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WO2019240424A1 - Appareil de navigation chirurgicale et système de navigation chirurgicale et procédé l'utilisant - Google Patents

Appareil de navigation chirurgicale et système de navigation chirurgicale et procédé l'utilisant Download PDF

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Publication number
WO2019240424A1
WO2019240424A1 PCT/KR2019/006785 KR2019006785W WO2019240424A1 WO 2019240424 A1 WO2019240424 A1 WO 2019240424A1 KR 2019006785 W KR2019006785 W KR 2019006785W WO 2019240424 A1 WO2019240424 A1 WO 2019240424A1
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WIPO (PCT)
Prior art keywords
surgical
bone
guide
surgery
diagnostic
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/KR2019/006785
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English (en)
Korean (ko)
Inventor
박일형
정상현
박철우
이현우
박영균
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Industry Academic Cooperation Foundation of KNU
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Industry Academic Cooperation Foundation of KNU
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Publication of WO2019240424A1 publication Critical patent/WO2019240424A1/fr
Anticipated expiration legal-status Critical
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    • 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
    • A61B50/00—Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers
    • A61B50/20—Holders specially adapted for surgical or diagnostic appliances or instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08—Clinical applications
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08—Clinical applications
    • A61B8/0875—Clinical applications for diagnosis of bone
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/52—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/5215—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data
    • A61B8/5238—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data for combining image data of patient, e.g. merging several images from different acquisition modes into one image
    • A61B8/5246—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data for combining image data of patient, e.g. merging several images from different acquisition modes into one image combining images from the same or different imaging techniques, e.g. color Doppler and B-mode
    • 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
    • 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
    • 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
    • A61B90/50—Supports for surgical instruments, e.g. articulated arms
    • 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
    • A61B2034/2063—Acoustic tracking systems, e.g. 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
    • A61B90/36—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

Definitions

  • the present invention relates to a surgical navigation device, a navigation surgical system and method using the same, and more particularly, to a surgical navigation device used in the treatment of bone, navigation navigation system and method using the same.
  • Bone tumors such as bone cysts, are tumors that develop in the bone.
  • the treatment of bone diseases for such lesions is the treatment of the lesion area, curettage, and cleansing. It is common to carry out therapeutic procedures for drug injection, bone cement insertion for bone formation.
  • the orthopedic surgical instrument In such conventional bone surgery, the orthopedic surgical instrument must inevitably enter the bone, and since the surgical instrument cannot be visually identified, a separate marker such as an optical or electromagnetic position tracker is attached to position the surgical instrument. Is estimated.
  • Patent Document 1 Korean Registered Patent No. 10-1154100
  • Patent Document 2 Korean Patent Publication No. 10-2016-0078363
  • One aspect of the present invention provides a surgical navigation device for diagnosing a site where a bone disease has occurred, and guiding a surgical tool for treatment to a predetermined location within a diagnosed bone, and a navigation surgical system and method using the same.
  • Surgical navigation device is mounted to the surgery table, the base frame portion formed with a rail surface in the longitudinal direction of the surgery table, an ultrasound diagnostic device for generating an ultrasound image is fastened, the ultrasound diagnostic device
  • a circular arc-shaped ultrasound diagnostic frame portion mounted on the rail surface in the width direction and a bone surgical endoscope are placed inside the bone so that the curve moves in the width direction of the surgery table while moving linearly along the length direction.
  • a guide port for guiding to the fastened, arc-shaped bone surgical endoscope guide mounted on the rail surface in the width direction so that the guide port is curved in the width direction of the surgical table while moving linearly along the length direction It includes a frame portion.
  • the ultrasonic diagnostic frame portion is mounted with the rail surface in the width direction, and guided by an arc-shaped ultrasonic diagnostic guide guide rail sliding linearly in the longitudinal direction along the rail surface, guided by the ultrasonic diagnostic guide rail to the width direction
  • a curved movement sliding bracket and installed on one side of the movement bracket is fastened to the ultrasound diagnostic device, and may include an ultrasound diagnostic fastener moving upwardly or vertically with respect to the movement direction of the movement bracket.
