A three-dimensional assisted positioning puncture frame for brain lesions

Abstract

A three-dimensional assisted puncture positioning frame for brain lesions belongs to the field of medical devices. The puncture positioning frame includes a sliding ruler, a handle is provided at one end of the sliding ruler, and a fixed card perpendicular to the sliding ruler is integrally provided at the opposite end. A sliding card is provided on the sliding ruler on the opposite side of the fixed card for sliding. The ends of the fixed card and the sliding card are respectively provided with puncture positioning fixings with opposite axes. The puncture positioning fixings on the fixed card and the sliding card are both arc-shaped grooves. A positioning needle is provided in the arc-shaped groove on the fixed card. The arc-shaped groove on the sliding card is provided with a positioning ruler and an adapter. The positioning ruler is provided with a central positioning port and multiple auxiliary positioning holes. The puncture positioning frame can reduce equipment investment, eliminate the need for guide plate printing, shorten surgical preparation time, and after accurate positioning and orientation, rescue surgery can be timely, which can reduce patient functional loss and save patients' lives.

Description

Technical Field

[0001] The invention relates to a positioning frame, in particular to a three-dimensional assisted puncture positioning frame for brain lesions, belonging to the field of medical devices. Background Art

[0002] Brain lesions are common clinical diseases. Mild cases can cause dizziness, nausea, insomnia, memory loss, dementia, and depression. Moderate cases can cause aphasia and limb changes. Severe cases can lead to bedridden paralysis, loss of consciousness, becoming a vegetative state, and even death.

[0003] In particular, cerebral hemorrhages caused by long-term hypertension are often acute and require immediate drainage of the intracranial hematoma for emergency treatment. Failure to do so can worsen the condition or even lead to death. Treating cerebral hemorrhage is a life-or-death struggle against time, where time is of the essence.

[0004] If patients with moderate cerebral hemorrhage do not receive timely treatment, the disease will become severe. The patients will suffer from partial or overall functional loss and need someone to accompany them for a long time to take care of them. In the long run, it will bring considerable mental and financial burdens to the patients and their families. Working-class families will become impoverished due to the disease, and families with low incomes will be even worse off. Therefore, effective treatment of brain diseases is particularly important.

[0005] Previously, brain diseases such as cerebral hemorrhage and brain cystic tumors generally required craniotomy or stereotactic surgery. This method has long operation time, high surgical risks, high treatment costs, and long postoperative recovery time, and there are many certain factors.

[0006] In recent years, with the development of science and technology, high technology has gradually been applied to medical equipment, and minimally invasive surgery has also been applied to brain surgery. In minimally invasive surgery, accurate positioning can avoid important organs, nerves, blood vessels, etc. of the human body, thereby maximizing the retention of the original functions of the human body and reducing the sequelae caused by the surgery.

[0007] Currently, among the existing brain surgery positioning methods, there are methods that use traditional stereotactic methods, positioning methods that use navigation technology, and methods that use augmented reality (VR), mixed reality (MR), and robotic positioning. Relatively speaking, the recently launched 3D printed surgical guide positioning method is relatively fast, accurate, low-cost, and has a short recovery time.

[0008] The application number for the 3D printing guide technology is 202022222559.2, which applied for a patent for "a puncture positioning plate for minimally invasive surgery." Figure 13The schematic diagram of the structure of titanium spacers of various shapes is shown. This spacer is a titanium spacer 30. The shape of the titanium spacer 30 includes polygons, such as a triangle 45, a hexagon 46, a pentagon 47, a trapezoid 48, and a square 49. It can also be circular. In addition, it can also have various shapes such as an ellipse 41, a heart 42, a combined petal shape 43, a cloud shape 40, and a polygon 44. At least one side of the titanium spacer 30 in these shapes that contacts the skin is flat, and a high-viscosity titanium sheet adhesive layer 32a is provided on the flat surface. The other side of the titanium spacer 30 is transferred with a reinforcement patch 34 through the high-viscosity adhesive layer. That is, the side of the titanium spacer 30 facing the human body is bonded to the reinforcement patch 34 using a reinforcement adhesive layer 32b. The side of the reinforcement patch 34 facing the human body is provided with a high-viscosity reinforcement adhesive layer 32b. The adhesive layer is a non-toxic, harmless, and non-irritating environmentally friendly adhesive.

