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WO2023037369A1 - Dispositifs, systèmes et méthodes de traitement nerveux - Google Patents

Dispositifs, systèmes et méthodes de traitement nerveux Download PDF

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Publication number
WO2023037369A1
WO2023037369A1 PCT/IL2022/050980 IL2022050980W WO2023037369A1 WO 2023037369 A1 WO2023037369 A1 WO 2023037369A1 IL 2022050980 W IL2022050980 W IL 2022050980W WO 2023037369 A1 WO2023037369 A1 WO 2023037369A1
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WO
WIPO (PCT)
Prior art keywords
nerve
treatment
model
subject
treatment volume
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/IL2022/050980
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English (en)
Inventor
Assaf Dekel
Danielle VALES
Mordechay Beyar
Oren Globerman
Jonathan Mendelson
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.)
G Knee Robotics Ltd
Original Assignee
G Knee Robotics Ltd
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Filing date
Publication date
Application filed by G Knee Robotics Ltd filed Critical G Knee Robotics Ltd
Publication of WO2023037369A1 publication Critical patent/WO2023037369A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • 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
    • 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
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G13/00—Operating tables; Auxiliary appliances therefor
    • A61G13/10—Parts, details or accessories
    • A61G13/12—Rests specially adapted therefor; Arrangements of patient-supporting surfaces
    • A61G13/1205—Rests specially adapted therefor; Arrangements of patient-supporting surfaces for specific parts of the body
    • A61G13/1245—Knees, upper or lower legs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00434—Neural system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577—Ablation
    • 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
    • A61B2034/101—Computer-aided simulation of surgical operations
    • A61B2034/105—Modelling of the patient, e.g. for ligaments or bones
    • 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
    • A61B2090/373—Surgical systems with images on a monitor during operation using light, e.g. by using optical scanners
    • 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
    • A61B2090/374—NMR or MRI
    • 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
    • A61B2090/3762—Surgical systems with images on a monitor during operation using X-rays, e.g. fluoroscopy using computed tomography systems [CT]
    • 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
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots

Definitions

  • the present invention relates to the field of medical treatments, and more particularly, to devices, systems and methods for medical treatments with fluoroscopy free guiding tools.
  • Nerve treatment may be performed for relief of pain symptoms (e.g. chronic pain symptoms) in various locations within a subject’s body.
  • peripheral nerve block treatment may include a genicular nerve block treatment that is performed for relief of pain symptoms (e.g. chronic pain symptoms) in a knee of a subject.
  • nerve treatment e.g. such as genicular nerve block treatment
  • nerve treatment is performed under fluoroscopy and optionally under ultrasound imaging of a treatment volume to detect landmarks (e.g. bony tissue landmarks and/or soft tissue landmarks) and, based on the detected landmarks, estimate locations of nerves to be treated within the treatment volume.
  • nerves are not visible in fluoroscopy and/or ultrasound imaging, the locations of nerves within the treatment volume can only be estimated. Nerve treatment that is based on estimated locations of nerves may be not optimal and/or may cause damage to tissues within the treatment volume. Furthermore, during fluoroscopy imaging, the subject and the physician are exposed to X-ray radiation which is undesirable. Moreover, fluoroscopy imaging may require expensive infrastructure.
  • Embodiments of the present invention may provide a system for a nerve treatment, which may include: a 3D scanner configured to generate a first 3D model including a 3D representation of a surface of a treatment volume of a subject in a global coordinate system; a computing device configured to: receive a second 3D model including a 3D representation of the surface of the treatment volume of the subject and an indication of a position of a nerve within the treatment volume of the subject in an arbitrary coordinate system; register the second 3D model with respect to the first 3D model in the global coordinate system; and based on the registration, determine a location of the nerve within the treatment volume of the subject in the global coordinate system; and a nerve treatment tool configured to apply a nerve treatment at the determined location of the nerve within the treatment volume of the subject.
  • a 3D scanner configured to generate a first 3D model including a 3D representation of a surface of a treatment volume of a subject in a global coordinate system
  • a computing device configured to: receive a second 3D model including a 3
  • the indication of the position of the nerve in the second 3D model includes a 3D representation of the nerve.
  • the computing device is configured to register the second 3D model with respect to the first 3D model based on the 3D representations of the surface of the treatment volume of the first 3D model and the second 3D model.
  • the computing device is configured to determine the location of the nerve further based on the position of the nerve with respect to the surface of the treatment volume indicated in the second 3D model.
  • the system includes a robotic device configured to navigate the nerve treatment tool to the determined location of the nerve within the treatment volume of the subject.
  • the robotic device is configured to at least one of: align the nerve treatment tool with the determined location of nerve; and penetrate the nerve treatment tool into the treatment volume of the subject to position the treatment tool at the determined location of nerve.
  • the computing device is configured to control the robotic device to navigate the treatment tool.
  • the system includes a fixation device configured to hold the treatment volume of the subject in a desired position and/or orientation.
  • the fixation device is configured to adjust the position and/or orientation of the treatment volume of the subject to substantially correspond to a position and/or orientation of the treatment volume of the subject in which the second 3D model has been generated.
  • the fixation device is configured to adjust the position and/or orientation of the treatment volume of the subject based on the registration of the second 3D model with respect to the first 3D model in the global coordinate system.
  • the system includes an imaging modality configured to generate the second 3D model.
  • the imaging modality is selected from a group consisting of magnetic resonance imaging (MRI) device and computed tomography (CT) device.
  • the nerve treatment tool is selected from a group consisting of nerve block treatment tools and nerve ablation tools.
  • the first 3D model includes a 3D representation of a skin of a knee region of the subject.
  • the second 3D model includes a 3D representation of a skin of a knee region of the subject and an indication of a position of at least one of superior medial genicular nerve, superior lateral genicular nerve and inferior medial genicular nerve in the knee region.
  • Some embodiments of the present invention may provide a method of a nerve treatment, which may include: by a 3D scanner, generating a first 3D model including a 3D representation of a surface of a treatment volume of a subject in a global coordinate system; by a computing device: receiving a second 3D model including a 3D representation of the surface of the treatment volume of the subject and an indication of a position of a nerve within the treatment volume of the subject in an arbitrary coordinate system; registering the second 3D model with respect to the first 3D model in the global coordinate system; and based on the registration, determining a location of the nerve within the treatment volume of the subject in the global coordinate system; and by a nerve treatment tool, applying a nerve treatment at the determined location of the nerve within the treatment volume of the subject.
  • the indication of the position of the nerve in the second 3D model includes a 3D representation of the nerve.
  • Some embodiments may include, by the computing device, registering the second 3D model with respect to the first 3D model based on the 3D representations of the surface of the treatment volume of the first 3D model and the second 3D model.
  • Some embodiments may include, by the computing device, determining the location of the nerve further based on the position of the nerve with respect to the surface of the treatment volume indicated in the second 3D model.
  • Some embodiments may include, by a robotic device, navigating the nerve treatment tool to the determined location of the nerve within the treatment volume of the subject. [0023] Some embodiments may include, by the robotic device, at least one of: aligning the nerve treatment tool with the determined location of nerve; and penetrating the nerve treatment tool into the treatment volume of the subject to position the treatment tool at the determined location of nerve.
