EP4236849A1 - Système de visualisation chirurgicale avec fenêtrage de champ de vision - Google Patents

Système de visualisation chirurgicale avec fenêtrage de champ de vision

Info

Publication number
EP4236849A1
EP4236849A1 EP22822209.7A EP22822209A EP4236849A1 EP 4236849 A1 EP4236849 A1 EP 4236849A1 EP 22822209 A EP22822209 A EP 22822209A EP 4236849 A1 EP4236849 A1 EP 4236849A1
Authority
EP
European Patent Office
Prior art keywords
view
field
critical structure
bounds
imaging devices
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
EP22822209.7A
Other languages
German (de)
English (en)
Inventor
Charles J. Scheib
Paul G. Ritchie
Sarah A. Moore
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Cilag GmbH International
Original Assignee
Cilag GmbH International
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from US17/528,759 external-priority patent/US20230148835A1/en
Application filed by Cilag GmbH International filed Critical Cilag GmbH International
Publication of EP4236849A1 publication Critical patent/EP4236849A1/fr
Pending legal-status Critical Current

Links

Classifications

    • 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
    • A61B34/25—User interfaces for surgical systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/361—Image-producing devices, e.g. surgical cameras
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/30—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
    • A61B2090/306—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure using optical fibres
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/30—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
    • A61B2090/309—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure using white LEDs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A61B2090/371—Surgical systems with images on a monitor during operation with simultaneous use of two cameras

