Method and apparatus for catheter location determination.

[Detailed Description of the Invention]

The positioning method of a catheter and its device Nestling Nomoto invention relate to the body tissue, method, and device for which the position in the blood vessel of the catheter within a large vein is especially decided correctly above all in a vein or an artery. Reform 2 Power It is y and an important point to often give an intravenous drip injection to the medical treatment of the illness of a human body of a certain kind in a medicine, a blood product, nourishment liquid, and other fluid a short period of time or for a long period of time at a patient's vein or artery system. When these parenteral solutions need to prescribe a medicine for the patient, a usual state method lets in a vein the plastic catheter which made intravenous puncture from crab 1-Les (Coat pipe), and was subsequently sterilized pass. The Celdy / the go method using the extended machine / sheath put on intravenous incision or a guide wire are included in the blood extraction inserting method replaced with this. In parenteral alimentation thing ingestion, cancer chemotherapy, and a frequent antibiotic therapy, in order to avoid damage to the lining membrane which met the blood vessel, the exit or tip of a catheter is arranged to the field where blood flow volume is high. The termination of the catheter chip for intravenous insertion is often arranged at a superior vena cava. Catheter arrangement operation attracts attention as central venous catheterization (CVC), and recognition that it is necessary to position a catheter chip correctly by abundant-ization of experience is increasing. The traditional method of checking exact arrangement of the intravenous catheter for medical treatment within the present superior vena cava or Industrial vein is the viewing method which used fluorescence perspective or an X ray film. However, it is inconvenient to expose a patient, clinical Star, and Nofu to radiation in addition, and it is unnecessary if the method for location replaced with it can be used. Therefore, the danger of expense, time, and radiation exposure is removed, and it is necessary to provide the information on real time for the landmark of an outside dissection organization to determine correctly the position of the catheter in a patient's inside of the body which does not need expensive and advanced Material science technical equipment or engineer. The indication of an invention The present invention is solved by generating output voltage with the detector which induces an exchange magnetic field in the above-mentioned requirements and other problems in position determination of a catheter in a patient's inside of the body. In order to insert with a catheter, it is allocated free [ attachment and detachment in a catheter ] for any of a detector or the source of a magnetic field they are. A detector is attached to the guide wire of a catheter with the best form. The display output voltage when output voltage is exchange and the phase by comparing with the output voltage of a detector the exchange supplied in order to generate a magnetic field and output voltage is not detected indicates a magnetic field and the relative location between detectors to be when exchange and 1800 phases have shifted is performed. Therefore, the object of the present invention is to provide the new method of determining correctly the position in the blood vessel of the catheter in a body tissue. The object of the present invention is to provide the new device which determines correctly the position in the blood vessel of the catheter in a body tissue. Other objects of the present invention are to provide the new catheter positioning method and device which do not need exposure to X-rays. Other objects of the present invention are to provide the new catheter positioning method and device which do not need extensive training but the clinical staff can be operating. The object of further others of the present invention has operation in providing an easy new catheter positioning method and device. The object of further others of the present invention is to provide a cheap new catheter positioning method and device. The object of further others of the present invention is to provide the new catheter positioning method and device which bring about real time catheter position information with the landmark of an outside dissection organization. Hereinafter, the above, other objects, and advantage of the present invention are clarified by detailed explanation of the example of the present invention explained in relation to a drawing. Brief explanation of the drawings An example is described with reference to an attached drawing. In a drawing, Drawing 1 is a schematic diagram showing the positioning method and device of a catheter in the living body [ concerning the present invention ] with the size in the moment there is a