WO2017000538A1 - Dispositif de positionnement précis en forme d'arc capable d'être assemblé et désassemblé - Google Patents

Dispositif de positionnement précis en forme d'arc capable d'être assemblé et désassemblé Download PDF

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Publication number
WO2017000538A1
WO2017000538A1 PCT/CN2016/070142 CN2016070142W WO2017000538A1 WO 2017000538 A1 WO2017000538 A1 WO 2017000538A1 CN 2016070142 W CN2016070142 W CN 2016070142W WO 2017000538 A1 WO2017000538 A1 WO 2017000538A1
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WO
WIPO (PCT)
Prior art keywords
rod
horizontal
circular arc
rocker
shaped
Prior art date
Application number
PCT/CN2016/070142
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English (en)
Chinese (zh)
Inventor
贺石生
范国鑫
Original Assignee
贺石生
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
Priority claimed from CN201510378745.6A external-priority patent/CN105125285B/zh
Priority claimed from CN201510796405.5A external-priority patent/CN105232122B/zh
Application filed by 贺石生 filed Critical 贺石生
Priority to CN201680000494.0A priority Critical patent/CN105916463B/zh
Publication of WO2017000538A1 publication Critical patent/WO2017000538A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/02—Instruments for taking cell samples or for biopsy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M19/00—Local anaesthesia; Hypothermia

Definitions

  • the invention belongs to the technical field of medical instruments, in particular to a detachable assembly arc-shaped precise positioning device.
  • the minimally invasive technique of the spine is to reduce the trauma of the surrounding tissue to minimize the surgical incision, less tissue damage, lighter systemic response, quick recovery period and good psychological effect.
  • minimally invasive spine technology has developed rapidly, and has achieved good practical results and good social benefits in the clinical treatment of spinal diseases. More and more spine surgeons have begun to pay attention to and carry out minimally invasive techniques for the spine.
  • minimally invasive spine techniques require precise surgical procedures within a limited field of view that must rely on the positioning of imaging equipment.
  • the traditional minimally invasive technique of the spine technique has low accuracy and many times of perspective, which leads to repeated radiation exposure of patients and medical staff, which is an important factor limiting the development of minimally invasive techniques.
  • Puncture is one of the commonly used examination methods or treatment methods in clinical medicine, and is of great value for the diagnosis and treatment of diseases.
  • the existing puncture methods often require puncture under fluoroscopy, and the direction and depth of puncture can be determined only by repeated perspective.
  • the location of the puncture is not necessarily accurate.
  • This method of relying solely on sensation is not accurate enough, and often requires a wealth of surgical experience, and can be completed with repeated perspective; both increase the operation time, and expose the medical staff and patients to X-ray radiation multiple times. If the positioning is not accurate, it will inevitably cause unnecessary structural damage, thereby increasing damage.
  • the object of the present invention is to overcome the defects of the prior art described above and to provide a detachable assembly arc-shaped precise positioning device capable of more accurate surgical positioning, shorter operation time, simple operation and less radiation of medical personnel.
  • a detachable assembly arc-shaped precise positioning device comprises a support unit and a three-dimensional adjustment unit, wherein the three-dimensional adjustment unit is connected with the support unit, and further comprises a guide positioning unit, wherein the guide positioning unit comprises a circular arc track and a guide Rod, holder and locator,
  • the guiding and positioning unit is further provided with a second slider, the second sliding block is connected to the three-dimensional adjusting unit, and the circular arc-shaped track is disposed on the second sliding block and can slide on the second sliding block
  • the second slider together with the circular arc track can be rotated in situ on the three-dimensional adjustment unit at an arbitrary angle around the vertical axis, and the three-dimensional adjustment unit drives the second slider and the circular arc track thereon , left and right, front and back three dimensions,
  • the guiding rod is connected on the circular arc track, and the guiding rod can slide along the circular arc track or move along the long axis direction of the guiding rod.
  • the holder is disposed on the guide rod for fixing the surgical instrument
  • the locator is provided with two rays emitted by two locators, and the axis of the holder is parallel or coincident with the radial line of the circular arc track, and the three lines are on the same plane, and the plane Parallel or coincide with the plane in which the circular arc is located, the three lines intersect at one point.
  • the two locators may be arranged on a circular arc track, or one locator may be arranged on a circular arc track, and another locator may be arranged in the three-dimensional adjustment unit.
  • the holder may be a needle guide, and the needle guide may be used to fix the needle.
  • the circular arc track length is at least a quarter arc length, and may be, for example, a quarter to a third arc.
  • the locator can emit visible light or infrared light. More preferably, the locator may be a laser locator or an infrared locator.
  • the support unit is selected from one of the following forms:
  • (a) is an L-shaped base, and the bottom of the L-shaped base is provided with a roller;
  • (d) is composed of a plurality of fixed arms, and the two fixed arms are hinged by a universal joint.
  • the above supporting unit can also be driven and fixed by means of pneumatic or electric motor.
  • the three-dimensional adjustment unit includes a lifting adjustment unit and a horizontal adjustment unit: the lifting adjustment unit can make a circle The curved track moves up and down, and the horizontal adjusting unit can move the circular arc track in the horizontal plane back and forth, left and right.
  • the three-dimensional adjustment unit may be composed of a common mechanical structure such as a screw or a screw rod, or may be constituted by a commonly used three-dimensional moving platform, and may be driven by a pneumatic or electric motor.
  • One of the implementations of the three-dimensional adjustment unit is:
  • the lifting and lowering adjustment unit is composed of two height-adjustable lifting rods, and is connected to the supporting unit through a fixing block, and the lifting movement of the lifting rod is adjusted by the rocking rod.
  • the lifting adjustment unit includes a first fixing block, a first lifting rod, a second lifting rod and a first rocking rod, and the first fixing block is mounted on a vertical arm of the L-shaped base, The first lifting rod and the second lifting rod are parallel to each other and vertically pass through the first fixing block, and the first rocking rod is mounted on the top of the vertical arm of the L-shaped base, and the A lifting rod and a second lifting rod are vertically connected, and the first lifting rod and the second lifting rod are driven to move up and down by rotating the first rocking rod.
