WO2002074500A2 - Device for display of the spatial position of a surgical instrument during an operation - Google Patents

Device for display of the spatial position of a surgical instrument during an operation Download PDF

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Publication number
WO2002074500A2
WO2002074500A2 PCT/EP2002/002279 EP0202279W WO02074500A2 WO 2002074500 A2 WO2002074500 A2 WO 2002074500A2 EP 0202279 W EP0202279 W EP 0202279W WO 02074500 A2 WO02074500 A2 WO 02074500A2
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WO
WIPO (PCT)
Prior art keywords
instrument
receiver
actual position
central computer
display device
Prior art date
Application number
PCT/EP2002/002279
Other languages
German (de)
French (fr)
Other versions
WO2002074500A3 (en
Inventor
Jürgen WAHRBURG
Original Assignee
Wahrburg Juergen
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Filing date
Publication date
Application filed by Wahrburg Juergen filed Critical Wahrburg Juergen
Priority to AU2002311027A priority Critical patent/AU2002311027A1/en
Publication of WO2002074500A2 publication Critical patent/WO2002074500A2/en
Publication of WO2002074500A3 publication Critical patent/WO2002074500A3/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00115—Electrical control of surgical instruments with audible or visual output
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00199—Electrical control of surgical instruments with a console, e.g. a control panel with a display
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/107—Visualisation of planned trajectories or target regions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046—Tracking techniques
    • A61B2034/2055—Optical tracking systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • 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

Definitions

  • the invention relates to a Norplatz for displaying the spatial position of a surgical instrument during an operation according to the preamble of claim 1 and "a Norcardi to support the orientation of a receiver.
  • Navigation systems include, as essential sub-components, a three-dimensional digitization system that records the spatial position and orientation of the surgical instruments during the operation through the interaction of movable transmitter elements and stationary receiver elements, and a central computer with a connected monitor, on which the current instrument position is displayed in the correct position a preoperative recording is displayed.
  • Navigation systems therefore offer the surgeon the essential advantage of being able to record at any time during the operation where the instrument being guided is located. This is particularly important if the surgical area is not fully visible, for example, when drilling in bones or using minimally invasive surgical techniques. In these cases, the navigation systems can be used to achieve more precise and documentable surgical results that are less dependent on the individual skill of the surgeon and limit the risk, particularly for younger, less experienced surgeons.
  • the surgeon In the case of surgical interventions that are carried out with the support of navigation systems, the surgeon usually specifies exactly which spatial positions the surgical instrument must assume during the operation during preoperative planning on the basis of preoperative recordings. These target positions are transmitted to the central computer of the navigation system, stored there and usually during operation together with the preoperative recording and the actual position of the instrument.
  • the target and actual positions of the surgical instruments are displayed exclusively on the screen of the central computer, in that corresponding graphical symbols are usually shown in the preoperative recording of the operating field.
  • the actual position is constantly updated on the screen in accordance with the movements carried out by the operator and recorded by the digitizing system. This requires extensive calculations in the central computer, which only allow a limited repetition frequency of the displayed image on the screen and can lead to a delayed display which is perceived as very annoying.
  • the surgeon In order to track the movement of the instrument position on the screen, the surgeon must continuously take his gaze away from the operating area for at least brief moments.
  • the invention is based on the object of designing a standard device of the type specified at the outset in such a way that the use of the navigation system is improved for the surgeon during the operation.
  • FIG. 1 shows a schematic representation of the structure of the device
  • FIG. 2 schematically shows the configuration of the guide device as a screen above an operating table
  • 3 shows an optical display device which can be attached to the instrument
  • FIG. 4 shows a schematic representation of the positioning of the receiver relative to the operating field.
  • FIG. 1 denotes a stationary receiver of a navigation device with receiving elements 2, which receive signals from a transmitter 4 attached to the surgical instrument 3 and pass them on to an central computer 5 via an electrical line 8.
  • the transmitter 4 on the surgical instrument 3 is connected for control via a line 9 to the central computer 5 or a supply unit arranged therein.
  • a screen 6 is connected to the central computer 5 via a line 10, on which a display of the surgical field generated in the central computer 5 is reproduced with the desired and actual position of the surgical instrument.
  • a memory device is provided in the central computer 5, in which the calculated image information of the operation field and the required target positions of the instrument are entered and stored in preparation for an operation. Furthermore, the central computer 5 displays the current actual position of the instrument 3 detected by the navigation device together with the target position and the operation field on the screen 6. This structure is known per se.
  • a separate, arbitrarily positionable guide device 7 is provided, which is connected via a line 11 to a comparison device in the central computer 5 in such a way that only the data of a comparison between the target and actual position of the instrument are taken and reproduced on the guide device 7.
  • the guide device 7 can, for. B. be designed as a small screen that can be positioned in the visual field of the surgeon and perceived by the surgeon so that he does not have to turn away from the operating field if he wants to read the position of the instrument on the control device.
  • FIG. 2 shows an exemplary embodiment of a guiding device in the form of a screen 20 above an operating table 12, to which a hinge 14 is attached via fastening rails 13. is brought, which holds the screen 20 above a patient 15 on the operating table, wherein the guide device in the form of the screen 20 can be adjusted into a position easily visible to the surgeon via the articulated arm 14.
  • a spatial coordinate system is reproduced on the screen 20, the surgical instrument 3 ′ being represented, for example, by a line that has to be moved to the zero point of the coordinate system that corresponds to the desired position, as shown by dashed lines Lines is indicated in Fig. 2.
  • the control device only takes over the data of the actual position of the instrument 3 from the central computer 5 for display in the form of a line, while the target position is represented by the zero point of the coordinate system.
  • crosshairs or similar markings reproduced in different colors or in different sizes can also be reproduced on the screen 20, which represent the desired position on the one hand and the actual position on the other hand.
  • the guide device can be designed as a display device which does not show the operator the absolute position of the surgical instrument as guide information, but only the deviation from the preoperatively determined target position.
  • the guide device can be made very small, so that it can be attached directly to the surgical instrument, as shown, for example, in FIG. 3.
  • a guide device in the form of an optical display device 21 is attached to the schematically represented surgical instrument 3 via a holder 16, on which illuminated directional arrows 17 are reproduced, which correspond to the coordinate directions of a spatial coordinate system and indicate to the operator the direction in which he does this Must move the instrument to reach the preoperatively determined target position.
  • by lighting up one or more directional arrows 17 the surgeon is shown the direction in which the instrument guided by him must be moved.
  • the luminosity of the directional arrows can be selected proportional to the extent of the deviation from the target position.
  • the directional arrows 17 are arranged approximately in a star shape around a light-emitting diode 18 which, for example, lights up green when the instrument 3 is in the correct target position. det. Instead of directional arrows, a sequence of light points or light-emitting diodes can be provided.
  • the guide device 7 can be designed as an acoustic guide device which outputs synthetically generated speech commands in order to indicate to the operator in which direction he has to move the surgical instrument in order to reach the desired position.
  • speech commands sound signals can also be used, wherein different sound frequencies can be used to differentiate the required correction direction and a volume proportional to the deviation.
  • sound signals can also be provided to support optical reproduction on the control device.
  • the guide device can be designed as a vibration transmitter, which is attached to the body of the surgeon in such a way that the surgeon recognizes in the vibrations emitted by the vibration transmitter in which direction the surgical instrument must be moved in order to reach the desired position.
  • a plurality of vibration transmitters can also be provided, which can be attached to the surgeon's body at various points.
  • the individual vibration transmitters can also convey the measure of the deviation from the desired position to the surgeon as information by means of the excitation frequency.
  • control device can also be controlled wirelessly by the central computer 5, so that no disruptive cables have to be laid. This is particularly advantageous when the guide device is attached to the instrument 3.
  • the guide device when the guide device is attached directly to the instrument 3, the guide device is designed to be sterilizable.
  • the intended use of navigation systems in the operating room requires the careful alignment of the stationary receiver 1 in such a way that its spatial measuring range encompasses the range of motion of the surgical instruments equipped with transmitting elements 4 in the operating area as completely as possible.
  • the alignment is usually carried out in two planes by rotating the receiver, which is attached to a holding arm or a tripod, about its horizontal and vertical axis.
  • the present invention teaches that the guide device 7, which can be positioned as desired, can also be used to provide the operating personnel with significantly improved support for achieving the precise, easily adjustable orientation of the receiver 1.
  • the control device 7 shows which axes and in which directions of rotation the operating personnel must move the receiver in order to adjust the center of its measuring range to the current position of the instrument equipped with transmitting elements 4.
  • a program is implemented in the central computer 5, the functionality of which, according to the invention, is to control the control device via the connecting line 11 in such a way that the required change in the receiver orientation is signaled to the operating personnel via the display device of the control device.
  • the navigation system is set up in detail in the following steps. The operating personnel first guides the instrument into a position that is in the measuring range of the receiver 1.
  • the software in the central computer 5 calculates from the measured spatial coordinates of the instrument 3 how the receiver orientation has to be changed in order to set the center of the measuring range to this instrument position. Based on this, the displays of the control device are controlled in such a way that they signal to the operating personnel the actions required to change the receiver orientation. The instrument is then slowly moved towards the center of the operating area, with the guide device 7 continuously signaling how the receiver alignment must be adjusted in order to follow the instrument movement and to keep the current instrument position in the center of the measuring range. Using this readjustment procedure, the instrument is guided to the center of the operating area so that the centers of the operating area and the measuring area coincide after completion of the readjustment. The area of operation is only covered in the best possible way by the measuring range of the receiver 1.
  • the use of the mobile guide device 7 according to the invention offers significant advantages over the prior art.
  • the alignment of the receiver 1 can take place in a targeted manner and therefore much faster instead of using a trial method, the best possible result of the receiver alignment is reproducibly achieved, and no additional hardware components, for example in the form of a laser pointer, are required.
  • FIG. 4 shows what the displays for signaling the required rotary movements of the receiver can look like on a guide device 7, which is designed in the form of a small screen 20.
  • the software in the central computer 5 is programmed according to the invention in such a way that it generates either a two-part image or two successive, in each case undivided images on the screen.
  • the images symbolically show in top view 22 and side view 23 the receiver 1, the spherically assumed measuring range 24 of the receiver, the current position 25 of the instrument in the measuring range, the vertical or horizontal axis of rotation 26, directional arrows 27 with a number of degrees 28, the direction and size of the Specify the required angle of rotation and the desired target position of the receiver orientation in dashed lines.
  • the illuminated directional arrows 17 indicate the movements required for the optimal alignment of the receiver.
  • the arrows marked “z” show the required rotation about the vertical axis of the receiver, the arrows marked “y” the rotation about the horizontal axis of the receiver and the arrows marked “x” the required linear movement of the tripod or support arm of the recipient.
  • the achievement of the optimal alignment is indicated by an additional signal such as the light-emitting diode 18.
  • the invention further teaches that the movements required for aligning the receiver are performed not only by the guide device 7 but also by a.
  • Display on the 'screen 6 of the central computer 5 can be displayed.
  • One exemplary embodiment represents the generation of one or two symbolic images, as explained above for a guide device with a small screen 20 with reference to FIG. 4.

