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Design Innovation Paper

The Retreating-Stop Needle Guide as an Alternative to Variable-Angle Needle Guides

[+] Author and Article Information
Andrew Neice

Department of Anesthesiology and
Perioperative Medicine,
Oregon Health & Science University,
3181 Southwest Sam Jackson Park Road,
Portland, OR 97239
e-mail: neice@ohsu.edu

1Corresponding author.

Manuscript received March 27, 2014; final manuscript received January 9, 2015; published online January 27, 2015. Assoc. Editor: John LaDisa.

J. Med. Devices 9(1), 015003 (Mar 01, 2015) (5 pages) Paper No: MED-14-1157; doi: 10.1115/1.4029581 History: Received March 27, 2014; Revised January 09, 2015; Online January 27, 2015

A new type of needle guide, a retreating-stop needle guide, is proposed and compared with existing variable-angle style needle guides. Compared to existing designs, this design gives the user finer control over the depth of needle insertion as well as preventing excessive needle advancement. For a subset of ultrasound guided procedures, particularly those that may benefit from out-of-plane approaches, retreating-stop needle guides could potentially improve needle placement. A prototype retreating-stop needle guide was constructed which has measurement resolution of 5 mm and a depth range of 3.0–7.5 cm, which is superior to commonly available existing needle guides. Resolutions of 2–3 mm are theoretically possible with this technique.

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Figures

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Fig. 1

Retreating-stop needle guide. This prototype was fabricated using 3D printing and conventional machining techniques. Photograph A shows the needle guide attached to the ultrasound head, before the depth stop is attached or the needle is inserted. The depth stop is shown in the inset of photograph A. Photograph B shows the guide after the operator has selected a depth, inserted the depth stop, and advanced the needle. Photograph C shows the guide with a deeper depth selected.

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Fig. 2

A computer generated model of a retreating-stop needle guide with the needle inserted at various depths, illustrating the change in depth along with the slight change in angle of the depth stop. The most shallow position corresponds to a depth of 3.0 cm, while the deepest corresponds to 7.5 cm, the corresponding angle of insertion varies from 50.2 deg to 71.5 deg, respectively.

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Fig. 3

Relevant dimensions in a retreating-stop needle guide with a fixed tissue insertion point. L refers to the length of the needle, F is the offset between the needle entry point and the ultrasound beam, D is the desired depth, x and y are the cartesian coordinates of the depth stop, and θ is the angle that the depth stop is rotated.

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Fig. 4

Measurement of depth to needle tip. The needle tip can be seen at the bottom of the ultrasound, and a calipers measurement is taken from the surface to the needle tip.

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Fig. 5

Scatter plot of depth settings versus depth measured by ultrasound, n = 5 per insertion depth

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Fig. 6

Photographs A and B show the needle inserted with different angles selected in a variable-angle needle guide. The guide pictured is an in-plane guide.

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Fig. 7

A schematic illustration of a variable-angle needle guide illustrating the factors that affect measurement resolution, here represented as R. Two possible needle paths using adjacent settings are shown. In this diagram, L refers to the length from the pivot point of the needle to the entry hole in the needle guide, θ refers to the change in angle between two depth settings, r refers to the radius of the needle guide holes, F refers to the offset between the pivot point and the plane of the ultrasound, and φ is the angle between the needle and the perpendicular to the ultrasound beam plane.

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