System and method for analysing a surgical operation by endoscopy

• US 9,649,169 B2
• Filed: 08/20/2008
• Issued: 05/16/2017
• Est. Priority Date: 08/24/2007
• Status: Active Grant

• Current Assignee: Université Grenoble Alpes
• Original Assignee: Université Grenoble Alpes
• Inventors: Messas, Aurel, Moreau-Gaudry, Alexandre, Cinquin, Philippe, Mozer, Pierre, Voros, Sandrine, Long, Jean-Alexandre
• Primary Examiner(s): Musselman, Timothy A
• Application Number:
  US12/674,847
• Publication Number:
  US 20110046476A1
• Time in Patent Office: 3,191 Days
• Field of Search: 434262-275
• CPC Class Codes: A61B 2017/00119 alarm; indicating an abnormal situation
• CPC Class Codes: A61B 2017/00128 related to intensity or progress of surgical action
• CPC Class Codes: A61B 2017/00274 Prostate operation, e.g. prostatectomy, turp, bhp treatment
• CPC Class Codes: A61B 2018/00547 Prostate
• CPC Class Codes: A61B 2034/252 indicating steps of a surgical procedure
• 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 2090/08021 of the patient or his organs
• CPC Class Codes: A61B 2090/364 Correlation of different images or relation of image positions in respect to the body
• CPC Class Codes: A61B 2090/3941 Photoluminescent markers
• CPC Class Codes: A61B 2090/3945 Active visible markers, e.g. light emitting diodes
• CPC Class Codes: A61B 2090/395 with marking agent for marking skin or other tissue
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• 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 34/35 for telesurgery
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: G09B 23/285 for injections, endoscopy, bronchoscopy, sigmoidscopy, insertion of contraceptive devices or enemas

Abstract

The invention concerns an analysis method for a surgical operation via endoscopy performed at an operative site in a volume located inside the body of an animal, characterized in that it comprises the steps consisting of:

• • detecting at least one instrument (1; 2; 3) present at the operative site,
  • detecting at least one portion of an organ (4) in the vicinity of the detected instrument (1; 2; 3),
  • determining the positioning of the detected instrument (1; 2; 3) relative to the detected organ (4), so that the detected instrument (1; 2; 3), the detected portion of organ (4) and their relative positioning form parameters defining a detected surgical step,
  • selecting, in a database, a conceptual surgical step corresponding to the detected surgical step from to the detected instrument (1; 2; 3), the detected portion of organ (4) and their relative positioning,
  • comparing the parameters of the detected surgical step with the parameters defining the selected conceptual surgical step to determine the differences between these parameters, providing information on the quality of the detected surgical step on the basis of the determined differences.

Claims

1. An analysis method for a surgical operation via endoscopy at an operative site in a volume located inside a body, the method comprising:

a) selecting the surgical operation to be performed;

b) detecting from an image of the operative site at least one instrument present therein,

c) detecting from the image of the operative site at least one portion of an organ in the vicinity of the detected instrument,

d) determining the positioning of the detected instrument relative to the detected organ, so that the detected instrument, the detected portion of organ, and their relative positioning form parameters defining a detected surgical step,

e) selecting in a database a conceptual surgical step corresponding to the detected surgical step of the selected surgical operation from the detected instrument, the detected portion of organ, and their relative positioning,

f) comparing the parameters of the detected surgical step with the parameters defining the selected conceptual surgical step to determine the differences between these parameters,

g) (i) comparing the parameters of the detected surgical step with the parameters of a step consisting of at least one past performed surgical step derived from at least one same surgical operation as the selected surgical operation performed previously from a different patient,

(ii) wherein said at least one past performed surgical step derived from at least one same previous surgical operation from a different patient is stored in a database with the conceptual surgical steps to make a comparison,

h) displaying an overlay image on the detected image from an endoscope showing a current position of the detected instrument and the detected organ, to indicate an optimal position of the instrument,

i) automatically varying in real time the overlay image based at least on step (g); and

j) providing information on the quality of the detected surgical step on the basis of determined differences.

2. The method of claim 1, wherein the method is applied during the surgical operation to provide real time assistance, and the method further comprises using a computer to automatically display information related to at least two of:

(a) a number of the instruments present, (b) a relative distance between the instruments, (c) time spent in a vicinity of the organ, or (d) a speed of surgical movements.

3. The method of claim 1, wherein the method is applied after the surgical operation to permit retrospective analysis of the surgical operation carried out, and the method further comprises using a computer to automatically display information related to at least two of:

(a) a number of the instruments present, (b) a relative distance between the instruments, (c) time spent in a vicinity of the organ, or (d) a speed of surgical movements.

