[go: up one dir, main page]

WO2023050307A1 - Système et procédé de biopsie pulmonaire compatible ct - Google Patents

Système et procédé de biopsie pulmonaire compatible ct Download PDF

Info

Publication number
WO2023050307A1
WO2023050307A1 PCT/CN2021/122164 CN2021122164W WO2023050307A1 WO 2023050307 A1 WO2023050307 A1 WO 2023050307A1 CN 2021122164 W CN2021122164 W CN 2021122164W WO 2023050307 A1 WO2023050307 A1 WO 2023050307A1
Authority
WO
WIPO (PCT)
Prior art keywords
puncture
needle
respiratory phase
image
guide rail
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/CN2021/122164
Other languages
English (en)
Chinese (zh)
Inventor
陈静涛
钱程
周寿军
曾泉
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Shenzhen Institute of Advanced Technology of CAS
Original Assignee
Shenzhen Institute of Advanced Technology of CAS
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Shenzhen Institute of Advanced Technology of CAS filed Critical Shenzhen Institute of Advanced Technology of CAS
Priority to PCT/CN2021/122164 priority Critical patent/WO2023050307A1/fr
Publication of WO2023050307A1 publication Critical patent/WO2023050307A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Images

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/34—Trocars; Puncturing needles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment

Definitions

  • the invention relates to the field of medical equipment, in particular to a CT-compatible lung biopsy system and method.
  • Lung cancer is the malignant tumor with the highest morbidity and mortality.
  • Early screening, early diagnosis and early treatment of lung cancer are the most effective ways to improve the five-year survival rate of lung cancer patients.
  • the determination of the nature of pulmonary nodules is an important part of the early diagnosis and treatment of lung cancer.
  • Percutaneous lung needle biopsy is currently the main biopsy method for pulmonary nodules. In this procedure, under the guidance of ultrasound or computed tomography (CT) images, doctors use a puncture needle to puncture the target nodule, and use a biopsy gun to extract tissue samples. benign and malignant.
  • CT computed tomography
  • Intraoperative CT is the main image-guided method for percutaneous lung biopsy: during the operation, the patient lies on the CT examination bed under local anesthesia. Scan the image for puncture needle path planning. Then the puncture needle was inserted percutaneously into the target nodule for tissue sampling, and finally the puncture needle was withdrawn and the positions of the puncture needle and the nodule were confirmed by intraoperative CT scan.
  • the puncture needle is easy to cause damage to the tissue structure on the puncture path, the puncture operation has extremely high requirements for the doctor's operation accuracy; at the same time, when using CT to guide the operation, the medical staff will inevitably be exposed to the radiation environment. However, it is extremely heavy and cannot protect the face and hands, which greatly increases the radiation damage and comprehensive burden of medical personnel.
  • the master-slave robot-assisted puncture allows the doctor to remotely control the movement of the puncture needle, so that the doctor can avoid direct exposure to the radiation environment, and can effectively solve the problems of insufficient operating accuracy and fatigue of the doctor.
  • the disadvantages of the existing manual puncture technique mainly include: for the puncture operation of the lung, when CT is used for multiple scans during the operation, the doctor has been exposed to relatively large radiation for many years.
  • many existing technologies have proposed puncture assistant robots with different structures.
  • the existing puncture-assisting robots are mainly divided into two categories: one is that only provides positioning function, and the doctor manually punctures; the other is that the robot automatically completes positioning and puncture.
  • the embodiment of the present application provides a CT-compatible lung biopsy system and method to solve the technical problem of lesion displacement caused by breathing during the existing puncture process, so as to achieve accurate puncture and reduce damage caused by mispuncture. Injuries and complications in the patient's body.
  • a CT-compatible pulmonary puncture biopsy system and method including an image processing unit, a puncture path planning unit, a motion control unit, a respiratory phase detection unit, and a robot puncture for performing puncture work. mechanism;
  • the image processing unit is used to display the CT image, determine the puncture level on the CT image, and mark the puncture target point and the puncture needle entry point to form a preoperative puncture path planning;
  • the respiratory phase detection unit is used to detect the respiratory phase in real time, and transmit the detection result of the respiratory phase to the puncture path planning unit;
  • the puncture path planning unit is used to generate a puncture path under any respiratory phase, and is used to adjust the puncture posture of the robot puncture mechanism, so that the puncture needle on the robot puncture mechanism is collinear with the puncture path;
  • the motion control unit is used to control the movement of the puncture mechanism of the robot and the puncture movement of the puncture needle.
  • the image processing unit includes:
  • the preoperative path planning module is used to select the appropriate puncture level according to the preoperative CT image, and select the puncture target point and epidermal needle entry point on the CT image of the puncture level, so as to plan the puncture needle path;
  • An intraoperative CT image acquisition module is used to acquire intraoperative CT images
  • the intraoperative image registration module is used to realize the superposition and fusion of preoperative CT images and intraoperative CT images by using elastic registration, and determine the puncture level;
