CN113317872B - Mandible operation space modeling method for intraoral incision - Google Patents
Mandible operation space modeling method for intraoral incision Download PDFInfo
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- 238000000034 method Methods 0.000 title claims abstract description 22
- 210000004373 mandible Anatomy 0.000 title abstract description 9
- 230000003287 optical effect Effects 0.000 claims description 18
- 239000000523 sample Substances 0.000 claims description 11
- 210000004400 mucous membrane Anatomy 0.000 claims description 8
- 210000000988 bone and bone Anatomy 0.000 claims description 7
- 238000001356 surgical procedure Methods 0.000 claims description 4
- 208000002847 Surgical Wound Diseases 0.000 claims description 3
- 238000002591 computed tomography Methods 0.000 description 4
- 210000004872 soft tissue Anatomy 0.000 description 4
- 238000005259 measurement Methods 0.000 description 3
- 210000000214 mouth Anatomy 0.000 description 3
- 238000004088 simulation Methods 0.000 description 3
- 238000004364 calculation method Methods 0.000 description 2
- 238000010276 construction Methods 0.000 description 2
- 210000003128 head Anatomy 0.000 description 2
- 239000003550 marker Substances 0.000 description 2
- 238000000691 measurement method Methods 0.000 description 2
- 238000012545 processing Methods 0.000 description 2
- 239000013598 vector Substances 0.000 description 2
- 238000010146 3D printing Methods 0.000 description 1
- 208000006735 Periostitis Diseases 0.000 description 1
- 208000004550 Postoperative Pain Diseases 0.000 description 1
- 206010052428 Wound Diseases 0.000 description 1
- 208000027418 Wounds and injury Diseases 0.000 description 1
- 238000013459 approach Methods 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000000740 bleeding effect Effects 0.000 description 1
- 230000000903 blocking effect Effects 0.000 description 1
- 238000013461 design Methods 0.000 description 1
- 238000011161 development Methods 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 238000010874 in vitro model Methods 0.000 description 1
- 208000015181 infectious disease Diseases 0.000 description 1
- 230000001788 irregular Effects 0.000 description 1
- 239000007769 metal material Substances 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 210000004877 mucosa Anatomy 0.000 description 1
- 210000003205 muscle Anatomy 0.000 description 1
- 210000003460 periosteum Anatomy 0.000 description 1
- 230000008092 positive effect Effects 0.000 description 1
- 230000000750 progressive effect Effects 0.000 description 1
- 238000011084 recovery Methods 0.000 description 1
- 230000037390 scarring Effects 0.000 description 1
- 238000004659 sterilization and disinfection Methods 0.000 description 1
- 239000000126 substance Substances 0.000 description 1
- 238000012549 training Methods 0.000 description 1
- 238000012795 verification Methods 0.000 description 1
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/101—Computer-aided simulation of surgical operations
- A61B2034/105—Modelling of the patient, e.g. for ligaments or bones
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/107—Visualisation of planned trajectories or target regions
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/108—Computer aided selection or customisation of medical implants or cutting guides
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- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
- Life Sciences & Earth Sciences (AREA)
- Biomedical Technology (AREA)
- Robotics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
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- Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
Abstract
The invention relates to a mandible operation space modeling method of an intraoral incision, which comprises the following steps: step (1): acquiring scanning data of the surgical body position of a patient; step (2): performing annular scanning on an operation incision space of a patient to obtain incision space data, and reconstructing the incision space data; step (3): constructing a notch model according to the reconstructed notch space data; step (4): and fitting the scanning data of the patient body position with the incision model to obtain a virtual oral cavity model. According to the invention, the incision space data are acquired and reconstructed, so that the purpose of constructing a more accurate actual operation space can be achieved, and the selection, planning and teaching of an operation scheme are facilitated.
Description
Technical Field
The invention relates to the technical field of computer-aided medical treatment, in particular to a mandible operation space modeling method for intraoral incision.
Background
The virtual simulation operation system is increasingly used in the surgical field, and is an indispensable tool in the fields of medical training, operation planning, scheme selection, medical instrument development and the like in both ethical and technical aspects.
