Flexible array for use in navigated surgery

• US 8,108,025 B2
• Filed: 04/24/2007
• Issued: 01/31/2012
• Est. Priority Date: 04/24/2007
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Csavoy, Andrew N., Solar, Matthew S., Waynik, Jeffrey M., Freas, Mark S.
• Primary Examiner(s): Casler, Brian
• Assistant Examiner(s): Lamprecht, Joel
• Application Number:
  US11/739,424
• Publication Number:
  US 20080269600A1
• Time in Patent Office: 1,743 Days
• Field of Search: 600/407, 600/426, 600/429, 606/130
• US Class Current: 600/407
• CPC Class Codes: A61B 2017/3407 including a base for support on the body
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• 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 2090/364 Correlation of different images or relation of image positions in respect to the body
• 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 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2090/3945 Active visible markers, e.g. light emitting diodes
• 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 46/00 Surgical drapes
• CPC Class Codes: A61B 90/17 for soft tissue, e.g. breast-holding devices
• CPC Class Codes: A61B 90/18 Retaining sheets, e.g. immobilising masks made from a thermoplastic material
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers

Abstract

A system can be used to determine a position of a structure in physical space. The system can include a flexible member, such as a drape, cloth, sheet, etc. that can include one or more trackable devices associated therewith. The trackable devices can be incorporated into the weave of a woven cloth or the matrix of a polymer member. The trackable devices can be used within a tracking system to determine the location of the trackable devices.

Claims

1. A system to determine a contour of a surface of a patient, the system comprising:

a flexible member having an edge, a top surface, and a bottom surface, wherein the top surface and the bottom surface are substantially co-extensive and have an area greater than the edge, wherein the flexible member is at least partially woven including a first fiber interlaced with a second fiber; and

a tracking device including a first coil formed on the first fiber and a second coil formed on the second fiber, wherein the tracking device is operable to determine a distinct position information regarding the surface of the patient;

wherein the flexible member is formable to a contour of the patient and is operable to assist in a registration of a patient space to an image space.

2. The system of claim 1, at least one of the first coil or the second coil is operable to receive an electromagnetic field, produce an electromagnetic field, or combinations thereof.

3. The flexible member system of claim 2, further comprising:

a tracking system including a localizer;

wherein the localizer includes at least one of a coil operable to receive an electromagnetic field, a coil operable to produce an electromagnetic field, or combinations thereof.

4. The system of claim 3, further comprising:

a processor operable to determine a contour of the patient based upon a determined position of the tracking sensor in the member.

5. The system of claim 4, wherein the contour is at least one of a 2D contour, a 3D contour, or combinations thereof.

6. The system of claim 1, where the flexible member is at least one of substantially non-porous or a completely woven sheet.

7. The system of claim 1, wherein the flexible member is a substantially non-porous member.

8. The flexible member system of claim 1,

wherein the first coil is substantially orthogonal to the second coil.

9. The system of claim 8, wherein the flexible member includes a plurality of the first coils and a plurality of the second coils to form a plurality of the tracking devices.

10. The system of claim 4, wherein the member includes a plurality of the tracking devices;

wherein each of the plurality of the tracking devices is operable to provide distinct position information;

wherein a plurality of the distinct position information can be analyzed with the processor to determine a contour of the patient.

11. The system of claim 10, further comprising:

an imaging system operable to acquire image data of the patient;

wherein the processor is operable to determine an image data contour;

wherein the processor is operable to correlate the determined contour of the patient and the image data contour.

12. The system of claim 11, wherein the determined contour of the patient and the image data contour are each at least one of a 2D contour, a 3D contour, or combinations thereof.

13. The flexible member system of claim 1, wherein the member defines a passage and a passage cover;

wherein the passage cover is operable to be moved to allow access to a selected portion of the patient.

14. The system of claim 1, wherein the member includes a surface area substantially great enough to contact a soft tissue surface of the patient without substantially deforming the soft tissue surface of the patient.

15. The system of claim 1, further comprising:

a tracking system;

wherein a position of at least a portion of the flexible member is operable to be tracked with the tracking system to determine a contour of the patient to be registered to an image data contour.

16. The system of claim 1, further comprising:

a fiducial marker associated with the flexible member operable to be imaged with an imaging system.

17. The system of claim 16, wherein the fiducial marker is one member with the tracking device.

40. The flexible member system of claim 3, with the first coil is formed around the first fiber and the second coil is formed around the second fiber.

