Method And Apparatus For Optimizing A Computer Assisted Surgical Procedure

• US 20080081982A1
• Filed: 03/08/2007
• Published: 04/03/2008
• Est. Priority Date: 09/29/2006
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Singhal, Ruchika, Simon, David, Lent, Mark S., Csavoy, Andrew N.
• Granted Patent: US 8,660,635 B2
• Time in Patent Office: Days
• US Class Current: 600/407
• 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: A61B 5/0066 Optical coherence imaging
• CPC Class Codes: A61B 5/0084 for introduction into the body, e.g. by catheters A61B5/1459 takes precedence
• CPC Class Codes: A61B 5/062 using magnetic field
• CPC Class Codes: A61B 5/066 Superposing sensor position on an image of the patient, e.g. obtained by ultrasound or x-ray imaging
• CPC Class Codes: A61B 5/7435 Displaying user selection data, e.g. icons in a graphical user interface
• CPC Class Codes: A61B 90/06 Measuring instruments not otherwise provided for
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 5/1048 Monitoring, verifying, controlling systems and methods
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• 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 20/70 relating to mental therapies, e.g. psychological therapy or autogenous training
• CPC Class Codes: G16H 30/20 for handling medical images, e.g. DICOM, HL7 or PACS
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders

Abstract

A method and apparatus for optimizing a computer assisted procedure is provided. A method and apparatus for performing a procedure is also provided. Data can be accessed and processed to optimize and perform a procedure. The data can be augmented or supplemented with patient specific data.

Claims

1. A method of performing a procedure on an anatomy of a patient, comprising:

determining the procedure;

obtaining patient specific data relevant to the determined procedure;

obtaining database data relevant to the determined procedure; and

planning the determined procedure based upon the obtained patient specific data and the obtained database data.

2. The method of claim 1, wherein planning the determined procedure, includes:

selecting a target in the anatomy;

determining a trajectory of an instrument to reach the selected target; and

determining a therapy to be applied to the anatomy via the instrument.

3. The method of claim 2, wherein determining the trajectory includes determining an entry point into the anatomy and a path for the instrument to take to reach a selected region of the anatomy.

4. The method of claim 1, further comprising;

navigating an instrument to achieve the plan.

5. The method of claim 4, wherein navigating the instrument includes:

providing a tracking system including localizer and a tracking device;

associating the tracking device with the instrument;

tracking the tracking device; and

determining the location of at least a portion of the instrument relative to the anatomy.

6. The method of claim 3, wherein the obtained patient specific data includes patient specific image data;

wherein determining an entry point includes determining an entry point with the obtained patient specific image data and wherein determining a path includes determining a path with the obtained patient specific image data.

7. The method of claim 6, further comprising:

navigating an instrument relative to the anatomy; and

superimposing an icon on the patient specific image data representing the position of the instrument relative to the anatomy.

8. The method of claim 7, further comprising:

providing a display device operable to display the patient specific image data and the icon;

providing an imaging system operable to obtain the patient specific image data;

providing a tracking system including a localizer and a tracking device; and

tracking a position of the instrument with the tracking system.

9. The method of claim 1, further comprising:

performing the procedure on the anatomy;

obtaining patient specific information while performing the procedure on the anatomy; and

augmenting the database data based upon the obtained patient specific information obtained while performing the procedure.

10. The method of claim 9, further comprising:

saving the augmented database data;

determining a second procedure; and

planning the determined second procedure based upon the obtained patient specific data and the augmented database data.

11. The method of claim 10, wherein the second procedure is performed on a second anatomy.

12. The method of claim 1, further comprising:

performing the determined procedure;

wherein planning the determined procedure includes determining a location for providing a therapy; and

performing the therapy on the anatomy, including at least one of electrically stimulating the anatomy, providing a chemical therapy to the anatomy, providing a biological therapy to the anatomy, providing a radiation based therapy to the anatomy, or combinations thereof.