[0009] Figure 14 It is a structural schematic diagram of a circular titanium positioning sheet. Before use, the titanium positioning sheet 30 has a high-viscosity adhesive layer facing the surface of the human skin, namely, the titanium sheet adhesive layer 32a. The reinforcing patch 34, which extends in whole or in part to the periphery of the titanium positioning sheet 30, is provided with a high-viscosity adhesive layer on the side facing the human skin, namely, the reinforcing adhesive layer 32b. Both the titanium sheet adhesive layer 32a and the reinforcing adhesive layer 32b are provided with a layer of release paper, namely, the titanium sheet release paper 33a and the reinforcing release paper 33b. When in use, the surface titanium sheet release paper 33a and the reinforcing release paper 33b are peeled off and pasted on the surface of the human body. In this embodiment, they are pasted on the head shape of the human body. When pasting, the hair needs to be shaved off.

[0010] The 3D printed guide titanium positioning plate positioning technology is to set a positioning plate on the surface of the patient's lesion, use existing medical equipment such as CT and MRI to scan the outside of the lesion, and obtain the external outline of the patient's lesion that can clearly display the positioning plate. Based on the patient's external outline, the three-dimensional modeling technology is used to design a guide plate that matches the patient's appearance and includes a guide plate positioning hole that matches the positioning hole on the positioning plate and an optimal puncture channel. The guide plate is a guide plate that can be locally stabilized outside the human body. Not only can the best puncture position be determined according to the lesion condition in the three-dimensional modeling, but the best puncture direction can also be obtained, avoiding the above-mentioned important human organs, nerves, blood vessels, etc., to maximize the retention of healthy human functions after surgery. After design, the guide plate is printed out using 3D printing technology. Before positioning, the center of the positioning hole in the positioning plate is marked so that the positioning hole on the guide plate matches the positioning mark, the puncture positioning is accurately implemented, and the operation is performed along the puncture channel.

[0011] Compared with other surgeries, this method can be used to treat general brain diseases with accurate positioning, less trauma, shorter operation time, lower surgical risks, shorter hospitalization time, and significantly reduced costs. However, as mentioned above, the treatment of cerebral hemorrhage is a race against time against death. Time is life. A quick operation can give the patient a healthy life. If there is any delay, the above-mentioned sequelae or death of varying degrees will occur.

[0012] Although using the above-mentioned optimal 3D printing technology to print out guides for positioning will achieve the best results, 3D printing technology printing equipment requires an investment of at least hundreds of thousands, and at most millions. The large investment, coupled with 3D printing materials and staffing, is also a considerable investment for ordinary hospitals. In addition, 3D printing of guides takes a certain amount of time. In order to save patients and gain time, doctors sometimes work all night to design and print guides. From attaching markers to the patient's head and performing external body scanning, to designing and printing the guides, the preparation work before surgery takes 3-6 hours. For patients with acute cerebral hemorrhage, time is life, and they need to race against time to establish the minimally invasive puncture position and puncture direction as soon as possible. Performing the operation as soon as possible has become the key to ensuring the patient's healthy function and a major issue facing medical staff. Summary of the Invention

[0013] In view of the reality that the existing 3D printing guide positioning technology has large equipment investment and a certain amount of time is required for design and printing, the present invention provides a 3D-assisted brain lesion puncture positioning frame, which uses the 3D-assisted two-point-one-line positioning method for precise positioning, eliminating the tedious process of designing and printing 3D guides and disinfecting 3D guides, greatly shortening the operation preparation time. This invention can reduce equipment investment, eliminate the guide design, 3D printing and disinfection processes in the existing technology, shorten the operation preparation time, and after accurate positioning and orientation, perform immediate rescue surgery, reduce patient functional loss, and save patients' lives.

[0014] The technical solution of the present invention is: a three-dimensional assisted puncture positioning frame for lower brain lesions, the puncture positioning frame includes a sliding ruler, a handle is provided on one end of the sliding ruler, and a fixed card perpendicular to the sliding ruler is integrally provided on the opposite end. A sliding card is slidably provided on the sliding ruler, and the fixed card and the sliding card are arranged relative to each other in the same direction of the sliding ruler. The fixed card and the sliding card are respectively provided with puncture positioning fixing pieces at the distal end of the sliding ruler. The puncture positioning fixing pieces on the fixed card and the sliding card are both arc-shaped grooves with openings facing the sliding ruler, and the axes of the arc-shaped grooves are on the same line. A positioning needle is provided in the arc-shaped groove on the fixed card, and a positioning ruler and an adapter are provided in the arc-shaped groove on the sliding card. A central positioning port and a plurality of auxiliary positioning holes are provided on the positioning ruler.

