Visualization positioning conduitTechnical field
The present invention relates to a kind of medical instruments, more particularly to a kind of medical catheter, or can be described as endoscope, specifically relate toAnd a kind of visualization positions conduit.
Background technique
Peripheral pulmonary lesion (peripheral pulmonary lesions) diagnosis is always puzzlement clinician'sOne problem.Common inspection method include conventional bronchoscope inspection, in wall of the chest Puncture Lung Biopsies, bronchus radial ultrasonic,Diagnostic operation etc..But peripheral pulmonary lesions cannot be viewed directly mostly under bronchoscope or rarely seen certain indirect signsAs, and bronchoscope is influenced peripheral pulmonary lesion diagnosis by size of tumor, and lesion is smaller, and diagnosis is lower.
After 2000, one new to be used for peripheral pulmonary lesion diagnostic techniques-electromagnetic navigation bronchoscope(electromagnetic navigation bronchoscopy, ENB) comes out.ENB technology collection simulation supporting system with can be bentThe advantages of formula bronchoscope, not only can be accurate to the peripheral pulmonary lesion portion that can not be reached up to conventional bronchoscopePosition, but available pathological tissues carry out pathologic finding (quoted from Chongqing Medical the 12nd phase of volume 42 in April, 2013: 1671-8348(2013) 12-1421-04).
Electromagnetic navigation system composition: 1. electromagnetic location plate: electromagnetic location plate is one piece of 56cm × 47cm × 1cm sizeMagnetic board, discharge low-frequency electromagnetic wave.When inspection, electromagnetic location plate is placed in the head side of bronchoscopy bed, and patient lies downSide thereon.2. navigation probe: retractable sensor probe is fixed in the tip of a flexible metallic cable, and probe will letterBreath is sent to computer.Probe and a root long 130cm, diameter are that the conduit of 1.9mm is integrated, this root conduit can be madeInstrument is operated for being placed in bronchoscope for service aisle (extendedworkingchannel, EWC), by navigatingSystem guides to target area is operated.Probe is placed in electromagnetic field, the fortune such as its orientation such as X, Y, Z axis and rotation, inclinationIt is dynamic to be captured by system.The information real-time display captured, and be superimposed with CT picture of patient.3. computer software and prisonVisual organ: in operating process, operator can by monitor from Coronal, sagittal plain, axle position watch 3 Victoria C T images and withThe anatomical position of the focal zone of image superposition marks, and can be appreciated that probe positions trend in operation.
ENB technology clinical manipulation process: 1. image positions: digitlization CT image being downloaded in ENB software, is led toCross the chest image and virtual bronchial tree rebuild and form axle position, Coronal and sagittal plain.In CT image and virtual branch gasThe corresponding anatomical position of pipe tree makees 5~7 labels.Focal zone is also done in the same fashion label.2. sensor is placed in patientChest carries out bronchoscopy to patient under local anaesthesia or general anesthesia, is placed in positioning probe from bronchoscope work duct, passes throughSoftware confirms telltale mark on virtual bronchoscopic image and same label in vivo, and two image superpositions are registrated.By calculatingMachine software automatically generates the navigation picture for reaching target area.3. operation: by navigation, bronchoscope is embedded in target segmental bronchus, it willProbe is pushed ahead under navigation after being inserted in EWC, and the electromagnetic wave information of sensor probe reception magnetic board release is simultaneously anti-by itIt is fed back to system, system can accurately perceive the position of probe, and operator can in due course be corrected probe positions.Reach lesion portionBehind position, probe is exited, merging bronchoscope operates instrument, can clearly be clamped after operation instrument and lesion and the relationship of pleuraThe operation such as take.
However, this electromagnetic navigation bronchoscope system lacks the dress of direct visualizztion after reaching target area by navigation probeIt sets, the direct symbol of lesion can not be presented directly to doctor, be unfavorable for doctor and directly diagnose.
US20070225559A1 patent proposes a kind of visualization catheter, has and is used for imaging device and individual workMake channel, electromagnetic location sensor is removably inserted into individual service aisle, can be collected simultaneously location information and imageInformation.Imaging device is imaging fiber.
