CN100511328C - Interventional simulator system - Google Patents
Interventional simulator system Download PDFInfo
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- CN100511328C CN100511328C CNB2003801048065A CN200380104806A CN100511328C CN 100511328 C CN100511328 C CN 100511328C CN B2003801048065 A CNB2003801048065 A CN B2003801048065A CN 200380104806 A CN200380104806 A CN 200380104806A CN 100511328 C CN100511328 C CN 100511328C
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- 238000004364 calculation method Methods 0.000 claims description 2
- 210000005240 left ventricle Anatomy 0.000 claims description 2
- 210000005241 right ventricle Anatomy 0.000 claims description 2
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- 238000013152 interventional procedure Methods 0.000 abstract 1
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- G—PHYSICS
- G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
- G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
- G09B23/00—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes
- G09B23/28—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine
- G09B23/285—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine for injections, endoscopy, bronchoscopy, sigmoidscopy, insertion of contraceptive devices or enemas
Abstract
The present invention relates to an interventional procedure simulation system and method, comprising a control unit and an interface unit, said control unit communicating with said interface unit to simulate handling of at least one instrument interfaced by said interface unit. The control unit comprises a database of vessels having hierarchy structure, each vessel having a diameter and a stiffness, and said instrument being a tool expendable in a simulated vessel. When the tool is expanded, a geometry of said vessel changes resulting in a fluid flow change.
Description
Technical field
The present invention relates to simulate the computer-controlled equipment of intervening operation, particularly use the obtained effect of special equipment.
Background technology
The principle of adult education, the aim of learning by doing and be devoted to the technical skill development theory is all emphasized playing the part of of in learning process key role experience.Analogue technique successfully is applied to current surgery and medicine education, and provides to trainee and practitioner, based on the necessary learning experience of these education theory foundation.All the have an opportunity learning experience of establishing criteria of all learners is acquired basic training and is reached the qualification level of regulation.By to Performance Evaluation and provide instant, individual other and detailed feedback information, simulation can make study simplify.Simulation can provide control setting, this set can repeat up to obtaining definite performance rate, and simulation can also reduce learner's pressure, increases their confidence, and before to patient, guarantee to reach under the situation of technical skills, improve the security in actual the setting.The practitioner can be by using the education of interference mode of simulation, the emerging program that improves their technical ability and learn to produce owing to scientific and technological progress.In addition, application simulation helps to solve practical problems, for example to the obtain employment requirement of time of medical worker, can provide independently study and the practice machine can be to address these problems to the trainee.By using this simulation means, solved the responsibility obligation of current Special attention will be given to and the problem that health care quality guarantees, and result data is used for guaranteeing to the public doctor's working ability.
Simulation should be considered to each current vital part being devoted to the educational procedure of expertise development.Simulation can be used to guarantee effectively teaching and study, provides the really reliable means that its technical ability is evaluated to the learner, and generated the relevant information that needs improved specified disadvantages, and the independent pre-instruction set of creating learner's technical ability.In order to obtain expected result, according to adult education, learning by doing and the principle of effectively feeding back should be offered specific course.This simulation can also be used for the program of continuing professional education and authentication of professional qualification.In development with obtain simulation, and during the effective exerciser that combines of foundation and educational pattern, need the input resource.Yet, effectively carry out the program of performing the operation rapidly, the raising of patient safety, and the minimizing of professor's various professional skill time of learner, the numerous advantages that produced by these factors all are easy to offset with the initial input of resource.This simulation also can be used to be evaluated at the effect of being worked hard in the education aspect, or even selects the individuality undergo training.Therefore, simulation has the potentiality that the surgery and medicine education in future produced significant impact.
Because the develop rapidly of field of computer technology, analogue technique particularly is applied to the analogue technique that surgery and medicine is educated, and has obtained obvious improvement.Yet existing known equipment can not carry out comprehensive simulated to employed different apparatuses with method.
According to the present invention, formerly do not propose or provide the prompting of the different apparatuses of simulation in the technology.
