WO2021137276A1 - Dispositif de forage, procédé de forage et mécanisme de fixation - Google Patents

Dispositif de forage, procédé de forage et mécanisme de fixation Download PDF

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Publication number
WO2021137276A1
WO2021137276A1 PCT/JP2020/042611 JP2020042611W WO2021137276A1 WO 2021137276 A1 WO2021137276 A1 WO 2021137276A1 JP 2020042611 W JP2020042611 W JP 2020042611W WO 2021137276 A1 WO2021137276 A1 WO 2021137276A1
Authority
WO
WIPO (PCT)
Prior art keywords
drilling
display
perforation
image
end point
Prior art date
Application number
PCT/JP2020/042611
Other languages
English (en)
Japanese (ja)
Inventor
橋元　伸晃
関　康弘
Original Assignee
公立大学法人公立諏訪東京理科大学
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 公立大学法人公立諏訪東京理科大学 filed Critical 公立大学法人公立諏訪東京理科大学
Priority to JP2021568454A priority Critical patent/JPWO2021137276A5/ja
Publication of WO2021137276A1 publication Critical patent/WO2021137276A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
    • B23B—TURNING; BORING
    • B23B45/00—Hand-held or like portable drilling machines, e.g. drill guns; Equipment therefor
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
    • B23B—TURNING; BORING
    • B23B49/00—Measuring or gauging equipment on boring machines for positioning or guiding the drill; Devices for indicating failure of drills during boring; Centering devices for holes to be bored
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
    • B23Q—DETAILS, COMPONENTS, OR ACCESSORIES FOR MACHINE TOOLS, e.g. ARRANGEMENTS FOR COPYING OR CONTROLLING; MACHINE TOOLS IN GENERAL CHARACTERISED BY THE CONSTRUCTION OF PARTICULAR DETAILS OR COMPONENTS; COMBINATIONS OR ASSOCIATIONS OF METAL-WORKING MACHINES, NOT DIRECTED TO A PARTICULAR RESULT
    • B23Q17/00—Arrangements for observing, indicating or measuring on machine tools
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
    • B23Q—DETAILS, COMPONENTS, OR ACCESSORIES FOR MACHINE TOOLS, e.g. ARRANGEMENTS FOR COPYING OR CONTROLLING; MACHINE TOOLS IN GENERAL CHARACTERISED BY THE CONSTRUCTION OF PARTICULAR DETAILS OR COMPONENTS; COMBINATIONS OR ASSOCIATIONS OF METAL-WORKING MACHINES, NOT DIRECTED TO A PARTICULAR RESULT
    • B23Q17/00—Arrangements for observing, indicating or measuring on machine tools
    • B23Q17/24—Arrangements for observing, indicating or measuring on machine tools using optics or electromagnetic waves
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B26—HAND CUTTING TOOLS; CUTTING; SEVERING
    • B26D—CUTTING; DETAILS COMMON TO MACHINES FOR PERFORATING, PUNCHING, CUTTING-OUT, STAMPING-OUT OR SEVERING
    • B26D5/00—Arrangements for operating and controlling machines or devices for cutting, cutting-out, stamping-out, punching, perforating, or severing by means other than cutting
    • B26D5/02—Means for moving the cutting member into its operative position for cutting
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B26—HAND CUTTING TOOLS; CUTTING; SEVERING
    • B26F—PERFORATING; PUNCHING; CUTTING-OUT; STAMPING-OUT; SEVERING BY MEANS OTHER THAN CUTTING
    • B26F1/00—Perforating; Punching; Cutting-out; Stamping-out; Apparatus therefor
    • B26F1/16—Perforating by tool or tools of the drill type
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B27—WORKING OR PRESERVING WOOD OR SIMILAR MATERIAL; NAILING OR STAPLING MACHINES IN GENERAL
    • B27C—PLANING, DRILLING, MILLING, TURNING OR UNIVERSAL MACHINES FOR WOOD OR SIMILAR MATERIAL
    • B27C3/00—Drilling machines or drilling devices; Equipment therefor
    • B27C3/08—Operator-supported drilling machines or devices
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B28—WORKING CEMENT, CLAY, OR STONE
    • B28D—WORKING STONE OR STONE-LIKE MATERIALS
    • B28D1/00—Working stone or stone-like materials, e.g. brick, concrete or glass, not provided for elsewhere; Machines, devices, tools therefor
    • B28D1/14—Working stone or stone-like materials, e.g. brick, concrete or glass, not provided for elsewhere; Machines, devices, tools therefor by boring or drilling
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B28—WORKING CEMENT, CLAY, OR STONE
    • B28D—WORKING STONE OR STONE-LIKE MATERIALS
    • B28D7/00—Accessories specially adapted for use with machines or devices of the preceding groups
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06F—ELECTRIC DIGITAL DATA PROCESSING
    • G06F3/00—Input arrangements for transferring data to be processed into a form capable of being handled by the computer; Output arrangements for transferring data from processing unit to output unit, e.g. interface arrangements
    • G06F3/01—Input arrangements or combined input and output arrangements for interaction between user and computer
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06F—ELECTRIC DIGITAL DATA PROCESSING
    • G06F3/00—Input arrangements for transferring data to be processed into a form capable of being handled by the computer; Output arrangements for transferring data from processing unit to output unit, e.g. interface arrangements
    • G06F3/01—Input arrangements or combined input and output arrangements for interaction between user and computer
    • G06F3/048—Interaction techniques based on graphical user interfaces [GUI]
    • G06F3/0481—Interaction techniques based on graphical user interfaces [GUI] based on specific properties of the displayed interaction object or a metaphor-based environment, e.g. interaction with desktop elements like windows or icons, or assisted by a cursor's changing behaviour or appearance

Definitions

  • the present invention relates to a drilling device, a drilling method and a fixing mechanism. Background technique
  • a perforation method has been proposed in which the perforation direction and perforation position are determined by firing and the perforation is superimposed on the actual image in the actual field of view.
  • Patent Document 1 There is a method disclosed in Patent Document 1 as such a perforation method using a technique.
  • this method when implant treatment is performed by drilling the patient's alveolar teeth (object to be perforated) and implanting a fixia, the object to be perforated is photographed.
  • the fixture embedding position is determined by simulating the fixture embedding using the ⁇ 3-chome captured image, and the position is measured on the ⁇ 3-chome captured image.
  • a mark indicating the fixture implantation position and implantation direction determined by the simulation is attached to the 0-chome imaging template.
  • a mockup of the actual size of the maxilla molded (impression) from the patient's oral cavity is performed by drilling the patient's alveolar teeth (object to be perforated) and implanting a fixia.
  • Patent Document 1 Japanese Patent Application Laid-Open No. 2 0 1 3 _ 3 4 7 6 4 Outline of Invention Problem to be Solved by Invention
  • the present invention has been made in view of such a problem, and a drilling device and a drilling method capable of performing accurate drilling without requiring a large-scale equipment (or a complicated process), and a drilled subject. It is an object of the present invention to provide a fixing mechanism capable of appropriately fixing a drilled object. Means to solve problems
  • the perforation device of the present invention is a perforation device for perforating an object to be perforated, and is a display capable of visually observing a real image to be perforated or imaged, a perforation tool, and a perforation mark jig.
  • the appearance information acquisition means for acquiring the appearance information of the drilling tool and the drilling mark jig, and the appearance information of the drilling tool and the drilling mark jig acquired by the appearance information acquiring means.
  • the perforation device has a display capable of visually observing a real image to be seen through or imaged, and an appearance information acquisition means for acquiring appearance information of a perforation tool or the like.
  • ⁇ 2021/137276 3 ⁇ (: 170? 2020/042611 Create a virtual 3D image including the perforation direction extension line and the perforation end point by referring to the appearance information of the drilling tool etc. acquired by the appearance information acquisition means, and the virtual
  • a control means to reflect the 3D image on the actual image and display it on the display, etc., based on the perforation direction extension line and the perforation end point (using, aiming at, as a guide), perforation is performed.
  • the drilling device that can perform accurate drilling without the need for large-scale equipment for ⁇ 3 shots of the object to be drilled, mockup (plaster model) creation, drilling simulation, etc.
  • the drilling end point and the drilling direction extension line can be changed in principle, so it can be flexibly adjusted according to the condition of the hole to be drilled at the time of drilling. In other words, even if the condition of the object to be drilled is different from what was expected in advance at the stage of drilling, it does not require large-scale equipment. It is possible to make various holes.
  • the present invention is an invention to which eight techniques are applied in the sense that a virtual three-dimensional image is reflected in a real image.
  • the "real image” is an image of an object that actually exists, and the "virtual 3D image” is created by ⁇ II (or computer, software) that does not exist or is invisible in reality.
  • a three-dimensional image. “Visible” means that either a real image that can be made farther than the focal length or a virtual image that can be made closer than the focal length can be seen.
  • “appearance information” includes "outer shape information” and "feature information” of drilling tools and the like. Since the "appearance" is the appearance seen from the outside, the “appearance information” refers to the information such as the three-dimensional image information obtained directly or indirectly by looking at the drilling tool or the like from the outside.
  • Outer shape information refers to information on the outer shape (including a part of the outer shape) of drilling tools, etc. Since the “outer shape” is the shape seen from the outside, the “outer shape information” refers to the information obtained by looking at the drilling tool or the like from the outside. For example, when there are contour shapes such as ellipses, triangles, and squares at the ends of drilling tools, or corners. ⁇ 2021/137276 4 Information such as the contour shape of the corner in ⁇ (: 170? 2020/042611.) (If the drilling tool is the drill 3 4 described later in Fig. 1 etc., the uneven shape of the drill bit itself. , The right-angled shape of the mounting part where the drill bit is attached to the chuck, the right-angled shape of the drill bit side end of the drilling tool body, the square shape of the gripping part 35 end, etc.)
  • “Characteristic information” is characteristic information on the appearance of a drilling tool or the like. For example, the position, shape (shape), pattern, meaning of the mark, or characteristic information on the appearance when a mark (mark mark, recognition mark, identification mark) is attached to a drilling tool, etc. ( Characteristic information such as bending). “Outer shape information” and “feature information” are not always clearly distinguished, and some appearances may combine both.
  • a virtual three-dimensional image including the drilling direction extension line and the drilling end point is created means, for example, the outer shape of the drilling tool or By referring to the appearance information such as the position of the mark provided on the outside of the tool, a virtual 3D image of the extension line of the drilling direction of the drilling tool can be created, or the outer shape of the drilling mark jig or the drilling mark jig can be created. It refers to creating a virtual three-dimensional image of the drilling end point of the drilling mark jig by referring to the appearance information such as the position of the mark provided on the outside of the tool.
  • the appearance information acquisition means for example, there are an image pickup means (camera), a shape measurement sensor using a laser, infrared rays, ultrasonic waves, and the like.
  • the drilling tool is provided with a first mark as the appearance information of the drilling tool, and the control means refers to the first mark. It is preferable to create the perforation direction extension line and display it on the display.
  • control means only needs to create the extension line in the drilling direction by referring to the first mark provided on the drilling tool, so that it is easy to create and requires a large-scale equipment. It becomes even easier to make an accurate drill without.
  • the drilling tool is provided with a plurality of the first marks based on the drilling direction, and the control means extends the drilling direction. ⁇ 2021/137276 5 ⁇ (: 170? 2020/042611 It is preferable to create a line with reference to the position information of the plurality of first marks and display it on the display.
  • control means only needs to create the extension line of the drilling direction by referring to the position information of the plurality of first marks provided based on the drilling direction, so that the control means is easy to create and is large-scale. It will be even easier to make accurate drills without the need for equipment.
  • the perforation mark jig is provided with a second mark as the appearance information of the perforation mark jig, and the control means sets the perforation end point. It is preferable to create it with reference to the second mark and display it on the display.
  • control means can create the drilling end point by referring to the second mark provided on the drilling mark jig, so that it is easy to create and does not require large-scale equipment. Accurate drilling becomes even easier.
  • the perforation mark jig is provided with a plurality of the second marks in the direction of the longer side of the jig (perforation end point direction), and the control means is It is preferable that the perforation end point is created with reference to the position information of the plurality of second marks and displayed on the display.
  • control means can create the drilling end point by referring to the position information of the plurality of second marks provided in the longitudinal direction (drilling end point direction) of the jig. Because it is good, it is easy to make, and it is even easier to make accurate drills without the need for large-scale equipment.
  • control means displays the virtual three-dimensional image of the drilling direction extension line and the virtual three-dimensional image of the drilling end point on the display at the time of drilling. It is preferable to display it.
  • the virtual 3D image of the extension line of the drilling direction and the virtual 3D image of the drilling end point are displayed on the display at the time of drilling, so that these displays are displayed when they are not related to drilling. It is possible to provide a perforation device in which the display is easier to see because the display is not displayed. ⁇ 0 2021/137276 6 ⁇ (: 17 2020/042611
  • the control means makes the virtual three-dimensional image of the drilling direction extension line and the virtual three-dimensional image of the drilling end point different from the actual image. It is preferable to display on the display in a display mode.
  • the "different display mode” means, for example, a virtual three-dimensional image (extension line in the drilling direction and end point of the drilling) when the appearance of the drilling tool, the drilling mark jig, or the like is in black and white. Is displayed in a different color tone (red, blue, etc.), or blinks when it is not blinking.
  • the drilling device of the present invention further includes a pass notification means for notifying that the drilling direction extension line of the drilling tool passes or does not pass through the drilling end point. Is preferable.
  • the drilling device of the present invention further includes a drilling notification means for notifying that the tip of the drilling portion of the drilling tool has approached or reached the drilling end point. Is preferable.
