Complete set of 3D-assisted light-guided puncture orientation instrument and orientation method thereof

Abstract

The invention relates to a complete set of 3D (three-dimensional)-assisted light-guided puncture orienting equipment and an orienting method thereof, and belongs to the field of medical instruments. The complete set of 3D-assisted light-guided puncture orienting equipment comprises two infrared or laser linear positioning lamps which are arranged on the scalp of a patient and face the head of the patient, and the two linear positioning lamps are arranged on one or two supports through angle adjusting devices; light of the two linear positioning lamps can be adjusted at any angle on the periphery of the scalp, the linear light of the two linear positioning lamps is in different directions, linear light rays formed by the two linear positioning lamps respectively pass through two positioning marks on the periphery of the scalp of a patient, and the puncture catheter is arranged on an extension line of a puncture center line outside the head. The brain focus puncture orienting device can cope with puncture orienting of various brain focuses, damage caused by contact of surgical instruments with the face and the five sense organs of a patient is avoided, and accurate and rapid orienting can be achieved.

Description

TECHNICAL FIELD

[0001] The present application relates to a puncture orientation apparatus and its orientation method, in particular to a 3D auxiliary light guide puncture orientation complete set of instruments and its orientation method, belonging to the field of medical instruments. BACKGROUND

[0002] The structure of the human brain is divided into cerebral hemispheres, internal capsule and subcortical white matter, basal ganglia, diencephalon, brain stem and cerebellum. The function of the cerebral hemisphere is extremely complex, in addition to movement and sensation, it is also related to human cognition, emotion, language, behavior and other high-level neural activities. The internal capsule and subcortical white matter are related to motor sensation, hearing and vision. The basal ganglia has extensive fiber connections with the cerebral cortex, thalamus, cerebellum and spinal cord. Its function is to coordinate with the brain and cerebellum to regulate voluntary movement, muscle tone posture and complex behavior activities. Overall, the function of the human brain is to maintain wakefulness and thinking. With so many functions in the limited intracranial space, each part is distributed with various functional control tissues. Once a lesion occurs in a certain part of the intracranial space, it will lead to loss of control of function, and it may be necessary to perform intracranial surgery for treatment.

[0003] Common intracranial surgeries include hematoma removal surgery, intracranial tumor surgery, ventriculoperitoneal shunt surgery, etc. How to avoid important blood vessels, nerves, important functional areas and other tissues in the intracranial space during surgery is a major issue. In order to reduce brain trauma, shorten surgery and hospitalization time, and reduce surgical risk, minimally invasive surgery has become the mainstream of brain surgery. However, the key to how to perform surgery in the brain lesion site is to find a puncture channel from the scalp to the lesion. This puncture channel needs to avoid important blood vessels, nerves, important functional areas, etc., and needs to reduce bleeding, and minimize or not leave postoperative sequelae.

[0004] With the development of technology, with the help of modern technical equipment, it has become a reality to determine the lesion position. Determining the puncture channel requires the doctor to seek the best puncture direction and position in a three-dimensional situation to achieve an ideal surgical effect and give the patient a healthy brain.

[0005] CN202022222559.2 patent discloses a puncture positioning sheet for minimally invasive surgery, the positioning sheet is a titanium positioning sheet, one side of the titanium positioning sheet is provided with a high-adhesion adhesive layer, a positioning hole is arranged in the middle, and the other side is bonded to a reinforcing patch by the high-adhesion adhesive layer, the reinforcing patch extends to the outer periphery of the titanium positioning sheet as a whole or in part, and the entire surface of the reinforcing patch facing the human skin is also provided with a high-adhesion adhesive layer; during use, at least three titanium positioning sheets and reinforcing patches are pasted on the outer surface of the human skin, by using the product, the recognition of images and pictures can be improved, the adhesion to the human body can be improved, accurate positioning can be achieved, three-dimensional modeling of the guide plate in the computer can be facilitated, the volume of the guide plate can be reduced, 3D printing can be quickly performed, corresponding guide plate positioning holes can be formed in the guide plate, the guide plate can be matched with the positioning marks of the human body, the speed of surgery can be accelerated, the positioning accuracy of the guide plate can be improved, and the original functions of the patient's cranium and brain can be protected.

