WO2019045321A1 - Système de surveillance de nerf peropératoire utilisant un biocapteur de pression - Google Patents

Système de surveillance de nerf peropératoire utilisant un biocapteur de pression Download PDF

Info

Publication number
WO2019045321A1
WO2019045321A1 PCT/KR2018/009287 KR2018009287W WO2019045321A1 WO 2019045321 A1 WO2019045321 A1 WO 2019045321A1 KR 2018009287 W KR2018009287 W KR 2018009287W WO 2019045321 A1 WO2019045321 A1 WO 2019045321A1
Authority
WO
WIPO (PCT)
Prior art keywords
nerve
pressure sensor
bio
pressure
muscle
Prior art date
Application number
PCT/KR2018/009287
Other languages
English (en)
Korean (ko)
Inventor
이병주
노정훈
Original Assignee
부산대학교 산학협력단
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 부산대학교 산학협력단 filed Critical 부산대학교 산학협력단
Publication of WO2019045321A1 publication Critical patent/WO2019045321A1/fr

Links

Images

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/40—Detecting, measuring or recording for evaluating the nervous system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0002—Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network
    • A61B5/0015—Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network characterised by features of the telemetry system
    • A61B5/0022—Monitoring a patient using a global network, e.g. telephone networks, internet
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7225—Details of analog processing, e.g. isolation amplifier, gain or sensitivity adjustment, filtering, baseline or drift compensation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
    • A61B2562/02—Details of sensors specially adapted for in-vivo measurements
    • A61B2562/0247—Pressure sensors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
    • A61B2562/02—Details of sensors specially adapted for in-vivo measurements
    • A61B2562/0261—Strain gauges

