CN1162251A - Appuratus and method for neurosurgical stereotactic procedures - Google Patents
Appuratus and method for neurosurgical stereotactic procedures Download PDFInfo
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- CN1162251A CN1162251A CN95195907A CN95195907A CN1162251A CN 1162251 A CN1162251 A CN 1162251A CN 95195907 A CN95195907 A CN 95195907A CN 95195907 A CN95195907 A CN 95195907A CN 1162251 A CN1162251 A CN 1162251A
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Abstract
An apparatus and method are disclosed for displaying a path between a selected target and selected points on a patient's skull and for guiding surgical instruments along any selected path. The system is comprised of an image display system, an articulated arm and probe, and a stereotactic system. The sub-systems are coupled to one another so that the articulated probe may be used to select patient fiducial points that correspond to selected image fiducial points. Using these points, the image display system coregisters the external locations to the displayed images so that the probe condition may be displayed with the displayed images. The system further permits the identification of a selected target within a patient's brain and to project a path from the external position to the target prior to the performance of a craniotomy. After evaluation of the path, a surgeon may lock the stereotactic system in place to preserve a selected surgical path and to guide instruments along that path. A method of utilizing the system to perform such surgical procedures is also described.
Description
Technical field
The present invention relates in general to the neurosurgery device, and the three-dimensional planning system that relates more specifically in neurosurgery, use.
Background of invention
During the seventies, developed the radioactivity picture system and more at large understood fully patient's internal state to help the surgeon.Particularly developed computer-aided tomography radiography (CAT) system, it is in order to improve the picture quality that obtains according to the data that produce during patient's radioactive scanning.Patient is placed in the stand, and radioactive source and radiation detector are then staggered relatively mutually so that rotate around a part of patient body.The data that radiation detector produces are utilized radiographic image or " thin slice " to produce this body part by computer, thereby give doctor with the view in whole area-of-interest greatly clearly.
After a while, the radiograph imaging system also comprises nuclear magnetic resonance (MRI) and positron radiation chromatography photograph (PET) imaging, and the energy that their produce image is not applying X-ray or analog.These devices are useful, because they provide different with the cat scan image or the additional information of relevant organ and cell tissue.In this application, the noun scanning device refers to imaging device, and irrelevant with the technology that is used to produce image.
Carry out neurosurgery and can study, repair or remove the pathology that is positioned at patient's brain.This operating environment is challenging, because the organ at interest place: brain, by thick relatively skeletal structure, skull, institute centers on.Concerning the surgeon, unique before the surgical operation can be the image that produces by imaging system near the method for brain.
Because inaccessiblility, the size of brain and be roughly the shape of hemisphere, in the brain locus of points determine require with reference to certain fixed external reference systems usually.For provide enough information to the surgeon to determine interesting areas on the image, such as tumor or infringement, developed various systems so that reference point or some reference points to be provided, they can be used for the structure that shows on patient's anatomical results and the image corresponding.These systems require have a framework to be firmly fixed at patient's head so that reference point or some reference points to be provided usually.In case reference configuration is connected with patient, view data is the fixed reference frame and producing according to relative imaging device just.Also promptly, there is mechanical connection between reference configuration and the imaging device here usually.Behind data collection, patient can remove from scanning device, but reference frame must still be connected on patient's head.Reference frame keep to connect in whole surgical procedures, like this, the surgeon can with about the image information of differences in patient and relative framework and localized, the intracranial position of patient is associated.
In some such systems, based on the data that the radioactive scanning device obtains, when providing the surprising ability in the zone at interest place in definite patient's brain for the surgeon, desired framework is then pretty troublesome, and makes obtaining of radioactivity data complicated.For keeping the position of reference frame, in whole scanning process and surgical procedures, it must keep being connected with patient head.Because reference frame can have several pound weights, and must be securely fixed on the head, they may be very uncomfortable to patient.The distance that framework people patient head is stretched out also becomes difficulty when handling patient.In addition, having the patient bigger than normal header usually can not be suitable with three-dimensional policy framework.
For uncomfortable to patient that the clumsiness that reduces reference frame and it cause, developed a kind of three-dimensional policy system, it uses a kind of skull ring that is mounted to patient's skull.This ring is a relatively little metal ring, adopts the porous screw to be installed in patient head.In case ring installs, the transfer plate with two holes is fixed in the ring, has a hole to have rotatable ball and the socket mechanism that is installed on wherein in two holes.Transfer plate also is provided with the labelling that lonizing radiation do not see through, and it can be discerned in the radiation image that scanning device produces.Patient is placed into to scanning device then, and a member that stretches out from ball and socket is connected with machine.In case patient is reserved in scanning device to collect view data, ball and socket are locked in fixed sensing.
Behind the image data collection, thrown off with the member that stretches out from the patient who is connected with scanning device from ring, like this, patient is removable.Ball and socket still are locked in its sensing, and like this, the sensing of the transfer ring on patient's skull can be duplicated afterwards so that determine target.
After the transfer plate of clamping ball and socket was removed in the skull ring that is mounted to patient head, this plate was connected to a member that stretches out on the framework platform, to duplicate its position and sensing on patient head.Check the image that scanning device produces, determine selected target, such as infringement or tumor, and the radiolabeled coordinate data of transfer plate.Use this coordinate data and the sign that is marked on the framework platform, handle the target label on the framework platform, thus the radiolabeled relatively target location of identification.Second ball and socket mechanism are placed in second hole of transfer plate.After this, so can stretch to distance and the path of impact point by second ball and socket to be determined to target such as the apparatus of vivisection probe.Then that the locking of second ball and socket is on the throne being retained to the sensing of target, then be marked on the probe to the distance of target.
Can remove from the member on being arranged in the framework platform so supporting the transfer plate of second ball and socket mechanism, and reinstall on the skull ring on patient's skull, and with blocked second ball and socket to be determined to the path of selected target.After this, can use vivisection probe mark patient skull, and on this aspect, carry out the craniotomy operation on patient's skull so that a hole is provided.So the vivisection probe can extend the degree of depth of labelling on the probe by the hole in second ball and the socket, so that the vivisection probe is placed within infringement or the swollen disease.Use this method, the surgeon can accurately place live body and resolve probe, and need not search positioning tumor or infringement before carrying out vivisection.Further specifying of above-mentioned technology and device sees U.S. Patent number 4805615 and 4955891 (U.S.Patent Nos.4805615 and 4955891), to its reference in addition.
