US20090088630A1 - Surgical navigation tracker, system and method - Google Patents
Surgical navigation tracker, system and method Download PDFInfo
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- US20090088630A1 US20090088630A1 US11/978,262 US97826208A US2009088630A1 US 20090088630 A1 US20090088630 A1 US 20090088630A1 US 97826208 A US97826208 A US 97826208A US 2009088630 A1 US2009088630 A1 US 2009088630A1
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- adapter
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- navigation
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- 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
- A61B2017/00477—Coupling
-
- 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
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/25—User interfaces for surgical systems
- A61B2034/256—User interfaces for surgical systems having a database of accessory information, e.g. including context sensitive help or scientific articles
-
- 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
- A61B34/25—User interfaces for surgical systems
Definitions
- This invention relates generally to a surgical navigation system. More particularly, this invention relates to a system, a tracking device, and an adapter to assist the surgical navigation system orient a surgical instrument or device relative to a body of a patient.
- FIG. 1A is a block diagram of the surgical navigation system of FIG. 1 ;
- FIG. 9 is a block diagram of a computer program embodying a further embodiment of the method of the present invention.
- FIG. 11 is an end elevational view similar to FIG. 5 of a further alternative embodiment of the adapter of the present invention.
- FIG. 15 is a bottom plan view of the adapter of FIG. 14 ;
- FIG. 19 is an end elevational view of the adapter similar to FIG. 4 showing the adapter relative to a surgical instrument having a square cross section;
- FIG. 23 is a bottom plan view of the adapter of FIG. 22 ;
- a spring loaded locking structure (not shown) that will allow the surface 224 to slide within the slit 238 until the locking structure reaches the locking detent 226 . At this time, the spring will bias the locking structure into the locking detent 226 and firmly hold the tracking device 118 in fixed relationship with the adapter 116 .
- a button 240 is pushed that will release the locking structure within the slit 238 and allow the tracking device to be removed from the adapter 116 .
- the surgical navigation system 100 can calculate the location of the instrument axis 312 relative to the tracker 118 .
- the surgical navigation system 100 will have the position and orientation of the apex 310 of the adapter 116 stored in the adapter database 428 relative to the position and orientation of the navigation tracker 118 that is attached to the adapter 116 .
- the surgical navigation system 100 will also have the value ⁇ 1 for the surgical instrument 312 stored in the instrument database. Using these values and the location and orientation of the navigation tracker 118 , the surgical navigation system 100 can calculate the effector axis of the instrument 312 in the block 432 .
- the adapter of the present invention may be made from any suitable material that is dimensionally stable and capable of being sterilized at least one time. Though it may be desirable that the interface be capable of being repeatedly sterilized, it is also possible that the adapters 116 of the present invention are designed as disposable single use items, which are sterilized upon manufacture, maintained in a sterile condition until use and then discarded. Suitable plastics, which are dimensionally stable and surgically acceptable, such as polyetheretherketone (PEEK), carbon or glass fiber reinforced PEEK, polysulfone, polycarbonate, nylon and mixtures thereof, can be used. In addition, suitable metals that are acceptable for use in surgery such as surgical stainless steel, titanium, tungsten carbide and other similar surgically suitable metals can be used. In one embodiment, the adapter 116 and the channel 218 will be constructed from materials having a hard surface to prevent wearing when the surgical instrument is moved along the surface of the channel 218 .
- PEEK polyetheretherketone
- suitable metals that are acceptable for use in surgery
- FIGS. 20 and 21 show a further embodiment of an adapter 500 .
- the adapter 500 has a body 502 with a connector 504 having a first end 506 attached to the body 502 and a second end 508 attached to a docking structure 510 .
- the docking structure 510 has a center lug 512 and two pins 514 that interfit with the navigation tracker 118 .
- the body 502 has a first side 516 , a second side 518 , a first end 520 , and a second end 522 .
- the second side 518 defines a geometrical feature 524 .
- the geometrical feature is a pair of arced surfaces 526 and 528 .
- FIG. 25 shows a further embodiment where each projection 620 and 622 have a U-shaped notch 640 .
- the adapter will be specially constructed to work with a particular device that has a slightly smaller radius than the radius of the bottom of the U-shaped notch 640 .
