doctor sterile person.
  • the non-sterile person installs the base 6 on the second covering means 4 (A04). It is desirable that the second covering means 4 and the base 6 are precisely positioned and fixed by various machine elements such as fitting, positioning pins, keys, bayonet, and snap fit.
  • the base 6 is mounted with an electrical component group for supplying power to the first positioning means 7 and the second positioning means 9 and acquiring signals, and is not sterilized.
  • the non-sterile person incorporates the first positioning means 7 into the base 6 (A05). It is desirable that the base 6 and the first positioning means 7 are precisely positioned and fixed by various machine elements such as fitting, positioning pins, keys, bayonet, and snap fit.
  • the non-sterile person incorporates the first covering means 8 into the first positioning means 7 while holding the side surface of the first covering means 8 (A06).
  • the non-sterile person since the first covering means 8 is sterilized, the non-sterile person has only the side surface of the first covering means 8 and does not touch the opening 8 a of the first covering means 8.
  • the first covering means 8 and the first positioning means 7 are precisely positioned and fixed by various machine elements such as fitting, positioning pins, keys, bayonet, and snap fit.
  • the first covering means 8 is incorporated into the first positioning means 7, and at the same time, the electrical connection with the electric substrate 11 provided on the first covering means 8 is made by coupling with the connection portion 32. Thus, connection to the electrical component group provided on the base 6 is made.
  • the non-sterile person incorporates the second positioning means 9 into the first covering means 8 (A07). It is desirable that the first covering means 8 and the second positioning means 9 are precisely positioned and fixed by various machine elements such as fitting, positioning pins, keys, bayonet, and snap fit.
  • the second positioning means 9 is incorporated into the first covering means 8 and at the same time, the electrical connection with the electric substrate 11 provided on the first covering means 8 is achieved by coupling with the connection portion 32. Assumed to be performed.
  • the stereo person incorporates the third covering means 10 into the second positioning means 9 (A08). It is desirable that the second positioning means 9 and the third covering means 10 are precisely positioned and fixed by various machine elements such as fitting, positioning pins, keys, bayonet, and snap fit. Further, when the third covering means 10 is incorporated, the doctor stereoperson does not touch the second positioning means 9 that is not sterilized.
  • the doctor serial person incorporates the holding unit 3 into the third covering means 10 (A09), and covers the entire medical instrument guide device 1 with a sterilized sheet 17 having a hole (A10). It is desirable that the size of the hole is formed to be approximately the same as that of the second opening 9a.
  • MRI is a visualization means (A11).
  • A11 a means for measuring the position and orientation of the medical instrument guide device 1
  • the rotation angles of the first and second rotational positioning means are calculated, and the first and second rotational positioning means Is set to a predetermined angle (A12).
  • the doctor passes the medical instrument 2 through the holding part 3, performs a therapeutic action by ablation (A13), and ends the operation (A14).
  • the first covering means 8 is configured to divide the region that must be sterilized and the region that is not sterilized.
  • the inside of the openings 10a and 8a can be kept in a sterilized state by being physically partitioned by the third covering means 10, it is possible to provide a medical instrument guide device suitable for a clinical workflow. it can.
  • a doctor's hand and other sterilized medical instruments can be inserted into the openings 10a, 8a and 4a, the usability for the doctor is improved.
  • the first covering means 8 can be mass-produced at low cost by resin molding, so that the manufacturing cost is reduced and it is easy to handle as a disposable. Disposable parts can be used at different surgical sites, so the sterilization process can be simplified and the safety in surgery can be improved. Furthermore, by mounting the electric board 11 in the first covering means 8 by in-mold injection, the doctor can touch the electric board 11 that is not sterilized without directly sterilizing the electric board 11. It is possible to construct a clinically adapted surgical workflow.
  • the first covering means 8 is formed of transparent polycarbonate (PC), it is possible to confirm the situation inside the medical instrument guiding apparatus 1 from the side. Further, since the first covering means 8 supports or fixes the first and second rotational positioning means over a wide range in the circumferential direction, the first covering means 8 improves the rigidity as a medical instrument guide device and guides the medical instrument. It is possible to improve the positioning accuracy. Further, as in the present embodiment, the first covering means 8 does not have an opening in a direction other than the drive axis direction of the first and second positioning means, so that the doctor can access the non-sterile site through this opening. Can reduce the possibility of access.
  • PC transparent polycarbonate
  • the application destination of this invention is not restricted to the puncture operation using an ablation needle.
