[go: up one dir, main page]
More Web Proxy on the site http://driver.im/

EP1328208A1 - Procede, dispositif et auxiliaire de navigation pour interventions medicales - Google Patents

Procede, dispositif et auxiliaire de navigation pour interventions medicales

Info

Publication number
EP1328208A1
EP1328208A1 EP01988558A EP01988558A EP1328208A1 EP 1328208 A1 EP1328208 A1 EP 1328208A1 EP 01988558 A EP01988558 A EP 01988558A EP 01988558 A EP01988558 A EP 01988558A EP 1328208 A1 EP1328208 A1 EP 1328208A1
Authority
EP
European Patent Office
Prior art keywords
navigation aid
navigation
intraoperative
image data
aid
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
EP01988558A
Other languages
German (de)
English (en)
Inventor
Marcus Vetter
Peter Hassenpflug
Gerald Glombitza
Ivo Wolf
Hans-Peter Meinzer
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Deutsches Krebsforschungszentrum DKFZ
Original Assignee
Deutsches Krebsforschungszentrum DKFZ
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Deutsches Krebsforschungszentrum DKFZ filed Critical Deutsches Krebsforschungszentrum DKFZ
Publication of EP1328208A1 publication Critical patent/EP1328208A1/fr
Ceased legal-status Critical Current

Links

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
    • 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
    • A61B90/10—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 for stereotaxic surgery, e.g. frame-based stereotaxis
    • A61B90/14—Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins
    • 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
    • A61B90/10—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 for stereotaxic surgery, e.g. frame-based stereotaxis
    • A61B90/14—Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins
    • A61B90/17—Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins for soft tissue, e.g. breast-holding devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/3203—Fluid jet cutting instruments
    • 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
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3983—Reference marker arrangements for use with image guided surgery
    • 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