  • the bone surgery endoscope guide frame portion is mounted with the rail surface in the width direction, the guide port guide rail of the arc shape to linearly slide in the longitudinal direction along the rail surface, guided by the guide port guide rail and the width
  • a movement bracket that slides along a direction and is installed on one side of the movement bracket and fastened to the guide port may include a guide port fastening portion moving vertically up or down with respect to the movement direction of the movement bracket.
  • the base frame portion may be selectively coupled to any one of the ultrasound diagnostic frame portion or the bone surgery endoscope guide frame portion.
  • the ultrasound diagnostic frame portion and the bone surgery endoscope guide frame portion may be mutually changeable and replaceable.
  • the base frame portion may be coupled to a lower portion of the rail surface, and may be formed in at least one fixing pin formed in the width direction and fixedly coupled to a bone located on the surgery table.
  • the base frame portion the lower end is coupled to the rail formed on the surgery table to move along the rail, the rail surface is supported from the rail by a support member may be located above the surgery table.
  • the navigation surgery system is installed on the surgery table, the ultrasound diagnostic device for taking an ultrasound image or a guide port for guiding the bone surgical endoscope to guide the bone surgery endoscope into the bone located on the surgery table selectively
  • a frame module controller and an ultrasound for controlling the operation of the navigation device, the surgical navigation device, and collecting measurement values for the position information and the posture information of the ultrasonic diagnostic device or the guide port selectively mounted on the surgical navigation device.
  • a three-dimensional diagnostic image of the bone region in which the lesion is generated is generated based on the ultrasound image photographed by the diagnostic apparatus, and the real time position of the entry position and the guide port are displayed together so that the guide port is guided to a preset entry position.
  • Surgical navigation It includes a console.
  • the surgical navigation device is mounted to the surgery table, the base frame portion formed with a rail surface in the longitudinal direction of the surgery table, the ultrasonic diagnostic device is fastened, the ultrasonic diagnostic device while moving linearly along the longitudinal direction
  • An arc-shaped ultrasonic diagnostic frame portion and the guide port are mounted to the rail surface in the width direction to be curved in the width direction of the operating table, and the guide port is linearly moved along the length direction. It may include an arc-shaped bone surgery endoscope guide frame portion mounted on the rail surface in the width direction, so as to move in the width direction of the.
  • the ultrasound diagnostic frame portion and the bone surgery endoscope guide frame portion is mounted with the rail surface in the width direction, the guide rail of the arc-shaped linearly sliding in the longitudinal direction along the rail surface, guided by the guide rail
  • a moving bracket that curves and slides along the width direction and is installed at one side of the moving bracket to fasten the ultrasound diagnostic device or the guide port and include a fastening part moving vertically upward or vertically with respect to the moving direction of the moving bracket. Can be.
  • the ultrasound diagnostic frame portion and the bone surgery endoscope guide frame portion may be mutually changeable and replaceable.
  • the surgical navigation console is a combination of a plurality of ultrasound images taken by the ultrasound diagnostic apparatus to reconstruct the three-dimensional image information, and using the reconstructed three-dimensional image information by analyzing the shape or density difference of the exoskeleton surface inside the bone The lesion area of can be detected.
  • the surgical navigation console may generate the 3D diagnostic image by matching the 3D image information reconstructed on the same bone region with an image generated by another device.
  • the surgical navigation device may generate a sensing value for the posture information and the position information of the ultrasonic diagnostic device or the guide port, which is fixedly coupled to the bone located on the surgery table and selectively mounted.
  • the surgical navigation console is set to the reference position of the bone fixedly coupled to the surgical navigation surgical device to the reference position, by converting the sensing value relative to the reference position in real time of the ultrasonic diagnostic apparatus or the guide port The position can be measured.
  • the navigation surgery method using a navigation surgical system comprising a surgical navigation device, a frame module controller and a surgical navigation console according to the present invention
  • the surgical navigation console the ultrasound is selectively mounted on the surgical navigation device Generating a three-dimensional diagnostic image of the bone region in which the lesion is generated based on the ultrasound image measured by the diagnostic device, the surgical navigation console, based on the diagnostic image planning position for entering the bone surgery endoscope And receiving the input position and displaying the planned position and the actual position of the guide port for guiding the bone surgical endoscope on the diagnosis image.