  • the horizontal adjustment unit includes a second fixed block, a first horizontal rod, a second horizontal rod, a second rocker and a third fixed block, and the second fixed block is mounted on the first lifting rod and the second lifting rod.
  • the first horizontal rod and the second horizontal rod are parallel to each other and one end is horizontally passed through the second fixed block, and the other end is connected to the third fixed block, the second
  • the rocker is vertically connected to the first horizontal rod and the second horizontal rod, and the first horizontal rod and the second horizontal rod are driven to rotate left and right horizontally by rotating the second rocking rod.
  • the first slider and the first adjustment knob are further movably mounted on the third fixing block, and the first adjustment knob is connected to the first slider by controlling the first adjustment knob
  • the first slider is moved back and forth, and then the circular arc track is driven to perform horizontal movement before and after.
  • the guiding and positioning unit further includes a first locking knob and a second adjusting knob, wherein the circular arc track is connected to the second slider and the first locking knob is connected, and the second slider is connected with the second adjusting knob.
  • the second adjustment knob By controlling the second adjustment knob to drive the circular arc track to rotate around the vertical axis, by controlling the first locking knob, the circular arc track can be locked or opened around the center of the circle.
  • the guiding and positioning unit further includes a second locking knob and a second locking wrench.
  • One end of the guiding rod is connected to the third sliding block, and the other end is connected with a holder, which can be extended and contracted along the long axis of the guiding rod.
  • the second locking knob Moving, by controlling the second locking knob, the telescopic movement of the guiding rod in the third sliding block can be locked, and the sliding movement of the third sliding block in the circular arc-shaped track can be locked by the second locking wrench.
  • the circular arc track, the first slider, the second slider, the third slider, the guide rod, and the needle guide can be easily disassembled, and can be used in surgery after being assembled and assembled lightly.
  • the detachable assembly arc-shaped precise positioning device further includes a storage rack horizontally mounted on the vertical rail for placing an instrument box during a surgical procedure, and placing the instrument box therein At least one set of sterilized circular arc-shaped rails, a first slider, a second slider, a third slider, a guide rod and a gripper or a needle guide, the total weight of the instrument box is not greater than the weight of the orthopedic instrument package.
  • a detachable assembly arc-shaped precise positioning device comprising:
  • Supporting unit an L-shaped base, the bottom of the L-shaped base is provided with a roller, and the base is provided with a roller and a ground-fixing brake device, which is convenient for moving and fixing the detachable assembled arc-shaped precise positioning device.
  • Lifting and adjusting unit consisting of two height-adjustable lifting rods connected to the supporting unit by a fixing block.
  • the horizontal adjusting unit is composed of two horizontal rods with adjustable lengths, and is connected to the lifting unit through a fixing block, and the horizontal rod and the lifting rod are perpendicular to each other.
  • the guiding and positioning unit comprises: a circular arc track and a guiding rod with a gripper, wherein the circular arc track is movably connected to the horizontal adjusting unit, and the guiding rod is slidably connected to the circular arc track by the sliding block.
  • the lifting and lowering adjustment unit comprises: a first fixing block, a first lifting rod, a second lifting rod and a first rocking rod, wherein the first fixing block is mounted on a vertical arm of the L-shaped base, The first lifting rod and the second lifting rod are parallel to each other and vertically pass through the first fixing block, and the first rocking rod is mounted on the top of the vertical arm of the L-shaped base, and The first lifting rod and the second lifting rod are vertically connected, and the first lifting rod and the second lifting rod are driven to move up and down by rotating the first rocking rod.
  • the horizontal adjustment unit includes a second fixed block, a first horizontal rod, a second horizontal rod, a second rocker and a third fixed block, and the second fixed block is mounted on the top of the first lifting rod and the second lifting rod.
  • the first horizontal rod and the second horizontal rod are parallel to each other and one end is horizontally passed through the second fixed block, and the other end is connected to the third fixed block, the second rocker
  • the first horizontal rod and the second horizontal rod are vertically connected to the first horizontal rod and the second horizontal rod, and the first horizontal rod and the second horizontal rod are driven to rotate horizontally by rotating the second horizontal rod.
  • the guiding and positioning unit may be a guiding and puncturing unit: including a circular arc track, a first adjusting knob, a second adjusting knob, a third adjusting knob, a guiding rod and a gripper, the leading end of the circular arc track Connecting a first slider and a second adjustment knob, wherein the first slider is movably mounted on the third fixing block, and the first adjustment knob is connected to the first slider, and is controlled by the first The adjusting knob moves the first slider back and forth, thereby driving the circular arc track to move back and forth, and controlling the second adjusting knob to drive the circular arc track to rotate at any angle of 0-360 degrees around the vertical axis;
  • the third slider is slidably connected to the circular arc track, the guide rod is connected to the holder at one end, and the third end is connected to the other end, and the guide rod can be telescopically moved along the long axis direction thereof.
  • the third adjustment knob is connected to the third slider, and the third slider is driven to move the guide rod along the circular arc track by controlling the third adjustment knob.
  • the detachable assembly arc-shaped precise positioning device of the invention may further comprise a movable three-dimensional rocker arc-shaped guiding spinal puncture aid, comprising a ground movable supporting part, a three-dimensional rocker adjusting part, and a circular arc angle guiding Positioning section, where:
  • the ground movable support portion includes a foot, a vertical rod and a cylinder, the vertical rod is fixed at one end to the foot, and the cylinder is sleeved under the vertical rod for maintaining the overall balance of the auxiliary device; the three-dimensional rocker
  • the adjustment portion is composed of three threaded rockers, three extension rods and a horizontal locking wrench; one end of the third extension rod is connected to the other end of the vertical rod, and a horizontal locking wrench is arranged at the connection between the third extension rod and the vertical rod.
