CN104146767A - Intraoperative navigation method and system for assisting in surgery - Google Patents
Intraoperative navigation method and system for assisting in surgery Download PDFInfo
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- 238000001356 surgical procedure Methods 0.000 title claims abstract description 35
- 238000000034 method Methods 0.000 title claims abstract description 33
- 239000003550 marker Substances 0.000 claims description 85
- 238000005481 NMR spectroscopy Methods 0.000 claims description 11
- 239000000463 material Substances 0.000 claims description 6
- 238000002372 labelling Methods 0.000 claims description 5
- 238000013507 mapping Methods 0.000 claims description 4
- 230000000694 effects Effects 0.000 description 5
- 230000002490 cerebral effect Effects 0.000 description 2
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- 239000000126 substance Substances 0.000 description 2
- 230000000007 visual effect Effects 0.000 description 2
- 206010058046 Post procedural complication Diseases 0.000 description 1
- 208000035965 Postoperative Complications Diseases 0.000 description 1
- 210000000988 bone and bone Anatomy 0.000 description 1
- 238000002594 fluoroscopy Methods 0.000 description 1
- 238000002675 image-guided surgery Methods 0.000 description 1
- 238000002513 implantation Methods 0.000 description 1
- 238000012544 monitoring process Methods 0.000 description 1
- 201000008482 osteoarthritis Diseases 0.000 description 1
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Abstract
The invention discloses an intraoperative navigation method and system for assisting in surgery. The method comprises the steps of preoperative scanning, establishment of a three-dimensional model, fixation of a first coordinate system reference mark and a second coordinate system reference mark, scanning through a structured light scanner, rough registration, refined registration and completion of the navigation process through a controller and a displayer. Due to the rough registration process, the process of refined registration between a three-dimensional image and a pre-registered region is very short, and registration preparation time before start of surgical navigation can be greatly shortened. Moreover, since two three-dimensional spaces are utilized for refined registration, the probability of errors is extremely low, and the accuracy and reliability of registration between a sick body and the three-dimensional model can be improved apparently; accordingly, the quality of the surgery is improved, and the success rate of the surgery is increased.
Description
Technical field
The present invention relates to medical instruments field, particularly relate to air navigation aid in a kind of art of assisted surgery.In addition, the invention still further relates to navigation system in a kind of art.
Background technology
In common surgical operation, the bone surgeries such as spinal column, joint and cerebral surgery operation because required precision is high, the reason such as complicated operation, post-operative complication be serious, cause that operating difficulty is large, mortality is high.Epidemiologic data shows, China has at least the department of cerebral surgery needs of patients of 1,000,000 to 1,500,000 osteoarthritis patients, 1,500,000 to 2,000,000 rachiopathy patients, 300,000 to 400,000 examples to carry out operative treatment every year at present.Navigation system provides visual information to doctor in operation process, carries out instrument navigation and monitoring, can greatly improve the success rate of operation.In the process that operation is navigated, in actual operation, instrumentation is still completed by doctor, and therefore this navigation system only plays assosting effect, belongs to the image-guided surgery of passive type.
The ultimate principle of operation guiding system is: the data of patient's sick body of preoperative acquisition is formed to threedimensional model after date processing, in the time of operation, first sick body and described threedimensional model are carried out to registration, in art, utilize navigation position instrument to follow the tracks of the position of operating theater instruments, provide virtual operation instrument in the described threedimensional model visual information in threedimensional model Xiang doctor, instruct doctor to complete concrete operation technique.
Traditional based on C type arm fluoroscopy images airmanship have that in art, hour of log-on is long, registration accuracy is low, the shortcomings such as radiation damage is large in poor image quality, art; In addition, can cause very large misery to patient by the second operation air navigation aid of prior implantation navigation label in early days, increase the probability infecting simultaneously, be replaced gradually at present.The CT image-guidance system generally adopting at present utilizes infrared technique to carry out following the tracks of in multiple spot registration and art, and wherein the most representative is Stryker operation guiding system.But this navigation system and method are very high to the required precision of multiple spot registration, greatly increase the operation easier of doctor in operation.In clinical operation, doctor is generally reflected in while utilizing this navigation system to carry out multiple spot registration, affected by operate miss and multiple spot method for registering, registration accuracy is very undesirable, and the quantity of information of multiple spot registration data is very limited, thus the probability that not only exists navigation system erroneous judgement to cause operation to fall flat, and navigation system is high to the verification mortality of multiple spot registration, doctor often needs repeatedly to carry out manual multiple spot registration, has extended operating time, has increased operation risk.