  • Generating the 3D diagnostic image comprises reconstructing 3D image information by combining a plurality of ultrasound images photographed by the ultrasound diagnostic apparatus, and analyzing the shape or density difference of the exoskeleton surface using the reconstructed 3D image information. It may be characterized by detecting the lesion area inside the bone.
  • the generating of the 3D diagnostic image may include generating the 3D diagnostic image by matching the 3D image information reconstructed on the same bone region with an image generated by another device. .
  • the displaying of the actual position on the diagnosis image may include setting an upper portion of a bone fixedly coupled to the surgical navigation surgical apparatus as a reference position, and converting the sensing value into a relative position with respect to the reference position to the ultrasonic diagnostic apparatus or It may be characterized by measuring the real-time location of the guide port.
  • Surgical tools for guiding to a predetermined position can provide a specialized surgical environment for bone surgery.
  • FIG. 1 is a view showing a schematic configuration of a navigation surgery system according to the present invention.
  • FIG. 2 is a conceptual diagram illustrating a schematic function of each component of the navigation surgical system of FIG. 1.
  • 3 to 8 are diagrams showing the specific configuration of the surgical navigation device of FIG.
  • FIG. 9 and 10 illustrate specific functions of the frame module controller of FIG. 1.
  • FIG. 11 is a block diagram illustrating a detailed configuration of the surgical navigation console of FIG. 1.
  • FIG. 12 is a flowchart illustrating a schematic flow of a navigation surgery method according to an embodiment of the present invention.
  • FIG. 1 and 2 is a diagram showing a schematic configuration of a navigation surgery system according to an embodiment of the present invention.
  • the navigation surgery system 1 diagnoses a bone region in which a bone tumor such as a bone cyst is generated by using an ultrasound diagnostic apparatus that generates an ultrasound diagnostic image, and diagnoses the bone region.
  • the insertion position of the bone surgical endoscope for treating the damaged area may be planned in advance, and at least one guide port for guiding the bone surgical endoscope may be inserted in the previously planned position.
  • the navigation surgical system 1 includes a surgical navigation device 100, a frame module controller 200 and a surgical navigation console 300.
  • Surgical navigation device 100 is equipped with a guide port for guiding the insertion position of the ultrasonic diagnostic device and bone surgery endoscope, and controls the multiple degree of freedom of the mounted surgical tool (ultrasound diagnosis, bone surgery endoscope) required for bone surgery Information can be collected.
  • the surgical navigation device 100 may be provided with a frame to which the ultrasound diagnostic apparatus is attached.
  • the surgical navigation device 100 may move the frame on which the ultrasound diagnosis apparatus is mounted to generate an ultrasound image of a bone region.
  • the surgical navigation device 100 may measure the position and posture information of the ultrasound diagnostic apparatus using a sensor provided in the frame.
  • the surgical navigation device 100 may be provided with a frame is attached to the guide port is inserted into the bone surgical endoscope.
  • the surgical navigation device 100 may move the frame on which the guide port is mounted to position the guide port at a predetermined surgical site.
  • Surgical navigation device 100 may measure the position and attitude information of the guide port using a sensor provided in the frame.
  • the frame module controller 200 may be connected to the surgical navigation device 100 by wire or wirelessly to control the operation of the surgical navigation device 100.
  • the frame module controller 200 controls the guide port to be inserted into a bone disease-producing region by moving the ultrasound diagnostic apparatus according to a user's operation to acquire an ultrasound image or by moving a frame equipped with a guide port. can do.
  • the frame module controller 200 may collect data generated while the surgical navigation device 100 is controlled.
  • the frame module controller 200 may receive an ultrasound image generated by the ultrasound diagnosis apparatus.
  • the frame module controller 200 may collect a sensing value for the position, angle, distance, posture, etc. of the ultrasonic diagnostic apparatus or the guide port measured by the frame equipped with the ultrasonic diagnostic apparatus and the frame equipped with the guide port.
  • the frame module controller 200 may transmit data including the collected ultrasound image and the sensing value to the surgical navigation console 300.
  • the surgical navigation console 300 may generate information necessary for bone surgery using the data received from the frame module controller 200.
  • the surgical navigation console 300 may generate diagnostic information about a site where a bone disease occurs.
