WO2018082449A1

WO2018082449A1 - Navigation and positioning device for tongue body ablation surgery and surgical instrument matching therewith

Info

Publication number: WO2018082449A1
Application number: PCT/CN2017/106847
Authority: WO
Inventors: 周星
Original assignee: 周星
Priority date: 2016-11-07
Filing date: 2017-10-19
Publication date: 2018-05-11
Also published as: CN108056811A; CN108056811B

Abstract

Disclosed is a navigation and positioning device for tongue body ablation surgery (99), comprising an upper positioning plate (1), a lower positioning plate (2), a fixing bracket (3) and a positioning mechanism (4). The upper positioning plate (1) has a geometry that matches the shape of the tongue body and the alveolar bone, and the lower positioning plate (2) has a geometry that matches the contour of the lower jaw. An upper end of the fixing bracket (3) is connected to the upper positioning plate (1), and a lower end of the fixing bracket (3) is connected to the lower positioning plate (2). The tongue body is fixed by the upper positioning plate (1), the lower positioning plate (2) and the osseous tissue of the lower jaw. The lower positioning plate (2) is provided with a surgical operation window (23), and the positioning mechanism (4) can guide a tongue body ablation surgical instrument (100) to be inserted to a target region to perform an ablation surgery. The positioning mechanism (4) is provided with a surgical operation hole (41). The surgical instrument (100) successively passes through the surgical operation hole (41) and the surgical operation window (23) and enters the tissue of the tongue body, and performs surgical operation on the target region under the navigation and positioning by the positioning mechanism (4). With the navigation and positioning device for tongue body ablation surgery, the surgical operation procedure is safer and more precise, controllable and convenient.

Description

Tongue ablation surgery navigation positioning device and its associated surgical instrument

Technical field

The invention relates to a medical instrument for tongue ablation surgery, in particular to a tongue ablation operation navigation positioning device used in radiofrequency ablation of a tongue tissue and a surgical instrument matched therewith.

Background technique

Hysteria and obstructive sleep apnea syndrome (hereinafter referred to as OSAS) is a common disease that has obvious harm to human health. The tongue drop caused by tongue hypertrophy is one of the main causes of snoring and OSAS. . Surgical resection or ablation of hypertrophic tongue tissue, especially for the removal of tongue tissue from the tongue and the base of the tongue, which can easily block the tongue and throat airway, can effectively open the pharyngeal airway and achieve therapeutic effects. Hysteria and OSAS caused by tongue fall. Various tongue excision or tongue ablation surgery along the oral cavity, complete the operation under direct vision, the surgical site is accurate; but there are incisions in the oral cavity, and there are many oral bacteria, the surgical incision is easy to infect, the patient is hard after surgery, and the rehabilitation period is long. . Professor Zhang Xiangmin, one of the designers of the present invention, invented a tongue ablation procedure along the mandibular neck advancement needle, which can perform radiofrequency ablation surgery on the back of the tongue and the base of the tongue; the surgical incision is at the bottom of the lower jaw of the neck, near the bottom of the mandible. There is no incision in the mouth, no oral bacterial infection, short recovery time after surgery, the patient feels good and the treatment effect is good. However, when such an operation is performed, the surgical site cannot be directly viewed, and the position of the tongue is likely to move, so that the surgical site is often difficult to accurately position. When performing such an operation, the determination of the surgical site depends on the doctor's penetration of the finger from the oral cavity, and the touch of the finger is performed by the doctor's experience, which is not conducive to the precise position of the surgical site, and the popularization of the technology. Therefore, this technology needs to be improved and improved to achieve precise positioning of the surgical site.

Summary of the invention

The object of the present invention is to design a tongue ablation surgical navigation and positioning device and a surgical instrument matched therewith. The core of the technical solution of the present invention is to fix the tongue and realize precise positioning of the surgical site. The tongue ablation surgical navigation positioning device of the present invention fixes the tongue between the upper positioning plate that fits the shape of the tongue and the lower positioning plate that fits the shape of the lower teeth and the bone structure of the lower gum, so that the tongue cannot move freely, and then Inserting a surgical instrument through the surgical window of the lower positioning plate, Under the guidance of the navigation and positioning mechanism, the precise positioning of the surgical site can effectively improve the safety and accuracy of the surgical procedure.

The tongue ablation surgery navigation positioning device of the present invention is characterized in that: the navigation system 99 comprises a positioning plate 1, a lower positioning plate 2, a fixing bracket 3 and a positioning mechanism 4;

A. The upper positioning plate 1 has a geometric shape matching the shape of the tongue and the alveolar bone, and the upper positioning plate 1 is provided with a connecting mechanism 11 connected to the fixing bracket 3, and the upper positioning plate 1 The proximal end of the fixing bracket 3 is connected to the upper end 31 of the fixing bracket 3, and the upper positioning plate 1 is placed on the tongue body, and the upper positioning plate 1 presses the tongue body and the lower teeth and The bony tissue of the alveolar bone cooperates to fix the tongue in the mandibular cavity;

B. The lower positioning plate 2 has a geometric shape matching the shape of the lower jaw, and the lower positioning plate 2 is provided with a connecting mechanism 21 connected to the fixing bracket 3, and the proximal end of the lower positioning plate 2 passes The connecting mechanism 21 is connected to the lower end 32 of the fixing bracket 3, and the lower positioning plate 2 can lift the lower jaw;

C, the upper end 31 of the fixing bracket 3 is connected to the upper positioning plate 1, the lower end 32 of the fixing bracket 3 is connected with the lower positioning plate 2, and the tongue body is the upper positioning plate 1 and the lower positioning plate 2 And the bone tissue on the lower jaw is fixed.

D. The positioning mechanism 4 is a navigation positioning mechanism capable of guiding a surgical device for ablation of a tongue to be inserted into a target area for performing an ablation operation, and the positioning mechanism 4 is provided with a surgical operation hole 41.

In use, the tongue 6 is fixed between the upper positioning plate 1 and the lower positioning plate 2, since the upper positioning plate 1 has a geometric shape matching the shape of the tongue and the alveolar bone, the lower The positioning plate 2 has a geometry matching the shape of the lower jaw 7, the upper positioning plate 1 presses and fixes the tongue 6 to the bottom of the mandible, and the tongue 6 can be comfortably fixed to the lower jaw. In the oral cavity, the comfort of the patient is improved, and the tongue 6 is prevented from being displaced during the operation of the doctor, and the deviation of the surgical site due to the displacement of the tongue 6 can be effectively avoided, thereby causing the patient to Accidental injuries make the procedure safer. Moreover, since the tongue 6 is fixed and cannot be displaced, the doctor does not need to adjust the position of the surgical instrument according to the real-time position of the tongue 6 during the clinical operation, which greatly facilitates the surgical operation process of the doctor.

Further, the upper positioning plate 1 is a cantilever structure in which the proximal end is fixed to the upper end 31 of the fixing bracket 3. The upper positioning plate 1 can be integrally formed on the upper end 31 of the fixing bracket 3, and can also be detachably fixed to the upper end 31 of the fixing bracket 3. Generally, in consideration of the convenient operation in clinical use, the upper positioning plate 1 can be detachably fixed to the upper end of the fixing bracket 3, and the specific connection manner can select a concave-convex card fit, a screw connection, an interference fit, and a pin. Connection, rivet connection, etc. Of course, those skilled in the art can also design other various types as needed. The fixed manner does not depart from the scope of protection of the present application.

The upper positioning plate 1 is manufactured based on three-dimensional data of a CT scan in which the tongue is naturally placed in the lower jaw cavity or three-dimensional data of an MRI scan or three-dimensional data provided by a 3D camera. Since the upper positioning plate 1 is manufactured according to the three-dimensional data of the patient, a good matching of the upper positioning plate 1 and the tongue body 6 can be sufficiently ensured, and the positioning is more accurate.

The upper positioning plate 1 is manufactured using 3D printing technology.

The upper positioning plate 1 is manufactured by a numerical control machining process.

The upper positioning plate 1 is manufactured using a resin stamping technique.

Here, the applicant only cites the above-mentioned three methods of manufacturing the upper positioning plate 1, but those skilled in the art can separately select other various manufacturing techniques as needed without departing from the scope of protection of the present patent application.