- FIG. 26 shows another embodiment where a connector 650 , similar to the connector 604 , projects from the body 602 90 degrees from the direction that the connector 604 projects from the body 602 . This alternative arrangement can allow added flexibility for the user to manipulate the surgical device 626 relative to the tracking device 118 .
- FIGS. 28 and 29 show a user manipulating a surgical device 800 relative to a further embodiment of an integral tracking device 802 .
- the user can place the surgical device 800 into each notch 804 to guide the surgical device to the proper location.
- the surgical device is not held firmly within the notches 804 , the user can manipulate the surgical device as needed as shown in FIG. 28 .
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- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Heart & Thoracic Surgery (AREA)
- Animal Behavior & Ethology (AREA)
- Veterinary Medicine (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Pathology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Robotics (AREA)
- Surgical Instruments (AREA)
- Manipulator (AREA)
Abstract
Description
- This application is a divisional of application Ser. No. 11/148,520, filed Jun. 9, 2005, which is a continuation-in-part of application Ser. No. 10/732,553, filed Dec. 10, 2003. Each of the preceding applications is incorporated by reference herein in its entirety.
- Not applicable
- Not applicable
- 1. Field of the Invention
- This invention relates generally to a surgical navigation system. More particularly, this invention relates to a system, a tracking device, and an adapter to assist the surgical navigation system orient a surgical instrument or device relative to a body of a patient.
- 2. Description of the Background of the Invention
- The use of image guided surgical navigation systems for assisting surgeons during surgery is quite common. Such systems are especially widely used during procedures requiring precise location of instruments such as neurosurgery and more recently orthopedic surgery. Typical surgical navigation systems utilize specially developed tools that include built in tracking devices or tool and adapter combinations that allow a tracking device to be affixed to a surgical tool. These tracking devices allow a surgeon to see the position and/or orientation of the surgical tool overlaid on a monitor in conjunction with a preoperative image or an intraoperative image of the patient. Preoperative images are typically prepared by MRI or CT scans, while intraoperative may be prepared by using a fluoroscope, low level x-ray or any similar device. The tracking devices typically use a plurality of optical emitters that can be detected by the navigation system to determine the position and orientation of the surgical instrument.
- One of the main challenges with present surgical navigation systems is the time required to properly apply and calibrate the tracking devices to work with conventional surgical instruments. Raab U.S. Pat. No. 5,251,127 teaches a computer aided surgery apparatus for positioning a surgical instrument that employs a computer driven instrumented linkage attached to a surgical instrument. Foley et al. U.S. Pat. No. 6,021,343 discloses a handheld surgical instrument with a tracking device that requires pre-dedicated and specially made surgical tool connections. Kienzle, III et al. U.S. Patent Application No. 2001/0036245 is directed towards a surgical tool with integrated localizing emitters for superimposing a representation of the tool over an image of a body in surgery.
- Dedicated adapters for surgical instruments are expensive and time consuming to develop. Additionally, most of these devices require calibration of the surgical instrument after the tracking device has been attached in order to determine the transformation between the tracking device and an axis of the instrument. Moctezuma de la Barrera et al. U.S. patent application Ser. No. 10/246,599 teaches a surgical instrument fixedly attached to a tracking device, wherein the calibration of the position and orientation of the surgical instrument is accomplished by a separate device. In addition, for orthopedic surgery, it is sometimes necessary to apply force to the surgical tool. This force can damage the precision tracking device, such as damaging the electronics, the LEDs, or disturbing the calibration of the tracking device, if the tracking device is firmly attached to the tool when the force is applied. The present device allows a surgeon to track the orientation of the effector axis or effector plane of a wide range of instruments without the need to either calibrate the tool tracker combination or fixedly attaching a tracking device to a surgical instrument. In addition, the devices of this invention can be used to place items in the body in precise locations. One example of devices that must be properly placed are shunts that are place in the brain to drain fluid.
- One embodiment of the present invention is directed towards an adapter to attach a navigation tracker to a surgical device. The adapter has a body and a connector having a first end attached to the body and a second end. An interface is attached to the second end to enable a navigation tracker to be attached to the adapter. The interface comprises a docking structure that releasably lacks the navigation tracker into a specified position with respect to the body. The body has geometrical features to enable a surgical device to be non-fixedly coupled to the body.
