Medical imaging and navigation system

• US 7,386,339 B2
• Filed: 02/13/2001
• Issued: 06/10/2008
• Est. Priority Date: 05/18/1999
• Status: Expired due to Fees

• Current Assignee: ST JUDE MEDICAL INTERNATIONAL HOLDING S. R.L.
• Original Assignee: MediGuide Ltd (Abbott Laboratories Incorporated)
• Inventors: Eicher, Uzi, Strommer, Gera M.
• Primary Examiner(s): Casler; Brian L.
• Assistant Examiner(s): Roy; Baisakhi
• Application Number:
  US09/782,528
• Publication Number:
  US 20010031919A1
• Time in Patent Office: 2,674 Days
• Field of Search: 600/407, 600/425, 600/426, 600437-439, 600/413, 600/417, 600427-429, 606/130, 378/20, 378/205, 378/69
• US Class Current: 600/424
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• 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 2090/367 creating a 3D dataset from 2D images using position information
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 2090/3958 emitting a signal
• 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 5/0066 Optical coherence imaging
• CPC Class Codes: A61B 5/015 By temperature mapping of body part
• 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 5/062 using magnetic field
• CPC Class Codes: A61B 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61B 8/0833 involving detecting or locating foreign bodies or organic structures
• CPC Class Codes: A61B 8/0841 for locating instruments
• 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 8/4254 using sensors mounted on the probe
• CPC Class Codes: A61B 8/463 characterised by displaying multiple images or images and diagnostic data on one display composite display in devices for short-range imaging with acoustic waves G01S7/52074
• CPC Class Codes: A61B 8/483 : involving the acquisition of a 3D volume of data
• CPC Class Codes: A61B 8/5238 : for combining image data of patient, e.g. merging several images from different acquisition modes into one image for image registration algorithms G06T7/30
• CPC Class Codes: A61B 90/10 : for stereotaxic surgery, e.g. frame-based stereotaxis
• CPC Class Codes: A61B 90/36 : Image-producing devices or illumination devices not otherwise provided for

Abstract

Medical imaging and navigation system including a processor, a display unit, a database, a medical positioning system (MPS), a two-dimensional imaging system, an inspected organ monitor interface, and a superimposing processor, the MPS including a transducer MPS sensor and a surgical tool MPS sensor, the two-dimensional imaging system including an imaging transducer, the processor being connected to the display unit, to the database, to the MPS, to the two-dimensional imaging system, to the inspected organ monitor interface, and to the superimposing processor, the inspected organ monitor interface being connected to an organ monitor, the surgical tool MPS sensor being firmly attached to a surgical tool, the transducer MPS sensor being firmly attached to the imaging transducer, the organ monitor monitoring an organ timing signal associated with an inspected organ.

Claims

1. Medical imaging and navigation system comprising:

a processor, connected to a display unit and to a database;

a medical positioning system (MPS), connected to said processor, including a transducer MPS sensor and a surgical tool MPS sensor, said surgical tool MPS sensor being firmly attached to a surgical tool;

a two-dimensional imaging system, connected to said processor, including an imaging transducer, said transducer MPS sensor being firmly attached to said imaging transducer;

an inspected organ monitor interface, connected to said processor and to an organ monitor, said organ monitor monitoring an organ timing signal associated with an inspected organ;

a superimposing processor, connected to said processor;

wherein said processor receives;

a plurality of two-dimensional images from said two-dimensional imaging system, acquired by said imaging transducer;

the location and orientation of said imaging transducer from said medical positioning system, as detected by said transducer MPS sensor in a coordinate system, for each said two-dimensional images;

said organ timing signal from said inspected organ monitor interface, as detected by said organ monitor, for each said two-dimensional images; and

the location and orientation of said surgical tool, from said medical positioning system, as detected by said surgical tool MPS sensor in the coordinate system of the transducer MPS sensor;

so that said location and orientation of said surgical tool and said location and orientation of said imaging transducer, are acquired in a single coordinate system, thereby eliminating computations for correlating said location and orientation of said transducer MPS sensor and said location and orientation of said surgical MPS sensor; and

wherein for each said two-dimensional images, said processor stores said two-dimensional image in said database together with said location and orientation information of said imaging transducer, respective of said two-dimensional image and said organ timing signal, respective of said two-dimensional image, wherein said processor selects at least one of said stored two-dimensional images, having a stored organ timing signal substantially equal to a real time detected organ timing signal, wherein said superimposing processor superimposes a representation of said surgical tool on a visual representation of said selected two-dimensional images, and wherein said display presents the result of said superimposing.

