Fiducials for placement of tissue closures

• US 20080262390A1
• Filed: 07/20/2007
• Published: 10/23/2008
• Est. Priority Date: 04/19/2007
• Status: Abandoned Application

• Current Assignee: Deep Science LLC (Intellectual Ventures LLC)
• Original Assignee: Searete LLC (Intellectual Ventures LLC)
• Inventors: Ishikawa, Muriel Y., Smith, Michael A., Tegreene, Clarence T., Boyden, Edward S., Jung, Edward K.Y., Rivet, Dennis J., Hyde, Roderick A., Sweeney, Elizabeth A., Wood, Victoria Y.H., Bangera, Mahalaxmi Gita, Leuthardt, Eric C., Wood, Lowell L.
• Application Number:
  US11/880,478
• Publication Number:
  US 20080262390A1
• Time in Patent Office: Days
• US Class Current: 600/587
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0466 Suture bridges
• CPC Class Codes: A61B 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 17/085 with adhesive layer
• CPC Class Codes: A61B 17/3474 Insufflating needles, e.g. Veress needles
• CPC Class Codes: A61B 2017/00004 (bio)absorbable, (bio)resorbable, resorptive for implantable prostheses A61F2210/0004
• CPC Class Codes: A61B 2017/00637 for sealing trocar wounds through abdominal wall
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/00884 enhancing wound closure
• CPC Class Codes: A61B 2017/00889 antimicrobial, disinfectant
• CPC Class Codes: A61B 2017/00893 pharmaceutically effective
• CPC Class Codes: A61B 2017/081 Tissue approximator A61B2017/1103, A61B17/8866 take precedence
• CPC Class Codes: A61B 2017/086 having flexible threads, filaments, laces or wires, e.g. parallel threads, extending laterally from a strip, e.g. for tying to opposing threads extending from a similar strip
• CPC Class Codes: A61B 2017/320052 Guides for cutting instruments by marking A61B2090/395
• CPC Class Codes: A61B 2034/101 Computer-aided simulation of surgical operations
• CPC Class Codes: A61B 2034/256 having a database of accessory information, e.g. including context sensitive help or scientific articles
• CPC Class Codes: A61B 2090/363 Use of fiducial points
• CPC Class Codes: A61B 2090/366 using projection of images directly onto the body
• CPC Class Codes: A61B 2090/3937 Visible markers
• CPC Class Codes: A61B 2090/395 with marking agent for marking skin or other tissue
• CPC Class Codes: A61B 2090/3987 : Applicators for implanting markers
• CPC Class Codes: A61B 34/10 : Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 90/39 : Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61B 90/96 : using barcodes

Abstract

Fiducial markings are placed on a patient to identify surgical parameters such as locations for an incision or a surgical closure.

Claims

1. A system for planning placement of tissue anchors during a surgery, comprising:

input circuitry configured to receive a signal including information relating to a planned surgery on a body of an animal; and

anchor placement circuitry configured to use the received signal to determine preferred placement of tissue anchors for the surgery.

2. The system of claim 1, wherein the input circuitry includes a sensor configured to measure a physiological parameter of the animal.

10. The system of claim 1, wherein the signal includes a physiological parameter of the animal.

12. The system of claim 1, wherein the anchor placement circuitry includes tissue modeling circuitry.

13. The system of claim 12, wherein the tissue modeling circuitry is configured to build a virtual model of at least a portion of the body.

16. The system of claim 1, wherein the anchor placement circuitry includes stress estimation circuitry.

20. The system of claim 1, wherein the anchor placement circuitry includes an anchor placement pattern library.

24. The system of claim 1, wherein the anchor placement circuitry includes anchor form factor selection circuitry.

29. The system of claim 1, further comprising an output configured to display the determined preferred placement of tissue anchors.

32. The system of claim 29, wherein the output includes a patient marking device.

36. The system of claim 29, wherein the output includes a printer that marks a tape with fiducial marks indicating the preferred placement of tissue anchors, wherein the tape is configured to be attached to the body of the animal.

3-9. -9. (canceled)

11. (canceled)

14-15. -15. (canceled)

17-19. -19. (canceled)

21-23. -23. (canceled)

25-28. -28. (canceled)

30-31. -31. (canceled)

33-35. -35. (canceled)

37-39. -39. (canceled)

40. A tool for placement of fiducial marks on a body of an animal, comprising:

a marking roller configured to be rolled along the surface of the body of the animal, wherein the marking roller includes a fiducial-marking surface configured to make at least one fiducial mark on the body as the fiducial-marking surface comes in contact with the surface of the body;

the at least one fiducial mark on the body indicating locations for a surgical incision and for a surgical closure element.

43. The tool of claim 40, wherein the at least one fiducial mark includes a substantially continuous line along a path followed by the roller.

44. The tool of claim 43, wherein the substantially continuous line indicates the planned location of the surgical incision.

45. The tool of claim 43, wherein the at least one fiducial mark includes an alignment mark offset from the substantially continuous line.

46. The tool of claim 45, wherein the alignment mark indicates the planned location of a surgical closure element.

47. The tool of claim 40, wherein the roller includes a cutting edge configured to cut tissue along a cutting path.

48. The tool of claim 47, wherein the cutting path indicates the location of the surgical incision.

53. The tool of claim 40, wherein the tool is configured to make the at least one fiducial mark on the animal'"'"'s skin.