US 4,907,973 patent disclosures a medical investigating system, in this system, people and system interaction, insertion information.System utilizes these information to set up the real unlimited environment model of the condition of substituting, and described condition is to import apparatus or or not exclusively import in the medical procedure of apparatus and run in body.These are by the video of broadcast as the simulated interior condition that occurs in the life, and by showing that what Monitoring Data realized, data comprise, for example blood pressure is breathed heart beat rate or the like.Mention volume of blood flow in the literary composition, but do not mention the variation of volume of blood flow and how to finish this simulation.
WO 01/88882 patent relates to a kind of method and a system, and its minimum level ground that is used to simulate courage, pancreas duodenoscopy imports the medical procedure of apparatus in body.System is designed to simulate actual courage, the medical procedure of pancreas duodenoscopy as much as possible, and the mode of realization provides simulated medical instrument, and sense of touch and visual feedback when simulator program acts on the modal patient are provided.Particularly preferred characteristics comprise, the multipath solution of virtual navigation in the dissection of complexity.In addition, system and method selectively and preferably is expelled to the saturating check result of the fluorescence that obtains in the mastoid process in conjunction with dyestuff power is contrasted.The injection of this dyestuff, and the radiography subsequently of the courage that exists in duodenoscopy, pancreas tract must accurately be simulated aspect visual feedback accurately.And courage, pancreas tract selectively and preferably are modeled into a plurality of splines (spline), more preferably are to be arranged to spline tree or other have a structure.Therefore, system and method in order to solve in courage, pancreas duodenoscopy program about this complicated and difficult problem of training of students, provides a total solution.Mention in the literary composition, in three steps, digitized image preferably should be clear and not have the vision artifact, then, it is stored in the database of institutional framework drawing.Preferably, before storage, should strengthen digitized image.More preferably, the institutional framework drawing also comprises animation.This animation can be simulated the effect that biofluid flows, such as blood flows downward owing to the influence of gravity.It is how to finish simulation that the variation of both not mentioning flow in the literary composition is not mentioned yet.
Summary of the invention
The main target of the preferred embodiment of the present invention is that for the expansion real time modelling that apparatus impacted in simulated blood vessel provides a novel efficient system, preferably, system is used for the diagnosis or the intervention program of cardiovascular or interior blood vessel.Another target of the present invention is to simulate in simulated blood vessel, for example the fluctuations in discharge of blood or other liquid.
Thus, intervention program simulation system of the present invention comprises a control assembly and an interface unit, communicate between control assembly and the interface unit, thus at least one apparatus that is connected with interface unit of simulation control.Apparatus is an instrument that can launch in simulated blood vessel, and when instrument launched, the geometric configuration of blood vessel changed, thereby causes blood flow to change.Simulated blood vessel interconnects in a hierarchical structure, and the blood flow in the contiguous simulated blood vessel of change influence of blood flow changes.
Description of drawings
With reference to following width of cloth figure, will further narrate without restriction the present invention:
Fig. 1 is the structural drawing of one embodiment of the invention.
Fig. 2 is the synoptic diagram of interface arrangement.
Fig. 3 is the synoptic diagram of simulated instrument.
A series of fluoroscope images when Fig. 4-6 is to use sacculus and support (stent).
A series of fluoroscope images when Fig. 7-10 is to use conduit.
A series of fluoroscope images when Figure 11-13 is to use distal embolic protection.
Figure 14 is the synoptic diagram of blood vessel structure.
Figure 15 is the level synoptic diagram of Figure 14 blood vessel structure.
Figure 16 is a model that is used to calculate radius, wherein is depicted as R (p) (from top to bottom): q=0, q=1, q=2 (p
0=4).
Figure 17 is another model that is used to calculate radius, wherein is depicted as R (p) (from left to right): p
0=2,4,6,8 (q=1).
Figure 18 is another model that is used to calculate radius, wherein is depicted as R (p) (from left to right): p
0=2,4,6,8 (q=2).
