Method and apparatus for guiding a penetrating tool into a three-dimensional object

• US 5,957,934 A
• Filed: 12/22/1997
• Issued: 09/28/1999
• Est. Priority Date: 12/22/1997
• Status: Expired due to Fees

• Current Assignee: Uri Rapoport
• Original Assignee: Uri Rapoport
• Inventors: Rapoport, Uri
• Primary Examiner(s): Dawson, Glenn K.
• Application Number:
  US08/996,451
• Time in Patent Office: 645 Days
• Field of Search: 606/130, 600/424, 600/417, 600/414, 600/426, 600/429, 600/550
• US Class Current: 606/130
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61B 90/37 Surgical systems with images on a monitor during operation

Abstract

A method and apparatus are described for guiding a penetrating tool to a predetermined point of interest within a three-dimensional object, such as a brain tumor within a human skull. A plurality of signal-transmitting markers disposed about the periphery of the object are used to determine the precise point of entry and slope of entry. A light ray is directed along the slope of entry to the point of entry, and a penetrating tool is directed along the path defined by the light ray. In a preferred embodiment, in which the point of interest is within the brain, additional signal-transmitting markers are placed through a very small skull opening directly at the point of interest and optionally about its periphery. When the skull is opened for surgery and the position of the point of interest in the brain shifts due to loss of pressure, the additional markers nevertheless will indicate the exact location of the point of interest.

Claims

1. A system for directing a penetrating tool through a three-dimensional object from a known point of entry and along a desired slope of entry to a known point of interest within the object, the apparatus comprising

(a) a plurality of peripheral markers suitable for placement about the periphery of the object, each peripheral marker capable of propagating a distinct signal;

(b) one or more internal markers suitable for placement within the object in the vicinity of the point of interest and in fixed relation thereto, each internal marker capable of propagating a distinct signal;

(c) a receiver capable of receiving and distinguishing the signals propagated by each of said peripheral and internal markers;

(d) a movable source of a light ray, the light ray being directable along a slope to intersect the object;

(e) a computer means adapted to receive information relating to said signals from said receiver and able to calculate and store the location coordinates of each of said peripheral and internal markers with respect to one another, said computer means further adapted to receive the location coordinates of said light source, and to indicate whether the light ray'"'"'s point of intersection with said object and slope correspond to the known point of entry and desired slope of entry, whereby the light ray can guide a penetrating tool through the known point of entry and along the desired slope of entry to the known point of interest.

2. The system of claim 1 further including a radar transmitter to which one or more of said markers respond in a unique manner so as to propagate distinct soundwave signals.

3. The system of claim 2 wherein said radar transmitter is integral with said receiver.

4. The system of claim 1 wherein one or more of said markers is a transmitter which propagates its own distinct electromagnetic signal.

5. The system of claim 1 wherein said light ray source is movable in response to signals received from said computer.

6. The system of claim 5 wherein said light ray source is integral with said receiver, and said receiver is movable in response to signals received from said computer mean.

7. The system of claim 1 wherein said apparatus is adapted for assisting a surgeon in directing a penetrating tool along the desired slope of entry into a skull to the known point of interest.

8. The system of claim 7 wherein said peripheral markers are adapted to be fixedly positioned in the skull.

9. The system of claim 7 wherein said one or more internal markers are suitable for placement at pre-determined locations within the brain.

10. The system of claim 1 further including an angular guide means, said angular guide means comprising a guide tube lockable in an orientation coincident with the desired slope of entry as indicated by said light ray, whereby tools directed through said guide tube will necessarily be guided along said desired slope of entry.

11. A guide means for guiding a tool along a predetermined slope, said guide means comprising

a support frame,

a movable positioning means supported by said support frame, said movable positioning means comprising a first rotating gear and a second rotating gear of smaller diameter than said first rotating gear and eccentrically mounted within the circumference thereof, and

a hollow guide tube pivotably mounted eccentrically in said second rotating gear and capable of being maintained fixedly oriented along said predetermined slope, said first and second rotating gears cooperating to position the pivotable mounting of said hollow guide tube at a predetermined point intersecting said predetermined slope, so that a tool positioned within said guide tube will be directed along said predetermined slope.

12. The guide means of claim 11 further including a removable insert coaxial with said hollow guide tube, said insert having an inner bore for precisely orienting said guide tube along said predetermined slope, said insert capable of being removed to allow a tool to be positioned within said guide tube.

13. A method for directing a penetrating tool through a known point of entry and along a desired slope of entry to a known point of interest within a three-dimensional object, comprising

(a) locating a plurality of peripheral markers about the periphery of the object, each marker capable of propagating a distinct signal,

(b) providing one or more internal markers within the object in the vicinity of the point of interest and in fixed relation thereto,

(c) providing a receiver capable of receiving and distinguishing the respective signals propagated by each of said peripheral and internal markers,

(d) determining the co-ordinates in three dimensions of each of said markers relative to the known point of interest,

(e) positioning a movable source of a light ray such that said light ray is directed generally toward said point of entry,

(f) determining the co-ordinates of said light ray source and the orientation of said ray of light relative to the known point of interest,

(g) determining from said co-ordinates whether said ray of light intersects said known point of entry and along said desired slope of entry,

(h) repeating steps (e)-(g) until said ray of light does intersect said point of entry along said desired slope of entry, and

(i) using said ray of light to guide a penetrating tool along said desired slope of entry at said known point of entry.

14. The method of claim 13 wherein one or more of said markers is a transmitter that propagates a distinct electromagnetic signal.

15. The method of claim 14 further including the step of providing a source of radar waves, one or more of said markers being responsive to said radar waves to propagate a distinct sound wave signal.

16. The method of claim 13 wherein said three-dimensional object is a skull and the method assists a surgeon in guiding a penetrating tool into the brain.

17. The method of claim 16 wherein the coordinates of said peripheral markers relative to the point of interest are determined from imaging scans taken with said markers in fixed positions.

18. The method of claim 17 wherein said imaging scans are selected from the group consisting of magnetic resonance imaging, computer tomography, and positron emission tomography.

19. The method of claim 13 wherein step (i) is accomplished by orienting a hollow guide tube such that said light ray passes therethrough, and directing the penetrating tool through the guide tube.