  • the puncture needle monitoring module is used for real-time feedback of the needle insertion process of the puncture needle.
  • the respiratory phase detection unit includes:
  • Respiration amplitude detection module used for real-time detection of respiration phase and sending out respiration phase signal
  • the respiratory phase judging module is used to receive the respiratory phase signal sent by the respiratory amplitude detection module, calculate the respiratory phase at any time in real time, and transmit the calculation result of the respiratory phase to the puncture path planning unit.
  • the puncture path planning unit includes:
  • the puncture path optimization module is used to receive the respiratory phase calculation result and generate a puncture path under any respiratory phase
  • the puncture needle posture adjustment module is configured to receive the puncture path and adjust the posture of the puncture needle so that the puncture needle can be collinear with the puncture path.
  • the motion control unit includes:
  • the actuator control module is used to control the movement of the robot puncture mechanism
  • the needle insertion mechanism control module is used to control the movement of the puncture needle.
  • the robot puncture mechanism includes:
  • an arched frame the arched frame includes set arched guide rails;
  • Arched guide rail slider the arched guide rail slider is installed on the arched rack and can slide on the arched guide rail;
  • the lifting arm can be moved up and down and installed on the arch guide rail slider;
  • the horizontal arm can be horizontally moved and installed on the lifting arm;
  • the swivel arm is rotatably installed on the horizontal arm;
  • the needle feeding mechanism is installed on the rotating arm and is used for puncturing.
  • the needle insertion mechanism includes a puncture needle, a needle holder and a needle insertion frame
  • the needle holder is movably mounted on the needle insertion frame
  • the puncture needle is installed on the needle holder.
  • the robot puncture mechanism also includes a fixed base, the fixed base is provided with a latch, the fixed end of the arched frame is rotatably installed on the fixed base, and the free end of the arched frame
  • the card lock can be freely opened and closed to lock or unlock the fixed base.
  • the technical solution adopted in the embodiment of the present application further includes: the robot puncture mechanism further includes a guide rail guide slider, and the arch guide rail slider is connected to the arch guide rail through the guide rail guide slider.
  • the robot puncture mechanism includes a lifting arm slider and a lifting arm screw motor
  • the arched guide rail slider is provided with a lifting arm screw guide rail
  • the lifting arm slider is connected to the lifting arm screw rod.
  • the lifting arm screw motor drives the lifting arm slider to move on the lifting arm screw guide rail.
  • the robot puncture mechanism includes a horizontal arm screw rod slider and a horizontal arm screw rod motor
  • the lifting arm is provided with a horizontal arm screw rod guide rail
  • the horizontal arm screw rod slider is connected to the horizontal arm screw rod.
  • the horizontal arm screw motor drives the horizontal arm screw rod slider to move on the horizontal arm screw rod guide rail.
  • the technical solution adopted in the embodiment of the present application also includes: a rotating arm motor is installed on the horizontal arm, the rotating arm is connected to the rotating arm motor, and the rotating arm motor drives the rotating arm to rotate.
  • a CT-compatible lung biopsy method comprising the following steps:
  • the CT equipment starts to scan
  • the intraoperative CT image is visualized and marked in real time, and the needle entry point and needle angle under the planned path are calculated based on the intraoperative CT image visualization mark, the registration result of the intraoperative CT image and the preoperative CT image;
  • the positioning of the actuator is completed, and the puncture needle on the actuator is controlled to perform automatic needle insertion.
  • the automatic needle feeding completed by the needle feeding mechanism on the control actuator includes:
  • the beneficial effect produced by the embodiment of the present application lies in: the CT-compatible lung biopsy system and method in the embodiment of the present application, the system includes: an image processing unit for displaying CT images, on the CT images Determine the puncture level, mark the puncture target point and the puncture needle entry point, and form the preoperative puncture path planning; the respiratory phase detection unit is used to detect the respiratory phase in real time, and transmit the respiratory phase detection results to the puncture path planning unit; The path planning unit is used to generate the puncture path under any respiratory phase, and is used to adjust the puncture posture of the robot puncture mechanism so that the puncture needle on the robot puncture mechanism is in line with the puncture path; the motion control unit is used to control the robot puncture mechanism movement, and control the puncture movement of the puncture needle.
  • the respiratory phase detection unit detects the respiratory phase of the patient during the puncture, so that an optimized puncture path can be generated according to the respiratory phase, so as to achieve accurate puncture and reduce the damage and complications in the patient's body caused by wrong puncture
  • Fig. 1 is the schematic diagram of the CT lung biopsy system of the present application
  • Fig. 2 is the structural representation of the robot puncture mechanism of the present application
  • Fig. 3 is another structural schematic diagram of the robot puncture mechanism of the present application.
  • Fig. 4 is another structural schematic diagram of the robot puncture mechanism of the present application.
