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WO2008154909A2 - Procédé de détermination d'une direction d'intervention d'un outil et mise en oeuvre de l'intervention d'un outil - Google Patents

Procédé de détermination d'une direction d'intervention d'un outil et mise en oeuvre de l'intervention d'un outil Download PDF

Info

Publication number
WO2008154909A2
WO2008154909A2 PCT/DE2008/001019 DE2008001019W WO2008154909A2 WO 2008154909 A2 WO2008154909 A2 WO 2008154909A2 DE 2008001019 W DE2008001019 W DE 2008001019W WO 2008154909 A2 WO2008154909 A2 WO 2008154909A2
Authority
WO
WIPO (PCT)
Prior art keywords
reference body
tool
tool guide
workpiece
guide
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/DE2008/001019
Other languages
German (de)
English (en)
Other versions
WO2008154909A3 (fr
Inventor
Rainer Burgkart
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Priority to EP08784224A priority Critical patent/EP2207495A2/fr
Publication of WO2008154909A2 publication Critical patent/WO2008154909A2/fr
Publication of WO2008154909A3 publication Critical patent/WO2008154909A3/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1703—Guides or aligning means for drills, mills, pins or wires using imaging means, e.g. by X-rays
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/14—Surgical saws
    • A61B17/15—Guides therefor
    • 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
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/107—Visualisation of planned trajectories or target regions
    • 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
    • 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
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A61B2090/376—Surgical systems with images on a monitor during operation using X-rays, e.g. fluoroscopy
    • 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
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A61B2090/378—Surgical systems with images on a monitor during operation using ultrasound
    • 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
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3983—Reference marker arrangements for use with image guided surgery

Definitions

  • navigation system offers. It is a system with a navigation camera capable of detecting reference points in space. If these reference points are fastened to the tool and to the workpiece, in the medical field to a body part, the spatial relationship between the workpiece and the tool can be established by means of the computer associated with the camera. It is clear to the person skilled in the art that the geometry of the tool and of the workpiece and the position of the reference points with respect to the tool and the workpiece must be known. These steps are well known because they are removable from the operating instructions of the navigation systems. To produce a bore, it is thus possible to display the workpiece together with the tool and the intended virtual drilling axis on a screen.
  • the drill is now guided by hand so that its spatial position and its forward movement, d. H. Bohrvorschubzi, coincides with the virtual drilling axis.
  • the surgeon must look at the monitor, d. H. away from the actually relevant work area, align and move the tool until the actual and target positions are identical.
  • This hand-eye coordination is exhausting and requires a good spatial imagination and a lot of training.
  • the tool should be aligned by such a tool guide so that the tool penetrates into the intended spatial orientation in the workpiece.
  • the method has the following method steps: a. Fixing a geometrically predetermined reference body to the workpiece to be machined, wherein the reference body
  • a reference body coupling piece is provided for the mechanically defined coupling of a tool guide, wherein the reference body coupling piece is either connected in one piece to the reference body or is connected to the reference body via a defined rigid connecting structure,
  • Providing a tool guide, which is either integrally connected to the reference body or in only a defined and known positional relationship to the reference body can be fastened and which is adapted to perform a suitable tool for machining the article. That is, there may be various embodiments in which either the tool guide is decoupled from the reference body or the tool guide is firmly connected to the reference body.
  • this latter step is eliminated if a one-piece design is present.
  • either the tool guide can be connected and disconnected by a separate setting device or the tool guide is fixedly connected to an adjusting device.
  • the method is performed, for example, with a C-arm X-ray machine.
  • a reference body of exactly known geometry is to be operated on, d. H. attached to machined workpiece.
  • This reference body must have structural features that are detectable by the respective imaging method (eg metal balls in X-ray-based methods), and whose spatial arrangement is unambiguous.
  • At least two X-ray images of different solid angles of the reference body and at least two X-ray images of different solid angles of the target structure are made.
  • Either the reference body as well as the target structure are simultaneously imaged on two images, or the coordinate systems of the images of reference body and target structure must be exactly known to each other (eg precisely measurable by path measuring systems in a mobile C-arm X-ray machine).
  • the solid angles of the images relative to one another are exactly determined by means of mathematical relationships and also the spatial position of the reference body relative to the 3D target structure.
  • the center of the target structure eg, a tumor to be biopsied
  • the image sequence is arbitrary, ie it is irrelevant whether this point is first marked in the first or in the second X-ray image (X-ray image 2).
  • the target structure is corresponding to X-ray image 2 on the epipolar line. If, on the epipolar line, a point is computer-aided or (semi-) automatically detected / marked, which is located in the center of the target structure, then an exact 3D target point is determined. This thus represents exactly the projection of the two corresponding points which were marked in X-ray images 1 and 2. In other words, if one imagines the determined 3D target point and the two X-ray image planes floating in space, the 3D target point projects exactly onto both the marked point in X-ray image 1 and the marked point in X-ray image 2.
  • the direction of the surgical procedure for example in the sense of a 3D target trajectory defining the tool engagement direction, can also be planned virtually at this time.
  • any point e.g. in the area of a favorable tool entry surface, mark in the X-ray image 1.
  • the reference body fixed to the workpiece also has a template receptacle with already described properties in a precisely known location, it is now possible to know the spatial relationship of the target structure with respect to the reference structure. and thus an exact 3D transformation can be calculated in relation to the template recording.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Public Health (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Veterinary Medicine (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Dentistry (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Robotics (AREA)
  • Apparatus For Radiation Diagnosis (AREA)
  • Analysing Materials By The Use Of Radiation (AREA)
  • Length-Measuring Devices Using Wave Or Particle Radiation (AREA)