Above-mentionedly carry out the collection that vivisectional method has been quickened view data in many aspects.At first, to compare with previously used reference frame be little to the reference configuration that is installed on patient's skull.Secondly, the removable plate that has ball and a socket aperture can make the target area before carrying out the craniotomy operation in patient's brain accurate location.The 3rd, the removable plate with ball and socket mechanism guarantees that plate correctly is placed on patient's skull, and remains on the framework platform accuracy of determining to the path of target.Though this method has been quickened determining of brain region of interest within greatly, it can not be for the surgeon provides the information of closing the intermediary cell tissue zone between the craniotomy hole and target area on the skull, and it is positioned at brain, and may be positioned at brain dearly.In addition, the position in the hole of the ball of reference rings and socket is not necessarily crossed in the sensing of the view data that scanning device produces, thereby can not provide between craniotomy hole and the target area view data on the different depth to help the surgeon path to target to be estimated.Like this, when the surgeon need not search for localizing objects, the surgeon needed to regain brain cell tissue along the path that arrives target carefully really.Not so, might damage some sensitizing ranges of stretching along this path.Above-mentioned reference system can not help the surgeon to determine the strict position of some sensitizing ranges like this before the craniotomy operation, and crossed the path to target.
The track of infringement or damage, minimum in determining brain in order to reduce to the infringement of intermediary's cell tissue, determine that it usually is crucial that suitable path arrives track by brain.Like this, determine the path of reaching the spot almost with determine on-the-spot the same key itself.Said system is unfavorable in this respect.
For view data being provided and placing joining of more automatization between the patient of operation, developed the system that carries out " registration mutually ".Mutually registration is a process, computer by it will be related with view data datum mark and the datum mark that is associated with patient body match.Usually, image-based is selected by using mouse and cursor, so that the point on identification patient skin on the display image.Articulated jib and probe are connected to computer so that the coordinate data of computer external point to be provided.User is used this arm and probe, selected element on one's body patient, their corresponding selected image-based on schedule, and computer is carried out respective point is carried out paired program.After selected enough counting (being at least 8 points usually), computer can be identified on the display image, and correspondence is pressed close to the point of the probe location of patient head.Such system is by the Massachusetts, thunder buchu Nie Ces Co.,Ltd of Brooklyn (Radionies o Brookline Masschusetts) makes, and with its product name " motion arm " labelling.
Such system provides " navigation " information to the surgeon, and also, the surgeon can be put probe to patient's head or the ad-hoc location in patient's head, and discerns this position on display image.By this method, the surgeon can be on display image the inspection area, and determine their nearness to probe location.Therefore, the surgeon can believe firmly to the correctness of the surgical operation approach of target.
Though these systems provide compellent navigation information, they still can not project the image of stable surgical approach on the radiation image that shows before the craniotomy operation is carried out.Stable path can not be throwed by such system, is because when at every turn needing to check the path, and the surgeon is can not be with probe directed consistently and be stabilized in strict same position.As a result, because probe is by hand, the path that such system can not confirm or indication passes to target enduringly.In addition, such system can not guarantee that the surgeon can advance along any paths that the surgeon selects according to the radiation image check result that shows.
The system that needs be so that the surgeon can carry out the path that the craniotomy operation is selected before carrying out, estimation passes to selected target, and this Route Locking is on the throne.The system that needs be can the craniotomy intra-operative and this operation afterwards the guided surgery doctor pass to target along the surgical approach of estimating.The method that needs is after the path is estimated, selects and keeps some the selected paths that pass to a plurality of targets.
Summary of the invention
These and other problem of previous known system can be overcome by the system that builds according to the principle of the invention.This system comprises the imaging display system that is used to show radiation image; Graphic based point selection device, it is connected with imaging system, is used for selection reference point on the image that shows on the display system; Target selector, it is connected with imaging system, is used for select target on the image that shows on the display system; Articulated jib and probe, it is connected with imaging system, can propose the space coordinates of probe with reference to imaging system, and like this, the position that is associated with probe just is presented on the display image.Patient's datum mark selector, it is connected with imaging system and articulated arms, is used for selection reference point on one's body patient, and these put the selected datum mark of corresponding display image.Registration processor is with patient's datum mark and the mutual on schedule registration of selected image-based mutually, and like this, the coordinate that articulated jib provides can match with display image, thereby the position of probe can be presented on the display image.The probe clamper is held in position near patient head with the Probe clip of articulated jib, and clamper is lockable selectively, so that remain close to the position of patient head.Adopt this system, the surgeon can be to being shown on the described display image, and the path between described probe location and the described selected target is estimated.
System gets so that patient when being scanned, is not fixed in patient's any flat board or framework reference substance in accordance with the principles of the present invention.This system with image-based on schedule with patient's the mutual registration of selected anatomical features, like this, probe location can be presented on the radiation image, and the path that will pass to selected target is incident upon on the image.The surgeon can estimate the path that passes to selected target, if this path is considered to acceptable, then probe location is locked on the throne.The surgeon can put on suitable vestige to carry out the craniotomy operation in patient head then.Use similar methods, the path that passes to other target can be determined and labelling before any craniotomy operation.
This system also comprises the surgical operating instrument sleeve pipe, and they are applicable to and are installed in the probe clamper that like this, apparatus can insert by sleeve pipe, passes to selected target along the path of estimating on correct sensing and position.Thereby the probe clamper can be used for accelerating selection and the estimation of surgeon to the path, and is after this keeping this path and along the guiding apparatus in this path.
System of the present invention also comprises arc delivery bar, in order to be determined to the radius of predesignating of selected target.Notched arc is rotatably mounted to reference lever, and the probe clamper that probe is installed then is applicable to slippage in notched arc.Like this, notched arc can be by the head rotation of hemispheric mode around patient, and probe card and clamper are then along the arc slippage of being with groove, so that estimated to determine some entrances by surgeon's application of radiation line display system.Imaging system also is provided with processor, it is used for the lonizing radiation data that scanning device produces are carried out interpolation of data, so that the view along probe that enters from any entrance is provided, these entrances are when hemispherical three-dimensional planning system is placed to probe and reaches clamper, select along this hemispherical three-dimensional planning system.Use this system, the surgeon can estimate some entrances, and selects wherein an entrance to patient's risk minimum.
Another advantage of native system is, selected when target, and after carrying out vivisection or surgical procedures on the target, the surgeon can select interested second target in patient's brain.After this time selected, the probe clamper can unclamp, and inserts probe again to determine to pass to second path of the second selected target.Can connect hemispherical three-dimensional planning system then, so that for estimation provides a plurality of entrances that pass to second target, in case selected suitable path just can undergo surgery on second target.Use this system can quicken surgical operation with this side worker, wherein radioactive seed can be implanted to each zone of tumor, and have the effect that radioactivity is confined to tumor region substantially.This class is used and also can be helped the surgeon accurately to place a plurality of degree of depth electrodes in patient's brain, so that monitor.
