Selector for telemedicine device / afterloading

Abstract

The invention relates to a medical device for delivering and positioning treatment emitting elements into a treatment channel for temporary placement in or on a patient's body for treating a tumor. The treatment emitting elements are connected to a delivery element and are driven by at least one drive motor. The device has a connection element comprising a plurality of connector openings. The connection element is for connecting a delivery tube to a respective connector opening. The delivery tube is connected to an applicator, needle, tube or catheter for driving the delivery element into the treatment channel. The device has a selector mechanism by which a plurality of delivery elements are driven. A ring-shaped guide device guides the delivery elements into the connector openings in the connection element. The ring-shaped guide device further comprises a plurality of spaced apart outlets. A plurality of patterns of inlets are connected to the outlets respectively by a guide channel. Each outlet is aligned with a connector opening in the connection element to allow a delivery element from each outlet to be driven into the connector opening.

Description

Technical Field

[0001] The present invention belongs to the field of medical treatment. In particular, the present invention belongs to the field of treating tumors. Background Art

[0002] Brachytherapy is a form of radiation therapy that uses at least one radioactive capsule (sealed source) or X-ray source that is temporarily inserted into or onto the patient's body near or inside a tumor. In this way, radiation damage to healthy tissue can be reduced compared to external radiation therapy and may result in more effective treatment.

[0003] In US20050261539 a brachytherapy device, commonly referred to as a brachytherapy afterloader, is described with a radioactive source temporarily placed in the patient's body. The radioactive source is delivered from a shielded safe through a (at least partially) flexible delivery element (e.g. wire, cord, composite structure, tube). The delivery element is driven by a motor through a switch (selector mechanism) along a delivery tube to an applicator. The applicator can connect a hollow needle with the delivery tube that receives the delivery element (including the capsule) into the patient's body. In a similar way, abnormal tissue can be treated or ablated by using a delivery element with another type of treatment emitting element in the distal region, such as a laser or optical fiber for laser ablation or targeted light therapy, or other elements for focused ultrasound, HIFU, thermotherapy, etc. In addition to the delivery element with the emitting element for the treatment application, one or more other delivery elements are usually sent before or during the treatment to ensure the treatment proceeds smoothly (e.g. dummy source cable, electromagnetic tracking sensor cable, in-vivo dosimetry cable, optical sensor cable, inductive sensor cable, etc.). The switch is able to accommodate multiple delivery elements with multiple motors. The rotatable part of the switch can switch the delivery elements between different delivery tubes by carrying the coupling elements containing the delivery elements to the delivery tubes. The main function of this switch is to ensure that all the applied delivery elements can be sent into any desired delivery tube so that the entire treatment can be performed safely and as quickly as possible. However, this switch seems to be limited in the availability of delivery tubes that can be switched to due to the blocking of the path to some delivery tubes by adjacent delivery wires. In addition, the support arm prevents the switch from rotating a full circle. The blocking of the path of some delivery elements to move to other delivery tubes by adjacent coupling elements and delivery elements means that adjacent coupling elements and feeding elements need to be retracted and displaced before the particular coupling element and delivery element can be moved. The displacement and repositioning of adjacent coupling elements can be a time-consuming operation that can delay or affect the treatment. In the case of three drive motors and three elements, there is also the danger of a collision coupling element between the support arm and two adjacent coupling elements, which can more than double the delay. Another possible disadvantage is the obscuring nature of the switch, i.e. it can be difficult to detect that the coupling element has successfully connected with the correct delivery tube and that the delivery tube connector is installed by the device operator in the correct switch opening and deep enough in the switch before the connector locking mechanism in the switch is activated and the delivery unit is sent out. Early detection of errors in the delivery tube installation or switching operation can prevent jams or delays during the treatment or, in the worst case, can prevent the delivery of the treatment emitting element to the incorrect location or not at all. SUMMARY