Abstract

The invention relates to a device for display of the spatial position of a surgical instrument during an operation, whereby, in addition to the conventional navigation device for the instrument guided by the operator, a separate guide device is provided which transmits real-time information on the instrument position to the operator and can be arranged in the field of view of the operator, or in the direct vicinity of the field of operation.

Description

Vorrichtung zum Anzeigen der räumlichen Position eines chirurgischen Instruments während einer Operation Device for displaying the spatial position of a surgical instrument during an operation
Die Erfindung betrifft eine Norrichtung zum Anzeigen der räumlichen Position eines chirurgischen Instruments während einer Operation nach dem Oberbegriff des Anspruchs 1 sowie "eine Norrichtung zur Unterstützung der Ausrichtung eines Empfängers.The invention relates to a Norrichtung for displaying the spatial position of a surgical instrument during an operation according to the preamble of claim 1 and "a Norrichtung to support the orientation of a receiver.
Die grundlegende Technologie von Νavigationssystemen ist seit einigen Jahren bekannt. Sie ist erfolgreich auf medizinische Anwendungen übertragen worden, etwa zur Unterstützung von Operationen in der Neurochirurgie und der orthopädischen Chirurgie. Navigationssyste- me umfassen als wesentliche Teilkomponenten ein dreidimensionales Digitalisierungssystem, das die räumliche Position und Orientierung der chirurgischen Instrumente während der Operation durch das Zusammenwirken von beweglichen Sendeelementen und stationären Empfängerelementen erfaßt, und einen Zentralrechner mit angeschlossenem Monitor, auf dem die aktuelle Instrumentenposition durch lagerichtige Einblendung in eine präoperative Aufnahme angezeigt wird.The basic technology of navigation systems has been known for several years. It has been successfully applied to medical applications, such as to support operations in neurosurgery and orthopedic surgery. Navigation systems include, as essential sub-components, a three-dimensional digitization system that records the spatial position and orientation of the surgical instruments during the operation through the interaction of movable transmitter elements and stationary receiver elements, and a central computer with a connected monitor, on which the current instrument position is displayed in the correct position a preoperative recording is displayed.
Navigationssysteme bieten damit dem Operateur den wesentlichen Vorteil, während der Operation jederzeit erfassen zu können, wo sich das von ihm geführte Instrument befindet. Dies ist vor allem von Bedeutung, wenn das Operationsgebiet nicht vollständig einsehbar ist, etwa bei Bohrungen in Knochen oder bei minimalinvasiven Operationstechniken. In diesen Fällen sind mit Hilfe der Navigationssysteme genauere und dokumentierbare Operationsergebnisse erzielbar, die weniger vom individuellen Geschick des Operateurs abhängen und das Risiko besonders für jüngere, weniger erfahrene Chirurgen begrenzen.Navigation systems therefore offer the surgeon the essential advantage of being able to record at any time during the operation where the instrument being guided is located. This is particularly important if the surgical area is not fully visible, for example, when drilling in bones or using minimally invasive surgical techniques. In these cases, the navigation systems can be used to achieve more precise and documentable surgical results that are less dependent on the individual skill of the surgeon and limit the risk, particularly for younger, less experienced surgeons.
Bei chirurgischen Eingriffen, die mit Unterstützung von Navigationssystemen durchgeführt werden, wird in der Regel bereits während der präoperativen Planung auf Basis präoperativer Aufnahmen vom Operateur genau festgelegt, welche räumlichen Positionen das chirurgische Instrument während der Operation einnehmen muß. Diese Sollpositionen werden in den Zentralrechner des Navigationssystems übertragen, dort gespeichert und üblicherweise während der Operation zusammen mit der präoperativen Aufnahme und der Istposition des Instrumentes angezeigt.In the case of surgical interventions that are carried out with the support of navigation systems, the surgeon usually specifies exactly which spatial positions the surgical instrument must assume during the operation during preoperative planning on the basis of preoperative recordings. These target positions are transmitted to the central computer of the navigation system, stored there and usually during operation together with the preoperative recording and the actual position of the instrument.
Bei bekannten Ausführungsformen der Navigationssysteme werden Soll- und Istposition der chirurgischen Instrumente ausschließlich am Bildschirm des Zentralrechners angezeigt, indem üblicherweise entsprechende grafische Symbole in die präoperative Aufnahme des Operationsfeldes eingeblendet werden. Die Istposition wird auf dem Bildschirm entsprechend den vom Operateur ausgeführten und vom Digitalisierungssystem erfaßten Bewegungen ständig .aktualisiert. Dazu sind umfangreiche Berechnungen im Zentralrechner erforderlich, die nur eine begrenzte Wiederhol-Frequenz des dargestellten Bildes auf dem Bildschirm ermöglichen und zu einer als sehr störend empfundenen verzögerten Darstellung führen können. Um die Bewegung der Instrumentenposition auf dem Bildschirm zu verfolgen, muß der Operateur fortlaufend zumindest für kurze Momente seinen Blick vom Operationsgebiet abwenden.In known embodiments of the navigation systems, the target and actual positions of the surgical instruments are displayed exclusively on the screen of the central computer, in that corresponding graphical symbols are usually shown in the preoperative recording of the operating field. The actual position is constantly updated on the screen in accordance with the movements carried out by the operator and recorded by the digitizing system. This requires extensive calculations in the central computer, which only allow a limited repetition frequency of the displayed image on the screen and can lead to a delayed display which is perceived as very annoying. In order to track the movement of the instrument position on the screen, the surgeon must continuously take his gaze away from the operating area for at least brief moments.
Der Erfindung liegt die Aufgabe zugrunde, eine Norrichtung der eingangs angegebenen Art so auszubilden, dass für den Operateur während der Operation die Nutzung des Navigationssystems verbessert wird.The invention is based on the object of designing a standard device of the type specified at the outset in such a way that the use of the navigation system is improved for the surgeon during the operation.