These and other advantage of the system that proposes according to the principle of the invention can reach additional detailed description with reference to the accompanying drawings and be understood fully.
Summary of drawings
The present invention can be embodied as various parts and configuration of components, is embodied as the arrangement of various steps and step.Accompanying drawing is only in order to show most preferred embodiment and other embodiment, rather than in order to limit invention.
Fig. 1 is the perspective diagram of the parts of an embodiment of system in accordance with the principles of the present invention;
Fig. 2 has showed a width of cloth representative screens, the image information that system generates in its displayed map 1; And
Fig. 3 is the most preferred embodiment view that is used for a three-dimensional planning subsystem of Fig. 1 system.
Detailed description of the invention
Shown in Fig. 1 is the neurosurgery three-dimensional planning system 10 that builds according to the principle of the invention.This system comprises image display subsystem 12, articulated jib and probe 18, and three-dimensional planning subsystem 16.Image display subsystem 12 shows the image that the view data that produces according to scanning device draws, or the image that draws according to the data that obtained by these interpolation of datas.Subsystem 12 receives the input that the operator is used for selection reference point, acceptance is from the coordinate data of articulated jib and probe, and the selected datum mark of the selected on one's body datum mark of patient 13 and patient's radiation image carried out mutual registration, so just can show the position of probe and to the path of selected target.Subsystem 12 also shows the image of articulated jib, therefore, can check the operation of arm and probe.
Articulated jib and probe 18 provide spatial data by encoder interfaces 20 to display subsystem 12.Spatial data is preferably produced by optical encoder 22, though also can use the spatial data production part of other type.Except the data that are used for the position probe position that provided by arm and probe 18, probe 24 also can provide rotation data, because it rotates to rotate the image that is shown on subsystem 12 around its longitudinal axis, this will be described in detail hereinafter.
When the surgeon guided probe to pass patient head, three-dimensional planning subsystem 16 was stablized probe 24.Subsystem 16 also comprises the parts that hereinafter will more describe in detail, and they make the probe can be locked on the throne, and this position is used to the guided surgery operating theater instruments and passes to selected target.Subsystem 16 also comprises the parts that hereinafter also will more describe in detail, and they can be used for providing a plurality of entrances for the surgical approach of the target that passes to patient inside, and the center of selected target zone is all aimed in all these entrances.These parts are that the surgeon gives security with the goodish degree of reliability, make what each probe location be provided all was meant with selected target.
The hyperfine pitch resolution monitor of multiple scaaning HG trinitron that monitor 32 has preferably been bought from U.S. Sony company (Sony Corporation of America) (Multi-Scan HG Trinitron superfine pitch resolution monitor).Computer 30 is preferably by the Texas, the platform Computer Company of good room stone (Dell Computers of Houston, Texas) the Dell 450DE/2DGX of Sheng Chaning.The tape drive 40 that is used to read image scan data is the California preferably, the Flanders difficult to understand data company in Santiago (Overland Data of San Diego, California) the 9 magnetic track tape drives of Sheng Chaning.Encoder interfaces 20 and articulated jib and probe 18 are by the California, and (ImmersionHuman Interface Corp of San Francisco California) produces in the immersion human body interface company in San Francisco.
Computer 30 is preferably carried out the continent by guest sunset Fo Nixi, The Nomos Corporation of a silk fort (Nomosof Pittsburgh, Pernsylvania) Kai Fa Ah taking off Lars (Atlas) program.Ah taking off Lars (Atlas) is a kind of computer program, and the radiation image that obtains according to the radiation scanning data that provided by tape is provided for it, and data are carried out interpolation to be provided at the additional views that does not occur in the radiation scanning data.Ah taking off Lars (Atlas) program in the most preferred embodiment is revised, so that by the data of encoder interfaces 20 receptions from articulated jib and probe 18.By 30 the park operation system of using a computer this program is packed into, in most preferred embodiment, this operating system is Microsoft disc operating system (MS-DOS).This Ah taking off Lars (Atlas) program comprises himself high-level input/output procedure and other computer resource function, so that can the use a computer I/O operation of basic layer of 30 park operation system of Ah taking off Lars (Atlas) program.In most preferred embodiment, computer 30 also is equipped with telephone interface, thereby can provide from afar such as the software of diagnosing and other support function by phone.
Articulated jib and probe 18 are installed on the surgical operation skull clip 46, and it then is installed on the operating-table 48 (it is the operating-table of known type).Substrate frame 50 (Fig. 1) is connected on the mounting sleeve 52, and it is mounted on the fixed star blast shape adapter 54 of surgical operation skull clip 46.Preferably fixedly helical or analog are mounted on the sleeve pipe 52 substrate frame 50 by hexagonal.The mating surface of sleeve pipe 52 and support 50 preferably has key, and like this, substrate frame 50 just has only a kind of possible sensing.When the aseptic substrate frame of use as will be discussed in more detail below with when placing the arm of surgical operation curtain, these characteristics are very important to the precision that keeps reference point.Substrate frame 50 at one end also comprises the locked installation screw 56 that is used for articulated jib, and comprises a hollow tubular extension rod 58 at its other end, in order to clamping articulated jib and probe 24.Screw 56 is being rotatably mounted around narrow slit 60, and this narrow slit cuts on substrate frame 50 for articulated jib and probe 18.
Articulated jib and probe 18 (Fig. 1) also comprise erection column bolt 62, two arm members 64 and probes 24.Articulated element 68 is connected and installed column bolt 62, arm member 64 and probe 24, to form arm and probe 18.On each pin joint, have rotation at two vertical planes, get so that each arm has two degree of freedom.Each arm member will preferably be provided with optical encoder 22 to the position of its respective hinge, and they are connected with arm with mutual vertical relation in each hinged place.Probe 24 is installed within the sleeve pipe 70 that is positioned at the arm outermost end, thereby it can rotate around its longitudinal axis.This rotational motion is used to rotate the radiation image that shows to the surgeon on monitor 32 screens by computer 30.What stretch out from articulated jib 18 1 ends is interface cable 72, and it terminates on the encoder interfaces 20.Encoder interfaces 20 will become to be used for turned position (angle) data of computer 30 from the data transaction of six optical encoders 22 of articulated jib 18.