  • the surgical navigation console 300 may preset the insertion position and entry plan of the bone surgical endoscope based on the diagnostic information.
  • the surgical navigation console 300 may display information about a distance and a posture between a preset insertion position and a current position of the guide port in real time.
  • FIG 3 is a view showing a specific configuration of the surgical navigation device 100 according to the present invention.
  • the surgical navigation device 100 includes a base frame portion 110, the ultrasound diagnostic frame portion 120 and the bone surgery endoscope guide frame portion 130.
  • the base frame unit 110 is mounted on the surgery table, and is a member for guiding the ultrasound diagnostic frame unit 120 and the bone surgery endoscope guide frame unit 130 to move on the surgery table. In this regard, it will be described with reference to FIG.
  • FIG 4 is a diagram illustrating an example of the base frame unit 110 coupled to the surgery table.
  • the base frame unit 110 may be combined with the surgery table 20. That is, the lower end of the base frame 110 is coupled to the rail 21 formed on the surgery table 20, and may move along the rail 21 in the longitudinal direction of the surgery table 20.
  • the rail surface 111 may be formed at an upper end of the base frame part 110.
  • the rail surface 111 may be supported from the rail 21 by the support member 112 and positioned above the surgical table 20.
  • the rail surface 111 may be disposed to have a length direction parallel to the length direction of the surgery table 20.
  • the rail surface 111 may be attached to or detached from any one of the ultrasound diagnostic frame unit 120 or the bone surgery endoscope guide frame unit 130. That is, the ultrasound diagnostic frame unit 120 and the bone surgery endoscope guide frame unit 130 may move along the rail surface 111 when fastened with the base frame unit 110, which may be the ultrasound diagnostic frame unit 120 and the bone. This means that the surgical endoscope guide frame unit 130 may be slid along the longitudinal direction of the surgical table 20.
  • the fixing pin 113 may be coupled to the lower portion of the rail surface 111. At least one fixing pin 113 may be provided, and may be formed in the width direction of the surgery table 20 to be fixedly coupled to a bone located in the surgery table 20. That is, the base frame 110 may be fixed to the bone of the patient by the fixing pin 113, accordingly, the surgical navigation device 100 according to the present invention is the position of the bone in which the fixing pin 113 is inserted You can set to an absolute position to represent the bone's other position relative to the absolute position.
  • the ultrasound diagnostic frame part 120 may be detachably attached to the rail surface 111 of the base frame part 110 and may be combined with the ultrasound diagnostic device so as to acquire the ultrasound image while moving along the rail surface 111. In this regard, it will be described with reference to FIGS. 5 and 6 together.
  • FIG 5 and 6 are views illustrating an example of the ultrasound diagnostic frame unit 120 coupled to the base frame unit 110.
  • the ultrasonic diagnostic apparatus frame part 120 may be composed of an ultrasonic diagnostic guide rail 121, a moving bracket 122, and an ultrasonic diagnostic fastener 123.
  • the ultrasonic diagnostic guide rail 121 is an arc-shaped member that is mounted on the rail surface 111 of the base frame part 110 and slides in the longitudinal direction of the surgical table 20 along the rail surface 111.
  • the ultrasound diagnostic guide rail 121 may be fastened to the rail surface 111 to be formed along a direction perpendicular to the length direction of the surgery table 20, that is, along the width direction of the surgery table 20.
  • the ultrasonic diagnostic guide rail 121 when the ultrasonic diagnostic guide rail 121 is mounted on the rail surface 111, it may be arranged in an arc shape having a central portion (P) of the center of the bone coupled with the fixing pin 113.
  • the moving bracket 122 is a member coupled to the ultrasound diagnostic guide rail 121 and may be guided by the ultrasound diagnostic guide rail 121 to slide along the width direction of the surgical table 20.
  • the circular arc-shaped ultrasonic diagnostic guide rail 121 may have grooves formed at its center by protruding both sides along the longitudinal direction, and the movement bracket 122 may have a circular arc shape to move along the ultrasonic diagnostic guide rail 121. Can be formed. Due to this structural feature, the moving bracket 122 can move while maintaining a constant distance from the central portion (P) of the bone at all times.
  • the ultrasound diagnosis unit fastening part 123 is installed at one side of the moving bracket 122 and is a member fastened to the ultrasound diagnosis unit 25.