  • Fig. 5 is the specific structural diagram of the puncture mechanism of the robot of the present application.
  • Fig. 6 is another specific structural diagram of the puncture mechanism of the robot of the present application.
  • Fig. 7 is the enlarged structural diagram of the puncture mechanism of the robot of the present application.
  • Fig. 8 is the internal structure diagram of the horizontal arm of the robot puncture mechanism of the present application.
  • Fig. 9 is a structural diagram of the needle insertion mechanism of the robot puncture mechanism of the present application.
  • Figure 10 is an enlarged view of the structure of the needle insertion mechanism of the robot puncture mechanism of the present application.
  • Fig. 11 is an enlarged view of another structure of the needle insertion mechanism of the robot puncture mechanism of the present application.
  • Fig. 12 is another enlarged view of the structure of the needle insertion mechanism of the robot puncture mechanism of the present application.
  • Fig. 13 is a flow chart of the CT lung biopsy method of the present application.
  • Fig. 14 is a specific flow chart of the CT lung biopsy method of the present application.
  • 101-image processing unit 101-image processing unit, 102-puncture path planning unit, 103-motion control unit, 104-robot puncture mechanism, 1041-mechanical arm, 1402-puncture mechanism, 1043-puncture needle clamping mechanism, 105-respiratory phase detection unit, 106-operation main hand;
  • a CT-compatible pulmonary puncture biopsy system is provided, as shown in FIG.
  • the image processing unit 101 is configured to display the CT image, determine the puncture level on the CT image, and identify the puncture target point and the puncture needle 2 entry point to form a preoperative puncture path planning;
  • a respiratory phase detection unit 105 configured to detect the respiratory phase in real time, and transmit the measured respiratory phase to the puncture path planning unit 102;
  • the puncture path planning unit 102 is used to generate a puncture path under any respiratory phase, and to adjust the puncture posture of the robot puncture mechanism 104, so that the puncture needle 2 on the robot puncture mechanism 104 is collinear with the puncture path;
  • the motion control unit 103 is used to control the motion of the robot puncturing mechanism 104 and the puncturing motion of the puncture needle 2 .
  • the CT-compatible lung biopsy system and method in the embodiment of the present application includes: an image processing unit 101, configured to display a CT image, determine the puncture level on the CT image, and identify the puncture target point and the puncture needle 2
  • the needle point forms the preoperative puncture path planning;
  • the respiratory phase detection unit 105 is used to detect the respiratory phase in real time, and transmits the measured respiratory phase to the puncture path planning unit 102;
  • the puncture path planning unit 102 is used to generate any respiratory phase
  • the puncture path below is used to adjust the puncture posture of the robot puncture mechanism 104, so that the puncture needle 2 on the robot puncture mechanism 104 is in line with the puncture path;
  • the motion control unit 103 is used to control the movement of the robot puncture mechanism 104, and control The puncture movement of the puncture needle 2.
  • the respiratory phase detection unit 105 detects the patient's respiratory phase during the puncture process, so that an optimized puncture path can be generated according to the respiratory phase, so as to achieve accurate puncture and reduce
  • This application aims to provide a CT-compatible lung biopsy system for lung nodule biopsy surgery, which is difficult to determine the point and angle of needle entry and needle entry angle, and difficult to locate lesions affected by breathing during the puncture process. It helps the doctor to position the puncture needle 2 before the puncture, and completes the real-time registration of the puncture path corresponding to the breathing during the puncture, so that the doctor can puncture the target area more accurately.
  • the CT compatible needle biopsy robot proposed in this application is compatible with most commonly used CT machine holes on the market, and can enter the CT machine hole with the CT machine tool as a whole.
  • the image processing unit 101 includes:
  • the preoperative path planning module is used to select a suitable puncture level according to the preoperative CT image, and select the puncture target point and epidermal needle entry point on the CT image of the puncture level, so as to plan the path of the puncture needle 2;
  • An intraoperative CT image acquisition module is used to acquire intraoperative CT images
  • the intraoperative image registration module is used to realize the superposition and fusion of preoperative CT images and intraoperative CT images by using elastic registration, and determine the puncture level;
  • the puncture needle 2 monitoring module is used to feed back the needle insertion process of the puncture needle 2 in real time.
  • the image processing unit 101 includes a preoperative path planning module, an intraoperative CT image acquisition module, an intraoperative CT image registration module, and a puncture needle 2 monitoring module.
  • the preoperative path planning module is mainly used for the preoperative doctor to select the appropriate puncture level according to the patient's CT image, and select the puncture target point and epidermal needle entry point on the CT image of the puncture level, so as to plan the path of the puncture needle 2;
  • the CT image acquisition module is mainly used to collect intraoperative CT images, and allows the operator to observe the situation inside the punctured tissue in real time;
  • the intraoperative CT image registration module mainly uses elastic registration to realize the superposition and fusion of preoperative and intraoperative CT images , and determine the puncture level.