  • Some embodiments may include, by the computing device, controlling the robotic device to navigate the treatment tool.
  • Some embodiments may include, by a fixation device, holding the treatment volume of the subject in a desired position and/or orientation.
  • Some embodiments may include, by the fixation device, adjusting the position and/or orientation of the treatment volume of the subject to substantially correspond to a position and/or orientation of the treatment volume of the subject in which the second 3D model has been generated.
  • Some embodiments may include, by the fixation device, adjusting the position and/or orientation of the treatment volume of the subject based on the registration of the second 3D model with respect to the first 3D model in the global coordinate system.
  • Some embodiments may include, by an imaging modality, generating the second 3D model.
  • the imaging modality is selected from a group consisting of magnetic resonance imaging (MRI) device and computed tomography (CT) device.
  • MRI magnetic resonance imaging
  • CT computed tomography
  • the nerve treatment tool is selected from a group consisting of nerve block treatment tools and nerve ablation tools.
  • the first 3D model includes a 3D representation of a skin of a knee region of the subject.
  • the second 3D model includes a 3D representation of a skin of a knee region of the subject and an indication of a position of at least one of superior medial genicular nerve, superior lateral genicular nerve and inferior medial genicular nerve in the knee region.
  • Fig. 1A is a schematic three-dimensional (3D) diagram of a system for a nerve treatment, the system including a 3D scanner, according to some embodiments of the invention
  • Fig. IB is a schematic two-dimensional (2D) diagram of the system of Fig. 1A and of a leg of a subject, according to some embodiments of the invention.
  • Figs. 2A, 2B and 2C are 3D representations of a first 3D model of a treatment region of a subject, a second 3D model of the treatment region of the subject and a registration result of the second 3D model with respect to the first 3D model, respectively, according to some embodiments of the invention;
  • FIG. 3 is a flowchart of a method of a nerve treatment, according to some embodiments of the invention.
  • Fig. 4 is a schematic 2D diagram of a system for a nerve treatment and of the leg of the subject, the system including an ultrasound device, according to some embodiments of the invention
  • FIG. 5 is a flowchart of a method of a nerve treatment, according to some embodiments of the invention.
  • Fig. 6 is a schematic 2D diagram of a system for a nerve treatment and of the leg of the subject, the system utilizing a fixation brace, according to some embodiments of the invention
  • Fig. 7 is a flowchart of a method of a nerve treatment, according to some embodiments of the invention.
  • Fig. 8 is a block diagram of an exemplary computing device which may be used with embodiments of the present invention.
  • Embodiments of the present invention may improve nerve treatment procedures, for example peripheral nerve block treatment procedures such as genicular nerve block treatment procedures.
  • a position of a nerve to be treated is determined based on 3D models of a treatment volume of a subject generated by an imaging modality such as, for example, magnetic resonance imaging (MRI) device or any other suitable imaging modality).
  • the 3D model is further registered to a global coordinate system of the treatment room based on imaging data from, e.g. a 3D scanner and/or an ultrasound device. Based on the registration, a location of the nerve within the treatment volume of the subject is determined in the global coordinate system.
  • the treatment is further applied by a nerve treatment tool at the determined location of the nerve within the treatment volume of the subject.
  • the 3D model may indicate an exact or at least more accurate position of the nerve within the treatment volume of the subject as compared to an estimated position of the nerve that can be obtained using prior art fluoroscopy imaging, thus improving the efficiency and safety of the nerve treatment as compared to prior art.
  • embodiments of the disclosed systems may avoid fluoroscopy imaging for registration of the treatment volume of the subject to the global coordinate system, thus preventing the subject from being exposed to radiation during the nerve treatment procedure.
  • Embodiments of the disclosed systems may require less infrastructure and may be cheaper than prior art system.
  • Embodiments of the disclosed systems may reduce the time required to perform the treatment procedure as compared to prior art systems.
  • Fig. 1A is a schematic 3D diagram of a system 100 for a nerve treatment, system 100 including a 3D scanner 110, according to some embodiments of the invention.
  • Fig. IB is a schematic 2D diagram of system 100 of Fig. 1 A and of a leg 80 of a subject, according to some embodiments of the invention.
  • Figs. 2A, 2B and 2C are 3D representations of a first 3D model 210 of a treatment region 84 of a subject, a second 3D model 220 of treatment region 84 of the subject and a registration result 230 of second 3D model 220 with respect to first 3D model 210, respectively, according to some embodiments of the invention.
  • System 100 may be used to perform a nerve treatment procedure, e.g. peripheral nerve block treatment or any other suitable nerve treatment procedure known in the art.
  • system 100 is used to perform treatment of nerve 82 in treatment volume 84 including a region around a knee of the subject (e.g. genicular nerve block treatment of superior medial genicular nerve, superior lateral genicular nerve and/or inferior medial genicular nerve; as schematically shown in Fig. IB).
  • system 100 may be used for nerve treatments in regions other than knee of the subject.
  • system 100 may be used for nerve treatments in shoulder, neck, upper back, lower back or any other suitable region of the subject’s body.
  • System 100 may be assembled in a treatment room.
  • System 100 may include a 3D scanner 110 (e.g. as shown in Figs. 1A and IB).
  • 3D scanner 110 may be disposed on, for example, an operating table 90 or at any other suitable location within the treatment room.
  • 3D scanner 110 may generate a first 3D model 210 (e.g. as schematically indicated in Fig. IB).
  • 3D scanner 110 may, for example, include Time-of-Flight sensor, Red, Green, Blue plus Depth (RGB-D) sensor or any other suitable 3D scanning device.
  • First 3D model 210 may include a 3D representation 212 of a surface 86 (e.g. a skin) of treatment volume 84 (e.g.
  • First 3D model 210 may be generated in a global (e.g. reference) coordinate system 102.
  • Global coordinate system 102 may be defined with respect to the treatment room, e.g. with respect to operating table 90 or any other suitable reference point in the treatment room.
  • First 3D model 210 may include a plurality of data values indicative of 3D representation 212 of surface 86 of treatment volume 84 of the subject in global coordinate system 102.
  • First 3D model 210 may be generated during the nerve treatment procedure (e.g. first 3D model 210 may be an operative 3D model).
  • System 100 may include a computing device 120 (e.g. as shown in Figs. 1A and IB).
  • Computing device 120 may receive (e.g. as an input) first 3D model 210 from 3D scanner 110.
  • 3D scanner 110 may obtain data indicative of 3D representation 212 of surface 86 of treatment volume 84, input the obtained data to computing device 120, and computing device 120 may generate first 3D model based on the data.
  • Computing device 120 may receive (e.g. as an input) a second 3D model 220 of treatment volume 84 of the subject (e.g. as schematically indicated in Fig. IB).
  • Second 3D model 220 may be generated using, for example, a magnetic resonance imaging (MRI) device, a computed tomography (CT) device or using any other suitable imaging modality.
  • Second 3D model 220 may be generated in an arbitrary coordinate system 70 (e.g. as shown in Fig. 2B).
  • Second 3D model 220 may include a 3D representation 222 of surface 86 of treatment volume 84 of the subject (e.g. as shown in Fig. 2B).
