AUXILLIARY DEVICE AND AUXILLIARY METHOD FOR EPIDURAL ANESTHESIA NEEDLE PLACEMENT
20220354534 · 2022-11-10
Inventors
Cpc classification
A61B17/3401
HUMAN NECESSITIES
A61B34/20
HUMAN NECESSITIES
International classification
A61B34/10
HUMAN NECESSITIES
Abstract
The present disclosure relates to an auxiliary device and auxiliary method for epidural anesthesia needle placement, the auxiliary device comprising: a needle placement unit (1), a motion guide unit (2) for driving the needle placement unit into movement, and a control unit (3) for supporting and controlling the motion guide unit (2), the needle placement unit (1) being electrically connected to the control unit (3); the needle placement unit (1) comprises: a first support (11) connected to the motion guide unit (2), a second support (12) slidably connected with the first support (11), a needle placement assembly (13) slidably connected with the second support (12), and a first drive (14) arranged on the first support (11) for driving the second support (12) into motion. The scheme of the present disclosure may perform a real-time multidimensional monitoring to the puncture process, achieving autonomous, precise, safe needle placement and puncture operations.
Claims
1. An auxiliary device for epidural anesthesia needle placement, comprising: a needle placement unit (1), a motion guide unit (2) for driving the needle placement unit (1) into movement, and a control unit (3) for bearing and controlling the motion guide unit (2), the needle placement unit being electrically connected to the control unit (3); the needle placement unit (1) comprises: a first support (11) for connecting to the motion guide unit (3), a second support (12) slidably connected with the first support (11), a needle placement assembly (13) slidably connected with the second support (12), and a first drive (14) arranged on the first support (11) for driving the second support (12) into movement.
2. The auxiliary device according to claim 1, wherein the movement direction of the needle placement assembly (13) on the second support (12) is parallel to the movement direction of the second support (12) on the first support (11).
3. The auxiliary device according to claim 1, wherein the first drive (14) drives the second support (12) to linearly reciprocate on the first support (11); the needle placement unit (13) reciprocates linearly on the second support (12).
4. The auxiliary device according to claim 1, wherein the needle placement assembly (13) is provided with a pressure sensor (131); in the movement direction of the needle placement assembly (13), a first stop (121) able to abut against the pressure sensor (131) and a second stop (122) for limiting a movement position of the needle placement assembly (13) are correspondingly disposed on second support (12).
5. The auxiliary device according to claim 4, wherein the needle placement assembly (13) also comprises: a third support (132) for slidably connecting the second support (12), a fourth support (133) for detachably connecting the third support (132), and a puncture needle (134) mounted on the fourth support (133).
6. The auxiliary device according to claim 5, wherein the space between the first stop (121) the second stop (122) is L1, the distance between an end of the pressure sensor (131) which abuts against the first stop (121) and an end of the third support (132) which abuts against the second stop (122) is L2, then L1≥L2.
7. The auxiliary device according to claim 5, wherein the fourth support (133) is provided with a sound detection module (1231) on a side in proximity to the puncture needle (134).
8. The auxiliary device according to claim 7, wherein the third support (132) is in clip-connection to the fourth support (133); the puncture needle (134) is in clip-connection to the fourth support (133).
9. The auxiliary device according to claim 8, wherein the puncture needle (134) comprises a puncture portion (1341) and a core portion (1342); the puncture portion (1341) is a hollow cylinder, the core potion (1342) being arranged coaxially with the puncture portion (1341) in a detachable manner in the hollow space of the puncture portion (1341); an end of the core portion (1342) is provided with a first structural member (1242a), an end of the puncture portion (1341) which is adjacent to the first structural member (1242a) adjoining the sound detection module (1231).
10. The auxiliary device according to claim 9, wherein the fourth support (133) is provided with an electric conductor for electrically connecting the control unit (3) and the puncture portion (1341); the puncture portion (1341) is provided with an insulating layer on its outer surface.
11. The auxiliary device according to claim 10, wherein the insulating layer is a Teflon coating.
12. The auxiliary device according to claim 1, wherein the first drive (14) comprises: a power source (141) and a lead screw pair (142) arranged integrally with a main shaft of the power source (141).