Current mandibular surgery is generally performed by means of an intraoral incision in order to avoid significant scarring. Because only CT data of a patient are used before operation, real-time CT scanning cannot be performed in operation, and the virtual simulation operation system can only simulate the osseous tissue of the patient. In the actual operation process, under the interference of surgical instruments such as a drag hook, soft tissues can deform and completely differ from preoperative data, so that effective prejudgment cannot be carried out on the actual operation access position and the movement range of the surgical instruments. For a virtual simulation surgical system, the effectiveness of the virtual simulation surgical system can be ensured only by a data source which is closer to the actual situation, and particularly for the osteotomy operation under the intraoral incision. Because of the lack of soft tissue information, the motion track of the electric saw under the control of the power system is difficult to simulate and plan well before operation, which results in the dislocation of the current virtual operation scheme and the actual operation condition.
Because incision of mandible operation adopts intraoral incision generally at present, after soft tissue such as cheek mucosa, muscle, periosteum are separated, under the assistance of drag hook, can form a small big irregular semi-closed tunnel form incision space in the mouth, ordinary infrared scanning device is difficult to obtain corresponding data in such narrow and small environment, utilizes the mode of marker, and the degree of difficulty of modeling is great in its art, takes time overlength.
Disclosure of Invention
The invention aims to solve the technical problem of providing a mandibular operation space modeling method of an intraoral incision, which can achieve the purpose of constructing a more accurate actual operation space by acquiring incision space data and reconstructing the incision space data.
The technical scheme adopted for solving the technical problems is as follows: provided is a mandibular operation space modeling method of an intraoral incision, comprising:
Step (1): acquiring scanning data of the surgical body position of a patient;
step (2): performing annular scanning on an operation incision space of a patient to obtain incision space data, and reconstructing the incision space data;
step (3): constructing a notch model according to the reconstructed notch space data;
step (4): and fitting the scanning data of the patient body position with the incision model to obtain a virtual oral cavity model.
The method also comprises the step of fixing the surgical position of the patient before the step (1).
In the step (2), the incision space of the patient is subjected to annular scanning to obtain incision space data, which specifically includes: and carrying out annular scanning on preset registration points at the junction of tooth slits and mucous membrane in the surgical incision space of the patient through the optical tracking equipment to acquire incision space data.
In the step (2), reconstructing the incision space data, specifically: and according to a spiral point taking mode, forming a plurality of triangular patches by all target data points in the incision space data according to 3 points which are continuous in sequence, wherein the triangular patches form reconstructed incision space data.
When the surgical incision space of the patient is subjected to annular scanning to obtain incision space data in the step (2), recording pose data of a probe tip on the optical tracking device corresponding to the incision space data, wherein the pose data of each group of the optical tracking device are recorded at least 50 times within a preset confidence interval range.
The step (4) further comprises: taking points of natural anatomical points on the bones of the patient to generate a natural anatomical point model, and fitting the natural anatomical point model, the incision model and the scanning data of the body position of the patient to obtain a virtual oral cavity model.
Advantageous effects
Due to the adoption of the technical scheme, compared with the prior art, the invention has the following advantages and positive effects: the invention obtains incision space data by carrying out annular scanning on the preset registration points at the junction of the tooth slits and the mucous membrane in the operation incision space of a real patient, and the data measurement method is real and effective; the invention reconstructs incision space data in a triangular patch construction mode, and the purpose of constructing more accurate actual operation space can be achieved through the reconstructed incision space data; the invention calculates a real and feasible operation scheme suitable for the operation field in preoperative planning software, needs comprehensive patient data, comprises bone tissues available by CT (computed tomography), also comprises soft tissues which possibly block surgical instruments in operation, and can predict whether blocking with a patient occurs in the operation of the mechanical arm along a preset path in advance by measuring the operation field of the real operation to reconstruct an operation incision space, thereby providing reference for the position limitation of the tail end of the surgical robot, furthest guaranteeing the feasibility of the operation of the mechanical arm and improving the safety of the robot parameters and the operation; the virtual operation simulation process is more realistic, the selection, planning and teaching of an operation scheme are facilitated, the later operation track simulation previewing is facilitated, the operation proficiency of doctors is higher, and the culture period of young doctors is effectively shortened; the invention can effectively shorten the operation time and the exposure time of the wound surface, is beneficial to reducing bleeding in the operation, reducing the infection risk, reducing the postoperative pain of patients, ensuring quicker recovery and helping to reduce the risk of the operation to the greatest extent.
