Pathway planning for use with a navigation planning and procedure system

• US 10,631,933 B2
• Filed: 08/31/2016
• Issued: 04/28/2020
• Est. Priority Date: 08/31/2016
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Krimsky, William S.
• Primary Examiner(s): Harward, Soren
• Application Number:
  US15/253,409
• Publication Number:
  US 20180060524A1
• Time in Patent Office: 1,336 Days
• Field of Search: None
• CPC Class Codes: A61B 2017/00809 Lung operations
• CPC Class Codes: A61B 2034/101 Computer-aided simulation of surgical operations
• 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 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• CPC Class Codes: A61B 2090/373 using light, e.g. by using optical scanners
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 2090/3925 ultrasonic
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• 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 34/25 User interfaces for surgical systems
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 30/20 for handling medical images, e.g. DICOM, HL7 or PACS
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders

Abstract

Disclosed are systems, devices, and methods for planning a procedure for treatment of tissue in a patient'"'"'s lungs. An exemplary method includes generating a three-dimensional (3D) model of the patient'"'"'s lungs, displaying the 3D model of the patient'"'"'s lungs, selecting a target location in the tissue of the patient'"'"'s lungs as displayed on the 3D model, identifying a point on a pleural surface of the patient'"'"'s lungs with access to the target location, determining an access path between the target location and the identified point on the pleural surface, calculating a risk of injury to intervening structures between the identified point on the pleural surface and the target location, based on the determined access path, and displaying the access path and the calculated risk of injury for the access path on the 3D model.

Claims

1. A method of planning a procedure for treatment of tissue in a patient'"'"'s lungs, the method comprising:

generating a three-dimensional (3D) model of the patient'"'"'s lungs;

displaying the 3D model of the patient'"'"'s lungs;

selecting a target location in the tissue of the patient'"'"'s lungs as displayed on the 3D model;

identifying a point on a pleural surface of the patient'"'"'s lungs with access to the target location;

determining an access path between the target location and the identified point on the pleural surface;

identifying a percutaneous entry point on an exterior of the patient'"'"'s body;

generating an insertion pathway between the identified percutaneous entry point and a point on the pleural surface;

determining if the point on the pleural surface of the generated insertion pathway is different from the identified point on the pleural surface of the access path;

generating a second insertion pathway if it is determined that the point on the pleural surface of the generated insertion pathway is different from the identified point on the pleural surface of the access path;

calculating a risk of injury to intervening structures between the identified point on the pleural surface of the access path and the target location, based on the access path;

using a tracking system to determine a position of a surgical tool in a body of a patient; and

displaying the access path, the insertion pathway, the position of the surgical tool, and the calculated risk of injury for the access path on the 3D model.

2. The method of claim 1, wherein the identified point on the pleural surface of the access path is a first identified point on the pleural surface and the access path is a first access path, and the method further comprises:

identifying a second point on the pleural surface with access to the target location;

determining a second access path between the target location and the second identified point on the pleural surface; and

calculating a risk of injury to intervening structures between the target location and the second identified point on the pleural surface, based on the determined second access path,

wherein displaying the first access path and the calculated risk of injury for the first access path on the 3D model further includes displaying the second access path and the calculated risk of injury for the second access path on the 3D model.

3. The method of claim 2, further comprising:

determining which of the first and second access paths has a lower calculated risk of injury; and

selecting the access path that is determined to have a lower risk of injury.

4. The method of claim 2, further comprising receiving a user input selecting one of the first and second access paths.

5. The method of claim 1, wherein the identified point on the pleural surface of the access path with access to the target location is identified based on input received from a user.

6. The method of claim 5, further comprising:

identifying an alternative point on the pleural surface with access to the target location;

determining an alternative access path between the alternative point on the pleural surface and the target location; and

calculating a risk of injury to intervening structures between the target location and the alternative point on the pleural surface, based on the determined alternative access path,

wherein displaying the access path and the calculated risk of injury for the access path on the 3D model further includes displaying the alternative access path and the calculated risk of injury for the alternative access path on the 3D model.

7. The method of claim 1, further comprising receiving a user input selecting a point on the target location as an end point for the access path,

wherein the access path is determined between the identified point on the pleural surface of the access path and the point on the target location.

8. The method of claim 7, further comprising:

identifying an alternative point on the target location as an alternative end point for the access path;

determining an alternative access path between the identified point on the pleural surface of the access path and the alternative point on the target location; and

calculating a risk of injury to intervening structures between the identified point on the pleural surface of the access path and the alternative point on the target location, based on the determined alternative access path,

wherein displaying the access path and the calculated risk of injury for the access path on the 3D model further includes displaying the alternative access path and the calculated risk of injury for the alternative access path on the 3D model.

9. The method of claim 1, further comprising providing an alert if the calculated risk of injury is more than a predetermined threshold.

10. The method of claim 1, wherein the access path is represented by a straight line.

11. The method of claim 1, wherein the access path is represented by a curved line.

12. The method of claim 1, wherein the intervening structures are one or more of an airway wall, nerves, vascular lumens, vascular structures, lymphatic lumens, and lymphatic structures.