[0015] The puncture positioning fixture is fixed to the end of the fixed card and the sliding card, the axis of the arc groove is parallel to the long side of the sliding ruler, the adapter matching the arc groove on the sliding card is arranged in the arc groove, the end of the arc groove on the sliding card opposite to the fixed card is provided with an annular piece positioning piece perpendicular to the axis of the arc groove, the inner circumference of the annular piece positioning piece is consistent with the inner circumference of the arc groove, and the annular piece positioning piece is provided with a drainage tube and a positioning ruler separation opening facing the sliding ruler.

[0016] The positioning ruler includes a central portion, and at least three strip rulers extend from the central portion to the periphery. The positioning rulers include multiple, and the central portions of different positioning rulers are respectively provided with a central hole that matches the inner diameter of the arc groove or the adapter provided on the inner periphery thereof. The central hole is connected to the intersection angle of a strip ruler to form a central positioning opening. The strip ruler is provided with multiple auxiliary positioning holes of different shapes, and a direction mark is marked on one direction of the strip ruler;

[0017] Furthermore, the fixed card and the sliding card extend perpendicularly to the same side of the sliding card, the distance between the fixed card and the sliding card and the sliding ruler is 10-20 cm, the puncture positioning fixture is located on the side of the sliding card away from the sliding ruler, and a locking bolt perpendicular to the sliding ruler is provided on the sliding ruler on the opposite side of the puncture positioning fixture, and the sliding distance between the sliding card and the fixed card on the sliding ruler is 0-40 cm;

[0018] Furthermore, the positioning needle includes a needle end and a rod body, a step is provided on the outer periphery of the rod body, the diameter of the needle end rod body on the side of the step close to the needle end is larger than the diameter of the needle handle rod body on the side away from the needle end, the length of the needle handle rod body away from the needle end of the positioning needle is larger than the length of the needle end rod body on the side close to the needle body, and the needle end rod body away from the needle end is arranged on the inner periphery of the circular arc groove or the circular arc of the adapter;

[0019] Furthermore, the sliding card is provided with a fine-tuning mechanism on the side facing the handle, the fine-tuning mechanism and the sliding card are slidably arranged on the sliding ruler in the same direction, the fine-tuning mechanism is provided with a fine-tuning locking bolt parallel to the locking bolt, the fine-tuning mechanism is provided with a micro-screw slidably connected to the sliding card in a direction parallel to the sliding ruler, the micro-screw is provided with a micro-screw nut, and the micro-screw nut is arranged in a recess of the fine-tuning mechanism.

[0020] The present invention has the following positive effects: a handle is provided on one end of the sliding ruler, a fixed card is provided on one side of the opposite end, the sliding ruler is slidably provided with the sliding card, the fixed card and the sliding card are relatively extended in the same direction perpendicular to the sliding ruler, and positioning pins are respectively provided at the ends of the fixed card. A straight line extending from the brain lesion to the scalp surface can be determined in advance under a three-dimensional state as the puncture direction. During actual positioning, the positions of the positioning holes are first marked on a pair of titanium positioning sheets facing the patient, the titanium positioning sheets are removed, and the positioning pins on the fixed card and the sliding card are respectively set at the pre-selected marked positions. Based on the positioning or orientation, the positioning marks on one side of the sliding card are used as the puncture points for puncture and treatment. In particular, an L-shaped notch is provided on one side of the arcuate groove at the end of the sliding card, and an adapter pin is provided on the outer periphery of the adapter corresponding to the L-shaped notch. This facilitates the use of puncture tools of different diameters along the arcuate groove at the end of the sliding card or the axis of the adapter. The annular positioning sheet is fixedly provided at the end of the puncture positioning fixture on the side of the sliding card facing the fixed card, which facilitates the compression of the positioning ruler and ensures safe and accurate puncture. The puncture positioning frame is configured with a positioning ruler, which is conducive to accurately finding the center position of the puncture point before and after the incision; a locking bolt is provided on the opposite side of the puncture positioning fixture on the sliding card to lock the sliding card to prevent the sliding displacement of the sliding card; the arc groove and the adapter are both trough-shaped arc structures greater than 1 / 2 and less than 3 / 2, which makes it convenient to replace the adapter; the use of the present invention can avoid the use of 3D printing equipment and printing materials, reduce equipment investment, and avoid the design of a three-dimensional modeling guide and the 3D printing of the guide, freeing doctors from 3D printing and reducing the doctors' labor intensity. The original 2-6 hours for determining the positioning and orientation plan and the 3D printing preparation time in three dimensions is shortened to the current 5-10 minutes, greatly shortening the preparation time before surgery, and the positioning and orientation are accurate, the rescue surgery is timely, and the different effects caused by the operations of different doctors can be avoided. Homogeneous treatment effects can be achieved, the patient's functional loss can be reduced, and the surgery can be performed in the shortest time, thus gaining precious time for saving the patient's life. BRIEF DESCRIPTION OF THE DRAWINGS