  • a medical instrument 2 a cryoneedle used for percutaneous cryotherapy, a biopsy needle used for biopsy surgery for the purpose of collecting tissue for use in pathological examination, and the purpose of searching for a needle puncture route A stylet or the like can be applied.
  • the invention is not limited to the percutaneous puncture operation, but can be applied to all operations in which a human body is injured, a medical device is guided inside the medical device, and the medical device is positioned. For example, laparoscopic surgery and application to an apparatus for holding and guiding an endoscope are conceivable.
  • the visualization means is not limited to MRI, and visualization means using X-rays or ultrasonic waves may be used.
  • the medical instrument guide apparatus 1 is configured using a nonmagnetic material.
  • the material can be appropriately changed in accordance with the visualization means.
  • materials for forming the first, second, and third covering means and the holding portion 3 resin, metal, ceramics, rubber, and the like are applicable.
  • MRI is used as a visualization means, application of a nonmagnetic metal is desirable when using a metal.
  • capsules containing hydrogen atoms are arranged as means for identifying and registering the relative position of the medical instrument guide device 1 with respect to the human body 13 is not limited to this.
  • a contrast agent capsule such as gadolinium may be used, and any means may be used as long as the posture / position of the medical instrument guide device can be identified by the visualization means.
  • a stage or the like may be provided between the medical instrument guide apparatus 1 and the MRI as means for determining the mechanical position for the MRI.
  • the configuration of the positioning means is not limited to the configuration of the piezoelectric actuator and the optical position detection means.
  • the position detection means an electromagnetic or capacitance encoder may be used in accordance with the visualization means.
  • the scale may be used as a position detecting unit, and the relative rotation angle between the fixed part and the rotating part may be measured.
  • a piezoelectric actuator inside the positioning means, and a motor or actuator is provided outside the positioning means, and the positioning means has only a transmission mechanism such as a link mechanism or a gear to drive an external motor or actuator.
  • the structure which transmits force may be sufficient.
  • a pneumatic actuator such as McKibben, or an actuator that operates by water pressure or hydraulic pressure may be applied.
  • the positioning means does not need to include an actuator, and may be a guide that has only position detection means and is operated manually.
  • the first and second positioning means which are rotary type positioning means, have sliding bearings 33 and 43, but smooth relative movement between the fixed portion and the rotating portion by a bearing such as a rolling bearing or an air bearing. May be realized.
  • the puncture operation is performed manually by a doctor, but an actuator for performing automatic puncture may be provided separately.
  • the holding unit 3 may include an actuator, a roller, and a position detection unit that automatically feed a medical instrument.
  • the holding unit can be configured so that the actuator and the position detection means that perform automatic feeding are sealed with resin by in-mold injection, the actuator and the position detection means provided in the holding unit 3 cannot be sterilized. However, there is a possibility that sterilization of the holding unit 3 may be facilitated.
  • the third covering means 10 and the holding unit 3 do not have to be formed separately, and may be formed integrally. By making it an integral part, the number of parts can be reduced, and mechanical errors caused by assembly can be reduced.
  • the example in which the electric substrate 11 is sealed inside the first covering means 8 is shown.
  • a sterilizable substrate is attached to the side surface of the first covering means 8.
  • a non-sterile person or the like may assemble an electric substrate that does not support sterilization.
  • the non-sterile person is assembled with the side surface of the first covering means 8
  • the area where the non-sterile person touches May be clearly defined as follows.
  • a grip portion for contact with a non-sterile person may be provided on the outer surface.
  • the area touched by the non-sterile person may be clearly displayed, for example, by color-coding the grip portion.
  • the outer surface is covered with a sterilized cover or film in advance, and the non-sterile person touches only the side surface of the cover or film, and the cover or film is removed after assembly.
  • a configuration in which the side surface of the means 8 can be touched is also possible.
  • the second covering means 4 since the second covering means 4 is placed on the sterilization sheet 15, the second covering means 4 itself does not necessarily have to be sterilized. In that case, the second covering means 4 may be handled by the non-sterile person, without touching the second person.
  • the first covering means 8 since the second covering means 4 is sterilized, the first covering means 8 does not need to cover the inside of the second covering means, and at least covers a base that is not sterilized. At this time, the lower end of the 1st coating
  • the third covering means 10 is not necessarily required.
  • the staple person needs to attach the holding unit 3 to the second positioning means 9 so as not to touch the second positioning means 9 that is not sterilized.
  • the holding unit 3 may be attached with the sterilization sheet 17 interposed therebetween.