magnetic field, and polarity. Drawing 2 is a sectional view of the Kate -Chill containing the detector fixed to the guide wire of the device of Drawing 1. Drawings 3A and 3B are wiring diagrams which constitute the electric circuit of the device of Drawing 1, when it set and places. It seems that it will become obvious or clear to extend a figure about the number of the parts which were drawn only in order that all figures might give explanation of the fundamental art of the present invention easy, and constitute a desirable example, a position, a relation, and a size at a person skilled in the art if you read and understand the place which the following of the present invention teaches. Similarly, the exact size and size ratio which suit specific power, weight, intensity, the same conditions, etc. will also become obvious to a person skilled in the art, if you read and understand the place which the following of the present invention teaches. The same number currently used in each figure of a drawing shows the same or similar parts. furthermore -- "-- the [ end 0 and / "] -- the time of side " near 1J, and 72nd" side, 7 they side ", and - base and the same term being used, These terms should be understood as what is used only in order to make it easy to have a relation only in the structure illustrated so that those who look at a drawing might understand, and to explain an invention. The form for inventing The device which determines the position at the tip of the catheter which is some of endermic catheters in a patient's vein or an artery or insertion approach devices concerning the present invention is shown in a figure, and most is an example in 10. Generally, as for this device 10, the detector 12 is put in order by catheter 16 in a vein, source 18 of AC electromagnetic energy and electronic control machine 20, and the line with the desirable form including exchange (AC) 4 Magnetic energy place pickup detector 12. a form with preferred energy source 18 -- the range of 50~35QKHz -- desirable AC magnetic field is made to generate and spread by the coil current of the range of 120~200mArms supplied in 1/4~1/2W on the frequency which concludes in a practical viewpoint that it is the range of 100~200 kHz, and is proposed It can arrange to the landmark of the surface dissection organization which is in agreement with the end position of a request of catheter point i14 in contact with the skin, the lines of magnetic flux of a magnetic field become right-angled to a skin side substantially by that cause, and energy source 18 pierces through a patient's body. Detector 12 induces AC magnetic field which came out of energy source 18, and in a desirable form, when energy #18 is approached physically, it generates small voltage. The net magnetic flux from which the lines of magnetic flux of the magnetic field which came out of energy source 18 are essentially detected to the axis of detector 12 when exactly perpendicular is zero, therefore detector 12 does not generate output voltage. If detector 12 crosses lines of magnetic flux perpendicularly, phase change will arise in the output voltage which arises in detector 12. Therefore, the position or direction of detector 12 to energy source 18 can be checked by analyzing the potential and the phase of voltage which arise in detector 12. Electronic control machine 20 is at an especially desirable form, AC current which makes energy source 18 produce a magnetic field is generated, and the voltage which arose in detector 12, and phase change of the voltage are monitored, It processes and amplifies, the signal occurred and detected is compared, and a visual signal or an audible signal is supplied to the indicator in which the relative position of detector 12 and energy source 18 is shown. With the best form, it is a solid object including almost cylindrical core 24 which detector 12 has been arranged in the best form at a cable jacket in the air or the tip of guide wire 22, and was formed with magnetic permeability material. It elongates to free one end of guide wire 22, and core 24 is attached suitably for guide wire 22 by adhesives 26 between the inside of guide wire 22, and the external surface of core 24, etc. Core 24 is projected from the free end of guide wire 22, and has coil 28 of the small-gage wire which has a diameter of 0 or 002 inches (0,051 mm) wound around guide wire 22 and the same axle at core 24. With the best form, fill 28 is 30~60 numbers of turns in 0.026 inch (0 or 66 mm) in diameter. As for coil 28, the lead is extended to controller 30 through the inside of the hollow of guide wire 22 including lead 30. Covering film 32 which covers coil 28 on core 24 may be provided. Catheter 16 and guide wire 22 may contain the ordinary positioning connector used for the customary catheter implantation way. Energy source 18 is allocated in the best form by finder 34 which has an almost long and slender form which an operator may