  • the control means is a jig contact point where the tip of the drilling mark jig comes into contact with the object to be drilled, or the jig contact point described above.
  • the jig contact point on a straight line connecting the drilling start point where the drilling tool starts drilling. ⁇ 2021/137276 7 It is preferable to display the point separated from ⁇ (: 170? 2020/042611 by a certain distance) as the drilling end point on the display.
  • the “jig contact point” is the “drilling target point”. In other words.
  • the tip of the drilling mark jig comes into contact with the object to be drilled, or the jig contact point and the drilling tool start drilling the object to be drilled. Since the point separated from the jig contact point by a certain distance on the straight line connecting the jigs is the drilling end point, the drilling end point can be easily determined or changed by changing the positions of the jig contact point and the drilling start point. It is possible to make accurate drilling without the need for large-scale equipment. For example, when the jig contact point is the drilling end point, the drilling end point can be easily determined or changed by bringing the tip of the drilling marker jig into contact with the object to be drilled.
  • the point on the straight line connecting the jig contact point and the drilling start point that is separated from the jig contact point by a certain distance is not the drilling that penetrates the object to be drilled, but the drilling mark. is difficult drilling inserting the tip of the use jigs (e.g., such as stopping the perforations in terms of _ constant distance spaced points or _ constant depth from the surface of the puncture hole target drilling, as it were constant from the surface Useful for cases such as (deep perforation)
  • the extension line in the drilling direction, the straight line connecting the jig contact point and the drilling start point, and the drilling direction are the jig contact point and the drilling.
  • drilling direction is a straight line connecting the jig contact point and punching starting point, that is, because it can be seen that on the basis of the straight line passing through the perforations endpoint, a more _ layers manner precise perforation It becomes possible.
  • control means display an image of the jig contact point on the display.
  • the display is a display in which a real image can be visually recognized by fluoroscopy.
  • "by see-through” means that the actual image on the other side of the display can be seen through see-through.
  • the actual image on the other side of the display may be an image that can be viewed straight, or may be, for example, an image reflected (reflected in a mirror) by a mirror.
  • the display allows the real image to be seen through fluoroscopy, the real image can be seen as it is, and distortion of the real image and deterioration of the resolution are less likely to occur.
  • the display is preferably a head mount display.
  • the display is a head-mounted display in this way, a person (operator, etc.) who pierces the display (head-mounted display) is attached to the head, so it changes according to the movement of the head. Since it is possible to see the actual image to be drilled and the virtual 3D image of the drilling end point reflected (superimposed) on it, the drilling work can be done easily and more accurate drilling can be performed. For example, it is useful when a surgeon makes a hole in a human or animal bone, or a carpenter makes a hole in a piece of wood.
  • the display is a display in which a real image can be visually recognized by imaging.
  • imaging means that the actual image captured by the imaging means can be visually displayed by being displayed on the display.
  • control means describes the display of the drilling end point so that the display position does not change even if the placement position of the drilling mark jig changes. It is preferable to display it on the display.
  • the display position of the perforation end point does not change, so that the perforator can maintain (maintain) the arrangement of the perforation mark jig.
  • the bondage of the body is released. For example, when a person who makes a hole holds (holds) the drilling jig in one hand (left hand) and holds the drilling tool in the other hand (right hand), the drilling mark is used. When the tool is placed in a predetermined position with one hand to determine the display position of the drilling end point, then the display position of the drilling end point is changed even if the placement position is changed by moving one hand away from the drilling mark jig. Does not change, so you can use one hand freely.
  • the position of the perforation mark jig with respect to the object to be perforated is maintained (maintained and fixed), so that the person who perforates maintains the arrangement of the perforation mark jig.
  • the restraint of the body is released, and it becomes possible to focus more on perforation. For example, during the drilling operation, the driller does not have to hold the drilling marker jig in his hand to maintain its placement position (posture) and is released from such physical restraints.
  • the appearance information acquisition means is an image pickup means.
  • Imaging means means, for example, a camera (photographer) that takes images of still images (still photographs) and moving images (movies, televisions, videos, etc.). It can be rephrased as a means of photography.
  • the appearance information can be obtained more easily.
  • the captured real image is displayed on the display, it is easier to display the real image on the display in addition to acquiring the appearance information.
  • the perforation device further irradiates the object to be perforated with a detection wave to acquire a two-dimensional perspective image of the object to be perforated.
  • the control means includes means, and the control means reflects the two-dimensional perspective image of the object to be perforated on the real image or the virtual three-dimensional image and displays it on the display.
  • the two-dimensional fluoroscopic image acquisition means is, for example, irradiating a perforated object with a detection wave such as an electromagnetic wave including X-rays or laser light, an ultrasonic wave, or the like, and transmitting, absorbing, or anti-trailing the object.
  • a detection wave such as an electromagnetic wave including X-rays or laser light, an ultrasonic wave, or the like
  • X-ray imaging device, ultrasonic imaging device, optical ultrasonic wave that detects two-dimensional fluoroscopic images of the object to be drilled (outer shape blocked by obstacles, internal structure such as broken parts, etc.) from the state of irradiation, photoacoustic, etc.
  • An image pickup device or the like is, for example, irradiating a perforated object with a detection wave such as an electromagnetic wave including X-rays or laser light, an ultrasonic wave, or the like, and transmitting, absorbing, or anti-trailing the object.
  • the two-dimensional perspective image of the object to be perforated is acquired by the two-dimensional perspective image acquisition means, and is reflected on the real image or the virtual three-dimensional image and displayed on the display (two-dimensional perspective).
  • Image acquisition does not require large-scale equipment such as 3D perspective image acquisition, and by using 2D perspective images, the reflection (superimposition) of virtual 3D images on real images is even more position-accurate (superimposition). (Including position correction) It is even easier to perform accurate drilling without the need for large-scale equipment. become.
  • the two-dimensional fluoroscopic image acquisition means is an X-ray imaging apparatus.
  • the perforation method of the present invention is a perforation method for perforating an object to be perforated other than a human living body, and is similar to a display in which a fluoroscopic or imaged actual image can be visually recognized.
  • Preparation process, drilling tool preparation process, drilling mark jig preparation process, drilling tool and appearance information of the drilling mark jig Is obtained a virtual three-dimensional image including a drilling direction extension line and a drilling end point is created with reference to the appearance information, and the virtual three-dimensional image is reflected in the actual image and displayed on the display.
  • the step of drilling the object to be drilled based on the drilling direction extension line and the drilling end point.
  • the fixing mechanism of the present invention is a fixing mechanism for fixing an object to be perforated having a through hole perforated by using any of the above perforation devices, and each has a pair of a head and a pair.
  • the screw portion and the first and second screws having the screw portion are inserted into the through hole from different holes of the through hole with the respective neg portion at the head, and the object to be perforated is between the heads.
  • the object to be drilled is fixed by fitting the pair of screw portions with the screw portion sandwiched between the two.
  • the pair of screw portions means a portion composed of screws that are related to each other, such as a male screw on one side and a female screw on the other side. Different through-hole openings are two different through-hole openings (one and the other).
  • the object to be drilled is formed so as to pass through the plurality of places (the object to be drilled divided into a plurality of objects).
  • the 1st and 2nd screws were squeezed into the through-hole through different through-hole openings with the neck part at the head, and the objects to be perforated (divided into multiple parts) between their heads.
  • the object to be drilled) is sandwiched, and the threads are fitted in the through hole to integrally fix (firmly fix) the object to be drilled.
  • the 1st and 2nd screws have a sharp point. ⁇ 2021/137276 12 ⁇ (: 170?
  • the object to be perforated is sandwiched between the two plates (via the plates) between the heads of the first and second screws, and the object to be perforated is fixed.
  • the material to be drilled is brittle or the target to be drilled is broken, they can be integrally fixed (via the plate) by being sandwiched between the plates. It becomes possible to fix the object to be drilled more appropriately.
  • the "living body” means a living body of a living thing. Organisms are humans, animals (dogs, cats, etc.), fish, etc. Examples of living organisms are human and animal bones. Perforations in living organisms include, for example, perforation (drilling) with a bone drill or insertion pin in human or animal surgery. "A living body that does not include humans” means to exclude humans from living bodies. A brief description of the drawing
  • FIG. 1 It is a figure for demonstrating the outline of the drilling apparatus 100 which concerns on Embodiment 1.
  • FIG. 1 It is a figure for demonstrating the outline of the drilling apparatus 100 which concerns on Embodiment 1.
  • FIG. 2 is a diagram for explaining a drilling mark jig 4 of the drilling device 100 according to the first embodiment.
  • Fig. 3 is a diagram for explaining a drilling tool 3 of the drilling device 100 according to the first embodiment. ⁇ 2021/137276 13 ⁇ (: 170? 2020/042611
  • Fig. 4 is a diagram for explaining an outline of a circuit or the like of the drilling device 100 according to the first embodiment.
  • FIG. 5 is a float chart for explaining a drilling method of the drilling device 100 according to the first embodiment.
  • Fig. 6 is a diagram for explaining how the display 1 looks when the perforation device 100 according to the first embodiment is used for perforation.
  • Fig. 7 is a diagram for explaining the arrangement of the drilling tool 3 and the drilling mark jig 4 when drilling with the drilling device 100 according to the first embodiment.
  • Fig. 8 is a diagram for explaining a modified example of the first mark 32 in the drilling device 100 according to the first embodiment.
  • Fig. 9 is a diagram for explaining a modified example of the second mark 4 2 in the drilling device 100 according to the first embodiment.
  • Fig. 10 is a diagram for explaining the drilling device 200 according to the second embodiment.
  • Fig. 11 is a diagram for explaining the drilling device 300 according to the third embodiment.
  • Fig. 12 is a diagram for explaining the drilling device 400 according to the fourth embodiment.
  • Fig. 13 is a diagram for explaining the drilling device 500 according to the fifth embodiment.
  • Fig. 14 is a diagram for explaining the drilling device 600 according to the sixth embodiment.
  • Fig. 15 is a diagram for explaining the drilling device 700 according to the seventh embodiment.
  • FIG. 16 is a diagram for explaining a drilling device 900 according to a ninth embodiment.
  • Fig. 17 is a diagram for explaining the drilling apparatus 100 0 according to the tenth embodiment.
  • Fig. 18 is a diagram for explaining the drilling device 110 0 according to the first embodiment.
  • Fig. 19 is a diagram for explaining an outline of the drilling device 120 according to the first embodiment.
  • Fig. 20 is a diagram for explaining the drilling device 1200 according to the first and second embodiments.
  • Fig. 21 is a diagram for explaining a drilling device 1300 according to a thirteenth embodiment.
  • Fig. 22 is a diagram for explaining a drilling device 1400 according to a fourth embodiment.
  • Fig. 23 is a diagram for explaining the drilling device 1500 according to the fifth embodiment.
  • Fig. 25 is a diagram for explaining the drilling device 1600 according to the 16th embodiment.
  • Fig. 26 is a diagram for explaining the fixing mechanism 170 according to the first embodiment.
  • Fig. 27 is a diagram for explaining the fixing mechanism 1800 according to the 18th embodiment. Form for carrying out the invention
  • FIGS. 1 to 7 The drilling apparatus and drilling method according to the first embodiment will be described with reference to FIGS. 1 to 7. First, it will be described with reference to FIGS. 1 to 4. About the outline of the drilling apparatus 100 according to the first embodiment using FIG. 1, the drilling mark jig 4 using FIG. 2, the drilling tool 3 using FIG. 3, and the hardware using FIG. The outline of the circuit configuration will be described.
  • the operator IV! is a living body (human or animal).
  • the object to be perforated is the object to be perforated with the perforation tool 3 (a perforation device that drills the bone ⁇ with a drill.
  • the perforation device 1 ⁇ ⁇ is a perspective or image of the actual image 1 1 (see Fig. 6).
  • the surgeon M drills with the drilling tool 3 based on a virtual three-dimensional image 1 2 including the drilling direction extension 3 1 and the drilling end point 4 1 reflected in the real image 1 1 seen on the display 1.
  • the perforation device 100 uses a kind of augmented reality (AR) technology in which the virtual three-dimensional image 1 2 is reflected on the real image 1 1 on the display 1.
  • AR augmented reality
  • the image of reality 1 1 is an image of an actual object that actually exists, and in contrast to this, it is an image created by control means 2 (CPU 2 1) that does not actually exist.
  • the perforation end point 4 1 and the perforation direction extension line 3 1 are virtual three-dimensional images 1 2 created by the control means 2 on the display 1, not the actual image 1 1.
  • a virtual three-dimensional image 1 2 (perforation end point 4 1 and perforation direction extension line 3 1) that cannot be seen in the real world is drawn in the figure.
  • the display 1 is a head-mounted display 6.
  • the real image 1 1 can be seen on the display 1, but the display 1 is a type in which the real image 1 1 can be seen through fluoroscopy (including semi-perspective) and an image captured by the imaging means 7.
  • Any type of display 1 may be used, and these can be easily configured by using, for example, a liquid crystal panel, an EL (Electro Luminescence) panel, or the like.
  • Display 1 provides a visual view of the real image 1 1 and display 1 shows a virtual 3D image 1 2 of the perforation end point 4 1 and the perforation direction extension 3 1.
  • Display 1 (head-mounted display 6) is equipped with an imaging means (camera) 7 as a means for acquiring appearance information.
  • the display 1 and the imaging means (camera) 7 and the control means (controller) 2 are connected by a cable 61, and signals are transmitted and received from one side to the other, or signals are transmitted and received between the two. .. If you want to display the captured real image 1 1 on the display 1, take a picture.