Abstract

L'invention concerne un procédé de détermination d'une direction d'interventiond'un outil et la mise en oeuvre de l'intervention d'un outil, procédé caractérisé en ce qu'il comprend les étapes suivantes : a. fixation, sur la pièce à usiner, d'un corps de référence géométriquement prédéterminé; b. établissement, par un processus d'imagerie, d'au moins deux images, par exemple, 2 images aux rayons X ou 2 images ultrasonores, à partir d'angles solides différents, sur lesquelles sont reproduites aussi bien la géométrie de la pièce à usiner que les caractéristiques de référence du corps de référence; c. calcul des coordonnées directionnelles, à partir de la position dans l'espace du corps de référence, et des coordonnées dans l'espace du volume de la pièce à usiner, l'usinage signifiant, pour la pièce, l'enlèvement, la modification ou l'ajout de matière; d. fourniture d'un guide-outil qui, ou bien est associé d'une seule pièce avec le corps de référence, ou bien ne peut être fixé qu'en relation de position définie et connue, vis-à-vis du corps de référence; e. ajustement, au moyen d'un dispositif de réglage, du guide-outil, à partir des coordonnées directionnelles déterminées à l'étape c; f. assemblage du guide-outil ajusté avec la pièce d'accouplement pour le corps de référence; et g. mise en place de l'outil sur le guide-outil et exécution de l'usinage.
PCT/DE2008/001019 2007-06-15 2008-06-14 Procédé de détermination d'une direction d'intervention d'un outil et mise en oeuvre de l'intervention d'un outil Ceased WO2008154909A2 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP08784224A EP2207495A2 (fr) 2007-06-15 2008-06-14 Procédé de détermination d'une direction d'intervention d'un outil et mise en oeuvre de l'intervention d'un outil

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102007028272 2007-06-15
DE102007028272.0 2007-06-15

Publications (2)

Publication Number Publication Date
WO2008154909A2 true WO2008154909A2 (fr) 2008-12-24
WO2008154909A3 WO2008154909A3 (fr) 2009-02-19

Family

ID=39941518

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/DE2008/001019 Ceased WO2008154909A2 (fr) 2007-06-15 2008-06-14 Procédé de détermination d'une direction d'intervention d'un outil et mise en oeuvre de l'intervention d'un outil

Country Status (2)

Country Link
EP (1) EP2207495A2 (fr)
WO (1) WO2008154909A2 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU2569720C1 (ru) * 2014-05-19 2015-11-27 Михаил Анатольевич Черных Устройство для пассивной навигации медицинского инструмента
EP3049032A4 (fr) * 2013-09-25 2017-07-05 Zimmer, Inc. Instrumentation spécifique à un patient (psi) de chirurgie orthopédique et systèmes et méthodes d'utilisation de rayons x pour la produire

Family Cites Families (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5799055A (en) * 1996-05-15 1998-08-25 Northwestern University Apparatus and method for planning a stereotactic surgical procedure using coordinated fluoroscopy
US6314310B1 (en) * 1997-02-14 2001-11-06 Biosense, Inc. X-ray guided surgical location system with extended mapping volume
WO2001064124A1 (fr) * 2000-03-01 2001-09-07 Surgical Navigation Technologies, Inc. Outil guide par image a canules multiples pour procedures guidees par image
US6711432B1 (en) * 2000-10-23 2004-03-23 Carnegie Mellon University Computer-aided orthopedic surgery
EP1690503B1 (fr) * 2005-02-15 2013-07-24 BrainLAB AG Mode d'utilisation pour le réglage de la position des guides de coupe d'un os

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP3049032A4 (fr) * 2013-09-25 2017-07-05 Zimmer, Inc. Instrumentation spécifique à un patient (psi) de chirurgie orthopédique et systèmes et méthodes d'utilisation de rayons x pour la produire
US9924950B2 (en) 2013-09-25 2018-03-27 Zimmer, Inc. Patient specific instrumentation (PSI) for orthopedic surgery and systems and methods for using X-rays to produce same
US10716579B2 (en) 2013-09-25 2020-07-21 Zimmer Inc. Patient specific instrumentation (PSI) for orthopedic surgery and systems and methods for using X-rays to produce same
US10881416B2 (en) 2013-09-25 2021-01-05 Zimmer Inc. Patient specific instrumentation (PSI) for orthopedic surgery
US11490902B2 (en) 2013-09-25 2022-11-08 Zimmer, Inc. Patient specific instrumentation (PSI) for orthopedic surgery and systems and methods for using X-rays to produce same
RU2569720C1 (ru) * 2014-05-19 2015-11-27 Михаил Анатольевич Черных Устройство для пассивной навигации медицинского инструмента

Also Published As

Publication number Publication date
EP2207495A2 (fr) 2010-07-21
WO2008154909A3 (fr) 2009-02-19

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