grasp at a racket ceremony by hand. The best form is a solid object including almost cylindrical core 36 in which energy source 18 was formed with magnetic permeability material. In the best form, core 36 is almost perpendicular to GRI of finder 34, and a A axis, and contains fill 38 of the small-gage wire which has a diameter of 0 or 030 inches (0,762 mm) wound in the direction of an axis. With the best form, coil 38 is the range of 80~100 numbers of turns which has a diameter of 0.71 inch (1 or 80 mm). As for coil 38, the lead is extended to controller 20 through the inside of finder 34 including lead 40. In the best form, finder 34 contains the member which performs a vision display or an audible display. Amber and red LED indicator 42.44 are especially allocated by finder 34, respectively, and it is System about voice tolan Stanisa like beaver 48! It may provide in Il machine 20. The best form and voice show that amber indicator 42 has energy source 18 in the tip 140 base side of catheter 16, and show that red indicator 44 has energy source 18 in the end side at tip 14 of catheter 16. suitable lead 50 to controller 20 provides and comes out from indicator 42.44. on--off switch 60 containing vision display for indication 62 like a green LED indicator is electrically connected to controller 20 by lead 64 suitable in series. As mentioned above, since the device concerning the present invention was explained, it is considered for it to be useful to explain the proved electric circuit here that it may be satisfied practically. Then, Drawings 3A and 3B which constitute the circuit diagram which illustrates electronic control machine 20 are referred to. First, when the top left corner part of Drawing 3A is observed, all the parts, i.e., guide wire 22, core 24, coil 28, and lead 3o of detector 12 appear. Controller 20 comprises many Sec / M A. The 1Sec/! I A is signal amplifier and selection machine Sekun word A, and consists of transformer T1, 1st operational amplifier Bi 1, the 2nd operational amplifier U2, and analog switch U3. The signal received from detector 12 through guide wire 22 is transformer T1 (it is a Rising transformer of l-10 in fact). - It is inputted into next side. The secondary side of transformer TI was connected to operational amplifier Ul, the operational amplifier amplified the signal, and it has obtained 200 times as many profits in the desirable form. Operational amplifier]

The signal with which Or and others was amplified is added to the 2nd operational amplifier U2. This 2nd operational amplifier U2 has 4 times as many profits with the desirable form. Quad switch DG201A of Intersil may be sufficient as analog switch U3, for example. Since the above-mentioned circuit expresses the actual circuit included in device"0, in the present stage, it points out that the device has the two modes, i.e., the 2 Normal" mode and the "deep" mode. Analog switch Tooth 30 function is operational amplifier U] because of normal mode operation.

It is choosing the output of Or and others, and choosing the output from operational amplifier U2 for deep mode operation. Analog switch U3 controls operation of indicator 72 for normal, and indicator 74 for deep. Although the signal amplified from operational amplifier U1 is directly outputted to phase detector IJ4 (this is mentioned below in detail) while controller 20 is operating by the normal mode, While operating in the deep mode, after the signal amplified from operational amplifier U1 is further amplified by work of the 2nd operational amplifier U2, it is outputted to phase detector U4. In fact, the signal sent to phase detector U4 must be amplified by even the minimum level of 700+eVp-p. Cefsilan explained below is finder coiled Leiber, and it is in a basic target, Inverter U'15 like 6-circuit inverter CD4049BH of RCA, It comprises three field effect transistor Q3.Q4.Q5 and coils 38 of finder 34, 0.01-micro F capacitor C38, and an attached circuit (probably, about this, it does not need to make reference in detail). It is an oscillating circuit which these components constitute, and the frequency is determined by the series resonance frequency influenced by the inductance of finder coil 38, and the capacitance of capacitor C38. In series resonance frequency, the maximum current flows into fill 38, therefore the maximum voltage is detected among the both ends of resistance R47. It turns out that this voltage is fed back to inverter 015 which can amplify a signal to sufficient level to drive field effect transistor Q3.Q4.Q5 to maximum voltage amplitude. By using feedback, with regards to the short period of the arbitrary elements of an attached circuit or long-term change which is visible to fill 38, capacitor C38, or the lower right corner of Drawing 3B, there is nothing and it is guaranteed that the current which flows through coil 38 always serves as the maximum. A part of oscillator output voltage is taken out from the