The present disclosure generally relates to minimally invasive procedures requiring an interventional tool to be inserted into a patient along a defined tool trajectory through at a specific incision point, particularly minimally invasive neurosurgical procedures (e.g. a biopsy). The present disclosure more particularly relates a registration of remote center-of-motion (“RCM”) by a remote center-of-motion robot to planned incision point into the patient for accurately positioning and orienting the interventional tool along a planned tool trajectory.
Image guided brain biopsy allows surgeons to accurately target deep seated brain lesions in a minimally invasive manner. Specifically, the patient's head is immobilized and registered to a pre-operative imaging scan (e.g., CT, MRI, US, etc.) using a tracking and localization system (e.g., optical, electromagnetic, mechanical or combination thereof). Typically, such registration is performed using markers placed on the skull of the patient and/or tracked manual pointers. Based on the known position as illustrated within the pre-operative imaging scan of the brain lesion with respect to the tracking system, an appropriate location of an incision point into the patient is identified by the surgeon for the biopsy. The surgeon then manually aligns the insertion angles of the tracked biopsy needle based on feedback from the image guided tracking system. As the needle is inserted by the surgeon, the image guidance tracking system confirms the needle trajectory and identifies when the correct insertion depth has been reached. To this ends, image guidance systems as known in the art may provide a mechanical needle guide which the surgeon aligns to the planned tool trajectory prior to needle insertion.
Even when using such image guidance, and assuming an accurate registration of the pre-operative imaging scan to the tracking system has been achieved, surgeons must perform a five-degree (5°) of freedom alignment in free space. Thus, user error in registration and/or needle alignment can lead to incorrect incision locations, and/or the interventional tool missing the target brain lesion inside the patient's head.
The present disclosure provides inventions using a robot mounted optical end-effector (e.g., laser pointer or an endoscope) for registering a remote center-of-motion (“RCM”) robot to an image of the patient during a minimally invasive procedure (e.g., a minimally invasive neurosurgical procedure). By registering the image of the patient to the RCM robot, an exact position and orientation of a planned tool trajectory for performing the procedure is automatically defined in an accurate manner. This in turn allows for the surgeon to deploy the interventional tool in a precise, controlled manner with minimal risk of human error.
One form of the inventions of the present disclosure is a robotic surgical system for a minimally invasive procedure involving a planned tool trajectory through a planned incision point into a patient.
The robotic surgical system employs an optical end-effector (e.g., a laser point or an endoscope) and a RCM robot for rotating the optical end-effector about a remote center-of-motion defined by a structural configuration of the RCM robot.
The robotic surgical system further employs a robot controller for controlling an optical pointing by the RCM robot of the optical end-effector to one or more markers attached to the patient, and for controlling an axial alignment by the RCE robot of the optical end-effector to the planned tool trajectory as illustrated within a volume image of the patient based on a registration of the remote center-of-motion to the planned incision point as illustrated within the volume image of the patient derived from an optical pointing by the RCM robot of the optical end-effector to the registration marker(s) attached to the patient.
A second form of the inventions of the present disclosure is a robotic surgical method for a minimally invasive procedure involving a planned tool trajectory through a planned incision point into a patient.
The robotic surgical method involves a RCM robot optically pointing an optical end-effector to one or more markers attached to the patient, and a registration module deriving a registration of a remote center-of-motion to the planned incision point as illustrated within a volume image of the patient from the optical pointing by the RCM robot to the optical end-effector to the marker(s) attached to the patient,
The remote center-of-motion is defined by a structural configuration of the RCM robot.
The robotic surgical method further involves the RCM robot axially aligning the optical end-effector to the planned tool trajectory as illustrated within the volume image of the patient based on the registration by the registration module of the remote center-of-motion to the planned incision point as illustrated within the volume image of the patient.
For purposes of the inventions of the present disclosure, terms of the art including, but not limited to, “planned tool trajectory”, “planned incision point”, “end-effector”, “remote center-of-motion”, “robot”, “marker” and “volume image”, are to be interpreted as understood in the art of the present disclosure and as exemplarily described herein.