  • Second 3D model 220 may include an indication 224 of a position of nerve 82 (or nerves 82) within treatment volume 84 of the subject, e.g. relative to surface 86 or any other suitable landmark in treatment volume 84 of the subject (e.g. as shown in Fig. 2B). Second 3D model 220 may include a 3D representation 226 of nerve 82 (or nerves 82) within treatment volume 84 of the subject (e.g. as shown in Fig. 2B).
  • second 3D model 220 may include a plurality of data values having a first subset of the plurality of data values indicative of 3D representation 222 of surface 86 of treatment volume 84 and/or a second subset of the plurality of data values indicative of the position of nerve 82 within treatment volume 84 of the subject and/or indicative of 3D representation 226 of nerve 82 in arbitrary coordinate system 70.
  • Second 3D model 220 may be, for example, generated prior to nerve treatment procedure (e.g. second 3D model 220 may be a pre-operative 3D model). In another example, second 3D model 220 may be generated during the nerve treatment procedure.
  • system 100 may include an imaging modality (e.g. MRI device, CT device or any other suitable imaging modality; not explicitly shown in Figs. 1A and IB) configured to generate second 3D model 220 during the nerve treatment procedure.
  • computing device 120 may receive data obtained by the imaging modality (e.g. such as MRI device) and, based on the data, generate second 3D model 220.
  • Computing device 120 may apply smoothing (e.g. subpixel smoothing) on the data values of second 3D model 220 or other suitable method to improve the quality of data values of 3D model 412 for registration and/or processing.
  • smoothing e.g. subpixel smoothing
  • Computing device 120 may register second 3D model 220 (e.g. generated using the imaging modality, e.g. such as MRI device) with respect to first 3D model 210 (e.g. generated using 3D scanner 110) in global coordinate system 102.
  • An example of a registration result 230 is schematically shown in Fig. 2C.
  • the registration may include transforming the data values of second 3D model 220 from arbitrary coordinate system 70 to global coordinate system 102.
  • the registration may be based on 3D surface representation 212 of first 3D model 210 and 3D surface representation 222 of second 3D model 220.
  • the registration may include alignment of 3D surface representation 222 of second 3D model 220 with 3D surface representation 212 of first 3D model 210 in global coordinate system 102.
  • the registration may, for example, include at least one of the following operations: masking of first 3D model 210 and/or of second 3D model 220; determining a center of gravity of 3D surface representation 212 of first 3D model 210 and a center of gravity of 3D surface representation 222 of second 3D model 220; based on the determined centers of gravity, aligning the 3D surface representation 222 of second 3D model 220 with respect to 3D surface representation 212 of first 3D model 210 in global coordinate system 102; and applying weighted iterative closest point (ICP) algorithm on the data values of second 3D model 220.
  • the registration may include any other suitable operations known in the art.
  • System 100 may include a display 124.
  • Computing device 120 present on display 124 first 3D model 210, second 3D model 220, registration result 230 or any other suitable information.
  • System 100 may include a fixation device 130.
  • Fixation device 130 may be disposed on, for example, operating table 90.
  • Fixation device 130 may hold treatment volume 84 of the subject in a desired position and/or orientation.
  • fixation device 130 may hold leg 80 of the subject (e.g. as shown in Fig. IB).
  • fixation device 130 includes a first member 132 and a second member 134.
  • First member 132 may receive at least a part of a crus of leg 80 and second member 134 may receive at least a part of a thigh of leg 80.
  • Fixation device 130 may adjust the position and/or orientation of treatment volume 84 of the subject, e.g. with respect to operating table 90.
  • a distance between first member 132 and second member 134 and/or an inclination angle of first member 132 with respect to operating table 90 and/or an inclination angle of second member 134 with respect to operating table 90 and/or an angle between first member 132 and second member 134 of fixation device 130 may be adjusted or changed to adjust the position and/or orientation of leg 80 (e.g. the relative position between the crus and the thigh of leg 80) with respect to operating table 90 (e.g. in global coordinate system 102).
  • Fixation device 130 may include an actuator 136 to actuate components of fixation device 130 (e.g. actuator 136 as schematically shown in Fig. IB).
  • computing device 120 may control fixation device 130 to adjust the position and/or orientation of treatment volume 84 of the subject.
  • fixation device 130 may be manually adjusted, e.g. by an operating physician, optionally based on instructions that may be presented, e.g. by computing device 120, on display 124.
  • Fixation device 130 may adjust the position and/or orientation of treatment volume 84 of the subject during the nerve treatment procedure to correspond (or substantially correspond) to a position and/or orientation of treatment volume 84 in which second 3D model 220 has been generated by the imaging modality (e.g. such as MRI device).
  • the imaging modality e.g. such as MRI device.
  • Adjusting the position and/or orientation of treatment volume 84 of the subject during the nerve treatment procedure to correspond (or substantially correspond) to the position and/or orientation of treatment volume 84 in which second 3D model 220 has been generated by the imaging modality may ensure that nerve 82 is positioned within treatment volume 84 at the same (or substantially the same) position and/or orientation with respect to surface 86 or any other suitable segment of treatment volume 84 as it was positioned during generation of second 3D model 220 by the imaging modality. This may ensure that during the nerve treatment procedure the nerve treatment is accurately applied to nerve 82.
  • Fixation device 130 may adjust the position and/or orientation of treatment volume 84 of the subject during the nerve treatment procedure to correspond (or substantially correspond) to the position and/or orientation of treatment volume 84 in which second 3D model 220 has been generated by the imaging modality based on the registration of second 3D model 220 with respect to first 3D model 102 in global coordinate system 102.
  • computing device 120 may calculate a difference between second 3D model 220 and first 3D model 102 or any other suitable metrics indicative of the accuracy of the registration between second 3D model 220 and first 3D model 210. If the difference (or any other suitable metrics) exceeds a specified (e.g.
  • computing device 120 may control fixation device 130 (or present on display 124 instructions relating to how manually adjust fixation device 130) to change the position and/or orientation of treatment volume 84 of the subject with respect to operating table 90 (e.g. in global coordinate system 102) to better correspond to the position and/or orientation in which second 3D model 220 has been generated by the imaging modality.
  • Computing device 120 may then recalculate the difference (or any other suitable metrics) and, if needed, cause fixation device 130 (or present on display 124 instructions relating to how manually adjust fixation device 130) to further change the position and/or orientation of treatment volume 84 of the subject with respect to operating table 90 (e.g. in global coordinate system 102) to better correspond to the position and/or orientation in which second 3D model 220 has been generated by the imaging modality.
  • These operations may be repeated until the difference (or any other suitable metrics) reaches a value that is below the specified threshold.
  • computing device 120 may determine a location of nerve 82 within treatment volume 84 of the subject in global coordinate system 102.
  • System 100 may include a nerve treatment tool 140.
  • Nerve treatment tool 140 may include a nerve block tool, a nerve ablation tool or any other suitable nerve treatment tool.
  • nerve block treatment tool 140 may be a radiofrequency (RF) needle.
  • RF radiofrequency
  • Nerve treatment tool 140 may apply a nerve treatment at the determined location of nerve 82 within treatment volume 84 of the subject (e.g. the determined location of nerve 82 in global coordinate system 102).
  • System 100 may include a robotic device 150.
  • Robotic device 150 may be disposed on, e.g. operating table 90.
