WO2008014670A1

WO2008014670A1 - Micro-invasive surgery x-ray puncturing and locating device and method

Info

Publication number: WO2008014670A1
Application number: PCT/CN2007/002173
Authority: WO
Inventors: Xiangshen Ni; Weihui Zhu
Original assignee: Xiangshen Ni; Weihui Zhu
Priority date: 2006-07-25
Filing date: 2007-07-16
Publication date: 2008-02-07
Also published as: CN1899221A; CN100444800C

Abstract

A micro-invasive surgery X-ray puncturing and locating device includes a C-arm X-ray machine, a guiding cartridge base and a puncturing needle guiding cartridge (5). The C-arm X-ray machine includes a C-arm (11), an image intensifier (10) and an X-ray tube (16). The C- arm (11) is mounted on the major shaft (13). The image intensifier (10) and the X-ray tube (16) have a common axis, and the intersection point of the common axis and the axis of the major shaft (13) is the center of the C- arm (11). The puncturing needle guiding cartridge (5) is mounted on the guiding cartridge base, and the axis of the puncturing needle guiding cartridge (5)passes through the center of the C-arm (11).

Description

Minimally invasive surgery X-ray puncture positioning device and method

The present invention relates to the field of medical devices, and more particularly to a medical device for use in minimally invasive surgery.

Background technique

In recent years, with the development of technology, the application of minimally invasive surgery in hospitals has received more and more attention. The use of urology, cavity surgery, orthopedics is becoming more and more popular, but the key to the success of many minimally invasive surgery depends on the doctor's wearing technique. The proficiency, which is one of the difficulties of minimally invasive technology. Nowadays, many doctors' puncture positioning is carried out under the guidance of a normal C-arm X-ray machine. It provides only a flat image, not an accurate spatial position. It can only be used as a reference. The doctor relies on experience. This greatly increases the risk and difficulty of surgery, which has discouraged many doctors and hindered the widespread application and development of this technology.

Summary of the invention

The technical problem to be solved by the present invention is to overcome the deficiencies of the prior art and provide a minimally invasive surgical X-ray boring positioning device and method capable of positioning the puncture position, thereby effectively reducing the risk and difficulty of minimally invasive surgery.

The technical solution adopted by the present invention to solve the technical problem thereof is as follows: The minimally invasive surgical X-ray puncture positioning device comprises a C-arm X-ray machine, a guiding cylinder seat and a puncture needle guiding cylinder, and the C-arm X-ray machine comprises a C-arm An image intensifier and an X-ray tube, the C-arm is mounted on the main shaft, the image intensifier and the X-ray tube are coaxial, and an intersection of the axis and the axis of the main shaft is a center of the c-arm, A puncture needle guiding barrel is mounted on the guiding cylinder base and the axis of the puncture needle guiding cylinder passes through the center of the C-arm. .

The guiding cylinder base comprises a C-shaped sliding arm, and the center of the C-shaped sliding arm is the center of the C-shaped arm.

The guiding cylinder base further comprises a C-shaped guide rail with the same rotation axis as the C-shaped arm, and the C-shaped sliding arm is slidably mounted on the C-shaped guide rail, the C-shaped guide rail and the C-shaped sliding arm are at the same center, the puncture needle The guiding cylinder is slidably mounted on the end of the C-shaped sliding arm by a slider.

The guiding cylinder base includes first and second parallelogram mechanisms, the first and second parallelogram mechanisms are hinged at a first hinge point, and the first parallelogram mechanism connects the first and second points of the first hinge point The rods are respectively connected with the second parallelogram mechanism to connect the third and fourth rods of the first hinge point, and the other hinge point of the second rod is connected with the output end of a driving device, the second parallelogram mechanism and the A slider seat is fixed to the fourth rod parallel to the fourth rod, and the needle guiding cylinder is slidably mounted on the slider holder, and the projection of the needle guiding cylinder axis coincides with the projection of the fifth rod axis.

The driving device comprises a Z-direction support rod, a Z-direction support sleeve, a rotary seat, an X-direction adjustment member and a Z-direction adjustment member, the Z-direction support rod end and the first parallelogram mechanism of the second rod a hinge point connection, the other end of which is supported on a Z-direction bearing sleeve, the Z-direction bearing sleeve is mounted on the rotating seat, the Z-direction adjusting member drives the Z-direction bearing rod relative to the Z-direction bearing sleeve in the Z-up direction The lower movement, the X-direction adjustment member drives the Z-direction support sleeve to move left and right relative to the rotary seat in the X direction, the rotary seat is rotatable on the ground and its axis of rotation passes through the center of the C-arm.