Definitions

  • Surgical systems may incorporate an imaging system, which may allow the clinician(s) to view the surgical site and/or one or more portions thereof on one or more displays such as a monitor.
  • the display(s) may be local and/or remote to a surgical theater.
  • An imaging system may include a scope with a camera that views the surgical site and transmits the view to a display that is viewable by the clinician.
  • Scopes include, but are not limited to, laparoscopes, robotic laparoscopes, arthroscopes, angioscopes, bronchoscopes, choledochoscopes, colonoscopes, cytoscopes, duodenoscopes, enteroscopes, esophagogastro-duodenoscopes (gastroscopes), endoscopes, laryngoscopes, nasopharyngo-neproscopes, sigmoidoscopes, thoracoscopes, ureteroscopes, and exoscopes.
  • Imaging systems may be limited by the information that they are able to recognize and/or convey to the clinician(s). For example, certain concealed structures, physical contours, and/or dimensions within a three-dimensional space may be unrecognizable intraoperatively by certain imaging systems. Additionally, certain imaging systems may be incapable of communicating and/or conveying certain information to the clinician(s) intraoperatively.
  • FIG. 1 depicts a schematic view of an exemplary surgical visualization system including an imaging device and a surgical device;
  • FIG. 2 depicts a schematic diagram of an exemplary control system that may be used with the surgical visualization system of FIG. 1;
  • FIG. 3 depicts a schematic diagram of another exemplary control system that may be used with the surgical visualization system of FIG. 1 ;
  • FIG. 4 depicts exemplary hyperspectral identifying signatures to differentiate anatomy from obscurants, and more particularly depicts a graphical representation of a ureter signature versus obscurants;
  • FIG. 5 depicts exemplary hyperspectral identifying signatures to differentiate anatomy from obscurants, and more particularly depicts a graphical representation of an artery signature versus obscurants
  • FIG. 6 depicts exemplary hyperspectral identifying signatures to differentiate anatomy from obscurants, and more particularly depicts a graphical representation of a nerve signature versus obscurants
  • FIG. 7A depicts a schematic view of an exemplary emitter assembly that may be incorporated into the surgical visualization system of FIG. 1, the emitter assembly including a single electromagnetic radiation (EMR) source, showing the emitter assembly in a first state;
  • EMR electromagnetic radiation
  • FIG. 7B depicts a schematic view of the emitter assembly of FIG. 7A, showing the emitter assembly in a second state
  • FIG. 7C depicts a schematic view of the emitter assembly of FIG. 7A, showing the emitter assembly in a third state;
  • FIG. 8 depicts an exemplary surgical visualization system including an imaging device and a surgical device
  • FIG. 9 depicts a method which may be used to allow a user to control a field of view which is displayed
  • FIG. 10 depicts a high level relationship between a field of view and a window within that field of view
  • FIG. 11 depicts a high level relationship between a field of view and a window within that field of view.
  • FIG. 12 a relationship between an array of sensors and portions of a field of view.
  • proximal and distal are defined herein relative to a surgeon, or other operator, grasping a surgical device.
  • proximal refers to the position of an element arranged closer to the surgeon
  • distal refers to the position of an element arranged further away from the surgeon.
  • spatial terms such as “top,” “bottom,” “upper,” “lower,” “vertical,” “horizontal,” or the like are used herein with reference to the drawings, it will be appreciated that such terms are used for exemplary description purposes only and are not intended to be limiting or absolute. In that regard, it will be understood that surgical instruments such as those disclosed herein may be used in a variety of orientations and positions not limited to those shown and described herein.
  • the terms “about,” “approximately,” and the like as used herein in connection with any numerical values or ranges of values are intended to encompass the exact value(s) referenced as well as a suitable tolerance that enables the referenced feature or combination of features to function for the intended purpose(s) described herein.
  • the phrase “based on” should be understood as referring to a relationship in which one thing is determined at least in part by what it is specified as being “based on.” This includes, but is not limited to, relationships where one thing is exclusively determined by another, which relationships may be referred to using the phrase “exclusively based on.”
  • FIG. 1 depicts a schematic view of a surgical visualization system (10) according to at least one aspect of the present disclosure.
  • the surgical visualization system (10) may create a visual representation of a critical structure (I la, 11b) within an anatomical field.
  • the surgical visualization system (10) may be used for clinical analysis and/or medical intervention, for example.
  • the surgical visualization system (10) may be used intraoperatively to provide real-time, or near real-time, information to the clinician regarding proximity data, dimensions, and/or distances during a surgical procedure.
  • the surgical visualization system (10) is configured for intraoperative identification of critical structure(s) and/or to facilitate the avoidance of critical structure(s) (I la, 1 lb) by a surgical device.
  • a clinician may avoid maneuvering a surgical device into a critical structure (I la, 11b) and/or a region in a predefined proximity of a critical structure (I la, 11b) during a surgical procedure.
  • the clinician may avoid dissection of and/or near a vein, artery, nerve, and/or vessel, for example, identified as a critical structure (I la, 11b), for example.
  • critical structure(s) (I la, 11b) may be determined on a patient-by-patient and/or a procedure-by-procedure basis.
  • Critical structures (I la, 11b) may be any anatomical structures of interest.
  • a critical structure (I la, 11b) may be a ureter, an artery such as a superior mesenteric artery, a vein such as a portal vein, a nerve such as a phrenic nerve, and/or a sub-surface tumor or cyst, among other anatomical structures.
  • a critical structure (I la, 11b) may be any foreign structure in the anatomical field, such as a surgical device, surgical fastener, clip, tack, bougie, band, and/or plate, for example.
  • a critical structure (I la, 11b) may be embedded in tissue.
  • a critical structure (I la, 11b) may be positioned below a surface of the tissue.
  • the tissue conceals the critical structure (I la, 11b) from the clinician’s view.
  • a critical structure (I la, 11b) may also be obscured from the view of an imaging device by the tissue.
  • the tissue may be fat, connective tissue, adhesions, and/or organs, for example.
  • a critical structure (I la, 11b) may be partially obscured from view.
  • a surgical visualization system (10) is shown being utilized intraoperatively to identify and facilitate avoidance of certain critical structures, such as a ureter (I la) and vessels (1 lb) in an organ (12) (the uterus in this example), that are not visible on a surface (13) of the organ (12).
  • certain critical structures such as a ureter (I la) and vessels (1 lb) in an organ (12) (the uterus in this example), that are not visible on a surface (13) of the organ (12).
  • the surgical visualization system (10) incorporates tissue identification and geometric surface mapping in combination with a distance sensor system (14).
  • these features of the surgical visualization system (10) may determine a position of a critical structure (I la, 11b) within the anatomical field and/or the proximity of a surgical device (16) to the surface (13) of the visible tissue and/or to a critical structure (1 la, 1 lb).
  • the surgical device (16) may include an end effector having opposing jaws (not shown) and/or other structures extending from the distal end of the shaft of the surgical device (16).
  • the surgical device (16) may be any suitable surgical device such as, for example, a dissector, a stapler, a grasper, a clip applier, a monopolar RF electrosurgical instrument, a bipolar RF electrosurgical instrument, and/or an ultrasonic instrument.
  • a surgical visualization system (10) may be configured to achieve identification of one or more critical structures (I la, 11b) and/or the proximity of a surgical device (16) to critical structure(s) (1 la, 1 lb).