- Other aspects and advantages of the present invention will become apparent upon consideration of the following detailed description.
-
FIG. 1 is a schematic view of the surgical navigation system; -
FIG. 1A is a block diagram of the surgical navigation system ofFIG. 1 ; -
FIG. 2 is an isometric view of one embodiment of the adapter of the present invention; -
FIG. 3 is a side elevational view of the adapter ofFIG. 2 ; -
FIG. 4 is an end elevational view of the adapter ofFIG. 2 ; -
FIG. 5 is an end elevational view of the adapter ofFIG. 2 from the end oppositeFIG. 4 ; -
FIG. 6 is an isometric view of the surgical instrument being held by a hand in a non-fixed relationship with adapter ofFIG. 2 connected to a navigation tracker; -
FIG. 7 is an exploded view of the surgical instrument, adapter, and navigation tracker ofFIG. 4 ; -
FIG. 8 is a block diagram of a computer program embodying one embodiment of the method of the present invention; -
FIG. 9 is a block diagram of a computer program embodying a further embodiment of the method of the present invention; -
FIG. 10 is an end elevational view similar toFIG. 5 of an alternative embodiment of the adapter of the present invention; -
FIG. 11 is an end elevational view similar toFIG. 5 of a further alternative embodiment of the adapter of the present invention; -
FIG. 12 is an end elevational view similar toFIG. 5 of an additional alternative embodiment of the adapter of the present invention; -
FIG. 13 is an end elevational view similar toFIG. 5 of a still further alternative embodiment of the adapter of the present invention; -
FIG. 14 is an end elevational view similar toFIG. 5 of another further embodiment of the adapter of the present invention; -
FIG. 15 is a bottom plan view of the adapter ofFIG. 14 ; -
FIG. 16 is an isometric view of a surgical drill with the adapter ofFIG. 14 in place; -
FIG. 17 is an isometric view of a surgical saw with the adapter ofFIG. 14 in place; -
FIG. 18 is an end elevational view of the adapter similar toFIG. 4 showing the adapter relative to a surgical instrument having a circular cross section; -
FIG. 19 is an end elevational view of the adapter similar toFIG. 4 showing the adapter relative to a surgical instrument having a square cross section; -
FIG. 20 is an isometric view of a further embodiment of the adapter of the present invention; -
FIG. 21 is a side view of the adapter ofFIG. 20 with a tracker attached; -
FIG. 22 is a side elevational view of a further embodiment of an adapter device showing the relation with a surgical device; -
FIG. 23 is a bottom plan view of the adapter ofFIG. 22 ; -
FIG. 24 is an end elevational view of the adapter ofFIG. 22 ; -
FIG. 25 is a view similar toFIG. 24 of a further embodiment of the adapter; -
FIG. 26 is a view similar toFIG. 24 of another further embodiment of the adapter; -
FIG. 27 is a perspective view of one embodiment of a tracking device with integral projections; -
FIG. 28 is a detailed view of a further embodiment of a tracking device similar toFIG. 27 showing the placement of a surgical device in the grooves; and -
FIG. 29 is a detailed view of the device ofFIG. 28 showing the user manipulating the surgical device relative to the tracking device. - With reference to the drawings, the present invention is directed towards a
surgical navigation system 100 for orienting asurgical instrument 102.FIGS. 1 and 1A are a schematic view and block diagram of thesurgical navigation system 100 that includes adisplay unit 104, acomputer system 106 and acamera array 120. Thecomputer system 106 may be housed in amoveable cart 108. Thecomputer system 106 may be any type of personal computer having amemory unit 110, aCPU 112, and astorage unit 114. Thedisplay unit 104 can be any conventional display usable with a personal computer. - The
camera array 120 is adapted to track anavigation tracker 118. Thecamera array 120 is further adapted to transmit data between thenavigation tracker 118 andcomputer system 106 representing the orientation of thesurgical instrument 102. In a preferred embodiment, the data is transmitted wirelessly between thenavigation tracker 118 and thecomputer system 106. Alternatively, a system that uses wires to transmit data between thenavigation tracker 118 and thecomputer system 106 can be used. - With reference to
FIG. 1 , thecamera array 120 includes afirst camera 122, asecond camera 124, and athird camera 126. In a preferred embodiment, the first, second and third cameras, 122, 124, and 126, are three CCD cameras adapted to detect the position of infrared signals (IR) generated by thenavigation tracker 118. - The
camera array 120 should be mounted in a stationary position with a sufficient line of sight to the operating room. In one embodiment, thecamera array 120 is mounted on arotatable arm 128 attached to themovable cart 108. In another embodiment, thecamera array 120 may be mounted onto an operating room wall (not shown) or onto other convenient surfaces or locations. - At least one infrared transceiver is used to communicate data to and from the
