APPARATUS AND METHOD FOR ORIENTING AN INSTRUMENT RELATIVE TO A TARGET OBJECT
20210212791 · 2021-07-15
Inventors
Cpc classification
A61B17/17
HUMAN NECESSITIES
A61B90/11
HUMAN NECESSITIES
A61B17/1739
HUMAN NECESSITIES
A61B2034/105
HUMAN NECESSITIES
A61B2017/568
HUMAN NECESSITIES
International classification
A61B90/11
HUMAN NECESSITIES
A61B17/17
HUMAN NECESSITIES
Abstract
The disclosure relates to an apparatus and to a method for fixing a target object in place and for orienting an instrument relative to the target object which has been fixed in place. The target object is here fixed in place by a first mask element. A second mask element is arranged on the outside thereof. By an adjusting facility, the second mask element may then be shifted relative to the first mask element, whereby the instrument retained by or passed through the second mask element is oriented.
Claims
1. An apparatus for fixing a target object in place and for orienting an instrument relative to the target object which has been fixed in place, the apparatus comprising: a first mask element; a second mask element configured to be arranged on an outer side of the first mask element remote from the target object; at least one base element, wherein the first mask element and the second mask element are configured to be fastened to the at least one base element; and an adjusting facility configured to be mechanically coupled to the second mask element, wherein the adjusting facility is configured to mechanically shift the second mask element relative to the first mask element.
2. The apparatus of claim 1, wherein the instrument is a medical instrument.
3. The apparatus of claim 1, wherein the adjusting facility comprises at least one eccentric element, wherein the second mask element is fastened to the at least one base element by the at least one eccentric element, and/or a first base element, to which the first mask element is fastened, and a second base element, to which the second mask element is fastened, are joined together, and wherein the second mask element is configured to be shifted by rotating the at least one eccentric element.
4. The apparatus of claim 3, wherein the at least one eccentric element is at least one eccentric screw.
5. The apparatus of claim 1, wherein the first and second mask elements each have, in a respective central region spaced from the base element, a plurality of openings passing through the respective mask element.
6. The apparatus of claim 1, wherein the first and second mask elements each comprise a thermoplastic material.
7. The apparatus of claim 6, wherein the thermoplastic materials of the first and second mask elements each has a glass transition temperature or softening temperature of at most 50 C.
8. The apparatus of claim 6, wherein the thermoplastic materials of the first and second mask elements are different thermoplastic materials, and wherein a glass transition temperature or softening temperature of the thermoplastic material of the first mask element is higher than a glass transition temperature or softening temperature of the thermoplastic material of the second mask element.
9. The apparatus of claim 1, further comprising: at least one reinforcing element, wherein the at least one reinforcing element is integrated into each mask element of the first and second mask elements.
10. The apparatus of claim 9, wherein the at least one reinforcing element is an aramid structure.
11. A method for orienting an instrument relative to a target object, the method comprising: applying a first mask element of an apparatus to the target object; immobilizing the first mask element on at least one base element of the apparatus to fix the target object in place; applying a second mask element of the apparatus to an outside of the first mask element and likewise at least in places surrounding the target object, wherein the second mask element is fastened to the at least one base element; and shifting the second mask element relative to the first mask element by an adjusting facility of the apparatus that is mechanically coupled to the second mask element.
12. The method of claim 11, wherein the instrument is a medical instrument.
13. The method of claim 11, wherein a tubular guide sleeve is arranged in a passage orifice which passes through one mask element of the first and second mask elements at a predetermined position.
14. The method of claim 13, further comprising: applying a spacer element to the first mask element prior to application of the second mask element, wherein the second mask element is subsequently applied to an outside of the spacer element.
15. The method of claim 14, wherein the spacer element comprises a thermally insulated material.
16. The method of claim 15, further comprising: automatically determining a suitable setting for the adjusting facility in order to achieve a predetermined target orientation of the instrument based on a predetermined model of the apparatus; and outputting, by a data processing facility, the suitable setting.