More particularly, for purposes of the inventions of the present disclosure, the term “optical end-effector” broadly encompasses any device serving as an end-effector of a robot and having optical capabilities for emitting and/or receiving any form of radiation, and the term “RCM robot” broadly encompasses any robot having a structural configuration defining a remote center-of-motion whereby the robot or a portion thereof is rotatable about a point spatially fixed from the robot. Examples of an optical end-effector include, but are not limited to, any type of laser pointer and endoscope as known in the art and exemplarily described herein, and an example of a RCM robot includes, but is not limited to, any type of concentric arc robot as known in the art and exemplarily described herein.
For purposes of the inventions of the present disclosure, the term “controller” broadly encompasses all structural configurations of an application specific main board or an application specific integrated circuit housed within or linked to a workstation for controlling an application of various inventive principles of the present disclosure as subsequently described herein. The structural configuration of the controller may include, but is not limited to, processor(s), computer-usable/computer readable storage medium(s), an operating system, application module(s), peripheral device controller(s), slot(s) and port(s).
Examples of the workstation include, but are not limited to, an assembly of one or more computing devices (e.g., a client computer, a desktop and a tablet), a display/monitor, and one or more input devices (e.g., a keyboard, joysticks and mouse).
For purposes of the inventions of the present disclosure, the term “application module” broadly encompasses a component of the controller consisting of an electronic circuit and/or an executable program (e.g., executable software and/firmware) for executing a specific application.
For purposes of the inventions of the present disclosure, descriptive labeling of the a controller herein as a “robot” controller and an “imaging” controller serves to identify a particular controller as described and claimed herein without specifying or implying any additional limitation to the term “controller”.
Similarly, for purposes of the inventions of the present disclosure, descriptive labeling of an application module herein as a “servo control” module and a “registration control” module serves to identify a particular application module as described and claimed herein without specifying or implying any additional limitation to the term “application module”.
The foregoing forms and other forms of the present disclosure as well as various features and advantages of the present disclosure will become further apparent from the following detailed description of various embodiments of the present disclosure read in conjunction with the accompanying drawings. The detailed description and drawings are merely illustrative of the present disclosure rather than limiting, the scope of the present disclosure being defined by the appended claims and equivalents thereof.
To facilitate an understanding of the present disclosure, the following description of
Referring to
Still referring to
For purposes of the inventions of the present disclosure, the term “robot platform” broadly encompasses any platform structurally configured for moving a RCM robot of the present disclosure within a Cartersian coordinate system whereby a remote center-of-motion of may be moved to a desired point within the Cartesian coordinate system.
For the embodiment of
In practice, robot platform 30 may be passive in terms of a manual manipulation of post 32 and/or robot holding arm 34, or active in terms of a motorized post 32 and/or a motorized joint 33 controlled by robot controller 60a for commanding command a translation, a pivot and/or an extension of base 31 and/or robot holding arm 34 via communication path 63a. For both passive and active embodiments of robot platform 30, post 32 and/or joint 33 may include encoders (not shown) for generating encoded signals informative of a pose of post 32 relative to base 31 and/or of a pose of robot holding arm 34 within the Cartesian coordinate system whereby robot controller 60a may track post 32 and/or robot holding arm 34.
Concentric arc robot 40 employs a pitch arc 42 mechanically coupled to a pitch actuator 41, and mechanically coupled to or physically integrated with a yaw actuator 43. concentric arc robot 40 further includes a yaw arc 44 mechanically coupled to yaw actuator 43, and mechanically coupled to or physically integrated with an end-effector holder 45.
Pitch actuator 41 includes an encoded motor (not shown) controllable by robot controller 60a via communication path 63a for selectively actuating pitch actuator 41 to simultaneously revolve pitch arc 42, yaw actuator 43, yaw arc 44, end-effector holder 45 and laser pointer 50 about a pitch axis PA of pitch actuator 41 as symbolized by the bidirectional arrow encircling pitch axis PA.
Yaw actuator 43 includes an encoded motor (not shown) controllable by robot controller 60a via communication path 63a for selectively actuating yaw actuator 43 to thereby revolve yaw actuator 43, yaw arc 44, end-effector holder 45 and laser pointer 50 about a yaw axis YA of yaw actuator 41 as symbolized by the directional arrow encircling yaw axis YA.
End-effector holder 45 is structurally configured as known in the art to hold laser pointer 50 whereby a laser beam LB emitted by laser pointer 50a is aligned with a longitudinal axis of end-effector holder 45.