  • Robotic device 150 may navigate nerve treatment tool 140 to the determined location of nerve 82 (e.g. the determined location of nerve 82 in global coordinate system 102) within treatment volume 84 of the subject.
  • Robotic device 150 may, for example, include a robotic arm (e.g. as schematically shown in Figs. 1A and IB) or any other suitable device.
  • robotic device 150 may align nerve treatment tool 140 with the determined location of nerve 82 within treatment volume 84 of the subject and/or cause nerve treatment tool 140 to penetrate through surface 86 of treatment volume 84 to position nerve treatment tool 140 at the determined location of nerve 82 within treatment volume 84 of the subject.
  • Computing device 120 may control robotic device 150 to navigate (e.g. align and/or penetrate) nerve treatment tool 140 to the determined location of nerve 82 within treatment volume 84 of the subject. At least part of the navigation of nerve treatment tool 140 may be performed manually, e.g. by an operating physician, optionally with an assistance of robotic device 150. For example, computing device 120 may control robotic device 150 to align nerve treatment tool 140 with the determined location of nerve 82 within treatment volume 84 of the subject while the operating physician may penetrate nerve treatment tool 140 through surface 86 of treatment volume 84 to position nerve treatment tool 140 at the determined location of nerve 82 within treatment volume 84 of the subject, or vice versa.
  • Robotic device 150 may subsequently navigate nerve treatment tool 140 to two or more different determined nerve locations within treatment volume 84 of the subject to subsequently apply nerve treatment to two or more respective nerves 82.
  • system 100 may include two or more robotic devices 150 configured to navigate two or more nerve treatment tools 140 to two or more determined nerve locations within treatment volume 84 of the subject to apply (e.g. simultaneously apply) treatment to two or more nerves 82.
  • System 100 may include a guiding subsystem 160.
  • Guiding subsystem 160 may assist with navigation of nerve treatment tool 140 to the determined location of nerve 82 (e.g. the determined location of nerve 82 in global coordinate system 102) within treatment volume 84 of the subject.
  • guiding subsystem 160 may include a camera 162.
  • Camera 162 may be disposed on, for example, a wall or a ceiling of the treatment room and/or on operating table 90.
  • Guiding subsystem 160 may include one or more markings 164 that may be disposed on nerve treatment tool 140. Based on images of one or more markings 164 obtained by camera 162, computing device 120 or a controller of guiding subsystem 160 may determine a location of nerve treatment tool 140 in global coordinate system 102.
  • computing device 120 or the controller of guiding subsystem 160 may generate instructions related to navigation of nerve treatment tool 140 to the determined location of nerve within treatment volume 84 of the subject.
  • Computing device 120 or the controller of guiding subsystem 160 may convey the instructions to the operating physician, e.g. by presenting the instructions on display 124.
  • Guiding subsystem 160 may be optional.
  • system 100 may include robotic device 150 and may not include guiding subsystem 160.
  • system 100 may include both robotic device 150 and guiding subsystem 160.
  • system 100 may include guiding subsystem 160 and may not include robotic device 150.
  • Guiding subsystem 160 may be not part of system 100.
  • guiding subsystem 160 may part of the treatment room equipment, while computing device 120 of system 100 may have an interface to connect to guiding subsystem 160.
  • 3D scanner 110 may be used (instead of camera 162) in combination with one or more markings 164 to assist with navigation of nerve treatment tool 140 to the determined location of nerve 82 within treatment volume 84 of the subject.
  • Guiding subsystems other than shown and described may be used in system 100. For example, magnetic based guiding systems, inertial sensors based guiding systems or various vision based guiding systems may be used.
  • System 100 may include an imaging device, e.g. such as an ultrasound device or an X-ray device (not explicitly shown), used for verifying that nerve treatment tool 140 is positioned at the correct location within treatment volume 84 of the subject, e.g. prior to applying the treatment to nerve 82.
  • an imaging device e.g. such as an ultrasound device or an X-ray device (not explicitly shown), used for verifying that nerve treatment tool 140 is positioned at the correct location within treatment volume 84 of the subject, e.g. prior to applying the treatment to nerve 82.
  • imaging device may be also used to assist with navigating of nerve treatment tool 140 to the determined location of nerve 82 within treatment volume 84 of the subject.
  • system 100 may operate tools other than nerve treatment tool 140 and may be used for procedures or treatments other than nerve treatments.
  • system 100 may be used for any kind of treatment that requires navigation (e.g. alignment and/or penetration) of a treatment tool into a specific location within the treatment volume of the subject, such as, e.g. anesthesia treatments, drug delivery treatments, aesthetic treatments, injection treatments (e.g. nerve blocks, C-reactive protein injections, hyaluronic acid injections in joints, etc.), biopsy procedures (e.g. in extremities and/or around boney regions), ablation procedures (e.g. RF ablation, cryogenic ablation, etc.), minimally invasive procedures (e.g. in extremities and/or near boney regions such as wrist, knee, ankle, etc.) or any other suitable treatments or procedures.
  • injection treatments e.g. nerve blocks, C-reactive protein injections, hyaluronic acid injections in joints, etc.
  • biopsy procedures e.g. in extremities and/or around boney regions
  • FIG. 3 is a flowchart of a method of a nerve treatment, according to some embodiments of the invention.
  • the nerve treatment may be performed using system 100 as described above with respect to Figs. 1A and IB. However, other systems may be used.
  • a first 3D model may be generated (e.g. first 3D model 210 as described above with respect to Figs. 1A and IB, and Figs. 2A and 2C).
  • the first 3D model may be generated by a 3D scanner (e.g. 3D scanner 110 described above with respect to Figs. 1 A and IB) or by a computing device (e.g. computing device 120 described above with respect to Figs. 1A and IB) based on data obtained by the 3D scanner.
  • the first 3D model may include a 3D representation of a surface of a treatment volume of a subject in a global coordinate system (e.g. 3D representation 212 of surface 86 of treatment volume 84 of the subject in global coordinate system 102, as described above with respect to Figs. 1A and IB and Figs. 2A and 2C).
  • a second 3D model may be received (e.g. second 3D model 220 as described above with respect to Figs. 1A and IB and Figs. 2B and 2C).
  • the second 3D model may be received by the computing device.
  • the second 3D model may be generated by a imaging modality such MRI device or CT device or by the computing device based on data obtained by the imaging modality (e.g. as described above with respect to Figs. 1A and IB).
  • the second 3D model may be generated in an arbitrary coordinate system (e.g. arbitrary coordinate system 70 as described above with respect to Figs. 1 A and IB and Fig. 2B).
  • the second 3D model may include a 3D representation of the surface of the treatment volume of the subject (e.g. 3D representation 222 of surface 86 of treatment volume 84 of the subject in arbitrary coordinate system 70, as described above with respect to Figs. 1 A and IB and Fig. 2B).
  • the second 3D model may include an indication of a position of the nerve (or nerves) within the treatment volume of the subject, e.g. relative to the surface or any other suitable landmark in the treatment volume of the subject (e.g. as described above with respect to Figs. 1 A and IB and Fig. 2B).
  • the second 3D model may include a 3D representation of the nerve (e.g. 3D representation 224 as described above with respect to Figs. 1A and IB and Fig. 2B) within the treatment volume of the subject.
  • the second 3D model may be, for example, generated prior to nerve treatment procedure. In another example, the second 3D model may be generated during nerve treatment procedure.
