CN115024832B - A navigation marker implanter for brain tumor surgery - Google Patents

Abstract

The present invention provides a navigation marker implanter for brain tumor surgery, comprising a guide tube; the guide tube comprises an outer sleeve, an implant core and an ejector pin, all of which are slender structures; the implant core is a flexible wire structure and is placed in the outer sleeve; the ejector pin is made of a rigid material; the bottom of the ejector pin abuts against the bottom of the implant core; the implant core and the ejector pin enter the brain tumor boundary together with the outer sleeve during the implantation process, and after being implanted in place, the outer sleeve is pulled out by the ejector pin against the bottom of the implant core, and then the ejector pin is pulled out after being disengaged from the abutment with the bottom of the implant core, and finally the implantation operation of the implant core is realized. It can effectively solve the navigation "drift" problem in brain tumor surgery.

Description

A navigation marker implanter for brain tumor surgery

Technical Field

The invention belongs to the technical field of medical devices, and in particular relates to a navigation marker implanter used for brain tumor surgery.

Background Art

Brain tumor resection refers to the removal of primary or metastatic tumors in brain tissue. The most common are gliomas, especially highly malignant gliomas with pathological grades III-IV, which are extremely life-threatening. The other type is other types of tumors, including metastatic tumors, congenital tumors, lymphomas, arteriovenous malformations, tuberculomas, and tumor-like infectious lesions. This type of brain tumor surgery is difficult, mainly because the tumor often looks similar to the surrounding normal brain tissue under the naked eye, and it is difficult for the surgeon to confirm the tumor boundary. Insufficient resection will result in residual tumors, and excessive resection will damage the surrounding normal brain tissue and there is a risk of serious complications.

In the existing technology, for the resection of brain tumors, in order to more accurately determine the surgical boundaries, the best method is neuronavigation technology. The development of neuronavigation technology has a history of more than 100 years, almost in sync with the development of neurosurgery. The earliest one was the frame navigation system, which nailed a stereotactic frame on the skull, calibrated the spatial coordinates of the frame, and then performed puncture and other operations along the frame to reach the target. Frame navigation is generally suitable for puncture operations and is difficult to apply to tumor resection. Recently, new navigation technologies such as magnetic field navigation and optical navigation have begun to appear. Using optical lenses or magnetic field positioning, a certain spatial position in the skull can be accurately located. In recent years, multimodal imaging technologies such as magnetic resonance, CT, ultrasound, and fluorescence have been integrated with navigation technology to more accurately depict the anatomical structure of brain tissue and improve the quality of navigation. Navigation under a microscope, the navigation mark is placed in the field of view of the microscope, which is convenient for real-time observation of the resection process. The application of surgical robot navigation system and VR/AR imaging has further improved the level of navigation automation.

Although neuronavigation technology has made great progress, there is still no good solution to the huge errors caused by brain tissue drift during surgery. The main causes of brain tissue drift include: the surrounding brain tissue collapses and deforms after the tumor resection volume is reduced; the brain tissue sinks and deforms after the loss of cerebrospinal fluid; the brain tissue atrophies and deforms after dehydration; gravity causes the brain tissue to sink and deform, etc. Neuronavigation determines the anatomical position of the brain tissue that is constantly deforming and drifting during surgery based on the results of preoperative imaging scans, which is bound to be different from the dynamic position of the actual brain tissue. This difference is called image drift (also known as brain drift, Brainshift). Foreign statistics show that the incidence rate is as high as 66%.

Therefore, how to solve the navigation "drift" problem has become a technical problem that people in this field need to solve urgently.

Summary of the invention

In order to solve the above-mentioned technical problem of navigation "drift", the present invention provides a navigation marker implanter for brain tumor surgery.

The inventive object of the present invention is achieved through the following technical scheme: a navigation marker implanter for brain tumor surgery, comprising a guide tube; the guide tube comprises an outer sleeve, an implant core and a ejector pin, all of which are slender structures; the implant core is a flexible wire structure and is placed in the outer sleeve; the ejector pin is made of a rigid material; the bottom of the ejector pin abuts against the bottom of the implant core; the implant core and the ejector pin enter the boundary of the brain tumor together with the outer sleeve during the implantation process, and after being implanted in place, the outer sleeve is pulled out by holding the bottom of the implant core with the ejector pin, and then the ejector pin is pulled out after being separated from the abutment with the bottom of the implant core, thereby finally completing the implantation operation of the implant core.