2. The system according to claim 1, wherein said visual representation is a three-dimensional reconstructed image produced from said selected two-dimensional images, according to the location and orientation information of said imaging transducer associated with each said selected two-dimensional images.

3. The system according to claim 2, wherein a renderer renders said visual representation according to reference coordinates.

4. The system according to claim 3, wherein said reference coordinates are selected from the list consisting of:

surgical tool coordinates;

inspected organ coordinates; and

coordinates of the body of the patient.

5. The system according to claim 4, wherein said visual representation is two-dimensional.

6. The system according to claim 5, wherein said representation of said surgical tool comprises a projection of a three-dimensional representation of said representation of said surgical tool, on said two-dimensional visual representation.

7. The system according to claim 1, wherein said representation of said surgical tool indicates an estimated location of said surgical tool.

8. The system according to claim 1, wherein said representation of said surgical tool indicates the orientation of said surgical tool.

9. The system according to claim 1, wherein portions of said surgical tool which are located above, below and within a viewed plane, are presented in different colors.

10. The system according to claim 1, wherein said representation of said surgical tool is in the form of a cursor.

11. The system according to claim 1, wherein said representation of said surgical tool is a pseudo realistic visualization of said surgical tool.

12. The system according to claim 1, wherein said visual representation is a three-dimensional reconstruction produced from said selected two-dimensional images, according to the location and orientation information of said imaging transducer associated with said selected two-dimensional images, discarding portions in said selected two-dimensional images which represent said surgical tool.

13. The system according to claim 1, wherein said medical positioning system further includes a goggles MPS sensor, wherein said display includes semi-transparent goggles, being attached to said goggles MPS sensor, and wherein said processor selects a viewing plane for said visual representation, according to the location and orientation information received from said goggles MPS sensor.

14. The system according to claim 13, wherein said location and orientation of said goggles MPS sensor is provided within said coordinate system.

15. The system according to claim 1, wherein said database is volumetric.

16. The system according to claim 1, wherein said display includes goggles.

17. The system according to claim 16, wherein said goggles are semi-transparent.

18. The system according to claim 1, wherein said two-dimensional imaging system is selected from the list consisting of:

ultra-sound;

inner-vascular ultra-sound;

X-ray;

Nuclear magnetic resonance;

Computerized tomography;

Position-emission tomography; and

Single-photon-emission tomography.

19. The system according to claim 1, wherein said surgical tool is selected from the list consisting of:

clamp;

laser cutter;

brush;

catheter;

stent;

balloon;

pace maker electrode;

solution dispensing unit;

neuron electrode;

substance collection unit;

surgical delivery tool;

gene delivery tool;

drug delivery tool; and

device delivery tool.

20. The system according to claim 1, wherein said medical positioning system further includes a body MPS sensor, for attaching to the body of the patient.

21. Medical imaging and navigation system comprising:

a processor, connected to a display unit and to a database;

a medical positioning system (MPS), connected to said processor, including a surgical tool MPS sensor being firmly attached to a surgical tool;

an inspected organ monitor interface, connected to said processor and to an organ monitor, said organ monitor monitoring an organ timing signal associated with an inspected organ; and

a superimposing processor, connected to said processor;

wherein said processor receives;

said organ timing signal from said inspected organ monitor interface, as detected by said organ monitor; and

the location and orientation of said surgical tool, from said medical positioning system, as detected by said surgical tool MPS sensor in a coordinate system;

wherein said processor selects images from said database, each said selected images having a stored organ timing signal substantially equal to a real-time detected organ timing signal, wherein said superimposing processor superimposes a representation of said surgical tool on said selected images, and wherein said display presents the result of said superimposing;

wherein said medical positioning system further includes a goggles MPS sensor, wherein said display includes semi-transparent goggles, being attached to said goggles MPS sensor, and wherein said processor selects a viewing plane for said visual representation, according to the location and orientation information received from said goggles MPS sensor;

so that said location and orientation information of said goggles MPS sensor is acquired within the coordinate system of said surgical tool MPS sensor, thereby eliminating computations for correlating said location and orientation of said goggles MPS sensor and said location and orientation of said surgical tool MPS sensor.