13. The method of claim 1, further comprising:

navigating an instrument to a position planned in the planning the determined procedure;

implanting the instrument into the anatomy; and

programming the instrument to provide a therapy.

14. The method of claim 1, further comprising:

displaying the obtained patient specific data;

selecting a therapy;

predicting a localized physiological affect of the therapy based at least in part on the database data.

15. The method of claim 1, wherein obtaining patient specific data includes at least one of obtaining image data, obtaining functional data, obtaining gating data, obtaining patient history data, or combinations thereof.

28. The method of claim 15, further comprising:

obtaining database data;

wherein illustrating a first localized physiological affect of a first therapy includes determination of a localized physiological affect from the database data.

29. The method of claim 28, further comprising:

determining a specific localized physiological affect on the anatomy after performing the first therapy on the anatomy; and

augmenting the database data to form an augmented database data including the determined specific localized physiological affect on the anatomy of the first therapy.

16. A method of performing a procedure on an anatomy of a patient, comprising:

selecting a position of the procedure within the anatomy;

obtaining data regarding the anatomy;

planning the procedure at least in part with the obtained data regarding the anatomy;

navigating an instrument to the selected position;

illustrating a first localized physiological affect of a first therapy on the anatomy; and

performing the first therapy on the anatomy.

17. The method of claim 16, further comprising:

obtaining a second set of data regarding the anatomy after performing the therapy;

illustrating a second localized physiological affect of a second therapy on the anatomy; and

performing the second therapy on the anatomy.

22. The method of claim 16, further comprising:

implanting the instrument into the anatomy prior to performing the first therapy.

23. The method of claim 22, wherein performing the first therapy occurs at a time subsequent to the completion of the selected procedure.

24. The method of claim 22, further comprising:

performing a second therapy on the anatomy;

wherein implanting the instrument includes implanting a plurality of the instruments;

wherein performing the first therapy include providing the first therapy via a first of the plurality of the instruments and providing the second therapy includes providing the second therapy via a second of the plurality of the instruments.

25. The method of claim 16, further comprising:

providing a display device;

wherein illustrating a first localized physiological effect includes displaying an icon relative to the obtained data regarding the anatomy.

26. The method of claim 24, wherein the icon includes a viewable feature that changes based upon the first therapy.

27. The method of claim 24, wherein the icon illustrates a geometrical shape of the first therapy, an identity of the first therapy, a time lapse effect of the first therapy, or combinations thereof.

18. The method of 17, further comprising:

determining a first general effect of the first therapy on the anatomy;

wherein the second therapy is at least one of identical to the first therapy, different than the first therapy, or combinations thereof.

19. A method of claim 18, further comprising:

augmenting the second therapy compared to the first therapy so that the second therapy is different from the first therapy;

wherein the different therapy includes a different electrical voltage, a different electrical pulse width, a different chemical delivered, a different dosage delivered, a different electrical lead activated, or combinations thereof.

20. The method of claim 18, further comprising:

determining a second general effect of the second therapy on the anatomy;

comparing the determined first general effect and the determined second general effect; and

determining an optimized therapy on the anatomy.

21. The method of claim 20, wherein the optimized therapy can be the same as the first therapy, the same as the second therapy, different from either of the first therapy or the second therapy, or combinations thereof.

30. A method of performing a procedure on an anatomy of a patient, comprising:

providing patient specific image data;

providing a first database data;

registering the patient specific image data and the first database data;

obtaining functional patient specific data;

refining the registration of the patient specific image data and the first database data;

performing a procedure on the patient, including;

navigating an instrument relative to the patient;

displaying a representation of the navigated instrument relative to the image data of the patient; and

forming a second database data with at least one of the obtained functional patient specific data, the obtained patient specific image data, or combinations thereof.

31. The method of claim 30, further comprising:

implanting a device in the patient; and

programming the device based upon the formed second database data.