  • the second 3D model may be registered with respect to the first 3D model in the global coordinate system (e.g. as described above with respect to Figs. 1A and IB and Fig. 2C).
  • the registration may be performed by the computing device.
  • the registration may be based on the 3D surface representation of first 3D model and the 3D surface representation of the second 3D model (e.g. as described above with respect to Figs. 1A and IB and Fig. 2C).
  • the registration may include alignment of the 3D surface representation of the second 3D model with the 3D surface representation of first 3D model (e.g. as described above with respect to Figs. 1A and IB and Fig. 2C).
  • the treatment volume of the subject may be held by a fixation device (e.g. fixation device 130 described above with respect to Figs. 1A and IB).
  • the treatment volume of the subject may be held in a desired position and/or orientation by the fixation device (e.g. as described above with respect to Figs. 1A and IB).
  • the position and/or orientation of the treatment volume may be adjusted by the fixation device (e.g. as described above with respect to Figs. 1A and IB).
  • the position and/or orientation of the treatment volume of the subject may be adjusted by the fixation device during the nerve treatment procedure to correspond (or substantially correspond) to a position and/or orientation of the treatment volume in which the second 3D model has been generated by the imaging modality (e.g. as described above with respect to Figs. 1A and IB).
  • the position and/or orientation of the treatment volume of the subject may be adjusted by the fixation device during the nerve treatment procedure to correspond (or substantially correspond) to the position and/or orientation of the treatment volume in which the second 3D model has been generated by the imaging modality based on the registration of the second 3D model with respect to the first 3D model in the global coordinate system (e.g. as described above with respect to Figs. 1A and IB).
  • the fixation device may be controlled by the computing device and/or manually adjusted by the operating physician, optionally based on instructions presented on a display (e.g. display 124; as described above with respect to Figs. 1 A and IB).
  • a location of the nerve within the treatment volume of the subject in the global coordinate system may be determined by the computing device (e.g. as described above with respect to Figs. 1A and IB).
  • the location of the nerve in the global coordinate system may be further determined based on the position of the nerve with respect to the surface of the treatment volume known from or indicated in the second 3D model (e.g. as described above with respect to Figs. 1A and IB).
  • a nerve treatment may be applied by a nerve treatment tool at the determined location of the nerve within the treatment volume of the subject (e.g. nerve treatment tool 140 described above with respect to Figs. 1A and IB).
  • the nerve treatment tool may be navigated to the determined location of the nerve (e.g. the determined location of the nerve in the global coordinate system) within the treatment volume of the subject.
  • the nerve treatment tool may be navigated by a robotic device (e.g. robotic device 150 described above with respect to Figs. 1A and IB).
  • the nerve treatment tool may be aligned by the robotic device with the determined location of the nerve within the treatment volume of the subject and/or penetrated by the robotic device through the surface of the treatment volume to position the nerve treatment tool at the determined location of the nerve within the treatment volume of the 16ubjectt.
  • the alignment and/or the penetration may be also performed manually, e.g. by an operating physician, optionally with an assistance of the robotic device and/or based on instructions generated by a guiding subsystem (e.g. guiding subsystem 160; as described above with respect to Figs. 1 A and IB).
  • a guiding subsystem e.g. guiding subsystem 160; as described above with respect to Figs. 1
  • Verification of that the nerve treatment tool is positioned at the correct location within the treatment volume of the subject may be performed by an imaging device (e.g. such as an ultrasound device or an X-ray device), prior to applying the treatment to the nerve (e.g. as described above with respect to Figs. 1A and IB).
  • the imaging device may be also used to assist with navigating of the nerve treatment tool to the determined location of the nerve within the treatment volume of the subject (e.g. as described above with respect to Figs. 1 A and IB).
  • Fig. 4 is a schematic 2D diagram of a system 400 for a nerve treatment and of leg 80 of the subject, system 400 including an ultrasound device 420, according to some embodiments of the invention.
  • System 400 may be used to perform a nerve treatment procedure, e.g. peripheral nerve block treatment or any other suitable nerve treatment procedure known in the art.
  • a nerve treatment procedure e.g. peripheral nerve block treatment or any other suitable nerve treatment procedure known in the art.
  • system 400 is used to perform treatment of nerve 82 in treatment volume 84 including the knee region of the subject
  • system 400 may be used for nerve treatments in regions other than knee of the subject.
  • System 400 may be assembled in the treatment room.
  • System 400 may include a computing device 410 (e.g. such as computing device 410 described above with respect to Figs. 1A and IB).
  • Computing device 410 may receive a 3D model 412.
  • 3D model 412 may include data values 412a indicative of a position of an anatomical landmark 88 (or anatomical landmarks 88) within treatment volume 84 and data values 412c indicative of a position of nerve 82 (or nerves 88) within treatment volume 84 of the subject.
  • Anatomical landmark 88 may, for example, include data indicative of the geometry of one or more bones within treatment volume 84 (e.g. shape of the surface, shape of the section of one or more bones, etc.).
  • 3D model 412 may be generated using, for example, MRI device, CT device or using any other suitable imaging modality.
  • 3D model 412 may be generated in an arbitrary coordinate system 412e.
  • 3D model 412 may be, for example, generated prior to nerve treatment procedure (e.g. 3D model 412 may be a pre-operative 3D model).
  • 3D model 412 may be generated during the nerve treatment procedure.
  • system 400 may include a imaging modality (e.g. MRI device, CT device or any other suitable imaging modality; not explicitly shown in Fig. 4) configured to generate 3D model 412 during the nerve treatment procedure.
  • computing device 410 may receive data obtained by the imaging modality and, based on the data, generate 3D model 412.
  • Computing device 410 may apply smoothing (e.g. subpixel smoothing) on the data values of 3D model 412 or other suitable method to improve the quality of data values of 3D model 412 for registration and/or processing.
  • smoothing e.g. subpixel smoothing
  • System 400 may include an ultrasound device 420.
  • Ultrasound device 420 may include an ultrasound probe 422 configured to obtain ultrasound data 422a indicative of a position of anatomical landmark(s) 88 within treatment volume 84 of the subject.
  • Ultrasound probe 422 may include a location sensor 424 configured to generate an ultrasound probe location data 426 indicative of a location of ultrasound probe 422 in a global coordinate system 402. Means other than location sensor 424 may be used on obtain ultrasound probe location data 426 indicative of the location of ultrasound probe 422 in global coordinate system 402.
  • system 400 may include a guiding subsystem (e.g. such as guiding subsystem 160 described above with respect to Figs.
  • Global coordinate system 402 may be defined with respect to the treatment room, e.g. with respect to operating table 90 or any other suitable reference point in the treatment room.
  • Computing device 410 may receive ultrasound data 422a and ultrasound probe location data 426.
  • computing device 410 may register 3D model 412 and ultrasound data 422 to global coordinate system 402. The registration may be based on data values 412a of 3D model 412 and ultrasound data 422a indicative of the position of anatomical landmark(s) 88 within treatment volume 84 of the subject.
  • System 400 may include a fixation device 430 (e.g. such as fixation device 130 described above with respect to Figs. 1A and IB).
  • Fixation device 430 may be disposed on, for example, operating table 90.