terminal area of two resistance R44 and R45, and it is supplied to comparison machine IU15 through the phase shift network containing variable resistor R24 and capacitor C21. Comparison machine IU5 amplifies an oscillator signal level even to the peak magnitude, and the voltage signal is impressed to Phase detector 4. Probably, by describing in detail the role performed by phase detector Bi 4 shows that phase detector U4 is what compares the phase of these two voltage signals in response to the amplification signal from detector 12, and the coiled live electrical engineering supplied from comparison machine IU5. phase comparator U4 -- nan -- the CD4046BCN comparison machine of Bunar Semicon daku 9H may be used. As finder 34 is shown in position m of Drawing 1 in schematic illustration, when it is in physical relationship near the base side of coil 28 of detector 12, two voltage is the phases mutual. Phase detector U4 produces a high average voltage output at the pin 2. This voltage is smoothed by even DC level (in fact about 7~9V) by resistance R11 and capacitor C1l. This smoothed voltage is impressed to pin 4 of comparison machine 2U5, it is operated so that that output pin 2 may become a zero bolt, and it makes amber indicator (LED) 42 turn on. However, since, as for two voltage, about 180 degrees of phases shift when [ as position I more specifically shows to Drawing 1 in schematic illustration, ] they of the coil of detector 12 have the coil 38, finder 34 and, King low DCi occurs at pin 4 of comparison machine 21j5, and pin 7 of other comparison machines 3U5, and amber indicator 42 is switched off, and red indicator 44, i.e., LED, is made to turn on. Needless to say, it will be understood that two resistance R12 and R13 and three diodes CRI, CR2, and CR3 constitute the network which defines the Threshold level for turn-on of the 2nd human power pin 5.6 of comparison machine 2U5.3U5. Therefore, phase detector U4 and comparison machine 2U5.3U5 have the function to make either of indicators 42.44 turn on. If what the audible Beef circuit which excites beaver 48 constitutes is explained, Two output bottles 2.1 of comparison machine 2U5.3U5 are connected to amber and red indicator 42.44, and the output signal of comparison machine 2U5.3U5 passes diode CR4 and CR5, product made from RCA 2 bean-jam-manufacturing circuit single stable multi-vibrator CD4538B H obtains -- it is sent to single stable multi-vibrator IU6.2U6. If any of amber indicator 42 or red indicator 44 light up and the light is subsequently more specifically put out, A signal is sent to corresponding single stable multi-vibrator IU6 (pin 4) or 2U6 (pin 12) (such multi-vibrator of two specified product made from RCA 2 bean-jam-manufacturing circuit single stable multi-vibrator CD4538BH is incorporated), The trigger of the corresponding single stable multi-vibrator is carried out, and the pulse of 3005 sec occurs at an output terminal (pin 7) or (pin 9) corresponding from specific multi-vibrator IU6 or 2U6. A single stable output pulse and an ON Kadrigger pulse are sent to NOR gateIU7 and 2U7, and a series of following phenomena happen. The amber indicator, i.e., L ED42, turns on for explanation, and when it assumes that finder 42 was moved, amber indicator, i.e., LED, 42 is turned off. Corresponding single stable multi-vibrator I U6 or 2tJ6, About multi-vibes lake IU6, a trigger is carried out via pin 4, and a trigger is carried out via pin 12 about multi-vibrator 2U6, and the pulse of 300 m5ec is produced into output bottle 7 of multi-vibrator IU6, or output bottle 9 of multi-vibrator 2U6. A single stable output pulse is applied to NOR gate 3U7. Single stable multi-vibrator IU6 generates the 300rasec pulse of a low level at the pin 7, and this is added to pin 6 of NOR gate lU7. However, as turned on finder 34 in red indicator or LED34 within 300 tnsec, when it is moved, low voltage arises at pin 1 of comparison machine 3U5, and this voltage passes along diode CR5 and is applied to pin 5 of NOR gate IU7. It is N when two signals of a low level go into NOR gate IU7 via pin 5.6. Output bottle 4 of R gate IU7 is made to produce a high-voltage level. When it comes to a high level, output bottle 10 of NOR gate 3U7 is lost, a pulse is produced, the trigger of the single stable multi-vibrator U8 is carried out, this generates the pulse of a high level, and beaver 48 makes Listening sound come out. Required current is supplied to beaver 48 by NPN transistor Q7. When red indicator 44 turns on an important thing which should be known after 3 *Q 5sec progress, under these conditions, pin 6 of NOR gate ITJ7 is a high level. The pin 5 being a low level is that it is uninfluential. Tori who drives single stable multi-vibes lake U8 does not generate - pulse inevitably, but beaver 48 is still silent. Also when red indicator 44 shifts to A state 9 of OFF of amber indicator 42 from the state of ON, the same result happens. Next, - Desbats