  • ⁇ 2021/137276 16 ⁇ (: 170? 2020/042611 Image means (camera) 7 has a function to capture a real image 1 1 for display on the display 1 in addition to the function as a means for acquiring appearance information. Have.
  • the drilling mark jig 4 has a needle portion 4 4 and a grip portion 4 5.
  • the second mark 4 2 is provided on the drilling mark jig 4 (here, the needle part 4 4) by, for example, unevenness, printing, or sticking a sticker on which the mark is printed.
  • the control means 2 captures the second mark 4 2 (appearance information) by the imaging means 7, calculates (calculates) the distance 4 6 to the tip 4 3 of the needle 4 4 (refers to the appearance information). ) Determine the drilling end point 4 1 and display it on display 1.
  • control means 2 uses the imaging means 7 to image the outer shape of the drilling mark jig 4 (either the entire outer shape or a part of the outer shape) instead of the second mark 4 2, and the appearance information thereof is referred to.
  • the perforation end point 4 1 may be determined and displayed on the display 1.
  • the drilling tool 3 held by the operator 1 ⁇ / 1 in the right hand is an electric drill, and is a drill 3 4 (drill bit) for drilling the object to be drilled.
  • the drill 3 4 has a grip 3 5 for gripping the drilling tool 3, and the drill 3 4 is attached to the grip 3 5 by the attachment mounting 3 7 (chuck).
  • the grip 35 has a built-in electric battery (not shown).
  • the 1st mark 3 2 is placed at a fixed distance 3 6 from the tip 3 3 by, for example, unevenness, printing, or sticking a sticker with the mark printed on it. , Is provided.
  • the control means 2 captures the first mark 3 2 by the imaging means 7, calculates (calculates) the drilling direction of the drill 3 4, determines the drilling direction extension line 3 1, and displays it on the display 1.
  • the surgeon 1 ⁇ / 1 grasps the grip portion 4 5 of the drilling mark jig 4 with his left hand, and the tip end of the needle portion 4 4 is boned. Make contact with the perforation end point 4 1 of. If the bone ⁇ ⁇ / 1 is exposed, contact it as it is, and if there is muscle 2 etc. on the outside, pierce the muscle 2 and bring the tip into contact with the bone ⁇ ⁇ / 1.
  • Reference numeral 4 30 is the point where the perforation mark jig 4 (the tip of the needle part 4 4 of the perforation mark jig 4) contacts the bone ⁇ ⁇ / 1 (jig contact point).
  • the jig contact point 4 3 0 is set as the drilling end point 4 1.
  • the control means 2 captures, for example, the first mark 32 of the drilling tool 3 or the outer shape (all or part of the outer shape) of the drilling tool 3 (appearance information).
  • the appearance information of the drilling tool 3 is acquired, and the appearance information of the drilling marker jig 4 is referred to to create a virtual three-dimensional image 1 2 of the drilling end point 4 1 and the actual image 1 1 It is reflected on the display 1 and displayed on the display 1.
  • the control means 2 creates a virtual three-dimensional image 1 2 of the drilling direction extension line 3 1 by referring to the appearance information of the drilling tool 3, and reflects it on the actual image 1 1 and displays it on the display 1. Let me. When drilling, the surgeon M can perform accurate drilling without the need for large-scale equipment by setting the drilling end point 4 1 and the drilling direction extension line 3 1 in the drilling plan (guide). It becomes.
  • Control means 2 is composed of a microcomputer, CPU (Central Processing Unit) 2 1, ROM (Read Only Memory, read-only memory) 22, RAM (Random Access Memory, memory that can be read and written arbitrarily). It has 23, ⁇ / ⁇ (Input / Output controller, input / output controller) 24, and the internal bus 25 of the microcomputer that electrically connects them.
  • ROM 22 stores programs (a series of instructions designed for processing, control, etc.) and various types of data for performing various controls including display control and input / output control, operations, etc. There is. Various data and programs are stored in RAM23, and the CPU is used as memory for work to perform various processes.
  • CPU 2 1 reads and executes a program that describes instructions (processes) for CPU 2 1.
  • the internal bus 25 of the control means (microcomputer) 2 is connected to the cable 61 via an interface 26, and the cable 6 1 acts as an external bus.
  • Cable 6 1 includes display 1, imaging means (turtle) ⁇ 2021/137276 18 ⁇ (: 170? 2020/042611 La) 7 etc. are connected, and control means 2 receives signals such as various data from these via cable 61, and various data such as various data. And outputs signals such as control signals.
  • the control means 2 can also be said to be ⁇ II 2 1 that reads a program and executes a function such as displaying it on the display 1.
  • FIG. 5 is a mouth chart for explaining the drilling method of the drilling device 100 according to the first embodiment.
  • FIG. 6 is a diagram for explaining how the display 1 appears when punching is performed by the drilling device 100 according to the first embodiment.
  • Fig. 6 (8) is a diagram to explain how the real image 1 1 and the virtual 3D image 1 2 of the perforation end point 4 1 reflected in it can be seen on the display 1. It is a figure for demonstrating how the virtual 3D image 1 2 of the perforation direction extension line 3 1 is further seen on the display 1.
  • reference numeral 11 is attached to the display unit of the display 1.
  • the images that can be seen are virtual images, whether they are images that are seen through fluoroscopy such as see-through or images that are captured by the imaging procedure 7. This is to show that it is a real image, not.
  • the virtual image virtual three-dimensional image
  • FIG. 6 a dotted line is drawn in the left-right direction of the solid line indicating the bone 1, and a dotted line is also drawn in the left-right direction through the perforation end point 41. This is easy to understand the present invention. It is a dotted line showing the position of the bone ⁇ / ⁇ / 1 drawn to make it clear, and is not shown on Display 1.
  • the perforation method of the perforation apparatus 100 is a step (3): a step of preparing a display 1 capable of seeing a fluoroscopic or imaged actual image 1 1.
  • Step (b) Step to prepare the drilling tool 3
  • Step (c) Step to prepare the drilling mark jig 4
  • Step (d) Appearance information of the drilling tool 3 and the drilling mark jig 4.
  • the process of displaying the image on the display 1 and the process (e) Includes the process of drilling the target W (W 1) to be drilled based on the drilling direction extension line 3 1 and the drilling end point 4 1.
  • Step (a) is a step of preparing a display 1 in which a fluoroscopic or imaged actual image 1 1 can be seen.
  • a display 1 is prepared so that the actual image 1 1 that can be seen through or imaged can be seen.
  • AR Augmented Reality
  • MR Mated Reality
  • VR Virtual Reality
  • These glasses differ only in what they display, so that the perspective or imaged real image 1 1 reflects a virtual 3D image 1 2 that includes the perforation direction extension 3 1 and the perforation end point 4 1. You can use it.
  • Step (b) is a step of preparing a drilling tool 3 for drilling the target W to be drilled.
  • a drilling tool 3 for drilling the target w (W1) to be drilled is prepared.
  • the control means 2 should acquire three-dimensional information on the appearance of the drilling tool 3 in advance prior to drilling by, for example, having the imaging means 7 photograph the drilling tool 3. Is preferable.
  • ROM 22 instead of ROM 2 2, for example, an optical disk, HDD, R ⁇ M2 2).
  • Various semiconductor memories other than the above may be used).
  • step (c) the drilling marker jig 4 (to indicate the drilling end point 41) is quasi. ⁇ 2021/137276 20 ⁇ (: 170? 2020/042611
  • the control means 2 causes the imaging means 7 to take a picture of the perforation mark jig 4, so that the three-dimensional information of the appearance of the perforation mark jig 4 is acquired in advance prior to the perforation.
  • Step ( ⁇ 0 acquires appearance information of the drilling tool 3 and the drilling marker jig 4, and with reference to the appearance information, virtual 3 including the drilling direction extension line 3 1 and the drilling end point 4 1
  • This is a process of creating a dimensional image 1 2 and displaying the virtual 3D image 1 2 on the display 1 by reflecting it on the actual image 1 1.
  • the imaging means 7 is the appearance of the drilling tool 3 and the like.
  • the control step 2 creates a virtual 3D image 1 2 including the perforation direction extension line 3 1 etc. by referring to the appearance information, and the virtual 3D image 1 2 is used as a real image 1 It is reflected in 1 and displayed on the display 1.
  • This process corresponds to, for example, steps 3 1 1 to 3 3 1 in Fig. 5.
  • the imaging means 7 acquires the appearance information of the drilling tool 3, etc.
  • the control means 2 refers to the appearance information to create a virtual three-dimensional image 1 2 and the virtual
  • a monocular camera is used as the imaging means 7, and the first mark 3 attached to the drilling tool 3 to the drilling marker jig 4 (perforation tool 3 etc.) is used as the appearance information acquired or referenced by the imaging means 7.
  • the case where the 2nd to 2nd marks 4 2 (marks 3 2 etc.) are used will be described.
  • control means 2 causes the imaging means 7 to go around the perforation tool 3 and take a picture, so that the three-dimensional image information of the appearance of the perforation tool 3 or the like is acquired and stored in advance prior to the perforation. Keep it.
  • the 3D image information of design ⁇ 0 may be stored. In this way, the entire appearance of the drilling tool 3 etc. ⁇ 2021/137276 21 ⁇ (: 170? 2020/042611 3D image information of the body and 3D image information such as mark 3 2 are acquired or memorized in advance. Image information will also be acquired or stored at the same time.
  • the control means 2 causes the image pickup means 7 to take a picture of the mark 3 2 and the like, and compares the taken image with a known three-dimensional image (information) acquired in advance. It is preferable that this imaging is performed multiple times by changing the relative positions of the imaging means 7 and the mark 3 2 and the like. This is because in the case of a monocular camera, the image obtained by imaging is a two-dimensional image, and three-dimensional image information can be acquired by changing the shooting position. Then, a three-dimensional image such as Mark 3 2 is created based on the known three-dimensional image according to the size of the captured image. Then, the position of the virtual 3D image is adjusted to the position of the captured image.
  • the shape (shape) of the virtual 3D image is matched with the shape of the captured image. If it is the same shape, match it as it is, and if it is a distorted shape, distort it. If the virtual 3D image such as Mark 3 2 created in this way is not superimposed so as to match the captured image, repeat the above operation multiple times so that it matches as much as possible. The size, position, and shape can be matched in any order. Then, based on the virtual 3D image such as the mark 3 2, a virtual 3D image 1 2 including the drilling direction extension line 3 1 is created, and the display 1 is reflected in the actual image 1 1 of the drilling tool 3. To display.
  • the appearance (information) acquired or referred to by the imaging means 7 is not limited to the mark 3 2 and the like, and may be, for example, the outer shape (information) of the drilling tool 3 and the like.
  • a virtual 3D image 1 2 including the perforation direction extension line 3 1 is created and perforated in the same way as when the mark 3 2 etc. is used. It can be reflected on the actual image 1 1 of the tool 3 and displayed on the display 1.
  • a head mount ⁇ 2021/137276 22 ⁇ (: 170? 2020/042611
  • a monocular camera as the imaging means 7, for example, a semiconductor laser that emits a radar wave and a light receiving element that receives light reflected from a drilling tool 3 or the like are used to receive light from the emission. It is also possible to perform 3D measurement or 3D image creation of a drilling tool 3 or the like by calculating the distance from the time until and the phase difference between the original wave and the reflected wave.
  • the invisible part of the tip of the needle part 4 4 (the part hidden by the object to be drilled and reaching the tip 4 3) is indicated by a dotted line.
  • the control means 2 may display the needle portion 4 4 at this hidden portion on the display 1 as a virtual three-dimensional image 1 2.
  • the tip 4 3 is the bone under the muscle ⁇ ⁇ / 2.
  • the operator 1 ⁇ / 1 sets an appropriate contact point as the perforation end point 4 1.
  • the control means 2 reflects the virtual three-dimensional image 1 2 including the perforation direction extension line 3 1 etc. on the actual image 1 1 of the object to be perforated etc. and displays it on the display 1.
  • a drilling guide display can be displayed.
  • “during drilling” means when drilling or when drilling from now on.
  • a switch on the drilling tool 3 ⁇ 2021/137276 23 By pressing ⁇ (: 170? 2020/042611 (not shown)
  • the control means 2 displays. Display the extension line 3 1 in the drilling direction on 1.
  • control means 2 when the operator 1 ⁇ / 1 tries to start drilling, the control means 2 (11 2 1) is pressed by pressing a switch (not shown) provided on the drilling marker jig 4. ), The control step 2 displays the drilling end point 4 1 on the display 1. Also, for example, when the surgeon IV! Is about to start drilling, control means 2 (9) by pressing a switch (not shown) provided on display 1 (head mount display 6). When the display command signal of the drilling direction extension line and the drilling end point is issued to 11 2 1), the control means 2 displays the drilling direction extension line 3 1 and the drilling end point 4 1 on the display 1. In this way, at the time of perforation, the control means 2 reflects the virtual three-dimensional image 1 2 including the perforation direction extension line 3 1 etc. on the actual image 1 1 of the object to be perforated and displays it on the display 1. ..
  • surgeon 1 ⁇ / 1 is a newcomer or an unfamiliar person (hereinafter referred to as "newcomer, etc.”), and the tip 4 3 of the drilling mark jig 4 is the object to be drilled (bone ⁇ ). If the person is not in contact with the appropriate place, for example, a person who is a proficient person or has a high level of skill (hereinafter referred to as "a proficient person, etc.") will replace the operator 1 ⁇ / 1 for the perforation mark.
