This application claims priority under 35 U.S.C. § 119 to European Patent Application No. 19169439.7, filed Apr. 16, 2019, the entire contents of which are hereby incorporated by reference.
The present disclosure generally relates to a tracker for surgical navigation. In particular, a tracker comprising a deformable patch is presented.
Many surgical procedures benefit from determining a position and orientation (i.e., a pose) of surgical objects, such as a surgical instrument and a patient, in an operating room. A surgical navigation system can be employed to track the surgical instrument relative to the patient and to calculate a current pose of the surgical instrument relative to registered three dimensional image data of the patient.
In a typical application of a surgical navigation system, the surgical instrument and the patient are each associated with a tracker, wherein three dimensional image data previously obtained by, for example, a computer tomography (CT) scan are initially registered with a pose of the patient tracker. By then continuously tracking the patient and the surgical instrument, the surgical navigation system can determine the pose of both surgical objects and calculate a spatial relationship between the surgical instrument and the three dimensional image data. The determined spatial relationship can, for example, be displayed on a screen, helping the surgeon guide the surgical instrument relative to the patient.
Trackers that are adapted to be attached to a skin surface of the patient often comprise a flexible patch carrying one or more light sources. It has been found that the shape of the skin surface differs from patient to patient, which may require a certain deformation of the patch upon applying same to the patient. Furthermore, the skin surface may be deformed during the surgery, e.g., due to movement of body parts or when opening an incision at the site of surgery. A deformation of the skin surface may, however, lead to a partial detachment of the tracker patch attached thereto, so that surgical navigation will be impaired. A deformation of the tracker patch may additionally impose a strain on electrical wiring of the light sources supported by the patch, especially when such wiring is also fixedly attached to the patch. Moreover, such wiring may prevent deformation of the patch or break when being strained.
There is a need for a tracker that solves one or more of the aforementioned or other problems.
According to one aspect, a tracker for surgical navigation is provided. The tracker comprises a patch being deformable in at least one direction and a tracker element selected from a light source or a coil, the tracker element being supported by the patch. The tracker further comprises an electrical connection electrically coupled to the tracker element and supported by the patch, the electrical connection having a meandering shape along the direction in which the patch is deformable.
The patch may be planar. The patch may be deformable in only one direction (i.e., uni-directionally). The patch may be deformable in any direction of an imaginary plane comprising the patch. The patch may be deformable isotropically. The patch may be bendable.
The patch may be elastically deformable. The patch may be stretchable and/or compressible. Alternatively, the patch may be at least partially plastically deformable. The patch may have a thickness between 0.05 mm and 2 mm. For example, the patch may have a thickness between 0.2 and 1 mm.
The meandering shape may be defined by the electrical connection repeatedly (e.g., more than three, five, ten or twenty times) crossing along its extension an imaginary line. That line may be straight or curved, as long as the radius of curvature of the line is smaller than a characteristic feature (e.g., a curvature) defining the meandering shape.
The meandering shape may comprise a periodic or aperiodic pattern. The periodic pattern may extend over a part or over the entire extension of the electrical connection. The periodic pattern may lie in a plane spanned by a planar patch.
The meandering shape may comprise at least one of a wave pattern, a rectangular wave pattern and a zigzag pattern. The meandering shape may have a single pattern that repeats itself. The meandering shape may have a plurality of different patterns. The plurality of different patterns may be arranged in series and/or may be superimposed.
The electrical connection may have a width between 5 μm and 50 μm. For example, the electrical connection may have a width between 10 μm and 40 μm, preferable between 15 μm and 30 μm.
The tracker may comprise a plurality of tracker elements and a plurality of electrical connections. The plurality of tracker elements may comprise one or more light sources and/or one or more coils. At least some of the tracker elements and electrical connections may be alternatingly electrically coupled in series. At least some of the electrical connections may be connected in parallel to at least some of the tracker elements. The tracker may comprise a junction of a plurality of electrical connections. The tracker may comprise a controller electrically connected with at least two of the tracker elements and configured to control operation of the at least two tracker elements independently. Independent operation of the at least two tracker elements may comprise at least one of providing different operation currents (including no current), different voltages and different operation frequencies.