  • the third covering means 10 is shown as a configuration covering the upper end portion and the side surface of the second positioning means 9, but this is not restrictive.
  • the covering range may be expanded by covering the first covering means 8 and the side surfaces of the medical instrument guide device.
  • the sterilization sheet 17 is not necessarily provided, and the process A10 in the workflow can be omitted.
  • the third covering means may cover the side surface of the second positioning means 9.
  • the structure which covers only the upper end surface of may be sufficient.
  • the holding unit 10 and the third covering unit may be integrally formed so that the steril person can hold the sterilized holding unit.
  • Steps A03 to A09 are separately assembled in an environment in which sterilization of the sterilized components is guaranteed to be maintained.
  • a medical instrument guide device assembled in advance on the human body 13 may be installed. In this case, when grasping a site where the sterilized state is maintained, the stereo person installs the medical instrument guide device, and when grasping a non-sterile site, the non-sterile person installs the medical instrument guide device. It is desirable to do.
  • the present invention it is possible to appropriately change the configuration of the medical instrument guide device and the material forming them according to the target of surgery and the workflow of each surgical procedure. Conversely, it is possible to appropriately change the operation workflow according to the configuration of the visualization means and the medical instrument guide apparatus.
  • FIG. 6A is a schematic perspective view of the medical instrument guide apparatus 101 according to the second embodiment
  • FIG. 6B is a schematic perspective view of the medical instrument guide apparatus 101 in which the fourth covering means 122 is not displayed. Is shown.
  • FIG. 6 (c) shows a schematic development view of the fourth covering means 122.
  • the first covering means 108 has an opening 108a as in the first embodiment, and a lateral hole 108b is provided on the side surface of the first covering means 108.
  • the edges forming the lateral holes 108b are desirably blended as shown in the figure and do not include sharp portions.
  • the translucent film-like fourth covering means 122 is attached to the side surface of the first covering means 108 so that the region 122b covers the lateral hole 108b.
  • the fourth covering means 122 is provided with a lug 122a, and the fourth covering means 122 can be removed from the first covering means 108 by pulling and pulling the lug 122a.
  • the first covering means 108 and the fourth covering means 122 are integrally sterilized.
  • FIG. 7A is a schematic cross-sectional view of the medical instrument guide device 101 cut along a plane parallel to the zx plane passing through the center of the medical instrument 2.
  • FIG. 7B illustrates the state in which the fourth covering means 122 is removed and the doctor puts the hand 123 into the lateral hole 108b in FIG. 7A.
  • the first covering means 108 is fixed to the first positioning means 7 and can be rotated around the LL ′ axis relative to the base 6 in the same manner as in the first embodiment. It is.
  • the second positioning means 9 is fixed to the first covering means 108, and the second rotating portion 42 and the third covering means 10 are the first covering means 108 as in the first embodiment.
  • the first covering means 108 uses, for example, polyetheretherketone (PEEK), which is a hard resin, and incorporates the electric substrate 11 by in-mold injection, as in the first embodiment.
  • PEEK polyetheretherketone
  • the molding temperature of polyetheretherketone (PEEK) is as high as about 400 [° C.], so that in-mold injection is applied to electronic components such as ICs mounted on the electric substrate 11.
  • the resin in the molten state is designed so as not to touch, or has a means for protecting the electronic component under a high temperature condition.
  • FIG. 8 shows an example of a puncture operation workflow in the second embodiment.
  • the operation is started (B00).
  • the sterle person puts a sterilized sheet 15 with holes on the human body (B01).
  • the puncture point and the center of the hole of the sterilization sheet 15 are substantially aligned, and the hole has a size necessary for operations such as puncture and disinfection.
  • the second covering means 4 is placed on the sterilizing sheet 15 so that the center person aligns the center of the opening 4a of the second covering means and the hole of the sterilizing sheet 15 (B02). At this time, it is desirable to fix the second covering means 4 to the human body 13 so as not to be displaced by a tape, a band, or other fixing means (not shown).
  • the serial person installs the RF coil 5 on the second covering means 4 for receiving the RF wave (B03).
  • the non-sterile person installs the base 6 on the second covering means 4 (B04).
  • the non-sterile person incorporates the first positioning means 7 into the base 6 (B05).
  • the non-sterile person incorporates the first covering means 108 into the first positioning means 7 while holding the side surface of the first covering means 108 (B06).
  • the first covering means 108 is sterilized integrally with the fourth covering means 122 in advance, and the non-sterile person has the first covering means 108 via the fourth covering means 122.
