Curved surgical instruments and method of mapping a curved path for stereotactic surgery

• US 6,701,173 B2
• Filed: 07/12/1999
• Issued: 03/02/2004
• Est. Priority Date: 02/27/1996
• Status: Expired due to Fees

• Current Assignee: Kent Ridge Digital Labs
• Original Assignee: Kent Ridge Digital Labs
• Inventors: Nowinski, Wieslaw Lucjan, Poston, Timothy
• Primary Examiner(s): MANTIS MERCADER, ELENI M
• Application Number:
  US08/945,474
• Publication Number:
  US 20030149351A1
• Time in Patent Office: 1,695 Days
• Field of Search: 600/407, 600/427, 600/382, 600/425, 600/429, 600/109, 600/111, 600/112, 600/104, 606/130, 606/108, 604/264, 604/280, 604/164, 604/116, 601/2, 601/46
• US Class Current: 600/407
• CPC Class Codes: A61B 2034/102 Modelling of surgical devices, implants or prosthesis
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2090/0811 for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
• 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 90/36 Image-producing devices or illumination devices not otherwise provided for

Abstract

The method of mapping a curved path for stereotactic surgery involves the selection of a helical-shaped path. The first step is to obtain an accurate image of the pertinent structures of the patient'"'"'s internal areas. The image includes the lesion or target region and a potential opening site. Using the image, the non-target areas surrounding the lesion area are determined and evaluated for the medical acceptability of passing through them. A curved path which is substantially helical in shape is then selected within the image such that the curve avoids these non-target areas but intersects the target region and the opening site. The corresponding surgical instrument which will be used to follow the selected curved path has a rigid body having a shape which is substantially identical to the path.

Claims

1. A method of mapping a curved path for stereotactic surgery using a rigid stereotactic surgical instrument to access an area of a patient'"'"'s body comprising:

a) obtaining an accurate image of an area of the body, said image including an opening site and a target region;

b) determining high-risk areas around said target region;

c) selecting a non-linear curve within said image, wherein said non-linear curve is substantially helical in shape along an entirety of a curved path extending between the opening site and the target region;

wherein said non-linear curve intersects said target region and said opening site but not said high-risk areas, said non-linear curve defining the curved path for which a rigid stereotactic surgical instrument having an identical shape to said non-linear curve is navigable to said target region;

d) providing a rigid stereotactic surgical instrument with a rigid tip; and

e) inserting the rigid stereotactic surgical instrument along the curved path selected in step (c) with the tip of the rigid stereotactic surgical instrument tracing said non-linear curve.

2. The method as recited in claim 1, wherein the non-linear curve in said selection step c) is a helix.

3. The method as recited in claim 2, wherein said selecting step c) includes:

i) marking a target point P in said target region;

ii)selecting straight line L as a helix axis; and

iii) tracing said non-linear curve around said line L maintaining a constant radius r and angle a with respect to said line L;

said non-linear curve intersecting said target point P.

4. The method as recited in claim 3, wherein said selecting step c) and said tracing step e) are performed substantially simultaneously.

5. The method as recited in claim 1, wherein said image obtaining step a) is performed using an imaging technique selected from the group of MRI, PET, CAT, plain radiography, SPECT, MEG, EEG, US, fMRI, angiography, color doppler, and reference maps of the body.

6. The method as recited in claim 5, further comprising the steps of digitizing said image creating a digitized image, and interfacing said digitized image with a computer.

7. The method as recited in claim 1, wherein the selecting step c) is performed immediately upon completion of the determining step b).

8. The method as recited in claim 7, wherein a virtual reality apparatus is used to execute at least one of the steps.

9. A method of mapping a curved path for stereotactic surgery using a rigid stereotactic surgical instrument, said method being aided by a virtual reality apparatus, said virtual reality apparatus including a display means, and a stylus for allowing a user to interact with said virtual reality apparatus via said display means, said virtual reality apparatus comprising means for displaying medical images on said display means and superimposing a helical curve of a selected radius r and angle within said images, said method comprising:

a) displaying an accurate image of an affected area of a patient'"'"'s body on said display means, said image including a target region;

b) determining high risk areas around said target region;

c) pointing said stylus to a point P in said target region;

d) moving said stylus until a helical curve from point P to an entry point into the patient is displayed on said display means such that no part of the helical curve intersects said high risk areas, said helical curve defining a curved path for which a rigid stereotactic surgical instrument having an identical shape as said helical curve is navigable to said target region.

10. The method as recited in claim 9 further comprising:

e) determining a location for an opening site;

f) determining whether said helical curve intersects the opening site; and

g) moving said stylus and selecting another helical curve which does not intersect said high-risk areas but intersects said opening site.

11. A method of mapping a least invasive curved path for stereotactic surgery using a rigid stereotactic surgical instrument comprising:

obtaining an accurate image of an affected area of a patient'"'"'s body, said image including a target region and an opening site;

determining high-risk areas around said target region;

assigning a medical acceptability value to each of said high-risk areas;

selecting a plurality of curves within said image wherein each of said plurality of curves is helical in shape, and said plurality of curves intersecting said target region and said opening site;

assigning a medical acceptability value to each of said plurality of curves based on its interaction with said high-risk areas;

comparing said plurality of curves based on said medical acceptability value; and

choosing a curve with an optimal value, said curve defining a curved path for which a rigid stereotactic surgical instrument having an identical shape as said curve is navigable to said target region.

12. A method of mapping a curved path for intracranial stereotactic surgery using a rigid stereotactic surgical instrument comprising:

obtaining an accurate image of an affected area of a patient'"'"'s intracranial area, said image including a target region and an opening site;

determining high-risk areas around said target region;

selecting a curve within said image wherein said curve is helical in shape,

wherein said curve intersects said target region and said opening site, but not said high-risk areas, said curve defining a curved path for which a rigid stereotactic surgical instrument having an identical shape as said curve is navigable to said target region.