  • the other end of the third extension rod is respectively connected to one end of the second extension rod and one end of the first extension rod, and the third extension rod and the second extension rod are horizontally placed, the first extension rod is vertically placed, and the third extension rod is extended.
  • the rod and the first extension rod are arranged perpendicularly to each other, the first extension rod is connected to the seventh rocker, and is driven up and down by the seventh rocker, the second extension rod is connected to the fifth rocker, and the fifth rocker is driven by the fifth rocker Moving horizontally back and forth, the third extension rod is connected to the sixth rocker, and is driven by the sixth rocker to move left and right in the horizontal direction;
  • the horizontal calibrator is located on a third extension rod for adjusting the horizontal balance and locking the horizontal state by a horizontal locking wrench;
  • the arc-shaped angle guiding positioning portion comprises a circular arc-shaped track, a third rocker, a fourth rocker, a guide bar and a gripper, wherein the arc-shaped track is a quarter arc, and the scale is provided thereon.
  • the arc-shaped track is connected to the fourth rocker, and the arc-shaped track is adjusted by the fourth rocker for 360-degree vertical rotation.
  • One end of the arc is provided with a horizontal locator, and the other end is provided with a vertical locator, one end of the guide rod
  • the third slider is located on the circular arc track, and the guide bar slider is connected to the third rocker, and the guide bar can slide on the circular arc track by the third slider under the driving of the third rocker.
  • a rod is provided at one end of the rod, and the needle inlet of the holder can directly reach the puncture target point by the puncture needle.
  • the foot of the ground movable supporting portion has a roller that can be freely moved, and a brake device that can fix the ground.
  • the third rocker, the fourth rocker, the fifth rocker, the sixth rocker, the seventh rocker, the first extension pole, the second extension pole, and the third extension pole are all X-rays
  • the horizontal calibrator can be used as a reference for adjusting the horizontal position of the three-dimensional rocker adjusting portion, and the horizontal position is locked by the horizontal locking wrench.
  • the method for using the detachable assembled circular arc positioning device proposed by the present invention is as follows: according to the front, rear and lateral perspective, the projection of the target target on the back side and the side surface of the body surface is determined, and marked by a marker, Then adjust the horizontal locator and the vertical locator to align the two body surface markers to determine that the target point is the intersection of the ray emitted by the two locators and the long axis of the holder, and adjust the circular arc of the circular orbit according to different surgical segments. Rotate straight to the proper angle, and adjust the guide rod on the circular arc track to slide along the circular arc track to the appropriate position, which is the appropriate surgical entry point.
  • the long axis of the holder (including the needle guide) is parallel or coincident with the long axis of the guide rod and coincides with the long axis of the surgical instrument (including the puncture needle) fixed thereto.
  • the support unit and the three-dimensional adjustment unit of different solutions in the invention can be used interchangeably or in combination, further increasing the stability of the support, and the flexibility of coarse adjustment and fine adjustment in the three-dimensional direction.
  • the radial line of the circular arc-shaped track refers to the line connecting the center of the circular arc track with a point on the circular arc track.
  • the circular arc, the circular arc shape and the curved shape in the present invention can be used interchangeably, and both refer to a portion between any two points on the circle.
  • the present invention has the following advantages:
  • the detachable assembly arc-shaped precise positioning device proposed by the invention can assist the medical staff to perform surgery during the operation, and can be widely applied to the intervertebral foramen puncture, epidural anesthesia, spinal tumor biopsy, spinal abscess puncture Orthopaedic surgery such as drainage and surgery in other departments such as neurosurgery and general surgery;
  • the circular movement of the circular arc track relative to its fixing device can prevent the patient's body from blocking the circular arc orbiting around the vertical axis, especially for some operations that are difficult for the surgical approach, such as Pedicle screw placement, lateral position for intervertebral foramen surgery, etc., it is very important to adjust the surgical approach angle to the appropriate position and expand the surgeon's surgical operation space, with outstanding substantive effects;
  • the positioning device of the invention can greatly improve the accuracy of the positioning operation including the puncture, save the fluoroscopy time and improve the operation efficiency;
  • the arc-shaped track, the first slider, the second slider, the third slider, the guide rod, and the holder can be easily disassembled, and can be used in surgery after being assembled and assembled lightly.
  • FIG. 1 is a schematic perspective view showing a three-dimensional structure of a detachable assembly arc-shaped precise positioning device in Embodiment 1;
  • FIG. 2 is a schematic front view showing the structure of a detachable assembled arc-shaped precise positioning device in Embodiment 1;
  • FIG. 3 is a schematic top plan view of a detachable assembly arc-shaped precise positioning device in Embodiment 1;
  • FIG. 4 is a schematic structural view 1 of the guiding positioning unit in different states in Embodiment 1;
  • FIG. 5 is a schematic structural view 2 of the guiding positioning unit in different states in Embodiment 1;
  • FIG. 6 is a schematic structural view 3 of the guiding positioning unit in different states in the first embodiment, and the broken line is the long axis of the holder;
  • FIG. 7 is a schematic top plan view of the guiding and positioning unit in Embodiment 2, showing that the two positioning instruments are on the circular arc track, and the positional relationship between the two positioning instruments, the holder and the circular arc track;
  • the locator is installed in a circular arc track
  • B and C are sectional views of the third slider, the guide bar and the holder in A
  • D is two locators mounted on the outside of the circular arc track;
  • FIG. 8 is a schematic structural view of a detachable assembled arc-shaped precise positioning device in Embodiment 3;
  • FIG. 9 is a schematic structural view of a detachable assembled arc-shaped precise positioning device in Embodiment 3.
  • FIG. 10 is a schematic structural view of a detachable assembled arc-shaped precise positioning device in Embodiment 3;
  • FIG. 11 is a schematic structural view of a detachable assembled arc-shaped precise positioning device in Embodiment 4.
  • Figure 12 is a schematic view 1 of the puncture direction adjustment
  • Figure 13 is a schematic diagram 2 of the puncture direction adjustment
  • FIG. 14 is a schematic structural view of a detachable assembled arc-shaped precise positioning device in Embodiment 5;
  • FIG. 15 is a schematic structural view of a detachable assembled arc-shaped precise positioning device in Embodiment 3.