Ung i - About 7 circuits of /Wow which consist of single stable multi-vibes lake Tooth 9 which functions as 1, if a livelihood is carried out, this multi-vibrator U9 is connected to the flip-flop or toggle circuit UIO. free, Bufro, and The UI O are wired so that Jamming and flip-flop UlO by which battery 66 was connected to controller 20 may be reset via capacitor c28. When pin 12 of flip-flop U10 becomes high (H), field effect transistor Q6 is turned off. For this reason, battery 66 is separated at least from that principal part by the controller 20. concrete target as a matter of fact. But when battery 66 is connected, component U9 and the UIO are always operating, but since these components are CMO3 integrated circuit devices, those consumption current is very small (it is less than [ 2micro ] eight). If switch 76 is pushed, multi-vibes lake U9 will output a pulse, the toggle of free and Buflop tJ10 will be carried out so that this may make transistor Q6 turn on, and battery 66 will be connected to other circuits by it. Although the feature of the present invention is making it possible to operate device lO by any in 7-Mull Mohd or the deep mode their being, Normal / deep change circuit part of controller 2o are explained below. This circuit part contains single stable multi-vibrator 016, such as one half of single stable multi-vibes lake CD4538BE of 2 circuits of RCAIR(s), fundamentally. Normal / deep change circuit part includes free, Ploflo, The U17, and switch 68. If switch 68 is closed and electric power is supplied to controller 20, controller 20 will serve as the normal mode. DC bus of Yori PostcodeIOV rises to this, and a positive pulse is sent to pin 10 of flip-flop U17 via capacitor C25. Pin 10 is "reset pin of flip-flop U17. If reset pin 10 just becomes, Q output of the pin 13 will serve as low (Low), the above-mentioned analog switch U3 will be thrown into the normal mode operation side, and pin 6 of amplifier Ul will be connected to pin 4 of phase detector L''4 via pin 6.7 of switch U3. Single stable multi-vibrator U16 functions as "Debouncer." If switch 68 is Instantaneous push(ed) by the user, more specifically, the operation will make a low pin 11 of multi-vibrator U16, By it, the trigger of the pulse of 200 m5ec is carried out to output pin 10 of multi-vibrator U16, and this carries out the toggle of the flip-flop 017 to desired deep mode operation. If output pin 12 of flip-flop U17 becomes a low, an electric passage will be formed between pins 2.3 of switch U3. The circuit between pins 6.7 formed for this normal mode operation is made to open wide, and it becomes deep mode operation. Indicator 72 shows normal mode operation, when an electric passage is formed between pins 10.11 of switch U3 and the light is switched on, and indicator 74 shows deep mode operation, when an electric passage is formed between pins 14.15 of switch U3 and the light is switched on. As [ market / by National Semiconductor / these / if two voltage regulators U13 and U14 are explained / next, / as LM805CT ] What should actually be recognized is that voltage regulator U13 is 3 terminal voltage Regenerator of the usual ±5v. The grounding pin is connected to zener diode CR9 of 5v to make the regulator of DClov. This +10v regulator supplies electric power to the component of most which is contained in the circuit which constitutes controller 20. Regulator U14 of another side constitutes the regulator of +7v with diode CR10SCRII and CR12, and supplies electric power only to the oscillator containing inverter 015 and transistor Q3.Q4.Q5 and fill 38. When the service voltage of battery 66 becomes low too much, when it becomes Z and less than [ Essential / 11.5V ], it is necessary to tell the user of device 10 about such a state in fact. Therefore, comparison machine tJ11 which has a source of internal constant voltage like Intersil S [ IcL7665] is used. The voltage from battery 66 is impressed between the partial pressures which consist of resistance R34, R35, R36, and R37, and battery voltage is compared with the internal voltage of comparison machine Ul l. The terminal area of resistance R34 and R35 is connected to input bottle 2 of comparison machine Ull, and, specifically, the terminal area of resistance R35 and R36 is connected to pin 3 of comparison machine Ull. Therefore, if a battery charger is more expensive than DC, -11, and 5V, it will become a low, and pin 7 of timer L'12 will serve as a low so that transistor Q2 may be made to turn on by this, and pin 1 of comparison machine Ull will make on-indicator or LED62 turn on. On the other hand, if battery voltage becomes lower than DC-11 *5v, pin 1 of comparison machine Ull will serve as a "high", and timer U12 (it is self-propelled multi-vibrator in fact) will blink on-indicator 78 by the pulse of per second about 2~3. Next, jack J4 used when charging battery 66 is explained. If a battery charger (not shown) is connected