WO2005067807A1 - Surgical navigation system - Google Patents

Surgical navigation system Download PDF

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Publication number
WO2005067807A1
WO2005067807A1 PCT/IB2005/050042 IB2005050042W WO2005067807A1 WO 2005067807 A1 WO2005067807 A1 WO 2005067807A1 IB 2005050042 W IB2005050042 W IB 2005050042W WO 2005067807 A1 WO2005067807 A1 WO 2005067807A1
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WO
WIPO (PCT)
Prior art keywords
microscope
markers
patient
measurement system
objects
Prior art date
Application number
PCT/IB2005/050042
Other languages
French (fr)
Inventor
Matthias Felber
Ion Pappas
Marco Caversaccio
Charles Baur
Original Assignee
Ecole Polytechnique Federale De Lausanne (Epfl)
Universite De Berne
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Application filed by Ecole Polytechnique Federale De Lausanne (Epfl), Universite De Berne filed Critical Ecole Polytechnique Federale De Lausanne (Epfl)
Publication of WO2005067807A1 publication Critical patent/WO2005067807A1/en

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, 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
    • A61B90/36Image-producing devices or illumination devices not otherwise provided for
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046Tracking techniques
    • A61B2034/2051Electromagnetic tracking systems
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046Tracking techniques
    • A61B2034/2055Optical tracking systems
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2072Reference field transducer attached to an instrument or patient
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10Computer-aided planning, simulation or modelling of surgical operations
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, 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
    • A61B90/20Surgical microscopes characterised by non-optical aspects

Definitions

  • the present invention relates to the field of computer-assisted surgery. It relates more specifically to surgical navigation systems which include a microscope.
  • a neuro-navigation system comprising a passive optical 3D measurement system, marked tools and optionally a microscope.
  • This invention provides a configuration where the measurement system is located somewhere in the operating room, outside the operating field. In the minimum case, the measurement system calculates the position of at least two optical reflectors, one located on the patient and the other on a surgical instrument. When used in conjunction with a microscope, an additional reflector is attached to the device to know its position relative to the operating field (patient and tool).
  • the Radionics company holder of the last two cited patents, offers the Microsight TM module [1], for monitoring microscopes.
  • This system composed of an optical marker fixed on the microscope as well as a ring installed on the focus development, can be mounted on several devices on the market.
  • the main disadvantages of the above systems are:
  • the present invention relates to a surgical navigation system as defined in claim 1.
  • the system illustrated in the single attached figure comprises a microscope 1 on which is rigidly fixed an optical 3D measuring device 2 whose purpose is to identify objects located in the operating field 3.
  • an optical 3D measuring device 2 On certain objects which one wants to know position (such as patient or surgical tools) are installed 4,5 optical markers.
  • the measurement system includes three linear cameras which by triangulation can identify the position of infrared LEDs located on the markers and deduce their position. If three or more LEDs are attached, it is also possible to know the orientation of the object.
  • the measurement system is rigidly linked to the microscope, the change of coordinates between the two devices is fixed and can only be calibrated once. Also, by knowing the position of the optical markers relative to the measurement system, it is possible to find this position relative to the reference frame of the microscopic image.
  • the patient and the tools are recorded using the various methods cited in the state of the art literature.
  • the microscope is calibrated, that is to say that the intrinsic parameters (focal length, optical center, distortion, ...) are calculated. If the real image is corrected and the optical parameters similarly adjusted in the virtual world, it is possible to superimpose virtual 3D objects on the real images.
  • the measuring system is placed so as not to add "blind spots" in the operating field, that is to say that the surgeons have more space and have less to worry about hiding the measuring system.
  • the invention proposes to reduce the total error. In the best of cases, the accuracy of the system presented decreases the total error by half compared to a configuration where a marker is placed on the microscope.
  • Radionics MicroSight TM system http://www.radionics.com/products/frameless/omnisight/omnisight modules.sht ml # micro