Definitions

  • the present invention relates to an intraoperative neural surveillance system using a bio-pressure sensor, and more particularly, to a neural surveillance system using a bio-pressure sensor, and more particularly,
  • a bio-pressure sensor In order to measure the EMG of the muscles, the pressure change at the contact surface of the skin or muscles caused by the movement of the muscle is measured using a bio-pressure sensor, not by inserting a conventional electrode or measuring the action potential change due to the muscle movement of the human body surface And the measured pressure change is transmitted by wire or wireless so that the user can visually confirm the nervousness through a graph or an audible alarm. Further, the measured result is transmitted to the mobile device through wireless communication, Using a bio-pressure sensor that allows easy identification To an intraoperative nerve monitoring system.
  • the precise identification of the nerve of the recipient in performing the surgery is an important part of preventing complications from nerve injury in many surgical procedures such as otorhinolaryngology, brain surgery, thoracic surgery, spine surgery, or orthopedic surgery.
  • an intraoperative neurological surveillance system is used to continuously monitor the nerve area of the patient during surgery.
  • the neural surveillance system is very helpful in preventing complications due to nerve injury that may occur even during surgery of the patient.
  • Electromyography is a technique for measuring and recording electrical signals from skeletal muscles.
  • the conventional neural surveillance system is a system for assessing whether or not a nerve is affected by electrical stimulation of a structure suspected to be a nerve by electromyography according to the movement of the muscle.
  • the nerve stimulation is performed using a separate nerve probe, as shown in FIG. 1, which can provide electrical stimulation separately from the medical instrument that performs surgery during surgery, and then the electromyogram generated by the nerve stimulation is inspected .
  • the method of measuring the EMG of the muscle varies depending on the region, but for the EMG measurement, a needle electrode method for inserting a needle-shaped electrode as shown in FIG. 2 into the muscle, And the surface derivation method in which the same electrode is attached to measure the action potential of the muscles.
  • the needle electrode method can reflect the electromyogram of the corresponding muscle, but the need for inserting the needle into the muscle causes pain, infection by the needle and bleeding.
  • the thyroid gland in thyroid surgery the needle can not be inserted in the position can not use the needle electrode method.
  • a surface derivation method is used to measure the action potential of the vocal cord muscle by using an electrode that can be attached to the electromyographic or intubation intubation tube fixed on the surface of the airway intubation tube as shown in FIG.
  • this surface derivation method requires that all of the two electrodes should be in contact with the vocal cords in an attached EMG to the tube for tracheal intubation. If one of the electrodes is displaced and the vocal cord contact is incomplete, the neural surveillance system will fail to operate . In other words, if the electromyographic electrode inserted or attached to the tube is moved due to the change of the posture of the patient or the insertion direction of the intubation tube, if one electrode moves and the contact with the vocal cords is poor, EMG can not be measured.
  • Electrophysiographic measurement using fixed or attachable electrodes on the surface of the intubation tube used frequently for thyroid surgery has the problem that accurate EMG can not be measured due to interference or noise due to needle or spatula.
  • An apparatus and method for monitoring a nervous system during surgery can simultaneously monitor the nervous system of a subject during surgery using peak amplitude and peak time of excitation potential and are not bound to various kinds of stimuli ≪ / RTI >
  • Korean Patent Laid-Open No. 10-2009-0115162 discloses a surgical navigation and neural surveillance integrated system with automated surgical assistance and control, including an instrument tracking system configured to track movement of the instrument, And a database containing technical information about the patient's anatomy; And determining an anatomical structure proximate to the instrumentation tracking system and the database, the anatomical structure proximate the instrumentation; Determining a portion of the technical information associated with the anatomical structure included in the database; And identifiers for a portion of the descriptive information in a user-selectable manner that allows the user to selectively obtain descriptive information in connection with either the surgical procedure or the anatomical structure.
  • the computer is configured to automatically determine an electrostimulation pattern from the location of the neural structure and to electrically stimulate the neural structure according to the determined electrical stimulation pattern, To an apparatus that is further programmed to control the neural surveillance system.
  • the present invention has been made to solve the above problems of the prior art, and it is an object of the present invention to provide a method and apparatus for measuring electromyography by electrical stimulation in order to confirm a nervous state during surgery,
  • a bio-pressure sensor is attached to the surface of the intubation tube tube in the form of a tape so that the insertion of a needle corresponding to at least two electrodes for conventional electromyography