  • the first covering means 8 is assembled without directly touching.
  • first covering means 108 and the first positioning means 7 are precisely positioned and fixed by various machine elements such as fitting, positioning pins, keys, bayonets, snap fits and the like.
  • first covering means 108 is incorporated into the first positioning means 7, and at the same time, the electrical connection with the electric substrate 11 provided on the first covering means 108 is achieved by coupling with the connection portion 32. This is a configuration that can be connected to an electrical component group provided on the base 6.
  • the non-sterile person incorporates the second positioning means 9 into the first covering means 8 (B07). It is desirable that the first covering means 108 and the second positioning means 9 are precisely positioned and fixed by various mechanical elements such as fittings, positioning pins, keys, bayonets, and snap fits.
  • the second positioning means 9 is incorporated into the first covering means 108, and at the same time, the electrical connection with the electric substrate 11 provided on the first covering means 108 is achieved by coupling with the connection portion 32. Done.
  • the stereo person incorporates the third covering means 10 into the second positioning means 9 (B08).
  • the non-sterile person pulls the lug 122a while pulling it, thereby removing the fourth covering means 122 (B09).
  • the non-sterile person is removed without touching the first covering means 108 and the third covering means 10.
  • the staple person incorporates the holding unit 3 into the third covering means 10 (B10), and covers the base 6 with a sterilized sheet 117 having a hole (B11) so that the base 6 is not exposed.
  • the size of the hole is the same as or slightly smaller than the outer dimension of the first covering means 108 on which the second positioning means 9 is mounted, and is covered so as to suppress the exposure of the base 6 as much as possible. Is desirable.
  • MRI which is a visualization means (B12).
  • the means for measuring the position and orientation of the medical instrument guide device 1 is the same as in the above-described embodiment.
  • the rotation angles of the first and second rotational positioning means are calculated, and the first and second rotational positioning means Is set to a predetermined angle (B13).
  • the doctor passes the medical instrument 2 through the holding unit 3, performs a therapeutic action by ablation (B14), and ends the operation (B15).
  • the doctor can visually check the affected area through the horizontal hole 108b, and insert the doctor's hand (FIG. 7B) or a sterilized medical instrument into the horizontal hole 108b, thereby providing accessibility to the affected area. It is possible to improve.
  • the form in which the fourth covering means 122 formed in a film shape is used as the covering means for covering the lateral hole 108b of the first covering means 108, but the configuration of the fourth covering means 122 is the same. It is not limited.
  • the fourth covering means 122 may be realized by a cap shape made of silicon rubber or the like.
  • the first and fourth coating means may be sterilized integrally, or may be combined after sterilization individually.
  • Steps B03 to B08 and B10 are separately assembled in an environment in which sterilization of the sterilized components is guaranteed to be maintained.
  • a medical device guide device assembled in advance on the human body 13 may be installed.
  • the stereo person when grasping a site where the sterilized state is maintained, the stereo person installs the medical instrument guide device, and when grasping a non-sterile site, the non-sterile person installs the medical instrument guide device. It is desirable to do. In this case, it is desirable to remove the fourth covering means (B09) by non-sterile person after the installation of the medical instrument guide device.
  • the present invention it is possible to appropriately change the configuration of the medical instrument guide device and the material forming them according to the target of surgery and the workflow of each surgical procedure. Conversely, it is possible to appropriately change the operation workflow according to the configuration of the visualization means and the medical instrument guide apparatus.
  • FIG. 9 is a schematic perspective view of a medical instrument guide apparatus 201 according to the third embodiment.
  • an electric substrate 211 is provided on the side surface of the first covering means 208.
  • the medical instrument guide device 201 includes fifth covering means 224 inside the opening.
  • the fifth covering means 224 has a bellows part having an opening 224a, and can be freely deformed in the expansion / contraction direction and the bending direction.
  • FIG. 10 is a schematic cross-sectional view of the medical instrument guide device 201 taken along a plane parallel to the zx plane passing through the center of the medical instrument 2.
  • the freely deformable configuration is not limited to the bellows configuration, and other configurations / members may be used as long as they can be deformed and / or expanded / contracted.
  • the first covering means 208 is treated as a component that cannot be sterilized by exposing the electric substrate 211.
  • the fifth covering means is a component that is made of resin, silicon rubber, or the like and can be easily sterilized.
  • the same reference numerals as in the above-described embodiment are used as to whether sterilization is necessary or not.