On the basis of the above technical solution, the present invention can be further improved or optimized as follows.

Furthermore, the outer sleeve includes a hollow section, the bottom is provided with an opening connected to the hollow section, and the side is provided with a side seam penetrating the hollow section along the length direction of the outer sleeve;

The implant core and the ejector pin are both placed in the hollow section of the outer sleeve along the length direction of the outer sleeve;

The top of the ejector pin is provided with a pulling portion and a clamping portion;

The pulling portion is detachably connected to the top of the implant core;

The clamping portion passes through the side seam and is clamped on the outer side wall of the outer sleeve.

Furthermore, the pulling portion has a fork, the top of the implant core is a knotted body or is provided with a stopper, the diameter of the knotted body or the stopper is larger than the opening size of the fork, and the knotted body or the stopper is clamped on the fork.

Furthermore, one end of the clamping portion is fixedly connected to the top of the ejector pin, and the other end is a hook passing through the side seam. A clamping groove or a clamping block adapted to the hook is provided on the side wall of the outer sleeve and above the side seam, and the hook is detachably clamped to the clamping groove or the clamping block.

Furthermore, an abutment block is fixedly connected to the bottom of the implant core, and an abutment groove matching the bottom of the ejector pin is provided on the top of the abutment block. During the implantation process, the bottom of the ejector pin abuts against the abutment groove.

Furthermore, the outer diameter of the abutment block is larger than the diameter of the implant core, and its shape is matched with the opening at the bottom of the outer sleeve, and the abutment block is embedded in the opening and blocks the opening.

Furthermore, the implant core is made of silicone, plastic or nylon and contains a fluorescent agent or dye.

Further, the implanter also includes a manipulator;

One end of the manipulator is a connecting part for connecting to a surgical robot, and the other end is a clamping part for clamping the guide tube.

Further, the clamping portion includes a movable claw, a fixed claw and a sleeve;

One end of the movable claw is rotatably connected to the fixed claw via a pin, and the other end is detachably connected via a screw;

When the movable claw and the fixed claw are closed, the middle part thereof forms a cylindrical cavity which is through from top to bottom and is used to fix the sleeve;

The sleeve is a two-petal structure, which, when buckled together, forms a cylindrical structure with a through hole in the middle, and the diameter of the through hole matches that of the guide tube;

The cylindrical structure is adapted to the cylindrical cavity.

Furthermore, a clamping section is provided on the top of the outer sleeve, and the clamping section is adapted to the through hole. During implantation, the manipulator clamps and fixes the guide tube through the clamping section.

The navigation marker implanter provided by the present invention can be used for brain tumor surgery. In view of the technical problem that the tumor boundary in the current neurosurgery brain tumor surgery is that the tumor boundary collapses during the operation, resulting in the navigation "drift" misalignment, the navigation marker implanter provided by the present invention can implant the implant core, the navigation marker, around the tumor one by one, to form a "fence-type" navigation marker around the tumor boundary, and the fence marks the edge of the tumor. During the operation, this flexible navigation marker is used as the resection boundary marking point for surgical navigation. This navigation marker can drift with the collapse of the brain tissue, and the relative relationship with the tumor and the surrounding normal tissue boundary will not change. At the beginning of the operation, the navigation marker is implanted at multiple points around the tumor boundary according to the preoperative plan with the assistance of traditional navigation technology, especially robot navigation, to form the fence boundary of the tumor. During the operation, as the tumor is gradually removed, the resection cavity expands and gradually approaches the marker fence. Regardless of the deformation of the brain tissue, when the marker of the present invention is observed to emerge from the deeply buried brain tissue during the operation, it means that the resection of this part has reached the boundary of the surgical plan, and the tumor can be accurately removed by following this boundary. The present invention overcomes the intraoperative "drift" defect that is difficult to resolve with traditional neuronavigation imaging technology through the assistance of pure physical structure.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG1 is a schematic structural diagram of a specific embodiment of a navigation marker implanter provided by the present invention;