  • the tip 4 3 of the tool 4 is to be drilled (contact the appropriate place of the bone ⁇ , and while maintaining the state, a proficient person or the like attaches the drilling mark jig 4 to the surgeon 1 ⁇ / 1 such as a newcomer. It may be handed over so that the exact location is the drilling end point 41.
  • the control means 2 is in a state where the tip 4 3 of the drilling mark jig 4 is in contact with the imaging means 7 (camera) and the drilling end point 4 1 at the object to be drilled (bone ⁇ ⁇ / 1). , Take a picture of the hole marking jig 4 (2nd mark 4 2) (3 1 3). As a result, the imaging means 7 (and the control means 2) acquires the appearance information of the drilling mark jig 4. It is necessary that the second mark 4 2 is exposed to the outside of the target to be perforated (the bone is exposed and can be imaged.
  • the control means 2 provides the appearance information of the drilling mark jig 4 acquired in advance ([0084].
  • 3D information refer to the appearance information (3D information) of the 2nd mark 4 2 (of the drilling mark jig 4) that was taken (comparing the two).
  • the control means 2 obtains the appearance information of the image pickup means 7 by causing the image pickup means 7 to capture the appearance information (three-dimensional information) of the second mark 4 2 (of the drilling mark jig 4). Operate as an acquisition means.
  • the drilling mark jig 4 is provided with a plurality of second marks 4 2 based on the long axis direction of the needle portion 4 4 (direction of the drilling end point), and the plurality of second marks 4 2 and Since the tip 4 3 of the needle in the plane formed by the long axis direction of the needle 4 4 is the perforation end point 4 1, the control means 2 refers to the appearance information obtained in advance. Create the perforation end point 4 1 by referring to the plurality of second marks 4 2 (appearance information of the perforation mark jig 4 obtained by taking and imaging in S 1 3).
  • the control means 2 displays the virtual three-dimensional image 1 2 of the drilling end point 4 1 on the display 1 (S 1 7).
  • the control means is a virtual three-dimensional image on display 1 that is visible (see-through) through display 1 or is imaged and displayed by imaging means 7.
  • 1 2 Virtual 3D original image of drilling end point 4 1 1 2
  • the point in contact with the bone W 1 of the tip 4 3 (of the needle part 4 4) of the drilling mark jig 4 is displayed as the drilling end point 4 1 (virtual 3D image 1 2).
  • each storage element of the RAM 2 3 is made to correspond to each pixel of the display 1 (in the case of the power display, each pixel is displayed).
  • Corresponds to the three primary colors (R, G, B) and corresponds to the three storage elements) rewrites the storage contents of the storage element, and displays according to the storage contents of the storage element with the driver for driving Display 1. 1 can be displayed and driven.
  • a storage means mounted on the display 1 for example, a semiconductor memory, is used to store the memory corresponding to each pixel of the display 1 and drive the display 1. ⁇ 2021/137276 25 ⁇ (: 170? 2020/042611 Display 1 may be displayed and driven by the driver.
  • the operator 1 ⁇ / 1 arranges the drilling tool 3 in the drilling direction toward the target to be drilled (3 2 1). If the surgeon 1 ⁇ / 1 is a newcomer and the drilling direction of the drilling tool 3 is not the appropriate direction, a skilled person or the like will temporarily replace the surgeon! ⁇ / 1 as a drilling tool. It is also possible for an expert or the like to hand over the drilling tool 3 to a new operator 1 ⁇ / 1 while pointing 3 in an appropriate direction and maintaining that direction.
  • the control means 2 causes the image pickup means 7 (camera) to take a picture in a state where the drilling tool 3 is arranged (held) in a drilling direction toward the object to be drilled (3). twenty three) .
  • the imaging means 7 acquires the appearance information of the drilling tool 3.
  • the first mark 3 2 must be the object to be drilled (it must be in a state where it can be exposed to the outside of the bone and can be imaged.
  • the control means 2 is the drilling tool 3 and the drilling tool acquired in advance.
  • For the appearance information (3D information) of 3 refer to the appearance information (3D information) of the 1st mark 3 2 of the projected drilling tool 3 (comparing the two) and extend the drilling direction.
  • Control means 2 captures the appearance information (3D information) of the 1st mark 3 2 (of the drilling tool 3) on the imaging means 7.
  • the imaging means 7 is made to function as an appearance information acquisition means for acquiring appearance information.
  • a plurality of first marks 3 2 are provided on the drilling tool 3 based on the drilling direction. Therefore, the control means 2 obtains the perforation direction extension line 3 1 by obtaining a plurality of first marks 3 2 (captured and imaged at 3 2 3) for the appearance information obtained in advance.
  • Create by referring to (Appearance information of tool 3) (similar to creating a drilling end point 4 1 by referring to multiple second marks 4 2).
  • Control means 2 displays a virtual three-dimensional image 1 2 of the perforation direction extension line 3 1 on the display 1 in the same manner as 3 1 7 (see 3 2 7, Fig. 6 (Snake)).
  • control means 2 is seen through the display 1 or is imaged by the image means 7 and displayed on the display 1 (the object to be drilled, the drilling tool 3, the drilling marker jig).
  • Real image of tool 4 etc. 1 1 to virtual 3D image ⁇ 2021/137276 26 ⁇ (: 170? 2020/042611
  • the display 1 is the actual image 1 1 is the image seen through or captured by the display.
  • the control means 2 is used for the drilling tool 3 and / or the drilling marker.
  • the position, tilt, and size (magnification) of the virtual 3D image 1 2 of the jig 4 are displayed on the display 1 so as to match the actual image 1 1.
  • control means 2 is a virtual three-dimensional image of a part (or all) of the appearance of the drilling tool 3 and / or the drilling mark jig 4 in addition to the drilling end point 4 1 and the drilling direction extension line 3 1. You may create 1 2 and overlay it on the actual image 1 1. By doing so, the position, inclination, and size (multiplication) of these virtual 3D images 1 2 match the actual image 1 1 1, and whether the drilling end point 4 1 and the drilling direction extension line 3 1 are correct. Can be easily recognized.
  • control means 2 displays the virtual three-dimensional image 1 2 of the perforation direction extension line 3 1 and the perforation end point 4 1 on the display 1 in a display mode different from that of the real image 1 1, and these are the real ones. It may be easier to recognize that it is not the image 1 1.
  • the different display modes are, for example, when the actual image 11 has a color tone based on black and white, it is displayed in a color different from the color tone (red, blue, gold, silver), or is displayed blinking.
  • the control means 2 displays the virtual tertiary image 1 2 of the perforation direction extension line 3 1 and the virtual 3D image 1 2 of the perforation end point 4 1 in the same display mode (for example, the same color and the same blinking). It may be displayed in a different display mode (for example, different colors, one blinking and the other not blinking).
  • the control means 2 detects the change by imaging by the imaging means 7, and the drilling direction extension line 3 corresponds to the change. Change the direction of 1 to display on display 1.
  • the control means 2 detects the change in the image taken by the imaging means 7, and changes the position of the drilling end point 4 1 in response to the change. ⁇ 2021/137276 27 ⁇ (: 170? 2020/042611 Display on Display 1.
  • the display 1 may be either a display in which a real image 1 1 can be seen through fluoroscopy, or a display in which an image obtained by capturing (imaging) the real image 1 1 by an imaging means 7 is displayed.
  • the display 1 is a display in which the real image 1 1 can be seen through see-through or the like
  • the main image seen on the display 1 is the real image 1 1 such as the see-through of the display 1.
  • the display 1 is a display that displays an image of the actual image 11 captured (photographed) by the imaging means 7, or if it is a visible display
  • the main image seen on the display 1 is captured by the imaging means 7.
  • the control means 2 reflects (superimposes) a virtual three-dimensional image 1 2 including the perforation direction extension line 3 1 and the perforation end point 4 1 on the actual image 1 1 that is seen through or captured and displayed by see-through or the like. ) To display.
  • the control means 2 may display (superimpose) the virtual three-dimensional image 1 2 on the real image 1 1 on the display 1 only by the perforation direction extension line 3 1 and the perforation end point 4 1.
  • Other virtual 3D images 1 2 may also be reflected (superimposed) and displayed.
  • a virtual three-dimensional image 1 2 of a part that cannot be seen by the operator! ⁇ / 1 may be created and displayed by a drilling tool 3 or a drilling marker jig 4. In this way, the invisible part of the drilling tool 3 or the like is displayed as a virtual three-dimensional image 1 2, so that more accurate drilling becomes possible.
  • a virtual three-dimensional image 1 2 of a part that can be seen by the operator! ⁇ / 1 (a part that can be imaged by the imaging means 7) is created with a drilling tool 3 or a drilling marker jig 4. It may be displayed.
  • the virtual 3D image 1 2 of the drilling tool 3 etc. matches their real image 1 1, the extension direction of the drilling direction extension line 3 1 and the position of the drilling end point 4 1 are accurate. It turns out that more accurate drilling is possible.
  • the extension direction of the drilling direction extension line 3 1 or the drilling end point 4 1 ⁇ 2021/137276 28 ⁇ (: 170? 2020/042611 Since the position may be inaccurate, it is possible to suppress inaccurate drilling.
  • a virtual 3D image 1 2 including the perforation end point 4 1 is created, and the virtual 3D image 1 2 is reflected on the real image 1 1 and displayed on the display 1.
  • the drilling method may be a drilling method including step (3), step ( ⁇ ), step ( ⁇ ), step (1), step (2) and step (6).
  • Step (6) is a step of drilling a pair to be drilled ( ⁇ is drilled based on the drilling direction extension line 3 1 and the drilling end point 41. This step corresponds to 3 3 3 in Fig. 5.
  • the operator 1 ⁇ / 1 pierces the piercing direction extension line 3 1 and the piercing end point 4 1 (virtual three-dimensional image 1 2) as a piercing guide (guide) display based on these indications (3). 3 3).
  • FIG. 7 shows the drilling tool 3 and the drilling mark jig 4 when drilling with the drilling device 100 according to the first embodiment. It is a figure for demonstrating the arrangement of. The squared area of Display 1 is visible.
  • the arrangement (arrangement position) of the drilling tool 3 and the drilling mark jig 4 is related to the imaging means 7, and the first mark 3 2 can be imaged, but the second marker _ In the case of a position where the image cannot be captured (see the dotted arrow from the imaging means 7 in the figure. This dotted arrow is drawn for the sake of clarity and is not actually shown).
  • a virtual 3D image 1 2 of the punching direction extension line 3 1 can be created, but a virtual 3D image 1 2 of the drilling end point 4 1 cannot be created. Therefore it is accurate ⁇ 2021/137276 29 ⁇ (: 170? 2020/042611 It becomes difficult to make a hole.
  • the positions of the drilling tool 3 and the drilling mark jig 4 are both the 1st mark 3 2 and the 2nd mark in relation to the imaging means 7. (Refer to the dotted arrow from the imaging means 7 in the figure. This dotted arrow is drawn for the sake of clarity and is not actually displayed.
  • a virtual three-dimensional image 1 2 of the drilling direction extension line 3 1 and the drilling end point 4 1 can be created. Therefore, it is possible to make an accurate drill. Therefore, as shown in Fig.
  • the surgeon 1 ⁇ / 1 puts the drilling tool 3 and the drilling marker jig 4 into the first mark 3 2 and the second mark in relation to the imaging means 7. Is arranged so that it can be imaged by the imaging means 7. The same applies when the imaging means 7 is not mounted on the display 1 (head-mounted display 6) but is mounted or installed in another place.
  • FIG. 8 is a diagram for explaining a modification of the second mark 4 2 (of the drilling mark jig 4) in the drilling device 100 according to the first embodiment. is there.
  • Figures 8 (8) to 8 ( ⁇ ) are diagrams for explaining variations of each.
  • the second mark 4 2 is provided in a straight line by providing it on the outer circumference of the needle portion 4 4.
  • the second mark 4 2 is provided in a straight line on the grip portion 4 5.
  • Fig. 8 (In ⁇ , the second mark 4 2 is provided with a straight line connecting a plurality of second marks 4 2 to the grip portion 4 5 based on the long axis direction of the needle portion 4 4.
  • the second mark 4 2 is provided on the grip portion 4 5 symmetrically with respect to the axial direction of the needle portion 4 4.
  • the second mark 4 2 is provided on the needle portion 4 4
  • the second mark 4 2 is provided in the grip portion 4 5 as a pattern or symbol.
  • Fig. 8 ( ⁇ ) it is provided in a distributed manner.
  • the second mark 4 2 is provided in a pattern over a wide range of the grip portion 45.
  • FIG. 9 is a diagram for explaining a modified example of the first mark 32 (of the drilling mark jig 4) in the drilling device 100 according to the first embodiment.
  • Fig. 9 (8) to Fig. 9 (0) are diagrams for explaining each modification, and are the same as Fig. 8 (8) to Fig. 8 ( ⁇ ).
  • the first mark 32 is provided linearly by being provided on the outer periphery of the drill 34.
  • Fig. 9 (Snake) the first mark 32 is provided linearly on the grip portion 35.
  • the first mark 32 is provided on the plurality of first marks 32 of the grip portion 35 based on the long axis direction of the drill 34.
  • the first mark 32 is the grip portion 35. Three of them are provided symmetrically with respect to the axial direction of the drill 34.
  • the first mark 32 is distributed between the drill 3 4 and the grip portion 35.
  • the first mark 32 is provided on the grip portion 35 as a pattern or symbol.
  • the first mark 32 is provided in a pattern over a wide range of the grip portion 35. Has been done.