navigation tracker 118. In the preferred embodiment, thesensor array 120 includes afirst transceiver 130 and asecond transceiver 132 located apart from each other. It should be noted that while both thenavigation tracker 118 and the transceivers, 130 and 132, may communicate via infrared signals, those skilled in the art will realize other wireless technologies such as radio frequency signals may be used as well as hardwired systems, so called electromagnetic communication. - The
camera array 120 is connected via acable 134 to alocalizer 136 or in some instances directly to the computer. Thelocalizer 136 cooperates with thecamera array 120 to identify the location of a plurality of LED's 138 on thenavigation tracker 118 within the line of sight of thesensor array 120. The first, second, and third cameras, 122, 124, and 126, contain their own orientation data and transmit that data and the orientation data from the plurality of LED's 138 to thelocalizer 136. In one embodiment, thelocalizer 136 converts the raw orientation data into the orientation of individual LED's of the plurality of LED's 138 and transmits this information to thecomputer system 106. In another embodiment, thelocalizer 136 converts the raw data into the orientation of thesurgical instrument 102 and transmits this information to thecomputer system 106. In a further embodiment, a software program in thecomputer system 106 can convert the raw data into the orientation of thesurgical instrument 102. In all embodiments, the conversion of the raw data is well known to one skilled in the art and need not be further discussed. Thecomputer system 106 may be controlled remotely by control buttons (not visible) located on thenavigation tracker 118. Thecomputer system 106 also includes akeyboard 140 and apointing device 142, such as a mouse or any alternative input means for operating thecomputer system 106. Thesurgical navigation system 100 is used by asurgeon 144 during a procedure on apatient 146. Preferably, thepatient 146 is located on a surgical bed or a table 148. - The preferred embodiment of the present invention includes a
surgical instrument 102 non-fixedly coupled to anadapter 116. Theadapter 116 is, however, coupled to anavigation tracker 118 that is in communication with thesensor array 120 andtransceivers - While the present invention is described using an active optical surgical navigation system, the system, method and adapters of the present invention can also be used with other surgical navigation technologies and systems, such as passive optical systems, magnetic based systems, inertial navigation based systems, combination systems, and the like.
-
FIGS. 2 to 5 show one embodiment of the present invention. Theadapter 116 includes abody 200, aconnector 202 having afirst end 204 attached to thebody 200 and asecond end 206 attached to adocking structure 208. Thebody 200 has afirst side 210, asecond side 212, afirst end 214, and asecond end 216. Thesecond side 212 defines ageometrical feature 242. In the case shown inFIGS. 2 to 5 , thegeometrical feature 242 is achannel 218 extending along the entire length of thesecond side 212. Thegeometrical feature 242 of theadapter 116 will define anadapter axis 244. Knowledge of the location of theadapter axis 244 relative to the location of thenavigation tracker 118 will be useful for those situations where only the angle of the instrument needs to be tracked by the surgical navigation system. Thedocking structure 208 has a firstbeveled side 220, a secondbeveled side 222 and asurface 224 that has alocking detent 226. Thedocking structure 208 engages cooperating structure on thenavigation tracker 118 as discussed hereinafter. -
FIGS. 6 and 7 show the embodiment ofFIG. 2 in an in-use situation on thesurgical instrument 102 with atracking device 118. Thetracking device 118 is a known device and has abody 228. Mounted in fixed positions on thebody 228 are theLEDs 138. Also depending from thebody 228 is a mountingbracket 230 having adistal end 232. Thedistal end 232 is attached to a pair ofwalls walls slit 238 that will slide over the first and secondbeveled sides slit 238 will mate in a precision mating arrangement with thedocking structure 208. In the interior of theslit 238 is a spring loaded locking structure (not shown) that will allow thesurface 224 to slide within theslit 238 until the locking structure reaches thelocking detent 226. At this time, the spring will bias the locking structure into thelocking detent 226 and firmly hold thetracking device 118 in fixed relationship with theadapter 116. To remove thetracking device 118 from the adapter, abutton 240 is pushed that will release the locking structure within theslit 238 and allow the tracking device to be removed from theadapter 116. - The