[0004] The present invention addresses or ameliorates at least one disadvantage of the prior art by providing a device for remotely delivering and positioning at least one delivery element containing a therapeutic emission element into at least one applicator, needle, tube, or catheter for temporary placement in or on a patient's body. The device comprises a plurality of delivery elements, wherein the therapeutic emission element is located distally or adjacent to the plurality of delivery elements; the plurality of delivery elements are movable by at least one drive motor. The device also comprises a connecting element comprising a plurality of connector openings. The connecting element is configured to connect a delivery tube connector to the corresponding connector openings. The delivery tube is connected to a treatment channel, such as an applicator, needle, tube, or catheter, and is configured to drive the delivery element through the connector opening and the delivery tube to the intended treatment area. The device comprises a selector mechanism (switch) that drives the plurality of delivery elements. The selector mechanism comprises a plurality of independently displaceable selector channels. Each selector channel corresponds to one of the delivery elements, enabling multiple delivery elements to be driven through the selector channels. The selector channels then guide the plurality of delivery elements into the treatment channel, which is connected to the connecting element.

[0005] The apparatus also includes a guide mechanism for guiding a plurality of conveyor elements into corresponding connector openings in the connecting element. The guide mechanism includes a plurality of inlets on a front surface of the annular guide mechanism facing away from the connecting element. The guide mechanism also includes a plurality of spaced-apart outlets on a rear surface thereof facing the connecting element. Each outlet is connected to a corresponding connector opening in the connecting plate, allowing a conveyor element from each outlet to be driven into the connector opening. The outlets of the guide mechanism are each connected to one or more inlets in the guide mechanism via guide channels formed in the guide mechanism.

[0006] In another aspect, a device is provided for delivering and positioning at least one transmitting element for therapeutic application into at least one treatment channel for temporary placement in or on a patient's body, the device comprising at least one delivery element; the transmitting element being located in a distal region of the delivery element and being slidable by at least one drive motor; and a connecting element comprising a plurality of connector openings for connecting a delivery tube to corresponding connector openings, the delivery tube being connectable to the treatment channel, the connecting element being configured to drive the delivery element through the connector openings and the delivery tube to the treatment channel. A selector mechanism is provided through which the delivery element is driven, the selector mechanism comprising a selector channel; the selector channel corresponding to the delivery element; the delivery element being driven through the selector channel for guiding the delivery element into the connecting element; and a detector being positioned near the center of the connecting element for detecting the position of the delivery tube and / or the selector channel. The central position of the detector facilitates providing an omnidirectional view for individually evaluating connections in the connector element. BRIEF DESCRIPTION OF THE DRAWINGS

[0007] Figure 1 An exploded view of an embodiment of the present invention is shown.

[0008] Figure 2 An embodiment of the invention is shown with an annular guide.

[0009] Figure 3 A partial view of an embodiment of the invention with an annular guide is shown.

[0010] Figure 4 A cross-sectional view illustrating an embodiment of the present invention is shown.

[0011] Figure 5 Another cross-sectional view of an embodiment of the present invention is shown.

[0012] Figure 6 Another cross-sectional view of an embodiment of the present invention is shown.

[0013] Figure 7 Another cross-sectional view of an embodiment of the present invention is shown with a light source.

[0014] Figure 8 An isometric view of an embodiment of the present invention is shown.

[0015] Figure 9 A framework view of an embodiment of the present invention is shown.

[0016] Figure 10 A cross-sectional view illustrating an embodiment of the present invention is shown.

[0017] Figure 11An isometric view of an embodiment of the present invention is shown.

[0018] 12(A, B) show isometric views of an embodiment of the present invention.

[0019] Figure 13 Another embodiment of the present invention is shown. DETAILED DESCRIPTION

[0020] The present invention provides an apparatus for delivering and positioning at least one therapeutic emitting element, such as a capsule 1, in which a radiation source is located. The capsule can contain a radiation source as is known in the art of brachytherapy, and by attaching the capsule to a delivery element, such as a wire, the radiation source can be delivered by winding the delivery wire in or out.

[0021] exist Figure 1 , an embodiment of the present invention is shown with a capsule 1 that can be transported from a shielded safe 2 to at least one treatment channel (e.g., a source guide channel of a needle, catheter, tube, or applicator) for temporary placement in or on a patient's body. The device is provided with at least one treatment emitting element (e.g., a radiation capsule 1) and a plurality of delivery wires 4. The capsule 1 can be connected to one end of one of the delivery wires 4, and the plurality of delivery wires 4 can slide when one of the drive motors 10 drives the associated delivery wire 4. The device can be equipped with a safe 2 for storing the radiation capsule 1, and can be provided with an outlet for placing the radiation capsule 1 into and taking it out of the safe 2 when the delivery wire 4 is driven. While storing the radiation source, the safe prevents radiation from the radiation source inside the safe from causing radioactive damage to unexpected objects or people or even patients outside the safe.