The upper positioning plate 1 is provided with an upper positioning plate ridge line 13 , and the upper positioning plate ridge line 13 can support the tongue body in the upper positioning plate 1 cavity according to the support of the lower gum tissue. Since the upper positioning plate ridge line 13 needs to collect and position the tongue body 6, the upper positioning plate ridge line 13 is usually made of a medical material having a certain strength, such as medical plastic, medical titanium alloy, Medical shape memory alloys, etc.

The upper positioning plate 1 is a thin-walled housing structure or a thin-walled mesh structure 16. Since the upper positioning plate 1 needs to be built in the patient's mouth, the upper positioning plate 1 generally selects a thin-walled structure, such as a thin-walled shell structure or a thin-walled mesh structure, in order to facilitate handling and increase patient comfort. Wait. Wherein, the thin-walled mesh structure 16 can increase the friction between the upper positioning plate 1 and the tongue body 6 to better fix the tongue body 6.

Further, the thin-walled mesh structure 16 includes a flexible mesh 16-1 that can be gathered and unfolded. The flexible mesh 16-1 is a mesh structure in which a soft wire or a wire is woven, and the woven wire or wire may be made of a polymer material such as a nylon thread or a polypropylene thread; or may be made of a metal material. Such as titanium wire, shape memory alloy wire and the like. Since the flexible mesh 16-1 can be conveniently gathered and unfolded, when the upper positioning plate ridge line 13 is formed of a shape memory alloy, the flexible mesh 16-1 can be first gathered and placed in the oral cavity. The flexible mesh 16-1 is unfolded over the surface of the tongue 6 by the shape recovery of the upper positioning plate ridge 13 made of a shape memory alloy, and the upper positioning plate ridge 13 The tongue 6 is collected in the cavity formed by the flexible mesh 16-1 of the upper positioning plate 1 with the support of the lower bony ossification. Since the upper positioning plate 1 can be gathered, it is more convenient to enter the oral cavity, especially for patients with small mouths.

The upper positioning plate 1 is a folded plate-like structure or a screen structure that can perform the gathering and unfolding activities. The upper positioning plate 1 may also be a folded plate structure or a screen structure. When in use, the upper positioning plate 1 is first folded into the oral cavity. The upper positioning plate 1 is then unfolded, and the positioning of the tongue 6 is another structure that facilitates entry into the oral cavity. Here, the applicant only cites two specific structures of the upper positioning plate 1 that can be folded or folded, but those skilled in the art can design other various specific structures that can be folded or folded as needed, and Depart from the scope of protection of this application.

The upper positioning plate 1 includes an arched structure 19. The upper positioning plate 1 has an arched structure 19 matching the surface curvature of the tongue body 6, which can more effectively fit the tongue body 6, and the tongue body 6 is better fixed.

The upper positioning plate 1 is made of a rigid transparent material. The upper positioning plate 1 is made of a rigid transparent material, on the one hand, the tongue 6 can be fixed by a rigid material, and the transparent material can facilitate the doctor to perform real-time operation on the tongue 6 during a clinical operation. Observe to facilitate timely judgment and treatment of the surgical procedure.

The upper positioning plate 1 is provided with a marker line 12 in the tongue. According to the anatomy of the tongue, it is found that there is a tough lingual fascia at the midline of the tongue. This tough fascia is very important for the traction of the tongue. Therefore, it is necessary to avoid this during the operation. The ligament of the layer of the tongue causes loss. Therefore, the upper positioning plate 1 is provided with a tongue marking line 12 to prompt the doctor to position the tongue during the operation to prevent the fascia of the tongue during the surgical operation. Cause accidental damage.

The distal end of the upper positioning plate 1 is provided with a tongue hook plate 14 which can pull and lift the tongue forward to maintain the opening of the tongue and throat airway. Since the tongue body 6 is composed of soft muscle and fascia tissue, when the upper positioning plate 1 presses and fixes the tongue body 6 in the direction of the bottom of the mandible, the tongue body 6 It will deform and move in the direction of external force. In order to prevent the lingual pharyngeal airway obstruction caused by the posterior movement of the tongue 6 to the base of the tongue, the distal end of the upper positioning 1 is provided with a tongue hook plate 14 which can be used for the tongue body 6 Pulling and lifting, keeping the airway of the tongue and throat open, to ensure the smooth operation of the operation.

The upper positioning plate 1 is provided with a scale 15 for marking. The upper positioning plate 1 is provided with a scale 15 for marking to identify the area where the operation is planned, so that preoperative simulation and navigation positioning settings can be performed according to the patient's three-dimensional data before the operation.

The upper positioning plate 1 or the upper end 31 of the fixing bracket 3 is provided with an imaging system 17, and the imaging system 17 can observe the condition of the tongue and the tongue back during the operation in real time. Since the upper positioning plate 1 is provided with the imaging system 17, the doctor can observe the condition of the tongue 1 in real time during the operation of the operation, and timely judge and deal with various situations occurring in the operation, the doctor The surgical procedure is safer.

Further, the lower positioning plate 2 is a cantilever structure in which the proximal end is fixed to the lower end 32 of the fixing bracket 3.

The lower positioning plate 2 is detachably mounted on the lower end 32 of the fixing bracket 3. The lower positioning plate 2 can be mounted on the fixing bracket 3 by a concave-convex card fit, a screw connection, an interference fit, a pin connection, a rivet connection, or the like. The lower end 32. The applicant does not list all the installation methods here, and those skilled in the art can design different installation methods according to actual needs, without departing from the scope of protection of the patent application.

The lower positioning plate 2 is integrally formed with the fixing bracket 3. In actual clinical applications, the lower positioning plate 2 can also be integrally manufactured together with the fixing bracket 3, and different design specifications can be used to meet the requirements of most patients, and the manufacturing cost can be better saved.

The lower positioning plate 2 is manufactured based on three-dimensional data of a CT scan of a mandibular shape or three-dimensional data of an MRI scan or three-dimensional data provided by a 3D camera. Since the lower positioning plate 2 is manufactured according to the three-dimensional data of the patient, it can be sufficiently ensured that the lower positioning plate 2 and the lower jaw shape are better matched, and the positioning is more accurate.

The lower positioning plate 2 is manufactured using 3D printing technology.

The lower positioning plate 2 is manufactured by a numerical control machining process.

The lower positioning plate 2 is manufactured by a resin stamping technique.

Here, the applicant only cites the above-mentioned three types of manufacturing methods of the lower positioning plate 2, but those skilled in the art can separately select other various manufacturing techniques as needed without departing from the scope of protection of the patent application.

The lower positioning plate 2 is provided with a scale marking line 22. The lower positioning plate 2 is provided with a scale marking line 22, which can identify the needle insertion area of the mandible, and is convenient for opening a surgical window, so that the patient's three-dimensional data can be used for preoperative simulation to determine the navigation path and the surgical field positioning.

The lower positioning plate 2 is provided with a surgical operation window 23 for allowing a surgical related instrument to pass. The surgical instrument 100 can perform various tissue ablation or ablation surgical procedures through the surgical operation window 23.

Further, the fixing bracket 3 includes an adjusting mechanism 33 capable of adjusting the spatial position of the upper positioning plate 1. Through the adjustment mechanism 33, the doctor can adjust the spatial position of the upper positioning plate 1 according to different contour sizes of each patient to better fix the tongue 6.

The adjustment mechanism 33 includes a sleeve 33-1 and a support post 33-2.

The support post 33-2 can slide in the sleeve 33-1, and is connected to the upper positioning plate 1 through the upper end 31 of the fixing bracket, and adjusts the support column 33-2 and the sleeve 33. The relative position of -1 can change the spatial position of the upper end 31 of the fixing bracket, thereby changing the spatial position of the upper positioning plate 1 connected to the upper end 31 of the fixing bracket.

Further, the adjustment mechanism 33 includes a ball joint 33-3, and the ball joint 33-3 is disposed on the fixed bracket The end 31 is connected to the sleeve 33-1; or the ball joint 33-3 is provided at the upper end 31 of the fixing bracket to be connected to the support post 33-2. By adjusting the ball joint 33-3, the spatial position of the upper positioning plate 1 can be adjusted to better press and fix the tongue body 6 in the direction of the bottom of the mandible.