surgical instrument 102 has ahandle 250, ashaft 252, anadapter tip 254 to hold various devices in position, aninstrument axis 256 and astriking surface 258. Theparticular instrument 102 shown inFIGS. 1 , 6 and 7 is an impactor used to insert implants attached to theadapter tip 254 during orthopedic surgery. Because theinstrument 102 will be struck with a hammer or other impacting device on the impactingsurface 258, it is desirable to navigate theinstrument 102 into proper position and then remove the delicate tracking device before theinstrument 102 is struck.FIG. 6 shows a surgeon'shand 270 holding theadapter 116 in a non-fixed coupling with theinstrument 102. When the term non-fixed coupling is used in this specification and in the attached claims, it means theadapter 116 is held in a reproducible relation to a surgical tool, such asinstrument 102, but is easily removable when the holding force is removed from the adapter. This term includes the situation where theadapter 116 is held in proximity to theinstrument 102 by a user's hand and will fall away from theinstrument 102 if the hand pressure is removed. Because theshaft 252 has a surface that is co-axial with theinstrument axis 256, theadapter 116 can be moved along theshaft 252 and the relation between thetracker 118 and theinstrument axis 256 remains the same. -
FIG. 8 is a block diagram of a computer program embodying the method of the present invention. The program begins at ablock 400 that determines if thenavigation tracker 118 has been activated. If thenavigation tracker 118 is not active, the program branches to ablock 402, which displays a message to prompt a user to activate thenavigation tracker 118. The program returns to theblock 400 and waits until thesurgical navigation system 100 receives a signal that thenavigation tracker 118 is active. When thesurgical navigation system 100 determines that thenavigation tracker 118 is active, the control passes to ablock 404 that displays a message that thenavigation tracker 118 is active and control then passes to ablock 406 that determines if the user needs to identify the effector axis of the surgical instrument. If the user responds “yes”, then control passes to ablock 408 that calibrates the particular instrument-adapter-tracker combination. Theblock 408 instructs the user to rotate the tool-adapter-tracker combination about the effector axis. Theblock 408 will determine the location of thetracker 118 as the combination is rotated and will calculate the relation between thetracker 118 and the effector axis. In a similar manner, theblock 408 can instruct a user to invert a tool-adapter-tracker combination where the tool has an effector plane. In this case, the plane of the tool is first placed on a fixed location and the location of the tracker is determined. The tool is then inverted and the plane of the tool is placed at the same location. The location effector plane of the tool relative to the tracker is the distance between the first and second locations of the tracker. Control then passes to ablock 410 that records the relation between thetracker 118 and the effector axis or effector plane in thememory unit 110 and displays the effector axis or plane on thedisplay unit 104. If the user responds “no” inblock 406, control passes to ablock 412 that records the axis of theadapter 116 inmemory unit 110 and displays the adapter axis on thedisplay unit 104. These methods of quickly calibrating the tool-adapter-tracker combination in theblock 408 are acceptable for applications requiring knowledge only of the location or the effector axis or the effector plane and the knowledge of the location of the tip or working surface of the tool is not required. In situations where only the relevant angle of the tool is required, there is no need to calibrate the adaptor and tracker to the effector axis of the instrument because the effector axis of the instrument will be parallel to the axis of theadapter 116. -
FIG. 9 is a block diagram of another computer program embodying the method of the present invention. This embodiment uses a series of databases that have been previously created relative to the potential tools, adapters and trackers that might be used with thesurgical navigation system 100. The program begins at ablock 420 that determines if thenavigation tracker 118 has been activated. If thenavigation tracker 118 is not active, the program branches to ablock 422, which displays a message to prompt a user to activate thenavigation tracker 118. The program returns to theblock 420 and waits until thesurgical navigation system 100 receives a signal that thenavigation tracker 118 is active. When thesurgical navigation system 100 determines that thenavigation tracker 118 is active, the control passes to ablock 424 that displays a message that thenavigation tracker 118 is active and control then passes to ablock 432 that calculates the orientation of the effector axis. Thissurgical navigation system 100 determines the location and orientation of thenavigation tracker 118 and theblock 426 stores this data in thememory unit 110. - It is envisioned that there will be a number of different configurations of the