Drawings
FIG. 1 is a flow chart of a method of an embodiment of the present invention;
FIG. 2 is a schematic diagram of the principle of the triangular patch composition according to the embodiment of the present invention;
Fig. 3 is a schematic view of preset registration points in the mouth according to an embodiment of the present invention.
Detailed Description
The application will be further illustrated with reference to specific examples. It is to be understood that these examples are illustrative of the present application and are not intended to limit the scope of the present application. Furthermore, it should be understood that various changes and modifications can be made by one skilled in the art after reading the teachings of the present application, and such equivalents are intended to fall within the scope of the application as defined in the appended claims.
The embodiment of the invention relates to a mandible operation space modeling method of an intraoral incision, which aims to solve the track planning problem in the mandible operation process of the intraoral incision, so that the virtual operation simulation process is more real, and therefore, the instrument pose, the patient position and the incision space of the actual osteotomy operation of a surgeon are required to be recorded in an operation environment, as shown in fig. 1, and the mandible operation space modeling method comprises the following steps:
Step (1): acquiring scanning data of the surgical body position of a patient;
step (2): performing annular scanning on an operation incision space of a patient to obtain incision space data, and reconstructing the incision space data;
step (3): constructing a notch model according to the reconstructed notch space data;
step (4): and fitting the scanning data of the patient body position with the incision model to obtain a virtual oral cavity model.
The method for modeling the mandibular operation space of the intraoral incision according to the present embodiment is described in detail below:
(1) Optical tracking device probe registration and debugging
A probe of an optical tracking device (MicronTracker, claron company, canada) is registered, and in its optically recognized standard coordinate system, the pose of its end is calibrated using a marker plate of the probe. On the in-vitro model, performing measurement verification of precision, randomly selecting a plurality of anatomical landmark points of the three-dimensional printing model, measuring corresponding coordinates, and performing distance calculation; the corresponding anatomical landmark point coordinates are measured in preoperative three-dimensional design software (chemicals 21.0,Materialise company,Belgium), distance calculation is performed, and comparison is performed with optical camera measurement data, so that theoretical errors are within 0.2 mm.
(2) Fixing the position of a patient
The body position of the patient with mandibular operation is the backward head position, and the incision in the mouth is selected and operated after the conventional disinfection and towel laying. For mandible fixation, the design of the chin fixator is carried out in three-dimensional modeling software in the early stage, and metal materials meeting the medical instrument standard are selected for mechanical processing. During operation, after the chin incision is completed, the chin fixator is installed, and the external pneumatic arms (Unitrac, aesculap, germany) are used for completing the chin fixation.
(3) Patient position data scanning
The method comprises the steps of utilizing a handheld optical scanner to scan data of the surgical position of a patient, pasting corresponding optical identification markers on the head, the face, the neck and the like of the patient, and utilizing an optical camera of the handheld optical scanner to identify the markers, so that real-time three-dimensional modeling is performed. In the post-processing software, corresponding data processing is carried out to obtain corresponding scanning data of the actual body position of the patient in operation.
(4) Patient incision spatial data measurement
The method comprises the steps of using a probe of an optical tracking device (MicronTracker, claron company, canada) to record relevant poses of a mark point and a tail end on the probe by using a camera tracking device at a fixed position of a patient, recording each group of poses at least 50 times, and recording the poses within a valid confidence interval range (P < 0.05).