13-25. (canceled)
Description
BRIEF DESCRIPTION OF THE DRAWINGS
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DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0058] In order to more clearly illustrates embodiments of the present disclosure or technical solutions in the prior art, figures used in the embodiments are simply introduced as follows. Apparently, the figures in the following description are merely some embodiments of the present disclosure. Person skilled in the art could also obtain other figures in accordance with these figures without contributing innovative effort.
[0059] As describing embodiments of the present disclosure, the orientations or position relationships represented by terms “longitudinal”, “transverse”, “upper”, “lower”, “front”, “rear”, “left”, “right”, “vertical”, “horizontal”, “top”, “bottom”, “inner”, “outer” are orientations or position relationships shown based on the related figures, which are merely for the purpose of describing and simplifying the present disclosure, but do not indicate or imply that the said devices or elements must have certain orientations, and are configured and operated in certain orientations, so that the above terms cannot be understood as limits to the present disclosure.
[0060] Hereinafter, the present disclosure is described in detail in combination with figures and specific embodiments that cannot be specified here, however, embodiments of the present disclosure are not limited to the following embodiments.
[0061] As shown in combination with
[0062] As shown in combination with
[0063] As shown in combination with
[0064] As shown in combination with
[0065] As shown in combination with
[0066] As shown in combination with
[0067] As shown in combination with
[0068] As shown in combination with
[0069] As shown in combination with
[0070] As shown in combination with
[0071] According to an embodiment of the present disclosure, if the space between the first stop 121 and the second stop 122 is L1, the distance between the end of pressure sensor 131 which abuts against the first stop 121 and the end of third stop 132 which abuts against the second stop is L2, L1≥L2. In the present embodiment, if the space between the first stop 121 and the second stop 122 is L1, the distance between the end of pressure sensor 131 which abuts against the first stop 121 and the end of third support 132 which abuts against the second stop 122 is L2, and the difference between L1 and L2 is less than or equal to 0.05 mm, L1-L2≤0.05 mm. In the present embodiment, in the case of high machining precision between components, a smaller difference between L1 and L2 is better, which may guarantee accuracy and precision of the puncture process.
[0072] According to an embodiment of the present disclosure, the motion guide unit 2 is a laser guide system having a function of surgery planning. In the present embodiment, the needle placement unit 1 carries out the puncture operation along a predefined path under the action of motion guide unit 2.
[0073] According to the present disclosure, by disposing a sound detection module on the fourth support, when the puncture needle enters in an object, followed by pulling out the core portion, the sound detection module may, due to the negative pressure produced between the external environment and the hollow space in the puncture portion, effectively and quickly detect the moment at which the needle core portion is pulled out of the puncture portion. Depending on the detected sound, the present disclosure may more quickly and accurately detect the quality of puncture, such that the device of the present disclosure may conveniently, effectively and multi-dimensionally evaluate the puncture result.
[0074] According to the present disclosure, by way of electrifying the puncture needle and providing an insulation layer on the outer surface of the puncture needle, the needle tip of the puncture needle becomes electrically conductive, and a corresponding puncture position is further obtained depending on the electric signal of the needle tip. In the case that a puncture operation is executed by the needle placement unit of the present disclosure, if the puncture needle touches a nerve root, the electric signal will stimulate the nerve, and the control unit will further acquire a corresponding electric signal, giving a sound signal, and at the same time triggering a protection mechanism and stopping the movement of the mechanism. Hence, the solution of the present disclosure further effectively enhances puncture precision of the present disclosure.
[0075] As shown in combination with
[0076] S1: obtaining a target point of a target region, controlling, by means of the control unit 3, the motion guide unit 2 to direct the needle placement unit 1 to the target point;
[0077] S2: driving the needle placement unit 1 in a puncture direction, receiving, by means of the control unit 3, an electric signal fed back from the needle placement unit, and determining whether a needle stopping signal is triggered depending on the electric signal, if yes, stop driving the needle placement unit 1;
[0078] S3: evaluating the puncture result of the needle placement unit 1 and outputting an evaluation result.