  • the figures are as follows: 1 vertical guide rail, 2 storage platform, 3 first fixed block, 4 first lifting rod, 5 second lifting rod, 6 first rocker, 7 third locking knob, 8 first locking wrench , 9 second rocker, 10 first horizontal bar, 11 vertical locator, 12 horizontal locator, 13 first adjustment knob, 14 second adjustment knob, 15 third fixed block, 16 first locking knob, 17 second Slider, 18 second locking wrench, 19 guide, 20 second locking knob, 21 third slider, 22 circular arc track, 23 gripper, 24 first slider, 25 second fixed block, 26 Two horizontal poles, 27 third rocker, 28 fourth rocker, 29 fifth rocker, 30 sixth rocker, 31 seventh rocker, 32 second extension pole, 33 first extension pole, 34 third extension Rod, 35 horizontal locking wrench, 36 vertical rod, 37 cylinder, 38 first fixed arm, 39 second fixed arm, 40 third fixed arm, 41 first universal joint, 42 second universal joint, 43 height Adjustment assembly, 44 level adjustment assembly, 45 third adjustment knob.
  • a detachable assembly arc-shaped precision positioning device includes a support unit, a three-dimensional adjustment unit, and a guide positioning unit.
  • the supporting unit comprises an L-shaped base composed of a base and a vertical rail 1 perpendicular to the base.
  • the base is provided with a roller and a ground-fixable braking device, which is convenient for moving and fixing the detachable assembly arc-shaped precise positioning device.
  • a stage 2 can be horizontally mounted on the vertical rail 1 for placing a spare instrument box during the operation, and the actual size of the stage is adjusted to the actual size of the operation.
  • the three-dimensional adjustment unit includes a lifting adjustment unit and a level adjustment unit.
  • the lifting adjustment unit comprises a first fixing block 3 disposed on the vertical rail 1, and the first fixing block 3 is connected with a first lifting rod 4 and a second lifting rod 5 which are slidably connected, the first lifting rod 4 and the second lifting rod
  • the rods 5 are parallel to each other, and the top end of the vertical rail 1 is mounted with a first rocker 6 which is vertically connected to the first lifting rod 4 and the second lifting rod 5, and controls the first rocker 6 to drive the first lifting and lowering
  • the rod 4 and the second lifting rod 5 are moved up and down.
  • the structure of the horizontal adjustment unit includes a second fixing block 25 at the top end of the first lifting rod 4 and the second lifting rod 5, and the second fixing block 25 is connected with the first horizontal rod 10 and the sliding parallel and parallel to each other.
  • the second horizontal rod 26, the first horizontal rod 10 and the second horizontal rod 26 are vertically connected with a second rocking rod 9, and the first horizontal rod 10 and the second horizontal rod 26 are driven to control the second horizontal rod 9 to be left and right (relative to The patient's) horizontal movement.
  • a third fixing block 15 is disposed on the other end of the first horizontal rod 10 and the second horizontal rod 26, and the first fixing block 15 is slidably coupled to the first fixing block 15, and the first adjusting knob 13 is mounted on the first sliding block 24.
  • the first slider 24 is horizontally moved back and forth by controlling the first adjustment knob 13.
  • the third locking knob 7 is coupled to the first slider 24 and functions to lock the sliding of the first slider 24 and the third fixing block 15.
  • first lifting rod 4 and the second lifting rod 5 may also be combined into one.
  • the two lifting rods have an outstanding effect on improving the overall stability of the device and reducing sway.
  • the first horizontal rod 10 and the second horizontal rod 26 may also be combined into one.
  • the two horizontal rods have outstanding effects on improving the overall stability of the device and reducing sway.
  • the guide positioning unit includes a circular arc track 22, a guide rod 19, a holder 23, a second slider 17, and two positioning instruments.
  • the circular arc track 22 Connected to the second slider 17,
  • the second slider 17 is connected to the first slider 24 of the three-dimensional adjustment unit, and is connected with a second adjustment knob 14 for driving the circular arc track 22 to be 0-360 degrees around the vertical axis by controlling the second adjustment knob 14. Rotating at any angle can also directly rotate the arc-shaped track to any angle within the range of 0-360 degrees.
  • FIG. 4 and FIG. 6 show different states of the arc-shaped track 22 and the second slider 17 when rotating.
  • the circular arc-shaped rail 22 is movable relative to the second slider 17 about its center, and FIGS. 4 and 5 show a state in which the circular arc-shaped rail 22 and the second slider 17 are in different positional relationships.
  • the circular arc track 22 can also be coupled with a first locking knob 16 that can be locked by the first locking knob 16 when the circular arc track 22 is moved relative to the second slider 17.
  • the structure or the relative movement can prevent the patient's body from blocking the arc-shaped track from rotating around the vertical axis, which is very important for adjusting the surgical approach angle and expanding the surgeon's surgical operation space, and has outstanding substantial effects. .
  • the intervertebral foramen surgery in the normal prone position is the posterior lateral approach. It is only necessary to rotate the circular arc around the vertical axis to obtain the ideal working path. However, other rear approaches are made by using the positioning device.
  • the positioning device When operating, such as pedicle screw placement, due to the body block, if the circular arc track can only rotate around the vertical axis, the ideal working path cannot be obtained, so the circular arc track must be circularly moved around the center of the circle.
  • the ideal working path can be obtained by moving the circular arc around the vertical axis after moving relative to the second slider. Therefore, circular motion of the circular arc around the center of the circle has great clinical significance and has outstanding substantive effects.
  • the lateral position is often used for intervertebral foramen surgery.
  • the circular arc can only rotate around the vertical axis and the ideal working path cannot be obtained.
  • the circular arc track In order to reach the ideal working path for puncture and other operations, the circular arc track must be circularly moved around the center of the circle, that is, moved relative to the second slider and rotated around the vertical axis. Therefore, the circular arc track is circularly moved around the center of the circle.
