Methods and apparatus for surgical planning

• US 7,607,440 B2
• Filed: 06/06/2002
• Issued: 10/27/2009
• Est. Priority Date: 06/07/2001
• Status: Active Grant

• Current Assignee: Inria Roquencourt, Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Original Assignee: Intuitive Surgical Incorporated (Intuitive Surgical Holdings, LLC)
• Inventors: Boissonnat, Jean-Daniel, Adhami, Louai, Coste-Maniere, Eve C., Guthart, Gary S., Carpentier, Alain
• Primary Examiner(s): Casler; Brian
• Assistant Examiner(s): Kish; James
• Application Number:
  US10/165,413
• Publication Number:
  US 20030109780A1
• Time in Patent Office: 2,700 Days
• Field of Search: 600/407, 600/416, 600/424, 600/426, 600/427, 700/245, 128/922
• US Class Current: 128/898
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/301 for introducing or steering flexible instruments inserted into the body, e.g. catheters or endoscopes
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/25 User interfaces for surgical systems
• CPC Class Codes: A61B 34/30 Surgical robots
• CPC Class Codes: A61B 34/35 for telesurgery
• CPC Class Codes: A61B 34/37 Master-slave robots A61B34/35 takes precedence
• CPC Class Codes: A61B 34/70 Manipulators specially adapted for use in surgery
• CPC Class Codes: A61B 90/361 Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61B 90/37 Surgical systems with images on a monitor during operation
• CPC Class Codes: B25J 9/1671 characterised by simulation, either to verify existing program or to create and verify new program, CAD/CAM oriented, graphic oriented programming systems
• CPC Class Codes: G05B 2219/40418 Presurgical planning, on screen indicate regions to be operated on
• CPC Class Codes: G06T 1/0014 Image feed-back for automatic industrial control, e.g. robot with camera robots B25J19/023
• CPC Class Codes: G06T 2207/10004 Still image; Photographic image
• CPC Class Codes: G06T 7/0012 Biomedical image inspection

Abstract

Methods and apparatus for enhancing surgical planning provide enhanced planning of entry port placement and/or robot position for laparoscopic, robotic, and other minimally invasive surgery. Various embodiments may be used in robotic surgery systems to identify advantageous entry ports for multiple robotic surgical tools into a patient to access a surgical site. Generally, data such as imaging data is processed and used to create a model of a surgical site, which can then be used to select advantageous entry port sites for two or more surgical tools based on multiple criteria. Advantageous robot positioning may also be determined, based on the entry port locations and other factors. Validation and simulation may then be provided to ensure feasibility of the selected port placements and/or robot positions. Such methods, apparatus, and systems may also be used in non-surgical contexts, such as for robotic port placement in munitions diffusion or hazardous waste handling.

Claims

1. A method for simulating a robotic surgical procedure on a computer, the method comprising:

identifying a plurality of port optimization criteria;

assigning numerical values to the port optimization criteria associated with each of at least two candidate port arrangements;

computing a cost metric for each candidate port arrangement, the cost metric comprising a weighted combination of the numerical values assigned to the port optimization criteria for that candidate port arrangement;

selecting the candidate port arrangement having an optimal value of the cost metric; and

simulating a robotic surgical procedure on a human body with the selected candidate port arrangement as the arrangement of a plurality of surgical entry ports in the human body.

2. The method as in claim 1, wherein the plurality of criteria includes at least one of robot kinematics, robot kinetics, robot work range, deviation of tool entry angle from normal, organ geometry, surgeon defined constraints, robot force limitations, and patient force limitations.

3. The method as in claim 1, wherein the plurality of criteria includes at least one of a deviation from a desired configuration, arm placement symmetry with respect to endoscope positioning, and tool entry angle with respect to surface normal.

4. The method as in claim 1, the assigning numerical values comprising employing imaging data acquired using at least one of computed tomography, magnetic resonance imaging, conventional radiography, and arterial angiography.

5. The method as in claim 1, further comprising determining positions for robotic arms individually holding one of a triplet of medical devices for insertion into three surgical entry ports.

6. The method as in claim 5, wherein the determination of the positions of the robotic arms is based at least in part on a set of criteria, the criteria including at least one of robot kinematics, robot kinetics, robot work range, deviation of tool entry angle from normal, organ geometry, surgeon defined constraints, robot force limitations, and patient force limitations.

7. The method as in claim 1, further comprising:

preparing a representation of a defined volume within the patient from a set of acquired data; and

facilitating a first simulation for enabling a user to simulate a medical procedure performed through said surgical entry ports, the first simulation based upon the representation of the defined volume, the advantageous locations of the entry ports, and a surgical protocol.

8. The method as in claim 7, further comprising:

enabling the user to reject one or more of the advantageous locations based on the first simulation;

determining different advantageous locations based on the user'"'"'s rejection; and

facilitating a second simulation for enabling the user to simulate the medical procedure, the second simulation being based upon the model of the defined volume, the different advantageous locations of the entry ports, and the surgical protocol.