Generally, the data of scanning device generation comprise view data and non-picture data.Non-picture data comprises parameter-definition, such as patient name, date, patient location, scanning sensing, sweep parameter and to each distinctive other imaging details in the different scanning device Producer.The most preferred embodiment of the program of carrying out on computer 30 will be taken passages out the common master data clauses and subclauses of all scanning device Producers, and the application image data file is stored in them in the keyword evaluation file.This keyword is estimated file and is comprised a keyword list, the evaluation of each data field of these keyword recognition and this field.For example, being used for after the data field evaluator of patient name is the date expression that is used for the patient name of row preface scanning.For the systematic analysis purpose, these files preferably people are readable, because they are not normally visited by user.
View data generally includes numeric data, and they are represented such as (Hounsfield) unitary progressive series of greys value or certain other brightness/contrast value, and well-known, these values can be used for producing image.These digital values are compressed, or are expressed as integer or real number value.The most preferred embodiment of the program of carrying out on computer 30 does not compress any compressed value, and converts all numeric datas to integer data.These data are stored in the image data file then.These files are preferably pressed the separated hierarchical file structure of patient data, and write in the dish by image studies project and series for each patient.
Pedal 36, mouse 34 and keyboard 38 can the person of being operated in order to provide input to computer 10.For example, mouse 34 can be used for controlling cursor on monitor 32 screens to select different options, and this will be explained below.For another example, pedal 36 can be used to activate selection to datum mark on one's body the patient by the surgeon.
In most preferred embodiment, the image display program of carrying out on computer 30 comprises graphical user interface (GUI), I/O (I/O) program library, articulated jib interface routine, and some application modules.The demonstration of data and menu on GUI interface control monitor 32 screens.The I/O library program is carried out such as the various input and output functions of reading view data from tape drive 40.The articulated jib interface provides the demonstration of menu and benchmark selected element in the bottom of monitor 32 screens of the most preferred embodiment of subsystem shown in Figure 1 12.At last,, the application module executive software to be to carry out conversion operations, for example, for the image interpolative data with the mutual registration of view data and selected patient's datum mark.
Shown in Fig. 1 is an alternative embodiment of three-dimensional planning subsystem 16, and it is connected to patient with articulated jib and probe 18, and the estimation of surgical approach and selection are carried out.This equipment comprises skull ring 80, transfer plate 82, rotary socket 84 and probe alignment ball 86.This equipment is shaved light at patient's hair, is ready to betadine, inject lidocaine after, by porous bone (cancelloas bone) screw skull ring 80 is fixed to and is applied on patient's head.After skull ring 80 is fixed, transfer plate 82 is installed on the skull ring by the pillar (not shown) of stretching out from skull.Rotary socket 84 is mounted on the skull ring by allene screw or analog.Rotary socket 84 comprises base 92 and the sleeve pipe 94 that protrudes upward.Probe alignment ball 86 is inserted in the sleeve pipe 94.Probe alignment ball 86 for example by adopting as shown in Figure 3 and the probe alignment sleeve of describing 193, is applicable to the end of accepting probe 24.Like this, probe 24 can be inserted in the probe alignment ball 86, moves together in probe and ball relative disease people scalp surface.
In case the surgeon chooses specific orientation based on the information that radiation image provides that shows on the monitor 32, can will tighten so that probe alignment ball 86 is fixing on the throne from sleeve pipe 94 outwardly directed screws 98.The surgical operating instrument sleeve pipe (not shown) of known type can be inserted in the probe alignment ball 86 then, make drill bit or other apparatus be able to and to insert by the apparatus sleeve pipe, to open patient's skull.Biopsy device also can be inserted into the target area by sleeve pipe.Like this, ring 80, transfer plate 82, socket 84 and using to the surgeon of ball 86 provide stabilised platform with position probe 24, and the orientation that will estimate lock reliably on the throne, thereby provide guiding for surgical procedures.
Also showed among Fig. 1 and be used to enter the on-the-spot hemispherical three-dimensional planning system of selecting.This equipment comprises arc delivery bar 100, rotating support arm 102, arc 104 and variable thimble assembly 106.After probe alignment ball 86 has been oriented, makes probe 24 definite objects, probe can be removed, arc is delivered bar 100 be inserted in the probe alignment ball 86.Then rotating support arm 102 is installed on the arc delivery bar 100, and adopts screw 110 that its distaff is fixed.Slip feather or wedge 112 are installed on the rotating support arm 102 with lockable mutual relation, are applicable to be assemblied in the track that cuts in arc 104.By the screw 118 of tightening rotating support arm 102, arc 104 can along the length of arc 104 in any fixed-site to arm 102.Variable cannula system 106 is suitable for having an awl equally, and it is placed in the arc 104 slippingly, thereby variable thimble assembly 106 can be locked in the position along the length of arc 104 on any position.Thimble assembly 106 also comprises socket, for example similar socket to probe clamper shown in Figure 3 192, and its fitted with probes 24, like this, the surgeon can be by the observation to the path on the monitor 32 that is shown in subsystem 12, and estimation is to the path of selected target.Because dynamic load bar 100 definite objects, supporting arm 102 and arc 104 can be by around targets and the hemisphere form of centring is rotated around patient's head.Preferably around arc delivery bar 100 locked in-positions, consequently central hole location in the variable thimble assembly 106 and arc 104 are around about 19 centimetres of the target range of centring for supporting arm 102.
The assembly of hemispherical three-dimensional planning system is able to the surgeon can be with the goodish degree of reliability around patient's head and operation probe 24 makes that socket is to point to previous selected target.By the 100 revolution arcs 104 of distaff simply and arc 104 in slippage sleeve pipe 106, for the surgeon provides the scenes in order to estimate in a large number, they can be used as operating guiding and lock on the throne.
Shown in Fig. 3 is the most preferred embodiment of three-dimensional planning system 16.This system comprises probe clamper cover 180 and rigidity bifurcated arm 182, and it is placed between sun blast shape adapter 54 and the sleeve pipe 52.Bifurcated arm 182 ends at pivot swivel 184, adjustable arm 186 is stretched out thus.Another adjustable arm 190 is stretched out from the pivot swivel 188 of arm 186 ends.190 end at probe clamper 192, and it is provided with transfer plate 82, ball outlet mechanism 84 and regulates ball 86 as having illustrated in conjunction with Fig. 1, and wherein ball 86 is applicable to fitted with probes alignment sleeve 193.Like this, subsystem 16 provides a rigidity adjustable arm, and probe clamper 192 and accessory part can be operated around patient's head by it, lock selectively then on the throne carrying out the guiding of path estimation, surgical operating instrument, or the connection of hemisphere system.