[0006] In this patent, taking the extraction of intracranial hematoma as an example, a directional positioning method using a puncture positioning sheet is disclosed, in which CT, MRI and the like are used for scanning to obtain a three-dimensional image of the brain including the positioning sheet; according to the lesion position, the best direction of the puncture catheter and the puncture path are determined, and the depth from the puncture point 43a to the lesion 43 is measured, Figure 4 is a plan view of the puncture positioning sheet made of metal titanium, the puncture positioning sheet 45 is provided with a positioning hole 46 in the middle, and the puncture positioning sheet 45 is bonded to the reinforcing patch 47, the cotton area of the reinforcing patch 47 is larger than the area of the puncture positioning sheet, Figure 5The structure diagram of the existing three-dimensional auxiliary brain lesion puncture positioning sheet and positioning guide plate is specifically that the three-dimensional image is copied to the three-dimensional software, the head skin surface is taken as the reference, the three-dimensional modeling is used to design the guide plate 40 arranged outside the head surface and the puncture guide pipe 42 integrated with the guide plate 40, the guide plate 40 includes the guide plate 40 positioning hole consistent with the positioning hole on the titanium positioning sheet, in the embodiment, three titanium positioning sheets are pasted on the patient's head skin, three guide plate positioning holes are formed on the guide plate, which are guide plate positioning hole one 41a, guide plate positioning hole two 41b and guide plate positioning hole three 41c; the guide plate 40 arranged on the head skin and the puncture guide pipe 42 integrated with the guide plate 40 are printed by using the 3D printer; the positioning marks are made on the head skin along the positioning holes on the three titanium positioning sheets, and the titanium positioning sheets are removed; the guide plate positioning hole one 41a, the guide plate positioning hole two 41b and the guide plate positioning hole three 41c are matched with the positioning marks made on the human skin, and the guide plate 40 is fixed; under the three-dimensional scanning medical instrument such as CT and MRI, the puncture instrument is inserted from the puncture guide pipe 42 until the lesion 43 part, and the corresponding minimally invasive surgery is performed, that is, the hole is first opened and then punctured to draw blood; after the minimally invasive surgery, the guide plate 40 and the puncture guide pipe 42 integrated with the guide plate 40 are removed, and 44 is the puncture center line. In order to identify the positions of the positioning sheets on both sides of the patient's head skin, different types of positioning sheets are pasted on both sides of the patient's head skin, and the positioning shapes on one side are not completely the same. The lesion 43 can be found, and the relative parts on both sides of the head periphery are the best puncture direction.

[0007] Generally, for brain diseases, this method can be said to be accurate positioning, small trauma, short operation time, small operation risk, short hospitalization time, and greatly reduced cost compared with other operations. However, the treatment of cerebral hemorrhage is a life-and-death competition with death, time is life, and rapid operation can give patients a healthy life. If there is a delay, different degrees of sequelae or death will occur.

[0008] Although the use of the above optimal 3D printing technology to print the guide plate for positioning can obtain the best effect, the 3D printing technology requires tens of thousands of investment in printing equipment, and hundreds of thousands of investment in more expensive equipment. In addition to the investment, the 3D printing raw materials and personnel allocation also require a considerable investment for ordinary hospitals. In addition, the 3D printing of the guide plate requires a certain amount of time. In order to save the patient, time is needed. Sometimes doctors design and print guide plates all night long, and the image machine scans the markers on the patient's head skin, and then the guide plate is designed and printed for the preparation work before the operation, which takes 2-6 hours. For patients with acute cerebral hemorrhage, time is life, and it is necessary to race against time to quickly establish the minimally invasive puncture position and the puncture direction, and to quickly perform the operation, which has become the key to ensuring the patient's healthy function.