Abstract

The invention relates to a surgical navigation system, comprising a microscope to which a 3D measuring apparatus is rigidly fixed, for localising objects within the field of operation. Markers are fixed to the objects the position of which is desirable to know, for example, the patient or surgical instruments, which are themselves connected to the measuring system. The change in coordinates between the measuring system and the microscope is fixed as the two devices are rigidly connected. Also, knowing the position of the markers relating to the measuring system, it is possible to calculate the change in coordinates between the markers and the image from the microscope. When the markers are recorded, in other words when the relationship between the real objects and the virtual objects is determined, the information can then be used as a navigational instrument and/or for enhanced reality. A typical application for enhanced reality is the superimposition of a 3D anatomical model of the patient on the microscope image, generated from a pre-operative scan of the patient.

Description

Système de navigation chirurgicale Surgical navigation system
Domaine de l'inventionField of the invention
La présente invention se situe dans le domaine de la chirurgie assistée par ordinateur. Elle se rapporte plus précisément aux systèmes de navigation chirurgicale qui comprennent un microscope.The present invention relates to the field of computer-assisted surgery. It relates more specifically to surgical navigation systems which include a microscope.
Etat de la techniqueState of the art
Dans le brevet US 6,351,659, détenu par la société BrainLAB [2], il est question d'un système de neuro-navigation comportant un système de mesure 3D optique passif, des outils marqués et optionnellement un microscope. Cette invention propose une configuration où le système de mesure est situé quelque part dans la salle d'opération, hors du champ opératoire. Dans le cas de figure minimum, Je système de mesure calcule la position d'au moins deux réflecteurs optiques, un situé sur le patient et l'autre sur un instrument chirurgical. Lors de l'utilisation conjointe avec un microscope, un réflecteur supplémentaire est fixé sur l'appareil pour connaître sa position relativement au champ opératoire (patient et outil).In US patent 6,351,659, owned by the company BrainLAB [2], there is a question of a neuro-navigation system comprising a passive optical 3D measurement system, marked tools and optionally a microscope. This invention provides a configuration where the measurement system is located somewhere in the operating room, outside the operating field. In the minimum case, the measurement system calculates the position of at least two optical reflectors, one located on the patient and the other on a surgical instrument. When used in conjunction with a microscope, an additional reflector is attached to the device to know its position relative to the operating field (patient and tool).
Les brevets US 6, 167,295 et US 6,275,725 décrivent un système similaire mais différant dans la technique de mesure optique ainsi que dans la technique d'enregistrement. Dans le cas de l'emploi optionnel d'un microscope, un marqueur supplémentaire est disposé sur l'appareil.US Patents 6,167,295 and US 6,275,725 describe a similar system but differing in the optical measurement technique as well as in the recording technique. If an optional microscope is used, an additional marker is placed on the device.
La société Radionics, détentrice des deux derniers brevet cités, propose le module Microsight™ [1], pour le suivi de microscopes. Ce système, composé d'un marqueur optique fixé sur le microscope ainsi que bague installée sur la mise au point de la focale, se monte sur plusieurs appareils du marché. Les principaux désavantages des systèmes précités sont :The Radionics company, holder of the last two cited patents, offers the Microsight ™ module [1], for monitoring microscopes. This system, composed of an optical marker fixed on the microscope as well as a ring installed on the focus development, can be mounted on several devices on the market. The main disadvantages of the above systems are:
- La nécessité de calibrer le système chaque fois que la bague et le marqueur sont montés ou démontés du système,- The need to calibrate the system each time the ring and the marker are mounted or removed from the system,
- La réduction du champ de travail de l'outil de mesure qui doit simultanément « voir » le marqueur situé sur le microscope ainsi que ceux placés sur le patient et les outils, - Le système de mesure doit avoir un champ de vision libre et « voir » les 3 marqueurs simultanément, ce qui réduit considérablement l'espace de travail déjà retreint du chirurgien,- The reduction of the working field of the measuring tool which must simultaneously "see" the marker located on the microscope as well as those placed on the patient and the tools, - The measuring system must have a free field of vision and " see »the 3 markers simultaneously, which considerably reduces the surgeon's already tightened workspace,
- Finalement, le désavantage majeur est une augmentation de l'erreur globale de positionnement. Comme ce qui intéresse le chirurgien est la position du patient et ses outils relativement au microscope, le fait de mettre un marqueur sur l'appareil plutôt que le système de mesure lui- même rajoute un changement de référentiel, ce qui amplifie les erreurs de position et d'orientation.- Finally, the major disadvantage is an increase in the overall positioning error. As what interests the surgeon is the position of the patient and his tools relative to the microscope, the fact of putting a marker on the device rather than the measurement system itself adds a change of reference frame, which amplifies the position errors and guidance.
Résumé de l'inventionSummary of the invention
La présente invention concerne un système de navigation chirurgicale tel que défini à la revendication 1.The present invention relates to a surgical navigation system as defined in claim 1.