17. The method of claim 11, further comprising: applying a spacer element to the first mask element prior to application of the second mask element, wherein the second mask element is subsequently applied to an outside of the spacer element.
18. The method of claim 17, wherein the spacer element comprises a thermally insulated material.
19. The method of claim 18, further comprising: automatically determining a suitable setting for the adjusting facility in order to achieve a predetermined target orientation of the instrument based on a predetermined model of the apparatus; and outputting, by a data processing facility, the suitable setting.
20. The method of claim 11, further comprising: automatically determining a suitable setting for the adjusting facility in order to achieve a predetermined target orientation of the instrument based on a predetermined model of the apparatus; and outputting, by a data processing facility, the suitable setting.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0050] Further features, details, and advantages of the present disclosure are revealed by the following description of exemplary embodiments and with the assistance of the drawings, in which:
[0051]
[0052]
[0053]
DETAILED DESCRIPTION
[0054] In the exemplary embodiments, the described components of the embodiments are in each case individual features of the disclosure to be considered independently of one another, which in each case also mutually independently further develop the disclosure and are therefore to be considered part of the disclosure either individually or in a combination other than that indicated. The described embodiments may furthermore also be supplemented by further, previously described features of the disclosure.
[0055] For clarity's sake, identical, functionally identical, or mutually corresponding elements are in each case designated in the figures with the same reference signs, even if different instances or examples of the corresponding elements may be involved.
[0056]
[0057] In order to fix the head of the patient 2 in place, e.g., to hold or position it stationarily, a first mask element 5 is tensioned at least in places over the patient 2 and immobilized on the frame element 3 by a plurality of fastening elements 6.
[0058] A data processing facility 7 with a processor 8 and a data memory 9 connected thereto and an acquisition facility 10 are additionally shown here schematically. The acquisition facility 10 is in the present case capable of acquiring the apparatus 1 and the head of the patient 2 fixed in place therein and transmitting corresponding acquisition data to the data processing facility 7. The data processing facility 7 and/or the acquisition facility 10 may here be part of the apparatus 1 or merely connected thereto.
[0059]
[0060] The adjusting facility 12 here includes at least one screw 13, (e.g., a plurality of eccentric screws). By rotation of the eccentric screws 13, the second mask element 11 retained thereby or the frame element 3 thereof, to which the second mask element 11 is fastened, may be shifted relative to the first mask element 5 or relative to the frame element 3 thereof or the part of the frame element thereof to which the first mask element 5 is fastened, and thus also relative to the patient 2 who has been fixed in place.
[0061] The two mask elements 5, 11 are here pierced by a guide sleeve 14 at a predetermined position. The instrument 15 may in the present case be guided through the guide sleeve 14 and brought into contact with the patient 2. On actuation of the adjusting facility 12 or of the eccentric screws 13, not only the second mask element 11, but also the guide sleeve 14 and optionally the instrument 15 guided therein are thus shifted, in particular tilted and thus oriented relative to the patient 2.
[0062] Use or a method for the use of the apparatus 1 will be explained below with the assistance of an exemplary sequence chart 16 shown schematically in
[0063] A model of the apparatus 1 and patient data of the patient 2 are provided in method act S1. The data may include a 3D model or a 3D image data set of the patient 2, a target region or region of interest for the instrument 15 and/or a predetermined target orientation of the instrument 15.
[0064] With the patient 2 arranged in the apparatus 1, the thermoplastic first mask element 5 is heated in method act S2 such that it is elastically or plastically deformable. In this state, the first mask element 5 is then shaped on the patient 2. Before, during or after cooling, and thus solidification, of the first mask element 5, the latter is then fastened, as shown in
[0065] In optional method act S3, an in particular thermally insulating spacer element may be applied on the outside, e.g., on the side remote from the patient 2, of the first mask element 5.