For system 10 is applied to neurosurgery, patient 13 is scanned in image analyzer to produce a series of images.One " series " can be that a group of a volume part of patient body is parallel, the image of equal intervals, and " thin slice " sometimes is otherwise known as.The image that constitutes series is preferably successive.Combination more than an image sequence so-called " research project " or " cover " also can be by system applies.That the example of series has is axial, coronal, rotate and the sagitta of arc.Axially series be from the top of patient's head to the substrate of skull, crown series be face from patient's head to the back, rotating series is the head that centers on patient, sagitta of arc series then is that side view from patient's head is to opposite side.Produce when axially series preferably is 0 ° at the stand angle, not so, may distort in the data of being undertaken by Ah taking off Lars (Atlas) program most preferred embodiment.
Be scanned after device produces in series, it can by deeply to magnetic medium to be transported to system 10.Usually, view data is written in the 9 magnetic track tapes 74, and it can be read by 9 magnetic track magnetic tape readers 40.User can drive computer 30, and drives 9 magnetic track tape interface programs in I/O (I/O) program library.By adopting this program, user can read in view data to computer 30 from 9 magnetic track tapes 74, and computer is stored data to hard disk drive or analog by appropriate format then.Computer 30 also can be accepted data from image analyzer by DAT reader, floppy disk, computer network or analog.
Be read into to computer storage in view data, the user executable program, it is with the display window of image radiation data show in monitor 32.By card crash touch the view icon of screen shown in Figure 2 for one (20, user can be selected particular figure.This action produces the display menu of various series or view, and user can be selected thus.After a selected series, first image of this series or thin slice are shown in the display window 122 just as shown in Figure 2.User can make slippage device 124 buttons on the mouse-based operation screen, watches the every width of cloth image in the series.
User can be chosen in the second series that second display window 126 shows.By card crash touch second window one view icon 128, set up second display window after, user can select to be shown in the particular series of this window, and similarly by making mouse-based operation slippage device button 130 watch different thin slices.
Computer 30 also can produce the second series that scanning device does not have generation.The generation of computer 30 these processes is to carry out interpolation of data by one of series that scanning device is produced to produce second series.For example, crown series can be produced by scanning device, and is shown in first display window of system.Show sagitta of arc series if user is chosen in second window, and it is not scanned the device generation, then system carries out interpolation with the data of every crown image right hand edge, produces sagitta of arc view by these data.This process repeats the parallel image of the same intervals in the crown perspective view, to set up second sagitta of arc series.
In most preferred embodiment, Ah taking off Lars (Atlas) program is scanned the view data reformatting data of the stereo-picture in zone with the generation expression.This is by the view data of single sheet is carried out interpolation, carries out to produce additional " thin slice " that scanning device do not obtained.This is preferably undertaken by producing so-called " Voxel " value, and these value representatives are cubical image value on yardstick, though other three-dimensional shape also can be used.For example, if series is the thin slice by expression 3mm, on behalf of the image of 0.5mm * 0.5mm, each pixel form, and the Voxels that then is interpolated preferably represents the cube of a 1mm * 1mm * 1mm.For interpolation is used for the Voxel value of plane of delineation Voxel, each combination that forms foursquare four adjacent pixels is averaged, the average result composition data of gained is to be formed on the Voxels in 1mm * 1mm * 1mm plane picture.Be positioned at the planar Voxels of the 2mm and the 3mm degree of depth for representative, the Voxel image in the face is preferably used and is combined to the proportional linear weight of the distance of datum plane 4mm planar the underlie plane of delineation (datum plane) lower with being positioned at the next one from selected plane.Certainly, as knowing in present technique, other interpolation scheme also can be used.After interpolative data produced, Ah taking off Lars (Atlas) used these data to produce any series of user requirement.
In case display window or window are set up, and show suitable image sequence in those windows, user just can be selected the graphic based point.This be by with mouse image-based shown in Figure 2 on schedule in the evaluator menu on the appropriate area card crash touch for one and to carry out.After one of in the activation graph picture point icon, user can be used Mus and show that 34 handle a reticule cursor and cross image, with its in alignment with special characteristic point after, card on the mouse button crash touch for one to cause performing a programme on computer 30, with point on the image and the match of selected picture point diagram.User can be right, for example says, 8 points carry out this program, though in the system according to principle of the present invention, fewer or many nodes also can be realized.But before registration produces mutually, need 3 points at least, and best, adopt about 8 to 10 points, then can obtain best mutual registration.
Mounting sleeve 52, substrate frame 50 and articulated jib and probe 18 are mounted on the skull clip 46 of clamping patient head.Skull clip 46 is the Ohio preferably, and Ohio Medical Instruments of Cincinnati (Ohio Medical Instrumant CO., Inc.of Cincinnati, Ohio) the skull clip of Sheng Chaning, and be marked as " MAYFIELD " clip of correction.Clip comprises the arm of ratchet 146 that is installed in the sleeve arm 148, also comprises the two dowel fixes folder (not shown) that is installed on the sleeve arm, and torque screw and pin 150 are installed on the arm of ratchet 146.By the process of knowing, regulate the head of clip with adaptive patient.
Being arranged on the sleeve arm is fixed star blast shape adapter 54, and mounting sleeve 52 is mounted thereon.The substrate frame 50 that is used for articulated jib and probe 18 is connected to mounting sleeve 52 by allene screw or analog, and articulated jib and probe 18 then are connected on the substrate frame 50 as previously mentioned.User must be placed to articulated jib the optical encoder that makes all side direction install and be positioned on the same side of each arm part.If arm is placed on the wrong position, then computer 30 and encoder interfaces 20 drill translate with articulated jib angle data apart, be positioned at the direction opposite as it, and show the position of probe improperly with its real motion.In case this arm is positioned at suitable position, probe 24 is placed in the tubulose extension rod 58 of substrate frame with the initialization of preparing probe (press among Fig. 1 shown in the pecked line).
By card crash touch probe initialization diagram 154 (Fig. 2) for one, user gets so that computer 30 begins to receive and articulated jib and probe 18 angle data input apart, and with the position of probe in extension rod 58 as datum mark and initialization.Show partly that in the bottom left of monitor 32 screens a viewing area 156 is arranged, it shows the position at the tip of each arm portion and probe 24.By probe 24 is withdrawn from tubulose extension rod 58, user can be handled articulated jib and probe tip in the space, and observes its motion on screen.Use this method, user can check optical encoder 22 whether to be in correct position, for example, and when moving up, with examining moving upward of probe by being in vertical position when probe.If the direction of motion of the probe that shows is opposite with the direction of probe tip real motion, user just knows that the initialization of arm is incorrect, should make articulated jib be in the appropriate location, repeats initialization.