  • to eliminate the instability of measurement signals caused by acupuncture or sputum by eliminating the risk of pain, hemorrhage or infection due to contact failure due to movement of the vocal fold muscle in contact with the two electrodes of the intubation intubation tube
  • the pressure value at the contact surface of the skin or muscle which is the analog value measured from the bio pressure sensor
  • a new bio-pressure sensor that can be easily accessed by a user's portable device such as a doctor using a wireless communication technology by converting the digital signal into a digital signal. do.
  • the present invention provides a surgical operation method for a surgeon who is suspected of being an area corresponding to a nerve during surgery, A nerve probe that performs stimulation, and a portion located between the skin and the contact surface of the body's muscles and muscles, stimulates the region where the nerve is suspected through the nerve probe, and when the region corresponds to the nerve, A bio-pressure sensor for detecting a change in pressure due to movement of the muscle, and a bio-pressure sensor for detecting movement of the muscle due to electrical stimulation generated by the nerve probe, and transmitting the detected pressure change to the output device A microcontroller; And an output device for receiving a digital signal corresponding to a pressure change received from the microcontroller and outputting the digital signal to a user.
  • the bio-pressure sensor of the intraoperative nerve monitoring system using the bio-pressure sensor according to the present invention can be applied to a pressure sensor using a mechanical pressure sensor, an electric pressure sensor, a semiconductor pressure sensor, a strain gauge, a displacement sensor, Is measured.
  • the microcontroller of the intraoperative neural surveillance system using the bio pressure sensor according to the present invention detects the bio-pressure sensor 120 at a predetermined period after the electric stimulation is applied to the nerve by the nerve probe 110, An A / D converter for converting an analog signal corresponding to a change in pressure transmitted from the detector into a digital signal; And a communicator for transmitting the digital signal corresponding to the pressure change converted from the A / D converter 134 to the output device 140 in a wired or wireless manner.
  • the change of the muscle resulting from the electrical stimulation to the nerve is compared with the conventional needle It is possible to eliminate the risk of pain, hemorrhage or infection due to electrode needle insertion for measuring EMG by the conventional needle electrode method, It is possible to prevent an error in a measurement signal due to interference or noise caused by a nerve cut and a liquid such as a needle or sputum caused by unmeasured measurement caused by not contacting all the two electrodes of the intubation intubation tube, Instead of expensive medical devices that output changes, the skin or muscle measured using a bio-pressure sensor By a change of pressure in the contact surface is converted into the digital signal can be easily can confirm the measured value so reduce costs from a mobile device, the effect capable of providing convenience to users.
  • FIG. 1 is an illustration of a neural probe that stimulates a nerve to probe a conventional neural path according to an embodiment of the present invention
  • FIG. 2 is an illustration of a two-pole needle electrode used in a needle electrode method for electromyography according to an embodiment of the present invention
  • FIG. 3 is an illustration of a two-dimensional surface electrode used in a surface derivation method for EMG measurement according to an embodiment of the present invention
  • FIG. 4 illustrates an example of a tracheal intubation tube for insertion of a vocal cord using a surface derivation method according to an embodiment of the present invention
  • FIG. 5 is a block diagram of an intraoperative nerve monitoring system using a bio-pressure sensor according to an embodiment of the present invention
  • FIG. 6 (a) is an exemplary view of a contact type bio pressure sensor according to an embodiment of the present invention.
  • FIG. 6 (b) is a comparative experiment of a conventional needle electrode for rabbit hind leg muscles and a contact type bio pressure sensor according to an embodiment of the present invention
  • FIG. 7A is an exemplary graph of an amplitude graph of an electromyogram measured on a rabbit hindlimb muscle using a conventional needle electrode method
  • FIG. 7 (b) is a graph illustrating an amplitude graph of an electromyogram measured on a rabbit hind leg muscle using a contact type bio pressure sensor according to an embodiment of the present invention
  • FIG. 8 (a) is a view showing the shape of a contact type pressure sensor attached to a tracheal intubation tube for insertion of a vocal cord according to an embodiment of the present invention
  • FIG. 8 (b) is an experimental drawing of a pressure sensor on the laryngeal nerve and stimulating the exposed laryngeal nerve with a nerve probe;
  • FIG. 9 is a block diagram of a microcontroller of an intraoperative nerve monitoring system using a bio pressure sensor according to an embodiment of the present invention.
  • FIG. 10 is an exemplary view of an EMG output apparatus received from a communicator of an intraoperative nerve monitoring system using a bio pressure sensor according to an embodiment of the present invention.
  • An intraoperative nerve monitoring system 100 using a bio pressure sensor includes a nerve probe 110, a bio pressure sensor 120, a microcontroller 130, and an output device 140 .
  • the neurological probe 110 performs electrical stimulation when the surgeon uses the surgical instrument 10 to perform a surgical operation in a surgical tissue, do.
  • the nerve probe 110 contacts the suspected portion of the nerve and applies a current from a power supply (not shown) to give a fine electrical stimulus.