[0009] Patent No. 202022429772.0 discloses a three-dimensional auxiliary brain lesion puncture positioning frame, Figure 6 is a structural diagram of a three-dimensional auxiliary brain lesion puncture positioning frame, which comprises a sliding ruler 50, one end of the sliding ruler 50 is provided with a handle 53, the opposite end of the handle 53 on the sliding ruler 50 is provided with a fixed card 52 integrated with the sliding ruler 50 in the vertical direction of the sliding ruler 50, a sliding card 51 is slidingly arranged on the sliding ruler 50, the fixed card 52 and the sliding card 51 are oppositely arranged in the same direction of the sliding ruler 50, the fixed card 52 and the sliding card 51 are respectively provided with puncture positioning fixtures at the distal end of the sliding ruler 50, the puncture positioning fixtures on the fixed card 52 and the sliding card 51 are arc-shaped grooves with openings facing the sliding ruler 50, the two arc-shaped grooves are arc-shaped groove one 54a and arc-shaped groove two 54b, the axes of the arc-shaped groove one 54a and the arc-shaped groove two 54b are on the same line, a positioning needle 55b is matched in the arc-shaped groove two 54b on the fixed card 52, and a fitting with a ring-shaped piece 55a at the end is arranged in the arc-shaped groove one 54a on the sliding card 51. During use, first, different shapes of puncture positioning pieces are pasted on the scalp of a patient with shaved hair under CT, MRI and other scanning medical instruments, then the lesion is three-dimensionally reconstructed and the best puncture direction through the lesion 43 on both sides is found, and the shapes of the positioning pieces on both sides are recorded. Before the operation, marks are made on the positioning holes with a marker pen as puncture points 43a and puncture points opposite ends 43b. When using the puncture positioning frame, the center of the positioning needle 55b and the ring-shaped piece 55a is arranged on the puncture points 43a and the puncture points opposite ends 43b marked on the scalp of the patient, and drilling and puncture and other intracranial operations are performed along the arc-shaped groove one 54a and the arc-shaped groove two 54b. Using this puncture positioning frame can avoid using 3D printing equipment and printing raw materials, reduce equipment investment, avoid designing a guide plate for three-dimensional modeling and 3D printing of the guide plate, liberate doctors from 3D printing, reduce the labor intensity of doctors, shorten the preparation time from 2-6 hours for determining positioning and orientation scheme and 3D printing to the current 5-10 minutes, greatly shorten the preparation time before the operation, and the positioning and orientation are accurate, the rescue operation is timely, and the difference effect caused by different doctors can be avoided, the homogenization treatment effect can be realized, the functional loss of the patient can be reduced, and the operation can be performed in the shortest time, which saves valuable time for rescuing the patient's life.

[0010] On this basis, the inventor improves the above-mentioned positioning frame, and applies for a patent No. 202121969737.6, an improved high-precision three-dimensional auxiliary brain lesion puncture positioning frame, which is mainly improved in the contact part with the scalp of the patient, and further optimizes the positioning structure.

[0011] In the above-mentioned patent 202022429772.0 and application number CN202121969737.6, the puncture positioning frame needs to contact the patient's head periphery, and since the lesion positions of all patients are different, the puncture direction found under three-dimensional assistance is different. Sometimes, in order to avoid important intracranial tissues, nerves, blood vessels and other parts, the puncture direction may be located on one side of the patient's face or the eyeball. If the sliding card 51 and the positioning part of the fixed card 52 are located on the patient's face or the eyeball and other important parts, they will contact the face or the eyeball, which may cause danger to the face during operation. If the puncture direction is located in the eye, the puncture positioning frame cannot be used for positioning, and the surgery will be in an embarrassing situation. How to solve this embarrassing situation is a new topic in the process of minimally invasive craniocerebral surgery. SUMMARY

[0012] To solve the problem that the mechanical positioning frame causes the puncture direction to be located on one side of the patient's face or the facial features, the present application provides a 3D-assisted light-guided puncture directional complete instrument and a directional method thereof. The purpose is to solve the problem that the puncture positioning frame cannot be used on the patient's face or the facial feature part, to avoid the risk of damage caused by the contact between the surgical instrument and the patient's face and the facial feature part, to shorten the operation time, and to meet the precise positioning of emergency patients in emergency situations without contact.

