Method and apparatus for performing stereotactic surgery

• US 7,313,430 B2
• Filed: 08/28/2003
• Issued: 12/25/2007
• Est. Priority Date: 08/28/2003
• Status: Active Grant

• Current Assignee: Surgical Navigation Technologies, Inc. (Medtronic Plc)
• Original Assignee: Medtronic Navigation Incorporated (Medtronic Plc)
• Inventors: Urquhart, Steven J, Schallhorn, Richard S
• Primary Examiner(s): Casler, Brian L.
• Assistant Examiner(s): Mehta, Parikha S.
• Application Number:
  US10/651,267
• Publication Number:
  US 20050049486A1
• Time in Patent Office: 1,580 Days
• Field of Search: 606/130, 600/407, 600424-429
• US Class Current: 600/429
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/00482 with a code
• 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 2034/2072 Reference field transducer attached to an instrument or patient
• CPC Class Codes: A61B 2034/256 having a database of accessory information, e.g. including context sensitive help or scientific articles
• CPC Class Codes: A61B 2090/365 augmented reality, i.e. correlating a live optical image with another image
• CPC Class Codes: A61B 2090/367 creating a 3D dataset from 2D images using position information
• CPC Class Codes: A61B 2090/3954 magnetic, e.g. NMR or MRI
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• 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 34/25 User interfaces for surgical systems
• 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: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/0539 Anchoring of brain electrode systems, e.g. within burr hole

Abstract

A stereotactic navigation system for navigating an instrument to a target within a patient may include a stereotactic head frame, an imaging device, a tracking device, a controller and a display. The stereotactic head frame is coupled to the patient and is used to assist in guiding the instrument to the target. The imaging device captures image data of the patient and of the stereotactic head frame. The tracking device is used to track the position of the instrument relative to the stereotactic head frame. The controller receives the image data from the imaging device and identifies the stereotactic head frame in the image data and automatically registers the image data with navigable patient space upon identifying the stereotactic head frame, while the display displays the image data.

Claims

1. A stereotactic navigation system for navigating an instrument to a target site within a patient, said stereotactic navigation system comprising:

a stereotactic head frame defining a navigable patient space and configured to be coupled to the patient and used to assist in guiding the instrument to the target site; and

a tracking device removably coupled to said stereotactic head frame in one unique location to be used with registration of the navigable patient space and image data of the patient and configured to track the position of the instrument relative to the stereotactic head frame, wherein said tracking device is further configured to be removed from the stereotactic head frame during acquisition of the image data of the patient with the stereotactic head frame; and

a coupling device including a first coupling portion defined by said stereotactic head frame and a second coupling portion defined by said tracking device complimentary to said first coupling portion; and

a processor system configured to recognize a position and an orientation of the first coupling portion;

wherein said tracking device is configured to be removably coupled to said stereotactic head frame at a unique location on said stereotactic head frame;

wherein the processor system is further configured to relate the position and orientation of the first coupling portion to a position and orientation of the tracking device to register the navigable patient space to the image data.

2. The stereotactic navigation system as defined in claim 1 wherein said tracking device includes a plurality of removable transmitter coil arrays, each configured to generate an electromagnetic navigation field.

3. The stereotactic navigation system as defined in claim 2 said coupling device includes an attachment device associated with each transmitter coil array configured to be used to removably couple each transmitter coil array at its corresponding unique location.

4. The stereotactic navigation system as defined in claim 3 wherein each attachment device includes a plurality of rods extending from at least one of each transmitter coil array, said stereotactic headframe, or combinations thereof, wherein each plurality of rods has a unique rod pattern and at least one of said stereotactic head frame, said each transmitter coil array, or combinations thereof has a complimentary unique receiving hole pattern;

wherein the complimentary unique pattern is configured to be recognized in image data with a processor system and the processor system is configured to relate the coupled position of the tracking device to the complimentary pattern to register the navigable patient space to the image data.

5. The stereotactic navigation system as defined in claim 2 wherein each transmitter coil array is formed from three orthogonal coils.

6. The stereotactic navigation system as defined in claim 2 further comprising a controller including the processor system in communication with each transmitter coil array and configured to automatically register image data with said navigable patient space defined by said stereotactic head frame.