  • Fixation device 430 may hold treatment volume 84 of the subject in a desired position and/or orientation (e.g. as described above with respect to Figs. 1A and IB).
  • Fixation device 430 may adjust the position and/or orientation of treatment volume 84 of the subject, e.g. with respect to operating table 90 (e.g. as described above with respect to Figs. 1A and IB).
  • Fixation device 430 may adjust the position and/or orientation of treatment volume 84 of the subject during the nerve treatment procedure to correspond (or substantially correspond) to a position and/or orientation of treatment volume 84 in which 3D model 412 has been generated by the imaging modality (e.g. as described above with respect to Figs. 1A and IB).
  • Fixation device 430 may be controlled by computing device 410 and/or may be manually adjusted by, e.g. an operating physician, optionally based on instructions presented by computing device 410 on a display 424 (e.g. as described above with respect to Figs. 1 A and IB).
  • computing device 410 may determine a location of nerve 82 within treatment volume 84 of the subject in global coordinate system 402.
  • System 400 may include a nerve treatment tool 440 (e.g. such as nerve treatment tool 140 described above with respect to Figs. 1A and IB).
  • Nerve treatment tool 440 may apply a nerve treatment at the determined location of nerve 82 within treatment volume 84 of the subject (e.g. the determined location of nerve 82 in global coordinate system 402).
  • System 400 may include a robotic device 450 (e.g. such as robotic device 150 described above with respect to Figs. 1A and IB).
  • Robotic device 450 may be disposed on, e.g. operating table 90.
  • Robotic device 450 may navigate nerve treatment tool 440 to the determined location of nerve 82 (e.g. the determined location of nerve 82 in global coordinate system 402) within treatment volume 84 of the subject (e.g. as described above with respect to Figs. 1A and IB).
  • Robotic device 450 may be controlled by computing device 410 to navigate (e.g. align and/or penetrate) nerve treatment tool 440 to the determined location of nerve 82 within treatment volume 84 of the subject (e.g. as described above with respect to Figs.
  • At least part of the navigation of nerve treatment tool 440 may be performed manually, e.g. by an operating physician, optionally with an assistance of robotic device 450 (e.g. as described above with respect to Figs. 1 A and IB).
  • System 400 may include a guiding subsystem (e.g. such as guiding subsystem 160 described above with respect to Figs. 1A and IB) to assist with determining ultrasound probe location data 436 and/or with navigation of nerve treatment tool 440 to the determined location of nerve 82 within treatment volume 84 of the subject (e.g. as described above with respect to Figs. 1A and IB).
  • a guiding subsystem e.g. such as guiding subsystem 160 described above with respect to Figs. 1A and IB
  • System 400 may include an imaging device (e.g. such as an X-ray device) to verify that nerve treatment tool 440 is positioned at the correct location within the treatment volume of the subject prior to applying the treatment to the nerve (e.g. as described above with respect to Figs. 1A and IB).
  • the imaging device may be also used to assist with navigating of nerve treatment tool 440 to the determined location of the nerve within the treatment volume of the subject (e.g. as described above with respect to Figs. 1 A and IB).
  • system 400 may operate tools other than nerve treatment tool 440 and may be used for procedures or treatments other than nerve treatments.
  • system 400 may be used for any kind of treatment that requires navigation (e.g. alignment and/or penetration) of a treatment tool into a specific location within the treatment volume of the subject, such as, e.g. anesthesia treatments, drug delivery treatments, aesthetic treatments, injection treatments (e.g. nerve blocks, C-reactive protein injections, hyaluronic acid injections in joints, etc.), biopsy procedures (e.g. in extremities and/or around boney regions), ablation procedures (e.g. RF ablation, cryogenic ablation, etc.), minimally invasive procedures (e.g. in extremities and/or near boney regions such as wrist, knee, ankle, etc.) or any other suitable treatments or procedures.
  • injection treatments e.g. nerve blocks, C-reactive protein injections, hyaluronic acid injections in joints, etc.
  • biopsy procedures e.g. in extremities and/or around boney regions
  • Fig. 5 is a flowchart of a method of a nerve treatment, according to some embodiments of the invention.
  • the nerve treatment may be performed using system 400 as described above with respect to Fig. 4. However, other systems may be used.
  • ultrasound data indicative of a position of a anatomical landmark within the treatment volume of the subject may be generated by an ultrasound probe of an ultrasound device (e.g. ultrasound device 420, ultrasound probe 422 and ultrasound data 422a described above with respect to Fig. 4).
  • an ultrasound device e.g. ultrasound device 420, ultrasound probe 422 and ultrasound data 422a described above with respect to Fig. 4.
  • a 3D model may be received by a computing device (e.g. 3D model 412 and computing device 410 described above with respect to Fig. 4).
  • the 3D model be indicative of a position of the anatomical landmark within the treatment volume and indicative of a position of the nerve within the treatment volume of the subject in an arbitrary coordinate system (e.g. as described above with respect to Fig. 4).
  • an ultrasound probe location data indicative of a location of the ultrasound probe in a global coordinate system e.g. location data 426 described above with respect to Fig. 4
  • the 3D model and the ultrasound data may be registered to the global coordinate system.
  • the treatment volume of the subject may be held in a desired position and/or orientation by a fixation device (e.g. fixation device 430 described above with respect to Fig. 4).
  • a fixation device e.g. fixation device 430 described above with respect to Fig. 4
  • the position and/or orientation of the treatment volume may be adjusted by the fixation device (e.g. as described above with respect to Fig. 4).
  • a location of the nerve within the treatment volume of the subject in the global coordinate system may be determined by the computing device (e.g. as described above with respect to Fig. 4).
  • the location of the nerve in the global coordinate system may be further determined based on the position of the nerve with respect to the surface of the treatment volume known from or indicated in the 3D model (e.g. as described above with respect to Fig. 4).
  • a nerve treatment may be applied by a nerve treatment tool at the determined location of the nerve within the treatment volume of the subject (e.g. nerve treatment tool 140 described above with respect to Fig. 4).
  • the nerve treatment tool may be navigated (e.g. aligned and/or penetrated) to the determined location of the nerve (e.g. the determined location of the nerve in the global coordinate system) within the treatment volume of the subject.
  • the nerve treatment tool may be navigated by a robotic device (e.g. robotic device 450 described above with respect to Fig. 4).
  • the alignment and/or the penetration may be also performed manually, e.g. by an operating physician, optionally with an assistance of the robotic device and/or based on instructions generated by a guiding subsystem (e.g. as described above with respect to Fig. 4).
  • Verification of that the nerve treatment tool is positioned at the correct location within the treatment volume of the subject may be performed by an imaging device (e.g. such as an ultrasound device or an X-ray device), prior to applying the treatment to the nerve (e.g. as described above with respect to Fig. 4).
  • the imaging device may be also used to assist with navigating of the nerve treatment tool to the determined location of the nerve within the treatment volume of the subject (e.g. as described above with respect to Fig. 4).
  • Fig. 6, is a schematic 2D diagram of a system 600 for a nerve treatment and of leg 80 of the subject, system 600 utilizing a fixation brace 605, according to some embodiments of the invention.
  • System 600 may be used to perform a nerve treatment procedure, e.g. peripheral nerve block treatment or any other suitable nerve treatment procedure known in the art.