adapter 116. As such, the distance between thenavigation tracker 118 and the effector axis of a particular surgical instrument may vary depending on the type ofadapter 116 used, and the type of instrument used. Each type ofadapter 116 can be encoded with a specific identifier that can be entered into thesurgical navigation system 100 and similarly thesurgical navigation system 100 can prompt the entry of coding information for particular tools that are used. Alternatively, these tools or instruments may also be able to directly communicate with thesurgical navigation system 100 and self identify the tool and/or the adapter. Ablock 428 is a database of stored dimensions for a number of adapters. The same may be done for each possible surgical instrument that can be used with thesurgical navigation system 100. Ablock 430 is a database of stored dimensions for various surgical instruments and their corresponding effector axes. Thesurgical navigation system 100 also will allow a user to manually input data for an adapter or a tool that is not found within the respective database. It is desirable, but not necessary, that thenavigation tracker 116 be a smart instrument that can relate its own configuration data to the surgical navigation system when thenavigation tracker 118 is activated by thesurgical navigation system 100. Once thesurgical navigation system 100 knows the identity of theparticular adapter 116 and thesurgical instrument 102, the correspondingdatabases navigation tracker 118 is activated. Thesurgical navigation system 100 identifies the dimensions of thenavigation tracker 118 in a conventional manner. - The program then proceeds to calculate the orientation of the effector axis of the
surgical instrument 102 from the stored data of thenavigation tracker 118 inblock 426 and the stored data obtained from theblocks block 432 calculates the orientation in a conventional fashion using algorithms that are well known and recognized by those skilled in the art. Ablock 434 stores the orientation data in thememory unit 110, and displays the orientation information on thedisplay 104 for use by theoperator 144. Combinations of the uses of databases for various components and the kinematic approach shown inFIG. 8 can also be used. -
FIGS. 10 , 11, 12, and 13 are alternative shapes of thegeometrical feature 242 inFIG. 2 for theadapter 116. Thefeature 242 a inFIG. 10 is circular, while thefeature 242 b inFIG. 11 is elliptical. InFIG. 12 , thesecond side 212 of theadapter 116 has awall 300 that is generally perpendicular to asurface 302 that extends from thewall 300 to aperiphery 304 of thebody 200. Thewall 300 and thesurface 302 form an “L” shapedgeometrical feature 242 c. Theadapter 116 a as shown inFIG. 12 is adapted to be used with surgical tools or instruments having a rectangular cross section and the open end of thesurface 302 enables theadapter 116 a as shown inFIG. 12 to be used with a wider variety of tools than if theadapter 116 a had a rectangular channel. The primary difference between this embodiment and the others previously mentioned is that in addition to an upward force exerted against thesurgical instrument 102 to hold thesurgical instrument 102 against thesurface 302 of thegeometrical feature 242 c, a lateral force is also applied to hold thesurgical instrument 102 against thewall 300 of thegeometrical feature 242 c. For instance, theadapter 116 a could be used with an instrument or tool that had a handle or shaft wider than the width of theadapter 116 a.FIG. 13 shows anadapter 116 b that has multiplegeometric features adapter 116 b to be used with different tools without having to remove the navigation tracker from theadapter 116 b. -
FIGS. 14 and 15 show a further embodiment of thegeometrical feature 242. Anadapter 116 c has abottom surface 112 a and three dependinglugs 312. The number of depending lugs is not particularly critical and any number more than 2 can be used. For instance, two longer lugs can be sufficient to hold the adapter in position on theinstrument 102, or four or more smaller lugs can be used to the same effect. -