22. The system according to claim 21, wherein said selected images are three-dimensional.

23. The system according to claim 21, wherein said selected images are two-dimensional.

24. The system according to claim 21, wherein said representation of said surgical tool comprises a projection of a three-dimensional representation of said representation of said surgical tool, on said two-dimensional images.

25. The system according to claim 21, wherein said database is volumetric.

26. The system according to claim 21, wherein said database is further coupled to an image acquisition system.

27. The system according to claim 21, wherein said display includes goggles.

28. The system according to claim 21, wherein said goggles are semi-transparent.

29. The system according to claim 21, wherein said location and orientation information of said goggles MPS sensor is provided within the coordinate system of said selected images.

30. The system according to claim 21, wherein said two-dimensional imaging system is selected from the list consisting of:

ultra-sound;

inner-vascular ultra-sound;

X-ray;

Nuclear magnetic resonance;

Computerized tomography;

Position-emission tomography; and

Single-photon-emission tomography.

31. The system according to claim 21, wherein said surgical tool is selected from the list consisting of:

clamp;

laser cutter;

brush;

catheter;

stent;

balloon;

pace maker electrode;

solution dispensing unit;

neuron electrode;

substance collection unit;

surgical delivery tool;

gene delivery tool;

drug delivery tool; and

device delivery tool.

32. The system according to claim 21, wherein said medical positioning system further includes a body MPS sensor, for attaching to the body of the patient.

33. Method for displaying an image sequence of a moving inspected organ, the method comprising the steps of:

detecting an organ timing signal of said inspected organ, said organ timing signal defining an organ timing signal cycle;

detecting a plurality of two-dimensional images of said inspected organ, using an image detector;

detecting the location and orientation of said image detector;

associating each of said two-dimensional images with said image detector location and orientation and with said detected organ timing signal;

reconstructing a plurality of three-dimensional images from said two-dimensional images, each said three-dimensional images being reconstructed from two-dimensional images selected from said two-dimensional images, said selected two-dimensional images corresponding to a selected position within said organ timing signal cycle;

selecting one of said three-dimensional images according to a real-time reading of said organ timing signal; and

displaying said selected three-dimensional image;

prior to said step of reconstructing;

detecting the location and orientation of a surgical tool; and

modifying at least one of said two-dimensional images, by discarding a portion of at least one of said two-dimensional images, said portion representing at least a portion of said surgical tool;

detecting the location and orientation of a surgical tool; and

modifying at least one of said two-dimensional images, by discarding a portion of at least one of said two-dimensional images, said portion representing at least a portion of said surgical tool;

wherein said detected location and orientation of said surgical tool and said detected location and orientation of said image detector, are acquired in a single coordinate system, thereby eliminating computations for correlating said location and orientation of said transducer MPS sensor and said location and orientation of said surgical MPS sensor.

34. The method according to claim 33, further comprising the step of superimposing a representation of said surgical tool onto said selected three-dimensional image, prior to said step of displaying.

35. The method according to claim 34, wherein said representation of said surgical tool indicates an estimated an estimated location of said surgical tool.

36. The method according to claim 34, wherein said representation of said surgical tool indicates the orientation of said surgical tool.

37. The method according to claim 34, wherein portions of said surgical tool which are located above, below and within a viewed plane, are presented in different colors.

38. The method according to claim 34, wherein said representation of said surgical tool is in the form of a cursor.

39. The method according to claim 34, wherein said representation of said surgical tool is a pseudo relistic visualization of said surgical tool.

40. The method according to claim 34, wherein said representation of said surgical tool comprises a projection of a three-dimensional representation of said representation of said surgical tool, on each of said two-dimensional images.

41. The method according to claim 33, further comprising the following steps, prior to said step of displaying:

detecting the location and orientation of a surgical tool; and

superimposing a representation of said surgical tool onto said selected three-dimensional image, according to said detected location and orientation of said surgical tool.