  • a nerve treatment procedure e.g. peripheral nerve block treatment or any other suitable nerve treatment procedure known in the art.
  • system 600 is used to perform treatment of nerve 82 in treatment volume 84 including the knee region of the subject
  • system 600 may be used for nerve treatments in regions other than knee of the subject.
  • System 600 may be assembled in the treatment room.
  • System 600 may include a computing device 610 (e.g. such as computing device 610 described above with respect to Figs. 1A and IB).
  • Computing device 610 may receive a 3D model 612.
  • 3D model 612 may include data values indicative of a position of nerve 82 within treatment volume 84 of the subject.
  • 3D model 612 may be generated using, for example, MRI device, CT device or using any other suitable imaging modality.
  • 3D model 612 may be, for example, generated prior to nerve treatment procedure (e.g. 3D model 612 may be a pre-operative 3D model).
  • 3D model 612 may be generated during the nerve treatment procedure.
  • system 600 may include a imaging modality (e.g. MRI device, CT device or any other suitable imaging modality; not explicitly shown in Fig. 6) configured to generate 3D model 612 during the nerve treatment procedure.
  • a imaging modality e.g. MRI device, CT device or any other suitable imaging
  • 3D model 612 may be generated while the subject is wearing a fixation brace 605 configured to hold treatment volume 84 of the subject in a desired position and/or orientation.
  • fixation brace 605 is configured to hold leg 80 of the subject in the desire position and orientation (e.g. hold foot in a flat post; hold knee at a desired angle; or any other suitable position and/or orientation).
  • Fixation brace 605 may include strips 605a.
  • Fixation brace 605 may include apertures giving an access to treatment volume 84.
  • Fixation brace 605 may include marks that are visible under MRI and/or fluoroscopy imaging.
  • treatment volume 84 of the subject may be disposed on, e.g. operating table 90, while treatment volume 84 is held by the same fixation brace 605 that was worn by the subject during the generation of 3D model 612.
  • Utilizing the same fixation brace 605 may ensure that treatment volume 84 is held during the nerve treatment procedure in the same (or substantially the same) position and/or orientation as it was during generation of 3D model 612 by the imaging modality. This may ensure that nerve 82 is positioned within treatment volume 84 at the same (or substantially the same) position and/or orientation with respect to surface 86 or any other suitable segment of treatment volume 84 as it was positioned during generation of 3D model 612 by the imaging modality. This may ensure that during the nerve treatment procedure the nerve treatment is accurately applied to nerve 82.
  • Fixation brace 605 may be disposed on operating table 90 in a known position and orientation in a global coordinate system 602 or the position and/or orientation of fixation brace 605 in global coordinate system 602 may be calculated (e.g. using optical or any other suitable means).
  • Global coordinate system 602 may be defined with respect to the treatment room, e.g. with respect to operating table 90 or any other suitable reference point in the treatment room.
  • computing device 610 may determine a location of nerve 82 within treatment volume 84 of the subject in global coordinate system 602.
  • System 600 may include a nerve treatment tool 640 (e.g. such as nerve treatment tool 140 described above with respect to Figs. 1A and IB).
  • Nerve treatment tool 640 may apply a nerve treatment at the determined location of nerve 82 within treatment volume 84 of the subject (e.g. the determined location of nerve 82 in global coordinate system 602).
  • System 600 may include a robotic device 650 (e.g. such as robotic device 150 described above with respect to Figs. 1A and IB).
  • Robotic device 650 may be disposed on, e.g. operating table 90 or on fixation brace 605.
  • Robotic device 650 may navigate nerve treatment tool 640 to the determined location of nerve 82 (e.g. the determined location of nerve 82 in global coordinate system 602) within treatment volume 84 of the subject (e.g. as described above with respect to Figs. 1A and IB).
  • Robotic device 650 may be controlled by computing device 610 to navigate (e.g. align and/or penetrate) nerve treatment tool 640 to the determined location of nerve 82 within treatment volume 84 of the subject (e.g.
  • At least part of the navigation of nerve treatment tool 640 may be performed manually, e.g. by an operating physician, optionally with an assistance of robotic device 650 (e.g. as described above with respect to Figs. 1 A and IB).
  • System 600 may include a guiding subsystem (e.g. such as guiding subsystem 160 described above with respect to Figs. 1 A and IB) to assist with navigation of nerve treatment tool 640 to the determined location of nerve 82 within treatment volume 84 of the subject (e.g. as described above with respect to Figs. 1 A and IB).
  • a guiding subsystem e.g. such as guiding subsystem 160 described above with respect to Figs. 1 A and IB
  • System 600 may include an imaging device (e.g. such as an X-ray device, ultrasound device or any ither suitable imaging device) to verify that nerve treatment tool 640 is positioned at the correct location within the treatment volume of the subject prior to applying the treatment to the nerve (e.g. as described above with respect to Figs. 1A and IB).
  • the imaging device may be also used to assist with navigating of nerve treatment tool 640 to the determined location of the nerve within the treatment volume of the subject (e.g. as described above with respect to Figs. 1A and IB).
  • system 600 may operate tools other than nerve treatment tool 640 and may be used for procedures or treatments other than nerve treatments.
  • system 600 may be used for any kind of treatment that requires navigation (e.g. alignment and/or penetration) of a treatment tool into a specific location within the treatment volume of the subject, such as, e.g. anesthesia treatments, drug delivery treatments, aesthetic treatments, injection treatments (e.g. nerve blocks, C-reactive protein injections, hyaluronic acid injections in joints, etc.), biopsy procedures (e.g. in extremities and/or around boney regions), ablation procedures (e.g. RF ablation, cryogenic ablation, etc.), minimally invasive procedures (e.g. in extremities and/or near boney regions such as wrist, knee, ankle, etc.) or any other suitable treatments or procedures.
  • injection treatments e.g. nerve blocks, C-reactive protein injections, hyaluronic acid injections in joints, etc.
  • biopsy procedures e.g. in extremities and/or around boney regions
  • FIG. 7 is a flowchart of a method of a nerve treatment, according to some embodiments of the invention.
  • the nerve treatment may be performed using system 600 as described above with respect to Fig. 6. However, other systems may be used.
  • a 3D model may be received by a computing device (e.g. 3D model 612 and computing device 610 described above with respect to Fig. 6).
  • the 3D model be indicative of a position of the nerve within the treatment volume of the subject (e.g. as described above with respect to Fig. 6).
  • the 3D model may be generated while a fixation brace (e.g. such as fixation brace 605 described above with respect to Fig. 6) is holding the treatment volume of the subject in a specified position and/or orientation.
  • the treatment volume of the subject may be disposed on an operating table while the fixation brace is holding the treatment volume of the subject in the specified position and/or orientation (e.g. as described above with respect to Fig. 6).
  • a location of the nerve within the treatment volume of the subject in the global coordinate system may be determined by the computing device.
  • a nerve treatment may be applied by a nerve treatment tool at the determined location of the nerve within the treatment volume of the subject (e.g. nerve treatment tool 640 described above with respect to Fig. 6).
  • the nerve treatment tool may be navigated (e.g. aligned and/or penetrated) to the determined location of the nerve (e.g. the determined location of the nerve in the global coordinate system) within the treatment volume of the subject.