Therefore, how improving Maturity and the reliability of Technology of surgery navigation, improve registration accuracy and registration efficiency, is those skilled in the art's guardian technique problems in the urgent need to address at present.
Summary of the invention
The object of this invention is to provide air navigation aid in a kind of art of assisted surgery, this air navigation aid can improve accuracy rate and the reliability of in art, navigating effectively, shortens the registration time, thereby improves quality and the success rate of operation.Another object of the present invention is to provide navigation system in a kind of art of assisted surgery, and this system can complete surgical navigational efficiently and accurately.
For achieving the above object, the invention provides air navigation aid in a kind of art of assisted surgery, comprise the following steps:
A, preoperative scanning, obtain and treat the three-dimensional data of operative site and be redeveloped into threedimensional model, and determine the first registration point group in pre-registration region and described pre-registration region on described threedimensional model;
B, on sick body, be fixedly connected with the first coordinate system reference marker, utilize structured light scanner to scan described sick body and described the first coordinate system reference marker, scanning result is formed to 3-D view and flow to controller, and withdraw structured light scanner; Utilize the operating theater instruments of navigation position instrument scanning with the second coordinate system reference marker, it is carried out to the demarcation of space coordinates position;
C, on described sick body, find the second registration point group by described operating theater instruments, after utilizing navigation position instrument scanning, the characteristic point of the characteristic point of described the second registration point group and described the first registration point group is carried out to thick registration one by one, and thick registration results is flowed to described controller;
D, controller by described 3-D view and described pre-registration region essence registration, are determined the accurate locus mapping relations between described sick body and described threedimensional model according to described thick registration results;
E, utilization navigation scanner sweep record the first coordinate system reference marker and the second coordinate system reference marker simultaneously, follow the tracks of the exact position of described the first coordinate system reference marker and described the second coordinate system reference marker, and on the display being connected with described controller, show relative position and the mutual relation of the corresponding virtual operation instrument of described operating theater instruments in threedimensional model, realize in art and navigating.
Preferably, described preoperative scanning is CT or nuclear magnetic resonance, NMR.
Preferably, described the first coordinate system reference marker and the second coordinate system reference marker are made by passive reflectorized material.
Preferably, described the first coordinate system reference marker and described the second coordinate system reference marker are the spherical or plane labelling being fixed on support.
The present invention also provides navigation system in a kind of art of assisted surgery, comprising:
Threedimensional model image, is obtained after the three-dimensional data of operative site is also rebuild and is obtained by medical image instrument, comprises pre-registration region and the first registration point group of being located at described pre-registration region;
The first coordinate system reference marker, is fixedly connected on sick body, for determining the station-keeping data of described sick body and the first coordinate system;
The second coordinate system reference marker, be fixedly connected in operating theater instruments, for determining the station-keeping data of described operating theater instruments and described the second coordinate system, described operating theater instruments is chosen the characteristic point of the second registration point group on described sick body, and with the characteristic point of described the first registration point group thick registration one by one;
Navigation position instrument, for following the tracks of described the first coordinate system reference marker and described the second coordinate system reference marker;
Structured light scanner, for scanning described sick body and described the first coordinate system reference marker, and obtains 3-D view, and this 3-D view and described pre-registration region are carried out smart registration;
Controller, the image result of obtaining for receiving described medical image instrument and described structured light scanner, utilizes threedimensional model, described the first coordinate system reference marker and described the second coordinate system reference marker to calculate described thick registration and smart registration process;
Display, for showing described threedimensional model, described sick body, described the first coordinate system reference marker, described the second coordinate system reference marker and described operating theater instruments, completes in art and navigates.