18. A method to determine a contour of a surface of a patient, the method comprising:

overlaying a flexible member atop an exterior surface of the patient to define a sterile field over the portion of the patient covered with the flexible member;

tracking a distinct location of a tracking device affixed to the flexible member with a tracking system;

determining the location of the tracking device regarding the surface of the patient; and

registering an image space with a physical space defined relative to the flexible member based at least in part on the determined location of the tracking device.

19. The method of claim 18, further comprising:

acquiring image data of the patient that defines the image space.

20. The method of claim 18, wherein overlaying a flexible member includes overlaying a polymer sheet including at least a portion of the tracking sensor.

21. The method of claim 18, wherein overlaying a flexible member includes overlaying a flexible member including an intersection of a first fiber and a second fiber with a first coil around the first fiber and a second coil around the second fiber, wherein the first coil and the second coil define the tracking device.

22. The method of claim 20, further comprising:

providing the tracking device as a substantially single unit member including at least a first coil and a second coil positioned substantially orthogonal to one another; and

at least one of embedding the tracking device into the flexible member, molding the tracking device into the flexible member, or combinations thereof.

23. The method of claim 18, further comprising:

associating a plurality of the tracking devices with the flexible member;

wherein overlaying the flexible member on the patient includes placing the plurality of the associated tracking devices over a selected surface area of the patient;

wherein tracking a location of the tracking device includes tracking a location of a plurality of points of the selected surface of the patient.

24. The method of claim 23, further comprising:

determining a contour of a surface of the patient based upon the tracked location of the plurality of tracking devices;

acquiring image data of the patient;

determining a contour in the image data; and

correlating the contour determined from the tracked location of the tracking devices and the contour of the image data.

25. The method of claim 23, further comprising:

basing the registering the image space and the physical space upon the correlated contours; and

performing an image guided procedure on the patient with the registered image space to physical space.

26. The method of claim 23, wherein the contour is at least one of a 2D contour, a 3D contour, or combinations thereof.

27. The method of claim 18, further comprising:

transmitting information wirelessly transmitting, transmitting over a wire, or combinations thereof from the tracking device.

28. The method of claim 18, further comprising:

providing a tracking system including the tracking device;

wherein the tracking system is at least one of an electromagnetic tracking system, an optical tracking system, an acoustic tracking system, or combinations thereof.

29. The method of claim 21, wherein the first coil is formed substantially orthogonal to the second coil.

39. The method of claim 18, further comprising:

providing a passage through the flexible member;

providing a cover over the passage; and

accessing the patient through the passage to maintain the surrounding sterile field.

30. A method to determine a contour of a surface of a patient, the method comprising:

positioning a flexible member formed of a first fiber woven with a second fiber on the patient;

determining a contour of the patient in acquired image data;

tracking a location of a tracking device including a first coil formed around the first fiber and a second coil formed around the second fiber;

determining a contour of the patient via tracking the location of the tracking device;

correlating the determined contour in the image data and the determined contour of the patient; and

registering an image space and a patient space.

31. The method of claim 30, wherein the first coil and second coil are substantially orthogonal to one another.

32. The method of claim 30,

wherein tracking a location of the tracking device includes tracking a location of a plurality of the tracking devices formed on the flexible member;

wherein determining a contour of the patient includes receiving position information from each of the plurality of the tracking devices and determining a contour based on the position information from the plurality of tracking devices.

33. The method of claim 30, further comprising:

selecting a surgical instrument; and

navigating the selected surgical instrument relative to the patient with the image data based upon the registration of the image space to the patient space.

34. The method of claim 33, further comprising:

displaying on a display device the acquired image data of the patient; and

displaying on the display device an icon representing a location of the surgical instrument relative to the patient superimposed on the image data.

35. The method of claim 33, wherein selecting a surgical instrument includes selecting at least one of a deep brain stimulation lead, a micro-electrode lead, a catheter, a cannula, an ablation device, or combinations thereof.

36. The method of claim 33, further comprising:

forming a sterile field relative to the patient with the flexible member;

opening a passage in the flexible member to provide a passage through the sterile field; and

passing the selected surgical instrument through the provided passage.

37. The method of claim 36, further comprising:

providing a cover over the passage to provide a substantially continuous sterile field continuous with the flexible member; and

removing the cover from the provided passage prior to passing the selected surgical instrument through the flexible member.

38. The method of claim 36, further comprising:

precisely tracking a location near the passage for the selected instrument.