  • the surgeon generally uses the surgical instrument 10 to find a suspected nerve area during surgery. When the surgeon places the surgical instrument 10, the surgeon substitutes the nerve probe 110 for electric stimulation to the nerve.
  • the bio-pressure sensor 120 is positioned between the skin and the contact surface contacting the muscles and muscles of the body. If the stimulus is given to the suspicious part through the nerve probe 110, if the corresponding part is the nerve, The movement of the muscles due to the electrical stimulation by the stimulation unit 110 occurs, and the change of pressure due to the movement of the muscles is sensed.
  • the bio-pressure sensor 120 can measure pressure by various methods of measuring pressure, such as mechanical pressure sensors, electrical pressure sensors, semiconductor pressure sensors, strain gauges, displacement sensors, acceleration sensors, and optical sensors.
  • FIG. 6 (a) is an exemplary view of a contact-type bio-pressure sensor according to an embodiment of the present invention.
  • the bio-pressure sensor 120 attaches a thin tape-type bio-pressure sensor to the contact surface of the skin or muscles so that the pressure change on the skin or muscle contact surface due to the movement of the muscle Detection.
  • FIG. 6 (b) is a comparative experimental view of a conventional needle electrode for a rabbit hind leg muscle and a contact type bio pressure sensor according to an embodiment of the present invention.
  • FIG. 7 (a) is a graph showing an amplitude graph of an electromyogram measured on a rabbit hind leg muscle using a conventional needle electrode method
  • FIG. 7 (b) FIG. 2 is a graph showing an amplitude graph of an electromyogram measured using a rabbit hindlimb muscle.
  • FIG. 7 (a) when the muscle of the rabbit hind leg is subjected to 1 mA of nerve stimulation using the neural probe 110, measurement is performed through the conventional inserted needle electrode measured in FIG. 6 (b)
  • Fig. 7 (b) the pressure change at the contact surface of the skin or muscle due to the muscle movement measured by the attachment type bio-pressure sensor by the nerve stimulation of 1 mA, which is the same environment
  • a graph is presented by converting the analog signal to a digital signal.
  • the amplitude values for the nerve stimulation can not be compared in the two methods, but it can be seen that the movement of the muscles by the nerve stimulation can be perceived in the same way.
  • FIG. 8 (a) is a view showing the shape of a pressure sensor attached to a tracheal intubation tube for insertion of a vocal cord according to an embodiment of the present invention
  • FIG. 8 (b) It is an experiment to stimulate the exposed laryngeal nerve with a neural probe.
  • an arrow mark is attached to the surface of the airway intubation tube in place of the two electrodes attached to the electromyogram measurement using the conventional surface derivation method Type bio pressure sensor 120 to measure the pressure change due to the movement of the vocal cord muscles according to the nerve stimulated by the nerve probe 110.
  • the bio pressure sensor 120 may be installed to surround the surface of the intubation intubation tube or may be installed to surround the surface of the intubation intubation tube by expanding the area of the bio pressure sensor 120.
  • the bio-pressure sensor 120 installed on the surface of the intubation tube of the intubation measures changes in pressure, it is difficult to determine whether the nerve is present or not due to the fact that the two electrodes are not in contact with each other in the EMG measurement by the conventional surface derivation method. It is possible to eliminate measurement errors due to electrical interference or signal noise due to a liquid component such as dust or sputum.
  • FIG. 8 (b) is a graph showing the results of stimulation of the nerve by the nerve probe 110 indicated by arrows on the exposed laryngeal nerve after thyroid surgery in a pig anesthetized with the intubation tube with the bio-pressure sensor 120 attached thereto, And an output device 140 is provided to check the movement of the vocal cord muscle measured by the bio-pressure sensor 120 attached to the intubation tube.
  • FIG. 9 is a microcontroller configuration diagram of an intraoperative nerve monitoring system using a bio pressure sensor according to an embodiment of the present invention.
  • the microcontroller 130 comprises a configuration including a detector 131, a filter 132, an amplifier 133, an A / D converter 134 and a communicator 135,
  • the bio-pressure sensor 120 detects the movement of the muscle due to the electrical stimulation generated by the bio-sensor 110 and transmits the detected pressure change to the output device 140.
  • the detector 131 detects a change in pressure according to the movement of the muscle measured from the bio pressure sensor 120 at a predetermined period after the electrical stimulation of the nerve occurs with the nerve probe 110.
  • electrical stimulation is performed on a certain part of the body using the nerve probe 110, muscle movement occurs after a certain interval when corresponding to the nerve.
  • the detector 131 detects whether electrical stimulation of the nerve probe 110 is generated, and then detects a change in pressure according to the movement of the muscle measured by the bio-pressure sensor 120.
  • the filter 132 removes high frequency or low frequency signals that can be added as noise to the change in pressure transmitted from the detector 131.
  • noise may be generated due to the precision, so that the noise can be removed by using the filter 132 to exhibit a more accurate pressure change.
  • the amplifier 133 increases the amplitude according to the noise-removed pressure change through the filter 132.