Definitions

  • the invention relates to a method, a device and a navigation aid for navigation during medical interventions on non-bony structures.
  • the invention relates in particular to the field of medical interventions on soft tissue structures of a body.
  • the invention proposes, on the one hand, that the non-bony structure is registered with its preoperative data, at least one navigation aid is fixed on or in the non-bony structure in a defined manner, and that the position of at least one substructure of the non- bony structure is determined.
  • Such a navigation aid makes it possible to define a locally exact coordinate system which is invariant over the course of the operation and which enables visualization of the surgeon's instruments or the like to important structures in the operated organ. This applies the more precisely, the closer the navigation aid is fixed in the vicinity of a planned cut or a point of interest.
  • the navigation aid if it is fixed in the structure, it can also be used for navigation in the depth of an organ or soft tissue.
  • the procedure according to the invention makes it possible for the first time in a non-osseous structure, such as in particular an organ or a soft tissue, to convey precise information about the movement or change of the non-osseous structure to a surgeon even in depth can, even if the surgeon cannot see the actual surgical site.
  • the position is preferably determined, at least cumulatively, in a data processing system, which considerably simplifies the design of the navigation method according to the invention.
  • an image data record of the non-osseous structure such as can be obtained by means of MR or CT, for example, can be stored beforehand, for example as part of operation planning.
  • the position of the substructure, which is usually also contained in this image data record is preferably determined on the basis of this image data record.
  • the organ to be operated including its important substructures, such as vessels and tumors, are segmented in the preoperative image data set - that is, their spatial position is represented from an image data set in object form - and the location of resection areas and navigation aids for navigation in the preoperative Data determined.
  • the position of the navigation aid anchored at the beginning or in the non-bony structure with respect to the non-bony structure in the image data record is preferably determined, or the navigation aid is already navigated to the predetermined location after previous planning and anchored.
  • the non-bony structure itself is preferably immobilized or fixed, which considerably facilitates this position determination and anchoring the navigation aid.
  • the immobilization or fixation of the non-osseous structure can be released so that the immobilization or fixation of the non-osseous structure takes place as quickly as possible in order to burden the organism as little as possible.
  • the non-osseous structure can be registered before the navigation aid is introduced, that is to say compared with regard to its preoperative and intraoperative data, so that the navigation aid can be attached or inserted appropriately navigated. In this way it can be ensured that the navigation aid is set as optimally as possible in accordance with a previous operation planning.
  • preoperative here refers to data, processes or measures that are obtained or carried out before an operation or treatment.
  • Intraoperative means data, processes or measures men denotes, which are raised or carried out on the patient in an interventional manner, ie during the actual intervention. Interventional interventions are preferably open surgical interventions and minimally invasive forms of diagnosis and therapy, such as LITT (laser-induced thermotherapy), RFA (radio frequency ablation) and cryotherapy.
  • registration can establish a relationship as well as between preoperative and premutative data as well as between preoperative and intra- or post-mutative data. It proves advantageous for the precision of the method according to the invention to first make a registration between preoperative and premutative data. This can then be followed by the course of an operation in which the non-bony structure, for example its position, shape and shape through a resection, changed significantly, accordingly by comparing it with post-mutative data. It has been found here that frequent adjustment during the operation significantly increases the accuracy of the tracking of the movement sequence.
  • a transformation can then be determined on the basis of the position of the navigation aid at the beginning of the intervention (in particular, pre-mute) and the position of the navigation aid during the intervention (in particular intra- or post-mutative), and this transformation for determining the position of the substructure or the entire structure non-bony structure can be applied to the image data record of the partial structure or of the entire non-bony structure. It goes without saying that in the vicinity of the navigation aid, this transformation will be much more precise than is the case with more distant substructures. Such a transformation thus enables an assignment between intraoperative image data and preoperative image data. Because such a transformation with a suitable choice of the associated coordinate systems, these should cover all necessary spatial dimensions, can be selected invertible, then an assignment of the preoperative image data to the intraoperative image data is also easily possible.
  • Such a procedure enables a geometric assignment of image data recorded before the intervention to the current position of the partial area, so that safety distances can be maintained even in the case of adverse optical and palpatory conditions.
  • By displaying the current position and instrument position in the pre- and intraoperative image data it is also possible for third parties to get an objective picture of the navigation.
  • the transformation does not necessarily have to be determined from the actual image data, but that this can also take place on the basis of other data corresponding to the image data, for example on the basis of measurement data.
  • the term "3d data” in the present context refers to any data record which, due to a spatial assignment, enables a non-bony structure to be characterized in terms of its spatial extent.
  • the image data can be stored and processed in a corresponding data processing system, and the display of the image data, depending on the specific configuration, can also be selected as desired by screens or printers or other aids.
  • the image data are preferably selected to be three-dimensional, so that the entire volume of the partial structure or the overall structure can be made available visually or in another suitable form, in particular also in preparation for the medical intervention.
  • suitable cuts and viewing angles can be selected from a three-dimensional image data set, which can be used for preparing for the operation and for subsequent implementation.
  • Essential structures or partial fractures can easily be identified and maintained intraoperatively by registering with the preoperative data, which was often not possible up to now due to a lack of orientation.
  • the method according to the invention makes it possible to update the navigation path or therapy proposal previously determined preoperatively intraoperatively. This is particularly advantageous, for example, in the case of new lesions or the like found during the operation.
  • an operation plan prepared preoperatively based on the preoperative data can preferably be checked and, if necessary, updated using the intraoperative data.
  • this is made possible by the fact that the circumstances currently found during an operation, such as the location of the newly found lesion or other information that could not be determined preoperatively or only very inaccurately, are integrated into the preoperative overall picture and related to this can be.
