JP4511351B2 - カテーテル誘導制御および映像化を行うための装置 - Google Patents
カテーテル誘導制御および映像化を行うための装置 Download PDFInfo
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- A61B5/06—Devices, other than using radiation, for detecting or locating foreign bodies ; determining position of probes within or on the body of the patient
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
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- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
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- A—HUMAN NECESSITIES
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- A61B5/06—Devices, other than using radiation, for detecting or locating foreign bodies ; determining position of probes within or on the body of the patient
- A61B5/061—Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body
- A61B5/062—Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body using magnetic field
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/74—Details of notification to user or communication with user or patient ; user input means
- A61B5/7455—Details of notification to user or communication with user or patient ; user input means characterised by tactile indication, e.g. vibration or electrical stimulation
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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- A61B2017/00022—Sensing or detecting at the treatment site
- A61B2017/00084—Temperature
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- A—HUMAN NECESSITIES
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- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/003—Steerable
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- A61B2017/00694—Aspects not otherwise provided for with means correcting for movement of or for synchronisation with the body
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- A61B2034/2046—Tracking techniques
- A61B2034/2051—Electromagnetic tracking systems
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- A—HUMAN NECESSITIES
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- A61B34/70—Manipulators specially adapted for use in surgery
- A61B34/73—Manipulators for magnetic surgery
- A61B2034/731—Arrangement of the coils or magnets
- A61B2034/732—Arrangement of the coils or magnets arranged around the patient, e.g. in a gantry
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- A—HUMAN NECESSITIES
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- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B2090/364—Correlation of different images or relation of image positions in respect to the body
- A61B2090/365—Correlation of different images or relation of image positions in respect to the body augmented reality, i.e. correlating a live optical image with another image
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- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/37—Surgical systems with images on a monitor during operation
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- A—HUMAN NECESSITIES
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- 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