The patch may have a meandering shape. The patch may comprise multiple fingers. At least two of the fingers may each support at least one tracker element and at least one electrical connection thereof. Each finger may support at least one tracker element and at least one electrical connection thereof.
At least a part of the patch may have the shape of a frame enclosing a central opening. The frame shape may be rectangular, elliptical, circular or polygonal.
The electrical connection may be printed onto the patch. Alternatively, or additionally, the electrical connection may comprise a wire.
The tracker may comprise a plurality of layers, wherein the electrical connection is arranged in at least one of the plurality of layers. The plurality of layers may be arranged in at least one of a top surface of the patch, a bottom surface of the patch and embedded inside the patch. In case the tracker comprises a plurality of electrical connections, at least some of the electrical connections may be arranged in different layers and/or at least some of the electrical connections may be arranged in a same layer. The tracker may comprise a via (also called vertical interconnection access) configured to electrically connect at least two of the plurality of layers. The electrical connection may be electrically connected with the via. The via may be electrically connected to multiple electrical connections that are arranged in separate layers.
The tracker may comprise an adhesive configured to attach the patch to a surface of a surgical object. The adhesive may be applied to the patch by printing or otherwise.
According to a second aspect, a method for operating a tracker for surgical navigation is provided. The tracker comprises a patch being deformable in at least one direction, at least two tracker elements selected, for example, from one or more light sources and one or more coils supported by the patch, and an electrical connection electrically coupled to each tracker element and supported by the patch, at least one of the electrical connections having a meandering shape along the direction in which the patch is deformable. The method comprises controlling operation of the at least two tracker elements independently.
According to a third aspect, a tracker for surgical navigation is provided. The tracker comprises a patch being deformable in at least one direction and a tracker element arranged on the patch. The tracker further comprises an electrical connection electrically coupled to the tracker element and supported by the patch, the electrical connection defining a non-linear pattern with a first pattern spacing along the direction in which the patch is deformable when the patch is not deformed, wherein the electrical connection is configured to assume a second pattern spacing in the at least one direction that is different than the first pattern spacing upon a deformation of the patch in the at least one direction.
The deformation may be a stretching, in which case the second pattern spacing is larger than the first pattern spacing. The non-linear pattern may have a meandering shape.
Further details, advantages and aspects of the present disclosure will become apparent from the following embodiments taken in conjunction with the drawings, wherein:
In the following description, exemplary embodiments of a tracker for surgical navigation and a method for operating a tracker will be explained with reference to the drawings. The same reference numerals will be used to denote the same or similar structural features.
The patch 12 is elastically deformable and therefore (at least partially) configured to return to its original shape after a deforming force is no longer applied. In particular, the patch 12 is stretchable and/or compressible. The patch 12 may be stretchable by more than 10%, more than 20% or more than 30% before it breaks.
The patch 12 shown in
The patch 12 shown in
The tracker 10 further comprises tracker element in form of a light source 14 supported by the patch 12. The light source 14 may comprise at least one of a light emitting diode (LED), an organic light emitting diode (OLED), a laser, an incan-descent light source and an optical fibre. The tracker 10 may comprise a plurality of light sources 14. With a larger number (such as two, three, four, or more) of light sources 14, the amount of trackable degrees of freedom and/or the tracking accuracy can be increased. The light source 14 is supported by the patch 12. The light source 14 shown in
A surgical navigation system (not shown) comprises the tracker 10 and a sensor system (not shown) configured to detect information indicative of at least one degree of freedom (e.g., position and orientation) of the tracker 10. To this end, the sensor system may comprise a camera configured to detect light emitted by a light source 14 of the tracker 10.