  • the depicted surgical visualization system (10) includes an imaging system that includes an imaging device (17), such as a camera or a scope, for example, that is configured to provide real-time views of the surgical site.
  • an imaging device (17) includes a spectral camera (e.g., a hyperspectral camera, multispectral camera, a fluorescence detecting camera, or selective spectral camera), which is configured to detect reflected or emitted spectral waveforms and generate a spectral cube of images based on the molecular response to the different wavelengths.
  • a spectral camera e.g., a hyperspectral camera, multispectral camera, a fluorescence detecting camera, or selective spectral camera
  • a surgical visualization system includes a plurality of subsystems — an imaging subsystem, a surface mapping subsystem, a tissue identification subsystem, and/or a distance determining subsystem. These subsystems may cooperate to intraoperatively provide advanced data synthesis and integrated information to the clinician(s).
  • the imaging device (17) of the present example includes an emitter (18), which is configured to emit spectral light in a plurality of wavelengths to obtain a spectral image of hidden structures, for example.
  • the imaging device (17) may also include a three- dimensional camera and associated electronic processing circuits in various instances.
  • the emitter (18) is an optical waveform emitter that is configured to emit electromagnetic radiation (e.g., near-infrared radiation (NIR) photons) that may penetrate the surface (13) of a tissue (12) and reach critical structure(s) (I la, 11b).
  • the imaging device (17) and optical waveform emitter (18) thereon may be positionable by a robotic arm or a surgeon manually operating the imaging device.
  • a corresponding waveform sensor e.g., an image sensor, spectrometer, or vibrational sensor, etc.
  • a corresponding waveform sensor e.g., an image sensor, spectrometer, or vibrational sensor, etc.
  • the wavelengths of the electromagnetic radiation emitted by the optical waveform emitter (18) may be configured to enable the identification of the type of anatomical and/or physical structure, such as critical structure(s) (Ila, 11b).
  • the identification of critical structure(s) (I la, 11b) may be accomplished through spectral analysis, photo-acoustics, fluorescence detection, and/or ultrasound, for example.
  • the wavelengths of the electromagnetic radiation may be variable.
  • the waveform sensor and optical waveform emitter (18) may be inclusive of a multispectral imaging system and/or a selective spectral imaging system, for example. In other instances, the waveform sensor and optical waveform emitter (18) may be inclusive of a photoacoustic imaging system, for example.
  • an optical waveform emitter (18) may be positioned on a separate surgical device from the imaging device (17).
  • the imaging device (17) may provide hyperspectral imaging in accordance with at least some of the teachings of U.S. Pat. No. 9,274,047, entitled “System and Method for Gross Anatomic Pathology Using Hyperspectral Imaging,” issued March 1, 2016, the disclosure of which is incorporated by reference herein in its entirety.
  • the depicted surgical visualization system (10) also includes an emitter (19), which is configured to emit a pattern of light, such as stripes, grid lines, and/or dots, to enable the determination of the topography or landscape of a surface (13).
  • an emitter (19) which is configured to emit a pattern of light, such as stripes, grid lines, and/or dots, to enable the determination of the topography or landscape of a surface (13).
  • projected light arrays may be used for three-dimensional scanning and registration on a surface (13).
  • the projected light arrays may be emitted from an emitter (19) located on a surgical device (16) and/or an imaging device (17), for example.
  • the projected light array is employed to determine the shape defined by the surface (13) of the tissue (12) and/or the motion of the surface (13) intraoperatively.
  • An imaging device (17) is configured to detect the projected light arrays reflected from the surface (13) to determine the topography of the surface (13) and various distances with respect to the surface (13).
  • a visualization system (10) may utilize patterned light in accordance with at least some of the teachings of U.S. Pat. Pub. No. 2017/0055819, entitled “Set Comprising a Surgical Instrument,” published March 2, 2017, the disclosure of which is incorporated by reference herein in its entirety; and/or U.S. Pat. Pub. No. 2017/0251900, entitled “Depiction System,” published September 7, 2017, the disclosure of which is incorporated by reference herein in its entirety.
  • the depicted surgical visualization system (10) also includes a distance sensor system (14) configured to determine one or more distances at the surgical site.
  • the distance sensor system (14) may include a time-of-flight distance sensor system that includes an emitter, such as the structured light emitter (19); and a receiver (not shown), which may be positioned on the surgical device (16).
  • the time- of-flight emitter may be separate from the structured light emitter.
  • the emitter portion of the time-of-flight distance sensor system (14) may include a laser source and the receiver portion of the time-of-flight distance sensor system (14) may include a matching sensor.
  • a time-of-flight distance sensor system (14) may detect the “time of flight,” or how long the laser light emitted by the structured light emitter (19) has taken to bounce back to the sensor portion of the receiver.
  • Use of a very narrow light source in a structured light emitter (19) may enable a distance sensor system (14) to determine the distance to the surface (13) of the tissue (12) directly in front of the distance sensor system (14).
  • a distance sensor system (14) may be employed to determine an emitter-to-tissue distance (d e ) from a structured light emitter (19) to the surface (13) of the tissue (12).
  • a device-to-tissue distance (dt) from the distal end of the surgical device (16) to the surface (13) of the tissue (12) may be obtainable from the known position of the emitter (19) on the shaft of the surgical device (16) relative to the distal end of the surgical device (16).
  • the device-to-tissue distance (dt) may be determined from the emitter-to-tissue distance (d e ).
  • the shaft of a surgical device (16) may include one or more articulation joints; and may be articulatable with respect to the emitter (19) and the jaws.
  • the articulation configuration may include a multi -joint vertebrae-like structure, for example.
  • a three-dimensional camera may be utilized to triangulate one or more distances to the surface (13).
  • a surgical visualization system (10) may be configured to determine the emitter-to-tissue distance (d e ) from an emitter (19) on a surgical device (16) to the surface (13) of a uterus (12) via structured light.
  • the surgical visualization system (10) is configured to extrapolate a device-to-tissue distance (dt) from the surgical device (16) to the surface (13) of the uterus (12) based on emitter-to-tissue distance (d e ).
  • the surgical visualization system (10) is also configured to determine a tissue-to-ureter distance (dx) from a ureter (I la) to the surface (13) and a camera-to-ureter distance (d w ), from the imaging device (17) to the ureter (I la).
  • Surgical visualization system (10) may determine the camera-to-ureter distance (d w ), with spectral imaging and time-of-flight sensors, for example.
  • a surgical visualization system (10) may determine (e.g., triangulate) a tissue-to-ureter distance (dA) (or depth) based on other distances and/or the surface mapping logic described herein.
  • FIG. 2 is a schematic diagram of a control system (20), which may be utilized with a surgical visualization system (10).
  • the depicted control system (20) includes a control circuit (21) in signal communication with a memory (22).
  • the memory (22) stores instructions executable by the control circuit (21) to determine and/or recognize critical structures (e.g., critical structures (I la, 11b) depicted in FIG. 1), determine and/or compute one or more distances and/or three-dimensional digital representations, and to communicate certain information to one or more clinicians.
  • the instructions stored within the memory (22) therefore constitute a computer program product comprising instructions which, when executed by the control circuit (21), cause it to perform as described above.
  • Such instructions may also be stored on any computer-readable medium (such as an optical disc, an SD card, a USB drive, etc., or a memory of a separate device), from which they may be copied into the memory (22) or executed directly.