The support post 33-2 is provided with a scale 33-4, and the scale 33-4 can accurately repeat the connection after the connection between the upper positioning plate 1 and the fixing bracket 3 is removed or reinstalled. The spatial position of the positioning plate 1.

The fixing bracket 3 is a non-adjustable rigid structure, and the upper end 31 of the fixing bracket is connected to the lower end 32 of the fixing bracket by a support arm 34. The fixing bracket 3 can also be designed as a non-adjustable rigid structure, and different specifications can be designed to meet the needs of different patients. The design structure is simple and the manufacturing cost is low.

The positioning mechanism 4 is a mechanical navigation positioning mechanism, and includes a navigation positioning template 42. The navigation positioning template 42 can define a surgical region to the projection area 5 centered on the surgical operation hole 41, and follow the surgical instrument along the operation. The depth and angle of the hole insertion are precisely positioned. The navigation positioning template 42 is fixed on the lower positioning plate 2, the position of the surgical operation hole 41 is matched with the position of the surgical operation window 23 of the lower positioning plate 2, and the surgical operation window can be directly directly 23 is used as the surgical operation hole 41. The surgical instrument 100 sequentially passes through the surgical operation hole 41 and the surgical operation window 23 and enters the tongue tissue. Before the operation, the surgical safety area is determined according to the patient's three-dimensional data. Generally, the surgical safety area is in the vicinity of the tongue contour nipple 4 cm, and the area of 4.5×4.5 cm symmetrically distributed along the midline of the tongue, the deepest part of the surgical instrument 100 can be inserted. The surface of the tongue 6 needs to be larger than 1.5 cm, and then the safety area is set as the projection area 5 of the navigation positioning template 42 centered on the surgical hole 41, so that the doctor can safely operate during surgery. Operation in the area makes the procedure safer. At the same time, the navigation positioning template 42 can also be accurately positioned according to the depth and angle of insertion of the surgical instrument 100 along the surgical operation hole 41, and the surgical procedure is safer and controllable.

The navigation positioning template 42 includes a side limiting block 42-1, an end limiting block 42-2, and a limiting hole 42-3. The side limiting block 42-1 is mounted on the lower positioning plate 2, The limiting hole 42-3 is disposed on the end limiting block 42-2. The side stop block 42-1 of the navigation positioning template 42 can define a safe operating region of the surgical instrument 100, and the end stop block 42-2 can define a safe insertion depth of the surgical instrument 100; The connection of the limiting hole 42-3 and the surgical operation hole 41 can determine the insertion angle of the surgical instrument 100 through the side limiting block 42-1, the end limiting block 42-2 and the limiting hole 42. -3 can accurately limit and position the safe area, insertion depth and insertion angle during the operation, making the operation process safe, precise and controllable.

Further, the positioning mechanism 4 is an electromagnetic navigation mechanism, including a magnetic positioning component 43 and a magnetic positioning device 43-1; the magnetic positioning component 43 is disposed at a front end of the surgical instrument, and the magnetic positioning device 43-1 is capable of positioning In the surgical device An electromagnetic device in the spatial position of the magnetic positioning element 43 at the front end of the machine. When the magnetic positioning element 43 moves, causing a change of the electromagnetic field, the change signal of the electromagnetic field is fed back to the magnetic positioning device 43-1, and the magnetic positioning device 43-1 processes the feedback signal, The spatial position of the magnetic positioning element 43 is displayed on the display device 43-3. Through the magnetic positioning component 43 and the magnetic positioning device 43-1, the position and the surgical path of the surgical instrument 100 can be displayed on the display device 43-3 in real time, the surgical operation process is more precise and intuitive, and the surgical procedure is safer. ,Convenience.

The positioning mechanism 4 is a magnetic navigation mechanism, and the positioning mechanism 4 includes a magnetic material powder or a ferromagnetic material powder 43-2; and the magnetic material powder or ferromagnetic material powder 43-2 is disposed on the upper positioning plate 1 In the closed cavity of the surgical field portion, the degree of aggregation of the magnetic positioning member 43 toward the front end of the surgical instrument according to the magnetic material powder or ferromagnetic material powder 43-2 and the magnetic material powder or ferromagnetic material powder 43- The size of the magnetic powder spot formed by 2 can position the surgical instrument. If the magnetic positioning member 43 is a permanent magnet member, the magnetic material powder or ferromagnetic material powder 43-2 is made of a ferromagnetic material such as iron powder. If the magnetic positioning member 43 is a ferromagnetic material member, the magnetic material powder or ferromagnetic material powder 43-2 is made of a magnetic powder. When the magnetic positioning member 43 moves, the magnetic material powder or the ferromagnetic material powder 43-2 moves and aggregates due to magnetic attraction, and the magnetic material powder is observed by the imaging system 17 during surgery. Or positioning the surgical instrument 100 with the degree of aggregation of the ferromagnetic material powder 43-2 to the magnetic positioning element 43 at the front end of the surgical instrument and the size of the magnetic powder spot formed by the magnetic material powder or the ferromagnetic material powder 43-2. . This simple method is low in manufacturing cost and easy to use, and basically meets the requirements for clinical use.

The positioning mechanism 4 is an optical positioning mechanism, including an optical fiber 44 and a light source 44-1; one end of the optical fiber 44 is connected to the light source 44-1, and the other end is connected to the front end of the surgical instrument, and the operation for inserting the tongue is determined. The spot brightness and size of the optical fiber 44 at the front end of the instrument can be calculated by calculating the distance between the front end of the surgical instrument and the surface of the tongue. During the operation, the imaging system 17 observes the brightness and size of the spot formed by the optical fiber 44 in real time to determine the distance between the front end of the surgical instrument 100 and the surface of the tongue to perform positioning.

Surgical instruments for tongue ablation. The surgical instrument 100 can be used in conjunction with claim 1. The surgical instrument 100 includes a scalpel, an electrosurgical knife, an ultrasonic scalpel, a radio frequency ablation electrode, a low temperature plasma knife, and the like. In clinical use, radiofrequency ablation of the tongue using a low temperature plasma knife can achieve better clinical results. Of course, those skilled in the art can design various other types of surgical instruments that meet the needs of use according to the needs, without departing from the scope of the claimed invention.

When the surgical instrument 10 is used in conjunction with the positioning mechanism 4 of the mechanical navigation, the surgical instrument 100 A scale 100-1 capable of marking the insertion depth of the surgical instrument is provided. The surgical instrument 100 sequentially enters the tongue tissue through the surgical operation hole 41 and the surgical operation window 23 to perform a surgical operation, and the surgical field can be defined in a safe surgical region centered on the surgical operation hole 41. The insertion depth and the insertion angle of the surgical instrument 100 are defined and set. When the doctor performs a surgical operation, the depth to which the surgical instrument 100 has been inserted is determined based on the scale 100-1 on the surgical instrument 100.

When the surgical instrument 100 is used in conjunction with the positioning mechanism 4 of electromagnetic navigation or magnetic navigation, the head of the surgical instrument 100 contains the magnetic positioning element 43.

When the surgical instrument 100 is used in conjunction with the positioning mechanism 4 of the electromagnetic navigation, when the surgical instrument 100 moves, the magnetic positioning element 43 moves, the electromagnetic field changes accordingly, and the electromagnetic field change signal is The magnetic positioning device 43-1 is fed back, and after the magnetic positioning device 43-1 processes the feedback signal, the spatial position of the magnetic positioning element 43 is displayed on the display device 43-3. Through the magnetic positioning component 43 and the magnetic positioning device 43-1, the position of the surgical instrument 100 can be displayed on the display device 43-3 in real time, the surgical operation process is more precise and intuitive, and the surgical procedure is safer and more convenient.

When the surgical instrument 100 is used in conjunction with the positioning mechanism 4 of magnetic navigation, if the magnetic positioning element 43 is a permanent magnet element, the magnetic material powder or ferromagnetic material powder 43-2 is made of a ferromagnetic material. Into, such as iron powder. If the magnetic positioning member 43 is a ferromagnetic material member, the magnetic material powder or ferromagnetic material powder 43-2 is made of a magnetic powder. When the magnetic positioning member 43 moves, the magnetic material powder or the ferromagnetic material powder 43-2 will move and gather with it due to magnetic attraction, and during the operation, by being disposed on the upper positioning plate 1 or the The imaging system 17 on the upper end 31 of the fixing bracket 3 observes the degree of aggregation of the magnetic material powder or ferromagnetic material powder 43-2 to the magnetic positioning member 43 at the front end of the surgical instrument and the magnetic material powder or ferromagnetic material powder. The magnetic powder spot size formed by 43-2 is used to position the surgical instrument 100.