FIG2 is a schematic diagram of the cross-sectional structure of the guide tube shown in FIG1 ;

FIG3 is a schematic diagram of the enlarged structure of point A shown in FIG2;

FIG4 is a schematic diagram of the enlarged structure of point B shown in FIG2;

FIG5 is a schematic diagram of the disassembled structure of a specific embodiment of the guide tube provided by the present invention in FIG1 ;

FIG6 is a schematic diagram of the three-dimensional structure of another specific embodiment of the navigation marker implanter provided by the present invention;

FIG7 is a schematic diagram of a partial disassembled structure of the specific embodiment shown in FIG6 ;

FIG8 is a schematic diagram of the disassembled structure of the sleeve;

FIG9 is a schematic structural diagram of the specific embodiment shown in FIG6 from another angle;

Among them, the part numbers in the figure are represented as follows:

100. guide tube, 200. manipulator, 1. outer sleeve, 2. implant core, 3. ejector pin, 4. connecting portion, 5. clamping portion, 6. pin shaft, 7. screw, 11. side seam, 12. clamping block, 13. open end, 14. clamping section, 21. stopper, 22. abutment block, 23. abutment groove, 31. pulling portion, 32. clamping portion, 51. movable claw, 52. fixed claw, 53. sleeve.

DETAILED DESCRIPTION

The present invention will be described in detail below with reference to the accompanying drawings and in combination with embodiments. The principles and features of the present invention are described below in combination with the accompanying drawings. It should be noted that the accompanying drawings are only schematic diagrams for illustrating the present invention, rather than real physical projection diagrams; in addition, the embodiments and features in the embodiments of the present application can be combined with each other without conflict. The examples cited are only used to explain the present invention and are not used to limit the scope of the present invention.

Fig. 1 is a schematic structural diagram of a specific embodiment of the navigation marker implanter provided by the present invention; Fig. 2 is a schematic structural diagram of the cross-section of the guide tube shown in Fig. 1; Fig. 3 is an enlarged structural diagram of point A shown in Fig. 2; Fig. 4 is an enlarged structural diagram of point B shown in Fig. 2; Fig. 5 is a schematic structural diagram of a specific embodiment of the guide tube provided by the present invention in Fig. 1 after disassembly; Fig. 6 is a schematic structural diagram of a three-dimensional structure of another specific embodiment of the navigation marker implanter provided by the present invention; Fig. 7 is a schematic structural diagram of a partial disassembly of the specific embodiment shown in Fig. 6; Fig. 8 is a schematic structural diagram of the disassembly of the sleeve; and Fig. 9 is a schematic structural diagram of the specific embodiment shown in Fig. 6 from another angle.

The present invention provides a navigation marker implanter for brain tumor surgery, including a guide tube 100; the guide tube 100 includes an outer sleeve 1, an implant core 2 and an ejector pin 3, all of which are slender structures; the implanter is used to implant the implant cores 2 one by one around the tumor in the human body during surgery, and the overall length of the guide tube 100 can be 15 to 30 cm, and the diameter is within 2 mm, as thin as possible, so as to minimize the incidental brain damage during the implantation process. The implant core 2 is a flexible wire structure and is placed in the outer sleeve 1; the ejector pin 3 is made of a rigid material, which can be a metal material; the bottom of the ejector pin 3 abuts against the bottom of the implant core 2; the implant core 2 and the ejector pin 3 enter together with the outer sleeve 1 during the implantation process, and after being implanted in place, the outer sleeve 1 is pulled out by the ejector pin 3 holding the bottom of the implant core 2, and then the ejector pin 3 is pulled out after being separated from the abutment with the bottom of the implant core 2, and finally the implantation operation of the implant core 2 is realized.