The puncture needle guiding cylinder is connected to the linear displacement sensor.

The minimally invasive surgery X-ray puncture positioning method comprises the following steps:

a) positioning the human lesion point on the center of the C-arm of the X-ray machine by adjusting the operating bed; b) aligning the axis of the puncture needle guiding cylinder mounted on the guiding cylinder base with the C-type by adjusting the guiding cylinder seat The center of the arm.

In the step a), the C-arms are respectively placed at two different positions, and the X-ray irradiation lesions are respectively performed, and the position of the operating bed is adjusted to make the last X-ray irradiation lesions on the imaging system. The images coincide, ie the lesion points are located at the center of the C-arm.

Step b) is followed by step cl): determining the total puncture displacement according to the initial position of the puncture needle; c2) driving the puncture needle to the center movement of the C-arm to determine the first movement of the puncture needle to the human skin Displacement, determining the puncture depth of the puncture needle according to the total displacement and the first displacement.

The invention has the beneficial effects that the positioning device can accurately position the piercing position, reduce the risk and difficulty of the minimally invasive surgery, and facilitate the promotion.

DRAWINGS

Fig. 1 is a schematic structural view of a first embodiment of the present invention.

Fig. 2 is a schematic diagram showing the positioning of a lesion point in the first embodiment of the present invention.

Figure 3 is a schematic diagram of a first embodiment of the present invention.

Figure 4 is a schematic diagram of a second embodiment of the present invention.

Fig. 5 is a front elevational view showing a second embodiment of the present invention. '

Figure 6 is a side view of a second embodiment of the present invention.

Fig. 7 is a schematic diagram showing the positioning of a lesion point in the second embodiment of the present invention.

Figures 8 to 10 are schematic views of the piercing needles in their initial positions, in contact with the skin, and at the point of reaching the lesion.

Figure 11 is a block diagram of the circuit of the present invention.

Figure 12 is a flow chart of the present invention. '

detailed description

The minimally invasive surgical X-ray puncture positioning device comprises a C-arm X-ray machine, a guiding cylinder seat and a piercing needle guiding cylinder, the C-arm X-ray machine comprising a C-arm, an image intensifier and an X-ray tube, The C-arm is mounted on the main shaft, the image intensifier and the X-ray tube are coaxial, the intersection of the axis and the axis of the main shaft is the center of the C-arm, and the puncture needle guiding cylinder is mounted on the guiding cylinder The needle guides the axis of the barrel through the center of the C-arm.

Please refer to FIG. 1 to FIG. 3, which are the first embodiment of the present invention. The positioning device comprises a C-arm X-ray machine, a guiding cylinder seat and a piercing needle guiding cylinder. The C-arm X-ray machine includes C-arm 11, image intensifier 10, X-ray tube 16 and development system, the C-arm 11 is rotatable about its main axis 13, and the image intensifier 10 and the X-ray tube 16 are respectively mounted on the C-arm 11 The two ends are coaxial, the axis of the main shaft 13 is ΟΌ, and the axis of the image intensifier 10 and the X-ray tube 16 is ΥΥ, and the intersection of the axis Ο 'Ο' and the axis Ο is defined as the C-arm Center 0 (when the C-arm is semi-circular, the center is the center of the C-arm). The guiding cylinder base comprises a C-shaped guide rail 15, a C-shaped sliding arm 9, a motor 12, a slider 4 and a slider holder 8, and the C-shaped rail 15 is fixed on the main shaft 13 (ie, the C-shaped guide rail 15 and the C-shaped arm 11) Same as the axis of rotation). One end of the C-shaped slide arm 9 is mounted on the C-shaped guide rail 15 and can move along a circular arc around the center 0 along the C-shaped guide rail 15. The radius of the inner circular arc surface of the C-shaped sliding wall 9 is R. The motor 12 drives the C-shaped slide arm 9 to slide along the C-shaped guide rail 15, and the center of the C-shaped guide rail 15 and the C-shaped slide arm 9 is the center 0 of the C-shaped arm 11. The slider holder 8 is fixed on the end surface of the other end of the C-shaped slide arm 9 , and the slider 4 is slidably mounted on the slider holder 8 , and the puncture needle guiding cylinder 5 is fixed on the slider 4 , and The axis of the puncture needle guiding cylinder 5 is directed to the center 0 of the C-shaped sliding arm 9. Further, a linear displacement sensor 7 is attached to the slider holder 8, and the linear displacement sensor 7 is connected to the piercing needle guiding cylinder 5.

