On-board tool tracking system and methods of computer assisted surgery

• US 10,080,617 B2
• Filed: 11/17/2016
• Issued: 09/25/2018
• Est. Priority Date: 06/27/2011
• Status: Active Grant

• Current Assignee: Board of Regents of the University of Nebraska
• Original Assignee: Board of Regents of the University of Nebraska
• Inventors: Haider, Hani, Al-Shawi, Ibrahim, Barrera, Osvaldo Andres
• Primary Examiner(s): Peng, Bo J
• Application Number:
  US15/354,778
• Publication Number:
  US 20170281280A1
• Time in Patent Office: 677 Days
• CPC Class Codes: A61B 1/3132 for laparoscopy
• CPC Class Codes: A61B 17/142 with reciprocating saw blades, e.g. with cutting edges at the distal end of the saw blades
• CPC Class Codes: A61B 17/1703 using imaging means, e.g. by X-rays
• CPC Class Codes: A61B 2034/102 Modelling of surgical devices, implants or prosthesis
• CPC Class Codes: A61B 2034/2057 Details of tracking cameras
• CPC Class Codes: A61B 2034/2065 Tracking using image or pattern recognition
• CPC Class Codes: A61B 2090/061 for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 34/37 Master-slave robots A61B34/35 takes precedence
• CPC Class Codes: A61B 34/76 Manipulators having means for providing feel, e.g. force or tactile feedback
• CPC Class Codes: A61B 5/00 Measuring for diagnostic purposes radiation diagnosis A61B6/00; diagnosis by ultrasonic, sonic or infrasonic waves A61B8/00; Identification of persons
• CPC Class Codes: A61B 5/061 Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body A61B1/00158 takes precedence
• CPC Class Codes: A61B 5/1076 for measuring dimensions inside body cavities, e.g. using catheters A61B3/1005 takes precedence
• CPC Class Codes: G06T 2207/30004 Biomedical image processing
• CPC Class Codes: G06V 2201/034 of medical instruments

Abstract

A number of improvements are provided relating to computer aided surgery utilizing an on tool tracking system. The various improvements relate generally to both the methods used during computer aided surgery and the devices used during such procedures. Other improvements relate to the structure of the tools used during a procedure and how the tools can be controlled using the OTT device. Still other improvements relate to methods of providing feedback during a procedure to improve either the efficiency or quality, or both, for a procedure including the rate of and type of data processed depending upon a CAS mode.

Claims

1. A method for computer assisted surgery (CAS) using a freehand surgical tool, the method comprising:

creating a three dimensional representation of a portion of a patient to which a bone or tissue cutting procedure is to be performed;

identifying an area of the three dimensional representation corresponding to the portion of bone or tissue for which the procedure is to be performed using an active element of the freehand surgical tool;

creating a surgical plan for the area of the three dimensional representation corresponding to the portion of bone or tissue;

determining a position of the portion of bone or tissue for which the procedure is to be performed;

determining a position of the freehand surgical tool;

calculating a distance between the position of the portion of bone or tissue and the position of the hand held surgical tool;

setting a mode of the hand held surgical tool to a hover tracking mode if the distance between the portion of bone or tissue and the hand held surgical tool is greater than a first threshold distance;

setting the mode of the hand held surgical tool to an site approach tracking mode if the distance between the portion of bone or tissue and the hand held surgical tool is less than the first threshold distance and is greater than a second threshold distance; and

setting the mode of the hand held surgical tool to an active step mode if the distance between the portion of bone or tissue and the hand held surgical tool is less than the second threshold distance,

wherein setting the mode to the hover tracking mode includes turning off a two-dimensional guidance graphical interface (GUI) associated with the hand held surgical tool, wherein setting the mode to the site approach tracking mode and the active step mode includes turning on the two-dimensional guidance GUI associated with the hand held surgical tool.

2. The method of claim 1, further comprising contacting the bone or tissue with the active element of the freehand surgical tool while the surgical tool is in an active step mode.

3. The method of claim 2, wherein contacting the bone or tissue with the active element includes making a plurality of planar cuts to a femur or tibia or knee.

4. The method of claim 3, wherein the plurality of planar cuts are part of a total knee replacement procedure.

5. The method of claim 4, wherein the plurality of planar cuts are pre-selected based on a configuration of a pre-determined prosthesis to be implanted in a patient.

6. The method of claim 5, further comprising changing the mode of the hand held surgical tool after performing the plurality of cuts to an implant fit evaluation mode.

7. The method of claim 6, further comprising comparing the plurality of planar cuts to the surgical plan and the prosthesis to be implanted to determine the compatibility of the implant with the plurality of cuts.

8. The method of claim 1, further comprising repeating determining the position of the portion of bone or tissue and determining the position of the hand held surgical tool.

9. The method of claim 1, wherein the hover tracking mode and site approach tracking mode allow for secondary tasks selected from the group consisting of:

calculation of motion between a femur and tibia, recalibration of a reference frame, and determination of the hand held surgical tool proximity to the reference frame, wherein the active step mode does not allow secondary tasks selected from the group consisting of;

calculation of motion between a femur and tibia, recalibration of a reference frame, and determination of the hand held surgical tool proximity to the reference frame, wherein the active step mode does not allow the secondary tasks.

10. The method of claim 1, wherein setting the mode to the hover tracking mode and the site approach tracking mode includes turning off a motor control function of the hand held surgical tool, wherein setting the mode to the active step mode includes enabling the motor control function of the hand held surgical tool.

11. The method of claim 1, wherein setting the mode to the hover tracking mode and site approach tracking mode includes turning off a projector on the hand held surgical tool, wherein setting the mode to the active step mode includes turning on the projector.

12. The method of claim 1, wherein setting the mode to the hover tracking mode includes turning off a display on the hand held surgical tool, wherein setting the mode to the site approach tracking mode and the active step mode includes turning on the display.

13. The method of claim 1, wherein changing the mode from the hover tracking mode to the site approach tracking mode includes increasing resources appropriated to the navigation and error calculation of the hand held surgical tool.

14. The method of claim 1, wherein changing the mode from the site approach tracking mode to the active step mode includes increasing resources appropriated to the navigation and error calculation, a tool motor controller, a two-dimensional guidance graphical interface associated with the hand held surgical tool, and a projector or display on the hand held surgical tool.

15. The method of claim 1, wherein the first threshold distance is greater than 200 mm and the second threshold distance is 100 mm to 200 mm.

16. The method of claim 1, wherein the second threshold distance is 70 mm to 100 mm.

17. The method of claim 1, wherein the second threshold distance is 10 mm to 0 mm.

18. The method of claim 1, further comprising setting the first threshold distance and the second threshold distance prior to determining the position of the portion of bone or tissue for which the procedure is to be performed.

19. The method of claim 1, further comprising attaching a reference frame including one or more position markers to the patient at a predetermined spatial orientation to the portion of bone or tissue, wherein determining the position of the portion of bone or tissue includes determining the position of the reference frame.

20. The method of claim 19, further comprising using a plurality of cameras to determine the position of the one or more position markers.

21. The method of claim 20, wherein the plurality of cameras are within or coupled to the housing.