  • the actual clinical problems have outstanding substantive effects.
  • the circular arc track 22 is connected to the first slider 24 via the second slider 17, and can be driven by the lifting adjustment unit and the horizontal adjusting unit to move up and down, and to move back and forth.
  • the guide rod 19 is connected to the circular arc-shaped rail 22 via the third slider 21, and is movable along the circular arc-shaped rail 22 or vertically along the long axis of the guide rod 19.
  • the third slider 21 can also be coupled to a second locking wrench 18 that can lock the position of the guide when the guide is moved into position.
  • a second locking knob 20 can also be connected to the third slider 21. By controlling the second locking knob 20, the upper and lower telescopic movement of the guiding rod 19 along the long axis of the guiding rod can be locked.
  • a vertical locator 11 there are two locators, a vertical locator 11 and a horizontal locator 12, and the horizontal locator 12 can be mounted on the circular arc track 22 (as shown in Figures 4, 5 and 6), and the vertical locator 11 can be mounted on In the three-dimensional adjustment unit (as shown in FIGS.
  • the vertical locator 11 may be mounted on the first slider 24 in the three-dimensional adjustment unit); or the two locators may all be mounted on the circular arc-shaped track 22 (as shown in Figure 7); and the rays emitted by the two locators and the long axis of the holder 23 are parallel or coincident with the radial line of the circular arc-shaped track, the three lines intersect at one point, and form a plane, The plane formed is parallel or coincident with the arcuate plane of the arcuate track.
  • the rays emitted by the vertical aligner 11 and the horizontal locator 12 are respectively aligned with the body surface projection points determined by the C-arm machine.
  • the positions of the vertical aligner 11 and the horizontal locator 12 may change according to the change of the position of the circular arc track, and the circular arc track 22 is at least a quarter arc, and the radius may be according to different parts.
  • the need for surgical positioning is adjusted, for example, from one quarter to one third of an arc.
  • the holder 23 is designed with multiple sockets to accommodate different sizes of surgical instruments, including puncture needles and the like.
  • the vertical aligner 11 and the horizontal locator 12 are both infrared or laser locators.
  • the patient parallels the long axis of the operating table, attaches the existing epidermis to the back and sides of the patient's body surface, and then uses the C-arm machine to take the standard anteroposterior and lateral slices, in the anteroposterior and lateral positions.
  • the puncture target point is determined on the film, and then marked on the back side and the side of the patient's body surface with a marker, and the general shape of the ipsilateral transverse process of the puncture target point is drawn on the patient's body surface; in addition, the patient's body surface is drawn by touching the patient's body surface. Out of shape;
  • the telescopic guide 19 positions the gripper 23 as close as possible to the needle insertion point of the patient's body surface.
  • the gripper 23 uses a needle guide;
  • the puncture needle can reach the puncture target point through the guide pin on the needle guide.
  • Embodiment 1 the difference from Embodiment 1 is that there are two locators, a vertical locator 11 and a horizontal locator 12, and the horizontal locator 12 and the vertical aligner 11 are both mounted on the circular arc guide 22
  • the ray emitted by the two locators and the long axis of the holder 23 are parallel or coincident with the radial line of the circular arc track, the three lines intersect at one point, and form a plane, and the formed plane and arc
  • the circular arc-shaped planes of the shaped rails 22 coincide.
  • two locators can be embedded in the circular arc-shaped rail 22, and the third slider, the guide rod and the holder can be connected as shown in Figs.
  • FIG. 7D The second embodiment is illustrated in Fig. 7D.
  • Two locators can be connected outside the circular arc track 22, and the rays emitted by the two locators and the long axis of the holder 23 are aligned with the radial line of the circular arc track. Parallel or coincident, the three lines intersect at a point and form a plane which is formed parallel to the arcuate plane of the arcuate track 22.
  • Embodiment 1 The difference from Embodiment 1 is that in the present embodiment, the support unit and the three-dimensional adjustment unit have different structures.
  • the support unit is composed of a plurality of fixed arms, and the two fixed arms are hinged by a universal joint.
  • there are three fixed arms which are a first fixed arm 38, a second fixed arm 39, and a third fixed arm 40, wherein the first fixed arm 38 is fixed at one end to a roof or a wall, and the first fixed arm The other end is hinged to the one end of the second fixed arm 39 through the first universal joint 41, and the other end of the second fixed arm 39 is hinged to the one end of the third fixed arm 40 through the second universal joint 42.
  • the third fixed arm 40 The other end is connected to the first slider 24.
  • the first slider 24 is driven by the fixed arm to move up and down, and to move back and forth.
  • the second implementation manner is as shown in FIG. 10 .
  • the first slider 24 is connected to one end of the horizontal adjustment component 44
  • the other end of the horizontal adjustment component 44 is connected to the height adjustment component 43
  • the height adjustment component 43 Connect directly to the operating bed.
  • the height adjustment component 43 and the level adjustment component 44 can adopt a conventional telescopic rod, a slide rail, or the like.
  • the support unit is composed of a foot, a vertical rod 36 and a cylinder 37, and one end of the vertical rod 36 is fixed on the foot, and the cylinder 37 is sleeved on Below the vertical bar for overall equipment balance.
  • a detachable assembly arc-shaped precise positioning device includes:
  • Supporting unit an L-shaped base is formed by a base and a vertical rail 1 perpendicular to the base.
  • the base is provided with a roller and a ground-fixable braking device, which is convenient for moving and fixing the detachable assembly arc-shaped precise positioning device.
  • a stage 2 can be horizontally mounted on the vertical rail 1 for placing a spare instrument box during the operation, and the actual size of the stage is adjusted to the actual size of the operation.
  • the shelf 2 is horizontally mounted on the vertical arm of the L-shaped base 1 for placing a spare instrument box during the operation, and the actual size can be adjusted according to the surgical requirements; in this embodiment, the length, width and height of the instrument box are separately asked.