[0013] The technical solution of the present application is: a 3D-assisted light-guided puncture directional complete instrument, including a puncture positioning sheet, two positioning marks determined by the puncture positioning sheet, the light-guided puncture directional complete instrument including two infrared or laser or linear positioning lamps set on the patient's scalp and the light direction towards the patient's scalp, the two infrared or linear positioning lamps are set on one or two supports through an angle adjusting device, the light of the two infrared or linear positioning lamps can be adjusted at any angle on the scalp, the linear light of the two infrared or linear positioning lamps is in different directions, the linear light formed by the two infrared or linear positioning lamps respectively towards different directions outside the patient's scalp and passes through the two positioning marks, one of the intersection points of the plane formed by the linear light of the two infrared or linear positioning lamps and the surface layer of the scalp is a puncture point, and the extension line of the two linear light plane intersection lines below the puncture auxiliary frame set outside the scalp, and the puncture auxiliary frame supports the puncture catheter; Further, the two infrared or linear positioning lamps are set on one or more supports by using one or more universal joints or / and flexible variable angle adjusting pipes, the height of the support is adjustable, and the angle of the linear light of the two infrared or linear positioning lamps is adjustable; Further, the height of the puncture auxiliary frame is adjustable, the upper end of the puncture auxiliary frame is provided with an upwardly open circular arc groove, the inclination angle of the circular arc groove is adjustable, the arc length of the circular arc groove is greater than 1 / 2 of the circumference, and when puncturing, the center of the circular arc groove is consistent with the intersection line of the two linear light planes; Further, the intersection angle of the light planes formed by the two positioning marks on the patient's scalp is close to 90°. 3D auxiliary light-guided puncture positioning method of the complete set of instruments, using the above light-guided puncture positioning complete set of instruments, puncture positioning sheet, the positioning steps of the light-guided puncture positioning complete set of instruments are as follows: 1) Determine the puncture direction using the disclosed puncture positioning sheet and puncture positioning method, and mark the puncture positioning marks on the patient's scalp; 2) Adjust the two infrared or laser linear positioning lamps so that the two light rays formed by them pass through the puncture positioning points respectively, and the two light rays form a plane intersection, and the intersection line of the two planes is the connecting line between the two puncture positioning marks; 3) The end of the puncture catheter is opposite to and in contact with the peripheral positioning mark on the scalp, and the two linear light rays are respectively irradiated on different peripheral parts of the puncture catheter. In this case, the puncture catheter is the puncture direction; 4) Adjust the puncture auxiliary frame so that the angle of the circular arc groove is consistent with the direction of the puncture catheter, the inclination direction of the circular arc groove is parallel to the direction of the puncture catheter, the bottom of the circular arc groove at the upper end of the puncture auxiliary frame is close to the lower part of the outer periphery of the puncture catheter, and the axis of the puncture catheter is consistent with the extension line of the intersection line of the two linear light planes on the outside of the scalp; 5) According to the depth of the puncture point to the lesion measured under three-dimensional modeling, the puncture positioning operation is implemented.

[0014] By using the puncture positioning sheet in CN202022222559.2 with CT and MRI images or pictures, not only can the titanium product puncture positioning sheet and human skin, bones, organs, blood vessels, etc. be clearly distinguished, but also the CT and MRI original data can be imported into a special three-dimensional modeling software to find the best puncture straight line path and detect the distance from the puncture point to the brain lesion, and the puncture direction is marked on the patient's scalp surface with a marker pen. By using two infrared or laser linear positioning lamps, the two linear light rays are adjusted to shine on the patient's scalp from different angles, and the intersection line of the two linear light rays is set on the extension line outside the patient's head to set the puncture catheter, and the two linear light rays are respectively irradiated to the puncture catheter axis direction, which can ensure that the puncture direction is consistent with the connecting line of the two positioning marks, further ensuring the accuracy of the puncture direction. Then, by adjusting the height and inclination angle of the arc groove on the auxiliary puncture support, the puncture catheter is set in the arc groove and ensured to be consistent with the puncture direction. According to the distance between the scalp outer layer and the lesion measured and recorded in the three-dimensional modeling, the precise operation is carried out. The bracket of the two infrared or laser linear positioning lamps can be set away from the operating table, which not only does not hinder the operation, but also can always maintain the positioning direction, overcoming the disadvantages of the existing puncture positioning frame that requires multiple people to operate simultaneously. Not only is the sterilization of the puncture positioning frame avoided, but also the situation of causing trauma to the patient's face or facial features is avoided, overcoming the awkward situation of the instrument being unable to use the puncture positioning frame on the patient's face or facial features, improving the positioning speed and accuracy, and ensuring the operability of all lesions. BRIEF DESCRIPTION OF DRAWINGS

[0015] Figure 1 Structure diagram of the infrared linear positioning lamp support set around the operating table.