Diese Aufgabe wird erfindungsgemäß durch die Merkmale im kennzeichnenden Teil des Anspruchs 1 gelöst. Dadurch, dass nur das Ergebnis des Vergleichs zwischen Soll- und Istposition an einer gesonderten Leiteinrichtung für den Operateur wiedergegeben wird, kann der Operateur verzögerungsfrei eine Information über die räumliche Position des Instruments erhalten, weil der Rechenaufwand für diesen Vergleich erheblich geringer ist als der für die zusätzliche Wiedergabe der im Zentralrechner gespeicherten Bildinformation des Operationsfeldes erforderliche Rechenaufwand. Zusätzlich wird eine solche Leiteinrichtung so gestaltet, dass sie in direkter Nähe des Operationsfeldes und im Gesichtsfeld des Operateurs angeordnet werden kann.This object is achieved by the features in the characterizing part of claim 1. Because only the result of the comparison between the target and actual position is reproduced on a separate control device for the operator, the operator can receive information about the spatial position of the instrument without delay, because the computational effort for this comparison is considerably less than that for the operator additional reproduction of the image information of the operating field stored in the central computer requires computing effort. In addition, such a guiding device is designed such that it can be arranged in the immediate vicinity of the operating field and in the field of vision of the surgeon.
Beispielsweise Ausführungsformen der Erfindung werden nachfolgend anhand der Zeichnung näher erläutert. Es zeigenFor example, embodiments of the invention are explained in more detail below with reference to the drawing. Show it
Fig. 1 in einer schematischen Darstellung den Aufbau der Vorrichtung, Fig. 2 schematisch die Ausgestaltung der Leiteinrichtung als Bildschirm über einem Operationstisch, Fig. 3 eine optische Anzeigeeinrichtung, die am Instrument anbringbar ist, und Fig. 4 eine schematische Darstellung der Positionierung des Empfängers relativ zum Operationsfeld.1 shows a schematic representation of the structure of the device, FIG. 2 schematically shows the configuration of the guide device as a screen above an operating table, 3 shows an optical display device which can be attached to the instrument, and FIG. 4 shows a schematic representation of the positioning of the receiver relative to the operating field.
In Fig. 1 ist mit 1 ein stationärer Empfänger einer Navigationseinrichtung mit Empfangsele- menten 2 bezeichnet, die Signale von einem am chirurgischen Instrument 3 angebrachten Sender 4 empfangen und über eine elektrische Leitung 8 an einen Zentralrechner 5 weitergeben. Der Sender 4 am chirurgischen Instrument 3 ist zur Ansteuerung über eine Leitung 9 mit dem Zentralrechner 5 bzw. einer in diesem angeordneten Versorgungseinheit verbunden. An den Zentralrechner 5 ist über eine Leitung 10 ein Bildschirm 6 angeschlossen, auf dem eine im Zentralrechner 5 erzeugte Darstellung des Operationsfeldes mit der Soll- und Istposition des chirurgischen Instruments wiedergegeben wird. Im Zentralrechner 5 ist eine Speicherein- richtung vorgesehen, in der die errechnete Bildinformation des Operationsfeldes und die erforderlichen Sollpositionen des Instruments bei der Vorbereitung einer Operation eingegeben und gespeichert werden. Weiterhin zeigt der Zentralrechner 5 die von der Navigationseinrichtung erfaßte aktuelle Istposition des Instrumentes 3 zusammen mit der Sollposition und dem Operationsfeld auf dem Bildschirm 6 an. Dieser Aufbau ist an sich bekannt.In FIG. 1, 1 denotes a stationary receiver of a navigation device with receiving elements 2, which receive signals from a transmitter 4 attached to the surgical instrument 3 and pass them on to an central computer 5 via an electrical line 8. The transmitter 4 on the surgical instrument 3 is connected for control via a line 9 to the central computer 5 or a supply unit arranged therein. A screen 6 is connected to the central computer 5 via a line 10, on which a display of the surgical field generated in the central computer 5 is reproduced with the desired and actual position of the surgical instrument. A memory device is provided in the central computer 5, in which the calculated image information of the operation field and the required target positions of the instrument are entered and stored in preparation for an operation. Furthermore, the central computer 5 displays the current actual position of the instrument 3 detected by the navigation device together with the target position and the operation field on the screen 6. This structure is known per se.
Erfindungsgemäß wird eine separate, beliebig positionierbare Leiteinrichtung 7 vorgesehen, die über eine Leitung 11 mit einer Vergleichseinrichtung im Zentralrechner 5 derart verbunden ist, dass nur die Daten eines Vergleichs zwischen Soll- und Istposition des Instrumentes abgenommen und an der Leiteinrichtung 7 wiedergegeben werden. Hierdurch entfällt für die Leiteinrichtung der Berechnungsaufwand für die zusätzliche Wiedergabe des Operationsfeldes, so dass Soll- und Istposition des Instrumentes 3 verzögerungsfrei an der Leiteinrichtung 7 wiedergegeben werden können, während die Wiedergabe am Bildschirm 6 mit Verzögerungen erfolgt, weil zusätzlich das Operationsfeld mit eingeblendet wird.According to the invention, a separate, arbitrarily positionable guide device 7 is provided, which is connected via a line 11 to a comparison device in the central computer 5 in such a way that only the data of a comparison between the target and actual position of the instrument are taken and reproduced on the guide device 7. This eliminates the computational effort for the additional display of the operating field for the control device, so that the target and actual position of the instrument 3 can be displayed on the control device 7 without delay, while the display on the screen 6 takes place with delays because the operating field is also shown.
Die Leiteinrichtung 7 kann z. B. als kleiner Bildschirm ausgestaltet sein, der im Gesichtsfeld des Operateurs positioniert und von diesem unmittelbar wahrgenommen werden kann, so dass er sich nicht vom Operationsfeld abzuwenden braucht, wenn er auf der Leiteinrichtung die Position des Instrumentes ablesen will.The guide device 7 can, for. B. be designed as a small screen that can be positioned in the visual field of the surgeon and perceived by the surgeon so that he does not have to turn away from the operating field if he wants to read the position of the instrument on the control device.
Fig. 2 zeigt ein Ausführungsbeispiel einer Leiteinrichtung in Form eines Bildschirms 20 über einem Operationstisch 12, an dem über Befestigungsschienen 13 ein Gelenkaim 14 ange- bracht ist, der den Bildschirm 20 über einem Patienten 15 auf dem Operationstisch hält, wobei über den Gelenkarm 14 die Leiteinrichtung in Form des Bildschirms 20 in eine für den Operateur leicht einsehbare Position verstellt werden kann.2 shows an exemplary embodiment of a guiding device in the form of a screen 20 above an operating table 12, to which a hinge 14 is attached via fastening rails 13. is brought, which holds the screen 20 above a patient 15 on the operating table, wherein the guide device in the form of the screen 20 can be adjusted into a position easily visible to the surgeon via the articulated arm 14.