[0022] In addition, the connecting element (e.g., plate) 5 of the device is shown as having a plurality of connector openings 6. Each connector opening 6 can be connected to a connector attached to a delivery tube 8 and one or more delivery tubes connected to an applicator 9, so that the delivery wire 4 can be driven through the connector opening 6 and the delivery tube 8 to the desired treatment channel. Typically, the applicator has multiple treatment channels to ensure appropriate dose distribution to the tumor or target location within the patient's body.

[0023] The apparatus has a selector mechanism 11 through which a plurality of transport wires 4 are driven. The selector mechanism 11 maintains a plurality of selector channels 9 (e.g., 9.1, 9.2, and 9.3), each of which corresponds to one of the transport wires 4. The transport wires 4 can be driven through the selector channels 9.1, 9.2, and 9.3, thereby guiding the transport wires 4 into the connector plate 5. By entering the connector plate 5, the driven transport wires 4 can enter the transport tube 8, which leads to the processing channel.

[0024] exist Figure 2 , an embodiment of the present invention is shown with a guide device 20 that guides multiple conveyor wires 4 into corresponding connector openings 6 and into a connecting element, such as a plate 5. Although the guide device 20 is annular in shape, other guide devices, such as rectangular, can also be used in conjunction with the connecting element. Furthermore, the guide device can preferably be static relative to the connector plate, but can also be designed to be movable, such as a selector channel. In this case, the guide device includes multiple guide elements or blocks that move along the selector channel.

[0025] The guide device 20 includes a plurality of inlets 21 spaced apart in a plurality of patterns 21.1, 21.2, 21.3 along the periphery of the front surface of the guide device 20 facing away from the connecting plate 5. By forming a concentric pattern of inlets 21, a particular pattern of inlets can be dedicated to receiving a delivery wire from one selector channel, although this is not necessary for the present invention, for example a linear arrangement of inlets is also possible. Each pattern 21 has a different radius along the front surface from the central axis of the guide device 20 to match the corresponding selector channel. In this way, the selector channel can be moved to any position without being blocked by another selector channel, which reduces the post-loading time required to perform the treatment. The front surface of the guide device 20 can also be shaped so that the front surface is perpendicular to each guide channel at the location of each inlet. Guide channel (see Figure 3 )'s entrance 21 may also be opened to form a larger opening to allow the conveying wire 4 to enter and thereby reduce the likelihood of the conveying wire 4 getting stuck during the transition from one part of the present invention to another.

[0026] exist Figure 3 , further shown is a portion of an embodiment of the present invention with a guide device 20 having a plurality of spaced-apart outlets 30 in the rear surface facing the connection plate 5. The outlets 30 (at Figure 2 ) are each connected to more than one corresponding inlet 21 by a guide channel 31, which branches the outlet to a plurality of inlets formed in the guide device 20. Each outlet 30 is aligned with a corresponding connector opening 6 in the connecting plate 5 to allow the conveying wire 4 fed through each outlet 30 to be driven into the connector opening 6. The guide device 20, the outlet 30 and the selector mechanism may preferably be radially spaced apart, (partially) have openings or are made of transparent material, and / or concentric chamfers to facilitate tracking the contents of the guide channel 31 or reduce manufacturing costs.

[0027] The selector channel 9 of the selector mechanism 11 (at Figure 1 ) are arranged to rotate independently of each other about a central axis to follow a plurality of spaced apart selector rings or inlets 21 (in Figure 2 The purpose of the guide is to allow all delivery wires the option of gaining access to a particular delivery tube so that once any wire 4 in a delivery tube 8 has been retracted out of the guide 20, the outlet of the guide is effectively shared between the different delivery wires.