to controller 20, Sufficient 14i4 style will flow through current restriction resistance R51 connected to jack j4 via fuse Fl. Charge indicator 70 flows through the charging current from resistance R51 into insulating diode CR6 which exhausts battery 66 and which carries out thing prevention. The voltage from a charger is impressed to pin 10 of flip-flop UIO via diode CR7. Pin 10 of flip-flop UIO is a reset pin. Flip-flop UIO is maintained by the power supply OFF state, and while the charger is connected, it is keeping use of controller 20 from being possible by this of it. For this reason, as long as battery 66 is connected to the charger via jack j4, it becomes impossible using device 10. If it puts in another way, in order to use device 10, as the charger was mentioned above, it must separate from controller 20. Next, the main components which consist of energy source 18 and controller 20 are explained. If a circuit is taken into consideration with physical explanation of the point about various components of device 10, it will not be considered that it is necessary to make reference especially about the component which accompanies it although he understands the directions of device 10, but in order to show a perfect circuit, the component in which versatility accompanies a figure is an example. In the above, since the fundamental composition of device 1o was explained, the operation and advantage are explained. Catheter 16 which contains detector 12 and guide wire 22 especially is introduced into a venous system or an artery system, and it may be made to advance it using pure catheter implantation art. catheter 16 was defined beforehand -- if length insertion is carried out, using the usual art, by a clinician, the handle of finder 34 will be grasped, switch 60 will be operated, and AC current will be supplied to energy source 18 of finder 34. Finder 34 is set in the position where a patient's skin is suitable, and it is made to move along with the route of the blood vessel which inserted catheter 16. If finder 34 approaches at tip 14 of catheter 16 as shown in Drawing 1 as position ■, Detector 12 induces the magnetic field produced by energy source 18, and generates small voltage, and this voltage is the current and the phase which are supplied to energy source 18, Amber indicator 42 is made to turn on and it indicates that finder 34 is approaching at tip 14 of detector 12, therefore catheter 16. If movement is continued in accordance with the course of the catheter expected, and energy source 18 of finder 34 comes right above detector 12 which becomes perpendicular [ the lines of magnetic flux of energy source 18 ] to the axis of detector 12 as shown in Drawing 1 as position ■, Detector 12 will not generate voltage but amber indicator 42 will disappear. If the energy source of finder 34 exceeds detector 12 as shown in Drawing 1 as position I, Detector 12 induces the magnetic field which occurred by energy source 18, and generates small voltage, About about 180 degrees of phases have shifted from the current which made it generate for energy source 18, this voltage makes red indicator 44 turn on, and it indicates that finder 34 passed tip 14 of catheter 16. If indicator 42.44 changes from the red from amber, or red to amber, beaver 48 will emit a short audible sound. In the position shown in Drawing 1 as position ■, indicator 42.44 blinks by turns by movement of detector 12 in a large vein for the usual breathing and the beat of the heart. By moving finder 34 which includes energy source 18 in accordance with the course of a catheter forward and backward, he is a clinician, From mutual blink of indicator 42.44, and the audible signal of beaver 48, clear directions that there is a solid shaft of the electromagnetic energy place of energy source 18 at tip 14 of catheter 16 right above arrangement Did detector 12 can be given. The position at tip 14 in a blood vessel floor is definite To fall apart to the landmark of an outside dissection organization. that adjustment of catheter 16 further inserts a catheter Or -- Pull out from an insert portion -- it can carry out especially more -- the position at tip 14 of catheter 16, It is decided by using device 10 according to instruction of the present invention until the position at the tip 14 is decided by the landmark of the outside dissection organization which is in agreement with the final position of a request at tip 14 of catheter 16. When turning neither of indicator 42.44 on, catheter 16 can perceive it as there being a possibility of going into other courses. In such a case, Finding can be taken out by moving finder 34 in accordance with other possible courses of catheter 16 until the position power <111 law of position Si of detector 12 and the tip 14 of catheter 16 is carried out. If the course of the pond used for catheter 16 is dissatisfied, re-positioning of catheter 16 is needed. Similarly, when red indicator 