  • the respiratory phase detection unit 105 includes:
  • Respiration amplitude detection module used for real-time detection of respiration phase and sending out respiration phase signal
  • the respiratory phase judging module is used to receive the respiratory phase signal sent by the respiratory amplitude detection module, calculate the respiratory phase at any time in real time, and transmit the calculation result of the respiratory phase to the puncture path planning unit 102 .
  • the respiratory phase detection unit 105 mainly uses the respiratory belt to detect the patient's respiratory phase in real time during the operation, and uses the output respiratory phase to select the corresponding optimal puncture path; Amplitude sensor.
  • the puncture path planning unit 102 includes:
  • the puncture path optimization module is used to receive the respiratory phase calculation result and generate a puncture path under any respiratory phase
  • the puncture needle posture adjustment module is configured to receive the puncture path and adjust the posture of the puncture needle 2 so that the puncture needle 2 can be collinear with the puncture path.
  • the dynamic puncture path optimization module mainly uses the preoperatively reconstructed movement trajectories of key organs in the full respiratory phase and the obstacle avoidance algorithm to generate the optimal puncture path in any respiratory phase;
  • the puncture needle attitude adjustment module is mainly used to adjust The posture of the puncture needle 2 is so that it can be collinear with the planned needle insertion trajectory.
  • the motion control unit 103 includes:
  • the actuator control module is used to control the movement of the robot puncture mechanism 104;
  • the needle insertion mechanism control module is used to control the movement of the puncture needle 2 .
  • the actuator control module mainly controls the six degrees of freedom of the actuator, and places the robot near the target position according to the instructions of the doctor's main terminal operation;
  • the needle insertion mechanism control module mainly controls the insertion of the puncture needle 2 into the target lesion.
  • CT compatible lung biopsy system of the present application is described in detail:
  • the application system includes: an image processing unit 101 , a puncture path planning unit, a motion control unit 103 and a respiratory phase detection unit 105 .
  • the image processing unit 101 first uses the preoperative CT image or image, and the doctor determines the puncture level through the CT image, and manually marks the puncture target point and the puncture needle 2 entry point on the CT image of the corresponding level, Form the preoperative puncture path planning; when the patient is lying on the CT examination bed and lock the puncture robot ring structure (arched guide rail 5), use the intraoperative CT image acquisition module to collect real-time intraoperative CT images; intraoperative image registration The module registers the intraoperative CT image with the preoperatively planned puncture level to determine the actual intraoperative puncture level; the results of the above modules will be input to the puncture path optimization module in the puncture path planning unit.
  • the patient is equipped with a sensor for real-time detection of respiration amplitude, and the respiration amplitude detection module in the respiration phase detection unit 105 transmits the signal to the respiration phase determination module, thereby calculating the respiration rate of the patient at any time in real time.
  • the respiratory phase determination module indicates that the respiratory phase enters the pre-scheduled respiratory gating range
  • the doctor can perform the puncture and signal the patient to hold his breath, and the puncture path planning unit
  • the puncture path optimization module in will input the corresponding puncture path to the puncture needle posture adjustment module to determine how the puncture needle 2 needs to move from the current position to the planned puncture position.
  • the mechanical arm 1041 and the needle insertion mechanism 4 in the puncture robot are controlled by the actuator control module in the motion control unit 103 to move to a specified position, so that the line where the puncture needle 2 is located is in line with The planned puncture needle 2 paths are collinear,.
  • the doctor controls and operates the main hand 106 to control the control module of the needle insertion mechanism 4, thereby pushing the puncture needle 2 into the needle or retreating.
  • the control module of the needle insertion mechanism 4 displays the position of the puncture needle 2 in the intraoperative CT image according to the distance advanced or retreated, and feeds back the image to the doctor through the healthy side module of the puncture needle 2 in the medical image processing unit 101 module.
  • the robot puncture mechanism 104 includes: the mechanical arm 1041 is a three-degree-of-freedom mechanical arm 1041, which is responsible for moving the three-degree-of-freedom puncture mechanism 1042 at the end to a specified position in space , the puncture needle clamping mechanism 1043 is responsible for clamping and disengaging the puncture needle 2 .
  • the system of the present application includes a robot puncture mechanism 104;
  • the robot puncture mechanism 104 specifically includes an arched guide rail 5, an arched guide rail slider 8, a lifting arm 9, a horizontal arm 10, a rotating arm 12 and
  • the arched guide rail 5 and the guide rail housing 11 mainly include a rack-and-pinion mechanism 23 as a drive module, and a guide rail guide slider 22 as a guide module, and the rack-and-pinion mechanism 23 is driven by a gear motor 36 .
  • the arched frame includes an arched guide rail 5; the robot puncture mechanism 104 also includes a fixed base 7, and the fixed base 7 is provided with a latch 35; the fixed end of the arched guide rail 5 is rotatably connected to the fixed base 7 by a hinge , the free end of the arched frame can be freely opened and closed through the latch 35 and locked or unlocked with the fixed base 7 .
