RU178470U1 - DEVICE FOR PREOPERATIVE SIMULATION OF SURGICAL PROCEDURE - Google Patents

Abstract

The technical solution relates to the field of medicine, is intended for preoperative planning and carrying out a training surgical operation, namely laparoscopic nephrectomy, using a three-dimensional patient model generated according to the patient’s research. The technical result from the use of this technical solution is to ensure the planning and rehearsal of a laparoscopy surgery , also this technical solution allows you to more accurately conduct a training session for surgeons. This technical result is achieved by creating a three-dimensional model of the abdominal cavity with the coordinates, size and orientation of organs in the abdominal cavity of a particular patient. A device for preoperative modeling of a surgical procedure, comprising: combined data bus: data acquisition unit containing information about the patient’s examination using a contrast medium, a block for creating a three-dimensional model of the patient’s abdominal cavity, a block of preoperative surgery modeling a procedure, a processor that reads and executes machine instructions (programs) from blocks of permanent data storage, temporary data storage, a permanent data storage unit, which is a permanent storage device, a temporary data storage unit, which is an online storage device that provides temporary data storage, power circuitry connected to the power supply, input / output interfaces, input / output means.

Description

FIELD OF TECHNOLOGY

The technical solution relates to the field of medicine, intended for preoperative planning and training surgical operations, namely laparoscopic nephrectomy, using a three-dimensional patient model generated according to the patient’s research.

BACKGROUND

To plan a surgical operation to transplant fragments of an organ, it is very important to provide the surgeon with visual information about the structure of the blood vessels of that organ, their exact location inside the organ, and which areas of the organ are washed by a vessel.

The technical solution Preoperative Surgical Simulation US 8500451 (B2) is known from the prior art, published on 08/06/2013, SIMBIONIX LTD.

This solution discloses a device and method for simulating a training surgical vessel operation (angioplasty) using a 3D model generated based on data from medical images of a real patient. The method includes receiving, using an input system a 3D model of blood vessels of a particular patient, generated on the basis of an array of patient research data (CT), simulating a surgical surgical operation using the resulting 3D model of a patient's blood vessels, while the modeling system receives and processes signals received from the tracking unit of interventional imitators instruments and sends signals to the power feedback generation unit.

The invention is intended for preoperative planning and rehearsal of a surgical operation on vessels, which does not allow it to be used for planning and rehearsing a surgical operation of laparoscopy.

The disadvantage of this technical solution is the lack of the possibility of a training operation of laparoscopy

The technical solution known is SYSTEM AND METHOD FOR PERFORMING COMPUTERIZED SIMULATIONS FOR IMAGE-GUIDED PROCEDURES USING A PATIENT SPECIFIC MODEL US8543338 (B2), published September 24, 2013, SIMBIONIX LTD.

This solution discloses a method and system for simulating a training surgical vessel operation (angioplasty) using a digital model of anatomical structures generated on the basis of medical image data of a real patient. The method includes creating a digital model of the patient’s anatomical structure based on the patient’s medical image data (patient study data), where the digital model includes the first 3D polygonal grid with data obtained from medical images (from the data present in the honey images); generation (calculation), based on data from medical images, data from adjacent anatomical structures; generating an expanded digital model including anatomical structures with medical image data, adjacent anatomical structures obtained by calculation, the first 3D polygonal grid, the second 3D polygonal grid obtained from adjacent anatomical structures, positioning of the second 3D polygonal grid with pickets of the first 3D polygonal grid; computer simulation of the procedure with visual control using an advanced digital model.

The solution is intended for preoperative planning and rehearsal of a vascular surgery, which does not allow it to be used for planning and rehearsing a laparoscopic surgery.

ESSENCE OF TECHNICAL SOLUTION

This technical solution is aimed at eliminating the disadvantages inherent in existing analogues.

The technical result from the use of this technical solution is to ensure the planning and rehearsal of the surgical operation of laparoscopy, also this technical solution allows you to more accurately conduct a training session for trained surgeons.

This technical result is achieved by creating a three-dimensional model of the abdominal cavity with the coordinates, size and orientation of organs in the space of the abdominal cavity of a particular patient.