  • the process of copying or direct execution involves the creation of a data carrier signal carrying the computer program product.
  • the memory (22) can store surface mapping logic (23), imaging logic (24), tissue identification logic (25), or distance determining logic (26) or any combinations of logic (23, 24, 25, 26).
  • the control system (20) also includes an imaging system (27) having one or more cameras (28) (like the imaging device (17) depicted in FIG. 1), one or more displays (29), one or more controls (30) or any combinations of these elements.
  • the one or more cameras (28) may include one or more image sensors (31) to receive signals from various light sources emitting light at various visible and invisible spectra (e.g., visible light, spectral imagers, three-dimensional lens, among others).
  • the display (29) may include one or more screens or monitors for depicting real, virtual, and/or virtually - augmented images and/or information to one or more clinicians.
  • a main component of a camera (28) includes an image sensor (31).
  • An image sensor (31) may include a Charge-Coupled Device (CCD) sensor, a Complementary Metal Oxide Semiconductor (CMOS) sensor, a short-wave infrared (SWIR) sensor, a hybrid CCD/CMOS architecture (sCMOS) sensor, and/or any other suitable kind(s) of technology.
  • An image sensor (31) may also include any suitable number of chips.
  • the depicted control system (20) also includes a spectral light source (32) and a structured light source (33).
  • a single source may be pulsed to emit wavelengths of light in the spectral light source (32) range and wavelengths of light in the structured light source (33) range.
  • a single light source may be pulsed to provide light in the invisible spectrum (e.g., infrared spectral light) and wavelengths of light on the visible spectrum.
  • a spectral light source (32) may include a hyperspectral light source, a multispectral light source, a fluorescence excitation light source, and/or a selective spectral light source, for example.
  • tissue identification logic (25) may identify critical structure(s) via data from a spectral light source (32) received by the image sensor (31) portion of a camera (28).
  • Surface mapping logic (23) may determine the surface contours of the visible tissue based on reflected structured light.
  • distance determining logic (26) may determine one or more distance(s) to the visible tissue and/or critical structure(s) (1 la, 1 lb).
  • One or more outputs from surface mapping logic (23), tissue identification logic (25), and distance determining logic (26) may be provided to imaging logic (24), and combined, blended, and/or overlaid to be conveyed to a clinician via the display (29) of the imaging system (27).
  • FIG. 3 depicts a schematic of another control system (40) for a surgical visualization system, such as the surgical visualization system (10) depicted in FIG. 1, for example.
  • This control system (40) is a conversion system that integrates spectral signature tissue identification and structured light tissue positioning to identify critical structures, especially when those structures are obscured by other tissue, such as fat, connective tissue, blood, and/or other organs, for example.
  • tissue variability such as differentiating tumors and/or non-healthy tissue from healthy tissue within an organ.
  • the control system (40) depicted in FIG. 3 is configured for implementing a hyperspectral or fluorescence imaging and visualization system in which a molecular response is utilized to detect and identify anatomy in a surgical field of view.
  • This control system (40) includes a conversion logic circuit (41) to convert tissue data to surgeon usable information.
  • the variable reflectance based on wavelengths with respect to obscuring material may be utilized to identify a critical structure in the anatomy.
  • this control system (40) combines the identified spectral signature and the structured light data in an image.
  • this control system (40) may be employed to create a three- dimensional data set for surgical use in a system with augmentation image overlays.
  • this control system (40) is configured to provide warnings to a clinician when in the proximity of one or more critical structures.
  • Various algorithms may be employed to guide robotic automation and semi-automated approaches based on the surgical procedure and proximity to the critical structure(s).
  • the control system (40) depicted in FIG. 3 is configured to detect the critical structure(s) and provide an image overlay of the critical structure and measure the distance to the surface of the visible tissue and the distance to the embedded/buried critical structure(s). In other instances, this control system (40) may measure the distance to the surface of the visible tissue or detect the critical structure(s) and provide an image overlay of the critical structure.
  • the control system (40) depicted in FIG. 3 includes a spectral control circuit (42).
  • the spectral control circuit (42) includes a processor (43) to receive video input signals from a video input processor (44).
  • the processor (43) is configured to process the video input signal from the video input processor (44) and provide a video output signal to a video output processor (45), which includes a hyperspectral video-out of interface control (metadata) data, for example.
  • the video output processor (45) provides the video output signal to an image overlay controller (46).
  • the video input processor (44) is coupled to a camera (47) at the patient side via a patient isolation circuit (48).
  • the camera (47) includes a solid state image sensor (50).
  • the camera (47) receives intraoperative images through optics (63) and the image sensor (50).
  • An isolated camera output signal (51) is provided to a color RGB fusion circuit (52), which employs a hardware register (53) and a Nios2 co-processor (54) to process the camera output signal (51).
  • a color RGB fusion output signal is provided to the video input processor (44) and a laser pulsing control circuit (55).
  • the laser pulsing control circuit (55) controls a light engine (56).
  • light engine (56) includes any one or more of lasers, LEDs, incandescent sources, and/or interface electronics configured to illuminate the patient’s body habitus with a chosen light source for imaging by a camera and/or analysis by a processor.
  • the light engine (56) outputs light in a plurality of wavelengths (XI, X2, X3 . . . Xn) including near infrared (NIR) and broadband white light.
  • the light output (58) from the light engine (56) illuminates targeted anatomy in an intraoperative surgical site (59).
  • the laser pulsing control circuit (55) also controls a laser pulse controller (60) for a laser pattern projector (61) that projects a laser light pattern (62), such as a grid or pattern of lines and/or dots, at a predetermined wavelength (X2) on the operative tissue or organ at the surgical site (59).
  • the camera (47) receives the patterned light as well as the reflected or emitted light output through camera optics (63).
  • the image sensor (50) converts the received light into a digital signal.
  • the color RGB fusion circuit (52) also outputs signals to the image overlay controller (46) and a video input module (64) for reading the laser light pattern (62) projected onto the targeted anatomy at the surgical site (59) by the laser pattern projector (61).
  • a processing module (65) processes the laser light pattern (62) and outputs a first video output signal (66) representative of the distance to the visible tissue at the surgical site (59). The data is provided to the image overlay controller (46).
  • the processing module (65) also outputs a second video signal (68) representative of a three-dimensional rendered shape of the tissue or organ of the targeted anatomy at the surgical site.
  • the first and second video output signals (66, 68) include data representative of the position of the critical structure on a three-dimensional surface model, which is provided to an integration module (69).
  • the integration module (69) may determine distance (dA) (FIG. 1) to a buried critical structure (e.g., via triangularization algorithms (70)), and that distance (dA) may be provided to the image overlay controller (46) via a video out processor (72).
  • the foregoing conversion logic may encompass a conversion logic circuit (41), intermediate video monitors (74), and a camera (56)/laser pattern projector (61) positioned at surgical site (59).