When the surgical instrument 100 is used in conjunction with the positioning mechanism 4 of the light navigation, the head of the surgical instrument 100 contains the optical fiber 44. During the operation, when the surgical instrument 100 is moved, the optical fiber 44 moves accordingly, and the brightness and size of the spot formed by the tissue of the tongue 6 also changes, and the imaging system 17 observes the real-time view. The brightness and size of the spot formed by the optical fiber 44 can be used to determine the distance between the front end of the surgical instrument 100 and the surface of the tongue.

The tongue ablation surgical navigation positioning device of the invention comprises an upper positioning plate 1, a lower positioning plate 2, a fixing bracket 3 and a positioning mechanism 4; the upper positioning plate 1 has a geometric shape matching the shape of the tongue and the alveolar bone The lower positioning plate 2 has a geometric shape matching the outer shape of the lower jaw 7, and the upper end 31 of the fixing bracket 3 and the upper positioning plate 1 The lower end 32 of the fixing bracket 3 is connected to the lower positioning plate 2, and the tongue is fixed by the upper positioning plate 1, the lower positioning plate 2 and the bone tissue on the lower jaw 7. The lower positioning plate 2 is provided with a surgical operation window 23, and the positioning mechanism 4 is a navigation positioning mechanism capable of guiding the insertion of the tongue ablation related surgical instrument into the target area for ablation operation, and the positioning mechanism 4 is provided with a surgical operation. Hole 41. The surgical instrument 100 sequentially enters the tongue tissue through the surgical operation hole 41 and the surgical operation window 23, and performs a surgical operation on the target area under the navigational positioning of the positioning mechanism 4. The tongue ablation surgical navigation positioning device of the invention makes the surgical operation process more safe, accurate, controllable and convenient.

DRAWINGS

1 is a perspective view showing the three-dimensional structure of the tongue ablation surgical navigation and positioning device of the present invention when viewed in a mechanical navigation position.

Figure 1-1 is a perspective view showing the structure of Figure 1 in a plan view.

Figure 1-2 is a cross-sectional view of Figure 1-1.

Figure 1-3 is a schematic diagram of the operation of Figure 1.

1-4 are schematic diagrams of the operation of FIG. 1.

2 is a schematic structural view of an upper positioning plate of a thin-walled plate-like structure.

Figure 2-1 is a bottom view of Figure 2.

Figure 3 is a schematic view of the structure of the foldable upper positioning plate.

4 is a schematic structural view of an upper positioning plate including an arch structure.

Figure 5 is a schematic view showing the structure of the upper positioning plate of the thin-walled mesh structure.

Fig. 6 is a schematic view showing the structure of the tongue ablation surgical navigation and positioning device of the present invention when the lower positioning plate and the fixing bracket are integrally manufactured.

Fig. 7 is a schematic view showing the structure of a tongue ablation surgical navigation and positioning device of the present invention comprising only one ball joint.

Fig. 8 is a schematic view showing the structure of a tongue ablation surgical navigation positioning device of the present invention integrally manufactured.

FIG. 9 is a schematic structural view of a tongue ablation surgical navigation and positioning device of the present invention during electromagnetic navigation positioning.

Fig. 10 is a structural schematic view of the tongue ablation surgical navigation and positioning device of the present invention when the magnetic powder material is positioned and positioned.

Figure 11 is a schematic view showing the structure of the tongue ablation surgical navigation and positioning device of the present invention at the time of optical navigation positioning.

In the above picture:

1 is the upper positioning plate, 2 is the lower positioning plate, 3 is the fixing bracket, 4 is the positioning mechanism, 5 is the projection area, and 6 is the tongue body. 7 is a lower jaw, 99 is a navigation and positioning device for tongue ablation surgery of the present invention, and 100 is a surgical instrument used in conjunction with a tongue ablation surgical navigation and positioning device.

11 is the connecting mechanism of the upper positioning plate, 12 is the marking line in the tongue, 13 is the ridge line of the upper positioning plate, 14 is the hook plate of the tongue, 15 is the marking scale, 16 is the mesh structure, 16-1 is the flexible net, 17 For the camera system, 18 is a hinge and 19 is an arched structure.

21 is a connection mechanism of the lower positioning plate, 22 is a scale marking line, and 23 is a surgical operation window.

31 is the upper end of the bracket, 32 is the lower end of the bracket, 33 is the adjustment mechanism, 33-1 is the sleeve, 33-2 is the support column, 33-3 is the ball joint, 33-4 is the scale, 33-5 is the pin, 34 is the support arm.

41 is the surgical operation hole, 42 is the navigation positioning template, 42-1 is the side limiting block, 42-2 is the end limiting block, 42-3 is the limiting hole, 43 is the magnetic positioning component, and 43-1 is the magnetic positioning. The device, 43-2 is a magnetic material powder or a ferromagnetic material powder, 43-3 is a display device, 44 is an optical fiber, and 44-1 is a light source.

100-1 is the scale.

detailed description

Embodiment 1: The tongue ablation surgery navigation positioning device of the invention of the mechanical navigation positioning mechanism

Referring to FIG. 1 to FIG. 8 , in the embodiment, the tongue ablation surgical navigation positioning device 99 includes a positioning plate 1 , a lower positioning plate 2 , a fixing bracket 3 , and a positioning mechanism 4 .

The upper positioning plate 1 has a geometric shape matching the shape of the tongue and the alveolar bone, and the upper positioning plate 1 is provided with a connecting mechanism 11 connected to the fixing bracket 3, and the upper positioning plate 1 is near The end is connected to the upper end 31 of the fixing bracket 3 via the connecting mechanism 11. The upper positioning plate 1 is placed on the tongue body 6. The upper positioning plate 1 presses the tongue body 6 and cooperates with the bone tissue of the lower teeth and the alveolar bone to fix the tongue body. Inside the jaw cavity.

The lower positioning plate 2 has a geometric shape matching the outer shape of the lower jaw 7, and the lower positioning plate 2 is provided with a connecting mechanism 21 connected to the fixing bracket 3, and the proximal end of the lower positioning plate 2 The lower positioning plate 2 is connected to the lower end 32 of the fixing bracket 3, and the lower positioning plate 2 can lift the lower jaw 7.

The upper end 31 of the fixing bracket 3 is connected to the upper positioning plate 1 , the lower end 32 of the fixing bracket 3 is connected to the lower positioning plate 2 , and the tongue body is the upper positioning plate 1 , the lower positioning plate 2 and the The bony tissue on the lower jaw 7 is fixed.

The positioning mechanism 4 is a navigation positioning mechanism capable of guiding the insertion of the surgical device into the target area for ablation surgery. In the embodiment, the positioning mechanism 4 is a mechanical navigation positioning mechanism, and the positioning mechanism 4 is provided. Have The surgical operation hole 41 is referred to FIG. 1 to FIG.

The upper positioning plate 1 is a cantilever structure in which the proximal end is fixed to the upper end 31 of the fixing bracket 3. In this embodiment, the upper positioning plate 1 is coupled to the upper end 31 of the fixing bracket 3 by means of a concave-convex card, with reference to FIGS. 1 to 3. The upper positioning plate 1 may also be integrally formed on the upper end 31 of the fixing bracket 3, or may be fixed to the upper end 31 of the fixing bracket 3 by a threaded connection, an interference fit, a pin connection, a rivet joint or the like. Of course, those skilled in the art can also design other various fixing manners as needed, without departing from the scope of protection of the present application.

In this embodiment, the upper positioning plate 1 is manufactured by 3D printing technology according to three-dimensional data of CT scan or MRI scan three-dimensional data naturally placed in the lower jaw cavity or 3D data provided by the 3D camera. Since the upper positioning plate 1 is manufactured according to the three-dimensional data of the patient, a good matching of the upper positioning plate 1 and the tongue body 6 can be sufficiently ensured, and the positioning is more accurate.

Of course, the upper positioning plate 1 can also be manufactured by a technique such as a numerical control processing technique or a resin stamping molding technique. Those skilled in the art can also select other various manufacturing techniques as needed without departing from the scope of protection of the present patent application.

