JP2584203Y2 - Needle holder for stereotaxic surgery device - Google Patents

Description

[Detailed description of the invention]

[0001]

BACKGROUND OF THE INVENTION The present invention relates to a fixing device for fixing a patient's head, which is mounted on a holder receiver movably provided in an arc shape with an affected part in the head as a virtual center point. The present invention relates to a needle holder for a stereotactic brain surgery apparatus that holds a treatment needle so as to be directed toward a patient.

[0002]

2. Description of the Related Art Conventionally, CT (Computed tomograrhy
) Induced stereotactic brain surgery, brain hematoma aspiration, in many diseases such as cerebral tumor biopsies, are widely used as an effective treatment. In this case, as is well known, the patient's head is fixed with a fixing device, a brain tomographic image is taken by X-ray CT, the affected part is measured, and a hole is made in a portion corresponding to the affected part in the skull,
A treatment needle is inserted through the hole to treat the affected part.

FIGS. 11 and 12 show a conventional stereotaxic apparatus. The frame-shaped fixing device 1 is provided with a fixing member 2 for fixing a patient's head (cranium). A movable frame 3 is attached to the fixed device 1. The movable frame 3 is provided with a rail member 4 having an arc-shaped groove 4a having an affected part in the head as a virtual center point K in an arrow X direction. Is provided so as to be movable.

[0004] The rail member 4 is provided with a holder receiver 5 movably along the groove 4a. The holder receiver 5 is provided with a treatment needle 6. The movable frame 3 is movable in the front-rear direction (arrow Z direction) and the vertical direction (arrow Y direction), and is rotatable about the marker 7 in the arrow P direction.

[0005] When treating the affected part, as shown in Fig. 12, the marker 7 is aligned with the side position of the affected part, and the center of the rail member 4 is aligned with the front position of the affected part.

[0006] Then, an angle adjustment is performed to insert the needle 6 into the affected part through a surgical hole pre-drilled in the skull. That is, the movable frame 3 is rotated by a predetermined angle in the direction of the arrow P, and the holder receiver 5 is rotated by a predetermined angle along the groove 4a. Thereafter, the affected area is operated on with the needle 6. In this case, the needle 6 can move by 30 ° from the center L (see FIG. 11) of the rail member 4 to both sides.

[0007]

[Problems to be solved by the invention] By the way,
A system in which the needle is directed from the top of the head to the affected area is generally used. Therefore, it is sufficient even if the movable range of the needle 6 is 30 ° from the center to both sides. However, recently, there has been a gradual increase in surgery in which the needle is directed from the temporal or occipital region to the affected area. In addition, as shown in FIG. 13, in consideration of the fact that this kind of surgical apparatus is used by being attached to a CT gantry 8 of a CT scanner, the current surgical apparatus may not be able to cope with this.

That is, as shown in FIG. 13, even if it is desired to rotate the needle 6 to the temporal region of the head, as described above, the holder receiver 5 is moved from the center to both sides within an angle range of 30 °. For this reason, the needle 6 cannot be moved to a required angular position.

Here, for example, it is conceivable to increase the arc length of the rail member 4 to increase the movable range of the needle 6. In this case, the proximal end 6a of the needle 6 is connected to the CT.
There was a problem that the needle 6 could not move to the required angular position because of contact with the gantry 8. Incidentally, while the diameter of the CT gantry 8 is 650 mm, the basic distance from the proximal end 6a of the needle 6 to the virtual center point is 240 mm (however, there is a slight adjustment distance in the centrifugal direction and the centripetal direction) mm. When the affected part is displaced from the center of the CT gantry 8, the proximal end 6a of the needle 6 comes into contact with the CT gantry 8.

Incidentally, in the prior art, the reason why the basic distance from the base end 6a of the needle 6 to the virtual center point K is 240 mm is that the holder receiver 5 is replaced with a skull drill. The above 240 mm was necessary in consideration of operability such as attachment and detachment.

However, recently, drilling with a drill has become possible with another device.
Dimensions are becoming less supportive.

When treating the affected part with the treatment needle 6, the holder receiver 5 is substantially the same as the rail member 4 when the tip of the needle 6 is visually observed or when the head is cleaned and disinfected. Since the rail member 4 is at the height position, the rail member 4 may be in the way.

[0013] Here, if a new surgical device is developed in consideration of the above-mentioned problems , the development cost and the product cost itself increase, and there is a problem that the existing surgical device cannot be used.

The present invention has been made in view of the above circumstances, and an object of the present invention is to prevent a therapeutic needle from coming into contact with a CT gantry and to extend the movable range thereof, thereby enabling the treatment needle to be moved from the temporal and occipital regions. It is an object of the present invention to provide a needle holder for a stereotactic brain surgery apparatus that enables stereotaxic surgery, improves surgical workability and visibility, and can be applied to an existing surgery apparatus to reduce an economic burden.