  • the filter 132 is connected to the amplifier 133 through the amplifier 133 so that the change of the pressure can be easily confirmed so that the movement of the muscle due to the stimulation of the nerve can be more accurately confirmed. It is necessary to amplify the input signal.
  • the A / D converter 134 converts an analog signal corresponding to a change in pressure transmitted from the detector 131 or the amplifier 133 into a digital signal. As the development of the digital device and the resolution of the analog signal are improved, many recent devices that receive, output or transmit the measured values from the sensor use digital signals, And converts the analog signal into a digital signal through the A / D converter 134. [
  • the communicator 135 transmits the digital signal corresponding to the pressure change converted from the A / D converter 134 to the output device 140 by wire or wirelessly.
  • the communicator 135 transmits the digital signal corresponding to the pressure change to the output device 140.
  • the communication device 135 transmits the digital signal in response to the pressure change to the output device 140.
  • wireless such as WiFi and Bluetooth, Lt; / RTI >
  • FIG. 10 is an exemplary diagram of an electromyography output device of an intraoperative nerve monitoring system using a bio pressure sensor according to an embodiment of the present invention.
  • the output device 140 receives a digital signal corresponding to the pressure change received from the communicator 135 of the microcontroller 130, and outputs the digital signal to the user.
  • the output device 140 may be visually represented graphically or audibly through a warning tone so that the user can easily recognize whether the user is nervous during surgery.
  • Output device 140 may be typically a wired or wireless monitor 141 that provides a visual display and may also appear through the user's portable device 142 using wireless communication and may also include an audible beep Can be output together.
  • FIG. 5 is a configuration diagram of an intraoperative nerve monitoring system using a bio pressure sensor according to an embodiment of the present invention.
  • the intraoperative nerve monitoring system 100 using the bio pressure sensor includes a nerve probe 110, a bio pressure sensor 120, a micro controller 130, (140).
  • the neurological probe 110 performs electrical stimulation when the surgeon uses the surgical instrument 10 to perform a surgical operation in a surgical tissue, do.
  • the nerve probe 110 contacts the suspected portion of the nerve and applies a current from a power supply (not shown) to give a fine electrical stimulus.
  • the surgeon generally uses the surgical instrument 10 to find a suspected nerve area during surgery. When the surgeon places the surgical instrument 10, the surgeon substitutes the nerve probe 110 for electric stimulation to the nerve.
  • the bio-pressure sensor 120 is positioned between the skin and the contact surface contacting the muscles and muscles of the body. If the stimulus is given to the suspicious part through the nerve probe 110, if the corresponding part is the nerve, The movement of the muscles due to the electrical stimulation by the stimulation unit 110 occurs, and the change of pressure due to the movement of the muscles is sensed.
  • the bio-pressure sensor 120 can measure pressure by various methods of measuring pressure, such as mechanical pressure sensors, electrical pressure sensors, semiconductor pressure sensors, strain gauges, displacement sensors, acceleration sensors, and optical sensors.
  • FIG. 6 (a) is an exemplary view of a contact-type bio-pressure sensor according to an embodiment of the present invention.
  • the bio-pressure sensor 120 attaches a thin tape-type bio-pressure sensor to the contact surface of the skin or muscles so that the pressure change on the skin or muscle contact surface due to the movement of the muscle Detection.
  • FIG. 6 (b) is a comparative experimental view of a conventional needle electrode for a rabbit hind leg muscle and a contact type bio pressure sensor according to an embodiment of the present invention.
  • FIG. 7 (a) is a graph showing an amplitude graph of an electromyogram measured on a rabbit hind leg muscle using a conventional needle electrode method
  • FIG. 7 (b) FIG. 2 is a graph showing an amplitude graph of an electromyogram measured using a rabbit hindlimb muscle.
  • FIG. 7 (a) when the muscle of the rabbit hind leg is subjected to 1 mA of nerve stimulation using the neural probe 110, measurement is performed through the conventional inserted needle electrode measured in FIG. 6 (b)
  • Fig. 7 (b) the pressure change at the contact surface of the skin or muscle due to the muscle movement measured by the attachment type bio-pressure sensor by the nerve stimulation of 1 mA, which is the same environment
  • a graph is presented by converting the analog signal to a digital signal.
  • the amplitude values for the nerve stimulation can not be compared in the two methods, but it can be seen that the movement of the muscles by the nerve stimulation can be perceived in the same way.
  • FIG. 8 (a) is a view showing the shape of a pressure sensor attached to a tracheal intubation tube for insertion of a vocal cord according to an embodiment of the present invention
  • FIG. 8 (b) It is an experiment to stimulate the exposed laryngeal nerve with a neural probe.
  • an arrow mark is attached to the surface of the airway intubation tube in place of the two electrodes attached to the electromyogram measurement using the conventional surface derivation method Type bio pressure sensor 120 to measure the pressure change due to the movement of the vocal cord muscles according to the nerve stimulated by the nerve probe 110.
  • the bio pressure sensor 120 may be installed to surround the surface of the intubation intubation tube or may be installed to surround the surface of the intubation intubation tube by expanding the area of the bio pressure sensor 120.