  • Preoperative data (75) from a CT or MRI scan may be employed to register or align certain three-dimensional deformable tissue in various instances.
  • Such preoperative data (75) may be provided to an integration module (69) and ultimately to the image overlay controller (46) so that such information may be overlaid with the views from the camera (47) and provided to video monitors (74).
  • Registration of preoperative data is further described herein and in U.S. Pat. Pub. No. 2020/0015907, entitled “Integration of Imaging Data,” published January 16, 2020, for example, which is incorporated by reference herein in its entirety.
  • Video monitors (74) may output the integrated/augmented views from the image overlay controller (46).
  • the clinician On a first monitor (74a), the clinician may toggle between (A) a view in which a three-dimensional rendering of the visible tissue is depicted and (B) an augmented view in which one or more hidden critical structures are depicted over the three- dimensional rendering of the visible tissue.
  • the clinician On a second monitor (74b), the clinician may toggle on distance measurements to one or more hidden critical structures and/or the surface of visible tissue, for example.
  • FIG. 4 depicts a graphical representation (76) of an illustrative ureter signature versus obscurants. The plots represent reflectance as a function of wavelength (nm) for wavelengths for fat, lung tissue, blood, and a ureter.
  • FIG. 5 depicts a graphical representation (77) of an illustrative artery signature versus obscurants. The plots represent reflectance as a function of wavelength (nm) for fat, lung tissue, blood, and a vessel.
  • FIG. 6 depicts a graphical representation (78) of an illustrative nerve signature versus obscurants. The plots represent reflectance as a function of wavelength (nm) for fat, lung tissue, blood, and a nerve.
  • select wavelengths for spectral imaging may be identified and utilized based on the anticipated critical structures and/or obscurants at a surgical site (i.e., “selective spectral” imaging). By utilizing selective spectral imaging, the amount of time required to obtain the spectral image may be minimized such that the information may be obtained in real-time, or near real-time, and utilized intraoperatively.
  • the wavelengths may be selected by a clinician or by a control circuit based on input by the clinician. In certain instances, the wavelengths may be selected based on machine learning and/or big data accessible to the control circuit via a cloud, for example.
  • a visualization system (10) includes a receiver assembly (e.g., positioned on a surgical device (16)), which may include a camera (47) including an image sensor (50) (FIG. 3), and an emitter assembly (80) (e.g., positioned on imaging device (17)), which may include an emitter (18) (FIG. 1) and/or a light engine (56) (FIG. 3).
  • a visualization system (10) may include a control circuit (82), which may include the control circuit (21) depicted in FIG. 2 and/or the spectral control circuit (42) depicted in FIG. 3, coupled to each of emitter assembly (80) and the receiver assembly.
  • An emitter assembly (80) may be configured to emit EMR at a variety of wavelengths (e.g., in the visible spectrum and/or in the IR spectrum) and/or as structured light (i.e., EMR projected in a particular known pattern).
  • a control circuit (82) may include, for example, hardwired circuitry, programmable circuitry (e.g., a computer processor coupled to a memory or field programmable gate array), state machine circuitry, firmware storing instructions executed by programmable circuitry, and any combination thereof.
  • an emitter assembly (80) may be configured to emit visible light, IR, and/or structured light from a single EMR source (84).
  • FIGS. 7A-7C illustrate a diagram of an emitter assembly (80) in alternative states, in accordance with at least one aspect of the present disclosure.
  • an emitter assembly (80) comprises a channel (86) connecting an EMR source (84) to an emitter (88) configured to emit visible light (e.g., RGB), IR, and/or structured light in response to being supplied EMR of particular wavelengths from the EMR source (84).
  • the channel (86) may include, for example, a fiber optic cable.
  • the EMR source (84) may include, for example, a light engine (56) (FIG. 3) including a plurality of light sources configured to selectively output light at respective wavelengths.
  • the emitter assembly (80) also comprises a white LED (90) connected to the emitter (88) via another channel (91).
  • the depicted emitter assembly (80) further includes a wavelength selector assembly (94) configured to direct EMR emitted from the light sources of the EMR source (84) toward the first emitter (88).
  • the wavelength selector assembly (94) includes a plurality of deflectors and/or reflectors configured to transmit EMR from the light sources of the EMR source (84) to the emitter (88).
  • a control circuit (82) may be electrically coupled to each light source of the EMR source (84) such that it may control the light outputted therefrom via applying voltages or control signals thereto.
  • the control circuit (82) may be configured to control the light sources of the EMR source (84) to direct EMR from the EMR source (84) to the emitter (88) in response to, for example, user input and/or detected parameters (e.g., parameters associated with the surgical instrument or the surgical site).
  • the control circuit (82) is coupled to the EMR source (84) such that it may control the wavelength of the EMR generated by the EMR source (84).
  • the control circuit (82) may control the light sources of the EMR source (84) either independently or in tandem with each other.
  • the control circuit (82) may adjust the wavelength of the EMR generated by the EMR source (84) according to which light sources of the EMR source (84) are activated. In other words, the control circuit (82) may control the EMR source (84) so that it produces EMR at a particular wavelength or within a particular wavelength range. For example, in FIG. 7A, the control circuit (82) has applied control signals to the nth light source of the EMR source (84) to cause it to emit EMR at an nth wavelength ( n), and has applied control signals to the remaining light sources of the EMR source (84) to prevent them from emitting EMR at their respective wavelengths. Conversely, in FIG.
  • control circuit (82) has applied control signals to the second light source of the EMR source (84) to cause it to emit EMR at a second wavelength (X2), and has applied control signals to the remaining light sources of the EMR source (84) to prevent them from emitting EMR at their respective wavelengths. Furthermore, in FIG. 7C the control circuit (82) has applied control signals to the light sources of the EMR source (84) to prevent them from emitting EMR at their respective wavelengths, and has applied control signals to a white LED source to cause it to emit white light.
  • any one or more of the surgical visualization system (10) depicted in FIG. 1, the control system (20) depicted in FIG. 2, the control system (40) depicted in FIG. 3, and/or the emitter assembly (80) depicted in FIGS. 7A and 7B may be configured and operable in accordance with at least some of the teachings of U.S. Pat. Pub. No. 2020/0015925, entitled “Combination Emitter and Camera Assembly,” published January 16, 2020, which is incorporated by reference above.
  • a surgical visualization system (10) may be incorporated into a robotic system in accordance with at least some of such teachings.
  • FIG. 8 An example illustrating this type of approach is provided in FIG. 8.
  • FIG. 8 An example illustrating this type of approach is provided in FIG. 8.
  • FIG. 8 depicts a scenario in which the imaging device (17) captures data regarding the anatomical field within a first field of view (801) of an anatomical field in which a surgeon would use one or more surgical devices (16) to perform a procedure.
  • the imaging device (17) captures data regarding the anatomical field within a first field of view (801) of an anatomical field in which a surgeon would use one or more surgical devices (16) to perform a procedure.
  • the procedure focuses on a tumor or other critical structure (11b)
  • all of the data regarding the entire first field of view may not be necessary, or may even be unhelpful and/or distracting to the surgeon. Instead, the surgeon may only desire to see data in a narrower second field of view (802). For example, if the first field of view (801) provides 270 degree visibility, only a smaller portion of that, such as a second field of view (802) of 42 degrees in the vertical direction and 72 degrees in the horizontal direction, may be useful to the surgeon.