  • the instrument box is equipped with 2 sets of circular arc track 22, holder 23 and the remaining disinfection parts, with a total weight of 14 kg, which can be operated twice in succession.
  • the three-dimensional adjustment unit includes a lifting adjustment unit and a level adjustment unit.
  • the lifting adjustment unit comprises a first fixing block 3, a first lifting rod 4, a second lifting rod 5 and a first rocking rod 6, the first fixing block 3 being mounted on the vertical arm of the L-shaped base 1, the first lifting rod 4 And the second lifting rod 5 are parallel to each other and vertically pass through the first fixing block 3, respectively, the first rocker 6 is mounted on the top end of the vertical arm of the L-shaped base 1, and is vertically connected with the first lifting rod 4 and the second lifting rod 5
  • the first lifting rod 4 and the second lifting rod 5 are driven to move up and down by rotating the first rocker 6; the lengths of the first lifting rod 4 and the second lifting rod 5 are both 1 meter, and the first adjustment is performed in this embodiment.
  • the distance between the top end of the lifting rod 4 and the second lifting rod 5 is 1.2 meters from the ground.
  • Level adjusting unit comprising a second fixing block 25, a first horizontal rod 10, a second horizontal rod 26, a second rocker 9 and a third fixing block 15, the second fixing block 25 being mounted on the first lifting rod 4 and the second
  • the top end of the lifting rod 5, the first horizontal rod 10 and the second horizontal rod 26 are parallel to each other and one end horizontally passes through the second fixing block 25, and the other end is connected with the third fixing block 15, the second rocker 9 and the first
  • a horizontal rod 10 and a second horizontal rod 26 are vertically connected, and the first horizontal rod 10 and the second horizontal rod 26 are horizontally moved by rotating the second rocking rod 9; the lengths of the first horizontal rod 10 and the second horizontal rod 26 are 0.5 m, and the width between the two is 200 mm.
  • the distance between the right end of the first horizontal rod 10 and the second horizontal rod 26 from the second fixed block 25 is adjusted to be 50 mm.
  • the guiding and positioning unit comprises a circular arc track 22, a second adjusting knob 14, a first adjusting knob 13, a third adjusting knob 45, a guiding rod 19 and a holder 23, and the first end of the circular arc track 22 is connected to the first sliding
  • the block 24 and the first adjusting knob 13, the first slider 24 is movably mounted on the third fixing block 15, the first adjusting knob 13 is connected to the first slider 24, and the first sliding knob 13 is controlled to make the first sliding
  • the block 24 moves back and forth, thereby driving the circular arc track 22 to move back and forth, and controlling the second adjustment knob 14 to drive the circular arc track 22 to rotate at any angle of 0-360 degrees around the vertical axis, or in the range of 0-360 degrees. Rotate the arc-shaped track directly to any angle;
  • One end of the guide rod 19 is connected to the holder 23, the other end is movably connected to the third slider 21, and the third slider 21 is movably mounted on the circular arc-shaped rail 22.
  • the third adjustment knob 45 is connected to the third slider 21, and the third slider 21 is driven to move the guide rod 19 along the circular arc track 22 by controlling the third adjustment knob, thereby driving the guide rod 19 along the circle.
  • the curved track 22 moves.
  • the circular arc track 22 is a quarter arc
  • the first end of the circular arc track 22 is provided with a vertical aligner 11 and a horizontal locator 12 is provided at the end.
  • the gripper 23 is a needle guide, and the needle guide of the needle guide adopts multiple sleeve design to adapt to different sizes of puncture needles; the guide pin mouth is matched with the reaming tool.
  • the diameter of the ring saw is from the novice personnel. Auxiliary surgery; the needle can be processed under the condition of the needle, and the disposable aseptic packaging is provided; the posterior guide can be directly designed with the reaming tool to provide the tool aseptic packaging.
  • the L-shaped base 1 is provided with a brake device that can fix the ground.
  • the first lifting rod 4, the second lifting rod 5, the first horizontal rod 10, and the second horizontal rod 26 are each made of a polymer material that is not developed under fluoroscopy.
  • the vertical aligner 11 and the horizontal locator 12 may be laser aligners or infrared locators.
  • the use method of the detachable assembly arc-shaped precise positioning device is taken as follows. The specific steps are as follows: (1) The paralyzed patient's parallel operating table has a long axis prone, and the existing epidermis locator is attached to the disease. The back and sides of the human body table, then use the C-arm machine to take the standard anterior-posterior and lateral slices, determine the target point on the anterior-posterior and lateral slices, and then mark them on the back and sides of the patient's body surface. At the same time, the general shape of the ipsilateral transverse process of the puncture target point is drawn on the patient's body surface; in addition, the shape of the patient is drawn by touching the body surface;
  • the ground movable supporting portion includes a foot 39 with a roller, a cylinder 37 and a vertical rod 36, and one end of the vertical rod 36 is fixed to the foot, and the cylinder 37 is placed on the vertical Below the straight rod 36, for maintaining the overall balance of the assister;
  • the three-dimensional rocker adjusting portion is composed of a fifth rocker 29, a sixth rocker 30, a seventh rocker 31, a first extension rod 33, and a second extension rod 32,
  • the three extension rods 34, the horizontal calibrator 38 and the horizontal locking wrench 35 are composed.
  • One end of the third extension rod 34 is connected to the other end of the vertical rod 36.
  • the third extension rod 34 is connected with the vertical rod 36 with a horizontal locking wrench 35.
  • the other end of the third extension rod 34 is connected to one end of the second extension rod 32, respectively.
  • one end of the first extension rod 33, the third extension rod 34 and the second extension rod 32 are horizontally placed, the first extension rod 33 is vertically placed, and the third extension rod 34, the second extension rod 32 and the first extension rod 33 are mutually Vertically arranged, the first extension rod 33 is connected to the seventh rocker 31, and is driven up and down by the seventh rocker 31.
  • the second extension rod 32 is connected to the fifth rocker 29, and is driven by the fifth rocker 29 to be horizontal.
