The present invention generally relates to a tracking of a navigation of an intervention instrument during a minimally invasive interventions and surgeries. The present invention specifically relates to a shaft tracker integrated on a shaft of the intervention instrument for facilitating the tracking of the navigation of the intervention instrument.
Electromagnetic (“EM”) tracking and optical tracking have proven to be useful tools for many minimally invasive interventions and surgeries. Specifically, intra-operative real-time imaging modalities (e.g., x-ray, endoscope and ultrasound) are linked with pre-operative imaging modalities (e.g., computed tomography and magnetic resonance imaging) via the aid of EM tracking or optical tracking whereby a pre-operative roadmap may be utilized to assist guidance to the real-time imaging. In addition, the instrument tip is dynamically tracked by having a tracking EM sensor coil or a tracking optical marker attached or embedded into the instrument itself whereby a physician may precisely localize the position and orientation of the instrument and its relationship to a target anatomical location based on the image fusion.
Conventionally, there are two approaches for enabling instrument tracking.
The first approach involves a position tracker built to a co-axial introducer system as shown in
As shown in
The advantage of hub tracker 32 is that it may be compatible with many different instruments and not be limited by gauge size and length. In addition, since hub tracker 32 is outside the patient body, hub tracker 32 does not interfere with the operation of the instrument (e.g. thermal ablation of the tumor) and does not increase the insertion size as in the introducer system 20 of
The present invention provides a shaft tracker integrated onto the shaft of the instrument and serving as a distal tip marker whereby the aforementioned disadvantages of the conventional designs are mitigated.
One form of the present invention is an intervention instrument employing shaft and a shaft tracker. The shaft extends between a distal tip and a proximal hub, and the shaft tracker partially or completely encircles the shaft and is movable to a primary tracking position along the shaft between the distal tip and the proximal hub. The primary tracking position is derived from a distance from an entry point of the distal tip into an anatomical region to a target location of the distal tip within the anatomical region. The shaft tracker includes a primary position sensor operable for tracking the shaft tracker relative to the anatomical region at or offset from the primary tracking position.
A second form of the present invention is an intervention system employing the intervention instrument and a tracking workstation interactive with the primary position sensor for tracking the shaft tracker along the shaft relative to the anatomical region.
A third form of the present invention is an interventional method involving a navigation of the intervention instrument relative to the anatomical region and a tracking of the shaft tracker as the intervention instrument is navigated relative to the anatomical region.
The foregoing forms and other forms of the present invention as well as various features and advantages of the present invention will become further apparent from the following detailed description of various embodiments of the present invention read in conjunction with the accompanying drawings. The detailed description and drawings are merely illustrative of the present invention rather than limiting, the scope of the present invention being defined by the appended claims and equivalents thereof.
An intervention system 40 as shown in
Tracking workstation 50 is any workstation structurally configured for registering an intra-operative real-time imaging modality (e.g., x-ray, endoscope or ultrasound) with a pre-operative imaging modality (e.g., computed tomography or magnetic resonance imaging) via the aid of a tracking workstation (e.g., an EM tracking workstation or an optical tracking workstation). As would be appreciated by those having skill in the art, the purpose of the image registration is to utilize the pre-operative image and/or the intra-operative image of an anatomical region as a visual guide for the intra-operative navigation of interventional instrument 60 from an entry point into an anatomical region to a target location within the anatomical region. To this end, tracker workstation includes position sensor(s) incorporated in instrument 60 as subsequently described herein. An example of tracking workstation 50 includes, but is not limited to, a PERCUNAV™ image fusion and navigation device as commercially sold by Philips.
Intervention instrument 60 is any instrument structurally configured with shaft 61 having a distal tip 61d and a proximal hub 61p, and a shaft tracker 62 partially or completely encircling shaft 61 between distal tip 61d and proximal hub 61p. Shaft tracker 62 is moveable along shaft 61 between distal tip 61 d and proximal hub 61p to a primary tracking position identified by an optional distance scale 66 of specified increments (e.g., 1 mm increments). Shaft tracker 62 incorporates a primary position sensor 63 (e.g., an electromagnetic coil from the EM tracking workstation or an optical marker from the optical tracking workstation) that provides tracking of the shaft tracker 62 relative to the anatomical region at or offset from the primary tracking position.
In practice, shaft 61 may have any size and shape, and be constructed from any material suitable for a particular minimally invasive intervention or surgery (e.g., a needle, a cannula, a guide wire, etc.)
A modified version 60′ of intervention instrument 60 is structurally configured with an auxiliary tracker 64 partially or completely encircling shaft 61 between distal tip 61d and proximal hub 61p. Auxiliary tracker 64 is moveable along shaft 61 between shaft tracker 62 and proximal hub 61p to an auxiliary tracking position identified by optional distance scale 65. Alternatively, auxiliary tracker 64 may be fixed at the auxiliary tracking position. Auxiliary tracker 64 incorporates an auxiliary position sensor 65 (e.g., an electromagnetic coil from the
EM tracking workstation or an optical marker from the optical tracking workstation) that provides tracking of the auxiliary tracker 64 relative to the anatomical region at or offset from the auxiliary tracking position.