Embodiment
An exemplary embodiments of foundation analogue means of the present invention as shown in Figure 1.Device 100 comprises a machine element 110 and an interface unit 120.Machine element 110 can be ordinary individual's computing machine (PC) or device similarly, or with the integrated parts of interface unit 120.The machine element of present embodiment and display 111, input media 112 is keyboard and mouse for example, and mutual communication between the communication interface (not showing).
Yet the application is not limited to a system that comprises the above control system and interface unit.The application can be applied to can be to self-deploying in any system that apparatus simulates.
By different modes, can make a 3D geometric figure:
-they can modeling in the 3D prototype software, promptly starts from scratch, and uses the anatomy textbook, and means such as video clipping are carried out, here for reference only.
-they can be according to patient data's formation of reality, and for example, these data are by having area of computer aided X line body section radiography (CT), Magnetic resonance imaging (MRI), ultrasound, scanister 130 acquisitions of fluoroscope etc.
Interface unit 200 as shown in Figure 2 as preferred embodiment, it accepts a plurality of apparatuses, apparatus be the simulation or be two apparatuses really and preferably at least.Interface unit comprises a plurality of movable envelope 216A-216C, and its quantity is consistent with the quantity of apparatus.Interface unit also comprises a common-rail 220 and the interconnecting component 226 as telescopic pipe.Interconnecting component 226 interconnects successively with envelope 216A-216C.Each envelope all has an opening, to guarantee instruments.Each envelope 216A-216C further comprises and is used to accept and the member of at least one apparatus of locking, and the member that moves and produce a power that is used to accept apparatus, and the force reaction of generation is in the apparatus with analog feature.Preferably, each envelope comprises a pick-up unit that is used to detect the apparatus type, and apparatus inserts and passes interconnecting component.Interface unit links to each other with control assembly (PC) measuring moving of each envelope, and regulates moving by a speed regulator and a range adjuster.Each envelope is connected with a tooth belt gearing to drive along track 220.Crank block that is placed on the moment of torsion wheel of each envelope assembling.Crank block has a matching surface, and the surface is pressed towards the direction of interlock apparatus wire clamp.And, having the outlet that the detection means of making passes in and out on each envelope, detection means is used to detect the situation that exists of the interior apparatus of envelope.Detection means can detect the thickness of each apparatus.Optical sensor is surveyed the situation that exists of in envelope apparatus.The vertically moving and rotating of control assembly measuring apparatus, and according to power that receives and moment of torsion provides apparatus vertically and the force feedback of sense of rotation.Latch members is used to clamp apparatus, and apparatus is connected on the center wall.Latch members comprises a moment of torsion wheel that is placed in the center wall.Crank block is placed on moment of torsion wheel inside, and crank block can move along the longitudinal, but it is fixed in sense of rotation.
Preferably, the dissimilar working methods that self-deploy instrument of system simulation.The instrument that self-deploys is made up of instrument itself and one deck sheath (flexible pipe) that covers on the instrument.When sheath was contraction, instrument itself was deployed into its " nature " shape.In some cases, also sheath might be retracted, cover on the instrument once more.
Example 1: the support that self-deploys.Support is forced at the top of hollow tubular, and hollow tubular extends on the top of lead, and support is covered by one deck sheath.Support is not connected with the bottom pipe.When the jacket shrinkage that covers, support opens gradually, reaches predetermined diameter (this diameter is the maximal value of diameter in the blood vessel, if vascular wall and support press together, this diameter will be littler).When sheath shrinks fully, entire bracket will break away from sheath and bottom pipe, and compress vascular wall.The current way of not recovering support self.
Example 2: distal protector (DPD).Distal protector 30 as shown in Figure 3 is " bicone " 31 and 32, and their two ends are connected on the single line 33, and is covered by one deck sheath (not showing).The distal portions of " cone " is the net 31 of a fine mesh, and it is used for sieving and is taken at the particle that intervention discharges.The proximal part of " cone " opens fully.When jacket shrinkage, cone becomes its " nature " shape, and is promptly middle the wideest.Because sheath links to each other with lower line, then it can be retracted, cover once more " cone ".
