Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
  • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
  • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
  • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
  • A61B2034/2046—Tracking techniques
  • A61B2034/2055—Optical tracking systems
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
  • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
  • A61B2034/2072—Reference field transducer attached to an instrument or patient
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
  • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
  • A61B2090/363—Use of fiducial points
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
  • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
  • A61B2090/364—Correlation of different images or relation of image positions in respect to the body
  • A61B2090/365—Correlation of different images or relation of image positions in respect to the body augmented reality, i.e. correlating a live optical image with another image
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
  • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations

Definitions

• Document WO 97/03601 also describes such a device.
• it includes monitoring means which are placed on organs, which allows dynamic overlapping of the real image and the model even when the organs or the camera are moving
• the positions of the real image and of the model are determined according to a frame of reference linked to the camera TRACKING system.
• a medical device comprising a display system making it possible to superimpose in real time and dynamically the real image of an operating field with a model of this same field, the positions of the real image and of the model. being determined with respect to the same frame of reference which is fixed with respect to the operating field and which is visible on the real image
• any measurement of the position of the organs and the superimposition of their real image with the corresponding model can be carried out only in the context of the operating field as viewed on the real image.
• the medical device of the present invention can be used with one or more cameras. If only one camera is used, a fixed reference frame is used which includes at least 3 points visible on the real image.
• the fixed frame of reference can have any shape, as long as it has a sufficient number of points on the real image and it is fixed relative to the operating field (the organs) It can be natural (anatomical marks) or artificial In this last category, it can be placed mechanically (incisions), chemically (biocompatible ink) or with the use of external markers (artificial object placed / positioned in the operating field)
• the reference system consists of at least 3 branches, the assembly being adapted to be simply placed on the organs to be operated or on neighboring organs which are fixed relative to the organs to be operated
• the device further comprises a series of reference points on a deformable member, these points being used to deform and adapt all or part of the model relative to the actual deformations
• a 3D model of the operating field is generally reconstructed using segmentation techniques, different benchmarks are chosen on the model (it can be, for example, relevant anatomical benchmarks) and incidentally information is added to the model.
• added information we can cite objects which correspond to real objects which are not visualized on the real image as observed during the operation as useful landmarks to locate pathologies or navigation information for the surgeons (anatomical place where an organ must -be resected for example)
• the position of the markers of the real image and of the model is recorded relative to the fixed frame of reference in the following manner
• Figure 1 shows an overview of a device according to the invention
• FIG. 2 illustrates a fixed frame of reference which can be used within the framework of the present invention
• FIG. 3 illustrates an example of superposition of a model on an endoscopic image
• FIG. 4 illustrates an example of superposition of an ultrasound image on an endoscopic image
• the device shown diagrammatically in FIG. 1 comprises an optical system (4) intended to visualize an operating field (2)
• operating field is meant the region of the patient (1) who is the subject of an operation and who must be visualized .
• the images captured by the optical system (4) are sent to a digital processing module (6)
• the device also includes a database (5) which contains models of the operating field (2) which have been previously reconstituted from imagers, such as a CT-Scan or an MRI.
• the images of the models are then superimposed with the real images of the operating field (2) by means of a display device (8) which is in the form of a screen or any other device (high vision system, microscope ( binocular) with integrated screen, etc.)
• the surgeon (7) can interact on the signal processing module (6) through an interaction device (12) to for example include information on the models which will be displayed on the screen (8).
• fixed reference system (3) is meant any system fixed with respect to the operating field and more precisely with respect to the organs which are the subject of the operation.
• FIG. 2 A fixed reference system (3) which can be used within the framework of the present invention is illustrated in FIG. 2.
• It essentially consists of a rod (13) provided towards one of its ends (14) with three branches (9) placed perpendicularly to the rod (13) and spaced from each other by an angle of about 120 °.
• ends (9) of the branches and the neighboring end of the rod (14) act as reference points.
• Part or all of the fixed reference system (3) is placed on the organ to be operated or on a close surface which is fixed relative to it.
• FIG. 3 illustrates an example of superposition of a model on an endoscopic image.
• the model helps the surgeon or any other interaction system (robot, "therapeutic” probe, etc.) to locate the regions that need to be treated.
• FIG. 4 illustrates an example of superposition of an ultrasound image (11) obtained by an ultrasound probe (10).
• the ultrasound image (1 1) being visible provided that the fixed frame of reference (3) and the imager are also visible.

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• Health & Medical Sciences (AREA)
• Surgery (AREA)
• Life Sciences & Earth Sciences (AREA)
• Engineering & Computer Science (AREA)
• Medical Informatics (AREA)
• General Health & Medical Sciences (AREA)
• Biomedical Technology (AREA)
• Heart & Thoracic Surgery (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Molecular Biology (AREA)
• Animal Behavior & Ethology (AREA)
• Veterinary Medicine (AREA)
• Public Health (AREA)
• Robotics (AREA)
• Oral & Maxillofacial Surgery (AREA)
• Pathology (AREA)
• Measuring And Recording Apparatus For Diagnosis (AREA)
• Image Processing (AREA)
• Ultra Sonic Daignosis Equipment (AREA)

Applications Claiming Priority (3)

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Citations (2)

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• 2001
  • 2001-03-21 EP EP01911331A patent/EP1274360A1/de not_active Ceased
  • 2001-03-21 AU AU2001240413A patent/AU2001240413A1/en not_active Abandoned
  • 2001-03-21 WO PCT/CH2001/000182 patent/WO2001076496A1/fr not_active Ceased

Patent Citations (2)

Non-Patent Citations (1)

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