The tracker 10 further comprises an electrical connection 16 electrically coupled to the light source 14. The electrical connection 16 may comprise or consist of copper, nickel, silver or gold, or an alloy thereof. The electrical connection 16 shown in
The electrical connection 16 illustrated in
Similarly, in the case the patch 12 is compressed (not shown), the electrical connection 16 further folds onto itself and compresses along with the patch 12. The meandering shape of the electrical connection essentially provides an elastic wiring for the tracker 10.
As becomes apparent from a comparison of
The coil 15 allows tracking of the tracker 10 via an electromagnetic tracking principle. One way to apply the electromagnetic tracking principle is to provide an electromagnetic field generator (not shown) that generates an electromagnetic field that induces a current in the coil 15. The current or a signal indicative of the induced current may be measured by a measuring device (not shown). Based on the current or signal, at least a part of a position and orientation of the coil 15 may be determined. By providing a plurality of coils 15, more degrees of freedom may be determined. Usually, a tracker 10 comprising two coils 15 arranged skewed relative to each other allows determining the position and orientation of the tracker 10.
A surgical navigation system (not shown) may be provided that comprises the tracker 10 and a sensor system (not shown) configured to detect information indicative of at least one degree of freedom (e.g., position and orientation) of the tracker 10. The sensor system may comprise a measuring device configured to detect a current and/or voltage induced in the coil 15 of the tracker 10. To this end, the surgical navigation system may comprise a field generator configured to generate an electric field that is capable of inducing a current in the coil 15 of the tracker 10.
The tracker 10 may comprise a plurality of coils 15. Furthermore, the tracker 10 may comprise at least one coil 15 and at least one light source 14. A tracker 10 with light sources 14 and coils 15 may be used as a hybrid-tracker that can be tracked optically as well as electromagnetically. The sensor system of the surgical navigation system may comprise the measuring device as described above and a camera configured to detect light emitted by a light source 14 of the tracker 10. Such a surgical navigation system is capable of tracking electromagnetically and optically.
The meandering shape of the electrical connection shown in
Some wave patterns (in particular wave patterns with a low degree of folding) are stackable next to each other in such a way that a plurality of electrical connections 16 with such a pattern can extend parallel to each other.
The examples of wave forms shown in
The tracker 10 may comprise a plurality of electrical connections 16 that need to be arranged close to each other. Such an arrangement may for example be required when providing a supply line and a return line for a light source 14, or when electrical connections 16 for a plurality of light sources 14 are necessary. Due to its meandering shape, the electrical line 16 extends into a width direction (e.g., Y direction in
Another (additional or alternative) approach is to provide a plurality of layers in the tracker 10, in which electrical connections 16 are arranged.
The tracker 10 comprises a patch 12 deformable in one or more directions of an imaginary plane defined by two orthogonal X and Y directions. Perpendicular to the X and Y directions extends a Z direction. Along the Z direction, the tracker 10 comprises a plurality of layers 18. The tracker 10 shown in
The tracker 10 shown in
The vias shown in
The electrical connections 16 from different layers are electrically connected by the vias 20. For example, via 20C is configured to electrically connect an electrical connection 16A arranged in the top layer 18A with an electrical connection 16D arranged in the bottom layer 18E.
Similarly, via 20A electrically connects an electrical connection 16E arranged in the top layer 18A with an electrical connection 16C arranged in layer 18B. In this way, the first light source 14A is provided with a supply line comprising the electrical connection 16B and a return line that comprises the electrical connections 16E, 16C and the via 20A.
The use of the vias 20 is not limited to electrically connecting electrical connections 16. Vias 20 may also electrically connect other electronic components of the tracker 10, such as a light source 14 or a power supply (not shown).
The tracker 10 comprises a controller 22. The controller 22 is electrically connected with the electrical connections 16 (and consequently also with the light sources 14). The controller 22 comprises a power supply (not shown) that is configured to provide electrical power to the light sources 14. The power supply may comprise at least one of a rechargeable or non-rechargeable battery, a capacitor, a receiver for wireless energy transfer, and a connector to a power outlet. The controller 22 is configured to operate the light sources 14. Light source operation comprises selectively providing electrical power (e.g., providing power or not providing power) to a light source 14. The operation may further comprise controlling at least one of an operation frequency, operation current, and operation voltage. The controller 22 may, for example, be configured to provide an operation current between 1 to 10 mA. Particularly for providing such low currents, the electrical connections 16 are not required to have a large width. The electrical connections may have a width between 10 μm to 50 μm. Electrical connections 16 with such a low width can be easily deformed and are particularly suited for a meandering shape that can unfold.