Description de l'inventionDescription of the invention
Le système illustré sur l'unique figure jointe comprend un microscope 1 sur lequel est rigidement fixé un appareil de mesure 3D optique 2 dont le but est de repérer des objets situés dans le champ opératoire 3. Sur certains objets dont on veut connaître la position (comme le patient ou des outils chirurgicaux ) sont installés des marqueurs optiques 4,5. Le système de mesure comprend trois caméras linéaires qui par triangulation peuvent repérer la position de LEDs infrarouges situées sur les marqueurs et déduire leur position. Si trois LEDs ou plus sont solidaires, il est également possible de connaître l'orientation de l'objet. Comme le système de mesure est rigidement lié au microscope, le changement de coordonnées entre les deux appareils est fixe et peut n'être calibré qu'une seule fois. Aussi, en connaissant la position des marqueurs optiques relativement au système de mesure, il est possible de retrouver cette position relativement au référentiel de l'image microscopique.The system illustrated in the single attached figure comprises a microscope 1 on which is rigidly fixed an optical 3D measuring device 2 whose purpose is to identify objects located in the operating field 3. On certain objects which one wants to know position (such as patient or surgical tools) are installed 4,5 optical markers. The measurement system includes three linear cameras which by triangulation can identify the position of infrared LEDs located on the markers and deduce their position. If three or more LEDs are attached, it is also possible to know the orientation of the object. As the measurement system is rigidly linked to the microscope, the change of coordinates between the two devices is fixed and can only be calibrated once. Also, by knowing the position of the optical markers relative to the measurement system, it is possible to find this position relative to the reference frame of the microscopic image.
Durant l'intervention le patient et les outils sont enregistrés au moyen des différentes méthodes citées dans la littérature de l'état de la technique. Le microscope est calibré, c'est-à-dire que les paramètres intrinsèques (focale, centre optique, distorsion, ...) sont calculés. Si l'image réelle est corrigée et les paramètres optiques similairement réglés dans le monde virtuel, il est possible de superposer des objets 3D virtuels sur les images réelles.During the intervention, the patient and the tools are recorded using the various methods cited in the state of the art literature. The microscope is calibrated, that is to say that the intrinsic parameters (focal length, optical center, distortion, ...) are calculated. If the real image is corrected and the optical parameters similarly adjusted in the virtual world, it is possible to superimpose virtual 3D objects on the real images.
Les avantages de solidariser le système de mesure au microscope sont les suivants :The advantages of joining the measurement system to the microscope are as follows:
- De par l'emplacement du système de mesure (proche de l'optique du microscope), l'ergonomie est améliorée. Le système de mesure est placé de telle sorte à ne pas rajouter des « angles morts » dans le champ opératoire, c'est-à-dire que les chirurgiens ont plus de place et ont moins à se soucier de masquer le système de mesure.- Due to the location of the measurement system (close to the optics of the microscope), ergonomics are improved. The measuring system is placed so as not to add "blind spots" in the operating field, that is to say that the surgeons have more space and have less to worry about hiding the measuring system.
- Le fait de n'avoir des marqueurs que dans un volume de travail réduit de 300 x 300 x 300 mm, permet d'avoir un système de mesure extrêmement compact et précis.- The fact of having markers only in a reduced working volume of 300 x 300 x 300 mm, makes it possible to have an extremely compact and precise measurement system.
- Par la position plongeant du système de mesure et le fait de ne pas devoir détecter un marqueur placé sur le microscope, l'amplitude d'orientation des marqueurs dans le champ opératoire est augmentée. Vu l'aspect additif du calcul d'erreur d'un tel système, l'invention propose de réduire l'erreur totale. Dans le meilleur des cas, la précision du système présenté diminue l'erreur totale de moitié comparativement à une configuration ou un marqueur est placé sur le microscope.- By the plunging position of the measuring system and the fact of not having to detect a marker placed on the microscope, the amplitude of orientation of the markers in the operating field is increased. Given the additive aspect of the error calculation of such a system, the invention proposes to reduce the total error. In the best of cases, the accuracy of the system presented decreases the total error by half compared to a configuration where a marker is placed on the microscope.
Références [1] Système MicroSight™ de Radionics : http://www.radionics.com/products/frameless/omnisight/omnisight modules.sht ml#micro [2] Système de réalité augmentée sur microscope de BrainLAB : http://www.brainlab.com/scripts/website full story.asp?article id=844&article tv pe id=82&retum=cms%References [1] Radionics MicroSight ™ system: http://www.radionics.com/products/frameless/omnisight/omnisight modules.sht ml # micro [2] BrainLAB augmented reality microscope system: http: // www .brainlab.com / scripts / website full story.asp? article id = 844 & article tv pe id = 82 & retum = cms%
[3] Brevet US 6,167,295: Optical and computer graphie stereotactic localizer[3] US patent 6,167,295: Optical and computer graphie stereotactic localizer
[4] Brevet US 6,275,725: Stereotactic optical navigation[4] US Patent 6,275,725: Stereotactic optical navigation
[5] Brevet US 6,351 ,659: Neuro-navigation System [5] US Patent 6,351,659: Neuro-navigation System