Specifically, the outer sleeve 1 can be made of a rigid material (such as stainless steel, titanium alloy, aluminum alloy and other metal materials) or a flexible material, such as silicone, soft plastic, etc., and the diameter is as thin as possible to reduce incidental brain damage during the puncture process. The outer sleeve 1 includes a hollow section, and an opening 13 connected to the hollow section is provided at the bottom, which is a pointed rounded structure, as shown in Figures 1 and 4. A side seam 11 that penetrates the hollow section is provided along the length direction of the outer sleeve 1; the implant core 2 and the ejector pin 3 are both placed in the hollow section of the outer sleeve 1 along the length direction of the outer sleeve 1; a pulling portion 31 and a clamping portion 32 are provided at the top of the ejector pin 3; the pulling portion 31 is detachably connected to the top of the implant core 2; the clamping portion 32 passes through the side seam 11 and is clamped to the outer wall of the outer sleeve 1. Since the implant core 2 is a flexible silk thread and is relatively soft, this structure can facilitate storage after disinfection, and the outer sleeve 1 can be used to protect it and avoid contamination. Secondly, the pulling portion 31 pulls the top of the implant core 2, and the bottom of the ejector pin 3 abuts against the bottom of the implant core 2, so that the implant core 2 is always in a taut state. During the implantation process, the implant core 2 will not be affected by the wrapping of the outer sleeve 1. If the outer sleeve 1 is a flexible tube, the soft outer sleeve 1 can be kept in a straight state under the support of the rigid ejector pin 3 for overall implantation. After implantation, the clamping portion 32 is disengaged from the clamping connection with the outer sleeve 1, and the clamping portion 32 can be pinched to pull the outer sleeve 1 upward. The clamping portion 32 can remain stable under the guidance of the side seam 11 and finally support the implant core 2 to remain at the desired implantation position. Then, the ejector pin 3 can be gently shaken or rotated, and pulled upward to separate the ejector pin 3 from the implant core 2, and finally the implant core 2 is implanted and retained.

Preferably, the pulling portion 31 can be a horizontal thin sheet, which is integrally formed with the rod body of the ejector pin 3 and has a fork or notch, as shown in Figure 5. The top of the implant core 2 is a knotted body or provided with a stopper 21, and the knotted body is a structure formed by the knotting of the thread, and the diameter of the knotted body or the stopper 21 is larger than the opening size of the fork, and the knotted body or the stopper 21 is clamped on the fork, as shown in Figure 3. This structure is simple and easy to implement, and can stably pull the implant core 2, and is convenient for separating the top of the ejector pin 3 from the top of the implant core 2, and can be done by pinching the top thread of the implant core 2 and gently pulling it to one side.

One end of the clamping part 32 is fixedly connected to the top of the ejector pin 3, and can be integrally formed with the rod body of the ejector pin 3. The other end is a hook that passes through the side seam 11, and can be a thin sheet-shaped structure with a vertical structure. The side wall of the outer sleeve 1 and the upper part of the side seam 11 are provided with a clamping block 12 adapted to the hook, and a clamping groove can also be provided on the outer sleeve 1. The hook is detachably clamped with the clamping groove or the clamping block 12, as shown in Figure 3. The matching connection between the clamping part 32 and the clamping block 12 can ensure that the ejector pin 3 remains stable during the overall implantation without moving up, down, left, and right.

In order to keep the bottom of the ejector pin 3 and the bottom of the implant core 2 stable against each other, the bottom of the implant core 2 is fixedly connected with an abutment block 22, which can be a larger spherical or conical structure, of course, its diameter is larger than the diameter of the implant core 2, and its shape is adapted to the opening 13 at the bottom of the outer sleeve 1, and the abutment block 22 is embedded in the opening 13 and blocks the opening 13, preferably forming a smooth conical shape. The top of the abutment block 22 is provided with an abutment groove 23 adapted to the bottom of the ejector pin 3, and the bottom of the ejector pin 3 abuts in the abutment groove 23 during the implantation process, as shown in FIG4.

In addition, the abutment block 22 is not only used to cooperate with the ejector pin 3 to tighten the implant core 2, but also, when the ejector pin 3 is pulled out after the entire implant is in place, the abutment block 22 can be surrounded by the surrounding tissue, thereby increasing the resistance, which is beneficial to the separation and extraction of the ejector pin 3 from the bottom of the implant core 2.

