Method and apparatus for performing a navigated procedure

• US 9,289,270 B2
• Filed: 11/25/2009
• Issued: 03/22/2016
• Est. Priority Date: 04/24/2007
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Gielen, Frans L. H., Appenrodt, Peter, Csavoy, Andrew N., Waynik, Jeffrey M., Freas, Mark S., Solar, Matthew S.
• Primary Examiner(s): Peng, Bo J
• Application Number:
  US12/626,223
• Publication Number:
  US 20100160771A1
• Time in Patent Office: 2,309 Days
• US Class Current: 1/1
• CPC Class Codes: A61B 2017/3407 including a base for support on the body
• CPC Class Codes: A61B 2017/3409 including needle or instrument drives
• 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 2034/2059 Mechanical position encoders
• CPC Class Codes: A61B 2034/2068 using pointers, e.g. pointers having reference marks for determining coordinates of body points
• CPC Class Codes: A61B 2090/101 for stereotaxic radiosurgery
• CPC Class Codes: A61B 2090/103 Cranial plugs for access to brain
• CPC Class Codes: A61B 2090/364 Correlation of different images or relation of image positions in respect to the body
• CPC Class Codes: A61B 2090/373 using light, e.g. by using optical scanners
• 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 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61B 90/18 Retaining sheets, e.g. immobilising masks made from a thermoplastic material

Abstract

A system can be used to navigate or guide an instrument or device into an anatomy of a patient. The navigation can occur with the use of image data acquired of the patient. The image data can be registered to the patient space for navigation. One or more tracking devices can be the associated with the patient and with guiding instruments for tracking guiding devices relative to the patient.

Claims

1. A system to track and determine a location of an instrument relative to a subject, comprising:

an alignment system including an alignment base configured to be fixed directly to the subject with a fixing member and a trajectory portion operable to selectively move relative to the alignment base and be fixed relative to the alignment base, wherein the trajectory portion has at least two slots therethrough to allow movement of the trajectory portion relative to the alignment base;

a drive system supported by the alignment system and configured to drive the instrument into the subject, wherein the drive system has an instrument engaging portion and a drive base to be connected directly to the trajectory portion, wherein the instrument engaging portion is moveable relative to the drive base that is connected to the trajectory portion;

a subject tracking device configured to be connected directly to the subject separate and spaced apart from the alignment system;

a drive system tracking device connected to the drive system having at least a first tracking device portion and an alignment system tracking device connected to the alignment system having at least a second tracking device portion; and

a tracking system configured to track the subject tracking device, the alignment system tracking device, and the drive system tracking device.

2. The system of claim 1,

wherein the drive system tracking device further includes at least the first tracking device portion connected to the drive base and a third tracking device portion connected to the instrument engaging portion configured to allow tracking of the drive base relative to the instrument engaging portion.

3. The system of claim 2, further comprising:

a display device operable to display the tracked position of at least one of the alignment base and the drive system relative to the subject.

4. The system of claim 3, wherein the display device is operable to further display a selected position of at least one of the alignment system and drive system relative to the subject and further operable to display an indication of whether at least one of the alignment system and the drive system are at the selected position relative to the subject.

5. The system of claim 1, further comprising:

a navigation processor operable to execute instructions to determine a relative position of the subject tracking device and the drive system tracking device and generate an output signal based upon the determined relative position of the subject tracking device and the drive system tracking device.

6. The system of claim 5, wherein the alignment system tracking device is connected directly to the alignment system when the drive system tracking device is connected directly to the drive system;

wherein the tracking system is further operable to simultaneously track the alignment system tracking device with the subject tracking device and the drive system tracking device;

wherein the navigation processor is operable to output a signal based upon a determined relative position of all of the subject tracking device, the drive system tracking device, and the alignment system tracking device.

7. The system of claim 6, wherein the tracking system includes at least one of an electromagnetic tracking system, an optical tracking system, an acoustic tracking system, and combinations thereof.

8. The system of claim 1, further comprising:

a signal emitting system operable to emit a signal to a user regarding the relative location of the alignment system and the drive system relative to the subject and provide a signal regarding if either of the alignment system or the drive system are at an unselected position relative to the subject.

9. The system of claim 1, wherein the tracking system includes an electromagnetic localizer;

wherein the alignment system tracking device is operable as the electromagnetic localizer to at least emit an electromagnetic field sensed by at least the drive system tracking device and a navigation processor is configured to determine a location of the drive system tracking device based thereon.