The working principle of the positioning device is as follows: The selected C-arms 11 are respectively placed at the position and the A ₂ B ₂ position, and the X-ray irradiation lesions respectively (the position indicated by 3 in Fig. 1 is the human body section), and the surgical bed 1 is adjusted. The height, front, back, left and right, so that the image of the last X-ray exposure spot on the imaging system (such as a computer screen or monitor) coincides, indicating that the lesion point has been placed at the center 0 of the C-arm 11.

The insertion angle m is selected (the adjustment of the puncture angle m is achieved by sliding the C-shaped slide arm along the C-shaped guide rail), and the piercing needle 6 is inserted into the puncture needle guiding cylinder 5 (the puncture needle is shared with the puncture needle guiding cylinder) The axis, and the axis passes through the center of the C-arm 0), and the handle of the tail of the puncture needle abuts against the upper end surface of the puncture needle guiding cylinder 5, and the vertical end of the puncture needle 6 to the arc surface of the C-shaped sliding arm 9 is marked. Distance a. The hand pushes through the needle 6 to drive the puncture needle guiding cylinder 5, and the slider 4 moves linearly along the slider seat 8. When the tip of the puncture needle contacts the surface of the human skin, the displacement _{ai of the} puncture needle 6 is obtained from the linear displacement sensor 7. and entered into the computer, the puncture needle can be obtained from the body surface to the displacement of the focal point 0 a _2,

a ₂ = R~ (a ₀ + a )

At this time, under the digital guidance of the computer, the puncture needle 6 completes the puncture from 0 _ ^ a2, and during the entire puncture process, the piercing needle 6 moves linearly toward the center O of the C-arm.

For the sake of safety, the alarm display can be set on the computer when the puncture is close to a2—distance to warn the doctor.

The movement of the threading needle guiding cylinder 5 of the machine and the circular telescopic movement of the C-shaped sliding arm 9 can be realized electrically or manually.

Please refer to FIG. 4 to FIG. 10, which are second embodiment of the present invention. The positioning device comprises a C-arm X-ray machine, a guiding cylinder seat and a puncture needle guiding cylinder. The C-arm X-ray machine includes The C-arm 14, the image intensifier 13, the X-ray tube 20, and the developing system, the C-arm 14 is rotatably mounted on the main frame 22 of the X-ray machine through the main shaft 17, and the main frame 22 further has a positioning shaft 19 The axis of the main shaft 17 is defined as an X-axis, the axis of the positioning shaft 19 is defined as a Z-axis, and the intersection of the X-axis and the Z-axis is defined as the center 0 of the C-arm 14 so that the Y-axis can be determined. Then establish an XYZ axis rectangular coordinate system. The image intensifier 13 and the X-ray tube 20 are respectively mounted on both ends of the C-arm 14 and are coaxial. When the C-arm 14 is in the initial position, the image intensifier 13, the X-ray tube 20 and the positioning shaft 19 are provided. Coaxial. The guiding cylinder base comprises a link mechanism 7 composed of a first parallelogram mechanism 71 and a second parallelogram mechanism 72, the rods C ₂ d, O!d of the first parallelogram mechanism and the rods of the second parallelogram mechanism respectively C _l( i ₂ , CiC ₃ common pole (ie forming rod C ₂ d ₂ and rod CC ^), the first and second parallelogram mechanisms are hinged to the hinge point (ie rod C ₂ d ₂ and rod intersecting the hinge point) d), and the axes of the rods of the first and second parallelogram mechanisms are coplanar. The guiding cylinder base is driven by a driving device comprising a supporting rod 6, a supporting sleeve 4, a rotating seat 1, and an X-direction adjustment a member 3 and a Z-direction adjusting member 5, the support rod 6 includes a first support rod 61 extending in the Z direction and a second support rod 62 extending perpendicular thereto and extending in the Y direction, the end of the first support rod 61 being mounted thereon On the support sleeve 4, the end of the second support rod 62 is fixed to the hinge point O of the first parallelogram mechanism 71. The support sleeve 4 extends in the Z direction, and is slidably mounted on the rotary base 1, the rotary base One end of 1 is stuck on the positioning shaft 19, and the other end is mounted with a roller 2, so that the rotating base 1 can be wound around the The fixed positioning shaft 19 rotates on the ground, that is, the rotation axis of the rotary base 1 passes through the center 0 of the C-arm 14. The Z-direction adjustment member 5 is used to adjust the support rod 6 so that the support rod 6 carries the entire linkage mechanism. 7 is moved up and down with respect to the support sleeve 4 in the Z direction, that is, for adjusting the distance A between the hinge point of the link mechanism 7 to the ground. The X-direction adjustment member 3 is used for adjusting the support sleeve 4 so that the support sleeve The cylinder 4 is moved to the left and right in the X direction with respect to the rotary base 1 with the support rod 6 and the link mechanism 7, that is, for adjusting the distance a between the axis of the first support rod 61 and the axis of the positioning shaft 19 (ie, the hinge point) The distance between the axes of the positioning shafts 19 is a). The threading needle guiding cylinder 12 is axially penetrated and fixed to the slider 11, and the slider 11 is slidably mounted on the slider seat 8, the slider seat 8 is attached to the rod of the link mechanism 7 (1 _{1 (} 1 ₂ (the rod d _{l (} i _{2 is} parallel to the rod 0^ ₃ ). On the plane where the axes of the rods of the link mechanism 7 are co-located, on the plane of projection of the puncture needle bar d _l axis of the guide cylinder 12 _(i axis ₂ coincides with the projection on the plane. the axis of the puncture needle guide tube 12 of the first support shaft 61 lever In the same plane (the plane parallel to the XZ plane), the center O of the C-arm is located on the plane and the plane is parallel to the first and second parallelogram mechanisms 71, 72. The slider seat 8 is also mounted with a linear displacement The sensor 9, the linear displacement sensor 9 is connected to the piercing needle guiding cylinder 12.