Bei dem in Fig. 2 dargestellten Ausfuhrungsbeispiel wird auf dem Bildschirm 20 ein räumliches Koordinatensystem wiedergegeben, wobei das chirurgische Instrument 3' beispielsweise durch einen Strich wiedergegeben wird, der auf den Nullpunkt des Koordinatensystems bewegt werden muss, der der Sollposition entspricht, wie dies durch gestrichelte Linien in Fig. 2 angedeutet ist. Hierbei übernimmt die Leiteinrichtung vom Zentralrechner 5 lediglich die Daten der Istposition des Instruments 3 zur Anzeige in Form eines Striches, während die Sollposition durch den Nullpunkt des Koordinatensystems wiedergegeben wird.In the exemplary embodiment shown in FIG. 2, a spatial coordinate system is reproduced on the screen 20, the surgical instrument 3 ′ being represented, for example, by a line that has to be moved to the zero point of the coordinate system that corresponds to the desired position, as shown by dashed lines Lines is indicated in Fig. 2. Here, the control device only takes over the data of the actual position of the instrument 3 from the central computer 5 for display in the form of a line, while the target position is represented by the zero point of the coordinate system.
Anstelle eines Koordinatensystems mit strichförmiger Darstellung des Instruments können auch in unterschiedlicher Farbe oder in unterschiedlicher Größe wiedergegebene Fadenkreuze oder dergleichen Markierungen auf dem Bildschirm 20 wiedergegeben werden, die einerseits die Sollposition und andererseits die Istposition wiedergeben.Instead of a coordinate system with a dashed representation of the instrument, crosshairs or similar markings reproduced in different colors or in different sizes can also be reproduced on the screen 20, which represent the desired position on the one hand and the actual position on the other hand.
Nach einer anderen- Ausgestaltung der Leiteinrichtung kann diese als Anzeigevorrichtung ausgebildet werden, die dem Operateur als Leitinformation nicht die absolute Position des chirurgischen Instruments anzeigt, sondern nur die Abweichung von der präoperativ festgelegten Sollposition. Hierdurch kann die Leiteinrichtung sehr klein ausgebildet werden, so dass sie direkt am chirurgischen Instrument befestigt werden kann, wie dies beispielsweise Fig. 3 zeigt. Hierbei ist an dem schematisch dargestellten chirurgischen Instrument 3 über einen Halter 16 eine Leiteinrichtung in Form einer optischen Anzeigeeinrichtung 21 angebracht ist, auf der beleuchtete Richtungspfeile 17 wiedergegeben werden, welche den Koordinatenrichtungen eines räumlichen Koordinatensystems entsprechen und dem Operateur die Richtung angeben, in die er das Instrument bewegen muss, um die präoperativ festgelegte Sollposition zu erreichen. Bei dieser Ausgestaltung wird durch Aufleuchten eines oder mehrerer Richtungspfeile 17 dem Operateur angezeigt, in welche Richtung das von ihm geführte Instrument bewegt werden muss. Hierbei kann die Leuchtstärke der Richtungspfeile proportional zum Maß der Abweichung von der Sollposition gewählt werden.According to another embodiment of the guide device, it can be designed as a display device which does not show the operator the absolute position of the surgical instrument as guide information, but only the deviation from the preoperatively determined target position. As a result, the guide device can be made very small, so that it can be attached directly to the surgical instrument, as shown, for example, in FIG. 3. In this case, a guide device in the form of an optical display device 21 is attached to the schematically represented surgical instrument 3 via a holder 16, on which illuminated directional arrows 17 are reproduced, which correspond to the coordinate directions of a spatial coordinate system and indicate to the operator the direction in which he does this Must move the instrument to reach the preoperatively determined target position. In this embodiment, by lighting up one or more directional arrows 17, the surgeon is shown the direction in which the instrument guided by him must be moved. The luminosity of the directional arrows can be selected proportional to the extent of the deviation from the target position.
Die Richtungspfeile 17 sind etwa sternförmig um eine Leuchtdiode 18 angeordnet, die beispielsweise grün aufleuchtet, wenn sich das Instrument 3 in der korrekten Sollposition befin- det. Anstelle von Richtungspfeilen kann eine Folge von Lichtpunkten oder Leuchtdioden vorgesehen werden.The directional arrows 17 are arranged approximately in a star shape around a light-emitting diode 18 which, for example, lights up green when the instrument 3 is in the correct target position. det. Instead of directional arrows, a sequence of light points or light-emitting diodes can be provided.
Während bei der Ausführungsform nach Fig. 2 die Sollposition durch den Nullpunkt des Koordinatensystems fest vorgegeben ist, werden bei der Ausführungsform nach Fig. 3 nur Korrektursignale wiedergegeben, in welche Richtung eine Korrektur vorgenommen werden muss. Die Sollposition selbst ist hierbei nicht dargestellt. Das Erreichen der Sollposition wird zweckmäßigerweise durch ein zusätzliches Signal wie die Leuchtdiode 18 angezeigt.While in the embodiment according to FIG. 2 the target position is fixed by the zero point of the coordinate system, in the embodiment according to FIG. 3 only correction signals are shown in which direction a correction has to be made. The target position itself is not shown here. Reaching the desired position is expediently indicated by an additional signal such as the light-emitting diode 18.
Nach einer weiteren Ausgestaltung kann die Leiteinrichtung 7 als akustische Leiteinrichtung ausgebildet sein, die synthetisch erzeugte Sprachko mandos ausgibt, um dem Operateur anzugeben, in welche Richtung er das chirurgische Instrument bewegen muss, um die Sollposition zu erreichen. Anstelle von Sprachkommandos können auch Tonsignale verwendet werden, wobei unterschiedliche Tonfrequenzen zur Unterscheidung der erforderlichen Korrekturrichtung und eine der Abweichung proportionale Lautstärke verwendet werden können. Solche Tonsignale können auch zur Unterstützung der optischen Wiedergabe an der Leiteinrichtung vorgesehen werden.According to a further embodiment, the guide device 7 can be designed as an acoustic guide device which outputs synthetically generated speech commands in order to indicate to the operator in which direction he has to move the surgical instrument in order to reach the desired position. Instead of voice commands, sound signals can also be used, wherein different sound frequencies can be used to differentiate the required correction direction and a volume proportional to the deviation. Such sound signals can also be provided to support optical reproduction on the control device.
