Surgery – Instruments – Stereotaxic device
Patent
1996-07-15
1998-05-19
Brown, Michael A.
Surgery
Instruments
Stereotaxic device
128857, A61B 1900
Patent
active
057529620
DESCRIPTION:
BRIEF SUMMARY
This invention is concerned with a method and apparatus for carrying out surgical procedures.
The invention is particularly concerned with the use of stereolithographic models constructed from tomographic data as a pre-operative aid in carrying out the surgical procedure and as a post-operative aid in monitoring a treated patient.
Modelling of anatomical regions using computed tomography data is well known for pre-operative planning and rehearsal of procedures and in the manufacture of prosthetic devices.
These modelling techniques employ digitised information from CAD-CAM design systems based on data captured and/or reconstructed from a variety of reflection and/or transmission scanning devices. Typically, such scanning device include X-Ray, magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), position emission tomography (PET) as well as ultrasonic imaging.
U.S. Pat. Nos. 4,436,684 and 4,976,737 describe the construction, by mechanical means of anatomical models from computed tomography data.
Of more recent times, stereolithographic modelling has gained prominence due to its ability to create highly accurate anatomical models replicating both internal and external features of a region under consideration. In particular, stereolithographically reproduced models have been used to permit pre-planning of surgical procedures and, in the case of plastic and reconstructive cranial surgery in particular, some degree of rehearsal of surgical procedures is possible.
Stereolithographic and other modelling processes are described in "Paediatric craniofacial surgery: Comparison of milling and stereolithography for 3D model manufacturing Pediatr. Radiol. (1992) 22: 458:460; "Computer-Aided Simulation, Analysis and Design in Orthopaedic Surgery", Orthopaedic Clinics of North America--Vol 17, No. 4, October 1986; and "Solid models for CT/MR image display: accuracy and utility in surgical planning", Vol 1444 Image Capture, Formatting and Display (1991): 2-8.
Generally speaking, stereolithographic modelling is employed mostly in the construction of models corresponding to bony tissue although with MRI tomography high resolution imaging of soft tissue has permitted reconstruction of three dimensional images of soft tissue organs for display on monitors. Such displays permit pre-operative planning and monitoring during surgical procedures such as biopsy sampling, radiotherapy implantation etc. A method of manufacturing stereolithographic models from computed tomography data is described in International Patent Application No. PCT/AU94/00536.
In many surgical procedures, particularly intracranial procedures, there is a need for precise location of soft tissue masses such as malignant lesions, tumours etc relative to other organs such as blood vessels and neural pathways to facilitate pre-operative planning to minimise the risk of accidental trauma to adjacent organs.
One technique for pre-operative planning employs a stereolithographic model of a cranial structure in combination with computed tomography data displayed on a viewing screen. This enables a surgeon to spatially visualise the three dimensional spatial juxtaposition of soft tissue masses within a cranial cavity and relative to structural features thereof.
While this technique is a significant improvement over the mental analysis of two dimensionally displayed reconstructions of three dimensional images, there remains an element of "guesswork" in mental spatial translation of two dimensional images to three dimensional space.
Another procedure involves the use of a stereotactic frame associated with a patients anatomy as a fixed reference datum in combination with computed tomography data to precisely spatially locate selected regions of soft tissue mass.
Stereotaxis procedures are described in "Guided Microsurgery by Computer-Assisted Three-Dimensional Analysis of Neuroanatomical Data Stereotactially Acquired", Stereotact. Funct. Neurosurg. 1990: 54455: 482-487; "Three-Dimensional Reconstruction of Neuroradiological Data within a Stereotactic Fr
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