The controller 22 is configured to operate at least two light sources 14 independently. For example, the controller 22 is configured to provide an operation current to only one light source 14 and not to another light source 14. The independent operation may further comprise at least one of a different operation frequency, different operation current, and different operation voltage. Independent control of different light sources 14 allows applying different functionality to different light sources 14 (e.g., one light source is used for indicating that the controller 22 is operational and another light source 14 is used for tracking), selecting different trackable light patterns, or tracking with two separate optical navigation system (e.g., operating at different operation frequencies or operating different types of light sources with different wave lengths).
The patch comprises multiple fingers 24A-C, wherein each of the fingers 24A-C branches out into sub fingers. The fingers 24A and C have a meandering shape. Each of the fingers 24A-C (and its corresponding sub fingers) supports at least one light source 14 and electrical connections 16 coupled with the light sources 14. In order to supply electrical power to the light sources 14 supported by the sub fingers, the tracker 10 comprises junctions 26 of a plurality (i.e., at least two) of the meandering electrical connections 16. Such a junction 26 may be located at a position of an electrical connection 16 at which another electrical connection 16 branches out (e.g., junction 26A). A junction 26 may also be located at a light source 14 (e.g., junction 26B). Furthermore, the junction may comprise a via (not shown).
When being attached to an uneven surface, such as a face of the patient, a tracker 10 comprising fingers 24A-C can adapt well to the shape of the surface.
The patch 12 comprises a plurality of electrical connections 16 that are coupled in series with the plurality of light sources 14. The electrical connections 16 could also be configured otherwise (see, e.g.,
When opening the incision in order to access the surgery site, skin around the incision deforms and is mainly pushed in a direction away from the incision. Since the tracker 10 is attached to the skin of the patient, a force is acting on the tracker 10. The patch 12 and the electrical connections 16 (due to their meandering shape) are deformable and can therefore adapt to the force by deformation.
The method 100 comprises a step 102 of controlling operation of the at least two tracker elements 14, 15 independently.
In case of controlling at least two light sources 14, controlling the operation independently comprises selectively providing a first electrical power to a first set of the at least two light sources 14 and a second electrical power to a second set of the at least two light sources 14, wherein the first and second electrical power can be different. Controlling the operation may further comprise adjusting for the at least two light sources 14 at least one of different operation frequencies, different operation currents, and different operation voltages. For example, an operation current between 1 to 10 mA may be provided to one or more of the light sources 14 that are to be tracked and a larger current may be provided to one or more of the light sources 14 that indicate that the tracker 10 is operating. Since detection means for optical navigation are becoming increasingly sensitive, the light sources 14 for tracking can emit with lower intensity and therefore require less operating current than light sources that need to be visible to the surgeon.
Controlling operation frequency independently for the at least two light sources 14 may comprise operating a first set of the at least two light sources 14 with a first frequency and operating a second set of the at least two light sources 14 with a second frequency, wherein the first and second operation frequency may be different. The first frequency may be synchronized with a first surgical navigation system and/or the second frequency may be synchronized with a second surgical navigation system.
The method may optionally comprise a step 104 of terminating operation of the first set of the at least two light sources 14. The method may optionally comprise a further step 106 of terminating operation of the second set of the at least two light sources 14.
The features described in relation to the exemplary embodiments shown in the drawings can be readily combined to result in different embodiments. It is apparent, therefore, that the present disclosure may be varied in many ways. Such variations are not to be regarded as a departure from the scope of the invention as defined by the claims appended hereto.
Number | Date | Country | Kind |
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19169439.7 | Apr 2019 | EP | regional |