Weiterhin kann die Leiteinrichtung als Vibrationsgeber ausgebildet werden, der am Körper des Operateurs so angebracht wird, dass der Operateur durch die vom Vibrationsgeber abgegebenen Schwingungen erkennt, in welche Richtung das chirurgische Instrument bewegt werden muss, um die Sollposition zu erreichen. Hierbei können auch mehrere Vibrationsgeber vorgesehen werden, die an verschiedenen Stellen am Körper des Operateurs angebracht werden können. Die einzelnen Vibrationsgeber können durch die Anregungsfrequenz auch das Maß der Abweichung von der Sollposition dem Operateur als Information vermitteln.Furthermore, the guide device can be designed as a vibration transmitter, which is attached to the body of the surgeon in such a way that the surgeon recognizes in the vibrations emitted by the vibration transmitter in which direction the surgical instrument must be moved in order to reach the desired position. In this case, a plurality of vibration transmitters can also be provided, which can be attached to the surgeon's body at various points. The individual vibration transmitters can also convey the measure of the deviation from the desired position to the surgeon as information by means of the excitation frequency.
Die Leiteinrichtung kann unabhängig von der Ausgestaltung auch auf drahtlosem Weg vom Zentralrechner 5 angesteuert werden, so dass keine störenden Kabel verlegt werden müssen. Dies ist insbesondere bei einer Anbringung der Leiteinrichtung am Instrument 3 von Vorteil.Regardless of the design, the control device can also be controlled wirelessly by the central computer 5, so that no disruptive cables have to be laid. This is particularly advantageous when the guide device is attached to the instrument 3.
Insbesondere bei einer Anbringung der Leiteinrichtung direkt am Instrument 3 wird die Leiteinrichtung sterilisierbar ausgebildet. Der bestimmungsgemäße Einsatz von Navigationssystemen im Operationssaal erfordert die sorgfältige Ausrichtung des stationären Empfängers 1 dergestalt, dass sein räumlicher Messbereich den Bewegungsraum der mit Sendeelementen 4 ausgestatteten chirurgischen Instrumente im Operationsgebiet möglichst vollständig umfasst. Die Ausrichtung erfolgt überli- cherweise in zwei Ebenen durch Drehung des an einem Haltearm oder einem Stativ befestigten Empfängers um seine Horizontal- und Vertikalachse.In particular when the guide device is attached directly to the instrument 3, the guide device is designed to be sterilizable. The intended use of navigation systems in the operating room requires the careful alignment of the stationary receiver 1 in such a way that its spatial measuring range encompasses the range of motion of the surgical instruments equipped with transmitting elements 4 in the operating area as completely as possible. The alignment is usually carried out in two planes by rotating the receiver, which is attached to a holding arm or a tripod, about its horizontal and vertical axis.
Bei bekannten Systemen besteht dabei die Schwierigkeit, dass das Bedienungspersonal, wel- ches die Ausrichtung durchfuhrt, allein aufgrund seines räumlichen Vorstellungsvermögens versuchen muss, eine möglichst optimale Einstellung zu finden. Der Stand der Technik bekannter Systeme besteht darin, dass auf dem Bildschirm 6 des Zentralrechners 5 lediglich angezeigt wird, ob sich die Sendeelemente eines Instrumentes im Messbereich des Empfängers befinden oder nicht. Bei dem Ausrichtungsvorgang muss die ausführende Person durch zeitaufwendiges Probieren, das heißt durch Bewegen des Instrumentes in gewünschte Positionen, herausfinden, ob sich das Instrument bei den vorliegenden Einstellungen schon im Messbereich befindet oder wie die Drehwinkel des Empfängers um Horizontal- und Vertikalachse geändert werden müssen, um dies zu erreichen. Bekanntgewordene Einstellhilfen bestehen aus einer am Empfänger angebrachten Zusatzeinrichtung, die einen Lichtstrahl - beispielsweise durch einen kleinen Laserzeiger - erzeugt, der genau auf der Messachse des Empfängers verläuft. Auch damit ist es der einrichtenden Person jedoch nicht möglich, das Zentrum und die Ausdehnung des beispielsweise kugelförmigen Messbereiches zu erkennen.In the case of known systems, there is the difficulty that the operating personnel who carry out the alignment have to try to find the best possible setting solely on the basis of their spatial imagination. The state of the art of known systems consists in that the screen 6 of the central computer 5 merely shows whether the transmission elements of an instrument are in the measurement range of the receiver or not. During the alignment process, the person performing the test must find out whether the instrument is already in the measuring range with the present settings or how the angles of rotation of the receiver about the horizontal and vertical axes have to be changed, by moving the instrument into the desired positions. to achieve this. Known adjustment aids consist of an additional device attached to the receiver, which generates a light beam - for example through a small laser pointer - that runs exactly on the measuring axis of the receiver. Even with this, however, the person setting it up is not able to recognize the center and the extent of the, for example, spherical measuring range.
Die vorliegende Erfindung lehrt, dass die beliebig positionierbare Leiteinrichtung 7 auch dazu verwendet werden kann, um dem Bedienungspersonal eine wesentlich verbesserte Unterstützung zur Erzielung der genauen, auf einfache Weise einstellbaren Ausrichtung des Empfängers 1 zu bieten. In der Einrichtungsphase des Navigationssystems wird dazu mit der Leiteinrichtung 7 angezeigt, um welche Achsen und in welchen Drehrichtungen das Bedienungspersonal den Empfänger bewegen muss, um das Zentrum seines Messbereiches auf die momentane Position des mit Sendeelementen 4 ausgestatteten Instrumentes einzustellen. Im Zentralrechner 5 wird ein Programm implementiert, dessen Funktionalität erfindungsgemäß darin besteht, die Leiteinrichtung über die Verbindungsleitung 11 so anzusteuern, dass dem Bedienungspersonal über die Anzeigevorrichtung der Leiteinrichtung die erforderliche Änderung der Empfängerausrichtung signalisiert wird. Die Einrichtung des Navigationssystems läuft im Einzelnen in folgenden Schritten ab. Das Bedienungspersonal führt das Instrument zunächst in eine Position, die im Messbereich des Empfängers 1 liegt. Die Software im Zentralrechner 5 berechnet erfindungsgemäß aus den gemessenen Raumkoordinaten des Instrumentes 3, wie die Empfängerausrichtung geändert werden muss, um das Zentrum des Messbereichs auf diese I strumentenposition einzustellen. Die Anzeigen der Leiteinrichtung werden darauf aufbauend so angesteuert, dass sie dem Bedienungspersonal die erforderlichen Aktionen zur Änderung der Empfängerausrichtung signalisieren. Sodann wird das Instrument langsam in Richtung auf das Zentrum des Operationsgebietes bewegt, wobei die Leiteinrichtung 7 fortlaufend signalisiert, wie die Empfängerausrichtung nachgestellt werden muss, um der Instrumentenbewegung zu folgen und die aktuelle Instrumentenposition weiterhin im Zentrum des Messbereiches zu halten. Unter Anwendung dieses Nachstellungsverfahrens wird das Instrument bis in das Zentrum des Operationsgebietes geführt, so dass nach Abschluss der Nachstellung die Zentren von Operationsgebiet und Messbereich zusammenfallen. Das Operationsgebiet wird nu -in bestmöglicher Weise durch den Messbereich des Empfängers 1 abgedeckt.The present invention teaches that the guide device 7, which can be positioned as desired, can also be used to provide the operating personnel with significantly improved support for achieving the precise, easily adjustable orientation