Preferably, when described structured light scanner and described navigation position instrument start registration, be located at the homonymy of described the first coordinate system reference marker.
Preferably, described structured light scanner and described navigation position instrument are installed on same integrated support, and all hinged with described integrated support.
Preferably, described medical image instrument is CT machine or nuclear magnetic resonance machine.
Preferably, described the first coordinate system reference marker and described the second coordinate system reference marker are made by passive reflectorized material.
Preferably, described the first coordinate system reference marker and described the second coordinate system reference marker are the spherical or plane labelling being fixed on support.
Air navigation aid in art provided by the present invention, for assisted surgery, navigates for medical worker completes surgical operation.This air navigation aid comprises preoperative sick body scanning, obtain and treat the three-dimensional data of operative site and be redeveloped into threedimensional model, and determine the first registration point group (comprise and be no less than three characteristic points) in pre-registration region and described pre-registration region on described threedimensional model; On sick body, be fixedly connected with the first coordinate system reference marker, utilize structured light scanner to scan described sick body and described the first coordinate system reference marker, and scanning result is formed to 3-D view flow to controller; Utilize the operating theater instruments of navigation position instrument scanning with the second coordinate system reference marker, it is carried out to the demarcation of space coordinates position; On described sick body, find successively the second registration point group by described operating theater instruments, after utilizing navigation position instrument scanning, the characteristic point of the characteristic point of described the second registration point group and described the first registration point group is carried out to thick registration one by one, and thick registration results is flowed to described controller; Controller by described 3-D view and described pre-registration region essence registration, is determined the accurate locus mapping relations between described sick body and described threedimensional model according to thick registration results; The exact position that utilizes navigation scanner to follow the tracks of described the first coordinate system reference marker and described the second coordinate system reference marker, and on the display being connected with described controller, show relative position and the mutual relation of the corresponding virtual operation instrument of described operating theater instruments in threedimensional model, realize in art and navigating.In above-mentioned navigation procedure, the pre-registration region of threedimensional model has corresponding with it entity area on sick body, the characteristic point of the first registration point group has corresponding with it substance feature point on sick body, while utilizing described operating theater instruments to find the second registration point group on sick body and do not require accurate aligning, slightly mate with the corresponding point of the first registration point group, roughly determine with threedimensional model in the mutual alignment of the first registration point.Utilize structured light scanner scanning sick body to obtain the 3-D view of the entity area corresponding with pre-registration region, this 3-D view and pre-registration region are carried out to smart registration, owing to there being the thick registration results of the first registration point group and the second registration point group, and utilizing controller automatically to calculate, 3-D view is very short with the time of the smart registration of pre-registration region.And, utilize two three dimensions to carry out smart registration, the probability that registration erroneous judgement occurs is extremely low, can obviously improve accuracy rate and the reliability of the threedimensional model registration in sick body and controller, thereby improves quality and the success rate of operation.
On the basis that above-mentioned air navigation aid is provided, the present invention also provides a kind of navigation system of applying above-mentioned air navigation aid; Because air navigation aid has above-mentioned technique effect, the navigation system of applying this air navigation aid also has corresponding technique effect.
Brief description of the drawings
Fig. 1 is the flow chart of a kind of detailed description of the invention of air navigation aid in the art of assisted surgery provided by the present invention;
Fig. 2 is the work schematic diagram of a kind of detailed description of the invention of navigation system in the art of assisted surgery provided by the present invention;
Comprising: structured light scanner 1, navigation position instrument 2, controller 3, the first coordinate system reference marker 4, the second coordinate system reference marker 5, display 6, sick body 7.
Detailed description of the invention
Core of the present invention is to provide air navigation aid in a kind of art of assisted surgery, and this air navigation aid can effectively improve accuracy rate and the reliability of in art, navigating, and shortens the registration time, thereby improves quality and the success rate of operation.Another core of the present invention is to provide navigation system in a kind of art of assisted surgery, and this system can complete surgical navigation by efficiently and accurately.
In order to make those skilled in the art person understand better the present invention program, below in conjunction with the drawings and specific embodiments, the present invention is described in further detail.