7. The stereotactic navigation system as defined in claim 6 further comprising an imaging device configured to capture said image data of said navigable patient space within the patient.

8. The stereotactic navigation system as defined in claim 7 further comprising a second tracking device associated with the instrument and configured to track a position of the instrument relative to said stereotactic head frame and a display configured to display said image data of said navigable patient space with a superimposed icon of the tracked instrument.

9. The stereotactic navigation system as defined in claim 8 wherein said stereotactic head frame includes a plurality of fiducial markers.

10. The stereotactic navigation system as defined in claim 9 wherein said plurality of fiducial markers are integral with said stereotactic head frame.

11. The stereotactic navigation system as defined in claim 10 wherein said second tracking device includes a plurality of removable transmitter coil arrays and said plurality of integral fiducial markers forms a portion of an attachment device associated with each transmitter coil array.

12. The stereotactic navigation system as defined in claim 11 wherein said plurality of fiducial markers defines a plurality of unique hole patterns in said stereotactic head frame.

13. The stereotactic navigation system as defined in claim 1 further comprising an x-adjustment stage, a y-adjustment stage, and a z-adjustment stage associated with said stereotactic head frame and configured to adjust the stereotactic head frame along an x-axis, a y-axis, and a z-axis, respectively.

14. The stereotactic navigation system as defined in claim 13 wherein each stage includes a tracking device configured to track a position of each stage.

15. The stereotactic navigation system as defined in claim 14 wherein each tracking device associated with each stage is configured to provide real-time feedback of adjustment of said stage relative to the target site.

16. The stereotactic navigation system as defined in claim 15 further comprising an instrument guide coupled to said stereotactic head frame, said instrument guide further including at least one tracking device configured to track the location of said instrument guide relative to said stereotactic head frame in order to identify an entry point of the instrument relative to the target site.

17. The stereotactic navigation system as defined in claim 15 further comprising a controller configured to automatically adjust the position of said x, y, and z-stages to align said stereotactic head frame to the target site.

18. The stereotactic navigation system as defined in claim 13 wherein at least one of said adjustment stages is automatically adjusted.

19. The stereotactic navigation system as defined in claim 18 wherein said at least one stage is automatically adjusted via a robotic device.

20. A stereotactic navigation system for navigating an instrument to a target site within a patient, said stereotactic navigation system comprising:

a stereotactic head frame defining a navigable patient space and configured to be coupled to the patient and used to assist in guiding the instrument to the target site;

an imaging device configured to capture image data of the navigable patient space and of the stereotactic head frame;

a tracking system including a tracking device removably coupled to said stereotactic head frame and configured to track the position of the instrument relative to the stereotactic head frame and track a frame point on the sterotactic head frame;

a controller configured to receive the image data from said imaging device and configured to identify said stereotactic head frame in said image data, said controller further configured to automatically register said image data with said navigable patient space upon identifying said stereotactic head frame in said image data and the tracked position of the frame point from the tracking system;

a display configured to display the image data; and

a coupling device including a first coupling portion defined by said stereotactic head frame and a second coupling portion defined by said tracking devices complimentary to said first coupling portion; and

a processor system configured to recognize a position and an orientation of the first coupling portion;

wherein each of said tracking device is configured to be removably coupled to said stereotactic head frame at a unique location on said stereotactic head frame;

wherein the processor system is further configured to relate the position and orientation of the first coupling portion to a position and orientation of the tracking device to register the navigable patient space to the image data.

21. The stereotactic navigation system as defined in claim 20 wherein said tracking device is configured to be removed from said stereotactic head frame during imaging of the patient.

22. The stereotactic navigation system as defined in claim 20 wherein said tracking device includes a plurality of removable transmitter coil arrays, each configured to generate an electromagnetic navigation field.

23. The stereotactic navigation system as defined in claim 20 wherein said imaging device is selected from a group of 2D, 3D or 4D imaging devices comprising at least a C-arm fluoroscopic imager, a magnetic resonance imager (MRI), a computed tomography (CT) imager, a positron emission tomography (PET) imager, an isocentric fluoroscopy imager, a bi-plane fluoroscopy imager, an ultrasound imager, a multi-slice computed tomography (MSCT) imager, a high-frequency ultrasound (HIFU) imager,an optical coherence tomography (OCT) imager, an intra-vascular ultrasound imager (IVUS), an ultrasound imager, an intra-operative CT imager, an intra-operative MRI imager, a single photon emission computer tomography (SPECT) imager, and a combination thereof.