  • the new therapy proposal both in its preoperative theoretical effects and in its intraoperative effects, can be recognized, discussed and implemented immediately and with minimal invasive effort for the patient.
  • a transformation can be determined between different intraoperative image data, for example between pre- and post-mutative image data or between different post-mutative image data.
  • the position of at least one operating tool is preferably determined during the intervention and determined relative to the partial structure or the non-bony structure. In this way, the surgeon immediately receives feedback about the position of his surgical tool in order to be able to use it precisely navigated. Accordingly, it is advantageous if the surgical instruments are detected with suitable measuring devices and measuring points in at least five or in their essential spatial degrees of freedom. In the case of axially active instruments such as needles or jet cutters, five degrees of freedom are usually sufficient in this regard. On the other hand, six degrees of freedom can also be recorded, as a result of which the corresponding or necessary transformations can be determined much more precisely.
  • the invention also proposes a navigation aid for navigation during medical interventions on non-bony structures, which has means for defining a local coordinate system.
  • a navigation aid which is attached to or inserted into the non-osseous structure, already gives the surgeon a purely visual or palpatory clue during an intervention.
  • the local coordinate system makes it possible to find a transformation that is valid in the environment of the navigation aid, by means of which image data of this environment, which were recorded at a different time of operation or at a different spatial position of the non-bony structure, can then be adapted to the new position.
  • the invention proposes a device for navigation during medical interventions on non-bony structures, which device for detecting the spatial position of at least one such navigation aid in at least five degrees of freedom.
  • a device for navigation during medical interventions on non-bony structures which device for detecting the spatial position of at least one such navigation aid in at least five degrees of freedom.
  • three degrees of freedom are necessary to determine the location of the navigation aid.
  • Two additional degrees of freedom are required because of the orientation of the navigation aid.
  • a sixth degree of freedom which would not require an additional definition in the event of a rotation invariance of the navigation aid, may be dispensed with.
  • the navigation aid preferably has a marker by means of which — if necessary — the navigation aid can be detected by an external sensor.
  • a marker which can be detected by an external sensor, can be designed to be passive, so that it can be made particularly small and without a connection to external measuring devices or power supplies.
  • a marker can also be selected actively so that it emits rays or similar information that make it detectable.
  • the marker is then preferably equipped with its own energy source. In this way, the navigation aid according to the invention does not unnecessarily restrict the already limited operating area with supply lines.
  • the navigation aid can have at least one sensor for localizing at least five spatial degrees of freedom of the navigation aid. have fe.
  • the way in which the degrees of freedom are determined is initially secondary.
  • interaction with means for generating a field, such as a gradient field, which has enabled the determination of the position and / or orientation of a sensor has proven particularly advantageous.
  • the corresponding measurement result can then be forwarded to a computer, for example. On the one hand, this can be done wirelessly but also via a corresponding data or measurement line.
  • the invention proposes in a preferred embodiment a needle-shaped navigation aid or a navigation aid with a needle-shaped extension for navigation during medical interventions on non-bony structures.
  • Your needle tip can preferably define the origin of a local coordinate system.
  • the navigation aid can include a soft-tissue anchor, which enables the navigation aid (in the case of a navigation unit with five degrees of freedom) to be fixed in translation and additionally rotationally invariably (in the case of a navigation unit with six degrees of freedom) in the non-bony structure, and a navigation unit, which in particular comprises a may have marker or sensor according to the invention.
  • the term “navigation unit” denotes any component of a navigation aid according to the invention which is used to localize the navigation can be used or is used.
  • This navigation unit enables the navigation aid to be recorded in a global coordinate system of a tracking system, as already described above.
  • surgical instruments can also have navigation units which enable the instruments to be recorded in the coordinates of the tracking system.
  • a local coordinate system can be defined in the depth of the organ in the vicinity of the target structure, which enables depth navigation, and on the other hand, only small deformations of the non-osseous structure are to be expected locally to the needle, if in the vicinity a resection is performed.
  • Such an arrangement also enables a more precise and simple navigation or orientation during a medical intervention, regardless of the other features of the present invention.
  • the navigation aid preferably comprises a needle, since a needle can be inserted into such a non-bony structure very easily and with minimal tissue injuries.
  • a needle can be inserted relatively deep into the structure so that it can also be used directly for depth navigation.
  • the navigation aid can have one or more soft-tissue anchors, such as hook elements or the like, which fix the navigation aid more reliably in the structure. It it is clear that clamps or the like can also be provided in order to ensure that the navigation aid is fixed in translation and possibly also in rotation.
  • the arrangement described above is particularly suitable for interaction with a data processing system if the navigation head or the navigation unit can be detected by a tracking system.
  • the position of the navigation aid or the surgical tool and a corresponding local coordinate system can be easily measured, forwarded to the data processing system and then their position can be determined with respect to the pre- and intraoperative image data.
  • the orientation in the environment of the target structure to be operated can be achieved by a physical definition of the coordinate system navigated to the target structure via the navigation aids.
  • individual spatial points such as measuring points or navigation units attached to the surgical tools, can then be tracked for navigation using suitable measuring devices.
  • the introduced physical coordinate system makes it possible to handle the global deformation of the non-osseous structure in the local coordinate system relative to the target structure, it being understood that the local coordinate system does not necessarily have to be selected in a Cartesian manner and can possibly also be selected in a lower dimension.
  • the deformation of larger areas of the non-osseous structure or the entire non-osseous structure can be approximately determined from the registration of the change in position relative to one another.
  • FIG. 1 shows a schematic representation of a liver, a first embodiment of an operation tool according to the invention, means according to the invention for recording intraoperative image data and a navigation aid according to the invention,
