Method and apparatus for performing stereotactic surgery

• US 7,925,328 B2
• Filed: 12/17/2007
• Issued: 04/12/2011
• 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, Schallhorn, Richard
• Primary Examiner(s): Casler; Brian
• Assistant Examiner(s): MEHTA, PARIKHA SOLANKI
• Application Number:
  US11/958,037
• Publication Number:
  US 20080097195A1
• Time in Patent Office: 1,212 Days
• Field of Search: 600/407, 600/411, 600/417, 600424-429, 606/130
• 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, the 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;

a tracking system with a plurality of tracking devices operable to be tracked;

a first sub-plurality of the plurality of tracking devices, configured to be coupled to the stereotactic head frame for use in tracking an instrument location of the instrument;

a processor system for registering the navigable patient space to acquired image data of the patient; and

an adjustment system configured to be coupled to the stereotactic head frame and including a stage to which a second sub-plurality of the plurality of tracking devices is configured to be connected, the adjustment system is configured for adjusting a location and orientation of the instrument relative to the target site by adjusting the stage, the adjustment system automatically adjusting the stereotactic head frame via a real-time closed loop feedback with the processor system and the stereotactic head frame.

2. The stereotactic navigation system of claim 1, wherein the stage of the adjustment system includes a plurality of stages, wherein each stage is configured to be tracked with the second sub-plurality of the plurality of tracking devices and wherein each stage is movable along a corresponding plurality of mutually orthogonal axes, wherein at least a first stage of the plurality of stages automatically is adjusted by the real-time closed loop feedback.

3. The stereotactic navigation system of claim 2, wherein at least the first stage is automatically adjusted by a robotic device.

4. The stereotactic navigation system of claim 1, wherein the stage of the adjustment system includes first, second and third stages movable along corresponding and mutually orthogonal first and second axes, the first, second and third stages automatically adjustable by a robotic device.

5. The stereotactic navigation system of claim 1, wherein the 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.

6. The stereotactic navigation system of claim 1, wherein the stage of the adjustment system includes a plurality of stages movable along a corresponding plurality of mutually orthogonal axes, at least a first stage of the plurality of stages adjustable by a user based on directions received by the work station.

7. The stereotactic navigation system of claim 1, in combination with the instrument, the instrument including a deep brain stimulation (DBS) lead, the DBS lead including a plurality of electromagnetic sensors for tracking the position of the lead.

8. The stereotactic navigation system of claim 1, in combination with the instrument, the instrument including a cannula having at least one tracking microelectrode and a deep brain stimulation lead passing through the cannula.

9. The stereotactic navigation system of claim 1, wherein the adjustment system automatically adjusts the stereotactic head frame based on the acquired image data.

10. A stereotactic navigation system for navigating an instrument to a target site within a patient, the 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;

a tracking device configured to be coupled to the stereotactic head frame for use in tracking the instrument;

a processor system for registering the navigable patient space to acquired image data of the patient; and

an adjustment system configured to be tracked and coupled to the stereotactic head frame, the adjustment system configured for adjusting a location and orientation of the instrument relative to the target site, the adjustment system automatically adjusting the stereotactic head frame via a real-time closed loop feedback with the processor system and the stereotactic head frame;

wherein at least the first stage is automatically adjusted by a robotic device and the robotic device includes an automated screw driver configured to drive a movement of at least the first stage.

11. The stereotactic navigation system of claim 10, wherein the screw driver includes a high gear setting for coarse adjustment and a low gear setting for fine adjustment.

12. A stereotactic navigation system for navigating an instrument to a target site within a patient, the 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;

a tracking device configured to be coupled to the stereotactic head frame for use in tracking the instrument;

a processor system for registering the navigable patient space to acquired image data of the patient;

an adjustment system configured to be tracked and coupled to the stereotactic head frame, the adjustment system configured for adjusting a location and orientation of the instrument relative to the target site, the adjustment system automatically adjusting the stereotactic head frame via a real-time closed loop feedback with the processor system and the stereotactic head frame; and

a coupling device including a first coupling portion defined by the stereotactic head frame and a second coupling portion defined by the tracking device, the second coupling portion being complementary to the first coupling portion;

wherein the processor system is configured to recognize a position and an orientation of the first coupling portion and 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.

13. The stereotactic navigation system of claim 12, wherein the tracking device is configured to be removably coupled to the stereotactic head frame at a unique location on the stereotactic head frame, the tracking device is further configured to track the position of the instrument relative to the stereotactic head frame and to be removed from the stereotactic head frame during acquisition of the image data of the patient with the stereotactic head frame.

14. The stereotactic navigation system of claim 13, wherein the tracking device includes a plurality of removable transmitter coil arrays, each configured to generate an electromagnetic navigation field.

15. The stereotactic navigation system of claim 14, wherein the 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.

16. The stereotactic navigation system of claim 14, wherein each transmitter coil array comprises three orthogonal coils.