The working principle of the positioning device is as follows: The selected C-arms 14 are respectively placed at the position and the A ₂ B ₂ position, and the lesions are respectively X-rayed (the reference numeral 16 in Figure 5 refers to the human body section), and the adjustment is performed. The displacement of the X, Y, and Ζ of the operating bed 18 causes the human lesion to be placed at 0 (the center of the C-arm and the origin of the Cartesian coordinate system), and the human disease is determined. The vertical distance B between the point O and the ground.

The link mechanism 7 is projected on a plane formed by the axis of the first support rod 61 and the axis of the puncture needle guiding cylinder 12, and the projections of the hinge points of the link mechanism 7 on the plane are also defined as 0. ₂ , d, C ₂ , C ₃ , , d ₂ (as shown in Figure 4). The vertical distance between the support rod 6 and the axis of the image intensifier 13 and the X-ray tube 20 is set to a, and A and a are adjusted so that O!Oa/cosm- ddf C^ satisfies the above conditions, and the adjustment angle n is arbitrarily adjusted ( The angle n is the puncture angle of the puncture needle, 0 < n < 90°, and the axis of the puncture needle guiding cylinder 12 is ensured to pass through the center 0 of the C-arm 14.

Referring to FIG. 4 and FIG. 8 to FIG. 10, the puncture needle 10 is inserted into the piercing needle guiding cylinder 12, and the tail handle 21 is abutted against the upper end surface of the piercing needle guiding cylinder 12, and the needle tip of the piercing needle 10 is measured to the hinge. The length e of the point d ₂ pushes the puncture needle 10 until the tip of the needle contacts the surface of the human skin, and the displacement distance _{ei of the} needle tip is obtained by the linear displacement sensor 9. Through the computer, the displacement e ₂ from the surface of the human skin to the lesion point 0 can be obtained. ,

Thus, under the guidance of the piercing needle guiding cylinder 12, from the surface of the skin, at the prompt of the electric number, the needle 10 is worn to complete the threading process from 0 to 0. .

For the sake of safety, an alarm can be set on the computer before the puncture is close to the lesion to warn the doctor.

The movement of the puncture needle guiding cylinder 12' of the positioning device navigator can be realized electrically or manually.

Referring to FIG. 12, the minimally invasive surgical X-ray puncture positioning method comprises the following steps: a) positioning the human lesion point on the center of the C-arm of the X-ray machine by adjusting the operating bed; b) installing by adjusting the guiding cylinder seat The axis of the puncture needle guiding cylinder on the guiding cylinder seat is aligned with the center of the C-arm.

c) determining the total displacement of the puncture according to the initial position of the piercing needle;

d) driving the needle guiding cylinder to drive the needle to move to the center of the C-arm, and determining the first displacement when the needle contacts the human skin, thereby determining the wearing of the needle according to the total displacement and the first displacement剌 Depth.