  • FIG. 2 shows a schematic illustration of a liver, a second embodiment of an operation tool according to the invention, means according to the invention for recording intraoperative image data and a navigation aid according to the invention and Fig. 3 different coordinate systems used in the aforementioned embodiments.
  • liver 1 and 2 show a liver 1 with a deep-lying tumor 2 in the right half of the liver.
  • the right hepatic vein 3 is fully covered by the tumor 2, while the middle hepatic vein 4 is within a safety distance when the tumor-bearing half of the liver is removed.
  • the left hepatic vein 5 is apparently not affected and must be preserved for survival.
  • a computer-assisted surgical planning in which a three-dimensional data set of the liver is determined using various measurement methods, such as ultrasound, CT, MR and the like (FIG. 3, Figs. A and B).
  • Dependent tissue and safety distance are calculated from the position of the tumor to the vessels and the resection areas and positions of the navigation aids are determined from this (see table).
  • Suitable anesthetic and surgical measures include, for example, jet ventilation and the abdominal cavity with cloths, as well as the fixation of the liver with a suitable gripper arm or with long needles penetrating the liver on a pad.
  • the planning data obtained preoperatively is compared with the geometry of the intraoperative site of the fixed liver 1 (table).
  • the liver 1 in the present exemplary embodiments is scanned with three-dimensional ultrasound (FIG. 3, FIG. C) and the image data set obtained in this way is registered with the image data obtained preoperatively, for example MR or CT image data, using a suitable mathematical transformation.
  • navigation needles 6 are now navigated, with the sensor 8 according to the invention being used for tracking the position of the navigation needles 6 with respect to navigation (Table A).
  • the navigation needles 6 have a soft tissue anchor 9, by means of which the navigation needles 6 can be fixed in the liver 1 so that they cannot slip and rotate.
  • the soft tissue anchor 9 is also a needle.
  • this additional soft-tissue anchor 9 can be dispensed with or this can be more complex, for example by hook clamps or by soft-tissue anchors that can be removed from the needle tip, as shown in FIG Figure 2 is listed as an example.
  • the navigation needle 6 can also first be inserted into the liver 1 and registered in the intraoperative image data virtually together with the first recording of an intraoperative image data set.
  • the navigation needle 6 also has a navigation head that can be detected by a tracking system.
  • the navigation head forms a structural unit with the needle 6, the needle tip 7 positioned close to the target structure being regarded as the origin of a coordinate system in these exemplary embodiments (FIG. 3, FIG. D).
  • the needle 6 in the exemplary embodiment according to FIG. 1 has an X-shaped cross section, so that rotation of the needle 6 around its main axis is not possible. In the embodiment of Figure 2, this rotational invariance is ensured by the soft tissue anchor 9.
  • a tracking system which provides a corresponding sensor field for determining the position of the navigation needles 6 (FIG. 3, FIG. A).
  • a sensor 17 A - for example a camera or an IR sensor - serves to position the corresponding markers 8A, 13A and 15A on the navigation needle 6 or on the navigation needles 6, on an ultrasound sensor 11 and on a jet cutter 14 to determine.
  • the tracking system comprises a magnetic gradient field 19, which is generated by two corresponding transmitters 17B and consists of two orthogonal partial gradient fields, this with regard to cumulatively or alternatively, another sensor field can also be provided.
  • Optical tracking methods are also possible, for example.
  • At least one navigation needle 6 is preferably used on a planned resection surface 10.
  • the fixation of the liver 1 can be removed.
  • the resection is carried out by means of a jet cutter 14, which can cut using a water jet 16.
  • the jet cutter 14 also includes a measuring point 15A or 15B (FIG. 3, FIG. E) that can be detected by the tracking system and that preferably locates the cutting tool with sub-millimeter precision within the spatial detection field of the sensor 17A or within the gradient field 19 and the correlation with the other coordinate systems (pre- and intraoperative image data, coordinate systems of the navigation aids) allows.
  • a Doppler ultrasound head 11 is also permanently connected with its detection field 12 to a measuring point 13A or 13B, which permits the position determination of the sound level in space and relative to the other coordinate systems.
  • a measuring point 13A or 13B which permits the position determination of the sound level in space and relative to the other coordinate systems.
  • the current position of the jet cutter 14 and the formwork level with respect to the liver 1 and its substructures can be determined. Images from the intraoperative ultrasound can now be easily assigned to the preoperative data because the current position and spatial relationship of both the sound level 12 and the navigation needle 6 is known from the tracking and because of the previous registration the relationship between pre and intraoperative image data is known and locally preserved via the navigation needle.
  • intraoperative and premutative image data in particular can be determined before the actual resection during the operation, and the liver 1 and the navigation needles 6 can be registered in this way. If more lesions than those identified during planning are discovered in the intraoperative image data, the proposed operation can be modified if necessary by transferring the intraoperatively recognized lesions to the preoperative image data by coordinate transformation and the resection proposal recalculated in the surgical planning system.
  • the position and orientation of the entire liver 1 can be localized roughly and in its surroundings, that is to say in substructures such as the target structure, extremely precisely in real time.
  • This enables important intraoperative structures to be assigned to their preoperative models.
  • By tracking the surgical tools 11 and 14, they can be displayed in real time in both pre- and intra-operative images.
  • this arrangement in combination with a 3D visualization of the current position of the surgical tools or the liver, including the substructures contained in it, in the preoperative and intraoperative image data, enables intuitive spatial interpretation, so that despite the high complexity of the target structures and the lack of them direct sense of touch and sight with regard to the non-bony structure itself, a good assessment of the geometric relationships is possible.
  • a transformation of the intraoperative image data to the existing preoperative data can be used to locate the tumor without further ado, a new resection proposal can be worked out and then implemented during the ongoing operation.
  • FIG. 3A shows an intraoperative global coordinate system x
  • FIG. 3B shows a coordinate system b for preoperative data
  • FIG. 3C an intraoperative coordinate system u
  • FIG. 3D shows a local intrahepatic or coordinate coordinate system (1, r, ⁇ ) and arranged within the non-bony structure
  • FIG. 3E shows a tool coordinate system w.
  • Assignments I and II are prerequisites for assignments III to V. After assignment II, the fixation of the non-bony structure can be removed.
  • the assignments I. and II are prerequisites for the assignments III to IV.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Pathology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Neurosurgery (AREA)
  • Robotics (AREA)
  • Apparatus For Radiation Diagnosis (AREA)
  • Measuring And Recording Apparatus For Diagnosis (AREA)
  • Ultra Sonic Daignosis Equipment (AREA)