[0016] Figure 2 Structure diagram of the puncture auxiliary support set around the operating table.

[0017] Figure 3 Arc groove 38 and its connection structure diagram.

[0018] Figure 4 Plan view of the puncture positioning sheet of the metal titanium product.

[0019] Figure 5 Structure diagram of the puncture positioning sheet and positioning guide plate under the existing three-dimensional assistance for brain lesions.

[0020] Figure 6 Structure diagram of the puncture positioning frame under the existing three-dimensional assistance for brain lesions.

[0021] Explanations of the symbols: infrared linear positioning lamp 10, support 11, universal joint 12a, universal joint 12b, magnetic block 13, threaded tube 14, infrared linear light 15, infrared linear positioning lamp 20, support 21, universal joint 22, threaded tube 24, infrared linear light 25, operating table 30, scalp 31, puncture auxiliary support 35, universal joint 36a, universal joint 36b, threaded tube 37, circular arc groove 38, guide plate 40, guide plate positioning hole 41a, guide plate positioning hole 41b, guide plate positioning hole 41c, puncture guide tube 42, lesion 43, puncture point 43a, opposite end of puncture point 43b, puncture center line 44, puncture positioning sheet 45, positioning hole 46, reinforcing sticker 47, sliding ruler 50, sliding clamp 51, fixed clamp 52, handle 53, arc groove 54a, arc groove 54b, positioning needle 55a, annular sheet 55b. DETAILED DESCRIPTION

[0022] The specific technical solutions of the present application will be described in detail below with reference to the accompanying drawings. In the following examples, infrared linear positioning lamps are used.

[0023] The technical solution of the present application is a 3D assisted light guided puncture directional complete instrument, Figure 1 is a schematic view of the structure of the infrared linear positioning lamp support arranged around the operating table, Figure 2 is a schematic view of the structure of the puncture auxiliary support arranged around the operating table, The puncture orientation complete set of instruments comprises two positioning marks on the patient's scalp 31 under 3D assistance, i.e. a puncture point 43a and a mark at the opposite end of the puncture point 43b, the line connecting the puncture point 43a and the opposite end of the puncture point 43b is a puncture center line 44, the puncture center line 44 passes through the lesion 43 in the patient's brain, the light guide puncture orientation complete set of instruments comprises two infrared linear positioning lamps arranged on the patient's scalp 31 and emitting light towards the patient's scalp 31, i.e. an infrared linear positioning lamp one 10 and an infrared linear positioning lamp two 20, the infrared linear positioning lamp one 10 and the infrared linear positioning lamp two 20 are arranged on one or two supports, i.e. a support one 11 and a support two 21, through an angle adjusting device, the infrared linear light one 15 of the infrared linear positioning lamp one 10 and the infrared linear light two 25 of the infrared linear positioning lamp two 20 can be adjusted at any angle on the scalp 31 respectively, the infrared linear light one 15 of the infrared linear positioning lamp one 10 and the infrared linear light two 25 of the infrared linear positioning lamp two 20 are in different directions respectively, and the extensions of the infrared linear light one 15 of the infrared linear positioning lamp one 10 and the infrared linear light two 25 of the infrared linear positioning lamp two 20 intersect, the infrared linear light one 15 and the infrared linear light two 25 formed by the infrared linear positioning lamp one 10 and the infrared linear positioning lamp two 20 respectively pass through the two positioning marks at the puncture point 43a and the opposite end of the puncture point 43b on the patient's scalp 31, the intersection line of the plane formed by the infrared linear light one 15 and the infrared linear light two 25 passing through the two positioning marks at the puncture point 43a and the opposite end of the puncture point 43b on the patient's scalp 31 is on a straight line with the line connecting the puncture point 43a and the opposite end of the puncture point 43b on the scalp 31, and the puncture auxiliary support 35 is arranged below the extension of the puncture center line 44 outside the scalp 31.