4. The method of claim 1, further comprising selecting in the database a surgery protocol comprising a succession of surgical steps with a view to performing a surgical operation, the selected surgery protocol corresponding to the selected surgical operation and to a succession of detected surgical steps.

5. The method of claim 4, wherein the surgery protocol is also selected based on parameters characteristic of the body, which is an animal, and may have an impact on conducting of the surgical operation.

6. The method of claim 4, wherein the information on quality comprises depiction of the required position of the instrument relative to the portion of the organ as per the selected conceptual surgical step and the selected surgery protocol.

7. The method of claim 6, wherein the information on quality comprises depiction of the instrument as the overlay over the detected image of the operative site, showing the required position of the instrument relative to the portion of the organ.

8. The method of claim 4, further comprising selecting in the database a succeeding past performed surgical step which, in the selected surgery protocol, follows after the detected surgical step, and displaying a depiction of the succeeding past performed surgical step.

9. The method of claim 4, wherein the additional information comprises triggering an alert if the last detected surgical step does not allow selection of a conceptual surgical step corresponding to the surgical operation being performed and to the succession of previous surgical steps.

10. The method of claim 1, wherein an endoscopic imaging technique is used for detection of the instrument and/or detection of the portion of the organ.

11. The method of claim 10, wherein, for detection of the portion of the organ, a labelling substance to label the organ is used, the substance containing a fluorescent substance and antibodies specific to the organ, and a camera of the endoscope being adapted for the band of fluorescence wavelengths of the labelling substance.

12. An analysis system for a surgical operation via endoscopy performed at an operative site in a volume located inside a body, comprising:

a) a database in which conceptual surgical steps and past performed surgical steps comprising surgical steps derived from previous specific surgical operations from a different patient(s) are stored,

b) at least one detector adapted to detect on an image of the operative site at least one instrument present at the operative site,

c) the at least one detector adapted to detect at least one organ in the vicinity of the detected instrument,

d) a computer adapted to determine positioning of the detected instrument relative to the detected organ,

e) the database being used to select a conceptual surgical step corresponding to a detected surgical step of the selected surgical operation in relation to the detected instrument, to the detected organ and to their relative positioning,

f) the computer being adapted to compare parameters of the detected surgical step with parameters defining the selected conceptual surgical step, and to determine the differences between these parameters,

g) the computer being adapted to compare the parameters of the detected surgical step with parameters of past performed surgical steps corresponding to the selected conceptual surgical step, and for fine-tuning the differences ascertained,

h) a display adapted to provide information on the quality of the detected surgical step on the basis of determined differences; and

i) the display also showing information related to at least one of;

(i) a number of the detected instruments present, (ii) a relative distance between the detected instruments, (iii) time spent in a vicinity of the detected organ, or (iv) a speed of surgical movements.

13. The system of claim 12, wherein the database is adapted to store surgery protocols, a surgery protocol being a succession of surgical steps with a view to performing a surgical operation, the system further comprising selecting, in the database, a surgery protocol corresponding to the surgical operation being performed, and to a succession of detected surgical steps.

14. The system of claim 13, wherein the display indicates the required position of the instrument relative to the portion of organ as per the selected conceptual surgical step and the selected surgery protocol in an overlay depiction.

15. The system of claim 12, wherein the information on quality is displayed as a depiction of the instrument as an overlay over an image of the operative site, showing the required position of the instrument relative to the portion of the organ.

16. The system of claim 12, wherein the displayed information includes at least one of:

the time spent in the vicinity of the detected organ, or the speed of the surgical movements.

17. The system of claim 12, further comprising an alert being triggered if the last detected surgical step does not allow selection of a conceptual surgical step corresponding to the surgical operation being performed and to the succession of prior surgical steps.

18. An analysis system for a surgical operation via endoscopy performed at an operative site, the system comprising:

(a) an endoscope camera detecting an image of at least one instrument and at least one organ at the operative site;

(b) a light source, adjacent to the operative site, used to increase an imaging contrast of at least one of;

the organ or the instrument;

(c) a database including data from previously detected surgical steps on at least one prior patient including previously detected incorrect instrument positions and previously detected ideal instrument positions; and

(d) an overlay image of the database data displayed over the endoscopic image.

19. The system of claim 18, further comprising a display showing a quantity of the detected instruments.

20. The system of claim 18, further comprising a display showing a relative distance between the detected instruments.

21. The system of claim 18, further comprising a display showing time spent in a vicinity of the detected organ.

22. The system of claim 18, further comprising a display showing movement speed of the surgical instruments.

23. The system of claim 18, wherein the overlay image is automatically varied in real-time based on the detected surgical performance.

24. The system of claim 18, wherein the light source includes a fluorescent substance.