Abstract

L'invention concerne un ou plusieurs auxiliaires de navigation (6) qui, introduits dans une structure non osseuse (1), permettent, grâce à leur positionnement, de maintenir l'état enregistré d'au moins une structure partielle de ladite structure non osseuse (1).
EP01988558A 2000-10-23 2001-10-23 Procede, dispositif et auxiliaire de navigation pour interventions medicales Ceased EP1328208A1 (fr)

Applications Claiming Priority (5)

Application Number Priority Date Filing Date Title
DE10052516 2000-10-23
DE10052516 2000-10-23
DE10052519 2000-10-23
DE10052519 2000-10-23
PCT/DE2001/003971 WO2002034152A1 (fr) 2000-10-23 2001-10-23 Procede, dispositif et auxiliaire de navigation pour interventions medicales

Publications (1)

Publication Number Publication Date
EP1328208A1 true EP1328208A1 (fr) 2003-07-23

Family

ID=26007464

Family Applications (1)

Application Number Title Priority Date Filing Date
EP01988558A Ceased EP1328208A1 (fr) 2000-10-23 2001-10-23 Procede, dispositif et auxiliaire de navigation pour interventions medicales

Country Status (5)

Country Link
US (1) US7953470B2 (fr)
EP (1) EP1328208A1 (fr)
AU (1) AU2002215822A1 (fr)
DE (1) DE10194615D2 (fr)
WO (1) WO2002034152A1 (fr)