42. The method according to claim 33, further comprising the following steps prior to said step of displaying:

detecting the location and orientation of a surgical tool; and

superimposing a representation of said detected location and orientation of said surgical tool, onto said selected three-dimensional image.

43. The method according to claim 33, further comprising, the following steps, after said step of selecting:

detecting the location and orientation of a point of view of a user; and

rendering said selected three-dimensional image according to said detected location and orientation of said point of view.

44. The method according to claim 43, further comprising the following steps prior to said step of rendering:

detecting the location and orientation a surgical tool; and

superimposing a representation of said surgical tool onto said selected three-dimensional image.

45. The method according to claim 43, further comprising the following steps, prior to said step of rendering:

detecting the location and orientation of a surgical tool; and

superimposing a representation of said detected location and orientation of said surgical tool onto said selected three-dimensional image.

46. The method according to claim 43, wherein said step of detecting said location and orientation of said point of view of said user, is performed using a location and orientation sensor attached to user worn goggles.

47. The method according to claim 46, wherein the information respective of said location and orientation sensor is provided with the coordinate system of a surgical tool.

48. The method according to claim 46, wherein the information respective of said location and orientation sensor is provided within the coordinate system of said inspected organ.

49. The method according to claim 46, wherein the information respective of said location and orientation sensor is provided within the coordinate system of the body of the patient.

50. The method according to claim 43, wherein said step of detecting said location and orientation of said point of view of said user, is performed using a location and orientation sensor attached to user worn semi-transparent goggles.

51. The method according to claim 33, wherein said surgical tool is selected from the list consisting of:

clamp;

laser cutter;

brush;

catheter;

stent;

balloon;

pace maker electrode;

solution dispensing unit;

neuron electrode;

substance collection unit;

surgical delivery tool;

gene delivery tool;

drug delivery tool; and

device delivery tool.

52. The method according to claim 33, further comprising the step of discarding portions in said selected two-dimensional images which represent a surgical tool, prior to said step of reconstructing.

53. The method according to claim 33, wherein said representation of said surgical tool comprises a projection of a three-dimensional representation of said representation of said surgical tool, on each of said two-dimensional images.

54. Method for displaying an image sequence of a moving inspected organ, the method comprising the steps of:

detecting an organ timing signal of said inspected organ, said organ timing signal defining an organ timing signal cycle;

selecting one of a previously stored three-dimensional images according to a real-time reading of said organ timing signal;

detecting the location and orientation of a surgical tool;

superimposing a representation of said surgical tool onto said selected three-dimensional image; and

displaying said superimposed three-dimensional image;

further comprising the following steps prior to said step of selecting;

detecting a plurality of two-dimensional images of said inspected organ, using an image detector;

detecting the location and orientation of said image detector;

associating each of said two-dimensional images with said location and orientation of said two-dimensional image and with a reading of said organ timing signal detected at the time of acquiring said two-dimensional image; and

reconstructing a plurality of three-dimensional images from said two-dimensional images, each said three-dimensional images being reconstructed from two-dimensional images selected from said two-dimensional images, said selected two-dimensional images corresponding to a selected position within said organ timing signal cycle;

wherein said detected location and orientation of said surgical tool and said detected location and orientation of said image detector, are acquired in a single coordinate system, thereby eliminating computations for correlating said detected location and orientation of said surgical tool and said detected location and orientation of said image detector.

55. The method according to claim 54, further comprising a step of modifying at least one of said two-dimensional images, by discarding a portion thereof which represents at least a portion of said surgical tool, wherein said step of modifying is performed following said step of associating, and following said step of detecting said surgical tool location and orientation.

56. The method according to claim 54, further comprising the following steps, before said step of displaying:

detecting the location and orientation of a point of view of user;

and

rendering said selected three-dimensional image according to said detected location and orientation of said point of view.

57. The method according to claim 56, wherein said step of detecting said location and orientation of said point of view of said user, is performed using a location and orientation sensor attached to user worn goggles.

58. The method according to claim 57, wherein the information respective of said location and orientation sensor is provided within the coordinate system of said surgical tool.

59. The method according to claim 57, wherein the information respective of said location and orientation sensor is provided within the coordinate system of said inspected organ.