In operation, system 40 executes a shaft tracking method of the present invention as represented by a flowchart 70 shown in
Specifically, a stage S71 of flowchart 70 encompasses an optional calibration of shaft tracker 62 relative to distal tip 61d of shaft 60 when a high tracking accuracy is required. In one embodiment of stage S71, an estimated offset of shaft sensor 62 to distal tip 61d is calibrated as needed to an actual offset of shaft sensor 62 to the distal tip 61d. For example, a pivoting tool that allows carrying out this calibration under sterile conditions has a simple tracked surface with a pivot point cut into it. The distal tip 61d of shaft 61 is placed into the pivot point to measure the sensed distance between shaft tracker 62 and distal tip 61d of shaft 60. In practice, the pivoting tool is sterilizable and reusable. Since shaft tracker 62 may be made to universally fit onto intervention instrument of different gauge sizes, a centering mechanism may be utilized to account for a possible lateral offset by keeping shaft 61 at any gauges always at the center of shaft tracker 62. Alternatively, a programming step may be used whereby the user enters the gauge of instrument 60 and then software may then account for the resulting off-axis shift.
Auxiliary tracker 64, if employed by intervention instrument 60, may be similarly calibrated if needed.
A stage S72 of flowchart 70 encompasses a pre-positioning of shaft tracker 62 along shaft 61 relative to the primary tracking position that is derived a distance from an entry point of the distal tip 61d into an anatomical region to a target location of the distal tip 61d within the anatomical region. For example, the distance from an entry point of the distal tip 61d into an anatomical region to a target location of the distal tip 61d within the anatomical region may be X mm and the primary tracking position is determined to be ≧X mm.
In a pre-operative locking embodiment of stage S72, an anatomical region of the patient is known via pre-operative images whereby the distance of a target location from an entry point is known. Prior to insertion of interventional instrument 60 into the entry point, shaft tracker 62 is moved and locked to the primary tracking position via scale 66 or via a manual measurement from the distal tip 61d. For this embodiment, a stage S73 of flowchart 70 encompasses a navigation of intervention instrument 60 into the entry point until such time shaft tracker 62 abuts the entry point or is substantially adjacent the entry point. Based on the locked primary tracking position of shaft tracker 62, the distal tip 61d of shaft 61 will have reached the target location upon shaft tracker 62 abutting the entry point.
In an intra-operative movement embodiment of stage S72 with intervention instrument employing auxiliary tracker 64, the anatomical region of the patient is also known via pre-operative images whereby the distance of the target location from the entry point is known. Prior to insertion of interventional instrument 60 into the entry point, shaft tracker 62 is moved to the distal tip 61d of shaft 61 and kept unlocked and auxiliary tracker 64 is moved to the auxiliary tracking position and is locked. Alternatively, auxiliary tracker 64 may be fixed at the auxiliary tracking position. For this embodiment, stage S73 of flowchart 70 encompasses a navigation of intervention instrument 60 into the entry point whereby shaft tracker 62 abuts the entry point and is moved along shaft 61 in a direction toward the primary tracking position. Intervention instrument 60 is navigated until such time the distance between shaft tracker 62 and auxiliary tracker 64 indicates shaft tracker 62 has been moved to the primary tracking position. Based on shaft tracker 62 reaching the primary tracking position, the distal tip 61d of shaft 61 will have reached the target location.
Exemplary embodiments 160 and 260 of intervention instrument 60 as respectively shown in
As shown in
In preparation, an anatomical region of the patient is known via pre-operative images whereby a distance of a target location from an entry point is known. Prior to insertion of interventional instrument 160 into the entry point, shaft tracker 164 is moved and locked to a primary tracking position via scale 66 or via a manual measurement from the distal tip 61d as shown in
As shown in
Auxiliary tracker 266 is moveable along shaft 261 between shaft tracker 264 and proximal hub 263 to an auxiliary tracking position identified by the distance scale. Alternatively, as shown in
In preparation, the anatomical region of the patient is known via pre-operative images whereby a distance of the target location from the entry point is known. Prior to insertion of interventional instrument 260 into an entry point 83 as shown in
From the description of
One exemplary benefit is the omission of a calibration stage unless a very high precision and accuracy is required. Specifically, since the insertion distal tip is predetermined and the shaft tracker is pre-operatively or intra-operatively moved to the primary tracking position, this inherently provides the tip offset distance that is required to track the tip position without any need for calibration of the shaft tracker to the distal tip.
A second exemplary benefit is the shaft tracker will not interfere with the operation of the intervention instrument since the shaft tracker remains outside the patient's body and also does not increase the size insertion hole size for the intervention instrument. As a result, the shaft track will not possess any issue of cancer seeding along the instrument shaft.
A third exemplary benefit is an increased accuracy and minimized inaccuracy due to bending of the instrument in view of procedures involving the shaft tracker being position closer to the distal tip as compared to the proximal hub.
A fourth exemplary benefit is the universal fit of a shaft tracker onto intervention instruments of different gauge sizes and the independence on the shaft tracker to a design of the instrument handle.
Although the present invention has been described with reference to exemplary aspects, features and implementations, the disclosed systems and methods are not limited to such exemplary aspects, features and/or implementations. Rather, as will be readily apparent to persons skilled in the art from the description provided herein, the disclosed systems and methods are susceptible to modifications, alterations and enhancements without departing from the spirit or scope of the present invention. Accordingly, the present invention expressly encompasses such modification, alterations and enhancements within the scope hereof.
Filing Document | Filing Date | Country | Kind |
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PCT/IB2013/051050 | 2/8/2013 | WO | 00 |
Number | Date | Country | |
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61596749 | Feb 2012 | US |