Optical fiber is coated togather by internal poles thin glass fiber silk and is formed.There are following defects for imaging fiber:
1. expensive, manufacturing process is complicated, and the more glass fibers of glass fiber filled under same area will be thinner,It is higher to technique requirement, less it is suitable for disposable product.
2. integrity problem: glass optical fiber imaging beam is coated by the monofilament of multiply 0.03mm or so, either plusIn work manufacture or use process, glass fiber all easily fractures, and easily loses, and can be formed in the picture one by one after fractureingStain requires operator relatively high.
3. image-quality problems: the diameter of individual glass fibers silk is >=0.03mm, can only in the range of diameter 0.5mmA pixel more than 200 is filled, image is not clear enough, if the glass fiber of filling is more, size will increase again, this drawbackIt is difficult to solve.By taking the product OVM6948 of Hao Wei company as an example, the size of pixel is 1.75um*1.75um, in its shape rulerIn the range of very little 0.65mm*0.65mm, 4W pixel can be exported.And can only be coated in the range of 0.65mm*0.65mm less than600 glass light fibrils.
The electromagnetic location sensor of US20070225559A1 patent is fixed on seal wire, and seal wire is wanted and conduit is under navigationIt promotes together, seal wire will exit behind in-position, then work under the work cavity for passing through conduit.The electromagnetic location sensor is consolidatedDetermine mode to have the following deficiencies:
1. the position of conduit insertion can not be accurately determined again after the extraction of electromagnetic location sensor, with initial bit before extractionInconsistent risk may be had by setting；
2. the complicated operation of doctor, the propulsion of seal wire and is exited, complicated for operation to be easy to produce operating error.
Therefore, this field needs to research and develop low a kind of cost that can overcome drawbacks described above, highly reliable, imaging clearly, accuratePositioning, visualization easy to use position conduit.
Summary of the invention
The technical problem to be solved in the present invention is to provide a kind of visualizations to position conduit, and which overcome lacking for the prior artFall into, solve expensive, glass fiber existing for existing fiber imaging catheter easily lose, integrity problem, image qualityIt is complicated for operation and the technical issues of be also easy to produce position error existing for problem and the fixed form of electromagnetic location sensor.
In order to solve the above technical problems, the present invention adopts the following technical scheme:
The leading end portion structure of a kind of visualization positioning conduit, the visualization positioning conduit includes cmos sensor, electromagnetic locationSensor and service aisle；The electromagnetic location sensor is located at the cmos sensor rear end, the cmos sensor placementIn in cmos sensor fixing seat, the electromagnetic location sensor is placed in electromagnetic location sensor fixing seat；The CMOSSensor fixing seat is connect with the electromagnetic location sensor fixing seat by clamping ring；Cmos sensor signal wire and CMOS are passedSensor connection, electromagnetic location sensor signal lines are connect with electromagnetic location sensor.
As currently preferred technical solution, the visualization positioning conduit further includes light structures.
As currently preferred technical solution, the light structures are as follows: light source is equipped in the cmos sensor, orThe visualization positioning conduit has individual light source equipment, and setting optical fiber connects light source and sets in visualization positioning conduitStandby that light is transmitted to front end from rear end, the optical fiber is glass optical fiber or plastic optical fiber.
As currently preferred technical solution, the light structures are as follows: LED light is equipped with beside the cmos sensorPearl is powered by electric wire to LED lamp bead.
As currently preferred technical solution, the electromagnetic location sensor fixing seat is cylinder, including the first skyChamber and the second cavity, wherein the first cavity is for placing electromagnetic location sensor, the second cavity is for placing service aisle, electromagnetismAlignment sensor signal wire and cmos sensor signal wire.
As currently preferred technical solution, the cmos sensor fixing seat is cylinder, including for placingThe cavity of cmos sensor, for placing the cavity of service aisle, for placing the cavity of light structures.
As currently preferred technical solution, the cmos sensor front end has imaging lens；The CMOS sensingThe size of device is less than or equal to 0.65*0.65mm；The diameter of the electromagnetic location sensor is less than or equal to 0.45mm；The work is logicalThe diameter in road is more than or equal to 1.2mm, and the diameter of the visualization positioning conduit is less than or equal to 2.6mm.
As currently preferred technical solution, the cmos sensor signal wire and electromagnetic location sensor signal lines are adoptedWith coaxial line, coaxial line is respectively inner core, insulating layer, shielded layer and outer quilt from inside to outside.