[0021] Figure 1 A schematic diagram of the front structure of the puncture positioning frame of the present invention.

[0022] Figure 2 along Figure 1 Schematic diagram of the cross section along the A-A1 direction.

[0023] Figure 3 Schematic diagram of the structure of the arc groove.

[0024] Figure 4 A schematic diagram of the structure of the adapter.

[0025] Figure 5Schematic diagram of the end face structure of the adapter.

[0026] Figure 6 Schematic diagram of the end face structure of the annular positioning piece.

[0027] Figure 7 Schematic diagram of the plane structure of the positioning ruler.

[0028] Figure 8 Schematic diagram of the front structure of the positioning pin.

[0029] Figure 9 Schematic diagram of brain positioning film.

[0030] Figure 10 Schematic diagram of puncture direction and puncture point debugging under 3D software.

[0031] Figure 11 A three-dimensional schematic diagram with positioning sheets attached in actual application.

[0032] Figure 12 Schematic diagram of the brain puncture positioning frame.

[0033] Figure 13 Schematic diagram of the structure of titanium positioning plates of various shapes.

[0034] Figure 14 Schematic diagram of the structure of a circular titanium spacer.

[0035] Explanation of reference numerals: 10-sliding ruler, 11-sliding card, 12-fixing card, 13-handle, 14a-arc groove 1, 14b-arc groove 2, 15a-ring plate, 15b-positioning pin, 16-fine adjustment mechanism, 17a-locking bolt, 17b-fine adjustment locking bolt, 18-micro screw nut, 19-micro screw, 19a-sliding screw end, 20-adapter, 21-L-shaped notch, 22-adapter pin, 23a-needle handle rod, 23b-needle end rod, 24-needle end, 25-center part, 2 6-center hole, 27-positioning ruler, 27a strip ruler, 28-separation opening, 29-auxiliary positioning hole, 30-titanium positioning piece, 31-positioning hole, 32a-titanium sheet adhesive layer, 32b-reinforced adhesive layer, 33a-titanium sheet titanium sheet release paper, 33b-reinforced release paper, 34-reinforced patch, 35-lesion, 40-cloud shape, 41-ellipse, 42-heart shape, 43-combined petal shape, 44-polygon, 45-triangle, 46-hexagon, 47-pentagon, 48-trapezoid, 49-square. DETAILED DESCRIPTION

[0036] The technical solution of the present invention will be described in detail below with reference to the accompanying drawings. During the positioning process, the device of the present invention and related accessories must be disinfected according to relevant regulations before they can be used for positioning and puncture in brain surgery.

[0037] The technical solution of the present invention is a three-dimensional assisted brain lesion puncture positioning frame. Figure 1 This is a front structural diagram of the puncture positioning frame of the present invention. Figure 2 It is along Figure 1 The puncture positioning frame includes a sliding ruler 10, a handle 13 is provided on one end of the sliding ruler 10, a fixed card 12 connected to the sliding ruler 10 is provided on the opposite end of the handle 13 of the sliding ruler 10 in the vertical direction of the sliding ruler 10, a sliding card 11 is slidably provided on the sliding ruler 10, the fixed card 12 and the sliding card 11 are arranged opposite to each other in the same direction of the sliding ruler 10, and the fixed card 12 and the sliding card 11 are respectively provided with a puncture positioning fixing piece at the distal end of the sliding ruler 10. The puncture positioning fixing members on 12 and the sliding card 11 are arcuate grooves with openings facing the sliding ruler 10. The two arcuate grooves are: arcuate groove 14a and arcuate groove 2 14b. The axes of arcuate groove 14a and arcuate groove 2 14b are on the same line. A positioning pin 15b is provided in arcuate groove 2 14b on the fixing card 12. The arcuate groove 14a on the sliding card 11 is provided with a positioning ruler 27 and an adapter 20. The positioning ruler 27 is provided with a central positioning port 28 and a plurality of auxiliary positioning holes 29.