  • the direction of the third extension rod 34 is connected to the sixth rocker 30, and is driven by the sixth rocker 30 to move left and right in the horizontal direction; the horizontal aligner 38 is located on the third extension rod 34.
  • the circular arc-shaped guide positioning portion includes a circular arc-shaped rail 22, a third rocker 27, a fourth rocker 28, a guide rod 19, and a needle guide 23, which is a quarter arc, on which
  • the circular arc track 22 is connected to the fourth rocker 28, and the circular rock track 22 is adjusted to rotate 360 degrees vertically by the fourth rocker 28, and the horizontal positioning device 12 is disposed at one end of the circular arc track 22,
  • the other end is provided with a vertical locator 11
  • one end of the guide rod 19 is located on the circular arc track 22 through the third slider 21
  • the third slider 21 is connected to the third rocker 27
  • the guide rod 19 passes through the
  • the three sliders can slide on the circular arc track 22 under the driving of the third rocker 27, and the other end of the guide bar 12 is provided with a gripper 23, and the needle insertion port of the gripper 23 can directly puncture the puncture needle. Reach the puncture target point.
  • the gripper 23 is a needle guide, and the vertical locator 11 and the horizontal locator 12 can be an infrared locator.
  • the paralyzed patient's parallel operating table is tilted on the long axis, the existing epidermis locator is attached to the back and side of the patient's body surface, and then the standard anterior and posterior and lateral slices are taken by the C-arm machine, in the anteroposterior and lateral sections.
  • the puncture target point is determined on the slice, and then marked on the back and sides of the patient's body surface with a marker, and the general shape of the ipsilateral transverse process of the puncture target point is drawn on the patient's body surface; in addition, the patient's body surface is drawn by touching the patient's body surface. Walking away;
  • the puncture needle can reach the puncture target point through the guide pin hole on the needle guide.

Landscapes

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

Abstract

L'invention concerne un dispositif de positionnement précis en forme d'arc capable d'être assemblé et désassemblé, comprenant une unité de support et une unité de réglage en trois dimensions reliée à l'unité de support, et comprenant en outre une unité de positionnement guidé qui comprend un rail en forme d'arc (22), une tige de guidage (19), un organe de préhension (23), ainsi que des localisateurs (11, 12). Un second bloc coulissant (17) est relié à l'unité de réglage en trois dimensions ; le rail en forme d'arc (22) est disposé sur le second bloc coulissant, peut coulisser sur le second bloc coulissant (17), et peut tourner dans la position d'origine autour d'un axe vertical à n'importe quel angle ; l'unité de réglage en trois dimensions peut entraîner le rail en forme d'arc (22) à se déplacer vers le haut et vers le bas, à gauche et à droite ou vers l'arrière et vers l'avant dans trois dimensions ; la tige de guidage peut soit glisser le long du rail en forme d'arc (22) ou se déplacer dans la direction de l'axe long de la tige de guidage (19) ; et le dispositif de préhension (23) est disposé sur la tige de guidage pour fixer un instrument chirurgical. Deux localisateurs (11,12) sont prévus, et les rayons émis depuis les deux localisateurs (11,12) et l'axe long de l'organe de préhension (23) sont parallèles à la ligne radiale du rail en forme d'arc (22) ou coïncident avec ladite ligne radiale, les trois lignes étant dans le même plan, qui est parallèle au plan dans lequel se trouve le rail en forme d'arc (22), ou bien chevauche ledit plan, et les trois lignes se coupant au niveau d'un point.
PCT/CN2016/070142 2015-07-02 2016-01-05 Dispositif de positionnement précis en forme d'arc capable d'être assemblé et désassemblé WO2017000538A1 (fr)

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CN201680000494.0A CN105916463B (zh) 2015-07-02 2016-01-05 可拆卸组装圆弧形精准定位设备