  • the above-mentioned drilling device 100 is the above-mentioned [1] [2] [3] [6] [8] [9] [
  • FIG. 1 ⁇ is a diagram for explaining the drilling device 200 according to the second embodiment.
  • the second embodiment will be described with reference to FIG. 10 showing how the display 1 looks, and the drawings of other parts will be omitted (the same applies to the other embodiments).
  • the drilling device 200 according to the second embodiment is basically the same as the drilling device 100 according to the first embodiment, but the drilling direction extension line 3 1 of the drilling tool 3 passes through the drilling end point 4 1. , Or a passage notification means for notifying that the drilling direction extension line 3 1 of the drilling tool 3 does not pass through the drilling end point 4 1 is further provided.
  • the display 1 is provided with a perforation end point passage notification display unit 843, which is used as a pass notification means for indicating whether or not the perforation end point extension line 3 1 passes through the perforation end point 4 1.
  • a perforation end point passage notification display unit 843 which is used as a pass notification means for indicating whether or not the perforation end point extension line 3 1 passes through the perforation end point 4 1.
  • the control means 2 is marked with an “X” as shown in Fig. 10 (Mi).
  • the message "The extension line of the drilling direction does not pass through the drilling end point” is displayed on the drilling end point passage notification display unit 8 4 8. Note that either the mark such as " ⁇ ” or "X” and the message may be used. Further, the control means 2 may be used in combination with sound (buzzer, music, voice, etc.).
  • the drilling apparatus 200 according to the second embodiment has the effect described in the above [4].
  • the perforation device 200 according to the second embodiment is a passage notification means for indicating whether or not the perforation direction extension line 3 1 passes through the perforation end point 4 1 (perforation end point passage notification display unit 8 4). Since it is the same as the perforation device 100 according to the first embodiment except that the perforation device 100 according to the first embodiment has the corresponding effect among the effects of the perforation device 100 according to the first embodiment or the drilling method.
  • FIG. 11 is a diagram for explaining the drilling device 300 according to the third embodiment.
  • the drilling device 300 according to the third embodiment is basically the same as the drilling device 100 according to the first embodiment, but the tip of the drilling portion of the drilling tool 3 approaches the drilling end point 41. The difference is that it is further provided with a perforation notification means for notifying that it has arrived or that it has arrived.
  • the display 1 is provided with a drilling end point distance notification display (85 3, 85 b), and the tip of the drilling part of the drilling tool 3 approaches or reaches the drilling end point 4 1. It is used as a perforation notification means to notify that the work has been done.
  • the control means 2 is used. , Display "(tip of perforation) 5 to end of perforation” on the perforation end point distance notification display 8 5 3.
  • the control means 2 is located near the drilling direction extension line 31. ⁇ 2021/137276 32 ⁇ (: 170? 2020/042611 An arrow from the tip of Lil 3 4 to the end point of drilling 4 1 and "After Is displayed (perforation end point distance notification display 8 5 ⁇ ).
  • the control means 2 reaches the “(drilling portion tip) drilling end point” as shown in Fig. 11 (Snake). Is displayed (Punching end point distance notification display 8 5 3). In addition, the control step 2 displays “reaching” in the vicinity of the drilling direction extension line 31 (drilling end point distance notification display unit 85 ⁇ ). Either one of the drilling end point distance notification display units 8 5 3 and 85 ⁇ may be used. The perforation end point distance notification display unit 8 5 The display of the ⁇ may be either a figure like an arrow or a message such as “5 01 01 more”. Further, the control means 2 may be used in combination with sound (buzzer, music, voice, etc.).
  • the drilling device 300 according to the third embodiment has the effect described in the above [5]. It should be noted that the drilling device 300 according to the third embodiment is further provided with a drilling notification means for notifying that the tip of the drilling portion of the drilling tool 3 has approached or reached the drilling end point 41. In terms of points, it is similar to the perforation device 100 according to the first embodiment, and therefore, it also has the corresponding effect among the effects of the perforation device 100 according to the first embodiment or the perforation method.
  • FIG. 1 2 is a diagram for explaining the drilling device 400 according to the fourth embodiment.
  • the drilling device 400 according to the fourth embodiment is basically the same as the drilling device 100 according to the first embodiment, but the position of the drilling mark jig 4 with respect to the object to be drilled is maintained. The difference is that it is equipped with placement maintenance means (jig attachment for perforation marks 48).
  • the drilling mark jig attachment 4 8 has a plurality of grips (4 8 3, 48 0). Then, one grip 4 8 3 in the multiple grips can grip the drilling mark jig 4, and another grip 4 80 is configured to grip the object to be drilled.
  • Each grip (4 8 3, 4 80) has a panel (4 8 dry, 4 8 9 ), and it is pierced by that force. ⁇ 2021/137276 33 ⁇ (: 170? 2020/042611 Hold the hole marking jig 4 and the object to be drilled, respectively.
  • grips (4 8 3, 4 8 ⁇ ) are the arms (4 8 4 8 ⁇ ⁇ )
  • the operator 1 ⁇ / 1 maintains the arrangement position (posture) of the perforation mark jig 4 with respect to the object to be perforated even if the perforation mark jig 4 is not gripped (perforation mark jig 4).
  • 4 of the tip 4 3 of the drilled the position of the point of contact to ⁇ is maintained).
  • panel 4 8 NOTE 4 8 9)
  • a member such as a bolt nut may be used instead.
  • the perforation device 400 according to the fourth embodiment has the effect described in the above [1 2].
  • the perforation device 400 according to the fourth embodiment has a perforated pair of the perforation mark jig 4.
  • the same as the drilling device 100 according to the first embodiment except that the placement maintaining means (jig attachment for drilling mark 48) for maintaining the placement position with respect to the elephant is further provided. Therefore, the first embodiment 1 Among the effects of the drilling device 100 or the drilling method according to the above, the corresponding effect is also obtained.
  • FIG. 13 is a diagram for explaining the drilling device 500 according to the fifth embodiment.
  • the drilling device 500 according to the fifth embodiment is basically the same as the drilling device 100 according to the first embodiment, but the position of the drilling mark jig 4 with respect to the object to be drilled is maintained. The difference is that it is provided with placement maintenance means.
  • the drilling device 500 (see FIG. 13) according to the fifth embodiment has a placement maintaining means for maintaining the placement position with respect to the object to be drilled, and the punching device 400 according to the fourth embodiment (see FIG. 13).
  • the arrangement maintaining means (perforation mark jig attachment 4 8) for maintaining the arrangement position with respect to the object to be perforated is separate from the perforation mark jig 4.
  • the arrangement maintaining means for maintaining the arrangement position with respect to the object to be drilled jig attachment for drilling mark 4 98, ⁇ 2021/137276 34 ⁇ (: 170? 2020/042611
  • FIG. 13 is a diagram for explaining the drilling device 500 according to the fifth embodiment, and Fig. 1 3 () shows the drilling mark jig 4 to be drilled (to a predetermined location with respect to ⁇ ).
  • Figure 1 is a diagram to explain how the arranged state can be seen on Display 1.
  • Fig. 13 (Snake) is a diagram for explaining the arranged state
  • Fig. 13 ( ⁇ is a cross-sectional view of the arranged part
  • Fig. 1 3 (0) is an explanatory view of a modified example.
  • the drilling mark jig (4) is covered with FIGS. 13 (), 13 (M) and 13 (as shown in ⁇ ). It is integrated with the placement maintenance means (jig attachment for drilling marks 489) that maintains the placement position with respect to the drilling target, so that the placement position (posture) of the drilling mark jig (4) with respect to the object to be drilled. ) Is maintained.
  • the drilling mark jig 4 has a threaded portion 4 5 3 (female screw) and a needle portion 4 4 3 and the tip 4 3 3 is targeted for drilling by rotating ( ⁇ ).
  • Thread part 4 4 3 There may be no needle part 4 4 3 and it may be composed of thread part 4 5 3 (female screw) up to the tip 4 3 3. Thread part 4 5 3 (female screw) is provided over the entire drilling direction. It is not necessary and may be provided in a part.
  • Jig fixture for perforation mark 4 9 has a threaded part 4 9 3 2 (female screw) and a cap (a part protruding like a cap around the threaded part 4 9 3 2) 4 9 3 Has 1 and.
  • the threaded part 4 9 3 2 (female screw) is the threaded part provided on the drilling mark jig 48.
  • the configuration corresponds to 4 5 3 (male screw) (screw pitch, unevenness, etc.).
  • the part facing the object to be perforated ( ⁇ ⁇ / 1) is a flat surface, a curved surface (concave surface, convex surface), etc., and the surface is the object to be perforated ( ⁇ placement position).
  • an adhesive material including an adhesive material
  • the drilling mark jig 4 is rotated a predetermined number of times (turns a screw) in a direction intersecting the drilling direction. As a result, the tip 4 3 3 is drilled to the target to be drilled ( ⁇ ⁇ 2021/137276 35 ⁇ (: 170? 2020/042611 The depth is adjusted, and the position of the drilling mark jig 4 with respect to the object to be drilled ( ⁇ ⁇ / 1) is maintained at the eaves part 4 9 3 1. In this way, it is constructed like a kind of insect pin or thumbtack.
  • the second mark is placed on the drilling mark jig 4 at a place where the tip 4 3 3 is outside the drilling target even if it penetrates into the drilling target and reaches the drilling end point. 4 2 8 is provided.
  • FIG. 1 3 (0) A modified example of the drilling apparatus 500 according to the fifth embodiment will be described with reference to FIG. 1 3 (0).
  • a perforation mark jig 4 is used, which replaces the perforation mark jig attachment 4 9 (perforation mark jig 4) shown in Fig. 13 (8) to ( ⁇ ).
  • the drilling mark jig mounting tool 4 98 is used.
  • the drilling mark jig mounting tool 4 9 is the drilling mark jig mounting tool.
  • a sucker 4 9 3 3 is added (added) to 4 9 8.
  • the sucker 4 9 3 3 is joined to the drilling mark jig 4 mine around the central thread 4 9 3 2, and others. The points are not joined.
  • Jig fixture for drilling mark 4 9 The target to be drilled (]
  • the suction cup 4 9 3 3 The target to be perforated (the air between ⁇ is released, and the perforation mark jig 4 ⁇ (perforation mark jig fixture 4 9 ⁇ ) becomes the target to be perforated (1).
  • the screw part 4 5 3 was a male screw and the screw part 4 9 3 2 was a female screw, but the screw part 4 5 3 is a female screw.
  • the threaded part 4 9 3 2 may be a male jig.
  • the drilling device 500 according to the fifth embodiment has the effect described in the above [1 2].
  • the drilling device 500 according to the fifth embodiment has a drilling mark jig (4, 5).
  • FIG. 14 is a diagram for explaining the drilling device 600 according to the sixth embodiment.
  • the perforation device 600 according to the sixth embodiment is basically the same as the perforation device 100 according to the first embodiment, but the control means 2 is for displaying the perforation end point 41 for a perforation mark. It differs from the drilling device 1 ⁇ according to the first embodiment in that the display 1 is displayed so that the display position does not change even if the arrangement position of the jig 4 changes.
  • the drilling device 600 when the drilling jig 4 is arranged, the drilling device 600 according to the sixth embodiment is in the arranged position by the control means 2.
  • the perforation end point 4 1 of the display position determined from the above is displayed on the display 1.
  • the drilling tool 3 is also positioned with the drilling direction toward the drilling end point 4 1, and the control means 2 shows the drilling direction extension line 3 1 on the display 1. This is the same as the drilling device 100 according to the first embodiment.
  • the control means 2 determines at the predetermined placement position upon receiving the drilling end point display position maintenance command.
  • the surgeon 1 ⁇ / 1 displays the display position of a certain drilling end point 4 1 (or a certain drilling end point 4 1 and a certain drilling direction extension line 3 1) regardless of the position of the physical drilling end point 4 1 as it is. If you want to maintain it (if you want to maintain the display position at a certain point), issue a drilling end point display position maintenance command command. For example, the operator!
  • ⁇ / 1 issues a drilling end point display position maintenance command (signal) by pressing the switch (not shown) provided on the drilling tool 3, ⁇ 11 2 1 (control means 2). ) Detects that the command is issued and executes the command, so that the display at the display position where the drilling end point 4 1 (or a drilling end point 4 1 and a drilling direction extension line 3 1) is displayed is displayed. Be maintained.
  • the perforation end point display (position) maintenance mode display unit 8 8 3 is provided to display “perforation end point display maintenance mode”, and the control means 2 is placed at the position where the drilling mark jig 4 is arranged. It is convenient to indicate that the perforation end point display maintenance mode is used to maintain the display position of the perforation end point 4 1 regardless.
  • ⁇ 2021/137276 37 ⁇ (: 170? 2020/042611 Fig. 14 (Snake) shows that the control means 2 displays the display 1 on the display 1 without changing the display position of the drilling end point 4 1 determined at the predetermined placement position. It is the figure which showed the display.
  • the control means 2 displays the display 1 as it is without changing the display position of the perforation end point 4 1 once determined, even though it is not directed to (the predetermined arrangement is not made).
  • the control means 2 provides a warning display unit 8 8 ⁇ ⁇ ⁇ on the display 1 and displays "Warning.
  • a warning such as "The target to be drilled has changed may not be displayed correctly" or "The drilling end point or the drilling direction extension line may not be displayed correctly” may be displayed.
  • a warning may be given by displaying a sign, a diagonal line, a mesh pattern, or the like.