Referring to FIG. 11, in the present invention, the output of each linear displacement sensor and image intensifier is connected to a control unit (such as a computer mainframe), and the control unit is connected to a developing system (such as a computer screen or a display), and the control is performed. The output of the unit is also connected to an actuator (such as a motor) whose output is connected to the drive.

The above is a further detailed description of the present invention in connection with the specific preferred embodiments, and the specific embodiments of the present invention are not limited to the description. For those skilled in the art to which the present invention pertains, a number of simple derivations or substitutions may be made without departing from the inventive concept, and should be considered as belonging to the invention as defined by the appended claims. protected range.

Claims

Rights request

A minimally invasive surgical X-ray puncture positioning device, comprising a C-arm X-ray machine, the C-arm X-ray machine comprising a C-arm, an image intensifier and an X-ray tube, the C-arm being mounted on the main shaft The image intensifier and the X-ray tube are coaxial, and the intersection of the axis and the axis of the main shaft is the center of the C-arm, and is characterized by: further comprising a guiding cylinder and a puncture needle guiding cylinder, the puncture needle guiding A barrel is mounted on the guide barrel seat and the axis of the piercing needle guiding barrel passes through the center of the C-arm.

2. The minimally invasive surgical X-ray puncture positioning device according to claim 1, wherein the guiding cylinder base comprises a C-shaped sliding arm, and a center of the C-shaped sliding arm is a center of the C-shaped arm.

3. The minimally invasive surgical X-ray threading positioning device according to claim 2, wherein the guiding cylinder base further comprises a C-shaped guide rail with the same axis of rotation as the C-arm, and the C-shaped sliding arm is slidably mounted. On the C-shaped guide rail, the C-shaped guide rail and the C-shaped slide arm are at the same center, and the through-needle guiding cylinder is slidably mounted on the end of the C-shaped sliding arm through a slider.

4. The minimally invasive surgical X-ray perforating positioning device according to claim 1, wherein the guiding cylinder base comprises first and second parallelogram mechanisms, and the first and second parallelogram mechanisms are hinged at a first hinge point, the first parallel joint mechanism connecting the first and second rods of the first hinge point and the second parallelogram mechanism respectively connecting the third and fourth rods of the first hinge point, the second The other hinge point of the rod is connected to the output end of a driving device, and the second parallelogram mechanism and the fourth rod parallel to the fourth rod are fixed with a slider seat, and the needle guiding cylinder is slidably mounted on the slider seat Above, and the projection of the thread of the needle guiding cylinder coincides with the projection of the axis of the fifth rod.

5. The minimally invasive surgical X-ray puncture positioning device according to claim 4, wherein the driving device comprises a Z-direction support rod, a Z-direction support sleeve, a rotary seat, an X-direction adjustment member, and a Z-direction adjustment. One end of the Z-direction support rod is connected to the hinge point of the second rod of the first parallelogram mechanism, and the other end is supported on the Z-direction support sleeve, and the Z-direction support sleeve is mounted on the rotary seat, the Z-direction The adjusting member drives the Z-direction supporting rod to move up and down with respect to the Z-direction supporting sleeve, and the X-direction adjusting member drives the Z-direction supporting sleeve to move left and right relative to the rotating seat in the X direction, and the rotating seat can be on the ground Rotate and its axis of rotation passes through the center of the C-arm.

The minimally invasive surgical X-ray puncture positioning device according to any one of claims 2 to 5, wherein the piercing needle guiding cylinder is connected to the linear displacement sensor.

7. A minimally invasive surgical X-ray puncture positioning method, comprising: the steps of: a) positioning a human lesion point on a center of an X-ray C-arm by adjusting an operating bed; b) adjusting the guiding cylinder a seat, the axis of the puncture needle guiding cylinder mounted on the guiding cylinder base is aligned with the center of the C-arm.

8. The minimally invasive surgical X-ray perforating positioning method according to claim 7, wherein in the step a), the C-arm is respectively placed at two different positions, and X-ray images are respectively taken. By projecting the position of the operating bed, the image of the last X-ray illuminating lesion on the imaging system coincides, that is, the lesion is positioned at the center of the c-arm.

9. The minimally invasive surgical X-ray perforating positioning method according to claim 7 or 8, wherein: after step b), there is a step cl): determining a total puncture displacement according to the initial position of the puncture needle ; c2) driving the puncture needle to the center of the C-arm to determine the first displacement of the puncture needle when moving to the human skin, and determining the puncture depth of the puncture needle according to the total displacement and the first displacement.