  • FIG. 12 shows an example of a workflow.
  • the operation is started (C00).
  • the sterle person puts a sterilized sheet 15 with holes on the human body (C01).
  • the puncture point and the center of the hole of the sterilization sheet 15 are substantially aligned, and the hole has a size necessary for operations such as puncture and disinfection.
  • the second covering means 4 is placed on the sterilizing sheet 15 so that the center person aligns the center of the opening 4a of the second covering means 4 and the hole of the sterilizing sheet 15 (C02). At this time, it is desirable to fix the second covering means 4 to the human body 13 so as not to be displaced by a tape, a band, or other fixing means (not shown).
  • the serial person installs the RF coil 5 on the second covering means 4 for receiving the RF wave (C03).
  • the non-sterile person installs the base 6 on the second covering means 4 (C04).
  • the non-sterile person incorporates the first positioning means 7 into the base 6 (C05).
  • the non-sterile person incorporates the first covering means 208 into the first positioning means 7 (C06). It is desirable that the first covering means 208 and the first positioning means 7 are precisely positioned and fixed by various machine elements such as fittings, positioning pins, keys, bayonets, and snap fits.
  • first covering means 208 is incorporated into the first positioning means 7 and at the same time, the electrical connection with the electric substrate 211 provided on the first covering means 208 is achieved by coupling with the connecting portion 32. Then, connection with the electrical component group provided on the base 6 is made.
  • the non-sterile person incorporates the second positioning means 9 into the first covering means 208 (C07). It is desirable that the first covering means 208 and the second positioning means 9 are precisely positioned and fixed by various mechanical elements such as fittings, positioning pins, keys, bayonets, and snap fits. Further, the second positioning means 9 is incorporated into the first covering means 208, and at the same time, the electrical connection with the electric substrate 211 provided on the first covering means 208 is achieved by coupling with the connecting portion 32. Made.
  • the stereo person incorporates the third covering means 10 into the second positioning means 9 (C08).
  • the stage person installs the fifth covering means 224 inside the medical instrument guide apparatus 201 as shown in FIG. 10 (C09). At this time, it is desirable that the stereo person is installed so that the opening 224a and the center of the hole of the sterilization sheet 15 are substantially aligned.
  • the staple person incorporates the holding unit 3 into the third covering means 10 (C10), and covers the entire medical instrument guide device 1 with a sterilized sheet 17 having a hole (C11). It is desirable that the size of the hole is approximately the same as that of the second opening 9a or the opening 224a of the fifth covering means 224. It is desirable to cover the second opening 9a so that the center of the second opening 9a and the center of the hole of the sterilization sheet are substantially aligned.
  • relative coordinate position and posture measurement of the medical instrument guide apparatus 201 with respect to the human body 13 is performed using MRI which is a visualization means (C12).
  • Means for measuring the position and orientation of the medical instrument guide device 201 are the same as those in the above-described embodiment.
  • the rotation angles of the first and second positioning means are calculated, and the first and second rotational positioning means The rotation angle is set to a predetermined angle (C13).
  • the fifth covering means 224 freely changes its shape to follow the movement of the first and third covering means.
  • the doctor passes the medical instrument 2 through the holding unit 3, performs a therapeutic action by ablation (C14), and ends the operation (C15).
  • the medical instrument guide device 201 is clinically treated. It can be adapted to the workflow.
  • the fifth covering means 224 can be made disposable by producing it by molding an inexpensive resin or silicon rubber. By using disposable parts, it is possible to improve the safety of the surgery and reduce the total cost by omitting the cleaning and sterilization steps after the surgery.
  • the base 7, the first positioning means 7, the first covering means 208, and the second covering means 4 may be assembled in advance.
  • the steps C04 to C07 can be replaced with one step, the workflow is further simplified, the operation time can be shortened, and the burden on the non-sterile person is reduced.
  • the first covering means 208 has been treated as being incapable of sterilization, a sterilizable thing similar to the first covering means 8 in the first embodiment may be applied. Assuming that the non-sterile person may accidentally touch the inside of the first covering means, the fifth covering means can be used to more securely separate the sterilized area from the non-sterile area. It becomes possible.
  • Steps C03 to C08 and C10 are separately assembled in an environment in which sterilization of the sterilized components is guaranteed to be maintained.
  • a medical device guide device assembled in advance on the human body 13 may be installed.
  • the stereo person when grasping a site where the sterilized state is maintained, the stereo person installs the medical instrument guide device, and when grasping a non-sterile site, the non-sterile person installs the medical instrument guide device. It is desirable to do.