  • the arched guide rail slider 8 is installed on the arched frame and can slide on the arched guide rail 5; the arched guide rail slider 8 is connected with the arched guide rail 5 through the guide rail guide slider 22, and can move along the guide rail to realize puncture Lateral movement of mechanism 1042.
  • the fixed base 7 is equipped with a connection point 37, and the fixed end of the arched guide rail 5 is equipped with an emergency stop button 15 for physical safety intervention.
  • Lifting arm 9 can be moved up and down and installed on the arched guide rail slider 8;
  • the robot puncture mechanism 104 includes a lifting arm slider 18 and a lifting arm screw motor 16, and the arched guide rail slider 8 is provided with a lifting arm screw guide rail 17 , the lifting arm screw motor 16 drives the lifting arm slider 18 to move on the lifting arm screw guide rail 17;
  • the lifting arm 9 is wrapped with a lifting arm shell 13, and is connected to the lifting arm screw guide rail through the lifting arm slider 18 17, it is driven by the lifting arm screw motor 16 to realize vertical lifting motion.
  • the lifting arm screw guide rail 17 is wrapped by the arched guide rail slider housing 14, and is equipped with a screw motor connection port 20, and a photoelectric switch 21 for the limit function of the slide rail.
  • Horizontal arm 10 can be installed on the lifting arm 9 that can move horizontally; Rod motor 19 drives the horizontal arm screw rod slider 24 to move on the horizontal arm screw rod guide rail 26; 26 sports.
  • the horizontal arm 10 is mainly used to provide the degree of freedom in translation of the head and feet.
  • the rotating arm motor 25 is rigidly connected to the horizontal arm 10 and performs translational movement together with the horizontal arm 10 .
  • Rotating arm 12 is rotatably installed on the horizontal arm 10; a rotating arm motor 25 is installed on the horizontal arm 10, and the rotating arm 12 is connected with the rotating arm motor 25, and the rotating arm motor 25 drives the rotating arm 12 to rotate; one end of the rotating arm 12 passes through
  • the rotating shaft is rigidly connected to the rotating arm motor 25 to realize the adjustment of the roll angle of the terminal piercing mechanism 1042 .
  • the other end of the rotating arm 12 is rigidly connected with the needle-introducing mechanism 4 through the rotating shaft and the flange 28, and the needle-introducing mechanism 4 and the rotating shaft are driven by the rotating motor 33 rigidly fixed in the rotating arm 12 to realize the pitch angle of the terminal puncture mechanism 1042 (in Fig. marked in ) movement.
  • the rotating arm 12 is provided with a locking button 6 and a development mark 34, the former is used for locking the rotational degree of freedom, and the latter is used for the development positioning under CT.
  • the needle advancing mechanism 4 is installed on the rotating arm 12 for puncturing; the needle advancing mechanism 4 includes.
  • the needle insertion mechanism 4 mainly includes the puncture needle 2, the needle holder 3, the needle insertion frame and the needle insertion screw guide rail 30, the needle holder 3 is movably installed on the needle insertion frame, and the puncture needle 2 is installed on the needle holder 3 .
  • the needle holder 3 is rigidly fixed on the slide block of the needle advance screw guide rail 30, driven by the needle advance screw motor 27 to complete the needle advance/retract movement.
  • the needle holder 3 realizes the opening and closing movement through the needle holder gear 31 and the needle holder rack 32, and is driven by the needle holder motor 29 rigidly connected to the slide block of the needle feeding screw guide rail 30.
  • the needle insertion mechanism 4 is also equipped with a developing mark 34 for showing the posture of puncturing under CT.
  • the puncture robot proposed in this application is also equipped with a touch screen 1 with function buttons on it, so that the doctor can fine-tune the position of the mechanism and lock the overall posture beside the operating table.
  • the slider 8, the lifting arm 9, the horizontal arm 10 and the rotating arm 12 quickly adjust the position and posture to complete the positioning.
  • the needle insertion mechanism 4 clamps the puncture needle 2 through the needle holder 3 and completes the coaxial needle insertion. After insertion, the needle holder 3 and The puncture needle 2 is disengaged. The doctor inserts a biopsy gun through the channel created by the coaxial needle to complete the biopsy sample.
  • the arched frame fixed on the operating bed is respectively equipped with a three-degree-of-freedom mechanical structure, which includes an arched motion mechanism (arch guide rail slider 8), a lifting motion mechanism (lifting arm 9) and a horizontal motion mechanism (horizontal arm 10) to realize the translational movement and arc motion of the mechanism, and the three-degree-of-freedom puncture mechanism 1042 (rotating arm 12 and needle insertion mechanism 4) can realize pitch and swing angle adjustment of the needle insertion mechanism 4 and needle advance/retraction, the puncture needle
  • the clamping mechanism 1043 is responsible for clamping and disengaging the puncture needle 2 .
  • the arched arm is realized by the rack and pinion guide rail
  • the lifting arm 9, the horizontal arm 10 and the needle feeding mechanism 4 are realized by the screw rod guide rail
  • the rotating arm 12 is driven by two rotating motors 33
  • the puncture needle clamping mechanism 1043 is realized by the gear teeth. article is realized.
  • the parameters of the puncture mechanism 1042 are set as follows: the pitch range of the needle insertion mechanism 4 is 45 degrees, the swing range is 360 degrees, and the movement range of the needle is 110 mm; 180 degree.
