Interactive system for local intervention inside a nonhumogeneou

Details Interactive system for local intervention inside a nonhumogeneou Interactive system for local intervention inside a nonhumogeneou

1992-06-22

1999-02-09

Casler, Brian

Surgery

Diagnostic testing

Detecting nuclear, electromagnetic, or ultrasonic radiation

606130, A61B 505

Patent

active

058686754

DESCRIPTION:

BRIEF SUMMARY
The invention relates to an interactive system for local intervention inside a region of a nonhomogeneous structure.
The performing of local interventions inside a nonhomogeneous structure, such as intracranial surgical operations or orthopedic surgery currently poses the problem of optimizing the intervention path or paths so as to secure, on the one hand, total intervention over the region or structure of interest, such as a tumor to be treated or explored and, on the other hand, minimal lesion to the regions neighboring or adjoining the region of interest, this entailing the localizing and then the selecting of the regions of the nonhomogeneous structure which are least sensitive to being traversed or the least susceptible to damage as regards the integrity of the structure.
Numerous works aimed at providing a solution to the abovementioned problem have hitherto been the subject of publications. Among the latter may be cited the article entitled "Three Dimensional Digitizer (Neuronavigator): New Equipment for computed Tomography Guided Stereotaxic Surgery", published by Eiju Watanabe, M.D., Takashi Watanabe, M.D., Shinya Manaka, M.D., Yoshiaki Mayanagi, M.D., and Kintomo Takakura, M.D. Department of Neurosurgery, Faculty of Medicine, University of Tokyo, Japan, in the journal Surgery Neurol. 1987: 27 pp. 543-547, by Elsevier Science Publishing Co., Inc. The Patent WO-A-88 09151 teaches a similar item of equipment.
In the abovementioned publications are described in particular a system and an operational mode on the basis of which a three-dimensional position marking system, of the probe type, makes it possible to mark the three-dimensional position coordinates of a nonhomogeneous structure, such as the head of a patient having to undergo a neurosurgical intervention, and then to put into correspondence as a function of the relative position of the nonhomoc.eneous structure a series of corresponding images consisting of two-dimensional images sectioned along an arbitrary direction, and obtained previously with the aid of a medical imaging method of the "scanner" type.
The system and the operational mode mentioned above offer a sure advantage for the intervening surgeon since the latter has available, during the intervention, apart from a direct view of the intervention, at least one two-dimensional sectional view enabling him to be aware, in the sectional plane, of the state of performance of the intervention.
However, and by virtue of the very design of the system and of the operational mode mentioned above, the latter allow neither a precise representation of the state of performance of the intervention, nor partially or totally automated conduct of the intervention in accordance with a program for advance of the instrument determined prior to the intervention.
Such a system and such an operational mode cannot therefore claim to eradicate all man-made risk, since the intervention is still conducted by the surgeon alone.
The objective of the present invention is to remedy the whole of the problem cited earlier, and in particular to propose a system permitting as exact as possible a correlation, at any instant, between an intervention modeling on the screen and the actual intervention, and furthermore the representation from one or more viewing angles, and if appropriate in one or more sectional planes, of the nonhomogeneous structure, the sectional plane or planes possibly being for example perpendicular to the direction of the path of advance of the instrument or of the intervention tool.
Another objective of the present invention is also the implementation of a system permitting simulation of an optimal trajectory of advance of the tool, so as to constitute an assisted or fully programed intervention.
Finally, an objective of the present invention is to propose a system making it possible, on the basis of the simulated trajectory and of the programed intervention, to steer the movement of the instrument or tool to the said trajectory so as to carry out the programed intervention.
The invention propose

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Roberts et al., "A Frameless Stereotoxic Integration of Computerized Tomographic Imaging and the Operating Microsc gsl", J. of Neuro. Surg. No. 65, 1986, pp. 545-549.

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