[0038] Figure 3 This is a schematic diagram of the structure of the arc groove. Figure 4 It is a structural diagram of the structure of the adapter. Figure 5 This is a schematic diagram of the end face structure of the adapter. The fixed card 12 and the sliding card 11 extend perpendicularly to the same side of the sliding card 10. The length of the fixed card 12 and the sliding card 11 ends from the sliding ruler 10 is 10-20 cm. The end faces of the arc groove 14a, arc groove 2 14b or the adapter 20 are perpendicular to the length direction. The puncture positioning fixture is fixed to the ends of the fixed card 12 and the sliding card 11. The axis of the arc groove is parallel to the long side of the sliding ruler 10. The puncture positioning fixture includes an arc groove including an arc groove 14a and an arc groove 2 14b. The arc groove 14a and the arc groove 2 14b are respectively welded and fixed to the ends of the sliding card 11 and the fixed card 12. The axis of the two arc grooves is parallel to the long side of the sliding ruler 10. The adapter 20 matched with the arc groove 14a on the sliding card 10 is set on the arc groove 14a. 4a, an annular piece positioning piece 27 perpendicular to the axis of the arc groove 14a is provided at the end of the arc groove 14a on the sliding card 11 opposite to the fixed card 12. The inner circumference of the annular piece positioning piece 27 coincides with the inner circumference of the arc groove 14a. A separation opening 28 for the drainage tube and the positioning ruler is opened on the side of the annular positioning piece 27 facing the sliding ruler 10. The inner end of the separation opening 28 is arc-shaped, and the radius of the arc is equal to the inner diameter of the arc groove 14a. The arc is part of the center hole.

[0039] Figure 6The annular positioning piece 15a is fixed to the end of the arc groove 1 14a facing the arc groove 2, and the inner circumference of the annular positioning piece 15a is consistent with the radius of the arc groove 1 14a.

[0040] Positioning pin 15b is a rod-shaped structure, fixed to the end of fixed card 12 and located within the inner periphery of arcuate groove 14b. A matching adapter 20 can be located within the inner periphery of arcuate groove 14a on the side of sliding card 11. Adapter 20 is positioned within arcuate groove 14a and has a similar shape to arcuate groove 14a, but its outer periphery is the same as the inner periphery of arcuate groove 14a.

[0041] Figure 7 The figure is a schematic diagram of the planar structure of a positioning ruler. The positioning ruler 27 includes a central portion 25, from which at least three strip rulers 27a extend outward. The positioning rulers 27 are multiple, and the central portions 25 of different positioning rulers 27 each have a central hole 26 that matches the inner diameter of the arc-shaped groove 14a or the adapter 20 provided on its inner periphery. The central hole 26 communicates with an intersection angle of the strip ruler 27a to form a central positioning opening 28. The strip ruler 27a is provided with multiple auxiliary positioning holes 29 of different shapes, and an orientation mark is marked on one direction of the strip ruler 27a.

[0042] In this embodiment, the positioning ruler 27 is a cross-shaped structure. In order to be able to quickly match the head positioning mark for the second time, there may be an "up" at one end as a directional mark. Generally, when positioning, the direction marked with "up" is facing upwards, which will match as quickly as possible (for the specific matching method, please refer to the positioning method described later). Arrows, etc. can also be used as directional marks.

[0043] The arc groove 14a at the end of the sliding card and the adapter 20 are both horse trough-type arc structures with a diameter greater than 1 / 2 and less than 3 / 2. An L-shaped notch 21 is provided on one side of the arc groove, and an adapter pin 22 corresponding to the L-shaped notch 21 is provided on the outer periphery of the adapter 20. When in use, the adapter pin 22 of the adapter 20 is matched with the L-shaped notch 21 on the arc groove and rotated along the arc direction to set the adapter 20 to the inner periphery of the arc groove 14a. Similarly, it can also be removed. The inner diameter of the arc groove 2 14b on the side of the fixed card 12 is consistent with the outer diameter of the needle handle rod 23a of the positioning needle 15b.

[0044] The inner diameter of the arc groove is less than 16 mm. The arc groove 14a and the adapter 20 set at the side end of the sliding card 11 are both trough-type arc structures greater than 1 / 2 and less than 3 / 2. The arc groove 14a is fixed to the annular positioning piece 15a on the side of the fixed card 12. The arc groove 14a includes arc structures with different inner diameters, which is the adapter 20. The inner diameter of the arc groove 2 14b is fixed to the outer diameter of the positioning rod.