  • the puncture mechanism 1042 is also equipped with an optical marking system.
  • the arched robotic arms 1041 are respectively openable and closed, and can be fine-tuned and locked in position by the function keys on the touch screen of the mechanism during the operation to complete the initial calibration.
  • a CT lung biopsy method which can realize the CT lung biopsy method by using the features in the above system, and the method includes the following steps:
  • S105 Register the CT image scanned during the operation with the CT image with the planned path before the operation to determine the puncture section during the operation;
  • S106 Visualize and mark the intraoperative CT image in real time, and calculate the needle insertion point and needle insertion angle under the planned path based on the intraoperative CT image visualization marker, the registration result of the intraoperative CT image and the preoperative CT image;
  • the respiratory gated puncture within a certain error range is realized, and the puncture of the puncture biopsy, especially the pulmonary nodule that is greatly affected by breathing, is improved. Biopsy accuracy, efficiency and safety.
  • the present application detects the respiratory phase of the patient during the puncture process, so that an optimized puncture path can be generated according to the respiratory phase, so as to achieve precise puncture and reduce damage and complications in the patient's body caused by erroneous puncture.
  • Step 1 preoperative preparation: the free end of the arched guide rail 5 is separated from the fixed base 7, the mechanism body is opened, the patient enters the CT examination bed, and a suitable puncture position is selected according to the doctor's advice. Finally, the arched guide rail 5 is closed and the latch 35 is locked.
  • Step 2 initial adjustment of the position of the puncture mechanism 1042: the doctor manipulates and operates the main hand 106 to move the actuator (robot puncture mechanism 104) above the patient's operation area, and then the assistant controls the three-degree-of-freedom sliding device through the touch screen 1 next to the actuator.
  • the rail mechanism and the three-degree-of-freedom puncture mechanism 1042 make the puncture mechanism 1042 more efficient, and the puncture coaxial needle is installed, and finally the locking mechanism is initialized.
  • Step 3 import the preoperative planning path: the doctor imports the preoperative CT images including the entire complete respiratory phase and the corresponding puncture path planning results into the image processing unit 101 at the main control terminal, and the imported data includes the preoperative The result of the optimal puncture path under the optimal respiratory phase selected by the doctor through the human-computer interaction recognition module.
  • Step 4 intraoperative CT scanning: the doctor remotely controls the CT machine tool and the actuator to enter the CT machine hole, the patient breathes normally according to the instructions of the preoperative breathing training, and the CT machine starts scanning.
  • Step 5 respiratory phase monitoring: the image acquisition module in the image processing unit 101 collects intraoperative real-time CT data, and the doctor monitors in real time through the display screen of the main control terminal. The doctor instructed the patient to hold his breath immediately.
  • Step 6 image registration: the image processing unit 101 quickly completes the intraoperative CT image registration with the preoperative CT image with the planned path, so as to determine the intraoperative puncture section.
  • Step 7 motion planning: the motion planning unit calculates the needle insertion point and needle insertion angle under the planned path according to the imaging marker 34 under the intraoperative real-time CT and the registration result of the intraoperative CT and the preoperative CT.
  • Step 8 motion execution: the motion control unit 103 drives the actuator to complete the positioning according to the calculation result of the motion planning unit, and controls the needle insertion mechanism 4 to complete automatic needle insertion. The whole process is remotely monitored by the doctor in real time at the main control terminal.
  • Step 9 the puncture needle 2 is inserted: when the needle is inserted, the puncture needle 2 detection module of the image processing unit 101 will feed back the needle insertion process of the puncture needle 2, especially the needle insertion depth, to the doctor in real time, and the doctor will judge whether the puncture needle 2 is accurate Under the pre-established puncture path to reach the target.
  • Step ten the puncture needle 2 is separated from the mechanism: after the puncture is completed, the puncture needle clamping mechanism 1043 is separated from the puncture needle 2, the actuator is reset as a whole and away from the puncture area, and the patient resumes normal breathing.
  • Step 11 biopsy sampling: the CT machine tool and mechanism exit the CT machine as a whole, and the doctor comes to the operating table and inserts the biopsy gun through the puncture channel established by the coaxial puncture needle 2 to complete the biopsy sampling.
  • Step 12 postoperative evaluation: the doctor completes the postoperative evaluation, including the evaluation of the operation process and possible postoperative complications.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Surgery (AREA)
  • Medical Informatics (AREA)
  • Animal Behavior & Ethology (AREA)
  • Public Health (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Molecular Biology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • General Health & Medical Sciences (AREA)
  • Biomedical Technology (AREA)
  • Pathology (AREA)
  • Robotics (AREA)
  • Physics & Mathematics (AREA)
  • Biophysics (AREA)
  • High Energy & Nuclear Physics (AREA)
  • Optics & Photonics (AREA)
  • Radiology & Medical Imaging (AREA)
  • Apparatus For Radiation Diagnosis (AREA)