17. The stereotactic navigation system of claim 14, wherein the processor system is configured to automatically register image data with the navigable patient space defined by the stereotactic head frame.

18. The stereotactic navigation system of claim 17, further comprising an imaging device configured to capture the image data of the navigable patient space within the patient.

19. The stereotactic navigation system of claim 18, further comprising a second tracking device associated with the instrument and configured to track a position of the instrument relative to the stereotactic head frame and a display configured to display the image data of the navigable patient space with a superimposed icon of the tracked instrument.

20. A stereotactic navigation system for navigating an instrument to a target site within a patient, the 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 first tracking device removably coupled to the stereotactic head frame and configured to track the position of the instrument relative to the stereotactic head frame;

an adjustment system configured to be tracked and coupled to the stereotactic head frame, the adjustment system including a plurality of stages configured to be tracked each with at least a second tracking device and each of the plurality of stages movable along a corresponding plurality of mutually orthogonal axes, the adjustment system configured for adjusting a location and orientation of the instrument relative to the target site; and

a tracking system including the first tracking device and the second tracking device to track locations of the first tracking device and the second tracking device;

a work station having a processor, a display screen and a user interface, the display screen configured to display the image data and a plurality of adjustment scales corresponding to the plurality of stages for adjusting the location and orientation of the instrument via the user interface, the work station configured to receive the image data from the imaging device, the work station further configured to automatically register the image data with the navigable patient space.

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

22. The stereotactic navigation system of claim 21, wherein the tracking device includes a plurality of removable transmitter coil arrays, each configured to generate an electromagnetic navigation field.

23. The stereotactic navigation system of claim 22, wherein the plurality of trackable stages are configured to adjust the stereotactic head frame along an x-axis, a y-axis, and a z-axis.

24. The stereotactic navigation system of claim 23, further comprising a tracking sensor associated with each axis and configured to track movement of the stereotactic head frame along each axis using the tracking device.

25. The stereotactic navigation system of claim 20, further comprising a tool guide adjustably coupled to the stereotactic head frame and configured to align an entry point of the instrument to the target site.

26. The stereotactic navigation system of claim 25, further comprising;

at least one tracking sensor associated with the tool guide;

wherein the at least one tracking sensor is configured to identify a location of the entry point relative to the target site.

27. A stereotactic navigation system for navigating an instrument to a target site within a patient, the 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 device removably coupled to the stereotactic head frame and configured to track the position of the instrument relative to the stereotactic head frame;

an adjustment system configured to be coupled to the stereotactic head frame, the adjustment system including a plurality of stages each configured to be movable along a corresponding plurality of mutually orthogonal axes, the adjustment system configured for adjusting a location and orientation of the instrument relative to the target site;

a tracking sensor associated with each of the plurality of mutually orthogonal axes and configured to track movement of the stereotactic head frame along each of the plurality of mutually orthogonal axes using the tracking device; and

a work station having a processor, a display screen and a user interface, the display screen configured to display the image data and a plurality of adjustment scales corresponding to the plurality of stages for adjusting the location and orientation of the instrument via the user interface, the work station configured to receive the image data from the imaging device, the work station further configured to automatically register the image data with the navigable patient space;

wherein the work station is further configured to identify the target site on the display screen and further configured to identify the location of a centroid of the stereotactic head frame relative to the target site on the display screen.

28. The stereotactic navigation system of claim 27, wherein the work station is further configured to provide real-time feedback of the adjustment of the stereotactic head frame and display the real-time feedback of the adjustment on the display screen.

29. A method for performing image guided stereotactic navigation, the method comprising:

attaching a stereotactic head frame defining navigable patient space on a patient;

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

attaching a first tracking device to the stereotactic head frame;

automatically registering the image data with the navigable patient space;

coupling an adjustment system to the stereotactic head frame, wherein the adjustment system includes a stage to which a second tracking device is connected, and wherein the adjustment system is configured for adjusting a location and orientation of an instrument relative to a target site by adjusting the stage;

adjusting the adjustment system via a real time closed loop feedback between a processor and the tracking device; and

tracking the second tracking device while adjusting the adjustment system.

30. The method of claim 29, wherein adjusting the stereotactic head frame includes automatically adjusting the stereotactic head frame using a robotic device.

31. The method of claim 29, wherein adjusting the stereotactic head frame includes adjusting the stereotactic head frame via a user interface communicating with the processor.

32. The method of claim 29, wherein adjusting the stereotactic head frame includes:

moving a screen slider displayed on a display screen connected to the user interface; and

moving a stage coupled to the stereotactic head frame, the stage corresponding to the screen slider.

33. The method of claim 32, further comprising identifying a target site in the image data on the display screen.

34. The method of claim 33, further comprising selecting a planned entry point for delivering an instrument to the target site.

35. The method of claim 34, further comprising displaying a representation of the instrument superimposed on the image data in relation to the target site.

36. The method of claim 32, further comprising identifying a target site in the image data on the display screen and identifying a location of a centroid of the stereotactic head frame relative to the target site on the display screen.