POSITIONING AND ORIENTATION OF SURGICAL TOOLS DURING PATIENT SPECIFIC PORT PLACEMENT

• US 20140350572A1
• Filed: 11/23/2012
• Published: 11/27/2014
• Est. Priority Date: 12/05/2011
• Status: Active Grant

• Current Assignee: Koninklijke Philips N.V.
• Original Assignee: Koninklijke Philips N.V.
• Inventors: Elhawary, Haytham, Popovic, Aleksandra, Chan, Raymond, Manzke, Robert
• Granted Patent: US 10,687,911 B2
• Time in Patent Office: Days
• US Class Current: 606/130
• CPC Class Codes: A61B 2034/304 including a freely orientable platform, e.g. so called 'Stewart platforms'
• CPC Class Codes: A61B 2090/103 Cranial plugs for access to brain
• CPC Class Codes: A61B 34/30 Surgical robots
• CPC Class Codes: A61B 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints

Abstract

A positioning apparatus includes a first portion (123) having a first opening (125) for alignment with a port entry point. A second portion (127) is positionable for alignment with the first opening from a plurality of different positions. An actuation mechanism (142) is coupled to at least one of the first portion and the second portion to set relative positions of the first and second portions to permit a tool axis formed between the first and second portions to be aligned through the first opening such that a tool (104) provided on the tool axis would include a known position and orientation.

Claims

1. A positioning apparatus, comprising:

a first portion (123) having a first opening (125) for alignment with a port entry point;

a second portion (127) being positionable for alignment with the first opening from a plurality of different positions; and

an actuation mechanism (142) coupled to at least one of the first portion and the second portion to set relative positions of the first and second portions to permit a tool axis formed between the first and second portions to be aligned through the first opening such that a tool (104) provided on the tool axis would include a known position and orientation.

2. The apparatus as recited in claim 1, wherein the actuation mechanism (144) includes at least one stage for actuating the second portion relative to the first opening.

3. The apparatus as recited in claim 1, wherein the actuation mechanism (144) includes two orthogonal stages for adjustment of the second portion relative to the first opening.

4. The apparatus as recited in claim 1, wherein the first opening (125) is formed in a plate that is coupled to a base by a second actuation mechanism (540, 506) and the second actuation mechanism includes at least one stage for actuating the base relative to the plate.

5. The apparatus as recited in claim 1, wherein the actuation mechanism (142) includes a plurality of piston-cylinder actuators (606).

6. The apparatus as recited in claim 1, wherein the first opening (125) is formed in a plate that engages a mounting position (128) on a subject such that the first opening corresponds with a port entry point in the subject.

7. The apparatus as recited in claim 6, further comprising a tool (104) passing through the first opening and a second opening in the second portion and entering the entry port into the subject along the tool axis such that the tool is maintained in a visible position by a scope inside the subject.

8. The apparatus as recited in claim 7, wherein the actuation mechanism (142) is computer controlled and set at a position based upon feedback from a position or view of the scope.

9. The apparatus as recited in claim 1, wherein the positioning apparatus (130) is located on a subject by a port localization system (120).

10. (canceled)

11. (canceled)

12. A positioning apparatus, comprising:

a first plate (406) having a first opening for alignment with a port entry point;

a second plate (408) having a second opening for alignment with the first opening; and

an actuation mechanism (412, 414) coupled to at least one of the first plate and the second plate and set to permit a tool axis to be aligned through the first and second openings such that a tool provided on the tool axis would pass through the port entry point with a known position and orientation.

13. A positioning apparatus, comprising:

a first slotted arch (704) hingedly coupled to a base (702);

a second slotted arch (706) hingedly coupled to the base and disposed orthogonally with respect to the first slotted arch; and

a channel (712) passing through a slot in the first slotted arch and a slot of the second slotted arch for alignment of the channel with a center of rotation corresponding with a port entry point such that rotation of the tool axis is controlled by rotations of the first and second slotted arches to provide alignment for a known position and orientation of the tool axis.

14. The apparatus as recited in claim 13, wherein at least one of the first and second slotted arches includes a brake to hold a position.

15. The apparatus as recited in claim 13, wherein the base (702) engages a mounting position on a subject such that the center of rotation corresponds with a port entry point in the subject.

16. The apparatus as recited in claim 15, further comprising a tool (104) passing through the channel and entering the entry port into the subject along the tool axis such that the tool is maintained in a visible position by a scope inside the subject.

17. (canceled)

18. (canceled)

19. A method for positioning instruments, comprising:

placing (802) a scope in a first port in a subject;

determining (804) a position for a second port for an instrument;

mounting (806) a positioning and orientation apparatus to the subject, the positioning and orientation apparatus including at least two openings with adjustable positions for aligning a tool axis with respect to the second port; and

positioning (808) a tool along the tool axis through the at least two openings in accordance with a field of view of the scope.

20. (canceled)

21. (canceled)

22. (canceled)

23. (canceled)