As currently preferred technical solution, the clamping ring and the electromagnetic location sensor fixing seat and describedCmos sensor fixing seat uses medical grade nonmetallic materials；The main body of the visualization positioning conduit and the service aisle are adoptedWith disposable extrusion molding pipe, material is medical grade material.
As currently preferred technical solution, electromagnetic location sensor rear end is equipped with snake bone structure, the snake boneStructure includes single use deflectable snake bone and bent angle control handwheel, before the bent angle control handwheel controls snake bone by rope tractionEnd bending.
As currently preferred technical solution, the bent angle control handwheel includes rotation axis, drum, drum cover, bent angleSpanner and screw；The both ends of the rotation axis are square structure, are inserted into the rectangular of the bent angle spanner and the drum respectivelyKong Zhong is locked with screw；Two groove of drum side is wirerope track, and wirerope is wound simultaneously by the hole on drumIt is weldingly fixed on drum, wirerope track is entered by the notch on drum；There are two three-way rope hole, steel for drum cover sideIt is drawn by two three-way rope holes at cord both ends；Clearance gap is less than the diameter of wirerope between drum cover and drum；On drum coverMultiple through-holes be location hole, with housing on detent fit；Threaded hole mounting screw on drum cover, screw root and drumRotary spacing stop block structure cooperation on wheel, limits rotating drum angle；The shell that bent angle controls handwheel is solid equipped with bourdon tubeDetermine part, have locating groove on the bourdon tube fixing piece, bent angle is fixed on by locating groove and is controlled on the shell of handwheel；InstituteBourdon tube fixing piece is stated equipped with through-hole, through-hole is interior to pass through bourdon tube and wirerope, is equipped with step in through-hole, realizes for limitThe bourdon tube that snake cyrtosis provides a supporting role；Bourdon tube fixing piece is fixed in described bourdon tube one end, and the other end is fixed on snakeBone rear end；Wirerope is through in bourdon tube, and snake bone front end is fixed in wirerope one end, and the other end is fixed on drum；It rotates curvedAngle spanner drives rotating drum, realizes wirerope drawing, drives snake cyrtosis.
Compared with prior art, the beneficial effects of the present invention are:
1. manufacturing cost is lower, and yield is high.The present invention uses cmos image sensor, and CMOS is criticized as a kind of electronic productThe product of automated production is measured, manufacturing cost is lower, and price uses glass well below the prior art from several pieces to several hundred members etc.The cost of glass imaging fiber beam, length is longer, and the cost of glass optical fiber imaging beam is higher, usually from thousands of to up to ten thousand members etc..
2. can be used as the use of Dispoable medical product, ethane via epoxyethane sterilization avoids cross-infection.Due to manufacture atOriginally it substantially reduces, ethylene oxide sterilizing can be passed through, used as disposable products, avoid the product reused due to sterilizing notThoroughly cause the cross-infection of patient.
3. product reliability is high.The prior art using glass optical fiber imaging beam is coated by the monofilament of multiply 0.03mm or soIt forms, either in processing and manufacturing or use process, all easily loses.And the letter for the cmos sensor output that the present invention usesIt number is transmitted by electric wire or coaxial line, the reliability of signal cable is much higher by glass optical fiber.
4. picture quality improves.By taking the product OVM6948 of Hao Wei company as an example, the size of pixel is 1.75um*1.75um can export 4W pixel in the range of its outer dimension 0.65mm*0.65mm.And in the model of 0.65mm*0.65mmLess than 600 glass light fibrils can only be coated in enclosing.Under comparable size, the imaging of COMS is more clear.
5. positioning more accurate.Since CMOS is to transmit signal by electric wire or coaxial line, the diameter of electric wire is usualAll be it is superfine, this is placed in signal transducer rear end to electromagnetic sensor and provides space.Electromagnetic positioners are fixed on conduitOn, in entire surgical procedure, it can be accurately positioned catheter position, there is no the risks of shift in position.
6. simplifying doctor's operation.The use of seal wire, electromagnetic positioners and cmos sensor can be saved in any caseIt is fixed on conduit simultaneously, doctor can be accurately positioned by conduit, under the premise of visualization guidance, reach lesions position, i.e.,The instruments such as lower biopsy forceps are sampled or treat.