[0079] As shown in combination with
[0080] As shown in combination with
[0081] As shown in combination with
[0082] In the present embodiment, a resistance change signal is adopted during the resistance monitoring. Referring to
[0083] In the present embodiment, a needle displacement signal is used in the needle displacement monitoring. Specifically, during the needle displacement monitoring, when the puncture needle enters skin, the pulse number of the stepping motor is recorded by means of a counter provided in the device so as to obtain the needle displacement signal in real time after piercing the puncture needle into skin. Further, in the step S2, when the electrical signal is a needle displacement signal, as the above stated, by way of acquiring CT data of the preoperative puncture site of the patient in advance, a planned route distance in the puncture operation may be obtained depending on the CT data, such that by comparing the planned route distance with an actual displacement, the system can provide prompt information and triggers a stop signal, when the actual displacement exceeds the planned route distance. In the embodiment, the entrance of puncture needle into the skin is determined depending on the change of pressure detected by the pressure sensor.
[0084] In the present embodiment, the electrophysiological monitoring uses an electrophysiological monitoring signal. Specifically, the intraoperative electro-neurophysiological monitoring is for monitoring the integrity of a function of nervous system in dangerous state during the surgery using various electro-neurophysiological techniques. Hence, it is an indispensable component for improvement of surgery quality to apply electrophysiological monitoring in clinical operations to monitor the integrity of nerve function, reducing nerve damage.
[0085] In modern surgical operations, various imaging techniques enormously contribute to the development of operative surgery in the aspect of anatomical structure. Result of the intraoperative electro-neurophysiological monitoring is to find out whether or not a nerve system is damaged in function, so as to objectively evaluate the integrity of nerve system function of a patient in neurosurgical, orthopedic, cardiac-surgical, and facial operations and etc., in order to provide reliable information for surgeons which may in turn perform the operation more smoothly and safely.
[0086] Hence, the present disclosure adopts myoelectric nerve monitoring technique in electro-neurophysiological monitoring techniques to know whether the puncture needle placed in human body is too close to spinal nerves via a stimulation electromyogram produced by stimulating nerve rootlets. The myoelectric nerve monitoring technique is applied in the present disclosure in such a way that the structure of the puncture needle is modified in the manner of combining the whole of the current myoelectric nerve monitoring system and anesthesia puncture. Referring to
[0087] In the present embodiment, the digital characteristic identification of puncture tissue differentiation uses a puncture tissue differentiation signal. Specifically, electrical conductivities under different tissues can be acquired in combination with the above mentioned electric signals fed back from the muscular electrical stimulation during neuro-electrophysiological monitoring. By establishing a data base of electrical conductivities of different issues in advance, the current position of the puncture needle can be further obtained by comparing the acquired electrical conductivity with the data base. Furthermore, a comparison result can be visually simulated and output on the display device, achieving visualization of the entire puncture process. In the present embodiment, whether the puncture needle 134 is in place according to the comparison result, if so, a needle stop signal is triggered to stop driving the needle placement unit 1.
[0088] According to an embodiment of the present disclosure, in step S3, a determination is made by using an assistant determination method of acoustic detection and/or an assistant determination method of pressure cavity detection, in the step of determining a puncture result of the needle placement unit 1.
[0089] In the present embodiment, the assistant determination method of acoustic detection is performed by means of a sound detection module 1231. In the embodiment, the assistant determination of acoustic detection is based on the principle of negative epidural pressure commonly used in clinic practice. When the puncture needle penetrates yellow ligament and reaches epidural space, the air outside the needle will be drawn into the negative pressure cavity at the moment the needle core is withdrawn. At this moment, there is an obvious “whoosh” which can be clearly heard with a recurrence rate of substantially 100% in clinic practice. Based on such a clinical phenomenon, the present solution adopts acoustic detection to carry out an assistant determination. In the present disclosure, a detection port of the sensor is encapsulated, which is in a position adjacent to the location at which the core portion 1342 and the puncture portion 1341 of the puncture needle are connected and which is aligned to an air inlet on the puncture needle tail (i.e., the puncture portion 1341 is opposite to a first member 1342a of the core portion 1342), in order to clearly and promptly acquire the sound produced in the withdrawal of the core portion 1342. When a target signal is generated, the sound detection module 1231 may detect a relative change of the acoustic signal, i.e., a result of air being sucked back into the negative pressure cavity is obtained, for the assistant determination of the puncture result.