[0024] In this embodiment, the patient lies on the operating table 30, the infrared linear positioning lamp one 10 and the infrared linear positioning lamp two 20 are arranged on the side of the operating table 30 respectively, since the peripheral puncture point 43a is located on the forehead side, therefore, the infrared linear positioning lamp two 20 is arranged on the side of the patient's back and emits light towards the patient, which is beneficial for performing the puncture operation from the front of the patient's forehead, the puncture auxiliary support 35 is arranged on one side of the end of the operating table 30 and extends to the side of the bed, which is convenient for operation. According to the different lesions 43 of the patient, the puncture direction and position are different, and the positions of the support of the infrared linear light and the puncture auxiliary support 35 can be arranged according to the situation.

[0025] The infrared linear positioning lamp one 10 and the infrared linear positioning lamp two 20 are arranged on one or more supports by one or more universal joints or / and flexible angle adjusting pipes, the height of the support is adjustable, the angle of the infrared linear light one 15 emitted by the infrared linear positioning lamp one 10 and the infrared linear light two 25 emitted by the infrared linear positioning lamp two 20 is adjustable; in the embodiment, the support one 11 and the support two 21 are used, the support one 11, the universal joint one 12a, the universal joint two 12b, the magnetic block 13, the threaded pipe one 14, the infrared linear light one 10 are sequentially arranged between the support one 11 and the infrared linear positioning lamp one 10, the universal joint one 12a and the universal joint two 12b are provided with locking positioning mechanisms; the same components as those between the support one 11 and the infrared linear positioning lamp one 10 are arranged between the support two 21 and the infrared linear positioning lamp two 20, including the universal joint three 22, the threaded pipe two 24 and the adjustable structure of the infrared linear light one 15; similarly, the universal joint three 22 is provided with the locking positioning mechanism, the same magnetic block is arranged on the side of the threaded pipe two 24 opposite to the infrared linear positioning lamp two 20 and is adsorbed on the plane of the support, and the infrared linear light two 25.

[0026] Figure 3 The height of the puncture auxiliary frame 35 is adjustable, the puncture auxiliary frame 35 is provided with the circular arc groove 38 at the upper end, the height of the circular arc groove 38 is adjustable, the arc length of the circular arc groove 38 is greater than 1 / 2 of the circumference, and the function is to put or take out the puncture catheter 42 from the opening of the circular arc groove 38, the puncture catheter 42 is made of medical silica gel pipe and is soft in texture, even if the opening width is less than the diameter of the puncture catheter 42, the puncture catheter 42 can also be pressed and taken out or put into the circular arc groove 38, the opening of the circular arc groove 38 is upward, the inclination angle of the circular arc groove 38 is adjustable, in order to facilitate adjustment, the circular arc groove 38 is also provided with the multi-direction and multi-angle adjusting mechanism, including the universal joint four 36a, the threaded pipe three 37, the universal joint four 36b and the corresponding magnetic block, when puncturing, the axis of the puncture catheter 42 is consistent with the intersection line of the two linear light planes, that is, the puncture center line 44, in the embodiment, the circular arc groove 38 and the puncture catheter 42 are matched with each other, that is, the outer diameter of the puncture catheter 42 is consistent with the inner diameter of the circular arc of the circular arc groove 38, of course, the inner diameter of the circular arc of the circular arc groove 38 can be slightly larger than the outer diameter of the puncture catheter 42, the puncture catheter 42 is supported by the groove bottom of the circular arc groove 38, as long as the axis of the puncture catheter 42 is consistent with the puncture center line 44.

[0027] Of course, the circular arc groove 38 can also use a U-shaped groove.

[0028] The intersection angle of the plane formed by the infrared linear light one 15 and the infrared linear light two 25 formed by the two positioning marks on the patient's scalp is close to 90°, that is, the irradiation direction of the infrared linear light one 15 formed by the infrared linear positioning lamp one 10 and the infrared linear light two 25 formed by the infrared linear positioning lamp two 20 is located at a position close to 90°.

[0029] The light emitting principle of the above-mentioned infrared linear positioning lamp is the same as the optical level used in the field of building.

[0030] Although in the present embodiment, the angle adjusting device utilizes the universal joint, threaded tube, magnetic block and the like arranged on the support, it is not limited thereto, and any device capable of arbitrarily adjusting the angle and direction of the linear light belongs to the scope of the present application.