7. the scope of application is wider, in addition to intravascular, it can be adapted for more human body non-vascular cavities.Such as lung's capillaryThe bronchial usual 2-3mm of diameter is even more small, in the case where same imaging effect, cmos sensor can accomplish it is smaller,Conduit thinner (can be equipped with 0.45mm even smaller electromagnetic location sensor, section 0.65*0.65mm is even smallerCmos sensor, is provided simultaneously with the even greater service aisle of 1.2mm, and the diameter of visualization positioning conduit is usually no more than2.6mm), it is more suitable for thinner non-vascular cavity.
Detailed description of the invention
The present invention is described in further detail with reference to the accompanying drawings and examples.
Fig. 1 is the structural schematic diagram using the electromagnetic navigation system of present invention visualization positioning conduit；
Fig. 2 is the use state diagram of electromagnetic navigation system；
Fig. 3 is the schematic cross-section of the leading end portion structure of present invention visualization positioning conduit；
Fig. 4 A and Fig. 4 B are the top view of the leading end portion structure of present invention visualization positioning conduit, and wherein Fig. 4 A represents illumination schemeOne, Fig. 4 B represent illumination scheme two；
Fig. 5 is the structural schematic diagram of cmos sensor fixing seat of the invention；
Fig. 6 is the structural schematic diagram of electromagnetic location sensor fixing seat of the invention；
Signal line structure schematic diagram Fig. 7 of the invention;
Fig. 8 is the structural schematic diagram of visualization positioning conduit of the present invention containing snake bone structure.
Fig. 9 A, Fig. 9 B and Fig. 9 C are the schematic diagram for the snake bone structure that electromagnetic location sensor rear end of the invention is designed.ItsIn, Fig. 9 A is the decomposition texture schematic diagram that bent angle controls handwheel；Fig. 9 B is that the limited block structure cooperation on screw and drum turnsDynamic structural schematic diagram；Fig. 9 C is the overall schematic of snake bone structure.
Figure 10 is the enlarged diagram of drum in Fig. 9 A.
Figure 11 is the enlarged diagram of drum cover in Fig. 9 A.
Figure 12 is the enlarged diagram of bourdon tube fixing piece in Fig. 9 C.
The reference numerals are as follows in figure:
1 is visualization positioning conduit, and 11 be leading end portion structure, and 2 be electromagnetic location plate, and 3 be navigation system, and 4 be image procossing systemSystem, 5 be display, and 111 be cmos sensor, and 112 be service aisle, 113 for optical fiber (glass optical fiber or plastic optical fiber, asDisposable product common plastics optical fiber), 114 be LED lamp bead, and 1111 be cmos sensor fixing seat, and 1112 pass for CMOSSensor signal line, 115 be electromagnetic location sensor, and 1151 be electromagnetic location sensor fixing seat, and 1152 sense for electromagnetic locationDevice signal wire, 116 be clamping ring, and A is the first cavity (placing electromagnetic location sensor), and B is that the second cavity (it is logical to place workFoul in road, signal wire etc.), C is inner core (signal transmission), and D is insulating layer, and E is shielded layer, and F is outer quilt, and 6 be snake bone structure,61 control handwheel for bent angle, and 611 be drum, and 6111 be wirerope track, and 6112 be hole, and 6113 be notch, and 612 be drum cover,6121 be three-way rope hole, and 6122 be location hole, and 6123 be threaded hole, and 613 be bent angle spanner, and 614 be screw, and 64 fix for bourdon tubePart, 641 be locating groove, and 642 be through-hole, and 624 be rotation axis, and 615 be rotary spacing block, and 62 be bourdon tube, and 63 be snake bone.
Specific embodiment
As shown in Figure 1, visualization positioning conduit 1 of the invention is connect with image processing system 4 and navigation system 3 respectively,The output (i.e. electromagnetic location sensor signal lines) of the electromagnetic locating signal all the way of visualization positioning conduit 1 can be directly connected to navigateIn system 3.Image processing system 4 is connect with navigation system 3, and main purpose is by endoscopic image and navigator fix information while to showShow in a screen, and can switch in real time.Just there is this function in present navigation software.So present way is imageThe function that processing system 4 has a video to export, vision signal is exported to navigation system 3, is then shown together by navigation system 3Show；Endoscopic image and navigation picture can also be overlapped by the later period, and the augmented reality for doing scope is shown.Image processing system 4It is equipped with display 5, display 5 is connect with navigation system 3 and image processing system 4 respectively.Electromagnetic location plate 2 is one block of electromagnetismPlate (i.e. magnetic field generator) discharges low-frequency electromagnetic wave.When inspection, electromagnetic location plate 2 is placed in the patient of bronchoscopy bedLower section interlayer, and patients surgery region is made to be located at the center of electromagnetic location plate 2, patient's prostrate is above electromagnetic location plate 2 (see figure2).Visualization positioning conduit 1 of the invention includes leading end portion structure 11.
As shown in figure 3, the leading end portion structure 11 includes cmos sensor 111, electromagnetic location sensor 115 and service aisle112, electromagnetic location sensor 115 is placed in 111 rear end of cmos sensor, and it is solid that cmos sensor 111 is placed in cmos sensorIn reservation 1111, electromagnetic location sensor 115 is placed in electromagnetic location sensor fixing seat 1151.Cmos sensor signal wire1112 connect with cmos sensor 111, and electromagnetic location sensor signal lines 1152 are connect with electromagnetic location sensor 115.CMOSSensor fixing seat 1111 is connect with electromagnetic location sensor fixing seat 1151 by clamping ring 116.
Visualization of the invention positions conduit 1, removes imaging arrangement (cmos sensor 111), and (electromagnetic location passes location structureSensor 115) outside, should also have light structures or for light emitting structure.As shown in Figure 4 A and 4 B shown in FIG., lighting method usually has twoKind.
Illumination scheme one is set in imaging sensor (cmos sensor 111) by light source or has individual light sourceLight is transmitted to front end from rear end by optical fiber 113 by equipment, to provide imaging required light, sees Fig. 4 A.Optical fiber 113 is glassGlass optical fiber or plastic optical fiber, as disposable product common plastics optical fiber.
Illumination scheme two, design is no less than one LED lamp bead 114 beside cmos sensor 111, is given by electric wireLED lamp bead 114 is powered, and to provide imaging required light, sees Fig. 4 B.
As shown in figure 5, cmos sensor fixing seat 1111 is cylinder, including the sky for placing cmos sensor 111Chamber, for placing the cavity of service aisle 112, for placing the cavity of optical fiber 113.
As shown in fig. 6, electromagnetic location sensor fixing seat 1151 is cylinder, including the first cavity A and the second cavity B,Wherein the first cavity A is for placing electromagnetic location sensor 115, and the second cavity B is for placing service aisle 112, CMOS sensingFoul in device signal wire 1112 etc..Cmos sensor signal wire 1112 is passed through from the second cavity B, electromagnetic location sensor 115It is fixed in the first cavity A, electromagnetic location sensor signal lines 1152 can be by the first cavity A and cmos sensor signal wire1112 pool together.
Determine as shown in figure 3, cmos sensor 111 and electromagnetic location sensor 115 are fixed on visualization by the present invention simultaneouslyPosition 1 end of conduit (leading end portion structure 11), while it being equipped with light emitting structure (see Fig. 4 A and Fig. 4 B), collect positioning and imaging technique in oneBody.
111 front end of cmos sensor has imaging lens.
The diameter minimum of electromagnetic location sensor 115 can be no more than 0.45mm, under square one, electromagnetic location sensor115 is smaller, and the diameter of visualization positioning conduit 1 is with regard to smaller.
The size minimum of cmos sensor 111 can be no more than 0.65*0.65mm, under square one, cmos sensor 111Size it is smaller, visualization positioning conduit 1 diameter can be smaller.
The diameter minimum of the service aisle 112 of visualization positioning conduit 1 can be no more than 1.2mm, under square one, visualizationThe service aisle 112 for positioning conduit 1 is smaller, and the diameter of visualization positioning conduit 1 can be smaller.