[0045] The puncture positioning fixture is located at the end of the sliding card 11 away from the sliding ruler 10. A locking bolt 17a perpendicular to the sliding ruler 10 is provided on the sliding ruler 10 on the opposite side of the puncture positioning fixture. The sliding distance between the sliding card 11 and the fixed card 12 on the sliding ruler 10 is 0-40 cm.

[0046] Figure 8 It is a schematic diagram of the front structure of the positioning needle, which includes a needle end 24 and a rod body. A step is provided on the outer periphery of the rod body. The diameter of the needle end rod body 23b close to the step of the needle end 24 is larger than the diameter of the needle handle rod body 23a away from the needle end 24. The length of the needle handle rod body 23a away from the needle end 24 of the positioning needle is larger than the length of the needle end rod body 23b close to the needle body. The needle end rod body 23b away from the needle end 24 is arranged on the inner periphery of the arc groove or the arc of the adapter 20.

[0047] The sliding card 11 is provided with a fine-tuning mechanism 16 on the side facing the handle 13. The fine-tuning mechanism 16 is slidingly arranged on the sliding ruler 10 in the same direction as the sliding card 11. 19a is the sliding screw end, which is rotated in the sliding card 11 about the screw axis. The sliding card 11 is provided with a clamping plate of the sliding screw end 19a on the side facing the fine-tuning mechanism. The clamping plate is fixed with a small screw. The fine-tuning mechanism 16 is provided with a fine-tuning locking bolt 17b parallel to the locking bolt 17a. The fine-tuning mechanism 16 is provided with a micro screw 19 slidingly connected to the sliding card 11 in a direction parallel to the sliding ruler 10. The micro screw 19 is provided with a micro screw nut 18, and the micro screw nut 18 is arranged in a recess of the fine-tuning mechanism 16.

[0048] The brain lesion puncture positioning frame and positioning ruler are made of stainless steel or titanium, which is conducive to disinfection before surgery.

[0049] A three-dimensional assisted positioning method for a puncture positioning frame for a brain lesion is provided, wherein positioning is performed using the above-mentioned two groups of titanium positioning pieces with multiple different peripheral shapes and the above-mentioned positioning frame puncture positioning frame. The specific steps of positioning and orientation are as follows:

[0050] 1) Using CT, MRI and other medical equipment to find the appropriate puncture location for the lesion 35;

[0051] 2) Figure 9 This is a schematic diagram of placing a positioning sheet on the brain. Before surgery, the patient's head is shaved. The approximate minimally invasive site and puncture direction are determined based on the lesion 35. A set of titanium positioning sheets 30 of various shapes are affixed to the scalp around the minimally invasive site. In the direction of puncture, another set of titanium positioning sheets 30 of various shapes are affixed to the scalp in the opposite direction of the appropriate minimally invasive puncture site through the lesion 35.

[0052] 3) Scanning with CT, MRI, etc. to obtain a three-dimensional image of the brain including multiple titanium positioning films;

[0053] 4) Export the brain image to a dedicated 3D modeling software to reconstruct the scan data and accurately design the puncture path, puncture location, and puncture depth;

[0054] A) Figure 10 It is a schematic diagram of puncture direction and puncture point debugging under 3D software. Figure 11 This is a three-dimensional schematic diagram with a positioning sheet attached in actual application. In the three-dimensional software, the optimal position on the brain lesion 35 is used as the predetermined point to determine the specific puncture location and direction. The puncture point is placed in the center of the positioning hole 31 of a titanium positioning sheet. The puncture direction avoids important organs, nerves, and important arteries, and a certain displacement margin is left around the predetermined point. Figure 10 and Figure 11 There are two different embodiments in the following. Figure 11 The reason why the part floating on the outer side of the head is that the skin part cannot be shown in the 3D photo, only the bones, lesions and other parts can be shown. In fact, the positioning film is attached to the scalp. Figure 11 The positioning in the figure is the puncture direction between the heart-shaped 42 titanium positioning piece 30 and the reminder 48 titanium positioning piece 30;

[0055] B) Extend from the puncture point through the predetermined dot on the lesion 35 to the opposite side of the scalp to determine the corresponding titanium positioning piece; in this embodiment, the puncture direction is set between the heart-shaped 42 and the center hole of the cloud-shaped 40 titanium positioning piece;