44 lights up first, since whether he is following other courses in which a cuff results and catheter 16 goes to an opposite direction to the insertion point of catheter 16 cannot enter, it should look out. When amber indicator 42 does not light up, finder 34 may be placed on the position which crossed tip 14 of catheter 16 from the start. The position of detector 12 can be known by moving finder 34 along with the skin of installation, and adjustment at tip 14 of catheter 16 and re-positioning are required for it at any case. To remember guide wire 22 is about detector 12 after having been arranged by use of device lO which requires tip 14 of catheter 16 for the present invention in the exact position was checked, It may pull out from catheter 16, leaving catheter 16 to the prescribed position of a vein or an artery system for use by the usual catheter art. Mei Various surgery apparatus which the magnetic field which device 10 concerning the present invention generated by source 18 of a magnetic field affects it, or is not given, That is, it turns out that it can use again with various surgery apparatus including ECG, a monitor, an electric surgery cauterization implement, fluorescence perspective, and an electric patient table, without being interfered by them. Therefore, in order to carry out clinical top-sequence alignment with the landmark of an outside dissection organization, device 10 concerning the present invention follows the inside of central venous catheterization, or it, gives the information on the real time about positioning at tip 14 of catheter 16, and it is * To. The necessity of exposing a patient and the clinical staff to excessive radiation, such as fluorescence fluoroscopy and X-rays, in catheter implantation operation can be abolished by using device 1o concerning the present invention. Device 10 is easy to use and the clinical staff can appoint the position at tip 14 of catheter 16 without great training correctly. Finder 34 is moved until amber indicator 42 in which it is shown that finder 34 is approaching the position at tip 14 especially lights up, And it is only required to continue movement of finder 34 carefully until red indicator 44 in which it is shown that finder 34 passed the position at tip 14 lights up (amber indicator 42 is switched off), to stop advance of finder 34 subsequently, and to make it exercise. Directions of finder 34 having passed through tip 14 top are given by beaver 48. Therefore, a clinician does not need to read or interpret the meter which causes misreading by a clinician's position, or other complicated gauges. It can be said that the traffic-lights type approaching method is used for the present invention in order to show a clinician a motion and position of a request of finder 34. It is since indicator 42.44 is allocated by finder 34 provided with the source of a magnetic field, The clinician does not need to turn cautions to separating from a patient, in order for the landmark of a patient's outside dissection organization to be able to receive visual directions and to read meter and/or a gauge, or requesting others and the staff, in order to carry out those reading. Therefore, since a clinician decides the position of detector 12 of catheter 16 by the place which the present invention teaches, he can turn all the attentiveness to moving finder 34. As mentioned above, although the fundamental composition of the present invention was explained, probably, the various extension and modification will be obvious for a person skilled in the art. For example, in the best form, detector 12 and source 18 of a magnetic field may make such combination reverse according to the instruction of the present invention, although included in catheter 16 and finder 34, respectively. Although the directions to which similarly finder 34 is moved in order to discover tip 14 of a catheter were described, Finder 34 is arranged to the place of the landmark of the outside dissection organization which is in agreement with the final position of a request at tip 14 of catheter 16, It could recognize that catheter 16 may be advanced using fil catheter implantation art until the right directions of the optimal position at tip 14 of catheter 16 are given by indicator 42.44 and beaver 48. Therefore, since the present invention described here can be materialized with other specific forms including some forms mentioned above, without separating from the intention or general special feature, an example described here is exemplary at all the points. It should be understood as not restrictive. The range of the present invention should be defined rather than the above-mentioned explanation based on the range of an attached claim, and all the modification which enters in the equivalent range and meaning of the range of a claim should be included in it. International search report Mei , , PCT/lls 89103989 international search report LIS 8903989 S^ 3]308