32. The method of claim 31, wherein programming the device includes at least one of selecting a dosage voltage, selecting a pulse width, selecting a material to be delivered, selecting a volume of a material to be delivered, or combinations thereof.

33. The method of claim 31, wherein implanting a device includes implanting a deep brain stimulation lead operable to deliver an electrical potential relative to the deep brain stimulation lead.

34. The method of claim 30, wherein forming the second database data includes altering a statistical data point in the database data;

wherein the statistical data point can be used to assist in identifying a region in a patient specific image data.

35. The method of claim 30, wherein registering the patient specific image data and the first database data includes morphing the patient specific image data to fit the first database data;

wherein refining the registration includes specifically identifying functional features, anatomical features, or combinations thereof in the patient specific image data.

36. The method of claim 30, further comprising:

providing a tracking system including a localizer and a tracking device;

providing an instrument associated with the tracking device;

wherein navigating the instrument includes determining a position of the instrument based upon the tracked location of the tracking device.

37. The method of claim 36, wherein the tracking device includes at least one of an optical tracking device, an electromagnetic tracking device, an acoustic tracking device, an accelerometer tracking device, a radiation tracking device, or combinations thereof.

38. The method of claim 36, further comprising:

displaying the refined registration of the patient specific image data and the first database data;

wherein displaying a representation of the navigated instrument includes displaying an icon representing the location of the instrument relative to the patient on a display device.

39. The method of claim 30, further comprising:

registering the patient specific image data and the second database data; and

identifying a target in the anatomy of the patient in the registered patient specific image data and the second database data.

40. The method of claim 39, wherein forming a second database data includes determining an average location of an anatomical feature based upon information from a plurality of patients.

41. The method of claim 30, further comprising:

identifying a target based upon the refined registration of the patient specific image data and the database data; and

providing a therapy to the target with the instrument.

42. A system for performing a procedure on an anatomy of a patient, comprising:

a first memory system storing database data;

an instrument operable to obtain functional patient specific data; and

a processor operable to access the first memory system and operable to execute instructions to perform an initial registration of the patient specific image data and the database data and perform a second registration of the patient specific image data and the database data based at least in part on the obtained functional patient specific data.

43. The system of claim 42, wherein the database data includes atlas data, average functional data, the functional patient specific data previously acquired, or combinations thereof.

44. The system of claim 42, further comprising:

a display device operable to display the patient specific image data after performing the second registration; and

an icon displayed on the display device to identify a target in the displayed image data.

45. The system of claim 44, wherein the target icon is created at a location defined via a user input, an automatic determination of the target by the processor, or combinations thereof.

46. The system of claim 44, further comprising:

a second icon operable to illustrate a predicted localized physiological affect of a therapy superimposed on the patient specific image data.

47. The system of claim 46, wherein the second icon displays a localized physiological affect of a voltage, an affect of a pulse width, an affect of the chemical volume delivered, an affect of a biological treatment delivered, an affect of a radiation treatment delivered, an affect of therapy over time, or combinations thereof.

48. The system of claim 47, further comprising:

a deep brain stimulation lead operable to be implanted in the anatomy of the patient; and

a treatment device operable to be programmed to provide a therapy through the deep brain stimulation lead implanted in the anatomy based at least in part on the localized physiological affect displayed on the display device.

49. The system of claim 48, further comprising:

a tracking system including a localizer and a tracking device, wherein the tracking device is associated with the deep brain stimulation lead.

50. The system of claim 42, further comprising:

an imaging system operable to obtain the patient specific image data; and

a tracking system including a localizer and a tracking device;

wherein a position of the tracking device is operable to be determined and indicated relative to the patient specific image data.

51. The system of claim 42, wherein the functional patient specific data includes at least one of a microelectrode recording data, pressure data, gating data, or combinations thereof.

52. The system of claim 42, wherein the instruction includes at least one of a microelectrode recorder, a catheter, a scope, a pressure monitor, or combinations thereof.