  • a method such as shown in FIG. 9 may be used to allow a user to control the field of view which would be displayed (e.g., via display (29)).
  • a first field of view would be captured in step (901). This may be done, for example, by an imaging device (17) capturing data regarding all portions of a surgical field which could then be collected by its sensor(s).
  • a second field of view would be displayed.
  • This may be done, for example, by extracting a portion of the data from the first field of view (e.g., a 72x42 degree window from a 270 degree field of view), and rendering an image from that portion of the data (e.g., on display (29)).
  • a portion of the data from the first field of view e.g., a 72x42 degree window from a 270 degree field of view
  • rendering an image from that portion of the data e.g., on display (29).
  • this may be done using a default portion of the first field of view.
  • a center portion of the first field of view may be extracted as shown in FIG. 10.
  • the relationship of the second field of view to the first field of view may be changed, such as by moving, resizing, or reshaping the second field of view.
  • a surgeon may input a command to change the view being presented to him or her (e.g., using controls (30) presented by an interface of an imaging system (27)).
  • a determination would be made as to whether the change required device movement. For example, if the surgeon provided a command indicating that the second field of view should be resized, rotated, or translated, a determination could be made whether the bounds of the second field of view following the resizing, translation or rotation would still be in the first field of view.
  • the imaging device used to capture the first field of view could be moved to ensure that the first field of view included all necessary data. For example, it may be disconnected and reinserted into a new trocar that would provide visibility of all necessary data (port hopping), or may be reoriented without being repositioned, such as by a scrub nurse or a robotic effector.
  • the second field of view may be updated without requiring movement of the imaging device.
  • FIG. 11 shows how a second field of view (802) may be translated and resized while remaining within the bounds of the first field of view (801).
  • a second field of view displayed to a surgeon may be augmented with information captured in the first field of view. For instance, if one or more critical structures was located inside the first field of view but outside the second field of view, a system implemented based on this disclosure may detect the critical structure in the data captured for the first field of view. In such a case, the display of the second field of view presented to the surgeon may be enhanced with information indicating the location of the critical structure. This information may include data such as the distance of the field of view relative to the critical structure, and/or other information such as the distance of the critical structure to the working devices being used in a procedure.
  • a divergence between the total data captured for a first field of view and the data needed to be displayed for a smaller second field of view may be utilized in order to reduce the computational load associated with providing real time imaging of an anatomical field.
  • a divergence between the total data captured for a first field of view and the data needed to be displayed for a smaller second field of view may be utilized in order to reduce the computational load associated with providing real time imaging of an anatomical field.
  • an image of an anatomical field may be captured using an array of sensors (1202), comprising individual sensors Si, S2, S3, ... S n .
  • This image captured by the full array (1202) may be the first field of view (801), and various portions of that first field of view (801) that are relevant to the procedure being performed may be identified.
  • the second field of view (802) corresponding to the portion of the anatomical field to be displayed to the surgeon may be identified based on factors such as commands provided by the surgeon, as described previously in the context of FIG. 9.
  • a critical structure (I la) may be identified using multispectral analysis and image recognition.
  • the sensors from the full array which corresponded to the identified second field of view (802) and critical structure (I la) may then be identified (e.g., based on each of the sensors capturing data from a particular part of the anatomical field), and only the data from those sensors may be presented to the surgeon, such as through display of a working view (i.e., the portion of the first field of view selected for display) and/or through display of a warning view (e.g., annotations on the working view indicating relative position of the critical structure).
  • a working view i.e., the portion of the first field of view selected for display
  • a warning view e.g., annotations on the working view indicating relative position of the critical structure.
  • only the data from those sensors may be subjected to processing after being collected, such as having image recognition applied to identify a critical structure.
  • a surgical visualization system may flash an entire scene, but then track and only display or apply advanced processing to relevant data.
  • FIG. 8 illustrated a single imaging device (17)
  • FIG. 12 illustrated a contiguous array of sensors (1201)
  • multiple independently deployed imaging devices or sensors may be used to capture data regarding an anatomical field, such as is described in U.S. Pat. App. No. 17/528,369, entitled “Surgical Visualization Image Enhancement,” filed on even date herewith, and incorporated by reference herein in its entirety.
  • an imaging device was moved (e.g., in step (905) of FIG.
  • the imaging device may simply be moved to recenter the second field of view within the (new) first field of view.
  • the imaging device may be moved in a manner that seeks to reduce the likelihood of additional movement by taking into account surrounding context. For example, in some cases when an imaging device was moved, it could be moved to a position which would maximize the amount of data captured regarding portions of the anatomical field that were not include in the previous first field of view, under the theory that the need for movement meant the previously imaged portions of the field were less likely to be relevant going forward.
  • Other variations and potential implementations are also possible, will be immediately apparent to, and could be implemented without undue experimentation by, one of ordinary skill in the art in light of this disclosure. Accordingly, the particular examples and illustrations provided herein should be understood as being illustrative only, and should not be treated as being limiting on the scope of protection provided by this document of any other document claiming the benefit of this disclosure.
  • a surgical visualization system comprising: (a) a set of one or more imaging devices, wherein the set of one or more imaging devices is adapted to capture a view of an interior of a cavity of a patient; (b) a display; and (c) a processor in operative communication with the set of one or more imaging devices and the display, wherein the processor is configured to present an interface on the display, the interface comprising a second field of view of the interior of the cavity of the patient, wherein the second field of view is comprised by the first field of view.
  • the processor is configured to, in response to receiving a command to modify the second field of view: (a) determine a modified set of bounds, wherein the modified set of bounds are bounds for the second field of view after modifying the second field of view based on the command; (b) determine whether the modified set of bounds is comprised within the first field of view; (c) based on a determination that the modified set of bounds is not comprised by the first field of view, generate a signal to modify the first field of view to completely comprise the modified set of bounds by moving one or more imaging devices from the set of one or more imaging devices; and (d) update the interface on the display by performing acts comprising causing the display to present the second field of view with the modified set of bounds.
  • Example 3 The surgical visualization system of Example 3, wherein the signal to modify the first field of view is an instruction presented on the display to move an imaging device from a first port in the cavity of the patient to a second port in the cavity of the patient.
