System for carrying out surgery, biopsy and ablation of a tumor or other physical anomaly

• US 5,868,673 A
• Filed: 03/11/1997
• Issued: 02/09/1999
• Est. Priority Date: 03/28/1995
• Status: Expired due to Fees

• Current Assignee: Sonometrics Corporation
• Original Assignee: Sonometrics Corporation
• Inventors: Vesely, Ivan
• Primary Examiner(s): Lateef, Marvin M.
• Assistant Examiner(s): SHAW, SHAWNA JEANNINE
• Application Number:
  US08/815,141
• Time in Patent Office: 700 Days
• Field of Search: 600/407, 600/414, 600/417, 600/439, 600/437, 600/461, 128/915, 128/916, 128/920, 128/899, 378/37, 378/205, 606/130, 601/2, 601/3
• US Class Current: 600/407
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• 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 2034/2063 Acoustic tracking systems, e.g. using ultrasound
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• CPC Class Codes: A61B 2090/363 Use of fiducial points
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 2090/3908 Soft tissue, e.g. breast tissue
• CPC Class Codes: A61B 2090/3929 Active markers
• CPC Class Codes: A61B 2090/3958 emitting a signal
• CPC Class Codes: A61B 2560/045 with a separable interface unit, e.g. for communication
• CPC Class Codes: A61B 2562/043 in a linear array
• 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 5/06 Devices, other than using radiation, for detecting or locating foreign bodies for removing same A61B17/50 ; determining position of probes within or on the body of the patient
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/4519 Muscles A61B5/389, A61B5/224 take precedence
• CPC Class Codes: A61B 5/4528 Joints A61B5/4533, A61B5/4538 take precedence
• CPC Class Codes: A61B 8/0833 involving detecting or locating foreign bodies or organic structures
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 8/4236 : characterised by adhesive patches
• CPC Class Codes: A61B 8/4245 : involving determining the position of the probe, e.g. with respect to an external reference frame or to the patient
• CPC Class Codes: A61B 8/483 : involving the acquisition of a 3D volume of data
• CPC Class Codes: A61B 90/10 : for stereotaxic surgery, e.g. frame-based stereotaxis
• CPC Class Codes: A61B 90/11 : with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61B 90/17 : for soft tissue, e.g. breast-holding devices
• CPC Class Codes: A61B 90/36 : Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61B 90/39 : Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61M 2025/0166 : Sensors, electrodes or the like for guiding the catheter to a target zone, e.g. image guided or magnetically guided
• CPC Class Codes: A61M 25/0105 : Steering means as part of the catheter or advancing means; Markers for positioning systems for detection of markers A61B
• CPC Class Codes: G01H 3/00 : Measuring characteristics of vibrations by using a detector in a fluid G01H7/00, G01H9/00, G01H11/00 take precedence
• CPC Class Codes: G01H 5/00 : Measuring propagation velocity of ultrasonic, sonic or infrasonic waves , e.g. of pressure waves
• CPC Class Codes: G01S 11/14 : using ultrasonic, sonic, or infrasonic waves
• CPC Class Codes: G01S 15/101 : Particularities of the measurement of distance G01S15/12, G01S15/14, and G01S15/18 take precedence
• CPC Class Codes: G01S 15/66 : Sonar tracking systems
• CPC Class Codes: G01S 15/86 : Combinations of sonar systems with lidar systems; Combinations of sonar systems with systems not using wave reflection
• CPC Class Codes: G01S 15/87 : Combinations of sonar systems
• CPC Class Codes: G01S 15/876 : Combination of several spaced transmitters or receivers of known location for determining the position of a transponder or a reflector G01S15/872 takes precedence
• CPC Class Codes: G01S 15/88 : Sonar systems specially adapted for specific applications seismic or acoustic prospecting or detecting G01V1/00
• CPC Class Codes: G01S 15/899 : Combination of imaging systems with ancillary equipment
• CPC Class Codes: G01S 15/8993 : Three dimensional imaging systems
• CPC Class Codes: G01S 5/18 : using ultrasonic, sonic, or infrasonic waves
• CPC Class Codes: G01S 7/52003 : Techniques for enhancing spatial resolution of targets G01S7/52046 takes precedence
• CPC Class Codes: G01S 7/5206 : Two-dimensional coordinated display of distance and direction; B-scan display
• CPC Class Codes: G01S 7/52074 : Composite displays, e.g. split-screen displays; Combination of multiple images or of images and alphanumeric tabular information
• CPC Class Codes: G01S 7/52079 : Constructional features constructional features of transducers B06B; mounting transducers G10K11/00; constructional features of ultrasonic medical diagnostic devices A61B8/44
• CPC Class Codes: G01S 7/6245 : Stereoscopic displays; Three-dimensional displays; Pseudo-three dimensional displays
• CPC Class Codes: Y02A 90/10 : Information and communication technologies [ICT] supporting adaptation to climate change, e.g. for weather forecasting or climate simulation