Families Citing this family (121)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2005010711A2 (fr) * 2003-07-21 2005-02-03 Johns Hopkins University Systeme et procede a ultrasons robotises en 5 dimensions
DE10359317A1 (de) * 2003-12-17 2005-07-21 Siemens Ag Verfahren zur gezielten Navigation eines medizinischen Instruments, insbesondere eines Katheders
EP1632194A1 (fr) * 2004-09-06 2006-03-08 DKFZ Deutsches Krebsforschungszentrum Aide à la navigation et système de navigation utilisé lors d'interventions médicales
US8219178B2 (en) 2007-02-16 2012-07-10 Catholic Healthcare West Method and system for performing invasive medical procedures using a surgical robot
US9782229B2 (en) 2007-02-16 2017-10-10 Globus Medical, Inc. Surgical robot platform
US10653497B2 (en) 2006-02-16 2020-05-19 Globus Medical, Inc. Surgical tool systems and methods
US10893912B2 (en) 2006-02-16 2021-01-19 Globus Medical Inc. Surgical tool systems and methods
US10357184B2 (en) 2012-06-21 2019-07-23 Globus Medical, Inc. Surgical tool systems and method
US20220096112A1 (en) 2007-01-02 2022-03-31 Aquabeam, Llc Tissue resection with pressure sensing
US9232959B2 (en) 2007-01-02 2016-01-12 Aquabeam, Llc Multi fluid tissue resection methods and devices
KR100941612B1 (ko) * 2007-10-16 2010-02-11 주식회사 사이버메드 골 종양 수술에서의 내비게이션 방법
EP3622910B1 (fr) 2008-03-06 2024-07-10 AquaBeam LLC Ablation et cautérisation de tissus à l'aide de l'énergie optique véhiculée dans un courant de fluide
US10905518B2 (en) 2010-07-09 2021-02-02 Edda Technology, Inc. Methods and systems for real-time surgical procedure assistance using an electronic organ map
WO2012131660A1 (fr) 2011-04-01 2012-10-04 Ecole Polytechnique Federale De Lausanne (Epfl) Système robotisé et procédé pour chirurgie rachidienne et autre
DE102011087748A1 (de) * 2011-12-05 2013-06-06 Deutsches Zentrum für Luft- und Raumfahrt e.V. Flüssigkeitsstrahlskalpell und Verfahren zum Betreiben eines Flüssigkeitsstrahlskalpells
ES2687817T3 (es) * 2012-02-29 2018-10-29 Procept Biorobotics Corporation Resección y tratamiento de tejido guiado por imagen automatizada
US12004905B2 (en) 2012-06-21 2024-06-11 Globus Medical, Inc. Medical imaging systems using robotic actuators and related methods
US11395706B2 (en) 2012-06-21 2022-07-26 Globus Medical Inc. Surgical robot platform
US11298196B2 (en) 2012-06-21 2022-04-12 Globus Medical Inc. Surgical robotic automation with tracking markers and controlled tool advancement
US10758315B2 (en) 2012-06-21 2020-09-01 Globus Medical Inc. Method and system for improving 2D-3D registration convergence
US10136954B2 (en) 2012-06-21 2018-11-27 Globus Medical, Inc. Surgical tool systems and method
US11864745B2 (en) 2012-06-21 2024-01-09 Globus Medical, Inc. Surgical robotic system with retractor
US11974822B2 (en) 2012-06-21 2024-05-07 Globus Medical Inc. Method for a surveillance marker in robotic-assisted surgery
US11793570B2 (en) 2012-06-21 2023-10-24 Globus Medical Inc. Surgical robotic automation with tracking markers
US10350013B2 (en) 2012-06-21 2019-07-16 Globus Medical, Inc. Surgical tool systems and methods
US11857149B2 (en) 2012-06-21 2024-01-02 Globus Medical, Inc. Surgical robotic systems with target trajectory deviation monitoring and related methods
US10231791B2 (en) 2012-06-21 2019-03-19 Globus Medical, Inc. Infrared signal based position recognition system for use with a robot-assisted surgery
US11317971B2 (en) 2012-06-21 2022-05-03 Globus Medical, Inc. Systems and methods related to robotic guidance in surgery
US11253327B2 (en) 2012-06-21 2022-02-22 Globus Medical, Inc. Systems and methods for automatically changing an end-effector on a surgical robot
US12220120B2 (en) 2012-06-21 2025-02-11 Globus Medical, Inc. Surgical robotic system with retractor
US11864839B2 (en) 2012-06-21 2024-01-09 Globus Medical Inc. Methods of adjusting a virtual implant and related surgical navigation systems
US11116576B2 (en) 2012-06-21 2021-09-14 Globus Medical Inc. Dynamic reference arrays and methods of use
US11399900B2 (en) 2012-06-21 2022-08-02 Globus Medical, Inc. Robotic systems providing co-registration using natural fiducials and related methods
US11045267B2 (en) 2012-06-21 2021-06-29 Globus Medical, Inc. Surgical robotic automation with tracking markers
US10624710B2 (en) 2012-06-21 2020-04-21 Globus Medical, Inc. System and method for measuring depth of instrumentation
US11857266B2 (en) 2012-06-21 2024-01-02 Globus Medical, Inc. System for a surveillance marker in robotic-assisted surgery
US11607149B2 (en) 2012-06-21 2023-03-21 Globus Medical Inc. Surgical tool systems and method
US9283048B2 (en) 2013-10-04 2016-03-15 KB Medical SA Apparatus and systems for precise guidance of surgical tools
EP3094272B1 (fr) 2014-01-15 2021-04-21 KB Medical SA Appareil entaillé pour guider un instrument pouvant être introduit le long d'un axe pendant une chirurgie rachidienne
WO2015121311A1 (fr) 2014-02-11 2015-08-20 KB Medical SA Poignée stérile de commande d'un système chirurgical robotique à partir d'un champ stérile
US10004562B2 (en) 2014-04-24 2018-06-26 Globus Medical, Inc. Surgical instrument holder for use with a robotic surgical system
WO2016008880A1 (fr) 2014-07-14 2016-01-21 KB Medical SA Instrument chirurgical anti-dérapage destiné à être utilisé pour préparer des trous dans un tissu osseux
EP3212110B1 (fr) * 2014-10-29 2024-02-28 Intellijoint Surgical Inc. Systèmes pour alignement anatomique et localisation chirurgicale
US10013808B2 (en) 2015-02-03 2018-07-03 Globus Medical, Inc. Surgeon head-mounted display apparatuses
US10555782B2 (en) 2015-02-18 2020-02-11 Globus Medical, Inc. Systems and methods for performing minimally invasive spinal surgery with a robotic surgical system using a percutaneous technique
US10058394B2 (en) 2015-07-31 2018-08-28 Globus Medical, Inc. Robot arm and methods of use
US10646298B2 (en) 2015-07-31 2020-05-12 Globus Medical, Inc. Robot arm and methods of use
US10080615B2 (en) 2015-08-12 2018-09-25 Globus Medical, Inc. Devices and methods for temporary mounting of parts to bone
EP3344179B1 (fr) 2015-08-31 2021-06-30 KB Medical SA Systèmes de chirurgie robotique
US10034716B2 (en) 2015-09-14 2018-07-31 Globus Medical, Inc. Surgical robotic systems and methods thereof
US9771092B2 (en) 2015-10-13 2017-09-26 Globus Medical, Inc. Stabilizer wheel assembly and methods of use
WO2017103196A1 (fr) 2015-12-18 2017-06-22 Koninklijke Philips N.V. Appareil et procédé de caractérisation d'un tissu d'un sujet
US10842453B2 (en) 2016-02-03 2020-11-24 Globus Medical, Inc. Portable medical imaging system
US11058378B2 (en) 2016-02-03 2021-07-13 Globus Medical, Inc. Portable medical imaging system
US11883217B2 (en) 2016-02-03 2024-01-30 Globus Medical, Inc. Portable medical imaging system and method
US10448910B2 (en) 2016-02-03 2019-10-22 Globus Medical, Inc. Portable medical imaging system
US10117632B2 (en) 2016-02-03 2018-11-06 Globus Medical, Inc. Portable medical imaging system with beam scanning collimator
US10866119B2 (en) 2016-03-14 2020-12-15 Globus Medical, Inc. Metal detector for detecting insertion of a surgical device into a hollow tube
EP3241518B1 (fr) 2016-04-11 2024-10-23 Globus Medical, Inc Systèmes d'outil chirurgical
JP7233841B2 (ja) 2017-01-18 2023-03-07 ケービー メディカル エスアー ロボット外科手術システムのロボットナビゲーション
US11071594B2 (en) 2017-03-16 2021-07-27 KB Medical SA Robotic navigation of robotic surgical systems
US20180289432A1 (en) 2017-04-05 2018-10-11 Kb Medical, Sa Robotic surgical systems for preparing holes in bone tissue and methods of their use
US11135015B2 (en) 2017-07-21 2021-10-05 Globus Medical, Inc. Robot surgical platform
JP6778242B2 (ja) 2017-11-09 2020-10-28 グローバス メディカル インコーポレイティッド 手術用ロッドを曲げるための手術用ロボットシステム、および関連する方法および装置