The upper positioning plate 1 is provided with an upper positioning plate ridge line 13 which is made of a shape memory alloy, and the upper positioning plate ridge line 13 can support the tongue body according to the bony tissue of the lower gums. In the upper positioning plate 1 cavity, reference is made to Figs. 2 and 2-1. Since the upper positioning plate ridge line 13 needs to collect and position the tongue body 6, the upper positioning plate ridge line 13 is usually made of a medical material having a certain strength, in addition to the shape memory alloy. It is made of materials such as medical plastics and medical titanium alloys.

The upper positioning plate 1 is a thin-walled housing structure or a thin-walled mesh structure 16. Since the upper positioning plate 1 needs to be built in the patient's mouth, the upper positioning plate 1 generally selects a thin-walled structure, such as a thin-walled shell structure or a thin-walled mesh structure, in order to facilitate handling and increase patient comfort. Wait. In this embodiment, the upper positioning plate 1 is a thin-walled plate-like structure.

The distal end of the upper positioning plate 1 is provided with a tongue hook plate 14 which can pull and lift the tongue forward to maintain the opening of the tongue and throat airway. Since the tongue body 6 is composed of soft muscles and fascia tissues, when the upper positioning plate 1 is pressed down and fixed, the tongue body 6 is deformed and moved in the direction of the external force. . To avoid The posterior movement of the tongue 6 to the base of the tongue causes a occlusion of the pharyngeal airway, which poses a surgical risk. The distal end of the upper positioning 1 is provided with a tongue-and-loop plate 14 which can pull the tongue 6 and Lifting up, keeping the airway of the tongue and throat open, to ensure the smooth operation of the surgery. The tongue hook plate 14 can also be designed with a non-slip pattern to better prevent the tongue body 6 from sliding backward.

The upper positioning plate 1 is provided with an imaging system 17, which can observe the condition of the tongue and the back of the tongue during the operation in real time. Since the upper positioning plate 1 is provided with the imaging system 17, the doctor can observe the condition of the tongue 1 in real time during the operation of the operation, and timely judge and deal with various situations occurring in the operation, the doctor The surgical procedure is safer.

The lower positioning plate 2 is a cantilever structure in which the proximal end is fixed to the lower end 32 of the fixing bracket 3.

In this embodiment, the lower positioning plate 2 is detachably mounted on the lower end 32 of the fixing bracket 3 by means of a concave-convex card engagement, with reference to FIG. 1 to FIG. The lower positioning plate 2 can also be mounted on the lower end 32 of the fixing bracket 3 by means of a screw connection, an interference fit, a pin connection, a rivet connection, etc., which applicants do not enumerate here, and those skilled in the art can also It is actually necessary to design different installation methods without departing from the scope of protection of this patent application.

In actual clinical applications, the lower positioning plate 2 can also be integrally manufactured together with the fixing bracket 3. Referring to FIG. 6, the design requirements are met to meet the requirements of most patients, thereby saving manufacturing costs.

In this embodiment, the lower positioning plate 2 is manufactured by 3D printing technology according to the three-dimensional data of the CT scan of the shape of the lower jaw 7 or the three-dimensional data of the MRI scan or the three-dimensional data provided by the 3D camera. Since the lower positioning plate 2 is manufactured according to the three-dimensional data of the patient, it can be sufficiently ensured that the shape of the lower positioning plate 2 and the lower jaw 7 are better matched, and the positioning is more precise.

The lower positioning plate 2 can also be manufactured by a numerical control processing technique, a resin stamping molding technique, or the like. Those skilled in the art can also select other various manufacturing techniques as needed without departing from the scope of protection of the present patent application.

The lower positioning plate 2 is provided with a surgical operation window 23 for allowing a surgical related instrument to pass. Surgical instrument 100 Surgical procedures for various tissue ablation or ablation can be performed through the surgical access window 23.

In this embodiment, the tongue ablation surgical navigation and positioning device 99 is provided with three fixing brackets 3. Each of the fixing brackets 3 includes an adjustment mechanism 33 that can adjust the spatial position of the upper positioning plate 1. Each of the adjustment mechanisms 33 includes a sleeve 33-1, a support post 33-2, and a ball joint 33-3, with reference to FIGS. 1 through 1-2.

The support post 33-2 is slidable within the sleeve 33-1, and the support post 33-2 and the sleeve 33-1 are fixed by pins 33-5. The upper end 31 of the fixing bracket is connected to the upper positioning plate 1 to adjust the relative position of the support post 33-2 and the sleeve 33-1, and the upper end 31 and the lower positioning of the fixing bracket can be changed. The spatial position between the plates 2, thereby changing the spatial position between the upper positioning plate 1 and the lower positioning plate 2 connected to the upper end 31 of the fixing bracket.

The ball joint 33-3 may be disposed at the upper end 31 of the fixing bracket and connected to the sleeve 33-1; or the upper end 31 of the fixing bracket may be connected to the support post 33-2. By adjusting the spatial position of the three ball joints 33-3, the stereoscopic spatial positioning of the upper positioning plate 1 can be achieved, and the tongue body 6 can be better pressed and fixed in the direction of the bottom of the mandible.

In this embodiment, the ball joint 33-3 is disposed on each of the fixing brackets 3. In clinical use, it may be necessary to adjust the direction of one or two of the fixing brackets 3 to adapt to the The shape of the tongue 6 is described, and therefore, the number of the ball joints 33-3 can be specifically selected according to clinical needs without departing from the scope of protection of the present patent application. As shown in FIG. 7 is a tongue ablation surgical navigation positioning device of the present invention having only one ball joint. At this time, by adjusting one of the ball joints 33-3, only the front and rear tilting of the upper positioning plate 1 can be adjusted. Angle, but the left and right tilt angles of the upper positioning plate 1 cannot be adjusted. The balance of the left and right inclination of the fixed bracket 3 is balanced by the sleeve slide structure provided on the left and right sides.

In this embodiment, the adjusting mechanism 33 of the fixing bracket 3 adopts a sleeve sliding rod structure. The adjusting mechanism of the fixing bracket 3 can also be used to manufacture the adjusting mechanism 33 by using a hinge structure, a rotating structure, an electric adjusting mechanism, etc., and the applicant does not list them one by one, and those skilled in the art can also design according to actual needs. Different installation methods are not deviated from the scope of protection of this patent application.

In this embodiment, the positioning mechanism 4 is a mechanical navigation positioning mechanism, and includes a navigation positioning template 42. The navigation positioning template 42 includes a side limiting block 42-1, an end limiting block 42-2, and a limiting hole 42-3; the side limiting block 42-1 is installed. On the lower positioning plate 2, the end limiting block 42-2 is mounted on the side limiting block 42-1, or may be integrally formed with the side limiting block 42-1. A limiting hole 42-3 is provided on the end limiting block 42-2. The navigation positioning template 42 is fixed on the lower positioning plate 2, the position of the surgical operation hole 41 is matched with the position of the surgical operation window 23 of the lower positioning plate 2, and the surgical operation window can be directly directly 23 is used as the surgical operation hole 41. The surgical instrument 100 sequentially passes through the surgical operation hole 41 and the surgical operation window 23 and enters the tongue tissue. Before the operation, the surgical safety area is determined according to the patient's three-dimensional data. Generally, the surgical safety area is in the vicinity of the tongue contour nipple 4 cm, and the area of 4.5×4.5 cm symmetrically distributed along the midline of the tongue, the deepest part of the surgical instrument 100 can be inserted. The surface of the tongue 6 needs to be larger than 1.5 cm, and then the security area is set as the projection area 5 of the navigation positioning template 42 centered on the surgical hole 41. That is, the surgical field is defined within the projection area 5 centered on the surgical hole 41. The side stop block 42-1 of the navigation positioning template 42 can define a safe operating region of the surgical instrument 100, and the end stop block 42-2 can define a safe insertion depth of the surgical instrument 100; The limiting hole 42-3 can determine the insertion angle of the surgical instrument 100. Referring to FIGS. 1-3 and 1-4, through the side limiting block 42-1, the end limiting block 42-2 and the limiting hole. 42-3 can accurately limit and position the safe area, insertion depth and insertion angle during the operation, making the operation process safe, accurate and controllable.