  • the ultrasound diagnosis fastener 123 may move in a direction perpendicular to the reference plane, that is, the vertical direction of the surgery table 20.
  • the ultrasonic diagnostic apparatus 25 is linearly moved along the longitudinal direction of the surgical table 20 by the ultrasonic diagnostic guide rail 121 moving along the rail surface 111. can do.
  • the ultrasonic diagnostic apparatus 25 performs circular motion along the width direction of the surgery table by the movement of the movement bracket 122 guided by the circular arc-shaped ultrasonic diagnostic guide rail 121.
  • the portion may be moved upward or downward in the vertical direction by the ultrasonic diagnostic fastener 123 in the process of moving along the longitudinal direction or the width direction.
  • the ultrasound diagnostic frame unit 120 may be provided with at least one sensor for measuring the position and position of the ultrasound diagnostic.
  • the ultrasound diagnostic frame unit 120 may generate a sensing value for a moving distance, a rotation angle, a distance from a bone, and the like of the ultrasound diagnostic device 25 using a sensor.
  • the bone surgical endoscope guide frame unit 130 is detachable from the rail surface 111 of the base frame unit 110 and may be coupled to the guide port so that the guide port can be inserted into the bone. In this regard, it will be described with reference to FIGS. 7 and 8 together.
  • FIG 7 and 8 are views illustrating an example of the bone surgery endoscope guide frame unit 130 combined with the base frame unit 110.
  • Bone surgery endoscope guide frame 130 may be composed of a guide port guide rail 131, a moving bracket 132 and a guide port fastening portion 133.
  • the guide port guide rail 131 is an arc-shaped member which is mounted on the rail surface 111 of the base frame part 110 and slides along the rail surface 111 in the longitudinal direction of the surgery table 20, and has a moving bracket ( 132 is a member that is guided by the guide port guide rail 121 and arc-moving along the width direction of the surgical table 20, the ultrasonic diagnostic fastener 133 is provided on one side of the moving bracket 132 guide port ( 35) can be moved in the vertical upper or lower direction of the movement direction.
  • the guide port guide rail 131, the moving bracket 132 and the guide port fastening portion 133 is the ultrasonic diagnostic guide rail 121, the moving bracket 122 and the ultrasonic diagnostic fastener of the ultrasonic diagnostic frame portion 120. It may be provided in a form similar to the (123). That is, the movement bracket 122 of the ultrasonic diagnostic guide frame 120 corresponding to the guide port guide rail 131 and the ultrasonic diagnostic frame 120 corresponding to the movement bracket 132 of the bone surgery endoscope guide frame 130. And the specific structure and function of the ultrasonic diagnostic fastener 123 corresponding to the ultrasonic diagnostic fastener 133 has been described above with reference to Figures 5 and 6, the repeated description will be omitted.
  • the bone surgical endoscope guide frame 130 is characterized in that the guide port 35 for guiding the bone surgical endoscope into the bone is mounted Can be.
  • the guide port 35 is a cylindrical member having a through hole, and may be inserted at a specific position of the bone according to the operation of the bone surgery endoscope guide frame 130. As will be described later, as the guide port 35 is fixedly inserted in a preplanned position, the bone surgical endoscope can always invade the bone at a constant position.
  • the bone surgery endoscope guide frame 130 may be provided with at least one sensor for measuring the position and position of the guide port 35.
  • the bone surgery endoscope guide frame unit 130 may generate a sensing value for a moving distance, a rotation angle, a distance from a bone, and the like of the guide port 35 using a sensor.
  • the bone surgery endoscope guide frame portion 130 is characterized in that provided with one or more. Specifically, the bone surgery endoscope guide frame unit 130 may be provided to correspond to the number of bone surgery endoscopes used for bone treatment.
  • Bone surgery endoscopy is a couch instrument to remove solid tissue inside the lesion area, an endoscopic instrument to see the progress or treatment range of the stool area, and a scrub and suction to remove solid tissue destroyed after the sofa work on the lesion site. It may include at least one of a drug injection device for treatment at the site from which the device and tissue have been removed.