Next, will narrate the present invention in conjunction with a plurality of examples, example is not limited to the following stated:
Fig. 4-6 is depicted as a series of drawing that self-deploys apparatus, is a support that self-deploys in this embodiment.This support that self-deploys is covered by one deck sheath, and during jacket shrinkage, support is deployed into a given size (still, because it touches vascular wall, then final size depends on " rigidity " and the support self characteristics of blood vessel).Support two characteristics visually, promptly its mode launched on blood vessel and the effect of effect all simulated.Subsequently, also can use " well-regulated " sacculus to make the blood vessel after expansion.Among Fig. 4, self-deploy support and be in position suitable in the blood vessel, but do not launch.Among Fig. 5, the jacket portions that covers on the support is shunk.Among Fig. 6, sheath shrinks fully and support launches (not being connected on the instrument).Simulator program has a plurality of initial values: self-deploy the static deployment diameter of apparatus, vessel initial inner diameter (in the simulation part) self-deploys the spring constant and the vessel stiffness of apparatus.These parameters are used for determining how simulator sets the border of apparatus and blood vessel (simulation part) expansion.If the use sheath, then its diameter also must count wherein.
Also can adopt and use sacculus and support in a like fashion; Sacculus (also being applicable to support) interacts with blood vessel, and blood vessel launches.Volume of blood flow changes thereupon, also can produce same situation during injection of contrast medium.Support is observable mode to simulated with a kind of its, and support is in original position when sacculus loses heart.Might be, put into a bigger sacculus earlier, then it be inflated again.This all can exert an influence to support and blood vessel, is exactly the expansion of so-called back.Also might be that earlier to inflated, Here it is, and so-called elder generation expands before using support.Utilize force feedback can realize simulation, thus, when using " greatly " sacculus to do inspection, the affected part that can feel by compressing.
According to most preferred embodiment of the present invention, blood vessel is arranged to a hierarchical structure.All blood vessels that provide in the database have as the hierarchical structure among Figure 14 and Figure 15, and it has shown how blood vessel connects.The variation of volume of blood flow can influence that the volume of blood flow in other blood vessels changes in the hierarchical structure in blood vessel.
System simulation sacculus apparatus and simulation sacculus are to the influence of pipe on every side, such as blood vessel or waste pipe.
Blood vessel has the tubulose geometry, and it has specific rigidity.The rigidity of different blood vessel can be different, and its rigidity of the different piece of same blood vessel also can be different.Especially, to be adjacent the rigidity of vasculature part be different to the rigidity at affected part (hemadostewnosis place).
The geometry of blood vessel can influence the flow of internal flow (blood).The affected part flows through reduction above all the other vascular trees flow partly of that.
Sacculus for instance, is used to strut the affected part, has therefore enlarged the narrow of blood vessel, has increased flow.Sacculus is under high pressure inflated.Each specific sacculus has predetermined size (diameter and length).Final diameter will depend on and act on its outside pressure total amount and the internal pressure of vascular wall when the doctor gives inflated.
The flow through flow of vascular tree of system-computed with geometry.Narrow will cause low discharge.The geometry of each vascular tree changes or when (or even wherein a part) takes place in kind the obstruction, all calculated flow rate once more.
The calculating of flow is identical with the method that solves the resistor network problem.Voltage is corresponding to pressure, and electric current is corresponding to flow, and resistance is corresponding to fluid resistance.The top of fluid network is at the left ventricle of heart, and pressure is the highest here, and the bottom of network is among the vein that is connected with the right ventricle of heart, and pressure there approaches zero.Middle blood vessel, for example, all vessel branches in the tree have the resistance to flow of calculating according to they diameters and length gauge.The algorithm of calculated flow rate is to carry out recursive calculation by tree, flow in calculating all branches and pressure.
The system-computed sacculus is to the influence of peripheral vessels wall.Depend on the size (diameter and length) of sacculus and be applied to the pressure of vascular wall, will produce different influences.If the rigidity difference of blood vessel is even same sacculus and identical pressure also can produce different influences to the blood vessel of same size.Identical sacculus with different pressures also can produce different influences to same vessel.