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
- A61M25/0133—Tip steering devices
- A61M25/0158—Tip steering devices with magnetic or electrical means, e.g. by using piezo materials, electroactive polymers, magnetic materials or by heating of shape memory materials
Description
図1A、1Bおよび1Cは、誘導、制御および映像化(GCI)装置501を備えたシステム700を示している。このシステム700はさらに、オペレータインターフェース装置500および手術医療装置502を備えている。図1Aは、種々の機能装置を備えたGCI装置501の1実施形態を示している。図1Aはさらに、これらの機能装置とオペレータインターフェース500、手術室内に設けられた補助装置502および患者390との間の全体的な関係を示している。図1Bは、これらの機能装置とそれらのコンポーネントのいくつかとの間の相互関係をさらに詳細に示している。
磁界センサ113Xおよび温度センサ(TS)122Xは対350を形成する。磁界センサ114Xおよび温度センサ(TS)123Xは対351を形成する。磁界センサ115Xおよび温度センサ(TS)124Xは対352を形成する。磁界センサ116Xおよび温度センサ(TS)125Xは対353を形成する。磁界センサ117Xおよび温度センサ(TS)126Xは対354を形成する。磁界センサ118Xおよび温度センサ(TS)127Xは対355を形成する。磁界センサ119Xおよび温度センサ(TS)128Xは対356を形成する。磁界センサ120Xおよび温度センサ(TS)129Xは対357を形成する。磁界センサ113Yおよび温度センサ(TS)122Yは対358を形成する。磁界センサ114Yおよび温度センサ(TS)123Yは対359を形成する。磁界センサ115Yおよび温度センサ(TS)124Yは対360を形成する。磁界センサ116Yおよび温度センサ(TS)125Yは対361を形成する。磁界センサ117Yおよび温度センサ(TS)126Yは対362を形成する。磁界センサ118Yおよび温度センサ(TS)127Yは対363を形成する。磁界センサ119Yおよび温度センサ(TS)128Yは対364を形成する。磁界センサ120Yおよび温度センサ(TS)129Yは対365を形成する。磁界センサ113Zおよび温度センサ(TS)122Zは対366を形成する。磁界センサ114Zおよび温度センサ(TS)123Zは対367を形成する。磁界センサ115Zおよび温度センサ(TS)124Zは対368を形成する。磁界センサ116Zおよび温度センサ(TS)125Zは対369を形成する。磁界センサ117Zおよび温度センサ(TS)126Zは対370を形成する。磁界センサ118Zおよび温度センサ(TS)127Zは対371を形成する。磁界センサ119Zおよび温度センサ(TS)128Zは対372を形成する。磁界センサ120Zおよび温度センサ(TS)129Zは対373を形成する。
aN:北双極子(たとえば、図18の(b)を参照)によって示される実際のカテーテルチップ構体の磁気素子の最遠端部
aS:南双極子(たとえば、図18の(b)を参照)によって示される実際のカテーテルチップ構体377の磁気素子の最近端部
aD:地点aNと地点aSとの間の距離(図18の(b)参照)に等しい実際のカテーテルチップ磁石377の長さ
XD:X軸に沿った対向する同軸の磁極の間の距離、すなわち、電磁石132Xと138Xの磁極面の間の距離(図19では参照符号606により示されている)
-x1,-x2,-x3,-x4:それぞれMFSとTSの対354、355、356、357(図13および19の(b)参照)
d:連続した各MFS/TS対の間の距離、すなわち、MFS/TS対354とMFS/TS対355、MFS/TS対355とMFS/TS対356等の間の距離(図19の(b)参照)
x1,x2,x3,x4:それぞれMFSとTSの対350、351、352、353(図13および19A参照)
ROT:X-Y平面における回転角度θ(図21では参照符号625により示されている)
ELEV:X-Z平面におけるELの角度(図22では参照符号626により示されている)
aN:北方向
aS:南方向
aD:チップ磁石の長さ
XD:対向する磁極132Xと138Xの間の距離
-x1,-x2,-x3,-x4:それぞれMFSとTSの対354、355、356、357
d:磁界センサと温度センサの対354および355等の間の距離
x1,x2,x3,x4:それぞれMFSとTSの対350、351、352、353
ROT:θ軸
ELEV:EL軸
AN=(Xn,Yn,Zn)
ここで、Xn、YnおよびZnはX、YおよびZ軸上における直交ベクトルANの射影であり(図18の(c)参照)、また、
AS=(Xs,Ys,Zs)
ここで、Xs、YsおよびZsはそれぞれX、YおよびZ軸上における直交ベクトルASの射影である。
αはX軸に対する角度である;
βはY軸に対する角度である;
γはZ軸に対する角度である。
X-Y平面では、X軸およびY軸に関して投影されたベクトルθXY(図18の(d)参照)の角度は次のように表される:
1.システム制御装置(SC)302がX軸制御装置および増幅器(XCA)305、Y軸制御装置および増幅器(YCA)310、ならびにZ軸制御装置および増幅器(ZCA)315の変調装置出力を阻止する。
2.X軸制御装置および増幅器(XCA)305、Y軸制御装置および増幅器(YCA)310、ならびにZ軸制御装置および増幅器(ZCA)315が磁界センサアレイ307、308、312、313、317および318の出力を読取る。
3.X軸制御装置および増幅器(XCA)305、Y軸制御装置および増幅器(YCA)310、ならびにZ軸制御装置および増幅器(ZCA)315が温度センサ(TS)アレイ306、309、311、314、316および319の出力を読取る。
4.X軸制御装置および増幅器(XCA)305、Y軸制御装置および増幅器(YCA)310、ならびにZ軸制御装置および増幅器(ZCA)315が補正データ(典型的に不揮発性メモリ105X、105Yおよび105Z中に記憶されている)を参照することにより磁界センサアレイ307、308、312、313、317および318の出力に対してデジタル温度補償を適用する。
5.システム制御装置(SC)302がX軸制御装置および増幅器(XCA)305、Y軸制御装置および増幅器(YCA)310、ならびにZ軸制御装置および増幅器(ZCA)315から補正された磁界センサデータを入力し、実際のチップによって生成された磁界の3つの直交する成分(Bx,By,Bz)から5軸データセットを補間(interpolate)する。以下の2つの関係を使用してチップ位置が計算される:
(a)力ベクトルB600の大きさは次の式によって与えられ:
