Methods and systems for selecting surgical approaches

• US 10,416,624 B2
• Filed: 12/13/2013
• Issued: 09/17/2019
• Est. Priority Date: 12/13/2012
• Status: Active Grant

• Current Assignee: University of Washington
• Original Assignee: University of Washington
• Inventors: Bly, Randall, Hannaford, Blake, Moe, Kris S.
• Primary Examiner(s): Anderson, Gregory A
• Application Number:
  US14/647,639
• Publication Number:
  US 20150297309A1
• Time in Patent Office: 2,104 Days
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: B29C 64/386 Data acquisition or data processing for additive manufacturing
• CPC Class Codes: G05B 15/02 electric
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

Described herein are methods and systems for selecting surgical approaches. One example method involves (1) receiving data indicating (a) one or more surgical target regions and (b) one or more surgical portals; (2) determining a plurality of surgical pathways; (3) determining a plurality of surgical approaches; (4) for each surgical approach in the plurality of surgical approaches, determining at least one approach characteristic, for each determined surgical pathway in the respective surgical approach, determining at least one pathway characteristic, and determining a surgical-approach ranking based on the determined at least one approach characteristic and the determined at least one pathway characteristic; (5) selecting a subset of the plurality of surgical approaches based on the determined surgical approach rankings; and (6) causing an output device to provide a representation of the selected subset of the plurality of surgical approaches.

Claims

1. A computer-implemented method comprising:

receiving data indicating (a) one or more surgical target regions and (b) one or more surgical portals using a computing system;

determining a plurality of surgical pathways using the computing system, wherein each surgical pathway in the plurality of surgical pathways comprises (a) a respective surgical target region of the one or more surgical target regions and (b) a respective surgical portal of the one or more surgical portals;

determining a plurality of surgical approaches using the computing system, wherein each surgical approach in the plurality of surgical approaches comprises at least a first determined surgical pathway;

for each surgical approach in the plurality of surgical approaches;

determining at least one approach characteristic using the computing system,

for each determined surgical pathway in the respective surgical approach, determining at least one pathway characteristic using the computing system, and

determining a surgical-approach ranking based on the determined at least one approach characteristic and the determined at least one pathway characteristic using the computing system;

wherein one or more surgical approaches in the plurality of surgical approaches further comprise a second determined surgical pathway, and wherein the at least one determined approach characteristic comprises an angulation between the first determined surgical pathway and the second determined surgical pathway;

selecting a subset of the plurality of surgical approaches based on the determined surgical approach rankings using the computing system;

causing an output device of the computing system to provide a representation of the selected subset of the plurality of surgical approaches;

causing the output device to provide at least a graphical pathway protection element based on a determined surgical pathway of one or more surgical approaches in the selected subset of the plurality of surgical approaches, wherein the pathway protection element is related to insertion of a surgical instrument in the determined surgical pathway, wherein the pathway protection element indicates one or more lock-outs indicating one or more regions where the surgical instrument is prevented from moving into and/or one or more lock-ins indicating one or more regions where the surgical instrument is prevented from moving from; and

providing one or more warnings using the computing system, the one or more warnings provided when the surgical instrument approaches a boundary of at least one of the one or more lock-outs and/or the one or more lock-ins.

2. The method of claim 1, wherein the output device comprises a graphical display, and wherein causing the graphical display to provide the representation comprises causing the graphical display to provide a three-dimensional graphical representation of the determined representation.

3. The method of claim 1, wherein the output device comprises an additive manufacturing machine;

and wherein causing the additive manufacturing machine to make the representation comprises causing the additive manufacturing machine to provide a physical representation of the determined representation.

4. The method of claim 1, further comprising:

receiving, at the computing device, data including one or more surgical performance parameters regarding a performed surgery; and

generating a score for the performed surgery using the computing device, the score based on the one or more surgical performance parameters.

5. The method of claim 1, wherein, for each determined surgical pathway, the at least one determined pathway characteristic comprises at least one of:

(a) a pathway length;

(b) an angulation between the determined surgical pathway and an anatomical plane;

(c) a volume of the determined surgical pathway;

(d) an intersected anatomical structure;

or (e) a distance that an anatomical structure is displaced to provide the surgical pathway.

6. The method of claim 1, further comprising:

causing a surgical instrument to move based on the selected subset of surgical approaches.

7. A computing system comprising:

an output device;

a physical computer readable medium; and

program instructions stored on the physical computer readable medium and executable by at least one processor to;

receive data indicating (a) one or more surgical target regions and (b) one or more surgical portals;

determine a plurality of surgical pathways, wherein each surgical pathway in the plurality of surgical pathways comprises (a) a respective surgical target region of the one or more surgical target regions and (b) a respective surgical portal of the one or more surgical portals;

determine a plurality of surgical approaches, wherein each surgical approach in the plurality of surgical approaches comprises at least a first determined surgical pathway;

for each surgical approach in the plurality of surgical approaches,

determine at least one approach characteristic,

for each determined surgical pathway in the respective surgical approach, determine at least one pathway characteristic, and

determine a surgical-approach ranking based on the determined at least one approach characteristic and the determined at least one pathway characteristic;