Please refer to Fig. 1, the flow chart of a kind of detailed description of the invention of air navigation aid in the art that Fig. 1 is assisted surgery provided by the present invention.
The invention provides a kind of air navigation aid, the method, for surgical operation, instructs medical worker to complete surgical operation by navigation.This air navigation aid comprises and preoperative sick body 7 being scanned, and obtains and treats the three-dimensional data of operative site and be redeveloped into threedimensional model, and on threedimensional model, determine the first registration point group in pre-registration region and pre-registration region, and it should comprise and is no less than three characteristic points; On sick body 7, be fixedly connected with the first coordinate system reference marker 4, utilize structured light scanner 1 to scan sick body 7 and the first coordinate system reference marker 4, and scanning result is formed to 3-D view flow to controller 3; Utilize navigation position instrument 2 to scan the operating theater instruments with the second coordinate system reference marker 5, it is carried out to the demarcation of space coordinates position; On sick body 7, find the second registration point group by described operating theater instruments, the characteristic point of the characteristic point of the second registration point group and the first registration point group is carried out one by one to slightly registration after utilizing navigation position instrument 2 scanning, and thick registration results is flowed to controller 3; Controller 3 by 3-D view and pre-registration region essence registration, is determined the accurate locus mapping relations between sick body 7 and threedimensional model according to thick registration results; Utilize navigation position instrument to follow the tracks of the exact position of the first coordinate system reference marker 4 and the second coordinate system reference marker 5, and on the display 6 being connected with controller 3, show with the operating theater instruments of the second coordinate system reference marker 5 relative position and the mutual relation in threedimensional model, realize in art and navigating.In above-mentioned navigation procedure, the pre-registration region of threedimensional model has corresponding with it entity area on sick body 7, the characteristic point of the first registration point group has corresponding with it substance feature point on sick body, while utilizing operating theater instruments to look for the second registration point group on sick body 7, can carry out thick registration with the corresponding point of the first registration point group, roughly determine with threedimensional model in the mutual alignment of the first registration point.Recycling structured light scanner 1 scans the 3-D view of the entity area that sick body 7 is that obtain, corresponding with pre-registration region, this 3-D view and pre-registration region are carried out to smart registration, thick registration and smart registration process all complete in controller 3, and show relative position and the mutual relation of the described corresponding virtual operation instrument of operating theater instruments with the second coordinate system reference marker 5 in threedimensional model by the display 6 being connected with controller 3, realize in art and navigating.Owing to there being the thick registration process of the first registration point group and the second registration point group, and utilize controller automatically to calculate, 3-D view is very short with the smart registration process of pre-registration region.And, utilize two three dimensions to carry out smart registration, the probability that error occurs is extremely low, can obviously improve accuracy rate and the reliability of the threedimensional model registration in sick body 7 and controller 3, thereby improves quality and the success rate of operation.
Please refer to Fig. 2, the work schematic diagram of a kind of detailed description of the invention of navigation system in the art that Fig. 2 is assisted surgery provided by the present invention.
Except air navigation aid in the art of above-mentioned assisted surgery, the present invention also provides navigation system in a kind of art of assisted surgery, and this navigation system comprises: threedimensional model, the first coordinate system reference marker 4, the second coordinate system reference marker 5, navigation position instrument 2, structured light scanner 1, controller 3 and display 6.Wherein, threedimensional model is obtained after the three-dimensional data of operative site is also rebuild and is obtained by medical image instrument, need can on threedimensional model, select in advance pre-registration region and be located at the first registration point group of pre-registration region according to operation, it should comprise and is no less than three characteristic points; On sick body 7, be fixedly connected with the first coordinate system reference marker 4, structured light scanner 1 scans sick body 7 and the first coordinate system reference marker 4, determines the station-keeping data of sick body 7 and first coordinate system reference marker 4 and the first coordinate system; In operating theater instruments, be fixedly connected with the second coordinate system reference marker 5, can determine the station-keeping data of operating theater instruments and the second coordinate system.Navigation position instrument 2 is followed the tracks of the first coordinate system reference marker 4 and the second coordinate system reference marker 5; Controller 3, according to the relative position of the first coordinate system reference marker 4 and the second coordinate system reference marker 5, calculates the relative position of operating theater instruments and sick body 7, and on display 6, shows the relative position of corresponding virtual operation instrument in threedimensional model.