60. The method according to claim 57, wherein the information respective of said location and orientation sensor is provided within the coordinate system of the body of the patient.

61. The method according to claim 56, wherein said step of detecting said location and orientation of said point of view of said user, is performed using a location and orientation sensor attached to user worn semi-transparent goggles.

62. The method according to claim 54, wherein said surgical tool is selected from the list consisting of:

clamp;

laser cutter;

brush;

catheter;

stent;

balloon;

pace maker electrode;

solution dispensing unit;

neuron electrode;

substance collection unit;

surgical delivery tool;

gene delivery tool;

drug delivery tool; and

device delivery tool.

63. The method according to claim 54, wherein said representation of said surgical tool indicates an estimated location of said surgical tool.

64. The method according to claim 54, wherein said representation of said surgical tool indicates the orientation of said surgical tool.

65. The method according to claim 54, wherein portions of said surgical tool which are located above, below and within a viewed plane, are presented in different colors.

66. The method according to claim 54, wherein said representation of said surgical tool is in the form of a cursor.

67. The method according to claim 54, wherein said representation of said surgical tool is a pseudo realistic visualization of said surgical tool.

68. The method according to claim 54, wherein said step of reconstruction is performed according to the location and orientation information associated with each said selected two-dimensional images.

69. The method according to claim 54, further comprising the step of discarding portions in said selected two-dimensional images which represent said surgical tool, prior to said step of reconstructing.

70. The method according to claim 54, wherein said representation of said surgical tool comprises a projection of a three-dimensional representation of said representation of said surgical tool, on each of said two-dimensional images.

71. Method for displaying an image sequence of a moving inspected organ, the method comprising the steps of:

detecting an organ timing signal of said inspected organ, said organ timing signal defining an organ timing signal cycle;

detecting the location and orientation of a point of view of a user;

selecting one of a previously stored three-dimensional images according to a real-time reading of said organ timing signal;

rendering said selected three-dimensional image according to said detected location and orientation of said point of view; and

displaying said selected three-dimensional image;

further comprising the following steps prior to said step of selecting;

detecting a plurality of two-dimensional images of said inspected organ, using an image detector;

detecting the location and orientation of said image detector;

associating each of said two-dimensional images with said location and orientation of said two-dimensional image and with a reading of said organ timing signal detected at the time of acquiring said two-dimensional image; and

reconstructing a plurality of three-dimensional images from said two-dimensional images, each said three-dimensional images being reconstructed from two-dimensional images selected from said two-dimensional images, said selected two-dimensional images corresponding to a selected position within said organ timing signal cycle;

further comprising the following steps prior to said step of reconstructing;

detecting the location and orientation of a surgical tool; and

modifying at least one of said two-dimensional images, by discarding a portion of at least one of said two-dimensional images, said portion representing at least a portion of said surgical tool;

wherein said detected location and orientation of said surgical tool and said detected location and orientation of said image detector, are acquired in a single coordinate system, thereby eliminating computations for correlating said detected location and orientation of said surgical tool and said detected location and orientation of said image detector.

72. The method according to claim 71, further comprising the step of superimposing a representation of said surgical tool onto said selected three-dimensional image, prior to said step of displaying.

73. The method according to claim 72, wherein said representation of said surgical tool indicates an estimated location of said surgical tool.

74. The method according to claim 72, wherein said representation of said surgical tool indicates the orientation of said surgical tool.

75. The method according to claim 72, wherein portions of said surgical tool which are located above, below and within a viewed plane, are presented in different colors.

76. The method according to claim 72, wherein said representation of said surgical tool is in the form of a cursor.

77. The method according to claim 72, wherein said representation of said surgical tool is a pseudo realistic visualization of said surgical tool.

78. The method according to claim 72, wherein said representation of said surgical tool comprises a projection of a three-dimensional representation of said representation of said surgical tool, on each of said two-dimensional images.

79. The method according to claim 71, further comprising the following steps, after said step of associating:

detecting the location and orientation of a surgical tool;

modifying at least one of said two-dimensional images, by discarding a portion of at least one of said two-dimensional images, which represents said surgical tool; and

superimposing a representation of said surgical tool onto said selected three-dimensional image.