[0031] The positioning method of the light-guided puncture directional complete instrument under the assistance of 3D is as follows: 1), the puncture positioning sheet and the puncture positioning method disclosed in CN202022222559.2 are used to determine the puncture direction, measure the depth from the puncture point 43a to the lesion 43, mark the puncture positioning marks on the patient's scalp 31, and the specific method is: paste a plurality of puncture positioning sheets 45 with different shapes on the patient's scalp 31, import the CT, MRI detection data into the three-dimensional modeling software, seek the best direction of puncturing through the lesion 43, measure the depth from the puncture point 43a to the lesion 43, and determine the puncture positioning sheets 45 on both sides, the connecting line of the positioning holes 46 on the puncture positioning sheets 45 on both sides is the puncture center line 44, before removing the puncture positioning sheets 45 on both sides, mark the positioning marks at both ends in the positioning holes 46 of the puncture center line 44 with a marker pen, in order to ensure that there is no mistake, and record the shapes of the puncture positioning sheets on both sides in the puncture direction, the positioning marks on both sides are the positions that the irradiation lines of the infrared linear light one 15 and the infrared linear light two 25 must pass through; 2), adjust the two infrared linear positioning lamps, so that the infrared linear light one 15 and the infrared linear light two 25 formed by the two infrared linear positioning lamps pass through the positioning mark positions of the puncture point 43a and the puncture point opposite end 43b respectively, the two light planes intersect, and the intersection line of the planes is the connecting line of the two puncture positioning marks, that is, the puncture center line 44; 3), the end of the puncture catheter 42 is in contact with the positioning marks on the scalp 31, so that the infrared linear light one 15 and the infrared linear light two 25 irradiate different outer peripheral parts of the puncture catheter 42 from different directions, in this case, the axis of the puncture catheter 42 is the puncture center line 44; 4) Adjust the puncture auxiliary frame 35, so that the angle of the circular arc groove 38 is consistent with the direction of the puncture catheter 42, and the direction of the circular arc groove 38 is parallel to the direction of the puncture catheter 42, and the bottom of the circular arc groove 38 at the upper end of the puncture auxiliary frame 35 is close to the lower part of the outer periphery of the puncture catheter, so that the axis of the puncture catheter intersects with the intersection line of the two linear light planes (the puncture center line 44) consistent with the extension line of the puncture center line 44 on the outside of the scalp; 5) According to the depth of the puncture point 43a to the lesion 43 measured during three-dimensional modeling, the puncture positioning operation is performed along the depth of the puncture catheter 42.

[0032] In order to prove the feasibility of the laser, the inventor specially purchased a laser linear device to conduct a test, and the results prove that the laser linear device has the same effect as the infrared linear device, and can also guide the direction of puncture.

[0033] By using the puncture positioning sheet 45 in CN202022222559.2 with CT and MRI images or pictures, not only can the titanium product puncture positioning sheet 45 and human skin, bones, organs, blood vessels be clearly distinguished, but also the original data of CT and MRI can be imported into three-dimensional modeling software to find the best puncture straight line path, detect the distance from the puncture point to the brain lesion 43, and mark the puncture direction on the patient's scalp 31 outside the shaved light head with a marker pen. By using infrared linear positioning lamp one 10 and infrared linear positioning lamp two 20, by adjusting the direction, the infrared linear light one 15 of the infrared linear positioning lamp one 10 and the infrared linear light two 25 of the infrared linear positioning lamp two 20 are respectively irradiated to the patient's scalp 31 from different angles. By adjusting the infrared linear light one 15 and the infrared linear light two 25, respectively making the infrared linear light one 15 and the infrared linear light two 25 pass through two positioning mark positions, setting the puncture catheter 42 on the extension line of the intersection line of the plane formed by the infrared linear light one 15 and the infrared linear light two 25 outside the patient's head, adjusting the angle of the puncture catheter 42, and making the infrared linear light one 15 and the infrared linear light two 25 simultaneously irradiate to the axis direction of the puncture catheter 42, the puncture direction can be ensured to be consistent with the connecting line of the two positioning marks, further ensuring the accuracy of the puncture direction. Then by adjusting the height and inclination angle of the arc groove 38 on the auxiliary puncture frame 35, the puncture catheter 42 is set in the arc groove 38, and the consistency of the puncture catheter with the puncture direction is ensured. According to the distance between the outer layer of the scalp 31 and the lesion 43 measured and recorded in three-dimensional modeling, precise surgery is performed. The support one 11 and the support two 21 can be respectively set at a position away from the operating table 30, which not only does not hinder the doctor's operation, but also can always keep the positioning direction, overcoming the disadvantages of the prior art that multiple people need to operate the puncture positioning frame at the same time. Not only the sterilization procedure of the puncture positioning frame is eliminated, but also the situation of causing trauma to the patient's face or facial position is avoided, overcoming the embarrassing situation that the puncture positioning frame cannot be used on the patient's face or facial position, improving the positioning speed and positioning accuracy, and ensuring the feasibility of all lesion surgeries.