[0028] exist Figure 4 , a cross-sectional view of an embodiment of the present invention is shown in which the guide device 20 has at least one viewing port 50 located in an inner surface 52 centered to the guide device 20. The contents of at least one guide channel 31 are visible to the optical detector 42 through the corresponding viewing port 50. The viewing port 50 serves as a means of detecting the presence of the delivery wire 4 or detecting the distal-most position of the delivery wire, therapeutic emission element, or capsule, and may also serve as a means of identifying or checking that the correct delivery wire or radiation source has been loaded. The viewing port 50 may further assist in detecting the presence of the delivery wire, therapeutic emission element, or capsule 1 (at Figure 1 In one embodiment, such an optical detector device may be provided without a guide device; for example, by monitoring the connector opening with an omnidirectional camera.

[0029] exist Figure 5, an embodiment of the present invention is shown having corresponding connector openings 6 already receiving connectors 7 in properly installed recessed positions 41, which are appropriately aligned and proximate to outlet 30. The connectors 7 are marked with one or more markings 43 that are visible to an optical detector 42 when the connectors 7 are in the recessed position 41. These markings 43 can be geometric circular engravings, patterns, letters, or numbers, but can also be any other distinguishable markings or coatings that can be used to verify the correct (recessed) positioning of the connectors, or to identify or verify the desired position of the connectors 7 and, therefore, the position for processing. For example, by virtue of the correct geometry of the chamfers 44, when the connectors 7 protrude through the connector plate 5 into the recessed positions 41, a line of sight is provided between the identification markings 43 of the corresponding connectors 7 and an optical detector 42 arranged in the center of the guide 20, such that the detector 42 is arranged near the center of the guide to detect the position of at least one of the selector channel and the connector opening, for example, from a central position, such as along the central axis of the selector mechanism 11, substantially omnidirectionally, thereby enabling a reduction in the number of detectors. Once the connector 7 protrudes into the recess, the purpose of being able to quickly verify or identify the connector 7 is primarily to verify the position of the connector insertion, verify whether the connector is inserted deep enough, and identify the type of connector inserted. This is to ensure that the connectors 7 are correctly positioned before they are locked, without locking jams, that the delivery wire 4 is driven into the intended delivery tube, and that the delivery tube is able to accommodate the driven delivery wire 4, without the wire wobbling or deflecting through the gap due to improper placement of the connector 7. Optionally, the guide device 20 can be formed with a chamfer 44 or an opening along the inner edge of the guide device 20 closest to the connection plate 5 so that the line of sight between the optical detector 42 and at least one of the corresponding connector 7 and / or connector opening 6 is not obstructed by the guide device 20. Special optical lenses can also be used or one or more reflectors 45.1, 45.2 can be arranged along the center of the guide device 20 to reflect an image of the contents of at least one guide channel 31 and / or the corresponding marking 43 of the connector 7 to the center of the guide device 20. In this way, the optical detector can detect the contents of the guide channel 31 and the marking 43 on the connector 7 and / or the connector opening without using multiple detectors, because the images of the contents and the marking 43 are reflected along the center of the guide device 20. The reflectors 45.1, 45.2 may also be prisms or refractors and fiber optic connectors or other known devices to produce a redirected line of sight. A slightly different embodiment is, for example Figures 3 to 6As shown, the sensor (and any optical device, if necessary) is installed in an opposite manner (that is, away from the plate 5 to see / look more downward), and a wide-angle lens is used to prevent the detection problem caused by the accumulation of dust at the detector or optical element. It is also possible to optionally provide at least one light source or use an optical filter for the selector to improve the detectability of the connector, transmission wire or capsule by, for example, enhancing contrast. For example, this can be a light source irradiated towards the area to be detected (so that the sensor can detect the reflection) or a light source irradiated towards the sensor from behind the area to be detected. For example, an embodiment can be at least one observation port 50 with a light source 60, which irradiates the guide channel 31, the connector 7 and the optical detector 42. The light source 60 can also be any other radiator compatible with the optical detector 42, such as an infrared light source. The optical detector 42 can be any other detector or detector assembly, which can detect the existence, position, identification, movement or quality of the transmission wire 4 and the connector 7 at a distance, such as an infrared sensor, an optical sensor, an imaging sensor (such as CMOS, CCD), a photodiode, an optoelectronic integrated circuit, a PSD or a camera, no matter whether with additional software or machine vision algorithms. Optical detectors 42 may also be used to detect or verify the position of each ring or selector channel relative to the entry location 21, see sight lines 200.1, 200.2, 200.3.