[0015]

SUMMARY OF THE INVENTION A needle holder for a stereotactic brain surgery apparatus according to the present invention includes a fixing device for fixing a patient's head, and a circular member having a diseased part in the head as a virtual center point on a rail member of the fixing device. Used in a stereotactic brain surgery apparatus provided with a holder receiver movably provided in an arc shape, and in a needle holder for a stereotactic brain surgery apparatus that holds a treatment needle so as to be directed to the virtual center point, A fixed base to be fixed, and the fixed base is provided so as to be rotatable about an axis extending in the direction of the virtual center point as a center of rotation, and a tip portion is deviated from the movement locus of the holder receiver toward the virtual center point. An arm portion, and a needle fixing portion provided at a distal end portion of the arm portion and fixing the treatment needle so as to be directed to the virtual center point.
Provided on one of said fixed base and said arm portion
A detent member having a size that protrudes outward from the outer surface of the fixing base, and a detent fixing provided on the other of the fixing base and the arm to fix the detent member at a rotation angle position Means.

[0016]

In the above-mentioned needle holder for the stereotactic brain surgery apparatus, the arm portion is provided with respect to the fixed base attached to the fixing device.
Since it is provided so as to be rotatable about the axis extending in the direction of the virtual center point as the center of rotation, if this arm is rotated left or right as viewed from the front, the needle fixing portion will be the length of this arm. Is wider than the movable range of the holder receiver.

In addition, since the arm portion rotates about the holder holder of the rail member, the distal end side of the arm portion, that is, the treatment needle side is separated from the rail member depending on the rotation angle, and the operability and visibility are improved. .

Further, since the needle fixing portion is shifted toward the virtual center point side from the movement locus of the holder receiver, the distance between the needle fixing portion and the virtual center point is shortened, and as a result, the needle fixing portion is fixed to the needle fixing portion. In addition, the base side of the treatment needle does not come into contact with the CT gantry.

Further, since the detent member extends to one of the fixed base and the arm portion, the detent point with the detent fixing means is the rotation center of the arm portion. The span from the fixed base is longer, and the fixed torque with respect to the turning moment of the arm is improved. That is,
When the rotation of the arm is stopped at the center of rotation of the arm,
Although the span is short and the fixing torque is small, according to this means, the fixing torque is large and the rotation of the arm portion can be reliably stopped and the load resistance can be improved.

[0020]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS A first embodiment of the present invention will be described below with reference to FIGS.

FIG. 2 shows the configuration of the stereotaxic apparatus. The fixing device 11 is configured by attaching four (only one of them is shown) a head fixing arm 13 and the like to a frame-shaped fixing frame 12. The fixing member 11 includes a support member 1.
The movable frame 15 is attached via the four and fourteen.

The movable frame 15 can be moved in the direction of arrow Y by the vertical movement of the support member 14.
4 can also be moved in the Z direction using the guide L4 as a guide, and the arrow P with the line L16 connecting the markers 16, ₁₆ as the center line.
It can also rotate in the direction. A rail member 17 is provided on the movable frame 15 so as to be movable in the direction of the arrow X. The rail member 17 has an arc-shaped groove 18 formed therein. The radius of the circular arc of the groove 18 is set such that the affected part in the patient's head is the virtual center point K. The virtual center point K is resides on the line L _16, also, the groove 18 is 30 ° to the right and left about its center L _18, are formed in an angular range of 30 °.

The rail member 17 has a holder receiver 19.
Are provided so as to be rotatable along the groove portion 18, and the holder receiver 19 is configured as shown in FIG. That is, the lower surface of the receiving body 20 is
The receiving main body 20 is provided with fixing screws 21 and 21 for fixing the position after the receiving body 20 is moved.

Further, a mounting boss portion 22 is formed in the receiving main body 20, and a holder mounting hole 23 is formed in the mounting boss portion 22 so that the axis S is directed to the virtual center point K. And a peephole 24 is formed. A marker 25 is formed in the peephole 24. Further, a pin 26 for holding the holder, whose upper end protrudes into the holder mounting hole 23, is fixed to a lower portion of the mounting boss portion 22, and a fixing screw 20a is provided at the upper portion.

A needle holder 27 according to the present invention is attached to the holder receiver 19, and the needle holder 27 is configured as shown in FIGS.

That is, the fixing base 28 is inserted through the holder mounting hole 23 and has a solid shaft shape. The outer surface of the fixing base 28 extends in the axial direction along with the holder locking pin 26.
A key groove 29 is formed so as to fit with the marker, and a marker 30 is engraved around the outer surface. 1 and 2, an arm 34 described later is attached to the fixed base 28.
Shows a state rotated 90 degrees to the left, and FIGS. 4 and 6 show a state in which the arm portion 34 is at the neutral position.