Abstract

A system for carrying out surgery on a bodily structure (e.g., breast and liver) with greater precision, accuracy, comfort and minimal invasiveness. A 3-dimensional tracking and imaging system (1000) is used to obtain an accurate position of an instrument as it is maneuvered by an operator, and to mark a location on the subject bodily structure. The system is particularly advantageous for surgical procedures for biopsying and destroying tumors in bodily structures which are easily deformable.

Claims

1. A method for carrying out surgery on a tumor in a bodily structure for the purpose of biopsy or ablation, comprising:

mounting a plurality of reference transducer means to fixed positions relative to a bodily structure to provide a reference frame;

obtaining a template image of the bodily structure;

registering the reference frame with the template image to obtain a 3-dimensional scene;

locating a beacon transducer means at the location of a tumor by displaying the position of the beacon transducer means within the 3-dimensional scene;

fixing the beacon transducer means at the location of the tumor to identify the location thereof; and

locating a first instrument means at the location of the tumor by displaying the position of the first instrument means relative to the reference frame and beacon transducer means.

2. A method according to claim 1, wherein said step of mounting a plurality of reference transducer means to fixed positions includes the step of mounting a plurality of transducer means to the surface of a breast.

3. A method according to claim 1, wherein the step of mounting a plurality of reference transducer means to fixed positions includes the step of mounting a plurality of transducer means to the external surface of a solid organ.

4. A method according to claim 1, wherein said step of obtaining a template image includes obtaining a mammogram.

5. A method according to claim 1, wherein said step of obtaining a template image includes obtaining a radiological image.

6. A method according to claim 1, wherein the step of locating the beacon transducer means at the location of the tumor includes the steps of:

attaching the beacon transducer means to a second instrument means;

moving the second instrument means to the location of the tumor;

detaching the beacon transducer means from the second instrument means; and

fixing the beacon transducer means at the location of the tumor.

7. A system for carrying out surgery on a tumor in a bodily structure for the purpose of biopsy or ablation, comprising:

a plurality of reference transducer means located at fixed positions on the bodily structure to provide a reference frame;

means for obtaining a template image of a bodily structure;

registration means for registering the reference frame with the template image to obtain a 3-dimensional scene;

display means for displaying the 3-dimensional scene of the bodily structure;

first instrument means for fixing the location of a beacon transducer means at the site of a tumor to identify the location of the tumor; and

second instrument means for performing a surgical procedure at the site of the tumor, wherein the second instrument means has a transducer means for indicating the position of the first instrument means relative to the reference frame and the location of the beacon transducer means.

8. A system according to claim 7, wherein said fixed positions are on the surface of a breast.

9. A system according to claim 7, wherein said fixed positions are on the external surface of a solid organ.

10. A system according to claim 7, wherein said template image is a mammogram.

11. A system according to claim 7, wherein said template image is a radiological image.

12. A system according to claim 7, wherein said first instrument means includes means for separating said beacon transducer means from said first instrument means.

13. A system according to claim 7, wherein each of said plurality of reference transducer means comprises:

a transducer device; and

support means for supporting the transducer device, said support means including an adhesive for affixing the reference transducer means to the fixed position on the bodily structure and a gel for acoustic coupling.

14. A system according to claim 13, wherein said transducer device includes a piezoelectric material transducer.

15. A method for carrying out surgery on a tumor in a bodily structure for the purpose of biopsy or ablation, comprising:

mounting a plurality of reference transducer means to fixed positions on a bodily structure to provide a reference frame;

obtaining a template image of the bodily structure;

registering the reference frame with the template image to obtain a 3-dimensional scene;

locating a trackable sleeve means at a location of the tumor by displaying the position of the sleeve means within the 3-dimensional scene; and

locating a first instrument means at the location of the tumor by positioning the first instrument means within the sleeve means.