After be sure oing that probe is suitably initialization, so user can be placed on probe tip the external point of patient's skull, they corresponding to previous selected image-based on schedule.Usually, these points comprise the bridge of the nose with the centrally aligned of eye socket or analog.Its way is, user at first block crash touch the selector button of contiguous patient point icon 158 for one, probe 24 is positioned on the point of patient's skull then, the image-based of patient's spot correlation connection that its correspondence one is activated on schedule.By forcing down pedal 36, patient's datum mark coordinate of being demarcated by probe location just joins with the patient's spot correlation that is activated.The reader it should be noted that the selection of patient's datum mark can be prior to image-based selection on schedule.
User choose at least three patients and image-based on schedule after, computer 30 beginning performing a programmes are so that with radiation image data and the mutual registration of selected patient's datum mark.For carrying out mutual registration, program is preferably carried out iterative algorithm.The screen of monitor 32 (Fig. 2) is provided with indicator window 160, so that the information of the quality of mutual registration between relevant radiation data and the selected patient's datum mark is provided to user.Usually, mutually registration is counted and is improved with selected, roughly counts goodish mutual registration between patient and the view data normally can be provided for 8 to 10.
Registration is preferably finished on one of program module of carrying out on the computer 30 by iterative algorithm mutually.Best algorithm is selected one group of image datum mark and corresponding patient's datum mark.Calculate the centre of form by each selected group how much charts determining.Then the coordinate transformation of one of centre of form is become the coordinate of second centre of form, and the point that is associated with first centre of form is converted too.To convert in first group and the coordinate difference of the point that converts is carried out power to determine total error amount or quality factor.Only change an increment then, calculate in first class mid point and second group poor between their respective point at the direction point that will be converted, and in addition square.If error result is less than quality factor, so the value that is increased becomes the point value in first group, and error result becomes new quality factor.
Carry out increment at equidirectional again and change, and calculate new error result.When error result during greater than current quality factor, the point that is converted is just thought best match.
Calculate and the change of valuation increment at other direction now.The increment on second direction change be performed until error result greater than quality factor till, and the previous point that converted just is considered to best match.So carrying out increment, direction formerly changes, till error result is greater than current quality factor.Again second direction test increment is changed.This process proceeds to conversion in any direction and does not produce till the error result less than current quality factor.When this takes place, carry out increment change and test according to foregoing such error of calculation result and quality factor in the 3rd direction.When changing the error result that does not produce greater than current quality factor at the increment of either direction, registration is finished mutually, in group a bit can realize the conversion of respective point to second group.
Sometimes, patient's datum mark is not accurately corresponding with selected point in the view data, thereby may reduce the calculating of mutual registration.By resetting corresponding " application " icon, cancel such point, can improve the calculating of mutual registration.Computer 30 makes user be able to activate and to cancel some points selectively, provides the optimal registration between patient and the view data to determine those points.The reader it should be noted that mutual registration improves along with increasing of datum mark number, yet action is to reselect one of image or patient's datum mark preferably, like this its corresponding preferably its counter pair.
User can or before mutual registration, or after it select target.This is to activate and on monitors 32 screens target icon 162 is set by using mouse 34, and uses mouse the interior zone that the cursor reticule moves to the patient's head that shows in the image is accomplished.Usually, interesting areas may be tumor, infringement, suspicious moving point, and the surgeon wishes to be that it places degree of depth electrode, or one in order to implant the zone of the radioactivity " seed " that the radioactivity surgery uses.The coordinate of target by card crash touch for one and target icon 162 to be set to set up.
After registration and target selection are finished mutually, user can be placed on probe 24 any position (as long as this zone is the part in scanner scans zone) on patient's skull, and the path from this point (arrow 172 expressions) to target (with reticule 174 expressions) obtains showing.The shown path to target shows preferably whether this path is present in really on this image sheet that shows constantly.To each position, be shown in the lower right corner of display window (Fig. 2) between probe location and the selected target along the distance that is shown the path.For example, the surgeon can be placed on probe on the point that is shown on the image sheet that just is being shown at present.But the surgeon also can be held in Probe clip such orientation, so that one or more thin slices will be crossed in the path from this probe 24 to target before arriving target.In this situation, be present in the most handy yellow expression in zone on the thin slice that just is being shown really, and the most handy red expression of the remainder in the path of the target that arrives (Fig. 2).Use mouse 34 and handle slippage device button 130, the surgeon can watch each part of destination path in suitable image sheet, until reaching the cell tissue of target to estimate that selected path is crossed.If the surgeon determines this path and has risk, is unacceptable, then the surgeon can select different sensings or different points on patient's skull, and reexamines the path.
By selecting view " to cross probe ", a series just is illustrated in second display window, and the slippage device button 130 that it can adopt mouse 34 to move this display window is handled.Use this method, the planar image that crosses probe 24 is showed to the target area from probe 24.Like this, the surgeon can estimate the path that reaches target by patient's brain cell tissue.
In case the selected particular path to selected target of surgeon, skull ring 80 can be mounted on patient's head, and transfer plate 82 is installed on the skull ring 80.Transfer plate 82 comprises probe alignment ball 86, and probe 24 can be positioned over wherein.After probe 24 was placed in the ball 86, it was removable so that select to the target area again, be the path of the best by surgeon's suggestion.When probe 24 was held on this position, ball 86 lockables were on the throne being determined to the path of target, and probe is removed.Preferably adopt the device that is shown in Fig. 3 to be attached on patient's head to avoid skull ring 80.
The most handy can disinfectant second substrate frame 50 and probe 24 replace being used for that datum mark is confirmed and the substrate frame and the probe of registration mutually.Can the disinfectant substrate frame and probe preferably make by the Lycoperdon polymorphum Vitt anodized aluminum, and disinfectant is not made by black anodizing aluminum.Sterilizable tubulose extension rod 58 and probe 24 preferably be shorter than its not the disinfectant congener to quicken sterilization.Yet the mounting sleeve 70 of probe 24 will be connected with the probe erection column bolt that the hinge of outermost stretches out on the second position from articulated jib, to guarantee that the reference point that is used for mutual registration can not disturbed.