  • Example 6 The surgical visualization system of Example 6, wherein the processor is configured to: (a) identify the critical structure using spectral processing; (b) apply the spectral processing selectively to only: (i) the second field of view; and (ii) a portion of the first field of view corresponding to the critical structure.
  • the surgical visualization system of Example 7 wherein: (a) the set of one or more imaging devices comprises a plurality of sensors, each of the plurality of sensors detecting data from a portion of the first field of view; (b) the processor is configured to: (i) for each sensor from the plurality of sensors, determine if that sensor is associated with the second field of view or the portion of the first field of view corresponding to the critical structure based on comparing the field of view of that sensor with the second field of view and the critical structure location; and (ii) selectively apply the spectral processing based on applying spectral processing only to data from: (A) sensors associated with the second field of view; and (B) sensors associated with the portion of the first field of view corresponding to the critical structure
  • a method comprising: (a) capturing an image of a first field of view of an interior of a cavity of a patient using a set of one or more imaging devices; (b) a processor in operative communication with the set of one or more imaging devices presenting an image on a display, the image comprising a second field of view of the interior of the cavity of the patient, wherein the second field of view is comprised by the first field of view.
  • Example 11 The method of Example 11, wherein: (a) the first field of view has a horizontal extent of 270 degrees; and (b) the second field of view has a horizontal extent of 72 degrees.
  • the method comprises: (a) receiving a command to modify the second field of view; (b) in response to receiving the command to modify the second field of view: (i) determining a modified set of bounds, wherein the modified set of bounds are bounds for the second field of view after modifying the second field of view based on the command; (ii) determining whether the modified set of bounds is comprised within the first field of view; (iii) based on a determination that the modified set of bounds is not comprised by the first field of view, generating a signal to modify the first field of view to completely comprise the modified set of bounds by moving one or more imaging devices from the set of one or more imaging devices; and (iv) updating the interface on the display by performing acts comprising causing the display to present the second field of view with the modified set of bounds.
  • Example 13 The method of Example 13, wherein the signal to modify the first field of view is an instruction to a robotic effector to reorient the one or more imaging devices from the set of one or more imaging devices.
  • Example 15 [00099] The method of Example 13, wherein the signal to modify the first field of view is an instruction presented on the display to move an imaging device from a first port in the cavity of the patient to a second port in the cavity of the patient.
  • Example 16 The method of Example 16, wherein the processor is configured to: (a) identify the critical structure using spectral processing; (b) apply the spectral processing selectively to only: (i) the second field of view; and (ii) a portion of the first field of view corresponding to the critical structure.
  • Example 19 The method of Example 17, wherein: (a) the set of one or more imaging devices comprises a plurality of sensors, each of the plurality of sensors detecting data from a portion of the first field of view; (b) the processor is configured to: (i) for each sensor from the plurality of sensors, determine if that sensor is associated with the second field of view or the portion of the first field of view corresponding to the critical structure based on comparing the field of view of that sensor with the second field of view and the critical structure location; and (ii) selectively apply the spectral processing based on applying spectral processing only to data from: (A) sensors associated with the second field of view; and (B) sensors associated with the portion of the first field of view corresponding to the critical structure. [000106] Example 19
  • Example 23 [000115] The non-transitory computer readable medium of any of Examples 21-22, wherein the method comprises, in response to receiving a command to modify the second field of view: (a) determining a modified set of bounds, wherein the modified set of bounds are bounds for the second field of view after modifying the second field of view based on the command; (b) determining whether the modified set of bounds is comprised within the first field of view; (c) based on a determination that the modified set of bounds is not comprised by the first field of view, generating a signal to modify the first field of view to completely comprise the modified set of bounds by moving one or more imaging devices from the set of one or more imaging devices; and (d) updating the interface on the display by performing acts comprising causing the display to present the second field of view with the modified set of bounds.
  • Example 23 The non-transitory computer readable medium of Example 23, wherein the signal to modify the first field of view is an instruction presented on the display to move an imaging device from a first port in the cavity of the patient to a second port in the cavity of the patient.
  • Example 27 The non-transitory computer readable medium of any of Examples 21-25, wherein the method comprises: (a) identifying a critical structure within the first field of view; and (b) based on identifying the critical structure at a critical structure location within the first field of view and outside of the second field of view, presenting an indication of the critical structure location on the interface.
  • Example 26 The non-transitory computer readable medium of Example 26, wherein the method comprises: (a) identifying the critical structure using spectral processing; (b) applying the spectral processing selectively to only: (i) the second field of view; and (ii) a portion of the first field of view corresponding to the critical structure.
  • the set of one or more imaging devices comprises a plurality of sensors, each of the plurality of sensors detecting data from a portion of the first field of view;
  • the method comprises: (i) for each sensor from the plurality of sensors, determining if that sensor is associated with the second field of view or the portion of the first field of view corresponding to the critical structure based on comparing the field of view of that sensor with the second field of view and the critical structure location; and (ii) selectively applying the spectral processing based on applying spectral processing only to data from: (A) sensors associated with the second field of view; and (B) sensors associated with the portion of the first field of view corresponding to the critical structure.
  • Versions of the devices described above may be designed to be disposed of after a single use, or they may be designed to be used multiple times. Versions may, in either or both cases, be reconditioned for reuse after at least one use. Reconditioning may include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, some versions of the device may be disassembled, and any number of the particular pieces or parts of the device may be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, some versions of the device may be reassembled for subsequent use either at a reconditioning facility, or by a user immediately prior to a procedure.
  • reconditioning of a device may utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.
  • versions described herein may be sterilized before and/or after a procedure.
  • the device is placed in a closed and sealed container, such as a plastic or TYVEK bag.
  • the container and device may then be placed in a field of radiation that may penetrate the container, such as gamma radiation, x-rays, or high-energy electrons.
  • the radiation may kill bacteria on the device and in the container.
  • the sterilized device may then be stored in the sterile container for later use.
  • a device may also be sterilized using any other technique known in the art, including but not limited to beta or gamma radiation, ethylene oxide, or steam.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Human Computer Interaction (AREA)
  • Robotics (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Pathology (AREA)
  • Endoscopes (AREA)