US11794338B2 (en) 2017-11-09 2023-10-24 Globus Medical Inc. Robotic rod benders and related mechanical and motor housings
US11382666B2 (en) 2017-11-09 2022-07-12 Globus Medical Inc. Methods providing bend plans for surgical rods and related controllers and computer program products
US11134862B2 (en) 2017-11-10 2021-10-05 Globus Medical, Inc. Methods of selecting surgical implants and related devices
US20190254753A1 (en) 2018-02-19 2019-08-22 Globus Medical, Inc. Augmented reality navigation systems for use with robotic surgical systems and methods of their use
US10573023B2 (en) 2018-04-09 2020-02-25 Globus Medical, Inc. Predictive visualization of medical imaging scanner component movement
US11337742B2 (en) 2018-11-05 2022-05-24 Globus Medical Inc Compliant orthopedic driver
US11278360B2 (en) 2018-11-16 2022-03-22 Globus Medical, Inc. End-effectors for surgical robotic systems having sealed optical components
US11602402B2 (en) 2018-12-04 2023-03-14 Globus Medical, Inc. Drill guide fixtures, cranial insertion fixtures, and related methods and robotic systems
US11744655B2 (en) 2018-12-04 2023-09-05 Globus Medical, Inc. Drill guide fixtures, cranial insertion fixtures, and related methods and robotic systems
US11571265B2 (en) 2019-03-22 2023-02-07 Globus Medical Inc. System for neuronavigation registration and robotic trajectory guidance, robotic surgery, and related methods and devices
US11419616B2 (en) 2019-03-22 2022-08-23 Globus Medical, Inc. System for neuronavigation registration and robotic trajectory guidance, robotic surgery, and related methods and devices
US20200297357A1 (en) 2019-03-22 2020-09-24 Globus Medical, Inc. System for neuronavigation registration and robotic trajectory guidance, robotic surgery, and related methods and devices
US11382549B2 (en) 2019-03-22 2022-07-12 Globus Medical, Inc. System for neuronavigation registration and robotic trajectory guidance, and related methods and devices
US11317978B2 (en) 2019-03-22 2022-05-03 Globus Medical, Inc. System for neuronavigation registration and robotic trajectory guidance, robotic surgery, and related methods and devices
US11806084B2 (en) 2019-03-22 2023-11-07 Globus Medical, Inc. System for neuronavigation registration and robotic trajectory guidance, and related methods and devices
US11045179B2 (en) 2019-05-20 2021-06-29 Global Medical Inc Robot-mounted retractor system
US11628023B2 (en) 2019-07-10 2023-04-18 Globus Medical, Inc. Robotic navigational system for interbody implants
US11571171B2 (en) 2019-09-24 2023-02-07 Globus Medical, Inc. Compound curve cable chain
US11864857B2 (en) 2019-09-27 2024-01-09 Globus Medical, Inc. Surgical robot with passive end effector
US11426178B2 (en) 2019-09-27 2022-08-30 Globus Medical Inc. Systems and methods for navigating a pin guide driver
US11890066B2 (en) 2019-09-30 2024-02-06 Globus Medical, Inc Surgical robot with passive end effector
US11510684B2 (en) 2019-10-14 2022-11-29 Globus Medical, Inc. Rotary motion passive end effector for surgical robots in orthopedic surgeries
US12133772B2 (en) 2019-12-10 2024-11-05 Globus Medical, Inc. Augmented reality headset for navigated robotic surgery
US12220176B2 (en) 2019-12-10 2025-02-11 Globus Medical, Inc. Extended reality instrument interaction zone for navigated robotic
US11992373B2 (en) 2019-12-10 2024-05-28 Globus Medical, Inc Augmented reality headset with varied opacity for navigated robotic surgery
US12064189B2 (en) 2019-12-13 2024-08-20 Globus Medical, Inc. Navigated instrument for use in robotic guided surgery
CN111260786B (zh) * 2020-01-06 2023-05-23 南京航空航天大学 一种智能超声多模态导航系统及方法
US11464581B2 (en) 2020-01-28 2022-10-11 Globus Medical, Inc. Pose measurement chaining for extended reality surgical navigation in visible and near infrared spectrums
US11382699B2 (en) 2020-02-10 2022-07-12 Globus Medical Inc. Extended reality visualization of optical tool tracking volume for computer assisted navigation in surgery
US11207150B2 (en) 2020-02-19 2021-12-28 Globus Medical, Inc. Displaying a virtual model of a planned instrument attachment to ensure correct selection of physical instrument attachment
US11253216B2 (en) 2020-04-28 2022-02-22 Globus Medical Inc. Fixtures for fluoroscopic imaging systems and related navigation systems and methods
US11607277B2 (en) 2020-04-29 2023-03-21 Globus Medical, Inc. Registration of surgical tool with reference array tracked by cameras of an extended reality headset for assisted navigation during surgery
US11382700B2 (en) 2020-05-08 2022-07-12 Globus Medical Inc. Extended reality headset tool tracking and control
US11510750B2 (en) 2020-05-08 2022-11-29 Globus Medical, Inc. Leveraging two-dimensional digital imaging and communication in medicine imagery in three-dimensional extended reality applications
US11153555B1 (en) 2020-05-08 2021-10-19 Globus Medical Inc. Extended reality headset camera system for computer assisted navigation in surgery
US12070276B2 (en) 2020-06-09 2024-08-27 Globus Medical Inc. Surgical object tracking in visible light via fiducial seeding and synthetic image registration
US11317973B2 (en) 2020-06-09 2022-05-03 Globus Medical, Inc. Camera tracking bar for computer assisted navigation during surgery
US11382713B2 (en) 2020-06-16 2022-07-12 Globus Medical, Inc. Navigated surgical system with eye to XR headset display calibration
US11877807B2 (en) 2020-07-10 2024-01-23 Globus Medical, Inc Instruments for navigated orthopedic surgeries
US11793588B2 (en) 2020-07-23 2023-10-24 Globus Medical, Inc. Sterile draping of robotic arms
US11737831B2 (en) 2020-09-02 2023-08-29 Globus Medical Inc. Surgical object tracking template generation for computer assisted navigation during surgical procedure
US11523785B2 (en) 2020-09-24 2022-12-13 Globus Medical, Inc. Increased cone beam computed tomography volume length without requiring stitching or longitudinal C-arm movement
US11911112B2 (en) 2020-10-27 2024-02-27 Globus Medical, Inc. Robotic navigational system
US12076091B2 (en) 2020-10-27 2024-09-03 Globus Medical, Inc. Robotic navigational system
US11941814B2 (en) 2020-11-04 2024-03-26 Globus Medical Inc. Auto segmentation using 2-D images taken during 3-D imaging spin
US11717350B2 (en) 2020-11-24 2023-08-08 Globus Medical Inc. Methods for robotic assistance and navigation in spinal surgery and related systems
US12161433B2 (en) 2021-01-08 2024-12-10 Globus Medical, Inc. System and method for ligament balancing with robotic assistance
US12150728B2 (en) 2021-04-14 2024-11-26 Globus Medical, Inc. End effector for a surgical robot
US12178523B2 (en) 2021-04-19 2024-12-31 Globus Medical, Inc. Computer assisted surgical navigation system for spine procedures
US11857273B2 (en) 2021-07-06 2024-01-02 Globus Medical, Inc. Ultrasonic robotic surgical navigation
US11439444B1 (en) 2021-07-22 2022-09-13 Globus Medical, Inc. Screw tower and rod reduction tool
US12201375B2 (en) 2021-09-16 2025-01-21 Globus Medical Inc. Extended reality systems for visualizing and controlling operating room equipment
US12184636B2 (en) 2021-10-04 2024-12-31 Globus Medical, Inc. Validating credential keys based on combinations of credential value strings and input order strings
US11911115B2 (en) 2021-12-20 2024-02-27 Globus Medical Inc. Flat panel registration fixture and method of using same
US12103480B2 (en) 2022-03-18 2024-10-01 Globus Medical Inc. Omni-wheel cable pusher
US12048493B2 (en) 2022-03-31 2024-07-30 Globus Medical, Inc. Camera tracking system identifying phantom markers during computer assisted surgery navigation
US12161427B2 (en) 2022-06-08 2024-12-10 Globus Medical, Inc. Surgical navigation system with flat panel registration fixture