10. A system to track and determine a location of an instrument relative to a subject, comprising:

an alignment system operable to be connected to the subject having a trajectory portion operable to be moved relative to the subject at an alignment device selected position and a fixing portion operable to fix the trajectory portion relative to the subject, wherein the trajectory portion has at least two slots therethrough configured to allow movement of the trajectory portion relative to the subject;

a drive system configured to be placed at a drive system selected position and to drive the instrument into the subject, wherein the drive system has a drive base to be connected to the trajectory portion, wherein the instrument is moveable relative to the drive base that is connected to the trajectory portion;

a subject tracking device configured to be connected directly to the subject separate and spaced apart from the alignment system;

a drive system tracking device connected to at least one of the alignment system and the drive system;

a tracking system to track the subject tracking device and the drive system tracking device; and

a navigation processor at least configured to;

determine whether either of the alignment device or the drive system have moved from either of the alignment device selected position and drive system selected position while moving the instrument into the subject with the drive system and while guiding the instrument with the alignment device at least by tracking the subject tracking device relative to the drive system tracking device,

generate an icon to illustrate a tracked position of the instrument relative to an icon of a planned path, and

output an alert signal if it is determined that either of the alignment device or the drive system has moved from the respective selected positions relative to the subject tracking device.

11. The system of claim 10, further comprising:

at least one of a micro-electrode or deep brain stimulation probe as the instrument.

12. The system of claim 10, wherein the navigation processor configured to determine whether the alignment device and the drive system have moved includes determining whether the alignment system or the drive system has moved after a time selected interval.

13. The system of claim 10, further comprising:

a display device operable to display an image representative of the subject;

wherein the navigation processor is further configured to determine a position for a display of an icon representing a position of at least one of the drive system or the instrument relative to the displayed image of the subject.

14. The system of claim 13, wherein the navigation processor includes a plurality of processors.

15. The system of claim 13, wherein output a signal includes displaying on the display device a selected position of at least one of the drive system, the alignment device, and the instrument relative to a representation of a pre-selected position of at least one of the respective drive system, alignment device, or an instrument selected position of the instrument.

16. The system of claim 10, further comprising:

an alignment system tracking device;

wherein the alignment system tracking device and the drive system tracking device are both electromagnetic tracking devices.

17. The system of claim 16, wherein the tracking system is an electromagnetic tracking system and the first coil is an electromagnetic localizer.

18. The system of claim 17, wherein the alignment system tracking device is operable as the electromagnetic localizer to at least emit the electromagnetic field sensed by at least the drive system tracking device and the navigation processor is configured to determine a location of the drive system tracking device based thereon.

19. The system of claim 16, wherein the alignment system includes a trajectory guide configured to move relative to a base and the alignment system tracking device is fixed to the trajectory guide.

20. The system of claim 10, wherein the navigation processor is configured to make a determination of a relative position of at least one of the alignment device, the drive system, or the instrument relative to the subject at least by tracking the subject tracking device.

21. A system to track and determine a location of an instrument relative to a subject, comprising:

an alignment device having at least a base configured to be fixed directly to the subject at a first selected position and a trajectory guide configured to move relative to the base via a first slot and a second slot extending through the trajectory guide, wherein the alignment device is operable to align the instrument relative to the subject for a selected procedure to be performed on the subject;

a drive system connected at a second selected position relative to the alignment device to drive the instrument into the subject for performing the selected procedure on the subject;

a tracking system including;

an alignment tracking device fixed to the alignment device, wherein the alignment tracking device is operable to allow tracking the alignment device;

a drive system tracking device affixed to the drive system; and

a subject tracking device configured to be connected directly to the subject spaced apart and separate from the alignment device to allow tracking of the subject;

wherein the tracking system is configured to generate a tracking signal regarding a tracked location of at least one of the alignment tracking device, the drive system tracking device, or the subject tracking device; and

a navigation processor configured to, with the generated tracking signal;

determine whether either of the alignment device or the drive system have moved from either of the first selected position or the second selected position while moving the instrument into the subject with the drive system and while guiding the instrument with the alignment device; and

output a signal if it is determined that either of the alignment device or the drive system has moved from the respective selected positions.

22. The system of claim 21,

wherein the alignment tracking device is fixed to the trajectory guide;

wherein the base is configured to contact the subject only near the portal and the subject tracking device is spaced away from the base.

23. The system of claim 21, further comprising:

a display device configured to display at least two of a position of the subject, the alignment device, the drive system, or the instrument to illustrate a relative position between the displayed at least two of the subject, the alignment device, the drive system, or the instrument.

24. The system of claim 23, wherein the determination of whether either of the alignment device or the drive system has moved from either of the first selected position or second selected position, the determination is based on an absolute respective selected positions and the determination is not made on movement of the alignment device or the drive system relative to the subject tracking device.

25. The system of claim 23, wherein the determination of whether either of the alignment device or the drive system has moved from either of the first selected position or second selected position, the determination is based on movement of the alignment device or the drive system relative to the subject tracking device.

26. The system of claim 21, wherein the tracking system further includes an electromagnetic localizer configured to emit an electromagnetic field, wherein the subject tracking device is configured to be selectively operated as the electromagnetic localizer to at least emit the electromagnetic field operable to track the alignment tracking device and the drive system tracking device by each sensing the electromagnetic field;

wherein the tracking signal regarding the tracked location generated by the tracking system is based on the sensing of the electromagnetic field.