After the sterile surgical operation curtain with holes with is positioned on the sleeve pipe 52, the disinfectant substrate frame is mounted on the pipe box 52.Before being mounted to articulated jib and probe 18 on the substrate frame 50, a sterile pipe shape curtain is placed on arm and the erection column bolt 62.Then probe mounting sleeve 70 is placed on the pipe shape curtain so that fix sterilizable probe 24 on the throne.Then probe is back to extension rod 58, the user card crash touch Lycoperdon polymorphum Vitt probe icon 176 (Fig. 2) one, like this, Ah taking off Lars (Atlas) the program length of probe 24 is relatively mated.The thickness of surgical operation curtain is offseted in the mechanism of sterilization part.Also promptly, the hole of mounting sleeve is suitably strengthened with the surgical operation curtain between payment mounting column and the sleeve pipe.Require this payment be in order to ensure, be used for the screw that probe is secured on the post can not removed probe tip from the centrage of post.Then the user card crash touch probe initialization icon 154 to check moving of arm one.Use previous selected datum mark, registration is an automatization mutually.
On this aspect, the surgeon can use the skull that suitable drill bit is opened patient, and the apparatus sleeve pipe is inserted in the transfer plate 82.Then, the surgeon can with, for example, biopsy needle directly is inserted into target by the indicated degree of depth, and confidence that can be suitable, biopsy needle is in the target area, and only is passed in the cell tissue of checking in the image that display window shows.After this process, surgeon's closable opening or the target area further handled.Equally, the surgeon can select other purpose, and as handling first they is handled.
At the skull hone lamella of installing 80, and with the locking of plate 82 on the throne after, the surgeon can determine to adorn an arc plate stem 100 so that a hemispherical apparatus navigation system to be provided, it is around the target area and centring.Its way is, arc plate stem 100 is mounted on the ball 86, rotating support arm 102 is mounted on the bar 100, and arc 104 is connected with supporting arm 102.Then variable component 106 is mounted on the arc 104 distaff 100 rotating support arms 102, supporting arm 102 slippage arcs 104 relatively; Perhaps move variable component 106, just can select any position around hemisphere along arc 104.On any such point, the surgeon is can be quite self-confident, the point that he the is provided with regional center that aims at the mark.
Though the explanation by alternative embodiment shows that to the present invention though illustrate quite in detail to embodiment, the applicant is not intended the application is confined to such details, or place restrictions in such details to the scope of major general's claims.Those those skilled in the art be it seems additional advantage and correction are easy to see.For example, MRI and CT image all can be loaded in the computer 30, and with the mutual registration of patient before, between them, can carry out mutual registration earlier.MRI scanning can be the surgeon provides the organ details, and CT scan can be the surgeon precise coordinates is provided.Therefore, from the aspect the most widely of invention, invent shown in being not limited to and the example of illustrated specific detail, representational picture system and displaying.For this reason, only otherwise depart from the spirit or scope of applicant's inventive concept, the difference different with these details can be arranged.
Claims (28)
1. neurosurgery three-dimensional planning system, this system comprises:
The imaging display system, it is used for display image;
Graphic based point selection device, it is connected with described imaging system, is used for being shown in selection reference point on the image of described display system;
Target selector, it is connected with described imaging system, is used for being shown in select target on the image of described display system;
Articulated jib and probe, it is connected with described imaging system, and described articulated jib provides the reference of described probe described imaging system space coordinates, and therefore, the position that is associated with described probe is shown described being shown on the image;
Patient's datum mark selector, it is connected with described imaging system, and described articulated jib is used for selection reference point on patient, these points are corresponding with the selected described datum mark of described graphic based point selection device;
Mutual registration processor, it is used for described selected patient's datum mark and the mutual on schedule registration of described selected image-based, like this, the described coordinate that described articulated jib provides can be shown the image pairing with described, thereby the path from the described probe location that is shown to described selected target can be displayed on described being shown on the image; And
The probe clamper, it be used for described Probe clip with described articulated jib be held in patient head near, described probe clamper can lock selectively, so that remain close to the position of described patient's skull, thereby the surgeon can be to being shown in the described image of being shown, path between described probe location and described selected target is estimated, and the fixed apparatus clamper, makes the arbitrary apparatus that is inserted in the described instrument holders to advance along with the described path that is shown.
2. system as claimed in claim 1, described graphic based point selection device provides the operator to select described datum mark on the image described being shown.
3. system as claimed in claim 2, described graphic based point selection device also comprises:
Menu, it provides the image-based predetermined number of evaluator on schedule; With
Activate icon, it is used for activating selected image-based selectively on schedule.
4. system as claimed in claim 1, described patient's datum mark selector also comprises:
The operator activates selector, and it is used to confirm patient's datum mark, and described operator activates selector can accept from the coordinate data of described articulated jib and probe to confirm patient's datum mark described image display system.
5. system as claimed in claim 1, described probe clamper is adjustable, is used to change the sensing of the described probe relative disease people skull in described clamper.
6. system as claimed in claim 5, it is ball and socket mechanism that described scalable is pointed to the probe clamper.
7. system as claimed in claim 1, described probe clamper also comprises:
The skull ring, it is mounted to patient's head; With
Transfer plate, it has position socket thereon, is used to lay described probe.
8. system as claimed in claim 7, described probe clamper also comprises ball and socket mechanism, it is applicable to and is installed in the described socket that described ball and socket mechanism may be locked in the described socket.
9. system as claimed in claim 1, described image display system also comprises:
The demonstration of described probe and articulated jib position, therefore the operation of described articulated jib and probe can be checked.
10. system as claimed in claim 1, wherein said mutual registration processor is finished iterative algorithm, in order to described selected patient's datum mark be used to produce the described mutual registration of lonizing radiation data that is shown radiation image.
11. system as claimed in claim 1 also comprises:
The three-dimensional planning system, it in order to selectively surgical operating instrument is placed on patient head near.
12. as the system of claim 11, described three-dimensional tactics system also comprises:
Arc delivery bar, described arc delivery bar can be installed in the described probe clamper, and therefore, described bar points to the selected target in the described patient head;
Supporting arm, it is installed into and can pulls the rotation of delivery bar around described arc; With
Arc, it is mounted to described supporting arm slippingly, and therefore to have determined one be the circumference at center with the described selected target in the described patient head to described arc.
13. a method that is used to estimate and fixedly pass to the outer product operation pathway of selected target, the step that this method comprises is:
The image that demonstration produces according to the scanning device view data;
Be chosen in the datum mark that is shown on the image;
Be chosen in the described target that is shown in the image;
The described space coordinates that is shown the image external point is provided;
Select one group of external point, they have the described space coordinates that is provided;
With described selected external point and the mutual on schedule registration of described selected image-based, like this, the path between one of described selected target and described external position can be shown on described display image; And
Selectively with probe stationary near patient head, like this, the surgeon can be to being shown on the described display image, and the described path between one of described external position and the described selected target estimates that apparatus can insert thus so that advance along the described path that is shown.