80. The method according to claim 71, wherein said step of detecting said location and orientation of said point of view of said user, is performed using a location and orientation sensor attached to user worn goggles.

81. The method according to claim 80, wherein the information respective of said location and orientation sensor is provided within the coordinate system of a surgical tool.

82. The method according to claim 80, wherein the information respective of said location and orientation sensor is provided within the coordinate system of said inspected organ.

83. The method according to claim 80, wherein the information respective of said location and orientation sensor is provided within the coordinate system of the body of the patient.

84. The method according to claim 71, wherein said step of detecting said location and orientation of said point of view of said user, is performed using a location and orientation sensor attached to user worn semi-transparent goggles.

85. The method according to claim 71, wherein said surgical tool is selected from the list consisting of:

clamp;

laser cutter;

brush;

catheter;

stent;

balloon;

peace maker electrode;

solution dispensing unit;

neuron electrode;

substance collection unit;

surgical delivery tool;

gene delivery tool;

drug delivery tool; and

device delivery tool.

86. The method according to claim 71, further comprising the step of discarding portions in said selected two-dimensional images which represent a surgical tool, prior to said step of reconstructing.

87. Method for displaying an image sequence of a moving inspected organ, each image in said image sequence being associated with the location and orientation thereof within a predetermined coordinate system, the method comprising the steps of:

detecting an organ timing signal of said inspected organ;

selecting one of a previously stored two-dimensional images according to a real-time reading of said organ timing signal; and

displaying said selected two-dimensional image;

further comprising the following steps, before said step of displaying;

detecting the location and orientation of a surgical tool; and

projecting a representation of said surgical tool onto said selected two-dimensional image;

wherein said detected location and orientation of said surgical tool and said detected location and orientation of said image detector, are acquired in a single coordinate system, thereby eliminating computations for correlating said detected location and orientation of said surgical tool and said detected location and orientation of said image detector.

88. The method according to claim 87, further comprising the preliminary steps of:

detecting a plurality of two-dimensional images of said inspected organ, using an image detector; and

detecting the location and orientation of said image detector for each said two-dimensional images.

89. The method according to claim 87, further comprising the preliminary step of storing said two-dimensional images and the respective said detected locations and orientations of said image detector, in a database.

90. The method according to claim 87, further comprising the preliminary steps of:

determining if at least one of said two-dimensional images deviates from a selected plane; and

reporting said deviation.

91. The method according to claim 87, further comprising the step of detecting the location and orientation of a point of view of a user, before said step of displaying, wherein said stored two-dimensional image is selected according to said detected location and orientation of said point of view.

92. The method according to claim 91, further comprising the preliminary steps of:

detecting a plurality of two-dimensional images of said inspected organ, using an image detector;

detecting the location and orientation of said image detector, respective of each of said two-dimensional images; and

storing said two-dimensional images and the respective said detected locations and orientations of said image detector, in a database.

93. The method according to claim 91, wherein said step of detecting said location and orientation of said point of view of said user, is performed using a location and orientation sensor attached to user worn goggles.

94. The method according to claim 87, wherein the information respective of said location and orientation sensor is provided within the coordinate system of a surgical tool.

95. The method according to claim 87, wherein the information respective of said location and orientation sensor is provided within the coordinate system of said inspected organ.

96. The method according to claim 87, wherein the information respective of said location and orientation sensor is provided within the coordinate system of the body of the patient.

97. The method according to claim 87, wherein said surgical tool is selected from the list consisting of:

clamp;

laser cutter;

brush;

catheter;

stent;

balloon;

pace maker electrode;

solution dispensing unit;

neuron electrode;

substance collection unit;

surgical delivery tool;

gene delivery tool;

drug delivery tool; and

device delivery tool.

98. The method according to claim 87, wherein said representation of said surgical tool indicates an estimated location of said surgical tool.

99. The method according to claim 87, wherein said representation of said surgical tool indicates the orientation of said surgical tool.

100. The method according to claim 87, wherein portions of said surgical tool which are located above, below and within said selected two-dimensional image, are presented in different colors.

101. The method according to claim 87, wherein said representation of said surgical tool is in the form of cursor.

102. The method according to claim 87, wherein said representation of said surgical tool is a pseudo realistic visualization of said surgical tool.