13. A navigation planning and procedure system comprising:

a display device;

a tracking system configured to determine a position of a surgical tool in a body of a patient;

at least one processor in communication with the display device; and

a memory storing instructions that, when executed by the at least one processor, cause the at least one processor to;

generate a three-dimensional (3D) model of a patient'"'"'s lungs;

cause the display device to display the 3D model of the patient'"'"'s lungs;

select a target location in tissue of the patient'"'"'s lungs as displayed on the 3D model;

identify a point on a pleural surface of the patient'"'"'s lungs with access to the target location;

determine an access path between the target location and the identified point on the pleural surface;

identify a percutaneous entry point on an exterior of the patient'"'"'s body;

generate an insertion pathway between the identified percutaneous entry point and a point on the pleural surface;

determine if the point on the pleural surface of the generated insertion pathway is different from the identified point on the pleural surface of the access path;

generate a second insertion pathway if it is determined that the point on the pleural surface of the generated insertion pathway is different from the identified point on the pleural surface of the access path;

calculate a risk of injury to intervening structures between the identified point on the pleural surface of the access path and the target location, based on the access path; and

cause the display device to display the access path, the insertion pathway, the position of the surgical tool, and the calculated risk of injury for the access path on the 3D model.

14. The navigation planning and procedure system of claim 13, wherein the identified point on the pleural surface of the access path is a first identified point on the pleural surface and the access path is a first access path, and wherein the memory further stores instructions which, when executed by the at least one processor, cause the at least one processor to:

identify a second point on the pleural surface with access to the target location;

determine a second access path between the target location and the second identified point on the pleural surface; and

calculate a risk of injury to intervening structures between the target location and the second identified point on the pleural surface, based on the determined second access path,

wherein displaying the first access path and the calculated risk of injury for the first access path on the 3D model further includes displaying the second access path and the calculated risk of injury for the second access path on the 3D model.

15. The navigation planning and procedure system of claim 14, wherein the memory further stores instructions which, when executed by the at least one processor, cause the at least one processor to:

determine which of the first and second access paths has a lower calculated risk of injury; and

select the access path that is determined to have a lower risk of injury.

16. The navigation planning and procedure system of claim 13, wherein the identified point on the pleural surface of the access path with access to the target location is identified based on input received from a user.

17. The navigation planning and procedure system of claim 16, wherein the memory further stores instructions which, when executed by the at least one processor, cause the at least one processor to:

identify an alternative point on the pleural surface with access to the target location;

determine an alternative access path between the alternative point on the pleural surface and the target location; and

calculate a risk of injury to intervening structures between the target location and the alternative point on the pleural surface, based on the determined alternative access path,

wherein displaying the access path and the calculated risk of injury for the access path on the 3D model further includes displaying the alternative access path and the calculated risk of injury for the alternative access path on the 3D model.

18. The navigation planning and procedure system of claim 13, wherein the memory further stores instructions which, when executed by the at least one processor, cause the at least one processor to receive a user input selecting a point on the target location as an end point for the access path,

wherein the access path is determined between the identified point on the pleural surface of the access path and the point on the target location.

19. The navigation planning and procedure system of claim 13, wherein the memory further stores instructions which, when executed by the at least one processor, cause the at least one processor to:

identify an alternative point on the target location as an alternative end point for the access path;

determine an alternative access path between the identified point on the pleural surface of the access path and the alternative point on the target location; and

calculate a risk of injury to intervening structures between the identified point on the pleural surface of the access path and the alternative point on the target location, based on the determined alternative access path,

wherein displaying the access path and the calculated risk of injury for the access path on the 3D model further includes displaying the alternative access path and the calculated risk of injury for the alternative access path on the 3D model.

20. A non-transitory computer-readable storage medium storing instructions which, when executed by a processor, cause the processor to:

generate a three-dimensional (3D) model of a patient'"'"'s lungs;

cause a display device to display the 3D model of the patient'"'"'s lungs;

identify a point on a pleural surface of the patient'"'"'s lungs with access to a target location in tissue of the patient'"'"'s lungs as displayed on the 3D model;

determine an access path between the target location and the identified point on the pleural surface;

identify a percutaneous entry point on an exterior of the patient'"'"'s body;

generate an insertion pathway between the identified percutaneous entry point and a point on the pleural surface;

determine if the point on the pleural surface of the generated insertion pathway is different from the identified point on the pleural surface of the access path;

generate a second insertion pathway if it is determined that the point on the pleural surface of the generated insertion pathway is different from the identified point on the pleural surface of the access path;

calculate a risk of injury to intervening structures between the target location and the identified point on the pleural surface of the access path, based on the access path;

receive data describing a position of a surgical tool within a body of a patient; and

cause a display device to display the access path, the insertion pathway, the position of the surgical tool, and the calculated risk of injury for the access path on the 3D model.