[0056] C) Confirm whether the extension line falls into the center hole of the positioning piece on the opposite side. If it does not enter the center position of the positioning piece on the opposite side, draw a line between the positioning holes 31 of the two positioning pieces to confirm:

[0057] (1) The connecting line is within the effective range of the predetermined point through the lesion 35;

[0058] ⑵ To be cautious, confirm that there are no important organs, nerves, or important arteries in the path from the puncture point to the lesion 35;

[0059] 5) Record the puncture point and the shape of the positioning film at the relative point in the surgical preparation record book;

[0060] 6) Before positioning the puncture, use a marker to mark the scalp from the titanium positioning center hole where the puncture point and the relative point are located according to the shape of the positioning piece recorded in the surgical preparation record book, and peel off all titanium positioning pieces stuck on the patient's scalp;

[0061] 7) On the puncture direction side, align the center of the center hole 26 of the positioning ruler 27 with the center of the mark on the scalp on the puncture direction side. Place the multi-directional strips 27a of the flexible positioning ruler 27 close to the scalp, align the orientation mark with the marked direction, and use a fine marker pen to mark different positioning marks on the scalp using the various positioning holes 29 on the positioning ruler.

[0062] 8) Remove the positioning ruler 27 and make a scalp incision on the puncture positioning mark on the puncture side;

[0063] 9) Return the positioning ruler 27 to its original position according to the auxiliary positioning marks and orientation marks of different shapes made on the scalp, and find the center position of the center hole of the positioning ruler 27 at the incision;

[0064] 10) Figure 12 This is a schematic diagram of a brain puncture positioning frame. As needed, pre-install a positioning pin 15b in the arc groove 2 14b on one side of the fixing card 12. As needed, install an adapter 20 of corresponding size in the arc groove 1 14a on the other side of the fixing card. Position the tip of the positioning pin 15b on the fixing card 12 at the corresponding point mark. Slide the sliding card 11 along the sliding ruler 10, aligning the arc groove 14a on the sliding card 11 with the center hole on the positioning ruler 27 at the puncture point on the puncture side. Tighten the locking bolt 17a.

[0065] 11) After positioning is completed, a puncture instrument or drainage tube is inserted along the arc-shaped groove 14a of the positioning frame or the groove of the adapter 20, and a corresponding minimally invasive surgery is performed at the designed depth, that is, first drilling the skull, piercing the dura mater, and slowly puncturing the drainage tube into the predetermined position of the lesion.

[0066] The present invention is provided with a handle 13 at one end of the sliding ruler 10, and a fixed card 12 perpendicular to the sliding ruler 10 is integrally provided at the opposite end. A sliding card 11 is slidably provided on the sliding ruler 10, and the fixed card 12 and the sliding card 11 are arranged relative to each other in the same direction of the sliding ruler 10. Positioning needles are respectively provided at the ends of the sliding card 11 and the fixed card 12. A straight line passing through the brain lesion 35 to the two titanium positioning holes on the surface of the cerebral cortex can be determined in advance in a three-dimensional state as the puncture direction. During actual positioning, the two previously determined titanium positioning holes 31 are first marked, and the needle end of the positioning needle on the fixed card 12 is set on the relative point mark on the periphery of the brain. The annular positioning piece at the end of the moving card 11 is set on the puncture point mark, and the side of the sliding card 11 is used as the puncture starting point. On the basis of positioning or orientation, puncture and treatment are carried out, especially an L-shaped notch 21 is opened on the side of the arc groove 14a on the side of the sliding card 11, and an adapter pin 22 corresponding to the L-shaped notch 21 is set on the periphery of the adapter 20, which is conducive to replacing puncture tools of different diameters and performing surgery along the axial direction of the arc groove 14a or the adapter 20. By setting an annular positioning piece 15a at the end of the puncture positioning fixture on the side of the sliding card 11 facing the fixed card 12, it is conducive to tightening the positioning ruler 27 to ensure safe and accurate puncture. The puncture positioning frame is configured with a positioning ruler 27, which is conducive to finding the center position of the puncture point before and after the incision; by providing a locking bolt 17a on the opposite side of the sliding card 11 where the puncture positioning fixing piece is provided, the sliding card 11 can be locked to prevent the sliding card 11 from sliding and displacement; by designing the arc groove and the adapter 20 into a trough-type arc structure greater than 1 / 2 and less than 3 / 2, the replacement of the adapter 20 can be ensured to meet the insertion requirements of puncture tools of different diameters. The use of the present invention can eliminate the need for designing and printing 3D guides, as well as the need for guide disinfection and printing equipment and raw materials, thereby reducing equipment investment and eliminating the need for guide design and 3D printing under the original three-dimensional modeling. Doctors can be liberated from the design and 3D printing, and their labor intensity can be reduced. The original 2-6 hours of preparation time for three-dimensional design and 3D printing can be shortened to the current 5-10 minutes, greatly shortening the preparation time before surgery. In addition, the positioning and orientation are accurate, and rescue surgery is timely. At the same time, the different effects of surgery performed by different doctors can be avoided, and homogeneous treatment effects can be achieved. The loss of patients' original functions can be reduced, and surgery can be performed in the shortest time, thus gaining precious time to save patients' lives.