In navigation procedure, operating theater instruments is chosen the second registration point group on sick body 7, and navigation position instrument 2 is followed the tracks of the process of reconnaissance, and the result of choosing is transported to controller 3, compare with the first registration point group in the threedimensional model being stored in controller 3, realize thick registration.
Structured light scanner 1 scans sick body 7 and the first coordinate system reference marker 4, and obtains the 3-D view of sick body 7, and this 3-D view flows to controller 3, in controller 3 with threedimensional model in pre-registration region carry out smart registration; And by display 6, registration results is shown.
Owing to there being the thick registration process of the first registration point group and the second registration point group, and utilize controller automatically to calculate, 3-D view is very short with the smart registration process of pre-registration region.And, utilize two three dimensions to carry out smart registration, the probability that error occurs is extremely low, can obviously improve accuracy rate and the reliability of the threedimensional model registration in sick body 7 and controller 3, thereby improves quality and the success rate of operation.
Air navigation aid provided by the present invention and navigation system are taking technological innovation and clinical practice as target, structured light is scanned to registration technique to be introduced in operating navigation procedure, the threedimensional model of structured light scanogram and preoperative scanning in art is carried out to registration, can significantly improve operating navigation accuracy and reliability, shorten operating time, improve operation quality, significantly reduce equipment cost and the surgery cost of existing airmanship, there is important technological value and wide application prospect.
In a kind of concrete embodiment, in air navigation aid provided by the present invention and navigation system, preoperative scanning can adopt CT or nuclear magnetic resonance, NMR collection to treat the three-dimensional data of operative site, and sets up threedimensional model according to three-dimensional data.CT and nuclear magnetic resonance scanning are all ripe Image Acquisition technology, and reliability is high.And CT machine and nuclear magnetic resonance machine are a lot of hospitals conventional equipments, utilize CT machine and nuclear magnetic resonance machine to obtain three-dimensional data, do not need additionally to increase equipment, can reduce operation cost.
In further technical scheme, the first coordinate system reference marker 4 can be made by passive reflectorized material, the first coordinate system reference marker 4 can be identified under the effect of other light such as light, need on the first coordinate system reference marker 4, additionally not increase light source, thereby the structure of simplifying the first coordinate system reference marker 4, reduces costs.And better simply structure is also convenient to medical worker and is operated in navigation procedure.In like manner, the second coordinate system reference marker 5 also can adopt passive reflectorized material to make, and its effect is identical, does not repeat them here.
Particularly, the first coordinate system reference marker 4 and the second coordinate system reference marker 5 are the spherical or plane labelling being fixed on support, simple in structure, can meet reflective requirement, reach the object of identification.
In operating room, while starting registration, structured light scanner 1 and navigation position instrument 2 are arranged with respect to the homonymy of the first coordinate system reference marker 4.Structured light scanner 1 and navigation position instrument 2 all can move according to the actual requirements and adjust position in navigation procedure, structured light scanner 1 can be withdrawn operating-table after scanning described sick body 7 and described the first coordinate system reference marker 4, only leave navigation position instrument and enter the surgical navigational stage, thereby empty operative space, prevent interference and collision between armarium and operating theater instruments.
Particularly, structured light scanner 1 and navigation position instrument 2 all can be installed on same integrated support, and all hinged with integrated support, in navigation procedure, structured light scanner 1 and navigation position instrument 2 all can move and adjust position, also after facilitating structured light scanner 1 to scan sick body 7 and the first coordinate system reference marker 4, withdraw operating-table, for operation facilitates.
Above air navigation aid and navigation system in the art of assisted surgery provided by the present invention are described in detail.Applied specific case herein principle of the present invention and embodiment are set forth, the explanation of above embodiment is just for helping to understand method of the present invention and core concept thereof.It should be pointed out that for those skilled in the art, under the premise without departing from the principles of the invention, can also carry out some improvement and modification to the present invention, these improvement and modification also fall in the protection domain of the claims in the present invention.