of the receiver 1. In the setup phase of the navigation system, the control device 7 shows which axes and in which directions of rotation the operating personnel must move the receiver in order to adjust the center of its measuring range to the current position of the instrument equipped with transmitting elements 4. A program is implemented in the central computer 5, the functionality of which, according to the invention, is to control the control device via the connecting line 11 in such a way that the required change in the receiver orientation is signaled to the operating personnel via the display device of the control device. The navigation system is set up in detail in the following steps. The operating personnel first guides the instrument into a position that is in the measuring range of the receiver 1. According to the invention, the software in the central computer 5 calculates from the measured spatial coordinates of the instrument 3 how the receiver orientation has to be changed in order to set the center of the measuring range to this instrument position. Based on this, the displays of the control device are controlled in such a way that they signal to the operating personnel the actions required to change the receiver orientation. The instrument is then slowly moved towards the center of the operating area, with the guide device 7 continuously signaling how the receiver alignment must be adjusted in order to follow the instrument movement and to keep the current instrument position in the center of the measuring range. Using this readjustment procedure, the instrument is guided to the center of the operating area so that the centers of the operating area and the measuring area coincide after completion of the readjustment. The area of operation is only covered in the best possible way by the measuring range of the receiver 1.
Gegenüber dem Stand der Technik bietet der erfindungsgemäße Einsatz der mobilen Leiteinrichtung 7 wesentliche Vorteile. Die Ausrichtung des Empfängers 1 kann statt mittels Probierverfahren zielgerichtet und damit wesentlich schneller erfolgen, es wird reproduzierbar das bestmögliche Ergebnis der Empfängerausrichtung erreicht, und es sind keine zusätzlichen Hardwarekomponenten, beispielsweise in Form eines Laserzeigers, erforderlich.The use of the mobile guide device 7 according to the invention offers significant advantages over the prior art. The alignment of the receiver 1 can take place in a targeted manner and therefore much faster instead of using a trial method, the best possible result of the receiver alignment is reproducibly achieved, and no additional hardware components, for example in the form of a laser pointer, are required.
Das in Fig. 4 dargestellte Ausführungsbeispiel zeigt, wie die Anzeigen zur Signalisierung der erforderlichen Drehbewegungen des Empfängers auf einer Leiteinrichtung 7 aussehen können, die in Form eines kleinen Bildschirmes 20 ausgeführt ist. Die Software im Zentralrechner 5 wird erfindungsgemäß so programmiert, dass sie auf dem Bildschirm entweder ein zweigeteiltes Bild oder zwei aufeinander folgende, jeweils ungeteilte Bilder erzeugt. Die Bilder zeigen symbolisch in Aufsicht 22 und Seitenansicht 23 den Empfänger 1, den kugelförmig angenommenen Messbereich 24 des Empfängers, die momentane Position 25 des Instrumentes im Messbereich, die vertikale beziehungsweise horizontale Drehachse 26, Richtungspfeile 27 mit einer Gradzahl 28, die Richtung und Größe der erforderlichen Drehwinkel angeben, und in gestrichelter Darstellung die gewünschte Zielposition der Empfängerausrichtung. Aus der Darstellung der momentanen Instrumentenposition im Messbereich und den weiteren Richtungspfeilen 27 mit Millimeterangabe 29 kann auch entnommen werden, wie die Grund- position von Stativ oder Haltearm des Empfängers linear verschoben werden muss, wenn das Zentrum des Messbereiches nicht allein durch Drehbewegungen auf diese Instrumentenposition justiert werden kann.The exemplary embodiment shown in FIG. 4 shows what the displays for signaling the required rotary movements of the receiver can look like on a guide device 7, which is designed in the form of a small screen 20. The software in the central computer 5 is programmed according to the invention in such a way that it generates either a two-part image or two successive, in each case undivided images on the screen. The images symbolically show in top view 22 and side view 23 the receiver 1, the spherically assumed measuring range 24 of the receiver, the current position 25 of the instrument in the measuring range, the vertical or horizontal axis of rotation 26, directional arrows 27 with a number of degrees 28, the direction and size of the Specify the required angle of rotation and the desired target position of the receiver orientation in dashed lines. From the representation of the current instrument position in the measuring range and the further direction arrows 27 with millimeter information 29, it can also be seen how the basic The position of the tripod or the holding arm of the receiver must be shifted linearly if the center of the measuring range cannot be adjusted to this instrument position solely by rotating movements.
Bei einer anderen Ausfuhrungsform der Leiteinrichtung 7 gemäß Fig. 3 geben die beleuchteten Richtungspfeile 17 die erforderlichen Bewegungen zur optimalen Ausrichtung des Empfängers an. Dabei zeigen die mit "z" gekennzeichneten Pfeile die erforderliche Drehung um die vertikale Achse des Empfängers, die mit "y" gekennzeichneten Pfeile die Drehung um die horizontale Achse des Empfängers und die mit "x" gekennzeichneten Pfeile die erforderliche lineare Bewegung des Stativs oder Haltearms des Empfängers an. Das Erreichen der optimalen Ausrichtung wird durch ein zusätzliches Signal wie die Leuchtdiode 18 angezeigt.In another embodiment of the guide device 7 according to FIG. 3, the illuminated directional arrows 17 indicate the movements required for the optimal alignment of the receiver. The arrows marked "z" show the required rotation about the vertical axis of the receiver, the arrows marked "y" the rotation about the horizontal axis of the receiver and the arrows marked "x" the required linear movement of the tripod or support arm of the recipient. The achievement of the optimal alignment is indicated by an additional signal such as the light-emitting diode 18.
Die Erfindung lehrt weiter, dass die erforderlichen Bewegungen zur Ausrichtung des Empfängers außer durch die Leiteinrichtung 7 auch durch eine. Anzeige auf dem'Bildschirm 6 des Zentralrechners 5 angezeigt werden können. Ein Ausführungsbeispiel stellt die Erzeugung von ein oder zwei symbolischen Bildern dar, wie sie oben für eine Leiteinrichtung mit kleinem Bildschirm 20 anhand von Fig. 4 erläutert wird. The invention further teaches that the movements required for aligning the receiver are performed not only by the guide device 7 but also by a. Display on the 'screen 6 of the central computer 5 can be displayed. One exemplary embodiment represents the generation of one or two symbolic images, as explained above for a guide device with a small screen 20 with reference to FIG. 4.