[0030] exist Figure 6 , another embodiment of the present invention is shown in which the geometry of the viewing port 70 is such that at least part of the opening is used to deflect light towards the center of the guide device 20 which may contain the optical detector 42. The viewing port 70 has a reflective surface which reflects an image of the contents of at least one guide channel 31 to the optical detector 42. For example, by opening the viewing port 70, a wider range of positions of the optical detector 42 is possible because it increases the number of positions where all viewing ports 70 are visible. When the optical detector 42 is additionally used to detect other criteria, such as the marking 43 on the connector 7 (in Figure 4 This may also be useful when .

[0031] exist Figure 7 , another embodiment of the present invention is shown in which the guiding means 20 is transparent (whether partially or completely) to allow light 80 to pass through the guiding means 20 and make the contents of the corresponding guiding channels 31 visible to the optical detector 42. By making (some parts of) the guiding means 20 from a transparent material, the entire length of all guiding channels 31 can be visible to the optical detector 42.

[0032] exist Figure 8, an embodiment of the invention is shown in FIG, wherein the guide means 20 is formed by guide blocks 90 spaced apart along the periphery. The respective guide blocks 90 contain guide channels 31 which connect the outlets 30 ( Figure 3 ) and corresponding inlets 21.1, 21.2, 21.3 ( Figure 2 ). The guide block 90 is further framed by a guide block frame 91 fixed to the selector frame 11. The guide block 20 can be of any shape and is not limited to a cubic or rectangular shape. The frame is any component capable of holding the guide block 20 in place.

[0033] One embodiment is to make the guide block 20 from divisible parts, so that the guide channel 31 of the desired shape can be produced better and more cheaply.

[0034] exist Figure 9 , another embodiment is shown in FIG, which uses guide blocks 90 to establish guide channel 31 by using the outer surface of guide block 90 as a separate portion of guide channel 31. Thus, when the guide blocks are placed against or near each other, the portions of guide channel 31 contained in the respective guide blocks 90 work together to form guide channel 31. This also facilitates cleaning of guide channel 31 if necessary. Furthermore, it may be helpful during maintenance, repair, or upgrades if a guide block 20 becomes damaged or needs to be replaced due to wear in the guide channel 31. Guide channel 31 can also be formed by two or more guide blocks 20 in series, such that the guide channel 31 in each block 20 is aligned with each subsequent guide block channel 31.

[0035] exist Figure 10 , an embodiment of the present invention is shown having a selector mechanism 11 which also has a selector frame 110 with a groove 111. The groove 111 is used to slidably accommodate a plurality of rotating selector elements, such as concentric rings 112. The concentric rings 112 are collectively driven by at least one drive actuator (in Figure 11 1, one motor per ring is shown as an example), and each selector channel 9 is attached to a corresponding ring 112. Each ring 112 has a radius corresponding to one of a plurality of patterns of spaced inlets 21, so that by rotating the ring 112 in the groove 111, the selector channel 9 can be aligned with the spaced inlets 21. The alignment of the selector channel 9 with the inlets 21 creates a unique path. Along this path, the conveying wire 4 ( Figure 1 ) can then be transported via the delivery tube 8 ( Figure 1 ) and the applicators 9 ( Figure 1) to a position in the patient's body. The grooves 111 may be other means for constraining the rings 112.1, 112.2, 112.3 to rotate in a desired pattern, such as rollers or magnetic tracks, or even guide rails, which may or may not be part of the selector frame 11.

[0036] Embodiments are possible with one or more rings, or geometries that are not completely closed around, or in which each ring is driven individually, and in which the rings form part of a drive system.

[0037] exist Figure 11 , a partial view of an embodiment of the present invention is shown in which the drive actuator 120 can be one or more rotatable actuators having corresponding rotational shafts 121 having running surfaces (not shown, such as gears) that drive at least one ring 112 by rotating the running surfaces of the actuator or shaft against the drive surfaces 122 of the ring 112.

[0038] In FIG12 , a partial view of the guide device 20 of the present invention is shown, wherein the driven ring 112 has a portion of an integrated Geneva wheel and the actuator is a small pin ( Figure 12B ) rotating disk.

[0039] Other means for driving the rings 112 are possible and may include concentric rings 112 driven by magnetic actuators or belt drives.

