Apparatus and method for surgical stereotactic procedures

• US 6,071,288 A
• Filed: 12/06/1997
• Issued: 06/06/2000
• Est. Priority Date: 09/30/1994
• Status: Expired due to Term

• Current Assignee: Schaerer Medical USA Incorporated
• Original Assignee: Ohio Medical Instrument Co., Inc.
• Inventors: Day, James L., Riker, Robert J., Miller, Erik G., Carol, Mark
• Primary Examiner(s): Casler, Brian L.
• Application Number:
  US08/986,292
• Time in Patent Office: 913 Days
• Field of Search: 606/130, 600/414, 600/426, 600/417, 600/429, 600/424
• US Class Current: 606/130
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2059 Mechanical position encoders
• CPC Class Codes: A61B 2034/2068 using pointers, e.g. pointers having reference marks for determining coordinates of body points
• 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 2090/364 Correlation of different images or relation of image positions in respect to the body
• 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 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 90/14 Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61B 90/50 Supports for surgical instruments, e.g. articulated arms

Abstract

An apparatus and method are disclosed for displaying a path between a selected target and selected points on a patient'"'"'s skull and for guiding surgical instruments along any selected path. The system is comprised of an image display system, an articulated arm and probe, and a stereotactic system. The sub-systems are coupled to one another so that the articulated probe may be used to select patient fiducial points that correspond to selected image fiducial points. Using these points, the image display system coregisters the external locations to the displayed images so that the probe condition may be displayed with the displayed images. The system further permits the identification of a selected target within a patient'"'"'s brain and to project a path from the external position to the target prior to the performance of a craniotomy. After evaluation of the path, a surgeon may lock the stereotactic system in place to preserve a selected surgical path and to guide instruments along that path. A method of utilizing the system to perform such surgical procedures is also described.

Claims

1. A stereotactic system comprising:

an imaging display system for displaying images;

an image fiducial selector coupled to the imaging display system for selecting fiducials on an image displayed on the display system;

a target selector coupled to the imaging system for selecting a target on an image displayed on the display system;

a spatial coordinate generator in communication with the imaging system and having a movable element, the spatial coordinate generator providing spatial coordinates of the movable element to the imaging system so that a position of the movable element is displayed on the displayed images;

a patient fiducial selector operable with the imaging system and the spatial coordinate generator for selecting fiducials on a patient that correspond to the fiducials selected by the image fiducial selector;

a coregistration processor for coregistering the selected patient fiducials to the selected image fiducials so that the coordinates provided by the spatial coordinate generator may be matched to the displayed images whereby a path from the movable element position to the selected target may be displayed on the displayed images; and

a holder mechanically and releasably secured at a desired position in proximity to a patient, the holder having a pivot member supporting the movable element, the holder being pivotable at the desired position with respect to the patient to allow a surgeon to evaluate and establish a path as displayed on the displayed image between the desired position and the selected target, the holder having a releasable clamp to fix the holder pivot member at a desired orientation directing the movable element along the desired path.

2. A stereotactic system comprising:

an imaging display system for displaying images;

an image fiducial selector coupled to the imaging display system for selecting fiducials on an image displayed on the display system;

a target selector coupled to the imaging system for selecting a target on an image displayed on the display system;

a spatial coordinate generator in communication with the imaging system and having a movable element mounted therewith, the spatial coordinate generator providing spatial coordinates of the movable element to the imaging system so that a position associated with the movable element is displayed on the displayed images;

a patient fiducial selector operable with the imaging system and the spatial coordinate generator for selecting fiducials on a patient that correspond to the fiducials selected by the image fiducial selector;

a coregistration processor for coregistering the selected patient fiducials to the selected image fiducials so that the coordinates provided by the spatial coordinate generator may be matched to the displayed images whereby a path from the movable element position to the selected target may be displayed on the displayed images; and

a holder mechanically and releasably secured at a desired position in proximity to a patient, the holder including an alignment element for supporting the movable element and being pivotable at the desired position with respect to the patient to allow a surgeon to evaluate and establish a desired path as displayed on the displayed image between the desired position and the selected target, the holder including a clamp for releasably locking the alignment element at a desired orientation directing the movable element along the desired path.

3. A method for evaluating and securing a surgical path to a selected target comprising the steps of:

displaying with an image display system images generated from scanner image data;

selecting displayed points representing fiducials on a displayed image, each of the displayed points having displayed coordinate values derived from the image data;

selecting a target point in the displayed image;

providing spatial coordinates of a point on a movable element external from the displayed image;

selecting with the movable element a set of external points representing external fiducials on a patient, the external points having respective provided spatial coordinates;

coregistering the selected external points with the selected image points so that a path may be displayed on the image display system between the selected target point and one of the external points;

selecting with the movable element a further external point;

mechanically and releasably securing a holder at the further external point;

supporting the movable element in the holder;

displaying a path extending linearly from movable element;

rotating the movable element to a desired orientation of the movable element without moving the holder from the further external point, so that the holder defines a linear path intersecting the further external point and the target point; and

releasably locking the movable element at the desired orientation, so that the holder fixedly defines the linear path independent of the imaging display system.

4. The method of claim 3 further comprising the step of using the holder locked in place to guide an instrument along the linear path to the target.