Claims

Ansprüche Expectations
1. Vorrichtung zum Anzeigen der räumlichen Position eines chirurgischen Instruments während einer Operation, umfassend eine Navigationseinrichtung mit Sende- und Empfangselementen (4, 2), einen Zentralrechner (5) mit einer Speichereinrichtung, in der Daten der errechneten Bildinformation des Operationsfeldes und der vorgegebenen Sollpositionen des Instrumentes (3) gespeichert sind, sowie einer Einrichtung zur Bestimmung der Istposi- fion des Instrumentes (3) aus den Signalen der Empfangselemente (2), und eine Anzeigeeinrichtung (6) zur graphischen Wiedergabe des Operationsfeldes einschließlich der aktuellen Istposition des Instrumentes (3) relativ zu dem Operationsfeld und der Sollposition, ' dadurch gekennzeichnet, dass im Zentralrechner (5) eine Vergleichseinrichtung vorgesehen ist zum Vergleichen der Raumkoordinaten der Soll- und Istposition des Instrumentes (3), und dass eine separate, unmittelbar im Blickfeld des Operateurs positionierbare Leiteinrichtung (7) vorgesehen ist, die mit der Vergleichseinrichtung des Zentralrechners (5) derart in Verbindung steht, dass nur das Ergebnis des Vergleichs zwischen Soll- und Istposition in der Form von Korrektursignalen an der im unmittelbaren Blickfeld des Operateurs angeordneten Leiteinrichtung wiedergegeben wird.1. A device for displaying the spatial position of a surgical instrument during an operation, comprising a navigation device with transmitting and receiving elements (4, 2), a central computer (5) with a storage device in which data of the calculated image information of the operating field and the predetermined target positions of the instrument (3) are stored, as well as a device for determining the actual position of the instrument (3) from the signals of the receiving elements (2), and a display device (6) for graphical representation of the operating field including the current actual position of the instrument (3 ) relative to the operating field and the target position, 'characterized in that a comparison device is provided in the central computer (5) for comparing the spatial coordinates of the target and actual position of the instrument (3), and that a separate control device which can be positioned directly in the operator's field of vision (7) is provided, ie e is connected to the comparison device of the central computer (5) in such a way that only the result of the comparison between the target and actual position is reproduced in the form of correction signals on the control device arranged in the immediate field of vision of the operator.
2. Vorrichtung nach Anspruch 1, wobei die Leiteinrichtung eine optische Anzeigeeinrichtung (20, 21) umfaßt, auf der die Soll- und Istposition des Instrumentes (3) in der Form von Markierungen wiedergegeben werden.2. Device according to claim 1, wherein the guide device comprises an optical display device (20, 21) on which the target and actual position of the instrument (3) are reproduced in the form of markings.
3. Vorrichtung nach Anspruch 2, wobei auf einer optischen Anzeigeeinrichtung (20) der Leiteinrichtung die Sollposition in der Form des Nullpunktes eines räumlichen Koordinatensystems und die Istposition des Instrumentes in Form einer Markierung, beispielsweise eines Striches (31), wiedergegeben wird. 3. Apparatus according to claim 2, wherein on an optical display device (20) of the guide device, the target position in the form of the zero point of a spatial coordinate system and the actual position of the instrument in the form of a marker, for example a line (31), is reproduced.
4. Vorrichtung nach Anspruch 1, wobei die Leiteinrichtung eine optische Anzeigeeinrichtung (21) umfaßt, die z. B. durch Richtungspfeile (17) wiedergibt, in welche Richtung das Instrument (3) zum Erreichen der Sollposition bewegt werden soll.4. The device according to claim 1, wherein the guide means comprises an optical display device (21) which, for. B. by directional arrows (17) in which direction the instrument (3) is to be moved to reach the desired position.
5. Vorrichtung nach Anspruch 4, wobei die Richtungspfeile (17) um eine Leuchtdiode (18) angeordnet sind, welche durch Aufleuchten das Erreichen der Sollposition durch das Instrument (3) anzeigt.5. The device according to claim 4, wherein the directional arrows (17) are arranged around a light-emitting diode (18), which lights up when the desired position is reached by the instrument (3).
6. Vorrichtung nach den vorhergehenden Ansprüchen, wobei die Anzeigeeinrichtung (20, 21) der Leiteinrichtung über einen Halter (16) am chirurgischen Instrument (3) angebracht ist.6. Device according to the preceding claims, wherein the display device (20, 21) of the guide device is attached to the surgical instrument (3) via a holder (16).
7. Vorrichtung nach den Ansprüchen 1 bis 5, wobei die optische Anzeigeeinrichtung (20, 21) der Leiteinrichtung mittels eines verstellbaren jelenkaimes (14)' über dem Operationsfeld angebracht ist.7. Device according to claims 1 to 5, wherein the optical display device (20, 21) of the guide device is attached by means of an adjustable jelenkaimes (14) 'over the operating field.
8. Vorrichtung nach Anspruch 1, wobei die Leiteinrichtung wenigstens eine akustische Signalabgabeeinrichtung aufweist, welche durch Sprachinformation oder Tonsignale mit unterschiedlicher Tonhöhe bzw. unterscheidbarer Signaltonfolge die erforderliche Korrektur der Istposition in Richtung Sollposition angibt.8. The device according to claim 1, wherein the guide device has at least one acoustic signal output device which indicates the required correction of the actual position in the direction of the desired position by means of voice information or sound signals with different pitch or different signal tone sequence.
9. Vorrichtung nach Anspruch 1, wobei die Leiteinrichtung wenigstens einen Vibrationsgeber umfaßt, durch dessen Vibrationen unterschiedlicher Intensität Korrektursignale abgegeben werden.9. The device according to claim 1, wherein the guide device comprises at least one vibration transmitter, by means of which vibrations of different intensity, correction signals are emitted.
10. Vorrichtung nach den vorherigen A_nsprüchen, wobei die Leiteinrichtung sterilisierbar ausgebildet ist.10. Device according to the previous claims, wherein the guide device is designed to be sterilizable.
11. Vorrichtung nach Anspruch 1, wobei die optische Anzeigeeinrichtung der Leiteinrichtung Leuchtdioden in einer ebenen oder räumlichen Gruppierung aufweist, und durch Aufleuchten einzelner Leuchtdioden oder mehrerer ein Korrektursignal wiedergegeben wird. 11. The device according to claim 1, wherein the optical display device of the guide device has light-emitting diodes in a flat or spatial grouping, and a correction signal is reproduced by lighting up individual light-emitting diodes or more.
12. Vorrichtung nach den vorhergehenden Ansprüchen, wobei die Leiteinrichtung auf drahtlosem Wege von dem Zentralrechner (5) bzw. dessen Vergleichseinrichtung angesteuert wird, beispielsweise durch Infrarotlicht oder HF-Wellen.12. The device according to the preceding claims, wherein the guide device is controlled wirelessly by the central computer (5) or its comparison device, for example by infrared light or RF waves.
13. Vorrichtung zur Unterstützung der manuellen Ausrichtung eines stationären Empfängers (1) bei der Einrichtung eines Navigationssystems, umfassend eine Navigationseinrichtung mit Sende- und Empfangselementen (4, 2), einen Zentralrechner (5) mit einer Speichereinrichtung, in der die räumliche Ausdehnung des Messbereiches des Empfängers (1) gespeichert ist, sowie einer Einrichtung zur Bestimmung der Istposition des Instrumentes (3) aus den Signalen der Empfangselemente (2), und eine Anzeigeeinrichtung (6), dadurch gekennzeichnet, dass im Zentralrechner eine Vergleichseinrichtung vorgesehen ist zum Vergleichen der Raumkoordinaten des Zentrums des Messbereiches des Empfängers (1) und der Istposition des Instrumentes (3), und dass eine separate, im Blickfeld des Bedienpersonals positionierbare Leiteinrichtung (7) vorgesehen ist, die mit der Vergleichseinrichtung des Zentralrechners (5) derart in Verbindung steht, dass in Form von Korrektursignalen angegeben wird, wie die Ausrichtung des Empfängers (1) geändert werden muss, um das Zentrum des Messbereiches des Empfängers (1) und die Istposition des Instrumentes (3) in Deckung zu bringen.13. Device for supporting the manual alignment of a stationary receiver (1) when setting up a navigation system, comprising a navigation device with transmitting and receiving elements (4, 2), a central computer (5) with a memory device in which the spatial extent of the measuring range of the receiver (1) and a device for determining the actual position of the instrument (3) from the signals of the receiving elements (2), and a display device (6), characterized in that a comparison device is provided in the central computer for comparing the spatial coordinates the center of the measuring range of the receiver (1) and the actual position of the instrument (3), and that a separate guiding device (7), which can be positioned in the field of vision of the operating personnel, is provided, which is connected to the comparison device of the central computer (5) in such a way that in the form of correction signals, such as the alignment of the receiver (1) must be changed in order to align the center of the measuring range of the receiver (1) and the actual position of the instrument (3).
14. Vorrichtung nach Anspruch 13, deren Leiteinrichtung (7) über Anzeige- und Signalabgabeeinrichtungen gemäß den Ansprüchen 2 bis 12 verfügt.14. The apparatus of claim 13, the control device (7) has display and signal output devices according to claims 2 to 12.
15. Vorrichtung nach Anspruch 13 , dadurch gekennzeichnet, dass auf der Anzeigeeinrichtung (6) die räumliche Ausdehnung des Messbereiches des Empfängers (1) und gleichzeitig die aktuelle Istposition des Instrumentes (3) innerhalb des Messbereiches dargestellt werden, und dass auf der Anzeigeeinrichtung (6) zusätzlich Korrektursignale eingeblendet werden, wie die Ausrichtung des Empfangers (1) geändert werden muss, um das Zentrum des Messbereiches des Empfängers (1) und die Istposition des Instrumentes (3) in Dek- kung zu bringen. 15. The apparatus according to claim 13, characterized in that the spatial extent of the measuring range of the receiver (1) and at the same time the current actual position of the instrument (3) within the measuring range are shown on the display device (6), and that on the display device (6 ) additional correction signals are faded in, as the orientation of the receiver (1) must be changed to the center of the The measuring range of the receiver (1) and the actual position of the instrument (3).
PCT/EP2002/002279 2001-03-02 2002-03-01 Device for display of the spatial position of a surgical instrument during an operation WO2002074500A2 (en)