As known in the art, a relative orientation of pitch actuator 41, yaw actuator 43 and end-effector holder 45 defines a remote center-of-motion RCM as an intersection of pitch axis PA, yaw axis YA and the end-effector axis (represented by laser beam LB). Based on encoded signals generated by active embodiments of robot platform 30, robot controller 60a executes a servo module 61a as known in the art for strategically positioning remote center-of-motion RCM relative to the head of patient 10. Based on encoded signals generated by pitch actuator 41 and yaw actuator 43, robot controller 60a executes servo module 61a as known in the art for tactically orienting laser pointer 50 relative to the markers attached to the head of the patient 10.
Generally in operation, the registration phase of the minimally invasive biopsy involves robot controller 60a executes a registration module 62a for registering remote center-of-motion RCM to the location of the incision point within volume image 21 of the head of patient 10 whereby laser beam LA is aligned with the tool trajectory TT planned during the imaging phase. A more detailed description of registration module 62a will be provided with the description of
Still referring to
To facilitate a further understanding of registration module 62a, the following is a description of an imaging phase and registration phase of an exemplary robotic image guidance method of the present disclosure as shown in
Referring to
For example,
Referring back to
Still referring to
Subsequent a completion of stage S88, a stage S90 of flowchart 80 encompasses the surgeon interfacing with servo module 61a for sequentially centering laser beam LB of laser pointer 50 on each marker whereby a stage S108 of flowchart 100 encompasses servo module 61a or registration module 62a recording an encoded position of pitch actuator 41 and yaw actuator 42 for a centering of laser beam LB on each marker.
For example,
And,
Subsequent to a completion of stage S108, a stage S110 of flowchart 100 encompasses registration module 62a processing the recorded encoded positions of pitch actuator 41 and yaw actuator 42 as known in the art to register concentric arc robot 40 to the markers and planned incision location as illustrated in volume image 21.
Based on the registration of stage S110, for un-encoded passive or active embodiments of robot platform 30 (“URP”), a stage S112 of flowchart 100 encompasses an automatic servo control via servo module 61a of pitch actuator 41 and/or yaw actuator 43 as needed to center laser beam LB on the planned incision location as exemplarily shown in
Subsequent to a completion of stage S110, a stage S92 of flowchart 80 encompasses the surgeon marking the incision location on the head of patient as indicated by laser beam LB during stage S112, and a stage S94 of flowchart 80 encompasses the surgeon manually manipulating a passive robot platform 30 or interfacing with servo module 61a for an active robot platform 30 to align the remote center-of-motion RCM with the incision marker during a stage S114 of flowchart 100 as exemplarily shown in
Subsequent to a completion of stages S94 and S114, a stage S96 of flowchart 90 encompasses the surgeon interfacing with servo module 61a for sequentially centering laser beam LB of laser pointer 50 on each marker including the incision marker whereby a stage S114 of flowchart 100 encompasses servo module 61a or registration module 62a recording an encoded position of pitch actuator 41 and yaw actuator 42 for a centering of laser beam LB on each marker.