A device for preoperative modeling of a surgical procedure is proposed, comprising: combined data bus: a unit for receiving data containing information about a patient’s examination using a contrast medium, a unit for creating a three-dimensional model of the patient’s abdominal cavity, a unit for preoperative modeling of a surgical procedure, a processor that reads and executes machine instructions ( programs) from blocks of permanent data storage, temporary storage of data, block of permanent data storage, representing a permanent memory unit temporarily storing data representing a random access memory providing temporary storage of data supply circuit connected to the power supply, input / output interfaces, I / O means.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 - visualization of the great vessels obtained using the CT method of the patient with intravenous contrast;

FIG. 2 - visualization of groups of vessels belonging to certain organs.

DETAILED DESCRIPTION OF THE TECHNICAL SOLUTION

Below we will consider some terms that will be used later in the description of the technical solution.

Laparoscopy is a modern method of surgery in which operations on the internal organs are carried out through small (usually 0.5-1.5 cm) openings, while traditional surgery requires large incisions.

X-ray contrast agents (syn. Contrast agents) - means used to visualize invisible or poorly visible in a conventional x-ray examination of organs or body cavities. R.'s effect of century based on a significant increase in the difference in the absorption of x-rays by the studied anatomical formations and the surrounding tissues.

Computed tomography is a non-destructive layer-by-layer study of the internal structure of an object. The method is based on the measurement and complex computer processing of the difference in the attenuation of x-ray radiation by tissues of different density. Currently, x-ray computed tomography is the main tomographic method for studying the internal organs of a person using x-ray radiation.

Voxel (colloquially voxel, English Voxel - formed from the words: volumetric (English volumetric) and pixel (English pixel)) - a volumetric image element containing the value of a raster element in three-dimensional space. Voxels are analogues of two-dimensional pixels for three-dimensional space. Voxel models are often used to visualize and analyze medical and scientific information.

This technical solution provides the possibility of planning and rehearsing a surgical operation of laparoscopy by creating a three-dimensional model of the abdominal cavity with the coordinates, size and orientation of organs in the space of the abdominal cavity of a particular patient, this technical solution also allows you to more accurately conduct a training session for trained surgeons.

This technical solution can be made in the form of a device for preoperative modeling of a surgical procedure containing data shared by a common bus: a unit for obtaining data containing information about a patient’s examination using a contrast medium, a unit for creating a three-dimensional model of the patient’s abdominal cavity, a unit for preoperative modeling of a surgical procedure, a processor, reading and executing machine instructions (programs) from blocks of permanent data storage, temporary data storage, block tinuous storing data representing a permanent memory unit temporarily storing data representing a random access memory providing temporary storage of data supply circuit connected to the power supply, input / output interfaces, I / O means.

As a means of exchanging information between units in this technical solution, a computer data exchange bus can be used.

The blocks used in this technical solution can be implemented using electronic components used to create digital integrated circuits. Not limited to, can be used microcircuits, the logic of which is determined during manufacture, or programmable logic integrated circuits (FPGA), the logic of which is set by programming.

For programming, programmers and debugging environments are used that allow you to specify the desired structure of a digital device in the form of a circuit diagram or programs in special equipment description languages: Verilog, VHDL, AHDL, etc. Alternative FPGAs are: programmable logic controllers (PLCs), base matrix crystals ( BMK) requiring a factory production process for programming; ASIC - specialized custom large integrated circuits (LSI), which are much more expensive in small-scale and single-unit production.

Blocks can also be implemented using read-only memory devices (see O. Lebedev. Memory microcircuits and their application. - M.: Radio and communications, 1990. - 160 s; Large integrated circuits of memory devices: Reference / A.Yu. Gordenov et al. - M.: Radio and Communications, 1990. - 288 s).

Thus, the implementation of all used blocks is achieved by standard means based on the classical principles of implementing the foundations of computer technology.

The block for obtaining data containing information about the study of the patient using a contrast medium has the following functionality:

Receive data containing information about the study of the patient using a contrast medium

Detailed information about the patient can be obtained from research data, for example, computed tomography (CT), magnetic resonance imaging (MRI), etc.

Modern tomography scanners store patient examination data in a special DICOM format. The DICOM file contains information about the intensity or density of tissues in a particular section, at each point of the section. Slices can be made in three planes: sagittal, frontal, horizontal. DICOM files are combined in a series and represent a set of consecutive sections of an organ or part of the body. We name the data in the series, all the points (voxels) of each slice in the series, the data array of the study, which is a 3x dimensional array, where each element of the array stores the coordinates of the point and the density of the tissue. Downloading, processing, using information stored in DICOM files does not present technical complexity based on their current level of technology.