For the implant core 2, it has a filament-like structure with a diameter not exceeding 1 mm. Through this flexible filament, it can be implanted at the edge of the tumor during brain tumor surgery. It deforms with the collapse and deformation of the brain tissue during the operation, which can ensure the real-time and accurate resection position in the surgical navigation. The length of the implant core 2 is 10cm to 25cm. This length can ensure that after implantation, a part of it is left outside the human body, which is convenient for removal and counting after the operation is completed, and it can also ensure that it will not be left in the body to cause medical accidents. The implant core 2 is made of flexible materials such as silicone, plastic or nylon, and the material stiffness is close to that of brain tissue. After the implant core is retained in the brain, it can be deformed synchronously with the deformation of the brain tissue. The implant core 2 carries a fluorescent agent or dye, and the implant core 2 can be combined with the fluorescent agent or dye by chemical synthesis or physical immersion. The boundary fence display can be enhanced during surgery, which is conducive to clearer distinction and observation by medical staff during surgery.

In clinical surgery, surgical robots can greatly assist doctors in performing various operations and ensure accuracy. Therefore, in order to ensure accurate and stable implantation of navigation markers, the navigation marker implanter provided by the present invention also includes a manipulator 200; one end of the manipulator 200 is a connecting part 4 for connecting to the surgical robot, and the other end is a clamping part 5 for clamping the guide tube 100.

As a preferred embodiment, the clamping part 5 includes a movable claw 51, a fixed claw 52 and a sleeve 53; the movable claw 51 is rotatably connected to the fixed claw 52 at one end by a pin 6, and the other end is detachably connected by a screw 7; when the movable claw 51 and the fixed claw 52 are closed, the middle part thereof forms a cylindrical cavity which is through from top to bottom and is used to fix the sleeve 53; the sleeve 53 is a two-petal structure, and the two petals are buckled to form a cylindrical structure with a through hole in the middle, and the diameter of the through hole is compatible with the guide tube 100; the cylindrical structure is compatible with the cylindrical cavity. A clamping section 14 is provided at the top of the outer sleeve 1, and the clamping section 14 is compatible with the through hole. When implanted, the manipulator 200 clamps and fixes the guide tube 100 through the clamping section 14.

The clamping part is designed in the form of a gripper and a sleeve, which can facilitate the assembly of the guide tube. At the same time, the sleeve is designed as a two-flap structure for easy cleaning. The sleeve can be designed in various specifications to be suitable for various forms of pipe clamping, such as drainage tubes.

In the description of the present invention, it is necessary to understand that the terms "up", "down", "front", "back", "left", "right", "vertical", "horizontal", "top", "bottom", "inside", "outside", "circumferential", etc., indicating the orientation or position relationship are based on the orientation or position relationship shown in the drawings, and are only for the convenience of describing the present invention and simplifying the description, rather than indicating or implying that the device or element referred to must have a specific orientation, be constructed and operated in a specific orientation, and therefore cannot be understood as a limitation on the present invention.

In the present invention, unless otherwise clearly specified and limited, the terms "installed", "connected", "connected", "fixed" and the like should be understood in a broad sense, for example, it can be a fixed connection, a detachable connection, or an integral connection; it can be a mechanical connection or an electrical connection; it can be a direct connection or an indirect connection through an intermediate medium, it can be the internal connection of two elements or the interaction relationship between two elements, unless otherwise clearly defined. For ordinary technicians in this field, the specific meanings of the above terms in the present invention can be understood according to specific circumstances.

In the present invention, unless otherwise clearly specified and limited, a first feature being "above" or "below" a second feature may mean that the first and second features are in direct contact, or the first and second features are in indirect contact through an intermediate medium. Moreover, a first feature being "above", "above" or "above" a second feature may mean that the first feature is directly above or obliquely above the second feature, or simply means that the first feature is higher in level than the second feature. A first feature being "below", "below" or "below" a second feature may mean that the first feature is directly below or obliquely below the second feature, or simply means that the first feature is lower in level than the second feature.

