Method for carrying out a medical procedure using a three-dimensional tracking and imaging system

• US 6,246,898 B1
• Filed: 05/08/1998
• Issued: 06/12/2001
• Est. Priority Date: 03/28/1995
• Status: Expired due to Fees

• Current Assignee: Sonometrics Corporation
• Original Assignee: Sonometrics Corporation
• Inventors: Burkhoff, Daniel, Vesely, Ivan, Klein, George, Smith, Wayne
• Primary Examiner(s): Casler, Brian L.
• Application Number:
  US09/074,860
• Time in Patent Office: 1,131 Days
• Field of Search: 600/407, 600/411, 600/424, 600/437, 600/439, 600/471, 600/425, 600/426, 600/427, 600/461, 600/462, 600/464, 606/130
• US Class Current: 600/424
• 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 2034/2051 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 34/70 Manipulators specially adapted for use in surgery
• 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 8/4245 : 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 15/8922 : the array being concentric or annular
• CPC Class Codes: G01S 15/8936 : using transducers mounted for mechanical movement in three dimensions
• 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 5/26 : Position of receiver fixed by co-ordinating a plurality of position lines defined by path-difference measurements G01S5/28 takes precedence
• CPC Class Codes: G01S 7/52003 : Techniques for enhancing spatial resolution of targets G01S7/52046 takes precedence
• CPC Class Codes: G01S 7/52026 : Extracting wanted echo signals Doppler systems G01S15/50; Doppler short range imaging systems G01S15/8979
• 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

Abstract

A method for carrying out a medical procedure using a 3-D tracking and imaging system (1600). A surgical instrument, such as a catheter, probe, sensor, pacemaker lead, needle, or the like is inserted into a living being, and the position of the surgical instrument is tracked as it moves through a medium in a bodily structure. The location of the surgical instrument relative to its immediate surroundings is displayed to improve a physician'"'"'s ability to precisely position the surgical instrument. The medical procedures including targeted drug delivery, sewing sutures, removal of an obstruction from the circulatory system, a biopsy, amniocentesis, brain surgery, measurement of cervical dilation, evaluation of knee stability, assessment of myocardial contractibility, eye surgery, prostate surgery, trans-myocardial revascularization (TMR), robotic surgery, and evaluation of RF transmissions.

Claims

1. A method of performing an in vivo medical procedure on an associated body using a 3-D tracking and imaging system, said method comprising:

mounting at least one mobile transducer to a medical instrument;

mounting a plurality of reference transducers to locations on the body, the plurality of reference transducers being distributed at positions substantially surrounding the body;

energizing the at least one mobile transducer and the plurality of reference transducers such that at least one respective transducer generates a positional signal and at least another respective transducer detects the positional signal, to measure time-of-flight of the positional signal;

sequentially varying the energizing of each of the at least one mobile transducer and the plurality of reference transducers according to a duty cycle such that each transducer alternates between transmit and receive modes over the course of the duty cycle;

generating three-dimensional coordinates of the mobile transducer relative to a reference frame established by the reference transducers; and

generating a display indicative of a positional path followed by said medical instrument.

2. A method according to claim 1, wherein said path is along the surface of the associated body.

3. A method according to claim 1, wherein said medical instrument is a probe.

4. An apparatus for performing an in vivo medical procedure on an associated body, said apparatus comprising:

at least one mobile transducer mounted to a catheter including a lumen;

a plurality of reference transducers mounted to locations on the body, the plurality of reference transducers being distributed at positions substantially surrounding the body;

means for energizing the at least one mobile transducer and the plurality of reference transducers such that at least one respective transducer generates a positional signal and at least another respective transducer detects the positional signal, to measure time-of-flight of the positional signal;

means for sequentially varying the energizing of each of the at least one mobile transducer and the plurality of reference transducers according to a duty cycle such that each transducer alternates between transmit and receive modes over the course of the duty cycle;

3-D generating means for generating three-dimensional coordinates of the at least one mobile transducer relating to a reference frame established by the plurality of reference transducers;

display means for generating a display indicative of a positional path followed by said catheter;

a needle extendible from a tip of the catheter; and

control means for extending the needle from the tip of the catheter and initiating a flow of fluid from the needle.

5. An apparatus according to claim 4, the apparatus further comprising radio frequency (RF) generation means for generating RF energy to ablate at least a portion of a bodily structure.

6. An apparatus according to claim 4, wherein said needle includes exit holes along its length to dispense fluid.