The surgical instrument 100 used in conjunction with the tongue ablation surgical navigation and positioning device 99 of the present embodiment may be a scalpel, an electrosurgical knife, an ultrasonic scalpel, a radio frequency ablation electrode, a low temperature plasma knife, or the like. Of course, those skilled in the art can design various other types of surgical instruments that meet the needs of use according to the needs, without departing from the scope of the claimed invention.

The surgical instrument 100 is provided with a scale 100-1 that can indicate the depth of insertion of the surgical instrument.

In clinical use, the upper positioning plate 1 and the lower positioning plate 2 are first printed by 3D printing according to the three-dimensional data of the CT scan of the patient's tongue and the lower jaw or the three-dimensional data of the MRI scan or the three-dimensional data provided by the 3D camera. Before the operation, the surgical simulation operation is performed in vitro according to the patient's three-dimensional data, the surgical navigation path is selected, and the surgical ablation area is determined. Typically, the surgical ablation zone is a region of 4.5 x 4.5 cm that is symmetrically distributed along the midline of the tongue at a depth of 4 cm around the tongue contour nipple. The deepest point at which the surgical instrument 100 can be inserted needs to be greater than 1.5 cm from the surface of the tongue 6 through The in vitro surgical simulation can determine various parameters of the upper positioning plate 1, the lower positioning plate 2, the fixed bracket 3 and the positioning mechanism 4 of the tongue ablation surgical navigation and positioning device 99, and record various parameters. The upper positioning plate 1 is then placed in the inlet cavity, and the upper positioning plate 1 is connected to the upper end 31 of the fixing bracket 3 by the connection mechanism 11 in a bump-and-groove manner. The lower positioning plate 2 is coupled to the lower end 32 of the fixing bracket 3 by means of a concave-convex card. Adjusting the position of the sleeve 33-1 and the support post 33-2 according to parameters determined during the simulation operation, and adjusting the direction of the ball joint 33-3, the upper positioning plate 1 will the tongue 6 Squeeze and fix the bottom of the mandible. The fixation of the tongue 6 by the tongue ablation surgical navigation and positioning device 99 is achieved. Then, the side limiting block 42-1 of the positioning mechanism 4 is mounted on the lower positioning plate 2, the positions of the surgical operation hole 41 and the surgical operation window 23 are adjusted, and the end position is limited. Block 42-2 is mounted on the side limiting block 42-1, and adjusts the direction of the limiting hole 42-3 to determine the angle at which the surgical instrument 100 enters the tongue 6, completing the tongue The installation of the body ablation surgical navigation and positioning device 99. During the operation, the surgical instrument 100 is sequentially passed through the surgical operation hole 41 and the surgical operation window 23 along the limiting hole 42-3 into the tongue body 6. The angle of the limiting hole 42-3 determines the angle at which the surgical instrument 100 enters the tongue 6. The surgeon can determine the surgical depth of the surgical instrument 100 into the tongue 6 in real time by the scale 100-1 on the surgical instrument 100. The surgeon can easily complete the entire surgical procedure by inserting the surgical instrument 100 into the different limiting holes 42-3.

During the operation, the patient's tongue is effectively fixed by the upper positioning plate 1 and the lower positioning plate 2 which are in good shape with the patient's tongue and lower jaw shape, and cannot be freely moved. The side limiting block 42-1 of the positioning mechanism 4 can define a safe operating area of the surgical instrument 100, and the end limiting block 42-2 can define a safe insertion depth of the surgical instrument 100; The position hole 42-3 can determine the insertion angle of the surgical instrument 100, and the combination of the side limiting block 42-1, the end limiting block 42-2 and the limiting hole 42-3 can be used during the operation operation. Precisely limit and position the surgical safety area, surgical instrument insertion depth and insertion angle. The tongue ablation surgical navigation positioning device of the invention makes the surgical operation process more safe, accurate, controllable and convenient.

In addition, the upper positioning plate 1 can also have various designs.

The upper positioning plate 1 can be designed as a thin-walled mesh structure 16 which increases the friction between the upper positioning plate 1 and the tongue 6 to better secure the tongue Body 6, to prevent the tongue from sliding.

Further, the thin-walled mesh structure 16 includes a flexible mesh 16-1 that can be gathered and unfolded, with reference to FIG. The flexible mesh 16-1 is a mesh structure in which a soft wire or a wire is woven, and the woven wire or wire may be made of a polymer material such as a nylon thread or a polypropylene thread; or may be made of a metal material. Such as titanium wire, shape memory alloy wire and the like. Since the flexible mesh 16-1 can be conveniently gathered and unfolded, when the upper positioning plate ridge line 13 is formed of a shape memory alloy, the flexible mesh 16-1 can be first gathered and placed in the oral cavity. The flexible mesh 16-1 is unfolded over the surface of the tongue 6 by the shape recovery of the upper positioning plate ridge 13 made of a shape memory alloy, and the upper positioning plate ridge 13 The tongue 6 is collected in the cavity formed by the flexible mesh 16-1 of the upper positioning plate 1 with the support of the lower bony ossification. Since the upper positioning plate 1 can be gathered, it is more convenient to enter the oral cavity, especially for patients with small mouths.

In use, the flexible mesh 16-1 is first gathered and placed in the patient's mouth, and under the effect of body temperature, shape memory The upper positioning plate ridge line 13 made of gold returns to a set shape, and the tongue body 1 is collected and fixed in the flexible mesh 16-1 of the upper positioning plate 1 by supporting the bony tissue of the lower gum.

The upper positioning plate 1 can also be designed as a folded plate-like structure or a screen structure capable of being gathered and unfolded, as shown in FIG. The upper positioning plate 1 is provided with a hinge 18, which can be folded and unfolded along the hinge 18. In use, the upper positioning plate 1 is first folded along the hinge 18, and after the oral cavity is inserted into the oral cavity, the upper positioning plate 1 is unfolded, and positioning the tongue body 6 is another convenient entry into the oral cavity. structure. Alternatively, those skilled in the art can also design other various structures that can be folded or folded as needed, without departing from the scope of the present application.

The upper positioning plate 1 can also be made of a rigid transparent material to form a thin-walled plate-like structure, with reference to FIG. 2 and FIG. 2-1. The upper positioning plate 1 is made of a rigid transparent material, on the one hand, the tongue 6 can be collected and fixed by a rigid material, and on the other hand, the transparent material can facilitate the doctor to the tongue 6 during a clinical operation. Real-time observation is performed to facilitate timely judgment and treatment of the surgical procedure.

The upper positioning plate 1 may further comprise an arched structure 19 matching the surface curvature of the tongue body 6. Referring to FIG. 4, the tongue body 6 can be more effectively attached, and the tongue body 6 can be more Well fixed.

Of course, those skilled in the art can design other upper positioning plates 1 of various shapes and structures as needed, without departing from the scope of protection of the present application.

In this embodiment, the fixing bracket 3 is an adjustable bracket, and the fixing bracket 3 can also be designed as a non-adjustable rigid structure. The upper end 31 of the fixing bracket and the lower end 32 of the fixing bracket pass through the supporting arm 34. Directly connected, the upper positioning plate 1, the lower positioning plate 2 and the fixed bracket 3 can be directly manufactured by 3D printing or the like according to the patient's three-dimensional data. Referring to FIG. 8, different specifications can be designed to meet different patients. The design is very simple and the manufacturing cost is low.

Embodiment 2: Electromagnetic navigation positioning mechanism of the tongue ablation surgery navigation positioning device of the invention

Referring to FIG. 9, the difference between this embodiment and Embodiment 1 is that the positioning mechanism 4 in this embodiment is an electromagnetic navigation positioning mechanism.

In this embodiment, the surgical operation hole 41 of the positioning mechanism 4 is the surgical operation window 23 of the lower positioning plate 2.

The positioning mechanism 4 includes a magnetic positioning component 43 and a magnetic positioning device 43-1; the magnetic positioning component 43 is disposed at a front end of the surgical instrument 100, and the magnetic positioning device 43-1 is positionable at a front end of the surgical instrument An electromagnetic device of the spatial position of the magnetic positioning element 43.