14. the system of claim 13, described probe positioning step also comprises:
Relative disease people's skull changes the sensing of described probe; With
Selectively described probe is locked in selected sensing.
15. the method as claim 13 also comprises:
Show the position of articulated jib and probe, like this, the operation of described articulated jib and probe just can be checked.
16. as the method for claim 13, described mutual step of registration also comprises:
Select the first picture group picture point;
Select second group of external point;
Calculate the geometric centre of form that every group of point determined;
Described first group of point is converted into the coordinate figure that corresponding described first centre of form is converted into described second centre of form;
According to the conversion of described first group of point, calculate quality factor;
By the increment in a direction, described first group of point converts;
Estimate whether described first group of point is a match that is better than the described point that do not convert; With
When described estimation on shown all directions during all less than described quality factor, converts described first group of point to described second group of point in image.
17. a neurosurgery three-dimensional planning system, this system of art comprises:
The skull clip, it is used for clamping patient's head;
Articulated jib, its end is connected with probe, and can be connected with the skull clip in the opposite end;
The probe clamper, it is positioned near the selected location of patient head, is used for Probe clip is held in the selected location.The probe clamper can lock selectively, so that probe is remained in selected the sensing at select location, thereby determines the path between a select location and the patient head internal object point, to promote estimation and the operation along this path.
18. as the neurosurgery three-dimensional planning system of claim 17, wherein the probe clamper comprises:
First member, it is positioned at select location;
Second member, it is supported by first member, and can relative first component movement, is used to lay and the clamping probe; With
Clip, its relative first and second member and placing are used for second member and probe are locked in the selected sensing of relative first member.
19. the neurosurgery three-dimensional planning system as claim 17 also comprises base, it is connected between the opposite end and skull clip of articulated jib.
20. as the neurosurgery three-dimensional planning system of claim 19, wherein the skull clip comprises first adapter that is connected with the arm of skull clip, base then be installed in can with second adapter that first adapter on the skull clip is connected on.
21. as the neurosurgery three-dimensional planning system of claim 20, wherein base also comprises releasable clip, is used to lay the axle that is connected with interlocking arm opposite end with clamping.
22. as the neurosurgery three-dimensional planning system of claim 21, wherein base also comprises cylinder, is used to lay and the initialization procedure of clamping probe with the quickening probe.
23., also comprise first disinfectant base, articulated jib and probe and second disinfectant base, articulated jib and the probe not as the neurosurgery three-dimensional planning system of claim 22.
24. as the neural outer of claim 23 and operation three-dimensional planning system, wherein each in first and second bases and first adapter all have the key system, therefore, each in first and second bases all is connected with first adapter in predetermined sensing.
25. through surgical operation three-dimensional planning system, wherein the probe clamper also comprises as Liu of claim 17:
Bar, its end is connected with the probe clamper with selected the sensing at select location; With
Socket, it is connected with the opposite end of this bar, and this bar moves to diverse location and sensing relatively, this socket fitted with probes, and Probe clip is held in second selected sensing of crosscut impact point.
26. as the neurosurgery three-dimensional planning system of claim 17, wherein the probe clamper also comprises:
Bar;
Rod holder is used for bar cramp is held in the selected sensing of select location;
Supporting arm, it can be along being connected with bar on the diverse location of this pole length;
The arc member, it can be connected with supporting arm; With
Sleeve pipe, it can be connected with the arc member at diverse location, and this sleeve pipe has socket, is used for laying and the clamping probe on second selected sensing of second select location and crosscut impact point.
27. surgical operation three-dimensional planning system, this system comprises:
Be used to support patient's device;
Articulated jib, its end is connected with probe, and can be connected with supporting patient's device in the opposite end;
The probe clamper, it is positioned near the select location the patient, be used for Probe clip is held in select location, the probe clamper can lock selectively, so that probe is remained in the selected sensing of select location, thereby the path between the impact point in definite select location and the patient is to promote estimation and the operation along this path.
28. surgical operation three-dimensional planning system, this system comprises:
Be used to support patient's device;
Articulated jib, it has mobilizable end and the anchor portion that can be connected with supporting patient's device;
Clamper, it is positioned near the select location the patient, be used for the movable end of articulated jib is clamped in select location, clamper can lock selectively, so that the movable end of articulated jib is remained in the selected sensing of select location, thereby the path between the impact point in definite select location and the patient is to promote estimation and the operation along this path.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN95195907A CN1162251A (en) | 1994-09-30 | 1995-09-28 | Appuratus and method for neurosurgical stereotactic procedures |
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US08/315,927 | 1994-09-30 | ||
| CN95195907A CN1162251A (en) | 1994-09-30 | 1995-09-28 | Appuratus and method for neurosurgical stereotactic procedures |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN1162251A true CN1162251A (en) | 1997-10-15 |
Family
ID=5083041
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN95195907A Pending CN1162251A (en) | 1994-09-30 | 1995-09-28 | Appuratus and method for neurosurgical stereotactic procedures |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN1162251A (en) |
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| CN100418489C (en) * | 2005-10-27 | 2008-09-17 | 上海交通大学 | Multimode medical figure registration system based on basic membrane used in surgical operation navigation |
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| CN100418489C (en) * | 2005-10-27 | 2008-09-17 | 上海交通大学 | Multimode medical figure registration system based on basic membrane used in surgical operation navigation |
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| CN103327925B (en) * | 2011-01-20 | 2016-12-14 | 美敦力巴肯研究中心有限公司 | For determining at least one method being suitable for path of the movement of the object in tissue |
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| US10080617B2 (en) | 2011-06-27 | 2018-09-25 | Board Of Regents Of The University Of Nebraska | On-board tool tracking system and methods of computer assisted surgery |
| US10219811B2 (en) | 2011-06-27 | 2019-03-05 | Board Of Regents Of The University Of Nebraska | On-board tool tracking system and methods of computer assisted surgery |
| CN104470455A (en) * | 2011-12-21 | 2015-03-25 | 美的洛博迪克斯公司 | Stabilizing apparatus for highly articulated probes with link arrangement, methods of formation thereof, and methods of use thereof |
| US10105149B2 (en) | 2013-03-15 | 2018-10-23 | Board Of Regents Of The University Of Nebraska | On-board tool tracking system and methods of computer assisted surgery |
| CN105377175A (en) * | 2013-03-15 | 2016-03-02 | 内布拉斯加大学评议会 | On-board tool tracking system and methods of computer assisted surgery |
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