Computed tomography stores x-ray density in files, which depends on the physical density of the tissues. To quantify the x-ray density, the Hounsfield scale is used, the range of tissue densities is -1024 to +3071 HU. Hounsfield averages: air -1000 HU, fat -120 HU, water 0 HU, soft tissue +40 HU, bones +400 HU and above.

The block for creating a three-dimensional model of the patient’s abdominal cavity has the following functionality:

The following parameters are isolated and determined from data containing information about the study of a patient using a contrast agent by filtering an array of research data in the range of densities corresponding to blood vessels: location, trajectory and size of the main blood vessels and groups of vessels washing the organs of the patient's abdominal cavity.

A patient’s CT scan does not allow one to distinguish one organ from another in automatic mode, since the density of internal organs is approximately the same, this is the main problem when generating a 3D patient model according to a CT scan. But there is a method for studying CT with intravenous contrast, which allows you to increase the "visibility" of arterial and venous vessels for x-ray radiation, while the density of blood vessels on the Hounsfield scale will be increased. This research method is used for CT angiography and allows you to evaluate the lumen of blood vessels, the presence of blood clots, aneurysms, thinning of the wall. Intravenous contrasting allows you to select the data on the vessels from the total array of data from the study of CT. In FIG. 1 shows the visualization of the great vessels obtained using the CT method of a patient with intravenous contrast.

Based on the parameters obtained in the previous step, a map of the patient’s blood vessels is created.

This is done by constructing the skeleton of the vessel model. The skeleton of the vessel model is a set of related data storing information about the trajectory of the vessels and the width of the vessel at each point of the trajectory. The principle of constructing a skeleton of a vessel model based on an array of research data is described in detail in the article by Yatchenko A.M., Krylov AS, Gavrilov AV, Arkhipov IV Building a 3D model of blood vessels from a series of CT images of the liver / Conf. Proc. of the 19th International Conference on Computer Graphics and Vision "GraphiCon'2009", Moscow, 2009.

First, data on the vessels is extracted by filtering the array of research data in the density range corresponding to the vessels. After binarization of the research data array, the vessels on the slice are presented in the form of simply connected regions of points; moreover, if two adjacent slices are projected onto each other, then the region of points of the same vessel will partially overlap each other. The degree of overlap depends on the step of the cut during the study, which can be from 0.5 mm. Partial overlapping of the areas of points belonging to one vessel on adjacent sections allows one to construct a vessel trajectory, the number of points in the area of vessel points allows one to calculate the approximate vessel width (vessel diameter), the presence of common areas of points of different vessels (when vessels are separated or combined) allows us to determine the relationship between vessels and build a skeleton model of blood vessels.

On the basis of the patient’s blood vessel map, a map of the patient’s abdominal cavity is created by correlating the location, trajectory and size of the main blood vessels and groups of vessels washing the organs of the patient’s abdominal cavity with the coordinates, size and orientation of organs in the space of the patient’s abdominal cavity.

Human blood vessels branch. The main great vessels have a larger diameter than the vessels that supply and remove blood from organs. The skeleton of the vessel model allows you to calculate, based on the width of the vessel at each point of the trajectory, the main trunk vessels and branches of the supply and discharge vessels. In one of the embodiments of the described technical solution, the doctor (or the operator, in a semi-automatic mode) determines the affiliation of the vascular branches in the skeleton of the vascular model to a specific organ.

By a group of vessels washing an organ is meant a set of vessels in space belonging to a particular organ. A group of vessels is calculated from each branch of vessels belonging to an organ, while vessels with the smallest width, as well as extreme vessels in each branch of vessels fall into the group of vessels. The group of vessels washing the organ contains information on the coordinates of the organ, the size (volume) of the organ, and the orientation of the organ in space.

In FIG. 2 shows a visualization of a group of vessels belonging to certain organs.

Based on the map of the patient’s abdominal cavity created in the previous step, a three-dimensional model of the patient’s abdominal cavity is created by scaling the template three-dimensional model of the patient.

Scaling of the abdominal cavity of the template three-dimensional model of the patient includes resizing the three-dimensional model of the abdominal cavity, changing the shape of the three-dimensional model of the abdominal cavity in accordance with the shape of the patient’s body.