  • 8 8 ⁇ , 8 8. , 8 8 is 8 8 alone, 8 8 alone, 8 8 alone, 8 8 13 and 8 80 combined, 8 8 13 and 8 80 1 combined, or 8 ⁇ 0 2021/137276 38 ⁇ (: 17 2020/042611
  • control means 2 may be used in combination with sound (buzzer, music, voice, etc.).
  • the drilling device 600 according to the sixth embodiment has the effect described in the above [1 1].
  • the control means 2 has a drilling end point 41.
  • the display position of the drilling end point 4 1 once determined is displayed on the display 1 so that the display position does not change even if the placement position of the drilling mark jig 4 changes. Since it is the same as the perforation device 100 according to the first embodiment, it also has the corresponding effect among the effects of the perforation device 100 according to the first embodiment or the perforation method.
  • Fig. 15 is a diagram for explaining the drilling device 700 (700, 700) according to the seventh embodiment.
  • Fig. 15 (8) is a diagram for explaining the drilling device 700
  • Fig. 15 (Mi) is a diagram for explaining 700.
  • the drilling device 700 (700, 700) according to the seventh embodiment is basically the same as the drilling device 100 according to the first embodiment, but the jig contact point in the first embodiment. Whereas 4 3 0 was set as the drilling end point 41, in the seventh embodiment, the jig contact point 4 3 0 and the drilling tool 3 to be drilled (the drilling start point 3 8 at which the drilling of ⁇ is started) are set. The difference is that the point on the straight line that is separated from the jig contact point 4 30 by a certain distance 4 4 0 is defined as the drilling end point 4 1.
  • the control means 2 has the jig contact point 4 30 and the drilling tool 3 to be drilled (].
  • the perforation tool 3 may not be perforated to the depth of the object to be perforated ( ⁇ ) or a hole (perforation). You may want to stop the perforation in the middle without penetrating the hole).
  • ⁇ 2021/137276 39 ⁇ (: 170? 2020/042611
  • the operator 1 ⁇ / 1 presses a switch (not shown) provided on the drilling tool 3 to contact the jig.
  • a signal is issued instructing that the point separated by 0 be the end point 4 1 of the drilling, and the command is executed when 0 9 11 2] receives it.
  • the command is executed in advance.
  • Means 2 displays the point separated from the jig contact point 4 30 by a certain distance 4 4 0 as the drilling end point 4 1 on the display 1. Note that the jig contact point 4 3 0 and the drilling start point 3 8 are displayed.
  • the connecting straight line 4 3 1 (the straight line passing through both points) is a straight line that coincides with the extension line 3 1 in the drilling direction.
  • control means 2 also displays the jig contact point 4 30 on the display 1, it becomes easier to determine or change the drilling end point 41. Furthermore, if the control means 2 displays the jig contact point 4 30 on the display 1 in a display mode different in size, color, etc. from the drilling end point 4 1, it is easy to distinguish between the two. If the display of the drilling direction extension line 3 1 is only the display of the tentative 3D image 1 2 between the drilling start point 3 8 drilling end point 4 1 and the drilling end point 4 3 0 drilling end point 4 3 0 A virtual 3D image 1 2 of a straight line between 4 1 may be displayed on display 1. Both straight lines may be displayed in different display modes such as line color and thickness.
  • FIG. 15 shows the drilling device 700 shown in Fig. 15 (Mi), the control means 2 has a jig contact point 4 30 and the drilling tool 3 has a drilling target ( ⁇ starts drilling).
  • Figure 1 5 shows the points separated from the jig contact point 4 3 0 by the jig contact point 4 3 0 on the straight line 4 3 1 connecting the start point 3 8 and the drilling end point 4 1 and the display 1. It is the same as the drilling device 700 8 shown in 8), but in Fig. 15 (8), the longitudinal direction (straight line) of the needle part 4 4 of the drilling mark jig 4 does not match the straight line 4 3 1.
  • Fig. 15 shows the longitudinal direction (straight line) of the needle part 4 4 of the drilling mark jig 4
  • the straight line 4 3 1 is the drilling method. ⁇ 2021/137276 40 ⁇ (: 170? 2020/042611 It can be rephrased as the extension line 3 1.
  • the longitudinal direction (straight line) of the needle part 4 4 of the drilling mark jig 4 matches the straight line 4 3 1 (drilling direction extension line 3 1), it may be different from the display when they do not match.
  • the control means 2 displays on the display 1 so as to change the display mode (for example, change from a non-blinking display to a blinking display, increase the line thickness, change the color, etc.), make an accurate hole. Becomes even easier.
  • Other points are the same as those of the drilling device 700 8 shown in Fig. 15 (8).
  • the drilling apparatus according to the seventh embodiment has the corresponding effect described in the above [6] [7].
  • the drilling device 70 0 (700, 700) according to the seventh embodiment is constant from the jig contact point 4 30 on the straight line connecting the jig contact point 4 3 0 drilling start point 3 8. Since the points other than the point where the separated points are set as the piercing end points 4 1 are the same as the piercing device 1 ⁇ ⁇ according to the first embodiment, the piercing device 100 0 or the piercing method according to the first embodiment. It also has the corresponding effect among the effects of.
  • the drilling device according to the eighth embodiment is basically the same as the punching device 100 according to the first embodiment, but a bone wire is used instead of the drilling tool 3. Therefore, it is different from the drilling device 1 ⁇ ⁇ according to the first embodiment.
  • the drilling device according to the eighth embodiment is the same as the punching device 100 according to the first embodiment except that the bone wire is used instead of the drilling tool 3, and thus the description thereof will be omitted.
  • percutaneous bone wire insertion is performed as a surgical treatment when the target to be perforated ( ⁇ is unstable due to large deformation of the fracture at various sites. Then, the intraoperative bone wire insertion direction and The guideline for the depth is by visual inspection and linear perspective. On the other hand, in the case of the eighth embodiment, it is possible to accurately grasp the bone wire insertion direction and the depth without requiring a large-scale device.
  • bone wire was inserted after fracture repair was performed during surgery, so if you want to take a picture of ⁇ -chome before surgery, use the ⁇ -chome image as it is. ⁇ 2021/137276 41 ⁇ (: 170? 2020/042611 was not possible.
  • the drilling device according to the eighth embodiment is the same as the punching device 100 according to the first embodiment except that the bone wire is used instead of the drilling tool 3.
  • the bone wire is used instead of the drilling tool 3.
  • FIG. 16 is a diagram for explaining the drilling device 900 according to the ninth embodiment.
  • the perforation device 900 according to the ninth embodiment is basically the same as the perforation device 100 according to the first embodiment, but the person who perforates is not the operator IV! But the carpenter IV! 9. , And, the difference is that the object to be perforated is not a living body but wood 9 (wood board ⁇ ⁇ / 91, ⁇ ⁇ / 9 2).
  • the object to be drilled ⁇ ⁇ / 9 ( ⁇ ⁇ / 91, ⁇ ⁇ / 92) is wood ⁇ ⁇ /. 9 (wood board ⁇ ⁇ / 9 1, ⁇ ⁇ / 9 2).
  • carpenter IV! 9 stacks the boards 9 1 and 92 of the target 9 (wood) to be drilled, punches them, passes bolts through the holes, and fixes them with nuts. It is a drilling device for
  • the perforator is not the operator IV! But the carpenter IV! 9, and the object to be perforated is wood 9 (wood board) instead of the living body. Since it is the same as the drilling device 100 according to the first embodiment in a point other than a certain point, it corresponds to the effect of the punching device 100 according to the first embodiment or the drilling method. ⁇ 2021/137276 42 ⁇ (: 170? 2020/042611 Has an effect.
  • FIG. 17 is a diagram for explaining the drilling device 100 0 0 according to the tenth embodiment.
  • the perforation device 100 0 according to the first embodiment is basically the same as the perforation device 100 0 according to the first embodiment, but the person who perforates is not the operator IV! But the steel frame construction worker 1 ⁇ . The difference is that it is / 110 and that the object to be perforated is a steel frame ⁇ ⁇ / 10 instead of a living body.
  • the object to be perforated ⁇ ⁇ / 10 is a steel frame (a pillar of a steel frame).
  • the drilling device 100 0 0 is for the steel frame construction contractor 1 ⁇ / 110 to drill the steel frame ⁇ ⁇ / 10 to be drilled and pass an electric wire or pipe through the hole. It is a drilling device.
  • the perforator is not the operator IV! But the steelworker IV! 10 0, and the object to be perforated is the steel frame instead of the living body. Since it is the same as the drilling device 100 according to the first embodiment except that it is 0, it has the corresponding effect among the effects of the drilling device 100 according to the first embodiment or the drilling method.
  • FIG. 18 is a diagram for explaining the drilling device 1 100 according to the first embodiment.
  • the drilling device 1 1 ⁇ ⁇ according to the first embodiment is basically the same as the piercing device 1 ⁇ ⁇ according to the first embodiment, but the person who pierces is not the operator IV! But the concrete fence construction worker IV. The difference is that it is! 1 1 and that the object to be perforated is not a living body but a concrete fence ⁇ ⁇ / 1 1.
  • the object to be drilled ⁇ ⁇ / 1 1 is a concrete fence.
  • the drilling device 1 1 0 0 is a drilling device for the concrete fence construction worker 1 ⁇ / 1 1 1 to drill the concrete fence to be drilled ⁇ ⁇ / 1 1 and install the guide plate. Is.
  • the perforator is not the operator IV! But the concrete fence construction worker IV! 1 1, and the object to be perforated is not the living body.
  • ⁇ 2021/137276 43 ⁇ (: 170? 2020/042611 Since it is the same as the perforation equipment 110 according to the first embodiment except that it is a concrete fence 1 1, the perforation device 1 according to the first embodiment It also has the corresponding effect among the effects of 0 0 or the drilling method.
  • FIG. 1 9 is a diagram for explaining the drilling device 1 2 0 0 according to the embodiment 12.
  • the perforation device 1 2 0 0 according to the first embodiment is basically the same as the perforation device 100 according to the first embodiment, but further, the detection wave 8 4 is irradiated to the object to be perforated ⁇ ⁇ / 1.
  • the two-dimensional perspective image acquisition means 8 1 for acquiring the two-dimensional perspective image 8 of the object 1 to be perforated is provided, and the two-dimensional perspective image 8 is reflected (superimposed) on the real image 1 1 or the virtual three-dimensional image 1 2. The difference is that it is displayed on display 1.
  • an X-ray imaging device was used as the two-dimensional fluoroscopic image acquisition means 81 (see FIG. 19).
  • the two-dimensional fluoroscopic image acquisition means 8 1 (X-ray imaging device) generates a detection wave 8 4 (X-ray) from the detection wave generator 8 2 (X-ray tube) and irradiates the object to be perforated ⁇ ⁇ / 1.
  • the detection wave 8 4 (X-ray) transmitted through the object to be perforated ⁇ ⁇ / 1 is detected by the detection unit 8 3 (image tube) and visualized to obtain a two-dimensional perspective image 8.
  • the control means 2 reflects the two-dimensional perspective image 8 on the real image 1 1 or the virtual three-dimensional image 1 2 and displays it on the display 1 by the general-purpose image recognition technology.
  • the detection wave 84 X-ray
  • the upper limit of the number of times may be set, such as once, twice, or three times.
  • FIG. 20 is a diagram for explaining the drilling device 1 2 0 0 according to the first embodiment, and FIGS. 20 (8) to (0) are shown on the display 1 at each stage of drilling. It is a figure for demonstrating the appearance.
  • the detection wave 84 is irradiated, the two-dimensional fluoroscopic image 8 of the object to be perforated ⁇ ⁇ / 1 (the outer shape of the object to be perforated ⁇ ⁇ / 1 shown by the dotted line and its diagonal fracture) is displayed.
  • Target to be perforated ⁇ 2021/137276 44 ⁇ (: 170? 2020/042611
  • the surgeon 1 ⁇ / 1 moves the drilling mark jig 4 while looking at the two-dimensional fluoroscopic image 8 etc. of the object to be drilled ⁇ ⁇ / 1 to determine the drilling end point 4 1 (Fig.). 2 0 (see ⁇ ).
  • the determined drilling end point 4 1 is represented on the display 1 by the control means 2 as a circle (or red).
  • the surgeon 1 ⁇ / 1 reflects (superimposes) on the actual image 1 1 and displays the virtual 3D image 1 2 of the perforation end point 4 1 and the 2D of the perforation target ⁇ ⁇ / 1. While looking at the perspective image 8 etc., move the drilling tool 3 so that the drilling direction extension line 3 1 passes through the drilling end point 4 1 (see Fig. 20 (0)). Upon passing, the control means 2 changes the perforation end point 41 to, for example, a square mark (or green).
  • the perforation mark jig 4 may move away from the perforation target ⁇ ⁇ / 1 or the perforation target ⁇ ⁇ / 1 may move. Even if the perforation end point 4 1 is moved according to the movement of the perforation target ⁇ ⁇ / 1 and the perforation end point 4 1 is displayed to indicate the same location relative to the perforation target ⁇ ⁇ / 1. Good.
  • Such control is performed, for example, by the control means 2 using a general-purpose image recognition technique or the like to identify the perforation end point 4 1 for the two-dimensional fluoroscopic image 8 of the perforation target ⁇ ⁇ / 1. be able to.
  • the drilling apparatus 1200 according to the above-described embodiment 1 2 has the effect described in the above [14].
  • the perforation device 120 according to the first embodiment is further provided with a two-dimensional perspective image acquisition means 81, except that the two-dimensional perspective image 8 of the object to be perforated ⁇ ⁇ / 1 is displayed. Since it is the same as the perforation device 100 according to the first embodiment, it also has the corresponding effect among the effects of the perforation device 100 according to the first embodiment.