24. The stereotactic navigation system as defined in claim 20 wherein said tracking device is selected from a group comprising an electromagnetic tracking device, an optical tracking device, a conductive tracking device, a fiber optic tracking device, and a combination thereof.

25. The stereotactic navigation system as defined in claim 20 wherein said tracking device is an electromagnetic tracking device having a transmitter coil array configured to generate an electromagnetic field in the region of the patient and a plurality of sensors associated with the instrument and said stereotactic head frame configured to sense the electromagnetic field.

26. The stereotactic navigation system as defined in claim 20 wherein said instrument is configured to deliver a therapy to the patient.

27. The stereotactic navigation system as defined in claim 26 wherein the therapy is selected from a group comprising lead placement, drug delivery, gene delivery, cell delivery, ablation, biopsy and a combination thereof.

28. The stereotactic navigation system as defined in claim 20 wherein said instrument is selected from at least one of a catheter, a guide wire, a stylet, a lead, a cannula, an insert, a needle, a biopsy tube, and a combination thereof.

29. The stereotactic navigation system as defined in claim 20 further comprising an adjustment device associated with said stereotactic head frame and configured to adjust said stereotactic head frame along an x-axis, a y-axis, and a z-axis.

30. The stereotactic navigation system as defined in claim 29 further comprising a tracking sensor associated with each axis configured to track movement of said stereotactic head frame along each axis.

31. The stereotactic navigation system as defined in claim 30 wherein said controller is further configured to identify the target on said display and further configured to identify the location of a centroid of said stereotactic head frame relative to said target on said display.

32. The stereotactic navigation system as defined in claim 31 wherein said controller is further configured to provide real-time feedback of the adjustment of said stereotactic head frame and display the real-time feedback of the adjustment on said display.

33. The stereotactic navigation system as defined in claim 29 further comprising a tool guide adjustably coupled to said stereotactic head frame and configured to align an entry point of the instrument to the target.

34. The stereotactic navigation system as defined in claim 33 further comprising at least one tracking sensor associated with said tool guide configured to identify a location of said entry point relative to said target.

35. The stereotactic navigation system as defined in claim 20 further comprising a fiducial head cage having a plurality of fiducial markers and configured to be attached to said stereotactic head frame, said fiducial head cage further configured to assist in automatic registration of the image data with the navigable patient space.

36. A method for performing image guided stereotactic navigation, said method comprising:

attaching a stereotactic head frame having a frame point and that defines navigable patient space on a patient;

capturing image data of the navigable patient space with the attached stereotactic head frame having the frame point;

attaching a tracking device to the stereotactic head frame at the frame point by interconnecting a first member associated with at least one of the tracking device, the stereotactic headframe, or combinations thereof, with a first member coupling portion defined by at least one of the tracking device, the stereotactic headframe, or combinations thereof, wherein the first member couples to the first member coupling portion at a unique location on the stereotactic headframe; and

automatically registering the image data with the navigable patient space by relating a location and orientation of the frame point to a position and orientation of the tracking device to correlate navigable patient space and the image data.

37. The method as defined in claim 36 further comprising identifying a target in the image data.

38. The method as defined in claim 37 further comprising adjusting the position of the stereotactic head frame to align a centroid of the stereotactic head frame with the selected target.

39. The method as defined in claim 38 further comprising automatically sensing the adjustment of said stereotactic head frame to confirm the positioning of the centroid of said stereotactic head frame with the target.

40. The method as defined in claim 39 further comprising selecting a planned entry point for delivering an instrument to the target.

41. The method as defined in claim 40 further comprising monitoring adjustment of the entry point to verify proper alignment of a tool guide attached to the stereotactic head frame.

42. The method as defined in claim 41 further comprising monitoring a position of the instrument as it is guided with the stereotactic head frame to the target.

43. The method as defined in claim 42 further comprising displaying a representation of the instrument superimposed on the image data in relation to the target.

44. The method as defined in claim 39 further comprising automatically adjusting the position of the stereotactic head frame to align the centroid with the target.

45. The method as defined in claim 39 further comprising manually adjusting the position of the stereotactic head frame to align the centroid with the target.