Abstract

La présente demande se rapporte au domaine des dispositifs médicaux, et se rapporte spécifiquement à un système de biopsie pulmonaire compatible CT et à un procédé. Le système comprend : une unité de traitement d'image, utilisée pour afficher une image CT, déterminer un niveau de perforation sur l'image CT, et marquer un point cible de perforation et un point d'insertion d'aiguille de perforation, formant un plan d'itinéraire de perforation préopératoire ; une unité de détection de phase respiratoire, utilisée pour la détection en temps réel d'une phase respiratoire, et la transmission d'un résultat de détection de phase respiratoire à une unité de planification d'itinéraire de perforation ; une unité de planification d'itinéraire de perforation, utilisée pour générer un itinéraire de perforation dans n'importe quelle phase respiratoire, et utilisée pour ajuster une attitude de perforation d'un mécanisme de perforation robotisé, de telle sorte qu'une aiguille de perforation sur le mécanisme de perforation de robot est colinéaire avec l'itinéraire de perforation ; et une unité de commande de mouvement, utilisée pour commander le mouvement du mécanisme de perforation robotisé et un mouvement de perforation de l'aiguille de perforation. Au cours d'un processus de perforation, la phase respiratoire du patient est détectée au moyen de l'unité de détection de phase respiratoire, de telle sorte qu'un itinéraire de perforation optimisé peut être généré en fonction de la phase respiratoire, ce qui permet d'obtenir une perforation précise et de réduire les dommages au corps du patient provoqués par une erreur de perforation.
PCT/CN2021/122164 2021-09-30 2021-09-30 Système et procédé de biopsie pulmonaire compatible ct Ceased WO2023050307A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/CN2021/122164 WO2023050307A1 (fr) 2021-09-30 2021-09-30 Système et procédé de biopsie pulmonaire compatible ct

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/CN2021/122164 WO2023050307A1 (fr) 2021-09-30 2021-09-30 Système et procédé de biopsie pulmonaire compatible ct

Publications (1)

Publication Number Publication Date
WO2023050307A1 true WO2023050307A1 (fr) 2023-04-06

Family

ID=85781134

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/CN2021/122164 Ceased WO2023050307A1 (fr) 2021-09-30 2021-09-30 Système et procédé de biopsie pulmonaire compatible ct

Country Status (1)

Country Link
WO (1) WO2023050307A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN117338422A (zh) * 2023-10-30 2024-01-05 赛诺威盛医疗科技(扬州)有限公司 空间注册及运动学解算机器人控制方法、系统及装置
CN117731376A (zh) * 2024-02-20 2024-03-22 四川省肿瘤医院 一种妇科肿瘤影像术前智能导向识别系统

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN102755195A (zh) * 2011-04-29 2012-10-31 陈德路 肿瘤等中心多角度非共面经皮穿刺方法
CN102949240A (zh) * 2011-08-26 2013-03-06 高欣 一种影像导航肺部介入手术系统
CN109330683A (zh) * 2018-09-07 2019-02-15 天津市肿瘤医院 一种基于患者肺部4d-ct的介入穿刺路径安全性评估方法
CN110638528A (zh) * 2018-06-26 2020-01-03 上海交通大学 手持式超声引导神经阻滞机器人
WO2020064924A1 (fr) * 2018-09-27 2020-04-02 Koninklijke Philips N.V. Guidage dans des procédures d'intervention pulmonaire
CN111067622A (zh) * 2019-12-09 2020-04-28 天津大学 一种面向肺部经皮穿刺的呼吸运动补偿方法
CN112286205A (zh) * 2020-11-13 2021-01-29 毕建平 一种穿刺路径规划方法、系统及机器人
CN113100935A (zh) * 2021-04-13 2021-07-13 上海大学 一种肺部穿刺手术术前穿刺路径规划方法及训练系统