Family Cites Families (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5662111A (en) * 1991-01-28 1997-09-02 Cosman; Eric R. Process of stereotactic optical navigation
US5868673A (en) * 1995-03-28 1999-02-09 Sonometrics Corporation System for carrying out surgery, biopsy and ablation of a tumor or other physical anomaly
US5853366A (en) * 1996-07-08 1998-12-29 Kelsey, Inc. Marker element for interstitial treatment and localizing device and method using same
EP1011424A1 (fr) 1997-03-03 2000-06-28 Schneider Medical Technologies, Inc. Dispositif et procede de formation d'images
US6175760B1 (en) * 1998-02-17 2001-01-16 University Of Iowa Research Foundation Lesion localizer for nuclear medicine
US6499488B1 (en) * 1999-10-28 2002-12-31 Winchester Development Associates Surgical sensor

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See references of WO0234152A1 *

Also Published As

Publication number Publication date
US7953470B2 (en) 2011-05-31
DE10194615D2 (de) 2003-10-02
AU2002215822A1 (en) 2002-05-06
US20040059216A1 (en) 2004-03-25
WO2002034152A1 (fr) 2002-05-02

Similar Documents

Publication Publication Date Title
WO2002034152A1 (fr) Procede, dispositif et auxiliaire de navigation pour interventions medicales
DE10136709B4 (de) Vorrichtung zum Durchführen von operativen Eingriffen sowie Verfahren zum Darstellen von Bildinformationen während eines solchen Eingriffs an einem Patienten
DE19914455B4 (de) Verfahren zur Bestimmung der Bewegung eines Organs oder Therapiegebiets eines Patienten sowie hierfür geeignetes System
DE102007045075B4 (de) Interventionelles medizinisches Diagnose- und/oder Therapiesystem
DE69922980T2 (de) Verfahren und vorrichtung zur positionierung eines geräts in einem körper
DE69532829T2 (de) Vorrichtung zur benutzung mit einem chirurgischen navigationssystem
DE60028582T2 (de) Verfahren und vorrichtung zur erleichterung bildgesteuerter chirurgie
DE102007059599A1 (de) Vorrichtung für eine medizinische Intervention, medizinisches Instrument und Betriebsverfahren für eine Vorrichtung für eine medizinische Intervention
DE102005044033A1 (de) Positionierungssystem für perkutane Interventionen
EP2135575A1 (fr) Procédé d'alignement d'instruments à fréquence libre
DE102010020284A1 (de) Bestimmung von 3D-Positionen und -Orientierungen von chirurgischen Objekten aus 2D-Röntgenbildern
DE19829224A1 (de) Verfahren zur Lokalisation von Behandlungszielen im Bereich weicher Körperteile
DE102007030137A1 (de) Führung für chirurgische Werkzeuge
DE102005037000A1 (de) Vorrichtung und Verfahren zur automatisierten Planung eines Zugangspfades für einen perkutanen, minimalinvasiven Eingriff
DE102013213727A1 (de) Interventionelles Bildgebungssystem
DE102010062340A1 (de) Verfahren zur Bildunterstützung der Navigation eines medizinischen Instruments und medizinische Untersuchungseinrichtung
DE19536180C2 (de) Verfahren und Vorrichtungen zur Lokalisierung eines Instruments
DE102011006537B4 (de) Verfahren zur Registrierung eines ersten Koordinatensystems einer ersten medizinischen Bildgebungseinrichtung mit einem zweiten Koordinatensystem einer zweiten medizinischen Bildgebungseinrichtung und/oder einem dritten Koordinatensystem eines medizinischen Instruments, welches durch Marker einer medizinischen Navigationseinrichtung definiert ist, und medizinisches Untersuchungs- und/oder Behandlungssystem
Adams et al. CAS—a navigation support for surgery
EP1464285B1 (fr) Recalage en perspective et visualisation des régions corporelles internes
DE102007008522A1 (de) Verfahren zum navigierten Bohren
DE102005024157A1 (de) Nadelpositioniersystem
DE202005014582U1 (de) Positionierungssystem für perkutane Interventionen
DE10137914B4 (de) Verfahren zur Ermittlung einer Koordinatentransformation für die Navigation eines Objekts
DE102006004703B4 (de) Verfahren und Anordnung zum Betreiben eines Positionierungsroboters

Legal Events

Date Code Title Description
PUAI Public reference made under article 153(3) epc to a published international application that has entered the european phase

Free format text: ORIGINAL CODE: 0009012

17P Request for examination filed

Effective date: 20030415

AK Designated contracting states

Designated state(s): AT BE CH CY DE DK ES FI FR GB GR IE IT LI LU MC NL PT SE TR

AX Request for extension of the european patent

Extension state: AL LT LV MK RO SI

RBV Designated contracting states (corrected)

Designated state(s): DE ES FR GB

STAA Information on the status of an ep patent application or granted ep patent

Free format text: STATUS: THE APPLICATION HAS BEEN REFUSED

18R Application refused

Effective date: 20060914