The surgical instrument 100 used in conjunction with the tongue ablation surgical navigation and positioning device 99 in this embodiment may It is a scalpel, an electric knife, an ultrasonic knife, a radio frequency ablation electrode, a low temperature plasma knife, and the like. Of course, those skilled in the art can design various other types of surgical instruments that meet the needs of use according to the needs, without departing from the scope of the claimed invention.

The head of the surgical instrument 100 contains the magnetic positioning element 43.

In clinical use, the upper positioning plate 1, the lower positioning plate 2 and the fixing bracket 3 of the tongue ablation surgical navigation positioning device 99 are installed, and after the fixation of the tongue 6 is achieved, the surgical instrument 100 is The surgical operation window 23 enters the tongue body, and when the surgical instrument 100 moves, the magnetic positioning component 43 moves to cause a change of an electromagnetic field, and a change signal of the electromagnetic field is fed back to the magnetic positioning device. 43-1, after the magnetic positioning device 43-1 processes the feedback signal, the spatial position of the magnetic positioning element 43 is displayed on the display device 43-3.

In the example of the present example, the position and the surgical path of the surgical instrument 100 can be displayed on the display device 43-3 in real time through the magnetic positioning component 43 and the magnetic positioning device 43-1, and the surgical operation process is more precise and intuitive. The surgical procedure is safer and more convenient.

Embodiment 3: Magnetic acupoint positioning mechanism of the present invention for tongue ablation surgery navigation positioning device

Referring to FIG. 10, the difference between this embodiment and the embodiment 2 is that, in the embodiment, the positioning mechanism 4 realizes the positioning of the surgical procedure by the change of the ordinary magnetic field.

The positioning mechanism 4 includes a magnetic material powder or a ferromagnetic material powder 43-2; the magnetic material powder or ferromagnetic material powder 43-2 is disposed in a closed cavity of the upper positioning plate 1 corresponding to a portion of the surgical region . An imaging system 17 is provided at an upper end of the fixing bracket 3.

The degree of aggregation of the magnetic material powder or ferromagnetic material powder 43-2 to the magnetic positioning member 43 at the front end of the surgical instrument and the magnetic powder spot formed by the magnetic material powder or the ferromagnetic material powder 43-2 are observed by the imaging system. The size enables positioning of the surgical instrument 100. If the magnetic positioning member 43 is a permanent magnet member, the magnetic material powder or ferromagnetic material powder 43-2 is made of a ferromagnetic material such as iron powder. If the magnetic positioning member 43 is a ferromagnetic material member, the magnetic material powder or ferromagnetic material powder 43-2 is made of a magnetic powder.

During operation, when the surgical instrument 100 is moved, the magnetic positioning element 43 moves accordingly due to the magnetic Sexual attraction, the magnetic material powder or ferromagnetic material powder 43-2 will move and gather with it, and the magnetic material powder or ferromagnetic material powder 43-2 is observed to the surgical instrument through the imaging system 17 during surgery. The degree of aggregation of the magnetic positioning member 43 at the front end and the size of the magnetic powder spot formed by the magnetic material powder or the ferromagnetic material powder 43-2 are used to position the surgical instrument 100.

Compared with the electromagnetic navigation positioning mechanism of the second embodiment, the embodiment has the advantages of simple structure and low manufacturing cost.

In addition, the positioning mechanism of the magnetic navigation of the embodiment can be used in combination with the positioning mechanism of the mechanical positioning navigation described in Embodiment 1, and the positioning mechanism of the mechanical positioning navigation defines the safe operation area, the deepest surgical depth, and the operation. With the insertion angle of the instrument 100, the surgical instrument 100 is positioned in real time by a magnetically navigated positioning mechanism, with reference to FIG.

Embodiment 4: The tongue ablation surgery navigation positioning device of the present invention of the optical navigation positioning mechanism

Referring to FIG. 11, the difference between this embodiment and Embodiment 3 is that the positioning mechanism 4 in this embodiment is an optical navigation positioning mechanism.

The positioning mechanism 4 includes an optical fiber 44 and a light source 44-1. One end of the optical fiber 44 is connected to the light source 44-1, and the other end is connected to the front end of the surgical instrument 100. The brightness and size of the optical fiber 44 at the front end of the surgical instrument inserted into the tongue can be determined to calculate the operation. The distance between the front end of the instrument and the surface of the tongue is positioned.

The head of the surgical instrument 100 contains the optical fiber 44. During the operation, when the surgical instrument 100 is moved, the optical fiber 44 moves accordingly, and the brightness and size of the spot formed by the tissue of the tongue 6 also changes, and the imaging system 17 observes the real-time view. The brightness and size of the spot formed by the optical fiber 44 can be used to determine the distance between the front end of the surgical instrument 100 and the surface of the tongue.

In this embodiment, only the optical fiber 44 needs to be placed in the head of the device 100, and the surgical system can be observed and controlled in cooperation with the imaging system 17, which is simpler than the

embodiments

1 and 2. Easy to operate.

In addition, the positioning mechanism of the optical navigation of the embodiment can be used in combination with the positioning mechanism of the mechanical positioning navigation described in Embodiment 1, and the safety surgical region, the deepest surgical depth, and the surgical instrument 100 are defined by the positioning mechanism of the mechanical positioning navigation. The insertion angle is real-time positioning of the surgical instrument 100 by a magnetically-guided positioning mechanism, with reference to FIG.

It should be noted that the structures disclosed and illustrated herein may be replaced with other structures having the same effect, and the embodiments described herein are not the only structures that implement the invention. Although the preferred embodiments of the present invention have been described and illustrated herein, it will be apparent to those skilled in the art that these embodiments are merely illustrative and that numerous changes and modifications can be made by those skilled in the art. The scope of the present invention is defined by the spirit and scope of the appended claims.

Claims

The tongue ablation surgical navigation positioning device is characterized in that: the navigation system (99) comprises a positioning plate (1), a lower positioning plate (2), a fixing bracket (3) and a positioning mechanism (4);

A. The upper positioning plate (1) has a geometric shape matching the shape of the tongue and the alveolar bone, and the upper positioning plate (1) is provided with a connection mechanism (11) connected to the fixing bracket (3). The proximal end of the upper positioning plate (1) is connected to the upper end (31) of the fixing bracket (3) by the connecting mechanism (11), and the upper positioning plate (1) is covered on the tongue The upper positioning plate (1) presses the tongue down and cooperates with the bony tissue of the lower teeth and the alveolar bone to fix the tongue in the lower jaw mouth;

B. The lower positioning plate (2) has a geometric shape matching the shape of the lower jaw, and the lower positioning plate (2) is provided with a connecting mechanism (21) connected to the fixing bracket (3), The proximal end of the lower positioning plate (2) is connected to the lower end (32) of the fixing bracket (3) through the connecting mechanism (21), and the lower positioning plate (2) can lift the lower jaw;

C. The upper end (31) of the fixing bracket (3) is connected to the upper positioning plate (1), and the lower end (32) of the fixing bracket (3) is connected with the lower positioning plate (2), the tongue body It is fixed by the upper positioning plate (1), the lower positioning plate (2) and the bone tissue on the lower jaw.

