Surgery – Instruments – Stereotaxic device
Reexamination Certificate
1999-08-02
2001-08-07
Philogene, Pedro (Department: 3732)
Surgery
Instruments
Stereotaxic device
Reexamination Certificate
active
06270506
ABSTRACT:
BACKGROUND OF THE INVENTION
1. Field of the Invention
The present invention relates to a medical targeting apparatus of the type having an assembly composed of several parts arranged so as to be able to be displaced relative to one another, an instrument control unit connected to the assembly, adjustment means for moving the parts and the instrument control unit relative to one another, a patient mount for positioning at least a body part of a patient in a diagnostic imaging apparatus, and a marking means, connected with the patient mount in a first position, for the production of a visible mark in an image of the body part.
2. Description of the Prior Art
In minimally invasive interventions in which the target region cannot be observed directly, the use of imaging methods such as e.g. ultrasound, X-rays or magnetic resonance allows a high degree of precision to be achieved in the positioning of a corresponding instrument. The progress of the intervention is, for example, made visible continuously. The planning of an optimal access path of the instrument to the target area also can take place using previously produced images. If necessary, a natural or artificial fixed point in the area under examination can be used as a reference point.
European Application 0 752 237 discloses a mounting means for a surgical instrument is known. The mounting means has several arms that are pivotably connected with one another via joints. The entire mounting means is connected in displaceable fashion to a patient positioning means by a rail system. However, this mounting means is not provided or suitable for surgical interventions with monitoring of diagnostic tomograms.
In U.S. Pat. No. 4,629,989, a diagnostic magnetic resonance apparatus with a laser marking apparatus is described. The laser marking apparatus serves for precisely positioning an area of examination in the imaging area of the magnetic resonance apparatus.
A medical targeting apparatus of the type initially described is known from U.S. Pat. No. 5,056,523. This known targeting apparatus is provided for positioning the tip of a probe relative to a target region in a protruding body part of a patient, such as for example a female breast, with X-ray monitoring. The body part to be examined is fixed between two plates that are parallel and are transparent to radiation. One of the plates has a number of through-holes for the probe. In addition, marks that are visible in a transillumination image are present on this plate as a localization aid. Using the transillumination images, a probe guide is positioned in such a way that the probe can be guided immediately on a path to the target region. An additional scale, that is arranged coplanar to the instrument control unit and that is shown on a transillumination image, makes it possible to determine the depth of penetration.
From U.S. Pat. No. 5,678,549, a stereotactic auxiliary unit for a nuclear magnetic resonance tomography apparatus spin tomograms is known that permits a localization in a female breast of data that are visible in a magnetic resonance tomogram. The breast is thereby fixed and compressed with two compression plates. At least one of the compression plates has bored guide holes, via which a needle localization, a needle marking, or also a biopsy can be carried out with a high degree of precision. RF antennas are also allocated to the compression plates for the reception of the nuclear magnetic resonance signal.
Since in general the imaging region of the diagnostic apparatus is already filled by the patient, only a limited space is available for the adjustment of a conventional medical targeting apparatus at the patient. Particularly with magnetic resonance apparatuses, little space is available for manipulations at the targeting apparatus.
Another problem is that the adjustment of the targeting apparatus relative to the target region takes place directly at the patient. The examination time is prolonged due to the adjustment time and the preparation time, which results in a considerable burden for the patient.
SUMMARY OF THE INVENTION
An object of the present invention is to facilitate the adjustment of a medical targeting apparatus relative to the target region, and to reduce the burden for the patient caused by the adjustment.
This object is achieved in accordance with the invention in a medical targeting apparatus of the type initially described having a fastening arrangement that can be actuated manually disposed on the assembly and/or on the patient mount, for detachably fastening of the assembly on the patient mount in first and second positions, the first and the second positions been spaced from, and having are a fixed relation to, one another. It is thereby possible to carry out the adjustment of the targeting apparatus independent of the patient, on the basis of the coordinates determined in the corresponding imagings of the body part. With the inventive targeting apparatus, an adjustment can take place outside the imaging region of the diagnostic apparatus. After the adjustment has taken place, the targeting apparatus is then brought into the application position and fixed thereat. No additional adjustments are required for the examination itself.
In an one embodiment, the adjustment is made easier by providing the parts which are displaceable relative to one another with measurement scales for reading their positions relative to one another.
In another embodiment the manually actuated fastening arrangement is a snap mechanism. A mechanically simple connection of the assembly to the patient mount is thus possible that is reliable and solid, but that can be detached.
In a further embodiment, the assembly is arranged in displaceable fashion in a guide fastened to the patient mount. After the adjustment of the coordinates, the targeting apparatus is displaced on the guide into the application position.
In another embodiment, the guide is oriented in the longitudinal direction of the patient bed. The adjustment can then take place at the head end or at the foot end, and afterwards the targeting apparatus is moved to the examination position.
REFERENCES:
patent: 4629989 (1986-12-01), Riehl et al.
patent: 4875478 (1989-10-01), Chen
patent: 5056523 (1991-10-01), Hotchkiss, Jr. et al.
patent: 5678549 (1997-10-01), Heywang-Koebrunner et al.
patent: 5730745 (1998-03-01), Schulte et al.
patent: 5876332 (1999-03-01), Looney
patent: 0 752 237 (1997-01-01), None
patent: 752237 (1997-01-01), None
Linsmeier Erwin
Sittek Harald
Philogene Pedro
Schiff & Hardin & Waite
Siemens Aktiengesellschaft
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