  • the bio-pressure sensor 120 installed on the surface of the intubation tube of the intubation measures changes in pressure, it is difficult to determine whether the nerve is present or not due to the fact that the two electrodes are not in contact with each other in the EMG measurement by the conventional surface derivation method. It is possible to eliminate measurement errors due to electrical interference or signal noise due to a liquid component such as dust or sputum.
  • FIG. 8 (b) is a graph showing the results of stimulation of the nerve by the nerve probe 110 indicated by arrows on the exposed laryngeal nerve after thyroid surgery in a pig anesthetized with the intubation tube with the bio-pressure sensor 120 attached thereto, And an output device 140 is provided to check the movement of the vocal cord muscle measured by the bio-pressure sensor 120 attached to the intubation tube.
  • FIG. 9 is a microcontroller configuration diagram of an intraoperative nerve monitoring system using a bio pressure sensor according to an embodiment of the present invention.
  • the microcontroller 130 comprises a configuration including a detector 131, a filter 132, an amplifier 133, an A / D converter 134 and a communicator 135,
  • the bio-pressure sensor 120 detects the movement of the muscle due to the electrical stimulation generated by the bio-sensor 110 and transmits the detected pressure change to the output device 140.
  • the detector 131 detects a change in pressure according to the movement of the muscle measured from the bio pressure sensor 120 at a predetermined period after the electrical stimulation of the nerve occurs with the nerve probe 110.
  • electrical stimulation is performed on a certain part of the body using the nerve probe 110, muscle movement occurs after a certain interval when corresponding to the nerve.
  • the detector 131 detects whether electrical stimulation of the nerve probe 110 is generated, and then detects a change in pressure according to the movement of the muscle measured by the bio-pressure sensor 120.
  • the filter 132 removes high frequency or low frequency signals that can be added as noise to the change in pressure transmitted from the detector 131.
  • noise may be generated due to the precision, so that the noise can be removed by using the filter 132 to exhibit a more accurate pressure change.
  • the amplifier 133 increases the amplitude according to the noise-removed pressure change through the filter 132.
  • the filter 132 is connected to the amplifier 133 through the amplifier 133 so that the change of the pressure can be easily confirmed so that the movement of the muscle due to the stimulation of the nerve can be more accurately confirmed. It is necessary to amplify the input signal.
  • the A / D converter 134 converts an analog signal corresponding to a change in pressure transmitted from the detector 131 or the amplifier 133 into a digital signal. As the development of the digital device and the resolution of the analog signal are improved, many recent devices that receive, output or transmit the measured values from the sensor use digital signals, And converts the analog signal into a digital signal through the A / D converter 134. [
  • the communicator 135 transmits the digital signal corresponding to the pressure change converted from the A / D converter 134 to the output device 140 by wire or wirelessly.
  • the communicator 135 transmits the digital signal corresponding to the pressure change to the output device 140.
  • wireless such as WiFi and Bluetooth, Lt; / RTI >
  • FIG. 10 is an exemplary diagram of an electromyography output device of an intraoperative nerve monitoring system using a bio pressure sensor according to an embodiment of the present invention.
  • the output device 140 receives a digital signal corresponding to the pressure change received from the communicator 135 of the microcontroller 130, and outputs the digital signal to the user.
  • the output device 140 may be visually represented graphically or audibly through a warning tone so that the user can easily recognize whether the user is nervous during surgery.
  • Output device 140 may be typically a wired or wireless monitor 141 that provides a visual display and may also appear through the user's portable device 142 using wireless communication and may also include an audible beep Can be output together.
  • the surgical nerve monitoring system using the bio-pressure sensor of the present invention is a system for measuring the electromyography of a corresponding muscle according to nerve stimulation in order to identify a portion corresponding to a nerve in order to prevent complications due to nerve damage during surgery,
  • the pressure change on the surface of the skin or muscle caused by the movement of the muscle is measured using a bio-pressure sensor, and the measured pressure change Can be transmitted by wire or wireless so that the user can be visually confirmed through a graph or an acoustic warning sound. Further, the measured result can be transmitted to a portable device through wireless communication and can be easily confirmed on a portable device. It is available in the medical field for related surgery. High.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • General Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Biophysics (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Physics & Mathematics (AREA)
  • Public Health (AREA)
  • Pathology (AREA)
  • Signal Processing (AREA)
  • Physiology (AREA)
  • Neurology (AREA)
  • Computer Networks & Wireless Communication (AREA)
  • Power Engineering (AREA)
  • Artificial Intelligence (AREA)
  • Computer Vision & Pattern Recognition (AREA)
  • Psychiatry (AREA)
  • Neurosurgery (AREA)
  • Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)