[0040] Figure 13 An embodiment is shown in which one or more moving optical detectors or optical components are used instead of a stationary central optical detector, which further improves the detectability of components when needed. For example, this could be a centrally located rotating detector or lens assembly (including actuator) 42.2, or a small optical reflectivity sensor 300.2 mounted on one of the slave selector rings via a light pad 300.1.

Claims

1. An apparatus for delivering and positioning at least one emitting element for therapeutic applications into at least one treatment channel for temporary placement in or on a patient's body, the apparatus comprising: multiple conveying elements; The transmitting element is in a distal region of one of the plurality of delivery elements, and the plurality of delivery elements are slidable by at least one drive motor; a connecting element comprising a plurality of connector openings, the connecting element being used to connect a delivery tube to corresponding connector openings, the delivery tube being connectable to a processing channel, and being used to drive the delivery element through the connector openings and the delivery tube to the processing channel; a selector mechanism, wherein the plurality of conveying elements are driven by the selector mechanism, the selector mechanism comprising a plurality of independently displaceable selector channels; wherein each selector channel corresponds to one of the plurality of conveying elements; wherein the plurality of conveying elements are driven through the selector channels to guide the plurality of conveying elements into the connecting element; wherein the apparatus is provided with a guiding device for guiding the plurality of conveying elements into corresponding connector openings in the connecting element; wherein the guide means comprises a plurality of spaced-apart outlets in a rear surface thereof facing the connecting element; wherein the outlets are aligned with a connector opening in the connecting element to allow a delivery element from the outlets to be driven into the connector opening; wherein the guide device comprises a plurality of inlets in a front surface of the guide device facing away from the connecting element, the plurality of inlets allowing the conveying elements from the corresponding selector channels to be driven into the corresponding inlets; The outlets of the guide device are each connected to one or more inlets of the guide device through a guide channel formed in the guide device.

2. The device according to claim 1, characterized in that The plurality of inlets in the guide arrangement are spaced apart in a plurality of concentric patterns; and wherein the selector channels of the selector mechanism are arranged to pivot independently of one another about a central axis to follow the plurality of inlets.

3. The device according to any one of the preceding claims, characterized in that The corresponding connector opening receives the corresponding connector in a recessed position; wherein the corresponding connector includes markings; wherein, when protruding into the recessed position, the recessed position provides a line of sight between the markings of the corresponding connector, and a detector arranged near the center of the annular guide device or connected to the rotating element.

4. The device according to claim 3, characterized in that The annular guide device includes at least one viewing port disposed in an inner surface centered to the annular guide device; wherein the contents of at least one guide channel are visible to the detector through the at least one viewing port.

5. The device according to claim 1, characterized in that Also included is at least one light source or filter to enhance detectability of the connector, delivery element, therapy emission element, capsule, rotary selector element, selector channel, or a component attached to one of the rotary selector element or selector channel.

6. The device according to claim 4, characterized in that A surface of the viewing port is a reflective surface that reflects an image of at least a portion of the contents of at least one guide channel to the detector.

7. The device according to claim 3, characterized in that At least part of the annular guide is transparent to allow light to pass through the annular guide and make the contents of the corresponding guide channel visible to the detector.

8. The device according to claim 3, characterized in that The annular guide device includes several guide blocks arranged in a circle; wherein, the corresponding guide block includes the guide channel and at least one of the outlets and the corresponding inlet connected thereto; wherein, the guide blocks are framed by a guide block frame fixed to the selector frame.

9. The device according to claim 7, characterized in that The guide channel is formed by a guide block made of more than one component.

10. The device according to claim 1, characterized in that The selector mechanism includes a selector frame having a groove that can slidably accommodate at least two rotating selector elements driven by a drive actuator; wherein each selector channel is attached to a corresponding rotating selector element; wherein each rotating selector element has a radius corresponding to one of a plurality of patterns of concentrically spaced inlets.

11. The device according to claim 10, characterized in that The drive actuator comprises a rotary actuator including a rotary element that drives at least one of the rotary selector elements by rotating the rotary element against a drive surface of the rotary selector element.

12. The device according to claim 3, characterized in that The detector is arranged to detect a position of at least one of the selector channel, the rotary selector element or any component attached to one of the selector channel or the rotary selector element.

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