D. The positioning mechanism (4) is a navigation positioning mechanism capable of guiding a surgical ablation related surgical instrument insertion into a target area for performing an ablation operation, and the positioning mechanism (4) is provided with a surgical operation hole (41).
The tongue ablation surgical navigation and positioning device according to claim 1, wherein the upper positioning plate (1) is a cantilever structure in which the proximal end is fixed to the upper end (31) of the fixing bracket (3).
The tongue ablation surgical navigation positioning device according to claim 1, wherein the upper positioning plate (1) is a three-dimensional data of a CT scan or a three-dimensional data or 3D of an MRI scan according to a natural placement of the tongue in the mandibular cavity. The 3D data provided by the camera is manufactured.
The tongue ablation surgical navigation positioning device according to claim 3, characterized in that the upper positioning plate (1) is manufactured by a 3D printing technique.
The tongue ablation surgical navigation positioning device according to claim 3, wherein the upper positioning plate (1) is manufactured by a numerical control machining process.
The tongue ablation surgical navigation positioning device according to claim 3, characterized in that the upper positioning plate (1) is manufactured by a resin stamping technique.
The tongue ablation surgical navigation and positioning device according to claim 1, wherein the upper positioning plate (1) is provided with an upper positioning plate ridge line (13), and the upper positioning plate ridge line (13) can be relied upon The gum tissue is supported to collect the tongue in the upper positioning plate (1) cavity.
The tongue ablation surgical navigation positioning device according to claim 1, characterized in that the upper positioning plate (1) is a thin-walled housing structure or a thin-walled mesh structure (16).
The tongue ablation surgical navigation positioning device according to claim 8, wherein the thin-walled mesh structure (16) comprises a flexible mesh (16-1) that can be gathered and deployed.
The tongue ablation surgical navigation and positioning device according to claim 1, wherein the upper positioning plate (1) is a folded plate-like structure or a screen structure capable of performing folding and unfolding activities.
The tongue ablation surgical navigation positioning device according to claim 1, characterized in that the upper positioning plate (1) comprises an arched structure (19).
The tongue ablation surgical navigation positioning device according to claim 1, characterized in that the upper positioning plate (1) is made of a rigid transparent material.
The tongue ablation surgical navigation and positioning device according to claim 1, characterized in that the upper positioning plate (1) is provided with an in-lingual identification line (12).
The tongue ablation surgical navigation positioning device according to claim 1, characterized in that: the distal end of the upper positioning plate (1) is provided with a tongue root hook plate (14), and the tongue root hook plate (14) can be placed in front of the tongue body. Pull and lift up to keep the airway open.
The tongue ablation surgical navigation positioning device according to claim 1, characterized in that the upper positioning plate (1) is provided with a scale (15) for identification.
The tongue ablation surgical navigation and positioning device according to claim 1, wherein the upper positioning plate (1) or the upper end (31) of the fixing bracket (3) is provided with a camera system (17), and the camera The system (17) can observe the condition of the tongue and the back of the tongue during the operation in real time.
The tongue ablation surgical navigation positioning device according to claim 1, wherein the lower positioning plate (2) is a cantilever structure in which the proximal end is fixed to the lower end (32) of the fixing bracket (3).
The tongue ablation surgical navigation and positioning device according to claim 1, characterized in that the lower positioning plate (2) is detachably mounted on the lower end (32) of the fixing bracket (3).
The tongue ablation surgical navigation positioning device according to claim 1, characterized in that the lower positioning plate (2) is integrally formed with the fixing bracket (3).
The tongue ablation surgical navigation positioning device according to claim 1, wherein the lower positioning plate (2) is manufactured according to three-dimensional data of a CT scan of the mandibular shape or three-dimensional data of an MRI scan or three-dimensional data provided by a 3D camera. of.
The tongue ablation surgical navigation and positioning device according to claim 19, wherein the lower positioning plate (2) is manufactured by using a 3D printing technique.
The tongue ablation surgical navigation positioning device according to claim 19, wherein the lower positioning plate (2) is manufactured by a numerical control machining process.
The tongue ablation surgical navigation positioning device according to claim 19, wherein the lower positioning plate (2) is manufactured by a resin stamping technique.
The tongue ablation surgical navigation and positioning device according to claim 1, wherein the lower positioning plate (2) is provided with a scale marking line (22).
The tongue ablation surgical navigation positioning device according to claim 1, wherein the lower positioning plate (2) is provided with a surgical operation window (23) for allowing a surgical related device to pass.
The tongue ablation surgical navigation and positioning device according to claim 1, characterized in that the fixing bracket (3) comprises an adjusting mechanism (33) capable of adjusting the spatial position of the upper positioning plate (1).
The tongue ablation surgical navigation positioning device according to claim 26, wherein the adjustment mechanism (33) comprises a sleeve (33-1) and a support column (33-2).
The tongue ablation surgical navigation positioning device according to claim 27, wherein said support column (33-2) is slidable within said sleeve (33-1) through said upper end of said fixing bracket (31) Connecting with the upper positioning plate (1), adjusting the relative position of the support column (33-2) and the sleeve (33-1), can change the spatial position of the upper end (31) of the fixing bracket, Thereby the spatial position of the upper positioning plate (1) connected to the upper end (31) of the fixing bracket is changed.
A tongue ablation surgical navigation positioning device according to claim 27, wherein said adjustment mechanism (33) comprising a ball joint (33-3), the ball joint (33-3) being provided at an upper end (31) of the fixing bracket and connected to the sleeve (33-1); or the ball joint (33-3) The upper end (31) of the fixing bracket is connected to the support column (33-2).
The tongue ablation surgical navigation positioning device according to claim 26, wherein the support column (33-2) is provided with a scale (33-4), and the scale (33-4) is removed or reassembled. After the connection between the upper positioning plate (1) and the fixing bracket (3), the spatial position of the upper positioning plate (1) can be accurately repeated.
The tongue ablation surgical navigation positioning device according to claim 1, wherein the fixing bracket (3) is an unadjustable rigid structure, and the upper end (31) of the fixing bracket and the lower end of the fixing bracket (32) ) connected by a support arm (34).
The tongue ablation surgical navigation and positioning device according to claim 1, wherein the positioning mechanism (4) is a mechanical navigation positioning mechanism, or an electromagnetic navigation positioning structure, or a light navigation positioning mechanism.
The tongue ablation surgical navigation positioning device according to claim 32, wherein the positioning mechanism (4) is a mechanical navigation positioning mechanism, including a navigation positioning template (42); and the navigation positioning template (42) can The surgical field is defined in a projection area (5) centered on the surgical operation hole (41) and is accurately positioned according to the depth and angle at which the surgical instrument is inserted along the surgical hole.
The tongue ablation surgical navigation and positioning device according to claim 33, wherein the navigation positioning template (42) comprises a side limiting block (42-1), an end limiting block (42-2) and a limiting hole. (42-3); the side limiting block (42-1) is mounted on the lower positioning plate (2), and the limiting hole (42-3) is disposed at the end limiting block (42- 2) On.
The tongue ablation surgical navigation positioning device according to claim 32, wherein the positioning mechanism (4) is an electromagnetic navigation mechanism, comprising a magnetic positioning component (43) and a magnetic positioning device (43-1); A positioning member (43) is provided at the front end of the surgical instrument, and the magnetic positioning device (43-1) is an electromagnetic device capable of positioning a spatial position of the magnetic positioning member (43) provided at the front end of the surgical instrument.
A tongue ablation surgical navigation positioning device according to claim 32, wherein said positioning mechanism (4) is a magnetic navigation mechanism comprising a magnetic material powder or a ferromagnetic material powder (43-2); said magnetic material powder Or a ferromagnetic material powder (43-2) is disposed in the closed cavity of the upper positioning plate (1) corresponding to the surgical region portion, and is operated according to the magnetic material powder or the ferromagnetic material powder (43-2) The degree of aggregation of the magnetic positioning elements (43) at the front end of the instrument and the size of the magnetic powder spots formed by the magnetic material powder or ferromagnetic material powder (43-2) can position the surgical instrument.
The tongue ablation surgical navigation positioning device according to claim 32, wherein the positioning mechanism (4) is an optical positioning mechanism comprising an optical fiber (44) and a light source (44-1); and one end of the optical fiber (44) Connected to the light source (44-1), the other end is connected to the front end of the surgical instrument, and the front end and the tongue of the surgical instrument can be calculated by judging the brightness and size of the spot of the optical fiber (44) at the front end of the surgical instrument inserted into the tongue. The distance from the surface of the body is positioned.
A surgical instrument for tongue ablation, characterized in that the surgical instrument (100) can be used in conjunction with the tongue ablation surgical navigation positioning device (99) according to claim 1, the surgical instrument (100) being a scalpel Or an electric knife, or an ultrasonic knife, or a radiofrequency ablation electrode, or a low temperature plasma knife.
The surgical instrument according to claim 38, wherein when said surgical instrument (100) is used in conjunction with said positioning mechanism (4) of mechanical navigation, said surgical instrument (100) is provided with an injectable surgery The scale of the instrument insertion depth (100-1).
The surgical instrument according to claim 38, wherein when said surgical instrument (100) is used in conjunction with said positioning mechanism (4) of electromagnetic navigation or magnetic navigation, the head of said surgical instrument (100) comprises The magnetic positioning element (43) of claim 33.
The surgical instrument according to claim 38, characterized in that when the surgical instrument (100) is used in conjunction with the positioning mechanism (4) of the light navigation, the head of the surgical instrument (100) contains claim 35 The optical fiber (44).