Abstract

La présente invention concerne un système de surveillance de nerf peropératoire utilisant un biocapteur de pression. Le système de surveillance de nerf peropératoire utilisant un biocapteur de pression, selon la présente invention, présente des caractéristiques techniques de : mesure, au moyen du biocapteur de pression, d'un changement de pression de surface dans une surface de contact d'une peau ou d'un muscle, causé par un mouvement du muscle correspondant ; transmission filaire ou sans fil du changement de pression mesuré de façon à permettre à un utilisateur d'identifier un nerf par l'intermédiaire d'un graphique visuel ou d'un son d'alarme auditive ; et, en outre, transmission du résultat mesuré à un dispositif portable par l'intermédiaire de communications sans fil de sorte que le résultat puisse être aisément vérifié dans le dispositif portable, contrairement aux procédés conventionnels d'insertion d'une électrode ou de mesure d'un changement de potentiel d'action causé par un mouvement musculaire d'une surface du corps humain de façon à identifier une partie correspondant au nerf pour prévenir des complications causées par un dommage neuronal pendant une chirurgie, et mesurer un électromyogramme d'un muscle correspondant en fonction d'une stimulation neuronale.
PCT/KR2018/009287 2017-08-30 2018-08-13 Système de surveillance de nerf peropératoire utilisant un biocapteur de pression WO2019045321A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
KR10-2017-0110330 2017-08-30
KR1020170110330A KR102062252B1 (ko) 2017-08-30 2017-08-30 바이오 압력센서를 이용한 수술 중 신경감시시스템

Publications (1)

Publication Number Publication Date
WO2019045321A1 true WO2019045321A1 (fr) 2019-03-07

Family

ID=65527742

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/KR2018/009287 WO2019045321A1 (fr) 2017-08-30 2018-08-13 Système de surveillance de nerf peropératoire utilisant un biocapteur de pression

Country Status (2)

Country Link
KR (1) KR102062252B1 (fr)
WO (1) WO2019045321A1 (fr)

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN114366309A (zh) * 2022-01-17 2022-04-19 上海锦立城医疗科技有限公司 一种具有神经监测功能的手术机器人

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
KR100745034B1 (ko) * 2006-06-19 2007-08-01 이우철 근육기능의 통합 진단분석장치
JP2011500144A (ja) * 2007-10-09 2011-01-06 イムセラ・メディカル・インコーポレーテッド 神経刺激のためのシステムおよび方法
KR20110010828A (ko) * 2008-06-02 2011-02-07 워쏘우 오르쏘페딕 인코포레이티드 외과시술을 위한 방법, 시스템 및 도구
JP2015507948A (ja) * 2012-01-26 2015-03-16 オートノミクス メディカル，インコーポレーテッド 制御された交感神経切除並びに顕微焼灼システム及び方法
JP2015513988A (ja) * 2012-04-09 2015-05-18 エシコン・エンド−サージェリィ・インコーポレイテッドＥｔｈｉｃｏｎ Ｅｎｄｏ−Ｓｕｒｇｅｒｙ，Ｉｎｃ． 神経検出機能を有する外科用器具