Claims

1. A complete set of instruments for puncture orientation under 3D assistance, comprising a puncture positioning sheet, two positioning marks determined by the puncture positioning sheet, characterized in that: The light-guided puncture orientation complete set comprises two infrared or laser or laser linear positioning lamps arranged on the patient's scalp and emitting light towards the patient's scalp, the two infrared or laser linear positioning lamps are arranged on one or two supports through angle adjusting devices, the light of the two infrared or laser linear positioning lamps can be adjusted at any angle on the scalp, the linear light of the two infrared or laser linear positioning lamps is in different directions, the linear light formed by the two infrared or laser linear positioning lamps respectively points to different directions outside the patient's scalp and passes through two positioning marks, one of the intersection points of the intersection line of the linear light plane formed by the two infrared or laser linear positioning lamps and the surface layer of the scalp is the puncture point, the two linear light plane intersection lines passing through the puncture point are arranged below the extension line of the puncture auxiliary support outside the scalp, and the puncture auxiliary support supports the puncture catheter.

2. The 3D assisted light guided puncture directional instrument kit according to claim 1, wherein: The two infrared or laser linear positioning lamps are arranged on one or more supports through one or more universal joints or / and flexible angle adjusting pipes, the height of the support is adjustable, and the angle of the linear light of the two infrared or laser linear positioning lamps is adjustable.

3. The 3D assisted light guided puncture targeting complete instrument of claim 1, wherein: The height of the puncture auxiliary support is adjustable, the upper end of the puncture auxiliary support is provided with an upwardly-opened circular-arc groove, the inclination angle of the circular-arc groove is adjustable, the arc length of the circular-arc groove is greater than 1 / 2 of a circle, and the center of the circular-arc groove is consistent with the intersection line of the two linear light planes during puncture.

4. The 3-D assisted light guided puncture targeting complete instrument of claim 1, wherein: The intersection angle of the light planes formed by the two positioning marks on the patient's scalp is close to 90°.

5. The positioning method of the light-guided puncture directional complete instrument under 3D assistance, using the light-guided puncture directional complete instrument and the puncture positioning sheet, characterized in that: The positioning steps of the light-guided puncture orientation complete set are as follows: 1) the puncture direction is determined, the depth from the puncture point to the lesion is measured, and the puncture positioning marks are marked on the patient's scalp by using the disclosed puncture positioning sheet and puncture positioning method; 2) the two infrared or laser linear positioning lamps are adjusted so that the two light rays respectively pass through the puncture positioning points, the two light rays form a plane intersection, and the two plane intersection lines are the connecting line between the two puncture positioning marks; 3) the end of the puncture catheter is opposite to and in contact with the positioning mark on the periphery of the head and brain, so that the two linear light rays are respectively irradiated on different peripheral parts of the puncture catheter, and in this case, the puncture catheter is the puncture direction; 4) the puncture auxiliary support is adjusted so that the angle of the circular-arc groove is consistent with the direction of the puncture catheter, the inclination direction of the circular-arc groove is parallel to the direction of the puncture catheter, the bottom of the circular-arc groove at the upper end of the puncture auxiliary support is close to the lower side of the periphery of the puncture catheter, and the center of the puncture catheter is consistent with the extension line of the intersection line of the two linear light planes outside the head and brain; 5) the puncture positioning operation is performed according to the depth of the puncture point to the lesion measured by the three-dimensional modeling.

Images