Resizing a three-dimensional model of the abdominal cavity can be done at two key points, which are determined by the operator in the data array of the study. In this case, the three-dimensional model of the abdominal cavity should also contain the corresponding key points. For example, the key points may be the beginning and end points of the lumbar spine. Knowing the resolution of the image and the distance between the slices in the series, you can calculate the distance between the key points and scale the three-dimensional model of the abdominal cavity in accordance with the calculated distance. In one embodiment of the described technical solution, key points are set by a doctor (or operator) based on research data, for example: when visualizing these data, mark the start and end points.

Patient study data stores information about the external borders of the patient’s abdominal cavity. Points on the external border of the abdominal cavity, have a density different from the density of the air, border on points with a density of air and are as close as possible to the outer borders of the cut. A set of points on the external border of the abdominal cavity determines the shape of the patient’s body and is used when changing the shape of the three-dimensional model of the abdominal cavity in accordance with the shape of the patient’s body.

Thus, based on an array of research data for a specific patient, a map of the organs of the patient’s abdominal cavity is constructed, which includes the sizes of the patient’s abdominal cavity, the coordinates of the organs, the size (volume) of organs, the orientation of organs in space, the skeleton of the vessel model, including the trajectory of the vessels and the width of the vessels in each point of the trajectory.

Template three-dimensional model of the patient includes a three-dimensional model of the abdominal cavity, three-dimensional models of organs.

In one embodiment of the described technical solution, scaling a template three-dimensional patient model in accordance with a map of the patient’s abdominal organs includes the following steps:

scaling of the abdominal cavity according to the size of the abdominal cavity of the patient;

scaling and positioning of organs;

generation of major vessels in accordance with the trajectory and size of the vessels.

Alternatively, scaling the template three-dimensional model of the patient in accordance with the map of the organs of the abdominal cavity of the patient may additionally include the selection of patterns of models of organs, for example: models with any defects affected by diseases.

As a result of scaling the template three-dimensional model of the patient in accordance with the map of the organs of the patient’s abdominal cavity, a three-dimensional model of the abdominal cavity is generated with organs and vessels, the location of which is similar to the location of organs and blood vessels in a real specific patient.

The block of preoperative modeling of a surgical procedure has the following functionality:

A three-dimensional model of the patient’s abdominal cavity created by the unit for creating a three-dimensional model of the patient’s abdominal cavity is used for subsequent simulation of a training surgical operation. Simulation of a training operation is disclosed in the prior art, laparoscopic surgery simulators are known that allow to simulate a surgical intervention, while the user, using input / output means, conducts the surgical operation in virtual space.

I / O interfaces (I / O) are standard ports and devices for pairing devices and transmitting data, selected based on the desired configuration of the device, in particular: USB (2.0, 3.0, USB-C, micro, mini), Ethernet, PCI , AGP, COM, LPT, PS / 2, SATA, Fire Wire, Lightning, etc.

I / O facilities are also selected from a well-known range of different devices, for example, a keyboard, touchpad, touch screen, monitor, projector, mouse, joystick, trackball, light pen, stylus, sound output devices (speakers, headphones, built-in speakers, buzzer) etc.

The power supply unit described in the technical solution may be an electronic device that provides the conversion of alternating electric current into direct current, with parameters necessary for powering other elements of the device to determine the interests of the child and assess the level of threats to the child on the Internet.

The processor can be an electronic unit or an integrated circuit (microprocessor) that executes machine instructions (programs). The information processing unit reads and executes machine instructions (programs) from the blocks of permanent data storage, temporary data storage.

The permanent data storage unit can be a ROM (read only memory), flash memory, hard disks (HDD), solid state drives (SSD), optical drives.

The temporary data storage unit is a RAM-operational memory device that provides temporary data storage.

It will be apparent to those skilled in the art that specific embodiments of a device for preoperative modeling of a surgical procedure are described herein for purposes of illustration, various modifications are permissible without departing from the spirit and scope of the invention.

Claims (1)

 A device for preoperative modeling of a surgical procedure containing data shared by a common bus: a unit for obtaining data containing information about a patient’s examination using a contrast medium, a unit for creating a three-dimensional model of the patient’s abdominal cavity, a unit for preoperative modeling of a surgical procedure, a processor that reads and executes machine instructions from constant units data storage, temporary data storage, a unit of permanent data storage, which is a permanent storage inayuschee device unit temporarily storing data representing a random access memory providing temporary storage of data, power supply circuit coupled to the power supply, input / output interfaces, I / O means.

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