  • the bone surgery endoscope guide frame unit 130 may include a first bone surgery endoscope guide frame equipped with a first guide port into which a sofa device, a cleaning / suction device, and a drug injection device are inserted. And a second bone surgical endoscope guide frame unit equipped with a second guide port into which the endoscope instrument for observing the treatment process is inserted.
  • the number of bone surgery endoscope guide frame portion 130 is not limited to the above-described embodiment, it may be provided in one or two or more according to the configuration of the bone surgery endoscope instruments, lesions and the like.
  • the frame module controller 200 may receive a sensing value measured by a sensor provided in the ultrasound diagnostic frame unit 120 and an ultrasound image measured by the ultrasound diagnostic device 25. have.
  • the sensing value is from the longitudinal movement distance of the ultrasonic diagnostic device 25, the rotation angle with respect to the width direction, and the bone when the ultrasonic diagnostic device 25 moves the surgery table 20 by the ultrasonic diagnostic frame part 120. It may include a measurement for the depth of.
  • the frame module controller 200 may measure a sensing value for a multi-degree of freedom exercise of the ultrasound diagnosis device 25.
  • the frame module controller 200 may convert the converted numerical data into the surgical navigation console 300 and transmit the ultrasound image measured by the ultrasound diagnostic device 25 together.
  • the frame module controller 200 may receive a sensing value measured by a sensor provided in the bone surgery endoscope guide frame 120.
  • the frame module controller 200 may measure a sensing value for a multi-degree of freedom movement of the guide port 35 mounted on the bone surgery endoscope guide frame 120.
  • the frame module controller 200 is mounted to each bone surgery endoscope guide frame 120.
  • the sensing value of the guide port 35 can be classified and received.
  • the frame module controller 200 may signal and transmit such a sensing value to provide the surgical navigation console 300 with information about which position of the soft tissue is currently located in the guide port 35.
  • FIG. 11 is a block diagram showing a specific configuration of the surgical navigation console 300.
  • the surgical navigation console 300 includes a diagnosis unit 310, a positioning unit 320, and a guide unit 330.
  • the diagnosis unit 310 may generate diagnostic information about a site where a bone disease occurs.
  • the surgical navigation console 300 may reconstruct the 3D image information by combining a plurality of 2D ultrasound images measuring the cross-section of the input bone.
  • Surgical navigation console 300 may analyze the shape and density difference of the exoskeleton using the reconstructed three-dimensional image information, through which it is possible to determine the area in which bone tumors, such as osteocytes, are generated in the bone.
  • the positioning unit 320 may set in advance the insertion position of the bone surgical endoscope to be inserted into the site where the bone disease occurs.
  • the surgical navigation console 300 is based on the reconstructed three-dimensional image information, the location information of the ultrasound diagnostic device 25 for the partial image MRI (Magnetic Resonance Imaging) image generated by another device or Computed CT Tomography) image and matching process can be performed. Accordingly, the user may plan the entrance position of the bone surgical endoscope based on the matched information provided by the positioning unit 320.
  • MRI Magnetic Resonance Imaging
  • the guide unit 330 may display the actual position of the bone surgery endoscope with respect to the entrance position of the preset bone surgery endoscope as image information.
  • the guide unit 330 may display an entry position (hereinafter, a planned position) of a bone surgery endoscope input from a user on a matched image received from the position setting unit 320.
  • the guide unit 330 may also display the current position (hereinafter, the actual position) of the bone surgery endoscope based on the sensing value for the guide port 35 received from the frame module controller 200.
  • the guide unit 330 converts the planned position and the actual position into a relative position with respect to the absolute position to display reliably. Can be.
  • the guide unit 330 may also display the information about the three-axis error attitude and the separation distance between the planned position and the actual position.
  • FIG. 12 is a flowchart illustrating a schematic flow of a navigation surgery method according to an embodiment of the present invention.
  • a series of procedures of the navigation surgery method described below may be performed by the navigation surgery system 1 described above.
  • the surgical navigation console 300 may generate diagnostic information on the bone site where the lesion is generated (710).
  • the surgical navigation apparatus 100 is in a state in which the ultrasound diagnostic frame portion 120 is mounted on the base frame portion 110.