It below is the typical method that analogue flow rate changes.The data of blood vessel and the characteristic of sacculus all are stored in the memory unit of computing machine.Pressure data is drawn from interface unit.
The algorithm of vessel diameter change carries out (simplification) in the following manner: use pressurizer, for example pump is inflated.When balloon diameter during less than blood vessel diameter, balloon diameter is the function of pump pressure, blood vessel uninfluenced (still, according to following method, because transverse cross-sectional area has changed, variation has also taken place flow).When balloon diameter is equal to, or greater than blood vessel diameter, blood vessel diameter begins to increase.The pressure vasoactive wall of sacculus, and in blood vessel, cause internal strain.This can cause the vascular wall expansion of depending on vessel stiffness successively, causes vessel radius to increase producing a new vascular wall area, and cause new internal force or the like on vascular wall.
The typical model that is applied in the machine element has following form:
Wherein, p is the pressure in the sacculus, and R (p) is the real radius of sacculus in the blood vessel, r
N(p) be the size of sacculus in the free space under the pressure of appointment, r
VIt is the initial radium of blood vessel.Q is the integer (referring to Figure 16) of a definite function line style, p
0Be pressure threshold (referring to Figure 17 and Figure 18).At last, k
BAnd k
VDetermine the rigidity of sacculus and blood vessel respectively.R (p) permeates lentamente to expand slowly.Notice that sacculus optionally increases, and has the size of blood vessel up to it.
For special circumstances, the possible p of being is a fixed value, and p
0It is default value.
During inflated, thereby sacculus can block and influences flow (referring to the whole obstruction of Fig. 8).
During the sacculus exhaust, will cause the permanent change of vessel geometry, thereby cause the variation of flow.
Replace sacculus, can be to use one to strut blood vessel, thereby change flow from expandable stent.
Program shown in Fig. 7-10, its mode that adopts be, at first conduit and lead are in advance near the coronary vessel tree on the right or the left side.Next, by the tube injection contrast preparation to determine affected part/organ narrow positions.Image can be changed to obtain the development of affected part the best.Also image can be exported, perhaps it be analyzed to carry out length and width measure by QCA (qualitative character assessment) program independently.Then, the user can determine its balloon size that need use (typically, in the front and back that inflated/support launches, will note some film circulation pictures).A thin wire (crown line) at first advances along conduit and penetrates vascular tree.An angle (at user option) can be made in the top of line, makes it run through vascular tree thereby then line is rotated, and draws/push operation, finds out the appropriate route through the affected part.Balloon is placed online top in advance, and uses the sign of radip-opaque to be located at correct position.Can injection of contrast medium, determine the appropriate position at balloon place.At last, balloon is launched and is kept a period of time, shrinks then.These all steps all simulated, and can finish in real life.
Thereby distal protector stops thrombus to be moved further blocks very little blood vessel (it can be the blood vessel that is just destroying in the brain).The filtration of using " basket " is connected with single line, and is covered by one deck sheath at first.Line and sheath are positioned at the position of passing damage, shrink sheath then, stay basket as the protection when the affected part is expanded.Next, the sheath of recovery closes up basket, and two co-contraction.The action of distal protector simulated, and comprises how people control it and control some observable characteristics.The protective device of other types also may be simulated, and for example, blocks the sacculus that flows during inflation.
Series of drawing shown in Figure 11-13:
Distal protector is in the appropriate location of blood vessel among Figure 11, and the jacket portions of precoat filter is shunk;
Jacket shrinkage among Figure 12, the sign of filtrator " bottom " begins " expansion ".
Sheath further shrinks among Figure 13.
Note that in the filtrator fluoroscope image in this application itself invisiblely, only can see gauge point.Because filtrator is connected with line, said sequence can be put upside down.