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Cited By (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9119655B2 (en) 2012-08-03 2015-09-01 Stryker Corporation Surgical manipulator capable of controlling a surgical instrument in multiple modes
US9226796B2 (en) 2012-08-03 2016-01-05 Stryker Corporation Method for detecting a disturbance as an energy applicator of a surgical instrument traverses a cutting path
US9480534B2 (en) 2012-08-03 2016-11-01 Stryker Corporation Navigation system and method for removing a volume of tissue from a patient
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US9652591B2 (en) 2013-03-13 2017-05-16 Stryker Corporation System and method for arranging objects in an operating room in preparation for surgical procedures
US9820818B2 (en) 2012-08-03 2017-11-21 Stryker Corporation System and method for controlling a surgical manipulator based on implant parameters
US9921712B2 (en) 2010-12-29 2018-03-20 Mako Surgical Corp. System and method for providing substantially stable control of a surgical tool
US11103315B2 (en) 2015-12-31 2021-08-31 Stryker Corporation Systems and methods of merging localization and vision data for object avoidance
US11202682B2 (en) 2016-12-16 2021-12-21 Mako Surgical Corp. Techniques for modifying tool operation in a surgical robotic system based on comparing actual and commanded states of the tool relative to a surgical site

Families Citing this family (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE10259250A1 (en) * 2002-12-17 2004-07-01 "Stiftung Caesar" (Center Of Advanced European Studies And Research) System to navigate dental tool for treatment on human or animal body has LEDs that signal to operator deviation of position and direction of instrument head from planning data
DE102006045100B4 (en) * 2006-09-21 2014-11-06 Universität Oldenburg Navigation device for a medical instrument
DE102011012460A1 (en) 2011-02-25 2012-08-30 Hicat Gmbh Surgical instrument with integrated navigation control
DE102015001575A1 (en) 2015-02-07 2016-08-11 Audi Ag Method and device for visualizing the movement of a robot

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5748767A (en) * 1988-02-01 1998-05-05 Faro Technology, Inc. Computer-aided surgery apparatus
DE19728788A1 (en) * 1997-07-05 1999-01-07 Nis Peter Boysen Position control of medical treatment table
DE19807884A1 (en) * 1998-02-25 1999-09-09 Schweikard Computer-aided intra-operative anatomical object visualization method used during complex brain surgery

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE3114918A1 (en) * 1981-04-13 1983-02-03 Brockmann, W., Dr., 2000 Hamburg Method and device for the video-optical determination of the position, and positioning of a rigid body in a space
GB9405299D0 (en) * 1994-03-17 1994-04-27 Roke Manor Research Improvements in or relating to video-based systems for computer assisted surgery and localisation
EP1051123A1 (en) * 1998-01-28 2000-11-15 Eric Richard Cosman Optical object tracking system

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5748767A (en) * 1988-02-01 1998-05-05 Faro Technology, Inc. Computer-aided surgery apparatus
DE19728788A1 (en) * 1997-07-05 1999-01-07 Nis Peter Boysen Position control of medical treatment table
DE19807884A1 (en) * 1998-02-25 1999-09-09 Schweikard Computer-aided intra-operative anatomical object visualization method used during complex brain surgery

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