  • the ultrasonic diagnostic apparatus 25 moves along the longitudinal direction of the surgical table 20 according to the coupling structure of the base frame 110 and the ultrasonic diagnostic guide rail 121, and the ultrasonic diagnostic guide rail 121 and the bracket 122 are provided.
  • the frame module controller 200 may collect sensing values according to the multiple degrees of freedom exercise of the ultrasound diagnosis apparatus 25 and transmit the sensing values to the surgical navigation console 300.
  • the surgical navigation console 300 may reconstruct the 3D image information using the plurality of cross-sectional images measured by the ultrasound diagnosis device 25.
  • the surgical navigation console 300 may analyze the reconstructed 3D image information to detect a region (region) in which the lesion is generated and generate diagnostic information including the detected region.
  • the surgical navigation console 300 may preset the entry position of the bone surgical endoscope based on the generated diagnostic information (730).
  • the surgical navigation console 300 may match the reconstructed 3D image with MRI or CT images received from other devices. In this process, the surgical navigation console 300 may generate sophisticated navigation information by reflecting the position / posture information of the ultrasound diagnostic device 25 and the absolute position set by the fixing pin 113 together. The surgical navigation console 300 may store the planned position of the bone surgery endoscope set by the user.
  • the surgical navigation console 300 may display the planned position and the actual position on the matched image (750).
  • the surgical navigation device 100 is a bone surgery endoscope guide frame portion 120 is mounted on the base frame portion 110, the frame module controller 200 is mounted to the bone surgery endoscope guide frame portion 120
  • the sensing value for the multiple degree of freedom posture and position of the guide port 35 may be transmitted to the surgical navigation console 300.
  • the surgical navigation console 300 may guide the user to position the guide port 35 at the planned position by displaying the actual position at the planned position together in the matched image.
  • the surgical navigation console 300 may display the position of each bone surgical endoscope in the matched image and output the image information in the bone treatment process.

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  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Public Health (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Physics & Mathematics (AREA)
  • Biophysics (AREA)
  • Robotics (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Rheumatology (AREA)
  • Gynecology & Obstetrics (AREA)
  • Computer Vision & Pattern Recognition (AREA)
  • Ultra Sonic Daignosis Equipment (AREA)

Abstract

L'invention concerne un appareil de navigation chirurgicale pouvant comprendre : une partie de cadre de base présentant une surface de rail formée le long de la direction longitudinale d'une table chirurgicale ; une partie arquée de cadre de dispositif de diagnostic ultrasonore à laquelle est fixé un dispositif de diagnostic ultrasonore pour générer une image ultrasonore et qui est montée sur la surface de rail dans la direction de la largeur pour permettre le déplacement curviligne du dispositif de diagnostic ultrasonore dans la direction de la largeur tout en se déplaçant linéairement le long de la direction longitudinale ; et une partie arquée de cadre de guidage d'endoscope de chirurgie osseuse à laquelle est fixé un orifice de guidage pour guider un endoscope de chirurgie osseuse et qui est montée sur la surface de rail dans la direction de la largeur pour permettre le déplacement curviligne de l'orifice de guidage dans la direction de la largeur de la table chirurgicale tout en se déplaçant linéairement le long de la direction longitudinale.
PCT/KR2019/006785 2018-06-12 2019-06-05 Appareil de navigation chirurgicale et système de navigation chirurgicale et procédé l'utilisant Ceased WO2019240424A1 (fr)

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KR10-2018-0067379 2018-06-12
KR1020180067379A KR102168462B1 (ko) 2018-06-12 2018-06-12 수술용 네비게이션 장치, 이를 이용한 네비게이션 수술 시스템 및 방법

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WO2019240424A1 true WO2019240424A1 (fr) 2019-12-19

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CN115089304A (zh) * 2022-06-28 2022-09-23 吉林大学 一种多臂多自由度式微创手术平台
CN117084667A (zh) * 2023-10-19 2023-11-21 山东第一医科大学第一附属医院(山东省千佛山医院) 一种用于骨科手术通道检测设备

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CN112370164A (zh) * 2020-11-03 2021-02-19 上海大学 一种空间混联骨盆骨折复位机器人
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CN117084667A (zh) * 2023-10-19 2023-11-21 山东第一医科大学第一附属医院(山东省千佛山医院) 一种用于骨科手术通道检测设备

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