9. The method as in claim 1, further comprising storing information of the advantageous locations in a memory.

10. An apparatus for simulation of a robotic surgical procedure, the apparatus comprising a tangible medium configured with machine readable code to:

identify a plurality of port optimization criteria;

assign numerical values to the port optimization criteria associated with each of at least two candidate port arrangements;

compute a cost metric for each candidate port arrangement, the cost metric comprising a weighted combination of the numerical values assigned to the port optimization criteria for that candidate port arrangement; and

select the candidate port arrangement having an optimal value of the cost metric;

wherein the machine readable code is further configured to facilitate simulation of a robotic surgical procedure on a human body with the selected candidate port arrangement as the arrangement of a plurality of surgical entry ports in the human body.

11. The apparatus as in claim 10, wherein the machine readable code is further configured to determine a preferred position for placement of a robotic apparatus relative to the plurality of surgical entry ports.

12. The apparatus as in claim 10, wherein the plurality of criteria includes at least one of robot kinematics, robot kinetics, robot work range, deviation of tool entry angle from normal, organ geometry, surgeon defined constraints, robot force limitations, and patient force limitations.

13. The apparatus as in claim 10, wherein the plurality of criteria includes at least one of a deviation from a desired configuration, arm placement symmetry with respect to endoscope positioning, and tool entry angle with respect to surface normal.

14. The apparatus as in claim 10, the machine readable code configured to assign numerical values by employing imaging data acquired using at least one of computed tomography, magnetic resonance imaging, conventional radiography, and arterial angiography.

15. The apparatus as in claim 10, the machine readable code further configured to determine positions for robotic arms individually holding one of a triplet of medical devices for insertion into three surgical entry ports.

16. The apparatus as in claim 15, wherein the determination of the positions of the robotic arms is based at least in part on a set of criteria, the criteria including at least one of robot kinematics, robot kinetics, robot work range, deviation of tool entry angle from normal, organ geometry, surgeon defined constraints, robot force limitations, and patient force limitations.

17. The apparatus as in claim 10, the machine readable code further configured to:

prepare a representation of a defined volume within the patient from a set of acquired data; and

facilitate a first simulation for enabling a user to simulate a medical procedure performed through said surgical entry ports, the first simulation based upon the representation of the defined volume, the advantageous locations of the entry ports, and a surgical protocol.

18. The apparatus as in claim 17, the machine readable code further configured to:

enable the user to reject one or more of the advantageous locations based on the first simulation;

determine different advantageous locations based on the user'"'"'s rejection; and

facilitate a second simulation for enabling the user to simulate the medical procedure, the second simulation being based upon the model of the defined volume, the different advantageous locations of the entry ports, and the surgical protocol.

19. The apparatus as in claim 10, the machine readable code further configured to store information of the advantageous locations in a memory.

20. A robotic surgical system comprising:

first and second robotic arms adapted to respectively hold first and second surgical tools for performing a medical procedure on a patient;

a third robotic arm adapted to hold an image capturing device, and

a computer for selecting a preferred arrangement of entry ports for the first and second robotic arms from among at least two candidate port arrangements, the computer configured to;

identify a plurality of port optimization criteria;

assign numerical values to the port optimization criteria associated with each candidate port arrangement;

compute a cost metric for each candidate port arrangement, the cost metric comprising a weighted combination of the numerical values assigned to the port optimization criteria for that candidate port arrangement;

select the candidate port arrangement having an optimal value of the cost metric as the preferred arrangement of the plurality of surgical entry ports;

wherein the computer is further configured to facilitate simulation of a robotic surgical procedure on the patient with the selected candidate port arrangement as the arrangement of a plurality of surgical entry ports in the patient.

21. The system of claim 20, wherein the computer further comprises a display device for displaying the simulation of the medical procedure.

22. The system as in claim 20, wherein the plurality of criteria includes at least one of robot kinematics, robot kinetics, robot work range, deviation of tool entry angle from normal, organ geometry, surgeon defined constraints, robot force limitations, and patient force limitations.

23. The system as in claim 20, wherein the plurality of criteria includes at least one of a deviation from a desired configuration, arm placement symmetry with respect to endoscope positioning, and tool entry angle with respect to surface normal.

24. The system as in claim 20, the computer configured to assign numerical values by employing imaging data acquired using at least one of computed tomography, magnetic resonance imaging, conventional radiography, and arterial angiography.

25. The system as in claim 20, the computer further configured to determine positions for robotic arms individually holding one of a triplet of medical devices for insertion into three surgical entry ports.

26. The system as in claim 25, wherein the determination of the positions of the robotic arms is based at least in part on a set of criteria, the criteria including at least one of robot kinematics, robot kinetics, robot work range, deviation of tool entry angle from normal, organ geometry, surgeon defined constraints, robot force limitations, and patient force limitations.

27. The system as in claim 20, the computer further configured to:

prepare a representation of a defined volume within the patient from a set of acquired data; and

facilitate a first simulation for enabling a user to simulate a medical procedure performed through said surgical entry ports, the first simulation based upon the representation of the defined volume, the advantageous locations of the entry ports, and a surgical protocol.

28. The system as in claim 27, the computer further configured to:

enable the user to reject one or more of the advantageous locations based on the first simulation;

determine different advantageous locations based on the user'"'"'s rejection; and

facilitate a second simulation for enabling the user to simulate the medical procedure, the second simulation being based upon the model of the defined volume, the different advantageous locations of the entry ports, and the surgical protocol.

29. The system as in claim 20, the computer further configured to store information of the advantageous locations in a memory.