Claims (10)
1. an air navigation aid in the art of assisted surgery, is characterized in that, comprises the following steps:
A, preoperative scanning, obtain and treat the three-dimensional data of operative site and be redeveloped into threedimensional model, and determine the first registration point group in pre-registration region and described pre-registration region on described threedimensional model;
B, on sick body, be fixedly connected with the first coordinate system reference marker, utilize structured light scanner to scan described sick body and described the first coordinate system reference marker, scanning result is formed to 3-D view and flow to controller, and withdraw structured light scanner; Utilize the operating theater instruments of navigation position instrument scanning with the second coordinate system reference marker, it is carried out to the demarcation of space coordinates position;
C, on described sick body, find the second registration point group by described operating theater instruments, after utilizing navigation position instrument scanning, the characteristic point of the characteristic point of described the second registration point group and described the first registration point group is carried out to thick registration one by one, and thick registration results is flowed to described controller;
D, controller by described 3-D view and described pre-registration region essence registration, are determined the accurate locus mapping relations between described sick body and described threedimensional model according to described thick registration results;
E, utilization navigation scanner sweep record the first coordinate system reference marker and the second coordinate system reference marker simultaneously, follow the tracks of the exact position of described the first coordinate system reference marker and described the second coordinate system reference marker, and on the display being connected with described controller, show relative position and the mutual relation of the corresponding virtual operation instrument of described operating theater instruments in threedimensional model, realize in art and navigating.
2. air navigation aid in the art of assisted surgery according to claim 1, is characterized in that, described preoperative scanning is CT or nuclear magnetic resonance, NMR.
3. air navigation aid in the art of assisted surgery according to claim 1, is characterized in that, described the first coordinate system reference marker and the second coordinate system reference marker are made by passive reflectorized material.
4. air navigation aid in the art of assisted surgery according to claim 3, is characterized in that, described the first coordinate system reference marker and described the second coordinate system reference marker are the spherical or plane labelling being fixed on support.
5. a navigation system in the art of assisted surgery, is characterized in that, comprising:
Threedimensional model image, is obtained after the three-dimensional data of operative site is also rebuild and is obtained by medical image instrument, comprises pre-registration region and the first registration point group of being located at described pre-registration region;
The first coordinate system reference marker, is fixedly connected on sick body, for determining the station-keeping data of described sick body and the first coordinate system;
The second coordinate system reference marker, be fixedly connected in operating theater instruments, for determining the station-keeping data of described operating theater instruments and described the second coordinate system, described operating theater instruments is chosen the characteristic point of the second registration point group on described sick body, and with the characteristic point of described the first registration point group thick registration one by one;
Navigation position instrument, for following the tracks of described the first coordinate system reference marker and described the second coordinate system reference marker;
Structured light scanner, for scanning described sick body and described the first coordinate system reference marker, and obtains 3-D view, and this 3-D view and described pre-registration region are carried out smart registration;
Controller, the image result of obtaining for receiving described medical image instrument and described structured light scanner, utilizes threedimensional model, described the first coordinate system reference marker and described the second coordinate system reference marker to calculate described thick registration and smart registration process;
Display, for showing described threedimensional model, described sick body, described the first coordinate system reference marker, described the second coordinate system reference marker and described operating theater instruments, completes in art and navigates.
6. navigation system in the art of assisted surgery according to claim 5, is characterized in that, is located at the homonymy of described the first coordinate system reference marker when described structured light scanner and described navigation position instrument start registration.
7. navigation system in the art of assisted surgery according to claim 6, is characterized in that, described structured light scanner and described navigation position instrument are installed on same integrated support, and all hinged with described integrated support.
8. navigation system in the art of assisted surgery according to claim 5, is characterized in that, described medical image instrument is CT machine or nuclear magnetic resonance machine.
9. navigation system in the art of assisted surgery according to claim 5, is characterized in that, described the first coordinate system reference marker and described the second coordinate system reference marker are made by passive reflectorized material.
10. navigation system in the art of assisted surgery according to claim 9, is characterized in that, described the first coordinate system reference marker and described the second coordinate system reference marker are the spherical or plane labelling being fixed on support.
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