Family Cites Families (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2592493B2 (ja) * 1988-04-09 1997-03-19 コーリン電子株式会社 筋弛緩モニタ
US8374673B2 (en) 2007-01-25 2013-02-12 Warsaw Orthopedic, Inc. Integrated surgical navigational and neuromonitoring system having automated surgical assistance and control
KR100877229B1 (ko) * 2007-05-14 2009-01-09 가천의과학대학교 산학협력단 인체의 운동 및 감각 기능 조절용 신경-전자 인터페이스장치
KR20140013043A (ko) * 2011-03-24 2014-02-04 캘리포니아 인스티튜트 오브 테크놀로지 신경자극기
KR101270935B1 (ko) 2012-01-19 2013-06-11 서울대학교산학협력단 수술 중 신경계 감시 장치 및 방법

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
KR100745034B1 (ko) * 2006-06-19 2007-08-01 이우철 근육기능의 통합 진단분석장치
JP2011500144A (ja) * 2007-10-09 2011-01-06 イムセラ・メディカル・インコーポレーテッド 神経刺激のためのシステムおよび方法
KR20110010828A (ko) * 2008-06-02 2011-02-07 워쏘우 오르쏘페딕 인코포레이티드 외과시술을 위한 방법, 시스템 및 도구
JP2015507948A (ja) * 2012-01-26 2015-03-16 オートノミクス メディカル，インコーポレーテッド 制御された交感神経切除並びに顕微焼灼システム及び方法
JP2015513988A (ja) * 2012-04-09 2015-05-18 エシコン・エンド−サージェリィ・インコーポレイテッドＥｔｈｉｃｏｎ Ｅｎｄｏ−Ｓｕｒｇｅｒｙ，Ｉｎｃ． 神経検出機能を有する外科用器具

Also Published As

Publication number Publication date
KR20190023914A (ko) 2019-03-08
KR102062252B1 (ko) 2020-01-03

Similar Documents

Publication Publication Date Title
US6725086B2 (en) Method and system for monitoring sedation, paralysis and neural-integrity
US8882679B2 (en) Neural monitoring system
CA1191207A (fr) Methode et appareil pour myographie vaginale
US5131401A (en) Method and apparatus for monitoring neuromuscular blockage
US8343065B2 (en) Neural event detection
AU752978B2 (en) A medical measuring system
JP2021164702A (ja) 定量的神経筋系遮断検知システム及び方法
WO2013019069A2 (fr) Appareil de mesure et de traitement de la dysphagie
US20090105788A1 (en) Minimally invasive nerve monitoring device and method
US11980460B2 (en) System and method for motion detection and accounting
US20120245482A1 (en) Anesthesia Monitoring Device and Method
CN113274038B (zh) 一种联合肌电和压力信号的唇形传感器装置
US20210290144A1 (en) Monitoring device and method for controlling threshold thereof
WO2017026829A1 (fr) Appareil de détection des vibrations
US20090326387A1 (en) Electrocardiogram and Respiration Monitoring in Animals
WO2019045321A1 (fr) Système de surveillance de nerf peropératoire utilisant un biocapteur de pression
WO2017010795A1 (fr) Point de contrôle épidural
WO2011129474A1 (fr) Dispositif et procédé de surveillance de la fonction pulmonaire utilisant l'impédance des deux mains
CN210961971U (zh) 一种神经监护系统
WO2023003229A1 (fr) Appareil de surveillance neurologique et son procédé de commande
WO2012115346A2 (fr) Dispositif et procédé de surveillance de nerfs faciaux
KR100555065B1 (ko) 경락진단장치
WO2021040390A1 (fr) Système de polysomnographie utilisant un modèle de lapin
CN109937003A (zh) 用于放置脊髓刺激器引线的系统和方法
WO2009123498A1 (fr) Dispositif de contrôle et d’estimation de processus physiologiques

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 18851164

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 18851164

Country of ref document: EP

Kind code of ref document: A1