In the description of this specification, the description with reference to the terms "one embodiment", "some embodiments", "example", "specific example", or "some examples" etc. means that the specific features, structures, materials or characteristics described in conjunction with the embodiment or example are included in at least one embodiment or example of the present invention. In this specification, the schematic representations of the above terms do not necessarily refer to the same embodiment or example. Moreover, the specific features, structures, materials or characteristics described may be combined in any one or more embodiments or examples in a suitable manner. In addition, those skilled in the art may combine and combine the different embodiments or examples described in this specification and the features of the different embodiments or examples, without contradiction.

Although the embodiments of the present invention have been shown and described above, it is to be understood that the above embodiments are exemplary and are not to be construed as limitations of the present invention. A person skilled in the art may change, modify, replace and vary the above embodiments within the scope of the present invention.

Claims (6)

1. A navigation marker implanter for brain tumor surgery, characterized in that it includes a guide tube; The guide tube includes an outer sleeve, an implant core and an ejector pin, all of which are elongated structures; The implant core is a flexible wire structure and is placed in the outer sleeve; The ejector pin is made of a rigid material; The bottom of the ejector pin abuts against the bottom of the implant core; The implant core and the ejector pin are inserted together with the outer sleeve during the implantation process. After being implanted in place, the outer sleeve is pulled out by the ejector pin against the bottom of the implant core, and then the ejector pin is pulled out after being separated from the abutment with the bottom of the implant core, thereby finally completing the implantation operation of the implant core. The outer sleeve comprises a hollow section, the bottom is provided with an opening connected to the hollow section, and the side is provided with a side seam penetrating the hollow section along the length direction of the outer sleeve; The implant core and the ejector pin are both placed in the hollow section of the outer sleeve along the length direction of the outer sleeve; The top of the ejector pin is provided with a pulling portion and a clamping portion; The pulling portion is detachably connected to the top of the implant core; The clamping portion passes through the side seam and is clamped to the outer side wall of the outer sleeve; The pulling portion has a fork, the top of the implant core is a knotted body or a stopper, the diameter of the knotted body or the stopper is larger than the opening size of the fork, and the knotted body or the stopper is clamped on the fork; The bottom of the implant core is fixedly connected with an abutment block, the top of which is provided with an abutment groove adapted to the bottom of the ejector pin, and the bottom of the ejector pin abuts against the abutment groove during the implantation process; The outer diameter of the abutment block is larger than the diameter of the implant core, and its shape is matched with the opening at the bottom of the outer sleeve. The abutment block is embedded in the opening and blocks the opening. 2. A navigation marker implanter for brain tumor surgery according to claim 1, characterized in that: One end of the clamping portion is fixedly connected to the top of the ejector pin, and the other end is a hook passing through the side seam. A clamping groove or a clamping block adapted to the hook is provided on the side wall of the outer sleeve and above the side seam, and the hook is detachably clamped to the clamping groove or the clamping block. 3. A navigation marker implanter for brain tumor surgery according to any one of claims 1 to 2, characterized in that: The implant core is made of silicone, plastic or nylon and is provided with a fluorescent agent or dye. 4. A navigation marker implanter for brain tumor surgery according to any one of claims 1 to 2, characterized in that: The implanter also includes a manipulator; One end of the manipulator is a connecting part for connecting to a surgical robot, and the other end is a clamping part for clamping the guide tube. 5. A navigation marker implanter for brain tumor surgery according to claim 4, characterized in that: The clamping part includes a movable claw, a fixed claw and a sleeve; One end of the movable claw is rotatably connected to the fixed claw via a pin, and the other end is detachably connected via a screw; When the movable claw and the fixed claw are closed, the middle part thereof forms a cylindrical cavity which is through from top to bottom and is used to fix the sleeve; The sleeve is a two-petal structure, which, when buckled together, forms a cylindrical structure with a through hole in the middle, and the diameter of the through hole matches that of the guide tube; The cylindrical structure is adapted to the cylindrical cavity. 6. A navigation marker implanter for brain tumor surgery according to claim 5, characterized in that: A clamping section is provided on the top of the outer sleeve, and the clamping section is matched with the through hole. During implantation, the manipulator clamps and fixes the guide tube through the clamping section.