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN102755195A (zh) * 2011-04-29 2012-10-31 陈德路 肿瘤等中心多角度非共面经皮穿刺方法
CN102949240A (zh) * 2011-08-26 2013-03-06 高欣 一种影像导航肺部介入手术系统
CN110638528A (zh) * 2018-06-26 2020-01-03 上海交通大学 手持式超声引导神经阻滞机器人
CN109330683A (zh) * 2018-09-07 2019-02-15 天津市肿瘤医院 一种基于患者肺部4d-ct的介入穿刺路径安全性评估方法
WO2020064924A1 (fr) * 2018-09-27 2020-04-02 Koninklijke Philips N.V. Guidage dans des procédures d'intervention pulmonaire
CN111067622A (zh) * 2019-12-09 2020-04-28 天津大学 一种面向肺部经皮穿刺的呼吸运动补偿方法
CN112286205A (zh) * 2020-11-13 2021-01-29 毕建平 一种穿刺路径规划方法、系统及机器人
CN113100935A (zh) * 2021-04-13 2021-07-13 上海大学 一种肺部穿刺手术术前穿刺路径规划方法及训练系统

Non-Patent Citations (2)

* Cited by examiner, † Cited by third party
Title
"Doctoral Dissertation", 1 October 2017, NORTHEASTERN UNIVERSITY, CN, article BAO, NAN: "The Key Technologies Research of Trajectory Planning and Surgery Navigation in CT Image-guide Lung Puncture", pages: 1 - 126, XP009544908 *
ANDREAS MELZER ; BERND GUTMANN ; THOMAS REMMELE ; RENATE WOLF ; ANDREAS LUKOSCHECK ; MICHAEL BOCK ; HUBERT BARDENHEUER ; HARALD FI: "INNOMOTION for Percutaneous Image-Guided Interventions", IEEE ENGINEERING IN MEDICINE AND BIOLOGY MAGAZINE, vol. 27, no. 3, 1 May 2008 (2008-05-01), US , pages 66 - 73, XP011215479, ISSN: 0739-5175 *

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN117338422A (zh) * 2023-10-30 2024-01-05 赛诺威盛医疗科技(扬州)有限公司 空间注册及运动学解算机器人控制方法、系统及装置
CN117338422B (zh) * 2023-10-30 2024-04-05 赛诺威盛医疗科技(扬州)有限公司 空间注册及运动学解算机器人控制方法、系统及装置
CN117731376A (zh) * 2024-02-20 2024-03-22 四川省肿瘤医院 一种妇科肿瘤影像术前智能导向识别系统
CN117731376B (zh) * 2024-02-20 2024-04-19 四川省肿瘤医院 一种妇科肿瘤影像术前智能导向识别系统

Similar Documents

Publication Publication Date Title
CN113940733B (zh) 一种ct兼容的肺部穿刺活检系统及方法
US12208220B2 (en) Active distal tip drive
CN113558735B (zh) 一种面向胆道穿刺的机器人穿刺定位方法及装置
Boctor et al. Three‐dimensional ultrasound‐guided robotic needle placement: an experimental evaluation
US10010308B2 (en) System and method for CT-guided needle biopsy
CN109475384B (zh) 自动插入装置
CA2589569C (fr) Dispositif de biopsie par irm
WO2023019479A1 (fr) Procédé et appareil de positionnement de perforation robot pour la perforation des voies biliaires
EP1363548B1 (fr) Dispositif d'imagerie diagnostique medicale
Zhou et al. CT‐guided robotic needle biopsy of lung nodules with respiratory motion–experimental system and preliminary test
WO2017043926A1 (fr) Procédé de guidage de processus d'intervention utilisant des images médicales et système pour processus d'intervention pour celui-ci
WO2023050307A1 (fr) Système et procédé de biopsie pulmonaire compatible ct
WO2017050201A1 (fr) Système de robot médical très peu invasif
CN215874870U (zh) 一种面向胆道穿刺的机器人穿刺定位装置
US20210169583A1 (en) Method for maintaining localization of distal catheter tip to target during ventilation and/or cardiac cycles
CN112494118A (zh) 一种多针穿刺系统
CN112353461B (zh) Ct实时定位精准穿刺机器人
CN112244953B (zh) 用于自动穿刺的机器手
CN113940759B (zh) 穿刺手术主控台及穿刺机器人
US20250107820A1 (en) Image-guided robotic system and method with step-wise needle insertion
CN114795473A (zh) 一种基于拼接影像的呼吸跟踪方法
US20240206862A1 (en) Intelligent articulation management for endoluminal devices
CN116236288A (zh) 一种微型穿刺机器人、穿刺系统及穿刺控制模型
JP2002034969A (ja) 断層撮影装置
US20240216013A1 (en) Deflectable pulmonary access tool

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 21958881

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 21958881

Country of ref document: EP

Kind code of ref document: A1

122 Ep: pct application non-entry in european phase

Ref document number: 21958881

Country of ref document: EP

Kind code of ref document: A1

32PN Ep: public notification in the ep bulletin as address of the adressee cannot be established

Free format text: NOTING OF LOSS OF RIGHTS PURSUANT TO RULE 112(1) EPC (EPO FORM 1205A DATED 23/09/2024)