Surgery – Endoscope – With means for indicating position – depth or condition of...
Patent
1995-01-31
1998-01-06
Reichard, Lynne A.
Surgery
Endoscope
With means for indicating position, depth or condition of...
1286531, 128922, A61B 104
Patent
active
057048975
DESCRIPTION:
BRIEF SUMMARY
BACKGROUND
1. Field of the Invention
The invention relates to a method for representing the interior of bodies with the following steps:
Providing an optical imaging system consisting of a camera and a monitor;
allocation of a spatial data field to the body disposed in a certain position;
continuous detection of the spatial position of the camera;
continued calculation of a representation of the data field which corresponds to the current angle of view of the camera;
simultaneous or alternative representation of the optical image and the data field on the monitor.
2. The Background Art
Endoscopes are used with increasing frequency in operations so as to reduce the stress for the patients. During this process the endoscopic image is represented on a video monitor. This means a substantial change in operating technique for the doctor.
In common operations the operating field is freely accessible to the eye, and there is a natural coordination of the hand movements. This is no longer the case in operations by means of an endoscope. There is no connection between the orientation of the endoscope and the direction of view of the user, i.e., the operating surgeon. As a result of this the movement of surgical instruments relative to the endoscope becomes dependent on the surgeon's faculty of three-dimensional visualization. The second disadvantage is the lack of spatial feeling, as usually only one endoscopic lens is used. For each operation it is generally necessary to have knowledge of organ and tumor borders and the anatomical situation. An overview over the operating field facilitates orientation.
The third aspect is planning the operation. In a freely accessible operating field there is a clear sequence of operating steps. The surgical instruments can be used intuitively. The operation by means of endoscopes places higher requirements. Even the positioning of the surgical instruments relative to the operating field requires planning.
In the field of stereotactic surgery there are methods which can be used in principle for endoscopical surgery too.
From DE-A 37 17 871 it is known to mix in data such as computer tomography (CT) representations into the operating microscope in order to obtain help in the navigation of surgical instruments. The represented CT-layers correspond to the plane to which the microscope is focussed. During a movement of the instrument the respective layers are displayed dynamically on the computer screen. The surgeon is to be supported in this way in the positioning of an instrument relative to an anatomical structure. In order to bring the microscopic image with the CT-representation into alignment, it is necessary that certain points which are marked by means of a laser beam are aimed at with the microscope and that thereafter the microscope is focused therethrough.
U.S. Pat. No. 4,722,056 describes a method in which a tomography image is overlapped with the focal plane of an operating microscope. The representation of a CT-layer is adjusted to the optical representation.
DE-A 41 34 481 relates to a microscope for stereotactic microsurgery. A laser locating system is used for determining the position of the microscope relative to the patient. The function is similar to that of the microscope which is described in U.S. Pat. No. 4,722,056.
In EP-A 488 987 of the applicant a method is described for overlapping data and optical representations. With this method it is possible, for example, to mix in axes of extremities into an optical representation in realtime.
In the field of endoscopic surgery complete CT-series of findings are rarely available. Moreover, the spatial reproduceability of the position of anatomical structures is limited primarily to the skull. In the abdominal region the intraoperative condition is not deduceable from a preoperative CT without any special measures. Furthermore, computer tomography is a relatively complex method which is not always readily available or cannot be used.
These known methods assume that the position of the patient prior to the operation can
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Leubecker John P.
Reichard Lynne A.
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