[0090] In the present embodiment, an injection pump is in communication with the puncture portion 1341 and is positively and negatively rotated to perform determination, in the step of performing a determination using the assistant determination method of pressure cavity detection. In the present embodiment, the injection pump is provided with a pressure cavity sensor therein. Specifically, the assistant determination of pressure cavity detection is depending on the “Bubble Method” commonly used in the clinic practice, i.e., if an injector is connected to the tail of the puncture needle, as pushing the injector, man may feel an obvious sensation of resistance, before the puncture needle pierces yellow ligament, and bubbles in the injector are compressed at the same time. After the puncture needle pierces yellow ligament, as pushing the injector, man may feel the resistance disappears, with the bubbles are not compressed and advanced in the direction of saline solution. Based on the above clinic phenomenon, in the present solution, the injection pump is connected for assistant determination of pressure cavity detection, only after withdrawing the needle core and obtaining the result of the assistant determination of acoustic detection.
[0091] In the present embodiment, the injection pump is a micro injection pump which is integrated with a pressure cavity sensor for detecting a liquid pressure. The principle of assistant determination of pressure cavity detection is that if the puncture needle does not pierce through yellow ligament, the injection pump rotates positively, the sensor will detect a rapid rise of liquid pressure, while the operator may feel an obvious sensation of resistance in needle advance, just like the feeling when bubbles are compressed in the “Bubble Method”. If the puncture needle has pierced through the yellow ligament, the liquid pressure detected by the senor remains substantially unchanged, at which moment the suction direction of the injection pump reverses and no cerebrospinal fluid flows out.
[0092] According to the disclosure, by way of performing a real-time, multi-dimensional monitoring to the puncture process of the needle placement unit, for example, monitoring the puncture resistance against the puncture needle in real time by means of the pressure sensor, a puncture depth is recorded once the skin has been pierced through; whether a nerve tissue is touched is monitored in real time by means of the electro-neurophysiological monitoring technique; a conductivity of the current tissue is detected in real time via an electric-signal detection sensor and the current puncture tissue is stimulated according to the conductivity data base. Based on the data detected by multiple sensors, it is determined whether the current position is the target position, ensuring precision of the puncture position during the puncture process, and further enhancing safety during the surgical operation.
[0093] According to the disclosure, having finished the puncture, i.e., when it is detected by means of the multiple sensors that the needle placement unit reaches the target position, the present disclosure also provides at least one determination means to assist the determination of puncture result, i.e., uses a sound detection module to detect the back-suction sound of air at the moment when the core portion is withdrawn. Further, an injection pump device with pressure cavity detection is provided for detecting whether the puncture needle is currently in the target position. By the aid of the above detection means, the accuracy of puncture position is further precisely determined.
[0094] According to the disclosure, visualization of the puncture process is achieved by detecting the conductivity of the current tissue by means of the electric signal detection sensor and stimulating the current puncture tissue according to the preset tissue conductivity data base, i.e., stimulating the real-time puncture position of the puncture needle and simultaneously calculating an advance path and distance of the puncture needle in the skin in real time by means of a surgery planning function of the apparatus in the present disclosure, calculating the current puncture position in real time via pressure data and stepping pulse data, then, by means of merging with stimulation data, accurately calculating the real position of the puncture needle piercing through the skin, and displaying the real position in the system UI interface so as to achieve precise visualization of the puncture process.
[0095] According to the disclosure, the needle placement unit in a form of a double-track arrangement bears, by the aid of the tracks, the bending moment produced by puncture force, preventing thereby the effect of bending moment and ensuring measurement precision and service life of the sensors.
[0096] The above content merely concerns examples of the embodiments of the present disclosure. The apparatuses and structures which are not described with details therein shall be understood to be implemented by means of the existing universal apparatuses and methods in the present field.
[0097] The above mentioned is only a scheme of the present disclosure and is not intended to limit the present disclosure. For a person skilled in the art, the present disclosure may have various modifications and variations. Any other modifications, equivalent substitutions, adaptations, and etc. made under the spirit and within the concept of the present disclosure shall be encompassed in the protection extent of the present disclosure.