The present invention is not limited to described embodiment, but can change in not breaking away from the accessory claim scope, and apparatus and method can be according to practical application, functional part, and factors such as demand and requirement are implemented in a different manner.
Claims (8)
1, the intervention program simulation system, comprise a control assembly and an interface unit, communicate between described control assembly and the described interface unit, thereby simulate the operation of at least one apparatus that links to each other with described interface unit, described control assembly comprises a blood vessel data storehouse, blood vessel wherein has hierarchical structure, each blood vessel has diameter and rigidity, and described apparatus is the instrument that can launch in simulated blood vessel, when described instrument was unfolded, the change of the geometric configuration of described blood vessel caused the variation of fluid flow, it is characterized in that, the rigidity of affected part blood vessel is different from the rigidity of blood vessels adjacent part, the simulation of each flow is that model carries out modeling with the resistor network, and wherein, voltage is corresponding to pressure, electric current is corresponding to flow, and resistance is corresponding to fluid resistance.
2, the system as claimed in claim 1 is characterized in that, described simulated blood vessel interconnects with a hierarchical structure, and the change of described fluid flow influences the variation of the fluid flow in the adjacent simulated blood vessel.
3, the system as claimed in claim 1 is characterized in that, described apparatus is a sacculus, support and/or distal protector.
4, the system as claimed in claim 1 is characterized in that, blood vessel has the tubulose geometry and has specific rigidity.
5, the system as claimed in claim 1 is characterized in that, the flow through flow of hierarchical structure of system-computed, and the geometric configuration of hierarchical structure is a vascular tree.
6, the method for analogue body inner fluid flow in the intervention program simulation system, system comprises a control assembly and an interface unit, communicate between described control assembly and the described interface unit, thereby simulate the operation of at least one apparatus that links to each other with described interface unit, the step that this method comprises is:
-a blood vessel data storehouse is provided in described control assembly, blood vessel has hierarchical structure, and each blood vessel has diameter and rigidity,
-provide described apparatus as the instrument that can in simulated blood vessel, launch,
-realize that the rigidity of affected part blood vessel is different from the rigidity of blood vessels adjacent part,
-when described instrument launched, the geometric configuration of described blood vessel changed, and causes the variation of fluid flow,
-be that model carries out modeling to the simulation of flow with the resistor network,
-voltage is corresponding to pressure, and electric current is corresponding to flow, and resistance is corresponding to fluid resistance.
7, method as claimed in claim 6 is characterized in that, the top of fluid network is at the left ventricle of heart, and the bottom of network with vein that the right ventricle of heart is connected among.
8, method as claimed in claim 7 is characterized in that, the calculating of flow is to carry out recursive calculation by tree, flow in calculating all branches and pressure.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US60/430,335 | 2002-12-03 | ||
| SE02035707 | 2002-12-03 | ||
| SE0203570A SE525169C2 (en) | 2002-12-03 | 2002-12-03 | Simulation device for invasive surgery |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN1720560A CN1720560A (en) | 2006-01-11 |
| CN100511328C true CN100511328C (en) | 2009-07-08 |
Family
ID=20289743
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CNB2003801048065A Expired - Fee Related CN100511328C (en) | 2002-12-03 | 2003-12-03 | Interventional simulator system |
Country Status (2)
| Country | Link |
|---|---|
| CN (1) | CN100511328C (en) |
| SE (1) | SE525169C2 (en) |
Families Citing this family (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP5730891B2 (en) * | 2009-11-12 | 2015-06-10 | レルダル メディカル アクティーゼルスカブ | Heartbeat simulation device |
-
2002
- 2002-12-03 SE SE0203570A patent/SE525169C2/en not_active IP Right Cessation
-
2003
- 2003-12-03 CN CNB2003801048065A patent/CN100511328C/en not_active Expired - Fee Related
Also Published As
| Publication number | Publication date |
|---|---|
| SE0203570D0 (en) | 2002-12-03 |
| SE0203570L (en) | 2004-08-02 |
| CN1720560A (en) | 2006-01-11 |
| SE525169C2 (en) | 2004-12-14 |
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