Claims

1. A three-dimensional assisted puncture positioning frame for brain lesions, characterized by: The puncture positioning frame includes a sliding ruler, a handle is provided on one end of the sliding ruler, and a fixed card perpendicular to the sliding ruler is integrally provided on the opposite end. A sliding card is slidably provided on the sliding ruler, and the fixed card and the sliding card are arranged relative to each other in the same direction of the sliding ruler. The fixed card and the sliding card are respectively provided with a puncture positioning fixture at the distal end of the sliding ruler. The puncture positioning fixtures on the fixed card and the sliding card are both arc-shaped grooves with openings facing the sliding ruler, and the axes of the arc-shaped grooves are on the same line. A positioning needle is provided in the arc-shaped groove on the fixed card, and a positioning ruler and an adapter are provided in the arc-shaped groove on the sliding card. A central positioning port and a plurality of auxiliary positioning holes are provided on the positioning ruler. The puncture positioning fixture is fixed to the fixed card and the end of the sliding card. The axis of the arc groove is parallel to the long side of the sliding ruler. The adapter matching the arc groove on the sliding card is set in the arc groove. The end of the arc groove on the sliding card opposite to the fixed card is provided with an annular piece positioning piece perpendicular to the axis of the arc groove. The inner circumference of the annular piece positioning piece is consistent with the inner circumference of the arc groove. The annular piece positioning piece is provided with a drainage tube and a positioning ruler separation opening facing the sliding ruler. The positioning ruler includes a central portion, from which at least three strip rulers extend toward the periphery. The positioning rulers include multiple ones, and the central portions of different positioning rulers are respectively provided with central holes that match the inner diameters of the adapters provided on the arc groove or its inner periphery. The central holes are connected with the cross angle of a strip ruler to form a central positioning opening. The strip ruler is provided with multiple auxiliary positioning holes of different shapes, and a directional mark is marked on one direction of the strip ruler.

2. The three-dimensional assisted puncture positioning frame for brain lesions according to claim 1, characterized in that: The fixed card and the sliding card extend vertically to the same side of the sliding card, the length between the fixed card and the sliding card and the sliding ruler is 10-20 cm, the puncture positioning fixture is located on the side of the sliding card away from the sliding ruler, and a locking bolt perpendicular to the sliding ruler is provided on the sliding ruler on the opposite side of the puncture positioning fixture, and the sliding distance between the sliding card and the fixed card on the sliding ruler is 0-40 cm.

3. The three-dimensional assisted puncture positioning frame for brain lesions according to claim 1, characterized in that: The positioning needle includes a needle end and a rod body, and a step is provided on the outer periphery of the rod body. The diameter of the needle end rod body on the side of the step close to the needle end is larger than the diameter of the needle handle rod body on the side away from the needle end. The length of the needle handle rod body of the positioning needle away from the needle end is larger than the length of the needle end rod body on the side close to the needle body. The needle end rod body away from the needle end is arranged on the inner periphery of the arc groove or the arc of the adapter.

4. The three-dimensional assisted puncture positioning frame for brain lesions according to claim 1, characterized in that: The sliding card is provided with a fine-tuning mechanism on the side facing the handle. The fine-tuning mechanism and the sliding card are slidably arranged on the sliding ruler in the same direction. The fine-tuning mechanism is provided with a fine-tuning locking bolt parallel to the locking bolt. The fine-tuning mechanism is provided with a micro-screw slidably connected to the sliding card in a direction parallel to the sliding ruler. The micro-screw is provided with a micro-screw nut, and the micro-screw nut is arranged in a recess of the fine-tuning mechanism.

Images