  • the two-dimensional fluoroscopic image acquisition means is an X-ray imaging device, it also has the effect described in [15] above.
  • FIG. 2 1 is a diagram for explaining the drilling apparatus 1300 according to the embodiment 13. ⁇ 2021/137276 45 ⁇ (: 170? 2020 / 042611, Fig. 2 1 (8)-(0) is a diagram for explaining what is visible on the display 1 at each stage of perforation.
  • the perforation device 1300 according to 3 is a more specific embodiment of the perforation device 1200 according to the 12th embodiment. Hereinafter, it will be described with reference to FIG. 21.
  • FIG. 2 1 (8) is acquired by the secondary original fluoroscopic image acquisition means 8 1 in the same manner as in FIG. 2 0 (Mi) described in the first embodiment.
  • the two-dimensional fluoroscopic image 8 (dotted line) of the object to be perforated ⁇ ⁇ / 1 is reflected and displayed on the actual image 11 by the control means 2, and it is shown how it can be seen on the display 1.
  • Bone ⁇ ⁇ / 1 muscles on display 1 The boundary with (two dotted lines in the vertical direction), the fractured part of the bone ⁇ ⁇ / 1 (dotted line in the diagonal direction), etc. are displayed in the two-dimensional fluoroscopic image 8.
  • the control means 2 performs image recognition of the appearance of the drilling mark jig 4.
  • Image recognition may be performed based on, for example, an image recognition command using a command button (not shown) by the operator 1 ⁇ / 1, a decision command at the perforation end point 41, or the like.
  • the control means 2 uses the recognition image of the perforation mark jig 4 (for example, appearance, second mark 4 2 (not shown), etc.). Based on the recognition image), the virtual 3D image 1 2 of the perforation end point 4 1 is reflected (superimposed) on the actual image 1 1 of the object to be perforated ⁇ ⁇ / 1 on the display 1, for example, a circle (circle). Or display in red) (see Fig. 21 (Mi)).
  • the display of the perforation end point 4 1 is the display command of the perforation end point 4 1 by the operator! ⁇ / 1,
  • the perforation end. ⁇ 2021/137276 46 ⁇ (: 170? 2020/042611 points 4 1 may be decided based on the decision command, etc.
  • the drilling end point 4 1 is adjusted to the movement based on those images. You may move to display the correct location. Also, when the determined drilling end point 4 1 moves and the distance connecting the points before and after the movement exceeds a certain level, a warning message is displayed, the drilling end point 4 1 is turned off, and a warning sound is emitted. You may give a warning by issuing it.
  • [0163] [4 Virtual 3D image display of perforation direction extension line 3 1]
  • the operator 1 ⁇ / 1 displays a display 1 in which the 2D perspective image 8 etc. of the perforation target ⁇ ⁇ / 1 is displayed.
  • Search for the drilling direction while looking at it see Fig. 2 1 (see ⁇ ).
  • the control means 2 performs image recognition of the appearance and the like of the drilling tool 3.
  • the virtual three-dimensional image 1 2 of the perforation direction extension line 3 1 is superimposed on the real image 1 1 and displayed on the display 1.
  • the display may be performed, for example, when the operator 1 ⁇ / 1 gives a display command of the drilling direction extension line 31.
  • the perforation mark jig 4 is separated from the perforation target ⁇ ⁇ / 1 or is to be perforated. Even if ⁇ ⁇ / 1 moves, the perforation end point 4 1 may be displayed so that it is located at the same location relative to the object to be perforated ⁇ ⁇ / 1.
  • the perforation device 1300 according to the above-described 1 3 is a more specific version of the perforation device 1 2 0 0 according to the 1 2nd embodiment.
  • the corresponding effect is obtained. If the display of the drilling end point 4 1 is changed according to the passage / non-passing of the drilling direction extension line 3 1 to the drilling end point 4 1, it is easy to know whether the drilling direction is correct or not. Is possible. Alternatively, by changing the display of the perforation end point 4 1 in response to the arrival / non-arrival of the perforation end point 4 1, it becomes possible to easily know the arrival / non-arrival of the perforation end point 41.
  • FIG. 2 2 is a diagram for explaining the drilling device 1400 according to the embodiment 14.
  • the drilling device 1400 according to the first 4 is basically the same as the drilling device 1300 according to the 1 3rd embodiment, but the jig contact point 4 3 0 is set to the drilling end point 4 1 The difference is that the point that is a certain distance (1_ 1) away from the jig contact point 4 30 in the direction opposite to the drilling progress direction is set as the drilling end point 4 1 (see Fig. 2 2 (0)).
  • Control means 2 displays a virtual three-dimensional image 1 2 of the jig contact point 4 30 on the display 1 with a circle (or red), for example (see Fig. 2 2 (Snake)).
  • control means 2 displays the virtual 3D image 1 2 of the perforation direction extension line 3 1 on the display 1. (See Fig. 2 2 (see ⁇ ).
  • the control means 2 is on the perforation direction extension line 3 1 in the perforation direction (perforation direction). ⁇ 2021/137276 49 ⁇ (: 170? 2020 / 042611)
  • the drilling end point 4 1 In the opposite direction (left direction) to the jig contact point 4 3 0, a certain distance 1_1 away from the jig contact point, the drilling end point 4 1 For example, it is displayed as a diamond (or blue) (see Fig. 2 2 (0)). This drilling end point 4 1 is, so to speak, the sizing position of the drilling before the drilling reaches the jig contact point 4 30.
  • control means 2 draws a circle 4 3 5 with a distance ⁇ 1 as a radius centered on the jig contact point 4 3 0, and the point where the circle 4 3 5 and the extension line 3 1 in the drilling direction intersect is the drilling end point 4
  • the perforation end point 4 1 is obtained and displayed by the software algorithm such as 1.
  • the control means 2 displays the jig contact point 4 30 with, for example, a triangular mark (or yellow). Change (Refer to Fig. 2 2 (Mimi)) Instead of changing the display of the jig contact point 4 30, the control means 2 displays, for example, the drilling end point 4 1 in the same manner as in the embodiment 1 3. It may be changed to a mark (or yellow).
  • the drilling end point 4 1 is determined by the operator 1 ⁇ / 1, the drilling mark jig 4 is separated from the drilling target ⁇ ⁇ / 1 or the drilling target is to be drilled, as in the embodiment 1 2. Even if ⁇ ⁇ / 1 moves, the perforation end point 4 1 may be displayed to indicate the same location relative to the perforation target ⁇ ⁇ / 1.
  • the drilling device 1 4 0 0 according to the above-described embodiment 1 4 has a point other than the point where a certain distance from the jig contact point 4 30 is set as the drilling end point 4 1 in the direction opposite to the drilling traveling direction. Since the above points are the same as those of the drilling device 1300 according to the first embodiment, the corresponding effect is obtained among the effects of the punching device 1300 according to the first embodiment. In addition, since the point at a certain distance from the jig contact point 4 30 is set as the drilling end point 41, the tip of the drilling mark jig 4 cannot contact the object to be drilled ⁇ ⁇ / 1. ⁇ 2021/137276 50 ⁇ (: 170? 2020/042611 can also be the end point of perforation 41, over-perforation (for example, target to be perforated) It also has the effect of suppressing (perforation until it penetrates).
  • FIG. 2 3 is a diagram for explaining the perforation device 1500 according to the first embodiment, and FIG. 24 is a perforation when there is a plate in the embodiment 15. It is a figure for demonstrating such as.
  • the perforation device 1500 according to the fifth embodiment is basically the same as the perforation device 1300 according to the first three embodiments, but the plate is arranged outside the object to be perforated (1). The points are different (see Figures 2 3 and 24).
  • the plate is subject to drilling with screws 95 (screws). It is screwed to and used to fix the fractured part of the object to be drilled ⁇ ⁇ / 1.
  • a hole 0 1 is provided in the plate to guide the screw 95 to be inserted into the plate (see Fig. 24 (Snake) and (see ⁇ ).
  • the tip of the screen 95 is covered.
  • the method of preventing the drilling target ⁇ ⁇ / 1 from jumping out see Fig. 24 (Snake)
  • there is a method of preventing it from popping out a little see Fig. 24 ( ⁇ )).
  • the former method According to the report, injuries caused by the apex are suppressed, and according to the latter method, the effect is stronger with the object to be perforated ⁇ ⁇ / 1 (its bone cortex) and the screw 95 (note that this implementation).
  • the apex is covered with muscle ⁇ ⁇ / 2, so injuries due to the apex are unlikely to occur.
  • the plate and screw 95 are made of metal such as stainless steel and titanium, ceramics, and plastic. If the plate and screw are made of different materials, the fixing is likely to loosen due to the difference in thermal expansion rate, but if the same material is used, such loosening can be reduced.
  • a play having a hole ⁇ 1 on the outside of the object to be drilled ( ⁇ ⁇ / 1). ⁇ 2021/137276 51 ⁇ (: 170? 2020/042611 ⁇ (: 170? 2020/042611 ⁇ ) is placed, so the surgeon 1 ⁇ / 1 first drills 3 4 into the hole of the plate 0 1 before drilling the target 1 Then, the operator 1 ⁇ / 1 moves the drilling tool 3 and adjusts the drilling direction extension line 3 1 to pass through the (provisional) drilling end point 4 1 in the first embodiment. Similar to 3, but unlike Embodiment 1, the drill 3 4 (drilling direction extension line 3 1) may swing in a direction different from the destination due to the hole 0 1 of the drilling guide plate.
  • the perforation direction may easily swing.
  • the operator 1 ⁇ / 1 looks at the two-dimensional perspective image 8 of the perforation target ⁇ ⁇ / 1 and drills 3 4 (Extension of drilling direction 3 1)
  • the swinging direction within the range of swinging direction
  • move the jig contact point 4 3 0 while searching for a suitable place for the drilling end point 4 1 and perform a suitable drilling.
  • Determine the end point 4 1 and the extension line 3 1 of the drilling direction and drill see Fig. 2 3 (M) to (M)).
  • the display of the drilling end point 4 1 changes when the drilling direction extension line 3 1 passes through the drilling end point 4 1 or when the drilling reaches the drilling end point 4 1. Is the same as in Embodiment 1 3 (see Fig. 23 (0) (o)).
  • the perforation device 1500 according to the above-described embodiment 1 5 is a perforation device 1 3 according to the embodiment 1 3 except for the point where the plate is arranged outside the object to be perforated (1). Since it is the same as 0 0, it has the corresponding effect among the effects of the drilling device 1300 according to the 13th embodiment. If there is a two-dimensional perspective image 8 of the object 1 to be perforated, it is possible to see the perforation target 1 even if the perforation direction extension line 3 1 is swung by the hole 0 1 of the plate. Since the end point 4 1 and the extension line 3 1 in the drilling direction can be determined, more accurate drilling becomes possible.
  • FIG. 25 (Min) is a figure for explaining the fixation of the perforated object 1 to be perforated.
  • the perforation apparatus 1 6 0 0 which concerns on Embodiment 1 6. Is basically the same as the drilling device 1500 0 according to the 15th embodiment, but the direction of the drill 3 4 (or screw 9 5') with respect to the hole 0 1'of the plate'is constant.
  • the plate' is located outside the object 1 to be drilled.
  • An example of such a plate' is that the diameter (or shape) of the hole 0 1 in the plate'is different from the diameter of the drill 34.
  • the control means 2 displays a virtual three-dimensional image 1 2 of the perforation direction extension line 3 1 which is uniquely determined on the display 1.
  • the surgeon IV! Places the tip of the drilling marker 4 at the intersection of the drilling direction extension line 31 with the outside of the hole target ⁇ ⁇ / 1.
  • the control means 2 sets the intersection as the jig contact point 4 30 and displays the virtual three-dimensional image 1 2 on the display 1.
  • This jig contact point 430 may be the drilling end point.
  • a point separated from the jig contact point 4300 by a certain distance (! _ 1) in the direction opposite to the drilling progress direction is set. It may be the perforation end point 41. Furthermore, when the perforation reaches the perforation end point 41, the display (shape, color, etc.) of the jig contact point 4 30 (or the perforation end point 4 1) may be changed (Fig. 25 (8)). See). Other points are the same as those in the 15th embodiment (or the 14th embodiment), and thus the description thereof will be omitted.
  • the screw 95' is attached to the perforated object 1.
  • ⁇ 2021/137276 53 ⁇ (: 170? 2020/042611 It is arranged in a hole (perforated hole) formed so as to straddle the fractured part.
  • the fractured part of the object to be perforated ⁇ ⁇ / 1 See Fig. 25 (Snake)).
  • the drilling device 1 6 0 0 the plate'that the direction of the drill 3 4 (or the screw 95') with respect to the hole ⁇ 1'of the plate'is constant is drilled.
  • the points other than being arranged outside the target 1 are the same as those of the drilling device 1500 (or 1400) according to the embodiment 1 5 (or 1 4), and therefore the embodiment 1 5 (or 1 4 0). Or, it has the corresponding effect among the effects of the drilling device 1500 (or 1400) according to 1 4).
  • FIG. 26 is a diagram for explaining the fixing mechanism 1700 according to the embodiment 17.
  • Fig. 2 6 (8) shows the state before inserting the 1st and 2nd screws (95 8 and 95) into the hole ⁇ ⁇ 2 1, and
  • Fig. 26 (8) shows the state when inserting the 1st and 2nd screws.
  • Fig. 2 6 ( ⁇ shows the object to be drilled Is illustrated in the cross-sectional view centered on the hole 21.