Abstract

Système de visualisation chirurgicale comprenant : (a) un ensemble d'un ou de plusieurs dispositifs d'imagerie, l'ensemble d'un ou de plusieurs dispositifs d'imagerie étant conçu pour capturer une image de l'intérieur d'une cavité d'un patient ; (b) un dispositif d'affichage ; et (c) un processeur en communication fonctionnelle avec l'ensemble d'un ou de plusieurs dispositifs d'imagerie et le dispositif d'affichage, le processeur étant configuré pour présenter une interface sur le dispositif d'affichage, l'interface comprenant un second champ de vision de l'intérieur de la cavité du patient, le second champ de vision étant inclus dans le premier champ de vision.
EP22822209.7A 2021-11-05 2022-11-07 Système de visualisation chirurgicale avec fenêtrage de champ de vision Pending EP4236849A1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US202163276306P 2021-11-05 2021-11-05
US17/528,759 US20230148835A1 (en) 2021-11-17 2021-11-17 Surgical visualization system with field of view windowing
PCT/IB2022/060675 WO2023079515A1 (fr) 2021-11-05 2022-11-07 Système de visualisation chirurgicale avec fenêtrage de champ de vision

Publications (1)

Publication Number Publication Date
EP4236849A1 true EP4236849A1 (fr) 2023-09-06

Family

ID=84487607

Family Applications (1)

Application Number Title Priority Date Filing Date
EP22822209.7A Pending EP4236849A1 (fr) 2021-11-05 2022-11-07 Système de visualisation chirurgicale avec fenêtrage de champ de vision

Country Status (2)

Country Link
EP (1) EP4236849A1 (fr)
WO (1) WO2023079515A1 (fr)

Family Cites Families (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9718190B2 (en) * 2006-06-29 2017-08-01 Intuitive Surgical Operations, Inc. Tool position and identification indicator displayed in a boundary area of a computer display screen
US9274047B2 (en) 2013-05-24 2016-03-01 Massachusetts Institute Of Technology Methods and apparatus for imaging of occluded objects
US11033182B2 (en) 2014-02-21 2021-06-15 3Dintegrated Aps Set comprising a surgical instrument
DK178899B1 (en) 2015-10-09 2017-05-08 3Dintegrated Aps A depiction system
CN110463174A (zh) * 2016-09-29 2019-11-15 美的洛博迪克斯公司 用于外科探针的光学系统，组成其的系统和方法，以及用于执行外科手术的方法
US20200015904A1 (en) 2018-07-16 2020-01-16 Ethicon Llc Surgical visualization controls

Also Published As

Publication number Publication date
WO2023079515A1 (fr) 2023-05-11

Similar Documents

Publication Publication Date Title
EP3845193B1 (fr) Système epour déterminer, ajuster et gérer la marge de résection autour d'un tissu d'un sujet
US11589731B2 (en) Visualization systems using structured light
EP3845194B1 (fr) Analyse de tendances chirurgicales par un système chirurgical et fourniture de recommandations d'utlisateur
EP3845173A1 (fr) Commande adaptative de système chirurgical en fonction des caractéristiques des particules de fumée chirurgicale
US11744667B2 (en) Adaptive visualization by a surgical system
EP3845139B1 (fr) Système chirurgical permettant de superposer des données d'instrument chirurgical sur une construction virtuelle tridimensionnelle d'un organe
US20210196098A1 (en) Surgical system control based on multiple sensed parameters
EP3845189A2 (fr) Système de visualisation chirurgical dynamique
US20230148835A1 (en) Surgical visualization system with field of view windowing
EP4066771A1 (fr) Systèmes de visualisation au moyen de lumière structurée
EP4236849A1 (fr) Système de visualisation chirurgicale avec fenêtrage de champ de vision
US20230013884A1 (en) Endoscope with synthetic aperture multispectral camera array
US20230020780A1 (en) Stereoscopic endoscope with critical structure depth estimation
US20230017411A1 (en) Endoscope with source and pixel level image modulation for multispectral imaging
US20230156174A1 (en) Surgical visualization image enhancement
US20230020346A1 (en) Scene adaptive endoscopic hyperspectral imaging system
EP4066772A1 (fr) Système et procédé pour déterminer, ajuster et gérer la marge de résection autour d'un tissu d'un sujet
US20230351636A1 (en) Online stereo calibration
WO2023079509A1 (fr) Amélioration d'image de visualisation chirurgicale
CN118159217A (zh) 使用多源成像的外科装置、系统和方法

Legal Events

Date Code Title Description
STAA Information on the status of an ep patent application or granted ep patent

Free format text: STATUS: UNKNOWN

STAA Information on the status of an ep patent application or granted ep patent

Free format text: STATUS: THE INTERNATIONAL PUBLICATION HAS BEEN MADE

PUAI Public reference made under article 153(3) epc to a published international application that has entered the european phase

Free format text: ORIGINAL CODE: 0009012

STAA Information on the status of an ep patent application or granted ep patent

Free format text: STATUS: REQUEST FOR EXAMINATION WAS MADE

17P Request for examination filed

Effective date: 20230531

AK Designated contracting states

Kind code of ref document: A1

Designated state(s): AL AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HR HU IE IS IT LI LT LU LV MC ME MK MT NL NO PL PT RO RS SE SI SK SM TR

STAA Information on the status of an ep patent application or granted ep patent

Free format text: STATUS: EXAMINATION IS IN PROGRESS

17Q First examination report despatched

Effective date: 20231020