At the right end of the fixed base 28 shown in FIGS. 4 and 5, a shaft 31 having a small diameter is integrally formed.
At the base end of the shaft portion 31, a rotation stopping member 32 is provided with a pin 3.
2a integrally attached. The detent member 32 has a large size projecting outside the outer surface of the fixed base 28.
It is formed in a substantially semicircular shape. A predetermined radius (for example, 5 m) is provided at the outer peripheral end of the rotation stopping member 32.
m), circular recesses 33 are formed at, for example, 15 ° intervals.

The axis Sa (see FIGS. 4 and 5) of the fixed base 28 and the axis S (see FIG. 3) coincide with each other. Are provided so as to be rotatable around the axis S extending to the virtual center point K. The arm portion 34 is roughly composed of a main body portion 35 and a sliding portion 36. The arm portion 34 is formed in a substantially triangular frame shape, and the base portion 35a is rotatable with the shaft portion 31. A fitting hole 37 is formed so as to fit into the hole, and is prevented from coming off by a retaining pin 38. A rack 39 is fixed to the oblique frame 35b of the main body 35.

On the other hand, a knob 40,
A pinion (not shown) pivotally operated by the knob 40 is provided, and can be slid in the direction of arrow R in FIG. The position after the sliding is fixed by a fixing screw 41.

The tip of the sliding portion 36 has a needle fixing portion 4
2 are attached as shown in FIG. The needle fixing portion 42 is made of carbon fiber and has a needle insertion hole 42a.
Are formed. The needle insertion hole 42a is formed such that the axis Sb is directed to the virtual center point K, and the axis Sb and the axis Sa of the fixed base 28 are 3
At an angle of 0 °. The sliding surface 36 has a cam surface 43.
a screw 43 is screwed into the needle insertion hole 4 through the cam surface 43a.
A fixing pin 44 projecting into 2a is provided.

The treatment needle 45 is inserted into the needle insertion hole 42a of the needle fixing part 42 and is attached via the above-mentioned tightening screw 43 and fixing pin 44, and is directed to the virtual center point K.

The needle fixing portion 42 is configured to be deviated toward the virtual center point K side from the movement locus of the holder receiver 19, that is, the groove portion 18 of the rail member 17. In other words, the basic distance from the needle fixing portion 42 to the virtual center point K is 240 mm in the related art, but is set to 140 mm in the present embodiment, for example. I am getting it.

As shown in FIGS. 1, 5 and 6, the main body 35 of the arm 34 has
A locking screw 46 is provided as a locking means for locking the screw. The locking screw 46 is formed with a fitting portion 47 that fits into the recess 33 of the locking member 32. The fitting portion 47 has a circular shape with a diameter of 10 mm.

Now, the needle holder 27 according to the present embodiment having the above-described structure will be described.
An example of use will be described.

First, as shown in FIGS. 1 and 2, the fixing base 28 is inserted into the mounting boss 22 of the holder receiver 19,
At this time, the marker 30 of the fixed base 28 is
Attach it with the fixing screw 20a in accordance with the marker 25. Thereafter, the movable frame 15 is moved to its markers 16, 16
Is adjusted so as to fit the affected part in the head, and the rail member 17 is adjusted so that the center L ₁₈ thereof fits the affected part. Thus, the affected part and the virtual center point K match. Thereafter, the arm 34 is rotated as appropriate, and the position after the rotation is fixed by a set screw 46.

FIGS. 8 and 9 schematically show the movable area of the needle fixing portion 42 of the needle holder 27 and thus the treatment needle 45. FIG. That is, as shown in FIG. 8 which shows the movable region of the treatment needle 45 in a plan view, the movable range of this needle 45 is The change angle β (30 °) of the needle holder 27 itself due to the rotation of the portion 34 is added, and the angle becomes 60 ° to the left and right sides, and eventually 120 °, so that the movable range of the needle 45 can be expanded.

Further, since the needle fixing portion 42 is deviated toward the virtual center point K from the movement locus of the holder receiver 19, the distance between the needle fixing portion 42 and the virtual center point K is shortened.
The base 45a side of the treatment needle 45 fixed to the needle fixing part 42 does not come into contact with the CT gantry. As a result, unlike the related art, surgery from the temporal and occipital directions is also possible.

Further, as can be seen from FIG. 9 as viewed from the front, when the arm 34 is turned slightly upward from the side-down state (solid line state), the rail member 17
The treatment needle 45 can be separated from the needle 45, and the tip of the needle 45 can be visually inspected and the head can be cleaned and disinfected without being disturbed by the rail member 17.