[0066] In method act S4, the thermoplastic second mask element 11 is heated such that it is elastically or plastically deformable. In this state, the second mask element 11 is applied onto the outside of the first mask element 5 or the spacer element and shaped.
[0067] Once the second mask element 11 has cooled and solidified, the optionally applied spacer element may be removed in optional method act S5.
[0068] The second mask element 11 is fastened to the frame element 3 in method act S6. This may proceed before, during or after complete hardening of the second mask element 11 and/or removal of the spacer element. Depending, for example, on the application and/or material selection or temperature of the second mask element 11, different variants, combinations or sequences of the described procedures may here be used to achieve an optimum result.
[0069] It may likewise be possible to remove the solidified first mask element 5 and/or the spacer element shaped thereon, and thus detach it from the patient 2, and then to shape the second mask element 11 thereon. In other words, the second mask element 11 may in this respect thus be shaped offline while nevertheless reproducing the shape of the patient 2, because the shape is then provided by the first mask element 5 already correspondingly shaped to the patient 2 or the correspondingly shaped spacer element. Thanks to the second mask element 11 being separately shaped, (e.g., remotely from the patient 2), the burden on the patient may possibly be reduced, a higher temperature may be used for the second mask element 11, or a material may be used for the second mask element 11 which would otherwise not be practical.
[0070] In method act S7, (e.g., with the mask elements 5, 11 fastened to the frame element 3), the guide sleeve 14 is arranged to pass through the two mask elements 5, 11. To this end, for example, using a drill compatible with the respective application, (e.g., by an MR-compatible drill), a hole may be drilled at a predetermined position through both masks 5, 11 and the guide sleeve 14 inserted or placed in this hole or bore. Additionally or alternatively, the mask elements 5, 11 may be locally heated at the predetermined position and then pierced by the guide sleeve 14. Ultimately, however, use of the guide sleeve 14 may be optional.
[0071] In method act S8, which is likewise possibly optional, a current actual state of the apparatus 1 of the patient 2 is acquired by the acquisition facility 10 as indicated in
[0072] In method act S9, based on the actual state and the predetermined model of the apparatus 1, the data processing facility 7 determines a suitable setting for the adjusting facility 12, which setting enables or achieves a predetermined or desired orientation of the instrument 15 or the guide sleeve 14. In the present case, corresponding software or a computer program may automatically determine a necessary or suitable setting or rotation of the eccentric screw 13, (or, for example, an alternatively used eccentric joint or the like), for setting or achieving the predetermined target orientation of the instrument 15, (e.g., a specific angle according to a predetermined planned entry path for the instrument 15).
[0073] In method act S10, the setting determined in this manner for the adjusting facility 12 is output and/or automatically or semi-automatically executed or set. Depending on the configuration of the apparatus 1 or of the adjusting facility 12, this may be carried out automatically or a respective user may be assisted in setting or executing the specific setting, for instance, by appropriate acoustic and/or optical and/or tactile instruction signals. A setting direction, a setting scope and/or the achievement of the specific setting may for instance be stated or indicated in this manner.
[0074] The described examples show overall how a mask may be fixed in place and an instrument 15, for example for an intervention needle, may be oriented inexpensively and in a manner, which is particularly gentle on the patient 2.
[0075] It is to be understood that the elements and features recited in the appended claims may be combined in different ways to produce new claims that likewise fall within the scope of the present disclosure. Thus, whereas the dependent claims appended below depend from only a single independent or dependent claim, it is to be understood that these dependent claims may, alternatively, be made to depend in the alternative from any preceding or following claim, whether independent or dependent, and that such new combinations are to be understood as forming a part of the present specification.
[0076] Although the disclosure has been illustrated and described in detail with reference to the exemplary embodiments, it is not limited by the disclosed examples and a person skilled in the art may derive other variations herefrom without departing from the scope the disclosure.