  • this cross section is not shown as an accurate cross section.
  • a virtual three-dimensional image 1 2 of the drilling end point 4 1 and the drilling direction extension line 3 1 is displayed on the display 1.
  • the two-dimensional fluoroscopic image acquisition means 8 1 for example, an X-ray imaging device
  • the first and second screws 95 8 and 95
  • the two-dimensional fluoroscopic image acquisition means 8 1 for example, an X-ray imaging device
  • the display similar to that shown in Fig. 26 is displayed.
  • the fixing mechanism 1700 shown in Fig. 26 has a head (95 8 3 and 9 5 ⁇ 3) and a pair of screw parts (95 8 1) that are matable to each other. , 95 ⁇ 1) and the 1st and 2nd screws (95 8 and 95 ⁇ ) with, respectively, with the threaded part at the beginning and different through holes ( ⁇ ⁇ / 2 1) (on the figure).
  • the object to be perforated ⁇ ⁇ / 1 is a hole ⁇ ⁇ / 2 1 (through hole) perforated by the perforation device (100, etc.) of any of the embodiments described above. Is formed (see Fig. 26 (8)).
  • the surgeon 1 ⁇ / 1 uses the virtual three-dimensional image 1 2 of the drilling end point 4 1 and the drilling direction extension line 3 1 displayed on the display 1 as a guide, and the first and second screens are used. Insert Liu (95 8 and 95) into the hole 2 1 of the through hole (see Fig. 26 (Mi)).
  • These 1st and 2nd screws (95 8 and 95) are the screw part (95 8 1 and 95 1), the head (95 8 3 and 95 3), and these. It has a cylindrical part (95 8 2, 95 ⁇ 2) provided between the two as needed.
  • the screw part 9 5 1 of the 1st screw -9 5 is provided on the outer circumference of the cylindrical part formed in a cylindrical shape, and the screw part 9 5 ⁇ 1 of the 2nd screw 9 5 is a hole ⁇ ⁇ on the outer circumference.
  • the inner circumference is provided on the inner circumference of the cylindrical portion corresponding to the outer circumference of the cylindrical shape.
  • the threaded parts (95 8 1, 95 ⁇ 1) are formed so that one is a male screw and the other is a female screw, and both screws are fitted to each other.
  • the heads of both screws (95 3, 95 3) are spherical, aspherical, flat, etc. and have no sharp edges.
  • the threaded part (95 1, 95 ⁇ 1) has a sharp point (including the unevenness of the screw) at the beginning.
  • the surgeon 1 ⁇ / 1 inserts the 1st and 2nd screws (95 8 and 95) into the hole ⁇ ⁇ 2 1 from the screw side into the hole 2 1 (through hole). , Fit the screw part (95 8 1, 9 5 ⁇ 1) in the hole ⁇ ⁇ 2 1. On the other hand, since the head (95 8 3, 9 5 6 3) is caught and stays at the mouth of the hole ⁇ ⁇ 2 1, the object to be perforated ⁇ ⁇ / 1 is between the heads (95 8 3). ⁇ 2021/137276 55 ⁇ (: 170? 2020/042611
  • the fixing mechanism 1 700 described above has the effects described in [16] above.
  • the two-dimensional fluoroscopic image acquisition means 81 X-ray imaging device
  • the operator IV! Sees the two-dimensional fluoroscopic image 8. It becomes possible to fix it more appropriately.
  • FIG. 27 is a diagram for explaining the fixing mechanism 1 800 according to the embodiment 18.
  • the fixing mechanism 1 800 according to the 18th embodiment is basically the same as the fixing mechanism 1 700 according to the 17th embodiment, but the plate to be drilled ⁇ ⁇ / 1 is arranged outside the plate (the plate to be drilled ⁇ ⁇ / 1). The difference is that they are fixed via 1, 92).
  • Fig. 27 (8) shows how the hole ⁇ ⁇ 2 1 is drilled
  • Fig. 27 (Mi) shows the perforated hole ⁇ ⁇ 2 1 in the first and second screens _ (95 8 and 95).
  • 2 7 ( ⁇ shows how the object to be drilled 1 is fixed.
  • the object to be drilled ⁇ ⁇ / 1 is a large area (target to be drilled ⁇ ⁇ / 1). It is crushed or crushed in the area (the area sandwiched between the two alternate long and short dash lines) between the upper and lower parts.
  • the operator 1 ⁇ / 1 first prepares a plate (1, 92) (see Fig. 27 (8)). Both the first and second plates (1, 2) may be prepared, but only one (1) may be prepared. In the 18th embodiment described here, both are prepared.
  • These 1st and 2nd plates (1, 2) are of a size that the heads of the 1st and 2nd screens (958, 95) (958, 95mi 2) cannot pass through. It has holes of shape (11, P 2 ⁇ ).
  • the surgeon 1 ⁇ / 1 puts the first and second play pieces (1, 92) on the outside (both sides) of the object to be perforated ⁇ ⁇ / 1, and puts the object 1 to be perforated divided into multiple parts by crushing or the like. Arrange so as to cover.
  • the operator 1 ⁇ / 1 puts the tip of the drill 34 of the drilling tool 3 into the hole 1 1 of the first plate 1.
  • the direction of the drill 34 is changed by the hole 1 1 and the direction of the drilling direction extension line 3 1 is easily changed (easy to swing).
  • 1st plate 1 or 2nd ⁇ 2021/137276 56 ⁇ (: 170? 2020/042611 Move the position of plate 2 appropriately and change the location of the drilling end point 4 1.
  • the location of this drilling end point 4 1 is the location of the hole 2 1 of the second plate 2.
  • the operator considers the condition of the object to be drilled ⁇ ⁇ / 1 while moving the drill 34.
  • the surgeon 1 ⁇ / 1 fits the screw part (95 8 1, 95 ⁇ 1) of the 1st and 2nd screws (95 8 and 95 ⁇ ) in the hole ⁇ ⁇ 2 1. Align (see Fig. 27 (see ⁇ ). At this time, the head (95 8 2, 95 ⁇ 2) stays at the hole (11, 92 ⁇ ) of the plate (1, 92), and further holes. 2 Cannot proceed into 1. This allows the object to be drilled ⁇ ⁇ / 1 to pass through the plate (1, 92) and between the heads of the first and second screws (95 8 and 95) (95). It is pinched and fixed between 8 3 95 and 3).
  • the fixing mechanism 1 800 according to the 18th embodiment has the effect described in the above [17]. Further, in the fixing mechanism 1 800 according to the first embodiment, the points other than the point where the object to be drilled ⁇ ⁇ / 1 is fixed via the plate (1, 92) arranged on the outside thereof, the first embodiment 1 Since it is the same as the fixing mechanism 1 700 according to 7, it also has the corresponding effect among the effects of the fixing mechanism 1 700 according to the 17th embodiment.
  • the steel frame construction contractor is used instead of the operator IV!
  • the object to be perforated ⁇ ⁇ / 1 is a steel frame (breakage) instead of the bone. It is an embodiment (without drawing). Even in this case, the only difference is that the object to be perforated ⁇ ⁇ / 1 is made of steel instead of bone, and therefore, it has the corresponding effect among the effects of Embodiments 1 2 to 18.
  • the control means 2 uses the imaging means 7 to refer to the appearance information of the drilling tool 3 or the drilling marker jig 4, but for example.
  • a shape measurement sensor that uses a laser, infrared rays, ultrasonic waves, etc. may be used.
  • the number of imaging means 7 is one, but may be multiple. In the case of multiple, 3D appearance information becomes even easier to obtain.
  • one imaging means 7 (appearance information acquisition means) is provided, and the imaging means 7 can be used for taking an image or referring to the appearance information.
  • the imaging means 7 is used for imaging, and in addition, it is equipped with an appearance information acquisition means (another imaging means or shape measurement sensor) that refers to appearance information. You may.
  • the imaging means 7 is mounted on the display 1 (head mount display 6).
  • the display 1 head mount display 6
  • the floor, the wall, the ceiling, the ground, the fence, the tripod, and the stand It may be mounted on a device with a caster or a device with a caster.
  • the display 1 is a head mount display 6 and is mounted on the head, but is not a head mount display 6, for example, a floor, a wall, or the like. It may be a display 1 mounted on a ceiling, ground, fence, tripod, stand (with or with a caster), etc.
  • the two-dimensional fluoroscopic image acquisition means 8 1 is an X-ray imager
  • the detection wave 8 4 is an X-ray
  • the detection wave generator 8 2 is an X-ray tube.
  • Part 8 3 is an image tube, but the two-dimensional fluoroscopic image acquisition means 8 1 is an ultrasonic imaging device, the detection wave 8 4 is an ultrasonic wave, the detection wave generator 8 2 is an ultrasonic generator, and the detection unit 8 3 is. It may be a reflected wave detecting means.
  • the two-dimensional fluoroscopic image acquisition means 8 1 is an optical ultrasonic imager
  • the detection wave 8 4 is a laser light (pulse light)
  • the detection wave generator 8 2 is a laser light generator
  • the detection unit 8 3 is irradiated with a laser light. It may be an ultrasonic detector that detects ultrasonic waves emitted from the location where the laser is generated.
  • 8 1 2D fluoroscopic image acquisition means 82 detection wave generator, 83 detection 5 ⁇ , 84 detection wave, 848 perforation end point passage notification display unit, 858 perforation end point distance notification display unit, 85 perforation end point distance notification display unit, 88 3 Drilling end point display maintenance mode Display, 88 Cylinder warning display, 880 Warning display, 95, 95'Screen, 95 8th 1st screw, 956 2nd screw, 95 8 1, 95 ⁇ 1 screw part, 95 8 2, 9562 Head, 95 8 3, 95 Mi 3 Cylindrical part ,,, Plate, 01, 01, Hole, 1 1st plate, 2 ... 2nd plate, 1 1, 2 1 hole

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Abstract

Un dispositif de forage 100 selon la présente invention comprend : un dispositif d'affichage 1 qui peut rendre visible une image réelle qui est vue à travers ou imagée ; un outil de forage 3 ; un gabarit de marquage de foret 4 ; un moyen d'imagerie 7 (un moyen d'acquisition d'informations d'aspect qui acquiert des informations d'aspect de l'outil de forage 3, par exemple) ; et un moyen de commande 2 qui crée une image tridimensionnelle virtuelle 12 comprenant une ligne d'extension de direction de forage 31 et un point d'extrémité de forage 41, la projette sur l'image réelle et l'affiche sur le dispositif d'affichage 1.　Le dispositif de forage 100 selon la présente invention permet un forage précis sans nécessiter un équipement important tel qu'une imagerie CT, une création de maquette, ou une simulation, comme cela était traditionnellement nécessaire.
PCT/JP2020/042611 2019-12-30 2020-11-16 Dispositif de forage, procédé de forage et mécanisme de fixation WO2021137276A1 (fr)

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Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH0421105A (ja) * 1990-05-16 1992-01-24 Hitachi Ltd マニピユレータの立体教示装置
JPH1014936A (ja) * 1996-07-05 1998-01-20 Homuzu Giken:Kk 骨接合ファスナー
US20100179418A1 (en) * 2008-06-16 2010-07-15 Matthias Mueller Instrument aligning method using a free reference
JP2011522983A (ja) * 2008-06-13 2011-08-04 サンドビク マイニング アンド コンストラクション オサケ ユキチュア 穿孔の表示方法および装置ならびに岩盤穿孔時のドリルロッド案内方法
JP2011528917A (ja) * 2008-02-28 2011-12-01 スミス アンド ネフュー インコーポレーテッド 目標物を特定するシステムおよび方法
JP2013034764A (ja) * 2011-08-10 2013-02-21 Akira Takebayashi サージカルガイド装置及びドリルの位置決め方法
WO2015018877A1 (fr) * 2013-08-06 2015-02-12 Point Targeting Ag Système de guidage chirurgical pour un forage orthoscopique
JP2016512086A (ja) * 2013-03-15 2016-04-25 デピュイ・シンセス・プロダクツ・インコーポレイテッド 骨修復システム、キット及び方法
WO2019141704A1 (fr) * 2018-01-22 2019-07-25 Medivation Ag Système de guidage chirurgical à réalité augmentée

Patent Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH0421105A (ja) * 1990-05-16 1992-01-24 Hitachi Ltd マニピユレータの立体教示装置
JPH1014936A (ja) * 1996-07-05 1998-01-20 Homuzu Giken:Kk 骨接合ファスナー
JP2011528917A (ja) * 2008-02-28 2011-12-01 スミス アンド ネフュー インコーポレーテッド 目標物を特定するシステムおよび方法
JP2011522983A (ja) * 2008-06-13 2011-08-04 サンドビク マイニング アンド コンストラクション オサケ ユキチュア 穿孔の表示方法および装置ならびに岩盤穿孔時のドリルロッド案内方法
US20100179418A1 (en) * 2008-06-16 2010-07-15 Matthias Mueller Instrument aligning method using a free reference
JP2013034764A (ja) * 2011-08-10 2013-02-21 Akira Takebayashi サージカルガイド装置及びドリルの位置決め方法
JP2016512086A (ja) * 2013-03-15 2016-04-25 デピュイ・シンセス・プロダクツ・インコーポレイテッド 骨修復システム、キット及び方法
WO2015018877A1 (fr) * 2013-08-06 2015-02-12 Point Targeting Ag Système de guidage chirurgical pour un forage orthoscopique
WO2019141704A1 (fr) * 2018-01-22 2019-07-25 Medivation Ag Système de guidage chirurgical à réalité augmentée

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