54. The tool of claim 40, wherein the tool is configured to make the at least one fiducial mark on a tissue of the animal selected from the group consisting of bone, muscle, organs, and connective tissue.

41-42. -42. (canceled)

49-52. -52. (canceled)

55. A surgical tool for placement of fiducial marks on a body of an animal, comprising:

a tape dispenser configured to dispense a tape configured for attachment to the body of the animal, wherein the tape includes at least one fiducial mark thereon that indicates a surgical plan.

56. The tool of claim 55, wherein the tape includes an adhesive layer configured to attach the tape to the body of the animal.

57. The tool of claim 55, wherein the at least one fiducial mark identifies an incision location.

58. The tool of claim 55, wherein the tape includes an opening for an incision.

61. The tool of claim 55, wherein the tape dispenser comprises a roller loaded with the marked tape.

63. The tool of claim 55, further comprising a printer configured to place the at least one fiducial mark on the tape.

59-60. -60. (canceled)

62. (canceled)

64-67. -67. (canceled)

68. A surgical tool for placement of fiducial marks on a body of an animal, comprising:

an energy source configured to induce a modification of an energy-responsive material on the body, wherein the modification forms at least one fiducial mark indicative of a surgical plan.

69. The tool of claim 68, wherein the at least one fiducial mark indicates an incision location.

70. The tool of claim 68, wherein the at least one fiducial mark indicates a location of a surgical closure element.

71. The tool of claim 68, further comprising:

identification circuitry configured to

identify an incision location for a surgical closure; and

determine an incision mark location for the at least one fiducial mark that characterizes the incision location for the surgical closure; and

controller circuitry configured to direct the energy source to modify the energy-responsive material in accordance with the determined incision mark location to form the at least one fiducial mark.

75. The tool of claim 68, wherein the energy source produces electromagnetic energy.

78. The tool of claim 68, wherein the energy source produces a particle beam.

72-74. -74. (canceled)

76-77. -77. (canceled)

79-84. -84. (canceled)

85. A method of preparing a patient for surgery, comprising:

identifying at least one preferred attachment point for a surgical closure; and

placing at least one fiducial mark at each of the at least one preferred attachment points, wherein the at least one fiducial mark is machine-readable.

86. The method of claim 85, wherein placing the at least one fiducial mark includes placing the at least one fiducial mark with a marking roller.

87. The method of claim 86, further comprising constructing the marking roller in a configuration to place the at least one fiducial mark at each of the at least one preferred attachment points.

88. The method of claim 85, wherein placing the at least one fiducial mark includes adhering a stabilizing member to the patient, wherein the stabilizing member includes the at least one fiducial mark.

89. The method of claim 85, wherein placing the at least one fiducial mark includes:

applying an energy-sensitive material to the patient; and

exposing the energy-sensitive material to a spatially patterned energy flux that modifies the energy-sensitive material to produce the at least one fiducial mark.

90. The method of claim 85, wherein identifying at least one preferred attachment point for a surgical closure includes measuring a physiological parameter of the patient.

91. The method of claim 85, wherein identifying at least one preferred attachment point for a surgical closure includes constructing a virtual model of at least a portion of the patient.

93. The method of claim 85, wherein identifying at least one preferred attachment point for a surgical closure includes determining expected stresses on a surgical closure at the at least one preferred attachment point.

92. (canceled)

94-99. -99. (canceled)

100. A method of preparing a patient for surgery, comprising:

identifying at least one preferred attachment point for a surgical closure; and

placing at least one fiducial mark on a stabilizing member configured to be adhered to the patient, wherein the at least one fiducial mark is placed to indicate the at least one preferred attachment point upon adhering the stabilizing member to the patient.

101. The method of claim 100, further comprising adhering the stabilizing member to the patient.

104. The method of claim 101, wherein adhering the stabilizing member to the patient includes loading the stabilizing member into a dispenser and dispensing the stabilizing member from the dispenser.

110. The method of claim 100, wherein placing the at least one fiducial mark on the stabilizing member includes printing the at least one fiducial mark on the stabilizing member.

111. The method of claim 100, wherein the stabilizing member includes at least one registration mark configured to identify a location for placement of the stabilizing member on the patient.

114. The method of claim 100, wherein the at least one fiducial mark includes three-dimensional surgical information.

102-103. -103. (canceled)

105-109. -109. (canceled)

112-113. -113. (canceled)

115-116. -116. (canceled)

117. A method of preparing the body of a patient for surgery, comprising:

identifying at least one preferred attachment point for a surgical closure;

applying an energy-responsive material to the body; and

exposing the energy-responsive material to a spatially patterned energy flux, wherein the spatially patterned energy flux modifies the energy-responsive material to form at least one fiducial mark placed to indicate the at least one preferred attachment point for the surgical closure.

118. The method of claim 117, wherein identifying at least one preferred attachment point for a surgical closure includes measuring a physiological parameter of the patient.

123. The method of claim 117, wherein the spatially patterned energy flux is electromagnetic radiation.

125. The method of claim 117, wherein the at least one fiducial mark includes three-dimensional surgical information.

119-122. -122. (canceled)

124. (canceled)

126-129. -129. (canceled)