Since the needle holder 27 of the present embodiment can be applied to an existing stereotactic brain surgery apparatus, the needle holder 27 may be attached to an existing holder, and the entire stereotactic brain surgery apparatus is purchased. Unlike the case, the economic burden can be reduced.

Further, the rotation stopping member 32 is fixed to the fixed base 2.
8 is formed so as to protrude outward from the outer surface, but the arm portion 3 is used as a rotation stop portion with the set screw 46.
The span from the fixed base portion 28, which is the center of rotation of the arm 4, becomes longer, and the fixing torque with respect to the turning moment of the arm portion 34 is improved. That is, at the center of rotation of the arm 34,
When the arm 34 is stopped, the span is short and the fixing torque is small. However, according to the present embodiment, the fixing torque is large, the rotation of the arm 34 is surely stopped, and the load resistance is improved. Can be achieved.

Particularly, in this embodiment, the needle fixing portion 42
Is formed of carbon fiber, it is possible to prevent generation of a virtual image during X-ray imaging of a brain tomographic image.

Next, FIG. 10 shows a second embodiment of the present invention. The needle holder 51 in this embodiment differs from the needle holder 27 of the first embodiment in the following points. That is, in the first embodiment, the arm portion 34 is connected to the main body portion 35 and the sliding portion 36.
However, in the needle holder 51 of the second embodiment, the arm portion 52 is formed by one member. In this case, the treatment needle 45 is attached to the needle fixing part 53 at the tip of the arm 52 so as to be movable in the direction toward and away from the virtual center point K.

Thus, also in the second embodiment,
The same effect as in the first embodiment can be obtained.

In each of the above embodiments, the rotation stopping member 3
2 is provided on the fixed base 28 and the set screw 46 (rotation fixing means) is provided on the arm 34, but these arrangements may be reversed. In addition, the present invention is not limited to the above embodiments, and can be implemented with various changes without departing from the gist, for example, the shape of the arm portion may be appropriately changed.

[0045]

As is apparent from the above description, the needle holder for the stereotaxic apparatus of the present invention can prevent the therapeutic needle from abutting on the CT gantry and can extend the movable range of the head. It also enables stereotactic surgery from the back of the head and improves surgical operation and visualization.It can also be applied to existing surgical devices, reducing the economic burden, and furthermore, turning the arm. An excellent effect is obtained in that it is possible to reliably stop and to improve the load resistance.

[Brief description of the drawings]

FIG. 1 is a perspective view of a needle holder showing a first embodiment of the present invention.

FIG. 2 is a perspective view of the stereotaxic apparatus with the needle holder attached.

FIG. 3 is a perspective view of a holder receiver.

FIG. 4 is a side view of the needle holder.

FIG. 5 is a longitudinal sectional side view of a member for stopping rotation.

FIG. 6 is a sectional view taken along the line AA of FIG. 5;

FIG. 7 is a longitudinal sectional side view of a needle fixing portion.

FIG. 8 is a schematic plan view for explaining a moving range of a needle fixing unit.

FIG. 9 is a front view of the same.

FIG. 10 is a partial perspective view showing a second embodiment of the present invention.

FIG. 11 is a perspective view of a stereotaxic apparatus showing a conventional example.

FIG. 12 is a side view.

FIG. 13 is a diagram schematically showing a state of an operation from a temporal direction.

[Explanation of symbols]

11 is a fixing device, 12 is a fixing frame, 13 is a head fixing arm, 15 is a movable frame, 17 is a rail member, 19 is a holder receiver, 27 is a needle holder, 28 is a fixed base, and 32 is a detent member. , 34 are an arm portion, 35 is a main body portion, 36 is a sliding portion, 42 is a needle fixing portion, 43 is a tightening screw, 43a is a cam surface, 45 is a treatment needle, and 46 is a set screw (fixing means for locking). Is shown.

Claims (1)

(57) [Scope of request for utility model registration] 1. A stereotactic brain comprising: a fixing device for fixing a patient's head; and a holder receiver provided on a rail member of the fixing device so as to be movable in an arc shape with an affected part in the head as a virtual center point. In a needle holder for a stereotactic brain surgery apparatus used for a surgical apparatus and holding a treatment needle so as to be directed to the virtual center point, a fixed base fixed to the holder receiver, and the virtual center point The arm is provided so as to be rotatable around an axis extending in the direction, and the tip is deviated to the virtual center point side from the movement locus of the holder receiver. A needle fixing unit for fixing the needle so as to be directed to the virtual center point,
Provided on one of said fixed base and said arm portion
A detent member having a size that protrudes outward from the outer surface of the fixing base, and a detent fixing provided on the other of the fixing base and the arm to fix the detent member at a rotation angle position Needle holder for a stereotaxic apparatus comprising: