X-ray or gamma ray systems or devices – Source support – Including movable source
Reexamination Certificate
2002-09-23
2004-11-09
Church, Craig E. (Department: 2882)
X-ray or gamma ray systems or devices
Source support
Including movable source
C378S195000
Reexamination Certificate
active
06814490
ABSTRACT:
The invention relates to a device for moving a medical apparatus in a controlled manner as claimed in the precharacterising part of claim
1
and to a method for moving a medical apparatus in a controlled manner as claimed in the precharacterising part of claim
25
.
X-ray apparatuses, particularly those having a C-shaped bow provided with an X-ray source mounted on one end and an X-ray receiver mounted on the other end thereof (in the following briefly referred to as “C-bow”) are part of the standard operating-theatre equipment in emergency surgery. Apparatuses of this type serve for intra-operative imaging purposes, making it possible to control the repositioning manoeuvres necessary for the treatment of bone fractures and to monitor the insertion of implants stabilising the fracture. When the C-bow is used in combination with modern surgical navigation systems, a continuous visualisation of the surgical procedure is made possible by means of fluoroscopic images which are created intra-operatively and may be stored in a computer.
As the procedure described above implies working with X-rays in the presence of persons, i.e. the patient and the operating-room staff, the positioning of the X-ray apparatus should be carried out in such a way as to avoid long periods of fluoroscopic exposure, in other words the exact position should be found right at the first attempt. However, according to the usual practice, the C-bow in the operating theatre is not moved by the operating surgeon him-/herself but by a member of the operating-room staff. The mere communication between the operating surgeon and said member of the operating-room staff concerning the execution of a specific movement of the apparatus relative to the patient may give rise to numerous errors. Often, the C-bow is used after an individual step of an operative procedure in order to control and document the success of the intervention. If a correction of the provisional result of an intervention is necessary, the C-bow must be removed again from the right position which had just been found with difficulty, as the apparatus would otherwise be in the way of the operating surgeon performing the correction on the implant or on the fracture site. In order to perform the control which is subsequently necessary, the C-bow must be brought into the “right” position again, which had already been determined before. This may often lead to long periods of exposure before the image intensifier will generate the right image. A C-bow provided with a “memory” for positions which have once been correctly adjusted would represent a considerable improvement.
A drive device for different vehicles comprising modular, motor driven and controllable rollers is known from WO 98/19875 GRANT. The drive device is controllable by means of a computer having wireless access e.g. to road maps or positioning systems.
A medical system provided with rollers is known from DE 197 01 346 SIEMENS. This known medical system is provided with controlling means for the rollers realized by means of rails and comprises a remote control unit.
Another medical device having motor driven and controllable rollers is known from U.S. Pat. No. 4,589,126 AUGUSTSSON. The control of the drive devices is realized in one embodiment of this known device by means of a computer.
Disadvantageous at these known device is that the computer serving for the control of the drive devices has to be programmed before the treatment or has to be fed with control instructions through an external “fix” positioning system.
The invention is intended to provide a remedy for this. It is accordingly an object of the invention to create a device for moving a medical apparatus, particularly an X-ray apparatus, in a controlled manner.
According to the invention, this object is achieved by means of a device for moving a medical apparatus, particularly an X-ray apparatus, in a controlled manner which shows the features of claim
1
, and by a method for moving a medical apparatus in a controlled manner which shows the features of claim
25
.
Variant without Surgical Navigation System (Basis Version)
The advantage achieved by this consists in the fact that here the X-ray apparatus is moved by the operating surgeon him-/herself. There is no need any more for a second person interpreting and executing the instructions of the operating surgeon which the latter has encoded in his own coordinate system.
The inventive device for moving a medical apparatus in a controlled manner enables a controllable positioning of an apparatus, in particular an X-ray apparatus, in the two dimensions (x/y) of a plane, especially a plane extending parallel to the floor of the operating theatre. The device comprises at least three motor-driven rollers provided with a first axis of rotation extending parallel to said plane and intersecting the centre of the roller, and a second axis of rotation extending perpendicularly to said plane and lying in the plane of the roller or parallel thereto. The rollers are fixedly positioned relative to each other. Each of the rollers is provided with a first drive device by means of which the roller may be rotated about the first axis of rotation and with a second drive device by means of which the roller may be rotated about the second axis of rotation in order to change its direction of travel.
The rollers may be fixed either directly on the medical apparatus via their second axes of rotation or may be fixed, via their second axes of rotation, on a frame serving as a platform for the medical apparatus. The version with a platform is particularly suitable for retrofitting existing apparatuses, whereas the version with the rollers fixed directly on the apparatus will rather be taken into consideration for new apparatuses.
Stepper motors, in particular electronically controllable stepper motors, may be used as first and second drive devices. Stepper motors based on digital drive technology are equally possible. Further details concerning stepper motors of this type may be found, for example, in
Dubbel; Taschenbuch für den Maschinenbau (Pocket Book of Mechanical Engineering); Eds. W. Beitz and K.-H. Grote; Springer Verlag, 19th edition, 1997; Pages: T9 and V29.
The X-ray apparatus according to the invention is preferably realised in the form of a C-bow which is mounted on the inventive device by means of a pedestal. C-bows are usually provided, in addition to the two directions of displacement defined by the plane extending parallel to the floor of the operating theatre, with further axes of motion permitting a movement of the C-bow relative to the displaceable pedestal, which merely serves for displacing the apparatus parallel to the floor. For the handling of the C-bow, at least one linear movement of the C-bow parallel to an axis extending vertically to the floor of the operating theatre (z-axis) as well as motions of rotation about at least two further axes are necessary.
These movements of the C-bow are equally performed in a motor-driven manner. The drive devices for these motions may equally be stepper motors, as described above for the rollers of the inventive device. Linear movements are suitably performed by linear motors such as those described in detail in Dubbel; Taschenbuch für den Maschinenbau (Pocket Book of Mechanical Engineering); Eds. W. Beitz and K.-H. Grote; Springer Verlag, 19th edition, 1997; Pages: T9 and V31.
All the drives mentioned above may either be subject to the direct visual control of the operating surgeon or be controlled by retrieval of stored data relating to a previously occupied position or projection.
1. In this embodiment of the X-ray apparatus according to the invention, the initial positioning of the C-bow is carried out by the operating surgeon under direct visual control by either of the following means:
a) by using a preferably wireless, sterilisable control console; or
b) by voice control (e.g. using the following instructions: forward, backward, to the right, to the left, fast, slowly, turn about axis A,B,C).
2. For permitting a positioning of the C-bow
Bopp Urs
Hehli Markus
Koller Silvio
Messmer Peter
Müller Paul
AO-Entwicklungsinstitut Davos
Church Craig E.
Rankin, Hill Porter & Clark LLP
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