Claims

Revendications claims
1. Système de navigation chirurgicale comprenant, - Un microscope (1 ), - Un système de mesure 3D (2) rigidement fixé au microscope (1 ), - Une représentation virtuelle du champ opératoire (3) comme l'anatomie du patient, les plans ou régions de résections, la géométrie des outils, etc., - Un système de marquage (4,5), détectable par le système de mesure 3D (2), placé sur certaines parties anatomiques du patient et / ou sur les outils, - Des moyens d'enregistrement pour mettre en correspondance les objets réels et virtuels par le biais de marqueurs (4,5), ainsi qu'un système de traitement permettant d'utiliser l'information provenant des marqueurs (4,5) comme aide chirurgicale.1. Surgical navigation system comprising, - A microscope (1), - A 3D measurement system (2) rigidly fixed to the microscope (1), - A virtual representation of the operating field (3) such as the patient's anatomy, resection plans or regions, tool geometry, etc., - A marking system (4,5), detectable by the 3D measurement system (2), placed on certain anatomical parts of the patient and / or on the tools, - Recording means for matching real and virtual objects by means of markers (4,5), as well as a processing system allowing to use the information coming from markers (4,5) as help surgical.
2. Système selon la revendication 1 où le système de mesure 3D (2) est un système optique.2. System according to claim 1 wherein the 3D measurement system (2) is an optical system.
3. Système selon la revendication 2 où le système travaille dans l'infrarouge et les marqueurs (4,5) sont composés d'une ou plusieurs LEDs.3. The system of claim 2 wherein the system works in the infrared and the markers (4,5) are composed of one or more LEDs.
4. Système selon la revendication 3 où les marqueurs (4,5) sont des réflecteurs passifs.4. The system of claim 3 wherein the markers (4,5) are passive reflectors.
5. Système selon la revendication 1 où le système de mesure (2) est un système électromagnétique.5. System according to claim 1 wherein the measurement system (2) is an electromagnetic system.
6. Système selon la revendication 2 où la position du patient et celle des outils sont repérés sans marqueurs supplémentaires, au moyen des particularités a priori connues détectées par traitement d'images, ces particularités étant par exemple la forme et la couleur. 6. The system of claim 2 wherein the position of the patient and that of the tools are identified without additional markers, by means of the a priori known features detected by image processing, these features being for example the shape and the color.
7. Méthode d'utilisation du système selon l'une quelconque des revendications précédentes où l'optique du microscope est calibrée et le moyen d'utiliser l'information consiste à superposer les données virtuelles sur une ou plusieurs images provenant du microscope.7. Method of using the system according to any one of the preceding claims, in which the optics of the microscope are calibrated and the means of using the information consists in superimposing the virtual data on one or more images coming from the microscope.
8. Méthode d'utilisation selon la revendication 7 où les paramètres optiques du microscope (par exemple le zoom) sont connus et compensés en temps-réel par le système de traitement. 8. Method of use according to claim 7 wherein the optical parameters of the microscope (for example the zoom) are known and compensated in real time by the processing system.
PCT/IB2005/050042 2004-01-09 2005-01-05 Surgical navigation system WO2005067807A1 (en)