FIGS. 16 and 17 illustrate the use of theadapter 116 c in conjunction with asurgical drill 330 and asurgical saw 360. Thesurgical drill 330 has adrill bit 332 with aneffector axis 334. As indicated inFIG. 14 , theadapter 116 c, shown without the attached navigation tracker for clarity, is held against atop surface 338 of thesurgical drill 330. So long as thetop surface 338 is co-linear with theeffector axis 334, the adapter can be moved along thetop surface 338 without affecting the relationship between theeffector axis 334 and theadapter 116 c. This tool-adapter-tracker combination can be calibrated using the method shown inFIG. 8 or a database can have sufficient information to perform the calibration without kinematic analysis of theeffector axis 334. In a similar manner, asaw blade 362 has aneffector plane 364. Anadapter 116 c is placed on atop surface 366 of thesurgical saw 360. Using the method outlined inFIG. 8 above the relation of theeffector plane 364 to theadapter 116 c can be determined and calibrated. It is also possible to use the database method ofFIG. 9 to calibrate theadapter 116 c with attached tracker to theeffector plane 364. - Referring to
FIGS. 18 and 19 , theadapter 116 is shown associated with surgical instruments of two different cross sections relative to an apex 310 of thechannel 218.FIG. 18 shows asurgical instrument 312 that has a circular cross section. Thesurgical instrument 312 has aninstrument axis 314. Thesurgical instrument 312 contacts thechannel 218 at twopoints 316 that are equidistant from thechannel apex 310. Thesurgical instrument 312 has aradius 318 and theinstrument axis 314 is a distance Δ1 from thechannel apex 310. So long as theradius 318 is constant along the length of thesurgical instrument 312 and thesurgical instrument 312 is straight, theadapter 116 can be moved along the length of thesurgical instrument 312 and the relation between theinstrument axis 314 and thetracker 118 will remain constant. Theadapter 116 and attached tracker are rotated around the instrument axis. The location of theinstrument axis 314 will remain fixed but the location of the tracker will change. The distance between theinstrument axis 314 and the tracker will remain constant. Alternatively, theinstrument 312, theadapter 116 and the attached tracker can also be rotated as a unit. Either method provides the basis for the rotation calibration method described above relative toFIG. 8 . The following is an example of how the database method ofFIG. 9 can calculate the location of theinstrument axis 312 relative to thetracker 118. Thesurgical navigation system 100 will have the position and orientation of the apex 310 of theadapter 116 stored in theadapter database 428 relative to the position and orientation of thenavigation tracker 118 that is attached to theadapter 116. Similarly, thesurgical navigation system 100 will also have the value Δ1 for thesurgical instrument 312 stored in the instrument database. Using these values and the location and orientation of thenavigation tracker 118, thesurgical navigation system 100 can calculate the effector axis of theinstrument 312 in theblock 432. - In a similar manner, a
surgical instrument 312 a as shown inFIG. 19 has a square or rectangular cross section that fits snugly against the apex 310. Since there can be no relative movement between theinstrument 312 a and the V shapedchannel 218, the entire combination of the instrument, the adapter and the tracker are rotated around theinstrument axis 314 a to perform the calibration as described above relative toFIG. 8 . With regard to the database method ofFIG. 9 , theinstrument 312 a has a known square cross section as shown by the distance Δ2 from aninstrument axis 314 a to the apex 310 and is stored in theinstrument database 430 as noted above. If the cross section of the instrument is not square theinstrument database 430 may include other parameters to enable thesurgical navigation system 100 to determine the effector axis or plane. One advantage of using a V shapedchannel 218 along with asurgical instrument 312 a having a square or rectangular cross section is that there is no relative rotation between theadapter 116 and thesurgical instrument 312 a. - The adapter of the present invention may be made from any suitable material that is dimensionally stable and capable of being sterilized at least one time. Though it may be desirable that the interface be capable of being repeatedly sterilized, it is also possible that the
adapters 116 of the present invention are designed as disposable single use items, which are sterilized upon manufacture, maintained in a sterile condition until use and then discarded. Suitable plastics, which are dimensionally stable and surgically acceptable, such as polyetheretherketone (PEEK), carbon or glass fiber reinforced PEEK, polysulfone, polycarbonate, nylon and mixtures thereof, can be used. In addition, suitable metals that are acceptable for use in surgery such as surgical stainless steel, titanium, tungsten carbide and other similar surgically suitable metals can be used. In one embodiment, theadapter 116 and thechannel 218 will be constructed from materials having a hard surface to prevent wearing when the surgical instrument is moved along the surface of thechannel 218. -