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CN201510378745.6 2015-07-02
CN201510378745.6A CN105125285B (zh) 2015-07-02 2015-07-02 可移动三维摇杆弧形导向脊柱穿刺辅助器及其使用方法
CN201510796405.5 2015-11-18
CN201510796405.5A CN105232122B (zh) 2015-11-18 2015-11-18 一种可拆卸组装手术精准定位设备

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CN106770301A (zh) * 2017-03-21 2017-05-31 青岛理工大学 一种油气两相流体射流稳定性评估装置
CN108597338A (zh) * 2018-05-30 2018-09-28 赵刘军 经皮椎体后凸成形术穿刺角度辅助装置和使用方法
CN109199563A (zh) * 2018-11-26 2019-01-15 杨英果 可三维调节的脊柱后路手术定位装置
CN109350197A (zh) * 2018-12-14 2019-02-19 右江民族医学院附属医院 颅内血肿微创穿刺术用精准穿刺定位支撑系统
CN109692033A (zh) * 2019-03-07 2019-04-30 谢林 一种经皮腰椎间孔镜穿刺辅助定位器
CN110063780A (zh) * 2019-05-22 2019-07-30 陈聚伍 数字化股骨颈导针机械导航瞄准仪
CN110123423A (zh) * 2019-04-26 2019-08-16 潘拓 脊柱靶心定位通道成型装置
CN110141329A (zh) * 2019-06-25 2019-08-20 浙江伽奈维医疗科技有限公司 数字化定位器系统
CN111991094A (zh) * 2020-08-25 2020-11-27 华北理工大学 一种口腔外科手术支架
CN112023195A (zh) * 2020-08-19 2020-12-04 无锡明慈心血管病医院有限公司 一种心血管科用麻醉辅助支架
CN112957103A (zh) * 2021-01-22 2021-06-15 昆明医科大学第二附属医院 一种疼痛科用穿刺导航固定器
CN113397661A (zh) * 2021-06-02 2021-09-17 河北医科大学第二医院 一种腹腔穿刺定位导航系统
CN113476114A (zh) * 2021-07-01 2021-10-08 吉林大学 一种神经介入用脑血管介入穿刺定位装置
CN113639780A (zh) * 2021-09-01 2021-11-12 江苏省海洋资源开发研究院(连云港) 一种空间光学遥感器三维通用全角度光学测量平台
CN113876435A (zh) * 2021-06-18 2022-01-04 上海极睿医疗科技有限公司 一种骨科手术用可调节定点指向作业机构
CN114366333A (zh) * 2022-01-27 2022-04-19 徐雷刚 乳腺肿瘤体表定位装置
CN114521942A (zh) * 2022-02-28 2022-05-24 德州雷奥巴赫医疗器械有限公司 一种脊柱微创穿刺定位装置
CN114848107A (zh) * 2022-06-13 2022-08-05 宜宾市第一人民医院 一种呼吸科用胸腔穿刺引导定位装置
CN115177336A (zh) * 2022-07-28 2022-10-14 濮阳市第五人民医院(濮阳市传染病医院、濮阳市结核病防治所) 一种脊柱结核脓液穿刺引流工具
CN115414098A (zh) * 2022-09-05 2022-12-02 中国医科大学 一种甲乳外科临床用高精度多角度穿刺引流装置
CN116327416A (zh) * 2023-05-22 2023-06-27 中国人民解放军军事科学院军事医学研究院 一种球基定位仪

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Publication number Priority date Publication date Assignee Title
CN106770301A (zh) * 2017-03-21 2017-05-31 青岛理工大学 一种油气两相流体射流稳定性评估装置
CN108597338A (zh) * 2018-05-30 2018-09-28 赵刘军 经皮椎体后凸成形术穿刺角度辅助装置和使用方法
CN108597338B (zh) * 2018-05-30 2024-05-31 宁波市第六医院 经皮椎体后凸成形术教学模型精确角度穿刺辅助装置及其使用方法
CN109199563A (zh) * 2018-11-26 2019-01-15 杨英果 可三维调节的脊柱后路手术定位装置
CN109350197A (zh) * 2018-12-14 2019-02-19 右江民族医学院附属医院 颅内血肿微创穿刺术用精准穿刺定位支撑系统
CN109350197B (zh) * 2018-12-14 2024-05-17 右江民族医学院附属医院 颅内血肿微创穿刺术用精准穿刺定位支撑系统
CN109692033A (zh) * 2019-03-07 2019-04-30 谢林 一种经皮腰椎间孔镜穿刺辅助定位器
CN109692033B (zh) * 2019-03-07 2023-08-11 谢林 一种经皮腰椎间孔镜穿刺辅助定位器
CN110123423A (zh) * 2019-04-26 2019-08-16 潘拓 脊柱靶心定位通道成型装置
CN110063780A (zh) * 2019-05-22 2019-07-30 陈聚伍 数字化股骨颈导针机械导航瞄准仪
CN110141329A (zh) * 2019-06-25 2019-08-20 浙江伽奈维医疗科技有限公司 数字化定位器系统
CN110141329B (zh) * 2019-06-25 2023-11-28 浙江伽奈维医疗科技有限公司 数字化定位器系统
CN112023195A (zh) * 2020-08-19 2020-12-04 无锡明慈心血管病医院有限公司 一种心血管科用麻醉辅助支架
CN112023195B (zh) * 2020-08-19 2022-04-08 无锡明慈心血管病医院有限公司 一种心血管科用麻醉辅助支架
CN111991094A (zh) * 2020-08-25 2020-11-27 华北理工大学 一种口腔外科手术支架
CN112957103B (zh) * 2021-01-22 2022-03-11 昆明医科大学第二附属医院 一种疼痛科用穿刺导航固定器
CN112957103A (zh) * 2021-01-22 2021-06-15 昆明医科大学第二附属医院 一种疼痛科用穿刺导航固定器
CN113397661A (zh) * 2021-06-02 2021-09-17 河北医科大学第二医院 一种腹腔穿刺定位导航系统
CN113876435A (zh) * 2021-06-18 2022-01-04 上海极睿医疗科技有限公司 一种骨科手术用可调节定点指向作业机构
CN113876435B (zh) * 2021-06-18 2023-06-27 上海极睿医疗科技有限公司 一种骨科手术用可调节定点指向作业机构
CN113476114A (zh) * 2021-07-01 2021-10-08 吉林大学 一种神经介入用脑血管介入穿刺定位装置
CN113639780A (zh) * 2021-09-01 2021-11-12 江苏省海洋资源开发研究院(连云港) 一种空间光学遥感器三维通用全角度光学测量平台
CN113639780B (zh) * 2021-09-01 2024-04-19 江苏省海洋资源开发研究院(连云港) 一种空间光学遥感器三维通用全角度光学测量平台
CN114366333A (zh) * 2022-01-27 2022-04-19 徐雷刚 乳腺肿瘤体表定位装置
CN114521942A (zh) * 2022-02-28 2022-05-24 德州雷奥巴赫医疗器械有限公司 一种脊柱微创穿刺定位装置
CN114848107A (zh) * 2022-06-13 2022-08-05 宜宾市第一人民医院 一种呼吸科用胸腔穿刺引导定位装置
CN114848107B (zh) * 2022-06-13 2023-01-13 宜宾市第一人民医院 一种呼吸科用胸腔穿刺引导定位装置
CN115177336A (zh) * 2022-07-28 2022-10-14 濮阳市第五人民医院(濮阳市传染病医院、濮阳市结核病防治所) 一种脊柱结核脓液穿刺引流工具
CN115414098B (zh) * 2022-09-05 2024-05-17 中国医科大学 一种甲乳外科临床用高精度多角度穿刺引流装置
CN115414098A (zh) * 2022-09-05 2022-12-02 中国医科大学 一种甲乳外科临床用高精度多角度穿刺引流装置
CN116327416B (zh) * 2023-05-22 2023-08-25 中国人民解放军军事科学院军事医学研究院 一种球基定位仪
CN116327416A (zh) * 2023-05-22 2023-06-27 中国人民解放军军事科学院军事医学研究院 一种球基定位仪

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