wherein one or more surgical approaches in the plurality of surgical approaches further comprise a second determined surgical pathway, and wherein the at least one determined approach characteristic comprises an angulation between the first determined surgical pathway and the second determined surgical pathway;

select a subset of the plurality of surgical approaches based on the determined surgical approach rankings;

cause the output device to provide a representation of the selected subset of the plurality of surgical approaches;

cause the output device to provide at least a graphical pathway protection element based on a determined surgical pathway of one or more surgical approaches in the selected subset of the plurality of surgical approaches, wherein the pathway protection element is related to insertion of a surgical instrument in the determined surgical pathway, wherein the pathway protection element indicates one or more lock-outs indicating one or more regions where the surgical instrument is prevented from moving into and/or one or more lock-ins indicating one or more regions where the surgical instrument is prevented from moving from; and

provide one or more warnings when the surgical instrument approaches a boundary of at least one of the one or more lock-outs and/or the one or more lock-ins.

8. The computing system of claim 7, wherein the output device comprises a graphical display, and wherein causing the graphical display to provide the representation comprises causing the graphical display to provide a three-dimensional graphical representation of the determined representation.

9. The computing system of claim 7, wherein the output device comprises an additive manufacturing machine;

and wherein causing the additive manufacturing machine to make the representation comprises causing the additive manufacturing machine to provide a physical representation of the determined representation.

10. The computing system of claim 7, wherein the program instructions are further executable by at least one processor to:

receive data including one or more surgical performance parameters regarding a performed surgery; and

generate a score for the performed surgery, the score based on the one or more surgical performance parameters.

11. The computing system of claim 7, wherein, for each determined surgical pathway, the at least one determined pathway characteristic comprises at least one of:

(a) a pathway length;

(b) an angulation between the determined surgical pathway and an anatomical plane;

(c) a volume of the determined surgical pathway;

(d) an intersected anatomical structure;

or (e) a distance that an anatomical structure is displaced to provide the surgical pathway.

12. The computing system of claim 7, wherein the program instructions are further executable by at least one processor to:

cause a surgical instrument to move based on the selected subset of surgical approaches.

13. A physical computer readable medium having stored therein instructions executable by a computing system to cause the computing system to perform functions comprising:

receiving data indicating (a) one or more surgical target regions and (b) one or more surgical portals;

determining a plurality of surgical pathways, wherein each surgical pathway in the plurality of surgical pathways comprises (a) a respective surgical target region of the one or more surgical target regions and (b) a respective surgical portal of the one or more surgical portals;

determining a plurality of surgical approaches, wherein each surgical approach in the plurality of surgical approaches comprises at least a first determined surgical pathway;

for each surgical approach in the plurality of surgical approaches,

determining at least one approach characteristic,

for each determined surgical pathway in the respective surgical approach, determining at least one pathway characteristic, and

determining a surgical-approach ranking based on the determined at least one approach characteristic and the determined at least one pathway characteristic;

wherein one or more surgical approaches in the plurality of surgical approaches further comprise a second determined surgical pathway, and wherein the at least one determined approach characteristic comprises an angulation between the first determined surgical pathway and the second determined surgical pathway;

selecting a subset of the plurality of surgical approaches based on the determined surgical approach rankings;

causing an output device to provide a representation of the selected subset of the plurality of surgical approaches;

causing the output device to provide at least a graphical pathway protection element based on a determined surgical pathway of one or more surgical approaches in the selected subset of the plurality of surgical approaches, wherein the pathway protection element is related to insertion of a surgical instrument in the determined surgical pathway, wherein the pathway protection element indicates one or more lock-outs indicating one or more regions where the surgical instrument is prevented from moving into and/or one or more lock-ins indicating one or more regions where the surgical instrument is prevented from moving from; and

providing one or more warnings when the surgical instrument approaches a boundary of at least one of the one or more lock-outs and/or the one or more lock-ins.

14. The physical computer readable medium of claim 13, wherein the output device comprises a graphical display, and wherein causing the graphical display to provide the representation comprises causing the graphical display to provide a three-dimensional graphical representation of the determined representation.

15. The physical computer readable medium of claim 13, wherein the output device comprises an additive manufacturing machine;

and wherein causing the additive manufacturing machine to make the representation comprises causing the additive manufacturing machine to provide a physical representation of the determined representation.

16. The physical computer readable medium of claim 13, wherein the functions further comprise:

receive data including one or more surgical performance parameters regarding a performed surgery; and

generate a score for the performed surgery, the score based on the one or more surgical performance parameters.

17. The physical computer readable medium of claim 13, wherein, for each determined surgical pathway, the at least one determined pathway characteristic comprises at least one of:

(a) a pathway length;

(b) an angulation between the determined surgical pathway and an anatomical plane;

(c) a volume of the determined surgical pathway;

(d) an intersected anatomical structure;

or (e) a distance that an anatomical structure is displaced to provide the surgical pathway.

18. The physical computer readable medium of claim 13, wherein the functions further comprise:

causing a surgical instrument to move based on the selected subset of surgical approaches.