7.システム制御装置(SC)302は、心臓位置(CP)とHPデータセットとを組合せることによって実際の位置(AP)を計算する。
8.システム制御装置(SC)302は、仮想チップ/較正固定制御装置(VT/CFC)303から仮想チップ405位置データを入力する。
9.システム制御装置(SC)302は、心臓位置(CP)データセットを仮想チップ(VT)からのものと組合せることによりDPを計算する。
10.その後、システム制御装置(SC)302は、DPをAPと比較することにより位置エラー(PE)を決定する。
11.位置エラーPEがエラーしきい値より低い場合には、システム制御装置(SC)302はX軸制御装置および増幅器(XCA)305、Y軸制御装置および増幅器(YCA)310、ならびにZ軸制御装置および増幅器(ZCA)315が同じ変調および極性を引き続き使用することを可能にする。
12.位置エラーPEがエラーしきい値より高い場合には、システム制御装置(SC)302はXCA305、YCA310およびZCA315に対する変調入力のデューティサイクルおよび、または極性を変更する。
Claims (17)
- 身体の外部で磁界を発生する磁界ソースと、
磁界を生成し、かつ前記磁界ソースからの磁界に応答して位置が変化する遠端部を有するツールと、
前記遠端部によって生成された磁界を感知する1以上の磁界センサと、
前記遠端部の位置を制御するために、位置およびコマンドの入力により前記磁界ソースを制御するシステム制御装置とを備えており、
前記システム制御装置は、閉ループフィードバックサーボシステムを備えており、
前記サーボシステムは、1つの器官の動的な位置を補償し、それによって前記遠端部が前記器官と実質的に一致して動くように前記磁界に対する前記遠端部の応答をオフセットする補正入力を備えており、
前記補正入力は、前記器官の前記動的な位置に関する補正データを提供する補助装置によって生成され、前記補正データは、それが前記センサ装置から得られた測定データと組合せられたとき、前記遠端部が前記器官と実質的に一致して動くように前記サーボシステムの応答をオフセットする、患者の体内に挿入されるカテーテル状のツールの動きを制御するための装置。 - 前記遠端部は、1以上の磁界センサおよび1以上の温度センサを備えている請求項1記載の装置。
- 前記遠端部は、センサデータを前記システム制御装置に提供する1以上の磁界センサを備えている請求項1記載の装置。
- さらに、オペレータインターフェース装置を備えている請求項1記載の装置。
- 前記補助装置は、X線装置、超音波装置およびレーダ装置の少なくとも1つである請求項1記載の装置。
- 前記システム制御装置は、前記位置およびコマンドの入力を可能にする仮想チップ装置を含んでいる請求項1記載の装置。
- さらに、較正を固定する較正固定装置と、
仮想チップと較正を固定する較正固定装置とを制御する制御装置と、
仮想チップ装置とを含んでいる請求項1記載の装置。 - さらに、X軸制御および増幅装置と、
Y軸制御および増幅装置と、
Z軸制御および増幅装置とを備えている請求項1記載の装置。 - さらに、通信制御装置と、
較正を固定する較正固定装置と、
1以上の温度センサとを備えている請求項1記載の装置。 - 前記温度センサは、前記磁界センサと対にされている請求項9記載の装置。
- 前記システム制御装置は、X軸制御装置、Y軸制御装置およびZ軸制御装置の動作を仮想チップ装置からの入力にしたがって調整する請求項1記載の装置。
- 前記仮想チップは、触覚フィードバックをオペレータに提供する請求項11記載の装置。
- 前記仮想チップは、前記遠端部の実際の位置と前記遠端部の所望の位置との間の位置エラーにしたがって触覚フィードバックをオペレータに提供する請求項11記載の装置。
- 前記システム制御装置は、前記遠端部を前記仮想チップの動きに追従させる請求項11記載の装置。
- 仮想チップの位置はエンコーダの位置情報により示され、
仮想チップ装置には、仮想チップの動きを制限する制限スイッチが設けられ、
前記エンコーダの位置情報と、制限スイッチ閉状態信号と、オペレータスイッチデータを前記仮想チップ装置から受信する、仮想チップと較正を固定する較正固定装置とを制御する制御装置をさらに含んでおり、
前記仮想チップと較正を固定する較正固定装置とを制御する制御装置は、触覚フィードバック応答制御を前記仮想チップに出力する請求項11記載の装置。 - 前記システム制御装置は、前記磁界センサからのデータを少なくとも部分的に使用して前記遠端部の位置エラーを計算し、前記磁界ソースを制御して前記位置エラーを補正するように構成されている請求項1記載の装置。
- 前記システム制御装置は、フィードバックデータをオペレータ制御に供給することにより触覚フィードバック応答を実行する請求項1記載の装置。
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2003
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- 2003-07-16 JP JP2004521863A patent/JP4511351B2/ja not_active Expired - Fee Related
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WO2004006795A1 (en) | 2004-01-22 |
US7873401B2 (en) | 2011-01-18 |
ATE440560T1 (de) | 2009-09-15 |
CN100438826C (zh) | 2008-12-03 |
AU2003249273A1 (en) | 2004-02-02 |
EP2105154A3 (en) | 2014-08-20 |
DE60328990D1 (de) | 2009-10-08 |
CA2493869C (en) | 2012-11-20 |
US20040019447A1 (en) | 2004-01-29 |
CN101444424A (zh) | 2009-06-03 |
EP2105154A2 (en) | 2009-09-30 |
US7769427B2 (en) | 2010-08-03 |
CA2493869A1 (en) | 2004-01-22 |
EP1521555B1 (en) | 2009-08-26 |
JP2005532878A (ja) | 2005-11-04 |
US20060116633A1 (en) | 2006-06-01 |
US20060116634A1 (en) | 2006-06-01 |
CN101444424B (zh) | 2012-04-04 |
EP1521555A1 (en) | 2005-04-13 |
CN1681448A (zh) | 2005-10-12 |
US20060114088A1 (en) | 2006-06-01 |
JP2010179116A (ja) | 2010-08-19 |
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