It is being equipped with 0.45mm even smaller electromagnetic location sensor 115, section 0.65*0.65mm even smaller cmosSensor 111, is provided simultaneously with the even greater service aisle 112 of 1.2mm, and visualization positioning 1 diameter of conduit is usually no more than2.6mm。
Since electromagnetic location sensor 115 is placed in 111 rear end of cmos sensor, electromagnetic location sensor 115 is apart from canThere is a fixed range L depending on changing positioning 1 end face of conduit, the position that will lead to actual position and electromagnetic navigation positioning is solid there are oneDetermine error, this fixed error can be usually eliminated by computerized algorithm.
Possessing electromagnetic location sensor is placed in cmos sensor rear end simultaneously, will there is two magnetic fields, in order to avoidSignal interferes with each other, and cmos sensor signal wire 1112 and electromagnetic location sensor signal lines 1152 usually select coaxial line, such asShown in Fig. 7, signal wire is respectively inner core C, insulating layer D from inside to outside, shielded layer E, outer by F.Wherein, inner core C: it is used for transmission heightLevel signal.Insulating layer D: mainly raising interference free performance prevents water, oxygen attack.Shielded layer E(outer conductor): it both can be withLow level signal is conducted by transmission circuit, and there is shielding action.It is outer by F(sheath): be one layer of outermost of insulating layer,It shields.
Clamping ring 116 is usually selected medical with electromagnetic location sensor fixing seat 1151 and cmos sensor fixing seat 1111Grade nonmetallic materials, to reduce cost.
It is used as disposable products, disposable squeeze usually can be selected in visualization positioning 1 main body of conduit and service aisle 112Medical grade material TPU, PEBAX etc. can be selected in formed pipe out, material.
As shown in figure 8, can also be designed in 115 rear end of electromagnetic location sensor in order to preferably control guiding-tube bend insertionSnake bone structure 6.Snake bone structure 6 includes single use deflectable snake bone 63 and bent angle controls handwheel 61, and bent angle control handwheel 61 passes through steelCord traction, control front end snake bone 63 are bent.
As shown in Fig. 9 A, Fig. 9 B and Fig. 9 C, snake bone structure 6 specifically includes single use deflectable snake bone 63, and bent angle controls handwheel61.It includes rotation axis 624, drum 611, drum cover 612, bent angle spanner 613, screw 614 that bent angle, which controls handwheel 61,.Rotation axis624 both ends are square structure, are inserted into the square hole of bent angle spanner 613 and drum 611 respectively, are locked with screw 614 solidFixed (see Fig. 9 A).611 side of drum, two groove is wirerope track 6111, and wirerope passes through three holes 6112 on drum 611It winds and is weldingly fixed on drum 611 (wirerope and drum 611 are using soldering and welding), lacked by two on drum 611Mouth 6113 is shown in Figure 10 into wirerope track 6111().There are two three-way rope holes 6121 for 612 side of drum cover, and wirerope both ends pass throughTwo three-way rope holes 6121 are drawn;Clearance gap is less than the diameter of wirerope between drum cover 612 and drum 611, can effectively preventWirerope derailing;612 6 through-holes of drum cover are location hole 6122, with the detent fit on housing;612 6 spiral shells of drum coverPit 6123 can mounting screw 614 according to actual needs, 615 structure of rotary spacing block on 614 root of screw and drum 611Cooperation, can limit 611 rotational angle of drum (see Fig. 9 B, Figure 10 and Figure 11).There are two positioning cards for band on bourdon tube fixing piece 64Slot 641 is fixed on bent angle by locating groove 641 and controls on the shell of handwheel 61.Bourdon tube fixing piece 64 is set there are two through-hole642, bourdon tube 62 and wirerope are passed through in through-hole 642, is equipped with step in through-hole 642, and limit spring pipe 62 is with (see Figure 12).It insertsEnter 62 one end of portion's bourdon tube and be fixed on bourdon tube fixing piece 64, the other end is fixed on 63 rear end of snake bone.Wirerope is through at bourdon tubeIn 62,63 front end of snake bone is fixed in wirerope one end, and the other end is fixed on drum 611 (actually two sections of wirerope, in operation portionDocking), bourdon tube 62 is to realize that snake cyrtosis provides a supporting role.Bent angle spanner 613 is rotated, drum 611 can be driven to rotate, it is realExisting wirerope drawing, drives insertion section front end snake bone 63 to be bent (Fig. 9 C).