The preset registration points selected in this embodiment include: as shown in fig. 3, 1, 2, 3, and 4 represent the reference numerals of 4 preset registration points, respectively, wherein the first registration point 1 is the intersection of the lower left and lower right tooth slits 1 and mucous membrane; the second registration point 2 is the interface between the tooth gap of the lower left tooth No. 3 and the tooth gap of the lower left tooth No. 4 and the mucous membrane; the third registration point 3 is the interface between the tooth gap of the lower left No. 5 and the tooth gap of the lower left No. 6 and the mucous membrane; the fourth registration point 4 is the interface between the tooth gap of the lower right tooth number 3 and the tooth gap of the lower right tooth number 4 and the mucous membrane. After incision is completed, under the fixation of an operation retractor, performing annular scanning on an operation incision space by using a probe of the optical tracking device after debugging to obtain incision space data, and recording pose data of a probe tip at the tail end of the corresponding optical tracking device.
(5) Incision space data reconstruction and model fitting
The incision space data to be collected is selected to be represented by an STL file format, and the data is collected by a probe of an optical sensor in operation, so that the collection time of the data is limited, and the data volume is limited. In combination, this embodiment employs a spiral dotting approach to construct the profile of the outlet lumen incision. The STL file in ASCII format is composed of a series of triangular patch unit planes with vector directions, each unit plane being composed of 3 vertex coordinates of a triangular patch and normal vectors of the triangular patch.
Further, according to the progressive triangular patch composition strategy of the sequence number adopted in the present embodiment, as shown in fig. 2, a-F is the acquired target data point, and automatic composition of triangular patches is performed through continuous 3 points, such as A, B, C to form a triangular patch, B, C, D to form a triangular patch, C, D, E to form a triangular patch, D, E, F to form a triangular patch, and all measured data points are continuously calculated, so that complete notch space data can be finally obtained through the reconstruction mode.
The text document generated after the data is measured by the probe of the optical sensor is read immediately to reconstruct the incision model. In order to facilitate registration of the incision model and the patient model (i.e. scan data of the patient), in the embodiment, after the spiral point taking scanning is performed on the incision, the point taking is performed on natural anatomical points on the bone of the patient, and the finally generated model not only comprises the incision model, but also comprises the selected natural anatomical point model, and the incision and the bone model with the matched relative relationship can be obtained by matching the generated natural anatomical point model with corresponding anatomical point features on the bone model of the patient in the later period.
Therefore, the incision space data is obtained by carrying out annular scanning on the preset registration points at the junction of the tooth slits and the mucous membrane in the operation incision space of a real patient, and the data measurement method is real and effective; the invention reconstructs incision space data in a triangular patch construction mode, and the purpose of constructing more accurate actual operation space can be achieved through the reconstructed incision space data.
Claims (4)
1. A method of spatial modeling of mandibular surgery for intraoral incisions, comprising:
Step (1): acquiring scanning data of the surgical body position of a patient;
step (2): performing annular scanning on an operation incision space of a patient to obtain incision space data, and reconstructing the incision space data;
step (3): constructing a notch model according to the reconstructed notch space data;
Step (4): fitting the scanning data of the patient operation body position with the incision model to obtain a virtual oral cavity model;
In the step (2), the incision space of the patient is subjected to annular scanning to obtain incision space data, which specifically includes: performing annular scanning on preset registration points at the junction of tooth slits and mucous membrane in the surgical incision space of a patient through optical tracking equipment to acquire incision space data;
In the step (2), reconstructing the incision space data, specifically: and according to a spiral point taking mode, forming a plurality of triangular patches by all target data points in the incision space data according to 3 points which are continuous in sequence, wherein the triangular patches form reconstructed incision space data.
2. The method of spatial modeling of mandibular surgery for an intraoral incision according to claim 1, wherein step (1) is preceded by fixing the operative position of the patient.
3. The method according to claim 1, wherein when the incision space is scanned in the step (2) to obtain the incision space data, the method further comprises recording pose data of a probe tip on an optical tracking device corresponding to the incision space data, wherein the pose data of each group of optical tracking devices is recorded at least 50 times within a preset confidence interval range.
4. The method of spatial modeling of mandibular surgery for an intraoral incision according to claim 1, wherein step (4) further comprises: taking points of natural anatomical points on the bones of the patient to generate a natural anatomical point model, and fitting the natural anatomical point model, the incision model and the scanning data of the operation body position of the patient to obtain a virtual oral cavity model.
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