  • the nerve treatment tool may be navigated by a robotic device (e.g. robotic device 650 described above with respect to Fig. 6).
  • the alignment and/or the penetration may be also performed manually, e.g. by an operating physician, optionally with an assistance of the robotic device and/or based on instructions generated by a guiding subsystem (e.g. as described above with respect to Fig. 6).
  • Verification of that the nerve treatment tool is positioned at the correct location within the treatment volume of the subject may be performed by an imaging device (e.g. such as an ultrasound device or an X-ray device), prior to applying the treatment to the nerve (e.g. as described above with respect to Fig. 6).
  • the imaging device may be also used to assist with navigating of the nerve treatment tool to the determined location of the nerve within the treatment volume of the subject (e.g. as described above with respect to Fig. 6).
  • FIG. 8 is a block diagram of an exemplary computing device 800 which may be used with embodiments of the present invention.
  • Computing device 800 may include a controller or processor 805 that may be, for example, a central processing unit processor (CPU), a chip or any suitable computing or computational device, an operating system 815, a memory 820, a storage 830, input devices 835 and output devices 840.
  • Operating system 815 may be or may include any code segment designed and/or configured to perform tasks involving coordination, scheduling, arbitration, supervising, controlling or otherwise managing operation of computing device 800, for example, scheduling execution of programs.
  • Memory 820 may be or may include, for example, a Random Access Memory (RAM), a read only memory (ROM), a Dynamic RAM (DRAM), a Synchronous DRAM (SD-RAM), a double data rate (DDR) memory chip, a Flash memory, a volatile memory, a non-volatile memory, a cache memory, a buffer, a short term memory unit, a long term memory unit, or other suitable memory units or storage units.
  • Memory 820 may be or may include a plurality of, possibly different, memory units.
  • Memory 820 may store for example, instructions to carry out a method (e.g., code 825), and/or data such as user responses, interruptions, etc.
  • Executable code 825 may be any executable code, e.g., an application, a program, a process, task or script. Executable code 825 may be executed by controller 805 possibly under control of operating system 815. In some embodiments, more than one computing device 800 or components of device 800 may be used for multiple functions described herein. For the various modules and functions described herein, one or more computing devices 800 or components of computing device 800 may be used. Devices that include components similar or different to those included in computing device 800 may be used, and may be connected to a network and used as a system. One or more processor(s) 805 may be configured to carry out embodiments of the present invention by for example executing software or code.
  • Storage 830 may be or may include, for example, a hard disk drive, a floppy disk drive, a Compact Disk (CD) drive, a CD- Recordable (CD-R) drive, a universal serial bus (USB) device or other suitable removable and/or fixed storage unit. In some embodiments, some of the components shown in Fig. 8 may be omitted.
  • Input devices 835 may be or may include a mouse, a keyboard, a touch screen or pad or any suitable input device. It will be recognized that any suitable number of input devices may be operatively connected to computing device 800 as shown by block 835.
  • Output devices 840 may include one or more displays, speakers and/or any other suitable output devices. It will be recognized that any suitable number of output devices may be operatively connected to computing device 800 as shown by block 840.
  • Any applicable input/output (VO) devices may be connected to computing device 800, for example, a wired or wireless network interface card (NIC), a modem, printer or facsimile machine, a universal serial bus (USB) device or external hard drive may be included in input devices 835 and/or output devices 840.
  • NIC network interface card
  • USB universal serial bus
  • Embodiments of the invention may include one or more article(s) (e.g., memory 820 or storage 830) such as a computer or processor non-transitory readable medium, or a computer or processor non-transitory storage medium, such as for example a memory, a disk drive, or a USB flash memory, encoding, including or storing instructions, e.g., computer-executable instructions, which, when executed by a processor or controller, carry out methods disclosed herein.
  • article(s) e.g., memory 820 or storage 830
  • a computer or processor non-transitory readable medium such as for example a memory, a disk drive, or a USB flash memory
  • encoding including or storing instructions, e.g., computer-executable instructions, which, when executed by a processor or controller, carry out methods disclosed herein.
  • the terms “plurality” and “a plurality” as used herein can include, for example, “multiple” or “two or more”.
  • the terms “plurality” or “a plurality” can be used throughout the specification to describe two or more components, devices, elements, units, parameters, or the like.
  • the term set when used herein can include one or more items.
  • the method embodiments described herein are not constrained to a particular order or sequence. Additionally, some of the described method embodiments or elements thereof can occur or be performed simultaneously, at the same point in time, or concurrently.

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  • Health & Medical Sciences (AREA)
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  • Engineering & Computer Science (AREA)
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  • General Health & Medical Sciences (AREA)
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  • Veterinary Medicine (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Medical Informatics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Gynecology & Obstetrics (AREA)
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  • Oral & Maxillofacial Surgery (AREA)
  • Radiology & Medical Imaging (AREA)
  • Robotics (AREA)
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Abstract

L'invention concerne un système de traitement nerveux, qui peut comprendre : un scanner 3D configuré pour générer un premier modèle 3D comprenant une représentation 3D d'une surface d'un volume à traiter d'un sujet dans un système de coordonnées global ; un dispositif de calcul configuré pour : recevoir un second modèle 3D comprenant une représentation 3D de la surface du volume à traiter du sujet et une indication d'une position d'un nerf au sein du volume à traiter du sujet dans un système de coordonnées arbitraire ; recaler le second modèle 3D par rapport au premier modèle 3D dans le système de coordonnées global ; et sur la base du recalage, déterminer un emplacement du nerf au sein du volume à traiter du sujet dans le système de coordonnées global ; et un instrument de traitement nerveux configuré pour appliquer un traitement nerveux à l'emplacement déterminé du nerf au sein du volume à traiter du sujet.
PCT/IL2022/050980 2021-09-09 2022-09-08 Dispositifs, systèmes et méthodes de traitement nerveux Ceased WO2023037369A1 (fr)

Applications Claiming Priority (4)

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US202163242095P 2021-09-09 2021-09-09
US63/242,095 2021-09-09
US202263330391P 2022-04-13 2022-04-13
US63/330,391 2022-04-13

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9119670B2 (en) * 2010-04-28 2015-09-01 Ryerson University System and methods for intraoperative guidance feedback
US9633435B2 (en) * 2015-09-25 2017-04-25 Siemens Healthcare Gmbh Calibrating RGB-D sensors to medical image scanners
US20180235709A1 (en) * 2015-08-14 2018-08-23 Intuitive Surgical Operations, Inc. Systems and Methods of Registration for Image-Guided Surgery
US20210201512A1 (en) * 2019-12-31 2021-07-01 Sonoscape Medical Corp. Method and apparatus for registering live medical image with anatomical model

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9119670B2 (en) * 2010-04-28 2015-09-01 Ryerson University System and methods for intraoperative guidance feedback
US20180235709A1 (en) * 2015-08-14 2018-08-23 Intuitive Surgical Operations, Inc. Systems and Methods of Registration for Image-Guided Surgery
US9633435B2 (en) * 2015-09-25 2017-04-25 Siemens Healthcare Gmbh Calibrating RGB-D sensors to medical image scanners
US20210201512A1 (en) * 2019-12-31 2021-07-01 Sonoscape Medical Corp. Method and apparatus for registering live medical image with anatomical model

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