  • the escape portion may be provided in the fifth covering means.
  • the present invention it is possible to appropriately change the configuration of the medical instrument guide device and the material forming them according to the target of surgery and the workflow of each surgical procedure. Conversely, it is possible to appropriately change the operation workflow according to the configuration of the visualization means and the medical instrument guide apparatus.
  • FIG. 13 shows a schematic perspective view of the third covering means 310 with the bellows mechanism in the present embodiment.
  • FIG. 14 is a schematic cross-sectional view of the medical instrument guide device 301 in the fourth embodiment cut along a plane parallel to the zx plane passing through the center of the medical instrument 2.
  • the first covering means 208 is treated as a component that cannot be sterilized by exposing the electric substrate 211 as in the third embodiment.
  • the third covering means with a bellows mechanism is composed of a bellows mechanism 310d, a covering portion 310b, and a connecting portion 310c, all of which are configured to be integrally sterilizable.
  • the bellows mechanism 310d is formed of a general resin, silicon rubber, or the like
  • the covering portion 310b is formed of a polyether ether ketone (PEEK) that is a hard resin.
  • PEEK polyether ether ketone
  • the connecting portion 310c is preferably formed of natural rubber, nitrile rubber or the like having high stretchability.
  • the same reference numerals as in the above-described embodiment are used as to whether sterilization is necessary or not.
  • steps A01 to A07 are the same as those described with reference to FIG. However, the difference from the details of step A06 of the first embodiment is that the first covering means 208 is not sterilized.
  • the staple person incorporates the third covering means 310 with the bellows mechanism into the second positioning means 9 (A08).
  • the second positioning means 9 and the third covering means 310 are precisely positioned and fixed by various machine elements such as fitting, positioning pins, keys, bayonet, snap fit, and the like. Further, when the third covering means 310 is incorporated, the steril person does not touch the non-sterilized second positioning means 9.
  • the staple person incorporates the holding portion 3 into the third covering means 310 with the bellows mechanism (A09), and covers the entire medical instrument guide device 301 with the sterilized sheet 17 having a hole (A10). It is desirable that the size of the hole is formed to be approximately the same size as the second opening 9a or the opening 310a of the third covering means 310 with the bellows mechanism. It is desirable to cover the second opening 9a so that the center of the second opening 9a and the center of the hole of the sterilization sheet are substantially aligned.
  • the remaining steps A11 to A14 are performed in the same manner as described with reference to FIG. These detailed explanations are omitted.
  • the bellows mechanism 310d of the third covering means 310 with the bellows mechanism can be freely changed in shape to move the first and second covering means.
  • the installation of the third covering means 310 with the bellows mechanism causes the connecting portion 310c to connect the covering portion 310b and the bellows mechanism 310d over the entire circumference. It is possible to prevent exposure of the non-sterile part.
  • the present embodiment in which the third covering means and the fifth covering means (bellows mechanism) described in the third embodiment are integrated, thereby reducing the number of component components of the medical instrument guide device 301 and the sterilization process. There is an advantage that the workflow can be simplified.
  • the connecting portion 310c is formed of a stretchable rubber.
  • a material having low stretchability is applied, and the bellows mechanism of the bellows 310d is bent instead of expanding and contracting the connecting portion 310c.
  • the movement of the first and second covering means may be followed using elasticity.
  • the covering portion 310b, the bellows 310d, and the connecting portion 310c do not need to be formed of different materials, and may be formed of the same material and integrally by injection molding. Since the number of man-hours is reduced, it leads to cost reduction and it is easy to handle as disposable parts.
  • the medical instrument guide assembled in advance in the environment in which it is ensured that the sterilized state of the sterilized components is maintained, and pre-assembled on the human body 13 before the step A10.
  • a device may be installed.
  • the present invention it is possible to appropriately change the configuration of the medical instrument guide device and the material forming them according to the target of surgery and the workflow of each surgical procedure. Conversely, it is possible to appropriately change the operation workflow according to the configuration of the visualization means and the medical instrument guide apparatus.
  • FIG. 16 is a schematic cross-sectional view of the medical instrument guide device 401 according to the fifth embodiment taken along a plane parallel to the zx plane passing through the center of the medical instrument 2.
  • the first covering means 208 is treated as a component that cannot be sterilized by exposing the electric substrate 211 as in the third embodiment.
  • FIG. 15 shows a schematic perspective view of the second covering means 404 with a bellows mechanism in the present embodiment.