16. A method according to claim 15, wherein the step of mounting a plurality of transducer means to fixed positions includes the step of mounting a plurality of transducer means to a solid organ under laparoscopic guidance.

17. A method according to claim 15, wherein said template image is a 2-dimensional ultrasound image.

18. A method according to claim 15, wherein said method further comprises the step of displaying a reference mark in the 3-dimensional scene, at the location of the tumor to facilitate locating the trackable sleeve means at the location of the tumor.

19. A method according to claim 15, wherein the method further includes the step of removing the trackable sleeve from the first instrument means.

20. A system for carrying out surgery on an anomaly in a bodily structure for the purpose of biopsy or ablation, comprising:

a plurality of reference transducer means mounted at fixed positions on a bodily structure to provide a reference frame;

means for obtaining a template image of the bodily structure;

registration means for registering the reference frame with the template image to obtain a 3-dimensional scene;

trackable sleeve means locatable relative to an associated anomaly to identify a location of a associated anomaly;

display means adapted for displaying the position of the trackable sleeve means within the 3-dimensional scene to locate the sleeve means at the location of the associated anomaly; and

first instrument means adapted for performing a surgical procedure at the location of the associated anomaly, the first instrument means located at the location of the associated anomaly by positioning the first instrument means within the sleeve means.

21. A system according to claim 20, wherein said fixed positions are located on an external surface of a solid organ.

22. A system according to claim 20, wherein said template image is a 2-dimensional ultrasound image.

23. A system according to claim 20, wherein said system further comprises means for displaying a reference mark in the 3-dimensional scene at the location of the associated anomaly to facilitate locating the trackable sleeve means at the location of the associated anomaly.

24. A system according to claim 20, wherein said first instrument means is a cryoprobe.

25. A method for carrying out surgery on a tumor in a bodily structure for the purpose of biopsy or ablation, comprising:

mounting a plurality of reference transducer means to a solid organ to provide a reference frame defining the position of the solid organ;

obtaining a template image of a bodily structure;

registering the reference frame with the template image to obtain a 3-dimensional scene;

locating a trackable instrument means at the location of a tumor by displaying the position of the trackable instrument means within the 3-dimensional scene;

arranging a sleeve means over the trackable instrument means;

removing the trackable instrument means from the sleeve means; and

inserting a second instrument means into the sleeve means.

26. A system according to claim 25, wherein said step of inserting a second instrument means into the trackable sleeve means includes inserting an ablation means into the trackable sleeve means.

27. A system for carrying out surgery on a tumor in a bodily structure for the purpose of biopsy or ablation, comprising:

a plurality of reference transducer means located at fixed positions on the bodily structure to provide a reference frame, wherein said plurality of reference transducer means include;

a transducer device, and

support means for supporting the transducer device, said support means including an adhesive for affixing the transducer device to the fixed position on the bodily structure and a gel for acoustic coupling;

means for obtaining a template image of a bodily structure;

registration means for registering the reference frame with the template image to obtain a 3-dimensional scene;

display means for displaying the 3-dimensional scene of the bodily structure;

first instrument means for fixing the location of a beacon transducer means at the site of a tumor to identify the location of the tumor; and

second instrument means for performing a surgical procedure at the site of the tumor, wherein the second instrument means has a transducer means for indicating the position of the first instrument means relative to the reference frame and the location of the beacon transducer means.

28. A method for carrying out surgery on a physical anomaly in a bodily structure for the purpose of biopsy or ablation, comprising:

mounting a plurality of reference transducer means to fixed positions relative to a bodily structure to provide a reference frame;

obtaining a template image of the bodily structure;

registering the reference frame with the template image to obtain a 3-dimensional scene;

locating a beacon transducer means at the location of a physical anomaly by displaying the position of the beacon transducer means within the 3-dimensional scene;

fixing the beacon transducer means at the location of the physical anomaly to identify the location thereof; and

locating a first instrument means at the location of the physical anomaly by displaying the position of the first instrument means relative to the reference frame and beacon transducer means.