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CH00032/04 2004-01-09
CH322004 2004-01-09

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2015144640A1 (en) * 2014-03-24 2015-10-01 Scopis Gmbh Electromagnetic navigation system for microscopic surgery

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US5377678A (en) * 1991-09-03 1995-01-03 General Electric Company Tracking system to follow the position and orientation of a device with radiofrequency fields
US6167295A (en) 1991-01-28 2000-12-26 Radionics, Inc. Optical and computer graphic stereotactic localizer
US6275725B1 (en) 1991-01-28 2001-08-14 Radionics, Inc. Stereotactic optical navigation
US6351659B1 (en) 1995-09-28 2002-02-26 Brainlab Med. Computersysteme Gmbh Neuro-navigation system
US6366799B1 (en) * 1996-02-15 2002-04-02 Biosense, Inc. Movable transmit or receive coils for location system
US20020151784A1 (en) * 1998-11-10 2002-10-17 Olympus Optical Co., Ltd. Surgical microscope
EP1279376A2 (en) * 2001-07-27 2003-01-29 G.D.S. Giorgi Dynamic Stereotaxy S.r.l. Device and procedure for computer-assisted microsurgery
US20030164953A1 (en) * 2002-03-01 2003-09-04 Thomas Bauch Operation lamp with camera system for 3D referencing
DE10225077A1 (en) * 2002-06-05 2003-12-24 Vr Magic Gmbh Operating theater object tracking system has moveable optical sensors with position measured in fixed reference system

Patent Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6167295A (en) 1991-01-28 2000-12-26 Radionics, Inc. Optical and computer graphic stereotactic localizer
US6275725B1 (en) 1991-01-28 2001-08-14 Radionics, Inc. Stereotactic optical navigation
US5377678A (en) * 1991-09-03 1995-01-03 General Electric Company Tracking system to follow the position and orientation of a device with radiofrequency fields
US6351659B1 (en) 1995-09-28 2002-02-26 Brainlab Med. Computersysteme Gmbh Neuro-navigation system
US6366799B1 (en) * 1996-02-15 2002-04-02 Biosense, Inc. Movable transmit or receive coils for location system
US20020151784A1 (en) * 1998-11-10 2002-10-17 Olympus Optical Co., Ltd. Surgical microscope
EP1279376A2 (en) * 2001-07-27 2003-01-29 G.D.S. Giorgi Dynamic Stereotaxy S.r.l. Device and procedure for computer-assisted microsurgery
US20030164953A1 (en) * 2002-03-01 2003-09-04 Thomas Bauch Operation lamp with camera system for 3D referencing
DE10225077A1 (en) * 2002-06-05 2003-12-24 Vr Magic Gmbh Operating theater object tracking system has moveable optical sensors with position measured in fixed reference system

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2015144640A1 (en) * 2014-03-24 2015-10-01 Scopis Gmbh Electromagnetic navigation system for microscopic surgery

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