  • coated means 404 with a bellows mechanism is comprised from the bellows-shaped coating
  • the covering portion 404d is formed of a general resin, silicon rubber, or the like
  • the covering portion 404b is formed of a polyether ether ketone (PEEK) that is a hard resin.
  • PEEK polyether ether ketone
  • the connecting portion 404c provided in the covering portion 404b restricts the movement of the covering portion 404d in the vertical direction (z-axis direction).
  • the covering means 404b not only functions as a covering, but also serves as a support member that supports the bellows-shaped covering portion 404d and stabilizes the position.
  • coordinate axes 404s, 404i, 404r, and 404l of the human body coordinate system are engraved on the covering portion 404b as rough marks when the cover portion 404b is installed on the human body 13.
  • 404s indicates the head direction (superior)
  • 404i indicates the lower limb direction (inferior)
  • 404r indicates the right hand direction (right)
  • 404l indicates the left hand direction (left).
  • the same reference numerals as in the above-described embodiment are used as to whether sterilization is necessary or not.
  • the connecting portion 404c connects the covering portions 404b and 404d over the entire circumference by the installation of the second covering means 404 with the bellows mechanism, the non-sterile is prevented due to the expansion and contraction of the bellows. Preventing the exposure of the part and ensuring separation from the non-sterile part near the skin leads to further improvement of the safety of the operation. Further, according to the present embodiment in which the second covering means and the fifth covering means are integrated, the number of parts constituting the medical instrument guide device 401 is reduced, and the second covering means 404 is made disposable so that it can be sterilized. There is an advantage that the process and the workflow can be simplified.
  • the connecting portion 404c combines the covering portion 404b and the covering portion 404d (bellows mechanism) so as to restrict the vertical movement of the covering portion 404d (bellows mechanism).
  • the covering portion 404b and the covering portion 404d may be integrally formed by injection molding or the like. In this case, since the number of parts manufacturing steps can be further reduced, the cost can be reduced and it can be easily handled as a disposable part. Further, by forming the side surface of the covering portion 404d (bellows mechanism) into a male screw shape and the connecting portion 404c as a female screw shape, the covering portion 404d (bellows mechanism) may be connected to be screwed into the covering portion 404b. Good. At this time, a bayonet mechanism may be employed in addition to the screw shape.
  • the sterilization sheet 15 is put on the human body 13 in FIG. 16, but since the second covering means 404b is sterilized, the sterilization sheet 15 in FIG. 16 and the process A01 in FIG. It can be omitted as appropriate.
  • the medical instrument guide assembled in advance in the environment in which it is ensured that the sterilized state of the sterilized components is maintained, and pre-assembled on the human body 13 before the step A10.
  • a device may be installed.
  • FIG. 17A shows a schematic perspective view of the medical instrument guide device 501
  • FIG. 17B is a plane parallel to the zx plane passing through the center of the medical instrument 2, and the medical instrument in the sixth embodiment.
  • disconnecting the instrument guide apparatus 501 is shown.
  • FIG. 17C is an enlarged view of a region E surrounded by a broken line in FIG.
  • 506 is a base
  • 508 is a first covering means
  • 504 is a second covering means.
  • the first covering means 508 and the second covering means 504 have openings 508a and 504a, respectively.
  • the first covering means 508 incorporates the electric substrate 11 by in-mold injection, as in the first embodiment.
  • the first covering means 508 and the second covering means 504 are handled as sterilizable members
  • the base 506 is handled as a part that cannot be sterilized by exposure of electronic parts.
  • the first covering means 508 and the second covering means 504 form a labyrinth mechanism 520 and can be rotated around the LL ′ axis without relative interference. is there.
  • the same reference numerals as in the above-described embodiment are used as to whether sterilization is necessary or not.
  • the shapes of the first covering means 508 and the second covering means 504 are the same as those of the first covering means 8 and the second covering means 4 described in the first embodiment. Is different. However, similarly, the first covering means and the second covering means can be installed, and an example of a surgical procedure (workflow) when performing the puncture operation described with reference to FIG. 5 is applicable.
  • the first covering means 508 covers a part of the first opening 7a that is not sterilized, and the second covering means 504 is not sterilized and the first base 506 and the first positioning means 7 are covered.
  • the openings 506a and 7a are partially covered.
  • the first covering means 508 and the second covering means 504 form a labyrinth mechanism 520, so that the non-sterile area is prevented from being exposed to the sterilization area, and wear powder such as a bearing flows into the sterilization area. Risk can be kept low, leading to further improvement in the safety of surgery.