FIGS. 20 and 21 show a further embodiment of anadapter 500. Theadapter 500 has abody 502 with aconnector 504 having afirst end 506 attached to thebody 502 and asecond end 508 attached to adocking structure 510. Thedocking structure 510 has acenter lug 512 and twopins 514 that interfit with thenavigation tracker 118. Thebody 502 has afirst side 516, asecond side 518, afirst end 520, and asecond end 522. Thesecond side 518 defines a geometrical feature 524. In this case, the geometrical feature is a pair of arcedsurfaces opening 530 between thearced surfaces adapter 500. The arced surfaces 526 and 528 will fit against tools that have a circular cross section. Thebody 502 also has a series ofcutouts 532 that will further reduce the weight of the adapter and may assist the user in grasping theadapter 500. - Referring to
FIGS. 22-24 , a further embodiment of the devices and system of the present inventions is shown. In this embodiment anadapter 600 has abody 602 and aconnector 604. Theconnector 604 has afirst end 606 and asecond end 608 that is connected to adocking structure 610. The docking structure is similar to those discussed above and is capable of interfitting with a navigation tracker, such as thenavigation tracker 118. Thebody 602 has afirst side 612, asecond side 614, afirst end 616, and asecond end 618. Twoprojections second side 614. In this embodiment, thesecond side 614 is on aplane 623. Each of theprojections notch surgical device 626. Thesurgical device 626 can be any of the surgical instruments or devices that have been discussed previously. In addition, thesurgical device 626 can be an object to be placed within the patient's body, such as a shunt or stint. In one embodiment, the depth of thenotches surgical device 626 on an angle relative to thesecond side 614 such that aneffector axis 627 of thesurgical device 626 will intersect theplane 623 approximately 70 mm from thefirst end 616. Thenotches sloping walls 628 that meet at an apex 630. The V-shapednotches surgical devices 626. Thesurgical device 626 will rest within thenotches respective walls 628. Thewalls 628 for each ofnotches notches projections surgical devices 626, the database will know the relative distance from the effector axis of the particularsurgical device 626 to thetracking device 118 and the angle of theeffector axis 627 relative to thetracking device 118. The distance from thesecond side 614 to the apex 630 of thenotch 624, Δ3, should be large enough so that a user can get their hand between thesecond side 614 and thesurgical device 626 to manipulate thesurgical device 626, if needed. -
FIG. 25 shows a further embodiment where eachprojection U-shaped notch 640. In this embodiment, the adapter will be specially constructed to work with a particular device that has a slightly smaller radius than the radius of the bottom of theU-shaped notch 640.FIG. 26 shows another embodiment where aconnector 650, similar to theconnector 604, projects from thebody 602 90 degrees from the direction that theconnector 604 projects from thebody 602. This alternative arrangement can allow added flexibility for the user to manipulate thesurgical device 626 relative to thetracking device 118. -
FIG. 27 shows a further embodiment where atracking device 700 hasintegral projections projections tracking device 700 and both are space apart and extend to the side of the tracking device 700 a sufficient distance to allow a user to place their hand within the space between the twoprojections projections U-shaped notches 708 to receive asurgical device 710, such as the shunt as shown inFIG. 27 . Thetracking device 700 hasintegral LEDs 712 that are similar to those described above. In addition, thetracking device 700 also has threeswitches 714 that are useful to control the surgical navigation system. -
FIGS. 28 and 29 show a user manipulating asurgical device 800 relative to a further embodiment of anintegral tracking device 802. The user can place thesurgical device 800 into eachnotch 804 to guide the surgical device to the proper location. In addition, because the surgical device is not held firmly within thenotches 804, the user can manipulate the surgical device as needed as shown inFIG. 28 . - Numerous modifications to the present invention will be apparent to those skilled in the art in view of the foregoing description. Accordingly, this description is to be construed as illustrative only and is presented for the purpose of enabling those skilled in the art to make and use the invention and to teach the best mode of carrying out same. The exclusive rights to all modifications that come within the scope of the appended claims are reserved.
Claims (15)
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US7771436B2 (en) | 2010-08-10 |
DE102006026913A1 (en) | 2007-04-12 |
US20050288575A1 (en) | 2005-12-29 |
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