Subsequent to the centering of laser beam LB on each marker, a stage S118 of flowchart 100 encompasses registration module 62a processing the recorded encoded positions of pitch actuator 41 and yaw actuator 42 as known in the art to register the remote center-of-motion RCM to incision marker as illustrated in volume image 21. Based on the registration of stage S118, a stage S120 of flowchart 100 encompasses an automatic servo control via servo module 61a of pitch actuator 41 and/or yaw actuator 43 as needed to axially align laser beam LB with the planned tool trajectory TT as shown in
Based on the registration of stage S110, for encoded passive embodiments of robot platform 30 (“EPRP”), stage S92 of flowchart 80 again encompasses the surgeon marking the incision location on the head of patient as indicated by laser beam LB during stage S112, and stage S94 of flowchart 80 again encompasses the surgeon manually manipulating a passive robot platform 30 to align the remote center-of-motion RCM with the incision marker during stage S114 of flowchart 100 as exemplarily shown in
With the encoding tracking of stage S106, a registration of the remote center-of-motion RCM to the incision maker in accordance with stage S116 and S118 is omitted in view of the registration of the remote center-of-motion RCM to the incision point as illustrated in volume image during stage S110. Thus, upon the surgeon acknowledging the confirmation of stage S114, servo module 61a proceeds from stage S114 to stage S120 for an automatic servo control via servo module 61a of pitch actuator 41 and/or yaw actuator 43 as needed to axially align laser beam LB with the planned tool trajectory TT as shown in
Based on the encoding tracking of stage S106 and registration of stage S110, for encoded active embodiments of robot platform 30 (“EARP”), a RCM alignment in accordance with stage S114 and a registration of the remote center-of-motion RCM to the incision maker in accordance with stage S116 and S118 are omitted in view of the registration of the remote center-of-motion RCM to the incision point as illustrated in volume image during stage S110. Thus, based on the platform tracking of stage S106 and the registration of stage S110, servo module 61a proceeds from stage S110 to stage S120 for an automatic servo control via servo module 61a of pitch actuator 41 and/or yaw actuator 43 as needed to axially align laser beam LB with the planned tool trajectory TT as shown in
Still referring to
Referring to
For example,
Also by example,
In practice, the controllers of
For example,
By further example,
Also in practice, a registration module of the present disclosure may be an application of an imaging controller of the present disclosure in communication with a robot controller of the present disclosure.
Referring to
Furthermore, as one having ordinary skill in the art will appreciate in view of the teachings provided herein, features, elements, components, etc. described in the present disclosure/specification and/or depicted in the
Moreover, all statements herein reciting principles, aspects, and embodiments of the invention, as well as specific examples thereof, are intended to encompass both structural and functional equivalents thereof. Additionally, it is intended that such equivalents include both currently known equivalents as well as equivalents developed in the future (e.g., any elements developed that can perform the same or substantially similar function, regardless of structure). Thus, for example, it will be appreciated by one having ordinary skill in the art in view of the teachings provided herein that any block diagrams presented herein can represent conceptual views of illustrative system components and/or circuitry embodying the principles of the invention. Similarly, one having ordinary skill in the art should appreciate in view of the teachings provided herein that any flow charts, flow diagrams and the like can represent various processes which can be substantially represented in computer readable storage media and so executed by a computer, processor or other device with processing capabilities, whether or not such computer or processor is explicitly shown.
Furthermore, exemplary embodiments of the present disclosure can take the form of a computer program product or application module accessible from a computer-usable and/or computer-readable storage medium providing program code and/or instructions for use by or in connection with, e.g., a computer or any instruction execution system. In accordance with the present disclosure, a computer-usable or computer readable storage medium can be any apparatus that can, e.g., include, store, communicate, propagate or transport the program for use by or in connection with the instruction execution system, apparatus or device. Such exemplary medium can be, e.g., an electronic, magnetic, optical, electromagnetic, infrared or semiconductor system (or apparatus or device) or a propagation medium. Examples of a computer-readable medium include, e.g., a semiconductor or solid state memory, magnetic tape, a removable computer diskette, a random access memory (RAM), a read-only memory (ROM), flash (drive), a rigid magnetic disk and an optical disk. Current examples of optical disks include compact disk—read only memory (CD-ROM), compact disk—read/write (CD-R/W) and DVD. Further, it should be understood that any new computer-readable medium which may hereafter be developed should also be considered as computer-readable medium as may be used or referred to in accordance with exemplary embodiments of the present disclosure and disclosure.
Having described preferred and exemplary embodiments of novel and inventive optical registration of a remote center-of-motion robot to a patient (which embodiments are intended to be illustrative and not limiting), it is noted that modifications and variations can be made by persons having ordinary skill in the art in light of the teachings provided herein, including the
Moreover, it is contemplated that corresponding and/or related systems incorporating and/or implementing the device or such as may be used/implemented in a device in accordance with the present disclosure are also contemplated and considered to be within the scope of the present disclosure. Further, corresponding and/or related method for manufacturing and/or using a device and/or system in accordance with the present disclosure are also contemplated and considered to be within the scope of the present disclosure.
Filing Document | Filing Date | Country | Kind |
---|---|---|---|
PCT/IB2016/055743 | 9/26/2016 | WO | 00 |
Number | Date | Country | |
---|---|---|---|
62233664 | Sep 2015 | US |