  • the sterilization sheet 15 is put on the human body 13, but since the second covering means 504 is sterilized, the sterilization sheet 15 in FIG. Step A01 can be omitted as appropriate.
  • the medical instrument guide assembled in advance in the environment in which it is ensured that the sterilized state of the sterilized components is maintained, and pre-assembled on the human body 13 before the step A10.
  • a device may be installed.
  • the second covering means 504 is provided for the first positioning means 7, and the first covering means 508 is provided for the second positioning means 9.
  • the first covering means may be provided for the first positioning means 7. That is, you may comprise the 1st coating
  • the present invention supplies a program that realizes one or more functions of the above-described embodiments to a system or apparatus via a network or a storage medium, and one or more processors in a computer of the system or apparatus read and execute the program This process can be realized. It can also be realized by a circuit (for example, ASIC) that realizes one or more functions.
  • a circuit for example, ASIC

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Pathology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

Dans la présente invention, un dispositif de guidage d'équipement médical est caractérisé par le fait d'être muni d'au moins une partie de retenue destinée à retenir et à guider l'équipement médical, d'un moyen de positionnement permettant de déterminer l'orientation de la partie de retenue, et d'au moins un moyen de recouvrement. Le moyen de recouvrement recouvre le moyen de positionnement, et l'équipement médical est disposé par rapport au moyen de positionnement recouvert.
PCT/JP2016/068799 2015-06-24 2016-06-24 Dispositif de guidage d'équipement médical WO2016208711A1 (fr)

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US201562184083P 2015-06-24 2015-06-24
US62/184,083 2015-06-24

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2019010232A1 (fr) 2017-07-07 2019-01-10 Canon U.S.A. Inc. Planification d'ablation à sondes multiples
JP2021528114A (ja) * 2018-04-20 2021-10-21 バーブ サージカル インコーポレイテッドＶｅｒｂ Ｓｕｒｇｉｃａｌ Ｉｎｃ． ロボットポート配置ガイド及び使用方法

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6254533B1 (en) * 2000-07-07 2001-07-03 Dexterity Surgical, Inc. Retractor assembly and method for surgical procedures
US20060184166A1 (en) * 2005-02-16 2006-08-17 Moises Valle Method and apparatus to automatically insert a probe into a cornea
JP2006314703A (ja) * 2005-05-16 2006-11-24 Fujinon Corp 腹腔鏡用支持装置
WO2014152685A1 (fr) * 2013-03-15 2014-09-25 The Brigham And Women's Hospital Manipulateur de placement d'aiguille ayant deux guides rotatifs
JP2014205041A (ja) * 2014-05-20 2014-10-30 株式会社八光 医療用処置具の挿入器具
JP2015507506A (ja) * 2012-01-10 2015-03-12 ボード オブ リージェンツ オブ ザ ユニバーシティ オブ ネブラスカ 外科的アクセスおよび挿入のための方法、システムならびに装置

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6254533B1 (en) * 2000-07-07 2001-07-03 Dexterity Surgical, Inc. Retractor assembly and method for surgical procedures
US20060184166A1 (en) * 2005-02-16 2006-08-17 Moises Valle Method and apparatus to automatically insert a probe into a cornea
JP2006314703A (ja) * 2005-05-16 2006-11-24 Fujinon Corp 腹腔鏡用支持装置
JP2015507506A (ja) * 2012-01-10 2015-03-12 ボード オブ リージェンツ オブ ザ ユニバーシティ オブ ネブラスカ 外科的アクセスおよび挿入のための方法、システムならびに装置
WO2014152685A1 (fr) * 2013-03-15 2014-09-25 The Brigham And Women's Hospital Manipulateur de placement d'aiguille ayant deux guides rotatifs
JP2014205041A (ja) * 2014-05-20 2014-10-30 株式会社八光 医療用処置具の挿入器具

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2019010232A1 (fr) 2017-07-07 2019-01-10 Canon U.S.A. Inc. Planification d'ablation à sondes multiples
JP2021528114A (ja) * 2018-04-20 2021-10-21 バーブ サージカル インコーポレイテッドＶｅｒｂ Ｓｕｒｇｉｃａｌ Ｉｎｃ． ロボットポート配置ガイド及び使用方法
JP7130770B2 (ja) 2018-04-20 2022-09-05 バーブ サージカル インコーポレイテッド ロボットポート配置ガイド及び使用方法

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